Intertrochanteric Varus Open Wedge Osteotomyin Legg-Calve-Perthes Disease Patients Older than 9 Years Old / 대한정형외과학회잡지

PURPOSE: To evaluate the outcome of intertrochanteric varus open wedge osteotomy in LCP in patients over 9 years old. MATERIALS AND METHODS: Thirty-three patients over 9 years old, who were diagnosed with LCP were treated by intertrochanteric varus open wedge osteotomies, from August 1989 to August 2002. The mean age of the patients was 10.2 years old (range, 9 to 14 years old), with a mean duration of follow-up of 7.7 years (range, 3.2 to 14.1 years). According to the Harring classification system, there were 3 group A, 21 group B, and 11 group C patients. There were thirty male and three female patient. There were 2 cases of female patients with bilateral extremity involvement of LCP. Radiographic outcome was assessed utilizing Stulberg's classification to grade residual deformities. RESULTS: 10 cases were Stulberg classes I and II (spherically congruent), 15 were classes III and IV (aspherically congruent), and 10 were class V (aspherically incongruent). Less involvement of the disease and treatment in the early stages produced better outcomes. CONCLUSION: Intertrochanteric varus open wedge osteotomy is a reliable treatment for LCP after the age of 9 years old, if the disease is evaluated individually according to the extent and stage of its involvement.

Trans-Scaphoid Perilunate Dislocation with Fractured Carpal Bones in a Child: A Case Report / 대한정형외과학회잡지

Transcarpal fractures and dislocations in children are rarely reported in the orthopedics literature. This is a case report of a 10-year-old boy who sustained a trans-scaphoid perilunate dislocation with fractures across the carpal structure: these included injuries to the capitate and triquetrum bones. Treatment consists of a closed reduction for the dislocation and using the dorsal approach, an open reduction with internal fixation of the fractures. The injury healed well with a full return of good wrist function. This unusual pattern of injury is described so that it may be more readily appreciated in the future.

Lateral Approach for Internal Fixation of the Distal Humeral Shaft Fractures

PURPOSE: To investigate the efficacy and advantages of the lateral approach for internal fixation of the distal humeral shaft fractures. MATERIALS AND METHODS: Twelve patients with distal humeral shaft fractures who underwent open reduction and internal fixation using plate and screws by lateral approach from January, 1997 to May, 2002 were investigated. Postoperative results after a minimum 1 year follow-up were assessed using union rate, elapsed time to union, postoperative complications such as iatrogenic radial nerve palsy, range of motion of the elbow joint. Clinical outcomes were evaluated with Mayo elbow performance scoring system. RESULTS: Union was achieved in all cases. The average time to union was 9 weeks (range, 7~12 weeks). Four cases of preoperative radial nerve palsy were revealed as contusion of the intact nerve and resolved completely by three months. The mean elbow range of motion was from 5 to 138 degrees. The average Mayo elbow performance score was 91 points; 9 cases ranked as excellent and 3 as good. CONCLUSION: Distal humeral shaft fractures can be treated successfully through open reduction and internal fixation using plate and screws. Lateral approach is recommended to stabilize distal humeral shaft fractures without compromising the range of motion of the elbow, and to protect or explore the injured radial nerves easily