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A Comparison of the Results between Internal Fixation and External Fixation in AO C Type Distal Radius Fractures
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Yoon min Lee, Hwa Sung Lee, Seok Whan Song, Jae Hoon Choi, Jong Tae Park
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J Korean Fract Soc 2018;31(3):87-93. Published online July 31, 2018
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DOI: https://doi.org/10.12671/jkfs.2018.31.3.87
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 Abstract
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- PURPOSE
The purpose of this study was to evaluate the radiological and clinical results of plate fixation and external fixation with additional devices for treating distal radius fracture in AO type C subtypes, and propose a treatment method according to the subtypes.
MATERIALS AND METHODS
Two hundred and one AO type C distal radius fracture patients were retrospectively reviewed. Eighty-five patients in group 1 were treated with volar or dorsal plate, and 116 patients in group 2, were treated with external fixation with additional fixation devices. Clinical (range of mtion, Green and O'Brien's score) and radiological outcomes were evaluated.
RESULTS
At the 12-month follow-up, group 1 showed flexion of 64.4°, extension of 68.3°, ulnar deviation of 30.6°, radial deviation of 20.8°, supination of 76.1°, and pronation of 79.4° in average; group 2 showed flexion of 60.5°, extension of 66.9°, ulnar deviation of 25.5°, radial deviation of 18.6°, supination of 73.5°, and pronation of 75.0° in average. The mean Green and O'Brien score was 92.2 in group 1 and 88.6 in group 2. The radial height of group 1 and group 2 was 11.6/11.4 mm; radial inclination was 23.2°/22.5°; volar tilt was 11.6°/8.7°; and the ulnar displacement was 1.27/0.93 mm.
CONCLUSION
Judicious surgical techniques during device application and tips for postoperative management during external fixation can produce similar clinical results compared with internal fixation patients.
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Citations
Citations to this article as recorded by  - Intra-articular fracture distal end radius external fixation versus locking volar radius plate: A comparative study
S.P.S Gill, Manish Raj, Santosh Singh, Ajay Rajpoot, Ankit Mittal, Nitin Yadav
Journal of Orthopedics, Traumatology and Rehabilitation.2019; 11(1): 31. CrossRef
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Treatment of Humeral Shaft Fracture with Retrograde Intramedullary Nail
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Ki Bum Choi, Soo Hwan Kang, Yoon Min Lee, Seok Whan Song, Youn Jun Kim
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J Korean Fract Soc 2013;26(4):299-304. Published online October 31, 2013
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DOI: https://doi.org/10.12671/jkfs.2013.26.4.299
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Abstract
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The purpose of this study was to report the outcome of treatment of humeral shaft fracture with retrograde intramedullary nail of advanced insertion opening.
MATERIALS AND METHODS
From April 2005 and August 2012, 22 patients with a humeral shaft fracture were treated by a single surgeon using the technique of retrograde intramedullary nail at Department of Orthopedic Surgery, Yeouido St. Mary's Hospital (Seoul, Korea). To avoid causing fractures at the insertion site, the entry point was more distally located than conventionally, and was extended proximally to include the proximal marginal cortex of the olecranon fossa. The outcome was evaluated clinically and radiologically.
RESULTS
The mean period of achievement of bony was 5.8 months (4-11 months). Additional fixations were needed in one patient with intraoperative lateral condylar fracture and 2 patients with postoperative nonunion. There were no limitations of movement or pain in the shoulder joint, and 8 cases had a 6.5degrees flexion contracture on average.
CONCLUSION
This retrograde intramedullary fixation technique using a distal entry portal near the olecranon fossa is particularly useful in humeral shaft fractures without a neurovascular injury. The risk of an intraoperative fracture (supracondylar fracture or fracture around the entry portal) can be decreased using this treatment. We recommend this technique because of the safety and the satisfactory outcome.
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Citations
Citations to this article as recorded by - HEALING PATTERN OF INTERLOCKED INTRAMEDULLARY NAILED HUMERAL SHAFT FRACTURE
Myung-Sang Moon, Dong-Hyeon Kim, Min-Geun Yoon, Sang-Yup Lee
Journal of Musculoskeletal Research.2016; 19(04): 1650018. CrossRef
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Posterior-Posterior Dual Plates Fixation for the Distal Humerus Fractures
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Yoon Min Lee, Seok Whan Song, Ki Bum Choi, Yoo Joon Sur, Sung Eun Kim
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J Korean Fract Soc 2013;26(4):254-260. Published online October 31, 2013
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DOI: https://doi.org/10.12671/jkfs.2013.26.4.254
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Abstract
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Fractures of the distal humerus are one of the challenging injuries due to its complex anatomy and accompanied comminution. For dual plate fixation, orthogonal or parallel plating is widely used, but the better of the two is debatable. The purpose of this study was to report another fixation technique that yielded good clinical results with early bone union of distal humerus fracture, namely, posterior-posterior plate fixation.
MATERIALS AND METHODS
From March 2003 to March 2012, 20 patients with distal humerus fractures were treated by posterior-posterior plate fixation. The triceps reflecting approach was used with anterior transposition of the ulnar nerve. The mean age at the time of injury was 45 years (range, 26 to 78 years). By AO classification of distal humerus fractures, there were one case of A2 and B3 respectively, two cases of each A3, C1 and C3, and twelve cases of C2.
RESULTS
The mean period of complete bone union was 7.1 weeks (range, 4 to 11 weeks). The mean flexion-extension range of motion of the elbow joint at last follow-up was 116.2 degrees. The mean pronation was 81.2 degrees and supination was 83.1 degrees. Plates and screws were removed at about nine months after the initial surgery. No cases showed complications or required additional operation.
CONCLUSION
Posterior-posterior dual plates fixation resulted in stable bicortical screw fixation, and insertion of lag screws were possible without interference. Posterior-posterior plating could be an easy and stable fixation method that provides good clinical results.
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Citations
Citations to this article as recorded by - Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study
Chien-An Shih, Fa-Chuan Kuan, Kai-Lan Hsu, Chih-Kai Hong, Cheng-Li Lin, Ming-Long Yeh, Wei-Ren Su
BMC Musculoskeletal Disorders.2021;[Epub] CrossRef
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213
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