Lateral Condylar Fracture of the Humerus in Children: An Epidemiological Analysis of 158 Cases

PURPOSE: To analyze the correlation of various factors by examining the epidemiology of lateral condylar fracture of the humerus which is the second most fracture among elbow fractures in children. MATERIALS AND METHODS: Of 158 cases treated for lateral condylar fracture of the humerus in children from April 1996 to March 2006, their age and sex distribution, the seasonal frequency, etiology, type of fracture, method of treatment, etc. were analyzed retrospectively. RESULTS: Boys were 113 cases, girls were 45 cases, and the mean age was 5.4 years. Regarding the seasonal occurrence, spring 43 cases, summer 44 cases, autumn 48 cases, and winter 23 cases had occurred. It occurred preferentially during the season when outdoor activity was most active. As its etiology, the accident in a playground was 39 cases, sports activity was 32 cases, traffic accident was 17 cases, slipping accident at home was 15 cases, falling accident at home was 14 cases, slip while playing with friends was 6 cases, a missing step while walking on stairs was 6 cases, fall from a height more than 2 floors was 4 cases, and the cases with unknown cause were 25 cases. According to the Jakob stage, the stage I was 42 cases, the stage II 77 cases, and the stage III was 39 cases. As treatment, cast immobilization was performed in 34 cases, closed reduction and percutaneous K-wire fixation was performed in 68 cases, and open reduction and K-wire fixation was performed in 56 cases. The prevalent causalities were play devices, accident during sports activity, and traffic accident, and in such cases, the displacement of fracture was severe and thus surgical treatments were performed in many cases (94%). CONCLUSION: It is thought that during the season when outdoor action is active, particularly, for kindergarten children or the lower grade primary school children, safety education is required to prevent the fracture by play devices, sports activity and traffic accident.

Late-onset Brachial Artery Occlusion caused by Subclavian Artery Stenosis after Clavicular Fracture: A Case Report

Although vascular injury after clavicular fracture is a extremely rare, it is a complication which is serious problem. Vascular injury associated with the fracture can be immediate or delayed. We report a case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture and include a review of the literature.

Outcome of Treatment for the Curly Toe Deformity / 대한정형외과학회잡지

PURPOSE: To analyze treatment outcome of curly toe and to suggest appropriate treatment modality according to the degree of deformity. MATERIALS AND METHODS: 26 patients with 37 curly toes were subject to study. The mean age was 20 months (range 6 to 42 months), and one neglected case aged 28 years. Grade 1 were treated with strapping. Grade 2 and 3 were treated with open flexor tenotomy. The degree of deformity was analyzed by utilizing grade which Hamer and others once used previously, and the condition of pre- and post-treatment was evaluated. RESULTS: Of 18 cases with preoperative condition grade 1, all cases had favourable results which showed 16 cases remaining in grade 1 and 2 cases becoming almost normal. The average grade was 0.88 at the last follow-up. Of 19 cases with preoperative condition grade 2 or grade 3, 5 cases had remained mild rotational deformity with grade 1, and 14 cases were recovered to normal. The average grade was 2.57 preoperatively and 0.26 postoperatively. CONCLUSIONS: It is very important to assess the degree of deformity before deciding treatment method for curly toe. In case of grade 2 or grade 3, an open flexor tenotomy has proven to be effective treatment. Surgical treatment may provide favorable results regardless of age, whenever it is performed in case with persistent severe deformity.

Treatment of the Segmental Fractures of Tibia with Ilizarov External Fixation

PURPOSE: To emphasis an effectiveness of the Ilizarov circular external fixator in treatment of the complicated segmental fractures of the tibia MATERIALS AND METHODS: We had analyzed 15 cases in 14 persons, treated from November 1993 to March 2000. We analyzed several considering factors including age, etiology, type of fracture, number of the segmentation, associated injuries, open or closed fracture, healing time, additional bone graft, clinical results and complications. RESULTS: The mean period of follow up was 22 months. The mean age was 45 years. The etiology was traffic accident in 13 persons. Open fracture were 11 cases (73%). Associated injuries were noted in 8 persons (53%). The number of segmentation were three segments in 9 cases (60%) and four segments in 6 cases (40%). Additional manipulations after first application were needed in 10 cases (67%). Bone graft were performed in 5 fracture site (9.8%), proximal fracture site in two and distal in two, middle in one. Mean period of application of external fixator for healing was 8.1 Months. Procedures for soft tissue injuries performed in 3 cases including two split thickness skin graft and distant flap surgery. The results were graded as excellent in 5 cases, good in 2 cases, fair in 1 cases, poor in 7 cases. Limitation of motion in ankle joint was major cause of poor results CONCLUSION: We considered that ilizarov circular external fixator is one of effective treatment modality in treatment of the complicated segmental tibia fractures.