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Case Report
Irreducible Ankle Fracture Dislocation due to Dislocated Tibialis Posterior Tendon - A Case Report -
Seungyup Shin, Bum-Soo Kim, Ji-Won Lee, Euisun Yoon
J Korean Fract Soc 2023;36(2):52-56.   Published online April 30, 2023
DOI: https://doi.org/10.12671/jkfs.2023.36.2.52
AbstractAbstract PDF
An irreducible ankle dislocation is a rare injury. The cause is a dislocation of the distal fibula anteriorly or posteriorly or the insertion of soft tissue, such as the deltoid ligament or posteromedial tendon. The tibialis posterior tendon can be dislocated through distal tibiofibular diastasis and prevent reduction of the ankle joint. The authors experienced anterolateral ankle fracture dislocation with a diastasis of the distal tibiofibular joint, and reduction was impossible because of impingement of the tibialis posterior tendon dislocated anteriorly through the distal tibiofibular diastasis. This paper reports the treatment of this injury.
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Original Articles
Comparison of the Size of the Posterior Malleolar Fragment in Trimalleolar Ankle Fractures Measured Using Lateral Plain Radiography and Three-Dimensional Computed Tomography
Gun-Woo Lee, Dong-Min Jung, Woo Kyoung Kwak, Keun-Bae Lee
J Korean Fract Soc 2022;35(3):91-96.   Published online July 31, 2022
DOI: https://doi.org/10.12671/jkfs.2022.35.3.91
AbstractAbstract PDF
Purpose
This study aimed to evaluate and compare the accuracy of the size of the posterior malleolar fragment measured using lateral plain radiography and three-dimensional computed tomography (3DCT) in patients with ankle trimalleolar fractures.
Materials and Methods
This study enrolled 80 patients (80 ankles) with ankle trimalleolar fractures and analyzed the size of the posterior malleolar fragments using plain radiography and 3D-CT. The articular involvement of the posterior malleolar fragments was measured as a percentage of the articular surface in the sagittal length of the tibial plafond using lateral plain radiography, and the articular surface area was directly measured using 3D-CT. In addition, we classified the patients into three groups based on the morphology of the posterior malleolar fracture, according to the Haraguchi classification method, and evaluated and compared the accuracy of the size of the posterior malleolar fragments.
Results
The mean articular involvement of the posterior malleolar fragments on plain radiography was 27.6% (range, 6.0%-53.1%), which was significantly higher than the mean of 21.9% (range, 4.7%-47.1%) measured using 3D-CT (p=0.004). In the analysis, according to the fracture morphology, the mean difference between the two methods was the largest for type I fractures at 9.1% (range, 1.8%-19.5%) and the smallest for type II fractures at 1.1% (range, –7.7% to 8.8%).
Conclusion
The articular involvement of posterior malleolar fragments measured using plain radiography showed low accuracy and significantly higher values than the actual articular involvement. Therefore, careful evaluation using 3D-CT is crucial for accurate analysis and optimal treatment in patients with ankle trimalleolar fractures.
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Assessment of Noncontiguous Posterior Malleolar Fractures in Distal One-Third Tibia Shaft Fractures with Proximal Fibula Fractures
Dae-Geun Kim, Byung Hoon Kwack
J Korean Fract Soc 2022;35(3):103-108.   Published online July 31, 2022
DOI: https://doi.org/10.12671/jkfs.2022.35.3.103
AbstractAbstract PDF
Purpose
Posterior malleolar fractures after intramedullary nail surgery rarely occur in distal tibia shaft fractures. The importance of preoperative ankle evaluation in preventing these fractures is also common knowledge. There are no studies in the literature on posterior malleolar fractures in distal onethird tibia shaft fractures except for distal metaphyseal tibia fractures to the best of our knowledge. The purpose of this study was to evaluate the incidence and radiological features of posterior malleolar fractures in distal one-third tibia shaft fractures with proximal fibula fractures.
Materials and Methods
Thirty-one patients diagnosed with distal one-third tibia shaft fractures with proximal fibula fractures from January 2016 to May 2021 were retrospectively reviewed. With the aid of plain radiographs and computed tomography (CT) scans, the fracture patterns of the tibia and fibula were classified according to the AO Foundation/Orthopedic Trauma Association (AO/OTA) classification, and posterior malleolar fractures were identified. The fracture pattern was classified according to the Haraguchi classification, and the angle between the bimalleolar axis and the posterior malleolar fracture line was measured when there was a posterior malleolar fracture.
Results
Out of the 31 distal one-third tibia shaft fractures with proximal fibula fractures, 16 cases (51.6%) had noncontiguous posterior malleolar fractures that were confirmed on a CT scan, while 3 cases (18.8%) were visible on initial plain radiographs. There was no statistically significant variation seen in the presence of a posterior malleolar fracture in the tibia (p=0.15) and fibula (p=0.87) fractures. According to the Haraguchi classification, there were 15 posterolateral-oblique fractures (Type I) and 1 medial-extension fracture (Type II), and the mean angle was 24.5°.
Conclusion
Noncontiguous posterior malleolar fractures occurred in approximately half of the distal one-third tibia shaft fractures with proximal fibula fractures, and a CT scan was considered necessary to diagnose posterior malleolar fractures before surgery
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Posterior Anti-Glide Plating for Supination External Rotation Type Lateral Malleolar Fractures: Clinical Comparison of Locking versus Non-Locking One-Third Semi-Tubular Plate Fixation
Jun Young Lee, Yong Jin Cho, Dong Hyuk Cha, Hyun Bai Choi, Jung Ho Lee
J Korean Fract Soc 2022;35(2):57-62.   Published online April 30, 2022
DOI: https://doi.org/10.12671/jkfs.2022.35.2.57
AbstractAbstract PDF
Purpose
The purpose of this study was to evaluate and compare the clinical and radiological outcomes between locking plates and non-locking plates using posterior anti-glide plating for supination external rotation type lateral malleolar fractures.
Materials and Methods
A total of 50 patients who underwent internal fixation of posterior anti-glide plating due to lateral malleolar fractures, classified as supination-external rotation (SER) as per the Lauge-Hansen classification system, at our hospital from January 2017 to November 2018 were retro-spectively evaluated. Patients were divided into two groups: 1/3 semi-tubular locking plate (24 patients) and 1/3 semi-tubular non-locking plate (26 patients). A radiographic assessment was performed after surgery to evaluate the time of bone union. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional score was measured after the surgery to evaluate the clinical outcomes.
