• Title/Summary/Keyword: 골절 고정술

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Anterior Instability of the Knee after Arthroscopic Treatment for Tibial Spine Fractures (경골극 골절의 관절경적 치료 후 슬관절의 전방 불안정성)

  • Choi, Chong-Hyuk;Kim, Sung-Hwan;Joo, Jong-Hwan;Kim, Hyung-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.26-32
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    • 2006
  • Purpose: We evaluated the result of the degree of reduction and anterior instability after arthroscopic treatment of tibial spine fractures. Materials and Methods: Thirty-two cases of tibial spine fractures treated with arthroscopic procedure could be evaluated and the mean follow-up period was $18\;(12{\sim}48)$ months. Evaluations included Lachman test, rotatory instability examination and side to side difference (SSD) using KT-2000 arthrometer. The degree of radiologic reduction was classified as accurate reduction, anterior elevation and reduction failure, according to which the degree of anterior instability was measured. Results: There were twenty three cases (71%) of accurate duction, eight cases (25%) of anterior elevation and one case (4%) of education failure. Eight (29%) of twenty eight cases with pull-out method showed anterior elevation. The SSDs of the accurate reduction and the anterior elevation group were 2.0 mm and 2.8 mm, respectively showing no significant difference. However, the percent age of grade 0 Lachman test and SSD less than 3 mm of the accurate reduction group were significantly higher. Conclusion: Accurate reduction is important in reducing anterior instability especially in unstable fractures. Therefore, arthroscopic pull-out method should be performed with great caution to avoid anterior elevation of the fracture fragment.

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Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction Using Achilles Allograft - Preliminary Report - (이중고리 동종 아킬레스건을 이용한 후방십자인대 재건 - 예비 보고 -)

  • Lim, Hong-Chul;Yoo, Jae-Chul;Han, Sang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.7-13
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    • 2002
  • Purpose : Preliminary report of the technique and trial of double bundle PCL reconstruction using Achilles allograft. Materials and Methods : From May 1999 to July 2000, 8 cases of PCL insufficient patients were treated with Achilles allograft reconstruction using the double bundle and double femoral tunnel technique. The tibial tunnel was prepared anteromedially. All other combined injuries within the knees were treated accordingly. Minimal follow-up period was 1 year. The results was assessed from the point of function and stability using Lysholm knee score and KT-2000 arthrometer. Results : Up to present follow up. 8 patients showed good sign of recovery with no instability (translation less than 2 mm) except olio that has been grafted-ligament rupture. In addition, none showed any sign of infection nor ROM limitation. Two complications were seen, which one had grafted-bone fracture and the other grafted-ligament rupture. The former occurred during operation and the latter occurred due to improper protection. Conclusion : Presently the follow up period is too short to draw any conclusive opinion but it is essential to select healthy and well sterilized allografts fur successful outcome. Double femoral tunnel technique seems to be more physiologic in PCL reconstruction. With these prerequisites, it seems to be a good alternative to use Achilles allografts fur the reconstruction of PCL. However, a longer follow-up is needed.

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Treatment of Malunion (부정유합의 치료)

  • Kim, Joon-Woo;Park, Kyeong-Hyeon;Oh, Chang-Wug
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.117-124
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    • 2021
  • Although current surgical techniques have reduced the incidence of malunion, it is still observed because of the complexity of the fracture or associated injuries. Osteotomy is needed when the amount of malunion is expected to result in an overload of cartilage and instability of the joint. Preoperative planning is essential when performing an osteotomy for malunion. Inadequate planning can result in serious complications, such as iatrogenic malalignment, intraoperative fracture, postoperative recurrence of deformity, or soft tissue injuries. In addition, a poor functional result can occur secondary to poor patient selection. This review article includes the surgical indications and planning to correct malunion. Various methods of corrective osteotomy are described according to the kinds of plane and fixation implants.

Delayed Diagnosis of Volar Dislocation of the Distal Ulna after Treatment of the Radial Shaft Fracture (요골 간부 골절 치료 후 지연 발견된 원위 척골의 전방 탈구)

  • Jeon, Suk Ha;Lee, Sanglim
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.427-432
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    • 2021
  • Delayed treatment of volar dislocation of the distal radioulnar joint can result in wrist pain, limited rotation of the forearm, and degenerative arthritis that could be managed only by salvage procedures. A 24-year-old male patient presented with wrist pain and a loss of forearm rotation after surgery for a radial shaft fracture. The shaft of the radius was fixed with a plate and screws with a volar angulation of 7°. The ulnar head was dislocated volar to the distal radius, and the bone defect in the ulnar head was impacted into the volar rim of the sigmoid notch of the radius, preventing the head from being reduced in the joint. Corrective osteotomy of the malunited radial shaft and sliding osteotomy of the proximal ulnar head were performed to fill the distal bone defect. Pain and range of the forearm rotation were improved at postoperative 19 months.

