PURPOSE To investigate the effect of defatted safflower seed or matairesinol on spontaneous bone formation in surgically induced bone defects in young rabbits MATERIALS AND METHODS: Bone defects(20% of original femoral length) were created at the midshaft of the femur in 52 young rabbits and stabilized with external fixation. The periosteum was preserved. Fifty-two rabbits were divided into four groups as follows; the group I fed on safflower seed powders(30%) and normal diet(70%), the group II on matairesinol (5%) and normal diet(95%), the group III on normal diet(100%) with intravenous injection of matairesinol, the group IV on normal diet(100%). Radiographs were taken weekly to evaluate the bone regeneration and union time. Biomechanical testing on the new bone formation area was performed to measure bending stiffness. The area of new bone formation was scanned by quantitative computed tomography to measure bone mineral density(BMD). RESULT The mean union time(weeks) was 7.2 in the group I, 8.6 in the group II, 8.8 in the group III, and 8.5 in the group IV and was significantly different between the group I and the other groups(p<0.05). The BMD and bone strength of the callus were compared between the group I and the group IV. The mean BMD was 310.45 +/-49.58 g/mm2 in the group I and 291.16 +/-55.79 g/mm2 in the group and there was significant difference(p<0.05). The mean bending stiffness was 415.33 +/-137.18 N/mm in the group I and 358.75 +/-107.32 N/mm in the group IV and there was significant difference(p<0.05). CONCLUSION The diet with safflower seed powder was effective for decreasing union time and increasing bone strength of the callus formed at the bone defect whereas the diet or injection with matairesinol was not effective. More experimental studies are necessary to prove the effect of matairesinol on the callus.
PURPOSE Many authors have supported open reduction and internal fixation of type II distal clavicle fractures because of high rates of nonunion and delayed union after conservative treatment. Authors analyzed thirty-nine cases of type II distal clavicle fractures which had been treated operatively and reviewed the result of operative treatment retrospectively. MATERIALS AND METHODS We evaluated 39 unstable distal 1/3 clavicular fractures with operative treatment from May 1992 to December 1999 and followed up for at least 1 year. According to the classification of Rockwood, type IIa was 28cases and IIb was 11 cases. We treated all the cases by open reduction, such as transacromial pin fixation in 27 cases, and plate and screws with or without bone graft in 12 cases. The operative method was chosen in operative field. RESULT We analyzed the results in term of the time to radiologic union, functional evaluation, and complications. Average time to union was 8.5 weeks in the cases of transacromial pin fixation and 12.7 weeks in the cases using plate and screws with or without bone graft. Functional results was evaluated by classification of functional results by Kona et al. In cases of transacromial pin fixation, excellent result was 13 cases and good was 14 cases. In cases of plate and screws, excellent result was 4 cases, good 6 cases, fair 1 case, and poor was 1 case. The complications of transacromial pin fixation were 4 cases of pin site infection and 1 case of pin migration. But, neither nonunion nor deep infection was appeared. The complication of plate and screws was 2 cases of metal failure in which were fixated by only two cortical screws on distal fragment. CONCLUSION We concluded that minimal open reduction and transacromial pin fixation is thought to be good method in treatment of distal 1/3 clavicular fracture in regard to the time to union, functional results, and complications.
OBJECTIVES The purpose of this study was to identify the biomechanical effect of periarticular half pin in the hybrid external fixator. METHODS Simulated tibial plateau fractures were created using a polyvinylchloride pipe. Seven frame configurations were tested : a four-ring Ilizarov frame, a hybrid frame with three wires on peri-articular fragment, hybrid frames with wires and half pins on peri-articular fragment by four different configurations, a hybrid frame constructed with multiple levels of fixation in the periarticular fragment. A materials testing machine was used to apply pure compression, anterior and posterior bending, medial and lateral bending, and torsion. Stiffness values were calculated from the load deformation and torque angle curves RESULTS: The overall stiffness of the hybrid frame was increased up to 30% by replacing a coronal tension wire with a half pin placed on the sagittal plane. The hybrid frame constructed with two wires and a half pin on the sagittal plane of the periarticular fragment showed overall stiffness compatible with that of multi-level peri-articular fixation frame. CONCLUSION Our results show that the half pin placed on the periarticular fragment can be a effective tool to increase the stiffness of hybrid external fixators in this periarticular tibia fracture model.
