Journal of Musculoskeletal Trauma

Recurrent Treatment Failure in Vancouver Classification Type C Periprosthetic Fractures around a Well Fixed Short Femoral Stem: Byeong Yeol Choi, Hong-Man Cho, Jiyeon Park; J Korean Fract Soc 2022;35(1):16-20. Published online January 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.1.16

Abstract PDF: A short femoral stem (type 1 cementless stem) is being increasingly used to perform total hip arthroplasty; however, various types of intra- or postoperative periprosthetic fractures have been reported in recent times. A 66-year-old woman with a history of bilateral total hip arthroplasties using a type 1B femoral stem was admitted 2 months post-operation for a Vancouver type C periprosthetic fracture. She underwent open reduction and internal fixation; however, we observed recurrent non-union and plate breakage at the same site. In this case report, we discuss the factors associated with treatment failure in patients with a Vancouver type C periprosthetic fracture following type 1 femoral stem im-plantation.

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Cortical Perforation Misidentified with Medial Condylar Fracture of Femur in Total Knee Arthroplasty: Case Report: Seung Suk Seo, Sang Won Moon; J Korean Fract Soc 2019;32(1):52-55. Published online January 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.1.52

Abstract PDF: Intraoperative fracture in total knee arthroplasty (TKA) is a rare complication. However, when it happens, additional surgery to fix the fracture site is needed. Therefore, it is important to diagnose intraoperative fractures in TKA exactly. The authors experienced two cases of cortical perforation of medial femoral condyle misidentified as the fracture in TKA. Cortical perforation could be misdiagnosed as the fracture, which could lead to unnecessary surgery. This is the first report about cortical perforation in TKA. We report two cases of intraoperative cortical perforations and describe the radiological characteristics.

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Risk Factors of Periprosthetic Fracture after Total Knee Arthroplasty: Ju Young Shin, Hyung Jun Kim, Seung Han Cha, Dong Heon Kim; J Korean Fract Soc 2012;25(1):1-7. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.1

Abstract PDF: PURPOSE
To evaluate the incidence rate and risk factors for periprosthetic fracture after total knee replacement (TKR).
MATERIALS AND METHODS
We carried out a retrospective case-control study of 596 patients (951 knees) who underwent TKR between 1999 and 2006 and who were followed up over 36 months. We classified patients into group I (study group) and group II (control group). We subdivided risk factors as pre-operative, intra-operative, and post-operative factors. Age, osteoporosis, revision arthroplasty, CVA, and alcohol dependence were categorized as pre-operative factors; anterior femoral notching and prosthetic types (mobile, fixed, and load-bearing) were considered intra-operative factors; and post-operative activity level was classified as a post-operative factor. We obtained information from the patients' charts, X-ray film, and telephone interviews.
RESULTS
The overall incidence rate was 2.25%; 3 patients were male, and 18 were female (14.28% and 85.72%, respectively). Old age (p<0.01, odds ratio=1.14), osteoporosis (p=0.01, odds ratio=4.74), revision arthroplasty (p=0.01, odds ratio=7.46), CVA (p=0.02, odds ratio=8.55), and alcohol dependence (p=0.03, odds ratio=44.54) were statistically significant among the pre-operative factors. Among the intra-operative factors, anterior femoral notching (p<0.01, odds ratio=11.74) was significant, and continued heavy labor (p<0.01, odds ratio=8.14) was significant among the post-operative factors.
CONCLUSION
We concluded that old age, osteoporosis, revision arthroplasty, comorbidity related with falling down, anterior femoral notching, and continued heavy labor were associated with periprosthetic fracture after TKR.

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Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly: Duk Hwan Kho, Ki Hwan Kim, Hyeung Jun Kim, Dong Heon Kim; J Korean Fract Soc 2009;22(4):239-245. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.239

Abstract PDF: PURPOSE
To evaluate the results of the treatment of femoral basicervical fractures aged 75 years or older. MATERIALS AND METHODS: We reviewed the clinical records of 60 patients who were older than 75 years and who underwent bipolar hemiarthroplasty for femoral basicervical fractures using calcar replacement stem between March 1999 and November 2005. The minimum follow up period was 2 years. We analyzed the results by conducting radiological and clinical evaluations such as assessing the patient's walking ability and modified Harris hip score, the activities of daily living, the associated medical conditions and arthritis, and postoperative disgnosis. RESULTS: The mean Harris hip score were 87.2 (74~92). Walking ability was recovered in 91% (55 cases) and activity of daily living was achived in 91% (55 cases). Press-fit fixations were 56 cases and bony ingrowth fixations were 57 cases. Stress shields were 28% (17 cases). Thigh pains were 5% (3 cases) and revision rate was 3% (2/60 cases). CONCLUSION: We consider bipolar hemiarthroplasty using calcar replacement stem in femoral basicervical fractures in the Elderly with severe osteoporosis is the useful treatment in view of the stable and rigid fixation of femoral stem, early ambulation, and the low rate of complications and death, even if the operation is technically very difficult.

