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Original Article
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
AbstractAbstract PDF
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 ΔKyphotic 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 1.7°±1.2° vs PPSF 5.9°±3.2°, 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.

Citations

Citations to this article as recorded by  
  • 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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Case Report
Spino-Pelvic Fixation in Unstable Sacral Fracture: A Case Report
Jung Hwan Choi, Kyu Tae Hwang, Seung Gun Lee, Chang Nam Kang
J Korean Fract Soc 2018;31(4):145-148.   Published online October 31, 2018
DOI: https://doi.org/10.12671/jkfs.2018.31.4.145
AbstractAbstract PDF
A 22-year-old female patient visited the emergency room (ER) after a pedestrian traffic accident in a drunken state. An examination at the ER revealed fractures at the right side of the sacral ala, sacral foramina, left anterior acetabulum, right inferior ramus, and right superior articular process of S1. She underwent spino-pelvic fixation and iliosacral (IS) screw fixation. One year later, bone union was completed and implant removal was performed and the treatment was completed without complications. The authors recommend spino-pelvic fixation and IS screw fixation for unstable sacral fractures as one of the excellent methods for obtaining posterior stability of the pelvis among the various treatments of unstable sacral fractures.
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Original Articles
The Effects of Extramedullary Reduction in Unstable Intertrochanteric Fracture: A Biomechanical Study Using Cadaver Bone
Young Chang Park, Soon Phil Yoon, Kyu Hyun Yang
J Korean Fract Soc 2018;31(3):79-86.   Published online July 31, 2018
DOI: https://doi.org/10.12671/jkfs.2018.31.3.79
AbstractAbstract PDF
PURPOSE
To prevent excessive sliding and subsequent fixation failures in unstable intertrochanteric fractures with posteromedial comminution, extramedullary reduction through overlapping of the anteromedial cortices of both proximal and distal fragments as a buttress has been introduced. The purpose of this study was to compare the biomechanical properties between two reduction methods-intramedullary reduction and extramedullary reduction-in treating unstable intertrochanteric fractures with posteromedial comminution (AO/OTA classification 31-A2.2).
MATERIALS AND METHODS
Eight pairs of frozen human cadaveric femora were used. The femora of each pair were randomly assigned to one of two groups: the intramedullary reduction group or the extramedullary reduction group. A single axial load-destruction test was conducted after cephalomedullary nailing. Axial stiffness, maximum load to failure, and energy absorbed to failure were compared between the two groups. Moreover, the pattern of mechanical failure was identified.
RESULTS
The mean axial stiffness in the extramedullary reduction group was 27.3% higher than that in the intramedullary reduction group (422.7 N/mm vs. 332.0 N/mm, p=0.017). Additionally, compared with the intramedullary reduction group, the mean maximum load to failure and mean energy absorbed to failure in the extramedullary group were 44.9% and 89.6% higher, respectively (2,848.7 N vs. 1,966.5 N, p=0.012 and 27,969.9 N·mm vs. 14,751.0 N·mm, p=0.012, respectively). In the intramedullary reduction group, the mechanical failure patterns were all sliding and varus deformities. In the extramedullary reduction group, sliding and varus deformities after external rotation were noted in 3 specimens, sliding and varus deformities after internal rotation were noted in 3 specimens, and medial slippage was noted in 2 specimens.
CONCLUSION
In unstable intertrochanteric fractures with posteromedial comminution, the biomechanical properties of extramedullary reduction are superior to those of intramedullary reduction. Anteromedial cortex could be the proper buttress, despite a comminuted posteromedial cortex. It could help enhance the stability of the bone-nail construct.

