PURPOSE To evaluate the usefulness of wire fixation in displaced acetabular fractures. MATERIALS AND METHODS From January 2000 to December 2005, 19 cases of displaced acetabular fracture were treated with wire fixation. According to Letournel's classification there were 9 both column fracture, 5 transverse fracture, 3 anterior column with posterior hemitransverse and 2 T-type fracture. Only wire fixation in 13 cases and wire with plate or wire with screw fixation in 6 cases. RESULTS We evaluate the accuracy of reduction by Matta' criteria, anatomical reduction in 12 cases, incomplete reduction in 4 cases, poor reduction in 2 cases and surgical secondary congruence in 1 case. The clinical results showed excellent in 12 cases, good in 4 cases, fair in 2 cases and poor in 1 case. The radiological results showed excellent in 10 cases, good in 4 cases, fair in 3 cases and poor in 2 cases. There were 4 cases of complication; wound infection in 1case, post-traumatic arthritis in 1 case and heterotopic ossification in 2 cases. CONCLUSION The cerclage wiring is a preferable method in internal fixation of displaced acetabular fractures that can facilitate reduction and achieve stable fixation.
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Comparative Results of Acetabular Both Column Fracture According to the Fixation Method Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park Hip & Pelvis.2011; 23(2): 131. CrossRef
PURPOSE To evaluate the results of fracture fixation between using Proximal Femoral Nail and using Proximal Femoral Nail A and to analyze the effectiveness of proximal femoral nail A. MATERIALS AND METHODS We reviewed 32 patients who suffered from intertrochanteric fracture in our hospital, which were 19 cases of PFN and 13 cases of PFNA. Retrospectively we evaluated mean operation time, amount of bleeding, beginning of ambulation, average union period, changes of neck shaft angle and complication on set of telephone interview and OPD. We also evaluated postoperative capability of function and mobility using 'Social function score' and 'Mobility score'. RESULTS PFNA showed shorter mean operation time, less bleeding, shorter average union period, earlier ambulation and less change of neck shaft angle than PFN. Although they didn't show statistical difference, postoperative capability of function and mobility showed statistical and mathematical difference on each group. CONCLUSION PFNA showed better results of postoperative function and mobility and less complications than PFN. So treatment using PFNA is better method than that of PFN.
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Treatment of the Proximal Femoral Fracture Using the New Design Cephalomedullary Nail: Prospective Outcomes Study Young Ho Roh, Joseph Rho, Kwang Woo Nam Journal of the Korean Fracture Society.2019; 32(1): 35. CrossRef
Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail Jae-Cheon Sim, Tae-Ho Kim, Ki-Do Hong, Sung-Sik Ha, Jong-Seong Lee Journal of the Korean Fracture Society.2013; 26(1): 37. CrossRef
Comparative Study of Proximal Femoral Nail Antirotation and Zimmer Natural Nail for the Treatment of Stable Intertrochanteric Fractures Jee-Hoon Kim, Oog-Jin Shon Journal of the Korean Fracture Society.2013; 26(4): 305. CrossRef
Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture Kwang-Jun Oh, Sung-Tae Lee, Suk-Ha Lee, Jin-Ho Hwang, Min-Suk Kang Journal of the Korean Fracture Society.2010; 23(1): 6. CrossRef
Treatment of the Unstable Intertrochanteric Fracture with Proximal Femoral Nail Antirotation: Comparison with Compression Hip Screw with Trochanteric Stabilizing Plate Tae-Ho Kim, Jong-Oh Kim, Seung-Yup Lee, Geon-Ung Yun Journal of the Korean Fracture Society.2010; 23(4): 353. CrossRef
Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture Jong Min Lim, Jeung Il Kim, Jong Seok Oh, Kuen Tak Suh, Jae Min Ahn, Dong Joon Kang Journal of the Korean Fracture Society.2010; 23(4): 360. CrossRef
PURPOSE To predict the feature and stability of intertrochanteric fractures with posterior fragment using preoperative 3D computed tomography and to investigate the importance of the posterior fragment in treatment of unstable intertrochanteric fracture. MATERIALS AND METHODS 15 cases of unstable fractures with posterior fragment which were treated with nail only between October 2006 to August 2007 were classified into 2 groups: study group (5 cases with cannulated screw fixation of posterior fragment) and control group (10 cases without cannulated screw fixation). The average difference of neck-shaft angle, neck screw sliding distance and the complications in the two groups were compared retrospectively after a follow up of at least 3 months. RESULTS The average difference of neck-shaft angle in study and control group was 3.8 and 7.5 degree (p>0.05), respectively. The average difference of neck screw sliding distance was 1.6 and 6.6 mm (p<0.05), respectively. Complication which required reoperation was not noted in study group and complications of 3 cases about neck screw lateral protrusion, proximal migration and Z-effect phenomenon were noted in control group. CONCLUSION The recognition and fixation of the posterior wall was found to be an important predictive factor in unstable intertrochanteric fracture treatment.
