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Original Articles
- The Operative Treatment of the Intertrochanteric Fracture of the Femur in Elderly Patients over 70 years old: Comparison between Survivor group and Non-survivor group
- Sang Won Park, Young Soo Byun, Dong Hoon Suh, Jae Hyo Jung
- J Korean Soc Fract 1998;11(4):725-731. Published online October 31, 1998
- DOI: https://doi.org/10.12671/jksf.1998.11.4.725
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Abstract
PDF - The intertrochanteric fractures of the femur are common in elderly. recently better implants and surgical techniques have improved the clinical results. But intertrochanteric fractures are still a major source of morbidity and mortality in elderly because of poor general condition and high incidence of osteoporosis. The primary goal of the treatment have been union of the fracture, but it is important to reduce the mortality rate and to return the patients to a prefracture ambulatory status. The authors analyzed the 63 intertrochanteric fractures of the femur in the elderly patients over 70 years old who had been treated at Korea University Hospital from January 1990 to December 1995 in order to determine the mortality rate and the prognostic factors associated with mortality. Also we analyzed the 44 patients in survivor group about their prefracture ambulatory ability and opst-operative ambulatory ability. The results were as follows; 1. There were 44 cases(69.8%) in survivor group and 19 cases(30.2%) in non survivor group. The mortlity rate was 20.6% at 1 year after operation. 2. Mortality was associated with the number of medical problems and interval between injury and peration. 3. The recovery of ambulatory ability was associated with the age at injury, associated medical problems, and preinjury ambulatory ability.
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- Results Following The Surgical Treatment of Acromioclavicular Joint dislocations; A Comparison of Phemister With Bosworth Operation
- Jin young Park, Suk Joo Lyu, Ki Hyuk Moon, Myung Ho Kim
- J Korean Soc Fract 1998;11(1):8-15. Published online January 31, 1998
- DOI: https://doi.org/10.12671/jksf.1998.11.1.8
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Abstract
PDF
- To compare the results the Bosworth with Phemister operation, we performed the Bosworth operation in 7 case and then Phemister operation in 9 case serially from 1994 to 1997 and followed them up postoperatively. The average follow-up was 19.2 months, with the longest being 32 months, and the shortest being 12 months. The extraarticular coracoclavicular fixation was done with a cancellous screw in Bosworth operation, the transarticular fixation with two or three Kirschner wires in Phemister operation and the coracoclavicular ligaments were sutured to all patient in phemister operation group. The average immobilization period 6.8 weeks(S.D.:1.0 weeks) in Bosworth operation, 6.5 weeks(S.D.:1.4 weeks) in Phemister operation. The cancellous screw or the Kirschner wires were removed in 12.6 weeks(S.D.:1.6 weeks) postoperatively in Bosworth operation, 11.8 weeks(S.D.:1.7 weeks) in Phemister operation and physiotheraphy was progressed to obtain the full range of motion. All of the patients were evaluated on a subjective(pain, night pain, medication. instability, activities of daily living), objective(range of motion) and roentgenographic(degree of displacement) basis at last follow-up. Shoulder function was assessed according to the shoulder score devised by the American Shoulder and Elbow Surgeons. The pain of Shoulder persisted remained in 1 case of Bosworth operation and in 3 cases of Phemister operation. The night pain around acromioclavicular joint was remained in 2 cases of Phemister operation. Average shoulder function index in Bosworth operation was 95 points and in Phemister operation 87 points. Average range of motion of Bosworth operation was 176degree (S.D.:9degree in forward elevation, 68degree(S.D.:11degree in external rotation, 88.6degree(S.D.:12degree in cross-rotation at 90degreeabduction, 22cm (S.D.:11cm) in cross-body adduction and T9 in internal rotation and Phemister operation 147degree(S.D. 18degree in forward elevation, 72degree S.D.:12degree in external body adduction and T8 in internal ratation. All of the patients were satisfied for results of operation. After surgery, loss of reduction was found in 3 of 7 in Bosworth operation and all of the patients were over 40 years and then conversions to Phemister operation was needed. According to short-term follow-up we prefer the transarticular Phemister method and Bosworth operation may be avoided in patients over 40 yeras old.
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