PURPOSE Percutaneous vertebroplasty is the procedure of bone cement injection and allogenous bone graft for pain relief in case of compression fracture, hemangioma etc. Recently, osteoporotic compression fracture increases as the old age increase. We analyzed the postoperative clinical symptoms and radiologic findings. MATERIALS AND METHODS From Jan. 2000 to Apr. 2001, we have analyzed 111 osteoporotic compression fractures(59 patients) at Kangneung hospital. Before the procedure, we checked BMD, bone scan and CT. Most common fracture site was the thoracolumbar junction area. Fluoroscopic control was necessary for the cement injection to prevent cement leakage. The amount of cement injection was 4.7ml. We have studied the increase of vertebral body height, symptom recovery time & pain relief, postoperative complications. RESULT The vertebral body height was increased from 55.5% to 70.3% postoperatively and the symptom was improved in 48 persons at POD 1, 3 persons at postoperative 2 weeks, and 4 persons at postoperative 2 months. Most common complication was cement leakage to the epidural vessel, disc space, and spinal canal. But serious complication-spinal canal leakage- was only 1 case and had been improved after decompression. CONCLUSION Percutaneous vertebroplasty with bone cement(PMMA) is effective treatment in osteoporotic compression fracture, especially in pain relief.
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PURPOSE To evaluate causes, treatment methods, outcomes and usefulness of external fixator after we have treated patients with proximal tibial nonunion successfully using external fixator. MATERIALS AND METHODS We treated the 10 patients with proximal tibial nonunion between December, 1991 and December, 2000. Mean follow-up period was 18.5 months. We analyzed numbers of operations, operative methods and causes of nonunion, and rated bony and functional results according to Paley's classification. RESULTS The causes of nonunion were infection in 6 cases, insecure fixation in 4 cases. Bony union was achieved in all 10 cases. The mean time of union was 12.9 months. Complications were developed in 8 cases. Pin site infection occurred in 7 cases, pain in 8 cases, joint stiffness in 2 cases, angular deformity in 2 cases. Functional results were excellent in one, good in four, fair in three, poor in two. CONCLUSIONS We concluded that external fixation method using external fixator such as Ilizarov in treating nonunion of proximal tibia was very useful because of offering advantages of bony shortening and compression, bony lengthening, bone grafting and early weight bearing in patient with infected nonunion and bone defect with many complications
PURPOSE To evaluate the efficacy of dynamization of static interlocking intramedullary nailing as a trial leading to bony union of femur shaft fracture, delayed union of femur shaft fracture underwent dynamization were investigated.
MATERIALS & METHODS: Between april 1995 and December 2000, 162 patients were treated static interlocking intramedullary nailing, 14 patients were selected who had underwent dynamization. The average age was 39 years old (range 24 to 61), they were 11 men and 3 women. The type of fractures were two communited, seven segmental and five simple fractures. Dynamization were done by removal of proximal or distal interlocking screw. We defined complete bony union as radiological and clinical bony union. Also we measured leg length discrepancy and angulation by radiologic parameters. RESULTS Of the 14 patients who showed delayed union, 7 patients were noted successful bony union by dynamization, and of the 7 patients who failed union by dynamization, 6 patients were noted bony union by supportive operative treatments(bone graft : 4 patients, nail exchanging : 1 patient, both method 1 patient). One patient was seen nonunion state because of patient's refusal of treatment. 7 patients who were noted successful bony union by dynamization had 2 degrees~6 degrees(average 4.14 degrees) varus-valgus angulation and 4 degrees~9 degrees(average 6 degrees) AP angulation, and 3 of the 7 patients showed leg length discrepancy(LLD) greater than 2 cm. The other 7 patients had 2 degrees~5 degrees(average 3.57 degrees) varus-valgus angulation and 3 degrees~7 degrees(average 5 degrees) AP angulation, and 2 of the 7 patients showed LLD greater than 2cm. Of the 14 patients, 5 patients showed limping. CONCLUSION Dynamization of intramedullary nainling is a simple and valuable method for improving bony union of femur shaft fracture in the case of delayed union. But if the delayed unions are seen due to large bone defect, supportive operative treatments (bone graft, nail exchanging etc.) to avoid significant complica-tion(shortening and angulation) is needed.
PURPOSE The purpose is to analyze the efficacy of the MR images in the diagnosis and the treatment of the tibial plateau fracture, by comparing the amount of depression in the plain radiograph and in the MR images. MATERIALS AND METHODS Both the MRI and the plain radiograph were performed in 14 patients from 1997 to March 2001. The Schatzker-fracture type and the amount of joint depression were measured and compared in the plain radiograph and the MR images. RESULT In the Schatzker's classification, both type I and II were largest in number. The average amount of joint depression was measured as 1.8 mm by plain radiograph and 5.5 mm by MRI, so the difference was measured as 3.7 mm. CONCLUSION In some cases the joint depressions were more than 3 mm by measuring in the MRI, even though the amount of joint depressions were much less by measuring in the plain radiograph. After measuring with MRI, the indication of the surgery may be expanded. In conclusion, as MRI in the tibial palteau fractures can give precise information of the amount and the position, it may help the prediction of the surgical indication and prognosis.
