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Original Articles
- Related Factors of Ligamentotaxis with Posterior Instrumentation for the Surgical Treatment of Thoracolumbar Bursting Fracture
- Sang Bum Kim, Taek Soo Jeon, Seung Hwan Kim, Han Chang, Cheol Mog Hwang
- J Korean Fract Soc 2010;23(2):213-219. Published online April 30, 2010
- DOI: https://doi.org/10.12671/jkfs.2010.23.2.213
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Abstract
PDF - PURPOSE
To investigate factors influencing the amount of indirect reduction by ligamentotaxis according to timing of surgery, extent of surgery, and characteristics of fractures.
MATERIALS AND METHODS
We reviewed 22 cases of thoracolumbar fracture which had been performed posterior instrumentation and fusion using pedicle screw system. We divided patients into each group according to timing of surgery, number of fusion segment, insertion of screw on fractured vertebra, and rupture of posterior ligament complex, and Denis type. We measured changes of kyphotic angle, anterior vertebral height and wedge angle on plain radiographs, and we compared spinal canal area before and after operation using computed tomographic scans.
RESULTS
Kyphotic angle, anterior vertebral height, wedge angle, and area of spinal canal showed significant improvement postoperatively. The wedge angle improved significantly operated within 3 days after injury, however, kyphotic angle and anterior vertebral height had no correlation with variable factors except the rupture of posterior ligament complex. The amount of restoration of spinal canal also affected only by rupture of posterior ligament complex.
CONCLUSION
There is little relationship between timing of surgery and canal restoration, so we cannot conclude that prompt operation helps reduction of narrowed spinal canal. Otherwise narrowed spinal canal had much less restored by ligamentotaxis when there were rupture of posterior ligament complexes.
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- Two stage Operative Treatment of Supracondylar Open Comminuted Fracture of Femur: Temporary fixation with Transarticular Ender nails
- Song Lee, Dong Ki Ahn, Seung Hwan Kim, Sung Wook Chun
- J Korean Soc Fract 2000;13(3):470-478. Published online July 31, 2000
- DOI: https://doi.org/10.12671/jksf.2000.13.3.470
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Abstract
PDF
- PURPOSE
In many cases of open comminuted supracondylar fracture, it is very hard to apply traditional methods. So we have used Ender nails for temporary transarticular fixation. We thought that it could provide enough stability to control the wound and didn't promote further soft tissue damage or infection. We performed 2nd stage rigid fixation and bone graft after soft tissue healing. We have studied to prove this staged operation valuable to treat the very severe open comminuted supracondylar fracture of femur.
MATERIALS AND METHODS
We analysed 16 cases which have been treated with such staged operation method from April 1992 to April 1996 about complication, union time and functional result in retrospective method.
RESULTS
We could prevent severe wound infection in all cases. We performed 2nd stage rigid fixation and bone graft average 6 weeks after first stage temporary fixation. The average union time was 8 months and average range of motion was 10degrees flexion contracture and 100degrees further flexion.
CONCLUSION
In patients with very severe open comminuted supracondylar fracture of femur, the temporary fixation with transarticular Ender nails allowed the successful initial management for the secondary rigid fixation and bone graft and time could be saved for management of concomitant injuries. So this new staged operation is considered as a good method for safety, union time and functional result.
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