Journal of Musculoskeletal Trauma

Use of Miniplate for Severe Comminuted Metadiaphyseal Fractures of the Distal Radius: Jong Ryoon Baek, Yong Cheol Yoon, Seung Hyun Baek; J Korean Fract Soc 2019;32(4):204-210. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.204

Abstract PDF: PURPOSE
This study investigated the clinical and radiological outcomes of patients undergoing provisional fixation in conjunction with locking plate fixation. Miniplates were used as the reduction plates for the surgical treatment of severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius.
MATERIALS AND METHODS
The radial length, radial inclination, volar tilt, and radial intra-articular step-off were measured preoperatively, postoperatively, and at one year after surgery in 12 patients (eight males, four females, mean age 55.4 years old). The patients underwent volar locking plate fixation with miniplate as a reduction plate for severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius. Clinical evaluations were conducted using the modified Mayo wrist score (MMWS).
RESULTS
Bone union was achieved in all cases. The mean MMWS was 81.8 points, including two excellent, three good, and seven fair cases. Radiological improvements were observed in the average radial length (preoperative, 6.4 mm; postoperative, 11.8 mm), average radial inclination (10.2Â° to 22.4Â°), average volar tilt (âˆ’4.5Â° to 10.6Â°), and average radial intra-articular step-off (4.8â€“0.8 mm) (all, p<0.05). Radiographic measurements obtained immediately after surgery and at the final follow-up revealed insignificant decreases in radial length (0.6 mm), radial inclination (0.4Â°), and volar tilt (0.9Â°) (all, p>0.05).
CONCLUSION
Miniplate fixation can be an effective treatment option as a reduction plate for the treatment of distal radial fractures, which is challenging to reduce and maintain due to severely comminuted metadiaphysis fractures with the intra-articular fracture.

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Comparison of the Treatment Results between Reduction with Percutaneous Wiring and Reduction without Percutaneous Wiring in Reverse Oblique Trochanteric Fractures (AO Classification 31-A3.3): Jae Woo Park, Oog Jin Shon, Seung Wan Lim; J Korean Fract Soc 2017;30(4):192-197. Published online October 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.4.192

Abstract PDF: PURPOSE
The aim of this study was to investigate the utility of percutaneous wiring in the reduction of reverse oblique trochanteric fractures (AO classification 31-A3.3) by analyzing the treatment results with or without the use of percutaneous wiring.
MATERIALS AND METHODS
Thirty-five cases from January 2008 to August 2014 that could be followed-up for at least one year were selected among patients with unstable trochanteric fractures who underwent either internal fixation or open reduction. Seventeen patients underwent surgery with percutaneous wire fixation but another 18 patients underwent surgery without it. All patients received a closed reduction and internal fixation with an intramedullary nail. The factors evaluated were as follows: the length of operation, loss of blood, length of in-hospital stay, lower limb function scale, return to preinjury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, time taken for bone attachment, quality of post-operative reduction, and complications.
RESULTS
No significant difference in the mean operative time, loss of blood, length of in hospital stay, lower limb function scale, return to pre-injury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, and quality of postoperative reduction was observed between the two groups. A significant difference was noted in the time taken for bone attachment (p=0.032). Bone attachment took 13.3 weeks (9â€“17 weeks) on average when fixed with percutaneous wiring and no patient was found to have any complications. When treated without percutaneous wiring, however, bone attachment took 17.8 weeks (12.5â€“28.0 weeks) on average and three cases resulted in delayed union.
CONCLUSION
Percutaneous wiring is a recommended treatment option for patients with an unstable trochanteric fracture.

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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; J Korean Fract Soc 2014;27(3):206-212. Published online July 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.3.206

PURPOSE
The purpose of this study is to evaluate the results of tension band wiring and additional circumferential wiring in treatment of comminuted patella fractures.
MATERIALS AND METHODS
A retrospective study of 67 patients with follow-up period longer than six months who underwent tension band wiring and additional circumferential wiring for comminuted patellar fracture from January 2004 to December 2012 was conducted. Analysis was based on radiological evaluation of bony union and articular surface displacement, and clinically by evaluating the postoperative function of the knee joint using the Levack scoring system.
RESULTS
Only one case out of 67 (1.5%) showed nonunion without metal breakage while good bone union was achieved in all other cases. Excluding the nonunion case, range of motion was 90 degrees minimum, 135 maximum, 129 on average. Average displacement was less than 2 mm, and 64 out of 67 cases showed satisfactory outcome with excellent functional score according to the Levack scoring system.
CONCLUSION
Tension band wiring and additional circumferential wiring technique for treatment of comminuted patella fractures can be considered as an effective treatment for achievement of good bone union and restoration of normal knee function.

