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Open ankle fracture, including compound loss of the lateral malleolus, lateral ankle ligaments, and overlying skin, is a severe injury and can result in ankle instability and permanent disability. Treatment of this injury is challenging and requires bone grafting and soft tissue reconstruction. In the present report, we describe a unique reconstruction technique for compound loss of the lateral malleolus, lateral ankle ligaments, and the overlying skin using a double-bundle Achilles tendon-bone allograft combined with a reverse sural fasciocutaneous flap. The patient obtained a stable ankle with nearly full range of motion and displayed satisfactory function during the follow-up period.

부산대학교 의과대학 정형외과학교실 Purpose: This study evaluated the clinical outcomes of debridement arthroplasty using the posteromedial approach in elbow joints with pain and bony limitation of motion. Materials and Methods: This study involved 16 elbows in 16 patients with pain and bony limitation of motion, which were treated by debridement arthroplasty using the posteromedial approach from March 2005 to March 2008. The mean follow up period was 27.6 (13~52) months. The clinical outcomes were analyzed using the Visual Analogue Scale(VAS) for pain scale, the preoperative and postoperative range of motion and the Mayo Elbow Performance Scores(MEPS). Results: The VAS was decreased significantly from a preoperative mean of 4.5 to a postoperative mean 1.1 (p

1 통신저자:김 동 헌 충청북도 충주시 교현동 620-5 건국대학교 의과대학 충주병원 정형외과학교실 Tel:043-840-8250ᆞFax:043-844-7300 E-mail:kdkim@kku.ac.kr 접수: 2011. 3. 1 심사(수정): 2011. 5. 31 게재확정: 2011. 11. 22 Address reprint requests to:Dong-Heon Kim, M.D. Department of Orthopaedic Surgery, College of Medicine, Konkuk University, 620-5, Kyohyun-dong, Chungju 380-704, Korea Tel:82-43-840-8250ᆞFax:82-43-844-7300 E-mail:kdkim@kku.ac.kr 인공 슬관절 전치환술 후 인공관절 치환물 주위 골절의 위험인자

Purpose: The purpose of this study is to evaluate the outcome after operative treatment with plate fixation in Vancouver B1 and C periprosthetic unstable femoral fractures. Materials and Methods: We conducted a retrospective assessment of 15 patients who had under gone treatment for a periprosthetic unstable femoral fracture around primary hip arthroplasty between April 1997 and July 2010. The mean age of patients was 69 years(53 to 82 years) at the time of surgery and the mean duration of follow-up was 29.2 months (six to 110 months). According to Vancouver classification, 10 patients were type B1 and five were type C. According to the time of operation, open reduction and internal fixation was performed using four different plates. Bone graft was applied in all patients, regardless of the type of plate. The present review describes the clinical and radiographic results. Results: All patients were able to ambulate without assistance of crutches or walkers. Of the 15 patients, the fracture site was united in all patients. Postoperative dislocation of the ipsilateral hip was observed in one patient; however, there was no occurrence of further complications, such as infections, nerve injuries, or loosening of the femoral stems. Conclusion: In Vancouver type B1 and C fractures, without any loosening of the femoral stems, open reduction with plate fixation using our operative methods provided a satisfactory result.

282 통신저자:서 정 탁 부산시 서구 아미동 1가 10 부산대학교 의학전문대학원 정형외과학교실 Tel:051-240-7248ᆞFax:051-247-8395 E-mail:jtsuh@pusan.ac.kr 본 논문의 요지는 2009년도 대한골절학회 추계학술대회에서 발표되었음. 이 논문은 부산대학교 자유과제 학술연구비(2년)에 의하여 연구되었음. 접수: 2009. 12. 30 심사 (수정): 2010. 2. 23 게재확정: 2010. 6. 16 Address reprint requests to:Jeung Tak Suh, M.D. Department of Orthopaedic Surgery, Pusan National University School of Medicine, 1-10, Ami-dong 1-ga, Seo-gu, Busan 602-739, Korea Tel:82-51-240-7248ᆞFax:82-51-247-8395 E-mail:jtsuh@pusan.ac.kr 잠김압박금속판을 이용한 대퇴 과상부 골절의 치료

Purpose: Bone graft is a widely accepted surgical treatment for scaphoid nonunion. The purpose of this study was to analyze and compare the clinical outcomes of the three different bone graft techniques, Matti-Russe technique, Fisk-Fernandez technique and vascularized bone grafting. Materials and Methods: This study involved 20 cases in 20 patients of established scaphoid nonunion who were treated with three different bone graft techniques and followed up for at least 1 year. We measured preoperative and postoperative pain, Mayo Modified Wrist Score (MMWS) and range of motion of the affected and normal side. For radiological evaluation we assessed bone union, avascular necrosis, and dorsal intercalated segment instability (DISI). Results: There were no significant differences among the three groups with respect to the pain, MMWS, and range of motion. The union rate and correction of DISI also made no significant difference. The time to achieve bone union, which averaged 2.6 months was significantly decreased in the vascularized bone graft group than in the other two groups. Conclusion: All three methods were proper surgical procedures for treatment of scaphoid nonunion because there was no statistically significant difference in clinical and radiological outcomes. Among these three methods the vascularized bone grafting had the shortest time to achieve bone union so it could result in the fast functional recovery of the patient.