Journal of Musculoskeletal Trauma

A Comparison of the Results between Internal Fixation and External Fixation in AO C Type Distal Radius Fractures: Yoon min Lee, Hwa Sung Lee, Seok Whan Song, Jae Hoon Choi, Jong Tae Park; J Korean Fract Soc 2018;31(3):87-93. Published online July 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.3.87

PURPOSE
The purpose of this study was to evaluate the radiological and clinical results of plate fixation and external fixation with additional devices for treating distal radius fracture in AO type C subtypes, and propose a treatment method according to the subtypes.
MATERIALS AND METHODS
Two hundred and one AO type C distal radius fracture patients were retrospectively reviewed. Eighty-five patients in group 1 were treated with volar or dorsal plate, and 116 patients in group 2, were treated with external fixation with additional fixation devices. Clinical (range of mtion, Green and O'Brien's score) and radiological outcomes were evaluated.
RESULTS
At the 12-month follow-up, group 1 showed flexion of 64.4Â°, extension of 68.3Â°, ulnar deviation of 30.6Â°, radial deviation of 20.8Â°, supination of 76.1Â°, and pronation of 79.4Â° in average; group 2 showed flexion of 60.5Â°, extension of 66.9Â°, ulnar deviation of 25.5Â°, radial deviation of 18.6Â°, supination of 73.5Â°, and pronation of 75.0Â° in average. The mean Green and O'Brien score was 92.2 in group 1 and 88.6 in group 2. The radial height of group 1 and group 2 was 11.6/11.4 mm; radial inclination was 23.2Â°/22.5Â°; volar tilt was 11.6Â°/8.7Â°; and the ulnar displacement was 1.27/0.93 mm.
CONCLUSION
Judicious surgical techniques during device application and tips for postoperative management during external fixation can produce similar clinical results compared with internal fixation patients.

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Intra-articular fracture distal end radius external fixation versus locking volar radius plate: A comparative study
S.P.S Gill, Manish Raj, Santosh Singh, Ajay Rajpoot, Ankit Mittal, Nitin Yadav
Journal of Orthopedics, Traumatology and Rehabilitation.2019; 11(1): 31. CrossRef

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Results of the Kapandji Procedure in the AO Type C Distal Radius Fracture in Patients over Age 60: Chul Hong Kim, Sung Soo Kim, Myung Jin Lee, Hyeon Jun Kim, Bo Kun Kim, Young Hoon Lim; J Korean Fract Soc 2012;25(3):191-196. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.191

Abstract PDF: PURPOSE
To evaluate the clinical and radiologic results of the Kapandji procedure in AO classification type C distal radius fracture patients over 60 years old.
MATERIALS AND METHODS
Twenty-one type C distal radius fracture patients over the age of 60 years who were treated with the Kapandji procedure from June 2004 to June 2009 in our hospital and had a post-operative follow-up period of more than 1 year were enrolled. The volar tilt, radial inclination, and radial length were measured for the radiographic analysis using the modified Lidstrom scoring system about post-operative reduction loss in every follow-up radiogram. The clinical result was assessed with a visual analogue scale (VAS) and Korean Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) score at the last follow-up.
RESULTS
The mean radiologic loss of volar tilt was 1.1degrees and the mean loss of radial length was 2.6 mm and the mean radial inclination loss was 2.7degrees compared with the immediate post-operative period and last follow-up period. The average VAS and DASH scores were 1.4 and 15.9.
CONCLUSION
The radiologic results of closed reduction and percutaneous pinning using the Kapandji technique for distal radius AO type C fracture patients over 60 years of age was not satisfactory. Nevertheless, the clinical results were satisfactory.

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Surgical Treatment of AO Type C Distal Femoral Fractures Using Locking Compression Plate (LCP-DF, Synthes(R)): Kap Jung Kim, Sang Ki Lee, Won Sik Choy, Won Cho Kwon, Do Hyun Lee; J Korean Fract Soc 2010;23(1):20-25. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.20

Abstract PDF

PURPOSE
To analyze the surgical results of AO type C distal femoral fractures using locking compression plate.
MATERIALS AND METHODS
From February 2006 to June 2008, 14 patients 15 cases were included. Injury mechanisms, combined injuries, radiologic and clinical results and postoperative complications were analyzed.
RESULTS
The mean age was 59.6 (30~77) years. The mean follow up period was 25 (12~40) months. AO types were 3 of C1, 5 of C2 and 7 of C3. Injury mechanisms were 9 of traffic accident, 5 of slip down and 1 of fall from a height. Four cases were combined with other extremity injuries or fractures. The mean radiologic union was obtained at postoperative 15 (13~20) weeks. The mean Neer's functional score was 74.2 (58~97); 3 of excellent, 5 of satisfactory and 7 of unsatisfactory. Postoperative complications were 2 of infection and 1 of nonunion. There were no mechanical failures or fixation loss with locking compression plate at the final follow up.
CONCLUSION
Internal fixation using locking compression plate for AO type C distal femoral fractures provided excellent fixations. At the final follow up, the clinical results were variable. The affecting factors on the final results seemed to be joint congruencies after anatomical reduction and active rehabilitation.

