From January 1979 to December 1983, eighty-five patients who had forearm bone fracture were treated by four different methods at the Department of Orthopedic Surgery, Chosun University Hospital. The results were as follows: 1. Among 85 patients, 12 patients were radius fractures, 19 patients were ulna fractures, 54 patients were both forearm bone fractures. 2. Closed fractures were 70 patients and the open fractures were 15 patients. 3. The mst common fracture site was middle third of the both radius and ulna. 4. The treatments were closed reduction with cast immobilization, intramedullary nailing or plate and screw fixation. 5. The time required for radiological bone union were shorter in compression plate fixation gmup, than those treated with other fixation device. 6. Functional result was claasified according to the rating system of Smith and Sage. The open reduction and internal fixation group had better results than the conservatively treated group.
Forearm ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Orthopedics ; Radius ; Radius Fractures ; Ulna ; Ulna Fractures

In the workshops where the rorating belts are used belt, injuries frequently occur for lack of a safety device. Those injuries have several characteristics compared with other long bone fractures. Those are mostly multiple open fractures with considerable soft tissue damages, forearm both bones and humerus fractures by bending force and rotational distraction as mechanism of the injury, and sometimes particularly segmental fracture of the radius. From Aug. 1972 to Jan. 1985, we have traced 47patients of multiple fractures of forearm and humerus by belt injuries except 17 patients of solitary fractures of forearm and humerus. 1. This injury is more prevalent in males(M:F=4:1) with the peak incidence between the third and fourth deades(59%). 2. Multiple fractures of forearm and humerus by belt injuries were classified by fracture numbers and mechanism of injury as follows: Type I Fractures of Forearm Both Bones(53.2%). Type II Fractures of Forearm Both Bones and Humerus(27.7%). Type IU Segmental Fracture of Radius and Ulna(10.6%). Type IV Segmental Fracture of Radius, Ulna and Humerus(8.5%). 3. Most were open fractures with soft tissue damages(74%). 4. Nerve paralysis was the most frequent associated injury(27%). 5. All but 7 cases were treated by open reduction. Implants used for internal fixation were compression plates in 20 cases as elective surgery and Rush pins in 15 cases of forearm open fractures as emergency surgery. 6. By Anderson's critcria, satisfactory result(excellent or good) was obtained in 55% of cases.
Education ; Emergencies ; Forearm ; Fractures, Bone ; Fractures, Multiple ; Fractures, Open ; Humans ; Humerus ; Incidence ; Paralysis ; Protective Devices ; Radius ; Ulna

The results of the treatment upon total 132 cases of ankle and foot fractures treated during the period from January 1969 to August 1978 at the Department of Orthopaedic Surgery, National Medical Center have been analysed and reported in this paper. 1. Sex ratio between male and female was 3.7:1. 68 cases (51.5%) cases out of 132 cases were in the age groups of 2nd and 3rd decades. remarkably higher than any other group. 2. 85 cases out of 132 cases were closed fractures and 47 cases were open fractures, but the incidence of the open fracture in higher in the fractures below the metatarsal bones and multiple fractures. 3. 59 cases out of 132 cases were ankle fractures 34 tarsal bone fractures 14 metatarsal bone fractures, 8 phalangeal bone fractures and 20 multiple fractures Accordingly, the incidence of the ankle fracture is higher than other fractures. 4. Ankle fracture was classified in 4 types according to the fracture mechanism (Lauge-Hansen classification). 20 cases out of 59 cases were pronation-abduction type, 15 cases were pronation-external rotation type, 14 cases were supination adduction type and 9 cases were supination-external rotation type. 15 cases out of 59 cases of the ankle fractures were treated by tension band compression internal fixation. The result of this method was much better than other methods. 5. 25 cases out of 35 cases of calcaneal fracture involved subtalar joint according to Rowe classification. 12 cases out of 25 cases of calcaneal fracture involved subtalar joint were Tongue type-C. In the treatment, no relation between restoration tuber angle or Gissane angle and the incidence of complication was obtained. 6. The incidence of the complication, such as secondary oateoarthritis, non union. malunion, occurred higher in the open and multiple fractures than closed and single fractures.
Ankle Fractures ; Ankle ; Classification ; Female ; Foot ; Fractures, Bone ; Fractures, Closed ; Fractures, Multiple ; Fractures, Open ; Humans ; Incidence ; Male ; Metatarsal Bones ; Methods ; Sex Ratio ; Subtalar Joint ; Supination ; Tarsal Bones ; Tongue

Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.
Accidental Falls ; *Bone Wires ; Child ; Fracture Fixation ; Humans ; *Humeral Fractures ; Male ; Multiple Trauma ; Radiography ; *Radius Fractures ; *Upper Extremity/diagnostic imaging/injuries/surgery

