PURPOSE To evaluate upper sacral morphology and anatomy of safe zone related to iliosacral screw fixation in Korean. MATERIALS AND METHODS 100 patients performed pelvis 3D CT scan were evaluated. We used 16 channel CT and analyzed reconstructed image (shaded-surface display, transparent image and reformat image). RESULT The angle between superior aspect of S1 body and iliac cortical density is 27.3°, between anterior cortical line of S1,2 body and horizontal plane 24.6°, and between superior aspect of S1 body and horizontal plane is 39.7°. The axis of S1, S2 pedicle is 32.5° and 15.6° toward anteromedial. The area of S1 pedicle according to sagittal plane and sagittal-oblique axis is 310.7 mm2 and 384.8 mm2. Also, S2 pedicle area is increased 163.1 mm2 to 188.4 mm2. The average depth of ala indentation is 5.1 mm and the maximal value is 9.5 mm. Distinct upper sacral dysplasia is 22%, transitional form is 32%. CONCLUSION We measured Korean upper sacrum with 3D-CT, found out dysplasia come up to 54%. Considering the frequency of dysplasia, the investigation of anatomy and technique is essential to sacroiliac screw insertion.
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Percutaneous posterior transiliac plate versus iliosacral screw fixation for posterior fixation of Tile C-type pelvic fractures: a retrospective comparative study Chul-Ho Kim, Jung Jae Kim, Ji Wan Kim BMC Musculoskeletal Disorders.2022;[Epub] CrossRef
Measurement of Optimal Insertion Angle for Iliosacral Screw Fixation Using Three-Dimensional Computed Tomography Scans Jung-Jae Kim, Chul-Young Jung, Jonathan G. Eastman, Hyoung-Keun Oh Clinics in Orthopedic Surgery.2016; 8(2): 133. CrossRef
PURPOSE To evaluate the results of surgical treatment of posterior wall fractures of the acetabulum and to determine the factors affecting the results. MATERIALS AND METHODS Thirty-one posterior wall fractures were reviewed; 7 type A1-1, 19 type A1-2 and 5 type A1-3 by AO classification. Postoperatively, the accuracy of the reduction was evaluated. At the final follow-up, clinical and radiographic results were evaluated with medical records and radiographs. The factors affecting the results were determined. RESULTS The reduction was graded as anatomical in 22 patients, imperfect in seven and poor in two. The clinical result was excellent in 21 hips, good in six, fair in three and poor in one. The quality of the reduction was strongly associated with the clinical result. The radiographic result was excellent in 22 hips, good in five, fair in two and poor in two. The clinical result was related closely to the radiographic result. Complications were osteoarthritis in three patients, osteonecrosis of the femoral head in one, heterotopic ossification in one, penetration of a screw into the joint in one and iatrogenic sciatic nerve injury in one. The factors affecting the clinical results were fracture patterns, the surgeon's experience, the accuracy of the reduction and late complications. CONCLUSION In this present series of posterior wall fractures, as their prognosis depends on the severity of the injury and the accuracy of the reduction, satisfactory result can be obtained by anatomical reduction with thorough preoperative planning and the surgeon's experience.
PURPOSE To evaluate the results after fixation with figure of eight and cerclage wiring for comminuted trochanteric fracture. Because comminution of the femoral trochanteric fracture in elderly patients is severer in the operating field than x-ray findings, so the fixation is more difficult. MATERIALS AND METHODS Between March 1998 and March 2004, the clinical records on twenty-eight patients more than 70 years old who underwent the bipolar hemiarthroplaty using calcar replacement type of femoral stem and followed more than 24 months were reviewed. Figure of eight and cerclage wiring was used for the comminuted trochanteric fracture of the femoral intertrochanteric fracture. The mean age was 80.4 (70~103) years. 19 cases were female, 9 cases were male. Mean follow-up period was 58 (24~92) months. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, radiologic findings and union of the fracture. RESULTS The mean duration of bony union was 12 weeks. The mean postoperative modified Harris hip score was 82.3. Preoperative walking ability was recovered in 23 cases (82%). Also basic activity of daily living was recovered in 22 cases (79%). Nonunion of trochanter was found in only one case by radiologic evaluation but clinical correlation was not significant. CONCLUSION We consider fixation with figure of eight and cerclage wiring for unstable intertrochanteric fracture of femur in the elderly patient is more appropriate in terms of convenience of fixation, duration of union, early ambulation and cost effectiveness.
