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Original Articles
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The Treatment of the displaced Distal Radius fractures-Prospective study-
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Jun Young Yang, Hyun Dae Shin, Kwang Jin Rhee, Jun Kyu Lee, Deuk Soo Hwang, Jang Ik Lee, Jung Hee Choi
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J Korean Soc Fract 1999;12(2):411-421. Published online April 30, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.2.411
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Abstract
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- Fractures of the distal end of the radius, including Colles'fractures, represent the most common fractures of the upper extremity. Over the past years, many clinicians had thought of fractures of the distal radius as being a group of injuries with a relatively good prognosis. Today, fractures of the distal radius are recognized as very complex injuries with variable prognosis that depend upon the fracture type and the treatment given. We performed a prospective study in 51 patients(52 cases), by using treatment protocol of Palmer, we treated each fracture according to physiological age, activity, X-ray findings and stability after closed reduction. Final outcomes were evaluated by modified clinical scoring system, criteria for anatomical results and combined functional and anatomical results. Results by using modified clinical scoring system were excellent; 8 cases, good; 16 cases, fair; 22 cases, and poor; 6 cases. Results by using criteria for anatomical results were excellent; 8 cases, good; 26 cases, fair; 10 cases; and poor; 8 cases. In wrist rating scales of New York Orthopaedic Hospital, excellent; 7 cases, good; 32 cases, fair; 6cases, and poor; 7 cases. In our study, fractures of the distal radius were occurred frequently in active young male with high energy injuries. Criteria about acceptable range of reduction in treatment protocol of Palmer were too wide to obtain satisfactory results. Results from many assessment systems did not matched with each other because of differences of point of views. The results of this study proposed that even acceptable reduction is obtained, better outcomes will be brought by operative modality due to decreased frequency of reduction loss and radial shortening. And also, physical therapy after fracture treatment is considered as one of the important factors influencing functional results and the satisfaction of patients themselves.
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The Operative Treatment of Acetabular Fracture
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Deuk Soo Hwang, Kwang Jin Rhee, Jun Young Yang, Jang Ik Lee
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J Korean Soc Fract 1999;12(2):212-219. Published online April 30, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.2.212
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Abstract
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- PURPOSE
To analysis clinical and radiological result of surgically treated acetabular fractures and to present appropriate surgical approach for fracture type.
MATERIAL AND METHODS: A review of 51 surgically treated acetabular fractures, treated between April 1988 and October 1996, using single surgical exposures and combined surgical exposures was conducted. The classification was used Judet & Letournel,s classification and the surgical approach was applied Kocher-Langenbeck, Ilioinguinal, and Combined approach according to fracture aspect. The result was rated on a radiographic as well as a clinical result scale based on Matta,s.
RESULTS
The most common fracture was 14 posterior wall fracture and 7 transverse fracture. the surgical approach was applied Kocher-Langenbeck 29 cases, ilioinguinal 10 cases, and combined approach 8 cases, triradiate approach 2 cases and Extended iliofemoral approach 1 case. A satisfactory reduction was obtained in 87% of the cases (concentric, gap < 3mm). Clinical results were excellent in 28%, good in 54%, fair in 12%, and poor in 6%. Radiologic results at followup indicated 40% excellent results, 35% good results, 16% fair results, and 9% poor results. Postoperative complications appeared in 7 cases including posttraumatic arthritis 2 cases. Two patients later required total hip arthroplasty for avascular necrosis of femoral head and posttraumatic arthritis.
CONCLUSION
Ilioinguinal approach was good method for access to the anterior wall and column fracture, but in case of severe comminuted medial wall fracture company with anterior column, internal fixation is impossible. So, accurate assesment of the fracture pattern by careful radiologic analysis is essential. The posterosuperior dome fracture is important to anatomical reduction because of high risk of posttraumatic arthritis. In case of Transverse fracture, T-shape fracture, and both column, the more displaced column was reduced first, followed by opposite column after reduction identify by intraoperative radiography. We can be attained satisfactory reduction. Therefore, combined approach was good surgical method for this complex fracture.
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