Volar plating seems to indicate that many surgeons believe it leads to superior results, and is attractive because of the ease of the operative approach and the soft tissue sleeve to protect digital and wrist tendons. And also it have a locking mechanism to produce the fixed angle device with a low profile and may be thought to be a new era in the surgical treatment of dorsally displaced distal radius fractures even in the face of comminuted or osteoporotic bone. Locked volar plating allows direct fracture reduction, stable fixation and provides stability enough to allow early mobilization and function. The results with volar locking or fixed angle fixation for the general treatment of unstable distal radius fractures in elderly patients has been favorable. Volar plating has fewer complications than external fixation and dorsal plating and allow for earlier return to function. The current indications, technical aspects, clinical results, and complications of the volar plating are being reviewed.
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Ultrasonographic Assessment of the Pronator Quadratus Muscle after Surgical Treatment for Distal Radius Fractures Dong Hyuk Choi, Hyun Kyun Chung, Ji Won Lee, Cheol Hwan Kim, Yong Soo Choi Journal of the Korean Fracture Society.2017; 30(2): 69. CrossRef
The Fate of Pronator Quadratus Muscle after Volar Locking Plating of Unstable Distal Radius Fractures Chae-Hyun Lim, Heun-Guyn Jung, Ju-Yeong Heo, Young-Jae Jang, Yong-Soo Choi Journal of the Korean Fracture Society.2014; 27(3): 191. CrossRef
Comparison of Operative Management in Distal Radius Fractures Using 3.5 mm Versus 2.4 mm Volar Locking Compression Plates Sung-Sik Ha, Tae-Ho Kim, Ki-Do Hong, Jae-Chun Sim, Jong Hyun Kim Journal of the Korean Fracture Society.2011; 24(2): 156. CrossRef
Treatment for Unstable Distal Radius Fracture with Osteoporosis -Internal Fixation versus External Fixation- Jin Rok Oh, Tae Yean Cho, Sung Min Kwan Journal of the Korean Fracture Society.2010; 23(1): 76. CrossRef
Short Term Results of Operative Management with 2.4 mm Volar Locking Compression Plates in Distal Radius Fractures Ki-Chul Park, Chang-Hun Lee Journal of the Korean Fracture Society.2009; 22(4): 264. CrossRef
PURPOSE To analyze related factors of radial nerve palsy in patients with humeral shaft fractures. MATERIALS AND METHODS We reviewed 107 paients with humeral shaft fracture between January 2000 and June 2007. Thirteen patients had radial nerve palsy after trauma and 9 patients after the operation. We analyzed contributing factors of radial nerve palsy associated with humeral shaft fracture including the cause of trauma, location and pattern of fracture, surgical approach and tourniquet application in cases of plate fixation, the exploration for the nerve and the time for operation. RESULTS The difference in the incidences of radial nerve palsy after trauma and operation was not significant according to the location and pattern of fracture. The tendency of higher rate of radial nerve palsy after trauma in oblique or comminuted fractures, and after operation in spiral fractures was observed. The operation using intramedullary nailing and radial nerve exploration significantly reduced the incidence of radial nerve palsy after operation (p=0.01 and p=0.02). Posterior approach in open reduction and plate fixation showed a tendency of lower incidence of radial nerve palsy after operation (p=0.78). In logistic regression analysis, radial nerve exploration was the only significant factor that reduced the possibility of radial nerve palsy after operation (17.27: odds ratio, p=0.02). CONCLUSION In humeral shaft fractures, we should take into consideration whether intramedullary nailing is possible or not. In cases of anterior or anterolateral approach of open reduction and plate fixation, radial nerve should be carefully inspected. In most cases, we recommend radial nerve exploration in order to minimize the possibility of radial nerve palsy after operation.
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Treatment of Radial Nerve Palsy Associated with Humeral Shaft Fracture Soo-Hong Han, Jin-Woo Cho, Han-Seung Ryu Archives of Hand and Microsurgery.2020; 25(1): 60. CrossRef
Associated Factors of Radial Nerve Palsy Combined with Humerus Shaft Fracture Si-Wuk Lee, Chul-Hyun Cho, Ki-Choer Bae Journal of the Korean Fracture Society.2014; 27(3): 185. CrossRef
Polarus Intramedullary Nail for Proximal Humeral and Humeral Shaft Fractures in Elderly Patients with Osteoporosis Youn-Soo Hwang, Kwang-Yeol Kim, Hyung-Chun Kim, Su-Han Ahn, Dong-Eun Lee Journal of the Korean Fracture Society.2013; 26(1): 14. CrossRef
Short Term Results of Operative Management with 2.4 mm Volar Locking Compression Plates in Distal Radius Fractures Ki-Chul Park, Chang-Hun Lee Journal of the Korean Fracture Society.2009; 22(4): 264. CrossRef
Plate Fixation of AO Type C3 Fractures of the Distal Radius Eun-Sun Moon, Myung-Sun Kim, Hyeong-Won Park, Min-Sun Choi Journal of the Korean Fracture Society.2009; 22(3): 172. CrossRef
Volar Plating of Distal Radius Fractures Kwang-Hyun Lee Journal of the Korean Fracture Society.2008; 21(4): 325. CrossRef
PURPOSE A The purpose of this retrospective study was to evaluate the results of compression plating and autogenous iliac bone graft in the management of humeral diaphyseal nonunion. MATERIALS AND METHODS Twenty patients who underwent the surgical treatments between May. 1998 and May. 2002 were included in this study. Nine of them are males and the others are females. The average age of them, when they was on operation, was 45 years. The symptoms lasted 23 months on average. They have been followed up for 33 months at an average. Treatment of nonunion consisted of resecting the atrophic nonunion, shortening the bone, apposing bleeding diaphyseal surface. Rigid fixation was then achieved using a compression plate and autogenous bone graft. RESULTS Solid bony union was achieved in all patients. In one patient, the bone was not healed at the first operation of plating and autogenous bone graft, but achieved union after the use of intramedullary nailing. In another patient, because of infected nonunion, we achieved union after several surgical debridement and stabilization by internal fixation. CONCLUSION This study documents that compression plate fixation with autogenous cancellous bone graft is a viable option with predictable and satisfactory results for humerus diaphyseal nonunion.
