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Comparison of Bipolar Hemiarthroplasty and Compression Hip screw on Treatment of Elderly Unstable Intertrochanteric Fractrues
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Ik Su Choi, Su In Roh, Dae Yeon Kim, Keun Il Lee, Seung Chan Ko
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J Korean Soc Fract 2000;13(1):56-63. Published online January 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.1.56
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 Abstract
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- PURPOSE
To evaluate and compare the clinical outcomes of bipolar hemiarthroplasty and compression hip screw on elderly with unstable intertrochanteric fractures We evaluated the clinical results of 65-year or older elderly patients with unstable intertrochanteric fractures between Jan. 1993 to Dec. 1997. 23 patients underwent compression hip screw treatment and 19 patients were treated with bipolar hemiarthroplasty. Functional evaluation was conducted at 3, 6 and 12 month after the operation by hip rating scale of Merle d'Aubigne. Complications, time to weight bearing and hospitalization period were also investigated.
RESULTS
For the bipolar hemiarthroplasty group, functional scale of good or above were seen in 74%, 72% and 67% of the group at 3 months, 6 months and 12 months. However in the compression hip screw group, the good or above results were shown in 57%, 52% and 43% of the group, thus showing a functional deterioration as time progresses. Comparing the overall clinical outcome, the bipolar hemiarthroplasty group showed better results, complication occurred in 26 cases of compression hip screw group and 8 cases of bipolar hemiarthroplasty group, showing better outcomes in the bipolar hemiarthroplasty group.
CONCLUSION
Comparing the length of hospital stay, time to weight bearing, complication and functional superiority of the treatment for elderly unstable intertrochanteric fractures, the bipolar hemiarthroplasty showed superior clinical outcomes than the compression hip screw. Moreover, patients with more unstable fractures and more severe osteoporosis showed better clinical results with bipolar hemiarthroplasty.
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Operative Treatment of Avulsion Fractures of the Calcaneal Tuberosity
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Ik Su Choi, Woo Il Kim, Hong Ju Ha, Jin Goo Kang, Seung Chan Ko
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J Korean Soc Fract 1999;12(4):968-974. Published online October 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.4.968
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Abstract
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- Avulsion fractures of the calcaneal tuberosity are rare injuries in extraarticular fractures of the calcaneus and were resulted from a separation of a shell of the posterior portion of the os calcis due to the pull of the Achilles tendon. Importance of anatomic reduction for the restoration of functional length of Achilles tendon were emphasized by many authors in the treatment of the fractures.
The purpose of this study is to evaluate the results of operative treatment in avulsion fractures of the calcaneal tuberosity and to analyse the results in accordance with various prognostic factors. This article has reviewed a series of 6 avulsion fractures of calcaneal tuberosity, treated from March 1991 to November 1996.
The results were as follows ; 1. In case of avulsion fracture of os calcaneus, open reduction and internal fixation was needed for the accurate anatomical reduction and maintenance of firm internal fixation.
2. The method of operative treatment was not significant influencing factor on the treatment result, however, it is more convenient to fix when cannulated screws were used because of the compressive effect on the fracture site.
3. Complications included superficial skin necrosis in one case, which resulted from the compression of bony fragment in case of avulsion fracture and another, wire fixation failure because of bone resorption resulted from wide soft tissue dissection.
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T-plate Fixation of Distal Radius Fractures in the Elderly
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Ik Su Choi, Woo Il Kim, Su In Roh, Hong Ju Ha, Jin Goo Kang, Seung Chan Ko
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J Korean Soc Fract 1999;12(2):452-460. Published online April 30, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.2.452
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Abstract
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- Recently, distal radius fractures are recognized as very complex injuries with a variable prognosis according to the fracture type and the treatment. Especially, there are several problems, including joint stiffness and skin necrosis due to a long term immobilization, radial shortening and collapse due to the loss of reduction in the elderly. Thus, the anatomical reduction and rigid internal fixation and early rehabilitation were recommanded. We analyzed 16 patients with distal radius fractures in the elderly, who were treated with open reduction and internal fixation with T-plate from January, 1991 to June, 1997 and were followed up for more than 12 months. The results were as follows ; 1. According to the Fernandez classification, 3 cases were type I, 3 cases were type II, 7 cases were type III, 1 case was type IV and 2 cases were type V. 2. As complications, there were 2 cases of arthritic change, 3 cases of radial shortening, and 1 case of screw loosening. 3. Anatomically satisfactory results were obtained in 75%(12 cases). 4. Functionally and clinically satisfactory results were obtained in 87%(14 cases). 5. In the treatment of distal radius fractures in the elderly, three dimensional structure and recovery of joint congruency were related to the clinical prognosis.
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