Results
The two groups showed similar distributions in sex, age, height, body mass index, fracture pattern, and mean follow-up period. Complete bone union was obtained in all cases and the mean bone union time was 13.00±3.38 weeks in Group 1 and 12.92±3.26 weeks in Group 2 (p=0.87). The mean AOFAS score at 24 weeks was 95.66±2.86 in Group 1 and 95.84±2.79 in Group 2 (p=0.82). The mean AOFAS score at 48 weeks was 97.25±3.54 in Group 1 and 96.57±3.07 in Group 2 (p=0.47). Two cases of complications were observed in the non-locking plate group.
Conclusion
For the treatment of Lauge-Hansen SER type lateral malleolar fracture, internal fixation us-ing locking 1/3 semi-tubular plate and non-locking 1/3 semi-tubular plate are both favorable fixation methods.
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Review Article
Treatment of Ankle Fracture and Dislocation
Chan Kang
J Korean Fract Soc 2022;35(1):38-49.   Published online January 31, 2022
DOI: https://doi.org/10.12671/jkfs.2022.35.1.38
AbstractAbstract PDF
Ankle fractures are the most common type of foot and ankle fracture injury. Several types of fractures occur in the ankle structures (medial malleolus, lateral malleolus, posterior malleolus, and Chaput’s tubercle) with various mechanisms and extent of fracture force. Moreover, fractures can be accompanied by other injuries, such as distal tibiofibular syndesmotic injury, medial deltoid ligament rupture, and lateral ligament complex rupture. Ankle dislocation can be accompanied when an injury is caused by a greater fracture force. Non-surgical treatments or combined surgeries may be performed depending on the mechanism and fracture type. Generally, a stable fracture maintaining anatomical reduction is treated conservatively, but surgical treatment is performed when this is not the case. Furthermore, surgeries for stable fractures can be offered when the patients demand early weight bearing due to their occupation, age, and performance state. Restoring the ankle mortise in its anatomical shape before the injury and starting early rehabilitation for functional recovery simultaneously until a union is achieved is important. Traumatic arthritis can occur if the treatment focuses only on fractures and neglects ligament injuries, such as distal tibiofibular syndesmotic injury and medial deltoid ligament rupture. Shortening, angular deformation, and rotational deformation of the fibular promote the progression of traumatic ankle arthritis in the long term, which may further cause chronic ankle pain. An overlooked displaced posterior malleolus fracture also causes traumatic arthritis through anteroposterior instability of the ankle joint.
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Original Articles
Comparing Outcomes of Screw Fixation and Non-Fixation for Small-Sized Posterior Malleolar Fragment in Ankle Trimalleolar Fractures
Jee-Wook Ko, Gun-Woo Lee, Keun-Bae Lee
J Korean Fract Soc 2021;34(1):8-15.   Published online January 31, 2021
DOI: https://doi.org/10.12671/jkfs.2021.34.1.8
AbstractAbstract PDF
Purpose
This study was undertaken to compare outcomes of screw fixation and non-fixation of a small-sized posterior malleolar fragment involving less than 25% articular surface in ankle trimalleolar fractures. Materials and Methods: A total of 32 consecutive ankles (32 patients), with posterior malleolar fragment involving 15%-25% of the joint surface, were enrolled in the study. Patients were divided into 2 groups according to whether the fragment was fixed or not (fixed: 20 ankles, non-fixed: 12 ankles). The minimum follow-up period was 12 months. Median size of the posterior malleolar fragment in the fixed and non-fixed groups were 24.6% (range, 22.3%-25.0%) and 22.1% (range, 17.4%-24.3%), respectively. Complications as well as clinical and radiographic outcomes were compared and analyzed between the two groups. Results: Clinical outcomes, including American Orthopaedic Foot & Ankle Society (p=0.501), visual analogue scale (p=0.578), and ankle range of motion (p=0.552), showed no difference between groups at the final follow-up. No differences were obtained in the radiographic outcomes, including joint stepoff (p=0.289) and fragment gap (p=0.289). Complications, including 1 case of delayed union and 1 case of wound infection, were reported in the fixed group. Conclusion: Clinical outcomes and radiographic outcomes of the non-fixation group were satisfactory and comparable to the fixation group. Our results indicate that anatomical reduction with small-sized posterior malleolar fragment in ankle trimalleolar fractures is sufficient for satisfactory outcomes, without the need for additional internal fixation.
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Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures
Jin Young Han, Ki Youn Kwon
J Korean Fract Soc 2020;33(1):1-8.   Published online January 31, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.1.1
AbstractAbstract PDF
PURPOSE
This study compared the clinical and radiological results between two groups of patients with percutaneous fixation or conventional fixation after hardware removal.
MATERIALS AND METHODS
The study analyzed 68 patients (43 open fixation and 43 percutaneous screw fixation [PSF] 25) who had undergone fixation for unstable thoracolumbar fractures. The radiologic results were obtained using the lateral radiographs taken before and after the fixation and at the time of hardware removal. The clinical results included the time of operation, blood loss, time to ambulation, duration of the hospital stay and the visual analogue scale.
RESULTS
The percutaneous pedicle screw fixation (PPSF) group showed better results than did the conventional posterior fixation (CPF) group (p<0.05) in regard to the perioperative data such as operation time, blood loss, and duration of the hospital stay. There were no significant differences in wedge angle, local kyphotic angle, and the ΔKyphotic angle on the postoperative plane radiographs between the two groups (p>0.05). There were no significant differences in the wedge angle and local kyphotic angle after implant removal (p>0.05) between the two groups as well. However, there were significant differences in the segmental montion angle (p<0.001), and the PPSF group showed a larger segmental motion angle than did the CPF group (CPF 1.7°±1.2° vs PPSF 5.9°±3.2°, respectively).
CONCLUSION
For the treatment of unstable thoracolumbar fractures, the PPSF technique could achieve better clinical results and an improved segmental motion angle after implant removal within a year than that of the conventional fixation method.