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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
Additional Fixations for Sliding Hip Screws in Treating Unstable Pertrochanteric Femoral Fractures (AO Type 31-A2): Short-Term Clinical Results Su Hyun Cho, Soo Ho Lee, Hyung Lae Cho, Jung Hoei Ku, Jae Hyuk Choi, Alex J Lee Clinics in Orthopedic Surgery.2011; 3(2): 107. CrossRef
PURPOSE The purpose of this study was to evaluate the efficacy of the surgical treatment through the comparison of LC-DCP (Limited Contact-Dynamic Compression Plate) versus LCP (Locking Compression Plate) fixation in the plate augmentation for the nonunion of femur shaft fractures after intramedullary nail fixation. MATERIALS AND METHODS Twenty-four patients with the nonunion of femur shaft fractures after intramedullary nail fixation who underwent plate augmentation were evaluated from Mar. 2001 to Sept. 2005. The group with LC-DCP augmentation was done bicortical screw fixation and the group with LCP was done monocortical fixation. RESULTS There was one case of nail breakage in LC-DCP group, but sound bony union were achieved uneventfully in all the cases of both group. LCP fixation was slightly superior to LC-DCP fixation in view of the bony union time, operating time, postoperative Hb down, amount of postoperative transfusion, but there was no statistical difference (p>0.05). CONCLUSION: We got the satisfactory results after monocortical LCP augmentation as well as bicortical LC-DCP fixation and have concluded that monocortical LCP fixation was an effective treatment option for nonunion of femur shaft fracture occurred after Intrmedullary nail fixation.
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Delayed Union and Nonunion: Current Concepts, Prevention, and Correction: A Review Kristin M. Bowers, David E. Anderson Bioengineering.2024; 11(6): 525. CrossRef
RETRACTED ARTICLE: An experimental study on stress-shielding effects of locked compression plates in fixing intact dog femur Xinwen Zhao, Wensen Jing, Zhe Yun, Xun Tong, Zhao Li, Jiajia Yu, Yaohui Zhang, Yabin Zhang, Zhixue Wang, Yanhua Wen, Heping Cai, Jun Wang, Baoan Ma, Haien Zhao Journal of Orthopaedic Surgery and Research.2021;[Epub] 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 cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation. MATERIALS AND METHODS We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test. RESULTS There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score. CONCLUSION The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.
PURPOSE To evaluate the clinical results of double tension band wiring for communited olecranon fractures involving proximal 1/3. MATERIALS AND METHODS We reviewed 9 cases of communited olecranon fractures involving proximal 1/3 treated with double tension band wiring followed for minimum 10 months. There were 2 cases of olecranon fractures involving only proximal 1/3, 6 cases of olecranon fractures involving from proximal 1/3 to middle 1/3 and 1 case of olecranon fractures involving from proximal 1/3 to distal 1/3. We analyzed the bone union time, radiologic results for gap, reduction loss, pin migration, pain, range of motion, complications and functional outcomes at last follow up. RESULTS All patients had solid bone union without additional surgery and average union time was 10.3 weeks. Anatomical reduction could be obtained in 8 of 9 cases but there was 1 mm step off in one case. 36 pins were used to fix the fractures, 1 pin of 18 distal pins and 2 pins of 18 proximal pins were migrated to backward but there was no reduction loss. Only 1 distal pin needed early removal due to skin irritation. Average range of motion ranged from flexion contracture 3.3 degrees to further flexion 137.8 degrees. On functional analysis, we got 8 cases of good result, 1 case of fair result and there was no poor result. CONCLUSION Double tension band wiring for comminuted olecranon fracture involving proximal 1/3 was concluded to give a firm fixation of the fracture site as bone union could be acquired without serious pin problems.
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Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
Olecranon Nonunion after Operative Treatment of Fracture Ho-Jung Kang, Ji-Sup Kim, Myung-Ho Shin, Il-Hyun Koh, Yun-Rak Choi Journal of the Korean Fracture Society.2015; 28(1): 30. CrossRef
PURPOSE The purpose of this study was to evaluate and compare the clinical & radiological outcome between LCP and conventional T-plate fixation in the treatment of distal radial fracture. MATERIALS AND METHODS From January 2000 to October 2006, 26 patients were treated by LCP fixation and 20 patients were treated by conventional T-plate fixation for distal radial fracture. We used the X-ray to calculate the radial inclination, radial length and volar tilting, then compared the loss of correction after the operation between both groups. We also evaluated the clinical functional outcome by Mayo wrist score. RESULTS The average follow-up since operation was ten months in both LCP and conventional T-plate fixation group. According to Frykmann classification, there were 1 case of type 1 (4%), 2 of type 2 (8%), 5 of type 3 (19%), 14 of type 4 (54%), 1 of type 5 (4%), 2 of type 7 (8%), 1 of type 8 (4%), and to AO classification, 4 of type A (15%), 22 of type C (85%) in LCP group. In conventional T-plate group, according to Frykmann classification, there were 12 cases of type 3 (60%), 4 of type 4 (20%), 3 of type 7 (15%), 1 of type 8 (5%), and to AO classification, 6 of type B (30%), 14 of type C (70%). In LCP group, the loss of correction between immediate post-operation and last follow-up was about 1.03 degrees in radial inclination, -1.09 mm in radial length, -2.08 degrees in volar tilting at each, and in conventional T-plate group, 2.4 degrees in radial inclination, -0.82 mm in radial length, -2.11 degrees in volar tilting at each. There was no statistical significance (p>0.05) in two groups. In the clinical functional outcome (according to Mayo wrist score), 92% of patient showed above good result in LCP group and 85% of patient showed above good result in conventional T-plate group. There was no infection, delayed union. CONCLUSION Treatment by Interposition of fragments and shortening in the intractable nonunion of humerus with a bony defect can achieve not only good functional result, shortened bone union time and improved in shoulder and elbow motion.
