• Title/Summary/Keyword: 골절 고정술

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Arthroscopic Cannulated Screw Fixation of Avulsion Fracture of the Intercondylar Eminence of the Tibia in a Child -A Case Report- (소아에서 발생한 전방 십자인대 견열 골절에서 유관 나사못을 이용한 관절경적 정복술 -증례보고-)

  • Moon, Kyu Pill;Kim, Kyung Taek;Kang, Min Soo;Park, Won Ro
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.62-65
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    • 2012
  • Avulsion fractures of the intercondylar eminence of the tibia are uncommon. This kind of fracture is most commonly found in adolescents, with an increasing incidence for those involved in competitive athletics. Recently, an arthroscopic procedure is preferred to reduce the operation-related morbidity. Screws, K-wires, Suture anchor have been described as fixation devices. Cannulated screw fixation is a simple method, but this instrument has the risk of causing damage to the growth plate. The authors report good results using cannulated screw in arthroscopic treatment for pediatric anterior cruciate ligament avulsion fracture.

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LATERAL CANTHOTOMY-CONJUNCTIVAL APPROACH TO THE LATERAL AND INFERIOR ORBIT (안와하연 및 측벽(frontozygomatic suture)에 대한 lateral canthotomy-conjunctival approach를 이용한 협골체 골절의 치료)

  • Kim, Hyoun-Chull;Byun, Sook;Yoon, Ok-Byung;Lee, Tae-Young;Esaki, Seiji;Kameyama, Tadamitsu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.99-103
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    • 1994
  • Various extraoral and intraoral approaches to reduction and fixation of zygomatic complex fractures were used. The method for exposure of inferior orbital area include the subciliary, inferior eyelid, infraorbital rim and conjunctions incisions. For exposure of frontozygomatic suture, lateral brow, coronal and b'ephaloplasty incisions were used. It is necessary that the usual approaches to the inferior and lateral orbit have two incisions. However, lateral canthotomy-conjunctival approach presented on this paper provide optimal exposure to lateral and inferior orbit.

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Comparison of Results Between Immediate Fixation Group and Delayed Reconstruction Group in Displaced Mid-shaft Fractures of the Clavicle (쇄골 전위성 간부 골절에서 조기 고정술 군과 지연 재건술 군 간의 결과 비교)

  • Kim, Doo-Sub;Rah, Jung-Ho;Yoon, Yeo-Seung;Lee, Chang-Ho
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.61-66
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    • 2009
  • Purpose: Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. Materials and Methods: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union. Results: The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p<0.05), but not for the range of motion score & the power score (p>0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group. Conclusion: Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options.

Migration of Early Broken Wire into the Popliteal Fossa through Popliteal Hiatus in Internally fixed Fracture of Patella - A Case Report - (내고정한 슬개골 골절에서 슬와공을 통한 조기 파절된 강선 조각의 슬와부로의 이동 - 증례보고 -)

  • Jeon, Ho-Seung;Jeon, Seung-Ju;Moon, Chan-Sam;Noh, Hang-Gi;Jeong, Hyung-Jun
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.170-173
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    • 2009
  • Wiring techniques in the fixation of patellar fracture are commonly used. Rigid fixation is essential for early rehabilitation. Breakages of wires after the fixation of patellar fracture are common with extracapsular migration if not removed for long term. But, we experienced a case of patellar fracture with early breakage of wiring and migration of the broken wire fragment into the popliteal fossa through the popliteal hiatus in 64- year-old man and we successfully treated this case, using both arthroscopic and open procedures. So we report this unusual case with a review of current literatures.

