PURPOSE To evaluate the results and complications of treatment using T-plate fixation for two- and three-part fractures of the proximal humerus. MATERIALS AND METHODS Between January 1996 and July 2003, thirty-three patients with two-part and three-part fractures of the proximal humerus were treated by T-plate fixation. There were 21 two-part fractures and 12 three-part fractures including three shoulder dislocations. The reduction was qualified and complications were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system. RESULTS Thirty-two cases (96.7%) were united, twenty-nine cases (87.9%) were reduced as good, and twenty-three cases (70%) had excellent or satisfactory results. There were four cases of loss of reduction, three cases of stiff joint, one case of nonunion, and one case of avascular necrosis of the humeral head, but no infection. No correlation was found between the final result and the type of fracture, age, gender, or quality of reduction. CONCLUSION T-plate fixation for proximal humeral fractures is a reliable method to obtain good results through satisfactory reduction, rigid fixation, and early movement. Additional tension band wiring can provide stable fixation for osteoporotic or comminuted fractures difficult to obtain stable fixation.
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The Surgical Outcomes for Isolated Greater Tuberosity Fracture of Proximal Humerus Eun-Sun Moon, Myung-Sun Kim, Young-Jin Kim Journal of the Korean Fracture Society.2007; 20(3): 239. CrossRef
PURPOSE To evaluate the effectiveness of a mini T-plate fixation in clavicle lateral end fractures. MATERIALS AND METHODS We reviewed eleven cases of calvicle lateral end fracture which were treated with open reduction and internal fixion with mini T-plate from May 2000 to December 2004. The follow up period was 12 months minimum. The radiologic result, pain and shoulder function were evaluated by the ASES shoulder score. RESULTS All cases showed satisfactory results. Seven cases (63%) were excellent, and four (37%) cases were good. There were no fair or poor results. All cases showed radiologic union by the fifteenth week. No complications such as metal breakage, limited motion, infections were seen. CONCLUSION This study demonstrates that using a mini T-plate fixation which is easy and induces no injury of acromiocalvicular joint, contributes to provide stable fixation in clavicle lateral end fractures.
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Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome Seong Cheol Moon, Chul Hee Lee, Jong Hoon Baek, Nam Su Cho, Yong Girl Rhee Journal of the Korean Fracture Society.2014; 27(2): 127. CrossRef
The Surgical Outcomes of Clavicle Lateral End Fractures Fixed with the Oblique T Locking Compession Plate Seung-Oh Nam, Young-Soo Byun, Dong-Ju Shin, Jung-Hoon Shin, Chung-Yeol Lee, Tae-Gyun Kim Journal of the Korean Fracture Society.2011; 24(1): 41. CrossRef
Comparison of Results of Tension Band Wire and Hook Plate in the Treatment of Unstable Fractures of the Distal Clavicle Chul-Hyun Park, Oog-Jin Shon, Jae-Sung Seo Journal of the Korean Fracture Society.2011; 24(1): 55. CrossRef
Recently, distal radius fractures are recognized as very complex injuries with a variable prognosis according to the fracture type and the treatment. Especially, there are several problems, including joint stiffness and skin necrosis due to a long term immobilization, radial shortening and collapse due to the loss of reduction in the elderly. Thus, the anatomical reduction and rigid internal fixation and early rehabilitation were recommanded. We analyzed 16 patients with distal radius fractures in the elderly, who were treated with open reduction and internal fixation with T-plate from January, 1991 to June, 1997 and were followed up for more than 12 months. The results were as follows ; 1. According to the Fernandez classification, 3 cases were type I, 3 cases were type II, 7 cases were type III, 1 case was type IV and 2 cases were type V. 2. As complications, there were 2 cases of arthritic change, 3 cases of radial shortening, and 1 case of screw loosening. 3. Anatomically satisfactory results were obtained in 75%(12 cases). 4. Functionally and clinically satisfactory results were obtained in 87%(14 cases). 5. In the treatment of distal radius fractures in the elderly, three dimensional structure and recovery of joint congruency were related to the clinical prognosis.
