PURPOSE To evaluate between DHS and ITST nail (2nd generation) on the treatment of unstable femur intertrochanteric fracture in patients over 70 years old. MATERIALS AND METHODS 61 cases of unstable intertrochanteric fracture (grouped 37 patients with DHS and 24 patients with ITST) who were taken the operation from Mar. 2003 to Sep. 2007 were analysed regarding to union time, sliding length of lag screws, operation time, blood loss, postoperative complications and functional recovery score by Skovron. RESULTS The mean union time was 14.7 weeks in study group (ITST). The mean union time was 16.2 weeks in control group (DHS). The lag screw slidings were 7.2 mm in study group and 8.7 mm in control group. The operation times were 57.9 min in study group and 76.9 min in control group. The amount of blood loss were 67.7 ml in study group and 227.4 ml in control group. The complications were 4 cases in study group and 4 cases in control group. The Skovron recovery scores were 76.5% in study group and 73.7% in control group. CONCLUSION From a practical point of short operation time, less amount of bleeding and less complication, author think that the ITST nail is useful implant for treatment of unstable femur intertrochanteric fracture in patient of old age.
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Unstable Intertrochanteric Fracture Treated with ITST: A Comparative Study between Groups with and without Comminution of Greater Trochanter Kyung-Sub Song, Sang-Ho Lee, Seong-Hun Jeong, Su-Keon Lee, Sung-Ha Hong Journal of the Korean Fracture Society.2014; 27(1): 36. CrossRef
Treatment of the Intertrochanteric Femoral Fracture with Proximal Femoral Nail: Nailing Using the Provisional K-wire Fixation Gu-Hee Jung Journal of the Korean Fracture Society.2011; 24(3): 223. CrossRef
PURPOSE To perform comparative analysis between the results of internal fixation using compression hip screw and cemented bipolar hemiarthroplasty in unstable intertrochanteric fracture in elderly patients. MATERIALS AND METHODS From January 2001 to October 2006, we reviewd 73 patients, who were treated surgically for unstable intertrochanteric fractures, with a minimum of 2 years follow up. The patient's age was older than 60 year old. The patients were divided into two groups and evaluated, retrospectively. One group was treated with cemented bipolar hemiarthroplasty (Group A, 34 cases), and the other group was treated with compression hip screw (Group B, 39 cases). We evaluated the amount of intraoperative bleeding, operative time, clinical results and complications between the two groups. RESULTS The amount of intraoperative bleeding and operative time were no statistically significant between the two groups. Group A showed a better result than Group B for clinical outcome using Johnson Daily Activity of Life. Complications in the group A were comprised of dislocation (1 case), nonunion of greater trochanter (1 case), infection (1 case) and loosening (1 case), and those in the group B were comprised of loss of fixation (8 cases) and infection (1 case). CONCLUSION We found that short-term outcomes of cemented bipolar hemiarthroplasty for unstable intertrochanteric fractures were satisfactory. However, a longer-follow up period is necessary to clarify the efficacy of cemented bipolar hemiarthroplasty.
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Early Rehabilitation in Elderly after Arthroplasty versus Internal Fixation for Unstable Intertrochanteric Fractures of Femur: Systematic Review and Meta-Analysis Jun-Il Yoo, Yong-Chan Ha, Jae-young Lim, Hyun Kang, Byung-Ho Yoon, Hyunho Kim Journal of Korean Medical Science.2017; 32(5): 858. CrossRef
The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim Hip & Pelvis.2014; 26(2): 99. CrossRef
PURPOSE To evaluate the usefulness of the retrograde intramedullary nailing for the treatment of segmental femoral shaft fracture including distal part. MATERIALS AND METHODS We reviewed 15 patients of segmental femoral fracture, who had treated with retrograde intramedullary nailing and followed-up more than 1 year from January 2003 to October 2007. There were 10 men, 5 women, and the mean age was 45 years old. There were associated fracture in 10 cases. We evaluate the time for union, non-union and malunion by radiologic finding and functional assessment by Sanders' criteria. RESULTS The mean time of union was 21 weeks. There was one delayed union in proximal fracture site. There was no shortening more than 1.5 cm, no angular deformity more than 10 degrees, no postoperative infection or instability. According to Sanders' criteria, there were excellent clinical results in 9 cases, good results in 5 cases and fair result in 1 case. CONCLUSION The retrograde intramedullary nailing can be a useful method for treatment of segmental femoral shaft fracture including distal part.