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Investigation Records of Each Tools Including ‘Nine Classical Acupuncture’ in Korean Classical Historical Books and Medical Books: A Study Based on an Electronic Database in Korea Hongmin Chu, Jaehoon Choi, Hyocheong Chae, Joohyun Lee, Myungseok Ryu Journal of Korean Medical Society of Acupotomology.2022; 6(1): 8. CrossRef
PURPOSE To compare the clinical results between interlocking IM nailing and LC-DCP fixation in the treatment of distal tibial shaft fracture. MATERIALS AND METHODS From August 1998 to August 2001, 23 patients were treated by interlocking IM nail and 15 patients were treated by LC-DCP for distal tibial shaft fracture. RESULTS Accoding to Robinson classification, there were 12 type 1 fractures (52.1%) and 11 type 2a fractures (47.8%) in the interlocking IM nailing group, and 4 type 1 fractures (26.7%), 8 type 2a fractures (53.4%) and 3 type 2c fractures (20.07%) in the LC-DCP fixation group. The average time to bony union was 16 weeks in the patients treated with interlocking IM nail and 12 weeks in the patients treated with LC-DCP. In the functional outcome (according to Klemm and Borner), 18 patients treated (78.2%) with interlocking IM nail showed satisfactory results and 13 patients (86.6%) treated with LC-DCP had satisfactory results. CONCLUSION We concluded that more satisfactory results could be obtained with LC-DCP fixation compared with interlocking IM nailing in the treatment of the distal tibial fracture.
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A Comparison of the Results between Intramedullary Nailing and Minimally Invasive Plate Osteosynthesis in Distal Tibia Fractures Chul-Hyun Park, Chi-Bum Choi, Bum-Jin Shim, Dong-Chul Lee, Oog-Jin Shon Journal of the Korean Orthopaedic Association.2014; 49(4): 285. CrossRef
Comparative Study Using of Treatment with Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Interlocking Intramedullary Nailing in Distal Tibia Fractures Chang Hwa Hong, Jong Seok Park, Sang Seon Lee, Soo Ik Awe, Woo Jong Kim, Ki Jin Jung Journal of the Korean Fracture Society.2010; 23(3): 296. CrossRef
A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures Kee-Byung Lee, Si-Young Song, Duek-Joo Kwon, Yong-Beom Lee, Nam-Kyou Rhee, Jun-Ha Choi Journal of the Korean Fracture Society.2008; 21(4): 286. CrossRef
Comparative Study of Intramedullary Nailing and Plate for Metaphyseal Fractures of the Distal Tibia Hoon Jeong, Jae-Doo Yoo, Young-Do Koh, Hoon-Sang Sohn Journal of the Korean Fracture Society.2007; 20(2): 154. CrossRef
PURPOSE The effects of ultrasound on mechanical properties of the callus in distraction osteogenesis was assessed in this study.
MATERIAL AND METHOD: Forty mature New Zealand white rabbits were divided into two groups (ultrasound group and control group). A midshaft femoral osteotomy was made and fixed with a small external fixator. After a latent period of a week, lengthening was performed at the rate of 1mm a day for 2 weeks. Low intensity ultrasound (EXOGEN inc, Piscataway, NJ U.S.A) was applied to the operated limb for 20 minutes a day in the ultrasound group, while the control group waited for natural maturation of the callus. The bone mineral density and mechanical properties such as ultimate load, ultimate stress, deflection at ultimate load, ultimate stiffness and energy absorption at ultimate load were measured and analyzed. RESULT The bone mineral density, the area of the callus, ultimate load, ultimate stress and energy absorption at ultimate load were not significantly different between the two groups (p>0.05). The ultimate stiffness in the ultrasound group was significantly higher than those of the control group (p<0.01). The deflection at ultimate load in the ultrasound group was significantly lower than those of the control group (p<0.01). CONCLUSION The low density ultrasound has a positive effect on the mechanical properties of the distracted callus in the rabbit femoral model in terms of the ultimate stiffness and the deflection at ultimate load.
PURPOSE Treatment of supracondylar fracture of the distal femur is challenging because of its characteristic anatomy and common occurrence of severe comminution. We evaluated the clinical results of 15 cases of AO type C supracondylar fracture. MATERIALS AND METHODS From December 1990 to November 1999, fifteen of 27 cases of AO type C supracondylar fracture of the distal femur were treated operatively. Mean follow-up period was one year and 5 months (range, 1 year-3 years and 3 months). The mean age of patients was 43.6 years. Eleven cases were treated by internal fixation and four cases by Ilizarov. Clinical results were evaluated by Schatzker and Lambert criteria. RESULT There were 5 excellent, 4 good, 1 fair and 1 poor results (81% satisfactory) in 11 cases treated by internal fixation and 1 excellent, 2 good, 1 fair results (75% satisfactory) in 4 cases treated by external fixation.