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A Novel Technique in Comminuted Patella Fractures: Minimally Invasive Pericerclage Osteosynthesis Using Drainage Trocar
Fırat Fidan, Abdülkadir Polat, Cengiz Kazdal, Emre Bal
Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy.2022; 18(4): 427. CrossRef
Current Treatment Strategies for Patella Fractures
David J. Hak, Philip F. Stahel, Dustin J. Schuett, Mark E. Hake, Cyril Mauffrey, E. Mark Hammerberg, Philip F. Stahel, David J. Hak
Orthopedics.2015; 38(6): 377. CrossRef

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Modified Tension Band Wiring Combined with Anti-Gliding Loop Augmentation Technique for the Treatment of Comminuted Patellar Fracture: Technical Note and Report of Early Results: Technical Note: Han Jun Lee, Jae Jun Yang, Ho Joong Jung, Hyoung Seok Jung; J Korean Fract Soc 2013;26(4):321-326. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.321

Abstract PDF: In order to investigate the feasibility of a modified tension band combined with anti-gliding loop augmentation technique for the treatment of comminuted patellar fracture, 21 patients with comminuted patellar fracture were enrolled in this study. After the modified tension band wiring of patellar fracture, a cerclage wire was passed around the patella. Anti-gliding loops were made on the bending sites of Kirshner-wires. A knot was tied using both ends of the anti-gliding loops, and the cerclage wire was tightened using proximal knots. Bone union was achieved at 4.5+/-1.5 months postoperatively without nonunion. The Lysholm score was 87.1+/-2.8, and the range of motion of the knee was 2.1degrees+/-3.4degrees to 132.2degrees+/-6.5degrees at the last follow-up. The modified tension band combined with anti-gliding loop augmentation technique might be considered an alternative modification of modified tension band wiring for the treatment of comminuted patellar fracture.

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Internal Fixation Using Double Plates for Comminuted Olecranon Fractures in Adults: Hyun Dae Shin, Jae Hoon Yang, Pil Sung Kim; J Korean Fract Soc 2009;22(3):166-171. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.166

Abstract PDF

PURPOSE
To evaluate the clinical usefulness of internal fixation with double plates for comminuted olecranon fractures.
MATERIALS AND METHODS
Nine patients with olecranon fractures which are classified into Mayo type IIB (7 cases) and type IIIB (2 cases) underwent internal fixation using double plates from June 2002 to September 2005. They were followed-up for more than 12 months and average period of follow-up was 14 (12~18) months. Six cases were males and three were females. Mean age was 40.7 (21~63) years. We used open reduction and internal fixation using double plates. Clinical assessment index was pain, range of motion (ROM), stability and function of joint at last follow-up. The sum of four indices were compared. Also, we evaluated starting time of full ROM exercise, bony union time and complications.
RESULTS
All cases started postoperative ROM within 7 days and clinical results were evaluated using Mayo elbow performance index. 'Excellent', 'good' were 2, 6 cases, respectively and 1 case was 'fair'. Elbow ROM was more than 110o in all cases except one. Mean radiological bony union time was 3.9 (2.5~5) months postoperatively. There were heterotrophic ossifications in 3 cases as complication.
CONCLUSION
Internal fixation using double plates for comminuted olecranon fractures in adults can be good treatment option which obtains good clinical results and enables early ROM.

