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Volume 24(4); October 2011
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Original Articles
Surgical Treatment of Femoral Unstable Intertrochanteric Fractures in Elderly Patients: Comparative Study between Compressive Hip Screws and Additional Trochanteric Stabilizing Plates
Kap Jung Kim, Dae Suk Yang, Sang Ki Lee, Won Sik Choy, Kyoung Wan Bae
J Korean Fract Soc 2011;24(4):295-300.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.295
AbstractAbstract PDF
PURPOSE
To evaluate the radiologic results between compressive hip screw and compressive hip screw with additional trochanteric stabilizing plate in patients with femoral unstable intertrochanteric fractures in patients with more 65 years old.
MATERIALS AND METHODS
From 2006 to May 2009, 121 cases were included. Group I (compressive hip screw only) was 54 cases and group II (compressive hip screw with trochanteric stabilizing plate) was 67 cases. We checked the lag screw sliding, lateral translation of greater trochanter, changes of neck-shaft angle and complications through periodic follow up of radiographs.
RESULTS
Mean lag screw sliding was 7.6 mm in group I and 3.9 mm in group II (p=0.001). Mean lateral translation of greater trochanter was 3.86 mm in group I and 0.59 mm in group II (p=0.01). Mean changes of neck-shaft angle was nearly the same, 3.57degrees in group I and 3.66degrees in group II. Complications were 15 cases in group I and 10 cases in group II.
CONCLUSION
Compressive hip screw with additional trochanteric stabilizing plate was effective surgical option in patients with femoral unstable intertrochanteric fractures in patients with more than 65 years old. It decreased lag screw sliding, lateral translation of greater trochanter and complication rates.

Citations

Citations to this article as recorded by  
  • The Role of Beta-Tricalcium Phosphate Graft in the Dynamic Hip Screw Fixation of Unstable Intertrochanter Fracture
    Chul-Ho Kim, Ji Wan Kim, Eic Ju Lim, Jae Suk Chang
    Journal of the Korean Fracture Society.2016; 29(4): 250.     CrossRef
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The Treatment of Subtrochanteric Fracture with Cephallomedually Nail: Minimal Incision and Lowman Clamp Assisted Reduction
Jang Seok Choi, Do Hyun Moon, Young Tae Noh
J Korean Fract Soc 2011;24(4):301-306.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.301
AbstractAbstract PDF
PURPOSE
To evaluate the radiographic results of patients with subtrochanteric femoral fracture using minimal incision and cephalomedullary nail technique.
MATERIALS AND METHODS
This study was performed on 54 patients, 54 cases of hip, recruited among patients who underwent minimal incision and Cephalomedullary nail from September 2005 to August 2008 and were available for 1-year or longer follow up. The gender ratio was 37 males and 17 females, and the mean age at the time of surgery was 57.4 years (range; 16~81 years). According to injury mechanism, traffic accident was 29 cases, fall down form high height was 18 cases, slip down was 7 cases. In classification by Seinsheimer, type II was 23 cases (m/c), type III was 18 cases, type IV was 13 cases. Average follow up period was 14 months (12~18). Radiographic evaluation was performed for time taking union, mal-union and complication.
RESULTS
53 of the 54 cases united. 39 of 54 reductions were anatomic. 19 fractures had a monir varus deformity of proximal fragment (between 2degrees and 5degrees). There was no varus deformity of more than 5degrees. 1 case that had been treated with PFN had nail breakage without trauma. There were no other complications.
CONCLUSION
Surgical treatment of subtrochanteric fractures with minimal incision and Cephalomedullary nail technique can reslut in excellent reduction without complications including inflammation & malunion. Careful attention to detail for using Lowman clamp is demanding to decrease soft tissue injury.