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Outcomes of dynamic hip screw augmented with trochanteric wiring for treatment of unstable type A2 intertrochanteric femur fractures Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam Injury.2017; 48: S72. CrossRef
Fixation of Greater Trochanter Using an AO Trochanteric Reattachment Device (AO TRD) in Arthroplasty for Intertrochanteric Femur Fracture of Elderly Patients Weon-Yoo Kim, Young-Yul Kim, Jae-Jung Jeong, Do-Joon Kang Hip & Pelvis.2013; 25(4): 274. CrossRef
Bipolar Hemiarthroplasty Using the Greater Trochanter Reattachment Device (GTRD) for Comminuted Intertrochanteric Femur Fracture in Elderly Patients Jin-Wan Kim, Young-Chul Ko, Chul-Young Jung, Il-Soo Eun, Hyeon-Soo Choi, Ok-Gul Kim, Young-June Kim Journal of the Korean Fracture Society.2009; 22(4): 232. CrossRef
PURPOSE To compare retrospectively the antegrade and retrograde nailing in the management of ipsilateral femoral neck and shaft fractures. MATERIALS AND METHODS Thirty-two patients (thirty-three injuries) were included in this study. Mean age of patients was 38 years-old in the antegrade nailing group (16 injuries) and 44 years-old in the retrograde nailing group (17 injuries). We compared the union of fractures and complications between two groups, and investigated the influencing factors. RESULTS Femoral shaft fracture was united in 10 cases (63%) of antegrade group and 12 cases (71%) of retrograde group, at 28.2 and 27.3 weeks respectively. Nonunion was more prevalent in Winquist-Hansen III and IV (5 in antegrade nailing, 3 in retrograde nailing) than I and II. Femoral neck fracture was united with 1 case of nonunion in each group. Nonunion developed from Garden stage IV, but fractures of Garden stage I and II united regardless of methods. CONCLUSION In ipsilateral femoral neck and shaft fractures, the kinds of methods did not affect the results of shaft fractures. Minimally displaced neck fractures also were not influenced by kinds of methods, but retrograde nailing may have a benefit in fixing the displaced neck fractures
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Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants J. D. Cnossen, Esther M. M. Van Lieshout, Michael H. J. Verhofstad Archives of Orthopaedic and Trauma Surgery.2023; 143(10): 6229. CrossRef
Retrograde Intramedullary Nailing or the Treatment of Segmental Femoral Shaft Fracture Including Distal Part Jong-Ho Yoon, Byung-Woo Ahn, Chong-Kwan Kim, Jin-Woo Jin, Ji-Hoon Lee, Hyun-Ku Cho, Joo-Hyun Lee Journal of the Korean Fracture Society.2009; 22(3): 145. CrossRef
The Treatment of IM Nailing of Femoral Shaft Fracture: Piriformis Fossa versus Trochanteric Entry Portal Hyun Kook Youn, Oog Jin Shon, Dong Sung Han Journal of the Korean Fracture Society.2008; 21(3): 200. CrossRef
PURPOSE To analyze the causes and the clinical results of treatment for the nonunion of femur shaft fractures that occurred after interlocking intramedullary nail fixation. MATERIALS AND METHODS We reviewed 19 cases of aseptic nonunion of femur shaft fracture in 174 patients after interlocking IM nailing from March 1999 to February 2004 and followed up for more than one year. First we investigated the factors causing nonunion. For operative options, two methods about exchange nailing and exchange nailing with bone graft were performed. Finally clinical results were analyzed with bone union rate by treatment methods and compared with the nonunion factors statistically. RESULTS According to the causes and types of nonunion, we performed larger IM nail change in 10 cases and IM nail change with bone graft in 9 cases. Bone union was achieved in all cases. Average bone union period were 18.5 weeks in exchange group and 16.1 weeks in exchange with bone graft group. There are significant difference between treatment methods statistically (p<0.05). Compared with the nonunion factors, initial open fracture and smoking groups showed late union rate statistically. CONCLUSION Based on our analysis, IM nail change is a useful method for nonunion after initial IM nailing in femoral shaft fracture, and additional bone graft that according to the radiologic pattern and stability, especially the fracture gap is also a useful option for nonunion treatment.
