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The Result Of Surgical Treatment Of The Femur Unstable Intertrochanteric Fracture Using Compression Hip Screw: Analysis Of Effect Of Degree Of Force On Trauma And Degree Of Osteoporosis
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Ki Do Hong, Sung Sik Ha, Sang Weon Park
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J Korean Soc Fract 2000;13(4):795-803. Published online October 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.4.795
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Abstract
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- PURPOSE
To analyise the effect of degree of force on trauma and degree of osteoporosis in femoral unstable intertrochanteric fracture's result of treatment using compression hip screw.
MATERIALS AND METHODS
From January 1993 to December 1997, 55 patients who were operated with compression hip screw and followed up for more than 1 year were devided into high and low energy injured group by the mechanism of the trauma and also devided low(gradeIV,V,VI) and high grade osteoporosis group(gradeI,II,III) by Singh's index. We analize and compare the result of treatment in each groups.
RESULTS
The averrage rate of mechanincal complication was 24%. The mechanical complication rate of the high grade osteoporosis group(34%) was higher than low grade osteoporosis group(9%)(p<0.05). The average subsidence of compression screw was 9.9mm and it shows significant difference between low(7.8mm ) and high grade osteoporosis group(11.5mm )(p<0.05). The average increased varus deformity of neckshaft angel during follow up was 3.8degrees and it shows singnificant defference between high energy injuried group(4.6degrees ) and low energy injuried group(2.7degrees)(p<0.05). No difference was seen in each groups for time of bone union(p>0.05). In view of functional recovery by Clawson's method, no difference between pre-injury and postoperative state was seen in 7 cases(22%) in high grade osteoporosis group and 13 cases(57%) in low grade osteoporosis group, thus worse functional recovery was seen in high grade osteoporosis group.
CONCLUSIONS
We observed higher mechanical complication rate, more compression screw subsidence and worse functional recovery in high grade osteoporosis group and more varus deformity in high energy injured group. Thus we need more attension to treatment and follow up in high energy injured, severe osteoporotic unstable intertrochanteric fracture.
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A Treatment of Carpal Scaphoid Fracture
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Ki Do Hong, Sung Sik Ha, Sang Weon Park
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J Korean Soc Fract 2000;13(4):1003-1010. Published online October 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.4.1003
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Abstract
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- PURPOSE
To analyze the clinical result of treatment of scaphoid fractures MATERIALS AND METHODS: From January 1994 to December 1998, we reviewed 25 carpal scaphoid fractures. Conservative treatment was performed in non-displaced, acute fractures and operative treatment was performed in others.
RESULT
Bony union takes average 13.6weeks of all cases and no statistical difference was seen between conservative treatment group(average : 12.7weeks) and operative treatment group(average : 14.1weeks). The complications were seen in 6 cases(24%), which were non-union in one case among the conservative treatment group, and non-union in one case, osteoarthritis in 3 cases and reflex sympathetic dystrophy in one case among the operative treatment group. Satisfactory results were 17(68%) of 25 cases by Maudsley's method. No statistical difference was seen between conservative treatment group(satisfactory results:78%) and operative treatment group(satisfactory results:63%)(p>0.05), but statistical difference was seen between acute fracture group(satisfactory result:81%) and others(satisfactory results:44%)(p<0.05).
CONCLUSION
More satisfactory result was seen in acute fracture group than in subacute and old fracture group, therefore we think early diagnosis has important role in result of treatment of scaphoid fracture. Also we think conservative treatment is preferable to non-displaced, acute fracture and operative treatment is preferable to others.
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