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Surgical Treatment of the Fracture of the Distal Humerus
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Chang Hyuk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Soo Il Han, Chang Jin Kang
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J Korean Soc Fract 1997;10(1):104-111. Published online January 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.1.104
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 Abstract
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- The treatment of the fracture of the distal humerus has remained one of the most difficult of all fractures to manage. The goal of treatment, which is the same for other intraarticular fractures, is to reestablish articular congruity, rigid fixation and early active motion as soon as possible. It appears that the use of plates is currently the most acceptable method of fixation. The aim of this study is to clarify the correlation between various fixation methods and functional end results, in order to help in choosing treatment modalities. We reviewed 11 cases of the fractures of the distal humerus treated surgically in Orthopaedic Department of Taegu Hyosung University Hospital between 1992 and 1995. Clinical end results were as follows: 1. Of the 11 cases, there was 6 males and 5 females. Age was from 13 years old to 83 years old and mean age was 46 years old.
2. Muller classification consisted of 4 cases of A2, 1 case of B2, 3 cases of Cl and 3 cases of C2. The mean length of follow up was 15 months. Except for 2 cases of open wound and nonunion, time from injury to surgery was 8 days. Mean period of initial exercise was 4 weeks.
3. All surgical incisions were done with posterior approach; they consisted of 5 cases of dual-contoured plates, 4 cases of plate with screw and 2 cases of K-wires with screw.
4. Mean range of elbow motion was flexion 123 and extension defect 14. There was no limition of pronation and supination compared with the normal side.
5. The functional result by Jupiter criteria was excellent in 5 cases, good in 4 cases, fair in 1 case and poor in 1 case.
6. There were complications in 1 case of plate broken and 1 case of nonunion.
7. In the distal fracture of the humerus, There were 82% of excellent of good result by over-all functional result of Jupiter.
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Treatment of Tibial Plateau Fracture Comparison of Functional and Radiologic End Result
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Chang Hyuk Choi, Soo Il Han, Seung Hee Kim
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J Korean Soc Fract 1996;9(4):984-992. Published online October 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.4.984
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Abstract
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- The aim of treating a tibial plateau fracture is to gain a stable, pain free knee motion, and to repair all associated lesion. Recently a preferred treatment is the open reduction and internal fixation of all displaced and unstable tibial plateau fracture in order to gain anatomic reduction and early knee motion. But functional recovery is relatively impaired in complex knee trauma, despite various treatment modalities. Observations based on long-term radiologicexaminations frequently did not correlate with the functional end results. When choosing the treatment modalities, there are many factors to consider which will influence the final results.
Forty-seven cases of tibial plateau fractures were treated from August 1988 to March 1995 and the average follow up period was fouty-eight months. The results were as follows: 1. Of the 47 patients, there were 34 male and 13 female patients, and the mean age was 49 years.
2. Causes of injury were traffic accidents(36 cases), falling down(7 cases), crushing injury(1 case), and others(3 cases), and the left side was more predominant(28 cases) than the right side (39 cases).
3. Treatment modalities were conservative treatment(16 cases), Illizarov external fixators(8 cases), tibial bolt(11 cases) and screw & wire(12 cases).
4. The range of motion of the knee joint averaged 116 degrees and the average start time of the range of motion exercise was 7.8 weeks. In the good to excellent clinical end results groups, there were meaningful statistical differences.
5. There were statiscal differences between type I(88%), II(80%) fractures and type IV(56%), VI(33%) fractures for the clinical end results.
6. We gained better results after treatment of closed fracture and isolated injury cases than open fracture or associated injury cases, but there were no statistical differences.
7. There were no statistical differences on treatment modalities.
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