COCLUSION: To get satisfactory results, AO type C supracondylar fracture of the distal femur need to be reduced anatomically and require rigid internal fixation. External fixation using Ilizarov can be an effective method of treatment in cases of open fracture and severe comminution with osteoporosis.
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Surgical Treatment of AO Type C Distal Femoral Fractures Using Locking Compression Plate (LCP-DF, Synthes®) Kap-Jung Kim, Sang Ki Lee, Won-Sik Choy, Won-Cho Kwon, Do Hyun Lee Journal of the Korean Fracture Society.2010; 23(1): 20. CrossRef
PURPOSE This is a retrospective study to analyze the functional results of closed reduction and percutaneous fixation of displaced unstable proximal humerus fractures. MATERIALS AND METHODS We report 23 patients, 20 with 2-part and 3 with 3-part proximal humerus fractures that can be reduced closed but remain unstable in which percutaneous fixation was performed. The fixation methods were multiple pinning in 10, multiple cannulated screw fixation in 8, Rush pin fixation in 3 and Rush pin combined with other methods in 2. The functional rusults were analyzed with Neer,scriteria. RESULTS The functional rusults were excellent in 14, satisfactory in 4 and unsatisfactory in 5. No significant difference was not noted in the long term follow-up results according to the fixation methods but Rush pin resulted in impingement and displacement of greater tuberosity. CONCLUSION Closed reduction and percutaneous fixation is a useful alternative to open reduction and internal fixation for the displaced 2-part or 3-part proximal humerus fractures that can be reduced closed but remain unstable.
PURPOSE We retrospectively reviewed the outcomes and efficacy of the percutaneous plate osteosynthesis for the distal tibia metaphyseal fracture. MATERIALS AND METHODS Twenty-one patients suffering from fractures of the distal tibial metaphysis, with or without minimally displaced extension into the ankle joint, were treated by percutaneous plate osteosynthesis with narrow LC-DCP. According to the AO/OTA classification, 17 fractures had no articular involvement (A1=8, A2=6, A3=3) while 4 included intraarticlar extension (C1=4). RESULTS At the final follow-ups(mean=20months), all the fractures healed without second procedures and the mean union time was 15.2 weeks. Only one patient had a malunion of rotational deformity due to inadequate prebending of plate, but there were no angular deformities over 5 degrees nor any shortenings of more than 1cm. There were no deep infections, nor any soft tissue compromise. Three patients had a partial limitation of ankle motion, but all the patients had excellent or satisfactory ankle function with mean OMA score of 89.1%. CONCLUSION Percutaneous plate osteosynthesis is a safe and worthwhile method of managing distal tibia metaphyseal fracture while avoiding some of the complications associated with conventional open plating methods.
PURPOSE To assess the relationship between the type of hip fracture-dislocation and nerve injury, the relationship between the treatment of hip fracture-dislocation and nerve recovery and the effectiveness of electromyography(EMG)-nerve conduction study(NCV) for the diagnosis of nerve injury and clinical result. MATERIALS AND METHODS We reviewed 8 cases associated with nerve injury of 52 cases which were diagnosed and treated for hip fracture-dislocation from March 1993 to December 1999 with an average follow up period 18.1 months. Mean age was 36.1 years. We assessed the diagnosis of nerve injury through physical exam at emergency room and follow up EMG-NCV. The clinical results of nerve recovery were evaluated according to the Clawson-Seddon classification. RESULT The cause of injury was motor vehicle accident in all cases. The outcome of the nerve injury was analyzed as 4 complete recovery, 3 partial recovery, 1 no recovery for 31 months follow up. The clinical result was analyzed as 7 satisfactory and 1 unsatisfactory. The latter was complete sciatic nerve injury, seemed to be recovered at follow up EMG-NCV but unsatisfactory for clinical result. CONCLUSION The nerve injury of the posterior hip fracture-dislocation was not rare and the rate of nerve injury was relatively good. The limitation as a clinical outcome was revealed in the EMG-NCV because one case which seemed to be recovered at follow up EMG-NCV was unsatisfactory for clinical result. In future, we think to require non-invasive, more reliable method for the diagnosis and follow up of the nerve injury and the study of the factor, can improve the nerve recovery.
