Recently, as the elderly population increases, the incidence of total knee arthroplasty has increased, with a concomitant increase in the frequency of periprosthetic fractures. To determine the treatment plan for fractures, the treatment method should be determined by the patient's age, osteoporosis, fixation status of the implant, and type of fracture. In recent years, operative treatment with reduction and stable fixation, rather than non-operative treatment, was used to promote early joint movement and gait. On the other hand, it is necessary to select an appropriate operative method to reduce complications of surgery, such as nonunion and infection, and expect a good prognosis. In this review, periprosthetic fractures were divided into femur, tibia, and patella fractures, and their causes, risk factors, classification, and treatment are discussed.
Heterotrophic ossification (HO) is a reactive disease presenting the formation of mature lamellar bone in soft tissues. It is known to occur following surgery, soft tissue injury, or central nervous system anomalies. However, a definite cause has not yet been clearly addressed. During the process of approach, reduction, and fixation while conducting surgeries, partial injury of soft tissue is inevitable. Additionally, secondary injuries may be caused during the active and passive range of motion exercises that should be done for the recovery of joint motion after surgery. The authors experienced cases of HO that may occur during surgery and rehabilitation after surgery. The authors recognized that special care is required for patients complaining of severe pain during the early stage of rehabilitation immediately after surgery. This study aimed to reaffirm the principles of fracture treatment by reviewing the cases and to investigate the occurrence of HO after fracture surgery.
PURPOSE The study examined the fusion site and characteristics of the subtalar arthrodesis after intraarticular calcaneal fractures using computed tomography. MATERIALS AND METHODS The clinical results and computed tomographic analysis of the fusion site were reviewed in 18 patients who were followed-up for a minimum of six months after undergoing subtalar arthrodesis due to traumatic arthritis caused by an intra-articular calcaneal fracture from December 2012 to April 2017. RESULTS An evaluation of clinical results after subtalar arthrodesis revealed statistically significant improvements. In all cases, arthritis was found in the injured articular surface, which was displaced superolaterally from the initial primary fracture line of the calcaneus. Six months after arthrodesis, the subtalar fusion rate was 80.0% (16/20). Of these, 14 cases had a cannulated screw inserted in the uninjured site that is medial to the primary fracture line. Joint fusion was observed on the uninjured articular surface in 17 cases (85.0%). CONCLUSION Joint fusion was initially achieved at the uninjured posterior facet after subtalar arthrodesis due to traumatic arthritis caused by a displaced intra-articular calcaneal fracture. This suggests that meticulous surgical techniques and cannulated screw positioning at the uninjured site will promote joint fusion.
PURPOSE We investigate the outcomes of treatment of patients with severe comminuted distal radius fractures with volar plate fixation using a pronator-preserving approach. MATERIALS AND METHODS Fourteen patients with severe comminution of the distal radius fractures for whom anatomical reduction of the fractures was deemed difficult to achieve with traditional approaches were enrolled. The gender ratio was 8 males to 6 females, and the average age of the patients was 64.9 years. According to the AO/OTA classification of fractures, 2 patients had 23-A3 fractures, 7 patients had 23-C2, and 5 patients had 23-C3. Radial length, radial inclination, and volar tilt were measured for radiologic evaluation. Modified Mayo wrist score (MMWS) was used for clinical outcome. RESULTS Bony union was achieved in all 14 patients without signs of complications. The average time-to-union was 4.3 months (3-6 months). The radiological findings at the final follow-up were as follows: the average radial inclination was 20.5degrees; the average volar tilt, 7.57degrees; and the average radial length, 11.8 mm. At the final follow-up, the results of the MMWS were 'Fair' in 1 patient, 'Good' in 4, and 'Excellent' in 9. CONCLUSION We propose that a pronator-preserving approach is an effective treatment for severe comminuted distal radius fracture.
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Use of Miniplate for Severe Comminuted Metadiaphyseal Fractures of the Distal Radius Jong-Ryoon Baek, Yong-Cheol Yoon, Seung Hyun Baek Journal of the Korean Fracture Society.2019; 32(4): 204. CrossRef
Minimally invasive plate osteosynthesis (MIPO) is beneficial for proximal tibial fractures since these injuries are mostly caused by high energy traumas. The advantages of MIPO are minimization of soft tissue dissection and preservation of periosteal vascularization. Lateral plating has mostly developed as MIPO for proximal tibial fractures. We introduce minimal invasive percutaneous plate stabilization using a medial locking plate as alternative treatment for proximal tibial fractures.
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Effect of Korean Medicine Treatments in Patients with Proximal Tibia Fracture: A Retrospective Observational Study Jung Min Lee, Eun-Jung Lee Journal of Korean Medicine Rehabilitation.2020; 30(3): 141. CrossRef
Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures Jae-Ang Sim, Kwang-Hui Kim, Yong-Seuk Lee, Sang-Jin Lee, Beom-Koo Lee Journal of the Korean Orthopaedic Association.2014; 49(4): 278. CrossRef
PURPOSE To evaluate the advantages of reduction of lateral and posterior displacement in unstable intertrochanteric fractures of the elderly. MATERIALS AND METHODS From January, 1997 to December, 2001, we reviewed 23 cases of unstable intertrochanteric fractures in the elderly, which underwent by reduction of lateral and posterior displacement. Using the device of internal fixation is dynamic compression hip screw (DHS), the follow up period was minimally 12 months (mean 16 months). We estimated the clinical results, the radiologic results and complications. RESULTS The satisfactory results was regarded as walking with walking frame and 21 cases (91.3%) showed satisfactory results. The average period of radiologic union was 18 weeks. The average sliding of lag screw was 5.3 mm and the average changes of femoral neck-shaft angle was 2.6 degree. As for the complications, 2 cases showed superficial infection and 2 cases showed pain over trochanteric area. CONCLUSION In the unstable intertrochanteric fractures of the elderly, treatment with reduction of lateral and posterior displacement can be considered one of reduction technique.
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Unstable Intertrochanteric Femoral Fracture Treated with Mini-incision Reduction Technique and Intramedullary Nail Oog Jin Shon, Dae Sung Kim Journal of the Korean Fracture Society.2010; 23(1): 13. CrossRef