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Operative Treatment of Tibial Plateau Fractures - Analysis of the factors affecting to the clincal results
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Byeong Yeon Seong, Wan Soo Park, Sang Yul Shin, Yuen Ki Woo, Taek Geon Lee, Man Jae Park, Seung Ki Lee
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J Korean Soc Fract 2002;15(1):87-96. Published online January 31, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.1.87
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Abstract
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- PURPOSE
The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. MATERIALS AND METHODS The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. RESULTS 18 of 19 cases that were ranged of ages between 30 years and 59 years showed good clinical results as criteria of Blokker. Schatzker type II was noted 11 cases(37.9%) as most common. 13 of 14 cases of the type I,II and III, were showed good clinical results, compare to 10 of 15 cases of the type IV,Vand VI. 12 of 18 cases which were related with associated soft tissue injuries, were showed good clinical results. CONCLUSION We could expect good clinical results if early knee joint mobilization following open reduction and rigid internal fixation could be obtained. Factors affecting clinical results are age, type of fracture, associated soft tissue injuries. Bad clinical results were related with young age group under 30 and over 60, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.
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The Results of Surgical Treatment of Intertrochanteric Fractures in the Elderly Patients Aged over 65 years : Comparative Study between Compression Hip Screw and Ender Nail Fixationt
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Byeong Yeon Seong, Chang Min Lee, Dong Sung Park
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J Korean Soc Fract 1999;12(4):802-811. Published online October 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.4.802
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- OBJECTIVES
: To analyse the comparative results of surgical treatment with compressive hip screw or Ender nail for intertrochanteric fracture in aged over 65 years.
MATERIALS & METHODS : From June 1990 to December 1997, 39 of 55 patients who were operated with compression hip screw or Ender nailing and followed up for more than 1 year. A retrospective survey was completed for 39 intertrochanteric fractures which were operated with compressive hip screw(22 patients, Group 1) or Ender nail(17 patients, Group 2). There was an average follow up of 48 months, with a range of 12 to 84 months. Radiographic measurements were performed in aspects of osteoporosis and fracture classification. Clinical evaluation of follow up was measured as Clawsons evaluation according to the fracture claffification and types of fixation. 23 of 39 cases(59%) were unstable and 26 of 39 cases(66.6%) showed below grade III in osteoporosis. Age, cause of fracture, fracture classification, accompanying diseases and Singhs index were identical to both group. RESULTS The mean radiologic bone union period was 16.4 weeks. The rate of complication was 7 cases(31.8%) in group I and 8 cases(47.0%) in group II. The rate of mortality was 3 cases(13.6%) in group I and 3 cases(17.6%) in group II. Satisfactory rate was 20 of 22cases(90.9%) in group I and 14 of 17 cases(82.3%) in group II. CONCLUSION : We suppose that compressive hip screw fixation for the elderly over 65 years who had intertrochanteric fracture and medical problem, produced good results as comparing to Ender nail fixation. The clinical satisfactory rate were superior in the compressive hip screw group comparing to Ender nail group. Cement fixation for eldly could help to fixate more in compression hip screw.
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Immediate Quadriparesis after Posterior Sublaminar Wiring for Cervical Fracture Dislocation: A Case Report
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Byeong Yeon Seong, Chan Ji Park, Dong Seong Park
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J Korean Soc Fract 1999;12(3):679-685. Published online July 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.3.679
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- Open reduction and internal fixation of the cervical spine is a commonly performed method of treatment for acute cervical fracture dislocation. A sudden or gradual worsening of the neurological status of a patient during reduction should alert the physician to the presence of high grade compression of the spinal canal.
Loss of neurological function during or after manipulation or open reduction and internal fixation should raise the suspicion of compression of the spinal cord from a lesion occupying the canal, such as a herniated disc, buckling of the ligamentum flavum, an epidural hematoma or bone fragments. Magnetic resonance imaging or myelogram are the most helpful diagnostic means and should be used initially if suspected. Treatment is anterior decompression and autogenous strut bone graft. Causes of our case include ruptured disc, vertebral end plate and posterior longitudinal ligament.
We experienced a case of immediate quadriparesis after posterior decompression and sublaminar wiring for cervical fracture dislocation which was resulted from ruptured disc, vertebral end plate and posterior longitudinal ligament.
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Treatment of Intraarticular Calcaneal Fractures using Ilizarov Exteranl Fixation
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Byeong Yeon Seong, Dong Seong Park, Seung Jun Park, Sang Wook Kim
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J Korean Soc Fract 1998;11(3):591-596. Published online July 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.3.591
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- Open reduction and internal fixation (ORIF) is gaining in popularity as method of choice for the treatment of displaced intraarticular calcaneal fracture since diagnosis and classification of computed tomography have become routine. But early weight-bearing cannot be allowed by convertional ORIF, and delayed weight-bearing may contributed to heel had pain and dystrophy. We performed combined technique of limited internal fixation and Ilizrov external fixation to ten-cases of displaced intraarticular calcaneal fractures, between February 1994 and February 1996. The follow-up period in this study was at least two years. This method can provide not only anatomical reduction, but also stable fixation. None of patients complained of heel pad pain, which was attributed to the desensitization of the heel by early weight-bearing. None of patients went on to late collapse of the posterior facet. clinical results were rated as excellent in six, good in three, and fair in one case. Pin-track infection, complicated operative technique, cumbersomeness and expensiveness of the external fixator itself were shortcomings of this method. We consider this method as one of options for the treatment of displaced intraarticular calcaneal fracture.
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- A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture
Jeong-Seok Moon, Woo-Chun Lee Journal of the Korean Fracture Society.2009; 22(1): 13. CrossRef
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Operative Results in AO Type C3 of Tibial Pilon Fracture: Limited Internal Fixation and Hybrid External Fixation
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Byeong Yeon Seong, dong Seong Park, seung Jun Park, Sang Wook Kim, Taek Geon Lee
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J Korean Soc Fract 1998;11(3):576-584. Published online July 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.3.576
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- The intraarticular fractures of the distal tibia has been the most difficult problem due to severe comminution of itself, little bone mass and poor circulation of soft tissue. Recently limited internal fixation with hybrid external fixation has been reported to provide a good clinical results for the severely commnuted or open pilon fractures as a AO type C3.
From February 1994 to February 1996, the authors analyzed the clincal and radiological results of 2 year follow-up in 7 cases of the AO type C3 pilon fractures who were treated with combination of limited internal fixation and hybrid externalfixation. 6 cases had good or excellent clinical and radiological results without any serious complications such as skin sloughs, skin infection, malunion and nonunion, but one case had a nonunion who were treated with internal fixation and autogenous iliac bone graft. We believe that the combination of limited internal fixation and hybrid external fixation that does not cross the ankle joint, provides the good clinical results in AO type C3 pilon fractures by early ankle joint motion.
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