Journal of Musculoskeletal Trauma

Operative Treatment of Tibial Plateau Fractures - Analysis of the factors affecting to the clincal results: Byeong Yeon Seong, Wan Soo Park, Sang Yul Shin, Yuen Ki Woo, Taek Geon Lee, Man Jae Park, Seung Ki Lee; J Korean Soc Fract 2002;15(1):87-96. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.87

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures.
MATERIALS AND METHODS
The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment.
RESULTS
18 of 19 cases that were ranged of ages between 30 years and 59 years showed good clinical results as criteria of Blokker. Schatzker type II was noted 11 cases(37.9%) as most common. 13 of 14 cases of the type I,II and III, were showed good clinical results, compare to 10 of 15 cases of the type IV,Vand VI. 12 of 18 cases which were related with associated soft tissue injuries, were showed good clinical results.
CONCLUSION
We could expect good clinical results if early knee joint mobilization following open reduction and rigid internal fixation could be obtained. Factors affecting clinical results are age, type of fracture, associated soft tissue injuries. Bad clinical results were related with young age group under 30 and over 60, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.

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Operative Results in AO Type C3 of Tibial Pilon Fracture: Limited Internal Fixation and Hybrid External Fixation: Byeong Yeon Seong, dong Seong Park, seung Jun Park, Sang Wook Kim, Taek Geon Lee; J Korean Soc Fract 1998;11(3):576-584. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.576

Abstract PDF: The intraarticular fractures of the distal tibia has been the most difficult problem due to severe comminution of itself, little bone mass and poor circulation of soft tissue. Recently limited internal fixation with hybrid external fixation has been reported to provide a good clinical results for the severely commnuted or open pilon fractures as a AO type C3. From February 1994 to February 1996, the authors analyzed the clincal and radiological results of 2 year follow-up in 7 cases of the AO type C3 pilon fractures who were treated with combination of limited internal fixation and hybrid externalfixation. 6 cases had good or excellent clinical and radiological results without any serious complications such as skin sloughs, skin infection, malunion and nonunion, but one case had a nonunion who were treated with internal fixation and autogenous iliac bone graft. We believe that the combination of limited internal fixation and hybrid external fixation that does not cross the ankle joint, provides the good clinical results in AO type C3 pilon fractures by early ankle joint motion.

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Severe Comminuted and Displaced Patellar Fracture Treated by Partial or Total Patellectomy: Kuen Tak Suh, Taek Geon Lee, Weon Wook Park, Chong Il Yoo, Kyu Yeol Lee, Bu Hwan Kim; J Korean Soc Fract 1997;10(4):851-859. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.851

Abstract PDF: The results of partial and total patellectomy as a treatment for severe comminuted and displaced patellar fracture were assessed retrospectively with the use of clinical criteria and radiologic findings. Sixteen patients treated with patellectomy(four total and twelve partial patellectomies) were followed up for an average of 3 years 4 months and valuated. According to the Bostmans fracture classification, there were type I In 5 cases(31%), type II in 7 cases(44%), and type III in 4 cases(25%). The results of the patellectomy were relatively good since excellent result was shown in 11(69%) among 16 cases. The comparison between partial and total patellectomy was difficult because the fracture patterns treated by these techniques were different. In this study, the result of the partial patellectomy was better than that of the total patellectomy, but their difference was not statisticaliy significant(P>0.05). The results of the study indicated that partial or total patellectomy could be one of the effective treatment methods for severe comminuted and displaced patellar fracture. However total patellectomy should be recommended only when the entire patella was too severely comminuted to function as a part of the extensor mechanism of the knee.

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Multiple Pinning in Femoral Neck Fractures: Kuen Tak Suh, Taek Geon Lee, Chang Il Yoo; J Korean Soc Fract 1997;10(4):727-737. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.727

Abstract PDF: The incidence of femoral neck fracture has steadily increased with lengthening of the average life span. The end results of treatement have been improving with the development of internal fixation devices. However, the anatomic characteristics of femoral neck has made the complications of nonunion and avascular necrosis as a common result. Authors analysed 47 patients, with over 2 years follow-up on an average, who were more than twenty years old and treated with multiple Knowles pins or cannulated screws during the period from February 1988 to February 1994. Following results were obtained. 1. Among 47 patients, 23 cases(49%) were male and 24 cases(51%) were female. The highest incidence was found in the sixth decade. 2. The most common cause of femoral neck rracture was slip down(55%). 3. According to the Gardens classification, the displaced fracture(Garden stage III and IV) was more common (68%), and according to the anatomic classification, transcervical type was the most common (40%). 4. Among 47 patients, there were 1 case of nonunion(7%) and 2 cases of avascular necrosis of femoral head(13%) in the nondisplaced fractures(15 cases), compared to 6 cases of nonunion(19%) and 8 cases of avascular necrosis of femoral head(25%) in the displaced fractures(32 cases). There were 4 cases of nonunion(15%) and 5 cases of avascular necrosis of femoral head(19%) among the 26 patients treated with multiple Knowles pins, compared to 3 cases of nonunion(14%) and 5 cases of avascular necrosis of femoral head(28%) among the 21 patients treated with cannulated screws. 3 cases of nonunion(10%) and 4 cases of avascular necrosis of femoral head(13%) were developed among 30 cases in which acceptable reduction was achieved after closed reduction. 4 cases of nonunion(24%) and 6 cases of avascular necrosis of femoral head(35%) were developed among 17 cases in which poor reduction was achieved. 11 cases(42%) were complicated among 26 cases below Singh index grade 3 and 6 cases(29%) were complicat among 21 cases above Singh index grade 4. 5. Factors that may affect the success of treatment in femoral neck fracture are not the type of internal fixation device used, but rather anatomic site of fracture, the degree of displacement, degree of osteoporsis and accuracy of reduction.

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