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Ipsilateral Fractures of the Femur and Tibia
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Hyoun Oh Cho, Kyeong Duck Kwak, Sung Do Cho, Cheol Soo Ryoo, Jang Ho Oh
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J Korean Soc Fract 1996;9(2):416-423. Published online April 30, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.2.416
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 Abstract
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- Concomitant ipsilateral femoral and tibial fractures are generally caused by high energy trauma with high incidence of associated injuries and complications.
Twenty-seven cases of ipsilateral fractures of the femur and tibia in 25 adults from 1990 through 1994 were reviewed and the patients were grouped according to the type of fracture and the method of treatment. Nine femoral fractures(33%) and 19 tibial fractures(70%) were open. All but one femoral fractures and 23 tibial fractures were treated operatively with plate and screws, intramedullary nail and external fixator. Local complications include 14 delayed or non-onions, 3 deep infections, 1 compartment syndrome and 2 below-the-knee amputations. Over-all, a good or excellent functional result was achieved in 20 cases(74%).
More use or rigid external fixation is recommended in the management of the tibial fracture, combined with internal fixation of the femoral fracture. Examination of the ipsilateral knee suggested that with the "floating knee injuries", disruption of ligaments is a common occurance and should always by suspected.
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Treatment for the Malunion of the Distal Radius
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Hyoun Oh Cho, Kyoung Duck Kwak, Sung Do Cho, Cheol Soo Ryoo, Woo Keun Jung
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J Korean Soc Fract 1996;9(2):290-294. Published online April 30, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.2.290
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- Malunited fractures of the distal radius may result in adequate function of the wrist with absence of pain in elderly patients. However, posttraumatic dedormity in younger, active patients is less well toterated, especially in those engaged in heavy manual work or who require a normal range of motion of the wrist. surgical correction of the malunion of the distal radius should be considered for this group of patients. Operation for the malunited fractures of the distal radius was performed in ten cases during the periods between January, 1990 and December, 1993, who were followed for an average of 15 months.The procedures included radial osteotomy(RO) in four malunions of short duration, radial osteotomy with ulnar shortening (RO & US) in these malunions of long duration and ulnar shortening(US) in three cases. We reviewed these cases retrospectively with respect to the clinical findings(pain, grip strength, range of motion of the wrist) and radiograpic changes(volar tilt, radial articular inclination and radiul shortening). Symptoms(radioulnar or radiocarpal pain) were improved in all cases. By compairing with the opposite sides, resedual loss of grip strength was 35% in RO group, 40% in RO & US and 31% in & US group. Residual loss of motion in flexion and extension or in deviation was similar in all groups, whill loss in rotation was less in RO or RO & US group than in US group. Inclination of the radial articular surface (radial inclination and volar tilt) was restored up to the degree similar to the opposite wrist in RO or US group, while was not in US group. Radial length was restored up to the dgegrees similar to the opposite wrist in all groups. The overall results were good or very good in five among the seven cases of RO group(with or without ulnar shortening), while good only in one among the cases of US group.
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Management of Femoral Shaft Fractures in the Adolescent
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Hyoun Oh Cho, Kyoung Kuck Kwak, Sung Do Cho, Cheol Soo Ryoo, Bub Jae Lee
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J Korean Soc Fract 1995;8(3):521-527. Published online July 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.3.521
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Abstract
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- Treatment of the femoral shaft fractures in adolescents with open physis is somewhat controversial. Historically, these fractures have been treated with nonoperative methods, but adolescents are less tolerant to the prolonged irnrnobilization than younger children. Futhermore, conservative treatment in this age group may be prone to result in more complications such as malunion and shortening than that in the younger age group. Therefore many authors prefer the operative method for femoral shaft fractures in the adoleseents.
The authors reviewed 22 cases of adolescent femoral shaft fractures treated during the period from January, 1958 to June 1992. Seven cases were treated conseratively, eleven by open reduction and intenal fixation with DCP, and four by closed intramedullary nailing. The patients treated with traction and casting showed more often complications such as angular deformity and bone shortening than in the operative methods. In comparing with those cases of plating, the patients of intramedullary nailing had statistically significant shorter ansthesic time and less blood loss in operation. All of the fractures treated with the intramedullary nails healed without malunion or leg length discrepancy, and there was no evidence of growth plate arrest. Results of this study suggest that closed intramedullary nailing of femur fractures in aldolescents is an effective treatment option.
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Angular Changes after Operative Treatment for the Supracondylar fractures of the Femur
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Hyoun Oh Cho, Kyoung Duek Kwak, Sung Do Cho, Cheol Soo Ryoo, Bub Jae Lee
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J Korean Soc Fract 1994;7(1):174-180. Published online May 31, 1994
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DOI: https://doi.org/10.12671/jksf.1994.7.1.174
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- A fractures of the distal femur is an extremely complex fracture with which to deal. Poor bone stock, proximity to the knee joint, and a truncated shape make this area of the femur less suitable for internal fixation than other areas. Ideal care still somewhat controversial. Major complications include nonunion, delayed union, infection, loss of fixation, Joint stiffness and angular deformity, etc.
The authors reviewed postoperative tiblo-femoral angular changes from the twenty six cases of supracondylar and intercondylar fractures of the femur treated operatively from January, 1988 to December, 1991. Fractures of a single condyle were excluded. The fractures were fixed internally with dynamic condylar screw(DCS) in nine cases, anatomic plate in nine, dynamic compression plate(DCP) in six and others in two. During the periods of follow up there noted varus change of 3.7 degrees in average. We reviewed retrospectively these postoperative varus or valgus angular changes with reference to the degree of injury, type of fracture, time elapsed from injury to operation, kind of internal fixation device, initial bone graft and postoperative brace supplement. Less angular changes in the tiblo-femoral angle with better results were noted in cases with lower energy injuries, AO type Al, A2 or Cl fractures, operation within 1 week of injury, internal fixation with DCS, initial bone graft and postoperative corrective brace supplement.
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A clinical analysis on postoperative residual anterior subluxation of the ankle
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Hyoun Ok Cho, Kyoung Duck Kwak, Sung Do Cho, Cheol Soo Ryoo, Jong Doe Back
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J Korean Soc Fract 1993;6(1):107-111. Published online May 31, 1993
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DOI: https://doi.org/10.12671/jksf.1993.6.1.107
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- No abstract available.
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