Fractures of the femoral shaft with marked bowing face some obstacles in fixation of the fracture such as difficulty in insertion of the intramedullary nail (IM nail) or exact contouring plate. Locking compression plates (LCP) are an option to manage this problem. However, we experienced consecutive breakage of LCP twice and IM nail once in an 80-year-old female. Finally, union of the fracture was achieved after fixation of the IM nail and additional plate together. Fractures of the femur shaft with marked bowing are thought to have different biomechanical properties; therefore, we present this case with a review of the literature.
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Comparative analysis of operation time and intraoperative fluoroscopy time in intramedullary and extramedullary fixation of trochanteric fractures Milan Mitkovic, Sasa Milenkovic, Ivan Micic, Predrag Stojiljkovic, Igor Kostic, Milorad Mitkovic Vojnosanitetski pregled.2022; 79(2): 177. CrossRef
Pre-operative planning for fracture fixation using locking plates: device configuration and other considerations Alisdair R. MacLeod, Pankaj Pankaj Injury.2018; 49: S12. CrossRef
Letter: Repeated Metal Breakage in a Femoral Shaft Fracture with Lateral Bowing - A Case Report - Hae Seok Koh Journal of the Korean Fracture Society.2012; 25(3): 240. CrossRef
PURPOSE To evaluate the clinical outcomes of operative treatment using a transolecranon approach with a dual locking plate for unstable intercondylar fractures of the distal humerus. MATERIALS AND METHODS Eighteen patients were followed for more than 1 year after surgical treatment for unstable intercondylar fractures of the humerus. Anterior transpositioning of the ulnar nerve and an early rehabilitation program to allow range of motion (ROM) exercise from postoperative week 1 were used for all cases. The clinical and functional evaluation was performed according to the Mayo Elbow Performance Index and Cassebaum's classification of ROM. RESULTS The range of elbow joint motion was a flexion contracture mean of 12.8 degrees to a further flexion mean of 119.3 degrees at the final follow-up. The Mayo Elbow Performance Index was an average of 88.5 points. Among the results, 6 were excellent, 9 good, 2 fair, and 1 poor. Therefore, 15 cases (83.3%) achieved satisfactory results. Fourteen cases (77.7%) achieved a satisfactory ROM according to Cassebaum's classification. All cases achieved bone union, and the interval to union was an average of 14.2 weeks. CONCLUSION Dual locking plate fixation through the transolecranon approach seems to be one of the effective treatment methods for unstable intercondylar fractures of the humerus because it enables the anatomical reduction and rigid fixation of articulation, and early rehabilitation exercise.
PURPOSE To evaluate the clinical and radiologic results of the arthroscopic treatment using TightRope(R) (Arthrex, Inc, Naples, FL) for management of acute acromioclavicular dislocation. MATERIALS AND METHODS Twelve patients with acromioclavicular joint dislocation Rockwood type V are underwent the arthroscopic acromioclavicular joint reconstruction using TightRope(R) between March, 2008 and March, 2009. The average age was 40.4 years (range 25~63 years) and mean follow-up was 10 months (range 8~16 months). The shoulders were evaluated using parameters include radiologic measurements by comparing the clavicle posteroanterior and lateral radiographs with the contralateral one. Clinical evaluation was made for pain, function, and range of joint motion by Constant score and KSS (Korean Shoulder Score). RESULTS All twelve patients returned to their work without pain in 3 months after operation. The average Constant score and KSS score was 98.4 (range 97~100) and 97.8 (range 97~100) at the last follow-up. Because of technical error and indication error, two patients showed failures of TightRope(R) fixation on the coracoid side and the acromioclavicular joint was redislocated, so these cases were excluded. 10 patients were satisfied with functional results and cosmetic appearance. CONCLUSION Considering its less morbidity, less hospitalization, excellent cosmesis, early rehabilitation, this new technique offers an attractive alternative in acromioclavicular joint stabilization if the early technical error would be overcome.
