PURPOSE Pediatric intra-articularproximal phalangeal head fractures of the big toe are very rare and few studies on this have been published. The purpose of this study is to present the diagnostic approach and surgical management of these extremely rare fractures, which might be easily underestimated or misdiagnosed. MATERIALS AND METHODS The study retrospectively reviewed all the patients who were diagnosed as intra-articular proximal phalangeal head fracture of the big toe and who underwent surgical intervention in our institution. The size of the bony fragment and hallux valgus interphalangeus angle were measured on the preoperative X-rays. The size and rotation of the osteochondral fragment, the presence of avascular necrosis, ligamentous injury and soft tissue entrapment were assessed on the preoperative magnetic resonance images (MRIs). The radiologic and functional evaluation were performed at 1 year postoperatively. RESULTS The average size of the bony fragments measured on the X-rays was 4.1 mm in width and 2.3 mm in length. Two cases showed hallux valgus interphalangeus. Preoperative MRI was performed in four cases and the average size of any osteochondral lesion was 5.3 mm in width, 3.9 mm in length, and 4.7 mm in height. Rotation of the osteochondral fragment was observed in one patient, and soft tissue entrapment was noted in two patients. Postoperatively, successful bony union was achieved in all the patients and the average time to union was 74.4 days. CONCLUSION Intra-articular proximal phalangeal head fractures of the big toe are very rare and often neglected due to incomplete ossification in the pediatric population. It is important to suspect the presence of this intra-articular fracture and to appropriately implement further evaluation. Nonunion of chronic cases as well as acute fractures can be successfully treated through open reduction and internal fixation using multiple K-wires.
PURPOSE The purpose of this study is to evaluate the results of operative treatment using a reconstruction nail after temporary K-wire fixation of the femoral neck for ipsilateral femoral neck and shaft fractures. MATERIALS AND METHODS A total of 11 cases were treated, which were followed-up for more than two years, between August 2007 and July 2012. The average age was 51 years (29-69 years) and men were dominant counting eight cases. All cases were operated with a reconstruction nail after temporary K-wire fixation of the femoral neck. Bone union periods, alignment, etc. were evaluated by radiological methods and accompanying damage and complications were also investigated. Functional evaluation was performed in accordance with Friedman and Wyman criteria at the last follow-up. RESULTS The average time for union of the femoral shaft was 22.5 weeks (12-32 weeks), and femoral neck was 13.1 weeks (8-20 weeks). There was no nonunion, and four femoral shaft fractures resulted in delayed union. There was one case of leg length discrepancy more than 2 cm long, but malalignment of more than 10 degrees was not observed. Avascular necrosis of the femoral head did not occur. Functional results were good in eight cases, fair in two cases, and poor in one case. CONCLUSION Treatment with reconstruction nailing after temporary K-wire fixation of the femoral neck is thought to be a good method which prevents neck displacement and has low complication rates.
PURPOSE To evaluate the radiologic and clinical results of percutaneous transverse fixation with K-wires for 5th metacarpal neck fracture. MATERIALS AND METHODS Between January 2007 and September 2010, 18 patients with a 5th metacarpal neck fracture, who underwent operative treatment, were included in this study. The surgical method was percutaneous transverse fixation using K-wires. We evaluated fracture angulation in oblique radiographs preoperatively, postoperatively, and at final follow-up, and used SPSS to perform statistical analysis. We also performed clinical evaluation using the Disabilities of the Arm, Shoulder and Hand (DASH) score. RESULTS All of the 18 cases were completely united, and in the oblique radiographs, the angulation was corrected from 50.69degrees to 11.68degrees. The average difference between postoperative and final follow-up angulations was 0.14degrees, which was statistically insignificant. Clinically, the DASH score was 1.030 and no complications were observed. CONCLUSION Percutaneous transverse fixation using K-wires could be one of the best ways to treat a 5th metacarpal neck fracture because of its simple method and low rate of complications.
PURPOSE To compare clinical outcomes of the plate and threaded K-wire for fixation of midshaft clavicular fractures. MATERIALS AND METHODS From 2005 Jan to 2009 May, medical records of 18 patients who underwent open reduction and internal fixation with plate (group 1) and 13 others who underwent intramedullary fixation with threaded K-wire (group 2) were reviewed. The mean follow up periods were 21.9 and 18.9months. The Functional results were evaluated with The Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant shoulder score. The statistical evaluation was assessed with Paired T-test, Chi-square test. RESULTS The DASH score were 11.5+/-2.7 in group 1 and 12.4+/-4.3 in group 2. The constant shoulder score were 92.0+/-3.1 in group 1 and 87.1+/-2.8 in group 2. Length of surgical wound (cm) were 10.6+/-3.4 in group 1 and 4.8+/-1.5 in group 2. Postoperative pain and range of motion change were superior in group 1. CONCLUSION There was no significant difference between the two groups in functional and radiological results. But, there were patient's complaints about length of surgical wound in group 1 and hardware irritation in group 2.