Treatment of Multiple Rib Fracture and Flail Chest with Judet's Strut-105 Case REport- (다발성 늑골골절 및 Flail Chest 환자에서 Judet's strut를 이용한 수술적 고정술 105례)

  • Park, Byeong-Sun;Jo, Wan-Jae;O, Jeong-U
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.803-808
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    • 1997
  • There were 105 patients with multiple rib fracture or flail chest who had underwent surgical rib fixation using judet's strut from Aug. 1989 to Aug. 1995. They were 86 men and 19 women, and the age distribution was from 17 to 77(mean $48\pm12).$ The most common cause of accident was a traffic accident(81%), The mean number of rib fracture was 5.5 and the distribution of patient were flail chest(72, 64.7%), severe displaced rib Fracture(18, 17.1%), traumatic chest wall deformity(10, 95%) and others(5, 4.7%). The operative mortality was 1 patient(0.96%) and the incidence of postoperative complication were 13 patients(12.3%). The duration of perioperative artificial ventilator therapy was $90.5\pm22.6$ hours. Our method allowed shorter duration of an artificial ventiatin and decreased a functional sequelae. We find this technique to be better than previously published methods, since it provides better stabilization and immobilization of he ribs and thus obviates the need for artificial ventilation and prevents post-traumatic chest deformity.

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Surgical Treatment for Type 11 Distal Clavicle Fracture using Mersilene tape and K-wire (Mersilene tape와 K-강선을 이용한 제 II형 원위부 쇄골 골절의 수술적 치료)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Kang, Shin-Taek;Whang, Chan-Ha;Hong, Chang-Wha;Lee, Bum-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.123-128
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    • 2006
  • Purpose: Surgical reconstruction is usually indicated for type II distal clavicle fracture due to high rate of nonunion and delayed union. We report the clinical outcome of a surgical technique for type II distal clavicle fracture using Mersilen tape and K-wire. Materials and Methods: From 1999 through 2003, this technique has been used on 11 patients with type II distal clavicle fracture. The procedure consist of fracture reduction with a Mersilene tape, repair of torn coracoclavicular ligament, and K-wire fixation of the fracture fragment. All patients with at least 12 months of complete postoperative follow-up were included for functional and radiographic evaluation. We used simple X-ray and UCLA scoring system and constant scoring system for evaluation at last follow up in OPD. Results: Solid union of the fracture could be achieved at 11 weeks after operation in all patients. All patients could return to the same level of preinjury activity. Good and excellent results were obtained in all patients according to UCLA system. Conclusion: This technique was simple procedure and allowed for stable fixation with early mobilization and early return to work and sports.

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Clinical Observation and Treatment of Fracture-Dislocation of Talus (거골 골절 및 탈구의 임상적 고찰)

  • Lee, Dong-Chul;Kim, Se-Dong;Jung, Hae-Hoon
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.302-311
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    • 1992
  • Talus is a important structure of the ankle joint and its function is critical for ambulation and weight bearing. The talus fracture is rare, but the complications of fracture and dislocation are serious and resulting in avascular necrosis, osteoarthritis. So its treatment is carefully considered at initial status. Authors reviewed 11 cases of fracture and dislocation of the talus treated at Yeungnam university hospital from 1984 to 1991. The longest follow up was 8 years and shortest, 1 year. The results were as follows. 1. There were all males, the average age was 30 years old. 2. The most common cause was fall down(8 cases), and next traffic accident(2cases), sports injury(1 case). 3. According to Marti-Weber classification, 1 cases was type I, 1 in type II, 4 in type III and 5 in type IV. 4. The method of treatment were open reduction and internal fixation in 6 cases, the others were closed reduction in 5 cases. 5. Final results(by Hawkins grading system) were as follows, 3 cases were excellent, 4 cases were good, 1 case was fair and 3 cases were poor. 6. Complications were AVN in 2 cases, degenerative arthritis in 8 cases, malunion in 1 case. 7. The range of motion of the ankle joint was relatively preserved(74%), but in the subtalar joint it was decreased(43%).

