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The Treatment of Posterolateral Malleolar Fractures using Percutaneous Reduction Technique
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Jae Sung Lee, Han Jun Lee, Jae Hyun Yoo, Hee Chun Kim
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J Korean Fract Soc 2009;22(1):19-23. Published online January 31, 2009
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DOI: https://doi.org/10.12671/jkfs.2009.22.1.19
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 Abstract
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- PURPOSE
To evaluate the usefullness of the percutaneous reduction technique with K-wire that could reduce the displaced posterolateral fracture fragment which persisted even after an anatomical reduction of the lateral malleolar fracture.
MATERIALS AND METHODS
From January 2004 to December 2006, we reviewed 72 patients who underwent surgical treatment for their trimalleolar fractures. We estimated the clinical and radiological results of 5 cases treated by percutaneous reduction technique with K-wire when more than the distal tibial articular step-off was left after reduction of the lateral malleolar fracture. The method of reduction starts with temporary fixation of lateral malleolar fracture followed by checking ankle radiographic image to confirm the accuracy of reduction. In case of incomplete reduction of the posterior fragment, a K-wire is inserted into the posterior fragment and pushed downward to the ankle joint level, and then lag screws were inserted.
RESULTS
The average articular involvement by the posterolateral fracture fragment was 30.2%. The average step-off after reduction of the lateral malleolar fracture was 3.7 mm. At the final follow up, step-off was less than 2 mm in all cases. In clinical results by Baird and Jackson score, 3 out of 5 cases were excellent, other 2 were good.
CONCLUSION
Percutaneous reduction technique for posterolateral fragment using the K-wire is relatively easy. This technique may be useful when the posterolateral fragment is large (more the 25% of articular surface) and not severely comminuted.
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Clinical Results of Locked Unreamed Nailing in Tibial Shaft Fractures
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Duck Yun Cho, Hee Chun Kim, Kyung Chul Kim
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J Korean Soc Fract 1997;10(3):575-582. Published online July 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.3.575
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- We reviewed the results of the treatment of 23 tibial shaft fractures in 22 patients by primary unlearned locked intramedullary nailing. The duration of follow-up was average 10.1 months (range, from 6 to 27 months).
The results were as follows : 1. There were 11 open and 12 closed fractures.
2. All fractures united clinically in an average time of 17.9 weeks(range 10 to 26 weeks), and radiologically in an average time of 19.4 weeks (range, 10 to 31 weeks).
3. Complications included 1(4.3%) case with delayed union and 3(13.0%) cases with malunion.
4. No patient had deep infection and there were no broken nails or screws in this series.
5. No fracture refuired an additional procedure before union, such as dynamization or bone graft.
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Clinical Study of Prognostic Factors in Patellar Fractures
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Duck Yun Cho, Hee Chun Kim, Chung Hwan Kim
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J Korean Soc Fract 1996;9(4):977-983. Published online October 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.4.977
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Abstract
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- Most authors report 70% to 80% good to excellent results following open reduction and internal fixation of fractures of the patella. As with most intraarticular fractures, the prognosis for healing and restoration of function in fractures of the patella is dependent on the amount of articular cartilage damage and exact reduction of fracture.
In order to document clinical results and describe any prognostic factors, we evaluated the results of 69 patellar fractures treated in 66 patients who had been treated with open reduction and internal fixation at the Department of Orthopaedic Surgery, Nationanl Medical Center, from January 1990 to December 1994.
The average age at the time of surgery was 41.2 years(16 years-75 years) and the average follow-up time was 38.7 months(14 months-74 months).
The results were as fellows: 1. The mechanism of injury(traffic accident), concomittant inury of ipsilateral lower extremity, fracture morphology, immgbilization period less than two weeks and accuracy of reduction were significant prognostic factors.
2. Age and method of fixation were not significant prognostic factors.
3. The brisement of knee under general anesthesia was helpful, that had been performed following bony union.
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Clinical analysis of fractures around the elbow joint in adults
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Duck Yun Cho, Joong Myung Lee, Hee Chun Kim, Hyeong Jin Kim
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J Korean Soc Fract 1995;8(2):430-438. Published online April 30, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.2.430
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Abstract
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- The fractures around the elbow joint in adults are relatively rare in comparision with that in children, but the late complications are more common in adult.
So, it is important to select the appropriate early management to prevent the late sequelae.
Complications are joint contracture, persistant pain, nonunion, deformity, neurologic symptom, infection. etc. Among them limited range of joint motion is the main problem.
We, authors have clinically and radiologically analyBed 48 cases of fracture around the elbow joint in adults over the age of 20 years, treated at the Department of Orthopaedic Surgery in National Medical Center from January 1984 through December 1993.
The results are as follows: 1. The age incidence was higher in active young persons and the male to female ratio was 3:2.
2. The most common cause of the injury was slip-down(46%), followed by traffic accident(29fo), falling, and athletic injury.
3. In total 48 cases, olecranon fractures were 29 cases, fractures of distal humerus 13 cases, radial head fractures 5 cases, and multiple fractures (including olecranon, radial head and intercondyle) was 1 case, Among them. open fractures were 5 cases.
4. Closed reduction with cast immobilization or K-wire fixation was performed in 8 cases, and open reduction and internal fixation was performed in 37 cases. In 3 cases. radial head resection was done.
5. The most common complication was limited range of the joint motion (9cases), followed by nerve injury(3 cases), infection(3 cases) and nonunion(1 cases).
6. Development of limited range of joint motion was increased in case of old age over 60 years(33%), open fracture(60%), longer immobilization period over 6 weeks(27%).
Though fracture around the elbow joint in adult is reletively rare. it frequently results in limitation of the joint motion and has poor prognosis For prevention of limitation of joint motion, rigid fixation and shortening of immobilization period and early rehabilitation are necessary.
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Citations
Citations to this article as recorded by  - Treatment of Ulnar Olecranon Fracture Using Acutrak Screw
Hyungchun Kim, Kwangryul Kim, Moonsup Lim, Youngil Park, Inhwan Hwang, Jihoon Lee
Journal of the Korean Fracture Society.2009; 22(4): 270. CrossRef
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