PURPOSE To analyze the clinical outcomes of surgical treatment of distal humerus intercondylar fractures through the transolecranon approach combined with anterior transposition of the ulnar nerve. MATERIALS AND METHODS Eight patients who had distal humerus intercondylar fractures were included in this study and underwent operative treatment through the transolecranon approach for sufficient operative field with anterior transposition of the ulnar nerve and fixed with reconstruction plate. RESULTS The results were evaluated using Riseborough and Radin rating criteria. Seven cases of eight cases were achieved good results with flexion contracture less than 30 degrees and forward flexion more than 115 degrees. However, one case was acheived poor result with 40 degrees of flexion contractue and 70 degrees of forward flexion. There were no the compressive ulnar neuropathy. CONCLUSION We found the transolecranon approach and anterior transposition of the ulnar nerve a viable option for surgical treatment of the distal humerus intercondylar fractures
Fracture of the distal humerus is rare, so the surgeons experience is limited. This injuries represent a constellation of complex articular fractures and anatomic complexity of distal humerus makes surgical treatment, open reduction and internal fixation is difficult. We analyze the clinical result of immediate open reduction, rigid internal fixation, and early postoperative motion. From Nov. 1990 to Sep. 1997, the authors analyzed the clinical results of 5 cases those who underwent operative treatment using transolecranon approach, internal fixation with Y plate and early motion for comminuted distal humeral intercondylar fracture. ROM exercise was started at average 2.2 weeks postoperatively. 4 of 5 patients obtained satisfactory results by Riseborough and Radin rating criteria. One patient obtained poor result of 40 degree flexion contracture and 90 degree further flexion of elbow. Transolecranon approach makes the complete anatomic reduction of articular surface possible and the satisfactory results is associated with immediate, complete anatomic reduction and rigid fixation in conjuction with early postoperative motion.
The Gamma nail combining the advantages of a sliding lag screw and the intramedullary femoral fixation is a advance in the treatment of trochanteric fractures. The Gamma nail is a new intramedullary device which has been applied in treatment of the trochanteric fractures with the benefits of closed technique such as low blood loss, low risk of infection, short operative time, short bone union period and early weight bearing and with the biomechanical advantages such as short lever arm and decreased bending moment. The implant can be used by the method of static or dynamic.
Intraoperative compression of the fracture segments can be achieved by acting on the sliding lag screw and further compression is given by weight bearing.
We studied 31 cases of patients who had the trochanteric fractures and treated opratively with Camma nail. The intertrochanteric fracture was 25 cases and subtrochanteric fracture was 6 cases.
Intraoperative complication was encountered failure of distal locking in 1 case. Postoperative complications were encounted superior cutting-out in 3 cases. As results of postoperative ambulation, 4 cases were death, 4 cases were bedridden state, 4 cases were ambulation state within house, 19 cases were social activity respectively.
Fracture of the capitate is a rare form of carpal injuries. It can occur with perilunate dislocation. In that case, capitate fracture associated with scaphoid fracture is common enough that it has been called the scaphocapitate fracture(or syndrome). A rare case of a displaced fracture of the capitate and unusual locked volar perilunate dislocation without scaphoid fracture is described. This carpal injury was treated by closed reduction and percutaneous pinning with one K-wire and the result is now excellent. A possible explantation of the mechanism underlying this conditian is offered and the literature is reviewed.
We reviewed 55 cases of open fracture of the forearm bones had been treated by conservative treatment or open reduction and intramedullary nailing or internal fixation with dynamic compression plate and analyzed the results by wound management and methods of treatment.The results were obtained as follows ;1. In the type I,II and type III-A open fractures, primary closure of the wound was reliable method of treatment. 2. The non-union rate was 44% in the positive culture test and 14.8% in the negative culture test. 3. Immediate internal fixation with dynamic compression plate was reliable method in the treatment of the type I, II open fractures.