Forearm bone fracture is a common injury in childhood. But there are many difficult problem to solve in treatment of the forearm bone fractures which are not encountered in the treatment of fracture of the other long bone. Forearm bone fracture in children differ from those in adult in a number of ways. The rapidity of healing, fuctional recovery together with the frequency of delayed or nonunion consitute the main features. More interesting, a deformity resulting from malunion may correct as bone growth proceeds. From August, 1973 to July, 1983, we have reviewed 66 cases of forearm bone fractures under 14 year old and which were treated in the Department of Orthopedic Surgery, Hanyang University Hospital. The results were as follows:1. 56 cases(84.8%) were male and most cases occured in school age. 2. 40 cases(60.7%) were both forearm bone fractures and most common site of the fracture was the distal 1/3. 3. The most common cause of the fractures was falling from height. Simple fracture was most common and greenstick fracture was next. Closed fractures were 61 cases (92.4%) and open fractures were 5 cases (7.6%) . 4. In roentgenologically, the younger the child was, the more rapid the duration of bone union was. Average duration of roentgenological union in conservative group was 8. 1 weeks, and that in operative group was 10. 1 weeks. So conservative group was more rapid in roentgenological bone union than operative group. 5. Accarding to the follow study of remodelling, the young the child and the nearer the fracture line was to the epiphyseal plate, the greater the potentialities for spontaneous correction were. 6. 62 cases (94.0%) showed excellent fuctionat result. According to 4 cases (6.0%) which showed good fuctional result, posterior angulation 17 degree, anterior angulation 15 degree and medial angulation 17 degree after reduction became more than 10 degree after remodelling.
Accidental Falls ; Adult ; Bone Development ; Child ; Clinical Study ; Congenital Abnormalities ; Forearm ; Fractures, Bone ; Fractures, Closed ; Fractures, Open ; Growth Plate ; Humans ; Male ; Orthopedics ; Radius ; Ulna

OBJECTIVETo study the mechanical properties and the clinical results of minimum-contact plate in the treatment of fractures.

METHODSFour-point bending and torsion tests were conducted to compare the new minimum contact plate (MCP) with dynamic compression plate (DCP) and limited contact dynamic compression plate (LC-DCP). The fracture healing time and growth of bony callus were observed in 29 cases of long bone fracture fixed with MCP to evaluate the advantages of this kind of plate.

RESULTSThe 29 patients who underwent MCP were followed up from 6 to 14 months. The average healing time for femoral, tibial and humeral fractures was 12, 13 and 10 weeks, respectively. All fractures were healed. No displacement of fracture, screw pullout, deformation or break of the plate were found.

CONCLUSIONSThe bending stiffness of MCP is significantly greater than that of DCP and LC-DCP (P<0.05). MCP can protect the periosteal blood supply against avascular osseous necrosis and accelerate bone healing. It is a kind of reliable and effective plate in treatment of fractures.

Adolescent ; Adult ; Aged ; Biomechanical Phenomena ; Bone Plates ; Child ; Female ; Femoral Fractures ; physiopathology ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Fracture Healing ; Fractures, Closed ; physiopathology ; surgery ; Fractures, Open ; physiopathology ; surgery ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Tibial Fractures ; physiopathology ; surgery ; Torsion Abnormality ; Treatment Outcome

PURPOSE: We reviewed the functional and radiological results of unstable intraarticular fractures of the distal radius treated by percutaneous pinning with an external fixator. MATERIALS AND METHODS: Twenty-seven cases of unstable intraarticular fractures of the distal radius were treated by percutaneous pinning and external fixation between October 1996 and September 1999, and followed up for more than 1 year. We classified them using the Frykman classification and evaluated functional and radiological results according to the subjective point system of Cole & Obletz and the objective evaluation by Scheck. RESULTS: Subjectively, we obtained the following results: excellent in 7 cases, good in 13 cases, fair in 6 cases and poor in 1 case, and objectively, 8 cases were excellent, 14 cases were good, 4 cases were fair and 1 case was poor. Radiographically, mean volar tilt, radial inclination and radial length were 9.5degrees, 22.1degrees and 10.3 mm respectively on the last follow-up. Two cases of reflex sympathetic dystrophy and one of each of skin necrosis, pin tract infection, joint stiffness and metacarpal bone fracture occurred during the follow-up period. CONCLUSION: Percutaneous pinning and external fixation is a useful method for reducing mal-alignment and radial length maintenance, preventing reduction loss and restoring the articular surface and function of the distal radius in cases of intraarticular comminution, open fracture with soft tissue injury and multiple injury.
Classification ; External Fixators* ; Follow-Up Studies ; Fractures, Bone ; Fractures, Open ; Intra-Articular Fractures* ; Joints ; Multiple Trauma ; Necrosis ; Radius* ; Reflex Sympathetic Dystrophy ; Skin ; Soft Tissue Injuries

