PURPOSE The purpose of this study is to analyze the radiographic and clinical results of intramedullary nailing after percutaneous reduction using pointed reduction forceps for spiral or oblique fractures of the distal tibia. The benefit of percutaneous reduction using pointed reduction forceps in anatomical reduction and maintenance was assessed. MATERIALS AND METHODS From January 2005 to December 2009, 47 cases of distal one-third tibial fracture were managed by intramedullary nailing using pointed reduction forceps. Thirty-eight cases were spiral fracture and nine cases were oblique fracture. In all cases, the percutaneous reduction was achieved using pointed reduction forceps under fluoroscopy control. While maintaining the reduction with the pointed reduction forceps, the intramedullary nail was inserted. The pointed reduction forceps were removed after insertion of proximal and distal inter-locking screws. Alignment was evaluated with anterior-posterior and lateral radiographs taken immediately post-operation and at the time of union. RESULTS At immediate post-operation, the mean displacement of valgus and anterior angulation was 0.57degrees and 0.24degrees, respectively. That of valgus and anterior angulation at bone union was 0.37degrees and 0.16degrees, respectively. The average duration of bone union was 16.1 weeks. CONCLUSION Intramedullary nailing with percutaneous reduction using pointed reduction forceps for distal tibial fractures was an easy and effective method for achievement of accurate alignment intra-operatively. Accurate alignment was successfully maintained until bone union.
PURPOSE This study was designed to compare the clinical and radiologic outcome of the patients who underwent percutaneous vertebroplasty among the groups based on follow-up period and BMD. MATERIALS AND METHODS A total of 99 patients (171 vertebral bodies) underwent percutaneous vertebroplasty from January 2001 to September 2003. The patients were divided into 3 groups by follow-up periods, and also divided into 2 groups by BMD. We investigated the difference of radiologic and clinical effects among the groups. Radiologic findings was assessed as vertebral height restoration rate and rate of reduction loss by measurement of the height of vertebral body. The clinical outcomes were graded into 5. The statistical analysis was done using Chi-squire test and Independent-samples T test. RESULTS Among the groups divided by follow-up period, there was no statistically significant difference of clinical and radiologic results except the rate of reduction loss between group I and group III (p>0.05). Between the groups divided by BMD, there was no statistically significant difference of clinical and radiologic results. CONCLUSION Percutaneous vertebroplasty with bone cement for the osteoporotic compression fracture is an efficient procedure and considered as technique producing pleasurable clinical and radiologic results regardless of follow up-period and BMD.
PURPOSE To evaluate the results of Cable plate fixation for the treatment of periprosthetic femoral fracture after hip arthroplasty. MATERIALS AND METHODS We reviewed 10 cases of periprosthetic femoral fractures after hip arthroplasty between Nov. 2002 and May 2004. The mean follow up periods were 20 months. The fractures were classified according to Vancouver classification. Seven cases of type B1, one case of type B3 and two cases of type C were treated with open reduction and internal fixation with Cable plate. Evaluation of results was based on mean union time, postoperative complications and Harris hip score. RESULTS The mean time for bony union was 4.8 months in type B1, 6 months in type B3 and 8 months in type C fracture. As for complications, there were refracture, metal breakage and nonunion. The postoperative mean Harris hip score was 91.5 points for type B1, 85 points for type B3 and 72.5 points for type C fracure. CONCLUSION Cable plate can be useful for treatment of periprosthetic femoral fractures after hip arthroplasty, but the selection of treatment methods should be cautiously made according to the type of fracture and status of patients.
