Previous management of chronic osteomyelitis has included antibiotic therapy, radical debridement, skin-grafting, distant cross-leg flaps, and local muscle flaps. Each of these modalities of treatment has limitations. However, over the last 20 years, vascularized fibular bone grafts have proved to be a valuable method of reconstruction of skeletal defects in the extremities following both infected and uninfected skeletal nonunions unresponsive to conventional methodology. We evaluated the efficacy of vascularized fibular graft in the treatment of chronic osteomyelitis of long bone. From August 1988 to June 1995, fourteen cases of chronic osteomyelitis of long bone which were followed for an average of 3 years duration were treated by vascularized fibular graft at the Department of Orthopaedic Surgery, Korea University Hospital.
The results were as follows; 1. Even if the long tubular bone infection was uncontrolled, vascularized fibular graft could be performed and it was highly resistent to local infection.
2. Twelve cases (85.7%) out of a fourteen cases had primarily obtained bony union.
3. Free vascularized fibular graft is significant and reliable porcedure of bone grafting for the treatment of chronic osteomyelitis of long tubular bones.
Changes in patellar fracture characteristics: A multicenter retrospective analysis of 1596 patellar fracture cases between 2003 and 2017 Seong-Eun Byun, Jae-Ang Sim, Yong Bum Joo, Ji Wan Kim, Wonchul Choi, Young Gon Na, Oog-Jin Shon Injury.2019; 50(12): 2287. CrossRef
Circumferential Wiring Combined with Tension Band Wiring in the Operative Treatment of Patella Fracture Jae-Chun Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung Journal of the Korean Fracture Society.2014; 27(1): 65. CrossRef
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.