Checkrein deformity of the great toe may occur after fracture of the distal third of tibia. It is due to adhesion of flexor hallucis longus muscle to callus. Charachteristic finding is shaply flexed great toe at ankle dorsiflexion and complete interphalangeal joint extension at ankle plantar flexion. We experienced a patient who had severe flexion deformity on the 2nd, 3rd, 4th toe and diagnosed as checkrein deformity of the lesser toes arised from calcaneal fracture. We can't find any report of checkrein deformity after fracture of calcaneus and we think this is very rare case. In operative field, we found fibrous contracture of quadratus plantae muscle which was adhered to flexor digitorum longus tendon. And we performed tenolysis, adhesiolysis and flexor digitorum longus tendon lengthening. 11 months after operation the patient showed excellent result with correction of the deformity.
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Dynamic Positional Deformity of the Hallux Byung-Ki Cho, Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Ji-Kang Park, Jung-Wook Oh The Journal of Foot and Ankle Surgery.2014; 53(6): 791. CrossRef
Checkrein Deformity by Incarcerated Posterior Tibial Tendon and Displaced Flexor Hallucis Longus Tendon following Ankle Dislocation - A Case Report - Su-Young Bae, Hyung-Jin Chung, Man-Young Kim Journal of the Korean Fracture Society.2011; 24(3): 271. CrossRef
Radial head resection is the accepted treatment of comminuted radial head fractures in adults, but the results are not always satisfactory. a number of well-known problems can ensue. These include chronic elbow and wrist pain, limited of motion, cubitus valgus, proximal radial migration, and new bone formation at the site of excision. Prosthetic replacement of radial head after excision offers theoretical advantages in the prevention of these problems. We are reporting three cases of patients, who had treated Swanson silastic prosthesis after comminuted radial head fracture associated posterior dislocation of the elbow.
From January 1991 to August 1996, we experienced 17 cases of metal failure among 150 cases of plate fixation of femur fracture.
We analyzed the cases and obtained the following results: 1. Among 17 cases, 15 cases were closed fracture and 2 cases were open fracture. In 11 cases, the fractures were located on the midshaft of femur and most of them was segmental or comminuted. According to AO classification, 14 cases(82%) were type B(B1:1, B2:4) and C(C1:7, C3:2).
2. The interval between initial operation and metal failure was 8 months on average.
3. The cause of metal failure were bone defect remaining after initial operation, fragment necrosis due to periosteal denuding of large free bone fragments, early weight bearing, selection of inappropriate implants and improper operation technique.
4. Plate breakages were occured in 11 cases and screw fractures and screw loosening in 6 cases. Most of plate breakage was due to remaining bone defects, and most of screw fractures and loosening was due to inappropriate implants and improper operation techinque.
In conclusion, accurate preoperative evaluation on the fracture site, fracture pattern and appropriate selection of internal fixative are important for proper bone healing. Based upon our result, we suggest semiopen technique with minimal soft tissue injury and initial early bone graft for bone defect.
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The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Kwang-Hee Park, Yoon-Ho Choi Journal of the Korean Fracture Society.2009; 22(4): 246. CrossRef
The major goals in the treatment of open fractures of the long bones are to prevent infection, avoid malunion or nonunion, achieve bone union, and restore limb and patient function as soon and as fully as possible. The treatment modalities adopted in open fractures still remains controversial, especially in Gustilo-Anderson Type III. It has been the fear of infection that has lead to the traditionally accepted opinion that immediate internal fixation of open fractures is contraindicated but, nowadays, it is no longer tabooed. Owing to the early meticulous wound debridment and irrigation, and the use of bactericidal antibiotics, the infection rate reduced remarkably. Fifty-five cases of open long bone fractures treated by immediate internal fixation within 24 hours from inury were reviewed, which were treated at the Department of Orthopedic Surgery, Soonchunhyang University hospital for nine and half years from June, 1985 to January, 1995.
The results were as follow: 1, There were 20 Type II , 19 Type III A, 10 Type IIIB and 5 Type IIIC open fractures treated by immediate internal fixation within 24 hours following to Gustilo-Andersons classification.
2. The most common causes of open fractures were traffic accident(84%).
3. The associated injuries of the patients treated by immediate infernal fixation were in sequence.:26 multitraumatized patient, 5 arterial injuries, 5 musculotendinous injuries, 3 major joint dislocations and so forth.
4. Normal bony union was achieved in 41 patients(73.2%), Delayed bony union was in 7 patient(12.5%) and nonunion in 8 patients(14.5%).
5. Primary wound healing was achieved in 40 patients(71.4%), superficial to moderate infection were in 5 patients(9%), deep to osteomyelitis in 11 patients(19.6%).
6. According to the subtypes of open fractures, deep to osteomyelitis were 80% in Type IIIC, 30% in Type IIIB, 10.6% in Type IIIA and 10% in Type II.