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A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture Seong-Ho Yoo, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Yeong-Joon Kim, Gyu-Taek Park, Chang-Hun Kwack Journal of the Korean Orthopaedic Association.2017; 52(1): 1. CrossRef
Plate fixation versus intramedullary fixation for midshaft clavicle fractures: Meta-analysis of complications and functional outcomes Hao Xiao, Hengbo Gao, Tuokang Zheng, Jianhui Zhao, Yingping Tian Journal of International Medical Research.2016; 44(2): 201. CrossRef
Meta-analysis of plate fixation versus intramedullary fixation for the treatment of mid-shaft clavicle fractures Bing Zhang, Yanbin Zhu, Fei Zhang, Wei Chen, Ye Tian, Yingze Zhang Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2015;[Epub] CrossRef
PURPOSE To evaluate the efficiency of provisional K-wire fixation in intertrochanteric fractures treated with proximal femoral nail (PFN). MATERIALS AND METHODS Twenty seven patients (by AO/OTA classification, A1 8 cases, A2 19 cases) were treated with PFN with percutaneous reduction and provisional K-wire fixation, and followed a mean 24.5 months. The adequacy of fracture reduction was assessed by Fogagnolo's classification and reestablishment of bone-to-bone contact with the medial anatomy. Functional results were evaluated by postoperative complications, Jensen's method and Harris hip score (HHS). RESULTS In all cases, the bone-to-bone contact with the medial anatomy was reestablished by percutaneous reduction and examination of Fogagnolo's classification showed a good reduction. The technical complications and error of starting point were not occurred. The mean HHS was 76.5 and means Jensen's grade was 2.1 grades. Complications included excessive sliding in 1 case and early cutting-out of screw in 1 case. CONCLUSION The provisional K-wire fixation in trochanteric fracture treated with PFN had an advantage in preventing technical complications because it facilitates a nail insertion in ideal position.
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Analysis of Low-Energy Trochanter Fracture Using the Multiplanar Computed Tomography Image: Application for Intramedullary Nail Fixation Gu-Hee Jung, Sung-Keun Heo, Hyun-Je Seo Journal of the Korean Fracture Society.2015; 28(3): 155. CrossRef
Morbidity and Mortality of the Elderly after Early Operation for Trochanteric Fractures Se-Ang Jang, Young-Ho Cho, Young-Soo Byun, Ki-Hong Park, Hyun-Seong Yoo, Chul Jung Journal of the Korean Fracture Society.2013; 26(3): 199. CrossRef
PURPOSE To evaluate radiological and clinical results of the antegrade intramedullary prebent K-wire fixation for the 5th metacarpal neck fracture. MATERIALS AND METHODS Between January, 2006 and December, 2009, 31 patients with displaced neck fracture of the fifth metacarpal who received antegrade intramedullary prebent K-wire fixation were included in this study. Radiological and clinical outcome evaluations were performed. RESULTS All the fractures were completely united. In the oblique radiographs, the average of preoperative angulation was corrected from 38.9degrees to 4.4degrees. The average difference between postoperative and final follow-up was 1.2degrees. Clinical outcomes were satisfactory except for one patient who had sustained ulnar nerve dorsal branch injury during surgery. CONCLUSION Antegrade intramedullary prebent K-wire fixation may be preferentially considered as one of the best ways to fix the displaced neck fractures of the fifth metacarpal.
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Clinical Outcomes of Customized Staple Fixation Using K-wire in Metacarpal Base or Neck Fractures Hong-ki Jin, Hyoung Min Kim, Yong Seung Oh, Jihoon Kim Journal of the Korean Fracture Society.2021; 34(1): 23. CrossRef
PURPOSE To evaluate the anatomic and functional outcome of retrograde intramedullary single wire fixation for metacarpal shaft fractures of the little finger. MATERIALS AND METHODS hirty one consecutive patients with closed metacarpal shaft fractures of the little finger who have been treated with retrograde intramedullary single wire fixation were evaluated. Fracture union and angulation were analyzed radiologically, and clinical evaluations were performed including range of motion, DASH score and complications. RESULTS Fracture union was achieved in all cases and callus formation was obvious at postoperative 41 days. Average angulation of fracture site was 3degrees in the coronal plane and 1.2degrees in the sagittal plane at the last follow up and no measurable metacarpal shortening was observed. Mean TAM was 253degrees and DASH score was 2.6. There were two cases of pin migration as intermediate complications. CONCLUSION Closed reduction with subsequent percutaneous retrograde K-wire fixation produced good radiological and functional results. We recommend this minimally invasive technique which provides adequate fixation of displaced little finger metacarpal shaft fractures with good functional results and low morbidity.
