• 대한족부족관절학회지
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• 제7권2호
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• pp.250-257
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• 2003

Purpose: Pilon fracture is caused by high energy and axial compression forces, and it is often associated with severe comminution and soft tissue injury. Recently, limited internal fixation of this fracture may avoid the soft tissue complications associated with formal open reduction and internal fixation and avoid incongruity of joint margin associated with conservative treatment. We have treated Ovadia and Beals type II or III pilon fracture with limited internal fixation and the results were satisfactory. Materials and Methods: We analyzed 15 cases of Ovadia and Beals type II or III fractures who were treated by limited internal fixation(K-wire or screw fixation) from January 1995 to December 2000. The average follow up period was 20 months(range, 12 to 38 months). According to the Ovadia and Beals classification, seven cases were type II, and eight cases were type III. Radiographic results were assessed by Ovadia and Beals criteria. We also assessed the functional results by Mast and Teipner criteria. Results: Radiographic results showed good in 67% and fair in 33% of cases. Clinical results showed good in 73% and fair in 27% of cases. There were no complications such as wound infection and skin necrosis, but traumatic arthritis were 2 cases. Conclusion: Pilon fractures are high energy injuries with significantly associated soft tissue damage and traumatic arthritis. Limited internal fixation offers good solution to Ovadia and Beals type II or III fracture.

• 대한족부족관절학회지
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• 제3권1호
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• pp.26-32
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• 1999

Fractures of the tibial pilon are the severe injuries to the ankle joint resulted from axial compression, shear and/or rotational forces. The pilon fractures have been difficult in management due to the severe comminution of articular surface and frequent soft tissue problem. Among many treatment options, limited internal fixation of the tibia with long screws and multiple pins augmented with external fixation or casting provide adequate stabilization without soft tissue compromise. Among the patients of pilon fracture admitted to our hospital from March 1993 to March 1997 who treated by limited internal fixation and external fixation or casting, 25cases are included who could be follow up for more than 10months. According to Ruedi and Allgower, typeI 3cases, typeII 14cases, typeIII 8cases. The authors analyzed the clinical and radiological results of the tibial pilon fractures according to Magnusson. The results were as follow. 1. 10cases at Ruedi-Allgower typeII were obtained above fair and 5cases at Ruedi-Allgower typeIII were obtained above fair. 2. The postoperative complications were skin problem(3cases) and infection(2cases), which were treated by antibiotics and flap surgery.

• 대한족부족관절학회지
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• 제6권2호
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• pp.208-210
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• 2002

We report a case of calcaneal tuberosity fracture, of which skin was at risk, treated urgently with limited open reduction and internal fixation, using 2 cannulated screws under local anesthesia.

• 대한족부족관절학회지
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• 제1권1호
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• pp.51-58
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• 1997

The purpose of this study is to evalute the efficacy af the Ilizarov external fixation for the surgical treatment. of the tibial plafond fractures. We reviewed retrospectively fourteen cases of tibial plafond fractures with moderate to severe soft. tissue damage, which were fixed with Ilizarov external fixator. Using the AO Muler classification, there were four Type C1 fractures, six Type C2 and four Type C3. In most, of the cases, the ankles were operated on with other associated fractures within a few days after injury. We reduced the fracture indirectly by soft issue taxis and fixed externally across the ankle joint. using the circular external fixator with tensioned wires and ankle hinge. In cases of inadequate closed reduction, we applied limited open reduction and internal fixation. Range of motion exercise began immediately. Postoperative follow-up averaged fourteen months (ranges, 8-30 months). Overall clinical results rated good or excellent in 7 cases, fair in 4 and poor in 3. There were three cases of pin tract infection which were resolved with short-term antibiotics and local care; one delayed wound closure in a patient. whose fracture was associated with Type III open wound; one wound slough in a patient associated with Type II open wound, which was closed later by skin graft; and one osteoarthritis. From this review, we concluded that cross-ankle circular external fixation with tensioned wires with or without. limited open reduction is a reasonable alternative for the treatment of the tibial plafond fractures with severe soft tissue damage.

