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Related Factors of Ligamentotaxis with Posterior Instrumentation for the Surgical Treatment of Thoracolumbar Bursting Fracture
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Sang Bum Kim, Taek Soo Jeon, Seung Hwan Kim, Han Chang, Cheol Mog Hwang
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J Korean Fract Soc 2010;23(2):213-219. Published online April 30, 2010
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DOI: https://doi.org/10.12671/jkfs.2010.23.2.213
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- PURPOSE
To investigate factors influencing the amount of indirect reduction by ligamentotaxis according to timing of surgery, extent of surgery, and characteristics of fractures.
MATERIALS AND METHODS
We reviewed 22 cases of thoracolumbar fracture which had been performed posterior instrumentation and fusion using pedicle screw system. We divided patients into each group according to timing of surgery, number of fusion segment, insertion of screw on fractured vertebra, and rupture of posterior ligament complex, and Denis type. We measured changes of kyphotic angle, anterior vertebral height and wedge angle on plain radiographs, and we compared spinal canal area before and after operation using computed tomographic scans.
RESULTS
Kyphotic angle, anterior vertebral height, wedge angle, and area of spinal canal showed significant improvement postoperatively. The wedge angle improved significantly operated within 3 days after injury, however, kyphotic angle and anterior vertebral height had no correlation with variable factors except the rupture of posterior ligament complex. The amount of restoration of spinal canal also affected only by rupture of posterior ligament complex.
CONCLUSION
There is little relationship between timing of surgery and canal restoration, so we cannot conclude that prompt operation helps reduction of narrowed spinal canal. Otherwise narrowed spinal canal had much less restored by ligamentotaxis when there were rupture of posterior ligament complexes.
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Treatment of Coronal Split Fracture of the Femoral Condyle
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Yong In, Seung Key Kim, Won Jong Bark, Jong Beom Park, Gun Chang, Han Chang
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J Korean Soc Fract 2000;13(4):855-860. Published online October 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.4.855
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- PURPOSE
To evaluate the results of treatment in 6 cases of coronal split fractures of the femoral condyle MATERIALS AND METHODS: Six cases of coronal split fractures of the femoral condyle were treated and followed up 16 to 36 months. Five cases were treated operatively. We used anteromedial approach for 3 cases, posteromedial approach for 1 case and posterolateral approach for other 1 case. Non-displaced case was treated conservatively with cast. We compared the results of each case using Letenneur assessment system.
RESULTS
All 3 cases approached anteromedially and the case approached posterolaterally showed good results. But the case approached posteromedially showed fair result with mild limitation of motion and pain. Non-displaced case treated with cast resulted in poor result with nonunion.
CONCLUSION
We propose operative treatment for coronal split fracture of the femoral condyle even though there is no displacement. Anteromedial approach and headless screw fixation could be the best method for reduction and fixation of fracture.
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Isolated Plantar Midtarsal Dislocation: A case Report
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Seung Key Kim, Jong Beom Park, Jong Hun Lee, Han Chang
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J Korean Soc Fract 1998;11(1):226-229. Published online January 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.1.226
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- Isolated plantar midtarsal dislocation is extremely rare injury. Only few cases have been reported previously in the literature. We experienced 1 case, a 16-year-old man. And we report a case with review of the literatue.
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Citations
Citations to this article as recorded by  - Combined Ipsilateral Fracture and Dislocation of Hip, Knee and Foot Joints - A Case Report -
Hyoung-Soo Kim, Ju-Hak Kim, Sang-Joon Park, Jae-Won Hyung
Journal of the Korean Fracture Society.2012; 25(1): 73. CrossRef
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Clinical and Radiologic Analysis of Occult Osseous Lesion on Magnetic Resonance Imaging in Acute Knee Injury
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Seung Key Kim, Jong Hun Lee, Nam Gee Lee, Chang Beom Park, Han Chang
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J Korean Soc Fract 1997;10(4):843-850. Published online October 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.4.843
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- Bone bruise or occult osseous lesion on magnetic resonance imaging was focused on the indirect sign of acute anterior cruciate ligament injury. But there were few reports which compared the location of bone bruise with the injured structure. The purposes of this study were to identify the common pattern of location of bone bruise, and to analyze the relationship between the location and injured structure or mechanism of injury. The authors reviewed 76 magnetic resonance imaging studies of the knee from March 1993 to May 1994 which show the sign of bone bruise in acute knee injury within six weeks. The mean age of the patient was 26.3 years and the main cause of injury was traffic accident. The final diagnosis was 20 cases of isolated medial collateral ligament injury, 17 cases of isolated anterior cruciate ligament injury, 16 cases of combined anterior cruciate and medial collateral ligament injury, 7 cases of meniscus injury, 6 cases of combined posterior cruciate and medial collateral ligament injury, 5 cases of isolated posterior cruciate ligament injury, 2 cases of patella dislocation, 1 case of lateral collateral ligment injury, and 2 cases of undiagnosed knee injury. In isolated MCL injuries, bone bruises were all confined to the lateral compartment. In isolated injury of ACL, the most common pattern of location of bone bruises were lateral tibial plateau and lateral femoral condyle(47.1%). In combined ACL and MCL injury, the most common pattern of location was lateral tibial plateau, only(43.8%). Bone bruise on MRI may be easy to detect during interpretation and we can obtain much information to decide the diagnosis and prognosis.