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Traumatic Bilateral Anterior Hip Dislocation: A Case Report Sung-Taek Jung, Hyun-Jong Kim, Myung-Sun Kim, Young-Jin Kim, Sang-Kwan Cho Journal of the Korean Fracture Society.2008; 21(1): 62. CrossRef
PURPOSE To investigate the relationship between the complications of intracapsular femoral neck fractures treated by multiple pinning and several affecting factors. MATERIALS AND METHODS Sixty-eight patients with intracapsular femoral neck fractures were treated by multiple pinning from March 1993 to January 2000 and followed at more than one year. Relationship between the complications such as failure of union, collapse of femoral head due to osteonecrosis of femoral head and several affecting factors including displacement of fracture according to Garden stage, state of reduction, position of screws, time interval from injury to operation, and fracture level were analyzed. The Fisher exact test, chi-square test, and multivariate logistic regression analysis were used to find the relevant factors influencing incidence of complications. Statistical significance was set at p < 0.05. RESULTS Position of screw was the most important single factor affecting the results of treatment of intracapsular femoral neck fracture (p=0.046). Moreover, the Garden stage and position of screw were revealed affecting the incidence of complications together with other factors (each p value was 0.028 and 0.027). CONCLUSION We considered that satisfactory position of screw was important to reduce complications after multiple pinning for intracapsular femoral neck fracture. And the results of operation also seemed to closely relate with multiple factors including Garden stage and status of reduction.
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Factors Predicting Complications after Internal Fixation of Femoral Neck Fractures Tae-Ho Kim, Jong-Oh Kim, Sung-Sik Kang Journal of the Korean Fracture Society.2009; 22(2): 79. CrossRef
PURPOSE The purpose of this article is to evaluate the factors affecting clinical result after surgical treatment of ankle fracture. We evaluate the radiologic features of initial, post-operative and last follow up ankle anteroposterior view. MATERIALS AND METHODS From Feb. 1997 to Jan. 2000, we operated 58 cases of ankle fractures involving bimalleolar and lateral malleolar area. 35 cases which were followed more than one year were enrolled into the study. We evaluated the clinical results according to radiologic features such as lateral displacement, height difference between both malleoli, mortise width, talar tilt and joint space width. RESULTS According to Olerud Moland Ankle score, 16 cases(46%) had excellent result and 9 cases(26%) had good result. Radiologically the average initial lateral displacement, height difference, mortise width in the group which had good and excellent results were 1.64mm, 8.85mm, 0.49 and that in the group of fair and poor result were 1.5mm, 10.57mm, 0.48, respectively.(P>0.05) CONCLUSION: The relationship between clinical result and radiologic features in the ankle bimalleolar and lateral malleolar fractures were not proved statistically. However, the tendency of affecting good clinical results which had malleolar height correction was seen.
PURPOSE The purpose of this study is to analyze the clinical and radiographic prognostic factors which may affect the postoperative clinical results of the unstable ankle fractures. MATERIALS AND METHODS This study is based on 75 unstable ankle fractures treated by open reduction and internal fixation from May 1994 to August 2000, with a minimum follow-up period of 12 months(range : 13 months-7 years 3 months). The 75 patients were average 40.5 years old with male: female ratio of 52:23. Based on Lauge-Hansen classification, the supination-external rotation type was the most common with 42 (56.0%) cases. The clinical results was assessed by American Orthopaedic Foot and Ankle Society(AOFAS) functional scale. The sex, age, side of injury, body weight, trauma-operation interval, operation time, cause of injury as the possible postoperative clinical prognostic factors and fracture type, anatomical reduction of fracture, preoperative medial clear space, postoperative medial clear space, talo-crural angle, talar tilt, tibio-fibular clear space, tibio-fibular overlap space as the possible radiographic prognostic factor were statistically analyzed RESULT: Postoperative AOFAS functional scale was average 81.0 points with 23(30.7%) cases excellent, 17(22.7%) good, 18(24.0%) fair and 17(22.7%) cases poor results. The age, the operation time(p<0.001) and the anatomical reduction of fracture(p<0.005) were found to be statistically significant factors affecting the prognosis. The other clinical and radiographic factors did not significantly affect the clinical results. CONCLUSION The surgically treated unstable ankle fractures in patients whose age was above 41 years old or operation time exceeding 90 minutes or unsatisfied anatomical reduction of fractures showed significantly poor clinical results.
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Analysis of Bone Mineral Density of Ankle Fracture Patients Tae Hyung Kim, Jae Hyung Lee, Seung-Hwan Park Journal of the Korean Orthopaedic Association.2021; 56(4): 334. CrossRef
PURPOSE The purpose of this study was to investigate the efficacy of bone graft use in the treatment of displaced intra-articular calcaneal fractures. MATERIALS AND METHODS We analysed retrospectively 40 displaced intra-articular calcaneal fractures, which had undergone open reduction and internal fixation without bone graft from June 1989 to July 1998. Radiological assessments were made from the lateral view of the affected calcaneus, recording the Bohler angle, the Gissane angle and ratio of height/width of the calcaneus. Matching criteria included Essex-Lopresti classification, method of fixation, age, and sex. RESULT The mean preoperative Bohler angle was -7 degrees(standard deviation [S D ] 1 8 degrees), postoperative Bohler angle was 21 degrees(SD 7 degrees), last follow-up Bohler angle was 1 9 degrees(SD 7 degrees). Bohler angle increased a mean 28 degrees(maximum 70 degrees, minimum 2 degrees). The preoperative Gissane angle was 104 degrees(SD 17.87 degrees), postoperative Gissane angle was 1 0 6 . 2 degrees(SD 10.07 degrees), last follow-up Gissane angle was 104.48 degrees(SD 10.1 degrees). The preoperative ratio of height/width of the calcaneus was 0.568(SD 0.076), postoperative ratio was 0.637(SD 0.037), last follow-up ratio was 0.648(SD 0.038). There was no significant differences in fracture pattern, method of fixation, age, and sex(P>0.05). CONCLUSION The result of this study showed that there was no significant change in serial radiologic evaluation. Bone graft was not served to the effectiveness or security in the treatment of displaced intra-articular calcaneal fractures.
