Bone Peg Fixation of the Femoral Head Fracture Associated with Posterior Dislocation of the Hip / 대한정형외과학회잡지

Seven cases of traumatic fractured femoral heads with posterior dislocation of the hip were treated at the Keimyung University Hospital between November 1973 and December 1981. All cases were followed from 6 months to 8 years. Five cases were caused by traffic accidents. The other two cases were caused by a landslide. In six cases, at first a closed reduction was performed under general anesthesia and the femoral head was reduced in the acetabulum, but in 5 of the 6 cases head fragments were not reduced. So, after one or more days, open reductions were performed on the remaining 5 cases by internal fixation with iliac bone pegs (two-four). In the remaining one case of the 6, who had a head injury and an intestinal rupture, after the closed reduction, one head fragment was reduced but not anatomically. But because of his poor general condition, conservative treatment was taken. During conservative treatment redislocation and displacement of the head fragment occurred at the 4th week after the closed reduction was done. So this case was also treated by the above method. The 7th case, who has an ipsilateral femoral neck and intertrochanteric fracture, was reduced by primary open reduction. By the classification of the Pipkins, there were 4 cases of Type I and Type II, III and IV each had I case. The post operative X-ray and follow-up study showed that two were classified as excellent, four as good and the one who had the ipsilateral femoral neck and intertrochanteric fracture (Pipkin's Type III) was classified as poor.

A Clinical Study of the Tibial Condylar Fractures which had Open Reductions / 대한정형외과학회잡지

The tibial plateau fracture is a fracture of the proximal end of the tibia, involving the articular surface and the supporting metaphysis of a major weight bearing joint. This fracture frequently accompanies soft tissue injury such as ligaments and menisci. So it often produces disability of the knee joint. Of the tibial plateau fractures which had been treated by open reductions at Keimyung University Hospital between May 1971 and December 1981, the 28 cases that were followed for 1 year to 3 years have been analysed according to its cause, classification, treatment and result. Open reduction is indicated in anyone with one or more of the following deformities as shown by roentgenograms: a compression greater than 6-8mm and a split greater than 5mm of the condyle. Anatomical considerations and a clinical end result study of the 28 fractures emphasize that the unacceptable results were from comminution of the fracture, associated soft tissue injury, osteoporosis, infection and other conditions that prevent early knee motion. Twenty-two cases (79 per cent) out of Twenty-eight revealed the rating of “ACCEPTABLE” according to Roberts criteria.