Citations

Citations to this article as recorded by  
  • Which side should be taken care of when positioning a lag screw in intertrochanteric femoral fracture: right or left?
    Min Uk Do, Kyeong Baek Kim, Sang-Min Lee, Hyun Tae Koo, Won Chul Shin
    European Journal of Trauma and Emergency Surgery.2025;[Epub]     CrossRef
  • The effect of anterior support screw (AS2) in unstable femoral trochanteric fractures: A multicenter randomized controlled trial
    Takashi Maehara, Takashi Hayakawa, Shunsuke Mukoyama, Yoshihisa Anraku, Takahiro Hamada, Hiroyuki Suzuki, Takeshi Doi, Tomohiko Shimizu, Masanori Yorimitsu, Hidefumi Teramoto, Takao Mae, Yasunori Okamoto, Jun Hara, Kazushi Mihara, Koichi Kanekasu
    Injury.2024; 55(10): 111725.     CrossRef
  • Anteromedial cortical support reduction of intertrochanteric fractures–A review
    Wenjun Xie, Liu Shi, Cheng Zhang, Xueliang Cui, Xiangxu Chen, Tian Xie, Sheng Zhang, Hui Chen, Yunfeng Rui
    Injury.2024; 55(12): 111926.     CrossRef
  • Anteromedial Cortical Support in Reduction of Trochanteric Hip Fractures
    Wei Mao, Chen-Dong Liu, Shi-Min Chang, Ao-Lei Yang, Choon Chiet Hong
    Journal of Bone and Joint Surgery.2024; 106(11): 1008.     CrossRef
  • Five states of reduction in OTA/AO A1.3 intertrochanteric fractures of the femur a biomechanical study
    Shu Li, Yong-Gang Bao, Rong-Hua Tian, Chun-Yang Meng, Hai-Bin Wang, Bin Wu, Xian-Min Bu
    BMC Musculoskeletal Disorders.2024;[Epub]     CrossRef
  • Intramedullary Impaction of the Basicervical Component is Determinant of Fixation Failure in a Simple Two-Part Pertrochanteric Fracture
    Seok Ha Hong, Kang Hun Yu, Seung Beom Han
    Journal of Orthopaedic Trauma.2024;[Epub]     CrossRef
  • Flexible reamer use to overcome entry point errors in proximal femoral nail application in severe obese intertrochanteric fracture patients
    Levent Horoz, Ali Ihsan Kilic, Cihan Kircil, Mehmet Fevzi Cakmak
    BMC Musculoskeletal Disorders.2024;[Epub]     CrossRef
  • Risk Factors Associated with Fixation Failure in Intertrochanteric Fracture Treated with Cephalomedullary Nail
    Hyung-Gon Ryu, Dae Won Shin, Beom Su Han, Sang-Min Kim
    Hip & Pelvis.2023; 35(3): 193.     CrossRef
  • Positive or negative anteromedial cortical support of unstable pertrochanteric femoral fractures: A finite element analysis study
    Qin Shao, Yue Zhang, Gui-Xin Sun, Chen-Song Yang, Na Liu, Da-Wei Chen, Biao Cheng
    Biomedicine & Pharmacotherapy.2021; 138: 111473.     CrossRef
  • Clinical and Radiologic Outcome of Intertrochanteric Fracture Treatment Using TFNA (Trochanteric Fixation Nail-Advanced)
    Hyeon Joon Lee, Hyun Bai Choi, Ba Rom Kim, Seung Hwan Jo, Sang Hong Lee
    Journal of the Korean Fracture Society.2021; 34(3): 105.     CrossRef
  • Factors Associated with Mechanical Complications in Intertrochanteric Fracture Treated with Proximal Femoral Nail Antirotation
    Oog-Jin Shon, Chang Hyun Choi, Chan Ho Park
    Hip & Pelvis.2021; 33(3): 154.     CrossRef
  • Additional Reduction Screw Fixation Technique for Pertrochanteric Hip Fractures: A Novel Method to Prevent Excessive Sliding in Cephalomedullary Nail Surgery
    Chul-Ho Kim, Han Soul Kim, Dou Hyun Moon
    Hip & Pelvis.2021; 33(3): 162.     CrossRef
  • Comparison of sliding distance of lag screw and nonunion rate according to anteromedial cortical support in intertrochanteric fracture fixation: A systematic review and meta-analysis
    Eic Ju Lim, Seungyeob Sakong, Whee Sung Son, Jae-Woo Cho, Jong-Keon Oh, Chul-Ho Kim
    Injury.2021; 52(10): 2787.     CrossRef
  • A new fluoroscopic view for evaluation of anteromedial cortex reduction quality during cephalomedullary nailing for intertrochanteric femur fractures: the 30° oblique tangential projection
    Shi-Yi Chen, Shi-Min Chang, Rujan Tuladhar, Zhen Wei, Wen-Feng Xiong, Sun-Jun Hu, Shou-Chao Du
    BMC Musculoskeletal Disorders.2020;[Epub]     CrossRef
  • New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail
    Junyoung Kim, Kihong Choi, Kyu Hyun Yang
    Journal of the Korean Orthopaedic Association.2020; 55(3): 193.     CrossRef
  • Effect of a synthetic osteoconductive bone graft substitute with zeta potential control (geneX®ds) in the treatment of intertrochanteric fracture: A single center experience of 115 consecutive proximal femoral nail antirotations
    Won Chul Shin, Jae Hoon Jang, Jae Yoon Jeong, Kuen Tak Suh, Nam Hoon Moon
    Journal of Orthopaedic Science.2019; 24(5): 842.     CrossRef
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Surgical Outcome of Posterior Pelvic Fixation Using S1, S2 Screws in Vertically Unstable Pelvic Ring Injury
Kwang Hee Yeo, Nam Hoon Moon, Jae Min Ahn, Jae Yoon Jeong, Jae Hoon Jang
J Korean Fract Soc 2018;31(1):9-17.   Published online January 31, 2018
DOI: https://doi.org/10.12671/jkfs.2018.31.1.9
AbstractAbstract PDF
PURPOSE
Iliosacral screw fixation is an effective and less invasive method that is used widely for the definitive treatment of unstable pelvic ring injuries. On the other hand, fixation failures after iliosacral screw fixation have been reported in vertically unstable pelvic ring injuries. This study examined the surgical outcomes of posterior pelvic fixation using S1 and S2 screws in vertically unstable pelvic ring injuries.
MATERIALS AND METHODS
Between January 2011 and April 2016, 17 patients with vertically unstable pelvic ring injuries who met the minimum 1 year follow-up criteria were treated with internal fixation using posterior pelvic S1 and S2 screws. Their mean age was 43.9 years. According to the AO/OTA classification, 10 patients had C1, 6 had C2, and 1 had C3 injuries. Surgical treatments of single or multiple steps, where necessary, were performed by two surgeons. The clinical and radiologic outcomes were assessed retrospectively using radiographs and medical records.
RESULTS
Overall, 16 patients had bone healing without screw loosening; however, one patient could not maintain anterior pelvic fixation because of an open fracture and deep infection in the anterior pelvic ring. Of five patients who complained of neurological symptoms after injury, three had partially recovered from their neurological deficit. At the last follow-up, the clinical outcomes according to the Majeed score were excellent in 5, good in 6, fair in 4, and poor in 2 patients. The postoperative radiologic outcomes by Matta and Tornetta's method were excellent in 5, good in 8, and fair in 4 patients. Malposition of the S2 screw was identified in one case. The mean time to union was 14.6 weeks after surgery.
CONCLUSION
S1 and S2 screw fixation can be an effective treatment option for posterior pelvic stabilization in vertically unstable pelvic ring injuries when considering the surgical outcomes, such as screw loosening and loss of reduction.

