Comparison of Results Between Internal Fixation of Both Bones and Internal Fixation of the Only Tibia for Distal Tibial and Fibular Fractures / 대한정형외과학회잡지

PURPOSE: This study undertaken to evaluate the clinical results between the fixation of both bones and the fixation of the only tibia for extra-articular distal tibial and fibular fracture, and to know if the fixation of both bones could be needed. MATERIALS AND METHODS: In a retrospective study from 1994 to 1999, thirty-seven patients who underwent internal fixation with plate and screws for both bones (Group I : 17 cases) and only tibia (Group II : 20 cases) for extra-articular distal 1/3 tibial and distal 1/4 fibular fractures, which were above distal tibio-fibular syndesmosis, were evaluated the period of union, range of motion and operative time. RESULTS: The union period of tibia was 124 days (Group I) and 126 days (Group II) and the cases of full ROM were 16 / 17 cases (94.1%) in Group I and 18 / 20 cases (90.0%) in Group II. The mean score was 94.6 points in Group I and 91.3 points in Group II by Baird scoring system (P>0.05), and the operative time was 147 minutes (Group I) and 106 minutes (Group II) (P<0.05). CONCLUSION: The clinical results in extra-articular distal tibial and fibular fractures, which were distal 1/4 and above distal tibio-fibular syndemosis, treated with internal fixation of the only tibia were as good as internal fixation of both bones. We thought that there is no need to fix distal fibular fracture in these cases.

Comparison of results between conservative treatment and operative treatment for clavicle fractures in adults / 대한정형외과학회잡지

PURPOSE: The conservative treatment in the clavicular fractures is the gold standard. However, we found that there were some complications including angulation of clavicle and shortening of clavicular length, long-period immobilization, and nonunion in conservative treatment. This study was undertaken to evaluate union period, nonunion rate, and clinical results between conservative treatment and surgical treatment in clavicular fractures. MATERIALS AND METHODS: We evaluated 67 clavicular fractures in adults with conservative treatment (42 cases) and operative treatment (25 cases) from 1991 to 1996 and followed up for at least 1 year. RESULTS: Nonunion occurred in 4 cases (9.5%) in conservative treatment and 1 case (4.0%) in operative treatment (p>0.05) . The excellent results were 12 cases (28.6%) in conservative treatment and 12 cases (48.0%) in operative treatment (p>0.05) . CONCLUSION: We concluded that the early surgical treatment of displaced, low contact area of fracture segments of the clavicle fracture with internal fixation, even though not statistically significant, provides clinical results that are superior to those obtained with conservative care in view of early exercise of the shoulder joint, union period, rate of nonunion, correction of angular deformity and cosmetic problem. We thought that it leaves much room for consideration about the early surgical treatment for these fractures.