Purpose Patients with diabetes are known to have poor clinical outcomes due to the high incidence of complications after ankle joint fracture surgery. This study reports the clinical and functional outcomes based on glycemic control status among patients with ankle joint fractures who underwent surgical treatment. Materials and Methods Among patients who underwent surgical treatment due to ankle joint fractures from January 2015 to October 2019, 253 patients with a minimum follow-up of 12 months were identified. We divided them into 3 groups: 195 patients with no diabetes (Group A), 26 patients with well-controlled diabetes (Group B), and 32 patients with uncontrolled diabetes (Group C). In addition, patients with lateral, medial malleolar, bimalleolar, and trimalleolar fractures were identified using radi-ography. The functional outcome measures used for evaluation were the Revised Foot Function Index (FFI), Short Musculoskeletal Function Assessment (SMFA), and the Foot and Ankle Outcome Score (FAOS). Results Bone union at 3 months after surgery was high in Group A, showing significant differences compared to the other groups. There was a significant difference between the groups in the incidence of arthropathy and one or more complications. However, the FFI, SMFA, and FAOS did not show significant differences between the groups. Conclusion The incidence of complications was high in patients with uncontrolled diabetes compared to the patients with well-controlled diabetes and those with no diabetes. However, functional outcomes showed no significant difference.
PURPOSE The purpose of this study was to evaluate the radiological and clinical results of plate fixation and external fixation with additional devices for treating distal radius fracture in AO type C subtypes, and propose a treatment method according to the subtypes. MATERIALS AND METHODS Two hundred and one AO type C distal radius fracture patients were retrospectively reviewed. Eighty-five patients in group 1 were treated with volar or dorsal plate, and 116 patients in group 2, were treated with external fixation with additional fixation devices. Clinical (range of mtion, Green and O'Brien's score) and radiological outcomes were evaluated. RESULTS At the 12-month follow-up, group 1 showed flexion of 64.4°, extension of 68.3°, ulnar deviation of 30.6°, radial deviation of 20.8°, supination of 76.1°, and pronation of 79.4° in average; group 2 showed flexion of 60.5°, extension of 66.9°, ulnar deviation of 25.5°, radial deviation of 18.6°, supination of 73.5°, and pronation of 75.0° in average. The mean Green and O'Brien score was 92.2 in group 1 and 88.6 in group 2. The radial height of group 1 and group 2 was 11.6/11.4 mm; radial inclination was 23.2°/22.5°; volar tilt was 11.6°/8.7°; and the ulnar displacement was 1.27/0.93 mm. CONCLUSION Judicious surgical techniques during device application and tips for postoperative management during external fixation can produce similar clinical results compared with internal fixation patients.
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Intra-articular fracture distal end radius external fixation versus locking volar radius plate: A comparative study S.P.S Gill, Manish Raj, Santosh Singh, Ajay Rajpoot, Ankit Mittal, Nitin Yadav Journal of Orthopedics, Traumatology and Rehabilitation.2019; 11(1): 31. CrossRef
PURPOSE To review the clinical results of eight cases of typeIII coronoid process fractures which were treated operatively. MATERIALS AND METHODS Eight patients with coronoid type III fracture were reviewed retrospectively. All were men with an average age of 33. There were three isolated fractures, two elbow dislocations, two radial head and neck fractures, and one medial collateral ligament rupture. Open reduction and internal fixation through anterior approach with canulated screws was used. The patients were followed up for a mean of 31 months (24 to 60). RESULTS Average active elbow joint motion at the most recent follow up was 105degrees. The average Mayo Elbow Performance Score was 76.9 (50 to 95). There was one excellent result, four good, two fair, and one poor. CONCLUSION Early open reduction and stable internal fixation provided a reliable method for the treatment of type III coronoid process fractures. Any associated ligament injuries to the elbow and fracture comminution were considered as important prognostic factors.
The displaced femoral neck fracture remains a major challenge to orthopedic surgeons, as the elderly population is increasing. Elderly patients with femoral neck fractures often have other medical conditions, fragile bones, and poor compliance. Thus, for elderly patients who need early ambulation and funtional recovery, bipolar prosthesis is accepted as an appropriate treatment. We report a study of 58 cases of bipolar hemiarthroplasty with a femoral neck fracture and a physiologic age older than 65 years from January 1991 to May 1996. The purpose of this study is to evaluate the functional outcome of bipolar hemiarthroplasty and correlation between preoperative medical conditions and Harris hip score in femoral neck fractures in the elderly patients. The results obtained were as followings.
1. 90% of patients had uncontrolled medical conditions. Cardiovascular and pulmonary disease were main preexisting medical conditions.
2. The preoperative medical conditions were important deteminants for the functional results after bipolar hemiarthroplasty.
3. Dislocated bipolar prosthesis needed open reduction or revision to total hip arthroplast due to disassembly of the prosthesis caused by attempted closed reduction.
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Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis - Comparative Analysis between Cementless Stem and Cemented Stem - Joon Soon Kang, Kyoung Ho Moon, Rhu Seop Kim, Sang Ho Lee, Jong Min Choi Journal of the Korean Fracture Society.2011; 24(1): 16. CrossRef