Journal of Musculoskeletal Trauma

Triplane Fracture Management: Prediction of Periosteal Entrapment and the Need for Open Reduction by Measurements of the Physeal Fracture Gap in Preoperative Computed Tomography Scans: Dae Hee Lee, Joo Han Kwon, Jae Uk Jung; J Korean Fract Soc 2024;37(1):1-7. Published online January 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.1.1

Abstract PDF: Purpose
This study measured the physeal fracture gap on preoperative ankle computed tomography (CT) to predict the periosteal entrapment that requires an open reduction in distal tibia triplane fractures.
Materials and Methods
This study retrospectively reviewed patients who had undergone internal fixation for a triplane fracture from April 2004 to September 2022. The demographic data, including age,body mass index, and past medical history, were analyzed. In the radiographic evaluations, ankle CT and ankle simple radiographs, including anteroposterior (AP), lateral, and mortise views, were taken preoperatively. Postoperatively, simple ankle radiographs were obtained periodically, including AP, mortise, and lateral views. The physeal fracture gap was measured on ankle CT, and the larger gap between the coronal and sagittal view of CT was selected. The residual physeal gap <2 mm was considered an adequate reduction.
Results
Of 17 cases, three demonstrated successful reduction using closed reduction techniques. Periosteal entrapment was observed in 14 cases open reduction cases. In all three closed reduction cases, the physeal gap estimated on preoperative ankle CT was under 3 mm with a mean gap of 2.4±0.2 mm (range, 2.1-2.5 mm). In the remaining 14 open reduction cases, the measured physeal gap was over 3 mm, averaging 5.0±2.7 mm (range, 3.1-12.2 mm). There was a significant difference in the preoperative physeal gap between the two groups (p<0.01). Overall, good reduction was achieved in all 17 cases; the postoperative physeal gap was under 2 mm with a mean of 1.0±0.5 mm (closed reduction group, 0.5±0.2 mm; open reduction group, 1.1±0.5 mm).
Conclusion
Open reduction is strongly recommended for triplane fractures with a physeal fracture gap of 3 mm or more in preoperative ankle CT, suggesting the possibility of an entrapped periosteum in the fracture gap.

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Calcified Anterior Tibial Artery Entrapment in Distal Third Tibial Fracture: A Case Report: Kyu Hyun Yang, Yougun Won, Sang Bum Kim, Won Kuen Park, You Sun Jung; J Korean Fract Soc 2016;29(1):68-72. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.68

In the distal third of the tibia, the anterior tibial artery runs close to the anterolateral surface of the tibial cortex. In a clinical situation, without vascular evaluation, injury or entrapment of the anterior tibial artery is difficult to detect. Because, an intact dorsalis pedis pulse is supplied with the collateral vessels of the posterior tibial artery. An entrapped anterior tibial artery can be injured during closed reduction in an emergency room or open reduction and internal fixation in the operating room. Care must be taken to prevent iatrogenic anterior tibial artery. In this case, an entrapped anterior tibial artery was observed in a simple radiograph and computed tomograph without contrast media for the vessel. We report on a rare case of calcified anterior tibial artery entrapment in a distal tibial fracture.

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Comparison of Time to Operation and Efficacies of Ultrasound-Guided Nerve Block and General Anesthesia in Emergency External Fixation of Lower Leg Fractures (AO 42, 43, 44)
Chan Kang, Sang-Bum Kim, Youn-Moo Heo, You-Gun Won, Byung-Hak Oh, June-Bum Jun, Gi-Soo Lee
The Journal of Foot and Ankle Surgery.2017; 56(5): 1019. CrossRef

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Interposition of Extensor Pollicis Longus Tendon in Smith's Fracture in a Child: A Case Report: Seung Ju Jeon, Haeng Kee Noh, Do Yeon Kim, Sung Hoon Jung, Jun Beum Shin, Ho Seung Jeon; J Korean Fract Soc 2013;26(1):65-68. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.65

Abstract PDF: Entrapment of the extensor pollicis longus tendon is reported rarely on Smith's fractures in children. In our case, a 15 year old boy with Smith's fracture received treatment of closed reduction at another hospital. When he visited our hospital, a wide gap at the fracture site was detected on radiograph and the thumb movement was limited. We have doubt the entrapment of the soft tissue, especially the tendon. We decided on open reduction. In the operation field, entrapment of the extensor pollicis longus tendon at the gap of the fracture site was found through dorsal approach. In addition, fracture treatment with K-wire fixation after reduction of extensonr pollicis longus tendon reduction was done. Therefore, we report this case with a review of the literatures.

