PURPOSE To compare the clinical outcomes of floating knee according to the presence of knee joint injury. MATERIALS AND METHODS Between March 2004 and March 2009, we investigated 36 patients, who underwent surgical treatment for floating knee injuries. We classified the floating knee into two groups as type I (12 cases) has no knee joint injury and type II (24 cases) has knee joint injury. We compared two groups about combined injury (orthopedics or other part), open fracture or not, neurovascular injury,union time, range of motion, and complication rate. RESULTS There is statistically no significant difference between two groups as type I (6 cases, 50%) and type II (13 cases, 54.2%) in orthopedic combined injury (p=0.813), and also same as type I (3 cases, 25%) and type II (12 cases, 50%) in combined injury on the other department (p=0.151), and in floating knee with open fracture as 4 type I (33%) and 12 type II (50%) of 16 cases (44%), and Gustilo-Anderson 3 type I, 4 type II, 1 IIIA, 4 IIIB, and 4 IIIC (p=0.423). There is statistically no significant difference between two groups in neurovascular injury as 1 type I (8.3%), and 3 type II (12.5%) (p=0.708). There is a statistically significant difference between two groups in the mean bone union time as 18.2+/-5.37 weeks (12~24 weeks) for type I and 24.95+/-9.85 weeks (16~33 weeks) for type II (p=0.045), and in the mean range of knee joint motion as 133+/-12.74 degree (120~150 degree) for type I and 105+/-19.00 degree (80~135 degree) for type II (p=0.012). CONCLUSION Floating knee with knee joint injury is severe itself and related with severe combined injuries, subsequent range of knee joint motion limitation, the delay of union time, and high complication rate. Therefore, we should take care in surgical treatment for this trauma entity.
PURPOSE Computed tomographic (CT) angiography is the first choice of diagnosis in traumatic vessel injury in the lower extremities, replacing angiography. The purpose of this study was to investigate the clinical reliability of CT angiography through a retrospective study. MATERIALS AND METHODS Seventeen patients underwent CT angiography before surgery for traumatic vessel injury in the lower extremities from 2009 to 2010, and a comparative analysis of operative findings in all patients with a positive predictive value and sensitivity were measured. RESULTS In all patients, 16 artery ruptures and 1 compartment syndrome occurred. In 15 artery ruptures, preoperative findings of CT angiography and surgical findings were consistent, and the positive predictive value was 93.8%. One patient with posterior tibial artery rupture was revealed as normal in CT angiography; thus, sensitivity was 93.8% (15/16 patients), and the accuracy rate was 88.2% (15/17 patients). CONCLUSION Though CT angiography is a reliable tool for diagnosis in traumatic vessel injury in the lower extremities, a more invasive test will be needed, especially peripheral angiography or diagnostic exploration, in cases of relatively small vessel injuries around the ankle or compartment syndrome because of low accuracy.
PURPOSE We analyzed the results and complications of the treatment of segmental fractures of the tibia associated with periarticular fracture by using Ilizarov external fixator. MATERIALS AND METHODS We reviewed 17 patients of segmental fractures of the tibia were treated by Ilizarov external fixator and were followed for a minimum one year. There were twelve closed fractures, three type 3A, and two type 3B open fractures. According to Melis classification, there were five type I, four type II, and eight type III. All closed fractures were reduced and fixed with Ilizarov external fixator within seven days. Open fractures were performed immediate wound irrigation and radical debridement and fixed with Ilizarov external fixator. Autogenous iliac bone graft was done in five severe comminuted fractures. Average time in bone graft was 7.5 weeks after operation. We analyzed bony union time according to configuration and site of the fractures, results of the treatment, and complications. The functional outome was assessed with rating system of Tucker. RESULTS In all cases, bony union was obtained, and average union time was 20.5 weeks. According to modified Melis classification, our results showed no difference between each criteria with respect to bony union and there was no difference bony union time between proximal and distal fracture site. There were two leg-length discrepancy less than 2 cm, one partial ankylosis of the knee joint, and ten pin tract infections. The functional results was excellent in 11 cases, good in 5 cases, and fair in one case. CONCLUSION Ilizarov external fixator can be useful method for the treatment of segmental fractures of the tibia associated with juxtaarticular fracture in respect of bony union and functional results.
PURPOSE To analyze the result of treatment for distal tibial fractures by interlocking intramedullary nailing. MATERIALS AND METHODS Eighteen patients who underwent interlocking intramedullary nailing for distal tibial fracture were followed up for more than one year. We analyzed the fracture configuration, presence of fibular fracture, angular deformity and bone union by follow-up radiograph, and complications. The functional results were assessed by Baird's ankle scoring system. RESULTS According to Robinson classification, there were 4 type I fractures, 12 type IIA fractures, and 2 type IIB fractures. All cases were combined with fibular fracture. The mean union period of 18 cases were 21.9 weeks. There were three complications with 3 cases of valgus deformity. In functional outcome according to Baird's ankle scoring system, 15 patients (83%) showed satisfactory results. CONCLUSION We concluded that interlocking intramedullary nailing is effective method for the treatment of the distal tibial fractures. However, to avoid valgus deformity of the distal tibia when combined distal fibular fracture, fibular reduction and rigid fixation should be needed.
