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Original Articles
- Treatment of Acetabular Fractures -Comparison of Conservative Treatment and Surgical Treatment According to AO Comprehensive Classification-
- Chang Hyuk choi, Koing Woo Kwun, shin Kun Kim, Sang Wook Lee, seung Hee Kim
- J Korean Soc Fract 1998;11(2):288-295. Published online April 30, 1998
- DOI: https://doi.org/10.12671/jksf.1998.11.2.288
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Abstract
PDF - Acetabular fracture is a severe injury associated with other body injuries. they result in permanent disability due to management difficulty and its complications such as traumatic arthritis, avascular necrosis of femoral head, etc.. In order to restore excellent function of hip joint, anatomic reduction and secure internal fixation followed by early mobilization are neccessary. We analysed 21 patients who were diagnosed as type A1 acetabular fracture from Jan. of 1991 to Dec. of 1996, and compared the functional results of conservative treatment method with that of surgical treatment method. The results were as follows. 1. Conservative management was done at 8 cases, and surgical management was done at 13 cases with open reduction and internal fixation. 2. The functional result by Goodwin criteria was all satisfactory in conservative reatment method and 12 cases(92%) in surgical treatment method. 3. Associated injuries were found in 18 cases, among them pelvic bone fracture was the most common fractured site and knee ligament injury was the most common soft tissue injury. 4. In the cases of larger acetabular fragment or in the presence of associated injury and instability after closed reduction, faster rehabilitation was achieved by starting early range of motion exercise and weight-bearing after surgical treatment than classical conservative treatment.
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- Treatment of Tibial Plateau Fracture Comparison of Functional and Radiologic End Result
- Chang Hyuk Choi, Soo Il Han, Seung Hee Kim
- J Korean Soc Fract 1996;9(4):984-992. Published online October 31, 1996
- DOI: https://doi.org/10.12671/jksf.1996.9.4.984
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Abstract
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- The aim of treating a tibial plateau fracture is to gain a stable, pain free knee motion, and to repair all associated lesion. Recently a preferred treatment is the open reduction and internal fixation of all displaced and unstable tibial plateau fracture in order to gain anatomic reduction and early knee motion. But functional recovery is relatively impaired in complex knee trauma, despite various treatment modalities. Observations based on long-term radiologicexaminations frequently did not correlate with the functional end results. When choosing the treatment modalities, there are many factors to consider which will influence the final results. Forty-seven cases of tibial plateau fractures were treated from August 1988 to March 1995 and the average follow up period was fouty-eight months. The results were as follows: 1. Of the 47 patients, there were 34 male and 13 female patients, and the mean age was 49 years. 2. Causes of injury were traffic accidents(36 cases), falling down(7 cases), crushing injury(1 case), and others(3 cases), and the left side was more predominant(28 cases) than the right side (39 cases). 3. Treatment modalities were conservative treatment(16 cases), Illizarov external fixators(8 cases), tibial bolt(11 cases) and screw & wire(12 cases). 4. The range of motion of the knee joint averaged 116 degrees and the average start time of the range of motion exercise was 7.8 weeks. In the good to excellent clinical end results groups, there were meaningful statistical differences. 5. There were statiscal differences between type I(88%), II(80%) fractures and type IV(56%), VI(33%) fractures for the clinical end results. 6. We gained better results after treatment of closed fracture and isolated injury cases than open fracture or associated injury cases, but there were no statistical differences. 7. There were no statistical differences on treatment modalities.
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