• Title/Summary/Keyword: Ankle fracture

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The Complication of the Talar Neck Fracture (거골 경부 골절의 합병증)

  • Seong, Byeong-Yeon;Park, Wan-Soo;Lee, Seung-Ki;Park, Chan-Ji;Kim, Dong-Won
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.119-125
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    • 2003
  • Purpose: The purpose of this study fracture. Materials and Methods: The clinical and radiological analysis were performed on 19 cases of the talus neck fractures who had been treated with conservative treatment or variable methods of operative treatment. Each cases followed up more than 1 year and 6 months from May 1989 to June 2001. The clinical results were analyzed according to the age, cause of injury, fracture type of Hawkins classification, associated soft tissue injury, method of treatments, complications, and Hawkins scoring system. Results: According to Hawkins classification, type I was 6 cases(32%), type II was 5 cases(26%), typeIII was 7 cases(37%), and typeIV was 1 case(5%). In all cases, complete bony union was obtained. According to the Hawkins scoring system, 8 cases(42%) were excellent and good. Avascular necrosis was 4 cases(25%). Traumatic arthritis was 10 cases which were occurred in type II, III and IV. An ankle fusion was 1 case. Conclusion: In talar neck fractures, non-displaced fracture treated by the cast immobilization and displaced fracture treated by early open reduction and internal fixation were expected good results. The complications were 77% of traumatic arthritis and 31% of avascular necrosis in type II, III and IV. We should preoperatively explain to the patient for high complication rates of traumatic osteoarthritis and avascular necrosis in the talus neck fractures.

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The Short Term Outcome of Surgical Treatment for the Fifth Metatarsal Base Fracture Using a Headless Cannulated Compression Screw (제 5중족골 기저부 골절의 무두유관압박나사를 사용한 수술적 치료의 단기 추시 결과)

  • Chon, Je-Gyun;Choi, Hyun;Kim, Jun-Beom;Sun, Doo-Hun;Shin, Sang-Yeop
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.3
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    • pp.131-134
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    • 2016
  • Purpose: This study aimed to evaluate the outcomes, including the complications, of open reduction and internal fixation using a headless cannulated compression screw for a fifth metatarsal base fracture. Materials and Methods: We retrospectively investigated 11 patients with 5th metatarsal base fracture who were treated with a headless cannulated compression screw. The mean follow-up period was 13 months (8~15 months), and the mean age was 46.5 years (21~70 years). We analyzed the patients' sex, age, time to union, amount of fracture displacement, and complications. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was used for clinical assessment. Results: The average amount of displacement decreased significantly from 3.4 mm (2.1~5.2 mm), preoperatively, to 0.4 mm (0~1.3 mm), postoperatively (p<0.001). The average bone union time was 54.1 days (41~68 days). There were no complications, such as a metal failure, irritation, and loss of a reduction. The mean AOFAS midfoot score was 97.7 (90~100) at 6 months, postoperatively. Conclusion: We suggest that a headless cannulated compression screw for 5th metatarsal base fracture is a useful and alternative method for a firm fixation without complications.

Outcomes of Immediate Operative Treatment of Ankle Trimalleolar Open Fractures (족관절 개방성 삼과골절의 즉각적인 수술의 결과)

  • Lee, Jun-Young;Cho, Yong-Jin;Kang, Sin-Wook;Cho, Yung-Min;Choi, Hyun-Bai
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.1
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    • pp.25-30
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    • 2020
  • Purpose: Generally, the treatment of ankle trimalleolar open fractures is divided into two stages: external fixation and debridement; and secondary internal fixation. On the other hand, this two-stage operation takes considerable treatment time and is challenging in procedures requiring reduction. The purpose of this study was to evaluate the radiologic and clinical results of an immediate one-stage internal fixation operation considering the wound conditions to overcome two stage operation disadvantages. Materials and Methods: From September 2009 to January 2018, 24 cases of ankle trimalleolar open fractures, who underwent immediate internal fixation and were followed up for at least one year, were studied retrospectively. The open wound was divided into the Gustilo-Anderson classification. Open reduction and internal fixation were performed on every medial and lateral malleolar fracture. On the other hand, with posterior malleolar fractures, surgical or conservative treatment was performed depending on the fragment size. The radiologic outcome was evaluated using the Burwell and Charnley criteria and American Orthopaedic Foot and Ankle Society (AOFAS) scores, and complications, such as infection and posttraumatic arthritis, were used for the clinical evaluation. Results: The wound was classified into eight cases (33.3%) of type I, 11 cases (45.8%) of type II, and five cases (20.8%) of type IIIa. The degree of reduction was anatomical, fair, and poor in 16 cases (66.7%), six cases (25.0%), and two cases (8.3%), respectively. The mean AOFAS score was 79 points, and there were complications, such as infection in three cases (12.5%) and post-traumatic arthritis in two cases (8.3%). Conclusion: Satisfactory results were obtained through immediate surgical treatment in ankle trimalleolar open fractures of types I, II, and IIIa.