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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
PURPOSE We tried to compare the results of Ilizarov external fixation cases with the cases of secondary intramedullary nailing after tempory Ilizarov fixation. MATERIALS AND METHODS From the January 1996 to February 2001 , 34 cases of severe open tibial shaft fracture in adults were treated with Ilizarov external fixation and secondary intramedullary nailing after temporary Ilizarov fixation. According to Gustilo- Anderson classification, it consisted of type II 2 ,IIIA 7 ,IIIB 9 ,IIIC 2cases in Ilizarov group ,and type II 2, IIIA 7, IIIB 5cases in secondary intramedullary nailing group. RESULT There was no significant difference in the union time of Ilizarov external fixation and secondary intramedullary nailing after temporary Ilizarov fixation. But the secondary nailed group had slightly better motion , less final angulation and felt more comfortable . It is the treatment preferred by patients and does not require the same high level of patient compliance as external fixation. CONCLUSION Secondary intramedullary nailing after temporary Ilizarov fixation is the useful method in the treatment of open fractures of tibia.
PURPOSE To evaluate the advantages of fixation of metaphysis by minimally invasive plate osteosynthesis(MIPO) technique for comminuted fractures of the proximal tibia.
MATERIALS & METHODS: from January 1997 to February 2000, 18 cases of comminuted fracture of the proximal tibia were treated using MIPO technique. Operation time, union time, radiologic alignment, range of motion of the knee joint, functional and anatomical results according to Rassmusen's grading criteria, complications were evaluated. Minimal follow-up time was 12 months. RESULTS Operation time was average 51 minutes (30-80 minutes). Time to bone healing was average 10.6 weeks (9-14 weeks) There was 1 case of valgus angular deformity greater than 5 degrees. 6 cases in acceptable bony alignment less than valgus 5 degrees and 11 cases were classified into normal bony alignment. Range of motion of the knee joint was 0-140 degrees in 13 cases, 0-120 degrees in 3 cases, 0-90 degrees in 1 case, 10-90 degrees in 1 case. Rasmussen's grading criteria for functional outcome revealed there were 14 cases(77.8%) excellent results, 4 cases(22.2%) good result. and grading criteria for anatomical outcome revealed there were 7 cases(38.9%) excellent results, 11 cases(61.1%) good result. CONCLUSION MIPO technique for comminuted fracture of the proximal tibia seems to be a good techinque to obtain more rapid bony union with less complication.
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Treatment of Proximal Tibia Fractures Using LCP by MIPO Technique Sang-Ho Ha, Dong-Hui Kim, Jun-Young Lee Journal of the Korean Fracture Society.2010; 23(1): 34. CrossRef
PURPOSE To evaluate the effectiveness of operative treatment in distal radius fracture with distal radioulnar joint injury.
MATERIAL AND METHOD: From January 1992 to January 2000, 66 cases of distal radius fracture with distal radioulnar joint injury who had been treated with conservative or operative methods were analyzed the final state of radius articular surface and distal radioulnar joint. RESULT In operatively treated cases(42 cases), the average of volar tilt was 3.74 degrees, ulnar inclination 21.9 degrees, radial length 9.74mm. In conservatively treated cases(24 cases), The average of volar tilt was 1.75 degrees, ulnar inclination 15.1 degrees, radial length 7.67mm. The state of distal radioulnar joints were as follows; In operatively treated cases, anatomical reduction 37(88%), joint widening 5, In conservatively treated cases, anatomical reduction 17(70%), joint widening or ulnar impingement syndrome 7. CONCLUSION In treatment of distal radius fracture with distal radioulnar injury, operative treatment is probably more effective in restoration of radius articular surface and distal radioulnar joint healing.