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The Treatment Outcomes of the Metacarpal Shaft and Neck Comminuted Fractures Using Modified Percutaneous Retrograde Intramedullary Kirschner Wire Fixation Seok Woo Hong, Young Ho Lee, Min Bom Kim, Goo Hyun Baek Archives of Hand and Microsurgery.2018; 23(3): 175. CrossRef
PURPOSE To analyze the treatment of clinical results of the percutaneous Kirschner wire fixation of acute mallet fractures percutaneousely reduced by towel clip. MATERIALS AND METHODS: From August 2005 to April 2009, we evaluated nine fingers in eight patients, more than three months follow up. The type of injury was a axial loading in seven cases and direct blow in two. The average follow-up period was 10.1 months (range: 3~41 months). The indication of operative treatment was the presence of large bony fragment or the palmar subluxation of the distal phalnx. RESULTS: The range of motion was 3.7degrees (0~10degrees) in extension lag and 76.7degrees (60~90degrees) of flexion of the distal interphalangeal joint. CONCLUSION: The percutaneous Kirschner wire fixation of acute mallet fractures percutaneousely reduced by towel clip is one of the easy and simple method to stabilizing of bony mallet fracture.
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Comparison of Surgical Outcomes of Percutaneous K-Wire Fixation in Bony Mallet Fingers with Use of Towel Clip versus 18-Gauge Needle Ho-Seung Jeon, Chan-Sam Moon, Seo-Goo Kang, Kyeong-Seop Song, Uk-Hyun Choi Journal of the Korean Society for Surgery of the Hand.2013; 18(1): 1. CrossRef
PURPOSE To evaluate the radiological and clinical outcomes after operative treatment of displaced supracondylar fractures in children with lateral K-wire fixation. MATERIALS AND METHODS 69 displaced supracondylar fractures treated by closed reduction and percutaneous lateral K-wire fixation were included in this study. Carrying angle and range of motion were measured and graded by the Flynn criteria. To assess the accuracy of the reduction, Baumann angle and lateral humerocapital angles were compared to the contralateral side, and to evaluate the stability of fixation both measurements were taken immediately postoperatively and after K-wire removal. RESULTS 55 cases (80%) were categorized as excellent and 12 cases (17%) as good. There were no significant statistical differences in Baumann angle and lateral humerocapital angle between postoperative and K-wire removal. Although there were 9 cases that showed differences in Baumann angle and 32 cases in lateral humerocapital angle of more than 10 degrees compared to the opposite side at the immediate postoperative radiograph, 9 cases showed satisfactory clinical results. CONCLUSION Closed reduction and lateral K-wire fixation is considered as an acceptable modality of the treatment of displaced supracondylar fractures in children, and clinical outcome is more closely correlated with carrying angle and stability of fracture site rather than rotational deformity or hyperextension of fragment measured radiographically.
PURPOSE To compare and analyse radiologic reduction loss between fixation with K-wire only group and fixation with K-wire and external fixator group for surgical treatment of distal radial fracture. MATERIALS AND METHOD We analysed 60 patients who received the operative treatment with K-wire fixation only or K-wire and external fixator and also were in regular follow up at least one year. We compared radiologic reduction loss of radial length, radial inclination and volar tilt between immediate post-operative radiograph and latest follow up radiograph according to operative methods, fracture patterns and age groups. RESULTS Reduction loss of volar tilt was greater in fixation with K-wire only group than fixation with K-wire and external fixator group (p<0.05). Reduction losses of radial length and radial inclination were more in intra-articular subgroup than extra-articular subgroup in fixation with K-wire only group (p<0.05). No significant difference of reduction loss was noted between intra-articular and extra-articular subgroups in fixation with K-wire and external fixator group. CONCLUSION More radiologic reduction loss can be expected in fixation with K-wire only group for intra-articular distal radius fracture compared with extra-articular distal radius fracture. Additional external fixation should be added in intra-articular distal radius fracture to reduce radiologic reduction loss.
PURPOSE Although the standard treatment of diaphyseal forearm fractures in children is conservative treatment with closed reduction and cast immobilization, unstable or irreducible fractures are usually needed by surgical intervention. The aim of this article is to determine the efficacy of the percutaneous transphyseal intramedullary K-wires fixation for the forearm diaphyseal fractures in children. MATERIALS AND METHODS In this retrospective study, we reviewed 18 cases of forearm diaphyseal fractures in children, which were treated with percutaneous transphyseal intramedullary nailing using K-wires from January 2001 to December 2004. We analyzed the period for radiologic bone union and the complications until the last follow-up. RESULTS The average period of follow-up was 15 months with mean age of 7.8 years. The average time to bone union was 6.2 weeks and nonunion, malunion, radio-ulnar synostosis and refracture were not found, just 2 local pin site infections were seen but healed by conservative treatment. Postoperative scar was small and the complications until the last follow-up were not found. CONCLUSION In the operative treatment of the forearm diaphyseal fractures in children, we think percutaneous transphyseal intramedullary K-wire fixation is one of the effective methods because of the minimal invasiveness, simplicity and easiness in removal.
