• 제목/요약/키워드: Fracture and dislocations

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상완골 근위부 골절 또는 골절 및 탈구에서의 상완골 두 치환술 (Hemiarthroplasty for Fractures or Fracture-Dislocations of the Proximal Humerus)

  • 김영규;엄기석
    • Clinics in Shoulder and Elbow
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    • 제3권1호
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    • pp.20-25
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    • 2000
  • Purpose : To evaluate functional results and study factors influencing results after humeral hemiarthroplasty for comminuted fractures of the proximal humerus. Materials and Methods: We reviewed 12 patients with average follow-up period of 23 months(12 to 42). The proximal humeral fractures consisted of one anatomical neck fracture, five three-part and six four-part fractures or fracture-dislocations. Constant score and Compito et al' evaluation system were used for clinical assessment. Statistical analysis was done with the Wilcoxon test. Results: Six cases of anatomical neck, three-part fractures or fracture-dislocations showed 61 points on the average Constant score and three unsatisfactory results on the Compito et al' evaluation; Six of four-part fractures or fracture-dislocations showed 51 points and three unsatisfactory results. There were 59(two unsatisfactory) for five non-associated dislocation and 53(four unsatistactory) for seven associated dislocation; 66(one unsatisfactory) for three under 60 years and 41(five unsatisfactory) for nine over 60 years; 67(two unsatisfactory) for seven tuberosity union and 41(four unsatisfactory) for five tuberosity non-union or resorption; 58(four unsatisfactory) for ten early operation within two weeks and 43(all unsatisfactory) for two delayed operation; and 18(unsatisfactory) for one case of a accompanied rotator cuff tear. Conclusion: We concluded that tuberosity union was important factor influencing the results. Also, we thought that age, timing of operation and accompanied rotator cuff tear could be influenced to results.

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거골 경부 골절 및 탈구의 수술적 치료 후 발생한 무혈성 괴사 (Avascular Necrosis after Operative Treatment for Fracture and Dislocations of the Talar Neck)

  • 공일규;서형연;이근배
    • 대한족부족관절학회지
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    • 제12권2호
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    • pp.163-167
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    • 2008
  • Purpose: To evaluate the incidence of avascular necrosis (AVN), prognostic reliability of the Hawkins sign, and clinical outcomes after operative treatment of fracture and dislocations of the talar neck. Materials and Methods: We analysed 16 patients with fracture and dislocations of the talar neck which were treated by open reduction and internal fixation and followed up for more than 2 years. The postoperative radiographs were examined for Hawkins sign and avascular necrosis was confirmed by bone scan. The assessment of clinical results was based on the Hawkins scoring system. Results: AVN was occurred in 2 of 16 cases (12.5%) only in type III. Hawkins sign was found 11 of 16 cases (68.8%), which included 8 cases in type II, 2 cases in type III and 1 case in type IV. The Hawkins sign was not observed in two cases with AVN. In contrast, only 2 of the 5 cases with a negative Hawkins sign developed AVN. According to Hawkins scoring system, 4 patients (25.0%) was in excellent, 7 patients (43.8%) in good, 4 patients (25.0%) in fair and 1 patient (6.3%) in poor. Conclusion: Incidence of AVN after operative treatment of fracture and dislocations of the talar neck was lower than that of previous reports. Hawkins sign had a high prognostic reliability, but absence of Hawkins' sign should not be considered a totally reliable indicator of development of avascular necrosis.

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Bilateral anterior dislocation in the hips: a case report

  • Dheeraj Makkar;Ravi Sauhta
    • Journal of Trauma and Injury
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    • 제36권1호
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    • pp.70-73
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    • 2023
  • The hip is a stable ball-and-socket joint. Bilateral anterior dislocations of the native hip joints account for fewer than 1% of all dislocations. We present a unique case of a bilateral anterior dislocation in a patient who presented to our institution within 6 hours of trauma. The dislocations were promptly reduced under propofol anesthesia in the operating room. The patient did not suffer a concurrent fracture. After the procedure, we performed regular X-ray examinations for 2 years to rule out the development of avascular necrosis of the head of the femur. The course of the patient was unremarkable.

