Purpose To evaluate the usefulness of percutaneous cannulated screws with tension band wiring (PC-STBW), a minimally invasive surgical technique, compared to conservative treatment for a minimally displaced patella transverse fracture. Materials and Methods The subjects included patients from 2010 to 2019 with transverse patella fractures, who were diagnosed as minimally displaced fractures, and were followed up for at least 1 year. Of these, 61 patients who were treated with cylinder casts were classified as Group A, and 53 patients who were treated with PCSTBW were classified as Group B. The clinical evaluation was carried out by evaluation of the radiographic bone union and calculation of the Bostman knee score. Any complications observed were investigated. Results All patients in both groups showed no further displacement of the fracture gap, and the bone union was achieved in all cases. The functional evaluation of the knee joint measured at the 8- and 12-week follow-up showed superior results in Group B wherein subjects were treated with surgery, and similar results were seen in both groups during the 6 months and 1-year follow-up. One case in Group A suffered the complication of knee stiffness. Conclusion For the treatment of minimally displaced transverse patellar fractures, both conservative treatment and PCSTBW showed similar good results at the 6-month and one-year follow-up. However, the PCSTBW technique showed superior clinical results in the early stage follow-up within 12 weeks.
PURPOSE As the functional demands for activities in elderly patients are increasing according to their life extension, the need for surgical treatment is also increasing in elderly patients with displaced intra-articular calcaneal fractures. In addition to the extensile lateral approach (ELA), which is a surgical procedure that showed good results on intra-articular calcaneal fractures, the minimally invasive approach (MIA) also showed an outstanding result. This study compared the radiological and clinical results of intraarticular calcaneus fractures in elderly patients in two groups: ELA and MIA. MATERIALS AND METHODS Thirty patients aged over 65 years with intra-articular calcaneus fractures, who could be followed-up more than 14 months, were included in this study. Thirteen patients of the MIA group and 17 patients of the ELA group were analyzed retrospectively using radiological and clinical assessments. RESULTS No significant difference in union time, posterior facet reduction accuracy, subtalar osteoarthritis frequency, Bohler angle, calcaneal width, American Orthopaedic Foot and Ankle Society score, visual analogue scale score, 36-item short form survey, and foot function index was observed between the two groups. The p-value of the average height of the calcaneus correction, average length of calcaneal correction, and average loss of correction length were <0.001, 0.005, and 0.015, respectively. The incidence of complications, including soft tissue necrosis and bone infection, were 23.1% in the ELA group and none in the MIA group. CONCLUSION The clinical outcomes were similar in the two groups. The degree of reduction of fracture showed a better result in the MIA group than the ELA group. Furthermore, there were no complications in the MIA group, whereas the ELA group showed some complications.
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Clinical and Radiological Outcomes of ‘Blocking Kirschner Wire Technique’ in Displaced Intra-Articular Calcaneal Fractures via the Extended Sinus Tarsi Approach Jeong-Kil Lee, Chan Kang, Sang-Bum Kim, Gi-Soo Lee, Jung-Mo Hwang, Byung-Kuk An Journal of the Korean Orthopaedic Association.2021; 56(3): 224. CrossRef
PURPOSE We evaluated the complications, radiological and clinical results after operative treatment using a mini-plate for fixation of displaced talar neck fractures. MATERIALS AND METHODS There were 20 cases of displaced talar neck fractures from May 2006 to December 2011; we performed a retrospective chart review of 15 patients treated by open reduction and internal fixation using a mini-plate who had more than 2 years of follow-up. According to Hawkin's classification, there were 7 cases of type II fractures and 8 cases of type III fractures. During postoperative 12-16 weeks we checked magnetic resonance imaging. The assessment of clinical results was based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale. RESULTS Mean union period was 11.6 weeks (10-15 weeks). Nonunion and malunion did not occur in all cases. The mean AOFAS score was 88.2 points (80-97 points). There were 5 cases of avascular necrosis. Of these, there were 3 cases of body collapse and 4 cases of post-traumatic arthritis. In the statistical analysis, there was no correlation between the elements including gender, Hawkin's classification and union rates and clinical results. CONCLUSION Mini-plate fixation of a displaced talar neck fracture is thought to be a good technique, with a low rate of malunion and also showed satisfactory results in radiological and clinical assessment.
