Efficacy of Temporal Fixation Using Threaded Trans-Calcaneal Pin in Patients with Ankle Fracture-Dislocation or Tibia Pilon Fractures / 대한족부족관절학회지

Purpose@#Ankle fractures with dislocations and pilon fractures at the distal tibia are usually associated with soft tissue damage caused by high-energy damage. Recently, a two-stage operation to perform internal fixation after the application of external fixation devices for stabilizing soft tissues has been accepted as the treatment of choice. This paper reports the clinical result of these injuries treated with threaded trans-calcaneal pin external fixation devices. @*Materials and Methods@#Thirty-three patients diagnosed with ankle fractures with dislocations or tibial pilon fractures without open wounds. They underwent surgical treatment with threaded trans-calcaneal pin external fixation from January 2008 to February were enrolled in this study. This study evaluated the visual analogue scale (VAS), foot function index (FFI), and Olerud & Molander score as well as whether complications occurred. @*Results@#The average VAS showed a meaningful decrease (p<0.001) from 7.4 before surgery to 2.6 after application of the external fixation device, and 1.4 at 12 months after surgery. The FFI also decreased significantly from 84.3 preoperatively to 20.3 at 12 months postoperatively (p<0.001). The Olerud & Molander score averaged 71.4 points, showing good clinical results. Complete bone union was observed in all patients. One patient each underwent debridement due to wound necrosis and infection in the pin insertion site. At the final follow-up, seven patients had posttraumatic ankle joint arthritis, according to a radiological examination. @*Conclusion@#Manual reduction and external fixation using a threaded trans-calcaneal pin is a suitable surgical technique that is easy to perform and shows good clinical outcomes in stabilizing soft tissue damage in fractures and dislocations of ankle fracture or tibia pilon fractures in foot and ankle injury.

Clinical observation on prematurity subjected for EEG

This study included fifty two premature babies in whom EEG was performed at National Medical Center, from Jan. 1990 to Jun. 1991. clinical and EEG records of all subjects were analyzed and the following results were obtained. 1) The day of first EEG performed were;11 cases within 10 days, 20 cases from 11 days to days, 13 cases from 21 days to 30 days and 8 cases beyond 31 days. 2) The results of first EEG were; within normal limit in 34 cases, mild abnormality in 3 cases, moderate abnormality in 11 cases and marked abnormality in 4 cases. 3) The abnormal EEG ratio according to the sex was higher in female than in male (43.5% vs 27.6%). 4) The abnormal EEG ratio according to the gestational age was higher in shorter gestational age group than in longer gestational age group (40.9% under 32 weeks of G.A. vs 30.0% beyond 33 weeks of G.A.). 5) The abnormal EEG ratio according to the birth weight was not significant. 6) The abnormal EEG ratio according to the ventilator use was higher in used group than in not used group (38.5% vs 30.8%). 7) Combined diseases in 18 cases of abnormal EEG group were jaundice (14 cases), hyaline membrane disease (7 cases), asphyxia (4 cases), anemia (4 cases), hydrocephalus, sepsis, PDA, hypocalcemia, UTI and IVH. 8) The mean apgar score in abnormal EEG group was lower than normal EEG group both in one minute and five minute. 9) Two cases among 18 cases of abnormal EEG group showed abnormal brain sonographic findings, but one case among 34 cases of normal EEG group showed abnormal brain sonographic finding. 10) Ten cases were followed up with serial EEG, six cases of which were treated with anticonvulsant. We observed normalization of the EEG in 5 cases of anticonvulsant treated group.

A clinical study on prematurity who received blood transfusion

A clinical study was made on 85 cases of prematurity under 37 weeks of gestational age who had history of blood transfusion during their admission at the National Medical Center from January 1989 to June 1992. The results were as follows: 1) Among 339 prematurity patients, 85 patients(25.1%) received blood transfusion once at least. 2) Male to female ratio was 1.13:1 and mean gestational age was 32.5 2.7weeks (range:25~36 weeks). 3) Most of blood transfusion(66/85 cases) were performed within first week of life. 4) 67 patients(78.8%) received blood transfusion 3 times or less. 5) Combined diseases were hyaline membrane disease(69.4%), jaundice(51.8%), sepsis(30.6%), PDA (14.1%), DIC (8.2%), pulmonary hemorrhage(7.1%), intraventricular hemorrhage (7.1%), pneumonia(7.1%) and hepatitis(4.7%). 6) Clinical manifestations at the time of blood transfusion were pallor (47.1%), decreased activity (44.7%), bradycardia (23.5%),apnea (21.2%), tachypnea (20.0%), lethargy (4.7%), poor weight gain (3.5%) and tachycardia (3.5%). 7) The values of hematocrit were significantly increased after transfusion(42.4 +/-7.2 vs 34.6 +/- 6.8vol%). 8) The episodes of bradycardia were significantly decreased after blood transfusion(0.09 +/- 0.39 vs 0.23+/- 0.78)while the episodes of apnea were not (0.15 +/-0.71 vs 0.27+/- 0.84).