Avulsion of triceps tendon from the olecranon is a rare injury. Since the first report of Partridge in 1968, fewer than 30 instances have been recorded in the English literature. The authors have experienced a case of the avulsion of the triceps tendon in 25 year-old male which was caused by a accidental fall from one meter height. The surgical treatment, the use of heavy wire sutures passed through the tendon and through holes drilled in the olecranon, produced successful results in two and half years follow-up period.
Accidental Falls ; Follow-Up Studies ; Humans ; Male ; Olecranon Process ; Sutures ; Tendons

Dislocation of talonavicular joint is a very rare injury and frequently misdiagnosed. We had treated an above injury with closed reduction and short leg cast followed by good result in 15 months follow-up.
Dislocations ; Follow-Up Studies ; Joints ; Leg

Ipsilateral fracture of the femur and tibia is also called “floating knee”. And it is well known that its treatment is difficult and functional result is poor in most cases because it has often comminuted, open fracture with severe soft tissue injuries. Authors reviewed 20 cases in 18 patients which were treated from September 1989 to March 1993. All were followed for more than one year. The results were as follows: 1. Among 20 cases of femoral fracture, 15 cases were treated with internal fixation and others with external fixation and among 18 cases of tibial fracture(2 amputations excluded), internal and external fixation were equal in number. 2. The bony union time was shorter in the intramedullary nailing than the plate and screws, and external fixations. 3. The end result was better in Group I(internal fixation for both fracture) than Group II (one or both fractures were treated with external fixator) because the femur had less severe comminution, and soft tissue injuries. 4. There were many complications in Group II than Group I, That is, wound infections, delayed union or non-unions. There were 11 operations for the treatment of complications,.
Amputation ; Clinical Study ; Femoral Fractures ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Open ; Humans ; Soft Tissue Injuries ; Tibia ; Wound Infection

Most fractures of the proximal humerus are managed well to simple conservative treatment. But open reduction and interhal fixation of the fragment is definitely indicated in certain types of displaced fractures. Thirty eight cases of fractures of the proximal humerus which were treated at Inje Medical College from January 1980 to December 1985 were analyzed both clinically and radiologically accordingto Neer's classification and the following results were obtained. l. Among the 38 patients, the ratio of male and female was 2.2:1 and the highest incidence was in the fifth decades. 2. The main cause of fracture was traffic accident, 20 cases (52. 6%) and the the next one was falling from a height. 3. According to the classification of Neer, one part acture(52.6%) was the most common type. 4. The common associated injuries were fracture of the lower extremities and forearms. 5. Thirty two cases(84.2%) were treated by conservative treatment and six cases by operative treatment. 6. Thirty eight cases were followed form 6 months to 5 years and 6 months, average 14.3 months, and the results were analyzed according to Neers criteria and 26 cases (68. 6%) showed excellent results. 7. Two cases of limitation of shoulder motion were observed as a complication and one cases of paralysis of deltoid muscle by axillary nerve injury was observed. Excellent functional result could be obtained by a simple external support with early motion in a minimal displacement of proximal humeral fracture. Satisfactory functional result could be obtained by a open reduction and internal fixation with early motion in a severely displaced fracture. But long term immobilization of shoulder could have a poor functional result.
Accidental Falls ; Accidents, Traffic ; Classification ; Clinical Study ; Deltoid Muscle ; Female ; Forearm ; Humans ; Humerus ; Immobilization ; Incidence ; Lower Extremity ; Male ; Paralysis ; Shoulder ; Shoulder Fractures

With the expending use of sublaminar segmental instrumentation, various complication, including paraplegia, paresis, dysesthesia and dural tears, have been reported. These findings suggest that the displacement of sublaminar wires toward the spinal eord during extraction followed by spinal cord damage. The cut surface of Luque sublaminar wire is sharp and has a barb and it may cause damage to the spinal cord. The cut end of Luque wire was inserted into the Intracath (a kind of angiocatheter) 16 gauge and pulled parallel to the lamina. And we found the Intracath followed by Lugue wire in the operating field. Lateral view of spine roentgenogram revealed that the radioopaque Intracath was passed under the lamina in 3 mm in depth. When the Luque wire is removed with inserting into the Intracath 16 gauge and pulled parallel to the lamina, the dura can be protected by the cut end of Luque wire.
Paraplegia ; Paresis ; Paresthesia ; Spinal Cord ; Spine ; Tears

We have experienced 52 intra-articular fractures(24 malleolar, 17 patellar, 11 olecranon) treated with tension band wiring from 1972 to 1981 and the results are as followings; 1. The operative technique is relatively simple and easy. 2. In avulsion fractures without communition, anatomical reduction and rigid internal fixation can be achieved. 3. In comminuted fractures, the fragments can be securely fixed with a few additional K-wires including tension band wiring. 4. In avulsion fractures, where the fragment is either too small for screw fixation or too osteoporotic a tension band wiring can be applied with no difficulty. 5. Early joint motion reduces the functional disability and promote the fracture healing.
Fracture Healing ; Fractures, Comminuted ; Joints ; Olecranon Process