Citations

Citations to this article as recorded by  
  • A Comparison of 2 Surgical Treatments for Thoracolumbar Burst Fractures: Temporary Osteosynthesis and Arthrodesis
    Halil Ibrahim Süner, Rafael Luque Pérez, Daniel Garríguez-Pérez, Marta Echevarría Marín, Jose Luis Pérez, Ignacio Domínguez
    World Neurosurgery.2022; 166: e419.     CrossRef
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Case Report
Avulsion Fracture of the Posterior Cruciate Ligament from Femoral Insertion Occurred in a Patient with Residual Poliomyelitis: A Case Report
Wonchul Choi, Taesup Kim
J Korean Fract Soc 2018;31(4):149-153.   Published online October 31, 2018
DOI: https://doi.org/10.12671/jkfs.2018.31.4.149
AbstractAbstract PDF
Avulsion fracture of the posterior cruciate ligament from its femoral insertion is quite rare, particularly in adults, and the treatment guidelines have not been established. A 68-year-old female patient with residual poliomyelitis presented with an avulsion fracture of the femoral insertion of the posterior cruciate ligament after a falling accident and was treated with arthroscopic headless compression screw fixation and pull-out suture of the avulsed ligament. We report this case with a relevant discussion of this type of injury.
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Original Articles
Surgical Outcome of Posterior Pelvic Fixation Using S1, S2 Screws in Vertically Unstable Pelvic Ring Injury
Kwang Hee Yeo, Nam Hoon Moon, Jae Min Ahn, Jae Yoon Jeong, Jae Hoon Jang
J Korean Fract Soc 2018;31(1):9-17.   Published online January 31, 2018
DOI: https://doi.org/10.12671/jkfs.2018.31.1.9
AbstractAbstract PDF
PURPOSE
Iliosacral screw fixation is an effective and less invasive method that is used widely for the definitive treatment of unstable pelvic ring injuries. On the other hand, fixation failures after iliosacral screw fixation have been reported in vertically unstable pelvic ring injuries. This study examined the surgical outcomes of posterior pelvic fixation using S1 and S2 screws in vertically unstable pelvic ring injuries.
MATERIALS AND METHODS
Between January 2011 and April 2016, 17 patients with vertically unstable pelvic ring injuries who met the minimum 1 year follow-up criteria were treated with internal fixation using posterior pelvic S1 and S2 screws. Their mean age was 43.9 years. According to the AO/OTA classification, 10 patients had C1, 6 had C2, and 1 had C3 injuries. Surgical treatments of single or multiple steps, where necessary, were performed by two surgeons. The clinical and radiologic outcomes were assessed retrospectively using radiographs and medical records.
RESULTS
Overall, 16 patients had bone healing without screw loosening; however, one patient could not maintain anterior pelvic fixation because of an open fracture and deep infection in the anterior pelvic ring. Of five patients who complained of neurological symptoms after injury, three had partially recovered from their neurological deficit. At the last follow-up, the clinical outcomes according to the Majeed score were excellent in 5, good in 6, fair in 4, and poor in 2 patients. The postoperative radiologic outcomes by Matta and Tornetta's method were excellent in 5, good in 8, and fair in 4 patients. Malposition of the S2 screw was identified in one case. The mean time to union was 14.6 weeks after surgery.
CONCLUSION
S1 and S2 screw fixation can be an effective treatment option for posterior pelvic stabilization in vertically unstable pelvic ring injuries when considering the surgical outcomes, such as screw loosening and loss of reduction.

Citations

Citations to this article as recorded by  
  • Fixation Options of Unstable Posterior Pelvic Ring Disruption: Ilio-Sacral Screw Fixation, S2AI Fixation, Posterior Tension Band Plate Fixation, and Spino-Pelvic Fixation
    Dong-Hee Kim, Jae Hoon Jang, Myungji Shin, Gu-Hee Jung
    Journal of the Korean Fracture Society.2019; 32(4): 240.     CrossRef
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Posterior Dual Plating for Distal Shaft Fractures of the Humerus
Chul Hyun Cho, Kwang Yeung Jeong, Beom Soo Kim
J Korean Fract Soc 2017;30(3):117-123.   Published online July 31, 2017
DOI: https://doi.org/10.12671/jkfs.2017.30.3.117
AbstractAbstract PDF
PURPOSE
To evaluate the results and efficacy of posterior dual plating for distal shaft fractures of the humerus.
MATERIALS AND METHODS
We retrospectively analyzed 12 patients, who underwent open reduction and internal fixation using posterior dual plating for distal shaft fractures of the humerus, between July 2007 and July 2015, with at least 6 months of follow-up. After locating the radial nerve without dissection via posterior triceps splitting, the fracture was stabilized using a short 3.5 mm locking compression plate. Then additional fixation, using a long 3.5 mm locking compression plate, was performed. The clinical outcomes were assessed in accordance with the Mayo Elbow Performance Index (MEPI) scoring system, and the radiological outcomes were assessed using serial plain radiographs.
RESULTS
Eleven patients (91.7%) had bony union, and the mean union period was 13.9 weeks. In one patient, delayed union was treated by autogenous iliac bone graft at 8 months after surgery, which resulted in bony union. The mean MEPI score was 95.8, and the clinical outcomes were excellent in 9 patients and good in 3 patients. Postoperative complications included 1 elbow stiffness by heterotopic ossification and 1 temporary radial nerve palsy. One patient with temporary radial nerve palsy was completely recovered within the first 4 days after surgery.
CONCLUSION
Posterior dual plating for distal shaft fractures of the humerus revealed satisfactory clinical and radiological outcomes. It can be a useful alternative to provide stable fixation without the need for a dissection of the radial nerve.
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The Significance of Calcaneal Posterior Tuberosity Fragment Reduction When Treated with Open Reduction in Displaced Intra-Articular Calcaneal Fractures
Hong Ki Park, Jong Ryoon Baek, Jang Seok Choi, Sang Jin Lee, Je Won Paik
J Korean Fract Soc 2016;29(4):233-241.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.233
AbstractAbstract PDF
PURPOSE
We attempt to evaluate the significance of calcaneal posterior tuberosity fragment reduction when treated with surgical open reduction in displaced intra-articular calcaneal fractures.
MATERIALS AND METHODS
A total of 90 patients with displaced intra-articular calcaneal fracture, between January 2010 and December 2015, treated with open reduction and internal fixation were enrolled in this study. At postoperative 3 months, we evaluated the reduction state of calcaneal posterior tuberosity fragment by measuring the degree of lateral displacement of the posterior tuberosity fragment on the calcaneal axial view. Moreover, we also evaluated the difference in the calcaneal length and height with the uninjured side on the lateral view of both sides. In addition, we estimated the reduction state of the posterior facet by measuring the degree of gap and step-off on the semi-coronal view of postoperative computed tomography and estimated the restoration of calcaneal angle by measuring the difference in Böhler's and Gissane angle with the uninjured side on the lateral view of both sides.
RESULTS
The correlation coefficient with 3 components for evaluating the reduction state of posterior tuberosity fragment and gap and step-off of posterior facet was r=0.538, 0.467, r=0.505, 0.456, r=0.518, and 0.493, respectively, and restoration of Böhler's and Gissane angle was r=0.647, 0.579, r=0.684, 0.630, r=0.670, and 0.628, respectively. The relationship of each component shows a significant correlation as all p-values were <0.01.
CONCLUSION
The precise reduction of calcaneal posterior tuberosity fragment developed by the primary fracture line was considered as an important process of anatomical reduction of calcaneal body, including the posterior facet and calcaneal angle restoration.
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Usefulness of Computed Tomography on Distal Tibia Intra-Articular Fracture Associated with Spiral Tibia Shaft Fracture
Seong Eun Byun, Sang June Lee, Uk Kim, Young Rak Choi, Soo Hong Han, Byong Guk Kim
J Korean Fract Soc 2016;29(2):114-120.   Published online April 30, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.2.114
AbstractAbstract PDF
PURPOSE
The purpose of this study is to evaluate the usefulness of computed tomography (CT) for spiral tibia shaft fracture by analyzing associated distal tibia intra-articular fractures diagnosed by CT only which met the indication of surgical fixation and were fixed.
MATERIALS AND METHODS
Ninety-five spiral tibia shaft fractures with preoperative ankle plain radiographs and CT were analyzed retrospectively. The incidence and type of associated distal tibia articular fractures were evaluated by reviewing ankle plain radiography and CT. The number of fractures diagnosed by CT that correspond with the indication of fixation and that were actually fixed were analyzed.
RESULTS
Among 95 spiral tibia shaft fractures, 62 cases (65.3%) were associated with distal tibia intra-articular fracture. There were 37 cases of posterior malleolar fracture, 5 cases of avulsion fracture of the distal anterior tibiofibular ligament, 5 cases of medial malleolar fracture, and 15 cases of complex fracture. Among 52 posterior malleolar fractures including complex fracture, 20 cases were diagnosed by ankle plain radiograph. Of these 20 cases, 16 posterior malleolar fractures (80.0%) met the indication of surgical fixation, and 14 cases were actually fixed with a screw. Among 32 posterior malleolar fractures diagnosed by CT only, 26 cases (81.3%) met the indication of surgical fixation and 18 cases (56.3%) were fixed by screw.
CONCLUSION
Approximately 50% of associated fractures were diagnosed by CT only and more than 80% of associated posterior malleolar fractures met the indication of surgical fixation and among these fractures, 18 cases (56.3%) were actually fixed by screw. This result suggests that CT is useful in diagnosis and treatment of distal tibia intra-articular fracture associated with spiral tibia shaft fracture.

