PURPOSE This study was designed to assess the necessity of additional supporting fixation to the traditional internal fixation for unstable intertrochanteric fractures of femur. MATERIALS AND METHODS Seventy two cases of unstable intertrochanteric fractures (modified Boyd-Anderson type III, IV) in the elderly were reviewed, which were internally fixed with Dynamic Hip Screw. 48 cases were treated with Dynamic Hip Screw only(Group I) and 24 cases with Dynamic Hip Screw and additional trochanteric supporting plate(Group II). In 13 cases with weak femoral cortx, we added wiring to the side plate. We measured neck-shaft angle, degrees of displacement of greater trochanteric fragment, slippage of hip screw on plain radiographs. RESULTS Varus change in neck-shaft angle, displacement of greater trochanteric fragment and slippage of hip screw revealed 7.3°, 5.4 mm, and 10.7 mm respectively in group I, while 2.1°, 0.1 mm and 3.8 mm respectively in group II. There were no pullout of cortical screws. CONCLUSION Internal fixation with additional trochanteric supporting plate to the conventional Dynamic Hip Screw was effective in unstable intertrochanteric fractures of the femur in the elderly. Added wiring to the side plate was also helpful in weak femoral cortex.
The purpose of this study is to evaluate the efficacy of augmentative plate fixation for the femoral nonunion after intramedullary nailing. We reviewed eleven femoral nonunion after intramedullary nailing, which were treated with augmentative plate internal fixation. All cases were initially managed with interlocking intramedullary nailing. Five were hypervascular and six were avascular. Leaving the intramedullay nail in situ, an augmentative plate fixation was applied to the fracture site to counter the rotational instability. A simultaneous bone grafting was performed in six avascular nonunion to repair the bony defect. The union time was 8.2 months in average( 7.8 months in hypervascular and 8.5 months in avascular). In conclusion, augmentative plating leaving the intramedullary nail in situ is an useful alternative for the treatment of femoral nonunion after intramedullary nailing. The technique is simple and does not require any special instruments. It facilitates an early weight bearing and gives a quick recovery from nonunion.
Citations
Citations to this article as recorded by
The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation Se Dong Kim, Oog Jin Sohn, Byung Hoon Kwack Journal of the Korean Fracture Society.2008; 21(2): 117. CrossRef
The fractures around the elbow joint in adults are relatively rare in comparision with that in childeren, but the late complications are more common in adults.
We have clinically and radiologically analyzed 14 cases of fractures around the elbow joint in adults from January 1995 to December 1998. All patients were treated by open reduction and application of medial and lateral bottress plates providing stable internal fixation enhance early motion. The patients were evaluated for range of motion, infection, pain, degenerative changes.
The 14 patients were available for follow-up study for average of 12 months. The result were good in nine, fair in two, poor in three. Traetment of choice for the type III and IV of distal humerus fracture is open reduction with stable internal fixation with plates combined with early active motion.
PURPOSE : The purpose of this study is to detect the factors influencing the results of treatment for Lisfranc injuries of the foot. MATERIALS and METHODS : We assessed the correlation between the AOFAS Scale and each of the variables which might influence the results of treatment in 25 cases of Lisfranc injuries, using the SPSS version 7.5. RESULTS The mean AOFAS Scale rated 81.48 points. The degrees of initial soft tissue injury had close correlation with the AOFAS Scale; while time from injury to operation, accuracy of reduction such as the alignment of the tarsometatarsal joints, gap between the first and the second metatarsal bases, and the foot arch angles had moderate correlation with AOFAS Scale(p<0.05). The age at operation, types of fractures, joint space of the tarsometatarsal joints had little or fair degrees of correlation with the AOFAS Scale(p>0.05). CONCLUSION : The factorf influencing the results of treatment for Lisfranc injuries included initial deree of soft tissue injury, time form injury to operation, and variables related to the accuracy of reduction such as the alignment of tarsometatarsal joints, gap between the first and the second metatarsal bases, and the maintenance of the foot arch.