손상된 후경골건 감입에 의한 족관절 골절 및 탈구의 정복 실패: 증례 보고 (A Irreducible Ankle Fracture and Dislocation Due to Injured Tibialis Posterior Tendon Interposition: A Case Report)

  • 이준영;박이규;장현웅
    • 대한족부족관절학회지
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    • 제21권2호
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    • pp.70-74
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    • 2017
  • Fractures and fracture-dislocations of the ankle are caused by a variety of mechanisms. In addition to fractures, injuries of soft tissue, such as ligaments, tendons, nerves, and muscles may also occur. Among these, a tibialis posterior tendon injury is difficult to be identified due to swelling and pain at the fracture site. It is difficult to observe tibialis posterior tendon injury on a simple radiograph; it is usually found during surgery by accident. There are some studies regarding irreducible ankle fracture-dislocations due to interposition of the tibialis posterior tendon; however, to the best of our knowledge, there has not been any report about interposition of injured tibialis posterior tendon. Herein, we report a case of an irreducible fracture-dislocation of the ankle due to injured tibialis posterior tendon interposition that was observed intraoperatively, interrupting the reduction of ankle fracture-dislocation. We obtained satisfactory clinical result after reduction of the trapped tendon, fracture reduction, and internal fixation; therefore, we are willing to report this case with the consent of the patient. This study was conducted with an approval from the local Institutional Ethics Review Board.

Reduction of superior-lateral intact mandibular condyle dislocation with bone traction hook

  • Kim, Bong Chul;Samayoa, Sara Rebeca Kang;Kim, Hyung Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제39권5호
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    • pp.238-241
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    • 2013
  • Lateral and superior-lateral dislocations of the intact condyle are a rare complication, following traumatic insult to the mandible. We report an unusual case of a 54-year-old male patient who experienced both types of dislocations of the intact condyles with symphysis fracture following a road-traffic accident. Under general anesthesia, conventional manipulation was unsuccessful in relocating the condyles into the glenoid fossa. After applying a percutaneous traction force, using a bone traction hook placed at the sigmoid notch, the displaced intact mandibular condyles were repositioned, and the symphyseal fracture was finally reduced and fixed. The mouth opening was within normal limits, and favorable occlusion was confirmed one month postoperatively. To our knowledge, this is the first case of dislocation of both intact condyles--associated with symphysis fracture--being reduced with bone traction hook.

Bilateral Asymmetric Traumatic Dislocation of the Hip Joint

  • Park, Hee Gon;Yi, Hyung Suk;Han, Kyoo Hong
    • Journal of Trauma and Injury
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    • 제31권1호
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    • pp.43-50
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    • 2018
  • Traumatic hip joint dislocations account for 2-5% of total joint dislocations. Bilateral asymmetric hip joint dislocation with anteriorly and posteriorly dislocation is an even more rare case because it was according to G. Loupasis reported in 11 cases only since 1879. We want to report 2 cases of bilateral asymmetric hip joint dislocation with unilateral acatabulum fracture which happened in our hospital. Bilateral asymmetric dislocation of hip joint accompanied by unilateral fracture of acetabulum is a very rare case so statistical verification cannot be done. However, close examinations are required at early treatment and follow-up because the patterns of dislocation and fracture of hip joint are variable and an orthopedic emergent condition and several complications may occur at both hip joints.

Ultrasonography in Sternoclavicular Joint Posterior Dislocation in an Adolescent - A Case Report

  • Noh, Young Min;Jeon, Seung Hyub;Yoon, Hyung Moon
    • Clinics in Shoulder and Elbow
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    • 제17권4호
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    • pp.205-208
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    • 2014
  • Sternoclavicular joint posterior dislocations are considered a very uncommon, and type of injury where if esophagus or airway injury occurs behind the clavicle, it poses a high risk to the patient. In addition, if epiphyseal fracture occurs as a result of the sternoclavicular joint posterior dislocation, surgical treatment is often required. However, in the absence of a complete ossification of the clavicle, it is difficult to differentiate between a simple dislocation and epiphyseal fracture-dislocation solely based on simple radiographs or computed tomography scans. In this case report, the authors present a case in which a sternoclavicular joint posterior dislocation was diagnosed in a 14-year-old male athlete. The case report discusses how the posterior dislocation without epiphyseal fracture was diagnosed using an ultrasound and subsequently treated with successful outcomes using manual reduction. The case report presents our findings along with discussion that includes a literature review of relevant research.

