PURPOSE The purpose of this study is to determine whether or not a patient's results are improved after removal of an internal fixative from a patient with no related symptoms. MATERIALS AND METHODS This prospective study included 87 patients who agreed to participate in the study and satisfied the criteria for selection and exclusion of patients who underwent the operation for removal of internal fixative due to broken bones from March 1st, 2004 to December 31st, 2011 at Daegu Catholic University Medical Center. The average replication period was 27 months (12-64 months) and the average age at the time of the operation for removal was 41.5 years (21-75 years) for 55 males and 32 females. The quality of life for all patients was evaluated using Short Form 36 (SF-36) surveys before the operation for removal and after a minimum of one year. RESULTS After an orthopedic operation for removal of internal fixative, physical health status showed statistically significant improvement (p=0.001); however mental health status did not (p=0.411). A satisfaction test for the subjective surgery written by patients indicated an improvement of subjective health status in 52.9% after the surgery for removal but with no difference in 29.9% compared to preoperation. CONCLUSION In case of an operation for removal of internal fixative for patients with no related symptoms with internal fixatives used for treatment of fractures showing agglutination opinions, an improvement was observed in physical health status, not in mental health status. When surgery for removal of internal fixative is performed for patients without related symptoms, consideration that subjective satisfaction of patients shows an improvement only in 52.9% will be helpful.
Fracture-dislocation of the sacrum that has not yet fully developed is common in the distal sacrococcygeal joint of children, but this injury is rarely seen in 1st Sacrum. Most of these patients have a severe neurological deficit, so this injury generally requires surgical decompression. We managed a three year old patient who had a S1 fracture-dislocation without a neurological deficit, and the patient was treated with simple skin traction and bed rest without surgery. The child had a satisfactory result, so we report on this case with reviewing the relevant literatures.
There are variable types in wrist joint injury. Most common case is simple distal radius fracture. And ulnar head dislocation associated with disruption of distal radioulnar ligament is unusual. Among thease injury types. volar dislocation of ulnar head in the distal radioulnar joint is not common and it is misdiagnosis frequently. So it needs to surgical operation frequently. The author reviews this injury with the relevant literature.
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.
PURPOSE The purpose of this study is to know the relationship of tibial nonunion with fibular nonunion in the tibio-fibular shaft fracture. MATERIALS AND METHODS From March 1998 to February 2004, 98 tibio-fibular shaft fractures which did not involve adjacent joints and were followed up at least 1 year were selected. The characteristics of patients and tibia shaft fracture were analyzed statistically to know the above relationship. RESULTS The patient's factor and tibia shaft fracture factor were not significant statistically. In patients with the fibular union, there was 1 case (1/68) of tibia nonunion, but in patients with the fibular nonunion, there were 6 cases (6/30) of tibia nonunion. So fibular nonunion was significant statistically associated with tibia nonunion (p=0.003). CONCLUSION Fibular nonunion was presumed to have a higher risk of tibia nonunion.
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The Risk Factors Associated with Nonunion after Surgical Treatment for Distal Fibular Fractures Jun Young Lee, Kwi Youn Choi, Sinwook Kang, Kang Yeol Ko Journal of Korean Foot and Ankle Society.2018; 22(3): 95. CrossRef
PURPOSE The Garden classification by which femur neck fracture is classified and the Boyd-Griffin classification by which trochanteric fracture is classified are studied on the reproducibility, repeatability, interobserver's and intraobserver's reliability and then reliability. MATERIALS AND METHODS 56 cases in femoral neck fracture and 60 cases in trochanteric fracture who were operated from May 1999 to December 2003 were classified by three observers who are hip surgeon, orthopaedic surgeon and senior residentship doctors three times. Femur neck fracture was classified by Garden's method which used commonly and trochanteric fracture was classified by Boyd-Griffin method which is classified by the pattern of fracture and degree of comminution. We got the interobserver's and intraobserver's Kappa score using the Stata 7.0 statistically. The statistical analysis was made by Stata 7.0. RESULTS Garden classification in femur neck fracture showed moderate agreement in intraobserver reliability and fair agreement in interobserver reliability. Boyd-Griffin classification in trochanteric fracture showed substantial agreement in intraobserver reliability and moderate agreement in interobserver reliability. CONCLUSION Boyd-Griffin classification showed over moderate agreement but Garden classification showed fair agreement, so using Garden classification in femur neck fracture has some problem in reliability and application.
