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Results after Less Invasive Locking Plating in Intra-Articular Fractures of the Distal Femur
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Sung Hyun Kim, Sung Hyun Yoon, Hee Gon Park, Jae Uk Jung
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J Korean Fract Soc 2019;32(1):14-20. Published online January 31, 2019
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DOI: https://doi.org/10.12671/jkfs.2019.32.1.14
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Abstract
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The purpose of this study was to determine the clinical outcomes after a less invasive locking plating technique in intra-articular fractures of the distal femur. MATERIALS AND METHODS This was a retrospective 19 case series of patients with distal femoral intraarticular fractures treated with a less invasive locking plating technique in a single center (Dankook University Hospital) from June 2010 to April 2016. Nineteen patients (11 males and 8 females) with a mean age of 55.9 years were enrolled. The functional outcomes were evaluated using the visual analogue scale (VAS), range of knee joint motion (flexion & extension), and Knee Society score. The radiology outcomes were evaluated with parameters measured in a plain radiograph (deviation angle of alignment axis on coronal and sagittal plane, mechanical lateral distal femur angle). RESULTS The mean follow-up period was 26.4 months (range, 12–72 months) and the mean duration to union was 15.94 weeks (range, 11–28 weeks). The mean VAS was 1.36 (range, 0–8) and the range of motion of the knee joint was extension 4.73° (range, 0°–30°) and flexion 107.36° (range, 60°–135°). The mean Knee Society score was 85.47 (range, 47–100). The mean deviation angle of the coronal alignment axis was 4.07° (range, 1.3°–8.8°), the mean deviation angle of the sagittal alignment axis was 3.23° (range, 0.7°–7.0°), and the mechanical lateral femoral angle was 87.75° (range, 82.8°–95.5°). Six patients had traumatic osteoarthritis at the final follow-up. CONCLUSION The purpose of this study was to evaluate the clinical and radiologic outcomes of intraarticular fractures of the distal femur in patients who underwent an anatomical reduction through an open reduction, and converted to an extra-articular fracture with rigid internal fixation. The results were relatively satisfactory.
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Atypical Bipolar Segmental Fracture of the Clavicle in an Adolescent: A Case Report
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Joong Bae Seo, Sung Hyun Yoon, Jun Kyom Kim, Sung Hyun Kim, Jae Sung Yoo
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J Korean Fract Soc 2018;31(1):18-21. Published online January 31, 2018
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DOI: https://doi.org/10.12671/jkfs.2018.31.1.18
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Abstract
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- Clavicular fractures commonly occur in adults and children. The usual site of these fractures is the mid clavicle with lateral end and medial end clavicular fractures being less common. Bipolar segmental clavicular injuries involving medial and lateral ends are rare but almost always occur in adults. This paper reports a very rare case of segmental clavicular fracture involving the medial and lateral end in an adolescent caused by direct trauma. The surgical management of a segmental fracture clavicle in an adolescent is reported with a discussion of the relevant literature.
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The Cause of Primary Reduction Failure in Hip Dislocation with or without Hip Fracture
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Hee Gon Park, Yong Eun Shin, Sung Hyun Kim
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J Korean Fract Soc 2017;30(1):9-15. Published online January 31, 2017
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DOI: https://doi.org/10.12671/jkfs.2017.30.1.9
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Abstract
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A rapid and accurate reduction is important for hip dislocated patients to avoid various potential complications, including avascular necrosis of the femoral head. We analyzed hip dislocation cases, ones that particularly failed during the primary reduction trial. MATERIALS AND METHODS Eighty-seven patients with hip dislocation, who visited the emergency department between January 2007 and September 2015, were retrospectively analyzed. Of them, 68 patients were successfully treated in the first closed reduction trial, and the remaining 19 patients were unsuccessful. Of the 19 unsuccessful first trial, 12 patients were successfully treated in the second closed reduction; however, in the remaining 7 patients, open reduction was performed in the operation room with general anesthesia. Every closed reduction was practiced by at least 2 orthopedic doctors, and open reduction was performed by a single senior author. RESULTS The rate of first reduction failure was higher, with statistical significance, in patients aged under 50 years, male gender, and those with combined around hip fractures, including femoral head and acetabular fracture (p<0.05). In particular, the presence of impacted fracture fragment in the hip joint and large size of the impacted fracture fragment was highly related to the failure of second closed reduction trial requiring open reduction. Conversely, the method of reduction, Thompson-Epstein classification, Pipkin classification were not related to the failure of closed reduction statistically (p>0.05). CONCLUSION To evaluate the patients with hip dislocation, realizing the type of dislocation, presence of accompanied fracture, location and size of fracture fragment, age, as well as gender of patients is important. If the fracture fragment is impacted in the hip joint and the size of the fragment is large, then the operative treatment is considered, rather than the repetitive trial of closed reduction by constraint.
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