Treatment of Diaphyseal Fractures of the Radius and Ulna with Dynamic Compression Plates: A Retrospective Study of 52 Fractures in 33 Patients / 대한정형외과학회잡지

Reduction of displaced diaphyseal fractures of the radius and ulna in adult must be nearly anatomical for restoration of mormal function. Most of the fractures require operative management, and various methods of open reduction and internal fixation have been recommended. Because we believe that anatomical reduction followed by rigid internal fixation provides the most satisfactory results for these injuries, dynamic compression plating method is frequently used in our hos pi tal. We studied 52 diaphyseal fractures of the forearm bone in 33 patients treated at the S.R.C.H. from May 1980 to December 1985. Of the 33 patients, 20 had fractures of the radius and ulna; 6, fractures of the radius only; and 7, fractures of the ulna only. The fractures of both bones were treated with plate and screws in 19 patients. In another one, the ulna was treated with plate and screws and the radius was treated by screw fixation only. The results were as follows: l. Of the 52 fractures, 51(98.1%) were united after the initial operation within 23 weeks. 2. The average time for radiological union of the fracture, excluding those complicated by infection or non-union, was 11.1 weeks for 24 radii and 10.9 weeks for 25 ulnae. 3. Only one patient(3.0%) was complicated by infection and only one(1.9%) non-union of radius occurred. 4. The functional results were excellent or satisfactory in 25 patients(83.3%). 5. We have found that in adults the auto compression plating is a successful method for the diaphyseal fractures of the forearm.

A Study of Fabella / 대한정형외과학회잡지

The fabella, a sesamoid bone that occasionally is found in humans on the gliding surface of the lateral head of the gastrocnemius, is a sign of an atavistjc pattern. The authors examined radiograph of knees of 817 patients for the presence of fabella and determined the incidence of fabella in traumatic patients as compared with non-traumatic patients with primary osteoarthrosis or vague pain in that knees. The results were as followes: l. 31.0% of 626 adult patients had at least a unilateral fabella. 2. There was no difference in the incidence of fabella according to sex (p<0.01). 3. The youngest boy showing the fabella was aged 12 years & 8 months, the youngest girl 15 years & 2 months. 4. 87.1% of the patients who had a fabella had one bilaterally. 5. Fabellae were more common in the patients with primary osteoarthrosis or vague pain in that knees. 6. It is our opinion that the presence of fabella is more important in the clinical aspect in Korea.

A Clinical Study of Subtrochanteric Fractures of the Femur / 대한정형외과학회잡지

Subtrochanteric fractures of the femur are difficult to manage successfully. Two factors, involvement of cortical bone tissue and concentration of stress, frequently have been mentioned as reasons for the high incidence of failure in the treatment of these fractures. We studied 37 patients with 38 subtrochanteric fractures treated at the Seoul Red Cross Hospital from Feb. 1978 to Nov. 1983. The results were obtained as follows: 1. Of the 37 patients studied, 29 were male and 8 female. The majority of male patients (representing 62.1%) were between 21 and 50 years of age, while 7 of 8 female patients were after 50years of age. 2. In 27 (73.0%) of our patients, the fracture resulted from high-energy trauma, traffic accident or fall from height. 3. Many fractures in the present series could not be classified in the manners described by Fielding, Zickel or Seinsheimer. So, we could not find any correlation between fracture type and used fixation device or its prognosis. 4. The associated injuries, which were relatively common in lower limb (10 cases) and pelvis (8 cases), made the fractures more difficult to treat. 5. Of the 38 fractures, 35 (92.1%) were treated by operative means. The Jewett nail was the device most commonly used, with a total of 11(31.4%) fractures being so treated. 6. The average time from operation to partial weight bearing was 12.9 weeks. 7. The average time untill clinical union was about 14 weeks and radiographic union about 24 weeks. 8. From these series, it was considered that, although early weight bearing is frequently impossihle, Jewett nail, plate and screw, compression hip screw, Judet plate or blade plate can be applied successfully to the treatment of subtrochanteric fractures of the femur if the most proper one which can stabilize the lesion effectively is selected and weight bearing is delayed for a sufficient period.