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Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing Suenghwan Jo, Gwang Chul Lee, Sang Hong Lee, Jun Young Lee, Dong Hwi Kim, Sung Hae Park, Young Min Cho Journal of the Korean Fracture Society.2019; 32(2): 83. CrossRef
Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef
Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture Sang Ho Ha, Jun Young Lee, Sang Hong Lee, Sung Hwan Jo, Jae Cheul Yu Journal of the Korean Fracture Society.2009; 22(4): 225. CrossRef
PURPOSE To assess the indication and effect of screw fixation in the transverse patellar fractures. MATERIALS AND METHODS We analysed the results of 14 transverse patellar fractures fixed with screws from January 1991 to May 2005. Mean follow-up period was 47 months (range, 12~143 months). We analysed the radiologic union, operation time, ROM and postoperative Lysholm score. RESULTS All fractures healed uneventfully. The mean displacement was decreased from 2.2 mm preoperatively to 0.3 mm postoperatively (p=0.001, Wilcoxon signed rank test). The mean operation time was 34 minutes (range, 20 to 60 minutes). Normal range of motion was achieved in 13 knees (92.9%). Average Lysholm score was 95.9 at final follow-up. CONCLUSION Screw fixation seemed to be useful for treatment of transverse patellar fracture even in comminuted fractures with large fragments. The advantage of this technique was the preservation of extensor mechanism, simplicity, short operation time and good cosmesis.
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Surgery of patellar fractures using a medial parapatellar approach Yong-Cheol Yoon, Jae-Ang Sim, Jin-Hun Hong Journal of Orthopaedic Surgery.2017;[Epub] CrossRef
Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef
PURPOSE To compare the radiological and clinical results between intramedullary nailing and plate fixation in the treatment of distal tibial fractures. MATERIALS AND METHODS 19 cases of distal tibial metaphyseal fractures within 4 cm of the ankle joint line were enrolled. Ten patients were treated with interlocking intramedullary nail and the others with plate and screws. RESULTS The mean union time was 14 weeks in nailing group and 16 weeks in plate group. The average angulation in AP view was 4.1 degrees in nailing group and 3.1 degrees in plate group. The average angulation in lateral view was 1.7 degrees in nailing group and 2.7 degrees in plate group. The rotational deformity was 2.8 degrees in nailing group and 1.7 degrees in plate group in average. There was no implant failure and soft tissue problem. CONCLUSION There was no difference in clinical and radiological results between intramedullary nailing and plate in the treatment of the distal tibial fractures and, considering the preservation of the soft tissue, the intramedullary nails are a reliable method for managing distal metaphyseal fractures of the tibia.
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Does a Customized 3D Printing Plate Based on Virtual Reduction Facilitate the Restoration of Original Anatomy in Fractures? Seung-Han Shin, Moo-Sub Kim, Do-Kun Yoon, Jae-Jin Lee, Yang-Guk Chung Journal of Personalized Medicine.2022; 12(6): 927. CrossRef
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
PURPOSE To report the technical experience of posterior plating for the distal fibular fracture. MATERIALS AND METHODS 20 Weber type-B fibular fractures were included in this study, which were treated with the posterior plating. 1/3 semitubular plate was used and orientation of all screws were intended to be perpendicular to the plate as possible. Fixation stability and maintenance of reduction after plating was assessed manually in the operating field. Clinical results were evaluated at least 1 year after operation, using American Orthopaedic Foot and Ankle Society (AFOAS) Ankle-Hindfoot score. RESULTS 5 cases were firmly stabilized without using any lag screw or fixation of distal fragment. For improving stability or achieving proper reduction, a lag screw was placed posteroanteriorly through the plate in 14 cases. Anteroposterior interfragmentary fixation in 1 case before plating, and contouring of the plate in 3 cases were needed in cases of which the posterior plating impeded reduction of distal fibular fracture. In all cases, fracture was stabilized without fixation through the most distal hole. There were no major postoperative complications. AFOAS score was 95.5±5.2. CONCLUSION The posterior plating technique for distal fibular fracture is regarded as a recommendable option. Additional fixation with interfragmentary screw or contouring of the plate, however, would be needed in some cases to achieve anatomical reduction or sufficient stability.
