PURPOSE To analyze the patterns of and risk factors for fixation failure after hip nailing in intertrochanteric (IT) hip fractures. MATERIALS AND METHODS Fourteen patients who sustained a fixation failure after hip nailing for IT hip fractures were enrolled in this study. The mean age at the index surgery was 74.5 years and the mean time to the fixation failure was 6.6 weeks. All of the serial radiographs up to the fixation failure and pre-operative 3-D computed tomography were analyzed. RESULTS According to AO classification, there were 7 stable fractures and 7 unstable ones. Of the total of 14 cases, 10 showed a comminution of the greater trochanter tip and incomplete anatomical reduction of the medial and anterior cortex at the fracture site. Of the 10 cases with appropriate position of the lag screw within the femoral head, 9 showed a high pertrochanteric fracture (HPF) pattern. The mechanism of the fixation failure was rotation of the femoral head in 7 of 9 cases with HPF and varus collapse of the proximal fragment in 4 of the other 5 cases. CONCLUSION The HPF pattern, the comminution of the greater trochanter tip, and incomplete reduction of the medial and anterior cortex may be additional risk factors of fixation failure after treating IT hip fractures with hip nailing in.
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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
PURPOSE To report the good results of two-stage treatment in pilon fractures. MATERIALS AND METHODS A retrospective study of 23 patients among 30 patients with pilon fractures from March 2006 to November 2008, who underwent two-stage treatment of pilon fractures with a minimum of 24 months follow-up. The mean follow-up period was 28 months (24~41 months). In the first stage of the operation, open reduction of the articular surface and external fixation were performed after minimal incision. As the soft tissue healed, locking compression plate fixation was performed with the Minimally invasive plate osteosynthesis. Radiographic evaluation was graded by the criteria of Burwell and Charnley, and functional assessment of the ankle was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. RESULTS The fractures were united within 16 weeks (12~30 weeks). The radiologic results showed anatomical reduction in 18 cases and a mean AOFAS score of 81. The mean range of ankle motion was 44 degrees. There were four complications: 1 case of wound infection and 3 cases of ankle osteoarthritis. CONCLUSION Two-stage treatment of pilon fractures is a good treatment method because it is designed to obtain early anatomical reduction, definitive stable fixation, low rates of soft tissue complication, and good range of ankle motion.
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Current Concepts in Management of Pilon Fracture Jun-Young Lee, Sang-Joon Lee Journal of the Korean Fracture Society.2014; 27(2): 173. CrossRef
PURPOSE The purpose of this study was to analyze the clinical effectiveness of open reduction in the treatment of distal humeral fracture using a newly designed combined approach of anterolateral and lateral approaches to protect the radial nerve. MATERIALS AND METHODS We investigated 24 consecutive cases of distal humeral fracture who received open reduction and internal fixation with a plate and screws with a minimum follow-up period of 1 year. We analyzed the patients' age, sex, fracture pattern, timing of the union, range of motion of the elbow joint, and complications. The Mayo elbow performance index (MEPI) was employed for the assessment of elbow joint function. RESULTS Clinical union was observed at 10.8 weeks (6~20 weeks) on average. Pre-operatively, there were 3 cases of incomplete radial nerve palsy. All of the cases recovered, and there was no additional radial nerve palsy due to surgery. According to the MEPI, 13 cases were "excellent" and 10 cases were "good" or better, comprising 95.83% of the cases. The range of motion at the elbow was 5.5 degrees (0~15 degrees) of extension, and 131.5 degrees (120~145 degrees) of flexion, suggesting no functional disability. The duration of return to work was 11.2 weeks (5~32 weeks) on average. There were no nonunion, malunion, or infection complications. CONCLUSION The combined anterolateral and lateral approach we designed is a clinically effective approach due to facilitation of protection of the radial nerve and attainment of adequate fixation space.
