PURPOSE We compared visible blood loss and calculated blood loss after intramedullary fixation in intertrochanteric fracture, and evaluated correlation between blood loss and its risk factors. MATERIALS AND METHODS A total of 256 patients who underwent closed reduction and intramedullary fixation in femoral intertrochanteric fracture between 2004 and 2013 were enrolled in this study. The total blood loss was calculated using the formula reported by Mercuiali and Brecher. We analyzed several factors, including fracture pattern (according to Evans classification), gender, age, body mass index (BMI), anesthesia method, cardiovascular and cerebrovascular disease, preoperative anemia, American Society of Anesthesiologists (ASA) score and use of antithrombotic agents. RESULTS Total calculated blood loss (2,100+/-1,632 ml) differed significantly from visible blood loss (564+/-319 ml). In addition, the blood loss of unstable fracture patient was 2,496+/-1,395 ml and multivariate analysis showed a significant relationship between blood loss and fracture pattern (p<0.01). However, other factors showed no statistically significant difference. CONCLUSION Total calculated blood loss was much greater than visible blood loss. Patients with unstable intertrochanteric fracture should be treated with care in order to reduce blood loss.
PURPOSE To perform comparative analysis between the results of internal fixation and hemiarthroplasty in unstable intertrochanteric fracture of osteoporotic bone. MATERIALS AND METHODS From February 2003 to February 2006, 36 patients treated surgically for unstable intertrochanteric fractures were evaluated. The patient's age was older than 70 year old; the T-score of preoperative bone mineral density (BMD) was lower than -3.0; they were followed up for more than 1 year. The patient were divided into two groups. One group was treated with dynamic hip screw or proximal femoral nail (Group A, 23 cases), and the other group was treated with bipolar hemiarthroplasty (Group B, 13 cases). The two groups were compared in terms of hip joint function using Clawson classification and radiologically. RESULTS Nonunion and fixation failure happened in 6 cases (26%) of gruop A. However, all patients in group B showed stable maintenance of implant. Recovery of hip joint function was found in 13 cases (43%) of group A, whereas 12 cases (93%) of group B recovered. CONCLUSION Nonunion and failure of fixation happened more frequently in internal fixation than bipolar hemiarthroplasty, and the postoperative hip joint function was better in bipolar hemiarthroplasty than internal fixation. Therefore, bipolar hemiarthroplasty might be better operative treatment for unstable intertrochanteric fracture of osteoporotic bone.
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The Stability Score of the Intramedullary Nailed Intertrochanteric Fractures: Stability of Nailed Fracture and Postoperative Patient Mobilization Sung-Rak Lee, Seong-Tae Kim, Min Geun Yoon, Myung-Sang Moon, Jee-Hyun Heo Clinics in Orthopedic Surgery.2013; 5(1): 10. CrossRef
Analysis of the Factors Involved in Failed Fixation in Elderly Intertrochanteric Femoral Fracture Joon Soon Kang, Ryuh Sup Kim, Bom Soo Kim, Young Tae Kim, Seung Hyun Hong Journal of the Korean Fracture Society.2012; 25(4): 263. CrossRef
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PURPOSE To evaluate the clinical and radiological result of surgical treatment of acromioclavicular joint dislocation, using modified Phemister technique with tension band wiring. MATERIALS AND METHODS We chose 17 patients who were able to follow up 1 year or more among the patients who were diagnosed as acromioclavicular joint dislocation in our hospital through January 2000 to Feburary 2005 and took modified Phemister technique with tension band wiring. Evaluation of the surgical results was done with the condition of pain, activity of daily living, range of motion, muscle tone by constant score system, and with preoperative, postoperative and last follow up radiographs. RESULTS Clinical evaluation was average 92 point by Constant score system from 84 point to 100 point. Subjective evaluation was 11 excellent (65%), 6 good (35%). Radiological evaluation was 9 excellent (54%), 6 good (38%), 2 fair (12%), and no poor group. On the final follow up, two cases showed inflammatory reaction at where pins were inserted, but after the removal of the pins, the inflammation was subsided. CONCLUSION The modified Phemister surgery for acromioclavicular dislocation is one of effective techniques, we can obtain firm fixation, exercise full range of motion early and there is no complication of re-dislocation.