Although avulsion fractures of greater and lesser trochanters rarely develop in hip fractures, avulsion fracture of short external rotators has not reported still online literature. Moreover, avulsion fracture of short external rotators can simulate the intertrochanteric fracture, and is difficult to differentiate from it on plain radiograph. This study is on the case 74-year old male patient who had avulsion fracture of short external rotators, and had the internal fixation with wire by open reduction under the diagnosis of the intertrochanteric fracture.
PURPOSE To evaluate the clinical and radiologic results of the fracture fixation using the Proximal Femoral Nail (PFN) or Gamma nail in patient with the intertrochanteric fractures. MATERIALS AND METHODS From January 1999 to February 2002, we reviewed 63 patients of intertrochanteric fractures including 31 patients managed with Gamma nail and 32 patients with PFN. In variate analysis of age, the pattern and stability of fracture, bone density (Singh index), preoperative patient activity, there was no difference between two groups. We evaluated the operation time, blood loss, stable reduction rate and varus reduction rate as operation-related factors, and radiologically investigated union time, the frequency of delayed union and nonunion, failure of fixation, status of the fracture line and complications. Functional results were evaluated by the possibility of early ambulation, ambulation ability at last follow up, and the pre and postoperative difference of ambulatory ability. RESULTS Mean operation time was 103+/-40 minutes in Gamma nail group and 101+/-28 minutes in PFN group. It was not statistically significant (p=0.801). Even though intraoperative blood loss was less in PFN group, it was not significant (p=0.601). Postoperative stable reduction rate was 31% in Gamma nail group and 30% in PFN group (p=0.934), suggesting not significant. Postoperative varus reduction and impacted amount of the fracture line was not significant. Delayed union developed in one case of Gamma nail group and 2 cases of PFN group. Mean loss of ambulation ability was 1.28 grade in Gamma nail group and 0.86 grade in PFN group (p=0.383). Statistical analysis was performed with the use of Student T test and Chi-square test. Analyses resulting in a p value of <0.05 were considered to show significance. CONCLUSION Generally, the radiologic and clinical results of intertrochanteric fractures were comparable for the PFN group and Gamma nail group. Even though it was not statistically significant, PFN group had superior results in operation time and blood loss than Gamma nail group for the fixation of the patients with intertrochanteric fracture.
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Treatment of Unstable Pertrochanteric Fractures with a Long Intramedullary Nail Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Dae Jung Huh Hip & Pelvis.2013; 25(1): 51. 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
Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteic Fractures in the Elderly Byung-Hak Kim, Young-Yool Chung, Sung-Chang Ki, Dae-Hyun Yoon, Ji-Hoon Ryu Journal of the Korean Orthopaedic Association.2011; 46(5): 399. CrossRef
Treatment of Intertrochanteric Fracture with Proximal Femoral Nail Dae Joong Kim, Sung Chan Ki, Young Yool Chung Journal of the Korean Fracture Society.2007; 20(1): 40. CrossRef
PURPOSE This study was performed to evaluate the results of treatment of the humerus shaft fracture with interlocking IM nail. MATERIALS AND METHODS The result of IM nailing for 29 patients with humerus shaft fracture were evaluated radiologically and clinically. We tried to compare the result of Seidel nail and that of interlocking nail. RESULTS The results were as follows ; 1. Nonunion rate was 50% in Seidel nail group and 27% in interlocking nail group(p=0.264). 2. Operation time was shorter in Seidel nail group(67.8min) than in interlocking nail group(115.4min)(p=0.002). 3. Fracture site distraction was present in 9 cases and resulted in nonunion in 8 cases. 4. Union time except the nonunion cases was 10.4weeks in Seidel nail group and 11.9weeks in interlocking nail group but was not considered to be significant due to many nonunion cases.
5. Proximal protrusion was present in 6 cases but resulted in shoulder LOM and pain in only 2 ). cases. CONCLUSION Although the operation time in Seidel nail group was shorter than in interlocking nail group, we couldn't find any other difference between the two nails. The results of treatment of humeral shaft fracture with interlocking nail was unsatisfactory in terms of union rate, complications, union time and functional result.