PURPOSE To evaluate the clinical efficacy of F-plate in displaced intra-articular fractures of calcaneus. MATERIALS AND METHODS Total 43 cases treated with F-plate and followed up at least six months postoperatively were reviewed. Radiographically, Böhler angle was measured and all cases were subdivided by Sanders classification. Each case was reviewed for the presence of local infection, traumatic arthritis, nonunion, and any breakage of plate or screw. Maryland foot score was used for clinical assessment and factors influencing on clinical results were determined. RESULTS The mean Böhler angle was improved from 0.5° (range: -24.7~35.5°) preoperatively to 25.8° (range: 14.2~38.6°) postoperatively and the angle at last follow-up was 23.5° (range: 10.2~37.5°), showing about 2.3 degree decline compared to postoperative Böhler angle. There were two cases of F-plate breakage and two cases of screw breakage but the metal breakage did not affect any change in Böhler angle. Other complications were; five cases of traumatic arthritis, one case of varus malunion and one case of deep wound infection. According to Maryland foot score, there were 10 excellent, 22 good, 10 fair and 1 poor result. Furthermore, Age, pre-operative Böhler angle and the patient's expectation on financial compensation had significant influences upon the clinical result. CONCLUSION F-plate fixation seems to yield firm fixation and satisfactory clinical results in the treatment of displaced intra-articular fractures of calcaneus.
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Clinical and Radiological Outcomes of ‘Blocking Kirschner Wire Technique’ in Displaced Intra-Articular Calcaneal Fractures via the Extended Sinus Tarsi Approach Jeong-Kil Lee, Chan Kang, Sang-Bum Kim, Gi-Soo Lee, Jung-Mo Hwang, Byung-Kuk An Journal of the Korean Orthopaedic Association.2021; 56(3): 224. CrossRef
Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef
Intra-articular Calcaneal Fractures Treated with Open Reduction and Internal Fixation -A Comparative Study between Groups with and without Bone Graft- Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Sung Hwan Jo, Hoon Yang Journal of the Korean Fracture Society.2010; 23(2): 180. CrossRef
PURPOSE To evaluate the overall surgical outcome of the tibial pilon comminuted fractures and perform the comparative analysis between the limited internal fixation-external fixation group and the delayed open reduction-internal fixation (ORIF) group. MATERIALS AND METHODS From June 1997 to June 2004, 17 tibial pilon comminuted fractures were treated with the limited internal fixation-external fixation (6 cases) or the delayed open reduction-internal fixation (11 cases). The average age of the patients was 47.7 years (range: 41~63 years), male was fourteen patients, female was three. Follow-up period was average 33.6 months (range: 12~84 months). The clinical outcomes were evaluated by using AOFAS ankle-hindfoot score and patient satisfaction was also evaluated. RESULTS AOFAS score at final follow-up was 80.4 points, and 88% of the patients were satisfied with the results. AOFAS scores of the external fixation group and the delayed ORIF group were average 77.0 points and 82.2 points respectively, which did not show the statistical difference (p>0.05). Bony union was achieved at average 16.0 weeks. There were 18 complications such as skin necrosis. CONCLUSION We have achieved relatively encouraging functional results and high patient satisfaction for pilon comminuted fractures, without significant result difference between the two surgical techniques.
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The Result of Using an Additional Mini-Locking Plate for Tibial Pilon Fractures Suenghwan Jo, Jun Young Lee, Boseon Kim, Kang Hyeon Ryu Journal of the Korean Fracture Society.2017; 30(2): 75. CrossRef
PURPOSE To evaluate the effectivity of interlocking intramedullary nailing for distal tibia fracture and prognostic factor to bone healing. MATERIALS AND METHODS From April 2000 to June 2005, 21 cases who had distal tibia fracture were treated by interlocking intramedullary nail were analyzed. The duration of follow-up was more than 1 year. We evaluated clinical results by IOWA ANKLE rating system and union time by simple X-ray. Furthermore, we estimated prognostic factor to union time. RESULTS The bone union was achieved at average 18.5 weeks. At the last follow-up, there was no non-union and infection. Average IOWA ANKLE rating score was 91.3 point. The union time was delayed in open and segmental fracture at initial fracture. And severe soft tissue injury in open fracture revealed bad result. CONCLUSION We concluded that interlocking intramedullary nail is effective method for treatment of the distal tibial fractures. And, adequate soft tissue management is important to bone healing and clinical outcome.