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Outcome of Type 3 Talar Neck Fractures by Means of Medial Malleolar Osteotomy and Large Distractor Sung Hae Park, Jun Young Lee, Jung Woo Lee Journal of the Korean Orthopaedic Association.2019; 54(1): 45. CrossRef
The Measurement of Normal Talus in Korean Cadaver Dong-Jun Ha, Heui-Chul Gwak, Jeon-Gyo Kim, Jung-Han Kim, Chang-Rak Lee, Young-Jun Kim, Jeong-Han Lee, Byung-Ho Ha, Ui-Cheol Kim Journal of Korean Foot and Ankle Society.2016; 20(4): 163. CrossRef
PURPOSE To evaluate the usefulness of wire fixation in displaced acetabular fractures. MATERIALS AND METHODS From January 2000 to December 2005, 19 cases of displaced acetabular fracture were treated with wire fixation. According to Letournel's classification there were 9 both column fracture, 5 transverse fracture, 3 anterior column with posterior hemitransverse and 2 T-type fracture. Only wire fixation in 13 cases and wire with plate or wire with screw fixation in 6 cases. RESULTS We evaluate the accuracy of reduction by Matta' criteria, anatomical reduction in 12 cases, incomplete reduction in 4 cases, poor reduction in 2 cases and surgical secondary congruence in 1 case. The clinical results showed excellent in 12 cases, good in 4 cases, fair in 2 cases and poor in 1 case. The radiological results showed excellent in 10 cases, good in 4 cases, fair in 3 cases and poor in 2 cases. There were 4 cases of complication; wound infection in 1case, post-traumatic arthritis in 1 case and heterotopic ossification in 2 cases. CONCLUSION The cerclage wiring is a preferable method in internal fixation of displaced acetabular fractures that can facilitate reduction and achieve stable fixation.
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Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef
Comparative Results of Acetabular Both Column Fracture According to the Fixation Method Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park Hip & Pelvis.2011; 23(2): 131. CrossRef
PURPOSE To evaluate a new treatment method by pin leverage technique in Gartland type III fractures to avoid forceful manipulation or open reduction. MATERIALS AND METHODS 99 cases were included in this study and divided into 3 groups (I;open reduction, II; closed reduction and percutaneous pin fixation, III; pin leverage technique), and we analyzed timing to operation, length of operation, associated neurovascular injuries, complications, and clinical and radiological outcomes at final follow-up. RESULTS The average length of operation 119, 57, and 68 minutes respectively. The associated nerve injuries were 8, 2, and 2 cases respectively. There were a case of superficial pin tract infection in group I, three cases of superficial pin tract infection and a case of iatrogenic ulnar nerve injury in group II. At final follow-up, clinical results were excellent or good in all cases and there were 5 cases (8.3%) of fair results in group II radiologically. Closed reduction with pin leverage technique were failed in 5 cases. CONCLUSION In treatment of Gartland type III fractures, pin leverage reduction technique is considered to be a good alternative prior to open reduction, because it provides shortened length of operation, avoidance of forceful manipulation and open reduction.