Citations

Citations to this article as recorded by  
  • The Treatment of Subtrochanteric Fractures with Proximal Femoral Nail Antirotation
    Chi Hyoung Pak, Sang Hong Lee, Sang Ho Ha, Gwang Chul Lee, Kyoung Chul Song
    Journal of the Korean Fracture Society.2013; 26(4): 284.     CrossRef
  • Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques
    Chul-Hyun Park, Chul-Wung Ha, Sang-Jin Park, Min-Su Ko, Oog-Jin Shon
    Journal of the Korean Fracture Society.2013; 26(2): 112.     CrossRef
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Clinical Outcome of Surgical Treatment for Fracture of the Femoral Shaft with Ipsilateral Fracture of the Proximal Femur
Hee Gon Park, Jae Sung Yoo
J Korean Fract Soc 2011;24(4):307-312.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.307
AbstractAbstract PDF
PURPOSE
To analyze diagnostic process and clinical data in cases of fracture of the femoral shaft with fracture of the proximal femur.
MATERIALS AND METHODS
We reviewed 24 cases of patient who undergone surgery for fracture of the femoral shaft with ipsilateral fracture of the proximal femur and more than 1 year of examination of follow up was available. Age, sex.location and classification of the fracture, the time of diagnosis and operation, the method of operation, the associated injuries, the time of bony union and complication were investigated, postoperative function was evaluated on Friedman and Wyman criteria.
RESULTS
Bony union showed significant difference in the displacement and comminution of fracture, postoperative function revealed significant difference according to the associated injuries. The 6 cases (25%) out of 24 cases are failed early diagnosis, 4 cases out of 6 cases was detected during operation and 2cases was found after surgery. 21 cases out of 24 cases of femoral shaft fractures showed union, 23 cases out of 24 cases of femoral neck fractures showed union. There were eleven good, eleven fair, and two poor functional result according to Friedman and Wyman criteria.
CONCLUSION
Precious clinical and radiologic examination is needed not to miss the diagnosis of proximal femur fractures in ipsilateral femoral shaft fractures with proximal femur fractures. Anatomical reduction and rigid fixation of proximal femur are important to reduce avascular necrosis of femoral head and nonunion of proximal femoral fractures.
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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
J Korean Fract Soc 2011;24(4):313-320.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.313
AbstractAbstract PDF
PURPOSE
To evaluate the union time and nonunion rate after intramedullary nailing of femoral shaft fracture in adult, we would like to analysis the operation techniques, comminution, contact surface and displacement.
MATERIALS AND METHODS
We reviewed retrospectively 53 patients undergoing femoral intramedullary nailing at least 2 years postoperatively and analysised the union time and nonunion rate by operation techniques, comminution, contact surface and displacement. Patients were operated by either antegrade or retrograde intramedullary nailing.
RESULTS
There were no differences in nonunion rate, the duration of bony union between antegrade and retrograde intramedullary nail groups. Significant differences were found in the duration of bony union between the Winquist and Hansen type I, II and the type III, IV (p<0.05). There were significant differences in the duration of bony union among simple, comminuted, and segmental fracture groups (p<0.05).
CONCLUSION
The union time is affected by not operation techniques and fracture displacement, but Winquist-Hansen classification and number of fracture fragments in intramedullary nailing of adult femoral shaft fracture.

Citations

Citations to this article as recorded by  
  • Extra-capsular proximal femoral fractures: a cohort comparison of union and complication rates after ballistic versus blunt trauma
    Jordan Cook Serotte, Kevin Chen, Julia Nascimben, Jason Strelzow
    European Journal of Orthopaedic Surgery & Traumatology.2025;[Epub]     CrossRef
  • Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
    Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
    Hip & Pelvis.2014; 26(2): 107.     CrossRef
  • Augmentative Locking Plate Fixation for the Treatment of Femoral Nonunion after Intramedullary Nailing
    Ki-Chul Park, Chul-Woong Kim, Kyu-Tae Hwang, Ye-Soo Park
    Journal of the Korean Fracture Society.2013; 26(4): 268.     CrossRef
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Treatment of Distal Femoral Fractures Using Polyaxial Locking Plate
Sang Eun Park, Hyun Taek Kang, Young Yul Kim, Jae Jung Jeong, Jung U Lee, Weon Yoo Kim
J Korean Fract Soc 2011;24(4):321-327.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.321
AbstractAbstract PDF
PURPOSE
To report the clinical outcome of polyaxial locking plate (Noncontact bridging (NCB) plate (Zimmer, Warsaw, Indiana)) for the treatment of distal femur fracture with minimal invasive percutaneous periosteal osteosynthsis (MIPPO) technique.
MATERIALS AND METHODS
Between February 2008 to April 2010, twenty six patients (11 men, 15 women), twenty eight cases diagnosed as distal femoral fractures are enrolled in this retrospective study. The mean age of the patients was 63 years (34 to 85) and the mean follow-up was 20.3 months (12 to 32). According to the AO/ASIF classification, 15 fractures were type A, 1 type B and 9 type C. And there were 3 periprsthetic fractures around knee. The analysis of the clinical and radiologic outcome were performed by Sanders functional evaluation scale and radiologic follow up after operation, respectively.
RESULTS
Among 28 cases, 25 cases united without additional operation. According to Sanders functional evaluation scale, there were 11 excellent, 9 good, 4 fair, 2 poor. As complications, there were 1 knee stiffness, 1 delayed union, 1 implant failure with refracture, 1 implant loosening. Three patients except one knee stiffness, underwent a second LISS plating using NCB plate and and bone grafting, resulting in a satisfactory final outcome.
CONCLUSION
Internal fixation using polyaxial locking plate with MIPO technique may be one of the most effective methods for the treatment of distal femoral fractures.

