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Percutaneous Iliosacral Screw Fixation with Cement Augmentation in Osteoporotic Sacral Fracture
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Cheol hwan Kim, Young yool Chung, Seung woo Shim, Sung nyun Baek, Choong young Kim
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J Korean Fract Soc 2019;32(4):165-172. Published online October 31, 2019
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DOI: https://doi.org/10.12671/jkfs.2019.32.4.165
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Abstract
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The prevalence of osteoporotic sacral fractures is increasing. Traditionally, conservative treatment is the 1st option, but it can increase the risk of comorbidity in the elderly. To reduce the complications and allow early mobility, iliosacral screw fixation with cement augmentation will be one of the treatment options for patients with osteoporotic sacral fractures. MATERIALS AND METHODS This study reviewed 25 patients (30 cases) who had undergone percutaneous iliosacral screw fixation with cement augmentation for osteoporotic sacral fractures from July 2012 to December 2018 with a minimum follow up of six months. The clinical outcomes were assessed using the measures of pain (visual analogue scale [VAS] score), hospital stay and the date when weight-bearing started. All patients were evaluated radiologically for pull-out of screw, bone-union, and cement-leakage. RESULTS Bone union was achieved in 30 cases (100%). The mean duration of the hospital stay was 24 days (4–66 days); weight-bearing was performed on an average nine days after surgery. The VAS scores immediately (3.16) and three months after surgery (2.63) were lower than that of the preoperative VAS score (8.3) (p<0.05). No cases of cement-leakage or neurologic symptoms were encountered. Two patients (6.7%) experienced a pulling-out of the screw, but bone-union was accomplished without any additional procedures. CONCLUSION Percutaneous iliosacral fixation with cement augmentation will be an appropriate and safe surgical option for osteoporotic sacral fractures in the elderly in terms of early weight-bearing, pain reduction, and bone-union.
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Citations
Citations to this article as recorded by 
- Role of Augmentation in the Fixation of Osteoporotic Fractures
Chinmoy Das, Partha Pratim Das Indian Journal of Orthopaedics.2025; 59(3): 294. CrossRef
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Treatment of the Femoral Fracture Using Sirus(R) Nail: A Comparison of Complication according to the Entry Potal
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Young Yool Chung, Dong Hyuk Choi, Dae Hyun Yoon, Jung Ho Lee, Ji Hun Park
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J Korean Fract Soc 2015;28(2):103-109. Published online April 30, 2015
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DOI: https://doi.org/10.12671/jkfs.2015.28.2.103
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Abstract
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The purpose of this study is to analyze the clinical results of fixation using Sirus(R) nail in patients with femoral subtrochanteric and shaft fracture and the difference in the frequency of complications according to the entry portal. MATERIALS AND METHODS From July 2006 to August 2013, at least 1-year clinical follow-up, we retrospectively analyzed 36 cases with femoral subtrochanteric (15 cases) and shaft fracture (21 cases) who underwent surgery using Sirus(R) nail. We reviewed the records of operation time, intra-operative amounts of bleeding and complications. At last follow-up, we reviewed clinical results by Ray-Sanders criteria and analyzed the periods of bone union on the radiograph. We also measured changing of the femoral neck-shaft angle in the subtrochanteric fractures and angulation in the shaft fractures, respectively. Considering anatomical variation of the trochanter and fracture position of subtrochanteric and femoral shaft, entry points were divided into subgroups, and the clinical results were compared. RESULTS The mean Ray-Sanders score was 27.4, 27 cases (75.0%) were good or excellent. The mean periods of bone union was 21.1 weeks in 31 cases. The mean neck-shaft angles were 135.7o preoperatively, 130.2o postoperatively. The mean angulation of the femur was 24.4o preoperatively, 2.4o postoperatively in patients of femoral shaft fractures. Despite no statistical significance, greater trochanter tip entry point and lateral entry point had a higher rate of frequency than medial entry point, with respect to the occurrence of iatrogenic fracture and malalignment. CONCLUSION Using Sirus(R) nail for femoral subtrochanteric and shaft fractures showed good clinical and radiographic results and a high rate of union. Medial entry point yielded slightly better results in the occurrence of iatrogenic fracture and malalignment, compared to greater trochanter tip entry point and lateral entry point.
