Treatment of Type 2 Distal Clavicle Fracture using Wolter Plate

PURPOSE: This study examined the clinical results of the treatment of type 2 distal clavicle fracture with using a Wolter plate. MATERIALS AND METHODS: Between 2004 and 2007, 16 patient treated for type 2 distal clavicle fracture using a Wolter plate were included in this study. Their average age was 32.6 years and the postoperative mean follow-up period was 22.9 months. The reduction and union were qualified according to the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and the Constant score RESULTS: By Kona's functional evaluation, there were 12 cases with excellent results, 3 cases with good results and 1 case of fair results and the average Constant score was 90. All 16 cases showed bony union. As complications, there was 1 case in which the protruded hook of the plate could be palpated at the skin, and 1 case showed an acromial fracture, but all the cases dispalyed successful bony union and there was no acromioclavicular joint arthritis, infection or any other complications. CONCLUSION: Wolter plate fixation for type 2 distal clavicle fracture is a reliable surgical method for satisfactory reduction and rigid fixation, a lower incidence of nonunion and excellent clinical result

Result of the Early Exercise and Rehabilitation after Limited Posterior Operative Treatment of the Calcaneal Fractures / 대한족부족관절학회지

PURPOSE: To evaluate the result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. MATERIALS AND METHODS: Between May 2005 and December 2007, 43 cases with intraarticular calcaneal fractures were treated by open reduction with K-wires and Steinmann pins. Mean age and mean follow-up period were 42.5 years old and 15 months. All patients were treated with the same postoperative protocol, the early exercise of subtalar joint without short leg splint and cast was began after postoperative 1 day, non-weight bearing crutch ambulation did after 2 weeks, partial-weight bearing crutch ambulation did after 6 weeks, without crutch ambulation did after 10 weeks. The fractures was classified by Essex-Lopresti and Sanders classification using radiographs and the functional outcomes were evaluated by circle draw exercise, AOFAS score. RESULTS: By Essex-Lopresti classification, the tongue type was 6 cases (14%), the joint depression type was 15 cases (35%), the combined type was 22 cases (51%). By Sanders classification, type II were 10 cases (23%), type III were 15 cases (58%), and type IV were 8 cases (19%). By AOFAS functional evaluation, the mean preoperative scores were 70.3 and 70.5 respectively, mean postoperative scores were 83.7 and 86.9 respectively. There were satisfactory results in 40 cases but 3 cases were unsatisfactory including on case of lateral impingement and 2 cases of traumatic arthritis of subtalar joint. CONCLUSION: We obtained satisfactory result of the early exercise of subtalar joint without short leg splint and cast and rehabilitation after limited posterior operative treatment of the calcaneal fractures.

Percutaneous Fixation with Cannulated Screws and Ilizarov External Fixator in Triplane Fracture of the Distal Tibial Epiphysis in Children / 대한족부족관절학회지

PURPOSE: To evaluate the result of percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fracture of the distal tibial epiphysis in children. MATERIALS AND METHODS: Between May 2004 and December 2007, 14 cases with triplane fractures were treated by percutaneous fixation with cannulated screws and Ilizarov external fixator after underwent CT imaging to assess the fracture pattern, articular disruption and to plan further management. Mean age and follow-up period were 14.1 years old and 15 months respectively. RESULTS: There were satisfactory results in all 14 cases that had excellent reduction and stable fixation. All cases regained full range of movement within 6 weeks. CONCLUSION: We obtained satisfactory result after percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fractures of the distal tibial epiphysis in children.

Predictors of Axillary Lymph Node Metastases in Patients with T1 Breast Cancer

PURPOSE: In T1 tumors, the reported incidence of lymph node metastasis ranges from 6% to 31%. The authors analyzed the clinical and the pathological parameters of T1 tumors for their association with the likelihood of axillary lymph node metastases (ALNM). METHODS: The authors reviewed data from 57 patients with T1 breast carcinomas who had undergone a level I/II axillary dissection from January 1996 to March 2000. The association between the incidence of ALNM and clinical/pathologic factors (age, site, size, neoadjuvant chemotherapy, histologic grade, lymphovascular invasion, estrogen receptor status, progesterone receptor status, p53, and c-erbB-2) were analyzed by using chi-square tests. RESULTS: Approximately 42% of the 57 patients with a T1 breast carcinoma had ALNM. Chi-square tests showed that lymph node metastases were associated with tumor size (P=0.043), lymphovascular invasion (P=0.001), and expression of c-erbB-2 (P=0.026). CONCLUSION: The authors conclude that the charac teristics of the primary tumor can be used to estimate the risk of ALNM in patients with a T1 breast carcinoma. Such a risk assessment might facillitate appropriate management.