Citations

Citations to this article as recorded by  
  • Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures
    Young Sung Kim, Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Soon Young Park
    Journal of the Korean Orthopaedic Association.2021; 56(4): 317.     CrossRef
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Usefulness of Spring Plate for Acetabular Posterior Wall Fracture Including Small Fragment
Jeong Hoon Kang, Sang Hong Lee, Hyeon Jun Lee
J Korean Fract Soc 2016;29(1):19-25.   Published online January 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.1.19
AbstractAbstract PDF
PURPOSE
We applied internal fixation using a spring plate against an acetabular posterior wall fracture including small fragments and then evaluated the clinical and radiological results and want to understand the usefulness of the spring plate.
MATERIALS AND METHODS
Fifteen patients in whom fixation was difficult using leg screws or a metal plate because of a small bone fragment, in patients with posterior wall acetabular fractures who presented in our hospital since August of 2011 to March of 2014 were enrolled. The mean age was 42.6 years (range 24-54 years) with relatively young patients, and they were followed-up for at least one year. We analyzed the rate of reduction after surgery using the classification of Matta in radiographs, and the classification of Borrelli in 3-dimensional computed tomography (CT) and clinical results were evaluated using the clinical grading system.
RESULTS
There were five cases of anatomical reduction, 9 cases of imperfect reduction, and 1 case of unsatisfactory reduction according to the classification of Matta. Except for one case during the follow-up period, the union of bone was successful without failure of fixation and the clinical results were 6 cases of excellence, 8 cases of good, and 1 case of failure. Articular displacement was also evaluated in postoperative CT scan according to Borrelli's criteria. The mean of gap and step off was 2.04 mm, 1.3 mm.
CONCLUSION
Use of leg screw fixation and so on in posterior wall fractures including a small fragment of the acetabular rim is not easy. However the method using spring plate fixation enables relatively accurate reduction and fixation for a small fragment and the clinical outcome showed satisfactory results.