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Recent Trends in Treatment of Supracondylar Fracture of Distal Humerus in Children Soon Chul Lee, Jong Sup Shim Journal of the Korean Fracture Society.2012; 25(1): 82. CrossRef
PURPOSE To evaluate the outcomes of minimal anterior approach and thumb assisted technique, in children with Gartland type III supracondylar humerus fracture, who were operated by this technique. MATERIALS AND METHODS Forty two children with Gartland type III supracondylar fractures of the humerus with severe swelling were taken up for minimal open reduction and K-wire fixation. The technique used was a minimal incision in the cubital fossa and thumb assisted reduction of the fracture. Stabilization of fractures was done with 1.6 mm Kirschner wires. RESULTS The outcomes were excellent in 40 cases good in 2 cases. No complications including malunion or scar contracture were seen. CONCLUSION This technique is safe, effective and can be used for irreducible, displaced supracondylar fractures of the humerus in children
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Supracondylar Humerus Fractures: Classification Based Treatment Algorithms Mudit Shah, Mandar Vikas Agashe Indian Journal of Orthopaedics.2021; 55(1): 68. CrossRef
Recent Trends in Treatment of Supracondylar Fracture of Distal Humerus in Children Soon Chul Lee, Jong Sup Shim Journal of the Korean Fracture Society.2012; 25(1): 82. CrossRef
Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique H.-Y. Lee, S.-J. Kim The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef
PURPOSE To evaluate the radiographic and clinical results of displaced transverse patellar fractures using a tensioned anterior figure-eight wire placed through two cannulated screws MATERIALS AND METHODS: 9 patients with displaced transverse patellar fractures treated with cannulated screws and figure-eight wiring were analyzed retrospectively. The mean age was 53 years (range, 22 to 68 years). Controlled passive range of motion exercise were started on the first postoperative day. Full weight bearing was allowed as tolerated. The patients were evaluated with radiographs, clinical examination and Levack's scoring system. RESULTS All fractures healed and mean time elapsed for union was 9.4 weeks (range, 8 to 12 weeks). All patients regained full knee range of motion. Clinical results according to the Levack's scoring system were excellent in 8 cases and good in 1 case. We found no complications like loss of reduction and soft tissue irritation caused by the wire and screw, loosening or migration of hardware. CONCLUSION Anterior figure-eight wiring through paired cannulated screws is appropriate for transverse patellar fractures, is possible early knee motion exercise and weight bearing.
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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
PURPOSE To evaluate indications and effectiveness of intramedullary K-wire fixation for distal radial fractures. MATERIALS AND METHODS Twenty one fractures of distal radius treated with intramedullary K-wire fixation from April 2001 to September 2002 were evaluated. The mean age was 67.8(range 46~82). Severely comminuted intra-articular fractures and Barton's fractures were excluded. One or two K-wires were added percutaneously. To assess the functional result, we used Green and O'Brien score system. The radiographic assessment included a scoring system based on measurements of radial length, radial inclination, volar tilt and step-off of the radial articular surface. RESULTS Average follow up period was 13.5 months. In functional result, excellent and good result were obtained in 18 cases (86%). In radiologic result, mean loss of radial length, radial inclination and volar tilt were 0.9 mm, 1.4degrees, 0.9degrees, respectively. CONCLUSION The advantages of intramedullary K-wire fixation were relatively simple procedure, low occurrence of soft tissue complications and early wrist motion. Intramedullary K-wire fixation was good to maintaining reduction in osteoporotic bone.
PURPOSE We performed a retrospective study of completely displaced supracondylar fracture of humerus in children to evaluate the result of primary open reduction and internal fixation for this injuries, and also to know whether it is recommendable or not for such injuries. MATERIALS AND METHODS For 5 years duration from March '96 to Feb. '01, we treated 58 cases of completely displaced supracondylar fractures of humerus in children. Among them we performed primary open reduction and internal fixation of this fracture in 14 cases. We followed up those cases more than 18 months and evaluated the results by Flynn et al. and Mark et al. criteria. RESULTS Eleven of them resulted in excellent grading by both Flynn and Mark criteria. Three cases not involved in excellent grading proved to be good result by Mark criteria. But by Flynn criteria, 2 cases showed good results and the other one proved to be fair. In all cases, the patient and parents were satisfied cosmetically and functionally. Only in one case, the recorded grading was different, fair by Flynn and good by Mark criteria. CONCLUSION Primary open reduction and internal fixation in the treatment of completely displaced and not easily reduced supracondylar fracture of humerus in children resulted excellent and good results with few complications, and patients were satisfied with the results functionally and cosmetically. So we recommend proceeding to primary open treatment and internal fixation for these difficult fractures with low threshold to open reduction.
