PURPOSE This study examined the clinical outcomes of comminuted intraarticular distal radius fractures treated by an anatomical reduction using a brick-work technique. MATERIALS AND METHODS Seventeen patients with AO/OTA type 23-C3 distal radius fractures were enrolled in this study. An anatomical reduction of the articular surface was achieved using a brick-work technique through the dorsal approach and dorsal plates were used for fixation. The postoperative functional results were assessed with the range of motion of the wrist and the modified Mayo wrist score (MMWS). In addition, the radial length, radial inclination, volar tilt, and Lidstrom score were evaluated from the radiology results. The mean postoperative follow-up period was 13.6 months. RESULTS All patients showed bony union and the mean range of motion of the injured wrists was 94% (92% to 95%) of the uninjured side. The mean MMWS was 85.3, and the functional results were excellent in 12 patients, good in 4, and fair in one at the final follow-up. Based on the final radiographic measurements, the radial length, volar tilt, and radial inclination were 11.4 mm (10.0 to 13.5 mm), 6.6° (−1.8° to 9.2°), and 21.3° (20.1° to 25.7°), respectively. The radiologic results according to the Lidstrom score were excellent in 14 patients and good in three. CONCLUSION An anatomical reduction with the brick-work technique is relatively easy, results in a reproducible clinical outcome, and could be a safe and effective treatment option for severe comminuted intraarticular distal radius fractures that are not amenable to volar plate fixation.
PURPOSE Iliosacral screw fixation is an effective and less invasive method that is used widely for the definitive treatment of unstable pelvic ring injuries. On the other hand, fixation failures after iliosacral screw fixation have been reported in vertically unstable pelvic ring injuries. This study examined the surgical outcomes of posterior pelvic fixation using S1 and S2 screws in vertically unstable pelvic ring injuries. MATERIALS AND METHODS Between January 2011 and April 2016, 17 patients with vertically unstable pelvic ring injuries who met the minimum 1 year follow-up criteria were treated with internal fixation using posterior pelvic S1 and S2 screws. Their mean age was 43.9 years. According to the AO/OTA classification, 10 patients had C1, 6 had C2, and 1 had C3 injuries. Surgical treatments of single or multiple steps, where necessary, were performed by two surgeons. The clinical and radiologic outcomes were assessed retrospectively using radiographs and medical records. RESULTS Overall, 16 patients had bone healing without screw loosening; however, one patient could not maintain anterior pelvic fixation because of an open fracture and deep infection in the anterior pelvic ring. Of five patients who complained of neurological symptoms after injury, three had partially recovered from their neurological deficit. At the last follow-up, the clinical outcomes according to the Majeed score were excellent in 5, good in 6, fair in 4, and poor in 2 patients. The postoperative radiologic outcomes by Matta and Tornetta's method were excellent in 5, good in 8, and fair in 4 patients. Malposition of the S2 screw was identified in one case. The mean time to union was 14.6 weeks after surgery. CONCLUSION S1 and S2 screw fixation can be an effective treatment option for posterior pelvic stabilization in vertically unstable pelvic ring injuries when considering the surgical outcomes, such as screw loosening and loss of reduction.
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Fixation Options of Unstable Posterior Pelvic Ring Disruption: Ilio-Sacral Screw Fixation, S2AI Fixation, Posterior Tension Band Plate Fixation, and Spino-Pelvic Fixation Dong-Hee Kim, Jae Hoon Jang, Myungji Shin, Gu-Hee Jung Journal of the Korean Fracture Society.2019; 32(4): 240. CrossRef
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.
Clavicle fractures are very common injuries in adults and children and the majority of these fractures occur in the midshaft. Traditionally, mid-clavicle fractures have been treated with conservative methods and the clinical outcomes of this method are believed to be excellent. On the other hand, recent studies have shown that the clinical results of severe comminuted or markedly displaced fractures after conservative management were not as favorable as previously described. Despite these concerns, the conservative treatment of mid-clavicle fractures is still an efficient method, which can be applied to all patients as a primary care. This review focuses on the proper indication, technique, and limitations of conservative treatment of mid-clavicle fractures.
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Two Patients Who Were Hospitalized for Clavicle Fracture Caused by a Traffic Accident and Improved with Korean Medicine Complex Treatment Deok Kang, ByungSoo Kang, Hwe-Joon Jeong, Dong-Hoon Shin, Kyung-Moon Shin, Ji-Hoon O, Jae-Woo Yang Journal of Korean Medicine Rehabilitation.2022; 32(3): 179. CrossRef
A proximal humeral fracture is an osteoporotic fracture that often occurs in elderly women. Approximately 80% of all proximal humeral fractures are non-displaced fractures, which can be treated with conservative treatment to achieve stable union. The treatment plan for fractures involving displaced and comminuted fractures is controversial. Malunion, avascular necrosis of the humeral head, and shoulder stiffness due to conservative treatment can occur but the functional deterioration is low and the patient satisfaction is high. The indications for the conservative management of proximal humeral fractures include a non-displaced fracture and a 2-part fracture, low-functional demanded 3-part fracture, and operative-limited 4-part fracture. Recently, the surgical indications have expanded as technological advances in surgical fixation methods and functional needs of elderly patients are increasing. Current treatment policy decisions tend to be determined by the personal preference and expert opinion rather than by evidence-based decision-making.
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The Effect of Postoperative Korean Traditional Medicine for the of Proximal Humeral Fracture: A Case Report Hyun Il Go, Hangyul Choi, Jieun Hong, Nam geun Cho Journal of Acupuncture Research.2019; 36(1): 50. CrossRef