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Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures: Ki Chan An, Dae Hyun Park, Yong Wook Kwon; J Korean Fract Soc 2011;24(3):256-261. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.256

Abstract PDF

PURPOSE
To investigate the relationship between the greenstick laminar fractures and the dural tear in low lumbar burst fractures and their optimal treatment.
MATERIALS AND METHODS
We enrolled 51 patients (52 cases) who had been diagnosed with low lumbar burst fracture from June 2003 to May 2007. The average age was 39 years (range, 22 to 58), 30 male patients (58.8%), and 21 female patients (41.2%). Average follow-up periods was 19 months (range, 11 to 45). Lumbar CT scan were taken 1 mm slices in precision for all patients. We judged it incomplete fracture if lumbar CT scans show loss of cortical continuity over 3 slices if there is an aggrement of two among one radiologist and two orthopaedic surgeons reached a consensus. Dural tear and entrapment of nerve root were confirmed intraoperatively by the senior surgeon.
RESULTS
In 52 burst fractures, complete lamina fractures occurred in 21 cases and there were green stick laminar fractures in 14 cases. Neurologic defect has been found in 12 cases, 5 (63%) from complete laminar fractures and 3 (37%) from green stick laminar fractures. Dural tears has been detected in 9 cases (26%), 4 (19%) from complete laminar fractures and 5 (36%) from green stick laminar fractures.
CONCLUSION
Dural tear and nerve root entrapment can be accompanied in patients with green stick fracture. There is necessary to consider the possibility of dural tear and nerve root entrapment before operation and to indentify carefully to the presence of nerve root entrapment during operation.

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Risk factors for damage to the dura mater in thoracic and lumbar spine injury
A. G. Martikyan, A. A. Grin, A. E. Talypov, S. L. Arakelyan
Hirurgiâ pozvonočnika (Spine Surgery).2022; 19(1): 31. CrossRef
Clinical Efficacy of Large-Channel Percutaneous Lumbar Endoscopic Decompression in the Treatment of Lumbar Spinal Stenosis Secondary to Old Compression Fractures
Junlin Liu, Qingquan Kong, Walter Munesu Chirume, Pin Feng, Bin Zhang, Junsong Ma, Yuan Hu
World Neurosurgery.2022; 166: e118. CrossRef
Diagnostics, pathogenesis and treatment of damage to the dura mater in spinal injury
A. G. Martikyan, A. A. Grin
Russian journal of neurosurgery.2018; 20(2): 74. CrossRef

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Bowel Entrapment by Fragments of Acetabular Fracture: A Case Report: Ji Wan Kim, Jung Jae Kim, Suk Kyung Hong, Kyu Hyuk Kyung, Jin Hee Kim; J Korean Fract Soc 2010;23(4):373-376. Published online October 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.4.373

Abstract PDF: Abdominal injuries are common in patients with pelvic or acetabular fracture. However intestinal entrapment or perforation caused by fragments of a pelvic or acetabular fracture is rare and to date there has been no report of this occurring in Korea so far. As it is difficult to diagnose intestinal entrapment caused by fragments of pelvic or acetabular fracture, the entrapment therefore results in intestinal perforation, sepsis, and a high mortality rate in the absence of early detection. We present a case of intestinal entrapment and perforation caused by fragments of acetabular fracture as well as a literature review.

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Irreducible Dislocation of the Interphalangeal Joint of the Great Toe with Lateral Collateral Ligament Entrapment: A Case Report: Duke Whan Chung, Bi O Jeong; J Korean Fract Soc 2009;22(2):110-113. Published online April 30, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.2.110

Abstract PDF

Dislocations of the interphalangeal joint of the great toe that are irreducible are very rare. Invagination of the plantar plate or the sesamoid bone into the IP joint, which prevents reduction. To our knowledge, however, dislocations of the IP joint of the great toe that were irreducible because of lateral collateral ligament entrapment, not invagination of the plantar plate or the sesamoid bone, have not been reported by any English literature. We report a 29-year-old ballet dancer who sustained an irreducible dislocation of the interphalangeal joint of the great toe owing to lateral collateral ligament entrapment.

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Open Reduction of a Dislocation of the Interphalangeal Joint of the Great Toe Neglected for 6 Weeks
Jae Kwang Kim, Rag-Gyu Kim
Journal of the Korean Orthopaedic Association.2011; 46(5): 426. CrossRef

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