Journal of Musculoskeletal Trauma

Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture: Sang Ho Ha, Jun Young Lee, Sang Hong Lee, Sung Hwan Jo, Jae Cheul Yu; J Korean Fract Soc 2009;22(4):225-231. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.225

Abstract PDF: PURPOSE
To evaluate the result of treatment of proximal femoral shaft fracture with limited open reduction and intramedullary nailing. MATERIALS AND METHODS: Fifteen patients who had limited open reduction and intramedullary nailing due to proximal femoral shaft fracture for follow-up for more than 12 months were selected between March 2001 and December 2005. The clinical and radiologic results were analyzed. Winquist-Hansen classification and OTA/AO classification were used. RESULTS: Thirteen cases achieved bone union and 2 cases showed delayed union. The mean bone union period was 21.3 weeks (14~32). There was no postoperative infection. Nonunion was observed in 2 cases of which bone union was acquired with the exchange of intramedullary nail and bone graft in one case and with the additional plate fixation and bone graft in the other case. CONCLUSION: Treating proximal femoral shaft fracture with limited open reduction and intramedullary nailing seems to be a technique to manage proximal femoral shaft fracture that has combined fracture or ipsilateral femoral fracture or is unable to acquire acceptable reduction with closed reduction.

Treatment of Acetabular Column Fractures with Limited Open Reduction and Screw Fixation: Jung Jae Kim, Hyoung Keun Oh, Sung Yoon Kim; J Korean Fract Soc 2007;20(1):26-32. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.26

Abstract PDF: PURPOSE
To evaluate the results of limited open reduction and screw fixation of acetabular fractures.
MATERIALS AND METHODS
Six acetabular fractures were treated with fluoroscopic guided screw fixation. The mean age was 46 years old and mean follow-up period was 18 months. There were 3 anterior column fractures, 2 transverse fractures and 1 both column fracture. Anterior column screw fixation was used in 5 cases and posterior column fixation in 1 case. Limited ilioinguinal approach was used in 4 cases and percutaneous screw fixation in 2 cases.
RESULTS
The mean union time was 16.6 weeks. The postoperative radiographic results revealed 2 cases with an anatomic reduction and 4 cases with an imperfect reduction. The clinical results showed 1 case with excellent, 4 cases with good and 1 case with fair. Regarding complication, there was 1 case of SI joint penestration without clinical symptoms.
CONCLUSION
Limited open reduction and screw fixation can be a useful alternative treatment for acetabular fractures in patients with minimally displaced fracture, severe multisystem trauma and soft tissue injury not suitable to traditional treatment.

Arthroscopically Assisted Limited Open Reduction and Ilizarov External Fixation of Tibial Pilon Fractures: Jin Young Lee, Gab Lae Kim, Hyung Seok Oh, Kun Ho Shin, Deok Yong Park; J Korean Fract Soc 2006;19(2):176-181. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.176

Abstract: PURPOSE
To evaluate the clinical results of the pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation.
MATERIALS AND METHODS
This is a retrospective study of the clinical result, bone union, complication and postoperative ankle function of 22 pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation between January 1999 to March 2004.
RESULTS
Clinical follow up averaged 16 months, with an average age of 39.2. All patients with type 1 and 2 fracture had excellent or good score by Ovadia and Beals criteria. Closed fractures healed within 13 weeks and open fractures within 16 weeks after surgery in average. Average range of motion of the ankle was 12o dorsiflexion (0~20 degree) and 25o plantar flexion (15~35 degree).
CONCLUSION
Minimal soft tissue dissection and anatomical reduction are very important factor for minimizing complication and satisfactory ankle function. So, arthroscopically assisted limited open reduction and Ilizarov external fixation is an effective treatment option for tibial pilon fractures.

Treatment of Articular Fracture of the Distal Tibia (Pilon Fracture) with Limited Open Reduction and External Fixator: Hui Taek Kim, Moon Bok Song; J Korean Soc Fract 2000;13(2):272-280. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.272

Abstract PDF: PURPOSE
: To evaluate the usefulness of the treatment method of limited open reduction for the articular surface and combined. external fixation in a tibial pilon fracture.
MATERIALS AND METHODS
: We reviewed 15 cases of pilon fracture treated by the combined internal and external fixation method. The fracture was classified by Ruedi and Allgower's classification: 3 cases of type I , 7 cases of type II and 5 cases of type III. The result was analyzed by Ovadia and Beals' radiologic, subjective and objective criteria of assessment.
RESULTS
: The results were 12 good and 3 fair in the radiologic evaluation; 1 excellent, 9 good, 3 fair and 2 poor in the objective evaluation; and 5 good, 8 fair, 2 poor in the subjective evaluation. The mean duration of the bony union was 6.5 months (5-11 months). The most common complication was the limitation of the ankle joint. Intra-articular arthroscopic adhesiolysis and extra-articular soft tissue release were helpful to increase the range of motion of the ankle joint.
CONCLUSION
: This technique provides a satisfactory result in the anatomical reduction of the articular fracture, in the management of the soft tissue problem particularly in open fracture, and permits early motion of the ankle joint in the pilon fracture.

A Clinical Study of the Tibial Pilon Fractures: Chil Soo Kwon, Jong Kuk Ahn, Jin Hyok Kim, Yerl Bo Sung, Hyung Jin Chung; J Korean Soc Fract 1997;10(2):338-345. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.338

Abstract PDF: The pilon fracture result from axial compression and rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displacement. It is managements are closed reduction and plaster immobilization, skeletal traction, fibular stabilization alone, limited open reduction and extemal fixation, primary arthrodesis, and even immediate amputation. Recently limited open reduction and external fixation has been proved to provide good clinical results for the severely comminuted or open pilon fractures. Authors reviewed 20 cases of the pilon fractures. Among them 10 cases were treated with limited open reduction and external fixation from October 1989 to January 1994. The results were as follows : 1. Age distribution was from 14 years to 77 years(mean ; 47 years). 2. Of the 20 cases, male were 14, and female were 6. 3. The cause of injury were tracffic accident in 10 cases, slip down in 6 and fall from a height in 4. 4. The most frequent type of fractures was type III(12 cases : 60%) according to Ruedi and Allgower classification. 5. Limited open reduction and external fixation(10 cases) has shown better results than classic open recduction and internal fixation for severely comminuted or open pilon fractures.

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