• 제목/요약/키워드: fracture fixation internal

검색결과 332건 처리시간 0.026초

전위된 거골 경부 골절의 수술적 치료 (Operative Treatment of Displaced Talar Neck Fracture)

  • 안재훈;백창현;최원식;김용인
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.190-195
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    • 2006
  • Purpose: To evaluate the results of open reduction and internal fixation for displaced talar neck fracture. Materials and Methods: Fourteen patients were followed for more than 1 year after open reduction and internal fixation of displaced talar neck fracture. The mean age was 41.5 years, and the mean follow-up period was 3.8 years. There were 10 type II, 3 type III and 1 type IV fractures per Hawkins. There were 3 open fractures. Clinically AOFAS ankle-hindfoot scale and Hawkins criteria were utilized. Radiologically quality of reduction, duration of bony union, avascular necrosis and posttraumatic arthritis were evaluated. Results: At last follow-up, AOFAS scale was mean 89.1 points. There were 8 excellent, 4 good, and 2 fair results according to Hawkins criteria. Radiologically anatomical reduction was obtained in 13 cases. Mean duration of bony union was 11.8 weeks. There were 3 avascular necrosis and 2 post-traumatic arthritis. There was no significant difference in the incidence of avascular necrosis between early operation group and surgically delayed group. Conclusion: Accurate open reduction and rigid internal fixation seem to be prerequisites for satisfactory treatment of a displaced talar neck fracture.

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족근-중족 관절 골절 탈구의 치료경험 (Treatment for Tarsometatarsal Fracture-Dislocation)

  • 정영기;유정한;박용욱;노동근;하성한
    • 대한족부족관절학회지
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    • 제1권2호
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    • pp.112-118
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    • 1997
  • Tarsometatarsal fracture-dislocation is uncommon but severe lesion. Since this lesion is sometimes difficult to recognize by roentgenography, it is easily overlooked. Three patients were treated with open reduction and internal fixation with 3.5 mm cannulated screw and K-wire, two had treatment with open reduction and internal fixation with 3.5 mm cannulated screw only and two had treatment with dosed reduction and short leg cast only between January 1994 and May 1996. The duration of follow-up ranged from twelve to twenty-nine months after the diagnosis. Results were assessed by a subjective questiormaire, physical examination, and radiographic analysis. Multiple fixation techniques for maintaining the reduction of tarsometatarsl joint have been introduced. We recent]y used the 3.5 mm cannulated screw for internal fixation of the tarso-first and second metatarsal fracture-dislocation. We think cannulated screw fixation has several advantages; 1. The cannulated screw fixation is more rigid than the K-wire fixation. 2. There is an decreased risk of screw breakage with early weight bearing. 3. It is possible to compress the involved joints, if necessary. There were no disability in all patients. One patient who was treated with delayed open reduction and internal fixation with 3.5 mm cannulated screw and K-wire had a radiographic mild degenerative arthritis. And one patient who was treated with dosed reduction and short leg cast had a mild metatarsus adductus. But. these two patients were symptom free. There was no correlation between the severity of the diastasis and the patient s functional result.

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안면골 골절에서 상하악 치열궁 복원을 위한 양측 대구치간 철사견인술의 유용성 (The usefulness of intermolar traction wiring for restoration of maxillary & mandibular dental arch in facial bone fracture)

  • 정재호;신승규;이준호;김용하
    • Archives of Plastic Surgery
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    • 제36권1호
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    • pp.56-60
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    • 2009
  • Purpose: Palatal fracture and mandible fracture result in instability of dental arch. Because they divide the maxillary and mandibular alveolus sagittally and / or transversely and comminute the dentition, they permit rotation of dental alveolar segments and significantly increase the potential for fracture malalignment, complicating fracture treatment. Previous treatment of palatal fracture consisted of palatal splint application and rigid palatal vault stabilization. This procedure result in patient's oral discomfort and removal of palate and screw. Mandible fracture often results in malocclusion due to widening of posterior aspect of dental arch. So we introduce more simple method using intermolar traction wiring, which can protect the widening of dental arch and rotation of dental alveolar segment. Methods: Arch bar and intermolar traction wiring with wire 1 - 0, or 2 - 0 was applied. After exposure of fracture line, neutrooclusion was maintained with intermaxillary fixation. And then open reduction & internal fixation on maxillary fracture line, commonly maxillary buttress, alveolar ridge, pyriform aperture except palatal vault or mandibular fracture line. After 1 week, intermolar traction wiring was removed. We checked occlusion and postoperative radiologic finding. Results: From June of 2007 to October of 2007, 10 patient, who have maxillary fracture with palatal fracture and mandible fracture, underwent open reduction & internal fixation with intermolar traction wiring. All have satisfactory occlusion and there were no complication, like gingiva disease, mouth opening impairment and nonunion. Conclusion: The intermolar traction wiring accompany open reduction and internal fixation can be alternative method for restoration of dental arch in facial bone fracture.

하악골 과두경부 골절의 정복술 시 retromandibular approach의 유용성에 관한 고찰 (RETROMANDIBULAR APPROACH FOR OPEN REDUCTION & INTERNAL FIXATION OF MANDIBULAR CONDYLAR NECK FRACTURE)

  • 백진아
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권6호
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    • pp.625-630
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    • 2007
  • Fractures of the mandibular condyle are account for between 26% and 57% of all mandibular fractures. Clinicians should decide how to treat the fractured condyle with many factors considered. Many surgical methods have been developed to reduction of fractured condyle and it' s internal fixation. In open reduction of fractured condylar neck and subcondyle, retromandibular approach offers a safe and effective approach for direct fixation due to easy access and low surgical morbidity.