Citations

Citations to this article as recorded by  
  • Usefulness of Reduction and Internal Fixation Using a 2.4 mm Hand Plating System in Type AO 33-A3 Distal Femur Fracture: Technical Note
    Bong-Ju Lee, Ja-Yeong Yoon, Seungha Woo
    Journal of the Korean Fracture Society.2023; 36(1): 25.     CrossRef
  • Incidence of nonunion after surgery of distal femoral fractures using contemporary fixation device: a meta‐analysis
    Byung-Ho Yoon, In Keun Park, Youngwoo Kim, Hyoung-Keun Oh, Suk Kyu Choo, Yerl-Bo Sung
    Archives of Orthopaedic and Trauma Surgery.2021; 141(2): 225.     CrossRef
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Treatment of the Trimalleolar Fracture Using Posterolateral Approach: Minimum 2-year Follow Up Results
Gwang Chul Lee, Jun Young Lee, Sang Ho Ha, Jae Won You, Sang Hong Lee, Hong Moon Sohn, Ki Young Nam, Kwang Hyo Seo
J Korean Fract Soc 2011;24(4):328-334.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.328
AbstractAbstract PDF
PURPOSE
To analyze the long term follow up results of treatment with posterolateral approach and to investigate its usefulness in the patients of trimalleolar fracture with posterior fragment which is above 25% of articular involvement.
MATERIALS AND METHODS
There were 34 cases of trimalleolar fracture in our hospital from May 2004 to April 2008. We investigated 20 patients who underwent operation with the posterolateral approach and over-2 years follow up cases. The mean follow up period was 34 (24~58) months. Preoperative posterior malleolar fragment involved above 25% of articular surface in all cases and displaced more than 2 mm in 11 cases. We analyzed the radiologic type of posterior malleolar fragments and evaluated the function and pain through AOFAS score and complications.
RESULTS
All cases showed primary union at mean 13.1 weeks. The complications are that partial ankylosis result of soft tissue contracture is seen in 2 cases (10%) and post-traumatic arthritis is seen in 1 cases (5%) and 17 cases (85%) of all patients are showed excellent AOFAS score.
CONCLUSION
The posterolateral approach is a valuable method because that it enables us to easily reduction and internal fixation of the posterior malleolus and lateral malleolus at one time and the results are satisfied for a long time follow up.

