Journal of Musculoskeletal Trauma

Ipsilateral Fractures of the Hip Joint and Femoral Shaft: Sang Won Park, Soon Hyuck Lee, Jung Ho Park, Hong Kun Lee; J Korean Soc Fract 1990;3(1):88-95. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.88

Abstract PDF: Ipsilateral fractures of the hip joint and femoral shaft, which generally occur by severe trauma, are frequently associated with multiple fractures and other injuries. Initially overlocked femur neck fracture may lead unpredicted complications, and femoral shaft fractures, usually comminuted, could be complicated with malunion, infection, limb shortening and limited ROM of knee joing. It is difficult to determine the type of fixation device and priority of fracture in treatment according to the variation of the site and pattern of fracture. Eleven pateints with ipsilateral fractures of hip joint and femoral shaft were treated at Korea university Haehwa hospital from Jan. 1984 to Oct. 1988. Among them, nine pateints were followed up more than twelve months. There were eight male and one female. The ages ranged from twenty-two to fifty-three years, the average being 37.6 years. Seven cases caused by traffic accident and fall down trauma in two cases. 1. The levels of hip joint fractures were 6 femoral neck, 1 basal neck-intertrochanteric, and 2 intertrochanteric region. 2. The levels of femoral shaft fractures were 3 proximal one-third and 6 middle one-third. 3. Eight fractures of the femoral shaft except one were comminuted or segmented. 4. Six patients has other fractures or organ injuries. 5. All nine pateints had operation. In six patients with femoral neck and shaft fractures, the femoral shaft fractures were first reduced and fixed, and femoral neck fractures were stabilized later, In three pateints with femoral shaft and basal neck or intertrochanteric fractures, both fractures reduced and fixed simultaneously. 6. Several devices were used according to the site and patterns of fractures. 7. There were complications in three cases:one coxa vara, limb shortening, and infection, knee joint sitffness, and avascular necrosis in one case.

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Pervention of the Cortical Breakage by Using the Lowman Clamp During the Flexible Intramedullary Nailing in the cases fo the Trochanteric Fractures: Moo Kyung Ko, Kyung Jo Woo, In jung Chare, Hong Kun Lee; J Korean Soc Fract 1989;2(2):263-268. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.263

Abstract PDF: Flexible intramedullary nailing has offered the many advantages in the treatment of the trochanteric fractures. But there has been many complications such as the knee joint pain, the deformity of external rotation of the femur, insufficient fixation of the fracture, peroneal nerve palsy, cortical breakage of insertion site of nailing and linear fracture of the femur. Of these complications, the cortical breakage and linear fractures of the femur was prevented by suing the Lownam clamp on the proximal site of insertion hole during the nailing. The authors have treated 31 cases of the trochanteric fractures with this method from March 1985 to December 1988 and the results are as follows: 1. There was neither cortical breakage nor linear fracture at the site of insertion hole in all cases of 31. 2. wide operation field was obtained with Lowman clamp by traction of muscles near by. 3. The handle of Lowman clamp can be used as indicator to determine the grade of anteversion. 4. It is confirmed that intramedullary nailing with Lowman clamp is simpler than conventional method and is highly recommended.

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A Clinical Study on the Tibial Condylar Fracture: Jae Young Cheon, Hak Yoon Kim, Sang Won Park, Hong Kun Lee; J Korean Soc Fract 1989;2(1):49-59. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.49

Abstract PDF: The tibial condylar fracture involving articular surface of the proximal tibia is common in traffic accidents. In the tibial condylar fracture, the injuries of soft tissue such as ligaments and menisci are frequently accompanied and the weight bearing surface are involved, too. So significant disability of the knee joint often results from the tibial condylar fracture. The fifty cases of the tibial condylar fracture treated at the orthopaedic department of Korea Univerity Hospital from January, 1982 to December, 1986 have been followed for 1 to 3 year The results obtained were sa follows: 1. among the fifty patients, the ratio of sex was 2.1:1 as male predoninant, and the prevalent age distributions were in the 3rd and 6th decade. 2. The most common cause of injury was traffic accident in 32 cases(64%). Second in frequency were falls in 7 cases(14%). 3. The laterality of injury was left in 29 cases(58%), right in 21 cases(42%). The locations of injury were lateral condyle in 34 cases(64%), medial condyle in eight cases(16%) and bicondyles in eight cases(16%). 4. According to the Hohls classification, the most common was type III in nineteen cases (38%). 5. The most common associated injuries were ipsilateral fibular fracture in 15 cases(30%) and ligament injury in 15 cases(30%) especially frequnt in type II and III. Among the ligament injuries, the medial collateral ligament tearing was eight cases(53%) as predominant. 6. Fifteen cases(30%) were treated by cast immobilization, two cases(4%) by skeletaltraction. Thirty-three cases(66%) were treated by operative method. 7. Thirty-seven cases(74%) revealed the rating of acceptable group according to Robertscriteria.

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