Résumé
The use of external fixator is popular in the treatment of open tibial fracture, severe comminuted fracture and segmental fracture, which minimizes further soft tissue injury and provides rigie fixation. The purpose of this study was to determine the complications and effectiveness of external fixation for treating the fractures of tibia. 33 patients with tibial fracture had been treated with external fixator from April 1993 to April 1994 at the orthopaedic department of Kang Dong Catholic General Hospital. We analysed 23 cases(21 patients) which could be followed up more than 12 months. The results were as follows; 1. Average duration with external fixator was 15.1 weeks. 2. Average time of bone union was 22.9 weeks. 3. 6 cases of pin tract infection were developed and they were treated with curettage and drainage, local antibiotics therapy, pin translation, or removal of external fixator. 4. The delayed union were developed in 5 cases, angulation deformity in 1 case, chronic osteomyelitis in 2 cases and soft tissue defect in 1 case. 5. Secondary operations caused by delayed union, valgus deformity, skin defect and bone exposure, were performed in 6 cases. 6. The use of external fixator provided good result in open fracture, intraarticular comminuted fracture, segmental fracture, and multiple injury, but chronic osteomyelitis and articular stiffness were developed in some cases.
Sujets)
Humains , Antibactériens , Malformations , Curetage , Drainage , Fixateurs externes , Fractures comminutives , Fractures ouvertes , Hôpitaux généraux , Polytraumatisme , Ostéomyélite , Peau , Traumatismes des tissus mous , Tibia , Fractures du tibiaRésumé
No abstract available.
Résumé
No abstract available.
Résumé
Ipsilateral fractures of the femur neck and shaft show diagnostic difficulties and complexity of the treatment. This femoral double fracture, when not initially diagnosed, carries a much high risk of complications, such as aseptic necrosis of the femoral head. Early recognition is of importance. The definitive treatment of a fractured femur should be begun after the ipsilateral hip and the knee joint have been examined clinically and radiologically. At the Department of Orthopedic Surgery, Dae Han General Hospital, from July 1985 to March 1990, four cases of the concomitant ipsilateral femur neck and shaft fracture had been treated and followed-up for 2.4 years in average (ranging from 1.1 to 4.7 years).
Sujets)
Fractures du col fémoral , Col du fémur , Fémur , Tête , Hanche , Hôpitaux généraux , Articulation du genou , Nécrose , OrthopédieRésumé
Tibia fractures are frequently occurred with increased traffic accident and industrial accident recently. And there are controversies in treatment of tibia fractures. From Jan. 1986 to Oct. 1988, tibial fractures of 107 cases in 105 patient, treated at the Department of Orthopedic Surgery of Dae Han Hospital, were analyzed. Results were obtained as follows. l. Of 105 patients, 85 patients were male & 20 patients were female. 2. The most common causes of fracture was traffic accident. 3. The most common level of fracture was middle one-third of tibial shaft. 4. Of 107 cases, conservative treatment was 35 cases and operative treatment in 72 cases. 5. Average union time was 16 weeks in conservative treatment & 18.5 weeks in operative treatment.
Sujets)
Femelle , Humains , Mâle , Accidents du travail , Accidents de la route , Orthopédie , Tibia , Fractures du tibiaRésumé
Osteocalcin is the major noncollagenous protein of the bone matrix and has been described as a sensitive marker reflecting bone turn-over rate. It's believed to play a role in the process of mineralization. The level of osteocalcin is considered to be influenced by other calcium regulating hormones. To obtain the normal value of osteocalcin in Korean young adults and to clarify the usefulness of osteocalcin as a marker reflecting bone turn-over in suspicious disuse-osteporotic patient, author measured the level of osteocalcin by radioimmunoassay. The results are; 1. The mean circulation osteocalcin level in healthy young adults was 4.43+ 1.09ng/ml. 2. In normal Korean male, the serum osteocalcin level was 4.38±1.16ng/ml and in normal Korean female, 4.48±1.02ng/ml. There was no significant difference in both sexes, but the serum osteocalcin level in female reveals some tendency of elevation when compared with male. 3. In suspicious disuse-osteoporotic patients, the mean serum osteocalcin level was 4.21±1.30ng/ml and this result shows no difference from that of normal young adults. 4. The level of osteocalcin measured in the normal young Korean adults shows no difference from the prerecorded INC level measured in the Western people. 5. In conclusion, the normal value of osteocalcin in normal young Korean adults is similar that of western people, and the measurement of osteocalcin in suspicious disuse-osteoporotic patients could not be used as a sensitive marker reflecting bone turn-over.