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Treatment of Periprosthetic Femoral Fracture according to the Vancouver Classification Il-Yong Choi, Duk-Moon Jung, Seoung-Pyo Seo, Young-Ho Kim The Journal of the Korean Orthopaedic Association.2007; 42(2): 147. CrossRef
PURPOSE To determine optimal levels of posterior fixation in thoraco-lumbar bursting fractures according to the Load-sharing classification. MATERIALS AND METHODS From Aug. 1999 to Aug. 2003, 50 patients who had been operated with the posterior fixation in one-body thoraco-lumbar bursting fracture were selected. They were divided into two groups, group I, 6 points and below in the Load-sharing score and group II, 7 points and above. And also, each groups subdivided into two subgroups, A (short segment fixation including below and above one body) and B (long segment fixation including below and upper two body). So patients subdivided into I-A, I-B, II-A, II-B. Change of the corrected kyphotic angle was measured and compared with each subgroups. RESULTS The loss of the corrected kyphotic angle was measured average 1.7degrees in group I and 4.1degrees in group II, and there was significant difference between two groups (p>0.05). The loss of the corrected kyphotic angle in the subgroups was average 1.8degrees in I-A, 1.6degrees in I-B, 3.5degrees in II-A and 4.9degrees in II-B. And there was significant difference statistically in I-A and II-A (p>0.05). CONCLUSION In the thoraco-lumbar bursting fracture with 6 points and below of the Load-sharing score, the fixation of the short segment is a useful method. But in the fracture with 7 points and above, the fixation of the short segment is not enough, and these findings be required the further evaluation for some cause of the loss of corrected angle and treatment modalities including the fixation of the long segment.
Analysis of Factors Affecting Postoperative Loss of Reduction in Unstable Thoracolumbar Fractures Jaewan Soh, Chang-Hwa Hong, Chung-Won Bang, Jae Chul Lee, Byung-Joon Shin Journal of Korean Society of Spine Surgery.2017; 24(3): 190. CrossRef
Analysis of Factors Affecting Postoperative Loss of Reduction in Unstable Thoracolumbar Fractures Jaewan Soh, Chang-Hwa Hong, Chung-Won Bang, Jae Chul Lee, Byung-Joon Shin Journal of Korean Society of Spine Surgery.2017; 24(3): 190. CrossRef
More than 5-Year Follow-up Results of Two-Level and Three-Level Posterior Fixations of Thoracolumbar Burst Fractures with Load-Sharing Scores of Seven and Eight Points Sub-Ri Park, Hwa-Yeop Na, Jung-Mook Kim, Dong-Chan Eun, Eui-Young Son Clinics in Orthopedic Surgery.2016; 8(1): 71. CrossRef
The Outcomes of Short and Long Segment Posterior Instrumentation of Thoracolumbar Burst Fractures with a Load Sharing Score of 7 or More Jeong Ho Seo, Kyu Yeol Lee Journal of Korean Society of Spine Surgery.2015; 22(3): 92. CrossRef
Comparison of Short Segment and Long Segment Posterior Instrumentation of Thoracolumbar and Lumbar Bursting Fractures at Load Sharing Score 7 or Above Hwa-Yeop Na, Young-Sang Lee, Joon-Cheol Choi, Woo-Seong Kim, Woo-Suk Song, Yu-Hun Jung, Tae-Hoon Park, Tae-Hwan Kim, Kang-Won Seo Journal of Korean Society of Spine Surgery.2013; 20(2): 44. CrossRef
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 Journal of the Korean Fracture Society.2011; 24(4): 354. CrossRef
Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level Jeong-Gook Seo, Jong-Ho Park, Jeong-Seok Moon, Woo-Chun Lee Journal of the Korean Fracture Society.2009; 22(1): 39. CrossRef
Most authors report 70% to 80% good to excellent results following open reduction and internal fixation of fractures of the patella. As with most intraarticular fractures, the prognosis for healing and restoration of function in fractures of the patella is dependent on the amount of articular cartilage damage and exact reduction of fracture.
In order to document clinical results and describe any prognostic factors, we evaluated the results of 69 patellar fractures treated in 66 patients who had been treated with open reduction and internal fixation at the Department of Orthopaedic Surgery, Nationanl Medical Center, from January 1990 to December 1994.
The average age at the time of surgery was 41.2 years(16 years-75 years) and the average follow-up time was 38.7 months(14 months-74 months).
The results were as fellows: 1. The mechanism of injury(traffic accident), concomittant inury of ipsilateral lower extremity, fracture morphology, immgbilization period less than two weeks and accuracy of reduction were significant prognostic factors.
2. Age and method of fixation were not significant prognostic factors.
3. The brisement of knee under general anesthesia was helpful, that had been performed following bony union.