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J Musculoskelet Trauma : Journal of Musculoskeletal Trauma

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Volume 29(4); October 2016
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Original Articles
The Significance of Calcaneal Posterior Tuberosity Fragment Reduction When Treated with Open Reduction in Displaced Intra-Articular Calcaneal Fractures
Hong Ki Park, Jong Ryoon Baek, Jang Seok Choi, Sang Jin Lee, Je Won Paik
J Korean Fract Soc 2016;29(4):233-241.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.233
AbstractAbstract PDF
PURPOSE
We attempt to evaluate the significance of calcaneal posterior tuberosity fragment reduction when treated with surgical open reduction in displaced intra-articular calcaneal fractures.
MATERIALS AND METHODS
A total of 90 patients with displaced intra-articular calcaneal fracture, between January 2010 and December 2015, treated with open reduction and internal fixation were enrolled in this study. At postoperative 3 months, we evaluated the reduction state of calcaneal posterior tuberosity fragment by measuring the degree of lateral displacement of the posterior tuberosity fragment on the calcaneal axial view. Moreover, we also evaluated the difference in the calcaneal length and height with the uninjured side on the lateral view of both sides. In addition, we estimated the reduction state of the posterior facet by measuring the degree of gap and step-off on the semi-coronal view of postoperative computed tomography and estimated the restoration of calcaneal angle by measuring the difference in Böhler's and Gissane angle with the uninjured side on the lateral view of both sides.
RESULTS
The correlation coefficient with 3 components for evaluating the reduction state of posterior tuberosity fragment and gap and step-off of posterior facet was r=0.538, 0.467, r=0.505, 0.456, r=0.518, and 0.493, respectively, and restoration of Böhler's and Gissane angle was r=0.647, 0.579, r=0.684, 0.630, r=0.670, and 0.628, respectively. The relationship of each component shows a significant correlation as all p-values were <0.01.
CONCLUSION
The precise reduction of calcaneal posterior tuberosity fragment developed by the primary fracture line was considered as an important process of anatomical reduction of calcaneal body, including the posterior facet and calcaneal angle restoration.
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The Mid-Term Result after Osteosynthesis of Intra-Articular Fractures of Distal Femur
Sam Guk Park, Jeong Jae Moon, Oog Jin Shon
J Korean Fract Soc 2016;29(4):242-249.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.242
AbstractAbstract PDF
PURPOSE
This study was to evaluate the radiological and clinical mid-term results and the presence of post-traumatic osteoarthritis after osteosynthesis in patients under the age of 50 years undergoing osteosynthesis for distal femur intra-articular fractures (AO/OTA 33-B & C) from high-energy trauma.
MATERIALS AND METHODS
Between January 2008 and January 2013, a total of twenty-one patients with more than three years of follow-up were enrolled. Recovery of the alignment of the lower extremity, union period, and the presence of post-traumatic osteoarthritis were confirmed by follow-up radiographs. Clinically, the range of motion, pain on fracture lesion, and Knee Society score (KSS) were evaluated.
RESULTS
The average duration of union was 18.2 weeks (10-28 weeks), and the alignment of the lower extremity was within normal range in all patients. Seven patients showed post-traumatic osteoarthritis at the final follow-up after more than three years. The presence of post-traumatic osteoarthritis was associated with the classification of fractures, coronal plane fracture, and age. The average range of motion, knee score among KSS, and function score at the last follow-up were 128.7°, 86.1, and 85.1, all showing a greater improvement when compared with the one-year follow-up scores.
CONCLUSION
The mid-term result was radiologically and clinically satisfactory. Furthermore, only 33.3% of patients showed a slight progress of post-traumatic osteoarthritis, which critically effects the prognosis.