Sujets)
Adulte , Femelle , Humains , Mâle , Jeune adulte , Trame osseuse , Calcium , Mineurs (métier) , Ostéocalcine , Dosage radioimmunologique , Valeurs de référenceRésumé
The acute anterior cruciate ligament injury is one of the most common ligament injury of the knee joint and there are many controversies in its treatment. Warren reported that the primary repair for the acute anterior cruciate ligament injuries was good, but some had opposite oppinions. Authors studied 23 patients of actue anterior cruciate ligament injury who were treated by primary repair from January, 1982 to December, 1984. The results were as followings: 1. The most common associated injury was MCL injury and posteromedial capsular injury(13 cases; 56.5%). 2. The most common detachment site of ACL was femoral attachment(11 cases; 47.8%) . 3. A medial Hocky Stick incision was found good in repairing the combined MCL and posteromedial capsular tear with ACL injury. 4. The results were good in 74% by Cincinnati score and in 87% by objective score. It is concluded that primary repair of the acute anterior cruciate ligament tear is cosidered successful.
Sujets)
Humains , Ligament croisé antérieur , Articulation du genou , Ligaments , LarmesRésumé
70 cases free fiap were performed from March 1978 to July 1985. The donor fiap were dorsalis pedis flap in 34 cases, groin flap in 8 cases, osteocutaeous flap in 3 cases, gracilis flap in 17 cases, and latissimus dorsi flap in 8 cases respectively. The success rate was 90% in total including partial success. The causes of failure were 2 cases infection necrosis, and 1 case kinking of drain vessel. The gracilis and latissimus dorsi myocutaneous flap were very satisfactory method for the reconstruction of the upper extremity flexion power, especially in the case of Volkmann's ischemic contracture. The neurovascular dorsalis pedis flap was regarded as excellent method for the heel pad reconstruction, and tactile sensation reconstruction of the hand.
Sujets)
Humains , Lambeaux tissulaires libres , Aine , Main , Talon , Contracture ischémique , Méthodes , Microchirurgie , Lambeau musculo-cutané , Nécrose , Sensation , Muscles superficiels du dos , Donneurs de tissus , Membre supérieurRésumé
The 5 patients, who had severe limitation of knee motion following open operative procedures, and were treated by the percutaneous release of adhesions under arthroscopy, were reviewed. The range of the knee motion and function were markedly improved. Therefore, intra-articular release of adhesions under arthroscopic control was assumed very useful.
Sujets)
Humains , Ankylose , Arthroscopie , Genou , Procédures de chirurgie opératoireRésumé
Because of the frequent misdiagnosis of the carpal injury, the orthopedic surgeon must know the mechanism of injury and exact radiological interpretation. We had encountered 114 cases of carpal injury, in which carpal fracture, carpal dislocation and instability were analysed by radiological examination. The following results were obtained: 1. In 75 carpal bone fractures, the most common fracture was scaphoid fracture (64 cases), the next com- mon one was triangular fracture (4 cases). 2. Among the 64 scaphoid fractures, the waist portion was the most frequent site (45 cases) and the least was tubercle fracture (2 cases). 3. Of the carpal bone fractures, the fresh fracture was 48 cases (64%) and old one was 27 cases (36%), these showed sclerosis, cystic change, and degenerative change in radiological examination. 4. In 14 carpal dislocations, perilunar dislocation was 2.5 times move common than lunate dislocation, and the trans-scaphoid perilunar dislocation was the most common dislocation. 5. Carpal instability was 25 cases. These were dorsiflexion instability, navicular rotary subluxation, and pal- mar-flexion instability. The most common instability was dorsiflexion instability.