Citations

Citations to this article as recorded by  
  • Outcomes of Immediate Operative Treatment of Ankle Trimalleolar Open Fractures
    Jun-Young Lee, Yong-Jin Cho, Sin-Wook Kang, Yung-Min Cho, Hyun-Bai Choi
    Journal of Korean Foot and Ankle Society.2020; 24(1): 25.     CrossRef
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Results of Hook Plate Fixation of Unstable Distal Clavicle Fractures
Hoon Sang Sohn, Byung Chul Jo
J Korean Fract Soc 2011;24(4):335-340.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.335
AbstractAbstract PDF
PURPOSE
This study evaluated the clinical and radiological outcomes of unstable distal clavicular fractures treated with an AO Hook plate.
MATERIALS AND METHODS
From March 2009 to October 2010, sixteen patients with distal clavicular fractures underwent open plating using an AO Hook plate. The clinical outcomes were assessed by measuring the UCLA scores and KSS sores, and the radiological outcomes were evaluated using simple radiographs at the final follow-up.
RESULTS
Fracture union was obtained in all patients at an average of 13.9 weeks (range, 9~20 weeks). The UCLA scoring system showed excellent results in 9 cases and good results in 7. The average KSS scores of distal clavicular fractures were 95.5. At the final follow-up, subacromial osteolysis developed in 11 cases (68.7%) of whom 3 suffered from pain around the acromion. Other complications occurred in 4 patients: one had a fracture adjacent to the plate proximally, two had a stiff shoulder with subacromial impingement, and one had hypoesthesia around the surgical wound.
CONCLUSION
Unstable distal clavicular fractures treated with a Hook plate provided rigid fixation and satisfactory outcomes considering the high union rate. Nevertheless, potential postoperative complications related to morphometric properties of the plate should be considered.
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Minimally Invasive Anterior Plating of Humeral Shaft Fractures
Hyun Joo Lee, Chang Wug Oh, Do Hyung Kim, Kyung Hyun Park
J Korean Fract Soc 2011;24(4):341-346.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.341
AbstractAbstract PDF
PURPOSE
We evaluated the efficacy and results of minimally invasive anterior plating for humeral shaft fracture.
MATERIALS AND METHODS
Twenty-two cases of humeral shaft fracture were reviewed, including 8 cases of type A, 8 of type B and 6 of type C (AO/OTA classification). There were three open fractures. The fracture was fixed with MIPO (minimally invasive plate osteosynthesis) technique under C-arm guide. A locking compression plate was located in anterior aspect of the humerus with at least three screws fixed in each fragment. Radiologic and functional results were evaluated.
RESULTS
In 20 of 22 cases, bony union was achieved with the mean period of 17.5 weeks, including 2 cases of delayed union. There were 2 cases of nonunion, which needed the further operative procedure. Except one case of distal 1/3 fracture, all cases showed satisfactory elbow and shoulder function with the mean Mayo elbow score of 17.4 and mean UCLA shoulder score of 97.3. In complication, there was one case of radial nerve palsy due to improper traction, but it was completely improved after 3 months. Otherwise, there was no complication including infection.
CONCLUSION
Anterior MIPO for humeral shaft fracture may be another option of operative methods with high union and low complication rate.