Citations

Citations to this article as recorded by  
  • Fixation Options of Unstable Posterior Pelvic Ring Disruption: Ilio-Sacral Screw Fixation, S2AI Fixation, Posterior Tension Band Plate Fixation, and Spino-Pelvic Fixation
    Dong-Hee Kim, Jae Hoon Jang, Myungji Shin, Gu-Hee Jung
    Journal of the Korean Fracture Society.2019; 32(4): 240.     CrossRef
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Comparison of the Treatment Results between Reduction with Percutaneous Wiring and Reduction without Percutaneous Wiring in Reverse Oblique Trochanteric Fractures (AO Classification 31-A3.3)
Jae Woo Park, Oog Jin Shon, Seung Wan Lim
J Korean Fract Soc 2017;30(4):192-197.   Published online October 31, 2017
DOI: https://doi.org/10.12671/jkfs.2017.30.4.192
AbstractAbstract PDF
PURPOSE
The aim of this study was to investigate the utility of percutaneous wiring in the reduction of reverse oblique trochanteric fractures (AO classification 31-A3.3) by analyzing the treatment results with or without the use of percutaneous wiring.
MATERIALS AND METHODS
Thirty-five cases from January 2008 to August 2014 that could be followed-up for at least one year were selected among patients with unstable trochanteric fractures who underwent either internal fixation or open reduction. Seventeen patients underwent surgery with percutaneous wire fixation but another 18 patients underwent surgery without it. All patients received a closed reduction and internal fixation with an intramedullary nail. The factors evaluated were as follows: the length of operation, loss of blood, length of in-hospital stay, lower limb function scale, return to preinjury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, time taken for bone attachment, quality of post-operative reduction, and complications.
RESULTS
No significant difference in the mean operative time, loss of blood, length of in hospital stay, lower limb function scale, return to pre-injury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, and quality of postoperative reduction was observed between the two groups. A significant difference was noted in the time taken for bone attachment (p=0.032). Bone attachment took 13.3 weeks (9–17 weeks) on average when fixed with percutaneous wiring and no patient was found to have any complications. When treated without percutaneous wiring, however, bone attachment took 17.8 weeks (12.5–28.0 weeks) on average and three cases resulted in delayed union.
CONCLUSION
Percutaneous wiring is a recommended treatment option for patients with an unstable trochanteric fracture.
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Fixation of the Greater Trochanter in Arthroplasty for Unstable Intertrochnateric Fracture
Dong Hyeok Choi, Ju Yeong Heo, Young Jae Jang, Young Yool Chung
J Korean Fract Soc 2014;27(1):58-64.   Published online January 31, 2014
DOI: https://doi.org/10.12671/jkfs.2014.27.1.58
AbstractAbstract PDF
PURPOSE
We classified fractures of the greater trochanter (GT) and evaluated fracture fragment stability according to GT type.
MATERIALS AND METHODS
A total of 43 patients with an unstable intertrochanteric fracture treated between January 2007 and July 2009 with bipolar hemiarthroplasty were included in this study. GT fractures were classified as type A, B, C, or D and fixed using either cerclage wiring alone, cerclage wiring and non-absorbable suture or a greater trochanteric reattachment (GTR) plate.
RESULTS
Type A fractures were fixed using cerclage wiring with non-absorbable suture in two cases, cerclage wiring in six cases and GTR plate in seven cases. Failure occurred in three cases of type A fractures treated with cerclage wiring alone. A total of 11 type B fractures were fixed with cerclage wiring (7), cerclage wiring and non-absorbable suture (3) and GTR plate (1). There was no failure of type B fractures. Type C fractures were fixed using cerclage wiring with non-absorbable suture in one case and GTR plate in three. There was no fixation in three cases. Of 10 type D fractures, six were treated with cerclage wiring and one with GTR plate. Fixation was not performed in three patients. There was no failure in type C and D type fractures.
CONCLUSION
Fracture fragment stability differed according to fracture types. Cerclage wiring alone was insufficient to fix type A fractures, so type A fracture required a stronger fixation method.

Citations

Citations to this article as recorded by  
  • Primary Arthroplasty for Unstable and Failed Intertrochanteric Fractures: Role of Multi-Planar Trochanteric Wiring Technique
    Javahir A. Pachore, Vikram Indrajit Shah, Sachin Upadhyay, Shrikunj Babulal Patel
    Hip & Pelvis.2023; 35(2): 108.     CrossRef
  • The Efficacy of Suture Fixation of the Greater Trochanter in Unstable Intertrochanteric Fractures
    Ki-Choul Kim, Hee-Gon Park, Jae-Wook Park
    Clinics in Orthopedic Surgery.2021; 13(4): 468.     CrossRef
  • Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?
    Kee Haeng Lee, Dong Hun Lee, Jong Ho Noh, Yoon Vin Kim
    Orthopaedics & Traumatology: Surgery & Research.2019; 105(1): 41.     CrossRef
  • Selecting Arthroplasty Fixation Approach Based on Greater Trochanter Fracture Type in Unstable Intertrochanteric Fractures
    Min-Wook Kim, Young-Yool Chung, Sung-an Lim, Seung-Woo Shim
    Hip & Pelvis.2019; 31(3): 144.     CrossRef
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Unstable Intertrochanteric Fracture Treated with ITST: A Comparative Study between Groups with and without Comminution of Greater Trochanter
Kyung Sub Song, Sang Ho Lee, Seong Hun Jeong, Su Keon Lee, Sung Ha Hong
J Korean Fract Soc 2014;27(1):36-41.   Published online January 31, 2014
DOI: https://doi.org/10.12671/jkfs.2014.27.1.36
AbstractAbstract PDF
PURPOSE
To evaluate whether the radiological and clinical results of treatment with intertrochanteric/subtrochanteric (ITST) nail on unstable intertrochanteric fractures are combined with comminution of the greater trochanter or not.
MATERIALS AND METHODS
We reviewed the results on 210 cases of unstable intertrochanteric fractures (grouped 88 patients with comminution of greater trochanter [GT] and 122 patients without comminution of GT) treated with ITST nail from January 2007 to October 2011, which was to be followed-up for more than 12 months.
RESULTS
The mean union time was 15.2 weeks in the study group (combined with comminution of GT). The mean union time was 14.7 weeks in control group (no comminution of GT). The lag screw sliding was 8.7 mm in the study group and 7.2 mm in the control group. Changes of neck-shaft angle was 4.2degrees in study group and 4.1degrees in control group. Tip-apex distance was 17.4 mm in study group and 16.4 mm in control group. The complications were 4 cases in each study group and control group. The clinical results checked by Skovron recovery scores decreased similarly in both groups, 73.7% in study group and 76.5% in control group. There were no significant differences in both groups according to radiological and clinical results.
CONCLUSION
The comminution of great trochanter does not affect on the radiological and clinical results when using the ITST nail of unstable intertrochanteric fractures.
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Operative Treatment of Unstable Pelvic Ring Injury
Sang Hong Lee, Sang Ho Ha, Young Kwan Lee, Sung Won Cho, Sang Soo Park
J Korean Fract Soc 2012;25(4):243-249.   Published online October 31, 2012
DOI: https://doi.org/10.12671/jkfs.2012.25.4.243
AbstractAbstract PDF
PURPOSE
To analyze the clinical and radiological results of the different fixation methods according to the type and displacement of unstable pelvic ring injuries.
MATERIALS AND METHODS
Twenty-three patients with unstable pelvic ring injuries from January 2005 to December 2009 were classified according to the AO/OTA classification system. When patients had been diagnosed with unstable pelvic ring injuries with partial instability, they were treated by anterior fixation with a plate and posterior percutaneous iliosacral screw fixation. When patients had been diagnosed with unstable pelvic ring injuries with complete instability, they were treated by open reduction and anterior to posterior fixation with a plate through the ilioinguinal approach. The radiological results were evaluated using Matta and Saucedo's method, and the clinical results were evaluated using Rommens and Hessmann's method.
RESULTS
The outcomes from the radiological evaluation were that the displacement of the posterior pelvic ring were improved by about 6.65 mm in unstable pelvic ring injuries with partial instability. The displacement of the posterior pelvic ring were improved by about 7.8 mm in unstable pelvic ring injuries with complete instability. The clinical results were excellent in 13 cases and good in 6 cases on latest follow-up.
CONCLUSION
Good results can be achieved by selecting the treatment method according to the type of unstable pelvic ring injurie and displacement.