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Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures Jung-Han Kim, Heui-Chul Gwak, Chang-Rack Lee, Yang-Hwan Jung Journal of Korean Foot and Ankle Society.2015; 19(3): 86. CrossRef
PURPOSE To evaluate the short-term results of two-staged delayed minimal invasive plate osteosynthesis in high-energy intraarticular fractures of the distal tibia. MATERIALS AND METHODS Thirteen patients, who underwent two-staged delayed minimal invasive plate osteosynthesis for intraarticular fractures of the distal tibia between January 2002 and July 2004, were followed for more than one year. The mean interval time between first stage and second stage of the procedures was 28.6 days (range, 14~34 days). By Ruedi-Allgower classification, there were two cases in type I, three cases in type II, and eight cases in type III. There were six cases in type B and seven cases in type C patients according to AO/OTA classification. Radiographs were graded by the criteria of Burwell and Charnley and ankle functions were graded by the criteria of Mast and Teipner. Union time and postoperative complications were also analysed. RESULTS Average union time was 16.9 weeks (range, 14~20 weeks) in twelve of the thirteen fractures, but there was one fracture resulting in soft tissue complication and infected nonunion. At the latest follow-up, review of the radiographic results showed that ten cases of fractures (77%) achieved an anatomic reduction, two cases (15%) achieved fair reduction and one case (8%) achieved a poor reduction. And clinical functional assessment showed that nine cases (69%) were good results, three cases were (23%) fair results and one case (8%) was poor result. CONCLUSION Two-staged delayed minimal invasive plate osteosynthesis is an excellent option for the treatment of high-energy intraarticular fractures of the distal tibia.
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Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn Journal of the Korean Fracture Society.2010; 23(3): 289. CrossRef
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PURPOSE To evaluate the results of limited open reduction and screw fixation of acetabular fractures. MATERIALS AND METHODS Six acetabular fractures were treated with fluoroscopic guided screw fixation. The mean age was 46 years old and mean follow-up period was 18 months. There were 3 anterior column fractures, 2 transverse fractures and 1 both column fracture. Anterior column screw fixation was used in 5 cases and posterior column fixation in 1 case. Limited ilioinguinal approach was used in 4 cases and percutaneous screw fixation in 2 cases. RESULTS The mean union time was 16.6 weeks. The postoperative radiographic results revealed 2 cases with an anatomic reduction and 4 cases with an imperfect reduction. The clinical results showed 1 case with excellent, 4 cases with good and 1 case with fair. Regarding complication, there was 1 case of SI joint penestration without clinical symptoms. CONCLUSION Limited open reduction and screw fixation can be a useful alternative treatment for acetabular fractures in patients with minimally displaced fracture, severe multisystem trauma and soft tissue injury not suitable to traditional treatment.
PURPOSE We analyzed the complications of femoral pertrochanteric fractures treated with proximal femoral nail (PFN®) to reduce the its complications. MATERIALS AND METHODS We evaluated the complications among 198 patients who were treated with PFN® from June 2001 to August 2005 in our hospital. RESULTS The complications were presented in 28 cases (14.1%). Cut-out of lag screw was in 1 case, cut-out of lag screw and antirotation screw were in 3 cases, cut-out of antirotation screw in 3 cases, of these femoral head fracture was in 1 case. Femoral neck fracture in 1 case, Osteonecrosis of femoral head in 1 case, cortical fracture during the insertion of distal interlocking screw in 1 case, breakage of drill bit intraoperatively in 1 case, fibrous union in 2 case, thigh skin irritation due to screw back-out in 3 cases, periprosthetic fractures in 2 cases, varus collapse more than 10 degrees in 4 cases, superficial and deep infections in 3 cases, breakage of nail in 1 case, varus collapse after PFN removal in 1 case, persistent thigh pain in 1 case. Of all these cases, 9 cases (4.5%) were required reoperation with general or spinal anesthesia. Complications related with screws or fracture reduction were 19 cases (9.6%) and, of these, 17 cases (89.5%) showed increased TAD (tip apex distance) or nonanatomical reduction. CONCLUSION To reduce the complications of PFN®, we need to exact surgical technique and anatomical reduction and consider the modification of implant design to prevent of cut-out of screws.
