• Title/Summary/Keyword: 관절 내 골절

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Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures (상완골 간부 골절에서 교합성 골수강 내 금속정 고정 후 잔존한 골절편 전위에 대한 임상적, 방사선학적 추시)

  • Yum, Jae-Kwang;Lim, Dong-Ju;Jung, Eui-Yub;Sohn, Su-Een
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.107-114
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    • 2013
  • Purpose: This study is designed to evaluate the clinical and radiographical results for the displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures. Materials and Methods: We retrospectively reviewed the results of 8 cases of humeral shaft fractures that have displacements of over 10 mm and under 20 mm after interlocking intramedullary nailing between July 2004 and August 2011. The mean age was 54.1 years (range, 43 to 70 years) and there were 3 male and 5 female patients. Radiographically, the time to bony union, change of displacement and angulation of the fracture site, and degree of improvement of these two factors were measured. Clinically, the range of motion of shoulder and elbow joints, postoperative pain and complications were evaluated. Results: All cases showed complete bony union in last follow-up. The mean time to bony union was 16.1 weeks. At the last follow-up, almost all cases had normal range of motion of shoulder and elbow joints. But, one case had stiffness of shoulder joint. Therefore, arthroscopic capsular release and manipulation was performed. One case had transient shoulder pain and the other case had transient elbow pain. In the two cases, pull-out of proximal interlocking screw were noted, but they finally had bony union. Conclusion: Although considerable displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures was present, we had excellent radiographical and clinical outcomes. Therefore, an additional procedure, such as open reduction or another fixation for the fracture site, was not necessary.

Femoral Bony Avulsion Fracture of the Posterior Cruciate Ligament in a Seventy one Year Old Man - A Case Report - (71세 남자에서 발생한 후방십자인대 대퇴골 부착부 견열 골절 - 1례 보고 -)

  • Lee, Yeong-Hyeon;Ahn, Gil-Yeong;Nam, Il-Hyun;Moon, Gi-Hyuk;Kim, Ki-Choul;Lee, Chae-Kyung;Lee, Sang-Chung
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.128-130
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    • 2010
  • Femoral avulsion fracture of posterior cruciate ligament (PCL) is rare, especially in adult. We experienced a case of femoral bony avulsion fracture of PCL. The patient was seventy one year old man with limitation of motion in the knee joint due to previous trauma and he was injured by fall down from 2 m height. We took CT scan and MRI study. We treated with arthroscopic repair technique using transfemoral two wire sutures. Second look arthroscopy was done for removal of the wires at postoperative one year.

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Subacromial Impingement Syndrome following Hook Plate Fixation for Distal Clavicle Fracture -A Case Report- (원위 쇄골 골절에 대한 금속판 고정술 이후 발생된 견봉하 충돌 증후군 - 증례보고 -)

  • Moon, Kyu-Pill;Kang, Min-Soo;Choi, Sung-Jong
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.19-21
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    • 2011
  • Clavicle Hook pate was commonly used in the injury around distal clavicle such as fractures, acromio-clavicular joint injury. We experienced a case of impingement syndrome following operation of distal clavicle fracture using Clavicle Hook plate. So we report this case with a reiview of current literatures.

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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.

Intraarticular Migration of the Staple Used for Extraarticular Lateral Collateral Ligament Repair - A Case Report - (슬관절 외측 측부인대 복원술시 사용된 staple의 관절내 이동 - 증례 보고 -)

  • Yoo, Jae-Chul;Bae, Sang-Wook;Kim, Byung-Kwan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.184-186
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    • 2006
  • Isolated lateral collateral ligament injury has been reported as avulsion fracture of attachment site or intrasubstance tear. The treatment of avulsion fracture of lateral collateral ligament was primary repair with anchor or staple. There are some reports about loosening or migration of staple which used in repairing meniscus of knee. There is, however, no report about loosening or migration of staple which was used for lateral collateral ligament repair. We report a case of migrated staple that was used for lateral collateral ligament repair, which was migrated to intraarticular posterolateral corner of the knee.

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Arthroscopic Reduction and Fixation of an Anterior Cruciate Ligament Avulsion Fracture From the Tibial Eminence Using Bioabsorbable Pins - Technical Note - (생흡수성 핀을 이용한 소아 경골 과간부 견열 골절의 관절경적 정복 및 고정 방법 - 수술 술기 -)

  • Lee, Su-Chan;Yang, Il-Soon;Seo, Hee-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.183-187
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    • 2009
  • Purpose: We describe a new and simple technique for arthroscopic fixation of tibial intercondylar eminence avulsion fracture using bioabsorbable pins in skeletally immature patients. Operative Technique: Diagnostic knee arthroscopy is performed using anterolateral and anteromedial portals. Fracture debris and blood clot are debrided to expose the injured site well. The fragment is reduced with the probe and fixed temporarily with a 1.1-mm diameter K-wire that is inserted percutaneously from the anterosuperior aspect of the knee joint. The drill guide is introduced into the joint and the fragment is secured by bioabsorbable, poly-p-dioxanone 1.3-mm pins inserted from different angles. The pins are 40 mm in length. The knee is placed in a long leg cast in extension for 4 weeks to assure that full extension is obtained. Conclusion: Arthroscopic fixation of an tibial intercondylar eminence avulsion fracture using bioabsorbable pins is not a technically demanding, suitable method that ensures fracture healing and restores the stability of the joint.