It is generally accepted that trochanteric fractures are best treated by internal fixation as it provide satisfactory reduction and fixation of the fractures allowing early mobilization of the patient thus avoiding general and local complication following this sort of trauma. Fourty-seven cases of trochanteric fracture of the femur were treated at the Department of Orthopedic Surgery, Paik Hospital, Seoul, Inje Medical College from June 1974 to June 1982 and clinical analysis was made with particular emphasis on the comparision between compression hip screw fixation and Jewett nail technique. The result of the analysis are as follows: l. 63% of the male patient belongs to active age group in contrary to common belief in age incidence and the common causes of the injury was traffic accidents and fall from height. 2. By the Tronzo classification of the intertrochanteric fracture, the most common type is type III and type V was predomonant in the traffic accidents group and 87% of all cases belongs to unstable category. 3. Of the seventeen associated injuries, visceral injuries, fracture of the lower extremities, fractures of the upper extremities, fractures of the pelvis were observed in order of frequency. 4. More general complications were observed among the conservatively treated group and local complications occurred mainly in the group treated with Jewett naiL 5. The compression hip screw method seemed to be superior to Jewett nail owi#ng to shorter operation time, less blood loss and less complications. 6. Ender nail appears to be a promising method of treatment in the elderly patient because it had shorter operation time, negligible blood loss, minimal stress to the patient and early mobilization and weight bearing.
Accidents, Traffic ; Aged ; Classification ; Clinical Study ; Early Ambulation ; Femur ; Hip ; Hip Fractures ; Humans ; Incidence ; Lower Extremity ; Male ; Methods ; Orthopedics ; Pelvis ; Seoul ; Upper Extremity ; Weight-Bearing

The tibial plafond fractures result from an axial compression snd rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displscement. It is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws. Basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The suthor analysed the 20 cases of the tibial plafond frsctures in 17 patients, which were trested at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from Jsnuary 1983 to March 1987. The longest durstion of followup was 2 years and 4 months and shortest one was 6 months, and the aversge was one year. The results were as follows : 1. Among the 17 patients, male were 16 and female was one. 2. The major causes of injury were a fall from a height. 3. The most frequent type of fracture was type C by Ruedi and Allgower classification. 4. Regardless of the method of trestment the type A and B were in good and fair result, but the type C were fair in 4 cases and poor in 8 cases. There were 7 cases of snkle fusion in poor group. 5. It is important to remind the basic steps in reconstruction and applied in sn individual csse especially in type C. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, esrly motion of the ankle joint is made possible. This early motion reduces stiffness of the ankle and win yeild the most sstisfying result. But the anatomic reduction of ank1 joint is difficult to be obtained in each case especially in type C and may consider an ankle fusion.
Ankle ; Ankle Joint ; Bone Transplantation ; Classification ; Clinical Study ; Female ; Fibula ; Follow-Up Studies ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Tibia

We have recently experienced a rare case of abdominal aortic injury caused by shearing force falling from 8 meter height in upright position. The patient was 43 year old and sustained Ll, L2, L5, compression fractures and both distal tibia and fibula comminuted fractures involving ankle joints. 2 years and 2 months later, marked stenosis of the distal abdominal aorta was found together with clinical manifestations of ischemia of both legs. Aorto-femoral bypass on both sides has completely relieved the symptoms.
Accidental Falls ; Ankle Joint ; Aorta, Abdominal ; Constriction, Pathologic ; Fibula ; Fractures, Comminuted ; Fractures, Compression ; Humans ; Ischemia ; Leg ; Tibia

The fractures of the distal femur are difficult to treat due to its severity of injuries and various complications. Recently, the complications including nonunion, delayed union and joint stiffness have decreased with development of new fixation device, technics and encouraging the early joint motion. We studied 50 cases of fractures treated at our hospital from January, 1980 to July, 1988 and the results obtained from this study were as follows:1. The age distribution was between 11 and 77 year-old, and the 3rd. 4th. decades were 64 % of total patients. 2. The most common cause of injuries was traffic accident(62%), and the open fractures were more common than the fractures of other reports(48%). 3. The types of fracture were unicondylar(21 cases), simple supracondylar(8), and intercondylar (21), according to Chiron's classification, and the intercondylar fractures were subdivided into type I (2 cases), type II A(6), type II B(10) and type III (3) by Neer's. 4. Among the 50 cases, the conservative treatments were done in 19 cases and the surgical one in 31 cases. The conservative treatments were done for undisplaced or minimal displsced fractures and the cases whose general conditions were so poor that operation were impossible. 5. In surgical treatments, the open reduction and the internal fixation(25 cases), the externsl fixation(4), the knee fusion(1) and the A-K amputation(1) were done. 6. The postoperative complications were joint stiffness(11 cases), malunion(3), delayed union(3) and infection(3). 7. The satisfactory results could be obtained by the open reduction and rigid internal fixation followed by early continous passive motion exercise of knee joint.
Age Distribution ; Classification ; Clinical Study ; Femur ; Fractures, Open ; Humans ; Joints ; Knee ; Knee Joint ; Postoperative Complications