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Proximal Femoral Nail Mechanical Failure: A Case Report and Biomechanical Study Dimitrios Papanikolopoulos, Christos Kalligeros, Apostolos Polyzos, Vasileios Spitas, Vasileios Soranoglou Cureus.2022;[Epub] CrossRef
Clinical and radiological outcomes of patients treated with the talon distalfix proximal femoral nail for intertrochanteric femur fractures Furkan Yapici, Hanifi Ucpunar, Yalkin Camurcu, Necati Emirhan, Oguzhan Tanoglu, Ismail Tardus Injury.2020; 51(4): 1045. CrossRef
Implant Fracture Analysis of the TFNA Proximal Femoral Nail Anton Lambers, Bertram Rieger, Alan Kop, Peter D’Alessandro, Piers Yates Journal of Bone and Joint Surgery.2019; 101(9): 804. CrossRef
Radiographic Outcomes of Osteosynthesis Using Proximal Femoral Nail Antirotation (PFNA) System in Intertrochanteric Femoral Fracture: Has PFNA II Solved All the Problems? Won Chul Shin, Jung Dong Seo, Sang Min Lee, Nam Hoon Moon, Jung Sub Lee, Kuen Tak Suh Hip & Pelvis.2017; 29(2): 104. CrossRef
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PFNA and PFN in Intertrochanteric Fractures - Comparison Study of Sliding - Suk Kyu Choo, Hyoung Keun Oh, Jun Young Choi Hip & Pelvis.2010; 22(1): 79. CrossRef
PURPOSE To evaluate the efficacy of proximal femoral nail for intertrochanteric fracture. MATERIALS AND METHODS From June 2001 to March 2005, 45 intertrochanteric fractures were treated with a proximal femoral nail for intertrochanteric fracture and followed-up at least one year. The average age was 71.3 years (34~91 years). The causes of fracture were slip down in 38 cases and fall down in 7 cases. Fractures were classified with AO classification; 20 cases in type A1, 22 cases in type A2 and 3 cases in type A3. Antirotational pin was used in 25 of 45 fractures according to fracture stability. Radiological result was determined with a union. Walking ability was evaluated in the last follow-up. RESULTS The fractures were fixed in anatomical position in 36 cases, in valgus position in 3 cases and varus position in 6 cases. Union was occurred in 43 of 45 cases. The sliding distance of lag screw was an average of 5.63 mm and it had no association with fracture type, TAD, usage of antirational screw, usage of distal screw and BMD. Twenty-six of 45 patients (57.7%) were recovered to pre-injury state of walking ability. Complications were occurred in 3 patients (6%). CONCLUSION Proximal femoral nail was a useful instrument for all type intertrochanteric fractures, but antirotational pin was not necessary in the stable type A1 intertrochnatirc fractures.