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Fixation of the Greater Trochanter in Arthroplasty for Unstable Intertrochnateric Fracture
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Dong Hyeok Choi, Ju Yeong Heo, Young Jae Jang, Young Yool Chung
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J Korean Fract Soc 2014;27(1):58-64. Published online January 31, 2014
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DOI: https://doi.org/10.12671/jkfs.2014.27.1.58
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We classified fractures of the greater trochanter (GT) and evaluated fracture fragment stability according to GT type. MATERIALS AND METHODS A total of 43 patients with an unstable intertrochanteric fracture treated between January 2007 and July 2009 with bipolar hemiarthroplasty were included in this study. GT fractures were classified as type A, B, C, or D and fixed using either cerclage wiring alone, cerclage wiring and non-absorbable suture or a greater trochanteric reattachment (GTR) plate. RESULTS Type A fractures were fixed using cerclage wiring with non-absorbable suture in two cases, cerclage wiring in six cases and GTR plate in seven cases. Failure occurred in three cases of type A fractures treated with cerclage wiring alone. A total of 11 type B fractures were fixed with cerclage wiring (7), cerclage wiring and non-absorbable suture (3) and GTR plate (1). There was no failure of type B fractures. Type C fractures were fixed using cerclage wiring with non-absorbable suture in one case and GTR plate in three. There was no fixation in three cases. Of 10 type D fractures, six were treated with cerclage wiring and one with GTR plate. Fixation was not performed in three patients. There was no failure in type C and D type fractures. CONCLUSION Fracture fragment stability differed according to fracture types. Cerclage wiring alone was insufficient to fix type A fractures, so type A fracture required a stronger fixation method.
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Citations
Citations to this article as recorded by 
- Primary Arthroplasty for Unstable and Failed Intertrochanteric Fractures: Role of Multi-Planar Trochanteric Wiring Technique
Javahir A. Pachore, Vikram Indrajit Shah, Sachin Upadhyay, Shrikunj Babulal Patel Hip & Pelvis.2023; 35(2): 108. CrossRef - The Efficacy of Suture Fixation of the Greater Trochanter in Unstable Intertrochanteric Fractures
Ki-Choul Kim, Hee-Gon Park, Jae-Wook Park Clinics in Orthopedic Surgery.2021; 13(4): 468. CrossRef - Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?
Kee Haeng Lee, Dong Hun Lee, Jong Ho Noh, Yoon Vin Kim Orthopaedics & Traumatology: Surgery & Research.2019; 105(1): 41. CrossRef - Selecting Arthroplasty Fixation Approach Based on Greater Trochanter Fracture Type in Unstable Intertrochanteric Fractures
Min-Wook Kim, Young-Yool Chung, Sung-an Lim, Seung-Woo Shim Hip & Pelvis.2019; 31(3): 144. CrossRef
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Treatment of Intertrochanteric Fracture with Proximal Femoral Nail
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Dae Joong Kim, Sung Chan Ki, Young Yool Chung
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J Korean Fract Soc 2007;20(1):40-44. Published online January 31, 2007
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DOI: https://doi.org/10.12671/jkfs.2007.20.1.40
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Abstract
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To evaluate the efficacy of proximal femoral nail for intertrochanteric fracture. MATERIALS AND METHODS From June 2001 to March 2005, 45 intertrochanteric fractures were treated with a proximal femoral nail for intertrochanteric fracture and followed-up at least one year. The average age was 71.3 years (34~91 years). The causes of fracture were slip down in 38 cases and fall down in 7 cases. Fractures were classified with AO classification; 20 cases in type A1, 22 cases in type A2 and 3 cases in type A3. Antirotational pin was used in 25 of 45 fractures according to fracture stability. Radiological result was determined with a union. Walking ability was evaluated in the last follow-up. RESULTS The fractures were fixed in anatomical position in 36 cases, in valgus position in 3 cases and varus position in 6 cases. Union was occurred in 43 of 45 cases. The sliding distance of lag screw was an average of 5.63 mm and it had no association with fracture type, TAD, usage of antirational screw, usage of distal screw and BMD. Twenty-six of 45 patients (57.7%) were recovered to pre-injury state of walking ability. Complications were occurred in 3 patients (6%). CONCLUSION Proximal femoral nail was a useful instrument for all type intertrochanteric fractures, but antirotational pin was not necessary in the stable type A1 intertrochnatirc fractures.
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Citations
Citations to this article as recorded by 
- Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteic Fractures in the Elderly
Byung-Hak Kim, Young-Yool Chung, Sung-Chang Ki, Dae-Hyun Yoon, Ji-Hoon Ryu Journal of the Korean Orthopaedic Association.2011; 46(5): 399. CrossRef
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