PURPOSE To compare anthropometric indicators around the hip between osteoporotic fracture group and control group. MATERIALS AND METHODS Thirty patients for osteoporotic hip fracture and the same number of patients for spine fracture who admitted our institute from November 2006 to March 2007 were matched with control patients without osteoporotic fracture. The waist circumference (WC), hip circumference (HC), thigh circumference (TC), and height were measured. From these measurements, waist to hip ratio (WHR), waist to thigh ratio (WTR), hip to thigh ratio (HTR), waist to height ratio (WHtR), hip to height ratio (HHtR), and thigh to height ratio (THtR) were calculated. All these indicators were compared between hip fracture and control group, and between spine fracture and control group. RESULTS Comparison between spine fracture and control group showed that the WC, WHR, WHtR were statistically significant, but all indicators failed to show accuracy in the ROC analysis. Comparison between hip fracture and control group demonstrated the TC, WTR, HTR, WHtR, HHtR, THtR were statistically significant. However, only the HTR showed fair accuracy in the ROC analysis. The area under the curve (AUC) of the HTR was 0.75 (95% confidence interval, 0.62 to 0.87) (p=0.001). CONCLUSION The HTR was fairly accurate in predicting the incidence of hip fracture compared with any other anthropometric indicators. Therefore, we can consider that the HTR has clinical usefulness.
PURPOSE To assess the results of staged MIPO (Minimally Invasive Plate Osteosynthesis) for proximal tibial fractures with compromised soft tissue. MATERIALS AND METHODS Eighteen proximal tibial fractures (AO 41:9 cases, AO 42:9 cases) included this study. Ten were open fractures. After temporary external fixation until soft tissue healed (mean 27.3 days), MIPO was performed secondarily without bone graft. We assessed the bony union and knee function, and affecting factors of the results were investigated. RESULTS All fractures united at 20 weeks (range, 11~32) except 1 case. Mean range of knee flexion was 134.4degrees and mean IOWA knee score was 89.1. There were 2 superficial and 2 delayed deep infections from open fractures (grade II:1 case, grade III:3 cases), although they healed after implant removal. Open fractures seem to influence the infection rate. Otherwise, there was no related factor affecting the results. CONCLUSION MIPO after temporary external fixation can provide favorable results in proximal tibial fractures with soft tissue injuries, but attention of delayed infection should be paid in open fractures.
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PURPOSE To compare the clinical results between the extensile lateral approach and sinus tarsi approach in the open reduction of the Sanders type II calcaneal fracture. MATERIALS AND METHODS From July 2002 to Februry 2007, thirty two patients having thirty three calcaneal fractures of Sanders type II were managed with open reduction and internal fixation using the extensile lateral approach or sinus tarsi approach. The mean age of 19 patients using extensile lateral approach was 43.3 years. The mean age of 13 patients using sinus tarsi approach was 46.3 years. Clinical outcome, radiographic parameters, and postoperative complications were compared between both groups. RESULTS There was no difference between two groups associated with patients demographs. The mean AOFAS score and VAS between both groups were not different (p=0.716, p=0.774). The mean Bohler's angle and Gissane's angle between both groups were not different (p=0.343, p=0.357). Two cases of sural nerve injury, one malunion, and one deep infection were occurred in the group of extensile lateral approach. However, patients using sinus tarsi approach had no postoperative complications. CONCLUSION The clinical results of sinus tarsi approach may be comparable with those of extensile lateral approach, with the advantages of reduced risk of postoperative complications.
