Journal of Musculoskeletal Trauma

Cephalomedullary Nailing with an Additional Cannulated Screw Fixation in Basicervical Femur Fractures: Keong-Hwan Kim, Woo Dong Nam, Yeon Sik Heo, Gu-Hee Jung; J Korean Fract Soc 2024;37(1):22-29. Published online January 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.1.22

Abstract PDF: Purpose
The purpose of this study is to analyze the clinical results of patients with basicervical fracture undergoing cephalomedullary nailing (CMN) with an additional cannulated screw fixation compared to only performing CMN. We hypothesized that a difference may exist in the clinical outcomes if an ad-ditional screw is fixed with CMN compared to only performing CMN in basicervical fracture.
Materials and Methods
A total of 28 consecutive patients who underwent CMN for basicervical fracture were included. In 9 cases, only CMN was conducted, and in 19 cases, an additional cannulated screw fixation was performed with CMN. Bone union, sliding distance, reduction status, and fixation failure were evaluated by postoperative radiography, and ambulatory ability was evaluated by functional results. These findings were compared between a group of CMN and a group of CMN with an additional cannulated screw.
Results
There were 4 males and 24 females with a mean age of 84 years (range, 69–100 years). No significant difference was found in postoperative reduction, tip-apex distance, bone union, and walking function recovery after surgery between the two groups, but in the sliding distance of the lag screw, the CMN group demonstrated more sliding (6.2 mm [range, 2.5–13.4 mm] vs 3.5 mm [range, 0.1– 9.2 mm]; p=0.045). Among the two groups, only one case of fixation failure at the postoperative four months was observed in the CMN group (p=0.321), and hemiarthroplasty with nail construct removal was performed.
Conclusion
CMN with additional cannulated screw fixation is a safe and reliable surgical option in basicervical fracture. It provided favorable clinical outcomes and may be a good alternative for treating basicervical fracture.

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Usefulness of Percutaneous Cannulated Screws with Tension Band Wiring for Minimally Displaced Fractures of the Patella: Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Eun Woo Bae; J Korean Fract Soc 2022;35(4):142-150. Published online October 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.4.142

Abstract PDF: Purpose
To evaluate the usefulness of percutaneous cannulated screws with tension band wiring (PC-STBW), a minimally invasive surgical technique, compared to conservative treatment for a minimally displaced patella transverse fracture.
Materials and Methods
The subjects included patients from 2010 to 2019 with transverse patella fractures, who were diagnosed as minimally displaced fractures, and were followed up for at least 1 year. Of these, 61 patients who were treated with cylinder casts were classified as Group A, and 53 patients who were treated with PCSTBW were classified as Group B. The clinical evaluation was carried out by evaluation of the radiographic bone union and calculation of the Bostman knee score. Any complications observed were investigated.
Results
All patients in both groups showed no further displacement of the fracture gap, and the bone union was achieved in all cases. The functional evaluation of the knee joint measured at the 8- and 12-week follow-up showed superior results in Group B wherein subjects were treated with surgery, and similar results were seen in both groups during the 6 months and 1-year follow-up. One case in Group A suffered the complication of knee stiffness.
Conclusion
For the treatment of minimally displaced transverse patellar fractures, both conservative treatment and PCSTBW showed similar good results at the 6-month and one-year follow-up. However, the PCSTBW technique showed superior clinical results in the early stage follow-up within 12 weeks.

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Computational Simulation of Multiple Cannulated Screw Fixation for Femoral Neck Fractures and the Anatomic Features for Clinical Applications: Jin Hoon Jeong, Gu Hee Jung; J Korean Fract Soc 2018;31(2):37-44. Published online April 30, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.2.37