Citations

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  • Biomechanical Comparison of Fixation Methods for Posterior Wall Fractures of the Acetabulum: Conventional Reconstruction Plate vs. Spring Plate vs. Variable Angle Locking Compression Plate
    HoeJeong Chung, Hoon-Sang Sohn, Jong-Keon Oh, Sangho Lee, DooSup Kim
    Medicina.2024; 60(6): 882.     CrossRef
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The Efficacy of Preserved Posterior Cortex in the Treatment of Infected Nonunion of the Tibia
Hyoung Min Kim, Il Jung Park, Youn Tae Roh, Byung Min Kang, Hyun Jin Lee, Jae Young Lee
J Korean Fract Soc 2014;27(4):301-307.   Published online October 31, 2014
DOI: https://doi.org/10.12671/jkfs.2014.27.4.301
AbstractAbstract PDF
PURPOSE
We studied the efficacy of preserved posterior cortex connecting to adjacent muscle or periosteum during wide debridement in the treatment of infected nonunion of the tibia.
MATERIALS AND METHODS
From January 2001 to May 2011, 12 cases of infected nonunion of the tibia with segmental defect larger than 4 cm after wide debridement were selected. The selected cases were categorized according to two groups; group 1 with preserved posterior cortex in the segmental defect site - six cases, group 2 without posterior cortex - six cases. The results were compared by assessing the size of bone defect, the interval between wide debridement and bone reconstruction, bony union time, complications, and clinical results.
RESULTS
The mean length of bone defect of group 1 was 7.6 cm (range 4.3-11.0 cm) and that of group 2 was 6.4 cm (range 4.0-12.0 cm). The interval between wide debridement and bone reconstruction was 10.0 weeks (range 5-18 weeks) for group 1, and 12.1 weeks (range 0-24 weeks) for group 2. The time for bony union of group 1 was 6.2 months (range 5-7 months), and that of group 2 was 10.8 months (range 7-18 months). In group 2, there were two cases of fatigue fracture and two cases of docking site nonunion after distraction osteogenesis.
CONCLUSION
The preserved posterior cortex after wide debridement of infected nonunion of the tibia helps bony union and reduces the treatment period.
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Posterior-Posterior Dual Plates Fixation for the Distal Humerus Fractures
Yoon Min Lee, Seok Whan Song, Ki Bum Choi, Yoo Joon Sur, Sung Eun Kim
J Korean Fract Soc 2013;26(4):254-260.   Published online October 31, 2013
DOI: https://doi.org/10.12671/jkfs.2013.26.4.254
AbstractAbstract PDF
PURPOSE
Fractures of the distal humerus are one of the challenging injuries due to its complex anatomy and accompanied comminution. For dual plate fixation, orthogonal or parallel plating is widely used, but the better of the two is debatable. The purpose of this study was to report another fixation technique that yielded good clinical results with early bone union of distal humerus fracture, namely, posterior-posterior plate fixation.
MATERIALS AND METHODS
From March 2003 to March 2012, 20 patients with distal humerus fractures were treated by posterior-posterior plate fixation. The triceps reflecting approach was used with anterior transposition of the ulnar nerve. The mean age at the time of injury was 45 years (range, 26 to 78 years). By AO classification of distal humerus fractures, there were one case of A2 and B3 respectively, two cases of each A3, C1 and C3, and twelve cases of C2.
RESULTS
The mean period of complete bone union was 7.1 weeks (range, 4 to 11 weeks). The mean flexion-extension range of motion of the elbow joint at last follow-up was 116.2 degrees. The mean pronation was 81.2 degrees and supination was 83.1 degrees. Plates and screws were removed at about nine months after the initial surgery. No cases showed complications or required additional operation.
CONCLUSION
Posterior-posterior dual plates fixation resulted in stable bicortical screw fixation, and insertion of lag screws were possible without interference. Posterior-posterior plating could be an easy and stable fixation method that provides good clinical results.

Citations

Citations to this article as recorded by  
  • Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study
    Chien-An Shih, Fa-Chuan Kuan, Kai-Lan Hsu, Chih-Kai Hong, Cheng-Li Lin, Ming-Long Yeh, Wei-Ren Su
    BMC Musculoskeletal Disorders.2021;[Epub]     CrossRef
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Case Report
Treatment of Traumatic Posterior Dislocation of the Sternoclavicular Joint: A Case Report
Dong Hee Kim, Do Hoon Kim, Seok Kwon Kang, Eui Chul Lee
J Korean Fract Soc 2013;26(1):56-59.   Published online January 31, 2013
DOI: https://doi.org/10.12671/jkfs.2013.26.1.56
AbstractAbstract PDF
Compared with acromioclavicular dislocation, dislocation of the clavicle at its sternal end is uncommon and accounts for 3% of all injuries to the shoulder girdle. Furthermore, the posterior dislocation of the sternoclavicular joint is relatively a rare injury compared to the other types of sternoclavicular dislocation. We report this case since we have experience with similar cases of traumatic posterior dislocation at the sternoclavicular joint, which were successfully treated with x-ray guided reduction.

Citations

Citations to this article as recorded by  
  • Posterior Sternoclavicular Dislocation: A Case Report
    So Hwa Yoon, Sun Ki Kim, Ki Jun Kim
    Journal of the Korean Society of Radiology.2015; 72(2): 128.     CrossRef
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Original Articles
Comparison of Surgical Outcomes in Thoracolumbar Fractures Having 6 or Less Scored by Load-Sharing Classification Based on Posterior Fusion Level
Jung Hoon Kim, Sung Soo Kim, Jin Ho Cho, Bo Hoon Jang, Jin Hwan Kim
J Korean Fract Soc 2013;26(1):21-26.   Published online January 31, 2013
DOI: https://doi.org/10.12671/jkfs.2013.26.1.21
AbstractAbstract PDF
PURPOSE
The aim of this study is to decide the optimal level of fusion with comparing the results between the short segment fusion and long segment fusion treated with pedicle screw instrumentation, including fractured vertebra in thoracolumbar junctional fractures.
MATERIALS AND METHODS
From February 2000 to November 2009, fifty three patients with junctional fracture of thoracolumbar spine were treated with pedicle screws and posterior fusion at our hospital. They were divided into two groups, the short segment group and long segment group. Preoperatively, immediate postoperative and last follow-up lateral radiological evaluation was done by measuring the correction and loss of segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle. In addition, operation time and amount of intraoperative bleeding were measured.
RESULTS
There were no significant differences of statistical analysis regarding the radiological variables between the two groups, especially the loss of corrected segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle (p>0.05). However, operative time in the short segment group (234 minutes) was shorter than the long segment group (284 minutes), and there was statistical significance (p=0.002).
CONCLUSION
We recommend the short segment transpediculr instrumentation one level above and one level below, including the fractured vertebra for thoracolumbar junctional fracture with 6 points or less of the load-sharing score.
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The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures
Seung Wook Baek, Kyu Dong Shim, Ye Soo Park
J Korean Fract Soc 2011;24(4):354-360.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.354
AbstractAbstract PDF
PURPOSE
Evaluate the effects of sagittal imbalance on the clinical outcomes in thoracolumbar burst fractures.
MATERIALS AND METHODS
We evaluated 11 patients who had received posterior fixation for unstable burst fractures. Radiologic assessment including the compression ratio, focal kyphotic angle and sagittal balance were obtained. The clinical outcomes were assessed by ODI, VAS and SF-36. We subdivided the patients into sagittal balance and imbalance group, and compared with clinical outcomes. The relationship between radiologic and clinical outcomes was examined using correlation analysis.
RESULTS
The radiologic assessment were changed on preoperative and postoperative as follows: mean compression ratio: 15.2%, 4.9%, mean focal kyphotic angle: 43.2degrees, 20.9degrees. The mean sagittal balance was 11.5 cm. The mean score of VAS, ODI, Physical and Mental Component Summary of SF-36 were 3.7, 45.8, 43.3 and 39.8, respectively. The ODI was significantly higher in sagittal imbalance group, and SF-36 was significantly higher in sagittal balance group (p<0.05). The VAS was correlated with compression ratio and focal kyphotic angle. The ODI and Mental Component Summary of SF-36 were correlated with sagittal imbalance.
CONCLUSION
Sagittal balance effects on the functions of spine, surgical treatment should be carefully considered with unstable burst fractures.
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Treatment of the Trimalleolar Fracture Using Posterolateral Approach: Minimum 2-year Follow Up Results
Gwang Chul Lee, Jun Young Lee, Sang Ho Ha, Jae Won You, Sang Hong Lee, Hong Moon Sohn, Ki Young Nam, Kwang Hyo Seo
J Korean Fract Soc 2011;24(4):328-334.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.328
AbstractAbstract PDF
PURPOSE
To analyze the long term follow up results of treatment with posterolateral approach and to investigate its usefulness in the patients of trimalleolar fracture with posterior fragment which is above 25% of articular involvement.
MATERIALS AND METHODS
There were 34 cases of trimalleolar fracture in our hospital from May 2004 to April 2008. We investigated 20 patients who underwent operation with the posterolateral approach and over-2 years follow up cases. The mean follow up period was 34 (24~58) months. Preoperative posterior malleolar fragment involved above 25% of articular surface in all cases and displaced more than 2 mm in 11 cases. We analyzed the radiologic type of posterior malleolar fragments and evaluated the function and pain through AOFAS score and complications.
RESULTS
All cases showed primary union at mean 13.1 weeks. The complications are that partial ankylosis result of soft tissue contracture is seen in 2 cases (10%) and post-traumatic arthritis is seen in 1 cases (5%) and 17 cases (85%) of all patients are showed excellent AOFAS score.
CONCLUSION
The posterolateral approach is a valuable method because that it enables us to easily reduction and internal fixation of the posterior malleolus and lateral malleolus at one time and the results are satisfied for a long time follow up.

