PURPOSE To evaluate indications and effectiveness of intramedullary K-wire fixation for distal radial fractures. MATERIALS AND METHODS Twenty one fractures of distal radius treated with intramedullary K-wire fixation from April 2001 to September 2002 were evaluated. The mean age was 67.8(range 46~82). Severely comminuted intra-articular fractures and Barton's fractures were excluded. One or two K-wires were added percutaneously. To assess the functional result, we used Green and O'Brien score system. The radiographic assessment included a scoring system based on measurements of radial length, radial inclination, volar tilt and step-off of the radial articular surface. RESULTS Average follow up period was 13.5 months. In functional result, excellent and good result were obtained in 18 cases (86%). In radiologic result, mean loss of radial length, radial inclination and volar tilt were 0.9 mm, 1.4degrees, 0.9degrees, respectively. CONCLUSION The advantages of intramedullary K-wire fixation were relatively simple procedure, low occurrence of soft tissue complications and early wrist motion. Intramedullary K-wire fixation was good to maintaining reduction in osteoporotic bone.
PURPOSE Fractures of the acetabulum remain a major challenge to the orthopedic surgeons. Although the operative treatment for the complex fractures is preferred, inaccurate reduction and then incongruity of the hip joint lead to serious complication such as premature osteoarthritis. We evaluated the results of surgical and conservative treatment for acetabular fractures. MATERIALS AND METHODS From January 1996 to March 2001, we reviewed 55 cases retrospectively. Posterior wall fracture (13 cases) was the most common by Letournel's classification and followed by both column fracture (10 cases). Causes of injuries included 41 cases of traffic accident and 8 cases of falling down. We divided the cases into an operation group (28 cases) and conservative group (27 cases) and evaluated the results as excellent, good, fair or poor according to Matta's clinical and radiological grade criteria. RESULTS Anatomical or satisfactory reduction was obtained in 22 cases of operative group and clinical results were excellent in 7 cases, good in 13 cases. Conservative group revealed excellent and good clinical results in 15 of 27 cases. CONCLUSION In cases of the displaced complex fractures, posterior wall fracture with instability and displaced fractures involving the weight bearing dome of the acetabulum, open reduction and internal fixation after accurate evaluation of the fracture pattern could allow earlier ROM exercise and have the result in better prognosis.
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Clinical Results of Surgical Treatment of Acetabular Fractures according to Quality of Reduction Sang-Hong Lee, Min-Kyu Shin, Sueng-Hwan Jo The Journal of the Korean Orthopaedic Association.2007; 42(2): 153. CrossRef
The goal of the treatment of femoral neck fractures is early ambulation to prevent the complications such as pneumoniae or atelectasis, deep vein thrombosis, pulmonary embolism, bed sore, general weakness. The authors have tried to asess the outcome and complication of multiple pinning (28 cases) and biploar endoprosthesis (35 cases) for femoral neck fractures in average 18 momths with the range of 12 months to 5 years from May 1990 to May 1996. The results were asessed by interval from injury to operation, post operative complication and mortality rate, weight bearing time, Lunceford hip grading method.
The results were as folllows: 1. Post operative complications rate were 43% in multiple pinning, and 26% in bipolar group.
2. The mortality rate was 14.2% in multiple pinning group and 11.4% in bipolar endoprosthesis group. 3. The functional results evaluated by Lunceford's methods were satisfactory in 64% of multiple pinning group and 71% in bipolar endoprosthesis group. We concluded that displaced fractures, subcapital fracture, severe osteoporosis, old fracture over 3 weeks in elderly patients, bipolar endoprosthesis gave a more reliable results.
Twenty one comminuted fractures of the proximal tibia in 21 patients were treated with Ilizarov external fixator from May 1990 to May 1996 in Pusan City Medical Center. The average duration of external fixation was 17weeks, and all of the fractures healed without bone graft. The mean time to union was 18weeks in closed comminuted fractures, and 21 weeks in Gustilo type I, II open fractures. The complications with this technique were pin tract infection 3 cases, pin loosening 6 cases, septic arthritis 1 case, post-traumatic osteoathritis 1 case, and joint ankylosis 1 case. The average duration of follow up was 18 months. The range of knee motion of 19 cases of the the 21 patients was at least 115-degrees arc. Post-operative immediate exercise was possible, and partial weight bearing with crutch was also possible after post-operative 4 weeks. We concluded that Ilizarov external fixation is a satisfactory technique for the treatment of selected comminuted fractures of the proximal tibia.