PURPOSE To evaluate the result of forearm shaft fracture treated by modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA). MATERIALS AND METHODS 15 patients with fracture of radius, ulna, radio-ulna shaft treated by modified interlocking intramedullary nail from December 2003 to February 2007 were analyzed. Modified interlocking intramedullary nail has paddle blade tip and fluted rod, so the distal screw fixation was not needed but had relatively firm fixation. It has advantages including short operation time, small operation scar. The average follow up period was 8.3 months (range, 5~15 months). We analyzed the results by average union time and the functional results according to Anderson's criteria. RESULTS The mean duration of union was 9.8 weeks in radius and 11.4 weeks in ulna. The average range of motion of forearm was 74.6 degree in supination and 72 degree in pronation.. Functional results assessed by Anderson were rated excellet in 12 cases, satisfactory in 3 cases. We found no complications such as delayed union, non-union, neurovascular injury and infection. CONCLUSION Modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA) is a viable therapeutic alternative in the management of forearm shaft fracture.
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Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults Sanglim Lee, Hee-Sung Lee, Yerl-Bo Sung, Jae-Kwang Yum Journal of the Korean Fracture Society.2009; 22(1): 30. CrossRef
PURPOSE To evaluate the result of percutaneous vertebroplasty in the treatment of osteorporotic stable burst fracture that has not neurologic symptom. MATERIALS AND METHODS A retrospective review was conducted in 37 vertebrae of 33 patinets with osteoporotic stable burst fracrure treated by percutaneous vertebroplasty from February 2000 to May 2003. Stable burst fracture was classified by McAfee. The operation was performed in the patient without neurologic symptom, BMD T-score was below -2.5 and hot uptake was seen in (99m)Tc bone scan. The operation was held from post-traumatic 7 to 32 days, average 17 days. Follow up period was from 5 months to 38 months, average 11 months. The result of the treatment was assesed by clinical finding (pain scale and work status by Denis) and radiologic findings (percentage height restored and change of kyphotic angle). RESULTS In clinical assessment, 27 had a satisfactory pain scale below the P3, 25 had a satisfactory work status below the W3. In the radiologic findings, percentage height restore was increased from 0% to 62%, average 23.3%. The preop. kyphotic angle was from -20 degree to 42 degree, average 8.9 degree. The postop. kyphotic angle was from -20 to 42 degree, average 6.5 degree. The kyphotic angle was decreased average 2.4 degree after operation. CONCLUSION Treatment of osteoporotic stable burst fracture with percutaneous vertebroplasty is the minimal invasive treatment that has satisfactory pain relief and reduction of fracture.
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Outcome Comparison between Percutaneous Vertebroplasty and Conservative Treatment in Acute Painful Osteoporotic Vertebral Compression Fracture Hwa-Yeop Na, Young-Sang Lee, Tae-Hoon Park, Tae-Hwan Kim, Kang-Won Seo Journal of Korean Society of Spine Surgery.2014; 21(2): 70. CrossRef
PURPOSE To evaluate the radiographic and clinical results of displaced transverse patellar fractures using a tensioned anterior figure-eight wire placed through two cannulated screws MATERIALS AND METHODS: 9 patients with displaced transverse patellar fractures treated with cannulated screws and figure-eight wiring were analyzed retrospectively. The mean age was 53 years (range, 22 to 68 years). Controlled passive range of motion exercise were started on the first postoperative day. Full weight bearing was allowed as tolerated. The patients were evaluated with radiographs, clinical examination and Levack's scoring system. RESULTS All fractures healed and mean time elapsed for union was 9.4 weeks (range, 8 to 12 weeks). All patients regained full knee range of motion. Clinical results according to the Levack's scoring system were excellent in 8 cases and good in 1 case. We found no complications like loss of reduction and soft tissue irritation caused by the wire and screw, loosening or migration of hardware. CONCLUSION Anterior figure-eight wiring through paired cannulated screws is appropriate for transverse patellar fractures, is possible early knee motion exercise and weight bearing.
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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 Acromioclavicular joint dislocation are frequently seen and various operation treatment modalities have been suggested. The purpose of this study is to compare the clinical results of two operative methods, Bosworth screw procedure and Wolter plate technique. MATERIALS AND METHODS We have analysed 30 patients with acromioclavicular dislocations, which had been treated by Bosworth screw & Wolter plate technique from June 1996 to February, 2002 with minimal 1 year follow up. All patients were assessed clinical and radiological results by ASES Score and UCLA Score. RESULTS Using the Shoulder evaluation scheme of ASES and UCLA Score at the one year follow up examination, 93.4% of the patients had excellent results in Wolter plate group. In Bosworth screw group, 4 complications such as loosening of the screw, or breakage of screw were seen. 2 complicated patients were over 40 years old and then conversions to Wolter plate operation was needed and obtained good results. CONCLUSION Bosworth procedure has a merit not to damage acromioclavicular joint, but the technique is difficult, sometimes may be encountered loss of fixation due to overcorrection and anterior displacement of the clavicle. However, Wolter plate implant provides enough stability for active postoperative physiotheraphy, and hence accelerates rehabilitation. Therefore, this technique is thought to be a good modality in the treatment of acute acromioclavicular seperation.