PURPOSE
To identify the anatomic features for clinical applications through a computational simulation of the fixation of three cannulated screws for a femoral neck fracture.
MATERIALS AND METHODS
Thirty cadaveric femurs underwent computed tomography and the images were transferred to the MimicsÂ® program, resulting in three-dimensional proximal femur models. A three-dimensional scan of the 7.0 mm cannulated screw was performed to enable computerized virtual fixation of multiple cannulated screws for femoral neck fractures. After positioning the screws definitively for cortical support, the intraosseous position of the cannulated screws was evaluated in the anteroposterior image and axial image direction.
RESULTS
Three cannulated screws located at the each ideal site showed an array of tilted triangles with anterior screw attachment and the shortest spacing between posterior and central screws. The central screw located at the lower side was placed in the mid-height of the lesser trochanter and slightly posterior, and directed toward the junction of femoral head and neck to achieve medial cortical support. All the posterior screws were limited in height by the trochanteric fossa and were located below the vastus ridge, but the anterior screws were located higher than the vastus ridge in 10 cases. To obtain the maximum spacing of the anterior and posterior screws on the axial plane, they should be positioned parallel to the cervical region nearest the cortical bone at a height not exceeding the vastus ridge.
CONCLUSION
The position of cannulated screws for cortical support were irregular triangular arrangements with the anterosuperior apex. The position of the ideal central screw in the anteroposterior view was at the mid-height of the lesser trochanter toward the junction of the femoral head and neck, and the anterior and posterior screws were parallel to the neck with a maximal spread just inferior to the vastus ridge.

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Computational Simulation of Femoral Neck System and Additional Cannulated Screws Fixation for Unstable Femoral Neck Fractures and the Biomechanical Features for Clinical Applications
Ju-Yeong Kim
Journal of the Korean Fracture Society.2023; 36(1): 1. CrossRef

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Factors Predicting Complications after Internal Fixation of Femoral Neck Fractures: Tae Ho Kim, Jong Oh Kim, Sung Sik Kang; J Korean Fract Soc 2009;22(2):79-84. Published online April 30, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.2.79

Abstract PDF: PURPOSE
To evaluate the factors predicting complications after internal fixation using multiple cannulated screws in the patients with femoral neck fracture, the authors performed a comparative study of a success group and a failure group and reviewed the literature.
MATERIALS AND METHODS
Sixty-eight patients with intracapsular femoral neck fractures were treated by multiple pinning from January 2000 to July 2007 and followed up more than one year. Relationships between the complications such as failure of union, collapse of femoral head due to osteonecrosis of femoral head and several affecting factors including the degree of displacement by Garden stage, state of reduction, position of screws, patient's age, time interval from injury to operation, anatomical fracture site and two weeks postoperative (99m)Tc-MDP bone scan were analyzed.
RESULTS
Statistically significant factors were the degree of displacement by Garden stage (p<0.001), reduction state (p<0.001) and postoperative two weeks (99m)Tc-MDP bone scan (p<0.001).
CONCLUSION
An accurate anatomical reduction is needed to decrease complications with multiple cannulated screws fixation of femoral neck fracture. Displacement of fracture by Garden stage and (99m)Tc-MDP bone scan are major factors predicting complications.

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Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture: Jae Kwang Kim, Jong Oh Kim, Seung Yup Lee, Nam Hoon Do; J Korean Fract Soc 2009;22(2):104-109. Published online April 30, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.2.104

Abstract PDF

PURPOSE
To report the surgical results of volar percutaneous cannulated compression screw fixation in subacute scaphoid fracture.
MATERIALS AND METHODS
Between January 2004 and January 2007, eight consecutive patients with subacute scaphoid waist fracture, who sought medical attention between 4 weeks to 6 months after injury, were included in this study. All patients were male of an average age 29.2 years (range, 19 to 44). Mean duration of injury was 10.3+/-4.1 weeks. An acutrak cannulated screw (Acumed, Hillsboro, OR) was introduced volarly under image intensifier guidance in all patients. We performed radiological evaluation preoperatively and postoperatively. And we performed 12 months postoperatively using grip strength, range of motion (ROM) of the wrist, Mayo Modified Wrist Score (MMWS) and Disabilities of the Arm, Shoulder and the Hand (DASH) score for functional evaluation.
RESULTS
Preoperative radiography showed minimal sclerosis line in three patients and a bone resorption around fracture sites in two patients. However, no patient had dorsal intercalated segment instability or more than 35 degrees of lateral intrascaphoid angle. Fractures united successfully at 11.6+/-2.1 weeks postoperatively without any requirement for a further procedure. At 12 months follow-up evaluations, ROM of the injured wrist was 93% of the uninjured wrist and grip strength of the injured wrist was 95% of the injured wrist. The mean MMWS was 93+/-6.6 and the mean DASH score was 4.8+/-1.2.
CONCLUSION
We believe that volar percutaneous cannulated screw fixation is a reliable method in case of subacute scaphoid waist fracture without scaphoid deformity or carpal instability.

