Journal of Musculoskeletal Trauma

Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures: Jin Young Han, Ki Youn Kwon; J Korean Fract Soc 2020;33(1):1-8. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.1

PURPOSE
This study compared the clinical and radiological results between two groups of patients with percutaneous fixation or conventional fixation after hardware removal.
MATERIALS AND METHODS
The study analyzed 68 patients (43 open fixation and 43 percutaneous screw fixation [PSF] 25) who had undergone fixation for unstable thoracolumbar fractures. The radiologic results were obtained using the lateral radiographs taken before and after the fixation and at the time of hardware removal. The clinical results included the time of operation, blood loss, time to ambulation, duration of the hospital stay and the visual analogue scale.
RESULTS
The percutaneous pedicle screw fixation (PPSF) group showed better results than did the conventional posterior fixation (CPF) group (p<0.05) in regard to the perioperative data such as operation time, blood loss, and duration of the hospital stay. There were no significant differences in wedge angle, local kyphotic angle, and the Î”Kyphotic angle on the postoperative plane radiographs between the two groups (p>0.05). There were no significant differences in the wedge angle and local kyphotic angle after implant removal (p>0.05) between the two groups as well. However, there were significant differences in the segmental montion angle (p<0.001), and the PPSF group showed a larger segmental motion angle than did the CPF group (CPF 1.7Â°Â±1.2Â° vs PPSF 5.9Â°Â±3.2Â°, respectively).
CONCLUSION
For the treatment of unstable thoracolumbar fractures, the PPSF technique could achieve better clinical results and an improved segmental motion angle after implant removal within a year than that of the conventional fixation method.

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A Comparison of 2 Surgical Treatments for Thoracolumbar Burst Fractures: Temporary Osteosynthesis and Arthrodesis
Halil Ibrahim Süner, Rafael Luque Pérez, Daniel Garríguez-Pérez, Marta Echevarría Marín, Jose Luis Pérez, Ignacio Domínguez
World Neurosurgery.2022; 166: e419. CrossRef

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Comparison of Quality of Life between Before and After Orthopaedic Implant Removal Surgery: Sang Bong Ko, Seung Bum Chae; J Korean Fract Soc 2016;29(2):101-106. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.101

Abstract PDF: PURPOSE
The purpose of this study is to determine whether or not a patient's results are improved after removal of an internal fixative from a patient with no related symptoms.
MATERIALS AND METHODS
This prospective study included 87 patients who agreed to participate in the study and satisfied the criteria for selection and exclusion of patients who underwent the operation for removal of internal fixative due to broken bones from March 1st, 2004 to December 31st, 2011 at Daegu Catholic University Medical Center. The average replication period was 27 months (12-64 months) and the average age at the time of the operation for removal was 41.5 years (21-75 years) for 55 males and 32 females. The quality of life for all patients was evaluated using Short Form 36 (SF-36) surveys before the operation for removal and after a minimum of one year.
RESULTS
After an orthopedic operation for removal of internal fixative, physical health status showed statistically significant improvement (p=0.001); however mental health status did not (p=0.411). A satisfaction test for the subjective surgery written by patients indicated an improvement of subjective health status in 52.9% after the surgery for removal but with no difference in 29.9% compared to preoperation.
CONCLUSION
In case of an operation for removal of internal fixative for patients with no related symptoms with internal fixatives used for treatment of fractures showing agglutination opinions, an improvement was observed in physical health status, not in mental health status. When surgery for removal of internal fixative is performed for patients without related symptoms, consideration that subjective satisfaction of patients shows an improvement only in 52.9% will be helpful.

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Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report: Ji Hwan Kim, Seung Oh Nam, Young Soo Byun, Han Sang Kim; J Korean Fract Soc 2015;28(1):71-76. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.71

Abstract PDF: Trochanteric entry femoral nails have been widely used for fixation of femoral shaft fractures because of easier identification of the entry point. Young patients usually request removal of the nail after healing of the fracture. We experienced a failure and difficulty in removal of the trochanteric entry nail in two adolescent patients. In the patient in which the nail could be removed with difficulty, dense compact bone was formed through the empty interlocking holes and the nail was held just like a latch. This finding was quite similar to the computed tomography findings of the patient in which the nail could not be removed. In order to remove the nail, the newly formed, dense compact bone in the interlocking holes must be broken and detached from the femur itself. We suggest that dense compact bone through the empty interlocking holes might be a clue for difficult removal of the trochanteric entry nail.