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Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Hip Fractures in the Elderly: Duk Hwan Kho, Ki Hwan Kim, Hyeung June Kim, Dong Heon Kim; J Korean Fract Soc 2008;21(3):232-239. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.232

Abstract PDF

PURPOSE
To evaluate the results of bipolar hemiarthroplasty using calcar replacement stem for hip fractures in elderly patients.
MATERIALS AND METHODS
Between March 1995 and March 2005, the clinical records on 68 cases more than 75 years old who underwent the bipolar hemiarthroplasty using calcar replacement stem and followed minimum 2 years were reviewed. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, complications, osteoporosis and radiologic findings.
RESULTS
The mean postoperative modified Harris hip score was 88.3 (69~95) in femoral neck fractures and 83.5 (63~91) in femoral intertrochanteric fractures. Walking ability was recovered in 82.3% (56 cases) and activity of daily living was achived in 82.3% (56 cases). Complications were thigh pain, infection, femoral stem subsidence, stress shield, dislocation.
CONCLUSION
We consider bipolar hemiarthroplasty using calcar replacement stem for unstable hip fractures in elderly patients with severe osteoporosis is the useful treatment in view of the stable and rigid fixation, early ambulation and the low rate of complications, even if the operation is technically very difficult.

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Bipolar Hemiarthroplasty With a Calcar Stem for the Management of a Failed Proximal Femoral Nail Anti-rotation Asia (PFNA2) in a Case of Geriatric Unstable Intertrochanteric Femur Fracture
Mukesh O Phalak, Tushar Chaudhari, Ajinkya K Chaudhari
Cureus.2024;[Epub] CrossRef
Bipolar Hemarthroplasty Using Cementless Conical Stem for Treatment of Dorr Type B and C Femoral Neck Fracture
Jeong Hoon Kang, Sang Hong Lee, Sung Jung
Hip & Pelvis.2015; 27(4): 232. CrossRef
Assessment of the Clinical Features of Bilateral Sequential Hip Fractures in the Elderly
Duk-Hwan Kho, Ju-Yong Shin, Hyeung-June Kim, Dong-Heon Kim
The Journal of the Korean Orthopaedic Association.2009; 44(3): 369. CrossRef
Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly
Duk-Hwan Kho, Ki-Hwan Kim, Hyeung-Jun Kim, Dong-Heon Kim
Journal of the Korean Fracture Society.2009; 22(4): 239. CrossRef

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Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail: Moon Jib Yoo, You Jin Kim, Jin Won Lee; J Korean Fract Soc 2008;21(1):19-23. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.19

Abstract PDF: PURPOSE
Retrograde intrameullary nail is one of the treatment of periprosthetic supracondylar femoral fracture after total knee replacement (TKR), but all TKRs will not permit to insert a supracondylar nail. Therefore, we have investigated the compatibility of the TKRs with supracondylar nail.
MATERIALS AND METHODS
Using trial femoral component of the 5 used TKRs in Korea and saw bone model, we checked their compatibility and measured the dimensions of the intercondylar notches in both cruciate retaining (CR) and posterior stabilized (PS) type.
RESULTS
Although most CR prostheses had an intercondylar notch large enough to accept a supracondylar nail, in some case, this was not possible due to the notch being situated too far posteriorly. The position of the intercondylar notch is also important factor in the PS prostheses.
CONCLUSION
The notch position, rather than the notch size, was the most important factor in determining nail compatibility with femoral stem.

