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KMID : 0365819770170020239
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Journal of Pusan Medical College
1977 Volume.17 No. 2 p.239 ~ p.244
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Clinical Observation on Tibial Shortening after Bony Union of Tibial and Fibular Fractures by Early Weight Bearing and P.T.B Cast Immobilization
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Abstract
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The author, at Department of Orthopaedic Surgery for full 17 months from June 1976 to October 1977, has treated 40 subcutaneous tibia] with or without fibular fractures, excluding open ones and those with other site injuries, by means of early weight bearing under patella tendon bearing cast.
The results obtained were as follows.
1. The age and sex distribution revealed 20 years of age the youngest, 54 the eldest and 32 males and 8 females.
2. The fracture site showed 4 in upper third, 10 in mid-third and 3 in lower third in tibial fractures alone, while 3 in upper, 15 in middle and 5 in lower third of the shafts in tibial and fibular fractures. Fracture line disclosed 7 transverse, 6 oblique and 4 comminuted in tibia] fractures, while 9 transvese, 7 oblique and 7 comminuted in both tibia] and fibular fractures.
3. Average healing time showed 94.4 days(13.5 weeks) in upper]/3 fractures, 111. 1 days(15.9 weeks) in middle and lower thirds. Considering the fracture type transverse ones were healed up in average 90,6 days(12.9 weeks), oblique ones 103.3 days(14.8 weeks), comminuted 120.8 days(17.3 weeks) with the aveage of 105.5 days(15.1 weeks) in total.
4. Tibial shortening from 2mm to 39mm (average 13.6mm) was noted in 36 out of 40 fractures; 15.6mm in upper third, 13.3 in middle and 13.1mm in lower third in average. Considering the fracture type, 7.9mm in transverse, 9.4mm in oblique and 22.9mm in comminutedfractures.
In short upper 1/3 fractures showed more shortening than mid and lower 1/3 fractures and comminuted fractures showed the most shortening.
In tibial fractrues alone both oblique and transvei se fractures showed similar shortenings but in tibia] and fibular fractures oblique fractures showed more shortening than transverse ones.
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