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四肢遠位端骨折의 治驗 6例

Six Cases of Lower-End Fracture

대한외과학회지 1964년 6권 3호 p.161 ~ 167
金榮瓏, 金奉健,
소속 상세정보
金榮瓏 (  ) - 가톨릭大學 醫學部 整形外科學敎室
金奉健 (  ) - 가톨릭大學 醫學部 整形外科學敎室

Abstract


1) Author reported here a case of cellos´ fracture and two cases of supracondylar fracture of the humerus and two cases of epiphyseal separation of the tibia with fibular fracture which were reduced by closed manipulation successfully. And one case of supracondylar fracture of the femur was difficult to reduce and maintain immobilized.
2) When displacement is present certain soft parts have been ruptured and conversely certain other soft parts usually remain intact; it is the latter which gives the clue to the reduction. If the undamaged soft parts are brought into normal relationship, the tone fragments will return to their normal position.
3) If a blunt oblique fracture is reduced by manipulation and is then slightly angulated in the direction of over-correction, the intact soft-tissue hinge will be put into slight tension. Under these conditions the bone ends will be pressed together and the fracture will retain some statility to a telescoping force while the hinge is in tension.
4) Immobilization of the supracondylar flexion fracture of the femur should be kept in angle of 135 degrees of affected knee to prevent from posterior displacement of the distal fragment by pulling of the gastro-cnemius muscle.
5) The posture of the arm should be decided depending on soft tissue avulsion aspect of the epicondylium(supination) rather than on pulling direction of the pronator teres (pronation) for immobilization of the supracondylay fracture of the humerus.

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