Citations

Citations to this article as recorded by  
  • 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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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
J Korean Fract Soc 2016;29(4):250-257.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.250
AbstractAbstract PDF
PURPOSE
The purpose of this study was to introduce our method of stabilizing unstable intertrochanteric fractures by using the dynamic hip screw (DHS) with a beta-tricalcium phosphate (β-TCP) graft and to compare the outcomes of this procedure with those of the conventional DHS without β-TCP.
MATERIALS AND METHODS
Patients who underwent surgery by using DHS between March 2002 and January 2016 were retrospectively reviewed for analysis of the outcomes. The inclusion criteria were: 1) age of 60 years and older; 2) low-energy fracture resulting from a fall from no greater than the standing height; 3) multifragmentary pertrochanteric fracture (AO classification 31-A2.2, 2.3); and 4) follow-up of over 3 months. We compared 29 patients (29 hips) who underwent surgery, using DHS without β-TCP, with 29 age-sex matched patients (29 hips) who underwent surgery using DHS with grafted β-TCP granules to empty the trochanter area after reaming. We investigated the fracture union rate, union time, and length of lag screw sliding.
RESULTS
Bone union was achieved in all cases. The mean union time was 7.0 weeks in the β-TCP group and 8 .8 weeks in the non-β-TCP group. The length of lag screw sliding was 3.6 mm in the β-TCP group and 5 .5 mm in the non-β-TCP group. There were no implant failure cases in both groups.
CONCLUSION
The β-TCP graft for reinforcement DHS acquired satisfactory clinical outcomes for treating unstable intertrochanteric fractures.
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Case Reports
Insufficiency Fracture of the Femoral Neck after Intramedullary Nailing for the Treatment of Atypical Femoral Fracture - A Case Report -
Nam Hoon Moon, Jae Hoon Jang, Tae Hyuk Hwang, Ki Young Park
J Korean Fract Soc 2016;29(4):258-264.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.258
AbstractAbstract PDF
Although several publications have reported delayed or non-union, there is a consensus that the standard treatment for atypical femoral fracture (AFF) is an intramedullary nailing. However, no case of tensile insufficiency fracture of femoral neck associated with intramedullary nailing in patients with AFF have been reported. Here, we report an 82-year-old woman with tensile type of insufficiency fracture of the femoral neck after intramedullary nailing for the treatment of AFF.
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Percutaneous Drainage and Sclerotherapy for Delayed Lumbar Morel-Lavalee Lesion: Two Case Reports
Hongsil Joo, Sang Gyo Seo, Sang Yeul Lee, Kun Yong Sung
J Korean Fract Soc 2016;29(4):265-269.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.265
AbstractAbstract PDF
Closed internal degloving is a significant soft-tissue injury associated with a trauma that results in a tear of the subcutaneous tissue away from the underlying fascia. Although the diagnosis of Morel-Lavallee lesion (MLL) is routinely based on clinical and radiological examinations, in one-third of the cases, there is a possibility that clinicians may fail to diagnose MLL due to its inconsistent clinical manifestations. Additionally, it often involves initial skin bruising due to underlying soft-tissue injury. We present two cases of delayed MLL without a fracture treated using percutaneous drainage and sclerotherapy. Our cases demonstrated successful treatment with a minimally invasive percutaneous approach. The potential advantage of using a percutaneous technique is to preserve the subdermal arterial plexus, which is the only remaining blood supply to the skin in the area of the lesion. Maintaining this blood supply may result in healthier skin at the time of any open procedure.