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Surgical Outcome of Stable Scaphoid Nonunion without Bone Graft
Eun Sun Moon, Myung Sun Kim, Il Kyu Kong, Min Sun Choi
Journal of the Korean Fracture Society.2010; 23(1): 69. CrossRef

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Treatment for the Supracondylar Fractures of the Distal Humerus with Cannulated Screw: Jin Soo Park, Young Khee Chung, Jung Han Yoo, Kyu Cheol Noh, Kook Jin Chung, Dong Nyoung Lee; J Korean Fract Soc 2007;20(1):58-63. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.58

Abstract PDF: PURPOSE
To evaluate the results of the treatment of the supracondylar fractures of the humerus according to the fixation methods with cannulated screw.
MATERIALS AND METHODS
Eight patients, aged 49 to 82 years (average, 65 years), were reviewed after a mean follow-up of 16 months (range, 12~24 months). According to AO classification all fractures were classified as type A2 (simple transverse supracondylar fracture). All patients underwent closed reduction. Percutaneous fixation with cannulated screws was performed in 8 patients. Three of 8 patients had associated medical problems and one patient had distal radius fracture. The functional results were assessed by the Mayo Elbow Performance Score.
RESULTS
Mean operation time was 59 minutes (45~75) and all the patients with cannulated screw fixation had bony union and were able to early ROM exercise. Mean ranges of motion was 5~120 degrees with excellent functional results. Functional evaluation of elbow joint by Mayo method showed mean value of 88 (75~95).
CONCLUSION
The cannulated screw fixation of supracondylar fracture of humerus, especially in the elderly aged group with medical disease had excellent functional results (rigid fixation & early ROM exercise) due to shortening of surgery time and anesthesic time, combined with decreased technical difficulties of the surgical procedure

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Subtrochanteric Fracture after Cannulatd Screw Fixation of Femoral Neck Fracture in a Child: A Case Report: Moo Sam Seo, Han Seong Park, Dae Won Jeong; J Korean Fract Soc 2006;19(3):392-395. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.392

Abstract: Though femoral neck fractures in adults are usually treated by fixation with multiple screws, subtrochanteric fracture at the insertion site is an uncommon complication, and in children, there has been a few reports about this complication after treatment of slipped capital femoral epiphysis. We report a subtrochanteric fracture at the insertion site of cannulated screws used in femoral neck fracture of a 9-years old boy.

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Analysis of Affecting Factors of Fixation Failure of Femoral Neck Fractures Using Internal Fixation: Soo Jae Yim, Seung Han Woo, Min Young Kim, Jong Seok Park, Eung Ha Kim, Yoo Sung Seo, Byung Il Lee; J Korean Fract Soc 2006;19(3):297-302. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.297

Abstract

PURPOSE
To evaluate the factors which influence on the fixation failure after internal fixation using multiple cannulated screws in the patients with femoral neck fracture.
MATERIALS AND METHODS
Ninty-six patients (male: 63, female: 33) who underwent closed reduction and internal fixation of femoral neck fracture between Feb. 1994 and Jun. 2002 with use of multiple cannulated screws. The mean age was 68 years (17~90) and mean follow-up period was average 50 months (36 months~6 years). The fixation failure was defined by change in fracture position above 10 mm, change in each screws position above 5%, backing above 20 mm, or perforation of the head, respectively. They were evaluated with the age, gender, fracture type, accuracy of reduction, placement of screws, posterior comminution and also studied the risk factors which influenced nonunion and the development of avascular necrosis.
RESULTS
Twenty-four patients out of 96 patients had radiographic signs of fixation failure. The incidence of nonunion in the fixation failure group was 41% (10/24) and AVN was 33% (8/24). There were statistically significant correlations between fixation failure and nonunion and that posterior comminution, poor reduction and improper placement of the screws were the major factors contributing to nonunion.
CONCLUSION
In case of femoral neck fracture of internal fixation using multiple cannulated screws, posterior comminution, poor reduction and improper placement of the screws were the major factors contributing to nonunion and fixation failure.

