Journal of Musculoskeletal Trauma

Original Articles

The Result of Conservative Treatment of Proximal Humerus Fracture in Elderly Patients: Seung Gil Baek, Chang Wug Oh, Young Soo Byun, Jong Keon Oh, Joon Woo Kim, Jong Pil Yoon, Hyun Joo Lee, Hyung Sub Kim; J Korean Fract Soc 2013;26(4):292-298. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.292

Abstract PDF: PURPOSE
With the increase in the old age population, proximal humerus fractures have been increasing recently. However, complications after operative treatment, such as fixation failure, are common because of osteoporosis. We treated proximal humerus fractures in patients with osteoporosis conservatively, and evaluated the radiographic and functional results by analyzing the factors affecting the results.
MATERIALS AND METHODS
Nineteen out of 30 cases for whom the clinical follow-up was over 1 year were included in this retrospective study. There were 17 females and 2 males, and the mean age was 73.2 years. The causes were slip from a short height (18 cases) and a minor car accident (1 case). We evaluated the union period, nonunion, malunion and the Constant score and analyzed several factors affecting the functional result, such as age, fracture pattern, and malunion.
RESULTS
Seventeen cases (89.5%) obtained union within 12.8 weeks on average. Neck-shaft angle was 125.3degrees on average, with seven cases of malunion. The Constant score was 84.1 on average, and there were excellent scores in 11 cases, good scores in 4 cases, and fair scores in 2 cases. Fracture pattern, neck-shaft angle, or malunion did not affect the functional outcome, and elderly patients showed poorer shoulder function.
CONCLUSION
Proximal humeral fractures with osteoporosis may achieve a high rate of bony union when treated with conservative methods. Despite the common occurrence of malunion, a satisfactory functional outcome may be expected.

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Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation: Ui Seoung Yoon, Jin Soo Kim, Jae Sung Seo, Jong Pil Yoon, Seung Yub Baek; J Korean Fract Soc 2010;23(3):270-275. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.270

Abstract PDF: PURPOSE
To analyze the causes of fixation failure of compression hip screw and evaluate outcomes of hip arthroplasty for reconstruction.
MATERIALS AND METHODS
We reviewed 108 femoral intertrochanteric fractures that underwent compression hip screw between January 1997 and December 2007. Failure group (group I) contained 28 cases who had hip arthroplasty for failed compression hip screw and the control group (group II) contained 80 cases who had successive compression hip screw. We analyzed the causes of failure of compression hip screw and evaluated the results of hip arthroplasty for reconstruction.
RESULTS
In group I, 21 cases (75%) were unstable fractures. Group II, 14 cases (17%) were unstable fractures. Tip-apex distance was 26.5 (18~35) mm in group I and 18.6 (8~22) mm in group II. Lateral wall fracture of greater trochanteric area was combined in 24 cases (85.7%) in group I and 9 cases (11.3%) in group II. Harris Hip Score improved from 33.5 (22~43) points to 84.2 (75~93) points after salvage hip arthroplasty.
CONCLUSION
We considered the causes of failed compression hip screw to be fracture instability, increased tip-apex distance and presence of lateral wall fracture of greater trochanter. Hip arthroplasty was found to be a useful method for failed compression hip screw.

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Internal Fixation for Femoral Neck Fracture in Patients between the Ages of Twenty and Forty Years: Ui Seoung Yoon, Jin Soo Kim, Hak Jin Min, Jae Seong Seo, Jong Pil Yoon, Joo Young Chung; J Korean Fract Soc 2010;23(1):1-5. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.1

Abstract PDF

PURPOSE
To retrospectively analysis of results of operatively treatment for femoral neck fracture occurred in twenties to thirties.
MATERIALS AND METHODS
20 patients were selected whom we were able to follow up at least 2 years after internal fixation for femoral neck fracture in twenties to thirties from 1998 to 2005. Mean age was 32.2 (21~39) and average follow up period was 26.3 (24~45) months. According to preoperative X-ray, there were 6 cases for Garden classification stage I, 10 for stage II and 4 for stage III, and 7 cases for subcapital fracture, 9 for transcervical fracture, 4 for basicervical fracture. In all cases, operations were performed within 12 hours after the injury. The operations were done after satisfying reduction with the Garden alignment index, with three cannulated screws for internal fixation. Postoperative results were analyzed by clinical symptoms and radiological examinations during follow up periods.
RESULTS
In immediately postoperative radiological examination, satisfying anatomical reduction with Garden alignment index was obtained in all cases, and unions were obtained within 4.5 months after the operation (3~6 month). Avascular necrosis of femoral head occurred in 7 cases of all patients (35.0%). The average time of occurrence of avascular necrosis of femoral head after operation was 10.7 months (9~15 months). Avascular necrosis was occutted 5 (31.3%) in fracture without displacement (Garden stage I, II), 2 (50.0%) in fracture with displacement (Garden stage III) and 4 in subcapital fracture, 3 in transcervical fracture.
CONCLUSION
The incidence of avascular necrosis of femoral head after the operation for displaced and nondisplaced femoral neck fracture between twenties and forty years was no significant difference.

Citations

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Comparison of Clinical Outcomes for Femoral Neck System and Cannulated Compression Screws in the Treatment of Femoral Neck Fracture
Jae Kwang Hwang, KiWon Lee, Dong-Kyo Seo, Joo-Yul Bae, Myeong-Geun Song, Hansuk Choi
Journal of the Korean Fracture Society.2023; 36(3): 77. CrossRef

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