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경골과 골절의 치료방법에 따른 방사선적 및 기능적 결과의 비교
김승희,최창혁,한수일 대한골절학회 1996 대한골절학회지 Vol.9 No.4
The aim of treating a tibial plateau fracture is to gain a stable, pain free knee motion. and to repair all associated lesion. Recently a preferred treatment is the open reduction and intern fixation of all displaced and unstable tibial plateau fracture in order to gain anatomic reduction and early knee motion. But functional recovery is relatively impaired in complex knee trauma, despite various treatment modalities. Observations based an long-term radiologicexaminations frequently did not correlate with the functional end results. When choosing the treatment modalities. there are many factors to consider which will influence the final results. Forty-seven cases of tibial plateau fractures were treated from August l988 to March l995 and the average follow up period was forty-eight months. The results were as follows: 1. Of the 47 patients, there were 34 male and 13 female patients, and the mean age was 49 years. 2. Causes of injury were: traffic accidents (36 cases), falling down (7 cases), crushing injury (1 case]. and others (3 cases), and the left side was more predominant (28 cases) than the right side (19. cases). 3. Treatment modalities were: conservative treatment ( l6 cases), Ilizarov external fixators (8 cases), tibial bolt ( 11 cases) and screw & wire ( l 2 cases). 4. The range of motion of the knee joint averaged 116 degre's and the average start time of the range of motion execise was 7.8 weeks. In the good to excellent clinical end results groups, there were meaningful statistical differences. 5. There were staiscal differences between type l(88%). II(80%) fractures and type IV(56%), VI(33%) fractures for de clinical end results. 6. We gained better results after treatment of closed fracture and isolated injury cases than open fracture or associated injury cases. but them were no statistical differences. 7. There were no statistical differences on treatment modalities.
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Salter-Harris 제 2 형 대퇴 원위부 성장판 손상에 대한 임상적 고찰
박병철,김익동,김풍택,유영구,한수일 대한골절학회 1990 대한골절학회지 Vol.3 No.2
Although most of distal femoral epiphyseal fracture is Salter-Harris type II, its prognosis is not uniformly good and poses several problems such as limb length discrepancy, varus or valgus angulation and limitation of knee motion. Authors experienced 9 cases of Salter-Harris type II distal femoral epiphyseal injuries who were treated at Kyoungpook National University Hospital from January, 1982 to June, 1987, All were followed for an average of two years and ten months (range, one to seven years) and analysed clinically. The results abtained were as follows. 1. 5 out of 9 cases were between 16 and 18 years of age. 2. Significant limb length discrepancy beyond 2cm occurred in only 1 case, lengthening of 0.6cm in 2 cases and less than 1.0cm shortening in 6 cases. 3. Valgus angulation of 10 degrees or less occurred in 5 cases and 20 degrees of valgus deformity in 1 case, Varus angulation of 5 degrees or less occurred in 2 cases and of 6 degrees in 1 case. 4. Limitation of knee motion was not observed in all cases. 5. Salter-Harris type II epiphyseal plate injuries does not always carry a good prognosis especially when involving the distal femoral epiphysis, It can bring about growth acceleration or deceleration and angular deformity. Early and annual folow-up until cessation of growth is mandatory.
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이상욱,김신근,최창혁,한수일,강창진,권�傷 대한골절학회 1997 대한골절학회지 Vol.10 No.1
The treatment of the fracture of the distal humerus has remained one of the most difficult of all fractures to manage. The goal of treatment, which is the same for other intraarticular fractures, is to reestablish articular congruity, rigid fixation and early active motion as soon as possible. It appears that the use of plates is currently the most acceptable method of fixation. The aim of this study is to clarify the correlation between various fixation methods and functional end results, in order to help in choosing treatment modalities. We reviewed 11 cases of the fractures of the distal humerus treated surgically in Orthopaedic Department of Taegu Hyosung University Hospital between l992 and 1995. Clinical end results were as follows: l. Of the 11 cases, there was 6 males and 5 females. Age was from 13years old to 83years old and mean age was 46years old. 2. Muller classification consisted of 4 cases of A2. 1 case of B2, 3 cases of C1 and 3 cases of C2. The mean length of follow up was l5 months. Except for 2 cases of open wound and nonunion, time from injury to surgery was 8 days. Mean period of initial exercise was 4 weeks. 3. All surgical incisions were done with posterior approach; they consisted of 5 cases of dualcontoured plates, 4 cases of plate with screw and 2 cases of K-wires with screw. 4. Mean range of elbow motion was flexion 123' and extension defect 14°. There was no limition of pronation and supination compared with the normal side. 5. The functional result by Jupiter criteria was excellent in 5 cases, good in 4 cases, fair in 1 case and poor in 1 case. 6. There were complications in 1 case of plate broken and 1 case of nonunion. 7. In the distal fracture of the humerus, There were 82% of excellent or good result by over-all functional result of Jupiter.
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