Journal of Musculoskeletal Trauma

Usefulness of Spring Plate for Acetabular Posterior Wall Fracture Including Small Fragment: Jeong Hoon Kang, Sang Hong Lee, Hyeon Jun Lee; J Korean Fract Soc 2016;29(1):19-25. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.19

PURPOSE
We applied internal fixation using a spring plate against an acetabular posterior wall fracture including small fragments and then evaluated the clinical and radiological results and want to understand the usefulness of the spring plate.
MATERIALS AND METHODS
Fifteen patients in whom fixation was difficult using leg screws or a metal plate because of a small bone fragment, in patients with posterior wall acetabular fractures who presented in our hospital since August of 2011 to March of 2014 were enrolled. The mean age was 42.6 years (range 24-54 years) with relatively young patients, and they were followed-up for at least one year. We analyzed the rate of reduction after surgery using the classification of Matta in radiographs, and the classification of Borrelli in 3-dimensional computed tomography (CT) and clinical results were evaluated using the clinical grading system.
RESULTS
There were five cases of anatomical reduction, 9 cases of imperfect reduction, and 1 case of unsatisfactory reduction according to the classification of Matta. Except for one case during the follow-up period, the union of bone was successful without failure of fixation and the clinical results were 6 cases of excellence, 8 cases of good, and 1 case of failure. Articular displacement was also evaluated in postoperative CT scan according to Borrelli's criteria. The mean of gap and step off was 2.04 mm, 1.3 mm.
CONCLUSION
Use of leg screw fixation and so on in posterior wall fractures including a small fragment of the acetabular rim is not easy. However the method using spring plate fixation enables relatively accurate reduction and fixation for a small fragment and the clinical outcome showed satisfactory results.

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Biomechanical Comparison of Fixation Methods for Posterior Wall Fractures of the Acetabulum: Conventional Reconstruction Plate vs. Spring Plate vs. Variable Angle Locking Compression Plate
HoeJeong Chung, Hoon-Sang Sohn, Jong-Keon Oh, Sangho Lee, DooSup Kim
Medicina.2024; 60(6): 882. CrossRef

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Modified Spring Plate for Treatment of Unstable Distal Clavicle Fractures: Sang Myung Lee, Il Jung Park, Hyung Min Kim, Jae Chul Park, Sung Gil Cho, Yoon Chung Kim, Seung Koo Rhee; J Korean Fract Soc 2010;23(1):64-68. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.64

Abstract PDF: PURPOSE
Unstable distal clavicle fractures should be treated surgically but may be difficult in firm fixation because of small distal fragment. Although a variety of fixation methods have been currently used, none of the methods seem to be firm fixation and little pain. We present a new technique using a spring plate which was modified from one third tubular plate and report the early results.
MATERIALS AND METHODS
Modified spring plate was made from one third tubular plate and the distal hole of the plate was cutting and sharpened by rasp. The sharp edge was bent just like an animal claw (C shape). Between May 2007 and June 2009, a total of six patients with distal clavicle fracture were treated using modified spring plate. A sling was applied in the immediate post operative period for six weeks and exercises were started immediately.
RESULTS
Union was achieved in all cases with excellent results without complication (mean Constant score, 96). All patients had returned to ordinary daily activities but mild limitation of abduction (150 degrees ) by seven weeks after surgery. After six months, the plate was removed.
CONCLUSION
The modified spring plate has provided stable fixation for unstable distal clavicle fixation without disturbance to the acromioclavicular joint, subacromial space, or rotator cuff.

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The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate: Dong Ju Shin, Young Soo Byun, Se Ang Chang, Hee Min Yun, Ho Won Park, Jae Young Park; J Korean Fract Soc 2009;22(3):159-165. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.159

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the surgical outcomes of isolated greater tuberosity fractures of the proximal humerus fixed with the spring plates.
MATERIALS AND METHODS
Fourteen patients who could be followed up at least 1 year after the surgical treatment of isolated greater tuberosity fracture were evaluated. Their mean age was 51 years (range, 25~73 years). The deltopectoral approach and fixation with the spring plate were performed in all cases. The spring plate was used in all cases. In some circumstances, sutures incorporating the rotator cuff, interfragmentary screw or tension band wire were added. We evaluated the clinical outcomes using UCLA scoring system and KSS (Korean Shoulder Score).
RESULTS
The mean UCLA score was 29.8 and the mean KSS was 89.4. The average time of bony union was 10.2 weeks (range, 7~14 weeks) after the surgery, including 1 case that was performed the secondary operation due to metal failure. The shoulder stiffness were observed in 4 cases and one case of infection was treated well without operation.
CONCLUSION
In the treatment of isolated greater tuberosity fractures of the proximal humerus, the spring plates fixation can be a good surgical option providing reliable functional results.