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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
PURPOSE To find out the efficiency of two staged operation of patients with high energy proximal tibia fracture with severe soft tissue damage, the first step being external fixation, and the second, internal fixation with plates. MATERIALS AND METHODS The study group was the 42 patients who had followed for one year out of a group of 56, performed the first step external fixation and the second step internal fixation with plates retrospectively, from March 2003 to March 2007. The average age of the study group was 51.4, 26 men, and 16 women participating in this study. The average time of follow up was 32 months. In the final follow up, investigations of the radiological assessments and functional abilities of the bony fusion were carried out along with the complications of the soft tissue. RESULTS The duration after the first step external fixation until second step internal fixation to be performed was 14.9 (6~40) days in average. The final bone fusion took about 15 weeks, and according to the final follow up, the range of motion of the knee was around 110.8 degrees (6.2~117 degrees). In 31 cases, only the internal fixation was performed, while in 11 cases, soft tissue reconstruction was carried out with the internal fixations. As for the complications there were 2 cases of deep soft tissue infection, 2 cases of nonunion, 1 case of malunion and 1 case of knee joint stiffness. CONCLUSION In cases of proximal tibia fracture with severe soft tissue damage, external fixation was important to secure the safety of the fracture, carry forward the anatomical alignment, plan the soft tissue safety and manage the wound to decrease the number of microbial in the next operation, which is the internal fixation with plates.
PURPOSE The purpose of this study was to evaluate the surgical outcomes of isolated greater tuberosity fractures of the proximal humerus fixed with the spring plates. MATERIALS AND METHODS Fourteen patients who could be followed up at least 1 year after the surgical treatment of isolated greater tuberosity fracture were evaluated. Their mean age was 51 years (range, 25~73 years). The deltopectoral approach and fixation with the spring plate were performed in all cases. The spring plate was used in all cases. In some circumstances, sutures incorporating the rotator cuff, interfragmentary screw or tension band wire were added. We evaluated the clinical outcomes using UCLA scoring system and KSS (Korean Shoulder Score). RESULTS The mean UCLA score was 29.8 and the mean KSS was 89.4. The average time of bony union was 10.2 weeks (range, 7~14 weeks) after the surgery, including 1 case that was performed the secondary operation due to metal failure. The shoulder stiffness were observed in 4 cases and one case of infection was treated well without operation. CONCLUSION In the treatment of isolated greater tuberosity fractures of the proximal humerus, the spring plates fixation can be a good surgical option providing reliable functional results.
PURPOSE To evaluate the clinical usefulness of internal fixation with double plates for comminuted olecranon fractures. MATERIALS AND METHODS Nine patients with olecranon fractures which are classified into Mayo type IIB (7 cases) and type IIIB (2 cases) underwent internal fixation using double plates from June 2002 to September 2005. They were followed-up for more than 12 months and average period of follow-up was 14 (12~18) months. Six cases were males and three were females. Mean age was 40.7 (21~63) years. We used open reduction and internal fixation using double plates. Clinical assessment index was pain, range of motion (ROM), stability and function of joint at last follow-up. The sum of four indices were compared. Also, we evaluated starting time of full ROM exercise, bony union time and complications. RESULTS All cases started postoperative ROM within 7 days and clinical results were evaluated using Mayo elbow performance index. 'Excellent', 'good' were 2, 6 cases, respectively and 1 case was 'fair'. Elbow ROM was more than 110o in all cases except one. Mean radiological bony union time was 3.9 (2.5~5) months postoperatively. There were heterotrophic ossifications in 3 cases as complication. CONCLUSION Internal fixation using double plates for comminuted olecranon fractures in adults can be good treatment option which obtains good clinical results and enables early ROM.
