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한수홍,차윤식,송원태 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.4
techBackground:To evaluate the efficacy of intramedullary K-wire fixation and interosseous wiring in the arthrodesis of the distal interphalangeal (DIP) joint with description of surgical procedure. Methods: We retrospectively analyzed 9 cases (7 women and 2 men) of DIP joint arthrodesis. The average age of patients was 44.2 years (range, 21 to 71 years) and the mean follow-up period was 19.6 months. Joint union was evaluated on the follow-up radiographs together with postoperative complications. Results: All cases achieved radiologic union of the arthrodesis site. There was no surgical complication except for one case of skin irritation by the interosseous wire knot which was removed during the follow-up period. Conclusions: Intramedullary K-wire fixation and interosseous wiring could be an alternative procedure of arthrodesis in the DIP joint.
상완골 원위 골절에서 주두 절골 시사전 천공 후 유관나사못 및 강선 고정
한수홍 ( Soo Hong Han ),이호재 ( Ho Jae Lee ),김우현 ( Woo Hyun Kim ),조용길 ( Yong Gil Jo ),송원태 ( Won Tae Song ) 대한골절학회 2015 대한골절학회지 Vol.28 No.2
Purpose: The olecranon osteotomy in intra-articular comminuted distal humerus fractures is a suggested technique for excellent exposure of articular fractures. However, complications including delayed union, nonunion of osteotomy site have been reported. Authors have applied predrilling for cannulated screw before osteotomy for achievement of rapid and accurate reposition of separation part and added wire fixation for secure stability. The purpose of this study is to evaluate the efficacy of this fixation procedure following the olecranon osteotomy during the internal fixation of intra-articular fracture of the distal humerus. Materials and Methods: This study retrospectively analyzed 14 cases (9 women and 5 men) of intra-articular distal humerus fractures in which the olecranon osteotomy was applied. The mean age of patients was 53.4 years (range, 25 to 83 years), and the average follow-up period was 15.9 months. Eleven cases were classified as AO 13-C3, and the other 3 cases were AO 13-C2. Reduction accuracy, union period of osteotomy site on follow-up radiographs and postoperative complications related to olecranon osteotomy were evaluated. Results: All osteotomized parts showed no position change and solid union with normal alignment at the last follow-up. The mean period of bony union was 3.5 months (range, 2 to 5 months). There were no complications related to olecranon osteotomy except one case of non-displaced fracture of the proximal ulnar shaft at the level of cannulated screw tip caused by forceful passive physical therapy. It was managed by conservative treatment without further problem. Conclusion: Predrilled cannulated screw and wire fixation following the olecranon osteotomy during internal fixation of intra- articular comminuted distal humerus fractures showed satisfactory results in the union of osteotomy site and it could be a recommendable procedure when fractures require olecranon osteotomy.