Citations

Citations to this article as recorded by  
  • Functional outcomes in pelvic fractures and the factors affecting them– A short term, prospective observational study at a tertiary care hospital
    Subhajit Ghosh, Sameer Aggarwal, Prasoon Kumar, Vishal Kumar
    Journal of Clinical Orthopaedics and Trauma.2019; 10(5): 896.     CrossRef
  • Outcome of Surgical Treatment of AO Type C Pelvic Ring Injury
    Do Hyeon Moon, Nam Ki Kim, Jun Sung Won, Jang Seok Choi, Dong Hyun Kim
    Hip & Pelvis.2014; 26(4): 269.     CrossRef
  • Minimally Invasive Plate Osteosynthesis for Humeral Proximal or Distal Shaft Fractures Using a 3.5/5.0 Metaphyseal Locking Plate
    Hyoung Keun Oh, Suk Kyu Choo, Jung Il Lee, Dong Hyun Seo
    Journal of the Korean Fracture Society.2012; 25(4): 305.     CrossRef
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The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures
Seung Wook Baek, Kyu Dong Shim, Ye Soo Park
J Korean Fract Soc 2011;24(4):354-360.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.354
AbstractAbstract PDF
PURPOSE
Evaluate the effects of sagittal imbalance on the clinical outcomes in thoracolumbar burst fractures.
MATERIALS AND METHODS
We evaluated 11 patients who had received posterior fixation for unstable burst fractures. Radiologic assessment including the compression ratio, focal kyphotic angle and sagittal balance were obtained. The clinical outcomes were assessed by ODI, VAS and SF-36. We subdivided the patients into sagittal balance and imbalance group, and compared with clinical outcomes. The relationship between radiologic and clinical outcomes was examined using correlation analysis.
RESULTS
The radiologic assessment were changed on preoperative and postoperative as follows: mean compression ratio: 15.2%, 4.9%, mean focal kyphotic angle: 43.2degrees, 20.9degrees. The mean sagittal balance was 11.5 cm. The mean score of VAS, ODI, Physical and Mental Component Summary of SF-36 were 3.7, 45.8, 43.3 and 39.8, respectively. The ODI was significantly higher in sagittal imbalance group, and SF-36 was significantly higher in sagittal balance group (p<0.05). The VAS was correlated with compression ratio and focal kyphotic angle. The ODI and Mental Component Summary of SF-36 were correlated with sagittal imbalance.
CONCLUSION
Sagittal balance effects on the functions of spine, surgical treatment should be carefully considered with unstable burst fractures.
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2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
Sung Jin Kim, Chul Hyun Cho
J Korean Fract Soc 2011;24(2):151-155.   Published online April 30, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.2.151
AbstractAbstract PDF
PURPOSE
To evaluate outcomes 2.4 mm volar locking compression plate for treatment of unstable distal radius fractures.
MATERIALS AND METHODS
We retrospectively analyzed the results in 22 cases, which were treated by 2.4 mm volar locking compression plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results.
RESULTS
All cases had bony union. The mean Mayo wrist performance score was 85.23. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 6.04 mm to 9.68 mm, radial inclination from 15.61degrees to 19.61degrees, volar tilt from -13.73degrees to 7.66degrees and intraarticular step-off from 0.79 mm to 0.33 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured 0.86 mm, radial inclination 0.41degrees, volar tilt 0.54degrees and intraarticular step-off 0.02 mm (p>0.05). Postoperative complication included that flexor pollicis longus and 2nd flexor digitorum profundus were ruptured in 1 case.
CONCLUSION
Treatment of unstable distal radius fractures using a 2.4 mm volar locking compression plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.

