• Title/Summary/Keyword: 관절 내 골절

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Arthroscopic Reduction and Internal Fixation of Intra-articular Fractures of Lateral Tibial Plateau (관절면을 침범한 경골 외과 골절의 관절경적 정복 및 내고정술)

  • Lee, Kwang-Won;Lee, Hang-Ho;Yang, Dong-Hyun;Choy, Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.53-60
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    • 2006
  • Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.

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Arthroscopically assisted Operative Treatment of Tibial Plateau Fracture (관절경을 이용한 경골 고평부 골절에 대한 수술적 치료)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Kang, Shin-Taek;Whang, Chan-Ha
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.45-52
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    • 2006
  • Purpose: We evaluated the results of operative treatment of tibial plateau fractures using both arthroscopy and fluoroscopy. Materials and Methods: From May 1999 to February 2003, tibial plateau fractures were treated with arthroscopy. Tweenty seven patients are followed up over two years and the average follow-up period was fourty one months. We classified the fractures according to the Schatzker classification. We reduced the fracture over 2mm depression and displacement on articular surface in simple radiologic finding. Firstly, we treated the associated injuries and reduced the fractures using Steinmann pins. Then, we accomplished internal fixation or external fixation. Both the postoperative clinical and radiological results were evaluated by Rasmussen system. Results: In all tweenty seven cases, the fractures were healed completely in average fourty one months. According to Rasmussen classification, we obtained the excellent or good results in 23 cases. An average range of motion was between 2.5 degrees and 130 degrees. However, postoperative infection developed in one case and the other had loss of reduction. Conclusions: We consider that arthroscopically assisted operative treatment of tibial plateau fracture is a useful method. We can reduce joint surface correctly and treat associated injuries with arthroscopy. There are less complications.

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Arthroscopic Pull-out Wire Fixation Using Cannulated Screw of Tibial Eminence Fractures (도관 나사못을 이용한 경골 과간 융기 골절의 관절경적 견인 봉합술)

  • Kim, Jong-Min;Kim, Hyung-Gyu;Park, Byeong-Mun;Song, Kyeong-Seop;Jung, Sung-Hoon;Noh, Haeng-Kee;Yoon, Jong-Joo
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.254-258
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    • 2009
  • Tibial eminence fracture is caused by distortion, excessive flexion and extension, varus and valgus injury of the knee joint in the form of avulsion fracture. A failure over the exact anatomical reduction of fragment can lead to instability and limitation of joint motion. Recently, a variety of arthroscopic assisted reduction and fixation technique have been used. In the tibial eminence fracture, we created an arthroscopic pull-out wire fixation technique using a cannulated screw that is easy and more convenient than in the conventional technique. So we report this technique with a review of current literatures.

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Comparison of the Outcomes according to the Injury Type of the Short Radiolunate Ligament in Fracture-Dislocation of the Radiocarpal Joint (요수근 관절의 골절-탈구에서 단요월상인대의 손상 형태에 따른 치료 결과의 비교)

  • Heo, Youn Moo;Kim, Tae Gyun;Song, Jae Hwang;Jang, Min Gu;Lee, Seok Won
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.51-60
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    • 2021
  • Purpose: Radiocarpal dislocation (RCD), which is caused by high-energy trauma, often involves radial styloid fractures and short radiolunate ligament (SRLL) injuries. Although SRLL injuries may occur as a simple rupture at the attachment site of radius, it may occur with a relatively large avulsed-fragment in the volar rim of the lunate facet of the radius. This study aimed to differentiate the injury type of SRLL and assess the differences in the treatment results depending on the treatment methods that have been applied in RCD with radial styloid fractures. Materials and Methods: Eighteen patients managed surgically with RCD were enrolled in this study. The patients were classified as Group 1 and Group 2 by using the Dumontier method. In this study, Group 2 was subdivided into 2A (purely ligamentous or small avulsion fracture of the volar rim of lunate facet) and 2B (large avulsed-fragment enough to internal fixation) according to the injury type of SRLL. Groups 2A and 2B were treated with direct repair and screw fixation, respectively. Pain, range of motion of the wrist joint, grip strength, and complications on final radiographs were examined. The outcomes were evaluated using patient-rated wrist evaluation (PRWE), and modified Mayo wrist score (MMWS). Results: All patients were Group 2 (six and twelve patients in 2A and 2B, respectively). The mean flexion to extension arch recovered 79%,and the mean grip strength was 72.9% of the uninjured side. Group 2A showed better recovery in extension, flexion and pronation than Group 2B, but there was no difference in radial deviation, ulnar deviation, supination, grip strength and pain. No differences in the PRWE and MMWS were observed between two groups. Complications included traumatic arthritis in seven patients and residual instability in five patients. Conclusion: When the SRLL was injured, the involvement of a large avulsion fracture on the anterior plane of the radiolunate did not affect the test results. On the other hand, it should be observed cautiously because avulsion fractures tend to disturb the joint's reduction through rotation or displacement. In addition, anatomical reduction and sturdy internal fixation are important for restoring the function of the SRLL.