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Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique H.-Y. Lee, S.-J. Kim The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef
PURPOSE To analyze the results of surgical treatment of the displaced distal radius fractures in elderly patients over 65 years old who were treated with percutaneous K-wire fixation only and percutaneous K-wire fixation with external fixation.
MATERIAL AND METHOD: We evaluated 24 cases of the distal radius fracture in patients older than 65 years from January 1998 to December 2001. The patients were followed up at least 12 months postoperatively. We compared the surgical results of 14 cases, treated with percutaneous K-wire fixation only with the surgical results of 10 cases, treated with percutaneous K-wire fixation with external fixation. We evaluated the functional results according to demerit point system and the radiographic results (radial length, radial inclination, volar tilt). RESULTS According to demerit point system, the mean score of demerit point was 9.9 in the group of percutaneous K-wire fixation and 5.3 in the group of percutaneous K-wire with external fixation respectively (p<0.05). In radiographic results, the percent of the mean loss of radial length, radial inclination and volar tilt were 23.2%, 12% and 41.7% in the group of percutaneous K-wire fixation and 11%, 5.9% and 27.4% in the group of percutaneous K-wire with external fixation respectively (p<0.05). CONCLUSION Percutaneous K-wire with external fixation showed better functional and radiographic results than percutaneous K-wire fixation only for the treatment of the displaced distal radius fractures in elderly patients older than 65 years and percutaneous K-wire with external fixation is thought to be a one of the most effective treatment of the displaced distal radius fractures in elderly patients.
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Osteoporotic Distal Radius Fracture-conservative Treatment Seok-Whan Song Journal of the Korean Fracture Society.2008; 21(1): 81. CrossRef
PURPOSE The purpose of this study was to evaluate the outcome of conservative treatment for minimal displaced lateral mallolar fracture using ankle brace. MATERIALS AND METHODS Eleven patients (eleven ankles) underwent conservative treatment with ankle brace for 8 weeks with full weight bearing ambulation. Inclusion criteria were minimal displacement (<3 mm) of fracture, no or mild tenderness or swelling on medial malleolar area and no lateral shift of talus. The patients were evaluated with AOFAS (the American Orthopedic Foot and Ankle society) Ankle-Hindfoot scale. RESULTS Average follow up was 103 weeks (36~192). All cases had normal range of motion of ankle. The average score of AOFAS Ankle-Hindfoot scale was 95 points. CONCLUSION The advantages of conservative treatment with ankle brace were early return to daily activity and work, comfort to the patients and a short period of rehabilitation. Conservative treatment with ankle brace for minimal displaced lateral malleolar fracture is recommended.
PURPOSE The purpose of this study was to investigate the efficacy of bone graft use in the treatment of displaced intra-articular calcaneal fractures. MATERIALS AND METHODS We analysed retrospectively 40 displaced intra-articular calcaneal fractures, which had undergone open reduction and internal fixation without bone graft from June 1989 to July 1998. Radiological assessments were made from the lateral view of the affected calcaneus, recording the Bohler angle, the Gissane angle and ratio of height/width of the calcaneus. Matching criteria included Essex-Lopresti classification, method of fixation, age, and sex. RESULT The mean preoperative Bohler angle was -7 degrees(standard deviation [S D ] 1 8 degrees), postoperative Bohler angle was 21 degrees(SD 7 degrees), last follow-up Bohler angle was 1 9 degrees(SD 7 degrees). Bohler angle increased a mean 28 degrees(maximum 70 degrees, minimum 2 degrees). The preoperative Gissane angle was 104 degrees(SD 17.87 degrees), postoperative Gissane angle was 1 0 6 . 2 degrees(SD 10.07 degrees), last follow-up Gissane angle was 104.48 degrees(SD 10.1 degrees). The preoperative ratio of height/width of the calcaneus was 0.568(SD 0.076), postoperative ratio was 0.637(SD 0.037), last follow-up ratio was 0.648(SD 0.038). There was no significant differences in fracture pattern, method of fixation, age, and sex(P>0.05). CONCLUSION The result of this study showed that there was no significant change in serial radiologic evaluation. Bone graft was not served to the effectiveness or security in the treatment of displaced intra-articular calcaneal fractures.
