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脛骨骨折의 對한 早期體中負荷의 臨床的 考察

Clinical Observation on Weight Bearing of the Tibial Fractures with Functional Below the knee Cast

대한정형외과학회지 1970년 5권 4호 p.189 ~ 195
丁昌熙, 孫鋌模,
소속 상세정보
丁昌熙 (  ) - 第十七陸軍病院 整形外科
孫鋌模 (  ) - 第十七陸軍病院 整形外科

Abstract


The early weight bearing in treatment for tibial fractures was reporded first by Gurd(1940) and in recent by Weissman(1966), Sarmiento(1967), and Brown(1969).
1. One hundred and fifty cases of fractures of the tibia treated at the Orthopedic Department of the 17 th Army Hospital during period of January 1968 to June 1970 were subjected to analysis. Of three groups, first group was applied functional below the knee cast after mannual reduction and started weight bearing on the 5-th weeks from injury, second group was treated with same method as first group except the reduction was achievd surgically, and third group was applied toe-to-groin cast after manipulation with no weight bearing until union.
2. Casting method; The toe-to-groin cast was applied on the day of injury after manipulation and functional below the knee cast was applied tightly after swelling was subsided. Supporting the leg on the table, we could obtain satisfactory alignment in all cases. Especial firm molding over the medial flare of the tibia, Patellar tendon and popliteal space was the most important step in applying this type of the cast. Finally rubber walking heel was held in place throught the tibias axis.
3. Traffic accident was the most common cause of the fractures in this series and it was 78 cases out of 150.
4. The average healing time of the first group was 15. 7 weeks, of second group was 19.4 weeks, and of third group was 23.5 weeks.
5. The open and/or comminuted fractures would delay healing time, and prolonged convalescent period. 6. Though slight shortening and angulation was observed in the early weight bearing groups, the final function was excellent.

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