Citations

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  • Outcomes of Immediate Operative Treatment of Ankle Trimalleolar Open Fractures
    Jun-Young Lee, Yong-Jin Cho, Sin-Wook Kang, Yung-Min Cho, Hyun-Bai Choi
    Journal of Korean Foot and Ankle Society.2020; 24(1): 25.     CrossRef
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Case Report
Checkrein Deformity by Incarcerated Posterior Tibial Tendon and Displaced Flexor Hallucis Longus Tendon following Ankle Dislocation: A Case Report
Su Young Bae, Hyung Jin Chung, Man Young Kim
J Korean Fract Soc 2011;24(3):271-276.   Published online July 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.3.271
AbstractAbstract PDF
We report a case of 20 year-old man who had unusual equinus and checkrein deformity following dislocation of his right ankle joint. He had been treated with distal tibiofibular screw fixation and external fixation. After removal of external fixator, he had suffered from progressive deformity of foot and ankle. Widening of distal tibiofibular joint and medial clear space was found on radiograph and it was revealed that posterior tibial tendon had been dislocated and incarcerated into the distal tibiofibular joint on MRI. We corrected the deformity with excision of incarcerated posterior tibial tendon, adhesiolysis and lengthening of flexor hallucis longus tendon, reconstruction of deltoid ligament and flexor digitorum longus tendon transfer.

Citations

Citations to this article as recorded by  
  • Management of Checkrein Deformity
    Min Gyu Kyung, Yun Jae Cho, Dong Yeon Lee
    Clinics in Orthopedic Surgery.2024; 16(1): 1.     CrossRef
  • A Neglected Extensor Hallucis Longus Tendon Rupture Caused by Arthritic Adhesion
    Sung Hun Won, Sung Hwan Kim, Young Koo Lee, Dong-Il Chun, Byung-Ryul Lee, Woo-Jong Kim
    Medicina.2023; 59(6): 1069.     CrossRef
  • The Checkrein Deformity of Extensor Hallucis Longus Tendon and Extensor Retinaculum Syndrome with Deep Peroneal Nerve Entrapment after Triplane Fracture: A Case Report
    Hyungon Gwak, Jungtae Ahn, Jae Hoon Lee
    Journal of Korean Foot and Ankle Society.2021; 25(3): 145.     CrossRef
  • Checkrein Deformity Due to Flexor Digitorum Longus Adhesion after Comminuted Calcaneus Fracture: A Case Report
    Jin Su Kim, Han Sang Lee, Ki Won Young, Keun Woo Lee, Hun Ki Cho, Sang Young Lee
    Journal of Korean Foot and Ankle Society.2015; 19(1): 35.     CrossRef
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Original Article
Treatment of the Posterior Malleolar Fracture Using Posterior Approach
Hyun Wook Chung, Dong Hwan Kim, Si Hoon Yoo, Jin Soo Suh
J Korean Fract Soc 2010;23(1):50-56.   Published online January 31, 2010
DOI: https://doi.org/10.12671/jkfs.2010.23.1.50
AbstractAbstract PDF
PURPOSE
For fixation of the large posterior malleolar fracture fragment, indirect anterior fixation with cannulated screw has been widely used, but the anatomical reduction is not always obtained. The purpose of this article is to evaluate the clinical result of posterior malleolar fractures treated with anatomical reduction and internal fixation using posterior approach.
MATERIALS AND METHODS
We have analyzed the 15 patients with posterior malleolar fractures, treated with posterior approach from August 2005 to August 2008. The mean follow up period was 17.6 months, We have reviewed the perioperative joint integrity, method of operation, postoperative care, bony union and complication. A clinical outcome was evaluated by AOFAS (American orthopedic foot and ankle society) scaling system and Olerud & Molander scoring system.
RESULTS
Among 15 cases, posterolateral approach and posteromedial approach were chosen in 9 cases and 6 cases respectively. The radiologic unions were achieved at 12.4 (12~18) weeks. Mean AOFAS score was 90.3 (72~98), and Olerud & Molander score was "excellent" in 5 cases, "good" in 7 cases, "fair" in 1 case and "poor" in 2 cases. Postoperative complications in 2 cases revealed a posttraumatic arthritis and a scar band contracture respectively.
CONCLUSION
In posterior malleolar fracture of ankle joint, the integrity of joint has closely affected clinical outcomes. We suggest that a posterior approach for posterior malleolar fracture with especially incarcerated fragments and comminuted fractures, can be a useful method for anatomical reduction and stable fixation, and satisfactory clinical results.

