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Analysis and Clinical Study on Fracture Dislocation of the Talus
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Ye Yeon Won, Chang Hoon Jeon, Jae In Ahn, Seung Jun Choi, Jung Mo Lee
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J Korean Soc Fract 2000;13(2):382-389. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.382
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 Abstract
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- PURPOSE
: Talar fractures are uncommon and so surgeon's experience in the treatment of the talar fracture is limited. This study was undertaken to evaluate the incidence, associated injuries, complications of talar fracture and results of treatment.
MATERIALS AND METHODS
: Authors experienced 15 cases of the talar fractures treated at Ajou university Hospital from 1995 to 1998 with minimal 1 year follow-up period and obtained following result.
RESULTS
: Of 15 cases, fall down injury was the most common cause of injury(11/15). 4 ipsilateral medial malleolar fractures, 2 lateral malleolar fractures and other associated injury was occured. According to the Hawkins' classification 5 cases in type I , 1 cases in typeII, 2 cases in typeIII were observed. 2 posttraumatic arthritis, 1 skin necrosis, 1 avascular necrosis, were observed as complications but nonunion was not observed.
CONCLUSIONS
: We suggest that early and accurate anatomical reduction and rigid internal fixation of the fracture dislocation of the talus canprevent complications such as acascular necrosis, posttraumatic arthritis.
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Predictors for saving the limb after popliteal artery injury
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Byoung Suck Kim, Woo Sig Kim, Byoung Hynn Min, Chang Hoon Jeon, Ye Yeon Won, Dae Woong Kim, Jae In Ahn
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J Korean Soc Fract 1999;12(4):879-884. Published online October 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.4.879
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Abstract
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- PURPOSE
: This study had been performed to evaluate the factors affecting either saving the limb or amputation after popliteal artery injury associated with fractures or dislocation around the knee.
MATERIALS and METHODS
: Twelve patients of popliteal artery injury were included. Authors had analysed nine probable factors as follows - age, sex, injury mechanisms, injury types, interval between injury and time to arrive at the hospital, interval between injury and time of operation, surgical methods for revascularization, severity of extremity injuries and fasciotomy, for discrimination between the limb-saving group and the amputation.
RESULTS
Ten patients were arrived at the hospital within 48 hours after the injury. Each patient was managed by end-to-end anastomosis in 6 cases and autogenous vein graft in 4 cases and among them, 2 cases needed additional amputation for vascular compromise. All limbs could be saved in which cases operate within 6 hours after the injury. However, the limb was lost in one of 6 cases(16.7%) between 6 and 20 hours, in one of two cases(50%) over 20 hours. One of 7 cases(14.3%) with the Mangled Extremity Severity Score(MESS) of 2 to 4 points, two of 4 cases(50%) with MESS of 5 to 6 points and one(100%) with MESS of 7 points were amputated.
All 4 patients associated with fasciotomy could save their limbs, however, two of 6 patients not associated with fasciotomy lost.
SUMMARY : Authors thought the most reliable predictors for saving the limbs after the popliteal artery injury might include the MESS and fasciotomy, however, ischemic time more than 6 hours might not be an absolute indication for amputation.
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Delayed Hemolytic Transfusion Reaction in Treatment of Multiple Fracture
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Ye Yeon Won, Byoung Hyun Min, Weon Ik Lee, Myeong Ryeol Song
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J Korean Soc Fract 1998;11(3):617-622. Published online July 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.3.617
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Abstract
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- This is a case report of delayed hemolytic transfusion reaction due to Anti-Le*b and Anti-JK*b in treatment of multiple fracture. The patient was a 14 year-old boy and had no history of transfusion or blood products. The patient underwent open reduction and internal fixtion for fracture of supracondyle of femur with massive blood transfusion. Abnormal finding of ABO incompatibility was not found as usual method. The patient developed a marked fall in hemoglobin and hematocrit value and a marked hyperbilirubinemia at 8 day after surgery, which suggested hemolytic anemia and jaundice. After the evaluation of this hemolytic anemia and jaundice, we found the anti-Le*b antibody and Anti-Jk*b antibody. A delayed hemolytic transfusion reaction represents an infrequent, but potentially hazardous complication of blood transfusion. The phenomenon usually oringinates from exposure to a blood group antigen by prior transfusion or pregnancy. delayed appearance of isoantibodies, first detected 4 to 14 days after the transfusion of apparently compatible blood, has been detected by the authors.
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Pelvic Bone Fractures in Children
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Byoung Suck Kim, Ye Yeon Won, Weon Ik Lee, Myeong Ryeol Song, Jae In Ahn
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J Korean Soc Fract 1998;11(1):107-114. Published online January 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.1.107
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Abstract
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- The pelvic bone fractures in children were uncommon, except for avulsion injuries in the literature and authors had 21 cases of children's pelvic bone fracture, ranging from 1 to 15 years. The mode of injury, type of fracture, associated injuries, morbidity and mortality, and out-come were retrospectively analyzed. The majority of injuries were from automobile-pedestrian collisions (81.0%). the Torode and Zieg type IV injury had the greatest morbidity, mortality, and complications. sixteen patients had non-orthopedic, associated injuries and fourteen required blood transfusions within initial 48 hours after injury. Two of them passed away due to hematologic unstableness. Twenty patients were managed by conservative method, except for one operative case by using of an external fixation device. This study included only 13 cases had average 1 year of follow-up. One acetabular dysplasia of 5 acetabular fractures was found at 12 months after injury. The nonoperative approach for the pelvic bone injury has had a satisfactory outcome in our hospital. so, authors think that if conservative methods will be properly applied, it may be one of the methods of treatment for the children's pelvic bone fracture. Even though there is no symptoms, long-term follow-up will be inevitable for checking more severe acetabular dysplasia and leg length discrepancy.
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Treatment of Type III Open Tibial Fractures with Repofix External Fixator
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Chang Hoon Jeon, Ye Yeon Won
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J Korean Soc Fract 1995;8(4):855-863. Published online October 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.4.855
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Abstract
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- We reviewed 18 patients with type III open tibial fracture from February 1992 to June 1995 (mean follow-up period 56.7 weeks) treated with Repofix external fixator. There were 16 men and 2 women. According to the Gustilos classification, there were type IIIa in 11 cases and type IIIb in 7 cases.
Mean period of removal of external fixator was 19.3 weeks and after removal of external fixator, cast immobillization was performed in 4 cases. Among them, bony unions were noted in 15 cases and there were nonunion in 2 cases and malunion in 1 case. The causes of nonunion were failure of accurate reduction in 1 cases and severe initial comminuted fracture in 1 case. Complications were nerve injury, pin site infection and ring-type osteomyelitis. After removal of external fixator, nerve injuries were recovered and pin site infections except 1 case were healed. Ring-type osteomylitis was occurred in 1 case after removal of external fixator and osteomyelitis was dured after curettage. When type III open tibial fractures were treated with Repofix external fixator, there were advantages of 1) early weight bearing, 2) sagittal and coronal reduction of fracture and 3) correction of rotation. With advantages, this external fixator was appropriate for the treatment of type III open tibial fractures.
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