PURPOSE To analyse the results of treatment of unstable intra-articular distal radius fractures using the percutaneous K-wire reduction-fixation and external fixator. MATERIALS AND METHODS A retrospective follow-up study of 22 cases was carried out. With use of the system of AO classification 9 cases were in C1 and 7 in C2, and 6 in C3. The average duration of follow-up for all fractures was 35 months. We evaluated the radiologic results, the functional results according to clinical evaluation scoring system by Green and O'Brien and osteoarthritis grade according to arthritic grading system by Knirk and Jupiter. RESULTS Excellent and good results were rated in 17 cases (77%) of all cases. At last follow-up the mean loss of radial length, radial inclination and volar tilt were 1.4 mm, 1.0o, and 1.4o respectively. Also 7 patients had grade I, 1 patient grade II, and 1 patient grade III arthritis. CONCLUSION We think that percutaneous K-wire reduction-fixation and external fixation is useful treatment method for the unstable intra-articular distal radius fracture. But severely comminuted AO type C3 fractures would need additional treatments such as open reduction and bone graft to acquire and maintain the articular reduction for better results.
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Management of Comminuted Intra-articular Fractures of the Distal Radius: Arthroscopically Assisted Reduction and Pin Fixation Supplemented with External Fixation Jong-Pil Kim, Hyun-Jin Yu The Journal of the Korean Orthopaedic Association.2009; 44(2): 233. CrossRef
Comparison of Outcomes for Unstable Distal Radius Intraarticular Fractures - T-locking Compression Plate versus External Fixator - Chul-Hyun Cho, Su-Won Jung, Sung-Won Sohn, Chul Hyung Kang, Ki-Cheor Bae, Kyung-Jae Lee Journal of the Korean Fracture Society.2008; 21(1): 51. CrossRef
Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures Chul Hyun Cho, Ki Choer Bae, Doo Hyun Kwon Journal of the Korean Fracture Society.2008; 21(3): 220. CrossRef
We report an unusual case of Kirschner wire migration from the proximal humerus into the thoracic cavity and diaphragm which induced pneumothorax and hemoperitoneum. An 81-year-old woman admitted to the emergency room due to sudden onset of dyspnea. X-rays showed pneumothorax and old proximal humerus fracture fixed with rush pins and K-wires. One of K-wires was seen on the diaphragm level at posterior gutter of chest wall. Through the abdomen, K-wire was removed from the diaphragm and a chest tube was inserted. The potential for K-wires to migrate must be recognized, and frequent postoperative radiographic studies have to be performed for the early detection of loosening and migration. It appears that if K-wires are used for fixation of proximal humerus, the lateral ends must be bent to prevent medial migration, and when the desired therapeutic goals have been achieved, these pins have to be susbsequently removed as soon as possible.
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Spinal Canal Migration of a K-Wire Used for Fixation of a Distal Clavicular Fracture Byung-Ill Lee, Yong-Beom Kim, Hyung-Suk Choi, Chang-Hyun Kim, Jung-Woo Ji Journal of the Korean Orthopaedic Association.2013; 48(3): 231. CrossRef
Early Intrathoracic Migration of K-wire Used for Fixation of Proximal Humerus Fracture Sang Jin Cheon, Ji Min Lee Journal of the Korean Orthopaedic Association.2011; 46(2): 167. CrossRef
PURPOSE To evaluate the results of surgical treatment of autogenous cancellous bone grafting combined with threaded K-wire fixation for scaphoid nonunions. MATERIALS AND METHODS We retrospectively reviewed the 13 patients with scaphoid nonunion, which was follow up at least 12 months from March 1999 to June 2003. According to the Mayo classification, two cases were type P (proximal third), eight cases were type W (waist) and three cases were type D (distal third). According to the Russe classification, eight cases showed horizontal oblique type, another two cases were transverse, and last three belonged to vertical oblique type. We assessed the radiologic bony union, correction of humpback deformity and lateral intrascaphoid angle and degenerative change of radioscaphoid joint, clinical results were evaluated using assessment of Maudsley. RESULTS Radiologic union was obtained in all cases, mean time of union was 15.4 weeks (13~17.4 weeks), and there was no radiological evidence of postoperative humpback deformity, intercarpal instability, proximal osteonecrosis and degenerative changes. According to assessment of Maudsley, there were 7 excellent cases, 4 good cases, 1 fair case and 1 poor case among these 13 cases. The final clinical results were 11 excellent cases, 2 good case in the aspect of wrist pain and tenderness. All range of motion was satisfactory to patients except 4 cases (3 fair, 1 poor) and every patients could return to work except 1 poor case. CONCLUSION The surgical treatment using a autogenous cancellous bone grafting combined with threaded K-wire fixation for scaphoid nonunion was a relatively straightforward technique, which provides simplicity, and high union rate.
