PURPOSE To evaluate the efficacy of short segment fixation in flexion-distraction injuries of thoracolumbar junction. MATERIALS AND METHODS Twenty-five patients with a flexion-distraction injury in thoracolumbar junction confirmed by radiogram or MRI and stabilized with a short construct spanning short segment were included in this study. We investigated the location of fractures, type of fractures, anterior or posterior vertebral body height, and preoperative and postoperative kyphotic angle of injuried motion-segments on radiologic examinations and clinical outcome on the Oswestry score. RESULTS A significant correction of deformity was achieved, from a mean preoperative kyphosis of 17.3 degrees to a mean postoperative kyphosis of 8.4 degrees. The loss of correction were minimal. The mean Oswestry score was 6.9, with 84% of patients having minimal disability (<20%) and no correlation with age, sex, the location of fractures, type of fractures, change of kyphotic angle. CONCLUSION This study demonstrates the efficacy of posterior open reduction and short segment fixation of flexion-distraction injuries.
PURPOSE To evaluate optimal placement of the Herbert/Whipple screw in scaphoid fracture. MATERIALS AND METHODS Forty eight models molded from four cadaver scaphoids were used for this study. Using the Herbert/Whipple jig, the guide wire was placed distal to proximal into each scaphoid with twelve method which were four entry points and three target points. Guide wire placement was then evaluated with three planes in the proximal, middle, distal planes and distance from the nearest cortex. RESULTS The most concentric position in the proximal plane was D5, in the middle plane C10. As distal entry point, the most concentric position in proximal plane was C. There were no statistical concentric, as middle, distal plane, and proximal entry point, CONCLUSION: The most ideal placement were D5 in proximal fractures of the scaphoid, C5 in distal fractures. In waist fractures of the scaphoid, there were relatively safe, except A0 and D0. The position of entry points was more important than that of target points for ideal screw placement.
PURPOSE To evaluate the correlation of the safe zone of percutaneous iliosacral screw fixation with sacral dysmorphism and sacral alar slope variation. MATERIALS AND METHODS We studied the plain radiographs and the pelvic bone CT images of 52 patients. We reviewed each cases in terms of Routt 's dysmorphism and sacral alar slope variation(anterior, coplanar and posterior to inter-ICD line). We divided each cases into narrow and wide groups by the width of safe zone for the transverse 6.5mm cannulated cancellous screw. The data were analysed by McNemar x2-test and Cochran Q-test(p<0.05). RESULTS Typical sacral dysmorphism was found in five cases(9%). Four cases with dysmorphism(80%) and eighteen non-dysmorphic cases(38.2%) revealed narrow safe zones. The sacral slopes were anterior in 16 cases, coplanar in 25 cases, and posterior in 11 cases. The safe zone was significantly narrow in the group with anterior slope variation. CONCLUSION We could not found definite correlation between sacral dysmorphism and a narrow safe zone because the incidence of dysmorphism was too low in our study which differed from Routt 's report. An anterior sacral alar slope on CT can be a significant risk indicator for potential narrow safe zone and the risk of screw malposition.
Citations
Citations to this article as recorded by
Measurement of Optimal Insertion Angle for Iliosacral Screw Fixation Using Three-Dimensional Computed Tomography Scans Jung-Jae Kim, Chul-Young Jung, Jonathan G. Eastman, Hyoung-Keun Oh Clinics in Orthopedic Surgery.2016; 8(2): 133. CrossRef
Operative Treatment of Unstable Pelvic Ring Injury Sang Hong Lee, Sang Ho Ha, Young Kwan Lee, Sung Won Cho, Sang Soo Park Journal of the Korean Fracture Society.2012; 25(4): 243. CrossRef
Upper Sacral Morphology Related to Iliosacral Screw Fixation in Korean Jung-Jae Kim, Chul-Young Jung, Hyoung-Keun Oh, Byoung-Se Yang, Jae-Suck Chang Journal of the Korean Fracture Society.2007; 20(2): 115. CrossRef