PURPOSE In the treatment of an unstable intraarticular distal radius fracture, we report the result of a retrospective study of reduction maintaining effect of external fixation. MATERIALS AND METHODS During the period from May 1996 to May 1999, 19 patients 20 cases with AO type C2, C3 distal radius fracture were treated by external fixation and followed-up for 2 years or longer. Six had AO type C2 fracture, and fourteen type C3. We evaluated immediate postoperative & follow-up radiological evaluation by volar tilt, radial inclination, radial length difference. As combined treatment, additional reduction maintaining effect of bone graft or internal fixation was evaluated also. RESULT Mean reduction loss of 2 years or longer follow-up after external fixation was volar tilt 7.2 degrees, radial inclination 4.3 degrees, radial length 3.1 mm. As additional reduction maintaining effect, internal fixation had statistically significant effect(p <0.05)-especially radial length maintenance, but bone graft not significant. CONCLUSIONS In unstable intraarticular distal radius fracture, after open reduction or bone graft etc. for intraarticular anatomic reduction, we consider external fixation or combined internal fixation for reduction maintenance.
PURPOSE To investigate the effect of bone connecting powder on stimulation of bone healing, we performed a biomechenical study using the rats in double blinded method. MATERIALS AND METHODS One hundred ten-week-old korean rats were used. We performed closed intramedullary nailing with #2 Kirschner wire on the right femur and then transverse fracture was created on the right femoral shaft. The rats were divided into two groups in double blind method, one group was bone connecting powder feeding group and the other was placebo group. The rats were euthenized four weeks after fracture. We measured the ultimate load, stiffness, ultimate stress by 3-point bending test using electromechanical testing machine. The code used for double blinded method was disclosed after biomechanical test. RESULT Biomechenical test was performed at four weeks after fracture, in which there were 38 rats alive in the study group and 36 rats alive in the placebo group. There were 5 nonunion in study group, 7 in placebo group. The ultimate load was 40.77 +/- 28.09N for study group, 32.39 +/-25.10N for placebo group and stiffness was 49.98 +/- 45.32N/mm, 40.52 +/-36.61N/mm respectively. We calculated the ultimate stress to correct the difference from each bone's shape and thickness and it was 11.017 +/- 10.170N/mm 2 , 6.659 +/-6.670N/mm 2 for each other(p=0.041). CONCLUSION On the basis of this biomechenical study, it may be concluded that fracture healing is stimulated by bone connecting powder.
PURPOSE To investigate whether injection of calcium sulfate salt powder could be used to facilitate consolidation of early & fast distraction osteogenesis. MATERIALS AND METHODS Group I was experimental group and Groups II and III were controls. After 3 days of latency period, a small distractor was distracted for a total of 8 mm for 4 days. Calcium sulfate salt powder suspended in carboxymethylcellulose(CMC) solution was injected, whereas CMC media alone was injected in one control group and without intervention in the other control group. Plain radiographs were taken on every weeks. We assesed the bone mineral density(BMD) at 3 and 6 weeks and %BMD was calculated. The rabbits were sacrificed at 6 weeks for histologic examination. RESULTS In radiography, the distracted area was consolidated in the experimental group but not in control groups. The % BMD of the experimental group was significantly greater than that of control groups at 6 weeks(p<0.01). In histologic examination, greater amount of newly formed bone was noted in the distraction zone of the experimental group, compared to two control groups. CONCLUSION Implantation of calcium sulfate powder can accelerate consolidation in distraction osteogenesis in rabbits.
PURPOSE The purpose of this study is to evaluate the results of treatment of comminuted femoral trochanteric fracture using dynamic hip screw(DHS) with trochanteric stabilizing plate(TSP) and DHS only. MATERIALS AND METHODS we analysed retrospectively 32 cases that has fracture extends over two or more levels of medial cortex(A2 of AO classification) and fracture extends through lateral cortex of femur(A3 of AO classicification) of femoral trochanteric fractures between 1997 and 2000. On simple AP radiograph of the DHS with TSP(n=16) and DHS only group(n=16), we reviewed bony union, slippage of lag screw, lateral displacement of greater trochanter. RESULT Bony union was observed in all cases. When bony union is done in follow up radiograph, Mean slippage of lag screw is 14.5mm in DHS only group, 12.6mm in DHS with TSP group and mean lateral displacement of greater trochanter is 9.8mm in DHS only group, 1.2mm in DHS with TSP group. CONCLUSION Use of DHS with TSP in comminuted femoral trochanteric fracture is lesser slippage of lag screw and lateral displacement of greater trochanter than DHS only used, and that is better method to maintain fracture reduction and internal fixation in treatment of comminuted femoral trochanteric fractures than DHS only.
