PURPOSE To assess the indication and effect of screw fixation in the transverse patellar fractures. MATERIALS AND METHODS We analysed the results of 14 transverse patellar fractures fixed with screws from January 1991 to May 2005. Mean follow-up period was 47 months (range, 12~143 months). We analysed the radiologic union, operation time, ROM and postoperative Lysholm score. RESULTS All fractures healed uneventfully. The mean displacement was decreased from 2.2 mm preoperatively to 0.3 mm postoperatively (p=0.001, Wilcoxon signed rank test). The mean operation time was 34 minutes (range, 20 to 60 minutes). Normal range of motion was achieved in 13 knees (92.9%). Average Lysholm score was 95.9 at final follow-up. CONCLUSION Screw fixation seemed to be useful for treatment of transverse patellar fracture even in comminuted fractures with large fragments. The advantage of this technique was the preservation of extensor mechanism, simplicity, short operation time and good cosmesis.
Citations
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Surgery of patellar fractures using a medial parapatellar approach Yong-Cheol Yoon, Jae-Ang Sim, Jin-Hun Hong Journal of Orthopaedic Surgery.2017;[Epub] CrossRef
Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef
PURPOSE To evaluate the pattern of meniscal tear according to the type of the tibial plateau fracture of Schatzker. MATERIALS AND METHODS Sixty two cases of tibial condyle fracture treated between the period of 1994 and 2003 were evaluated.
The fracture type was classified according to Schatzker. The pattern and extent of the meniscus tear were compared with the fracture classification. Statistical analysis was made with the Fisher's exact test. RESULTS Meniscus tear was noted in 29 cases out of 62 fractures (46.8%). The twenty cases of minimally displaced fractures treated conservatively showed no meniscal tear. Of 18 cases of the most common type I fracture 2 (11.2%) had a meniscus tear. Of 16 type II fractures 12 (75%) had a meniscus tear. The type III fracture showed the highest prevalence of meniscus tear (76.9%, 10/13). There was statistically significant relationtionship between the type of fractures and the rate of meniscus tear (p<0.0001). CONCLUSION The meniscus tear frequently occurred in tibial plateau fractures in Schatzker type II and III. Associated meniscus tears should be born in mind when those types of fracture are encountered.
PURPOSE To establish a general guide line in the treatment of the patellar fracture MATERIALS AND METHODS: Twenty three patellar fractures followed for 2.2 years in average, treated with internal fixation were evaluated retrospectively. The primary fixations were the metal screw fixation in 7, the Dall-Miles' cable circumferential fixation in 14 and combination of both methods in 2 cases. The additional fixations were the tension band wiring in 9, the load sharing cable fixation in 3 and combination of both methods in 5 cases. The initial postoperative immobilazation of the knee joint in flexion, preferably 90degrees, for 7 days was effective to gain full range of motion RESULTS: Complete union without displacement was achieved in all cases. Full ROM was achieved in all cases except one. CONCLUSION The choice of internal fixation need to be individualized according to the level of comminution, bone strength, fracture site and soft tissue damage. A strong internal fixation, initial immobilization in flexion followed by early ROM exercise were important factors to gain good result.
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Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases Ji-Hye Geum, Hyeon-Jun Woo, Jong-gyu Kim, Jung-Han Lee Journal of Korean Medicine Rehabilitation.2020; 30(4): 203. CrossRef
Treatment of Transverse Patellar Fracture with Cannulated Screws Jung-Man Kim, Ju-Seok Yoo, Yong-Jin Kwon, Jang-Ok Cheon Journal of the Korean Fracture Society.2007; 20(2): 149. CrossRef
PURPOSE Untreated meniscus injuries accompanied with fractures of lateral tibial condyle may cause prolonged pain and post-traumatic arthritis. Lateral displacement of fractured fragment of lateral tibial condyle was found to be related to the incidence of lateral meniscus tear. We established the risk groups for lateral meniscus injuries on the basis of the degree of the lateral displacement of lateral tibial condyle. MATERIALS and METHODS Risk groups for lateral meniscus injury in fractures of lateral tibial condyle were evaluated in 39 knees, retrospectively, using plain roentgenograms and arthroscopic findings. On the knee anteroposterior radiography, displacement of lateral tibia condyle were classified into three groups according to the probability of lateral meniscus INJURY: high risk group for above 8mm of lateral displacement; moderate risk group for 4-8mm; low risk group for less than 4mm. RESULTS High risk group has ten meniscus injuries among 13 knees(76.9%) and moderate risk group had the seven meniscus injuries of 18 knees(38.9%). Low risk group of eight knees had no meniscus injury(0%). These different incidences among groups were statistically significant(p<0.05). CONCLUSIONS The authors suggest that the incidence of lateral meniscus injury was related to the degree of lateral displacement of lateral tibial condyle, and our definition of risk groups are useful for prediction of lateral meniscus injury in fracture of lateral tibial condyle.
Seven patients with femur fractures were treated with external fixators. The average age at fracture Intertrochanteric fracture of the femur, of which reported mortality ranges from 15% to 20%, usually occurs in the elderly and is usually comminuted and unstable. Many operative techniques have been developed for early exercise and walking ambulation to reduce mortality and morbidity, but they still have disadvantages. Few papers has been reported on hemiarthroplasty for intertrochanteric fracture in elderly patient, but they did not preserve the calcar femorale which is very impartant anatomic portion for weight transmission after hemiarthroplasty Therefore, the purpose of this paper is to analyze clinical outcome of hemiarthroplasty with preseuation of calcar femorale and wiring of greater trochanter for intertro chante ric fracture.
From March 1993 through March 1995. 28 elderly patients had undergone hemiarthroplasty with preservation of calcar femorale and wiring of greater trochanter for the treatment of severely comminuted and osteoporotic intertrochanteric fractures. Mean follow-up period was 17.5 months ranging from 12 months to 28 months.
The results obtained were as follows : 1. The most common type by Boyd-Griffin classification was II(73%).
2. Twenty five cases(83%) had osteoporosis, which was evaluated by Singh index.
3. The average operating time was 42.8 minutes and average hospitalifation period was 20.6 days.
4. Excellent functional results according to hip rating scale of Merie DAubigne were obtained in 24 cases(80%).
5. Creater trochanter fixed with wire was united in average 4.4months postoperatively.
6. One case(3%) developed loosening of implant at postoperative 13 months.
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.