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Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Unstable Intertrochanteric Fractures in Elderly Patients: Duk Hwan Kho, Kyou Hyeun Kim, Ju Young Shin, Sin Woo Lim, Dong Heon Kim; J Korean Soc Fract 2003;16(1):22-28. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.22

Abstract PDF

PURPOSE
The purpose of this paper is to analyze the operating time, timing of ambulation, functional results and complications using the calcar replacement stem for the severely comminuted unstable intertrochanteric fractures in the elderly patients.
MATERIALS AND METHODS
From August 1991 through January 2001, 20 elderly patients over the 75 year old patients had undergone bipolar hemiarthroplasty with calcar replacement stem for the treatment of unstable intertrochanteric fractures.
RESULTS
The mean operating time was 45 minutes and mean Harris Hip Score was 84.7. Ambulation with walker was started at post-operative 8 days and full weight bearing was 6.9 weeks, each. Complications were 2 cases of wound infection, 1 case of severe thigh pain and 1 case of dislocation.
CONCLUSION
Early ambulation, functional restoration and decrease of the complications with bipolar hemiarthroplasty using calcar replacement stem for severely comminuted unstable intertrochanteric fractures in elderly patients, therefore this methods seems to be one of the effective treatments.

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Pre- and Perioperative Risk Factors of Post Hip Fracture Surgery Walking Failure in the Elderly
YoungJi Ko
Geriatric Orthopaedic Surgery & Rehabilitation.2019;[Epub] CrossRef
A STUDY OF PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY OF HIP IN ELDERLY PATIENTS WITH OSTEOPOROTIC, UNSTABLE INTERTROCHANTERIC FRACTURE
Maheshwar Lakkireddy, Radhakrishna Rapaka, Naveen Gouru, Shivaprasad Rapur
Journal of Evidence Based Medicine and Healthcare.2015; 2(35): 5447. CrossRef
Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients
Sung-Hwan Kim, Soo-Won Lee, Gyu-Min Kong, Mid-Um JeaGal
Hip & Pelvis.2012; 24(1): 45. CrossRef

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Treatment of intertrochanteric fractures with bipolar hemiarthroplasty in the elderly: Kyou hyeun Kim, Duk hwan Kho, Joon ho Yang, Dong heon Kim; J Korean Soc Fract 2001;14(2):174-180. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.174

Abstract PDF

PURPOSE
To compare the timing of ambulation, complications and functional results between the autogenous femoral head graft and the calcar replacement type stem in the severe comminuted fracture of the elderly patients with unstability.
MATERIALS AND METHODS
25 intertrochanteric femoral fracture patients who had bipolar hemiarthroplasty were followed for more than 1 year. 17 patients had autogenous femoral head graft and 8 patients had calcar replacement type stem.
RESULT
The mean operating time for autogenous femoral head graft was 1.7 hours, and calcar replacement type stem was 1.3 hours. Postoperative Harris functional score was 84.1 for the autogenous femoral head graft group and 82.2 for the calcar replacement type stem group.
Discussion
: Both autogenous femoral head graft augmentation and fixation using the calcar replacement type stem result in rigid fixation, which enables the patients to ambulate early and to have low complication rate. Both techniques seem to be effective for the treatment of intertrochanteric fractures.

Citations

Citations to this article as recorded by

Analysis of Missed Fractures by Bone Scan in Elderly Hip Fracture Patients with Osteoporosis
Tae Hun Lee, Yeong Hyun Lee, Seo Won Kang
Journal of the Korean Fracture Society.2024; 37(3): 144. CrossRef
Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -
Chae-Hyun Lim, Young-Yool Chung, Jeong-Seok Kim, Chung-Young Kim
Hip & Pelvis.2013; 25(1): 44. CrossRef
Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years - The Factors Influencing the Postoperative Mortality -
Jun-Dong Chang, Je-Hyun Yoo, Sang-Soo Lee, Tae-Young Kim, Kyu-Hak Jung, Yong-Kuk Kim
Hip & Pelvis.2010; 22(4): 283. CrossRef

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Swanson Prosthesis Replacement of the Comminuted Radial Head Fracture Associated with Posterior Dislocation of the Elbow: 3 Cases Experienced: Soo Kyoon Rah, Jin Il Kim, Chi Soo Sohn, Yon Il KIm, Chang Uk Choi; J Korean Soc Fract 1998;11(1):47-55. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.47

Abstract PDF: Radial head resection is the accepted treatment of comminuted radial head fractures in adults, but the results are not always satisfactory. a number of well-known problems can ensue. These include chronic elbow and wrist pain, limited of motion, cubitus valgus, proximal radial migration, and new bone formation at the site of excision. Prosthetic replacement of radial head after excision offers theoretical advantages in the prevention of these problems. We are reporting three cases of patients, who had treated Swanson silastic prosthesis after comminuted radial head fracture associated posterior dislocation of the elbow.