PURPOSE To evaluate the differences of the outcome between external fixator and external fixator supplemented with K-wire in the treatment of distal radius fractures. MATERIALS AND METHODS Twenty-one cases which underwent external fixation (external fixation group) and 28 cases, external fixation supplemented with K-wire (external fixation with K-wire group), were analyzed. Radial length, radial inclination and volar tilt were compared in preoperative, immediate postoperative radiographs, and radiographs after removal of external fixator between two groups. And functional outcome including flexion, extension, pronation and supination of wrist were compared between two groups and wrist pain, as well. RESULT Radial length and radial inclination in the postoperative radiographs and radiographs after removal of external fixator showed no difference between two groups, but volar tilt of external fixation group measured 2.1+/-4.2 degrees, 1.3+/-3.8 degrees and external fixation with K-wire group, 8.8+/-2.3 degrees, 8.5+/-2.4 degrees respectively, so that external fixation with K-wire group showed better reduction and maintenance. Wrist flexion and extension about postoperative 6 months measured 25.6+/-8.2 degrees, 25.1+/-10.2 degrees, respectively, in external fixation group and 42.5+/-15.2 degrees, 33.6+/-9.5 degrees in external fixation with K-wire group, so that external fixation with K-wire group showed better functional results. CONCLUSION In the treatment of distal radius fractures, to obtain better reduction and function result, external fixations supplemented with K-wire need to be taken into consideration.
PURPOSE To evaluate indications and effectiveness of intramedullary K-wire fixation for distal radial fractures. MATERIALS AND METHODS Twenty one fractures of distal radius treated with intramedullary K-wire fixation from April 2001 to September 2002 were evaluated. The mean age was 67.8(range 46~82). Severely comminuted intra-articular fractures and Barton's fractures were excluded. One or two K-wires were added percutaneously. To assess the functional result, we used Green and O'Brien score system. The radiographic assessment included a scoring system based on measurements of radial length, radial inclination, volar tilt and step-off of the radial articular surface. RESULTS Average follow up period was 13.5 months. In functional result, excellent and good result were obtained in 18 cases (86%). In radiologic result, mean loss of radial length, radial inclination and volar tilt were 0.9 mm, 1.4degrees, 0.9degrees, respectively. CONCLUSION The advantages of intramedullary K-wire fixation were relatively simple procedure, low occurrence of soft tissue complications and early wrist motion. Intramedullary K-wire fixation was good to maintaining reduction in osteoporotic bone.
PURPOSE To report the effectiveness of Kirschner wire fixation for the treatment of unstable tibial shaft fractures in children. MATERIALS AND METHODS We analyzed 15 cases of pediatric tibial shaft fractures treated at our hospital with fixation using K-wire and followed up for more than 1 year from July 1998 to January 2002. The subjects included 11 boys and 4 girls. The ages ranged from 3 to 10 years at the time of injury, with the average age being 7.9 years. We examined the presence of angulation, leg length discrepancy, joint motion limitation, and complications. RESULTS Bony fusion was obtained in all patients by an average of postoperative 9.5 weeks. At the time of last follow-up (by an average of postoperative 1 year and 4 months), anterior and posterior radiographs showed an average of 4.2degree angulation, and lateral radiographs showed an average of 4.4degree angulation. The affected leg was extended by an average of 3.7 mm compared to the opposite leg according to Bell-Thompson's radiographs. As for complications, infection was developed around the pin in 3 cases but treated with the administration of oral antibiotics and sterilization around the site without progressing to deep infection. We could not observe joint motion limitation, pain and difficulties related with discrepancy in leg length. CONCLUSION We concluded that fixation using K-wire for children with tibial shaft fractures was a safe and effective method of surgery that could be performed easily, did not require secondary surgery to remove the wire, and showed sufficient stability after fixation.
Intercondylar fractures of the distal humerus are very rare in children. The pattern of the fracture would suggest that the mechanism of injury involves a fall directly on the flexed elbow. Most agree that the undisplaced fracture can be managed conservatively. With increasing displacement and comminution, the opinions tend to differ. We suggest that closed reduction with percutaneous K wire pinning and open reduction with percutaneous K wire pinning offer a satisfactory methods by which to treat displaced intercondylar fracture in children.