Citations

Citations to this article as recorded by  
  • Treatment of the Communited Distal Radius Fracture Using Volar Locking Plate Fixation with Allogenic Cancellous Bone Graft in the Elderly
    Je Kang Hong, Chang Hyun Shin
    Journal of the Korean Fracture Society.2015; 28(1): 8.     CrossRef
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The Efficiency of Additional Fixation of the Alternative Bone Substitute in Unstable Intertrochanteric Fractures of Femur Treated with Gamma Nail
Jong Oh Kim, Young One Ko, Mi Hyun Song
J Korean Fract Soc 2011;24(1):1-6.   Published online January 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.1.1
AbstractAbstract PDF
PURPOSE
To evaluate the efficiency of additional fixation of the alternative bone substitute in unstable intertrochanteric fractures treated with gamma nail and alternative bone substitute and only with gamma nail.
MATERIALS AND METHODS
Radiologic comparison was done between forty-four patients of unstable intertrochanteric fracture (AO type A2.2, A2.3) during six months. The patients were divided into two groups, a group treated with gamma nail and alternative bone substitute (22 patients, group 1) and another group treated only with gamma nail (22 patients, group 2). Postoperative reduction status, Cleveland index, Tip-apex distance and complications during the follow-up period was compared. Lag screw slippage and femoral neck-shaft angle change were measured between two groups.
RESULTS
No significant difference of reduction status, Cleveland index and Tip-apex distance was found. In group II, there was a 1 more case of cutting-out of the lag screw, but also there was a significant difference. Lesser change in lag screw slippage and neck-shaft angle change was investigated.
CONCLUSION
As there are lesser lag screw slippage and neck-shaft angle change, alternative bone substitutes applied in unstable intertrochanteric fractures seems to be useful in maintaining reduction and preventing failure of internal fixation when proper reduction and screw insertion is performed.
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Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients
Han Jun Lee, Jong Won Kim, Jae Sung Lee, Jae June Yang, Woo Young Hwang
J Korean Fract Soc 2010;23(3):276-281.   Published online July 31, 2010
DOI: https://doi.org/10.12671/jkfs.2010.23.3.276
AbstractAbstract PDF
PURPOSE
To evaluate clinicoradiological outcomes after cementless bipoloar hemiarthroplasty in elderly patients with femoral intertrochanteric fractures.
MATERIALS AND METHODS
From March 2006 to February 2008, 28 patients-all in patients greater than 80 years of age, classified unstable intertrochanteric fractures in Evans classification-were followed for more than 1 year. 24 patients were women and 4 patients were men. The mean age of the patients was 84.6 years, the mean follow-up period was 16.3 months. Harris hip score, postoperative inguinal and thigh pain, Parker and Palmer mobility score were analyzed clinically. The radiological results were assessed using various radiological indicies including bone-union, fit and alignment change of femoral stem and vertical subsidence.
RESULTS
The average Harris hip score was 82.9, Parker and Palmer mobility score preoperative 8.0 changed to 5.2 postoperatively. More than moderate pain was presented in 1 case. There were no cases of varus deformity or osteolysis. All stems were stable without significant alignment change or subsidence except 1 case of periprosthetic fracture. There were no dislocation, thromboembolism, death during operation or hospital days.
CONCLUSION
In elderly patients, cementless bipolar hemiarthroplasty is good treatment method of unstable intertrochanteric fracture and short-term clinicoradiological outcomes proved to be satisfactory.

Citations

Citations to this article as recorded by  
  • The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures
    Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim
    Hip & Pelvis.2014; 26(2): 99.     CrossRef
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Proximal Femoral Nail Antirotation versus Compression Hip Screw with Trochanter Stabilizing Plate for Unstable Intertrochanteric Hip Fractures
Jae Young Rho, Sang Bum Kim, Youn Moo Heo, Seong Jin Cho, Dong Sik Chae, Woo Suk Lee
J Korean Fract Soc 2010;23(2):161-166.   Published online April 30, 2010
DOI: https://doi.org/10.12671/jkfs.2010.23.2.161
AbstractAbstract PDF
PURPOSE
To analyze and compare the clinical and radiologic results of treatments in unstable intertrochanteric fractures of the femur with proximal femoral nail antirotation (PFNA) and compression hip screw with trochanter stabilizing plate (CHS with TSP).
MATERIALS AND METHODS
We retrospectively reviewed the results of 66 cases of unstable intertrochanteric fractures of the femur treated with PFNA (Group I) and CHS with TSP (Group II) which could be followed up for minimum a year. We evaluated several comparative factors such as operation time, blood loss, time to bone union, changes in neck-shaft angle, sliding of screw (or blade), complications, postoperative pain, social-function score of Jensen, and mobility score of Parker and Palmer.
RESULTS
Group I showed shorter operation time and less blood loss with significance than group II (p<0.05), but there were no differences between the groups in the mean time to bone union, changes in neck-shaft angle, sliding of screw (or blade), complications, postoperative pain, and social-function score of Jensen (p>0.05). Two cases of cutting out of the blade through the femoral head were found in group I. One case of cutting out of the screw, one case of the breakage of the plate, and loosening of the plate were found in group II as complications.
CONCLUSION
We think that there were no significant differences between PFNA and CHS with TSP in view point of radiologic and clinical outcomes in unstable intertrochanteric fractures of the femur, but PFNA is less invasive device than CHS with TSP, therefore it may be useful device in elderly patients.

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  • Results of Use of Compression Hip Screw with Trochanter Stabilizing Plate for Reverse Oblique Intertrochanteric Fracture
    Byung-Woo Min, Kyung-Jae Lee, Gyo-Wook Kim, Ki-Cheor Bae, Si-Wook Lee, Du-Han Kim
    Journal of the Korean Fracture Society.2014; 27(2): 120.     CrossRef
  • Effectiveness of the Valgus Reduction Technique in Treatment of Intertrochanteric Fractures Using Proximal Femoral Nail Antirotation
    Ji-Kang Park, Hyun-Chul Shon, Yong-Min Kim, Eui-Sung Choi, Dong-Soo Kim, Kyoung-Jin Park, Byung-Ki Cho, Jung-Kwon Cha, Sang-Woo Kang
    Journal of the Korean Orthopaedic Association.2013; 48(6): 441.     CrossRef
  • A Comparison of Intramedullary and Extramedullary Fixations for the Treatment of Reverse Oblique or Transverse Intertrochanteric Femoral Fractures
    Yerl-Bo Sung, Jung-Yun Choi, Eui-Yub Jung
    Hip & Pelvis.2012; 24(2): 109.     CrossRef
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Treatment for Unstable Distal Radius Fracture with Osteoporosis: Internal Fixation versus External Fixation
Jin Rok Oh, Tae Yean Cho, Sung Min Kwan
J Korean Fract Soc 2010;23(1):76-82.   Published online January 31, 2010
DOI: https://doi.org/10.12671/jkfs.2010.23.1.76
AbstractAbstract PDF
PURPOSE
To compare the functional and radiological outcomes of volar plating to that of external fixation for treating unstable osteoporotic distal radius fracture.
MATERIALS AND METHODS
From March 2006 to March 2008, 36 patients with osteoporosis over 60-year old were selected for this study. They were divided into two groups; group I (open reduction and internal fixation with volar fixed angle plate) and group II (closed reduction and external fixation). Clinical outcomes and radiologic outcomes were evaluated.
RESULTS
There was no statistical difference between group I and group II in range of motion and DASH score, BMD score. However, the grip strength and PRWE score were found to be higher in group II (p<0.05). In radiologic evaluation, group I showed higher radial inclination, volar tilting angle (p<0.05).
CONCLUSION
Internal fixation using Volar-fixed Angle Plate seems to give more stable fixation for distal articular fragments compared to external fixation. it could allow early postoperative exercise and could result in low incidence of postoperative complication such as pin track infections and joint stiffness. Therefore, the internal fixation could be more desirable treatment method to manage unstable distal radius fracture.

