Journal of Musculoskeletal Trauma

Mortality-Related Risk Factors in Total Hip Arthroplasty for Femoral Neck Fractures in Elderly Patients: Jae Sung Suh, Hyung Gon Ryu, Young Ju Roh, Dae Won Shin; J Korean Fract Soc 2022;35(2):51-56. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.51

Abstract PDF: Purpose
Total hip arthroplasty (THA) using dual mobility components (DMC) is a reasonable surgical option for displaced femoral neck fractures in elderly patients, resulting in lower dislocation rates and improved stability. The purpose of this study was to investigate the clinical outcomes and risk factors responsible for mortality in elderly patients who were diagnosed with a displaced femoral neck fracture and had undergone DMC-THA.
Materials and Methods
Out of 147 cases of THA from December 2018 to June 2020, a total of 79 cases were enrolled in this study, with the following characteristics: (1) Garden stage III or IV, (2) over 75 years of age, and (3) over 1 year of follow-up. All the patients received DMC-THA surgery using the anterolateral approach.
Results
The mean follow-up period was 15.0±8.43 months and a total of one dislocation case was observed. The mortality rate was 17.7% (14/79), and it was especially higher in patients with a past medical history of malignancy (odds ratio [OR]=7.18, p=0.03) or a cognitive disorder such as dementia (OR=5.48, p=0.03). Preoperative low initial hemoglobin levels (OR=0.65, p=0.04) and low UCLA (Uni-versity of California at Los Angeles) score (OR=0.47, p=0.02) were also associated with mortality.
Conclusion
When considering THA as a treatment approach in elderly patients with a displaced femoral neck fracture, a high mortality rate is expected in patients with low preoperative hemoglobin levels or a history of malignancy or cognitive disorders. Hence, thorough monitoring and management should be undertaken before and after surgery.

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Posterior Anti-Glide Plating for Supination External Rotation Type Lateral Malleolar Fractures: Clinical Comparison of Locking versus Non-Locking One-Third Semi-Tubular Plate Fixation: Jun Young Lee, Yong Jin Cho, Dong Hyuk Cha, Hyun Bai Choi, Jung Ho Lee; J Korean Fract Soc 2022;35(2):57-62. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.57

Abstract PDF: Purpose
The purpose of this study was to evaluate and compare the clinical and radiological outcomes between locking plates and non-locking plates using posterior anti-glide plating for supination external rotation type lateral malleolar fractures.
Materials and Methods
A total of 50 patients who underwent internal fixation of posterior anti-glide plating due to lateral malleolar fractures, classified as supination-external rotation (SER) as per the Lauge-Hansen classification system, at our hospital from January 2017 to November 2018 were retro-spectively evaluated. Patients were divided into two groups: 1/3 semi-tubular locking plate (24 patients) and 1/3 semi-tubular non-locking plate (26 patients). A radiographic assessment was performed after surgery to evaluate the time of bone union. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional score was measured after the surgery to evaluate the clinical outcomes.
Results
The two groups showed similar distributions in sex, age, height, body mass index, fracture pattern, and mean follow-up period. Complete bone union was obtained in all cases and the mean bone union time was 13.00±3.38 weeks in Group 1 and 12.92±3.26 weeks in Group 2 (p=0.87). The mean AOFAS score at 24 weeks was 95.66±2.86 in Group 1 and 95.84±2.79 in Group 2 (p=0.82). The mean AOFAS score at 48 weeks was 97.25±3.54 in Group 1 and 96.57±3.07 in Group 2 (p=0.47). Two cases of complications were observed in the non-locking plate group.
Conclusion
For the treatment of Lauge-Hansen SER type lateral malleolar fracture, internal fixation us-ing locking 1/3 semi-tubular plate and non-locking 1/3 semi-tubular plate are both favorable fixation methods.

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Two-Year Follow-Up Results after Tendon Graft and Corrective Osteotomy for the Delayed Rupture of the 2nd-5th Flexor Tendons due to a Malunion of a Distal Radius Fracture - A Case Report -: Jeung-Hwan Seo, Hyun-Gon Gwak, Jae Hoon Lee; J Korean Fract Soc 2022;35(2):63-67. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.63

Abstract PDF: The delayed rupture of the flexor tendons is a rare complication of malunited distal radius fractures after nonoperative management. The known cause of a flexor tendon rupture is attrition between the palmarly displaced ulnar head and the involved tendons. Sharp bony spurs on the volar side of the malunited distal radius can also cause flexor tendon rupture. About 30 cases have been reported in literature. There were only four case reports about the delayed rupture of the 2nd, 3rd, 4th, and 5th flexor tendons. In this case, we experienced flexor digitorum superficialis and flexor digitorum profundus tendon ruptures of the index, middle, ring, and little fingers, after 8 months following the malunion of a distal radius fracture. At two years follow-up after tendon graft and corrective osteotomy, the range of motion and motor weakness of the 2nd, 3rd, 4th, and 5th fingers improved.

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Isolated Avulsion Fracture of the Subscapularis from the Lesser Tuberosity of the Humerus in a 12-Year-Old Boy - A Case Report -: Shin Seung Park, Chung Shik Shin, Won Bin Song; J Korean Fract Soc 2022;35(2):68-73. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.68

Abstract PDF: An isolated avulsion fracture of the subscapularis from the lesser tuberosity of the proximal humerus is rare in the pediatric population and only a couple of cases have been described in literature. A 12-yearold right-handed boy, was admitted to the hospital with left shoulder pain after falling down the previ-ous day. Physical examination revealed tenderness on the lesser tuberosity and intertubercular groove of the humerus and a limited range of motion. Ultrasonography, computed tomography, and magnetic resonance imaging showed an isolated avulsion fracture of the subscapularis tendon from the lesser tuberosity of the humerus, accompanied by medial subluxation of the long head of the biceps tendon. In this case, a subscapularis avulsion fracture which is rare in this age group was detected at an early stage, and surgical treatment resulted in positive outcomes. Subscapularis avulsion fractures in children are difficult to diagnose in the early stages, and if not treated on time, the symptomatic improvement may be delayed. Timely and accurate diagnosis and treatment can help faster return to normal activi-ties. We would therefore like to report this case with a literature review.

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Current Treatment of Calcaneal Fractures and Dislocation: Dae Jin Nam, Sung Hyun Lee; J Korean Fract Soc 2022;35(2):74-82. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.74

Abstract PDF: Calcaneal fractures are the most common fractures occurring in the tarsal bone. In the past, surgical treatments were not preferred because they were accompanied by severe comminution and soft tissue complications. In recent years, there have been great advancements in the treatment of calcaneal fractures owing to the development of new surgical techniques and instruments. However, a standard treatment method has not yet been established. In this review article, we summarize the latest information on the indications and treatment methods of calcaneal fractures.

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Lisfranc Joint Injury: Bi O Jeong, Jungtae Ahn; J Korean Fract Soc 2022;35(2):83-89. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.83

Abstract PDF: The Lisfranc joint complex is composed of complex bony structures, ligaments, and soft tissues and has a systematic interrelationship. Sufficient radiologic modalities should be considered for an accurate initial diagnosis. Based on an accurate understanding of normal anatomy and restoration of anatomical relationships, the diagnosis should be obtained, and more discussion is needed on detailed treatment strategies.

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