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Adolescent Distal Humerus Fractures: ORIF Versus CRPP Phillip Bell, Brian P. Scannell, Bryan J. Loeffler, Brian K. Brighton, R. Glenn Gaston, Virginia Casey, Melissa E. Peters, Steven Frick, Lisa Cannada, Kelly L. Vanderhave Journal of Pediatric Orthopaedics.2017; 37(8): 511. CrossRef
PURPOSE To review the result of bony mallet finger treated with a closed reduction using extension block K-wire MATERIALS AND METHODS: Between January 2001 and November 2002, among the patients with bony mallet finger underwent closed reduction using extension block K-wire, we retrospectively reviewed 14 patients with 14 fractures who had a minimum follow-up of 12 months. RESULTS There were 10 men and 4 women, with an average follow-up for all cases 15.7 months (range, 12 months~18 months). According to Crawford's evaluation criteria, we obtained 7 excellent, 5 good, 2 fair. We obtained bony union in all patients, with no remained pain. The average ROM was 67 degrees at postoperative 12 months. Postoperative complications occurred in two cases, which were nail deformity and mild osteoarthritis at the distal interphalangeal joint. There was no pin site infection. CONCLUSION This technique is not only easier but also less invasive than other techniques for reduction of mallet finger. Also, it shows excellent result with lower complication rate. So, it seems a reliable treatment for bony mallet finger.
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Osteoarthritis after Extension Block Technique for the Bony Mallet Finger Sung Hoon Koh, Jung Hyun Park, Jin Soo Kim, Si Young Roh, Kyung Jin Lee, Dong Chul Lee Archives of Hand and Microsurgery.2021; 26(4): 238. CrossRef
Comparison of Surgical Outcomes of Percutaneous K-Wire Fixation in Bony Mallet Fingers with Use of Towel Clip versus 18-Gauge Needle Ho-Seung Jeon, Chan-Sam Moon, Seo-Goo Kang, Kyeong-Seop Song, Uk-Hyun Choi Journal of the Korean Society for Surgery of the Hand.2013; 18(1): 1. CrossRef
Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip Chung Soo Han, Duke Whan Chung, Bi O Jeong, Hyun Chul Park, Jin Young Kim, Cheol Hee Park, Jin Sung Park Journal of the Korean Fracture Society.2009; 22(4): 283. CrossRef
PURPOSE To analyze the clinical results of the treatment of Mason type II radial head fractures using closed reduction and K-wire internal fixation under C-arm guide by radiologically and functionally. MATERIALS AND METHODS Between March 2001 and October 2003, 7 patients with Mason type II radial head fracture were treated by closed reduction and internal fixation using K-wires under C-arm guide. The average age of the patients was 38 (5 to 57) years old, and average duration of follow up was 20 (5 to 36) months. At last follow up, we evaluated the radiological results and functional results by classifying excellent, good, fair and poor according to functional rating system of Broberg and Morrey. RESULTS The range of motion of the elbow at last follow up, average flexion contracture was 1.4 (0 to 10) degrees, further average flexion was 146.4 (140 to 150) degrees, average supination was 74.2 (70 to 80) degrees and average pronation was 75 (70 to 80) degrees. In the functional results, 6 cases were excellent and 1 case was good. In the radiological evaluations, the average time of union was 5 (4 to 6) weeks after the operation and no serious complication was occurred in any cases. CONCLUSION In the treatment of Mason type II radial head fracures, closed reduction and K-wire internal fixation under C-arm guide was an effective method of treatment with satisfactory results and no complications.
PURPOSE To analyze the results of surgical treatment of the displaced distal radius fractures in elderly patients over 65 years old who were treated with percutaneous K-wire fixation only and percutaneous K-wire fixation with external fixation.
MATERIAL AND METHOD: We evaluated 24 cases of the distal radius fracture in patients older than 65 years from January 1998 to December 2001. The patients were followed up at least 12 months postoperatively. We compared the surgical results of 14 cases, treated with percutaneous K-wire fixation only with the surgical results of 10 cases, treated with percutaneous K-wire fixation with external fixation. We evaluated the functional results according to demerit point system and the radiographic results (radial length, radial inclination, volar tilt). RESULTS According to demerit point system, the mean score of demerit point was 9.9 in the group of percutaneous K-wire fixation and 5.3 in the group of percutaneous K-wire with external fixation respectively (p<0.05). In radiographic results, the percent of the mean loss of radial length, radial inclination and volar tilt were 23.2%, 12% and 41.7% in the group of percutaneous K-wire fixation and 11%, 5.9% and 27.4% in the group of percutaneous K-wire with external fixation respectively (p<0.05). CONCLUSION Percutaneous K-wire with external fixation showed better functional and radiographic results than percutaneous K-wire fixation only for the treatment of the displaced distal radius fractures in elderly patients older than 65 years and percutaneous K-wire with external fixation is thought to be a one of the most effective treatment of the displaced distal radius fractures in elderly patients.