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Clinical Results of Internal Fixation of Subcapital Femoral Neck Fractures
Joon Soon Kang, Kyoung Ho Moon, Joong Sup Shin, Eun Ho Shin, Chi Hoon Ahn, Geon Hong Choi
Clinics in Orthopedic Surgery.2016; 8(2): 146. CrossRef
Internal Fixation for Femoral Neck Fracture in Patients between the Ages of Twenty and Forty Years
Ui-Seoung Yoon, Jin-Soo Kim, Hak-Jin Min, Jae-Seong Seo, Jong-Pil Yoon, Joo-Young Chung
Journal of the Korean Fracture Society.2010; 23(1): 1. CrossRef
Factors Predicting Complications after Internal Fixation of Femoral Neck Fractures
Tae-Ho Kim, Jong-Oh Kim, Sung-Sik Kang
Journal of the Korean Fracture Society.2009; 22(2): 79. CrossRef

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Transverse Fracture through Screw Site after Cannulated Screw Fixation in Vertical Patella Fracture: A Case Report: Suk Kang, Phil Hyun Chung, Chung Soo Hwang, Jong Pil Kim, Young Sung Kim, Chong Suck Parke; J Korean Fract Soc 2006;19(1):96-99. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.96

Abstract

Many complications after operative treatment of patella including redisplacement of fracture, refracture, weakness of extensor muscles, patellofemoral joint arthritis, metal failure, malunion, infection, avascular necrosis were reported. We report a case of transverse fracture of patella through the cannulated screw fixation site used to fix previous vertical patella fracture with a review of the literatures.

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Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef

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Cannulated Screw Fixation for 4 Part Fractures of the Neck of Humerus: Ho Jung Kang, Doo Hyung Lee, Hong Kee Yoon, Soo Bong Hahn; J Korean Fract Soc 2005;18(4):432-436. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.432

Abstract PDF

PURPOSE
To analyze radiological and functional results after open reduction and internal fixation for fractures of the neck of humerus (4-part) using cannulated screws. MATERIAL AND METHODS: Between January 1997 and April 2004, 11 patients with neck of humerus fracture (4-part) were treated operatively by open reduction and internal fixation with cannulated screws. Two surgical approaches (deltopectoral for 9 cases and deltoid splitting for 2 cases) were used. The mean age was 36 years old and the mean duration of follow-up was 56 months. ASES (American Shoulder and Elbow Surgeons) score was checked to evaluate the function in shoulder joint. We used 2 cannulated screws in 2 cases, 3~4 screws in 6 cases and over 5 screws in 3 cases for fixation. In 2 cases, K-wires were used additionally and autoiliac bone graft was done in 1 cases which had poor bone mass.
RESULTS
All cases got bony union at 5.6 months on average. In functional assessment of shoulder, eight patients got excellent, one got good points. There were complications including shoulder stiffness in 2 cases, avascular necrosis of humeral head in 1 case and subacromial impingement syndrome in 1 case.
CONCLUSION
Internal fixation using cannulated screws for fractures of humerus neck (4 part) showed good bony union and functional results in patients under 50 years old who had average bone quality.