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Selective Arterial Thrombolysis with Urokinase in Popliteal Arterial Occlusion Developed after Total Hip Replacement Arthroplasty: Seung Koo Rhee, Kee Yong Ha, Nam Gee Lee, Jong Bum Park; J Korean Soc Fract 1995;8(1):79-83. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.79

Abstract PDF: A 60 year old patient with a sudden thromboembolic occlusion of ipsilateral popliteal artery on four days after the total hip replacement (THR) were treated with high-dose urokinase by direct intraarterial selective infusion. The cause of arterial occlusion after THR was not clear, but it was thought to be caused by spontaneous thrornboembolism in an elderly patient accompanied with diffuse arteriosclerosis, and this multifocal arteriosclerosis was caused not to perform the vein graft immediately. The initial infusion therapy with 4,000 IU/min for 2 hours of urokinase was failed but the second trial with same doses of urokinase in another 2 hours was succeed with complete clot lysis. Then 500,000 IU/24 hours of urokinase was infused again, and total 1,500,000 IU/28 hours was used in this patient. But massive internal bleeding from the operation site, hip joint, for more than 1,400 co was leaked because of bleeding tendency induced by extensive use of urokinase within short duration, and minor toe amputations should be performed on 2 weeks after thrombolysis because of distal migration of small thromboembolic particles. It was suggested that the peripheral arterial occlusion resulting from thromboembolism after joint replacement, especially in an elderly patient with diffuse arteriosclerosis, could develop, and it could be successfully treated with an initially high-dose urokinase regimen if it is detected earlier, rather than vein graft or amputation.

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Treatment of Femoral Neck Fractures in the Elderly Patiene: Chung Nam Kang, Kwon Jae Roh, Yeo Hon Yun, Dong Jun Kim, Cheol Min Kim; J Korean Soc Fract 1995;8(1):61-67. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.61

Abstract PDF: We analyzed 41 femoral neck fractures in 40 elderly patients aged over 65 years. All of them were treated by surgery and followed for average 22 months (range, 14 to 52 months) at the Ewha Womans University Hospital from 1988 to 1992. Of these, 15 cases were treated with internal fixation and 26 cases with endoprosthetic or total hip replacement arthroplasty For the level of fractures the most common features were subcapital, that were moderately to severely (Gardens stage III or IV) displaced. In the internal fuation group the results were unsatisfactory in the cases of subcapital type, moderate to severe (Gardens stage III or IV) displacement, Pauwels type III and those with osteoporosis (below stage III in Singh index). Our short term follow-up results showed that the prosthetic replacement group were generally superior in that they were not affected by the types of fractures and the degree of osteoporosis.

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Silicone Rubber Replacement of the Severely Fractured Radial Head: Byung Woo Min, Chang Soo Kang, Young Sik Pyun, Kwang Soon Song, Young Wook Ha; J Korean Soc Fract 1994;7(1):43-48. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.43

Abstract PDF: The best method of treatment for displaced comminuted fractures of the radial head is still controversial. Early excision of the fractured radial head has been favored by a number of authors. but problems such as chronic pain in the elbow, forearm or wrist, restricted movement of the elbow, late subluxation of the distal radio-ulnar joint can ensue. So prosthetic replacement of the radial head had been advocated either for acute treatment of a fracture or for delayed treatment, when conservative treatment has failed. We analyzed 10 patients with comminuted radial head fracture treated by silastic prosthesls replacement shortly after injury from Jan. 1988 to Dec. 1992. The results were as follows. 1. Age distribution at operation was varied from 19 to 57 year with the average at 40.9 year. 2. The average time interval between initial radial head fracture and silastic prosthetic replacement was about 10 days(range 4 days to 18 days). 3. 6 patients(60%) were free of elbow, pain 2 patients(20%) had intermittent mild pain especially at night and 2 patients(20%) had mild pain only after heavy work. 4. All patients were free of wrist pain 5. There was no patient of breaking or tilting of prosthesis radiologically. 6. Overall assessment showed excellent in 4 patients(40%), good in 4 patients(40%) and poor in 2 patients(20%).

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A case study on primary total hip replacement for the subtrochanter ic fracture associated with flexon contracture and ankylosing hip: Jang Jung Kim, Taik Keun Ahn, Jong Oh Kim, Taik Seon Kim, Jae Ik Shim; J Korean Soc Fract 1991;4(2):293-297. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.293

Abstract PDF: No abstract available.

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