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Surgical Treatment of the Patellar Fractures
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Hak Yeong Jeong, Seung Wook Yang, Young Cheol Shin, Han Sung Park, Tae Ho Joo
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J Korean Soc Fract 1995;8(3):578-585. Published online July 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.3.578
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 Abstract
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- Recently the incidence of the patellar fracture has been increasing because of frequent traffic accidents and industrial accidents, and its treatment is considered very important due to the involvement of the articular suface occurs in most of the cases. Comminuted displaced fractures of the patella which are difficult to reduce accurately and to get stable internal fixation, may lead to traumatic osteoarthritis, chondromalacia, extension lag and limited ROM of the knee joint.
The retrospective review was undertaken of 49 patients with patellar fractures treated by surgical methods and a follow up of more than 1 year at the Department of Orthopaedic Surgery at Maryknoll Hospital between Aug. 1987 and Jan. 1994.
The findings were as follows: 1. Most fractures were encountered in man from twenties to forties.
2. The most common cause of fractures was traffic accident, followed by slip down or fall down.
3. Comminuted fracture was the most common type in this series.
4. Large separated fragments of the patella should be accurately reduced with rigid fixation in the rationale of the intraarticular fracture.
5. The most favorable results were obtained by Modified Tension Band Wiring with supplementary oircurnferential wiring for comminuted fractures and the result was superior to other operative methods.
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Operative Treatment with Plate Screw Devices for Distal Femoral Fracture
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Hak Yeong Jeong, Seung Wook Yang, Young Cheol Shin, Han Sung Park
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J Korean Soc Fract 1994;7(2):512-521. Published online November 30, 1994
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DOI: https://doi.org/10.12671/jksf.1994.7.2.512
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Abstract
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- Until 1960, conservative managemant was considered superior to operative treatment of distal femoral fracture. But with advancement of new fixation divices and techniques, open reduction and internal fixation is recent trend.
From May, 1986, to May, 1993, at Pusan Maryknoll hospital, the results of 39 cases of distal femoral fracture treated operatively with plate screw devices were analyzed after minimum follow up of 1 year according to the rating system of Schatzker and lambert.
The results were as follows: 1. Average radiologic union time was 16.3 weeks.
2. According to Schatzker and Lamberts criteria, excellent was 17 cases, good in 13 cases, fair in 5 cases and failure in 4 cases.
3. For fixation of distal femoral fracture with severe comminution at metaphyseal portion, the condylar blade plate and dynamic condylar screw showed better result than anatomical plate.
4. With extensile approach, the dynamic condylar screw showed excellent result for distal femoral fracture with intraarticular comminution.
We concluded that wide exposure enough for accurate reduction of fracture fragments aud joint surface and rigid internal fixation were the cornerstone for treatment of the distal femoral fracture.
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