Journal of Musculoskeletal Trauma

Computational Simulation of Multiple Cannulated Screw Fixation for Femoral Neck Fractures and the Anatomic Features for Clinical Applications: Jin Hoon Jeong, Gu Hee Jung; J Korean Fract Soc 2018;31(2):37-44. Published online April 30, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.2.37

PURPOSE
To identify the anatomic features for clinical applications through a computational simulation of the fixation of three cannulated screws for a femoral neck fracture.
MATERIALS AND METHODS
Thirty cadaveric femurs underwent computed tomography and the images were transferred to the MimicsÂ® program, resulting in three-dimensional proximal femur models. A three-dimensional scan of the 7.0 mm cannulated screw was performed to enable computerized virtual fixation of multiple cannulated screws for femoral neck fractures. After positioning the screws definitively for cortical support, the intraosseous position of the cannulated screws was evaluated in the anteroposterior image and axial image direction.
RESULTS
Three cannulated screws located at the each ideal site showed an array of tilted triangles with anterior screw attachment and the shortest spacing between posterior and central screws. The central screw located at the lower side was placed in the mid-height of the lesser trochanter and slightly posterior, and directed toward the junction of femoral head and neck to achieve medial cortical support. All the posterior screws were limited in height by the trochanteric fossa and were located below the vastus ridge, but the anterior screws were located higher than the vastus ridge in 10 cases. To obtain the maximum spacing of the anterior and posterior screws on the axial plane, they should be positioned parallel to the cervical region nearest the cortical bone at a height not exceeding the vastus ridge.
CONCLUSION
The position of cannulated screws for cortical support were irregular triangular arrangements with the anterosuperior apex. The position of the ideal central screw in the anteroposterior view was at the mid-height of the lesser trochanter toward the junction of the femoral head and neck, and the anterior and posterior screws were parallel to the neck with a maximal spread just inferior to the vastus ridge.

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Computational Simulation of Femoral Neck System and Additional Cannulated Screws Fixation for Unstable Femoral Neck Fractures and the Biomechanical Features for Clinical Applications
Ju-Yeong Kim
Journal of the Korean Fracture Society.2023; 36(1): 1. CrossRef

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Transverse Fracture through Screw Site after Cannulated Screw Fixation in Vertical Patella Fracture: A Case Report: Suk Kang, Phil Hyun Chung, Chung Soo Hwang, Jong Pil Kim, Young Sung Kim, Chong Suck Parke; J Korean Fract Soc 2006;19(1):96-99. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.96

Abstract

Many complications after operative treatment of patella including redisplacement of fracture, refracture, weakness of extensor muscles, patellofemoral joint arthritis, metal failure, malunion, infection, avascular necrosis were reported. We report a case of transverse fracture of patella through the cannulated screw fixation site used to fix previous vertical patella fracture with a review of the literatures.

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Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef

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Arthroscopic Reduction and Percutaneous Cannulated Screw Fixation for Longitudinal Fractures of Patella: Jung Han Yoo, Yung Khee Chung, Yong Wook Park, Jin Sub Kim, Deuk Soo Jun, Ho Jin Lee; J Korean Soc Fract 2000;13(1):103-108. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.103

Abstract PDF: A variety of surgical modalities for fractures of patella have been described. We used arthroscopic reduction and percutaneous screw fixation for six cases of longitudinal fracture of patella. Ages of the patients ranged from 25 to 33 years. the postoperative regimen was one week long leg splint for reducing the pain, followed by continuous passive range of motion exercise of the knee including active one and quadriceps strengthening exercise until the full range of motion was gained, with progressive partial to full weight bearing with crutches. The follow-up period was from 12 to 54 monhts. Results were assessed subjectively and objectively with retrograde study. The full range of knee motion was recovered from 20 to 35 days postoperatively, The radiographic bone union was achieved from 31 to 42 days. And all patient had good results according to Lysholm and Gillquist scoring system. We had no experience of complication except one which is prominence of screw end. So, we believed that the arthroscopic reduction and percutaneous cannulated screw fixation for longitudinal fractures of patella is the useful surgical method.

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Treatment of A-C joint dislocation with cannulated screw fixation under local anesthesia: Bu Hwan Kim, Jong In Yim, Deog Jeong Kang; J Korean Soc Fract 1996;9(1):185-192. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.185

Abstract PDF: In 1941, Bosworth used noncannulated coracoclavicular lag screw to Oeat acute A-C joint dislocation. In 1989, Tsou fixed coracoclavicular joint with percutaneous cannulated screw under general anesthesia in the treatment of acute A-C joint complete dislocations. We tried to treat 10 cases of acute A-C joint dislocations with cannulated screw fixation of C-C joint under local anesthesia, so we report the results with review of literatures. The results were as follows 1. Results of treatment were good in 7 cases, fair in 2 cases, and poor in 1 case by Weaver and Dunn evaluation criteria. 2. The operations were done under local anesthesia, but in two cases operation ended under general anesthesia due to discomfort of the patients. 3. In skeletally thin patient, it was very difficult to make accurate hole and we experienced an iatrogenic fracture of clavicle and coracoid process. This technique is not recommendable in skeletally thin patient. 4. Operation took 42 minutes on average(from 30 minutes to 105 minutes) though it took more time in the early cases. 5. We had several complications in 3 patients. Misdirection of screw(1 case), screw loosening and pull out(1 case), subluxation of A-C joint after removal of screw(2 cases), and iatrogenic fracture of clavicle and coracoid process(1 case) but no case of metal breakage or infection.

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