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小兒遊離四肢骨骨折의 臨床的 考察

A Statistical UI!servvtion an Fracture of the Extremities in Children

대한외과학회지 1962년 4권 2호 p.103 ~ 111
李永胄, 金榮悳,
소속 상세정보
李永胄 (  ) - 서울赤十字病院 外科
金榮悳 (  ) - 서울赤十字病院 外科

Abstract


It is the purpose of this paper to analyse and evaluate fractures ii el ildreg who were less than 15 years old, and who have been treated in the Surgical Department of the Seoul Iced Cross Hospital during the 5 year period from September 1956 to August 1961 inclusive.
1) The total number of fracture cases was 1052 during the same period. Of the 1052 cases, 879 cases or 83.6% were fractures in adults, and 173 cases or 16.4% were in children.
2) The total number of fractures of the extremities was 639. Of the 639 cases, 487 cases or 76.2 % were in adults, and 152 cases, or 24.8Y in children.
3) Concerning the seasonal Lincidence in this series, 31 cases during 4ugpst seas the highest incidence and this tend to decrease gradually towards December.
4) The ratio between male and female was approxituately 2.4:1, namely 10 c ses in males and 45cases in females.
5) The cause of the fractures pf the extremities in this series was as follows: 80 cases or 52.6% were due to traffic accidents; 51 cases or 33.6% were due to falls from a height or falls on the ground: 12 case a qr ?. Y ;o: due tp a heavy blow; 5 cases or 3.3% : an explosion disaster; 3 cases or 2.0%: birth injury; I cases or 0.7%: a crushing injury in a mec1}anical accident.
0) These figures increased until the ages reached 6-7 years, and again increased gradually up to tho age of 1.3,.14,. The highest incidence was found among the age group of I4-15 years.
In this aeries, 133 eases or 87. q% were treated by closed reduction with excellent anatomical and functional results, and 21 cases, or 13,, 8$ were treated by open ,reduction.
Pi irioag the ¢ cases of open reduction f pr fractures of the femur, homeade Kiintschen type nitramedullar nailing method was used.
For the remaining cases the fragment involved was fastened with a loop! of wire or with a metal, plate. In children with fractures of the extremities, excellent results were pbtaiue l by conseryatwe treatment.
Open reduction of such fractures in children was rarely in4iFatelt, for, in contrast tp adults, children exhibit a phenomenal capacity to rp-establish their r or pal length, aligns pent and continuity of fractured bones even if there was some degree of gross diS lace rent or _overriding´ folIpvwii1 he reduction and immobilization.
Complete anatomical reduction with endo And appositiontof the fractured; ends is net essential for the purpose of an excellent cosmetic result, for in childliogd, physiological compensation usually readjusts itself without a noticeable disfigurement.

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