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Comparison study between valgus and varus type in Neer 's 3 and 4 part proximal humerus fracture
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Chang Hyuk Choi, Koing Woo Kwon, Shin Kun Kim, Sang Wook Lee, Dong Kyu Shin, Seung Jin Lee
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J Korean Soc Fract 2002;15(4):558-565. Published online October 31, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.4.558
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 Abstract
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- PURPOSE
We reclassified three- and four-part proximal humerus fractures by Neer ' s classification into valgus & varus type, and compared the results of these groups.
MATERIALS & METHODS: 21 cases classified as three- and four-part fracture in Neer 's classification were treated surgically and followed for 12 months. We reclassfied the 21cases valgus and varus type fractures, according to angulation of fractures, facing of humeral head, and dominant displaced tuberosity. Functional evaluation was done by UCLA shoulder rating scale.
RESULTS
Neer 's three- and four-part proximal humerus fractures could be reclassified based on angulation, facing of humeral head, and dominant tuberosity displacement. The functional results according to UCLA shoulder rating scale were good or excellant in 8 of 9 cases of valgus type(89%), and at 4 in 10 cases of varus type(40%). The clinical result of the valgus type was better than that of the varus type.
CONCLUSION
Based on reclassification system of proximal humerus fractures, clinical results and radiographic findings including angulation, facing of head, and dominant tuberosity displacement showed close relationship. Neurovascular complication were more frequent in the varus type. Therefore, careful evaluation including surgical approach and soft tissue status should be considered in the varus type of complex proximal humerus fracture.
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Operative Treatment of the Intercondyle of the Humerus in adults
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Hyun Dae Shin, Kwang Jin Rhee, June Kyu Lee, Won Sok Lee, Seung Jin Lee
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J Korean Soc Fract 1998;11(2):345-353. Published online April 30, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.2.345
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Abstract
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- We had studied the results of operative treatments in twenty-seven interconylar fractures of the distal end of the humerus over a ten-year period retrospectively. From march 1989 to February 1996, 27 patients were included in this study. The fracture patterns were classified according to the system of Muller et al. and evaluated the results of the involved elbow by Jupiter's scale. The mean follow-up was 47.8 months. The operation method was open reduction by wide exposure and transolecranon approach and internal fixation between two condyles by cancellous screw or Hebert screw and two reconstruction plate rectangularly each other. Among 27, 17 were men and left elbow were 15. The mean average age was 50.2 (23- 72)years old. The most common injury mechanism was direct trauma in 18 cases(62.9%). By Muller classification C3 type were 12 cases(44.4%), while C1 were 5 cases and C2 were 5 cases and C2 were 10 cases. At last follow-up the elow ROM was average flexion angle 107 degrees(18 to 125 degrees). Except intolerable pain and partial stiffness of elbow, the postoperative complications were 4 cases ; dsyesthia of ulnar nerve were 2, infection were 1, and heterotopic ossification was 1 case. The results of excellent and good were 20 cases(74.1%). In 7 cases of fair and poor results, C3 were 4 cases and C2 were 2 cases. It was concluded that the transolecranon approach and dual-plate fixation on humerus for fractures of the intercondyle of the humerus was satisfactory and necessary to effort of rigid fixation and a early rehabilitation after operation as possible.
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Percutaneous & Minimal Internal Fixation of Displaced Intraarticular Calcaneal Fractures
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Deuk Soo Hwang, June Kyu Lee, Hong Rok Oh, Seung Jin Lee
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J Korean Soc Fract 1997;10(1):233-241. Published online January 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.1.233
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Abstract
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- A displaced intraarticular fracture of the calcaneus is difficult to reduction and to restore its function, and its management still remains controversies. Treatment recomendation ranges from conservative to operative method using percutaneous pins, bone grafting and open reduction with internal or external flxators.
We analysed retrospectively 24 displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation of intraarticular fracture of posterior facet in whole 48 cases(36 person) calcaneal fractures between January 1990 to April 1996 at the Department of Orthopaedic Surgery, Chungnam National University Hospital. A single Ollier approach was used in all cases. And we did not add any bone graft on the defected portion of calcaneal fractures.
The technique and the result were as follows ; 1. An approach to the sinus tarsi with only Oiliers small lateral incision made an offer a good field for open reduction to the displaced posterior facet of calcaneus and diminishes the risk of lateral soft tissue problems.
2. Even only minimal internal fixation of thalamic joint fragment and percutaneous axial pin fixation of the body is enough to prevent the calcaneal redisplacement and provides enough stability to permit functional aftercare(early exercise and weight bearing) with a good result.
3. The Bohler angle is technically difficult to restoration to normal range of angle in our minimal operative method.
4. A bone graft is an alternative and is not necessary.
We proposed our experience obtained in 24 cases as a good method ofr treatment of displaced intraarticular calcaneal fracture, especially in joint depressioin type and tongue type without severe comminution.
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Citations
Citations to this article as recorded by  - A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture
Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 13. CrossRef
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