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Arthroscopic Treatment of Osteochondral Fractures Associated with Patella Dislocation (슬개골 탈구에 동반된 골연골 골절의 관절경적 치료)

  • Lee Byung-Ill;Min Kyung-Dae;Choi Hyung-Suk
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.104-110
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    • 2001
  • Purpose : To analyze the patterns of osteochondral fracture associated with patellar dislocation and to assess the results of arthroscopic treatment. Materials and Methods : Fourteen patients were treated from March, 1989 to April, 1998 for patellar dislocations with osteochondral fracture. The average follow-up was 32 months. All were treated by arthroscopic procedures. The location and size of the fracture fragments were recorded. To assess the functional results, we used Larsen & Lauridson's score system. Results : Osteochondral fractures were found 8 cases in medial side of patella, 1 case in lateral side of patella, 5 cases in lateral margin of lateral femoral condyle. The range of maximal diameter of osteochondral fragment was from 1cm to 4.2cm. Treatments include fragment excision only in 6 cases, excision and medial retinacular repair in 2 cases, excision and medial retinacular repair and lateral retinacular release in 3 cases, and internal fixation only in 3 cases. The functional results were excellent in 5 cases$(36\%)$. good in 6 cases$(43\%)$, fair in 1 case$(7\%)$ and poor in 2 cases$(14\%)$. Conclusion : In osteochondral fractures associated with patellar dislocation, arthroscopic treatment is useful to diagnose precisely, to determine proper treatment modality, and to minimize the complications.

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Nonunion of Tibial Eminence Fracture in Child - 2 cases Report - (소아 경골 극 골절의 불유합 - 2예 보고 -)

  • Hur, Yoon-Moo;Chung, Whan-Yong;Kim, Sang-Bum;Kim, Sung-Hun;Rhu, Seung-Reol
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.192-198
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    • 2006
  • The general consensus is that tibial eminence fractures have an excellent prognosis. But symptomatic nonunions requiring reduction and grafting have been reported. This report presents two cases of nonunion after tibial eminence fracture in eight years old boys which were treated with arthroscopy-guided reattachment and internal fixation and obtained good outcome.

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Operative Treatment of Capitellar Fractures Associated with/without Other Injury Around the Elbow (단순 혹은 주관절 주위 손상을 동반한 소두 골절의 수술적 치료)

  • Kang, Ho-Jung;Park, Kwang-Hwan;Lee, Jung-Kil;Choi, Yun-Rak;Hahn, Soo-Bong;Kim, Sung-Jae
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.142-149
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    • 2009
  • Purpose: We wanted to assess the radiological and clinical results and the prognostic factors after an operation for capitellar fractures associated with/without other injury around the elbow. Materials and Methods: Among the 25 patients (mean age: 49 years-old) who underwent open reduction and internal fixation for capitellar fractures, there were nineteen type 1 fractures and six type 3 fractures. The mean follow up period was 14.8 months. We assessed the factors affecting the radiological and functional results, such as the fracture pattern, the patient age and the surgical approaches. Results: In 24 of 25 patients, bony union was achieved at postoperative 1 year. There were eighteen excellent, four good, two fair and one poor functional results according to the Broberg and Morrey elbow score. The most common type was type 1 and the most common associated injury was lateral condylar fracture. The patients with type 1 fracture rather than the patients with type 3 fracture and the patients who had an extraarticular associated fracture rather than an intraarticular associated fracture had better clinical outcomes. Conclusion: 22 (88%) of the patients were satisfied at the result. The type of capitellar fracture and an associated intraarticular elbow fracture were shown to be important prognostic factors in this study.

Application of Hinged Transarticular External Skeletal Fixator (HTAESF) for Proximal Tibial Physeal Fracture in a Dog (개의 근위 경골 성장판 골절에서 경첩 관절경유 외고정의 적용)

  • Kim, Kwan;Heo, Su-Young;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.502-505
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    • 2012
  • An 8-month-old, 3.5 kg intact female Toy Poodle was presented for non-weight-bearing lameness on left hindlimb. In radiological testing, left proximal tibal type II Salter-Harris physeal fracture and fibular fracture were seen. Following open reduction, the fracture was stabilized with cross-pins, tension band wires, and a hinged transarticular external skeletal fixator (HTAESF). The range of the HTAESF was increased to $25^{\circ}$ at 7 days postsurgery and to $70^{\circ}$ at 14 days post-surgery. The HTAESF was removed 3 weeks after surgery. At 6 weeks post-surgery, the fracture was successfully healed with no complications and the patient recovered a normal gait. Seven months post-surgery, the patient had a normal gait and a normal stifle joint range of motion compared to the contralateral normal limb. This is a case in which the combined use of cross-pins, tension band wires, and HTAESF was successful for treatment of a proximal tibial physeal fracture in a dog. It is thought that these methods are beneficial for stability of fracture site and recover of joint's normal range of motion through early joint movement.