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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
PURPOSE This retrospective study was performed to know the clinical results after closed reduction and open reduction for completely displaced supracondylar fractures of distal humerus in children. MATERIALS AND METHODS Twenty-eight cases of this injury at the mean age of 6.4 (range 21- 138 months), have been followed up over the minimum of one year. The types according to the position of displacement were 15 in posteromedial, and 13 in posterolateral displacement. There were 4 cases of associated nerve palsies (3;median, 1; radial). We tried the closed reduction (17 cases), but open reduction (11 cases) was indicated in irreducible cases with or without severe swelling. Then, the fractures were stabilized by percutaneous K-wires with lateral (23 cases) or cross pinning (5 cases). The differences of Baumann's angle, humero-ulnar angle, and elbow motion to uninjured side were calculated, and Flynn's criteria was used for evaluation. RESULTS All fractures were united without any infection or soft tissue compromise. The symptoms of injured nerve recovered within 8 weeks. According to Flynn's cirteria, results were excellent in eleven, good in 12, fair in 2, and poor in 3. The rates of satisfactory results over good were similiar between closed and open reduction, and the other factors including age and type of displacement were not meaningful. The mean Baumann's angle was 8.7 in closed and 6.6 in open reduction group. None of the patients showed restricted elbow motion above 10 degrees, even in 3 cases of hypertrophic scars in the group of open reduction. CONCLUSION The selective use of open reduction in completely displced supracondylar fractures of distal humerus in children, would show results as good as closed reduction.
PURPOSE The purpose of this study was to know the usefulness of bony union and faster recovery of shoulder motions by the open reduction and internal fixation with the reconstruction plate for the displaced clavicle shaft fracture of adults.
MATERIAL AND METHOD: From January 1993 to December 1997, for 5 years, we analyzed 28 cases which underwent for a year of displaced clavicular shaft fracture over 11mm after open reduction and internal fixation with the reconstruction plate and supplementary iliac bone graft. RESULT At all 28 cases, there were united without delayed union for average 7.2 weeks after operation. Motion of the shoulder joint were returned to normal within 1.8 weeks except two cases who had combined humerus fracture and partial gastrectomy for peptic ulcer. CONCLUSION It seems that operative treatment with the reconstruction plate and supplementary bone graft for the displaced clavicle shaft fracture of adults showed effective union and faster recovery of shoulder motions.
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Does cerclage wiring interfere with fracture healing of osteosynthesis in comminuted midshaft clavicle fractures? A multicenter study Hyo Jin Lee, Yong Bok Park, Chang Heon Shim, Young Min Noh Orthopaedics & Traumatology: Surgery & Research.2021; 107(8): 103091. CrossRef
Anatomical Reduction of All Fracture Fragments and Fixation Using Inter-Fragmentary Screw and Plate in Comminuted and Displaced Clavicle Mid-Shaft Fracture Kyoung Hwan Koh, Min Soo Shon, Seung Won Lee, Jong Ho Kim, Jae Chul Yoo Journal of the Korean Fracture Society.2012; 25(4): 300. CrossRef
Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing? Jae-Kwang Yum, Yong-Woon Shin, Hee-Sung Lee, Jae-Gu Park Journal of the Korean Fracture Society.2011; 24(2): 138. CrossRef
PURPOSE To analysis clinical and radiological results of operative treatment of displaced acetabular fractures and establish the guideline for the operative treatment of displaced acetabular fracture with the analysis of the clinical and radiological results. MATERIALS AND METHODS A clinical analysis was performed on 36 patients with displaced acetabular fractures who had been operated on and followed for minimum 1 year period from January 1993 to December 1998. Clinical outcome was analyzed clinically by Harris hip scoring system and radiologically by Matta's roentgenographic grading system. RESULTS According to Letournel's classification, we had 25 elementary fractures(69%) and 12 associated fracture(31%). Among the elementary fractures, the posterior wall fracture was the most common type(17 cases, 47%) and both column fracture was the most common type among associated fractures(5 cases, 11%).