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A Specialized Fibular Locking Plate for Lateral Malleolar Fractures Eui Dong Yeo, Hak Jun Kim, Woo In Cho, Young Koo Lee The Journal of Foot and Ankle Surgery.2015; 54(6): 1067. CrossRef
PURPOSE To evaluate the post-operative functional reduction of the shoulder joint and the impacting factors to post-operative shoulder joint function in interlocking IM nailing treatment of humeral shaft fracture. MATERIALS AND METHODS From April 1999 to August 2004, 35 patients (35 cases) whom admitted to hospital for humeral shaft fracture and treated using interlocking intramedullary nail were followed up for more than 1 year. 1 year post-operative shoulder joint function were evaluated using American Shoulder Elbow Surgery Scale (ASES). Pre-operative shoulder joint pain, radiologically degenerative change and extent of nail protrusion were evaluated, and each factor was correlated with function of the shoulder joint. RESULTS 33 cases out of 35 cases showed union and average union period was 12 weeks. Complications consisted of 2 cases of nonunion, 1 case of infection, 1 case of loosening of distal fixing screw, 1 case of radial nerve palsy and 1 case of axillary nerve palsy. Shoulder joint function 3 months after operation : mean ASES score 78.2, 12 months after operation : mean ASES score 89.6. Pre-operative shoulder joint pain and nail protrusion showed to be statistically related to shoulder joint function. CONCLUSION If the operation leaves no protrusion of intramedullary nail, it can be concluded to be relatively safe and effective.
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Comparison of the Result of the Intramedullary Nail Fixation and Plate Fixation in Humeral Shaft Fracture with Butterfly Fragments Duk-Hwan Kho, Hyeung-June Kim, Byoung-Min Kim, Hyun-Ryong Hwang The Korean Journal of Sports Medicine.2016; 34(2): 120. CrossRef
Plain Radiograph Analysis of the Distal Humerus Posterior Bowing That May Affect Interlocking Intramedullary Nailing for Humerus Shaft Fracture Jaekwang Yum, Kyunghwan Boo, Minkyu Sung, Jiseok Jang Journal of the Korean Orthopaedic Association.2015; 50(1): 31. CrossRef
Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef
Surgical Treatment of Pathologic Humeral Fracture Ho Jung Kang, Byoung Yoon Hwang, Jae Jeong Lee, Kyu Ho Shin, Soo Bong Hahn, Sung Jae Kim Journal of the Korean Fracture Society.2010; 23(2): 187. CrossRef
PURPOSE To evaluate the therapeutic effects of chevron olecranon osteotomy and bilateral reconstruction plate as operative treatment for distal humerus intercondylar fracture. MATERIALS AND METHODS Among patients operated for distal humerus intercondylar fracture in our hospital from June, 1997 to October, 2005, 26 patients were selected who could be followed-up for more than one year. The average follow-up period was 15 months. All olecranon osteotomies were chevron osteotomy and all fractures were treated with internal fixation using bilateral reconstruction plate. The ulnar nerve was checked in all cases. Three patients in which case the plate might irritate the ulnar nerve, received with ulnar nerve anterior transposition. Cassebaum's classification and Mayo elbow performance score were used to evaluate at three, six and twelve months. RESULTS Mean bone union period was 11.7 weeks. There were 9 excellent cases, 11 good cases, 4 fair cases and 2 poor cases. Mean flexion contracture was 11° and further flexion was 126° at last follow-up. CONCLUSION Bilateral reconstruction plate internal fixation using chevron olecranon osteotomy showed strong fixation and good clinical results and it is possible for early rehabilitation treatment.