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Results of Use of Compression Hip Screw with Trochanter Stabilizing Plate for Reverse Oblique Intertrochanteric Fracture Byung-Woo Min, Kyung-Jae Lee, Gyo-Wook Kim, Ki-Cheor Bae, Si-Wook Lee, Du-Han Kim Journal of the Korean Fracture Society.2014; 27(2): 120. CrossRef
A Comparison of Intramedullary and Extramedullary Fixations for the Treatment of Reverse Oblique or Transverse Intertrochanteric Femoral Fractures Yerl-Bo Sung, Jung-Yun Choi, Eui-Yub Jung Hip & Pelvis.2012; 24(2): 109. CrossRef
INTRODUCTION: Minimally invasive percutaneous plate osteosynthesis(MIPPO) was performed to treat distal tibial shaft fracture, and the results were compared to those of open plate fixation to find appropriate treatments MATERIALS AND METHODS: Among the patients who visited the Orthopedics Department at our hospital and were diagnosed with distal tibial shaft fracture, 12 cases that received MIPPO and 14 cases receiving open plate fixation were chosen for the study. The average age of patients were 57.8 and 50.8 years, and the male:female ratio was 1:1 in both cases. The average post-operative follow up period was 18 months and 19.5 months, and simple X-ray was done to evaluate the fracture healing. RESULTS The cases that received MIPPO, the operation time was 46.5 minutes and the average period of hospitalization was 25.3 days. There were no Nonunion, one case of delayed union, and one case of superficial infection. In the open plate fixation group, was 115.6 minutes and 48.3 days. Nonunion was in two cases, delayed union in two cases, superficial infection in one case, and deep infection in two cases. The nonunion cases were later given autogenous bone graft and fracture healing was attained. CONCLUSION By performing MIPPO quicker recovery of the patient can be made. Infection and nonunion, the most important complications due to operation, can be reduced. MIPPO thus seems to be the method leading to more close physiologic bone fusion in the treatment of distal tibial shaft fracture.
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The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture Seong-Jun Ahn, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Seong-Ho Yoo, Kwan-Taek Oh Journal of the Korean Fracture Society.2013; 26(4): 314. CrossRef
PURPOSE To compare clinical outcomes and complications between pediatric patients with femoral shaft fracture who had undergone conservative treatment and retrograde flexible intramedullary nailing. MATERIALS AND METHODS 51 cases of 46 pediatric patients who had femoral shaft fracture were retrospectively studied. Hip spica cast was applied 3~6 weeks after traction in 24 cases of conservative treatment group and closed reduction and internal fixation with flexible nails were performed in 27 cases. RESULT Neither pain, limitation of joint motion, nor nonunion was reported in both groups. In radiologic evaluation, 4 cases of angulation more than 10 degrees were observed in conservative treatment group and none of surgical treatment group. In leg length discrepancy(LLD) over 10 mm, there was none in surgical treatment group, but 4 cases were seen in the conservative group. Two cases of limping were observed only in the conservative group. Mean time to weight bearing was earlier in surgical treatment group(7.5 weeks) than that in the conservative group(10.8 weeks). CONCLUSION As treatment of pediatric femoral shaft fracture, retrograde flexible intramedullary nailing had less complications such as LLD and angulation and enabled earlier rehabilitation than conservative treatment.
PURPOSE To evalute the anatomical and functional outcome after treatment for proximal humerus fracture according to surgical and conservative treatment and assess the final results according to treatment methods. MATERIALS AND METHODS Forty-two cases with follow-up over 12 months were divided into three groups: conservative treatment (Group 1, 20 cases), closed reduction with Rush or percutaneous pin fixation (Group 2, 11 cases), proximal intramedullary interlocking nailing(Group 3, 11 cases). The functional outcome was obtained by modified neer method using self-assessed score paper and the anatomical outcome was obtained by paavolainen method using radiologic film score. Statistics in comparing with the result of each group was analized by variance analysis using Generalized Liner Model and Fisher?s exact test. RESULT Anatomical reduction was best obtained in group 3 (p< 0.05) and mean duration of bone union was 10.33 weeks. Functional score was also best obtained in group 3 (p<0.05). Complication was noted in 9 cases. There was only 1 case in group 3. In studing of overall outcome, the group 3 has good result than other groups. CONCLUSION Proximal intramedullary interlocking nailing in displaced proximal humerus fracture can be demonstrated as better method for anatomical reduction(p<0.05) than other methods because it can make insertion of locking screw ease with multiple direction for anatomical reduction and can provides a sufficient fixation for early rehabilitation and union , while minimizing complication.
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Does medial support decrease major complications of unstable proximal humerus fractures treated with locking plate? Woo-Bin Jung, Eun-Sun Moon, Sung-Kyu Kim, David Kovacevic, Myung-Sun Kim BMC Musculoskeletal Disorders.2013;[Epub] CrossRef
Comparison of Results between Internal Plate Fixation and Hemiarthroplasty in Comminuted Proximal Humerus Fracture Doo-Sup Kim, Dong-Kyu Lee, Chang-Ho Yi, Jang-Hee Park, Jung-Ho Rah Journal of the Korean Fracture Society.2011; 24(2): 144. CrossRef