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Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques Oog-Jin Shon, Ji-Hoon Shin, Chul-Wung Ha Journal of the Korean Fracture Society.2013; 26(1): 50. CrossRef
Interlocking Intramedullary Nail in Distal Tibia Fracture Oog Jin Shon, Sung Min Chung Journal of the Korean Fracture Society.2007; 20(1): 13. CrossRef
PURPOSE The purpose of this study was to analyze the associated injury, difficulties in management and complications with surgery, and to suggest the guideline according to the severity and type of injury in the management of both tibia fractures.
MATERIAL AND METHOD: We analyzed 12 patients, 8 men and 4 women and their age was 43.4 years old in average. The cause of injury was traffic accident in 10, autobike in 1 and farm machine injury in 1 case. There were both open tibia fracture in 6, one side open fracture in 2 and both closed fracture in 4 cases. We analyzed the average interval from injury to operation, duration of hospitalization, duration of both side bone union and complications. RESULTS In both open tibia fracture, the average interval from injury to operation was 12.5 days, average duration of hospitalization was 3.2 months, and average duration of bone union was 14.5 months. In one side open fracture, the average interval to operation was 25 days, average duration of hospitalization was 3.75 months, and average duration of bone union was 8.7 months. In both closed fracture, the average interval to operation was 15 days, average duration of hospitalization was 1.92 months, and average duration of bone union was 4.8 months. CONCLUSION Both tibia fractures were caused by high energy and also associated with multiple injury, and fracture stability and soft tissue damage should be evaluated thoroughly before surgery. Anatomical reduction and rigid fixation should be necessary to reduce the post-surgical complications.
PURPOSE The purpose was to evaluate the postoperative periprosthetic femur fracture of hip arthroplasty and relative problems of management using plate fixation.
MATERIAL AND METHOD: We reviewed 37 cases of femoral fractures out of 1,270 (1,183 primary hips and 97 revision hips) hips which received hip arthroplasty during the observation period (1985~1998). We classified them according to the stability and the location of the fractures related to the stem tip: Proximal (I), middle (around stem) (II) and distal (III). Then we subclassified the fractures as cortical perforation or a fissure, undisplaced (A), displaced (B) and unstable prosthesis (C). we managed periprosthetic fracture with splint applied or cerclage proximal fracture (type I), plate fixation and bone grafts in the stem tip (type II) or distal fracture (type III). In unstable fractures, we revised them with long fluted stems. RESULT The average union time is 3.1 months (range, 2~6.2 months). After management of fracture with plate showed 5 complications, two nonunion and three refractures. The causes of nonunion are early weight bearing and a too short plate. The causes of refracture are screw fixation and empty hole just distal to stem tip. The other caused by the roles of stress riser in proximal screw of blade plate in management of supracondylar fracture. CONCLUSION We recommend the use of cerclage band system or fixed in a more proximal site in long plate and bone graft. In unstable prosthesis, we had taken a best results after revised with distal fluted stem, in which we don't need further distal stability like a additional cerclage or locking screw and additional bone graft.
Fractures of the olecranon of ulna are caused by a number of different mechanisms including a direct blow, a fall on the stretched hand with the elbow in flexion leading to an avulsion fracture by the contracture of the triceps, and by higher energy trauma.
Olecranon fractures are intraarticular and frequently unable to manage by manipulation, therefore an open reduction and internal fixation procedure is usually indicated.
Authors have experienced and compared the results of 21 cases who were treated by plating and tension-band wiring technique from March 1989 through February 1996 at the Department of Orthopedic Surgery, Chonbuk National Liniversity llospital.
The results were as follows, 1. fractures treated by plating were type II. C comminuted fractures(6 cases, 28%), type II. D frac ture/dislocations(2 cases,10%) and type II. B transverse and oblique fractures(2 cases, 10%) in Coltons classification.
2. Plating was the preferred technique for the type II. C and II. D fractures which need autogenous iliac cancellous bone grafting and early active rehabilitation.
3. All of 21 cases were followed up for more than 15 months after surgery and showed good and excellent results according to Weseleys criteria.
4. In tension-band wiring, olecranon bursitis was occurred in 1 case.
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The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture In-Tae Hong, Kyunghun Jung, Yoon Seok Kim, Soo-Hong Han Archives of Hand and Microsurgery.2019; 24(2): 133. CrossRef
Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures Bo-Kun Kim, Hyun-Dae Shin, Kyung-Cheon Kim, Yoo-Sun Jeon Journal of the Korean Orthopaedic Association.2011; 46(2): 146. CrossRef
Internal Fixation Using Double Plates for Comminuted Olecranon Fractures in Adults Hyun-Dae Shin, Jae-Hoon Yang, Pil-Sung Kim Journal of the Korean Fracture Society.2009; 22(3): 166. CrossRef