Journal of Musculoskeletal Trauma

Treatments of the Malunited Tibial Shaft Fracture: Taik Seon Kim, Jae Ik Shim, Sung Jong Lee, Suk Ha Lee, Yeon Sik Yu, Young Bae Kim, Kwang Yeol Park; J Korean Soc Fract 2000;13(4):897-904. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.897

Abstract PDF: PURPOSE
The malunited diaphyseal tibia fractures result in tibial shortening, angular deformities, gait disturbance, development of joint pain, etc. The authors analyzed the results of treatment consist of corrective osteotomy for diaphyseal malunion with internal or external fixation.
MATERIALS AND METHODS
The authors reviewed 18 cases of tibial diaphyseal malunion treated in Korea Veterans Hospital between January 1992 and December 1998. Mean follow-up period was 4.2 years. The preoperative deformities were varus, anterior or posterior bowing and shortening. The preoperative symptoms were knee joint pain, ankle joint pain, and gait disturbance. Corrective osteotomy was done on the site of malunion in all cases. Fixation were done with IM nailings(13 cases), plates(3 cases) and Ilizarov external fixator. We analyzed the unions radiologically and the knee pains with HSS score.
RESULTS
All malunions were successfully corrected. Mean duration of union was 4.5 month. In the coronal plane, preoperative varus deformity(mean 16.5degrees varus) was corrected to 3degrees of valgus. In the saggital plane, anterior and posterior bowing was corrected to neutral. In 15 cases of the patient with knee joint pain, the mean HSS score was improved from 69 preopertively to 82 postoperatively.
CONCLUSION
The correction of tibia diaphyseal malunion had good results by osteotomy at the malunited site and firm internal or external fixation. And it also improved knee joint pain significantly.

86 View
1 Download

Femoral Trochanteric Fracture Treated with Ender Nails in Elderly Patients: Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yu, Eui Sang Seil; J Korean Soc Fract 2000;13(2):343-351. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.343

Abstract PDF: PURPOSE
: To analyze the clinical and radiological result of femoral trochanteric fractures treated by using Ender nails in elderly patients. MATERIAL AND METHODS :Sixty seven patients of femoral trochanteric fractures treated at Korean Veterans Hospital from 1993 to 1997 were included in this study. Under the C-arm guided, closed reduction and internal fixation with Ender nails was done within one week. According to Kyle classification, we classfied type I in 12case, type II in 20cases, type III in 25cases, typeIV in 20 cases and analyzed duration of bone union, ambulatory ability and postoperative complication.
RESULT
: The duration of union was from 14 weeks to 17 weeks and the mean was about 15.5 weeks. Thirty seven(60.7%) patients maintained their prefracture ambulatory ability at a postoperative 1 year and twenty four(39.3%) patient lost some degree of ambulatory ability. Postoperative complications were the knee pain and the limitation of the motion of the knee in 10 cases(14.9%), external rotation deformity in 7 cases(10.4%), distal migration of nails in 4 cases(5.9%), proximal migration of nails in 2 cases(2.(%), nonunion in 2 cases(2.9%).
CONCLUSION
: We conclude that the treatment by using Ender nails is one of the proper methods in elderly femoral trochanteric fracture with associated medical complication.

48 View
1 Download

Treatments of the Tibial Condylar Fractures: Taik Seon Kim, Jae Ik Shim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yu, Hong Man Cho; J Korean Soc Fract 2000;13(2):311-319. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.311

Abstract PDF: PURPOSE
: In the proximal tibial condylar fractures, the authors analyzed the treatment results clinically and radiologically, after arthroscopically assisted accurate anatomical reduction of articular surface and rigid internal fixation with early mobilization.
MATERIALS AND METHODS
: We reviewed 56 cases of tibial condylar fracture that were treated at our the orthopaedic department between January 1990 and December 1996 and the follow-up period was 1 year above. According to Schatzker's classifications, we classified the type of fracture and we analyzed the results by average union time and Porter's criteria after accurate anatomical reduction of articular surface and rigid assisted redcution of articular surface and internal fixation.
RESULTS
: According to Schatzker's classification, Type I 15cases, TypeII 14cases, TypeIII 6 cases, TypeIV 7cases, TypeV 3cases, TypeVI 11cases, Associated soft tissue injuries were total 22cases the were MCL injuries 12 cases, lateral meniscal injuries 6 cases. The average union time was 15.5 weeks and by Porter's criteria, 56 cases, of which 39 cases(71%) had an good result.
CONCLUSION
: we considered that good results can be obtained by assistant use of arthroscopy and rigid internal fixation with early mobilization, that accurate diagnosis and appropriate treatments of accampaning injuries according to the type of fractures, and accurate anatomical reduction of articualr surface.

43 View
1 Download

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

Comparative analysis for syndesmotic Fixation vs Non-syndesmotic Fixation of distal Tibiofibular Diastasis: Duk Uong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk ha Lee, Dong ki Lee, Yeon Sik Yu, Jae Yeon Moon; J Korean Soc Fract 1998;11(3):585-590. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.585

Abstract PDF: The ankle fracture with diastasis of distal tibiofibular jointis caused by an axial loading force with concomitant external rotation or other force. Many surgeons have treated this injuries by rigid fixation medial and lateral malleoli with syndesmotic fixation. But recently, syndesmotic fixation is not required to maintain the syndesmotic fixation on ankle fracture. seventy-five patients of ankle fracture with syndesmotic injury treated at Korea veterans Hospital from Jan. 1990 to Dec. 1996 were analysed in clinical and radiological aspect. The syndesmotic fixation was not necessary if the both medial and lateral injury was rigidly stabilized by fixation or ligament repair.

96 View
1 Download

Search