PURPOSE : The goal of this study is to decrease the chance of the lower limb loss resulting from the delayed diagnosis of arterial thrombosis after first operation in a patient of the closed fractures around the knee by early diagnosis and proper management via studying several prognostic factors. MATERIALS AND METHODS : We have reviewed 8 cases of delayed diagnosed arterial thrombosis patient who was follow up for 1 year or more March 1987 to February 1997, retrospectively. We have followed ip the clinical results. RESULTS : The amputation rate was 50%(4/8), and among associated injuries, tibial or peroneal nerve palsy was combined in 75%(6/8). The time interval from initial trauma to diagnosis was significantly different between amputation group(77hours) and non amputation group(34.25hours). Better results were obtained in cases who had early diagnosis and treated with end to end anastomosis than vein graft. CONCLUSION : It is very important that the vascular status should be assessed not only at the first examination but also repeatedly over the ensuing hours and days with caution, even though there was absence of ischemic sign.
PURPOSE : In children, fractures of the femoral shaft have been traditionally treated by immobilization in a spica cast, either immediately or after a period in traction except open fracture or for patient with head injuries. More recently, there has been a growing trend towards surgical treatment with widening of the indications including isolated femoral fractures. To evaluate the clinical, radiological results of surgical treatment for femoral shaft fractures in children, we reviewed 13 cases of femoral shaft fractures in children treated with flexible intramedullary nailing and followed for more than 12 months.
MATERIALS & METHODS : The average age of the patients was 11 years and 4 months(range 10- 14 years). The average follow-up period was 1 years and 3 months(range 1 years-1 years and 8 months)after surgery. 10 cases and 3 cases were inserted through antegrade and retrograde entry, RESULTS: No major complications were found except 1 intraoperative iatrogenic fracture and 2 postoperative bursitis ;all fractures were united and radiologic union was obtained at 9.5 weeks after surgery. CONCLUSION : The clinical results obtained using flexible intramedullary nails for the stabilization of femoral shaft fracture in children are comparable to non-operative treatment, but with less disruption to family life and a shorter hospitalization while achieving near anatomic alingment, maintaining lengh, and allowing early active motion at the hip and knee.
Fracture of the calcaneus is the most commonly encountered among fracture of tarsal bone and it is difficult to obtain accurate reduction because the calcaneus has cancellous trabecular enclosed with thin cortical bone. In the past, the result of treatment was poor. Recently, closed reduction and axial pin fixation for tongue type fracture and open reduction and internal fixation for joint depression type fractures are considered as generally accepted treatment methods. The purpose of this study is to evaluate the efficacy of axial pin fixation in joint depression(group A) and tongue type(group B). Retrospective study was performed in 20 patient(23 feet) with intraarticular calcaneal fractures which were treated with axial pin fixation from July 1993 to June 1996. Minimum follow up period was 1 year(average 20 months). The obtaining results were as follows : 1. Cause of injury was fall down in the 18 cases(90%). 2. We obtained excellent or good results from the performance of operation within 2 weeks on trauma patient, in the 16 cases(69%). And we obtained excellent or good results in the 14 cases, showing above 20degreesof postoperative B.. ohler angle. 3. In fracture of joint depression type, there is no relationship between clinical result and degree of joint depression in follow up CT. 4. The complications were subtalar arthritis and two neuroma in sural nerve. We propose our experience obtained in 23 cases that axial pin fixation was a good method for treatment of intraarticular fracture, joint depression type as well as tongue type.
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Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method Gyu Min Kong, Byoung Ho Suh, Dong Joon Kim Journal of the Korean Fracture Society.2007; 20(2): 178. CrossRef