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Clinical Assessment after the Volar Locking Plate Removal of Distal Radius Fracture: Hee Chul Gwak, Joo Yong Kim, Gyu Min Kong, Jung Won Kim, Jae Yong Kwak, Dong Gyun Kim; J Korean Fract Soc 2014;27(1):23-28. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.23

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the clinical outcomes after removing the volar locking plate for distal radius fracture.
MATERIALS AND METHODS
We reviewed retrospectively the medical records of 34 patients, 36 cases after removing the plates among 150 patients, with 162 cases that underwent open reduction and internal fixation using the volar locking plate between January 2006 and May 2011. We performed preoperative and postoperative clinical assessments using the quick-disabilities of the arm, shoulder and hand (Q-DASH), the visual analog scale (VAS) score, and the range of motion on wrist, grip and pinch power.
RESULTS
The major reason for plate removal was the time to remove the plate according to the fracture union and the patient's demand without other specific complaints (28 cases). The mean preoperative VAS score was 1.78 and the mean postoperative VAS score 1.81 (p=0.64). The mean preoperative Q-DASH score was 30.02 and the mean postoperative Q-DASH score 38.46 (p<0.001). The mean preoperative grip and pinch power were 18.14 kg and 7.67 kg. The mean postoperative grip and pinch power were 15.27 kg and 6.94 kg (p=0.23).
CONCLUSION
The removal of the volar locking plate for distal radius fracture should be decided by considering the patient's clinical and socioeconomic conditions carefully.

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Failure of Removal of Stripped Locking Screw after Locking Compression Plating: Sung Jin Kim, Kyung Jae Lee; J Korean Fract Soc 2011;24(2):169-173. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.169

Abstract PDF

PURPOSE
The purpose of this study was to evaluate the incidence and possible causes of stripped locking screws that make difficult to remove the locking compression plate. We also tried to find the useful methods to remove the stripped locking screws.
MATERIALS AND METHODS
Between May 2005 and January 2009, 84 patients who underwent operations for removal of locking compression plate were included in this study. We removed 298 3.5-mm locking screws and 289 5.0-mm locking screws in these patients. We retrospectively investigated the incidence and possible causes of stripped locking screws and evaluated the pros and cons of the methods that we have used to remove the stripped locking screws.
RESULTS
17 out of 298 3.5-mm locking screws (5.7%) and 2 out of 289 5.0-mm locking screws (0.7%) were encountered with difficulties by hexagonal driver during removal because of the stripping of the hexagonal recess. First we used the conical extraction screw for all the stripped locking screws and only 3 screws were removed successfully. We removed 3 screws by cutting the plate around the stripped locking screw and twisting the plate with the screw and we removed 1 screw by the use of hallow reamer after cutting the plate. Twelve screw shafts were left except grinding of screw head by metal-cutting burr. There was one iatrogenic re-fracture in whom we have used with hallow reamer.
CONCLUSION
At the time of locking compression plate removal, difficulties of locking screw removal due to the stripping of the hexagonal recess should be expected and surgeon must prepare several methods to solve this problem.

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An inexpensive and rapid method for removal of multiple stripped locking screws following locking plating: A case report
Won Ro Park, Jae Hoon Jang
International Journal of Surgery Case Reports.2019; 57: 134. CrossRef

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Stripping of the Hexagonal Recess in the Process of LCP (Locking Compression Plate) Removal: Jong Keon Oh, Chang Wug Oh, Hoon Jung, Kwon Jae Roh, Tae Ho Kim; J Korean Fract Soc 2006;19(2):283-287. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.283

Abstract

PURPOSE
To report the difficulties in the process of locking head screw removal due to the stripping of the hexagonal recess of the screw head.
MATERIALS AND METHODS
We have removed 113 5.0-self tapping locking head screws and 202 3.5-self tapping locking head screws from 34 patients with fracture healing and 5 patients complicated with infection. All of the operations were done by one surgeon. All the screws were placed with the use of torque limiting attachment or driver.
RESULTS
All of 113 5.0-self tapping locking head screws were removed without difficulties with an usual manner. 21 out of 202 3.5-self tapping locking head screws were removed with many difficulties due to the stripping of the hexagonal recess. 3 screws were removed successfully with the use of conical extraction screw. 12 screws were taken out by further stripping and destruction of the screw head. In 6 situations where the only one screw was left stripped, the plate was bent around the stripped screw and then it was removed by turning the plate as a handle. One screw was removed with the partial breakage of the near cortex upon lifting the plate after failed attempt of using conical extraction screw.
CONCLUSION
Although we have followed the guidelines at the time of insertion we have experienced difficulties in the removal of 3.5 locking head screws due to the stripping of the hexagonal recess. Care should be taken at the time of removal of the locking plate especially for the 3.5 locking screws.