PURPOSE To evaluate the result of joint depression type of intraarticular calcaneal fractures treated with Essex-Lopresti method. MATERIALS AND METHODS From March 2001 to February 2005, Thirty two patients' joint depression type of intraarticular calcaneal fractures which treated with Essex-Lopresti method were clinically and radiographically evaluated retrospectively. RESULTS According to Creighton-Nebraska Health Foundation Assessment Score (C-N score), there were 5 excellent, 11 good, 6 fair and 10 poor results. Böhler angle was corrected from 10.3 degrees to 24.5 degrees. There was a positive correlation between size of depressed fragment and C-N score (p<0.01). CONCLUSION Essex-Lopresti method can substitute open reduction methods in joint depression type of intraarticular calcaneal fractures which have relatively large depressed joint fragments.
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Treatment of Calcaneus Fractures: Recent Trend for Acute Fractures and Complications Woo-Chun Lee Journal of the Korean Fracture Society.2007; 20(4): 361. CrossRef
PURPOSE To evaluate the usefulness of internal fixation with modified Steinmann pins and tension band wiring technique in comminuted proximal humeral fracture with osteoporosis and the correlations among bone mineral density, age, Neer's score and period of union. MATERIALS AND METHODS Twelve cases of comminuted proximal humeral fracture with osteoporosis were surgically treated with modified Steinmann pins and tension band technique, and followed up for an average 20.8 months (range, 6~39 months). Average age was 73.6 years old (range, 59~85 years old). Results were assessed using Neer's evaluation criteria. RESULTS Excellent results were noted in eight cases and satisfactory results in four cases. Radiological union was obtained in all cases. Two cases showed impingement syndrome of the proximal portions of Steinmann pins, which were managed by early removal of the metal. One case developed operative wound infection, which were managed by antibiotics therapy, irrigation and secondary closure. CONCLUSION Internal fixation using modified Steinmann pins and tension band wiring technique for proximal humeral fracture, with osteoporosis, makes complete union of fracture, minimizes risk of complications, and enables early rehabilitation by rendering relatively rigid fixation.
PURPOSE To determine the usefulness of flexible intramedullary fixation in pediatric forearm diaphyseal fractures. MATERIALS AND METHODS We reviewed 22 cases of forearm diaphyseal fractures treated with flexible intramedullary nail and K-wire. The radiographic assessment was based on the time to union, maintenance of reduction and angular deformity. The functional outcome was assessed with the range of motion and complications at last follow up. RESULTS Average length of follow up was 13.9 months with mean age of 10.8 years and the time to union was 5.2 weeks. There were no angular deformity and fuctional results were excellent in all cases. There were 5 cases of soft tissue irritation of nail insertion site as post operative complication which was resolved after nail removal. CONCLUSION Flexible intramedullary for pediatric forearm bone fractures is an effective and safe method which gives a good functional outcome.
PURPOSE To compare the clinical and radiological results after surgical treatments of the avulsion fractures of ACL between children and adults. MATERIALS AND METHODS 40 cases (18 cases of children, 22 cases of adults), who underwent surgical treatments after avulsion fractures of the ACL and followed up more than one year, were enrolled. Fractures were classified by modified Meyers & McKeever criteria. Range of motion, LK score, Lachman test, Pivot-Shift test, quadriceps muscle atropy and Telos® stress arthrometer were compared. RESULTS The types of fracture in children were categorized into 8 cases of type II, 10 cases of type III, and 2, 15, 5 cases of type II, III, IV each in adult group. Mean LK score showed significant difference between 99.3 points in children and 89.5 points in adults (p<0.05). In addition, accompanied injuries and the high degree of fracture leaded low LK score. However, there was no significant difference in range of motion, Lachman test and Pivot-Shift test. Anterior laxity by Telos® device showed an average of 2.0 mm in children, 2.5 mm in adults (p>0.05). CONCLUSION Children group showed better treatment results of avulsion fracture of ACL. Higher incidence of type II fractures and less combined injuries considered to be factors for better results.
Overall, the percutaneous vertebroplasty has low complication rate. Nevertheless, severe complications can occur. The majority of these are related to cement leakage. The cement migration through perivertebral venous system can lead to fatal complication. We present a case of death by hemothorax due to cement leakage following percutaneous vertebroplasty with literature review.