Journal of Musculoskeletal Trauma

Treatment of Nonunion in Femoral Supracondylar and Intercondylar Fracture: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yu, Eun No Lee, Yoon Yeup Kim; J Korean Soc Fract 1999;12(4):844-850. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.844

Abstract PDF: The femoral supracondylar and intercondylar fractures are difficult to be treated due to severe soft tissue damage, comminution, intraarticular extension of fracture and injury to the quadriceps mechanism frequently. The causes of nonunion are inadequate anatomical reduction, fixation failure, bone defect and infection occasionally, which is difficult to be treated. The authors analyzed 16 cases with nonunion of femoral supracondylar and intercondylar fracture who had been treated surgicdlly from January 1990 to December 1991 According to AO/ASIF classification in the initial fracture patterns, type A were 8 cases, type B was 1 case and type C were 7 cases. The duration between initial treatment and surgical treatment of nonunion was 6 months in average. The causes of nonunion were fixation failure due to inadequate device selection in 9 cases, inadequate anatomical reduction or surgical technique in 4 cases and infection in 3 cases. The treatmentt were internal fixation with Dynamic condylar screw(DCS) in 9 cases, internal fixation with condylar blade plate in 4 cases, monofocal lenghtening with Ilizarov in 1 case and bifocal lenghtening with Ilizarov in 2 cases. According to Schatzker classification, the good result was obtained in 11 cases(68.8%). The complications were 3 knee joint ankyloses, 2 superficial wound infections, 1 delayed union and 1 deep vein thrombosis. In conclusion, the requirement for the good result in treatment of nonunion are exact anatomical reduction, rigid fixation and autogenous bone graft.

91 View
1 Download

Treatment of Comminuted Supracondylar and Intercondylar Femoral Fractures with AO Dynamic Condylar Screw: Kyung Chul Kim, Jae Yeul Choi, Hwa jae Jeong, Bon Seep Koo, Kyung Ho Kim; J Korean Soc Fract 1999;12(2):253-258. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.253

Abstract PDF: Between 1990 and 1995, 22 comminuted supracondylar and intercondylar femoral fractures in 22 patients were treated with the AO dynamic condylar screw(DCS). Minimum twelve months of clinical and radiographic follow-up evaluation were available on all patients. All cases achieved clinical and radiographic bony union. Functional results were graded using a Schatzker and Lambert's criteria. Results were seen to be excellent to good to fair in 100% of A2 cases, 86% of C2 cases, 75% of A3 cases and 67% of C3 cases. The more comminuted fractures were found to have worse clinical results and more radiographic malunion. The ability to obtain good fixation in osteoporotic bone is distinct advantage of the DCS. The results of DCS fixation compare favorably with previous studies using other fixation devices in comminuted supracondylar and intercondylar femoral fractures

100 View
0 Download

Treatment of the Supracondylar and Intercondylar Fracture of the Humerus in Adults: Sang Won Park, Young Soo Byun, Ki Hoon Kang, Sang Won Han; J Korean Soc Fract 1998;11(2):378-383. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.378

Abstract PDF: Supracondylar and intercondylar fracture of the adult humerus is uncommon and present a difficult management problem. The purpose of this study is to analyse the clinical results according to types of the fracture and methods of the treatment. The authors reviewed twenty-eight patients treated for supracondylar and intercondlar fracture of the adult humerus at the Department of Orthopaedic Surgery, Korea University Hospital from January 1990 to August 1996. The mean follow up period was 41 months (12months to 79months). The results were as follows: 1. According to AO classification, there were 9 cases(32%) of Type A, and 19 cases(68%) of Type C. 2. The Methods of treatment were closed reduction and cast immobilization in 4 cases, closed reduction and fixation with K-wire or screw in 11 cases, open reduction and fixation with K-wire or screw in 7 cases and open reduction and plate fixation in 6 cases. 3. Poor results can be expected after closed reduction and cast immobilization, open fracture, above 60 years old, and Type C according to AO classification.

54 View
2 Download

Delayed Management of Supracondylar and Intercondylar Fracture of the Femur Using the Composite Graft(Autograft+Processing Allograft): Young Kyun Woo, Seung Koo Rhee, Soen Yong Kwon, Hwa Sung Lee, Joo Yup Lee; J Korean Soc Fract 1996;9(4):951-957. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.951

