A Clinical Study of Colles Fractures / 대한정형외과학회잡지

Twenty-six cases of Colles fracture were treated with closed reduction and percutaneous K-wire fixation under C-arm field and then wrist was immobilized by sugar tong splint and then short arm splint from Jan. 1982 to Dec. 1985 at the department of orthopaedic surgery of St. Benedict hospital. A prospective study was made and evaluated under the subjective and objective criteria of Gartland and Werley, and the objective criteria of Scheck. The result of this study were as follow: 1. The incidence of Colles fracture was highest in 3rd decade(26.9%) and 7th decade(23.1%) respectively. In the 3rd decade the reason for the highest incidence was the job-related accident during the productive age and they were male patients. 2. The main cause of the injury was falling accident comprising of 53.8% and the male to female ratio was about equal. 3. Among the 26 cases treated with the percutaneous K-wire fixation, the result was satisfactory in 92.2% but was unsatisfactory in one case with severe comminuted fracture. 4. The percutaneous K-wire fixation for Colles fracture had less complication and more advantages such as the early disappearance of edema by early exercies, the early returning of range of motion of joint to normal, and the comfortable cast immobilization in neutral position of wrist. 5. The percutaneous K-wire fixation for Colles fracture was applicable to the concept that the anatomical reduction and maintenance would lead to the improvement of the joint function. 6. The percutaneous K-wire fixation for Colles fracture was indicated when neurologic sign developed after reduction of fracture by classic methord and when the exercise of joint was required in the old age. 7. When the articular surface of the radius was severely comminuted and the distal radius became severely osteoporotic, the result from the use of percutaneous K-wire fixation was also poor. In this case we considered the use of an external fixator.

Clinical Observation of Acute Hematogenous Osteomyelitis in Children / 대한정형외과학회잡지

After the discovery of penicillin by Fleming, a great improvement in the treatment of osteomyelitis was obtained and the mortality rate in the acute stage was markedly decreased. But, because of abuse of the antibiotics and resulting resistant organisms to antibiotics, the incidence of acute hematogenous osteomyelitis tends to increase recently. During the period of 6 years extending from 1979 to 1984, we have treated 45 cases of acute hematogenous osteomyelitis in children and clinical analysis was made about the causes of the development of chronic osteomyelitis with particular emphasis on the time interval from onset to treatment, and on the operative methods in the surgical treatments. The following results were obtained; 1. The incidence in males was 1.5 times greater than females. 2. Age incidence showed that it was most prevalent in the age group of 6 to 15 with 66.2% of the total cases. 3. The most common sites of the involvement was femur and tibia in orders. 4. Most of cases showed pain, local tenderness, pyrexia, loss of motion, swelling, and heat of the involved limbs. 5. Among the causative organisms, staphylococcus aureus was most prevalent one. 6. Cephalosporin, methicillin, gentamicin showed the highest sensitivity while penicillin showed marked resistancy (80%). 7. Time interval from onset to treatment was persistently an important factor in the development of chronicity. 8. Bone fenestration was the best method in the surgical treatments of acute hematogenous osteomyelitis in children. 9. Early diagnosis, adequate antibiotics, and early surgical decompression and drainage (esp. bone fenestration) were considered to be the essential part of management of acute hematogenous osteomyelitis in preventing its chronicity.