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Open reduction and internal fixation with conventional plate via L-shaped lateral approach versus internal fixation with percutaneous plate via a sinus tarsi approach for calcaneal fractures – A randomized controlled trial Shengli Xia, Yaogang Lu, Huizhong Wang, Zuming Wu, Ziping Wang International Journal of Surgery.2014; 12(5): 475. 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 usefullness of the percutaneous reduction technique with K-wire that could reduce the displaced posterolateral fracture fragment which persisted even after an anatomical reduction of the lateral malleolar fracture. MATERIALS AND METHODS From January 2004 to December 2006, we reviewed 72 patients who underwent surgical treatment for their trimalleolar fractures. We estimated the clinical and radiological results of 5 cases treated by percutaneous reduction technique with K-wire when more than the distal tibial articular step-off was left after reduction of the lateral malleolar fracture. The method of reduction starts with temporary fixation of lateral malleolar fracture followed by checking ankle radiographic image to confirm the accuracy of reduction. In case of incomplete reduction of the posterior fragment, a K-wire is inserted into the posterior fragment and pushed downward to the ankle joint level, and then lag screws were inserted. RESULTS The average articular involvement by the posterolateral fracture fragment was 30.2%. The average step-off after reduction of the lateral malleolar fracture was 3.7 mm. At the final follow up, step-off was less than 2 mm in all cases. In clinical results by Baird and Jackson score, 3 out of 5 cases were excellent, other 2 were good. CONCLUSION Percutaneous reduction technique for posterolateral fragment using the K-wire is relatively easy. This technique may be useful when the posterolateral fragment is large (more the 25% of articular surface) and not severely comminuted.
PURPOSE To evaluate the clinical results after operative treatment with the double tension band wire fixation in Neer type II and III distal clavicle fractures. MATERIALS AND METHODS Ten patients with type II and III distal clavicle fractures were evaluated, who operated with double tension band wire fixation technique, from Febrary 2007 to June 2008, and could be followed-up for more than 1 year after operation. Postoperative assessments were evaluated on plain x-ray, pain, and clinical finding according to the functional criteria by Kona et al. RESULTS Average duration from operation to fracture union was 8 weeks in all cases. There were 8 excellent and 2 good results. It was no other significant complications such as K-wire migration, breakage, infection, and AC joint arthritis. CONCLUSION Double tension band wire fixation technique seems to be an effective method for type II or III distal clavicle fracture with multiple compressive axis, without injury of the AC joint and loosening of the fixation.
PURPOSE To evaluate the usefulness of interlocking intramedullary nailing for operative treatment of forearm shaft fractures in adults. MATERIALS AND METHODS Thirteen forearm shaft fractures in 12 patients were fixated with 13 Acumed forearm intramedullary rods (ulna: 8, radius: 5). The average age was 36.7 years and mean follow-up period was 15.2 months. The union time was measured when there was no tenderness over the fracture site and the bridging callus was evident in at least two sides of the cortex. The range of motion of the joint and the rotation of the forearm was measured and the functional results were evaluated with Grace and Eversmann's rating system. RESULTS Radiologic union was observed at 11.8 weeks postoperatively in 11 cases out of 13. No limitation of motion was observed. Nine had excellent or good functional results. In one Galeazzi fracture, radial shaft became displaced after nailing and should be re-stabilized with plate. Proximal interlocking screws were improperly inserted in one ulnar nail. Implants were removed in 7 cases. Removal guide screw was broken while removing the intramedullary nail in one case of ulnar shaft fracture. CONCLUSION Interlocking intramedullay nailing might be a treatment option for the middle 1/3 shaft fractures of the adult forearm bone with favorable results.
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PURPOSE To evaluate the relationship between the level of screw fixation and the stability of the segment of endplate fracture after posterior pedicle screw instrumentation for thoracic and lumbar burst fractures. MATERIALS AND METHODS The 41 patients of burst fractures who had been operated with pedicle screw instrumentation were retrospectively evaluated. The patients were divided into two groups by the levels of screw fixation. One group was treated with screws fixed by one-level to the direction of fractured endplate (One-level group, 16 cases). The other group was treated with screws fixed by two-level to the direction of endplate fracture (Two-level group, 25 cases). The two groups were compared by the radiographic changes of kyphotic angle between the day of surgery and 6 months after surgery. RESULTS At the 6 months, one-level group showed the change of kyphotic angle of 17.5+/-2.4 degrees, which was different from two-level group of 5.2+/-0.8 degrees (p=0.000). CONCLUSION In posterior pedicle screws fixation for thoracic and lumbar burst fractures, 2 vertebrae to the direction of the endplate fracture should be included to prevent the postoperative kyphotic change.
PURPOSE This study investigated the effect of COX-2 inhibitor on the expression of MMP-13 in the healing process of fracture.
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