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An inexpensive and rapid method for removal of multiple stripped locking screws following locking plating: A case report
Won Ro Park, Jae Hoon Jang
International Journal of Surgery Case Reports.2019; 57: 134. CrossRef
Factors affecting accurate drill sleeve insertion in locking compression plates
J.-J. Kim, J.-W. Kim, H.-S. Yu, H.-S. Lee, H.-K. Oh
Orthopaedics & Traumatology: Surgery & Research.2013; 99(7): 823. CrossRef
Pitfalls and Complications in the Application of the Locking Plate
Jong-Keon Oh
Journal of the Korean Fracture Society.2007; 20(4): 355. CrossRef

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Prevention of Fracture During Removal of ILMN in Tibia Fracture: Bu Hwan Kim, Myoung Hee Choi, Sang Hun Yi, Mu Jung Heo; J Korean Soc Fract 2001;14(4):628-631. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.628

Abstract PDF: PURPOSE
Sometimes we experience refracture of tibia during removal of ILMN after complete union of fracture. We evaluated surgical technique in order to know how we can avoid the fracture of posterior cortex of tibia during removal of ILMN.
MATERIALS AND METHODS
From Jan. 1993 to Dec. 1999, we removed 86 cases of ILMN used for tibia fracture. Among them, 40 cases of Ace titanium ILMN were removed. We compared the fracture rate of tibia during removal of Ace titanium ILMN.
RESULTS
The refracture rate during removal of Ace titanium ILMN was 17.2% (5/29cases) previously, but after careful "slow and steady" removal of nail, the refracture rate was reduced to 0%(0/11 cases, P<0.05).
CONCLUSION
Take some cares during removal of ILMN is important to reduce the fracture rate of tibia during removal of Ace titanium ILMN.

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Intraoperative Fracture of the Tibia Associated with Removal of the Interlocking Intramedullary Nail: Report of 5 cases: Chan Hoon Yoo, Young Soo Byun, Hong Tae Kim, Hyun Min Kim, Yeon Min Park, Soo Yeol Jeon; J Korean Soc Fract 1999;12(3):538-542. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.538

Abstract PDF

We have experienced five cases of intraoperative fracture of the tibia assoicated with removal of ACE interlocking tibial nail. All fractures occured in young patients whose ages ranged from eighteen to twenty-nine years(mean, 24 years). We think the main reason of the fracture was characteristic design of ACE nail such as prominent distal angulation and posterior longitudinal slot. The other factors were age of the patient, material of the nail and timing of removal of the nail. In conclusion, we advise caution in the removal of the ACE reamed interlocking intramedullary tibial nail in young patient.

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Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report
Ji-Hwan Kim, Seung-Oh Nam, Young-Soo Byun, Han-Sang Kim
Journal of the Korean Fracture Society.2015; 28(1): 71. CrossRef

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The Problems on Removal of the tibial intramedullary nails: Tai Seung Kim, Seong Pil Lee, Khun Sung Whang; J Korean Soc Fract 1999;12(2):301-306. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.301

Abstract PDF: Closed intramedullary nailing with interlocking screws has been a widely accepted method for the fixation of fractures of the long bones. As a rule, the nail can be removed during the second year. Before the operation, solid healing of the fracture must be demonstrated by x-rays in two planes. When solid bone healing of the fracture has occurred, a connective tissue interface forms around the foreign body. This connective tissue can ossify later and make it difficult to remove the nail after it has been in place for a number of years. Theoretically, removal of the nail should be an uncomplicated procedure. Occasionally, one runs into problems, however, and every surgeon who has had enough experience with intramedullary nailing can remember cases in which removal of the nail was more difficult than its insertion. So, we tried to review our cases for problems on removal of the tibial nails and to discuss its etiologies.

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Refracture of the Femur after Plate Removal: Sung Kwan Hwang, Jung Ho Rah, Hee Jeon Park, Yeo Seung Yoon, Jae Beom Han; J Korean Soc Fract 1995;8(4):799-806. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.799

Abstract PDF

Internal fixation with dynamic compression plate is an accepted method of treating diaphyseal fractures of the adult femur. Good results have been reported using the principles laid down by the AO group(Muller et al 1979). Refracture after secure union of a broken femur has been achieved is rare, but it is most devastating complication. There were 5 refractures out of 64 removals after fractures of the femur at the department of Orthopaedic Surgery, Yonsei University Wonju college of Medicine between January, 1988 and June, 1994. After clinical and roentgenographical analysis, following results were obtained. 1. The causes of the refracture were trivial injuries or slip down injury. 2. Among 5 cases, the average time from insertion to removal was 19.2 months, with a ranged from 16 to 28 months. 3. The internal from removal of implant to refracture was 5.6 wks, with a range from 3 to 9 weeks. 4. The incidence of refracture in out hospital(7.8%) was somewhat higher than reported incidence by others. 5. The femur plates should not be removed prior to 2 years postoperatively and its removal should be postponed, if possible. 6. It is reasonable to postpone its removal until bone strength is adequate for full activity.

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Refractures of the Upper Extremity in Children
Hui Wan Park, Ick Hwan Yang, Sun Young Joo, Kun Bo Park, Hyun Woo Kim
Yonsei Medical Journal.2007; 48(2): 255. CrossRef

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Refracture of long bones after implant removal report of 6 cases: Duck Yeon Cho, Jae Gon Seo, Hwan Cheon Hwang; J Korean Soc Fract 1991;4(1):139-146. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.139

Abstract PDF: No abstract available.

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