전위된 관절 내 종골 골절의 치료 (Management of Displaced Intra-articular Calcaneal Fracture)

  • 이준영;나웅채
    • 대한족부족관절학회지
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    • 제19권4호
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    • pp.137-141
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    • 2015
  • Recently, open reduction and internal fixation has been the treatment of choice for displaced intra-articular calcaneal fractures for many orthopaedic surgeons. However controversy still surrounds the optimal treatment with regard to whether displaced intra-articular calcaneal fractures should be treated operatively or conservatively. Conservative treatments include use of splint, rest, leg elevation, icing, use of analgesics and early mobilization. Operative treatment is open reduction and internal fixation, performed through an extensile lateral approach with interfragmentary screws and application of a neutralization plate. We reviewed the question of whether operative treatment by open reduction and internal fixation provides a benefit compared with conservative treatment for displaced intra-articular calcaneal fractures.

생체 흡수성 판과 나사못을 이용한 족근 관절 골절의 치료 (Fixation with Bioabsorbable Polylactide Plate and Screws for the Treatment of the Ankle Fractures)

  • 권덕주;이용범;신준
    • 대한족부족관절학회지
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    • 제13권1호
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    • pp.80-84
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    • 2009
  • Purpose: The purpose of this article is to assess the efficacy of a bioabsorbable polylactide (PLA) plate and screw for treating injuries of ankle fractures. Materials and Methods: 24 patients who underwent an open reduction and internal fixation operation for ankle fractures from July 2005 to March 2007 were enrolled into the study. There were 15 men and 9 women. The average age of the patients was 44 years and the average follow-up period was 16 years and two months (16.2 months). All cases were divided into low grade fracture patient (11) who belongs in type A and B of Danis-Weber classification and high grade fracture patient (13) who belongs in type C1, C2 of Danis-Weber classification, and each groups were analyzed by clinical (Meyer score) and radiological finding at the time of their last follow-up evaluation. Results: The clinical results according to Meyer scoring system, showed that all patient with low grade fracture had good to excellent result, but only 54% of patient with high grade fracture had good to excellent result. According to Cedell's radiologic finding, there were 91% cases above fair in low grade fracture. But there were 62% of patient above fair result in high grade fracture, the reduction losses were seen in 38% of patient with high grade fracture. Conclusion: Bioabsorbable PLA plate and screw is good internal fixation device which doesn't have additional operation for removal of implant because of slow absorption within the human body. It showed sufficient strength for acquisition and maintenance of reduction in low grade fracture, but need attention to use because of many cases of reduction loss in high grade fracture. So, it seems to be safe and effective when used in heeling of low grade fracture under considering about type of fracture sufficiently.

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Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen

  • Choi, Kyunghak;Jung, Kwang-Hwan;Keum, Min Ae;Kim, Sungjeep;Kim, Jihoon T;Kyoung, Kyu-Hyouck
    • Journal of Trauma and Injury
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    • 제33권1호
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    • pp.18-22
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    • 2020
  • Purpose: Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods: This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results: A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44-98), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions: Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.

외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경감압 및 기구고정술 (Anterolateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture)

  • 배장호
    • Journal of Yeungnam Medical Science
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    • 제13권2호
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    • pp.234-242
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    • 1996
  • 영남대학교 의과대학 부속병원 신경외과에서 1994년 l월부터 1994년 12월까지 1년간 흉요추접합부 파열골절로 입원한 환자중 전측방경유법으로 10례를 수술로 치료경험 하였던 바, 척추골절이 척수원추 상부이면서 전방의 골편에 의해 척수신경이 압박되고 있는 불안정 파열골절시는 전방도달술에 의한 늑골 골융합 및 Kaneda기기내고정술로 좋은 결과를 기대할 수 있겠고, 척수 후주의 심한 손상이나 또는 3 column을 전체가 손상된 불안정 파열골절의 경우에는 후방접근법이나 후측방접근법으로 신경감압 및 내고정술 시행하는 것이 좋은 치료법이라 할 수 있겠다.

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관절경을 이용한 족관절 외과 골절의 비관혈적 정복술 및 내고정술 (Arthroscope-guided Closed Reduction and Internal Fixation of the Lateral Malleolar Fracture)

  • 신성일;김갑래;현윤석;반태서;김태화
    • 대한족부족관절학회지
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    • 제12권1호
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    • pp.74-79
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    • 2008
  • Purpose: In this study, we introduced an newly developed technique of operation for fracture of lateral malleolus of the ankle. We treated the fracture by close reduction and internal fixation using arthroscopy. Materials and Methods: From July 2006 to June 2007, we had treated 23 cases of lateral malleolar fracture (SER type) by closed reduction and internal fixation with arthroscopy and followed them up more six month. Operation time, union time, clinical and functional result were evaluated. Results: After the final follow-up, all the fractures were healed with satisfactory bony union. The subjective result was excellent in 15 cases (65%), good in 8 cases (35%), the objective result was excellent in 13 cases (57%), good in 10 cases (43%), and the roentgenographic result was excellent in 17 cases (74%), good in 6 cases (26%). Conclusion: Closed reduction and internal fixation with arthroscopy technique is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including corrective anatomical reduction and minimizing complication associated with injury of soft tissue.

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