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Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteic Fractures in the Elderly Byung-Hak Kim, Young-Yool Chung, Sung-Chang Ki, Dae-Hyun Yoon, Ji-Hoon Ryu Journal of the Korean Orthopaedic Association.2011; 46(5): 399. CrossRef
PURPOSE To evaluate the results according to the difference of age and bone mineral density (BMD) of the surgical treatments using open intramedullary nail with tension sutures and lock suture on proximal humeral three part fracture. MATERIALS AND METHODS 30 patients treated by open intramedullary nail with tension band and lock suture technique on proximal humeral fractures were reviewed. After treatment, average follow up periods was 50 months (range; 17~143 month). Postoperative clinical outcome was evaluated using ASES functional score, Neer score and constant score. RESULTS Bony union were obtained all except one case. Range of motion, mean forward elevation was 142°, mean external rotation was 56°, mean external rotation at 90° abduction was 68°. Average pain score of visual analog scale was 1.5. Average functional score of American Shoulder and Elbow Society was 86. Average Neer score was 89. Constant score was 85. Pain and functional score of group I were better than those of group, however, there was no statistically significant difference (p>0.05). In the comparison between group III and group IV, the results were same (p>0.05). CONCLUSION The patients treated using open intramedullary nailing, tension band and lock suture could enable early ROM exercise and show good clinical results. This treatment method will be useful in old age osteoprorotic patients.
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Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures Chung Hee Oh, Joo Han Oh, Sae Hoon Kim, Ki Hyun Jo, Sung Woo Bin, Hyun Sik Gong Journal of the Korean Fracture Society.2008; 21(3): 213. CrossRef
PURPOSE To evaluate prospectively the results of early active exercise after open Bankart repair of traumatic anterior shoulder instability. MATERIALS AND METHODS From January, 2001 to June, 2003, 26 patients who were followed up at least 1 year after open Bankart repair for traumatic anterior shoulder instability were evaluated. Average age was 23.9 years old (range, 19~43) with 24 males and 2 females. We evaluated them using the functional shoulder scores (modified Rowe score, ASES score), range of motion, VAS pain scale, patient's subjective satisfaction and return to unlimited daily living activity. RESULTS The shoulder functional scores increased significantly. At last follow up, the final range of motion were flexion in average 5° deficit in comparison to normal side, external rotation in average 10o deficit, and internal rotation in T9. The patient's subjective satisfaction was good in 2l patients (81%). Return to unlimited daily activity was possible in 23 patients (88.5%), and 19 patients (73%) rejoined to sports activity before injury. There were complications including anterior recurrent subluxation in 1 case, weakness of subscapularis muscle in 1 case. CONCLUSION In traumatic anterior shoulder instability, early active range of motion exercise after open Bankart repair does not decrease shoulder stability. Early exercise can be useful for returning to previous level of sports activity in young active patients.
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
PURPOSE To evaluate radiologic and clinical results of bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture. MATERIALS AND METHODS Between April, 2005 and February, 2006, 17 patients treated by bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture were evaluated. All patients were reviewed clinically and radiologically after operation. RESULTS All of 17 cases of fractures were completely united. In the anteroposterior radiographs, the average of preoperative angulation was corrected from 34.4° to 5.2°. Also, in the oblique radiographs, radiographic results of angulation correction were satisfactory which was corrected from 44.2° to 11.7°. Although, the averages of difference between postoperative and final follow-up angulations were 1.5° in the anteroposterior radiographs and 0.9° in the oblique radiographs, they were not statistically different. All patients were excellent clinically except 1 patient who has moderate joint stiffness after operation. CONCLUSION Selecting of appropriate patients who is indicated, bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture could be a good treatment method without complications.