PURPOSE To present our operative experiences with carpometacarpal (CMC) injuries, excluding thumb. MATERIALS AND METHODS Thirty four fracture and dislocations of CMC joint excluding thumb were reviewed retrospectively. Emphases were placed on injury mechanisms, anatomical location, times between diagnosis and surgery, treatment and complications. RESULTS The average age of patients was 31.5 years. 19 cases of axial loading by blow as an injury mechanism. The 5th CMC joint was found to be the most frequently involved single joint (18 cases of 34 cases). Dorsal dislocation of CMC joints was present in 12 cases. Comminution of the carpal or metacarpal bone was present in 18 cases. The average time to surgery was 6 days. Twenty-seven cases were operated upon by closed reduction and percutaneous pinning. Seven cases were treated by open reduction and internal fixation. In the last follow up period, a clinically full hand function was restored in 31 cases. Intermittent pain was present in 6 cases in which there was grip weakness in 4 cases and limitation of motion in 3 cases. However, all cases were able to activities of daily living. CONCLUSION We obtained good outcomes in CMC joint injuries through the accurate diagnosis and proper operative treatment.
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Clinical Study on Percutaneous Intramedullary Bioresorbable Pin Fixation for Fourth and Fifth Metacarpal Bone Fracture Sang Hwan Lee, Sang Hun Kim, Eun Soo Park, Seung Min Nam, Ho Seong Shin Journal of the Korean Society for Surgery of the Hand.2017; 22(2): 105. CrossRef
Percutaneous retrograde intramedullary single wire fixation for metacarpal shaft fracture of the little finger Soo-Hong Han, Seung-Yong Rhee, Soon-Chul Lee, Seung-Chul Han, Yoon-Sik Cha European Journal of Orthopaedic Surgery & Traumatology.2013; 23(8): 883. CrossRef
Operative Treatment in the Delayed Diagnosed Fracture and Dislocation of Hamatometacarpal Joint Suk Ha Lee, Jong Wong Park, Jin Il Kim, Seoung Joon Lee Journal of the Korean Fracture Society.2011; 24(3): 249. CrossRef
Comparison of Early Fixation and Late Fusion of 4, 5th Carpometacarpal Joint in the Intra-Articular Fractures of 4th and 5th Metacarpal Base Chang Ho Yi, Jin Rok Oh Journal of the Korean Fracture Society.2011; 24(1): 60. CrossRef
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Fracture-Dislocation of the Carpometacarpal Joint with the Fracture of Hamate Jin Woong Yi, Whan Young Chung, Woo Suk Lee, Cheol Yong Park, Youn Moo Heo Journal of the Korean Fracture Society.2008; 21(4): 297. CrossRef
PURPOSE To analyze the results between PFN (Proximal Femoral Nail) and DHS (Dynamic Hip Screw) on the operative treatment of unstable intertrochanteric fractures retrospectively. MATERIALS AND METHODS 35 cases of unstable intertrochanteric fractures (grouped 24 patients with DHS and 11 patients with PFN) who were taken the operations from Jan. 2001 to Mar. 2002 were analysed regarding to union state, union time, operation time, sliding length of lag screws, blood loss, postoperative complications and functional recovery scores by Sk?vron with ANOVA and multivariate linear regression. RESULTS The means of union time were 17.9 weeks (DHS) and 17.0 weeks (PFN), sliding length of lag screws were 3.9 mm (DHS) and 2.1 mm (PFN), perioperative blood losses were 743 cc (DHS) and 736 cc (PFN), operation time were 93.4 minutes (DHS) and 102 minutes (PFN), and the functional recovery scores by Sk?vron were 71.8% (DHS) and 76.8% (PFN), respectively. The results of our study indicate that there were not statistically significant differences between PFN and DHS groups in treatment of unstable intertrochanteric fractures (p>0.05). But, there was less sliding of lag screws in PFN group in statistical significance (p<0.05). CONCLUSION Authors think that PFN is one of the useful implants in treating unstable intertrochanteric fractures of the femur in regarding to sliding.
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The Efficiency of Additional Fixation of the Alternative Bone Substitute in Unstable Intertrochanteric Fractures of Femur Treated with Gamma Nail Jong-Oh Kim, Young-One Ko, Mi-Hyun Song Journal of the Korean Fracture Society.2011; 24(1): 1. CrossRef
PURPOSE The purpose of this study was to evaluate the risk factors in the occurrence of scapholunate dissociation in relation to the intra-articular fracture of distal radius. MATERIALS AND METHODS We performed a retrospective evaluation of 170 cases of the fractures. Average age was 52 years(range, 24-85 years). We reviewed both medical records and radiographic films and analyzed the data according to age, width of the medullary cavity of the third metacarpal bone and fracture morphology. RESULTS Nine cases(5.3%) of scapholunate dissociation, mean age of 56 years, all had widened medullary cavity, radial styloid process fracture with radial displacement, a vertical fracture line invading articular surface, depression of scaphoid facet(6 cases) and lunate facet(3 cases). Degree of fracture displacement was not significant. CONCLUSION In distal radius intra-articular fracture which occurred in old patient with widened metacarpal medulla and had a radially displaced radial styloid fracture, an articular surface involving vertical fracture line and a depression of scaphoid or lunate facet, we should be careful in the concurrence of scapholunate dissociation.