PURPOSE This study was conducted in order to demonstrate the radiologic and clinical results of using the Asian type gamma 3 nail in treatment of trochanteric fractures. MATERIALS AND METHODS Patients underwent operations with gamma 3 nails between August 2010 and August 2012. For the radiologic evaluation, we analyzed bone quality, fracture pattern, reduction quality, union period, and position of lag screw (tip-apex distance, Cleveland index). For the clinical evaluation, we analyzed mobility score of Palmer and Parker and Jensen's functional score. RESULTS The mean union was taken at 17.4 weeks (14-25 weeks). Two cases (4.3%) underwent reoperation due to cutting out of the hip screws. The clinical outcomes of Parker and Palmer's average mobility score changed from 7.3 to 5.8 (79%), Jensen's functional score was 1.3 to 1.8 (72%). CONCLUSION We achieved excellent clinical and radiological outcomes; therefore, Asian type gamma 3 nail is effective in treatment of trochanteric fractures of the femur in Korea.
Bilateral avulsion fractures of the tibial tubercles are extremely rare. There is no case report about this in Korean literature. We present simultaneous bilateral tibial tuberosity fractures in 14-year-old adolescent male fell on the ground during running. These fractures were managed by open reduction and screw fixation. We gained complete union and removed metal after 6 months. Functional results were excellent 6 month after surgical treatment.
PURPOSE To evaluate the results of the treatment of the supracondylar fractures of the humerus according to the fixation methods with cannulated screw. MATERIALS AND METHODS Eight patients, aged 49 to 82 years (average, 65 years), were reviewed after a mean follow-up of 16 months (range, 12~24 months). According to AO classification all fractures were classified as type A2 (simple transverse supracondylar fracture). All patients underwent closed reduction. Percutaneous fixation with cannulated screws was performed in 8 patients. Three of 8 patients had associated medical problems and one patient had distal radius fracture. The functional results were assessed by the Mayo Elbow Performance Score. RESULTS Mean operation time was 59 minutes (45~75) and all the patients with cannulated screw fixation had bony union and were able to early ROM exercise. Mean ranges of motion was 5~120 degrees with excellent functional results. Functional evaluation of elbow joint by Mayo method showed mean value of 88 (75~95). CONCLUSION The cannulated screw fixation of supracondylar fracture of humerus, especially in the elderly aged group with medical disease had excellent functional results (rigid fixation & early ROM exercise) due to shortening of surgery time and anesthesic time, combined with decreased technical difficulties of the surgical procedure
PURPOSE To evaluate the radiographic and clinical outcomes of patients with displaced proximal humerus fractures (two-part and three-part) treated with the Polarus interlocking nail, comparing their fractures types. MATERIALS AND METHODS There were 22 patients with displaced proximal humerus fractures. There were 10 surgical neck (SN) and 1 anatomical neck (AN) two-part fractures and 10 greater tuberosity/surgical neck (GT/SN) and 1 GT/AN three-part fractures. All patients were surgically treated solely with the Polarus interlocking nail using a closed technique. Functional assessment was obtained using the American Shoulder and Elbow Surgeons (ASES) score, which grade outcomes as excellent (>75), satisfactory (50~75), poor (<50) results. Radiographic outcome measurements included fracture alignment (neck-shaft angle), loosening of screw, fixation and hardware failure, and malunion and nonunion. RESULTS Overall, the average ASES score was 80.2 (range 46.0 to 98.0). There were 15/22 (68.2%) excellent, 6/22 (27.3%) satisfactory, and 1/22 (4.5%) poor results. All shoulders healed radiographically without evidence of avascular necrosis of the humeral head. When comparing patients with two-part fractures (n=11) with patients having three-part fractures (n=11), there were statistically significant differences with ASES outcome measures (p<0.05). But, there were no statistically significant differences in age-related analysis (p>0.05). CONCLUSION Both displaced two-part fractures and three-part GT/SN fractures can have above satisfactory functional and radiographic outcomes with the Polarus interlocking nail using a closed technique. Even though displaced three-part GT/SN fractures in elderly osteopenic patients (>60 years), we treated successfully with the Polarus interlocking nail.
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Polarus Intramedullary Nail for Proximal Humeral and Humeral Shaft Fractures in Elderly Patients with Osteoporosis Youn-Soo Hwang, Kwang-Yeol Kim, Hyung-Chun Kim, Su-Han Ahn, Dong-Eun Lee Journal of the Korean Fracture Society.2013; 26(1): 14. CrossRef
Intramedullary Nailing for Complex Fractures of the Proximal and Midshaft of the Humerus Chul-Hyun Cho, Gu-Hee Jung, Kyo-Wook Kim Journal of the Korean Fracture Society.2011; 24(3): 237. CrossRef