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Osteoporotic Distal Radius Fracture-conservative Treatment Seok-Whan Song Journal of the Korean Fracture Society.2008; 21(1): 81. CrossRef
PURPOSE For the treatment of displaced children supracondylar fractures, closed reduction and lateral pinning were performed consecutively and their results were analyzed. MATERIALS AND METHODS During the period from January 1997 to May 2001, all children with displaced supracondylar fractures of the humerus were treated by closed reduction and lateral K-wire pinning. Among them, 44 fractures with more than 1 year follow up were selected. Carrying angle and range of motion were measured. Baumann angle and lateral humerocapital angles were measured from the anteroposterior and lateral radiograph 3 times (immediate post op, K-wire removal, last follow up). RESULTS Results were graded according to the criteria of Flynn et al. using both cosmetic and functional evaluation. According to the cosmetic factor, 36 cases (82%) were excellent and 8 cases (18%) were good. According to the functional factor, 39 cases (88%) were excellent and 5 cases (12%) were good. No statiscally significant differences, as seen on Baumann and humerocapital angle, between immediate post operative films and films taken at the time of K-wire removal (p=0.082, p=0.27). There was no significant differences in Baumann and humerocapital angle at the time of K-wire removal and last follow up (p=0.19, p=0.27). CONCLUSION Closed reduction and lateral K-wire pinning is considered as an acceptable modality of the treatment of displaced children supracondylar fractures.
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Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique H.-Y. Lee, S.-J. Kim The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef
PURPOSE We investigated the treatment modality and clinical results in flexion-type supracondylar fractures of the humerus in children. MATERIALS AND METHODS 11 cases of flexion-type supracondylar fractures of the humerus(3 type I, 5 type II, 3 type III) were treated, 3 fractures(3 type I) with extension cast, 6 fractures(5 type II, 1 type III) with two lateral percutaneous K-wire fixation, 2 fractures(2 type III) with open reduction and crossed pin fixation. The K-wire were removed after 4-6 weeks of operation and the follow-up period ranged from 12 months to 26 months, averaging 18 months. RESULTS By Flynn 's functional and cosmetic criteria, nine cases were good and excellent results, one case (type III with two lateral percutaneous pin fixation) is fair result. CONCLUSION As the same methods of the extension-type supracondylar fractures, the K-wire fixation is useful method in the treatment of flexion-type supracondylar fractures of the humerus in children.
PURPOSE We evaluated the results of the displaced supracondylar fractures in children treated by closed reduction and cast immobilization, closed reduction and crossed K-wires fixation or open reduction with minimal incision and crossed K-wires fixation. MATERIALS AND METHOD We retrospectively reviewed the results after 1 year of the treatment of 71 extension-type fractures (Gartland type II - 19 cases, type III - 52 cases) of supracondylar humeral fractures in children under age of 8 years. Closed reduction was impossible in 20 cases (1 type II, 19 type III) and we performed open reduction with minimal incision and cross percutaneous pinning. We measured Baumanns angle and range of motion of elbow and evaluated the results by Flynns criteria. RESULT By Flynns criteria, 91.5 % of satisfactory (excellent, good) results in cosmetic factor and 97.2 % in functional factor. The result of closed reduction and percutaneous pinning is more excellent in functional factor and that of the minimal open reduction and percutaneous pinning in cosmetic factor but over all satisfactory results were similar. CONCLUSION The treatment of the displaced supracondylar humeral fractures in children needs accurate and delicate reduction and firm fixation to prevent deformity and to preserve function of the elbow. Open reduction with minimal incision instead of general incision for the manually irreducible supracondylar humeral fractures would be a reliable and convenient method for the treatment of supracondylar humeral fractures in children.
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Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique H.-Y. Lee, S.-J. Kim The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef
PURPOSE The purpose of this study is to analyze the result and complications of treatment using percutaneous K-wire stabilization for fractures of the proximal humerus.
MATERIALS & METHOD: To be eligible for the study, total 12 patients of displaced two, three or four part fractures of the proximal humerus were treated, 10 females and 2 males with a mean age of 52 years (range 18-76 year). Reduction was obtained by longitudinal traction combined with posterior pressure on the humeral shaft. After reduction, minimum two 2.5mm terminal threaded pin or smooth tip K-wire was inserted. RESULTS Union rate of 83.3% was observed at an average 2.7 months. Range of motion of shoulder was 125 degrees of forward flexion, 114 degrees of abduction. Patients of 83.3% had good or excellent functional result. Four patients had a mild, superficial pin tract infection associated with loosening of the pin. The infections resolved with removal of pin and oral antibiotics. Valgus deformity was developed in a patient however the patient subsequently had a good functional result and nonunion were developed in two cases. CONCLUSION The technique of closed reduction and percutaneous pinning is quite demanding procedure, although it may appear to be deceptively simples. The good indications for the use of this procedure seems to patients with severe comminuted fractures, old age with osteoporosis. For the more rigid fixation, terminally threaded pins should be used, not smooth pin.
