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Operative Treatment of the Fracture of Patella
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Kyu Yeol Lee, Hyung Hwan Lee, Sung Soo Kim, Sung Keun Sohn
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J Korean Soc Fract 1996;9(3):622-630. Published online July 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.3.622
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 Abstract
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- The patella, the largest human sesamoid bone, is important functional component of the knee extensor mechanism and its treatment is considered to be very important because the fracture involvement to the articular surface occures in most of the cases.
We report 40 cases of fractures of patella treated with operative methods from January 1990 to June 1995 at the department of orthopaedic surgery, Dong-A university hospital.
The results are as follows.
1. Among 40 cases, 29 cases were male and 24 cases were belong to 3rd decade and 4th decade.
2. The most common cause of injury was slip down or fall down.
3. The pattenrs of fracture were transeverse in 21 cases, vertical in 2 and comminuted in 17.
4. The methods of surgical treatment were modified tension band wiring in 33 cases, circumferential wiring in 2, partial patellectomy in 4 and total patellectomy in 1.
5. In patient treated with modified tension band wiring, range of motion of the knee was 128 and mean duration of bone union was 9.2 weeks.
6. Complications were limitation of range of motion in 3 cases, refracture by slip down in 1 case and wire migration in 1 case.
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Treatment of acromioclavicular dislocation by a Phemister method
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Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Sung Soo Kim, Hyung Hwan Lee
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J Korean Soc Fract 1996;9(1):154-160. Published online January 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.1.154
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Abstract
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- Acromio-clavicular joint dislocation occurs when both acromioclavicular and coracoclavicular ligaments are ruptured and brings to deformity, arthralgia and limitation of motion of the shoulder joint. The treatment of complete acromioclavicular dislocation is controversial, and both of the conservative and surgical treatment are reported to be relatively successful. But, conservative treatment have many disadvantages and now rarely advocated. Recently, there are increasing tendencies to treat the acromioclavicular dislocatioll with anatomical reduction of acromioclavicular joint and rigid internal fixation for early movement of shoulder Joint. We report the results of 16 cases of acute acromioclavicular dislocation treated with Phemister or modified Phemister method.
The results are as follows.
1. Among 16 cases,14 cases were males and 9 cases were belong to 3rd decade and 4th decade.
2. The most common cause of injuries was slip down.
3. Postoperative difference in coracoclavicular distance on radiogram was 0.1 mm on average.
4. Clinical results were excellent in 14 cases, good in 1 case and acceptable in 1 case.
5. Complications were redislocation in 1 case and K-wire migration in 1 case, but there was no arhritic changes on the affected A-C joint.
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The Use of Gamma Nail in Peritrochanteric Fractures of the Femur
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Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Hyung Hwan Lee
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J Korean Soc Fract 1995;8(4):753-759. Published online October 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.4.753
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Abstract
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- In old age, trochanteric fracture occurs easily by trivial external force due to osteoprosis and many kinds of treatment has been performed. The goal of treatment in elderly patients with trochanteric fractures is restoration of function to preoperative ambulatory status at the earliest possible time. For this purpose operative treatment is gernerally recommended. The success of operative treatment depends on the stable reduction and secure fixation.
Gamma nail is a new intramedullary device which has been applied in the treatment of trochanteric fractures with the benefits of the closed technique such as low blood loss, low risk of infection and short operative time. The implant can be used by the method of static or dynamic. Intraoperative compression of the fracture segments can be achieved by acting on the sliding lag screw and further compression is given by weight bearing.
We studied 22 cases of patient who had the trochanteric fracture and treated operatively with gamma-locking nail at the department of orthopaedic surgery, Dong-A university hospital from January 1993 to December 1994. Among 22 cases, 7 cases were stable fracture and 14 cases were unstable fracture by the Evans classification. Mean operation time was 76 minutes and mean blood loss was 303 mf and intraoperative and postoperative complicatins were encountered in 3 cases, femur shaft fracture in 2 casea and lag screw displacement on the femoral head in 1 case.
Based on the above results, we have experienced limited utiliBation of the nail because of the mappropriateness between nail and femur itself and non-skillful application technique. We think that if nail shape and assembly for fixating distal screw are improved, Gamma-interlocking nail is a good interraf fixation device which allows early weight bearing ambulation.
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