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  • Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis
    Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin
    Journal of the Korean Fracture Society.2013; 26(4): 248.     CrossRef
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Unstable Intertrochanteric Femoral Fracture Treated with Mini-incision Reduction Technique and Intramedullary Nail
Oog Jin Shon, Dae Sung Kim
J Korean Fract Soc 2010;23(1):13-19.   Published online January 31, 2010
DOI: https://doi.org/10.12671/jkfs.2010.23.1.13
AbstractAbstract PDF
PURPOSE
To evaluate the efficacy of mini-incision reduction technique in unstable intertrochanteric femoral fracture treated with intramedullary nail.
MATERIALS AND METHODS
From January, 2005 to December, 2007, we selected 26 patients of unstable intertrochanteric femoral fracture which underwent anatomic reduction by mini-incision reduction technique using various instruments, and treated with intramedullary nail. We evaluated the radiological results with the union time, change of femoral neck-shaft angle and distance of lag screw sliding by follow-up radiography, and the clinical results with the mobility score of Parker and Palmer, Salvati and Wilson hip function scoring system and Jensen index.
RESULTS
The mean union time was 18.9 weeks. The mean changes of femoral neck-shaft angle was 4.1 degree. The mean distance of lag screw sliding was 4.4 mm. Decrease of mobility score of Parker and Palmer, Salvati and Wilson hip function score was showed, and social function score of Jensen maintained 54% compared with preoperative score.
CONCLUSION
Mini-incision reduction technique using various instruments showed satisfactory clinical and radiological results, and we believe that it is a recommendable method in unstable intertrochanteric femoral fracture which manual reduction is difficult.
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The Comparison between ITST(TM) (Intertrochanteric/Subtrochanteric) & DHS (Dynamic Hip Screw) in Unstable Femur Intertrochanteric Fracture
Ho Seung Jeon, Byung Mun Park, Kyung Sub Song, Hyung Gyu Kim, Jong Ju Yun
J Korean Fract Soc 2009;22(3):131-137.   Published online July 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.3.131
AbstractAbstract PDF
PURPOSE
To evaluate between DHS and ITST nail (2nd generation) on the treatment of unstable femur intertrochanteric fracture in patients over 70 years old.
MATERIALS AND METHODS
61 cases of unstable intertrochanteric fracture (grouped 37 patients with DHS and 24 patients with ITST) who were taken the operation from Mar. 2003 to Sep. 2007 were analysed regarding to union time, sliding length of lag screws, operation time, blood loss, postoperative complications and functional recovery score by Skovron.
RESULTS
The mean union time was 14.7 weeks in study group (ITST). The mean union time was 16.2 weeks in control group (DHS). The lag screw slidings were 7.2 mm in study group and 8.7 mm in control group. The operation times were 57.9 min in study group and 76.9 min in control group. The amount of blood loss were 67.7 ml in study group and 227.4 ml in control group. The complications were 4 cases in study group and 4 cases in control group. The Skovron recovery scores were 76.5% in study group and 73.7% in control group.
CONCLUSION
From a practical point of short operation time, less amount of bleeding and less complication, author think that the ITST nail is useful implant for treatment of unstable femur intertrochanteric fracture in patient of old age.

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  • Unstable Intertrochanteric Fracture Treated with ITST: A Comparative Study between Groups with and without Comminution of Greater Trochanter
    Kyung-Sub Song, Sang-Ho Lee, Seong-Hun Jeong, Su-Keon Lee, Sung-Ha Hong
    Journal of the Korean Fracture Society.2014; 27(1): 36.     CrossRef
  • Treatment of the Intertrochanteric Femoral Fracture with Proximal Femoral Nail: Nailing Using the Provisional K-wire Fixation
    Gu-Hee Jung
    Journal of the Korean Fracture Society.2011; 24(3): 223.     CrossRef
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Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
Chul Hyun Cho, Ki Choer Bae, Doo Hyun Kwon
J Korean Fract Soc 2008;21(3):220-224.   Published online July 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.3.220
AbstractAbstract PDF
PURPOSE
To evaluate outcomes volar T-locking compression plate for treatment of unstable distal radius fractures.
MATERIALS AND METHODS
We retrospectively analysed the results in 35 cases, which were treated by volar plating with T-LCP. We evaluated the clinical results according to the Mayo wrist scoring system and radiographic results.
RESULTS
The mean score was 83.86 respectively. Between preoperative and immediate postoperative radiographic measurements, averaged radial length was improved from 5.75 mm to 11.53 mm, radial inclination from 12.86 degrees to 22.56 degrees, volar tilt from -3.64 degrees to 9.90 degrees and intraarticular step-off from 1.48 mm to 0.42 mm. Between immediate postoperative and latest follow-up radiographic measurements, mean loss of radial length measured 0.43 mm, radial inclination 0.46 degrees, volar tilt 0.89 degrees.
CONCLUSION
Treatment of unstable distal radius fractures using a volar T-LCP showed satisfactory outcomes. We think that it is good surgical option to allow return to daily living, result in early postsurgical wrist motion.