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The Surgical Outcomes for Isolated Greater Tuberosity Fracture of Proximal Humerus
Eun-Sun Moon, Myung-Sun Kim, Young-Jin Kim
Journal of the Korean Fracture Society.2007; 20(3): 239. CrossRef

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Treatment of Displaced Transverse Patellar Fractures with Cannulated Screws and Figure-Eight Wiring: Shin Kwon Choi, Dong Kil Ham, Moon Sup Yim, Kwang Yul Kim, Hung Sup Shin; J Korean Fract Soc 2005;18(2):149-154. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.149

Abstract PDF

PURPOSE
To evaluate the radiographic and clinical results of displaced transverse patellar fractures using a tensioned anterior figure-eight wire placed through two cannulated screws MATERIALS AND METHODS: 9 patients with displaced transverse patellar fractures treated with cannulated screws and figure-eight wiring were analyzed retrospectively. The mean age was 53 years (range, 22 to 68 years). Controlled passive range of motion exercise were started on the first postoperative day. Full weight bearing was allowed as tolerated. The patients were evaluated with radiographs, clinical examination and Levack's scoring system.
RESULTS
All fractures healed and mean time elapsed for union was 9.4 weeks (range, 8 to 12 weeks). All patients regained full knee range of motion. Clinical results according to the Levack's scoring system were excellent in 8 cases and good in 1 case. We found no complications like loss of reduction and soft tissue irritation caused by the wire and screw, loosening or migration of hardware.
CONCLUSION
Anterior figure-eight wiring through paired cannulated screws is appropriate for transverse patellar fractures, is possible early knee motion exercise and weight bearing.

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Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef

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The Treatment of Patellar Fracture with Modified Tension Band Wiring, using Cannulated Screws: Chul Won Ha, Jong Il Sun; J Korean Fract Soc 2004;17(2):117-121. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.117

Abstract PDF

PURPOSE
We have followed up the patients of the patellar fracture who had been treated with modified tension band wiring using cannulated screws. Since we have seen excellent clinical results, we would like to show the practical use of this operative method.
MATERIALS AND METHODS
We analyzed the operation time, the time elapsed for union, and complications of 9 cases of the patellar fracture who were treated with this operative method at our hospital recently.
RESULTS
Mean operation time (from the incision to the skin suture) was 68.3 min (40~120 min) and mean time elapsed for union was 9.7 weeks (8~12 wks). Mean time for full range of motion was 1 week in 5 cases of transverse fracture, 3 weeks (2~4 wks) in 3 cases of comminuted fracture. We found no complications like limitation of range of motion of the knee, loss of the reduction, irritation and migration of the hardware, and infection.
CONCLUSION
This surgical technique provides stable fixation, allowes early motion excercise by minimizing injury to extensor mechanism and accompanies reduced rate of complications such as loss of the reduction, irritation or displacement of the hardware

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Evolution in the Management of Patella Fractures
Mahak Baid, Sid Narula, Jonathan R. Manara, William Blakeney
Journal of Clinical Medicine.2024; 13(5): 1426. CrossRef
Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef
Treatment of Transverse Patellar Fracture with Cannulated Screws
Jung-Man Kim, Ju-Seok Yoo, Yong-Jin Kwon, Jang-Ok Cheon
Journal of the Korean Fracture Society.2007; 20(2): 149. CrossRef

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Operative Treatment of the Clavicular Fracture with Cannulated Screw: Byung Jik Kim, Suk Kyu Choo, Jin Hwan Kim, Sang Min Lee, Dong Soo Kim; J Korean Soc Fract 2003;16(4):555-562. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.555

Abstract PDF: PURPOSE
To investigate the utility of cannulated screw in operative treatment of the clavicular fracture.
MATERIALS AND METHODS
From December 1999 to December 2002, 23 patients with clavicular fracture were underwent operative treatment with cannulated screw. Their mean age was 40.1 years and the sites of fracture were 16 cases in middle 1/3, 7 cases in lateral 1/3, 12 cases were comminnuted fracture. The clinical and radiological results were evaluated.
RESULTS
According to the Kang's criteria, the clinical results were excellent in 18 cases (78.3%), good in 4 cases (17.4%) and fair in 1 case. Radiologically, all cases showed bone union and the average time was 7.9 weeks. Complications such as infection, nonunion, metal failure has not been observed.
CONCLUSION
Open reduction and internal fixation with cannulated screw could be considered as an alternative method of treatment in clavicular fracture, when indications for primary surgical treatment are presents.

