PURPOSE The purpose of this study was to evaluate the effect of parathyroid hormone (PTH) on fracture healing in elderly patients. MATERIALS AND METHODS We analyzed the radiologic results in 14 patients. Group I (n=7) was administrated intermittent PTH after surgical treatment and group II (n=7) was treated only with surgery. We checked the time of initial callus formation, bridging callus formation, and bone union through periodic follow-up radiographs by a radiologist who did not know the patient's information. RESULTS The mean time to initial callus formation was 6 weeks for group I, compared with 6.7 weeks for group II. The mean time to bridging callus formation was 15.9 weeks for group I, compared with 23.0 weeks for group II. The mean time to bone union was 28.7 weeks for group I, compared with 41.9 weeks for group II. The difference in the cumulative detection rate (CDR) of the initial callus formation of group I and II was not statistically significant (p=0.793). However, the CDR of the bridging callus formation and bone union for group I were higher than those of group II (p=0.008, p=0.001, respectively). CONCLUSION The intermittent PTH administration after surgical treatment and maximum possible preservation of the periosteum in elderly patients accelerates fracture healing.
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Injuries about the ankle joint resulted in not only fractures of the bone but also ruture of the ligamentous and soft tissue structures and it is important that accurate reduction and rigid internal fixation of fracture as well as repair of ruptured ligament should be performed.
The author analyzed 35 cases of the trimalleolar fractures of the ankle which were admitted and treated in Department of Orthopaedic Surgery, Hanyang University Hospital from january 1984 to December 1988.
The results obtained from this study were as follows; 1. Among the 35 cases, male was 25 cases(71.4%), female was 10 cases(28.6%), and average age was 37.43 years.
2. The main cause of the fracture was 18 cases of slip down(51.43%), and other causes were traffic accident(22.86%), fall from a height(17.14%), sports injury(5.71%), and other injuries(2.86%).
3. Open fractures were 2 cases(5.7%), and closed fractures 33 cases(94.3%).
4. According to the classification of Lauge-Hansen, the pronation-external rotation type was 22 cases(62.86%), and the supination-external rotation type, 13 cases(37.14%).
5. Open reduction was performed in 25 cases(71.43%), and closed reduction 10 cases(28.57%).
6. The average period of the cast immobilization after open reduction was 10.7 weeks, and 8. Fractures with a posterior marginal fragment invoving 25 percent of more of the tibial articular surface, open reduction was recommended.
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Treatment of the Posterior Malleolar Fragment of Trimalleolar Fracture Using Posterolateral Approach - Preliminary Report - Jun-Young Lee, Sang-Ho Ha, Kyung-Hwan Noh, Sang-Jun Lee The Journal of the Korean Orthopaedic Association.2009; 44(4): 422. CrossRef
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