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        대퇴골 과상부 및 과간 골절 불유합의 치료

        이성종,이석하,이동기,유연식,심재익,김택선,이덕용,이은노,김윤엽 대한골절학회 1999 대한골절학회지 Vol.12 No.4

        The femoral supracondylar and intercondylar fractures are difficult to be treated due to severe soft tissue damage, comminution, intraarticular extension of fracture and injury to the quadriceps mechanism frequently. The causes of nonunion are inadequate anatomical reduction, fixation failure, bone defect and infection occasionally, which is difficult to be treated. The authors analyzed 16 cases with nonunion of femoral supracondylar and intercondylar fracture who had been treated surgically from January 1990 to December 1997. According to AO/ASIF classification in the initial fracture patterns, type A were 8 cases, type B was 1 case and type C were 7 cases. The duration between initial treatment and surgical treatment of nonunion was 6 months in average. The causes of nonunion were fixation failure due to inadequate device selection in 9 cases, inadequate anatomical reduction or surgical technique in 4 cases and infection in 3 cases. The treatments were internal fixation with Dynamic condylar screw(DCS) in 9 cases, internal fixation with condylar blade plate in 4 cases, monofocal lenghtening with Ilizarov in 1 case and bifocal lenghtening with Ilizarov in 2 cases. According to Schatzker classification, the good result was obtained in 11 cases(68.8%). The complications were 3 knee joint ankyloses, 2 superficial wound infections, 1 delayed union and 1 deep vein thrombosis. In conclusion, the requirement for the good result in treatment of nonunion are exact anatomical reduction, rigid fixation and autogenous bone graft.

      • KCI등재

        소아 상완골 외과 골절의 치료

        이성종,이석하,이동기,성낙훈,김택선,심재익,이덕용,유연식,이은노 대한골절학회 1999 대한골절학회지 Vol.12 No.3

        The authors analysed the 40 patients of the lateral condyle fracture of the humerus in children who were admitted in Korea Veterans Hospital in Seoul from Jan. 1990 to Dec. 1997. The fracture type and the displacement was classified according to Milch type and Jakob stage. Clinical analysis was performed on 40 patients with lateral condyle fracture of humerus, who could be followed up. The patients were followed up from 12 months to 63 months with an average of 23' months. Average duration of bone union was 6 weeks after operation. The significant differences in outcome were notified from open reduction and internal fixation in comparison to closed reduction and percutaneous pinning. According to the criteria of Hardacre, we obtained excellent result in 16 cases(40%), good result in 22 cases(55%) and poor results in 2 cases(5%).

      • KCI등재

        장기간 간과된 슬개골 골절 불유합의 치료 - 4례 보고 -

        이성종,이석하,이동기,김택선,심재익,이덕용,유연식,이은노,조홍만 대한골절학회 1999 대한골절학회지 Vol.12 No.3

        Non-union of patella fracture was rare reported. We reported our experience with four cases of non-union of patella fracture treated by surgical intervention. Surgical management by skeletal traction and tension band wiring achieved union of the fracture in all four cases. The patients also recovered an excellent range of movement and strength in the affected knees.

      • KCI등재

        골수강내 금속정을 이용한 경골 원위 1/3 골절의 치료

        이성종,이석하,김택선,심재익,유창무,이은노 대한골절학회 1995 대한골절학회지 Vol.8 No.2

        Recently, there is seen frequently the tibial fracture due to the increased traffic accident and the high energy trauma, and this fracture has many problems in a treatment because of nonunion, malunion, angular deformity, shortening and infection. In the treatment of distal 1/3 fracture of tibia, interlocking intramedullary nailing has been popularized because it enables preservation of the range of motion of the joint, early weight bearing and early bony union. Between Jan. 1988 and Dec. 1993 intramedullary nailing of the tibial fracture has been perfomed in 4lcases, of which 38 cases were acute fractures and 3 cases were nonunion with folow up of more than one year. The results were as follows; 1. Closed nailing technique was accomplished in 38 cases and 3 were opened. 2. The mean fracture healing period was 18.6 weeks and each mean fracture healing time was 19 weeks in Brooker nail and 18.5 weeks in interlocking nail, and so there was no signiticant difference in bone union time between two devices. 3. According to the functional classification of Klemm and Borner, out of 41 cases, 26 were excellent, 8 were good, 5 were fair and 2 were poor. 4. The complications were infection in 4 cases, delayed union in 2 cases, angular deformity in 1 case and partial ankylosis of knee in 1 case. 5. In the cases associated with soft tissue injury and comminuted fracture of distal I/3 of lower leg, Brooker nail was considered an useful treatment when distal interlocking screw fixation was not appropriate.

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