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Comparison of the Radiological Outcomes of an Anatomical Quadrilateral Surface Plate with a Pelvic Reconstruction Plate in Acetabulum Fractures
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Sung Hyun Yoon, Hee Gon Park, Dong Uk Lee
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J Korean Fract Soc 2024;37(2):95-101. Published online April 30, 2024
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DOI: https://doi.org/10.12671/jkfs.2024.37.2.95
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 Abstract
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- Purpose
This study compared the radiological outcomes of fixation using an anatomical quadrilateral surface plate with those using a traditional pelvic reconstruction plate for fractures involving the quadrilateral surface or superomedial wall of the acetabulum.
Materials and Methods
From 2015 to 2022, 47 patients who met the inclusion and exclusion criteria were analyzed retrospectively. Internal fixation of an acetabular fracture was achieved with a pelvic reconstruction plate (n=28) or an anatomical quadrilateral surface plate (n=19). The ability to achieve immediate postoperative anatomical reduction and the long-term outcomes were assessed by confirming the arthritic changes. Immediate postoperative reduction quality and long-term radiological outcomes for post-traumatic arthritis were assessed using the Matta scoring system on standard radiographs.
Results
The assessment of immediate postoperative reduction in the pelvic reconstruction plate group was satisfactory in 16 patients (57.1%) and unsatisfactory in 12 patients (42.9%). In the anatomical quadrilateral surface plate group, the results were satisfactory in 16 patients (84.2%) and unsatisfactory in 3 patients (15.8%). When evaluating over an extended follow-up period in the pelvic reconstruction plate group, 19 patients (67.9%) demonstrated satisfactory, while 9 patients (32.1%) had unsatisfactory outcomes. In the anatomical quadrilateral surface plate group, 12 patients (63.2%) achieved satisfactory, and 7 patients (36.8%) had unsatisfactory outcomes. The immediate postoperative reduction quality was superior in the anatomical quadrilateral surface plate group (p=0.03). Comparing longterm results, the anatomical quadrilateral surface plate group did not have statistically more favorable outcomes (p=0.49).
Conclusion
In this study, the anatomical quadrilateral surface plate achieved sufficiently good radiological results without significant difference from the existing pelvic reconstruction plate. It was concluded that it is a useful option that can replace the existing metal plate in the selection of surgery for acetabular fractures.
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Risk Factors of Fixation Failure in Femoral Neck Fractures
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Sung Hyun Yoon, Kyu Beom Kim, Hyung Jun Lee, Kyung Wook Kim
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J Korean Fract Soc 2023;36(4):118-124. Published online October 31, 2023
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DOI: https://doi.org/10.12671/jkfs.2023.36.4.118
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Abstract
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- Purpose
Internal fixation after a femoral neck fracture (FNF) is one of the conventional treatment options for the young and active elderly patients. However, fixation failure of internal fixation is a probable complication. The treatment of fixation failure after a primary internal fixation of the FNF remains a challenge.
Materials and Methods
Between July 2002 and March 2017, 83 patients who underwent internal fixation after FNF were retrospectively analyzed. Radiological assessments, including Pauwels’ angle, fracture level, reduction quality, and bone union, were measured, preoperatively and postoperatively.
Moreover, intraoperative variables such as time to surgery, surgical time, and estimated blood loss were also evaluated.
Results
The patients were divided into the fixation failure and the non-failure groups. Among the 83 patients, 17 cases (20.5%) of fixation failure after the primary internal fixation of the FNF were identi-fied. When comparing the two groups according to the radiographic data, Pauwels’ angle and the reduction quality based on Garden’s angle showed significant differences (p<0.001). Moreover, when comparing the intraoperative variables, unlike the surgical time and estimated blood loss, significant differences were noted in the time interval from injury to surgery and specifically in whether the surgery was performed within 12 hours after injury (p<0.001).
Conclusion
Pauwels’ angle, reduction quality, and time to surgery are the major factors that can predict the possibility of internal fixation failure of the FNF. Early and accurate anatomical reduction is needed to decrease complications after the internal fixation of the FNF.
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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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- PURPOSE
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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