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Lunate dislocation and perilunte dislocation with or without fracture
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Won Jong Bahk, Jong Min Sohn, Nam Gee Lee, Seung Key Kim, Young Joo Park, Han Chang
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J Korean Soc Fract 1996;9(1):42-49. Published online January 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.1.42
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- The lnate dislocation and perilunte dislocation with or without fracture, occupying about 10% of carpal injury, might b classified as a same category of injury resulted from similar mechanim. Initial diagnosis was missed often. In case of failure of closed reduction, open reduction and internal fixation will be necessary. The authors analyzed retrospectively 15 patients with lunate dislocation and perilunate dislication without fracture(Group A)and perlunate dislication with scaphoid fracture(Group B) who were treated from 1989 to 1994 at our hespital. The follow-up periods were 7 months to 60 months with mean of 23.2 months. The results were as follows.
1.Group A were 2 cases of anterior dislication of lunate and 8 cases of perilunate dislocation Group B were 5 cases of transscaphoid perilunate fracture-dislocation. The direction of perilunar dislocation with or without scaphoid fracture was posterior in all cases.
2.The causes of injury were fall from height in 7 cases, slip in 3 cases, traffic accident in 3 cases and crushing injury in 2 cases.
3.The overall clinical results by modified Green and OBriens clinical score were excellent in 4 cases(26.7%), good in 4 cases (26.7%),fair in 4 cases(26.7)and poor in 3 cases(20%).
4.9 out of 10 cases (90%) in Group A and 3 out of 5 cases(60%) in Group B were superior to fair.
Early treatment within 3 days injury was performed in 11 cases (7 in Group A,4 in Group B), The average point was 85 and 70, respectively and there was no statisticat significance between two groups(P>0.05). Treatment was delayed beyond two weeks after injury due to missed initial diagnosis and open wound in 4 cases(3 in Group A,1 in Grdup B). The final tesults were 1 case of good, 1 case of fair, 1 case of poor in Group a, and 1 case of poor in Group B. There was no statistical significance between the early treatment cases and delayed treatment cases(P>0.05). In conclusion, ounate and perilunate dislocation without scaphoid fracture can be treated by early operation to get and maintain the anatomical reduction. The authors thought that the presence of scaphoid fracture, nonanatomic reduction and delay in treatment are poor prognostic factors.
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Complications and Its Treatment of Ankle Fractures
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In Kim, Seung Ko Rhee, Soon Yong Kwon, Ki Won Kim, Yong Keun Cho, Han Chang, Won Jong Bahk, Nam Kee Lee, Seung Ki Kim
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J Korean Soc Fract 1995;8(4):736-746. Published online October 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.4.736
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- We have investigated total 294 cases of ankle fractures, which were treated and followed for average 17 months after treatment at St. Marys hospital since 1980, to detect the complications and to define their provoking factors. The results were as follows; 1. Twenty-six cases out of total 294 cases of ankle fracture(8.8%) were complicated clinically and radiologically.
2. Their complications are osteoarthritis(8/26, 31%), diastasis of distal tibio-fibular syndesmosis(9/26, 34.6%), varus ankle deformity(5/26, 19.2%), malunion(6/26, 23%), non-union and ankle instability(each 2/26, 7.7%) in its order, but 14 cases of the 26 cases complained painful limited ankle motion and limp. So, clinical symptoms are not closely related with radiologic changes in complications of ankle fracture.
3. The complications are common in elderly patients over 50 of their ages(12.26, 46%) and in younger patients under 16 of their ages(5/26, 20%).
4. The complications are frequently found in pronation-external rotation injuries(6/61, 1O%), pronation-dorsiflexion(9/14, 64%) and supination-external rotation injuries(8/165, 4.8%) in orders.
5. Malpractice with misuse of instrument(12/26, 46%), mistakes in preoperative evaluation and neglect any ankle fracture or diastasis of syndesmosis(8/26, 30.7%) and severity of injuries(6.26, 23%) are common causes of complications of ankle fractures.
6. Varus ankle deformity due to early epiphyseal closure are shown in 5 cases(5/28, 20%) and three of them are treated with supramalleolar corrective osteotomies and Langenskiolds physolysis In conclusion, the complications of ankle fracture could be reduced by accurate pre-operative evaluation to detect the hidden soft tissue injuries or fracture mechanism and by also anatomic reduction, rigid internal fixation and early ankle motions. childrens ankle fracture will induce angular deformity and limb length discrepancy due to frequent epjphyseal damage, so long-term follow up should be kept in mind until their skeletal growth are ceased.
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