Biodegradable Meniscus Screw Fixation of Thin Flap Osteochondral Fracture - Two Case Report - (흡수성 반월상 연골나사를 사용한 얇은 골연골 골절의 치료 - 증례 보고 -)

  • Chon, Je-Gyun;Sun, Doo-Hoon;Song, In-Soo;Kim, Young-Woo;Jung, Jae-Yong;Lee, Bong-Ju
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.131-134
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    • 2010
  • Inappropriate treatment of osteochondral fracture can cause osteoarthritis, pain, functional disorder. With large osteochondral fracture, reduction and fixation of the fragment using metal implant. However, when the bone fragment had less than 2mm, the fragment extracted because of difficulty of fragment fixation. Authors treated patients with fracture fragment thickness less than 2mm of osteochondral dissecans in medial femoral condyle and patella fracture using biodegradable meniscus screw, and then we obtained good result.

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Traumatic Posterior Dislocation of the Shoulder with Ipsilateral Humeral Surgical Neck Fracture in a Child - A Case Report - (소아에서 동측 상완골 외과적 경부 골절을 동반한 외상성 견관절 후방 탈구 - 증례 보고 -)

  • Kang, Suk;Chung, Phil-Hyun;Kim, Jong-Pil;Kim, Young-Sung;Lee, Ho-Min;Kim, Jong-Hyun
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.80-83
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    • 2011
  • Purpose: Traumatic posterior dislocation of the shoulder in a child is extremely rare, and posterior dislocation of the shoulder concomitant with ipsilateral humeral surgical neck fracture has not been reported in a child previously in Korea. Materials and Methods: The authors treated a 10-year-old with posterior dislocation of left shoulder and an ipsilateral humeral surgical neck fracture, that occurred during Taekwondo practice, by open reduction of the shoulder and pin fixation under general anesthesia. Results: A normal range of motion with complete union and good remodeling was achieved without redislocation or avascular necrosis of humeral head at 1 year after surgery. Conclusion: The authors report a successfully treated case of traumatic posterior dislocation of the shoulder with an ipsilateral humeral surgical neck fracture in child.

Diagnosis and Management of Suspected Deltoid Injury (삼각인대 손상 의심 시 진단과 치료방법)

  • Yang, Sung Hun;Lee, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.16-21
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    • 2022
  • When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.

A Clinical Study of Femur Neck Fractures (대퇴 경부 골절의 임상적 고찰)

  • Koo, Hwan-Mo;Ahn, Myun-Whan;Ihin, Joo-Choul
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.69-80
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    • 1990
  • A clinical analysis was done on 23 patients(24 hips) with fracture of the femoral neck, who had been admitted and treated at our Orthopedic department during the period of 4 years, from Jan, 1984 to May 1988. The results were as follows : 1. 23 patients were comprised of 4 males and 19 females, and 11 patients were over 65 years old. 2. 18 cases of 24 cases were due to minor traumas such as slipping down, and for over 65 years old, all cases were due to simple minor traumas, 8 cases were showed a severe osteoporosis, below grade 3 of the Singh's index. 3. 14 cases of 24 cases were displaced subcapital fractures, and 6 cases displaced transcervical fractures. Only 4 cases were the undisplaced transcervical fractures. 4. In treatment of fractures internal fixations after manipulation were performed in 14 cases and primary arthroplasties in 10 cases. Secondary arthroplasties were done in complicated 4 cases of 14 cases treated with internal fixations. 5. Complications after internal fixation were developed in 7 cases out of 14 cases, avascular necrosis in 6, nonunions in 2, pin migrations in 3, and metal failure in 1 case. 6. In 14 arthroplasty immediate surgical fitness of femoral stem were related to late loosening of femoral stem(correlation coefficient r=-0.68, p<0.01).

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