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Biomechanical Comparison of Dual and Posterior Locking Plates in an Ex Vivo Comminuted Olecranon Fracture Model Andrew D. Sobel, Jacob M. Babu, Travis D. Blood, E. Scott Paxton The Journal of Hand Surgery.2022; 47(8): 796.e1. CrossRef
Surgical Treatment of Comminuted Olecranon Fracture Using Locking Compression Plate Fixation Eunchang Lee, Seong-Hee Cho, Jun-Il Yoo, Jin-Hyung Im, Dong-Geun Kang, Jin Sung Park Archives of Hand and Microsurgery.2021; 26(1): 18. CrossRef
The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture In-Tae Hong, Kyunghun Jung, Yoon Seok Kim, Soo-Hong Han Archives of Hand and Microsurgery.2019; 24(2): 133. CrossRef
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
A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures Bo-Kun Kim, Hyun-Dae Shin, Kyung-Cheon Kim, Yoo-Sun Jeon Journal of the Korean Orthopaedic Association.2011; 46(2): 146. CrossRef
PURPOSE To evaluate clinical and radiographic results of open reduction and internal fixation with plate in AO type C3 distal radius fracture. MATERIALS AND METHODS We treated 18 fractures and the mean follow up was 16 months. The average age was 47.1 years old, 12 male and 6 female were included. There were 9 C3.1 fracture, 5 C3.2 and 4 C3.3. Green & O'Brien's modified clinical scoring system and Demerit Point system were applied to evaluate clinical results, for radiographic evaluation, radial length, radial inclination, volar tilt, and Sarmiento's Criteria for Anatomic results were assessed. RESULTS Clinical results were 5 of excellent, 7 of good, and 6 of fair by Green & O'Brien's score and were 5 of excellent, 6 of good, and 7 of fair by Demerit point. There was no significant difference of radiographic results between immediate postoperation and last follow-up, and Sarmiento's Criteria showed 8 excellent, 4 good, and 6 fair. CONCLUSION The open reduction and internal fixation with plate in AO type C3 distal radius is considered as a good treatment method that particularly benefits from fracture stable fixation without fixation loss and early rehabilitation.
PURPOSE To evaluate the usefulness of wrist arthroscopic examination in patient with persistent pain after the triquetral dorsal chip fracture and also to determine its relationship with TFCC injury in the triquetral dorsal chip fracture patient manifesting persistent pain. MATERIALS AND METHODS This study is based on six cases presenting persistent pain in the ulnar aspect after the triqeutral posterior cord fracture that were treated conservatively. Wrist arthroscopy was carried out for all six cases. All were preoperatively and postoperatively evaluated using VAS pain scale, grip power, ulnar grind test, Kleinman shearing test and lunotriquetral ballottment test. RESULTS Preoperatively, ulnar grind test yielded positive results in all six cases, Kleiman shearing test proved positive in three cases and lunotriquetral ballottment test yielded positive result in one case. In the arthroscopic findings, synovitis and TFCC injury were detected in all cases, and based on Palmer classification of TFCC injury, type IA was determined in five cases and type ID in one case. Arthroscopic TFCC partial resection and synovectomy were carried out. VAS pain scale improved from an average 8 points preoperatively to 3 points postoperatively. The difference of grip power between the normal and the other side improved from average of 15 lb preoperatively to 5 lb postoperatively. Based on postoperatively physical examination at 6 weeks, all cases yielded negative results in the ulnar grind test and Kleiman shearing test. CONCLUSION We think that TFCC injury is one of the causes of persistent pain after triquetral dorsal chip fracture. We recommend an arthroscopic TFCC partial resection as a valuable treatment option.
We are reporting a case that a 61-year-old patient who had simultaneous anterior dislocation of left hip and anterior dislocation of right knee after fall from a height injury was treated by closed reduction respectively.
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Posterior cruciate ligament avulsion fracture is occurred by high energy trauma, usually in motor vehicle accident or sports injury. Bilateral posterior cruciate ligament avulsion fracture is not yet reported in Korea. Authors report a case of bilateral posterior cruciate ligament avulsion fracture in 16-years-old man treated with anatomical reduction and internal fixation with a review of literature.
The ipsilateral femoral segmental and tibial fractures seldom occur such as traffic accidents needed high energy mechanisms. For these fractures, surgical stabilization and early mobilization of joint produce can be the best clinical outcomes. We have experienced a case of ipsilateral femoral segmental and tibial fracture and gained good clinical results with surgical treatment. We have reported here on this case and included a review of the relevant literature.
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