Pelvic nonunion is very difficult to treat. According to the nonunion site, anterior or posterior surgical approach should be used selectively. And if the nonunion site is located in both anterior and posterior, both anterior and posterior surgical approach should be used. We report a case of testicular necrosis after ilioinguinal approach used as a anterior approach to pelvis to treat pelvic nonunion developed as a result of unstable pelvic ring injury.
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Anatomical Study of Symphysis Pubis Using 3 Dimensional Computed Tomography in Koreans Ji Wan Kim, Jung Min Park, Jae Suk Chang Journal of the Korean Fracture Society.2013; 26(1): 32. CrossRef
PURPOSE To evaluate the radiologic and functional results of treatment in proximal tibial plateau fracture using lateral submeniscal approach, which is a relatively minimally invasive approach to tibial condylar articular surface. MATERIALS AND METHODS Twenty three cases of tibial plateau fracture which treated with submeniscal approach were analyzed with one year follow up. The results were evaluated by immediate postoperative radiographic and Hohl's clinical evaluation. RESULTS Tibial articular surface could be in operation field and the articular surface could be restored the anatomically by elevating the depressed articular surface and bone graft to the empty space. The postoperative radiography showed that most cases (91%) could be reduced adequately (within 2 mm). The clinical evaluation by Hohl's criteria revealed excellent 7 cases (30%), good 12 cases (52%), fair 3 cases (13%), and one poor case (4%). CONCLUSION Submeniscal approach can identify the articular surface and intraarticular soft tissues with minimal incision, and allows anatomical reduction, sufficient bone graft, rigid plate fixation and soft tissue treatment, therefore it is one of the good approach in treatment of proximal tibial plateau fracture.
OBJECTIVES To establish the precise diagnosis of a comminuted pertrochanteric fracture with femoral neck fracture in a senile osteoporotic patient and report of a preliminary clinical results of early bipolar hemiarthroplasty.
MATERIAL & METHODS: Consecutive seven cases of comminuted pertrochanteric fractures who were suspicious to have combination with femoral neck fracture were evaluated. All cases had routine radiographs and CT scans of proximal femur and performed with bipolar hemiarthroplasties. Observation of the retrieved femoral head to evaluate a fracture and recorded with photograph. Postoperative evaluation was done with Daubine & Postel clinical grading with medical recording and personal telephone. The clinical evaluation was focused on the recovery for preinjured walking distance. RESULTS All patients were proved to have combination with pertrochanteric fractures and femoral neck fractures. In addition, all patients were recovered to more than good in clinical grading and pre-injured walking distance. CONCLUSION To make a precise diagnosis of pertrochanteric fractures with femoral neck fracture it is recommended to perform the CT scan with prompt reading of the simple radiographs in suspicious case. An early bipolar hemiarthroplasty was also recommended to treat this kind of senile difficult fracture.
The goals in the treatment of a tibial plateau fracture are to obtain a stable, aligned, mobile and painless joint and to minimize the risk of post-traumatic osteoarthritis. Most recently the management of tibial plateau fractures has been via arthroscopy. Proponents of arthroscopic techniques advocate their use not only to better visualize the surface of the tibia but also to evaluate the rest of the joint. This retrospective study compared the results of arthroscopic and conventional treatment of tibial plateau fractures from January 1988 through April 1995. Forty-seven knees of tibial plateau fractures were involved in this study.
Sixteen of these patients were treated with arthroscopic reduction and autogenous bone graft with or without internal fixation, while the remaining 31 underwent open reduction, bone graft and internal fixation.
The results are as follows: 1. The average time to full weight bearing was 10.2 weeks (range 7-14 weeks) in the arthroscopic group and 13.5 weeks(7.2-18 weeks) in the open reduction group.
2. The incidence of lateral meniscus tear was 56%(9/16) in the arthroscopic reduction group and 29%(9/31) in the open reduction group.
3. Flexion of at least 130 was obtained in 81%(13/16) of arthroscopic reduction group, while only Tabl 58%(16/31) in the open reduction group. Full extension was obtained in 93%(15/16) of arthroscopic reduction group, and in 83%(26/31) in the open reduction group.
4. Complications occurred more frequently in the open reduction group than in the arthroscopic reduction group.