Citations

Citations to this article as recorded by  
  • Single lateral approach for open reduction and internal fixation of posterior malleolar fragment in Weber B rotational ankle fracture
    Jaehyung Lee, Hwan Ryu, Jae Yong Park
    Medicine.2023; 102(3): e32725.     CrossRef
  • Posterior Malleolus Fractures in Trimalleolar Ankle Fractures: Malleolus versus Transyndesmal Fixation
    Bilgehan Tosun, Ozgur Selek, Umit Gok, Halil Ceylan
    Indian Journal of Orthopaedics.2018; 52(3): 309.     CrossRef
  • Single Oblique Posterolateral Approach for Open Reduction and Internal Fixation of Posterior Malleolar Fractures With an Associated Lateral Malleolar Fracture
    Jun Young Choi, Ji Hoon Kim, Hyeong Tak Ko, Jin Soo Suh
    The Journal of Foot and Ankle Surgery.2015; 54(4): 559.     CrossRef
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Case Report
Bilateral PCL Avulsion Fracture from Tibial Attatchment Site in a 16-years-old Male : A Case Report
Hee Gon Park
J Korean Fract Soc 2009;22(3):189-192.   Published online July 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.3.189
AbstractAbstract PDF
Posterior cruciate ligament avulsion fracture is occurred by high energy trauma, usually in motor vehicle accident or sports injury. Bilateral posterior cruciate ligament avulsion fracture is not yet reported in Korea. Authors report a case of bilateral posterior cruciate ligament avulsion fracture in 16-years-old man treated with anatomical reduction and internal fixation with a review of literature.
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Original Articles
Radiologic Analysis and Treatment of Posterior Malleolar Fractures of the Ankle
Jae Sung Lee, Soo Yong Kang, Han Jun Lee, Young Bong Ko
J Korean Fract Soc 2009;22(2):98-103.   Published online April 30, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.2.98
AbstractAbstract PDF
PURPOSE
The purpose of this study was to classify posterior malleolar fractures according to the position of fragments and to analyze radiologic features of each type.
MATERIALS AND METHODS
We analyzed forty-six patients of ankle fractures involving a posterior malleolus who were treated between January 2004 and December 2007. The posterior malleolar fractures were categorized into three types (posterolateral, posteromedial, shell) based on the major fracture line. In each type, we analyzed amount of displacement, involvement of articular surface, existence of subluxation and osteochondral impacted fragments.
RESULTS
The forty-six patients were categorized into three types: Posterolateral (PL) type (33 cases, 72%), Posteromedial (PM) type (8 cases, 17%), shell type (5 cases, 11%). Of the 8 cases with PM type, 7 cases showed displacement more than Grade II, 4 cases showed subluxation of ankle joint, and 3 cases showed osteochondral impacted fragment. Average involvement of articular surface of PM type is 35% (15~65%).
CONCLUSION
Posterior malleolar fractures with medial extension tended to have adverse effect on ankle stability and Preoperative CT scan is essential for evaluation of fracture type and determination of appropriate surgical approach.

Citations

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  • Treatment of Isolated Posterior Malleolus Fracture in the Ankle
    Ji Hoon Kim, Seong Mu Cha, Dae Yeon Jo, Jin Soo Suh
    Journal of the Korean Orthopaedic Association.2014; 49(1): 29.     CrossRef
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The Treatment of Posterolateral Malleolar Fractures using Percutaneous Reduction Technique
Jae Sung Lee, Han Jun Lee, Jae Hyun Yoo, Hee Chun Kim
J Korean Fract Soc 2009;22(1):19-23.   Published online January 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.1.19
AbstractAbstract PDF
PURPOSE
To evaluate the usefullness of the percutaneous reduction technique with K-wire that could reduce the displaced posterolateral fracture fragment which persisted even after an anatomical reduction of the lateral malleolar fracture.
MATERIALS AND METHODS
From January 2004 to December 2006, we reviewed 72 patients who underwent surgical treatment for their trimalleolar fractures. We estimated the clinical and radiological results of 5 cases treated by percutaneous reduction technique with K-wire when more than the distal tibial articular step-off was left after reduction of the lateral malleolar fracture. The method of reduction starts with temporary fixation of lateral malleolar fracture followed by checking ankle radiographic image to confirm the accuracy of reduction. In case of incomplete reduction of the posterior fragment, a K-wire is inserted into the posterior fragment and pushed downward to the ankle joint level, and then lag screws were inserted.
RESULTS
The average articular involvement by the posterolateral fracture fragment was 30.2%. The average step-off after reduction of the lateral malleolar fracture was 3.7 mm. At the final follow up, step-off was less than 2 mm in all cases. In clinical results by Baird and Jackson score, 3 out of 5 cases were excellent, other 2 were good.
CONCLUSION
Percutaneous reduction technique for posterolateral fragment using the K-wire is relatively easy. This technique may be useful when the posterolateral fragment is large (more the 25% of articular surface) and not severely comminuted.
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Case Report
Traumatic Simultaneous Bilateral Hip Dislocation in the Elderly Patient: A Case Report
Koing Woo Keon, Sang Bong Ko
J Korean Fract Soc 2007;20(4):335-338.   Published online October 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.4.335
AbstractAbstract PDF
Traumatic simultaneous bilateral hip dislocation is reported rarely, but the most of them are limited in young patients. The authors managed the elderly patients whose both hip was dislocated traumatically, simultaneously and who didn't have any other underlying disease and other associated fracture - femur, hip joint and pelvis, with a review of the relevant literature.
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Original Articles
Posterior Plating in Distal Fibular Fracture
Choong Hyeok Choi, Young A Cho, Jae Hoon Kim, Il Hoon Sung
J Korean Fract Soc 2007;20(2):161-165.   Published online April 30, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.2.161
AbstractAbstract PDF
PURPOSE
To report the technical experience of posterior plating for the distal fibular fracture.
MATERIALS AND METHODS
20 Weber type-B fibular fractures were included in this study, which were treated with the posterior plating. 1/3 semitubular plate was used and orientation of all screws were intended to be perpendicular to the plate as possible. Fixation stability and maintenance of reduction after plating was assessed manually in the operating field. Clinical results were evaluated at least 1 year after operation, using American Orthopaedic Foot and Ankle Society (AFOAS) Ankle-Hindfoot score.
RESULTS
5 cases were firmly stabilized without using any lag screw or fixation of distal fragment. For improving stability or achieving proper reduction, a lag screw was placed posteroanteriorly through the plate in 14 cases. Anteroposterior interfragmentary fixation in 1 case before plating, and contouring of the plate in 3 cases were needed in cases of which the posterior plating impeded reduction of distal fibular fracture. In all cases, fracture was stabilized without fixation through the most distal hole. There were no major postoperative complications. AFOAS score was 95.5±5.2.
CONCLUSION
The posterior plating technique for distal fibular fracture is regarded as a recommendable option. Additional fixation with interfragmentary screw or contouring of the plate, however, would be needed in some cases to achieve anatomical reduction or sufficient stability.

