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Double-Plating in the Comminuted Supracondylar Fracture of the Distal Femur
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Taek Rim Yoon, Sung Taek Jung, Hyoung Yeon Seo
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J Korean Soc Fract 1997;10(4):778-784. Published online October 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.4.778
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 Abstract
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- Supracondylar fracture of femur is not well suited to internal fixation. A wide canal, a thin cortex, comminution and compound wound make open reduction more difficult. Especially, type C2 and C3 on AO classification is problematic. The cases of nine patients who had type C2 or C3 fracture including three open fractures and deficient medial-cortical buttress were reviewed. Stable fixation was achieved with the lateral condylar buttress plate. Additional stabilization with a medial plate and bone graft from the iliac crest was applied in all nine patients. At an average duration of follow-up nineteen months(range from twelve to forty-eight months), all of the fracture had healed. Evaluation of the functional outcome revealed two excellent, three good and four fair results. In three patient, less than 90 degree of flexion of the knee was present and in six, the arc of flexion was limited to between 90 and 110 degrees. One patient had two centimeter shortening, one had medial screw loosening which need not additional fixation. The results of our study suggest that, for the treatment of patients who have a difficult fracture in whom stable fixation of the distal part of the femur cannot be achieved with a condylar buttress plate because of medial cortical communition, a short distal condylar fragment, or loss of metaphyseal bone, double-plating is indicated.
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Supracondylar Osteotomy in Cubitus Valgus by Posterior Approach and Internal Fixation with Y-plate
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Eun Sun Moon, Jae Hyung Park, Hyoung Yeon Seo
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J Korean Soc Fract 1997;10(4):912-917. Published online October 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.4.912
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Abstract
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- Cubitus valgus may arise as the sequele of a number of different condition for example, a premature epiphysiodesis of the lateral condylar physis, nonunion or malunion of the lateral condylar fracture, rarely supracondylar fracture of the humerus. Cubitus valgus has more functional loss of extension and possibly the late development of a tardy ulnar nerve paralysis and less significant cosmetic effect. Authors treated the 7 patients who had cubitus valgus developing as a sequele of nonunion of the lateral condyle of the humerus, by the medial closed wedge osteotomy and internal fixation with the lateral arm cut anatomical Y-plate through posterior approach. Five males and two females were followed average 19 months(range 5 to 37 months). A mean age at the time of the operation was 17.1 years(range 13 to 25 years). Symptoms of tardy ulnar nerve palsy was shown in 5 patients. Two patients were treated due to disappearing cosmetic problem. The carrying angle was mean valgus 31 (range 22~50) preoperatively. The carrying angle was changed from mean valgus 9.6(range 3-15) immediate postoperatively to valgus 9(range 3-14) followed state. The duration of external immobilization after operation was mean 4.1 weeks(range 3-5 weeks). Range of motion of the elbow was fully recovered in 6 cases. The neurologic deficit of the tardy ulnar nerve palsy was fully recovered in all five patients. The result of supracondlar osteotomy was excellent in 4 cases(57.1%), good in 2 cases(28.6%) and poor in 1 case(14.3%). In conlusion, internal fixation with the lateral arm cut anatomical Y-plate after medial closed wedge osteotomy through the posterior approach can be recommanded as a method of treatment for the cubitus valgus.
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