A elinical analysis of treatment of stiff finger: A report of 13 cases / 대한정형외과학회잡지

Injury of the hand has been progressively increasing with industrial development in recent years. In spite of careful and proper surgical treatment, orthopedic surgeon is frequently faced with a hand which fails to function properly because of limited flexion or extension in the metacarpophalangeal and interphalangeal joints. The author has experienced 13 cases of stiff fingers from 1968 to 1973 and the result of the treatment is reported in this paper. 1. 12 cases out of 13 were in age group between 11 to 30 years of age. 2. The types of injury were variable as; 5 cases of laceration, 5 cases of crushing injury, 2 cases of wringer injury, and 1 case of open fracture. Those were injuried by roller, glass, pressor, drill and gun-shot. 3. Involved anatomical structurs in stiff finger joints were much variable, mainly depending upon varying degrees of intial injury. We have classified them roughly in 4 groups; 1 Ruptured or sutured tendon adhesion. 2. Intrinsic muscles and tendon adhesion, and capsule and collateral contracture. 3. Resultant massive scar contracture including joints, and ligaments. 4. Osseus adhesion with soft tissues including tendon. 4. 17 times of reconstructive surgery were performed in 14 stiff joint with skin graft, Z-plasty, adhesiolysis, capsulotomy, capsulectomy, resection of cord portion of collateral ligament, tenolysis and arthroplasty alternatively or unitedly except of tenodesis and arthrodesis in remained 2 joints. 5. Post-operative immobilization was performed with plaster splint, stein mann pin and K-wire accordingly. The period of immobilization was variable from 2 weeks to 4 weeks. Physical therapy is enforced to begin as soon as possible. The period of follow-up was from 2 months to 19 months and average 6 1/2 month.. 6. Consequently, the range of active motion is increased to 55° and passive motion to 61° from preoperative status in PIP and MP joints. 7. The preoperative position of the joints and cause of the joint stiffness don't gave no significant influence to the end result. Satisfactory end result was obtained by proper, careful and meticulous surgery with early and extensive physical therapy.

Comminuted Fracture of the Knee / 대한정형외과학회잡지

The knee is a weight-bearing joint which is subjected to a great variety of static and dynamic loads. The comminuted fracture of the knee is caused by severe violent trauma, which requires well planned therapeutic procedures because of restoration of joint surface and avoidence of subsequent joint stiffness. authores have experienced 8 cases of various types of comminuted fractures of the knees at the department of orthopedic surgery, The National Medical Center, during the years from 1967 to 1972 They were analized and concluded as following. 1. The mode of the injury was considerably higher in falling type of trauma as 4 out of 8 cases Type III of comminuted fracture of the tibial plateau had higher incidence, 4 out of 5 cases and Grade III type of comminuted fracture of the femoral condyle was 2 out of 3 cases 2. 2 cases out of 8 had complicated injuries, such as peroneal nerve injuries in the Type III of comminuted fracture of the tibial condyle and meniscus injury in 1 case. 3. Conservative treatment was given to 2 cases in 1 of Group 1 and 1 of Group III type of comminuted fracture of femoral condyle, and open reduction & internal fixation was given to 6 cases with satisfactory result in all cases Average healing time was 73.5 days. 4. 1 case was complicated after operation by superficial wound infection but healed up without difficulty.

A Clinical Study of the Unstable Pelvic Fractures involving Sacro-iliac Joint / 대한정형외과학회잡지

The unstable pelvic fracture involving sacro-iliac joint produced by excessive force, is relatively rare but causes a multiplicity of complications and presents a major therapeutic problem. The clinical results were obtained as follows: 1. 9 patients out of 16 were in age group between 20 to 29 year, Male and female ratio was 5:3 2. 10 patients out of 16 were produced by traffic accident. 7 patients among 16 were included in vertical shear type and 5 in lateral compression type. 3. There were 44 associated injuries in 15 patients. Fractures in other region were the most common associated injury in 20 and injuries of the genito-uninary system in 8. 4. All of the cases were treated conservatively and their result were excellent or good except 1 patient in pelvic disruption type, who has had paraplegia due to fracture-dislocation of L4-5.

Clinical study of Traumatic Fracture-Dislocation of the Hip / 대한정형외과학회잡지

Traumatic fracture-dislocation of the hip is a mutilating injury which often comprises multiplicity of complications and requires well planned therapeutic procedures. In this paper 36 cases of fracture-dislocation of the hips treated at the Department of Orthopedic Surgery, The National Medical Center, during the years from 1959 to 1971 is reported. 1. The incidence of the injury is remarkably higher in the male than in the female as 29 versus 7, and it was higher in the age group of 20-30 years. It is of interest the incidence is equally distributed in age group of 10 to 60 years in this series. 2. The mode of the injury was considerably higher in falling type of trauma as 16 cases out of 36 cases, and the incidence of posterior dislocation was higher than other type of disIoatons, 22 cases out of 36 cases. Grade III type of the injury had higher incidence than other grades of the injuries, 17 cases out of 36 cases. 3. 14 cases out of 36 cases had complicated injuries in other part of the bodies, and among them 18 was complicated fractures. Sciatic nerve paralysis and head injuries were complicted in four respectively. 4. Seven out of eight cases treated by conservative treatment had good results, and seven out of 12 cases treated by primary acetabuIosynthesis had good results. As a whole the conservative treatment had better result than that of the surgicaI treatment, this seems to be derived from the fact that the surgically treated group had higher proportion of higher grade of injuries than in the group of the conservative treatment. 5. The higher grade of the injury the poorer the results of the treatment. The post-operative and post-therapeutic complications mostly occurred among the cases, who had delayed treatment for more than two monsths after the injury had been sustained. Aseptic necrosis in the femoral head occured in four cases and reccurrent dislocation occurred in three cases in this series.