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Posterior Dual Plating for Distal Shaft Fractures of the Humerus Chul-Hyun Cho, Kwang-Yeung Jeong, Beom-Soo Kim Journal of the Korean Fracture Society.2017; 30(3): 117. CrossRef
Modified Combined Approach for Distal Humerus Shaft Fracture: Anterolateral and Lateral Bimodal Approach Tong Joo Lee, Dae Gyu Kwon, Suk In Na, Seung Do Cha Clinics in Orthopedic Surgery.2013; 5(3): 209. CrossRef
PURPOSE To evaluate the clinical and radiologic results of the Kapandji procedure in AO classification type C distal radius fracture patients over 60 years old. MATERIALS AND METHODS Twenty-one type C distal radius fracture patients over the age of 60 years who were treated with the Kapandji procedure from June 2004 to June 2009 in our hospital and had a post-operative follow-up period of more than 1 year were enrolled. The volar tilt, radial inclination, and radial length were measured for the radiographic analysis using the modified Lidstrom scoring system about post-operative reduction loss in every follow-up radiogram. The clinical result was assessed with a visual analogue scale (VAS) and Korean Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) score at the last follow-up. RESULTS The mean radiologic loss of volar tilt was 1.1degrees and the mean loss of radial length was 2.6 mm and the mean radial inclination loss was 2.7degrees compared with the immediate post-operative period and last follow-up period. The average VAS and DASH scores were 1.4 and 15.9. CONCLUSION The radiologic results of closed reduction and percutaneous pinning using the Kapandji technique for distal radius AO type C fracture patients over 60 years of age was not satisfactory. Nevertheless, the clinical results were satisfactory.
PURPOSE To compare the outcomes of distal radius fractures in a fixed-angle volar locking plate group and variable-angle volar locking plate group. MATERIALS AND METHODS Forty-one patients observed at least 6 months after surgery were included in this retrospective study. We used the range of motion, visual analogue scale score, Disabilities of the Arm, Shoulder and Hand Questionnaire score, and radiologic findings to measure the clinical results. RESULTS No differences in clinical results or radiologic results were noted between the fixed-angle volar locking plate group and variable-angle volar locking plate group. CONCLUSION We believe that it is important to minimize complications by using appropriate screws and plates according to the fracture type, though no differences in the surgical outcome were noted between the fixed-angle volar locking plate group and variable-angle volar locking plate group with distal radius fracture.
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Volar locking plate fixation for distal radius fractures: did variable-angle plates make difference? Mohamed Abdel-Wahed, Ahmed Abdel-Zaher Khater, Mahmoud Ahmed El-Desouky International Orthopaedics.2022; 46(9): 2165. CrossRef
Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef
Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin Journal of the Korean Fracture Society.2013; 26(4): 248. CrossRef
PURPOSE To examine the relationship between injury severity and patterns of associated injury in spinal fracture. MATERIALS AND METHODS From March 2004 to March 2010, a retrospective study was conducted on 291 patients who had undergone surgeries due to spinal fractures. Spinal fractures were categorized as upper cervical, lower cervical, thoracic, thoracolumbar, and lumbar region, and the severity of fracture was measured using the Abbreviated Injury Scale and Injury Severity Score (ISS). We evaluated the correlation between the fracture site and the incidence and injury severity of the associated injury, and compared the neurologic damage according to the presence/absence of the associated injury. RESULTS Spinal fracture occurred in the thoracic (43.5%) and lower cervical (30.0%) levels, and associated injury developed in 134 patients (47%). The area of associated injury was in the extremity (41.2%), thorax (25.5%), head, neck, and face (21.9%). Lower cervical fracture (34.5%) had a lower prevalence than thoracic (81%) and lumbar fracture (61%). The average ISS of the associated injury was 17.14 for the thoracic fracture, 12.30 for the lower cervical fracture, 8.7 for the thoracolumbar fracture and 5.69 for the lumbar fracture. Neurologic damage was highly frequent in the lower cervical fracture and included 54 patients (62.1%) and was less frequent in the upper cervical fracture, which included 7 patients (17.9%) (p=0.032). CONCLUSION Although the associated injury was less frequent in the lower cervical spine among the spinal fractures that underwent surgical treatment, there was a high risk of neurologic damage in the case of associated injury; therefore, there is a need to pay special attention to patients that suffer damage in this area. In addition, since the degree of the associated injury in the thoracic and lower cervical fracture is significant, an appropriate management strategy for the associated injury must be considered.