The management of the two part surgical neck fracture, three part fracture and fracture-dislocation of proximal humerus is still under debate. Various method of internal fixation have been reported but none of these methods have been consistently successful. The purpose of this study is to analyze the result of open reduction and internal fixation surgical neck fracture, three-part fracture and fracture-dislocation in proximal humerus. From Janunary. 1991 to July 1996, fifteen patiens were reviewed and the result were summerized as follows.
1. There were 8 two-part surgical neck fracture, 3 three-part fracture, 4 three-part fracture-dislocalion.
2. The results were analyzed accroding to scoring system of Neer; the excellent or satis-factory results were seen in 11 cases, but unsatisfactory results were seen in 4 cases.
3. Complication occured as follows; joint disability in 4 cases, high positioning of plate in 1 case of joint disability.
4. We concluded that T-plate offers satisfpctory reduction and good stability at high risk of joint disability. Early mobilization is required in the prevenion of joint disability of shoulder.
Fracture of distal radius represent the most common fractures of upper extremity. Recently, distal radius fractures are recognized as very complex injuries with a variable prognosis according to the fracture type and the treatment. Because unstable distal radius fractures have a high incidence of secondary displacement and shortening, they are not amenable to the traditional methods of closed manipulation.
We classified distal radius fractures by Fernandez classification and analysed thirty-six cases of fractures followed up more than one year at Dae-Dong Hospital from March 1993 to September 1994 after ORIF with T-plate.
The result were as follows: 1. ORIF of unstable fracture of distal radius with small T-plate, selective bone graft using volar approach, 81% of the patients had a rating of good or excellent by the modified scoring system of Green and OBrien.
2. Severely comminuted fractures as Fernandez type V necessitated additional fixation such as external fixator.
3. Femandez classification based on the mechanism of injury was helpful in planning the treatment of unstable distal radius fractures.
In the treatment of Unstable fractures of the Distal Radius, selecting a right method of treatment that can give the best result is very difficult. Many complications can be developed if improper mothods are chosen o treat these fractures.
We analyzed 25 patients with unstable fractures of the distal raduis, being treated with open reduction and internal fixation with T-plate from May 1986 to December in 1994 and, being followed for more than 12 months.
The results were as follows; 1. In twenty-five patients, 17 cases were Cellosfractures, 2 cases Smith fractures and 6 cases Bartons fractures.
2. In follow-up roentgenogram, the mean values of the radial length, radial deviation, volar tilt and step-off are 18.8 mm,20.3 ,8 ,0.2mm respectively.
3. Recovery of wrist function was correlated with the degree of correction of volar tilt angle in the postoperative roentgenogram .
4. In 25 patients treated with open reduction and internal fixation using the T-plate, satisfactory result was obtained in 88% (22 cases) of patients, We concluded that this is the effective method for treating unstable fractures of the distal radius because this method permits early motion of the wrist by firm and stable fixation.
The shoulder is especially susceptible to stiffness following injury because of the formation of adhesions. Early mobilization prior to maturation of adhesions around the joint gliding surface is, therefore, an essential step in the management of the proximal humerus comminuted fractures. Our aims were accurate reduction and stable fixation to allow early mobilization and to achieve full functional recovery. During the eight-year period from January 1986 to June 1994,51 cases patients were treated surgically for comminuted fractures of the proximal part of the humerus by T-plate at our hospital.
The results were summarized as follows; 1. There were 17 cases of the two-part fractures, 31 cases of the three-part fractures and 3 cases of the four-part fractures following to Neers classification.
2. The most common cause of injury was road traffic accident(34 cases).
3. The excellent or satisfactory results were seen 82% of the two-part fractures and 81% of the three-part fractures, whereas 67% of the four-part fractures.
4. The most frequent complication of comminuted fractures were motion limitation and pain(5 cases), delayed union(2 cases), plate bending(1 case) and infection(1 case) but avascular necrosis of the humeral head, non-union, myositis ossificans and plate breakage had not been developed in these cases.
5. T-plate was one of the good internal fixation devices for surgical treatment of the comminuted fractures of the proximal humerus.