ABSTRACT
The "flosting knee" is the term applied to the flail knee joint segment resulting from a fracture of the shaft of adiacent metanhysis of the ipsilateralfemur and tibia. The various methods of treatment of the "floating knee" were adapted by many authors according to degree of the comminution, degree of the soft tissue injury, general condition state of the fracture. Authors experienced the floating knee in 52 cases on 51 patients who were treated at Soon Chun Hyang University Hospital in the period of 4 years and 5 months from January 1985 to June 1989 and among them, 45 cases were treated by operative method and 7 cases by conservative methods at least one of the femur and tibia, The results were as follews;1. Floating Knee occured six times more in male and the peak age was third and fourth decades. 2. The most common cause of fractures was traffie aecident and there was difficulty in diagnosis of ligamentous disruption of the ipsilateral knee. 3. The common fracture site were middle one third and the most common fracture shape was comminuted in both femur and tibia. 4. A good or excellent functional result was aohieved in treated with open reduction and rigid fixation of both fracture and there were no significant difference in group of the internal fixation of both femur and tibia. 5. Intramedullary nailing on the femur and plate fixation on the tibia provided rigid fixation of fracture and the it made possible early joint motion exercise and ambulation and the average healing time of fracuture was much shortened. 6. The most common concomitant injury were soft tissue injury and delayed or nonuion and osteomyelitis were developed more frequently in the plate and screw fixation group of the open fracture.
Subject(s)
Humans , Male , Clinical Study , Diagnosis , Femur , Fracture Fixation, Intramedullary , Fractures, Open , Joints , Knee , Knee Joint , Ligaments , Methods , Osteomyelitis , Soft Tissue Injuries , Tibia , WalkingABSTRACT
Acetabular fractures assume great clinical importance because acetabular is weight bearing joint in the lower extremity. The undisplaced fractures of the acetabulum gave satisfactory results with closed method, but the treatment of displaced fractures have been controversial. A clinical analysis was performed on the 72 patients with displaced acetabular fractures, who had been treated at Soonchunhyang University Hospital from January 1980 to December 1989. The results obtained were as follows. 1. The prevalent age ranged from 21 to 50 years, which comprised 86.1% of all, and the ratio between male and female was 3:l. 2. The most common cause of injury was traffic accident, which comprised 76.4%. 3. According to Letournel's classification, simple fracture was 38 cases (52.8%), associated fracture was 34 cases (47.2%) and hip dislocation was associated in 28 cases (38.9%) and most common was posterior (20.8%). 4. Closed treatment was done in 47 cases and open treatment in 25 cases. 5. Results of open treatment group were better than closed treatment group in both clinical and roentgenographic study. 6. The complication were occured in 14 (29.8%) out of 47 cases of closed treatment group, and 10 (40.0%) out of 25 cases of open treatment group. 7. Not only choice of treatment but also determination of surgical approach require accurate assessment of the fracture pattern in this region of complex bony architecture by careful radilogic analysis.
Subject(s)
Female , Humans , Male , Accidents, Traffic , Acetabulum , Classification , Hip Dislocation , Joints , Lower Extremity , Methods , Weight-BearingABSTRACT
There are many controversies concering primary treatment of fractures of the tibial shaft. Recently, flexible intramedullary nailing for the tibial shaft fracture has gained popularity, because of promotimg osteogenesis with early weight bearing and preventing ankylosis of the joints. Authors carried out retrospective study of the 142 tibial shaft fractures in 141 patients, and results were as analyzed. The results were as follow:l. Among 141 patients, 116 cases were male and 25 cases were female. The average age was 37 years and the most cause of injury was traffic accident. 2. The number of cases of closed and open fractures were 71 cases, respectively. The most common type of the fracture was comminuted and the level was middle third. 3. The number nails were inserted from two to five according to width of the medullary cavity and to gain of the stability after reduction at the fracture site. 4. Average bone union in X-ray was 17.8 weeks, 96 cases were united within 20 weeks and 43 cases were united after 21 weeks. 5. Complications were 3 cases of non-union and 17 cases of valgus deformity, within 12 degrees.
Subject(s)
Female , Humans , Male , Accidents, Traffic , Ankylosis , Congenital Abnormalities , Fracture Fixation, Intramedullary , Fractures, Open , Joints , Osteogenesis , Retrospective Studies , Tibia , Weight-BearingABSTRACT
A total of 601 anesthesias given to the patients over age 60 who were admitted to Han Gang Sung Shim Hospital during the period from Jan. 1976 to Dec. 1980, were subjected to this clinical review. 1) Of the total 15,609 cases, 601 cases(3.8%) were over 60 years of age consisting of 315 male(52.4%) and 286 female(47.6%). 2) Among the 601 geriatric patients, 453 cases were 60~69 years of age(75.4%), 128 cases were 70~79 years of age(21.3%) and 20 cases were over 80 years of age(3.3%). 3) In the surgical group, 358 cases(59.7%) were general surgery, 120 cases(20.0%) were orthopedic surgery, 34 cases(5.6%) were urology, 20 cases(3.3%) were gynecology respectively. 4) The techniques of anesthesia were 545 cases(90.7%) of general anesthesia, 22 cases(3.7%) of spinal anesthesia and 17 cases(2.8%) of axillary block. 5) Anesthetics were diethly-ether 24 cases(36.3%) and halothane 22 cases(33.3%) in 1976. But there were 5 diethly-ether cases(0.3%) and 120 halothane cases(91.6%) in 1980. 6) For the duration of anesthesia, 81 cases(13%) were within 1 hour, 238 cases(39.6%) within 2 hours, 156 cases(26.0%) within 3 hours and 21 cases over 5 hours. 7) In the classification of physical status of the geriatric patients, 42 cases(7.0%) were class l, 201 cases(33.2%) were class ll, 109 cases (18.1%) were class lll and 8 cases(1.3%) were class lV. 8) Emergency cases were 223 cases(37.1%) and 378 cases(62.9%) were elective. 9) The findings of preoperative chest X-rays revealed that 227 cases(48.8%) were within normal limits, 56 cases(12.0%) had hypertensive heart disease, 24 cases(5.1%) had senile fibrosis, 22 cases(5.1%) had unstabilized tuberculosis and 14 cases(3%) had pneumonis. 10) In the preoperative R.K.G., which covered 50% of the patients, 115 cases(38.3%) were within normal limit, 41 cases(13.6%) showed L.V.H., 30 cases(10.0%) had sinus bradycardia, 13 cases (4.3%) had myocardial lschemia and 7 cases(2.3%) had R.B.B.B. 11) Post-operative mortality rate was 5.8% in 1976, 4.0% in 1977, 3.6% in 1978 and 2.1% in 1980, and over all mortality rate was 3.1%.