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Operative Treatment of patellar Fractures
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Chang Kwan Kim, Jeong Hwan Kim, Sang Yup Lee, Young Hwan Kim, Chae Ik Chung, Jeong Gee Hong
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J Korean Soc Fract 1999;12(4):858-864. Published online October 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.4.858
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Abstract
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- We studied 45 patients of patella fracture who were treated by surgical method from March 1990 to December 1991. The results were analysed to evaluate the functional results of the knee according to methods of fixation and severity of comminution.
The results were as follows.
1. Out of 45 cases, 11 cases were tredted by tension band wiring, 19 cases by modified tension band wiring, 5 cases by tension band wiring by circumferential wiring, 8 cases by circumferential wiring, and 2 cases by screw fixation.
2. The mean fracture healing period was 6.9 weeks in cases of tension band wiring, 6.5 weeks in cases of modified tension band wiring, 5.2 weeks in cases of tension band wiring with circumferential wiring, and 7.3 weeks in cases of circumferential wiring.
3. The most favorable result was obtained in cases which were fixed with tension band wiring and circumferential wiring.
4. Modified tension band wiring seems to be a good method for displaced transverse fracture and comminuted fracture with large fragments and tension band wiring with circumferential wiring is for severely comminuted fracture with small fragments.
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Ankle Fracture with Syndesmosis Separation : Radiographic Landmark and Results of Trans-Syndesmotic Screw Fixation
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Chong Kwan Kim, Byung Woo Ahn, Sang Guk Lee, Young Hwan Kim, Chae Ik Chung, Sik Hwang
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J Korean Soc Fract 1999;12(4):948-955. Published online October 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.4.948
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Abstract
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- In the treatment of ankle f1racture, anatomical reduction and restoration of ankle mortise is very important. But tranf-syndesmotic screw fixation for syndesmosis seperation is dependent on the condition in operation field. The purpose of this study is to analyse the radiographic and clinical relults. to evaluate the need for trans-syndesmotic screw fixaition, and to know the effectiveness of radiogrphic landmarks for diagnofis of the syndesmosis separation, retrospectively. The patients were divided into two groups. The Croup I(25cases) were treated with trant-syndetmotic screw and group II(42 cases) were treated without trans-syndesmotic screw fixation .
The clinical results were excellent in 13, good 9 in group I and excellent in 19, good in 17 in group II. The radiographic results were excellent in 6, good in 8 in group I and excellent in 23, good 14 in group II. In the radiographic findings, the false negative result of tibiofibular overlap was 15.6%(M: 20.8%, F: 10.4%), tibiofibular clear space was 16.8%(M: 21.6%, F: 11.9%) and ratio of tibiofibular overlap to fibular width was 14.2%(M: 14.9%, F: 13.6%).
There was no siginificant statsitical difference in the ratio of tibiofibular overlap to fibular width between male and female.
We consider that the ratio of tibiofibular overlap to tibiofibular width are more reliable diagnostic criteria for syndemosis separation than the tibiofibular overlap and tibiofibular clear space. Trans-syndesmotic tcrew fixation is not alswaya required to maintain the integrity of the tibiofibular syndesmosis if the diastasis was satisfactorily reduced with rigid fixation.
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