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  • Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate
    Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
    Journal of the Korean Fracture Society.2015; 28(1): 46.     CrossRef
  • The Fate of Pronator Quadratus Muscle after Volar Locking Plating of Unstable Distal Radius Fractures
    Chae-Hyun Lim, Heun-Guyn Jung, Ju-Yeong Heo, Young-Jae Jang, Yong-Soo Choi
    Journal of the Korean Fracture Society.2014; 27(3): 191.     CrossRef
  • 2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
    Sung-Jin Kim, Chul-Hyun Cho
    Journal of the Korean Fracture Society.2011; 24(2): 151.     CrossRef
  • Short Term Results of Operative Management with 2.4 mm Volar Locking Compression Plates in Distal Radius Fractures
    Ki-Chul Park, Chang-Hun Lee
    Journal of the Korean Fracture Society.2009; 22(4): 264.     CrossRef
  • Plate Fixation of AO Type C3 Fractures of the Distal Radius
    Eun-Sun Moon, Myung-Sun Kim, Hyeong-Won Park, Min-Sun Choi
    Journal of the Korean Fracture Society.2009; 22(3): 172.     CrossRef
  • Biosorption of Mercury (II) from Aqueous Solutions by Zygnema fanicum Algae
    Gh. Shams Khoramabad, A. Jafari, J. Hasanvand Jamshidi
    Journal of Applied Sciences.2008; 8(11): 2168.     CrossRef
  • Volar Plating of Distal Radius Fractures
    Kwang-Hyun Lee
    Journal of the Korean Fracture Society.2008; 21(4): 325.     CrossRef
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Comparison of Outcomes for Unstable Distal Radius Intraarticular Fractures: T-locking Compression Plate versus External Fixator
Chul Hyun Cho, Su Won Jung, Sung Won Sohn, Chul Hyung Kang, Ki Cheor Bae, Kyung Jae Lee
J Korean Fract Soc 2008;21(1):51-56.   Published online January 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.1.51
AbstractAbstract PDF
PURPOSE
To compare the outcomes between T-locking compression plate (T-LCP) and external fixator (EF) for unstable distal radius intraarticular fractures.
MATERIALS AND METHODS
We retrospectively analysed the results in 22 cases with T-LCP, 20 cases with EF. We evaluated the clinical results according to the Mayo Wrist Scoring System, radiographic results.
RESULTS
The mean score was 84.6 in the T-LCP group and 80.5 in the EF group respectively. Final radiographic measurements for the T-LCP group averaged 10.5 mm radial length, 21.7degrees radial inclination, 9.8degrees volar tilt and 0.25 mm intraarticular step-off. The EF group averaged 10.1 mm radial length, 20.3 degrees radial inclination, 6.3 degrees volar tilt and 0.73 mm intraarticular step-off.
CONCLUSION
Both groups showed satisfactory final clinical outcomes. But T-LCP group allowed return to daily living, resulting in early postsurgical wrist motion. By the anatomical reduction, final volar tilt, intraarticular step-off were statistically better in the T-LCP group.

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  • Comparative Analysis of the Results of Fixed-angle versus Variable-angle Volar Locking Plate for Distal Radius Fracture Fixation
    Seung-Do Cha, Jai-Hyung Park, Hyung-Soo Kim, Soo-Tae Chung, Jeong-Hyun Yoo, Joo-Hak Kim, Jung-Hwan Park
    Journal of the Korean Fracture Society.2012; 25(3): 197.     CrossRef
  • Treatment for Unstable Distal Radius Fracture with Osteoporosis -Internal Fixation versus External Fixation-
    Jin Rok Oh, Tae Yean Cho, Sung Min Kwan
    Journal of the Korean Fracture Society.2010; 23(1): 76.     CrossRef
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Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone
Haw Jae Jung, Jae Yeol Choi, Hun Kyu Shin, Eugene Kim, Se Jin Park, Yong Taek Lee, Gwang Sin Kim, Jong Min Kim
J Korean Fract Soc 2007;20(4):291-296.   Published online October 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.4.291
AbstractAbstract PDF
PURPOSE
To perform comparative analysis between the results of internal fixation and hemiarthroplasty in unstable intertrochanteric fracture of osteoporotic bone.
MATERIALS AND METHODS
From February 2003 to February 2006, 36 patients treated surgically for unstable intertrochanteric fractures were evaluated. The patient's age was older than 70 year old; the T-score of preoperative bone mineral density (BMD) was lower than -3.0; they were followed up for more than 1 year. The patient were divided into two groups. One group was treated with dynamic hip screw or proximal femoral nail (Group A, 23 cases), and the other group was treated with bipolar hemiarthroplasty (Group B, 13 cases). The two groups were compared in terms of hip joint function using Clawson classification and radiologically.
RESULTS
Nonunion and fixation failure happened in 6 cases (26%) of gruop A. However, all patients in group B showed stable maintenance of implant. Recovery of hip joint function was found in 13 cases (43%) of group A, whereas 12 cases (93%) of group B recovered.
CONCLUSION
Nonunion and failure of fixation happened more frequently in internal fixation than bipolar hemiarthroplasty, and the postoperative hip joint function was better in bipolar hemiarthroplasty than internal fixation. Therefore, bipolar hemiarthroplasty might be better operative treatment for unstable intertrochanteric fracture of osteoporotic bone.

