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- Analsis of the Distal Tibial Physeal and Epiphyseal Injury
- In Ho Choi, Choon Ki Lee, Duk Yong Lee, Se Il Suk, Song Choi, Yong Hoon Kim, Suk Kee Tae, Seong Il Kim
- J Korean Soc Fract 1989;2(2):164-173. Published online November 30, 1989
- DOI: https://doi.org/10.12671/jksf.1989.2.2.164
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Abstract
PDF - We have reviewed 21 cases of physeal and epiphyseal fracture of the distal tibia including one case of juvenile Tillaux fracture and four cases of triplane fracture. The patterns of fracture were correlated with the mechanism of injury using the modified Lauge-Hansen method and sysemic classification of the triplane frature was proposed. Treatment included closed reduction and cast(9 cases), closed reduction and percutaneous pin fixation(4 cases), and open reduction(8 cases). Two of the nine patients treated by means of closed reduction and cast had ankle joint incongruity or progressive varus deformity requiring corrective ost eotomy. These two patients had either Salter-Harris Type III ro Type IV fracture after supination-inversion injury. In one patient, who had 100 per cent displacement of the distal tibial epiphysis and degloving injury of the ankle, premature physeal arrest developed after open reduction and internal fixaion for Salter-Harris Type Tyre I fracture. If there are triagular metaphseal ledge along with the juvenile Tillaux fracture-like vertical epiphyseal fracture line on the antero-posterior view and Salter-Harris Type II or Type IV frature on the lateral view, a certain type of triplane fracture is strongly suggested. Plain radiographs, however, could not accurately demontrate the detailed configuration of the triplane fracture, instead computerized axial tomography was very helpful us to analyse the true dimensions of the triplane fracture. We agree that displace Salter-Harri Type III or Type IV and transitional fractures with a fracture gap of more than two millimeters in the weight-bearing portion of the epiphysis regure open reduction.
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- A Study of Classification of Ankle Fractures
- Se Il Suk, Choon Ki Lee, Soo Ho Lee, Suk Kee Tae, Song Choi
- J Korean Soc Fract 1989;2(2):155-163. Published online November 30, 1989
- DOI: https://doi.org/10.12671/jksf.1989.2.2.155
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Abstract
PDF
- Lauge-Hansens classification system and Webers classification system are the two most commonly used systems in ankle fractures. both are based on causative mechanism but both have some deficiencies. Authors intended to decide which is easily applicable in clinical practice and shwich provides more information about treatement, especially that of diastasis. So we analysed 143 cases of ankle fractures in Seoul National University Hospital, Kang-nam General Hospital and Namseoul Hospital from January 1983 to December 1988. The results obtained are as follows. 1. Webers type A fractures correspond not only supination-adduction but also to pronation-abduction and pronation-dorsiflexion. Type B fractures correspond most closely to supination-external rotation and possibly to pronation abduction and pronation external rotation. Type C fractures show the nearest equivalence to pronation-external rotation and occasionally correspond to supination-external roation or pronation-abduction. 2. Diastasis was noted in 16 cases(28%) of type B and in 18 cases(74%) of type C and this lower incidence was seemed to be due to neglect of diastasis at physical examination or during operation. 3. It seemed to be more reasonable to fix the diastasis with tibiofibular fixation screw especially in type C. 4. Webers simpler classification system, which can explain the hidden ligamentous injury such as diastasis, was more easily applicable in daily use than Lauge-Hansen classification.
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