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Treatment of Radial Neck Fracture in Children: A Report of Six Cases
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Choong Gil Lee, Jin Woo Kwon, Young Dae Park, Jae Hyum Park, Young Suk Lee
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J Korean Soc Fract 1995;8(3):645-650. Published online July 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.3.645
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 Abstract
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- From December 1992, 6 fractures of the radial neck in children were treated at Sunrin General Hospital and followed up at least 6 months.
The purpose of this study is to review the initial fracture angulation, associated injuries, method of treatment, and clinical and radiologic results.
The following results were obtained; 1. There were 3 boys and 3 girls with an average age of 11 years.
2. Among 6 cases, associated injuries were accompanied in 4 cases.
3. Among 6 cases,5 cases were treated conservatively and 1 case of radial head posterior dislocation was treated by open reduction and pin fixation.
4. Angulation of less than 30 degrees were treated by simple cast immobilization(2 cases), of more than 30 degrees were by closed reduction and cast irnrnobilization(3 cases).
5. Elbow partial stiffness occurred in 2 cases.
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Treatment of Ankle Fractures in Children
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Choong Gil Lee, Jin woo Kwon, young Dae Park, Jae Hyum Park, Sung Ho Shin
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J Korean Soc Fract 1995;8(3):637-644. Published online July 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.3.637
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Abstract
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- The purpose of this study is to find the effective treatment method by evaluating the frequency and causes of complication in each Salter-Harris types.
The materials were 26 ankle physeal injuries treated from 1989 to 1994 with least follow-up of 12 months(ranged 12 to 62 months).
The results were as follows.
1. There were 14 boys and 12 girls with an average age of 11 years(range,3-15years) 2. According to Dias and Tachdjian classification, mechanisms of injury were pronation-eversion external rotation type in 7, supination-inversion type in 6, supination-plantar flexion type in 4, supination-external rotation type in 2, Tillaux in 3, unclassified in 4.
3. Amomg 26 cases operative treatment was done in 11 cases that include 4 cases of closed reduction & percutaneous pinning and 7 cases of open reduction & internal fixation.
4. Among 26 cases, complication occurred in 4 cases, in which 3 cases were treated by closed reduction and cast irnrnobilization only or with percutaneous pinning.
5. It is most important for prevention of complication that Salter-Harris type II, III, IV fractures were to be reduced accurately and fixed adequately.
6. Because Tillaux fracture ocurs near the age of epiphyseal closure, there were no clinically significant deformity after long term follow up.
In 3 cases of Tillaux fracture, the resluts were good.
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Posterior Fracture Dislocation of the Hip with Fracture of the Femoral Head
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Choong Gil Lee, Jin Woo Kwon, Jun Wan Park, Young Dae Park, Sung Ho Shin
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J Korean Soc Fract 1994;7(2):302-307. Published online November 30, 1994
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DOI: https://doi.org/10.12671/jksf.1994.7.2.302
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Abstract
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- The femoral head rarely is fractured in fracture-dislocation of the hip and probably result from forces transmitted axially along the femoral shaft with the hip flexed 60 degrees or less in neutral abduction and adduction.
Pipkin subclassified Epstein-Thompson type 5 fracture-dislocations into four additional subtypes according to head fragment location and presence of neck, acetabulum fracture. Hougaard and Thomsen reviewed 203 posterior hip dislocations and found that 13 patients with a fracture of the femoral head(Pipkin type 1,2). 1 with fractures of femoral head and neck(Pipkin type 3), 2 with fractures of femoral had and acetabulum(Pipkin type 4). Epstein, Wiss, and Cozen reported that 11 cases of Pipkin type 1,26 of type 2,8 of type 3, and 10 of type 4.
We experienced 2 cases of Pipkin type 3 and 3 of type 4 from January, 1990 and the results obtained were as follows.
1. By Pipkin classification, type 3 was 2 cases and type 4 was 3 cases.
2. In 2 cases of type 3, was treated by primary bipolar endoprosthesis due to comminution of head, neck and the other was by emergency open reduction of dislocation, multiple Knowles pinning of neck fracture, screw fixation of large head fragmnt, multiple knowles pinning of neck fracture, screw fixation of large head fragment, and quardratus femoris pedicled bone graft.
3. In 3 cases of type 4, one was reduced successfully by manipulation and treated conservatively. Two cases were initially treated by closed reduction and delayed open screws fixation of large acetabular rim fragments, during which head fragments were not removed.
4. There had been no clinical or radiological evidence of avascular necrosis of femoral head at 17 months follow up, but increased isotope uptake on bone scanning in type 3 patient.
5. All type 4 patients had not complained of hip pain and no evidence of radiological avascular necrosis of femoral heads at average 29 months follow up.
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