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Coracoclavicular Ligament Augmentation Using Endobutton for Unstable Distal Clavicle Fractures - Preliminary Report - (불안정성 쇄골 원위부 골절에서의 Endobutton을 이용한 오구 쇄골 인대 보강술 - 예비 보고 -)

  • Cho, Chul-Hyun;Jung, Gu-Hee;Sin, Hong-Kwan;Lee, Young-Kuk;Park, Jin-Hyun
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.1-5
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    • 2011
  • Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after operative treatment using endobuttons for unstable distal clavicle fractures. Materials and Methods: Between October 2007 and September 2009, 9 consecutive patients who were followed up for at least more than 12 months after operative treatment using a TightRope$^{(R)}$ were studied. The radiologic results on the serial plain radiographs and the clinical results according to the American Shoulder Elbow Surgeons (ASES) score were analyzed. Result: Bony union was shown in 8 cases (88.9%) and the average time to union was 12.9 (range: 9~16) weeks. The average coracoclavicular distances at the postoperative and final follow-up were 5.6 mm and 6.2 mm, respectively, with no statistically significant difference (p>0.05). The average ASES score was 90.3 (range: 78~96) and the clinical outcomes were 6 excellent, 2 good and one fair. There were no complications such as implant failure or infection except for one case of nonunion due to loss of the initial reduction. Conclusion: A major advantage of TightRope$^{(R)}$ fixation for unstable distal clavicle fractures is that no further surgery is needed to remove the implant. We suggest that this technique provides an alternative for fracture with a distal fragment, which is difficult to fix.

The Volar Plating of Fracture of the Coronoid Process - Report of Two Cases - (구상돌기 골절에서 내측 접근법을 통한 전방 금속판 고정술 - 2예 보고 -)

  • Jung, Gu-Hee;Cho, Chul-Hyun;Jang, Jae-Ho;Kim, Jae-Do
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.260-265
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    • 2010
  • Purpose: To report the clinical results of two cases of coronoid process fractures that were treated with volar plating through a medial approach. Materials and Methods: Two fractures of the coronoid process that needed to be fixed were managed with open reduction and internal fixation through a medial approach using 2.4 mm locking compression plates (Compact Hand set$^{(R)}$, Synthes, Switzerland). The patients were followed up for 14 months and 17 months and were evaluated using the Mayo Elbow Performance Score (MEPS). Results: The MEPS was 95 for Case 1 and 100 for Case 2. Active elbow joint motions were $5^{\circ}-120^{\circ}$ (Case 1) and $0^{\circ}-130^{\circ}$ (Case 2). Supination and pronation fully recovered. Conclusion: Satisfactory results can be obtained in cases of coronoid process fractures because volar plating through a medial approach allows sound fixation and early mobilization of the elbow joint.

Pseudoaneurysm Originating from the Lateral Femoral Circumflex Artery after Retrograde Intramedullary Nailing of a Distal Femur Shaft Fracture (원위 대퇴골 골절에서 역행성 골수 정 시행 후 발생한 외측 대퇴 회선 동맥 기원의 가성동맥류)

  • Yu, Jeongseok;Lee, Beom-Seok;Kim, Han-Bit
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.535-539
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    • 2021
  • Vascular complications following a femoral fracture are rare but can result in serious issues. Several case studies have reported pseudoaneurysms occurring after direct trauma or the insertion of a proximal femoral nail in the case of a proximal femoral fracture. The authors encountered an 85-year-old patient treated with retrograde intramedullary nail fixation for a distal femur fracture and suffered a decrease in the hemoglobin level, swelling, and pain on the 9th day after surgery. The authors initially attributed the temporary hematoma and pain to ordinary postoperative processes. On the 16th day after surgery, a pseudoaneurysm originating from the descending branch of the lateral femoral convolutional artery was diagnosed and treated by percutaneous vascular embolization. After the procedure, the hemoglobin level increased, and the swelling and pain decreased.

