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제한된 관혈적 정복 및 Ilizarov 체외고정기기를 이용한 경골 천정골절의 치료
김부환,임종인,강덕정,임용균,남욱 대한골절학회 1998 대한골절학회지 Vol.11 No.4
The authors retrospectively reviewed 22 pilon fractures in 22 patients treated with limited ORIF with external fixation by Ilizarov method. Clinical follow up averaged 28 months (range, 16-45 months). Interfragmental screw fixation of key fragments were done in fifteen cases and bone-grafting was done in thirteen cases. The average duration of external fixation was fourteen weeks. All of the fractures healed (one after delayed bone-grafting). The subjective and objective results were classified according to Ovadia and Beals. Sixteen patients (72%) had good and excellent results at final follow up. On the basis of these early results, the prevalence of complications associated with pilon fractures and their treatments can be decreased by external fixation of Ilizarov method and limited internal fixation. We conclude that this method is good treatment modality on tibial pilon frature.
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국소마취하에서 cannulated screw를 이용한 견봉쇄골관절 탈구의 치료
김부환,임종인,강덕정 대한골절학회 1996 대한골절학회지 Vol.9 No.1
In 1941, Bosworth used noncannulated coracoclavicular lag screw to treat acute A-C joint dislocation. In 1989, Tsou fixed coracoclavicular joint with percutaneous cannulated screw under general anesthesia in the treatment of acute A-C joint complete dislocations. We tried to treat 10 cases of acute A-C joint dislocations with cannulated screw fixation of C-C joint under local anesthesia, so we report the results with review of literatures. The results were as follows 1. Results of treatment were good in 7 cases, fair in 2 cases, and poor in 1 case by Weaver and Dunn evaluation criteria. 2. The operations were done under local anesthesia, but in two cases operation ended under general anesthesia due to discomfort of the patients. 3. In skeletally thin patient, it was very difficult to make accurate hole and we experienced an iatrogenic fracture of clavicle and coracoid process. This technique is not recommendable in skeletally thin patient. 4. Operation took 42 minutes on average(from 30 minutes to 105 minutes) though it took more time in the early cases. 5. We had several complications in 3 patients. Misdirection of screw(1 case), screw loosening and pull out(1 case), subluxation of A-C joint after removal of screw(2 cases), and iatrogenic fracture of clavicle and coracoid process(1 case) but no case of metal breakage or infection.
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Miniplate 및 Miniscrew를 이용한 수부골절의 치료
김부환,임종인,강덕정 대한골절학회 1997 대한골절학회지 Vol.10 No.1
The functional end result is more important than fracture healing in the hand fracture treatment. Accurate open reduction and internal fixation with miniplate and miniscrew for metacarpal and phalangeal fractures of hand provides firm fixation and allows early postoperative mobilization which reduce the incidence of joint stiffness and tendon adhesion. The authors have reviewed l7 cases of metacarpal and phalangeal fractures of the hand in 13 patients which were treated with miniplate and miniscrew fixations in the department of orthopaedic surgery, Dae Dong General Hospital from Mar. l994 to Feb. 1996. The following results were obtained. 1. The firm fixation allowed range-of-motion exercises in most patients between 3 - l4 days. 2. The roentgenographic union was obtained within 14.8 weeks in average. 3. The mean TAM(total active motion) range at last follow up was 247° in the metacarpal fracture and 226° in the phalangeal fracture. 4. The complications(tendon adhesion & loss of reduction) occurred in 2 cases (11.8%). In conclusion, fixation with miniplate and miniscrew for metacarpal and phalangeal fractures of the hand is considered to be an effective method in the treatment of metacarpal & phalangeal fractures.
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역도경기중 발생한 양측 상완골 내상과 골절 치험 1례 : A Case Report
김부환,임종인,강덕정 대한스포츠의학회 1997 대한스포츠의학회지 Vol.15 No.1
Fracture of medial epicondyle of humerus constitutes approximately 10% of all elbow injuries in children. The mechanism of injury is usually a valgus stress of the joint, which produces traction on the medical epicondyle flexor muscles. We experienced fixation yielded excellent result.
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