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Subcoracoid impingement After the Fixation of the Fractured Coracoid Process -A Case Report- (견관절 오구돌기 골절의 고정 후 발생한 오구돌기하 충돌증후군 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Cho, Su-Hyun;Hwang, Tae-Hyok;Park, Man-Jun;Choi, Jae-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.192-195
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    • 2010
  • Subcoracoid impingement resulting from abnormal contact between the anterosuperior humerus and the anterior coracoacromial arch represents an uncommon source of anterior shoulder pain. Certain operative procedures can also alter the relationship between the coracoid and the lesser tuberosity, leading to impingement of the interventing soft tissue, including the subscapularis and the bursa. We describe an unique case of subcoracoid impingement with the tear of subscapularis tendon after the internal fixation of the fractured coracoid process with cannulated screw due to crowding of the coracohumeral space. Arthroscopic removal of the screw and repair of the subscapularis in our patient resulted in successful resolution of his symptoms. Although subcoracoid impingement is a rare cause of shoulder pain, failure to diagnose and treat this condition may represent a significant cause of failed shoulder surgery.

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Comparison of Antiglide Plate Fixation and Lateral Plate Fixation for Danis-Weber Type B Isolated Lateral Malleolar Fractures (족관절 외과의 Danis-Weber B형 단독 골절에 있어서 활주 방지 금속판고정술과 외측 금속판고정술의 비교)

  • Ha, Joong-Won;Kim, Hyoung-Bok;Ko, Min-Suk;Yoon, Han-Kook
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.153-158
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    • 2011
  • Purpose: This study was performed retrospectively and to compare the clinical outcomes of the surgical management using Antiglide plating and lateral plating for Danis-Weber type B isolated lateral malleolar fractures. Materials and Methods: Between March 2004 and March 2009, 92 patients were followed up for more than 6 months after surgical treatment. 49 patients were treated with Antiglide plating, whereas the remaining 43 patients underwent lateral plating. The results of the two groups were analyzed both radiographically and clinically using Ankle scoring system. Results: Both groups were comparable for age, sex distribution, time to surgery, and operation time. Bone union was noted at average of 8 weeks in all fractures. The mean ankle score was similar in both groups (94% versus 93%). Conclusion: Antiglide plating for Danis-Weber type B isolated lateral malleolar fracture is one of the good methods which has some advantages such as early ankle motion, ambulation and smaller operative incision.

Accompanying Lesions and Clinical Results in the Greater Tuberosity Fracture of the Humerus with Anterior Shoulder Dislocation Under the Age of Forty (40세 이하에서 견관절 전방 탈구가 동반된 상완골 대결절 골절에서 관절내 병변 및 임상 결과)

  • Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Kyu;Park, Hyeun-Kook;Park, Jang-Hee;Shin, John
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.20-26
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    • 2011
  • Purpose: The purpose of this study is to investigate the accompanying lesions of humerus greater tuberosity fracture with anterior shoulder dislocation and to analyze its clinical results. Materials and Methods: From May 2005 to November 2008, arthroscopy was performed on a total of 30 selected patients who were diagnosed with humerus greater tuberosity fracture with anterior shoulder dislocation and who were also under the age of 40. The preoperative and postoperative Constant and Rowe scores were compared. Results: There was a total of 21 cases of anteroinferior labral lesions: 2 Bankart lesions, 4 bony Bankart lesions, 4 Perthes lesions, 2 free ALPSA lesions, 3 GLAD lesions and 6 capsular tears. For other lesions, 5 rotator cuff partial tears, 3 SLAP lesions and 1 biceps tendon rupture were found. The constant scores were increased from 56.3 to 94.43 points (p=0.034), and the Rowe scores were increased from 52.56 to 91.76 points (p=0.026). Conclusion: For humerus greater tuberosity fracture with anterior shoulder dislocation, the accompanying lesion was identified and the fracture was treated using arthroscopy. Good clinical results and bone union were achieved. According to the secondary arthroscopic findings, all of the Perthes lesion, the free ALPSA lesion, the GLAD lesion and the capsular tear spontaneously healed or they did not progress to extended rupture although arthroscopic suture was not performed. Any postoperative secondary instability was not observed.