Search Results

1.Treatment for the Femoral Shaft Fractures in Adolescents.

Hyoun Oh CHO ; Kyung Duk KWAK ; Sung Do CHO ; Il Jong YANG

The Journal of the Korean Orthopaedic Association 1997;32(2):376-383

Treatment for the femoral shaft fractures in adolescents is somewhat controversial. These fractures have been treated nonoperatively, but adolescents tolerate prolonged immobilization less well than younger children and conservative treatment in this age group may result in more complicationssuch as malunion, shortening and angular deformities more often than those in the younger age group. Recently there has been a tendency to choose the operative method rather than traditional traction and casting technique for femoral shaft fractures in elderly children and adolescent The purpose of this study is to find better treatment for the femoral shaft fractures in adolescents. Fifty six femoral shaft fractures in 56 patients aged 10 to 14 years old were treated with traction followed by casting, open reduction and internal fixation with plate, closed intramedullary nailing, or external fixation using A-0 external fixator, and evaluated respectively for at least 1 year. External fixation may be benefit to patients with concomittant injuries and result in psychological settle down, early mobilization out of bed, short hospital stay, save of cost,and early return to daily living activities without any disadvantages such as malunion, leg length discrepancy or awareness of growing arrest in spite of negligible pin tract infection. Result of this study suggests that external fixation for the femoral shaft fractures may be an one of the attractive treatment option in adolescents.
Activities of Daily Living ; Adolescent* ; Aged ; Child ; Congenital Abnormalities ; Early Ambulation ; External Fixators ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Leg ; Length of Stay ; Traction

Although there are various methods of operative treatment for hony mallet finger, the operative technique is not so easy and complications such as joint stiffness, sott tissue prohlems, infection, change of nail shape and arthrosis are common. The authors performed operations for 26 cases of hony mallet fingers, fixing the hony frapment by Kirschner wire, pull-out wire suture and miniscrew respectively, from Jan. l988 to Jun. l996. The results were as follows. l. According to Niechajev's classification. there were 3 cases of type B, 7 cases of type C, l4 cases of type D, and 2 cases of type E. And 11 cases were accompanied hy crushing injury. 2. Involved fingers were third finger in 11cases, fit'th finger in 7 cases, fourth finger in 5 cases, second finger in 2 cases. and thumb in I case. 3. The hony mallet finger was caused hy occupational injury in l6 cases, direct blow in 7 cases and sports injury in 3 cases. 4. The fractured fragment was fixed hy Kirschner wire in 9 cases, by pull-out suture in 9 cases and by miniscrew in 8 cases. 5. The results were evaluated hy Kanies scale. Sixteen cases had satisfactory results. Seven cases (87.5%) were satisfactory in miniscrew fixations. 5 cascs (55.6%) in pull-out wire suture methocls and 2 cases (22.2%) in Kirschner wire tixations. 6. The complications were joint incongruity in 4 cases, dorsal prominece in 6 cases, painful limitation of motion in 2 cases which were treated by arthrodesis, pin site infection in 2 cases and hreakage of wire suture in 1 case. 7. The miniscrew fixation offered relatively firm fixation, low complication rate, and good results. so it can be considered as one of the good methods of treatment for hony mallet finger.
Arthrodesis ; Athletic Injuries ; Classification ; Fingers* ; Joints ; Occupational Injuries ; Sutures ; Thumb