PURPOSE To evaluate the results of internal fixation and autogenous bone graft for the phalangeal nonunion in the hand. MATERIALS AND METHODS From Feb. 2000 until May 2006, thirteen cases that had been treated for non-union of phalanges in the hand were investigated retrospectively. Seven cases were treated with mini-plate fixation and autogenous cancellous graft and six cases with Kirschner wire fixation and autogenous cancellous graft. We analyzed bony union period radiographically and clinical results according to Belsky's score. RESULTS Thirteen cases obtained bony union. Seven cases of mini-plate fixation and bone graft, and six cases of K-wire fixation and bone graft achieved the bony union postoperatively on average 7.9 weeks and 6.3 weeks, respectively. Clinical results were "good" in four cases and "poor" in nine cases according to the Belsky's score. Only one of ten cases with associated injuries, such as tendon, nerve, arterial injuries and other finger fractures in the injured hand, had the good clinical result, but all three cases without associated injuries had the good one. CONCLUSION Internal fixation and autogenous bone graft can be a successful treatment of phalangeal nonunion. However, more careful choice of surgical treatment methods and preoperative explanation of poor post-operative results or complications should be made for phalangeal nonunion with associated injuries in the finger because of poor outcome in those cases.
PURPOSE Receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG) have been shown to be important regulators of osteoclastogenesis during bone remodeling, and their expressions were examined during fracture healing in a mouse model of tibial fracture. However, studies linking RANKL and OPG in patients with head injury and fracture are lacking. We evaluated the changes in serum levels of RANKL and OPG in patients with head injury and fracture (head injury group) and in patients with fracture (fracture group) and compared these with levels found in healthy control subjects. MATERIALS AND METHODS 18 male patients of head injury and fracture and 20 male patients of fracture alone were enrolled. 20 healthy men were recruited to serve as controls. Within the first few hours of admission to hospital, at 4, 8 and 12 weeks after injury 20 ml of blood were obtained from 18 patients with head injury and fracture and 20 patients with fracture only. RESULTS RANKL levels were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury. OPG levels were significantly higher in the head injury group than in the fracture group at 4, 8 and 12 weeks after injury. RANKL/OPG ratios were significantly lower in the head injury group than in the controls immediately after and 4, 8 and 12 weeks after injury, and were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury. CONCLUSION We have shown changes in the profiles of RANKL, OPG and RANKL to OPG ratio. The altered RANKL, OPG and RANKL/OPG ratio in the head injury group lasted longer than in those of the fracture group.
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PURPOSE To evaluate the efficacy of the in situ late osteosynthesis for slightly displaced fractures of the lateral humeral condyle. MATERIALS AND METHODS From 2000 to 2004, 12 patients (8 boys and 4 girls) were managed with in situ late osteosynthesis for fractures of the lateral humeral condyle. The average age at the time of operation was 6 years 1 month (1 year 7 months~9 years 1 month), and the mean amount of fragment displacement was 3.3 mm (2.0~4.5 mm). The operative procedure included curettage and in situ fixation of the fragment RESULTS: Bony union was achieved in all cases after avg. 48 months (33~73 months) follow-up assessment. According to the score system of Dhillon et al, 7 patients had excellent, 3 had good, 2 had fair results. None of the patients developed avascular necrosis or premature closure of the epiphysis. CONCLUSION We suggest that in situ fixation is an effective method for the late treatment of slightly displaced fracture of the lateral humeral condyle.
PURPOSE To evaluate the result of forearm shaft fracture treated by modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA). MATERIALS AND METHODS 15 patients with fracture of radius, ulna, radio-ulna shaft treated by modified interlocking intramedullary nail from December 2003 to February 2007 were analyzed. Modified interlocking intramedullary nail has paddle blade tip and fluted rod, so the distal screw fixation was not needed but had relatively firm fixation. It has advantages including short operation time, small operation scar. The average follow up period was 8.3 months (range, 5~15 months). We analyzed the results by average union time and the functional results according to Anderson's criteria. RESULTS The mean duration of union was 9.8 weeks in radius and 11.4 weeks in ulna. The average range of motion of forearm was 74.6 degree in supination and 72 degree in pronation.. Functional results assessed by Anderson were rated excellet in 12 cases, satisfactory in 3 cases. We found no complications such as delayed union, non-union, neurovascular injury and infection. CONCLUSION Modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA) is a viable therapeutic alternative in the management of forearm shaft fracture.
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