ILIZAROV FIXATION FOR THE TYPE C TIBIAL PLAFOND FRACTURES (C형 경골천정 골절에 대한 일리자로브 외고정술)

  • Cho, Hyoun-Oh;Kwak, Kyoung-Duck;Cho, Sung-Do;Kim, Byung-Yong;Oh, Jang-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.1
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    • pp.51-58
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    • 1997
  • The purpose of this study is to evalute the efficacy af the Ilizarov external fixation for the surgical treatment. of the tibial plafond fractures. We reviewed retrospectively fourteen cases of tibial plafond fractures with moderate to severe soft. tissue damage, which were fixed with Ilizarov external fixator. Using the AO Muler classification, there were four Type C1 fractures, six Type C2 and four Type C3. In most, of the cases, the ankles were operated on with other associated fractures within a few days after injury. We reduced the fracture indirectly by soft issue taxis and fixed externally across the ankle joint. using the circular external fixator with tensioned wires and ankle hinge. In cases of inadequate closed reduction, we applied limited open reduction and internal fixation. Range of motion exercise began immediately. Postoperative follow-up averaged fourteen months (ranges, 8-30 months). Overall clinical results rated good or excellent in 7 cases, fair in 4 and poor in 3. There were three cases of pin tract infection which were resolved with short-term antibiotics and local care; one delayed wound closure in a patient. whose fracture was associated with Type III open wound; one wound slough in a patient associated with Type II open wound, which was closed later by skin graft; and one osteoarthritis. From this review, we concluded that cross-ankle circular external fixation with tensioned wires with or without. limited open reduction is a reasonable alternative for the treatment of the tibial plafond fractures with severe soft tissue damage.

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Fifth Metatarsal Stress Fracture (운동선수의 제5 중족골 피로골절)

  • Lee, Kyung-Tai;Park, Young-Uk;JeGal, Hyuk;Kim, Jun-Beom
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.87-93
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    • 2012
  • Fractures located at the metaphyseal/diaphyseal junction at the base of the fifth metatarsal were first described by Sir Robert Jones in 1902. However, ever since, there has been disagreement and debate regarding the diagnosis, classification, pathomechanics, the incidences, and potential causes of delayed unions and nonunions, and the optimal method of treatment. It appears to be widely agreed that proximal fractures of the metaphyseal/diaphyseal region of the fifth metatarsal are prone to delayed union or even nonunion. Several classifications of proximal fifth metatarsal stress fractures have been devised. Torg et al. classified fractures involving the proximal part of the diaphysis of the fifth metatarsal into three types. The Torg classification is a good grading system that can be used to determine the type of surgery needed as well as for the prediction of prognosis. The ''plantar gap'' might add to the decision-making process for surgery and improve the prediction of patient prognosis. In addition, the new classification using 'plantar gap' might be used for classification of fifth metatarsal stress fracture. Fifth metatarsal stress fractures can be treated conservatively or surgically, and excellent results have been reported for surgery with rapid recovery in athletes. Intramedullary screw fixation has become a popular form of fixation for fifth metatarsal stress fractures. Bone grafting presents the problems of a longer recovery time and additional skin incision for harvesting. The modified tension band wiring is an useful and simple option for surgical treatment of challenging fifth metatarsal stress fractures.