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A STUDY OF SURGICAL MANAGEMENT OF DISTAL FEMORAL FRACTURES BY DISTAL FEMORAL LOCKING COMPRESSION PLATE OSTEOSYNTHESIS
Dema Rajaiah, Yerukala Ramana, Kuppa Srinivas, Venkateswar Reddy S
Journal of Evidence Based Medicine and Healthcare.2016; 3(66): 3584. CrossRef

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Plate Fixation of AO Type C3 Fractures of the Distal Radius: Eun Sun Moon, Myung Sun Kim, Hyeong Won Park, Min Sun Choi; J Korean Fract Soc 2009;22(3):172-178. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.172

Abstract PDF: PURPOSE
To evaluate clinical and radiographic results of open reduction and internal fixation with plate in AO type C3 distal radius fracture.
MATERIALS AND METHODS
We treated 18 fractures and the mean follow up was 16 months. The average age was 47.1 years old, 12 male and 6 female were included. There were 9 C3.1 fracture, 5 C3.2 and 4 C3.3. Green & O'Brien's modified clinical scoring system and Demerit Point system were applied to evaluate clinical results, for radiographic evaluation, radial length, radial inclination, volar tilt, and Sarmiento's Criteria for Anatomic results were assessed.
RESULTS
Clinical results were 5 of excellent, 7 of good, and 6 of fair by Green & O'Brien's score and were 5 of excellent, 6 of good, and 7 of fair by Demerit point. There was no significant difference of radiographic results between immediate postoperation and last follow-up, and Sarmiento's Criteria showed 8 excellent, 4 good, and 6 fair.
CONCLUSION
The open reduction and internal fixation with plate in AO type C3 distal radius is considered as a good treatment method that particularly benefits from fracture stable fixation without fixation loss and early rehabilitation.

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Operative Treatment for AO Type C Supracondylar Fractures of the Distal Femur: Ho Rim Choi, Joon Min Song, Hee Kwon, Youm Gyu Ko, Jang Geun Lee, Chang Hun Yoon; J Korean Soc Fract 2002;15(2):166-172. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.166

Abstract PDF

PURPOSE
Treatment of supracondylar fracture of the distal femur is challenging because of its characteristic anatomy and common occurrence of severe comminution. We evaluated the clinical results of 15 cases of AO type C supracondylar fracture.
MATERIALS AND METHODS
From December 1990 to November 1999, fifteen of 27 cases of AO type C supracondylar fracture of the distal femur were treated operatively. Mean follow-up period was one year and 5 months (range, 1 year-3 years and 3 months). The mean age of patients was 43.6 years. Eleven cases were treated by internal fixation and four cases by Ilizarov. Clinical results were evaluated by Schatzker and Lambert criteria.
RESULT
There were 5 excellent, 4 good, 1 fair and 1 poor results (81% satisfactory) in 11 cases treated by internal fixation and 1 excellent, 2 good, 1 fair results (75% satisfactory) in 4 cases treated by external fixation. COCLUSION: To get satisfactory results, AO type C supracondylar fracture of the distal femur need to be reduced anatomically and require rigid internal fixation. External fixation using Ilizarov can be an effective method of treatment in cases of open fracture and severe comminution with osteoporosis.

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Surgical Treatment of AO Type C Distal Femoral Fractures Using Locking Compression Plate (LCP-DF, Synthes®)
Kap-Jung Kim, Sang Ki Lee, Won-Sik Choy, Won-Cho Kwon, Do Hyun Lee
Journal of the Korean Fracture Society.2010; 23(1): 20. CrossRef

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A Clinical Experience of Surgical Treatment for Type C of AO Classification of Supracondylar Fractures of the Femur: Yung Khee Chung, Jung Han Yoo, Myung Ryool Park, Baek Yong Song, Yong Wook Park, Jun Tae Kim; J Korean Soc Fract 1995;8(1):22-30. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.22

Abstract PDF: The treatment of supracondylar fractures of the femur remains many problem because of its complications. Particularly, the type C fracture of AO classification causes the traumatic arthritis, limitation of motion, shortening, as well as angular deformity, especially varus. In the past, there has been a reluctance toward treatment of supracondylar fractures of the frmur with internal fixation. But, recently, a trend toward internal fixation has become evident and good results has been reported by several authors. We studied 9 cases of type C of AO classification of supracondylar fracture of the femur at our hospital from January,1989 to February, 1993. The longest follow up was 49 months and the shortest was 12 months, the average being 22.2 months And the results were as follows 1. Age distribution was between 29 and 60 years old, and the ratio between male and females was 5:4. The most common cause of injury was traffic accident. 2. Seven patients were associated with injuries of other parts and the most frequent associated fracture was patellar fracture and the most common associated injury was cerebral contusion. 3. The average time of clincal union was 22 weeks in operative treatment and 13 weeks in conserv alive treatment. 4. In type C AO classification, 6 out of 9 cases treated by anatomical reduction and early motion achieved good to excellent results(50%), but all type C3 fractures is healed in slightly varus position. 5. In conclusion, type C3 of the supracondylar fracture of femur should be reduced to the neutral or slightly valgus position, or the ends of distal cancellous screws should be penetrated the medial femoral cortex because of progressing varus deformity after operation.

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