A Clinical comparison between One Plane Unilateral and One Plane bilateral Frame of External Fixation in the Treatment of Tibial Open Fractures / 대한정형외과학회잡지

External fixation was improved in its material, design and techniques as a specific method of open fracture treatment. Seventy-three, tibial open fracture, patients were treated with external fixator in Korea Veterans Hospital from January 1983 to April 1988. Each fixation method was divided into two types;one-plane unilateral frame and one-plane bilateral frame. 1. The duration of external fixation was 14.3 weeks in averge, 15.4 weeks in one plane unilateral frame and 13.2 weeks in one plane bilateral frame. 2. Secondary operation for bony union was performed 19 cases in one plane unilateral frame and 8 cases in one plane bilateral frame. 3. The union time was 23.6 weeks in average, 26.8 weeks in one plane unilateral frame and 21.4 weeks in one plane bilateral frame. 4. The common complications were delayed union and nonunion (7 cases) and pin tract infection (5 cases) in one plane unilateral frame, and pin tract infection ( 9 cases), joint stiffness (4 cases) and delayed union and nonunion (3 cases) in one plane bilateral frame. 5. External fixation gave rigid fixation and easy wound access, but did not give excellent bony union. 6. One plane bilateral frame showed more or less better result than one plane unilateral frame except some complications.

Treatment of Nonunion of Forearm Bone in Military Injured Patients / 대한정형외과학회잡지

Nonunion of fractures of forearm bone occurs frequently. These patients usually suffer from pain and functional disturbance of the hand and forearm. With the introduction of compression plate for the treatment of nonunion at the Campbell Clinic in 1959, a modification of the Nicoll graft was advised. The authors analysed 23 cases of the nonunion of forearm bone, in which military injured patients were admitted and treated by bone graft with internal fixation using various devices in Department of Orthopaedic Surgery of Korea Veterans Hospital from Sep. 1983 to Aug. 1988.

A Clinical Study of Hand Tumors / 대한정형외과학회잡지

Hand tumorsare many and varied, although benign tumors are common. The pathology and histology of these tumors are not unlike these characteristics of the tumor when it occurs elsewhere. Early diagnosis and proper treatment of all hand tumors have been emphasized since the growth of tumors and pain can cause disturbance of intrinsic function of the hand. For the period of 10 years from 1977 to 1986, 105 cases of hand tumor were treated surgically and the results of clinical observation were as follows ; l. Among 105 cases, benign tumor was 101 cases(96.2%) Bone origin tumor was 20 cases, in which enchondroma and enchondromatosis were 17 cases(70%). Soft tissue origin tumor was 85 cases, in which ganglion was 54 cases(63.5%). 2. Among 105 cases, 42 cases were male and 63 cases were female. In age distribution, it showed even distribution. 3. In the duration of wymptom, 51 cases were below 1 year(48.6%). 4. The tumor occured 85 cases in soft tissue, 14 in phalanx, 7 in metacarpal and 1 in carpal bone. 5. The tumors were treated by excision or curettage and bone graft with good improvement, but postoperatively recurred in 2 cases of Hemangioma. Ampuation was performed in 3 cases of malignant tumors without recurrence.

Clinical Study of Reconstruction on Old Flexor Tendon Injuries / 대한정형외과학회잡지

T The Flexor tendon injury caused by trauma of hand and forearm is commonly reported and earlier treatment for trauma is recommendable. But in many cases, earlier treatment is often not possible due to degree of injured tissues and infection. Specially in cases of severe trauma and damage of tendon sheath and pulley, the solution of limitation of motion is still remained as a difficult problem up to present due to scar tissue adhesion to surrounding tissues even after the primary treatment. The Department of orthopaedic surgery of National Medical Center during four years from 1981 to 1985 have treated 22 patients (27 fingers) of old flexor tendon injuries with tendon reconstruction and followed up more than for 6 months for clinieal study arrd the results ase as follows: 1. The old flexor tendon injuries are composed of 18 patients of the first decade and the second decade, especially in male. 2. The main causes of injury were deep lacerations by sharp objects (12 patients, 55.6%) and crushing injuries (9 patients, 40.8%). 3. Tendon injuries were mostly occurred in the index and ring finger. The incidence rate was equal between the 2 fingers, 25.7% representatively. Most of the injuries (21 cases, 77.8%) occurred in the zone II (Kleinert classification). 4. According to Boyes' classification, Grade 2 was 16 patients (19 cases): Grade 4, 3 patients (4 cases): Grade 3, 2 patients (3 cases): and Grade 5, 1 patient. 5. The operation method in zone II was free tendon graft in 10 cases and staged tendon graft in 7 cases. 6. The timing of operation depends on whether the open wounds were completely healed or not as well as subsidence of swelling. In case of swelling. In case of stiff fingers normal range of motions should be restored by vigorous exercise before operation. 7. According to the assessment based on strickland and Glovac, 20 cases out of 22 cases (13 cases of free tendon graft and 9 cases of staged tendon graft were satisfactory result.

The Clinical Study of First Metacarpal Base Fracture / 대한정형외과학회잡지

The first metacarpal base fracture is classified as extra-articular fracture, intra-articular fracture and epiphyseal injury. Intra-articular fracture was firstly described in 1882 by Bennett and Rolando described about Y shape comminuted fracture in the first metacarpal base in 1910. In 1938, Robert wrote about oblique fracture injured by first metacarpal base fracture. First metacarpal base fracture can be adjusted easily by C/R, but it is difficult to maintain the good axis. In case of fail of reduction, malunion, joint stiffness and traumatic arthritis can be shown as complications and finally some problems in grasping and pinching are resulted. Therefore, firstly the most accurate reduction, secondarily effective method to maintain the condition and thirdly the protection of limitation of motion are goal of treatment. Authors reviewed 17 cases treated by 0/R & C/R for the past 5 years from 1975 to 1980 at National Medical Center, especially reviewed the cases of which observation more than 1 year was possible. The results were as followings: 1. The incidence of first metacarpal base fracture was 1.0% of all fractures & dislocations. 2. Out of 17 cases, there were 14 male and right side 9 cases and left side was 8 cases. 3. The most common case of fracture was injury at work and traffic accident, sports injury, slipping down and falling down. 4. The method of treatment were C/R & percutaneous pinning in 10 cases and 0/R & K-wire fixation were 7 cases. 5. The result of treatment showed 8 excellent, 1 good, 1 fair, out of 10 cases of C/R and percutaneous pinning. In 0/R and K-wire fixation, 4 excellent, 2 good, and 1 fair showed out of 7 cases. 6. Soft tissue infection was appeared from 1 case of open fracture which accompanied second metacarpal fracture as complication and it caused adduction contracture in first web space.