Two Part Triplane Fracture with Extention through Medial Malleolus (Four Cases Report) (족관절 내과를 침범한 두 부분 삼면 골절(4예 보고))

  • Cha, Seung-Do;Kim, Hyung-Soo;Chung, Soo-Tae;Yoo, Jeong-Hyun;Park, Jai-Hyung;Kim, Joo-Hak;Kim, Yong-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.179-183
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    • 2009
  • The triplane fracture has been described as a fracture of the distal tibial epiphysis occurring across three planes-sagittal, transverse and coronal. The characteristic pattern of fusion of distal tibial epiphysis explains the special configuration of the fragments in the triplane fracture. According to Dias-Tachdjian classification, triplane fracture is classified two part fracture, three part fracture, four part fracture and two part fracture with extension to the medial malleolus. Among four types, two part triplane fracture with extension to the medial malleolus is a relatively rare injury and generally is not treated by closed reduction. Such fractures should have an anatomic reduction and adequate fixation to restore the joint congruity and obtain an anatomic reduction of the growth plate to prevent a future growth deformity. This is usually best accomplished with an open reduction and screw fixation or k-wire fixation. We experienced two part triplane fracture with extension to medial malleolus and check the CT to define the extent of the injury completely. And then we underwent open reduction and screw fixation for the fracture. As a result, we present four cases of two part triplane fracture with extension with review of related literatures.

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Ankle Syndesmotic Injury (족근 관절 경비 인대 결합 손상)

  • Gwak, Heui-Chul;Kwon, Young-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.4
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    • pp.187-194
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    • 2011
  • Ankle injuries may involve the distal tibiofibular syndesmosis and can be associated with a variable degree of trauma to the soft tissue and osseous structures that play an important role in ankle joint stability. Ankle syndesmotic injury may occur solely as a soft tissue injury or in association with variable ankle fractures. Ankle syndesmotic injury does not necessarily lead to ankle instability; however, the coexistence of deltoid ligament injury critically destabilizes the ankle joint. The prevalence of these injuries may be higher than previously reported. The diagnosis of syndesmotic injury as not always easy because isolated ankle sprains may be missed in the absence of a frank diastasis and syndesmotic instability may be unnoticed in the presence of bimalleolar ankle fractures. Controversies arise at almost every phase of treatment includings : type of fixation(screw size, type of implant), number of cortices required for fixation and of need for hardware removal. Regardless of controversies, the most important goal should be restore and maintain the normal tibiofibular relationship to allow for healing of the ligamentous structures of the syndesmosis.

Calcaneal Insufficiency Avulsion Fracture in a Well-Controlled Type 2 Diabetic Patient: A Case Report

  • Kim, Seong-Tae;Moon, Myung-Sang;Kwon, Ki-Tae;Park, Bong-Keun;Ha, Chang Won;Ahn, Jungtae
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.2
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    • pp.73-76
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    • 2015
  • The calcaneal insufficiency avulsion fracture usually occurs in an area of fused apophysis in adults without significant history of trauma or overuse activities. It is an uncommon injury which has been described in patients with complicated diabetes, Charcot neuroarthropathy, amyloidosis with neuropathy, severe osteoporosis, and other conditions. Discussion of the issue of fracture location is still not sufficient. We report on a case of a 50-year-old male who experienced a non-traumatic diabetic calcaneal insufficiency fracture. Intraoperatively, a biopsy specimen was obtained from the exposed fracture site for histological study. We assume that the calcaneal fused apophyseal line is the weak point of failure due to various incomplete mixtures of trabecular bone, woven bone, and cartilaginous tissues, and may fail when repeated tensile stress is imposed.

Fracture of Os Peroneum with Rupture of the Peroneus Longus Tendon (A Case Report) (장 비골건 파열에 동반된 비부골 골절(1예 보고))

  • Bae, Su-Young;Chung, Hyung-Jin;Oh, Jong-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.207-210
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    • 2009
  • We report a rare case of painful Os peroneum syndrome (POPS) of 54 year-old man who had suffered from chronic pain on lateral foot after varus ankle injury and been treated successfully with surgical excision of the fractured Os peroneum and repair of ruptured peroneus longus tendon at a same time.

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Medial malleolar fracture associated with deltoid ligament rupture following ankle pronation injury (족관절 회내 손상에서 발생한 삼각인대 파열을 동반한 내과 골절)

  • Park, Chan Ho;Park, Jae Woo;Park, Chul Hyun;Park, Sang-Jin
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.146-148
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    • 2017
  • Concurrent injury of medial malleolus and deltoid ligament is difficult to occur considering the injury mechanism. When the concurrent injury comes about, the deltoid ligament injury could be missed and it may lead to medial ankle instability. There are few reported cases of the concurrent injury and domestic case of concurrent failure of both structures over the medial side has been reported just once; however, the injury mechanism is different from this case. The authors report a case of medial malleolus fracture with deltoid ligament rupture following pronation injury with a review of necessity of repairing deltoid ligament for ankle stability.