Abstract PDF: There are many difficuties and problems to get anatomical reduction and rigid internal fixation in treatment of supracondylar and intercondylar fracture of the fumur. Authors reviewed and clinically analysed 7 patients w.ith svpracondylar and intercondylar fracture of the femur treated by delayed reconstruction from August 1993 to Decfmber 1995. Of 1 cases, there were 5 cases of open and 2 cases of closed fracture. According to AO classification, 7 cases were classified as followed; A3 type-l case, C2 type-4 cases, and C3 type-2 cases. They underwent surgical treatment at average 35 days after injury(range from 25 days to 58 days). Main causes of delay in surgical treatment were poor preoperative condition associated with mulliple injuries in 3 cases, wound problems at the site of open fracture in 3 cases and the combined state in 1 case. For internal fixation of fractures, a supracondylar nail in 4 cases and a dynamic condylar screw in 3 cases were used, and the bony defective area of fracture site in all 1 cases was replaced by the composite graft made of the autogenous cancellous bone and the processing allograft(Tutoplast). The period of follow up was from 8 months to 30 months(average time 14.8 months). There were no infection or allograft-rejection postoperatively. Clinical union was achieved from 6 months to 10 months in 6 cases, and nonunion associated with incomplete incorporation of graft bone was developed in 1 case. In 6 cases of clinical union, clinical assessment estimated by Schatzker and Lamberts criteria was fair in 1 case and failure in 5 cases, and change of tibiofemoral alignment occurred in 2 cases. The above poor clinical results could be considered to be derived from the delayed operative intervention resulting in joint stiffness due to soft tissue contracture, arthritis and large bony defect. In conclusion, even if it showed poor clinical results, the composite graft made of the autogenous cancellous bone and the pmcessing allograft could serve as a possible alternative for restoration of large bony defect in delayed management of supracondylar and intercondylar fracture of the fumur.

35 View
0 Download

Treatment of Infected Nonunion in Supracondylar and Intercondylar Fractures of the Femur after Open Reduction and Internal Fixations: Ho Geun Chang, Eung Joo Lee, Sang Chun Ahn; J Korean Soc Fract 1996;9(4):921-929. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.921

Abstract PDF: The postoperative complications in open reduction and internal fination of supracondylar and intercondylar fractures of the femur include leg length discrepanfy, infection, skin necrosis, irritation by implants, valgus or varus deformity, bony destruction associated with vascular disturbance, instability of thr knee joint and translation of the frartured surface. The most vulnerable complication among them may be infection. Then infected nonunion is dangerous to the patients and its treatment is very difficult. Authors evaluated 25 cases of 25 patients who were treated and followed up evaluation over one year in the department of Orthopaedic Surgery, College of Medicine, Hallym University from January, 1988 to June, 1995. All cases were treated by open reduction & internal fixations. Four cases of them had developed infected nonunion. After we treated these cases wr could reach following results: 1. The cause of infection was primarily staphylococcus aureus in all cases. 2. Among 4 cases of infected nonunion, external fixator was preformed in 3 patients and interlocking IM nailing in remainder. 3. The infection was managed with intravenous antibiotics, frequent irrigation. insertion of antibiotic impregnated beads and daily dressing. 4. Erythrocyte sedimentation rate was normalized at average 8.5 months(range, from 1.5 to 26 months). 5. The union was accomplished at mean 5.4 months in 21 cases without infection and at mean 17.7 months(range, from 10 to 35 months) in 4 cases with infued nonuion after infection developed. 6. The main complications were limitated range of motion of the knee(30 to 100 degree flexion) and shortening of affected extremity. 7. In conclusion, we suggest that early removal of implant in situ, external fination and bone graft after infection controlled is an adequate plan for the treatment of infected nonunion in supracondylar and intracondylar fractures of the femur.

44 View
0 Download

The Treatment of the Supracondylar-Intercondylar Fracture of the Femur: Joo Tae Park, Gil Yeong Ahn, Il Hyun Nam, Jung Kyu Ji; J Korean Soc Fract 1995;8(1):31-38. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.31

Abstract PDF: Although not as common as femoral shaft fracture, supracondylar-intercondylar fracture of the femur present considerable challanges in management. Because supracondylar-intercondylar fracture is frequently accompanied by severe soft tissue damage, comminution and intraarticular extension of fracture, it can produce some disability of the knee joint, So recently, early anatomical reduction, rigid internal fixation and early rehabilitation was recommended. The authors analyzed twenty cases of supracondylar-intercondylar fracture that treated at the Department of Orthopaedic Surgery of Pohang Saint Marys hospital from March, 1990 to December, 1993. The object of this study is to evaluate the corelation between the rigid internal fixation and early rehabilitation, The average follow up period was 18.3 months(form 14 to 27 months,) The results were as follows; 1, Among the twenty cases, male was more common than female and the prevalent age was 4th decade(50%). 2. The most common cause of injury was trafnc accident in 15 cases(75%). 3. During 1st 3weeks after operation, we started active R.0.M. exercise by using Thomas splint with Pearson attatchment and long leg brace with ischial weight bearing was applied from 3months to 6months (averge 4.2 months). We permit partial bearing Sweets after operation, 4. According to Schatzker and Lambert criteria, excellent were 16 cases, good 3 cases, feir 1 case. 5. We obtained satisfactory by rigid internal fixation and early rehabilitation.

38 View
0 Download

Search