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Operative Treatment of Intraarticular Calcaneal Fractures Combined with Multiple Injuries using Closed Reduction and Cannulated Screw Fixation: Dae Moo Shim, Tae Kyun Kim, Soo Uk Chae, Seok Hyun Kweon; J Korean Soc Fract 2002;15(4):439-445. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.439

Abstract PDF: PURPOSE
To evaluate the radiological and clinical results of closed reduction and cannulated screw percutaneous fixation of intraarticular calcaneal fractures combined with multiple injuries.
MATERIALS AND METHODS
We reviewed 15 cases of 13 patients intraarticular calcaneal fractures combined with multiple injuries which were treated with closed reduction and cannulated screw percutaneous fixation between June 1998 to June 2001 and minimum follow up period of 12 months(12-27 months). The results were based on the assessment criteria of Salama and the analysis of Bohler 's angle, states of subtalar joint and deformities of calcaneus. Based on the Sanders classification, there were 2 cases(13%) of type I, 9 cases(60%) of type II and 4 cases(27%) of type III.
RESULTS
The preoperative Bohler 's angles were between 5 degrees to 35 degrees, postoperative Bohler 's angles were between 15 degrees to 45 degrees and the last follow up Bohler 's angles were between 15 degrees to 40 degrees . The postoperative complication of subtalar arthritis were developed in 5 cases and deformities of calcaneus were developed in 4 cases. Based on the assessment criteria of Salama, the functional results were excellent in 2 cases, good in 8 cases, fair in 3 cases, and poor in 2 cases.
CONCLUSION
The closed reduction and cannulated screw percutaneous fixation of intraarticular calcaneal fractures combined with multiple injuries was thought to be a useful method of treatment at the state of not delayed operating time and not position changing.

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Treatment of Tibial Plateau Fractures by Cannulated screw Fixation: Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Seung Ju Jeon, Kang Woo Chung; J Korean Soc Fract 2001;14(1):73-78. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.73

Abstract PDF: PURPOSE
The results of treatment of tibial plateau fractures by extensive soft tissue exposure were less satisfactory even if anatomical reduction was achieved. The purpose of this study is to assess the functional and radiological results of the treatment of tibial plateau fractures by cannulated screw fixation to decrease soft tissue injury and operation time.
MATERIALS AND METHODS
From January 1996 to February 2000, 19 patients were treated by limited open reduction and internal fixation by cannulated screw. According to scoring of Rasmussen, the functional results were rated.
RESULTS
In all cases, Bony union was obtained and according to scoring of Rasmussen, excellent in 1 case, good in 14, fair in 4 cases. There were 2 cases of limitation of joint motion and 2 cases of persistant pain as sequale.
CONCLUSION
We considered that if accurate preoperative evaluation was done, Cannulated screw fixaction was easier and faster method than other methods for treatment of tibial plateau fractures.

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Treatment of Femoral Neck Fracture (Comparison of Knowles Pin and Cannulated Screw Fixation): Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Young Bae Kim, Shin Pyo Kang; J Korean Soc Fract 2000;13(4):809-816. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.809

Abstract PDF: PURPOSE
The authors have analyzed clinical and radiological results of the femoral neck fractures to evaluate the difference Knowles pin and cannulated screw fixation group.
MATERIALS AND METHODS
The patients were devided into two group retrospectively, Group I included 35 cases that were treated with Knowles pin fixation for femoral neck fracture and Group II included 30 cases that were treated with cannuled screw fixation for femoral neck fracture. Clinical information included operation time, total blood loss and functional outcome. Postoperative X-ray information included Garden alignment index, duration of union and complication(P>0.05).
RESULTS
There was no difference between the two fixation group regarding duration of union, functional outcome by Lanceford's method and complication(P>0.05).
CONCLUSION
Knowles pin fixation and cannulated screw fixation were considered to be proper as a fixaton method in a fracture of the femur neck.