PURPOSE We investigated the treatment modality and clinical results in flexion-type supracondylar fractures of the humerus in children. MATERIALS AND METHODS 11 cases of flexion-type supracondylar fractures of the humerus(3 type I, 5 type II, 3 type III) were treated, 3 fractures(3 type I) with extension cast, 6 fractures(5 type II, 1 type III) with two lateral percutaneous K-wire fixation, 2 fractures(2 type III) with open reduction and crossed pin fixation. The K-wire were removed after 4-6 weeks of operation and the follow-up period ranged from 12 months to 26 months, averaging 18 months. RESULTS By Flynn 's functional and cosmetic criteria, nine cases were good and excellent results, one case (type III with two lateral percutaneous pin fixation) is fair result. CONCLUSION As the same methods of the extension-type supracondylar fractures, the K-wire fixation is useful method in the treatment of flexion-type supracondylar fractures of the humerus in children.
PURPOSE To analyzed the degree of pain relief of 40 patients with osteoporotic thoracolumbar compression fracture treated by percutaneous vertebroplasty with bone cement. MATERIALS AND METHODS We studied 40 cases of the osteoporotic thoracolumbar compression fracture from January 2000 to June 2000. It was evaluated with simple Xray, bone scan, bone mineral density and CT for the patients 1)who had the compressed wedge fracture of vertebral body on simple X-ray, 2)who had increased bony uptakes of fracture site on bone scan, 3)who were under -2.5 in T-score on bone mineral density, 4)who were not relieved the pain to analgesic drug medication for more than 3 month with no radiating pain, 5)who had no fracture of posterior wall of vertebral body on CT in the case of acute fracture. We performed percutaneous vertebroplasty with bone cement and observed the degree of pain relief using pain scale pre-/ postoperation. RESULTS The average pain point decreased from 6.17 points to 1.06 points at postoperative 1 day, total decreased points were 5.11 points. The average pain point was 1.05 at postoperative 6 months in the patients followed up for more than 6 months. CONCLUSION Percutaneous vertebroplasty with bone cement is valuable method in the treatment of osteoporotic thoracolumbar compression fracture, providing pain relief, prevention of complication originated from long term traction and bed rest, unwearing brace and early ambulation
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Treatment of Combined Degenerative Lumbar Disease and Adjacent Vertebral Fracture Jae-Lim Cho, IL-Hoon Sung, Seung-Wook Baek, Ye-Soo Park Journal of Korean Society of Spine Surgery.2008; 15(4): 236. CrossRef
There are a few of reports of delayed rupture of flexor tendon around the wrist and hand by attrition. Only 4 cases of delayed flexor tendon rupture of finger except rupture of flexor pollicis longus after Cellos fracture were reported until now. Several causes of the delayed rupture of the tendon around the wrist and hand were reported by many authors. Cellos fracture is one of the cause of the attritional rupture. But the frequency of the attritonal rupture of the flexor tendon was only one-third of the extensor tendons. Furthermore, flexor tendons of the finger were less commonly affected than that of the thumb by their anatomical features. We would like to report a very rare case of delayed rupture of flexor digitorum profundus on 73 year old male patient by attrition on the bony spur which was formed by malunion of distal radial fracture about 10 years ago. They were treated by direct repair for ring finger and free tendon graft with flexor digitorum sublimis of middle finger for little finger. After 1 year follow up, range of motion and flexion power were recovered to nearly normal.
The tibial Pilon fracture is difficult to manage because high energy axial compression and rotational forces which make severe injuries to the ankle joint, which result in impaction, severe comminution, metaphyseal disruption and soft tissue trauma.
Though there are variable methods of treatment including manipulation and cast, calcaneal traction and cast, external fixation, pin and plaster, limited open reduction and external fixation, open reduction and internal fixation and arthrodesis, most of authors reported better result after a surgical treatment than that of conservative treatment. While there is no doubt that the treatment of ankle joint injuries is much improved today, complications are still very common for many reasons.
We have reviewed the 19 cases of the tibial plafond fractures on 18 patients which were treated at orthopedic department, Walles Memorial Baptist Hospital, from March 1991 to February 1995.
The results were as follows .
1. There were so much combined injuries that physician must evaluate other injury such as spinal compression fracture.
2. The most frequent type of pilon fracture was type 3, the 2nd was type 5 by Ovadia and Beals classification.
3. Regardless of the treatment method, type 1 and 2 were excellent subjective result by Ovadia and Beals subjective evaluation classificatioin, but in case of type 3, 4 we could get a good and excellent result by anatomical open reduction and internal fixation.
4. We could reduce complications of the postoperative wound infection and skin necrosis by posteromedial and posterolateral approach after skeletal traction and manual reduction for more than one week.