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Biomechanical Comparison of Dual and Posterior Locking Plates in an Ex Vivo Comminuted Olecranon Fracture Model
Andrew D. Sobel, Jacob M. Babu, Travis D. Blood, E. Scott Paxton
The Journal of Hand Surgery.2022; 47(8): 796.e1. CrossRef
Surgical Treatment of Comminuted Olecranon Fracture Using Locking Compression Plate Fixation
Eunchang Lee, Seong-Hee Cho, Jun-Il Yoo, Jin-Hyung Im, Dong-Geun Kang, Jin Sung Park
Archives of Hand and Microsurgery.2021; 26(1): 18. CrossRef
The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture
In-Tae Hong, Kyunghun Jung, Yoon Seok Kim, Soo-Hong Han
Archives of Hand and Microsurgery.2019; 24(2): 133. CrossRef
Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates
Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon
Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures
Bo-Kun Kim, Hyun-Dae Shin, Kyung-Cheon Kim, Yoo-Sun Jeon
Journal of the Korean Orthopaedic Association.2011; 46(2): 146. CrossRef

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Primary Subtalar Arthrodesis for the Treatment of Intra-articular Calcaneal Comminuted Fractures: Hong Geun Jung, Yu Jin Kim, Suk Ha Jeon; J Korean Fract Soc 2006;19(4):418-423. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.418

Abstract

PURPOSE
To evaluate the functional outcomes of the severely comminuted intra-articular calcaneal fractures that were selectively treated with primary subtalar arthrodesis.
MATERIALS AND METHODS
This study is based on the 9 patients, 10 feet of intra-articular severely comminuted calcaneal fractures that were treated with open reduction and internal fixation with primary subtalar arthrodesis due to inability to reconstruct the subtalar articular surface with follow-up of more than 1 year. Postoperative clinical evaluation was performed with AOFAS Hindfoot functional scores. The patient satisfaction, returning to previous occupation and complications were also investigated.
RESULTS
Follow-up period was average 20.3 months. Overall AOFAS functional score at final follow-up was average 71.8 points and VAS pain score was 3.9. Fifty percent of the patients were satisfied with the surgery and 80% of the patients were able to return to their previous occupations at average 8.4 months after trauma. Post-operative complications were 2 cases of sural nerve injuries and 1 hindfoot valgus malunion.
CONCLUSION
We concluded that the primary subtalar arthrodesis is a viable surgical option for severely comminuted calcaneal fractures with favorable functional result and early returning of most patients to their previous occupations.

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Joint-Sparing Surgical Management of Sanders IV Displaced Intra-Articular Calcaneal Fractures
Thomas S. Roukis
Clinics in Podiatric Medicine and Surgery.2019; 36(2): 251. CrossRef
Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures
Seung Hun Woo, Hyung-Jin Chung, Su-Young Bae, Sun-Kyu Kim
Journal of the Korean Orthopaedic Association.2017; 52(1): 49. CrossRef
Bilateral Open Transcalcaneal Fracture with Talonavicular Dislocation - A Case Report -
Hun Park, Sung Jin Shin, Sang Rim Kim, Kwang Woo Nam, Sung Wook Choi, Kyu Bum Seo, Jun Young Seo
Journal of the Korean Fracture Society.2011; 24(1): 87. CrossRef
Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef

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Treatment of Commiuted Fractures of the Proximal Tibia Using Ilizarov External Fixator: Jae Ik Lee, Myung Hwan Son, Jae Hong Park, Kang Hoon Kim; J Korean Soc Fract 1998;11(1):198-204. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.198

Abstract PDF: Twenty one comminuted fractures of the proximal tibia in 21 patients were treated with Ilizarov external fixator from May 1990 to May 1996 in Pusan City Medical Center. The average duration of external fixation was 17weeks, and all of the fractures healed without bone graft. The mean time to union was 18weeks in closed comminuted fractures, and 21 weeks in Gustilo type I, II open fractures. The complications with this technique were pin tract infection 3 cases, pin loosening 6 cases, septic arthritis 1 case, post-traumatic osteoathritis 1 case, and joint ankylosis 1 case. The average duration of follow up was 18 months. The range of knee motion of 19 cases of the the 21 patients was at least 115-degrees arc. Post-operative immediate exercise was possible, and partial weight bearing with crutch was also possible after post-operative 4 weeks. We concluded that Ilizarov external fixation is a satisfactory technique for the treatment of selected comminuted fractures of the proximal tibia.

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