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Treatment of Femoral Neck Fractures with Cannulated Screws: Chan Hoon Yoo, Hong Tae Kim, Young Soo Byun, Sang Chul Shin, Byung Doo Jang, Kyoung Hoon Hyun; J Korean Soc Fract 2000;13(3):445-453. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.445

Abstract PDF: PURPOSE
This study was performed to evaluate the results of femoral neck fractures in adult treated with cannulated screws and the factors that may affect results.
MATERIALS AND METHODS
From April 1992 to December 1998, the authors analysed 53 cases of femoral neck fracture treated with cannulated screws and followed more than one year. According to Garden's classification and anatomic location, we classified the fracture type. We used Garden alignment index for the accuracy of reduction and Singh index for the degree of osteoporosis. The clinical results were analysed by Lunceford's assessment.
RESULTS
According to Lunceford's assessment, the results were good or excellent in 40 cases(75%). Mean bony union time was 16.3 weeks. There were 10 cases(19%) of avascular necrosis of the femoral head, 6 cases(11%) of nonunion and 2 cases(4%) of malunion. There were significant relationship between complication rate and accuracy of reduction(P<0.01), operative delay more than 7 days(P<0.05).
CONCLUSION
The important factors that may affect the results are accuracy of reduction and interval between injury and time of operation, the others were degree of displacement, anatomic site, degree of osteoporosis. The results of this study indicate that cannulated screw fixation is an effective method for femoral neck fractures in adult.

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Arthroscopic Reduction and Percutaneous Cannulated Screw Fixation for Longitudinal Fractures of Patella: Jung Han Yoo, Yung Khee Chung, Yong Wook Park, Jin Sub Kim, Deuk Soo Jun, Ho Jin Lee; J Korean Soc Fract 2000;13(1):103-108. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.103

Abstract PDF: A variety of surgical modalities for fractures of patella have been described. We used arthroscopic reduction and percutaneous screw fixation for six cases of longitudinal fracture of patella. Ages of the patients ranged from 25 to 33 years. the postoperative regimen was one week long leg splint for reducing the pain, followed by continuous passive range of motion exercise of the knee including active one and quadriceps strengthening exercise until the full range of motion was gained, with progressive partial to full weight bearing with crutches. The follow-up period was from 12 to 54 monhts. Results were assessed subjectively and objectively with retrograde study. The full range of knee motion was recovered from 20 to 35 days postoperatively, The radiographic bone union was achieved from 31 to 42 days. And all patient had good results according to Lysholm and Gillquist scoring system. We had no experience of complication except one which is prominence of screw end. So, we believed that the arthroscopic reduction and percutaneous cannulated screw fixation for longitudinal fractures of patella is the useful surgical method.

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Treatment of A-C joint dislocation with cannulated screw fixation under local anesthesia: Bu Hwan Kim, Jong In Yim, Deog Jeong Kang; J Korean Soc Fract 1996;9(1):185-192. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.185

Abstract PDF: In 1941, Bosworth used noncannulated coracoclavicular lag screw to Oeat acute A-C joint dislocation. In 1989, Tsou fixed coracoclavicular joint with percutaneous cannulated screw under general anesthesia in the treatment of acute A-C joint complete dislocations. We tried to treat 10 cases of acute A-C joint dislocations with cannulated screw fixation of C-C joint under local anesthesia, so we report the results with review of literatures. The results were as follows 1. Results of treatment were good in 7 cases, fair in 2 cases, and poor in 1 case by Weaver and Dunn evaluation criteria. 2. The operations were done under local anesthesia, but in two cases operation ended under general anesthesia due to discomfort of the patients. 3. In skeletally thin patient, it was very difficult to make accurate hole and we experienced an iatrogenic fracture of clavicle and coracoid process. This technique is not recommendable in skeletally thin patient. 4. Operation took 42 minutes on average(from 30 minutes to 105 minutes) though it took more time in the early cases. 5. We had several complications in 3 patients. Misdirection of screw(1 case), screw loosening and pull out(1 case), subluxation of A-C joint after removal of screw(2 cases), and iatrogenic fracture of clavicle and coracoid process(1 case) but no case of metal breakage or infection.

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