ABSTRACT
Infected nonunion of the long bone, while less common today than in the past, continues to challenge orthopaedic surgeons. Various treatment methods including current techniques of internal fixation, bone graft, electrical stimulation and external fixation have been tried, but results are not always satisfactory. Authors reported successful treatment of infected nonunion by rigid internal fixation with one plate and autogenous bone graft in previous volumes 1989. Recently we adopted dual plate method, by which we overcame a greater amount of bone defect and obtained more rigid internal fixation. We have treated 14 cases of infected nonunion with this method from Oct. 1992 to Oct. 1994, and the results are as follows; 1. Tibia fractures were 9 cases, and femur fractures were 5 cases. 2. Six cases showed large bone defect. The average bone defect was 4.5cm in length and we could overcome it by Dual plate method and autogenous bone graft. 3. Six cases which showed large bone defect were united in average 5 months. 4. In remaining 8 cases, union was obtained in average 3 months.
Subject(s)
Electric Stimulation , Femur , Tibia , TransplantsABSTRACT
The authors reviewed 50 patients of congenital dislocation of the hip who had surgical treatment at the Department of Orthopedic Surgery, Seoul National University Children's Hospital from October, 1985 to August, 1993. We investigated the contributing factors to coxa magna after surgical treatment and it's relationship to the avascular necrosis of femoral head, and observed the influnce of coxa magna on the development of the hip joint. Coxa magna was defined as a femoral head with the greatest diameter 15% greater than the opposite side. To assess the development of the acetabulum in the hips with coxa magna, radiographical horizontal and vertical parameters were measured preoperatively, and at postoperative 1 year, 2 year, and 3 year or more. Twenty-one of fifty hips had coxa manga. The incidence of coxa magna increased in patients who had open reduction at younger age(average 30 months), compared to older age(average 44 months). Neither femoral osteotomy nor pelvic osteotomy increased statistically the incidence of coxa magna. Avascular necrosis of femoral head did not necessarily resulted in coxa magna. There were not statistically significant differences in the coverage ratios of femoral head by the acetabulum between coxa magna positive and negative groups, because lateral acetabular growth accompanied in accordance with enlargement of femoral head in the majority of cases with coxa magna. Open reduction alone caused concomitant vertical overgrowth of ipsilateral hemi-pelvis with resultant pelvic tilt and leg length inequality(IHD>5mm, upto 2cm) in 6 of 10 cases. The patients, who had coxa magna with good radiological results by Severin's classification, underwent open reduction at younger age and had lesser enlargement of the femoral head, compared to those with fair or poor results.