수지 골절-탈구 치료의 최신 지견 (The Current Concepts in Treatment of Fracture-Dislocations of the Finger)

  • 강호정;김지섭
    • 대한정형외과학회지
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    • 제55권6호
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    • pp.457-471
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    • 2020
  • 수지는 복잡한 구조와 필수적인 기능을 가진 신체 부위로, 외상에 노출되기 가장 쉬운 부위이다. 수지 골절의 치료 원칙은 적절한 고정으로 골절부의 안정성을 획득하는 것과 안정성을 담보로 한 조기 관절 운동 간의 균형을 신중하게 결정하는 것이다. 치료에도 불구하고 합병증으로 강직이나 변형 등으로 인해 기능적, 미용적 문제가 되는 경우가 많다. 본 종설은 수지 골절 치료의 최신 지견을 소개하고, 치료가 어렵고 결과가 좋지 않은 것으로 알려진 관절면의 손상을 포함한 지절 관절 주위의 골절 및 탈구 위주로 정리하였으며, 치료 증례 소개와 합병증에 대한 접근 및 치료 순서로 기술하였다.

OUT-OF-PILE MECHANICAL PERFORMANCE AND MICROSTRUCTURE OF RECRYSTALLIZED ZR-1.5 NB-O-S ALLOYS

  • Ko, S.;Lee, J.M.;Hong, S.I.
    • Nuclear Engineering and Technology
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    • 제43권5호
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    • pp.421-428
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    • 2011
  • The out-of-pile mechanical performance and microstructure of recrystallized Zr-1.5 Nb-S alloy was investigated. The strength of the recrystallized Zr-1.5Nb-O-S alloys was observed to increase with the addition of sulfur over a wide temperature range, from room temperature up to $300^{\circ}C$. A yield drop and stress serrations due to dynamic strain were observed at room temperature and $300^{\circ}C$. Wavy and curved dislocations and loosely knit tangles were observed after strained to 0.07 at room temperature, suggesting that cross slip is easier. At $300^{\circ}C$, however, dislocations were observed to be straight and aligned along the slip plane, suggesting that cross slip is rather difficult. At $300^{\circ}C$, oxygen atoms are likely to exert a drag force on moving dislocations, intensifying the dynamic strain aging effect. Oxygen atoms segregated at partial dislocations of a screw dislocation with the edge component may hinder the cross slip, resulting in the rather straight dislocations distributed on the major slip planes. Recrystallized Zr-Nb-S alloys exhibited ductile fracture surfaces, supporting the beneficial effect of sulfur in zirconium alloys. Oxidation resistance in air was also found to be improved with the addition of sulfur in Zr-1.5 Nb-O alloys.

유구골 체부 관상면 골절의 치료 (Treatment of Hamate Body Coronal Fracture)

  • 이상현;김누리;장재훈;안태영
    • Journal of Trauma and Injury
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    • 제27권3호
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    • pp.57-62
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    • 2014
  • Purpose: A hamate body coronal fracture is well known as a very rare fracture in the carpal bones and is also hard to diagnose in initial stage due to the bone's architecture. We report our experience in treatment of such a fracture, and we present a review of the relevant literatures. Methods: Four patients who experienced hamate body coronal fractures from October 2006 to October 2013 were enrolled in this study. One patient also had an associated Capitate fracture, and two patients had associated dislocations of the $4^{th}$ metacarpal joint. We performed open reduction and mini-screw fixation on the four patients. In addition, a K-wire was fixed for the two patients with dislocations. Results: The average follow-up period was 24.5 months after surgery, and bone union was observed at the $8^{th}$ week after surgery. We confirmed that bone union had been completed for all the patients, and functional tests showed that joint motion was in the normal range without complications. Conclusion: When a patient has consistent pain on the ulnar side of the wrist, a hamate fracture should be suspected. Computer tomography is better than a simple X-ray scan for confirming the diagnosis of a hamate body coronal fracture. An open reduction and mini-screw fixation led to a good result.