-
Peritalar Dislocations or Fracture-Dislocations
-
Seung Koo Rhee, Hwa Sung Lee, Jong Bum Park, Jin Wha Chung, Eui Yong Um, Whi Ju Whang
-
J Korean Soc Fract 2001;14(4):689-697. Published online October 31, 2001
-
DOI: https://doi.org/10.12671/jksf.2001.14.4.689
-
-
 Abstract
 PDF
- PURPOSE
To find the proper way and timing of treatment for minimizing the posttraumatic complication of peritalar dislocation or fracture-dislocation.
MATERIALS AND METHODS
We reviewed total 12 cases of peritalar dislocation or fracture-dislocation that consist of 9 cases of subtalar joint dislocations, I case of talonavicular joint dislocation and 2 cases of talar fracture-dislocations. Closed reduction was performed for subtalar dislocation without suturing the torn ligaments. The average follow up period was 25 months.
RESULTS
Of 9 subtalar dislocations, 8 cases presented acceptable results. But 1 case of a 28-year-old male patient with prolonged heavy sports activity history presented pain and mild limping. The other 3 cases of talo-navicular joint dislocation and talar fracture-dislocations presented acceptable results except one complaining of scar contracture.
CONCLUSION
Complications such as early skin necrosis or neurovascular damage could be prevented by early closed reduction for peritalar dislocations or fracture dislocations, and the repair of torn ligaments of ankle joint in peritalar dislocations did not affect the end results.
-
Selective Arterial Thrombolysis with Urokinase in Popliteal Arterial Occlusion Developed after Total Hip Replacement Arthroplasty
-
Seung Koo Rhee, Kee Yong Ha, Nam Gee Lee, Jong Bum Park
-
J Korean Soc Fract 1995;8(1):79-83. Published online January 31, 1995
-
DOI: https://doi.org/10.12671/jksf.1995.8.1.79
-
-
Abstract
PDF
- A 60 year old patient with a sudden thromboembolic occlusion of ipsilateral popliteal artery on four days after the total hip replacement (THR) were treated with high-dose urokinase by direct intraarterial selective infusion.
The cause of arterial occlusion after THR was not clear, but it was thought to be caused by spontaneous thrornboembolism in an elderly patient accompanied with diffuse arteriosclerosis, and this multifocal arteriosclerosis was caused not to perform the vein graft immediately.
The initial infusion therapy with 4,000 IU/min for 2 hours of urokinase was failed but the second trial with same doses of urokinase in another 2 hours was succeed with complete clot lysis.
Then 500,000 IU/24 hours of urokinase was infused again, and total 1,500,000 IU/28 hours was used in this patient. But massive internal bleeding from the operation site, hip joint, for more than 1,400 co was leaked because of bleeding tendency induced by extensive use of urokinase within short duration, and minor toe amputations should be performed on 2 weeks after thrombolysis because of distal migration of small thromboembolic particles.
It was suggested that the peripheral arterial occlusion resulting from thromboembolism after joint replacement, especially in an elderly patient with diffuse arteriosclerosis, could develop, and it could be successfully treated with an initially high-dose urokinase regimen if it is detected earlier, rather than vein graft or amputation.
|
E-submission
KFS