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Management of Acetabular Fracture: Myung Sik Park, Hyung Ju Park; J Korean Soc Fract 1999;12(1):47-55. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.47

Abstract PDF

Acetabular fractures are relatively uncommon, but frequency is becoming increasingly with the increase of automobile accident. Undisplaced acetabular fractures have a good prognosis, but major displaced acetabular fractures have always given rise to difficulty and have a problem if fractures are not accurately evaluated, classified and reduced anatomically. The priciples of treatment are to restore the fractured acetabulm to its normal anatomy, to maintain and restore the function and accordingly early joint motion to promote healing and to prevent joint adhesion. However, the treatment of displaced fracture of acetabulum has been controversal. Judet, Pennal and Matta advocated open reduction and internal fixation for displaced fracture of acetavbulum. But, Watson Jones and Crenshaw reported that closed reduciton such as traction was used, good result could be obtained. The authors studied the sex and age distribution, classification according to roentgenographic findings, associated injuries, methods of treatment and prognosis among 67 patients who were admitted to the department of Orthopedic Sugery of Chonbuk National University Hospital under diagnosis of acetabular fracture and we evaluate the usefulness of spring plate for posterior wall fracture of acetabulum. The results were as follows, 1. The prevalant age was fourth decade and the cause of injury was traffic accident in the majority. The most common type of fracture was posterior wall fracture and the second was transverse fracture by Letournel classification 2. The complications were posttraumatic arthritis in 21%, ectopic ossification, peroneal nerve palsy and wound infection. The prognosis of the total hip arthroplasty for complicated traumatic arthritis was relatively poor than others. 3. Satisfactory results by clinical criteria(by Postel) of operative treatment were 71% and conservative treatment 46%. In the majority of displaced acetabular fractures, open reduction and internal fixation was recommended. If surgery is attempted, it is essential to achieve an anatomical reduction and firm fixation by fully understanding the pathologic anatomy and by choosing an appropriate approach fixation device. We can make a satisfactory results by the treatment with spring plates in the comminuted posterior column fractures or posteior wall fractures that was difficulty in the treatment by simple plates.

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Spectroscopic studies and evanescent optical fibre wave sensing of Cu2+ based on activated mesostructured silica matrix
Othman Belhadj Miled, Clément Sanchez, Jacques Livage
Journal of Materials Science.2005; 40(17): 4523. CrossRef

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Hooked Spring Plate : Its uses in paterior wall acetabular fracture fixation: Joo Chul Ihn, Poong Taek Kim, Dong Kyu Shin; J Korean Soc Fract 1994;7(2):606-615. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.606

Abstract PDF

For fixation of small osteochondral fracture fragment which was difficult to fix with ordinary fixation device in comminuted acetabular posterior wall fracture, we employed a modified 3.5mm one thired tubular plate that was shaped into so-called hooked spring plate. During operation, one end of a plate with two to five hole is flattened for a lenght of 1cm. The flattened end is fashioned into two spikes by trimming the end to the adjacent screw holes with a wire cutter. The resultant spikes are bent to 90 with respect to the plate. The residual proteion of the plates is contoured with convex bow with respect to the surface of the bone. The hooks are placed either through the capsule and around the edge of the fragment or they are embedded into the fragment itself. Six consecutive patients undergoing Kocher-Langenbeck approach for open reduction with internal fixation of posterior wall acetabular fracture(7/91-1.93) were reviewed. There were five simple type and one associated type, as transverse and posterior wall. In two cases application of spring plate in isolation was done. In four cases application of spring plate as part of a reconstruction plate assembly was done All six fractures progressed to union without any loss of the reduction of fixation. In conclusion, the application of spring plate is mechanically sound, valuable for fixation of difficult small osteochondral fractures with avoidance of intaarticular penetration of metal. This method eliminates the need to employ screws in the immediate juxta-articular portion of the plate and promotes early rehabilitation.

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The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate
Dong-Ju Shin, Young-Soo Byun, Se-Ang Chang, Hee-Min Yun, Ho-Won Park, Jae-Young Park
Journal of the Korean Fracture Society.2009; 22(3): 159. CrossRef

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