A Clinical Study of Pathological Fracture of Long Bones / 대한정형외과학회잡지

A pathological fracture occurs spontaneously or with minimal trauma. The underlying pathological changes may be subtle and the diagnosis not obvious. The two goals in the treatment of pathologic fracture in weight bearing long bones are to provide relief of pain by secure fixation of the fracture and to permit early smbulation and a prompt return to prefracture status. Thirteen cases of pathological fracture were treated during the period from June, 1986 to February, 1988 at Kangnam Sacred Heart Hospital. The results are as follows. 1. Most patients were over 45 of age. 2. Malignancy was the common cause. 3. Most frequent involved site was femur. 4. Occured by trivial trauma such as slip down injury. 5. Satisfactory result by curettage, open reduction and internal fixation, bone graft or bone cement augmentation.

Clinical Study for External Fixators of Open Tibial Fractures / 대한정형외과학회잡지

From August, 1981 to November, 19S5, the Hoffmann and Monofixateur apparatus were employed in the treatment of thirty five open tibial fractures that we considered to have a poor prognosis with more conventional forms of treatment. The results were obtained as follows; l. Application of Monofixateur was minimum iatrogenic soft tissue injuries and easier, simpler than Hoffmann and two external fixators were favorable device with rigidity in wound management. 2. Two external fixators could obtained sufficient stability when 3 or more pins were applied at each fragment of fracture in Hoffmann and 2 or more pins in Monofixateur. Monofixateur could obtained high stability with small number of fixation components and more stronger against anterior-posterior bending and in Hoffmann more stronger against lateral bending. 3. External components of Monofixteur was located in anterior surface, therefore dynamization converted tensile force of anterior surface of tibia to compression force and then bone union was activated. 4. After operation, in Hoffmann correction of compression, distraction and angular, rotational deformity were possible and in Monofixateur correction of compression distraction, and anterior or posterior angulation was possible. 5. Because of rigid stability of two external Bxators, these allowed early movement, avoiding joint stiffness and duration ambulation unilateral assembly of device in position biomechanically favorable. 6. The lateral view of fracture site could not be confirmed accurately due to overlapping of Hoffmann's adjustable connecting rod and bony shadow. In Monofixateur A-P and lateral view of Fx. site could be confirmed. 7. Accurate reduction and compression played a important role in bone union. 8. The time to fixation for all of the fractures averaged 20 weeks in Hoffmann and 16 weeks in Monofixateur. The time to union averaged 24 weeks in Hoffmann and 20 weeks in Monofixateur.