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- A Clinical Study of rmmediate Internal Fixation(within 24 Hrs) in Open Fractures of The Long Bones
- Yoon Sik Kim, Jae Eung Yoo, Chi Soo Sohn, Jong Seouk Park, Hee Kwon, Joon Min Song, Soo Kyun Rah
- J Korean Soc Fract 1996;9(3):593-604. Published online July 31, 1996
- DOI: https://doi.org/10.12671/jksf.1996.9.3.593
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Abstract
PDF - The major goals in the treatment of open fractures of the long bones are to prevent infection, avoid malunion or nonunion, achieve bone union, and restore limb and patient function as soon and as fully as possible. The treatment modalities adopted in open fractures still remains controversial, especially in Gustilo-Anderson Type III. It has been the fear of infection that has lead to the traditionally accepted opinion that immediate internal fixation of open fractures is contraindicated but, nowadays, it is no longer tabooed. Owing to the early meticulous wound debridment and irrigation, and the use of bactericidal antibiotics, the infection rate reduced remarkably. Fifty-five cases of open long bone fractures treated by immediate internal fixation within 24 hours from inury were reviewed, which were treated at the Department of Orthopedic Surgery, Soonchunhyang University hospital for nine and half years from June, 1985 to January, 1995. The results were as follow: 1, There were 20 Type II , 19 Type III A, 10 Type IIIB and 5 Type IIIC open fractures treated by immediate internal fixation within 24 hours following to Gustilo-Andersons classification. 2. The most common causes of open fractures were traffic accident(84%). 3. The associated injuries of the patients treated by immediate infernal fixation were in sequence.:26 multitraumatized patient, 5 arterial injuries, 5 musculotendinous injuries, 3 major joint dislocations and so forth. 4. Normal bony union was achieved in 41 patients(73.2%), Delayed bony union was in 7 patient(12.5%) and nonunion in 8 patients(14.5%). 5. Primary wound healing was achieved in 40 patients(71.4%), superficial to moderate infection were in 5 patients(9%), deep to osteomyelitis in 11 patients(19.6%). 6. According to the subtypes of open fractures, deep to osteomyelitis were 80% in Type IIIC, 30% in Type IIIB, 10.6% in Type IIIA and 10% in Type II.
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- Treatment of the Ipsilateral fracture of Femur and Tibia in Children
- Jong Seok Park, Yoon Sik Kim, Hee Kwon, Jun Min Song, Soo Kyun Rah, Chang Uk Choi
- J Korean Soc Fract 1996;9(1):129-136. Published online January 31, 1996
- DOI: https://doi.org/10.12671/jksf.1996.9.1.129
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Abstract
PDF
- Sixteen cases of fracture of the femur and tibia on the same leg in children below 16 year age were treated in Soonchunyang Univ. Hospital during the period 1988-1993. We studied all of these patients, classified by LettsNew classification of pediatric floating knee, retrospectively with analysis of treatment and results. The results were as follows; 1. Among the 16 cases,14 cases were male(88%), and 10 cases(63%) were at their first decade and 6 cases(37%) were at second decades. 2. The main cause of injury was traffic accident;15 cases(94%). 3. The most common concomitant injury was fracture in other site;5 cases(31%). 4. Among the 9 cases of conservative treatment, limping and leg length inequality were occurred in 6 cases(61%), and malunion in 5 cases(56fo). 5. Among the 7 cases of operative treatment, limping was occurred in 1 cases(14%), leg length inequality was in 2 cases(29%), and malunion in 3 cases(43%). 6. Among the 10 cases at first decade, limping was occurred in the 6 cases(75%) out of 8 cases of conservative treatment, but it was not occurred in 2 cases of operative treatment. According to the results, we suggest that at least one fracture should be rigidly fixed in all cases.
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