• 대한족부족관절학회지
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• 제1권2호
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• pp.102-111
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• 1997

저자들은 1993년 9월부터 1996년 5월까지 본원 정형외과에 입원하여 Pilon 골절로 치료받고 1년 이상 추시 가능하였던 19례(18명)를 대상으로 다음과 같은 결론을 얻었다. 1. Ovadia와 Beals의 분류상 제1형이 2례, 제2형이 3례, 제3형이 10례, 제4형이 1례, 제5형이 3례였고, 제3형이 53%로 가장 많았으며, 교통사고와 추락손상 등 고에너지 손상에 의한 골절이 16례로 전체의 약 84%를 차지하였다. 2. 손상의 정도가 비교적 적은 제1형과 제2형에서는 모두 양호 이상의 임상결과를 나타내었으며, 제4형과 5형에서는 손상의 정도가 심하고 이로인한 정확한 정복의 어려움으로 인해 보통 이하의 성적을 나타내었다. 3. 합병증은 외상후 관절염이 6례로 가장 많았으며 손상정도가 심한 3형 이상에서 정확한 정복이 이루어지지 않은 경우에 발생하였으며, 방사선학적 평가가 보통이하였던 제3형 3례에서 부정 유합이 발생하였으나 임상결과와의 연관성은 없었다. 4. 저자들은 제한된 관혈적 정복 및 내고정술로 연부조직의 합병증을 현격히 줄일 수 있었으며, 손상의 정도가 적고 정확한 정복이 가능한 경우, Pilon 골절의 좋은 치료 술식의 하나라고 사료된다.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.105-115
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• 2016

Purpose: While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years. Methods: This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment. Results: The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury. Conclusion: We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications.

• Clinics in Shoulder and Elbow
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• 제19권4호
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• pp.249-251
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• 2016

iepicondylar fracture of the humerus is very rare in adults. To date, there have been limited evidence of this injury in the English literature. We report a case of a 65-year-old female with a biepicondylar fracture of the left distal humerus without dislocation. Open reduction and internal fixation with K-wires, cannulated screw, and suture anchor were performed. We obtained stability of the elbow and a satisfactory functional outcome. Because this type of injury is associated with varus and valgus instability, operative reduction and fixation are essential in order to gain stability and early recovery of normal function.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권5호
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• pp.474-481
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• 2006

The endoscopic assisted approach for the treatment of condylar fracture is a less invasive alternative treatment modality and is considered to be able to overcome the limited access to the operation field to obtain an accurate reduction and fixation. Six patients with condylar neck and subcondylar fracture underwent the endoscopic assisted open reduction and internal fixation through the transoral approach at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The endoscope was inserted through an intraoral incision and the reduction of fracture fragment was performed via a transbuccal approach with two transcutaneous stab incisions. Five patients showed anatomic reduction without any complications. One patient, whose fracture site was fixed with a single plate, showed displacement of fractured condylar segment during the follow up period. No patient had any facial nerve damage.

• 대한구순구개열학회지
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• 제12권2호
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• pp.85-94
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• 2009

Cleft lip and palate patients show midface hypoplasia, maxillary hypoplasia due to scar of previous surgery, and manifest as a class III malocclusion, retruded midface and shallow palate. These deformities have been treated with traditional orthognathic surgery. Although conventional Le Fort I osteotomy was performed on most cleft patinets with midface hypoplasia, it showed limited amount of maxillary advancement and high relapse tendency. Recently, when great amount of advancement are required in severe maxillary hypoplasia, distraction osteogenesis using RED system is widely used. But, several months of consolidation period is needed after distraction osteogenesis, occlusal relationship is not stable until mandibular setback surgery has done in mandibular hyperplasia cases and during these period, patients may feel discomfort. We present clinical cases of immediate rigid internal fixation after completion of maxillary distraction using RED system and simultaneous mandibular setback procedure in adult cleft and lip patients who show both maxillary hypoplasia and mandibular prognathism.

• 대한관절경학회지
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• 제3권2호
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• pp.127-131
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• 1999

경골 과간 융기부의 견열 굴절은 비교적 드물지 않게 관찰되는 손상으로, 전위된 견열 골절편은 해부학적 정복과 견고한 고정을 필요로 한다. 그러나 관절경적 수술 방법을 포함한 대부분의 잘 알려진 수술 방법들은 비교적 복잡한 수술 기법과 정교한 수술 술기를 필요로 하며, 이에 따른 수술 시간의 지연과 수술 합병증으로 창상 감염, 조기 성장판 폐쇄 및 조기 관절 운동을 제한하는 고정력의 소실 등이 발생할 수 있다. 이에 저자들은 전외측 및 중앙부, 내측 mid-patella 입구를 사용한 관절경적 기법을 이용하여, 골편의 정복에 삽관 나사못을 사용함으로써, 비교적 짧은 수술 시간 안에 만족스런 정복과 고정을 얻을 수 있었으며, 술 후 조기에 능동적 관절 운동을 허용할 수 있었다. 또한 분쇄 골절의 경우 와셔를 사용함으로써 만족스런 고정을 얻을 수 있었다. 저자들의 방법은 수술 기법의 용이함과 금속 제거 시의 안전성, IV형 분쇄 골절에도 적용할 수 있는 점, 추가적인 피부 절개가 필요없다는 점, 성장기 소아에서 성장판의 손상 가능성을 줄일 수 있는 등의 장점이 있다고 사료된다.