PURPOSE To know the advantages and disadvantages of this procedure by analyzing the results of internal fixation with K-wires for clavicular shaft fractures in young women. MATERIALS AND METHODS Twelve patients were followed for more than 1 year after the operation. All patients were female and average age was 28 years with average follow-up of 14 months. All cases were displaced fractures of the middle third with tenting of the skin and 2 cases were type 1 open fractures. After the operation, we investigated time to union, changes of K-wire, scar and disadvantages periodically. RESULTS There was no nonunion and time to union averaged 11.8 weeks. Migration and bending of the K-wires occured in one case. The length of surgical scar was about 4cm and the K-wires were easily removed under local anesthesia. But all patients complained of frequent radiographic evaluation, relatively long period of immobilization and irritation of the K-wires on medial part of the clavicle. CONCLUSION We think that internal fixation with the K-wires is one of the effective treatment options for the clavicular shaft fractures in young women.
PURPOSE To analyze children with displaced supracondylar fractures of the humerus that were treated by immediate closed reduction and then maintained by lateral percutaneous K-wire fixation. MATERIALS AND METHODS 70 cases of supracondylar fractures of the humerus(5 type I, 19 type II, 46 type III) were treated, 14 fractures(5 type I, 7 type II, 2 type III) with cast, 49 fractures(12 type II, 37 type III) with lateral percutaneous pinning, 7 fractures(7 type III) with open reduction and internal fixation. The K-wire were removed after averaging 6.2 weeks of operation in out patient clinic. The follow-up period ranged from 6 months to 28 months, averaging 13 months. RESULT By Flynn's functional and cosmetic criteria, 47 fractures(95.9%) among 49 fractures, treated with immediate closed reduction and lateral percutaneous pinning, resulted in satisfactory criteria. Only one fracture was reoperated due to reduction loss. CONCLUSION Immediate closed reduction and lateral percutaneous K-wire fixation appears to be safe and reliable option for the treatment of supracondylar fractures of the humerus in children.
PURPOSE We report the results of treatment of the clavicular shaft fractures with Kwires. MATERIALS AND METHODS We treated 25 cases of clavicular shaft fractures with Kwires from June, 1998 to March, 2000 and analyzed the union period, functional results and complications. RESULTS Clinical union period was 3.2 weeks, radiologic union period was 8.3 weeks. The functional results were excellent or good in 21 cases(84 %) and there was no delayed or nonunion. CONCLUSION In the treatment of the clavicular shaft fractures, intramedullary fixation with K-wires is thought to be simple and effective method.
PURPOSE To evaluate the clinical validity of the percutaneous K-wire fixation in applying to unstable extraarticular fracture of distal radius of patients who are older than 50 years.
MATERIAL AND METHODS: The validity of K-wire fixation was examined, using subjective study of Cole and Oblelz and objective study of Scheck, on the 20 cases of unstable extraarticular fracture of distal radius of patients older than 50 years, who were treated with percutaneous K-wire fixation and followed up more than 1 year, out of 160 patients with distal radius fracture, treated in the department of orthopedic surgery of our hospital from January 1994 to August 1998. RESULTS The result was examined with subjective study of Cole and Oblelz and objective study of Scheck. Combined judgement was made by adding up the scores of both objective and subjective study. 5 excellent cases and 12 good cases were brought forth by subjective study. Objective study achieved the result of average 18 degree of radial angle, 9.8mm of radial length and 3.6 degree of volar angle. Combined judgement achieved a good result of 3 excellent cases, 14 good cases and 3 fair cases. CONCLUSION Percutaneous K-wire fixation is expected to be a simple, less invasive, more effective and valuable operation method in the treatment of extraarticular fracture of distal radius with severe comminution
PURPOSE : To evaluate the role of the additional external fixator in maintenance of reduction with was known as an important prognostic factor for the treatment of intra-articular distal radius frctures.
MATERIAL AND METHOD : Thirty cases of unstalbe intra-articular fractures of the distal radius, which were treated by operative method, were classified by Frykman's method and grouped in two(group A and B). The group A was treated by closed reduction and percutaneous K-wire fixation and long arm cast immobilization. The group B was treated by treated by closed reduction and percutaneous K-wire fixation with use of additional external fixator. The end results were evaluated by the Demerit Point Rating System(by Sarmiento) & radiologic evaluation(radiologic index : radial length, radial tilt, volar tilt) RESULTS : By the Demerit point rating system, excellent and good results were rated by 45.5% in group A and 75% in group B and poor results were found in 3 cases which were Frykman type VII or VIII in group A. Radiologically, radial length loss was rated by 11%, radial tilt loss by 10.8% and volar tilt loss by 47% in group A and 3.1%, 6.8%, 29% each in group B(p<0.05). CONCLUSION : We think that additional use of external fixator, after percutaneous K-wire fixation, may have an important role in maintenance of reduction and group prognosis for the treament of intra-articular distal radius fractures.