Surgical approaches were 22 Kocher-Langenbeck, 8 extended iliofemoral, 3 triradiate transtrochanteric, 3 ilioinguinal. The mean duration of follow up after the operation was 2.2 years (range, 1 to 7 years). Among thirty six patients who had followed up more than one year, the satisfactory results were achieved in 27 cases (75%) on clinical grade and 26 cases (72%) on radiographic grade. The complications were developed in 20 cases out of 36 cases including posttraumatic arthritis 7 cases, heterotopic ossification 4 cases. CONCLUSION In the majority of the displaced acetabular fractures, accurate open reduction and internal fixation was recommended. It seems that the satisfactory operative reduction of the fracture is the factor that correlates with a satisfactory clinical result according to our study. Therefore in the surgical treatment of the acetabuluar fractures, it is essential to achieve an anatomical reduction and firm fixation by fully understanding the pathologic anatomy and by choosing an appropriate approach and fixation device.
Forty five patients above the age of 60 with displaced femoral neck fractures were treated by bipolar hemiarthroplasty in Kangbuk Samsung hospital from January 1990 to January 1995. We evaluated these patients for comparison of the results between the cemented and uncemented femoral fixation, especially in elderly patients with medical illness or osteoporosis. During a follow up period of more than two years, the authors found less thigh pain(5.2% versus 38%) and slightly higher Harris hip scores(84.5 versus 80.0 points) in the cemented group in comparison with the uncemented group. Radiographic examination showed less radiolucent zones in the cemented group. Comparing the operative time(86.2 versus 83.8 minutes), hospital stay(4.7 weeks versus 5.3 weeks), blood loss(385 versus 381 ml) during the operation. The postoperative mortality rate was 2%, and the follow-up mortality rate was 11% in the first year. There was no significant difference between two groups in mortality rate. Thus in bipolar hemiarthroplasty in elderly patients with displaced femoral neck fracture, we have obtained satisfactory results despite of poor bone condition and osteoporosis except thigh pain. But the follow up period was too short to assess the late complications of the hemiarthroplasty such as acetabular erosion, implant loosening, so long-term follow up will be necessary
After distal radius fracture, delayed rupture of extensor pollicis longus is rare. It is known that delayed rupture of extensor pollicis longus tendon result from undisplaced distal radius fracture. We have experienced a case of rupture of the extensor pollicis longus tendon after undisplaced distal radius fracture, and treated with palmaris longus tendon graft. the result were satisfactory without complications.
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Extensor Pollicis Longus Rupture after Distal Radius Fracture Nam-Young Cho, Chang-Young Seo, Myung-Sun Kim, Ha-Sung Kim, Keun-Bae Lee Journal of the Korean Fracture Society.2012; 25(1): 52. CrossRef
Flexor Pollicis Longus Tendon Rupture as a Complication of a Closed Distal Radius Fracture - A Case Report - Do-Young Kim, Eun-Min Seo, Woo-Dong Nam, Seung-Jae Park, Sang-Soo Lee Journal of the Korean Fracture Society.2011; 24(2): 191. CrossRef
Management of displaced fractures of the acetabulum represents one of the greatest challenges in fracture surgery. The results had been proved to be successful after anatomical reduction and stable internal fixation. The purpose of this study is to analyze the clinical results and complications of open reduction of the displaced acetabular fractures to minimize the complications, and to present suggestions for the treatment of these fractures. We reviewed our experience with 23 displaced acetabular fractures which had been treated by open reduction to evaluate the clinical results and complications.
The results were as follows; 1. The most common type of elementary fractures was posterior wall fractures according to Letournel's classification. 2. Excellent or good results were obtained in 88% among the satisfactory reduction group, and it means that accurate reduction was the most reliable factors contributing to successful clinical outcomes. 3. Complications were 1 deep infection, 2 ectopic bone formation, 1 intraarticular hardware, and 1 chondrolysis. 4. In the treatment of displaced acetabular fractures, careful initial assessment using radiograph, angiogram and 3-D CT, appropriate selection of surgical approach and accurate surgical clinical outcome and minimize the complication rate.