In this report, we describe an extremely unusual Monteggia equivalent type 1 lesion in a 10-year-old boy following a fall from a height of 1 m. On the plain radiographs, our patient had a particular Monteggia equivalent type 1 injury associating a posterior elbow dislocation with diaphyseal radius and ulna fractures. The patient was treated by closed reduction technique. At six months of follow-up, the fractures were consolidated and the elbow was stable. To our knowledge, only 8 adult cases and one paediatric observation with similar lesions had been reported through medical literature. Therefore, the aim of our case report is to remind this rare entity and also to provide a comprehensive review of the literature related to this uncommon lesion.
Child ; Closed Fracture Reduction ; methods ; Elbow Joint ; injuries ; Humans ; Joint Dislocations ; surgery ; Male ; Monteggia's Fracture ; surgery ; Radius Fractures ; surgery

BACKGROUND: The number of facial bone fractures are steadily increasing because of increment of traffic volume and expansion of social activity. Also the forms of the fractures show to be more complicated due to increase of traffic vehicles. Facial region has an important role in human aesthetic and functional aspects. Therefore, it it very important to diagnose accurately and treat promptly and appropriately the fracture, to minimize deformity and functional disturbance in the face and enable the patient to socialize normally. OBJECTIVE: Our objective of this study is to elucidate general characteristics of clinical aspect in the facial bone fractures by analyzing the cases with facial bone fractures who diagnosed and treated at Nam Kwang Hospital for recent 2 years. MATERIALS AND METHODS: The authors reviewed retrospectively the medical records of 115 patients among 200 patients with facial bone fractures, excluding 85 patients who had only nasal bone fractures, diagnosed and treated at Nam Kwang Hospital from Jan. 1995 to Dec. 1996. The records of the cases were examined and analyzed according to sex and age distribution, cause of injury, symptoms and signs, associated injuries, frequency and treatment modality in each region, and complications. Results and CONCLUSIONS: The results were as follows; 1) Ninty cases(78.3%) were male and the peak age group was third decade(33.0%). 2) The most common cause of injury was motor vehicle accident(53.0%). 3) The most common symptoms and signs were pain, tenderness and edema(100%). 4) The most common associated injury was soft tissue injury(58.3%). 5) Single facial bone fracture was more common(68.7%) and among them, mandibular fracture was the most common. 6) The incidences of anatomical locations of facial bone fracture were mandible(45.2%), zygoma(39.1%), maxilla(17.4%) and frontal bone(14.8%), in order of frequency. 7) In zygomatic fractures, arch fracture was the most common(46.7%). 8) In maxillary fractures, complete Le Fort fracture type I was the most common(20.0%). 9) In orbital fractures, pure blow-out fracture was the most common(52.9%). 10) In mandibular fractures, symphysis and parasymphysis were the most common anatomical site(48.1%). 11) The cases treated with surgical approach were 70.4%. 12) The most common complication was infraorbital nerve dysfunction(6.1%).
Age Distribution ; Congenital Abnormalities ; Facial Bones* ; Humans ; Incidence ; Male ; Mandibular Fractures ; Maxillary Fractures ; Medical Records ; Motor Vehicles ; Nasal Bone* ; Orbital Fractures ; Retrospective Studies ; Zygomatic Fractures

Segmental fracture of the femoral shaft is known as an unusual injury, usually caused by severe force and associated with marked damage to the soft tissue, and is difficult to treat due to these causes it is a controversal topic in regard to the treatment. Authors analysed 14 cases of segmental fracture of the femoral shaft, except cases associated with hip fracture, which had received operative treatment at Dept. of Orthopaedic Surgery, College of Medicine, Chosun University, from Jan. 1985 to Dec. 1990. The results are summarized as follows; 1. Of 14 cases, there were 12 cases of male and 2 cases of female: male was predominant. Most cases were at their 3rd and 6th decades of age. 2. Traffic accidents were the main causes of injury(11 out of 14 cases.) 3. There were 13 closed fracture and 1 open fracture. 4. In most cases, they accompanied injuries to other vital organ. Among 14 cases, 5 cases accompanied head injury. 5. We treated these fracture by flexible intramedullary nailing in 7 cases, open reduction and internal fixation with plate in 5 cases, locked intramedullary nailing in 2 cases. Bony union was more rapid in the distal fracture than in the proximal fracture. 6. Among 14 cases, primary bone grafting was done in 2 cases. In the group where primary bone grafting had not been done, dealyed union appeared but nonunion was not seen. 7. We could obtain rapid bony union and decreased operation time in the cases which were treated with intramedullary fixation, and thought that intramedullary fixation was a relatively good method in type of this fracture.
Accidents, Traffic ; Bone Transplantation ; Craniocerebral Trauma ; Female ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hip ; Humans ; Male ; Methods