Journal of Musculoskeletal Trauma

Original Articles

Effect of Additional Medial Locking Plate Fixation and Autogenous Bone Graft for Distal Femur Nonunion after Lateral Locking Plate Fixation: Ho Min Lee, Jong Pil Kim, In Hwa Baek, Han Sol Moon, Sun Kyo Nam; J Korean Fract Soc 2024;37(1):30-38. Published online January 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.1.30

Abstract PDF: Purpose
This study examined the outcomes of additional medial locking plate fixation and autogenous bone grafting in the treatment of nonunions that occurred after initial fixation for distal femoral fractures using lateral locking plates.
Materials and Methods
The study involved eleven patients who initially underwent minimally invasive lateral locking plate fixation for distal femoral fractures between January 2008 and December 2020. The initial procedure was followed by additional medial locking plate fixation and autogenous bone grafting for clinically and radiographically confirmed nonunions, while leaving the stable lateral locking plate in situ. A clinical evaluation of the bone union time, knee joint range of motion, visual analog scale (VAS) pain scores, presence of postoperative complications, and functional evaluations using the lower extremity functional scale (LEFS) were performed.
Results
In all cases, bone union was achieved in an average of 6.1 months after the secondary surgery. The range of knee joint motion, weight-bearing ability, and VAS and LEFS scores improved at the final follow-up compared to the preoperative conditions. All patients could walk without walking assistive devices and did not experience pain at the fracture site. On the other hand, three patients complained of pain in the lateral knee joint caused by irritation by the lateral locking plate; hence, lateral hardware removal was performed. One patient complained of mild paresthesia at the anteromedial incision site. Severe complications, such as deep infection or metal failure, were not observed.
Conclusion
For nonunion with stable lateral locking plates after minimally invasive lateral locking plate fixation of distal femur fractures, additional medial locking plate fixation and autogenous bone grafting, while leaving the lateral locking plate intact, can achieve successful bone union.

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Treatment of Isolated Lateral Malleolar Fractures Using Locking Compression Plate Fixation and Tension Band Wiring Fixation: Woojin Shin, Seondo Kim, Jiyeon Park; J Korean Fract Soc 2020;33(1):16-21. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.16

Abstract PDF: PURPOSE
The purpose of this study was to compare the clinical and radiological outcomes of locking compression plate (LCP)-screw fixation and tension band wiring (TBW) fixation in isolated lateral malleolar fractures.
MATERIALS AND METHODS
From May 2016 to August 2018, 52 patients with isolated lateral malleolar fracture were retrospectively reviewed. They were divided into 30 cases of the LCP fixation group (Group I) and 22 cases of the TBW fixation group (Group II). The clinical and radiological results of those groups were compared. Pearson chi-square tests and independent t-tests were used in the statistical analysis.
RESULTS
The mean length of the surgical incision was 8.3 cm in Group I and 4.9 cm in Group II. Radiological union was obtained at a mean of 8.4 weeks in both groups. The mean American Orthopaedic Foot and Ankle Society score was 90 (range, 85â€“97) and 92 (range, 85â€“100) in Groups I and II, respectively, at the last follow up.
CONCLUSION
Both the LCP-screw and TBW techniques revealed excellent results in isolated lateral malleolar fractures. The tension band technique may be a fine alternative method of fixation in the treatment of isolated lateral malleolar fracture.

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Treatment of Periprosthetic Femoral Fractures Following Total Knee Arthroplasty: Lih Wang, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Jin Soo Hwang, Sun Hyo Kim; J Korean Fract Soc 2014;27(1):42-49. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.42

Abstract PDF

PURPOSE
The purpose of this study is to compare the treatment results of fracture fixations by using two minimal invasive techniques for patients with periprosthetic femoral fractures following total knee arthroplasty.
MATERIALS AND METHODS
We reviewed 36 patients (5 males, 31 females) of periprosthetic femoral fractures whom were treated surgically between January 2005 and January 2011. Mean patient age was 68.9 years (range, 43 to 81 years) old and the follow-up period averaged 41 months (range, 18 to 72 months). Nineteen patients were treated with minimal invasive locking plate fixations (group I) and 17 patients with retrograde intramedullary nailing (group II). Clinical and radiological outcomes in each group were comparatively analyzed.
RESULTS
Successful bone unions occurred in all patients and the mean time to bone union was 3.7 months in group I and 4.2 months in group II. There were no statistical differences between the two groups according to mean operative time and mean intraoperative blood loss. There were also no statistical differences between two groups according to clinical outcomes but the valgus deformity was apparent in group II and radiological outcomes revealed significant differences between the two groups.
CONCLUSION
For the treatment of periprosthetic femoral fractures after total knee arthroplasty, two minimal invasive techniques have shown good clinical results. However, the minimal invasive plate fixation showed better results in the radiological alignments.

Citations

Citations to this article as recorded by

The Result of Treatment of Femoral Periprosthetic Fractures after Total Knee Arthroplasty
Jun-Beom Kim, In-Soo Song, Dong-Hyuk Sun, Hyun Choi
Journal of the Korean Orthopaedic Association.2014; 49(6): 446. CrossRef

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