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Coracoclavicular Ligament Augmentation Using Tight-Rope®for Acute Acromioclavicular Joint Dislocation - Preliminary Report - Seok Hyun Kweon, Sang Su Choi, Seong In Lee, Jeong Woo Kim, Kwang Mee Kim The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 115. CrossRef
Coracoclavicular Ligament Augmentation Using Endobutton for Unstable Distal Clavicle Fractures - Preliminary Report - Chul-Hyun Cho, Gu-Hee Jung, Hong-Kwan Sin, Young-Kuk Lee, Jin-Hyun Park The Journal of the Korean Shoulder and Elbow Society.2011; 14(1): 1. CrossRef
PURPOSE To compare the results of open fixation and closed percutaneous pinning in managing Jakob stage II lateral condylar fractures of children's elbow. MATERIALS AND METHODS Since Febuary 2000, We operated 21 children with Jakob stage II lateral condylar fractures of elbow. Eleven of the 21 were treated with closed percutaneous pinning, open fixation was done to the other 10 children. Each patient was evaluated about range of motion, carrying angle, scar satisfaction and radiologic findings for comparison between closed pinning and open fixation groups. RESULTS Open fixation group showed 3.8 degrees decrease of elbow motion while closed pinning group showed no significant decrease. Carrying angle and radiologic findings were not different between the two groups. Open fixation group expressed dissatisfaction to their scars (average 5.2 cm) whereas all the patients of closed pinning group were satisfied with their functional and cosmetic outcomes. CONCLUSION In managing Jakob stage II lateral condyle fractures of children's elbow, closed percutaneous pinning was thought to be superior to open fixation because of the same functional outcome and much better cosmetic results.
PURPOSE To assess diagnostic efficacy of the MRI in thoracolumbar fractures, especially in changes of bone and soft tissue which cannot be documented by other diagnostic tools. MATERIALS AND METHODS Among 85 patients managed for thoracolumbar fractures between January 1997 and June 2003, MRI was performed in 30 patients to get more informations. Plain X-ray, CT and MRI of these cases were reviewed retrospectively by two orthopaedic spine surgeons and one radiologist to investigate the informations which only MRI could afford. RESULTS 14 (46.7%) among 30 patients had occult fractures of vertebrae other than main fracture which had not been diagnosed as fractured. Besides 6 patients who showed distraction of posterior structure on plain X-ray, injury of posterior ligament complex was confirmed by MRI in 12(40%) patients. Additionally, MRI visualized other soft tissue injuries such as intramuscular and subcutaneous hematoma, changes of the spinal cord and intervertebral disc. In 16 among 30 patients, informations achieved from MRI were the most important factors in deciding treatment modality. CONCLUSION MRI seems to be efficient in visualizing not only soft tissue injury such as ligament but also occult fractures of additional vertebra in thoracolumbar fractures, therefore MRI seems to be an important diagnostic tool in decision of treatment modalities, especially in cases of uncertain stability.
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Measurement Discrepancy of Sagittal Parameters between Plain Radiography and 3D Computed Tomography in Thoracolumbar and Lumbar Fractures Dong-Soo Kim, Yong-Min Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Ji-Kang Park, Hyun-Cheol Lee Journal of the Korean Orthopaedic Association.2012; 47(3): 198. CrossRef
Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures Ki-Chan An, Dae Hyun Park, Yong-Wook Kwon Journal of the Korean Fracture Society.2011; 24(3): 256. CrossRef
The purpose of this study is to analyze the results of treatment of posterior wall fracture of acetabulum, which were treated at our hospital from September 1994 to December 1996. Among 24 posterior wall fractures, 15 cases were confirmed as isolated posterior wall fractures and nine fractures were associated with other acetabular fracture(4 transverse fracture, 3 both column fracture, and 2 posterior column fracture). Clinical follow-up was performed for a minimum of 2 years. The posterior wall fracture was classified according to fracture size(type 1<25%, type 2: 25-50%, type 3: 50-75%, type 4: >75%) and comminution (A: without comminution, B: with comminution, C: impacted) on standard roentgenogram and CT scan. Fourteen among 24 posterior wall fractures were followed for a minimum of 2 years, and the mean Harrif hip score was 91.2. Dislocation of hip occurred in 12 hips(50%). There was no definite difference of Harris hip score in regard to fracture size and comminution of posterior wall. Fractures with posterior hip dislocation had poor result compared with fractures without posterior hip dislocation. Anatomical reduction showed better clinical result than imperfect and poor reductions.
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Surgical Treatment of Posterior Wall Fractures of the Acetabulum Young-Soo Byun, Se-Ang Chang, Young-Ho Cho, Dae-Hee Hwang, Sung-Rak Lee, Sang-Hee Kim Journal of the Korean Fracture Society.2007; 20(2): 123. CrossRef