Citations

Citations to this article as recorded by  
  • Surgical Treatment of a Delayed Diagnosed Morel-Lavallee lesion: A Case Report
    Choong Hyeon Kim, Woo Young Choi, Kyung Min Son, Ji Seon Cheon
    Journal of Wound Management and Research.2017; 13(2): 62.     CrossRef
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Acute Patellar Osteomyelitis in a Child after a Blunt Trauma: Case Report
Hoe Jeong Chung, Doo Sup Kim, Jun Seop Yeom, Young Hwan Jang
J Korean Fract Soc 2016;29(4):270-275.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.270
AbstractAbstract PDF
Osteomyelitis of the patella is a very uncommon condition that occurs mostly in the pediatric population. In addition to its rarity, nonspecific and variable clinical presentations usually lead to postponement in making the correct diagnosis. Moreover, it is often missed as prepatellar bursitis or septic arthritis of the knee. Nonetheless making early diagnosis and initiating prompt treatment is most important to preventing this condition from becoming chronic. In this case report, the authors encountered this rare condition of the patella in a child that was first misdiagnosed with pyogenic arthritis or prepatellar bursitis of the knee. The delay in making the diagnosis led to intractable progression of the disease, and sequestrectomy was required to stabilize the condition.

Citations

Citations to this article as recorded by  
  • Osteomyelitis of the Patella With Extension Into Parapatellar Soft Tissues in a Six-Year-Old Boy: A Case Report
    Abdulla Abdelwahab, Faatimah Irfaanah Muzammil, Abdulla Nidal, Mason Alnouri, Sattar Alshryda
    Cureus.2024;[Epub]     CrossRef
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Review Articles
Fractures of the Tarsal Bone
Young Hwan Park, Hak Jun Kim, Soo Hyun Kim
J Korean Fract Soc 2016;29(4):276-282.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.276
AbstractAbstract PDF
Fractures of the tarsal bone, such as the navicular, cuboid, and cuneiform, are very rare. These injuries can lead to serious walking difficulties due to pain and deformity of the foot with delayed diagnosis of tarsal bone fractures during an injury to multiple lower extremities. The diagnosis can be done on simple radiographs. Sometime weight bearing radiographs or stress radiographs may be needed for further evaluation. Computed tomography is the most widely available diagnostic tool. Navicular and cuneiform account for the medial column of the foot, whereas cuboid for the lateral column. The treatment of tarsal bone fractures is primarily conservative management, but operative treatment is recommended for intra-articular displacement, dislocation, or shortening of the medial or lateral column of the foot. The operative treatments include screw fixation, plate fixation, or external fixation. Complications include malunion, nonunion, posttraumatic arthritis, avascular necrosis, and deformity of the foot. Tarsal bone fracture has to be evaluated carefully to prevent serious complications.

Citations

Citations to this article as recorded by  
  • Effects of Acupuncture Treatment and Taping Therapy After Lisfranc Joint Injuries: A Case Report
    Shin-Ae Kim, Su-Woo Kang, Eun-Ji Lee, Min-Kyung Kwak, Hui-Gyeong Jeong, Jae-Uk Sul
    Journal of Acupuncture Research.2017; 34(4): 197.     CrossRef
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Lisfranc Joint Injuries: Diagnosis and Treatment
Hyun Seok Yim, Sung Ha Hong, Ki Sun Sung
J Korean Fract Soc 2016;29(4):283-293.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.283
AbstractAbstract PDF
Injuries to the Lisfranc joint are relatively rare, but they are often misdiagnosed or inadequately treated, resulting in poor long-term outcomes. Understanding of anatomical structure and injury mechanism, careful clinical and radiographic evaluations are needed to recognize and treat Lisfranc joint injuries. In this article, we review the anatomy, biomechanics, injury mechanisms, injury classification, clinical presentation, radiographic evaluation, treatment, outcome, and complications of Lisfranc joint injuries.

Citations

Citations to this article as recorded by  
  • Lisfranc Sports Injuries: What Do We Know So Far?
    Godsfavour C Maduka, Divinegrace C Maduka, Naeem Yusuf
    Cureus.2023;[Epub]     CrossRef
  • Effects of Acupuncture Treatment and Taping Therapy After Lisfranc Joint Injuries: A Case Report
    Shin-Ae Kim, Su-Woo Kang, Eun-Ji Lee, Min-Kyung Kwak, Hui-Gyeong Jeong, Jae-Uk Sul
    Journal of Acupuncture Research.2017; 34(4): 197.     CrossRef
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