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The Clinical Effects of Complex Korean Medicine Treatment in Patients with Cervical Spine Fracture Caused by Traffic Accident: A Report of 2 Cases Si-Hoon Han, Gi-Eon Lee, Kyeong-Sang Jo, Da-Young Byun, Min-Seok Oh Journal of Korean Medicine Rehabilitation.2018; 28(2): 113. CrossRef
Clinical results of early stabilization of spine fractures in polytrauma patients Ki-Chul Park, Ye-Soo Park, Wan-Sik Seo, Jun-Ki Moon, Bo-Hyun Kim Journal of Critical Care.2014; 29(4): 694.e7. CrossRef
PURPOSE To evaluate the effectiveness of magnetic resonance imaging (MRI) for the diagnosis and usefulness of vertebroplasty in osteoporotic occult vertebral fractures. MATERIALS AND METHODS Of 472 osteoporotic vertebral fractures treated from May 2003 to July 2009, 45 patients were diagnosed with occult osteoporotic vertebral fracture. Their medical charts and radiographs were reviewed. The degree of vertebral body collapse was graded by a semiquantitative method. In order to increase the reliability, interpretation was based on radiographic diagnoses from 3 orthopedic surgeons. Vertebroplasty was performed at 31 of the 45 patients, for whom conservative treatment failed. Pre-operatively and post-operatively, pain was evaluated using a visual analog scale (VAS). RESULTS We observed 55 occult fractures in 45 patients. Forty vertebrae (72.7%) among the 55 vertebrae were just adjacent to an old vertebral fracture with deformation of the vertebral body. The rediagnosis rate of occult fracture attempted without MRI was only 21.8%. The average pre-operative VAS score of 8.07 (6~9) was improved to 2.43 after surgery and showed no delayed vertebral body collapse. CONCLUSION Gadolinium enhancement of MRI is critical to the diagnosis of occult vertebral fractures, which are 9% of whole osteoporotic vertebral fractures. Seventy-two point seven percent of occult vertebral fractures were just adjacent to an old vertebral fracture with collapse of the vertebral body. This means that if vertebroplasty is performed without thorough MRI examination, it may fail.
Acute compartment syndrome of the thigh, which usually occurs in the anterior compartment, is a rare condition. It can have various causes including femur fractures, vessel injury, pseudoaneurysm of the femoral or popliteal artery, and use of anticoagulant. However, there have been few reports of acute compartment syndrome of the thigh without fracture caused by blunt trauma. We report 4 cases of acute compartment syndrome of the thigh without fracture caused by blunt trauma, in which three patients were treated with fasciotomy and a Vacuum-Assisted wound Closure system and the other one had a delayed diagnosis, and eventually underwent above-knee amputation.
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The authors report the case of a patient with the combination of a Type I Monteggia equivalent lesion and Essex-Lopresti injury. This combination of injury is very rare, and an associated distal radioulnar injury is often missed. We hope our experience illustrates the need to examine the wrist joint carefully and to be aware of the potential for distal radioulnar joint instability in all patients with type I Monteggia equivalent lesions.
Paratricipital Approach for AO/OTA Type C2 Intra-Articular Fracture of Distal Humerus Chul-Hyung Lee, Doo-Hun Sun, Deukhee Jung, Chung-Han An Journal of the Korean Fracture Society.2019; 32(3): 128. CrossRef
How Difficult Is It to Surgically Treat AO-C Type Distal Humerus Fractures for Inexperienced Orthopedic Surgeons? Seong Ho Yoo, Suk Woong Kang, Moo Ho Song, Young Jun Kim, Hyuck Bae Journal of the Korean Fracture Society.2018; 31(2): 45. CrossRef
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