Clavicle fracture is one of the most common fracture, which had been managed via conservative methods with some exceptions such as nonunion. Operative treatment had been regarded as an important cause of nonunion and poor outcome. Nowadays, however, the goal of fracture treatment has become anatomical reduction, rigid fixation and early rehabilitation for better final results. We managed 43 clavicular shaft fracture which was displaced above 11mm, with conservative treatment (23 cases) and operative treatment (20 cases) since 1990 to 1995. All patients achieved good union in both group, except 5 nonunions of conservative treatment and no significant difference in union time. By functional evaluation of shoulder by Weitzman, final results were excellent in 17, good in 2 cases, fair in 1 case with operative treatment and excellent in 12, good in 4, fair in 3 and poor in 4 cases with conservative treatment. It was concluded that early operative treatment of clavicular shaft fracture showed better result than conservative treatment, especially in displaced and comminuted ones.
Fracture of the base of the second metacarpal bone is usually undisplaced or minimallly displaced. There were some reports of traumatic avulsion fracture of the extensor carpi radialis longus from the base of the second metacarpal. In most cases, the fragments were displaced into dorsal side However, there is noreport uf displaced fracture of the base of the second metacarpal into volar side in English papers. We are reporting a case in which the fragment was displaced into volar side.
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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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
The treatment of supracondylar fracture of humerus in children has so many pitfalls as to be once called - supracondylar dilemma -.
The authors analyzed the follow up results of 53 displaced extension type supracondylar fractures treated by closed reduction and cast, closed reduction and percutaneous pinning, skeletal traction and open reduction from 1993 to 1995.
The following results were obtained : 1. Closed reduction and percutaneous pinning produced the best radiographic and clinical result by Flynns criteria when compared to other methods.
2. No difference in radiographical stability was found between percutaneous pinning with one medial and one lateral pin as opposed to two lateral pins.
3. There was a strong correlation between the change in Baumanns angle and the carrying angle(p=0.03).
The authors surveyed the clinical study of 17 cases of scaphoid fractures from March 1989 to September 1994 with minimal 1 year follow up at Department of Orthopedic Surgery, Lee-Rha general Hospital.
The following conclusions were obtained through clinical survey.
1. Of all 17 cases, they were 13 males and 4 females; Among the 13 males, 10 cases were aged between 20 and 39 years, forming 58.8% of all.
2. All 17 cases were treated by open reduction. Unions were obtained at average 11.5 weeks in 7 cases treated with Herbert screw fixation and 12 weeks in 10 cases treated with K-wire fixation.
3. Two of ten K-wire treated cases resulted in delayed union, one of seven Herbert screw treated cases resulted in delayed union.
4. Unions were obtained at average 20 weeks in 3 cases of delayed union. We concluded that open reduction and K-wire fixation were recomanded for the compatible treatment method of displaced waist fracture of scaphoid.
The complete fracture-separation of proximal radial epiphysis is a comparatively rare injury In the original discription about this injury by Jeffery, the complete displacement of fracture was produced by a result of spontaneous reduction of dislocated elbow after initial nondisplaced fracture of radial neck with dislocation of elbow, We have experienced of development of complete posterior displaced radial neck fracture after reduction of the posterior elbow dislocation.
The heavy labours have been using the safety shoes widespreadly in recent years and the incidence of the toe injuries have been significantly reduced largely due to the increased effectiveness of the steel toe cap in the safety shoes.
When heavy material fall over the foot dorsum wearing safety shoes, toe cap was rotated backward and tapped the proximal phalanx of the great toe, and so the displaced fracture of the proximal phalanx occurred largely by distraction.
We have reviewed 67 cases among 80 cases, which resulted in many complication such as delayed union, nonunion, and malunion etc...
So we suggest the method of treatment and the modification of toe cap in safety shoes.