Dual Plate Fixation for Periprosthetic Femur Fracture after Total Knee Arthroplasty (슬관절 전치환술 후 발생한 대퇴골 삽입물 주위 골절의 이중 금속판 고정술)

  • Kim, Dong Hwi;Cha, Dong Hyuk;Ko, Kang Yeol
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.26-33
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    • 2021
  • Purpose: This study evaluated the results of dual plate fixation for periprosthetic femur fracture after total knee arthroplasty (TKA). Materials and Methods: From October 2007 to February 2013, 23 cases of periprosthetic femur fracture after TKA were treated at the author's hospital. There were 13 cases of fixation using a medial and lateral dual plate when the stability of the fracture site could not be achieved by one side fixation with a follow-up of more than one year. The cases included no loosening of the femoral component in fractures that were categorized as Lewis-Rorabeck classification II and supracondylar comminuted fractures and elongation of the fracture line to the lateral epicondyle of the femur or stem in the medullary canal. The mean age was 72 years (65-82 years), and 11 cases were female. Three cases had a stem due to revision. The mean bone marrow density was -3.2 (-1.7 to -4.4), and the mean period from primary TKA to periprosthetic fractures was 28 months (1-108 months). The mean follow-up period was 23 months (12-65 months). The medial fracture site was first exposed via the subvastus approach. Second, the supplementary plate was fixed on the lateral side of the fracture using a minimally invasive plate osteosynthesis technique. The average union time, complications, and Hospital for Special Surgery Knee Score (HSS) at the last follow-up were evaluated. Results: The mean union time was 17.4 weeks (7-40 weeks). Two cases showed delayed bone union and nonunion occurred in one case, in whom bone union was achieved three months later after re-fixation using a dual plate with an autogenous bone graft. The mean varusvalgus angulation was 1.67 degrees (-1.2-4.9 degrees), and the mean anterior-posterior angulation was 2.86 degrees (0-4.9 degrees) at the last follow-up. The mean knee range of motion was 90 degrees, and the HSS score was 85 points (70-95 points) at the last follow-up. Conclusion: Dual plate fixation for periprosthetic femur fractures that had not achieved stability by one side plate fixation after TKA showed a good clinical result that allowed early rehabilitation.

Transpatellar Cannulated Screw Fixation of Displaced Tibial Intercondylar Eminence Fractures (전위성 경골 과간 융기부 골절의 슬개골 하단을 통한 삽관 나사못 고정술)

  • Nha Koung Wook;Jung Byung Hyun;Suh Jin Soo;Suk Seung Yeub;Park Gyu Won;Chae Dong Ju
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.25-30
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    • 2002
  • Purpose : To evaluate the clinical results of displaced tibial intercondylar eminence fractures which were treated with transpatellar cannulated screw fixation. Materials and Methods : Ten patients with displaced tibial intercondylar eminence fractures were treated between December 1998 and May 2001 and then followed up for more than one year. They were treated arthroscopic reduction and fixation of fracture site by cannulated screw through the hole of nonarticular surface of inferior patella. They were prospectively evaluated with regard to their clinical and radiologic results. Results : Radiologic unions occurred at an average of 9.2 weeks. Average anterior displacements were 1.8 mm in stress x-rays and 1.1 mm in KT-2000 arthrometer. Average loss of extension was $4.1^{\circ}$. Functional results were excellent in 7 cases and good in 3 cases. Conclusion : Arthroscopic transpatellar cannulated screw fixation is one of the useful methods for the treatment of displaced tibial intercondylar eminence fractures.

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Total Elbow Arthroplasty for the Fracture of Elbow Arthrodesis Site - A Case Report - (주관절 전치환술로 치료한 주관절 관절 고정술 부위의 골절 - 증례 보고 -)

  • Kim, Myung-Ho;Seo, Joong-Bae;Hwang, Sung-Su
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.246-250
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    • 2007
  • Total elbow arthroplasty is a relatively rare procedure compared with total knee or total hip arthroplasty. Total elbow arthroplasty for bony ankylosis is even rarer, and the results are often unsatisfactory. We report a patient who gained good mobility of the elbow after total elbow arthroplasty for the treatment of fractured arthrodesis site with which the patient had lived with for 12 years.