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A Case of Surgically Treated by Transperitoneal Approach in Delayed Neurological Deficit after Sacral Fracture: A Case Report
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Young Soo Jang, Jong Seok Lee, Jae Hyuk Choi, Sung Ju Bae, Chan Il Bae
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J Korean Fract Soc 2013;26(1):69-72. Published online January 31, 2013
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DOI: https://doi.org/10.12671/jkfs.2013.26.1.69
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 Abstract
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- This study reviews a case of sacral fracture with delayed onset neurological deficit that showed good results after decompressive surgery. The delayed neurological deficit appeared at 4 weeks after injury and it was treated with anterior decompression through transperitoneal approach. A 23-year-old woman was injured in a car accident and had bilateral pubic rami fractures and fractures of the sacral ala on the right side. She was treated with external fixation devices for approximately four weeks, but complained of pain and numbness. The dorsiflexion and plantalflexion of the right ankle was weakened and graded as grade 2. Preoperative pelvic and sacral radiographs, computed tomography, magnetic resonance imaging and electromyelography, and nerve conduction study were performed to identify the region of neurological deficit, and we decided to implement neurological decompression. By transperitoneal approach, we performed bone curratage and decompression around the region of sacral alar slope and S1 foramen. The pain and numbness of the right foot cleared up. Dorsiflexion and plantalflexion of the right ankle improved to grade 5. Anterior decompression by transperitoneal approach proved to bring satisfactory results in a patient, who presented delayed neurological deficit after sacral fracture.
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The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation
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Jong Won Kim, Hyun Soo Park, Young Soo Jang, Jae Hyuk Choi, Sung Ju Bae, Chan Il Bae
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J Korean Fract Soc 2012;25(4):257-262. Published online October 31, 2012
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DOI: https://doi.org/10.12671/jkfs.2012.25.4.257
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Abstract
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- PURPOSE
This study was performed to evaluate the results of treating intertrochanteric fracture with proximal femoral nail antirotation (PFNA).
MATERIALS AND METHODS
We performed PFNA on 41 intertrochanteric femur fracture patients from May 2008, to August 2010. We analyzed the operation time, blood loss, recovery of ambulatory function, T-score, the tip apex distance (TAD), the sliding distance of the blade, neck-shaft angle, and complications.
RESULTS
The mean operation time was 51 minutes and the mean amount of blood loss was 350 ml. The time to ambulation averaged 7.2 days. Thirty-two cases (79%) recovered their previous walking status at 6 months after operation. The average T-score was 3.3 and TAD was 12.3 mm (8.6~27 mm). 35 cases (87%) achieved acceptable reduction. The average amount of PFNA blade sliding was 3.3 mm. The neck-shaft angle was changed 2.6 degrees varus displacement at the final follow-up. There was one case of nonunion due to tuberculosis infection.
CONCLUSION
The findings from this study indicate that PFNA is a useful and reliable choice for the treatment of intertrochanteric fracture of the femur.
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