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Percutaneous retrograde intramedullary single wire fixation for metacarpal shaft fracture of the little finger Soo-Hong Han, Seung-Yong Rhee, Soon-Chul Lee, Seung-Chul Han, Yoon-Sik Cha European Journal of Orthopaedic Surgery & Traumatology.2013; 23(8): 883. CrossRef
Treatment of 5th Metacarpal Neck Fracture Using Percutaneous Transverse Fixation with K-Wires Jae-Hak Jung, Kwan-Hee Lee, Yong-Ju Kim, Woo-Jin Lee, Sung-Hyun Choi Journal of the Korean Fracture Society.2012; 25(4): 317. CrossRef
Antegrade Intramedullary Prebent K-wire Fixation for the 5th Metacarpal Neck Fracture Tae-Hyung Kim, Bo Hyeon Kim, In-Ho Jung, Dong-Hyun Kim Journal of the Korean Fracture Society.2011; 24(1): 67. CrossRef
Percutaneous Retrograde Intramedullary Pin Fixation for Isolated Metacarpal Shaft Fracture of the Little Finger Soo Hong Han, Hyung Ku Yoon, Dong Eun Shin, Seung Chul Han, Young Woong Kim Journal of the Korean Fracture Society.2010; 23(4): 367. CrossRef
PURPOSE To evaluate the biomechanical results according to various anterior spinal fixation methodology in the treatment of thoracolumbar spine fracture. MATERIALS AND METHODS The comparative analysis of fixation method was evaluated by three dimensional finite element model using the 1 mm reconstruction image of CT. Authors evaluated the flexion, extension, lateral bending, torsional stresses with 12 fixation methods for the compression and burst fracture. RESULTS In biomechanical analysis, stiffness of body-fixation device was more stable in two-rod system in compression fracture and was stable in one-rod, two-rod system in burst fracture, but two-rod system was showed over-increase of stiffness. CONCLUSION Authors recommend the usage of two-rod system in anterior fixation only and anterior one-rod system in anterior-posterior fixation.
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PURPOSE We are to find the method to objectify postoperative prognosis, analyzing the factors confluencing the result of kyphoplasty in osteoporotic vertebral compression fracture (OVCF). MATERIALS AND METHODS Our study included 50 patients (55 vertebral bodies) who have undergone kyphoplasty from Sep. 2004 until Oct. 2005. We divided in the group according to bone mineral density (BMD), compression rate, recovery rate and cement leakage. We verified the significance of each group, using independent t-test, and ANOVA test among observers. RESULTS We performed kyphoplasty on 55 vertebral bodies, 12 cases with more than 0.4 g/cm2 in BMD (mean: 0.53 g/cm2) and their mean preoperative compression rate (CR), immediate postoperative recovery rate (RR-IPO), and recovery rate after 6 months (RR-6M) was each 30.58%, 12.35%P, 9.93%P. 15 cases under 0.4 g/cm2 (mean 0.31 g/cm2), and their CR, RR-IPO and RR-6M was 26.73%, 11.77%P, 5.26%P respectively. The p-value was 0.004. Another studies according to CR, RR-IPO and leakage of cement revealed the better results in the cases of the lower CR, the smaller reduction and abscecnce of cement leakage, but statistically insignificant (p=0.309, 0.069, 0.356). CONCLUSION Preoperative BMD was most important factor that confluencing postoperative radiological result in OVCF. Other factors were also thought to be confluencing factors, but statistically insignificant..
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Pseudoaneurysm is one of the complications of arterial injuries by trauma. The case report in children is rare, although not in adult. A 7-year and 10-month girl was visited with the complaints of pain and a mass in her right leg. At first, the radiograph of right tibia showed a remarkable cortical erosion from without, suggesting mass effect by a soft tissue tumor. She had a history of fracture of right tibia, and then manipulative reduction and K-wire fixation at 11 months ago. Arteriography showed a formation of the pseudoaneurysm originated from the posterior tibial artery. The operation was done through the ligation of artery at proximal and distal to pseudoaneurysm, and then excision of mass. At 5 year follow-up, the configuration and function of right foot was normal. Eventually, the cause of the mass formation is thought by the trauma of fracture fragment at the time of accidents, but the possibility of penetrated injuries by K-wire should be ruled out, which is used frequently in children's fracture. We experienced a case of traumatic pseudoaneurysm of posterior tibal artery with tibial fracture, especially occurred in pediatric patient, and presented the result of long-term follow-up.
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Costoclavicular syndrome is one of the four syndromes of thoracic outlet syndrome in which have similiar symptoms, and may result from cervical and thoracic scoliosis, formation of excessive callus or nonunion after fractures of clavicle or first rib. Conservative treatment may be offered. Surgical treatment includes scalenectomy with supraclavicular approach, transaxillary first rib resection with scalenectomy and correction of clavicular abnormality. The purpose of this paper is to evaluate the result of surgical intervention in costoclavicular syndrome of a 38-year old man with clavicular nonunion after an operation.
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