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권칠수,김용옥,정병현,공경석 대한골절학회 1995 대한골절학회지 Vol.8 No.1
There are many difficult problems in the treatment of infected nonunions of the femur, e.g, eradication of infection and osseous union even in the presence of devastating infection. To solve these difficult problems, various methods were tried including thorugh debridement and rigid internal fixation or external fixation, and bone graft. Recently, large bone defect due to resection of infected bone was treated excellently using Ilizamv extemal fixator. Authors treated 13 cases of infected nonunions of femur with Ilizamv extemal fixator from september 1989 to July 1994. The results were as follows. 1. Among 13 cases of infected nonunion of femoral fracture, 1 case was treated with intemal fixation and others with external fixation, and obtaned bone union in all cases. 2. Mean number of previous surgery in other hospital was 3.2(1-5) times and mean number of surgery in our hospital was 2.5(1-5) times. 3. Lengthening(including length of internal bone transport) was performed from 2.5cm to 22cm. 4. Duration of treatment was from 4 months to 27 months(Mean: 11 months). In conclusion, infected femoral nonunion in very selective cases could be treated with retention of internal fixation (Exchange of nail, or plate and screws). But converison to external fixator should be well prepared in most cases. Infected nonunion could be managed in staged surgery with use of modular extemal fixator like Ilizamv external fixator. Management of infection, malposition, and shortening could be controlled more safely and more definitely with the ring external fixator.
권칠수,성열보,황선영,안종국,김진혁 대한골절학회 1997 대한골절학회지 Vol.10 No.2
Dislocation of metatarsophalangeal joints of foot is rare. The mechanism of dislocation is severe hyperextension, the dislocation being dorsal type. The dislocation may be irreducible. Dislocation of the lesser metatarsophalangeal joints is usually dorsolateral and occurs as a result of extreme medial or lateral displacement of a digit on the metatarsal head. Closed reduction is impossible because of interposion of the soft tissue. The metatarsophalangeal joints were exposed by making a dorsal longitudinul incision. The fibrocartilaginous plate on the plantar surface and dosol capsule and deep transverse metatarsal ligament on the dorsal surface were found to be interposed between teh metatarsal head and base of proximal phalanges. The flexor tendon and lumbrical tendon were found in the lateral and medial side of the metatarsal neck. We experienced a case of dorsal dislocation of 2nd, 3rd and 4th metatarsophalangeal joint in a 23 years old man who was injured autocycle accident. Closed reduction failed and open reduction via dorsal longitudinal approach revealed button-holing of the metatarsal head, which had made closed reduction impossble. Concerning about the rarity and anatomical characteristic of these injuries, we report this case with reviewing of the literatures.