Citations

Citations to this article as recorded by  
  • Minimal Invasive Plate Osteosynthesis versus Conventional Open Plating in Simple Humeral Shaft Fracture (AO Type A, B1, B2)
    Boseon Kim, GwangChul Lee, Hyunwoong Jang
    Journal of the Korean Fracture Society.2017; 30(3): 124.     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
  • Operative Treatment of Humerus Shaft Fracture: Conventional Open Plating or Minimally Invasive Plate Osteosynthesis
    Hyun-Joo Lee, Chang-Wug Oh
    Journal of the Korean Fracture Society.2012; 25(2): 155.     CrossRef
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Surgical Treatment of the Perilunate Dislocation and the Lunate Dislocation with Dorsal Approach
Soo Hong Han, Jin Myoung Dan, Dong Hoon Lee, Young Woong Kim
J Korean Fract Soc 2011;24(4):347-353.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.347
AbstractAbstract PDF
PURPOSE
To evaluate the clinical and radiologic outcomes of the perilunate dislocation and the lunate dislocation which were managed surgically through a dorsal approach.
MATERIALS AND METHODS
Retrospective reviews of the 13 patients who had minimum 1-year follow-up after surgical treatment through isolated dorsal approach for their perilunate dislocations or the lunate dislocations were performed. The case that dislocated lunate migrated proximally through the wrist was excluded in this series. We evaluated the DASH score in questionnaire method and Mayo wrist score to analyze the clinical outcomes. Radiologic results were investigated by measurement of the scapho-lunate angle, and fracture union was also evaluated in the case of trans-scaphoid dislocation.
RESULTS
The mean DASH Score was 16.3 points (range, 10.8~26.7 points) and the mean Mayo wrist score was 79 points (range, 65~90 points) at the final follow-up. There were 2 cases of excellent, 7 cases of good and 4 cases of fair in the Mayo wrist score. On the radiologic analysis, the mean scapho-lunate angle was 49.0degrees (range, 35~55degrees) and all cases were within the normal range. All cases of the trans-scaphoid perilunate dislocation achieved bone union.
CONCLUSION
Author's cases showed satisfactory outcomes in clinically and radiologically. Isolated dorsal approach could give anatomical reduction and appropriate internal fixation in treatment of the perilunate dislocations and the lunate dislocations except the rare case of proximal migration of the lunate through the wrist.
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The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures
Seung Wook Baek, Kyu Dong Shim, Ye Soo Park
J Korean Fract Soc 2011;24(4):354-360.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.354
AbstractAbstract PDF
PURPOSE
Evaluate the effects of sagittal imbalance on the clinical outcomes in thoracolumbar burst fractures.
MATERIALS AND METHODS
We evaluated 11 patients who had received posterior fixation for unstable burst fractures. Radiologic assessment including the compression ratio, focal kyphotic angle and sagittal balance were obtained. The clinical outcomes were assessed by ODI, VAS and SF-36. We subdivided the patients into sagittal balance and imbalance group, and compared with clinical outcomes. The relationship between radiologic and clinical outcomes was examined using correlation analysis.
RESULTS
The radiologic assessment were changed on preoperative and postoperative as follows: mean compression ratio: 15.2%, 4.9%, mean focal kyphotic angle: 43.2degrees, 20.9degrees. The mean sagittal balance was 11.5 cm. The mean score of VAS, ODI, Physical and Mental Component Summary of SF-36 were 3.7, 45.8, 43.3 and 39.8, respectively. The ODI was significantly higher in sagittal imbalance group, and SF-36 was significantly higher in sagittal balance group (p<0.05). The VAS was correlated with compression ratio and focal kyphotic angle. The ODI and Mental Component Summary of SF-36 were correlated with sagittal imbalance.
CONCLUSION
Sagittal balance effects on the functions of spine, surgical treatment should be carefully considered with unstable burst fractures.
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Cement Leakage into Disc after Kyphoplasty: Does It Increases the Risk of New Adjacent Vertebral Fractures?
Hoon Sang Sohn, Seong Kee Shin, Eun Seok Seo, Kang Seob Chang
J Korean Fract Soc 2011;24(4):361-366.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.361
AbstractAbstract PDF
PURPOSE
This study aims to investigate the relationship between cement leakage into the disc during percutaneous balloon kyphoplasty and subsequent compression fractures in adjacent vertebrae during treatment of osteoporotic vertebral compression fracture.
MATERIALS AND METHODS
103 patients (118 vertebrae) who have been treated with balloon kyphoplasty due to osteoporotic compression fracture from June 2007 to July 2010 were retrospectively analyzed. The group was composed of 13 males and 90 females. The mean age was 75 years (57~95 years). The mean follow-up period was 10 months (6~30 months). Patients were divided into two groups; one with cement leakage into the disc and the other without cement leakage into the disc. The study was performed to determine whether subsequent compression fractures in adjacent vertebrae were related to several factors.
RESULTS
The cement leakages into the disc occurred in 16 of 118 vertebrae. Of the 16 vertebrae with cement leakage into the disc, 5 (31%) had subsequent adjacent vertebral compression fractures; however, of the 102 vertebrae in which cement leakage did not occur, only 11 (11%) had subsequent adjacent vertebral compression fractures (p<0.05). Of the 16 vertebrae with cement leakage into the disc, subsequent adjacent vertebral compression fractures occurred 1 vertebrae of 10 vertebrae with definite trauma history. Out of the 6 vertebrae with cement leakage and no definite trauma history, 4 vertebrae (67%) had subsequent adjacent vertebral compression fractures (p<0.05).
CONCLUSION
The cement leakage into the disc significantly increases the incidence of subsequent adjacent vertebral compression fractures. Most of the subsequent fractures occurred in the early post-operative period. When cement leakage into the disc occurred in patients with no definite trauma history such as slip down, the incidence of subsequent adjacent vertebral compression fracture increased significantly.
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Case Report
Treatment of Nonunion of Tibia with Extracorporeal Shock Wave Therapy: A Case Report
Seung Yong Sung, Han Kook Yoon, Jeung Yeul Jung
J Korean Fract Soc 2011;24(4):367-370.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.367
AbstractAbstract PDF
Almost tibia fractures can be surgically treated, but nonunion may occur in 10~30%, and they may accompany various complications by operation. This research was designed to review literatures and report a case of patient with nonunion of the tibia that showed good result when performing the extracorporeal shock wave therapy as a conservative treatment.
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Review Articles
Sacral Fractures
Young Soo Byun, Se Ang Chang
J Korean Fract Soc 2011;24(4):371-381.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.371
AbstractAbstract PDF
No abstract available.

Citations

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  • Laminoplasty for Treatment of Transverse Sacral Fracture: A Case Report
    Young Soo Jang, Jak Jang, Sung Ju Bae, Chan Il Bae, Sung Bae Park
    Journal of the Korean Fracture Society.2014; 27(2): 157.     CrossRef
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Revision Total Knee Arthroplasty in the Treatment of Periprosthetic Fracture around the Knee
Kang Il Kim, Kye Youl Cho, Donggeun Kang
J Korean Fract Soc 2011;24(4):382-387.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.382
AbstractAbstract PDF
No abstract available.
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