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Original Articles
- Surgical Treatment of Intra-articular Fracture of the Os Calcis
- Soo Kil Kim, Young Gyu Kim, Bum Gu Lee, Jin Hong Ko, Su Chan Lee, Young Kim
- J Korean Soc Fract 1996;9(2):354-365. Published online April 30, 1996
- DOI: https://doi.org/10.12671/jksf.1996.9.2.354
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Abstract
PDF - Intra-articular fractures involving the posterior facet of the subtalar joint are associated with significant and prolonged disability. But, the treatment of choice for displaced intra-articular calcaneal fractures remains controversial. We treated 30 displaced intra-articular fractures of the calcaneus by open 1eduction and internal fixation through the lateral approach with autogenous bone graft at the Department of Orthopaedic Surgery, Choong-ang Gil and Dong Inchon Gil Ceneral Hospital from January 1990 to October 1994 The clinical and radiographic analyses were as follows. 1. Of 26 patients, 20 patients were male and 6 patients were female. 2. The main cause fractures of calcaneus was a fall from a height in 23 cases(88%) and most of associ ated fractures were spine injury in 6 patients. 3. Fracture was classified according to Essex-Lopresti classification. 13 cases were tongue type, 17 cases were joint depression type. 4. Alt Open reduction and internal fixation through the laterl approach with bone graft was performed in joint depression type and tongue type. 5. The preoperative ayerage Bohlers angle was - 5. The postoperative avereage Bohlers angle was -24, Which was increased significantly. 6. Complications were 12 cases ; included heel pad pain in 8 caLes, osteomyelitis and superficial wound infection in 2 cases, transient sensory hypesthesia on the lateral side of the foot in 2 cases. 7. Based on assessement of Salama, the results were excellent in 5 cases, good in 1 Teases, fair in 6 cases, poor in 2 cases.
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- Clinical Study of Tibial Shaft Fractures
- Soo Kil Kim, Keung Bae Rhee, Sae Jung Oh, Kye Seok Yang
- J Korean Soc Fract 1989;2(1):71-81. Published online June 30, 1989
- DOI: https://doi.org/10.12671/jksf.1989.2.1.71
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Abstract
PDF
- The tibia has poor soft tissue coverage and poor blood supply in anatomy, but it is the most commonly fractured bone of all the long bones, therefore tibial fractures are much controversy concerning the method of treatment because of frequent complications. The 63 adult patients(67 fractures) with fractures of the shaft of the tibia were treated at the Department of Orthopaedic Surgery, Choong Ang Gil Hospital during the 4 years from Jan. 1984 to Dec. 1987. by the group, the 24 cases(25 fractures) were treated with conservative methods, the 21 cases(23 fractures) were treated with self compression plate & screw fixation and the 18 cases(19 fractures) were treated with Ender nailing. The results obtained were as follows; 1. The average time of bone union was the 17.7 weeks.;the 14.1 weeks in the Ender nailing, the 17.5 weeks in conservative treatment methods, the 21.2 weeks in the compression plate & screws fixation. While hte rate of bone union was the 91.0%.;the 96.0% in conservative treatment method, the 86.9% in the compression plate & srews fixation, the 89.5 in the Ender nailing. 2. In the average time of bone union among the various levels of fractures, middle one third(16.7 weeks) healed more rapidly than the proximal one third(18.4 weeks) and distal one third(18.3 weeks). 3. As to the types and natures of fracture, average time of bone union was longer in open fractures(19.9 weeks) and comminuted fractures(20.6 weeks) than closed fractures(17.0 weeks) and simple fractures(15.5 weeks). 4. By the modified Ellis classification of tibial fractures, average time of bone union was the 16.2 weeks in minor severity, the 18.3 weeks in moderate severity, and the 20.1 weeks in major severity. Therefore the higher the severity, the longer the average time of bone union and the higher the complication. 5. In an intact fibula, tibial fractures healed more rapidly and the complications ocurred in the concomitant fibular fractures. 6. The complication of the tibial fractures were 28 cases, and most important complication were impairment of joint function, malunion and common peroneal nerve injury in conservative method, nonunion and infection in the compression plate and screws fixation, and delayed union in the Ender nailing.
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