Citations

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  • A Specialized Fibular Locking Plate for Lateral Malleolar Fractures
    Eui Dong Yeo, Hak Jun Kim, Woo In Cho, Young Koo Lee
    The Journal of Foot and Ankle Surgery.2015; 54(6): 1067.     CrossRef
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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
J Korean Fract Soc 2007;20(2):123-128.   Published online April 30, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.2.123
AbstractAbstract PDF
PURPOSE
To evaluate the results of surgical treatment of posterior wall fractures of the acetabulum and to determine the factors affecting the results.
MATERIALS AND METHODS
Thirty-one posterior wall fractures were reviewed; 7 type A1-1, 19 type A1-2 and 5 type A1-3 by AO classification. Postoperatively, the accuracy of the reduction was evaluated. At the final follow-up, clinical and radiographic results were evaluated with medical records and radiographs. The factors affecting the results were determined.
RESULTS
The reduction was graded as anatomical in 22 patients, imperfect in seven and poor in two. The clinical result was excellent in 21 hips, good in six, fair in three and poor in one. The quality of the reduction was strongly associated with the clinical result. The radiographic result was excellent in 22 hips, good in five, fair in two and poor in two. The clinical result was related closely to the radiographic result. Complications were osteoarthritis in three patients, osteonecrosis of the femoral head in one, heterotopic ossification in one, penetration of a screw into the joint in one and iatrogenic sciatic nerve injury in one. The factors affecting the clinical results were fracture patterns, the surgeon's experience, the accuracy of the reduction and late complications.
CONCLUSION
In this present series of posterior wall fractures, as their prognosis depends on the severity of the injury and the accuracy of the reduction, satisfactory result can be obtained by anatomical reduction with thorough preoperative planning and the surgeon's experience.
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Case Report
Traumatic Pseudoaneurysm of Posterior Tibial Artery in a Child: A Case Report
Tai Seung Kim, Kuhn Sung Whang, Woo Young Seo
J Korean Fract Soc 2007;20(1):83-85.   Published online January 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.1.83
AbstractAbstract PDF
Pseudoaneurysm is one of the complications of arterial injuries by trauma. The case report in children is rare, although not in adult. A 7-year and 10-month girl was visited with the complaints of pain and a mass in her right leg. At first, the radiograph of right tibia showed a remarkable cortical erosion from without, suggesting mass effect by a soft tissue tumor. She had a history of fracture of right tibia, and then manipulative reduction and K-wire fixation at 11 months ago. Arteriography showed a formation of the pseudoaneurysm originated from the posterior tibial artery. The operation was done through the ligation of artery at proximal and distal to pseudoaneurysm, and then excision of mass. At 5 year follow-up, the configuration and function of right foot was normal. Eventually, the cause of the mass formation is thought by the trauma of fracture fragment at the time of accidents, but the possibility of penetrated injuries by K-wire should be ruled out, which is used frequently in children's fracture. We experienced a case of traumatic pseudoaneurysm of posterior tibal artery with tibial fracture, especially occurred in pediatric patient, and presented the result of long-term follow-up.

Citations

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  • Coil Embolization of a Pseudoaneurysm of the Anterior Tibial Artery: A Case Report
    Tae-Hyun Wang, Hyung-Lae Cho, Ki-Bong Park, Duc-Hee Kim
    Journal of Korean Foot and Ankle Society.2016; 20(1): 43.     CrossRef
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Original Article
Treatment of Complex Tibial Plateau Fractures: A Modified Patient Positioning for the Combined Anterior and Posterior Approaches
Jong Keon Oh, Chang Wug Oh, Seung Beom Hahn, Kwon Jae Roh, Kwan Hee Lee
J Korean Fract Soc 2006;19(3):396-400.   Published online July 31, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.3.396
AbstractAbstract
We have treated thirteen complex plateau fractures involving both condyles with one of the following conditions with the use of the combined anterior and posterior approaches in a modified supine position. Associated PCL avulsion fracture, displacement of major fracture plane dominantly at the back, large coronal fracture fragment involving medial or lateral condyles. A patient is placed on an operation table in supine position with a bump under the contralateral buttock. The well leg is placed in a lithotomy position and the injured leg is placed over a sterilized Mayo stand separately. For the posterior approach the table was tilt toward the injured side with the hip abducted and rotated externally. With a modified patient's positioning we were able to use combined anterior and posterior approaches simultaneously for the management of certain complex plateau fractures without changing the draping.

Citations

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  • Current Concepts in Management of Tibia Plateau Fracture
    Sang Hak Lee, Kang-Il Kim
    Journal of the Korean Fracture Society.2014; 27(3): 245.     CrossRef
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Case Report
Malunion of the Odontoid Process Developing Cervical Myelopathy: A Case Report
Teak Soo Jeon, Sang Bum Kim, Whan Yong Chung, Woo Sik Kim, Sung Hun Kim, Tae Kyun Kim
J Korean Fract Soc 2006;19(3):378-380.   Published online July 31, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.3.378
AbstractAbstract
Late-onset progressive myelopathy, years after odontoid fracture, is considered a rarity. Undiagnosed or untreated odontoid fractures may develop into nonunion or malunion, thereby leading to secondary delayed cervical myelopathy. We present a case of a 50-year-old man with malunion of odontoid fracture. We had a good result following one-staged posterior decompression and occipito-cervical fusion.

Citations

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  • Surgical Management of Type II Odontoid Fractures in a Resource-Limited Setting: A Case Series
    Ntsambi Glennie, Israël A Maoneo, Kisubi Michel, Chérubin Tshiunza, Antoine Beltchika
    Cureus.2024;[Epub]     CrossRef
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