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  • The Stability Score of the Intramedullary Nailed Intertrochanteric Fractures: Stability of Nailed Fracture and Postoperative Patient Mobilization
    Sung-Rak Lee, Seong-Tae Kim, Min Geun Yoon, Myung-Sang Moon, Jee-Hyun Heo
    Clinics in Orthopedic Surgery.2013; 5(1): 10.     CrossRef
  • Analysis of the Factors Involved in Failed Fixation in Elderly Intertrochanteric Femoral Fracture
    Joon Soon Kang, Ryuh Sup Kim, Bom Soo Kim, Young Tae Kim, Seung Hyun Hong
    Journal of the Korean Fracture Society.2012; 25(4): 263.     CrossRef
  • Results of Osteoporotic Treatment Drug after Periarticular Fracture of Hip
    Soo Jae Yim, Young Koo Lee, Cheong Kwan Kim, Hyun Seok Song, Hee Kyung Kang
    Journal of the Korean Fracture Society.2010; 23(2): 167.     CrossRef
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The Treatement of the Unstable Proximal Humerus Fracture Using Bifurcate Angled Blade Plate with Tension Band Wiring
Kuen Tak Suh, Hyoung Lok Roh, Myung Soo Youn, Jung Sub Lee
J Korean Fract Soc 2006;19(4):424-430.   Published online October 31, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.4.424
AbstractAbstract
PURPOSE
To evaluate the results of internal fixation with bifurcate angled blade plate and tension band wiring of greater tuberosity or rotator cuff for the unstable proximal humerus fracture.
MATERIALS AND METHODS
Nineteen cases of unstable proximal humerus fracture who were followed up for more than 1 year were treated using bifurcate angled blade plate and tension band wiring between March 2003 and March 2005. Average age of the patients was 46.5 years (range, 24 to 69), and there were 9 male and 10 female patients. The radiological results were evaluated by bony union and neck shaft angle. In addition, the clinical results were evaluated by Neer's evaluation criteria.
RESULTS
In 18 out of 19 cases, bony union was obtained in average 12.5 weeks after operation. The neck shaft angles of sixteen cases were between 120 and 140 degrees by Paavolainen method. According to Neer's evaluation criteria, 17 cases showed excellent or good results.
CONCLUSION
The patients treated using bifurcate angled blade plate and tension band wiring could exercise earlier because of good initial stability. Also, the radiological and clinical results were relatively good. The treatment of unstable proximal humerus fracture with bifurcate angled blade plate and tension band wiring was considered as a good method.

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  • Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures
    Chung Hee Oh, Joo Han Oh, Sae Hoon Kim, Ki Hyun Jo, Sung Woo Bin, Hyun Sik Gong
    Journal of the Korean Fracture Society.2008; 21(3): 213.     CrossRef
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External Fixation with Five Pins for Unstable Fractures of the Distal Radius
Kyoung Duck Kwak, Cheol Eun Ko, Seung Il Baek, Sang Min Ahn, Chan Jong Jung, Ki Baek Ahn, Jae Su Roh
J Korean Fract Soc 2006;19(3):346-351.   Published online July 31, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.3.346
AbstractAbstract
PURPOSE
To evaluate the results of five-pin external fixation, with the fifth pin stabilizing the distal radius articular fragment, for unstable distal radial fractures.
MATERIALS AND METHODS
Twenty cases of unstable distal radial fractures were treated with five-pin external fixation (5-pin group). The fifth pin was inserted into the distal articular fragment and attached to the external fixation frame. Metacarpal pins were removed at sixth week in 12 cases and at third in 8 cases, and radial pins were removed at eighth or ninth week. The radiographic results of 5-pin group were compared with those of 20 cases of traditional four-pin external fixation (4-pin group).
RESULTS
The postoperative radial inclination was 23.1 degrees in 5-pin group and 22.2 degrees in 4-pin group; while at last follow-up 21.8o and 15.1 degrees respectively. Postoperative volar tilt was 8.5 degrees and 7.3o; while at last follow-up 6.3 degrees and 0.1 degrees respectively. Postoperative radial shortening was 0.3 mm, 0.4 mm; while at last follow-up 1.1 mm and 2.1 mm respectively. In 5-pin group, there were no significant differences in results whether the metacarpal pins were removed at sixth or third week.
CONCLUSION
Five-pin external fixation, with the fifth pin stabilizing the distal articular fragment, enhanced early motion of the wrist maintaining fracture stability in unstable fractures of the distal radius.
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T Plate Fixation for Unstable Fracture of Distal Clavicle
Ho Jung Kang, Kwan Kyu Park, Hong Kee Yoon, Hyung Keun Song, Soo Bong Hahn
J Korean Fract Soc 2006;19(3):329-334.   Published online July 31, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.3.329
AbstractAbstract
PURPOSE
To review clinical and radiological results after open reduction and internal fixation with T plate for unstable distal clavicle fractures.
MATERIALS AND METHODS
From July. 1999 to December 2002, nine patients with distal clavicle Neer type II fractures were treated by open reduction and internal fixation with T plate. The bony union was confirmed by plain radiography. The clinical results were analyzed according to the classification by Kona et al.
RESULTS
Average time to fracture union was 8 weeks in all cases. The functional results were as follows: excellent in 7 cases and good in 2 cases. Screw loosening occurred in one case, but bony union was achieved.
CONCLUSION
We recommend T plate fixation as another treatment method for unstable distal clavicle fractures.

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  • Usefulness of the Additional K-Wire Fixation and Suture for Reinforce the Treatment of Distal Clavicle Fracture Using Modified Tension Band Wiring
    Seung-Bum Chae, Chang-Hyuk Choi, Dong-Young Kim
    Journal of the Korean Fracture Society.2016; 29(2): 107.     CrossRef
  • Treatment of Distal Clavicle Fracture Using Hook Plate
    Su-Han Ahn, Hyeong-Jo Yoon, Kwang-Yeol Kim, Hyung-Chun Kim, In-Yeol Kim
    Journal of the Korean Fracture Society.2011; 24(1): 48.     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
  • Results of Hook Plate Fixation of Unstable Distal Clavicle Fractures
    Hoon-Sang Sohn, Byung Chul Jo
    Journal of the Korean Fracture Society.2011; 24(4): 335.     CrossRef
  • 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
    Journal of the Korean Fracture Society.2010; 23(1): 64.     CrossRef
  • Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle
    Kyeong-Seop Song, Hyung-Gyu Kim, Byeong-Mun Park, Jong-Min Kim, Sung-Hoon Jung, Bong-Seok Yang
    Journal of the Korean Fracture Society.2009; 22(1): 24.     CrossRef
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Treatment of Distal Radius Fractures Using the Percutaneous K-wire Reduction-Fixation and External Fixator
Sang Jin Cheon, Ja Gyung Ku, Dong Ho Lee, Hui Taek Kim, Jeung Tak Suh
J Korean Fract Soc 2006;19(2):228-235.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.228
AbstractAbstract
PURPOSE
To analyse the results of treatment of unstable intra-articular distal radius fractures using the percutaneous K-wire reduction-fixation and external fixator.
MATERIALS AND METHODS
A retrospective follow-up study of 22 cases was carried out. With use of the system of AO classification 9 cases were in C1 and 7 in C2, and 6 in C3. The average duration of follow-up for all fractures was 35 months. We evaluated the radiologic results, the functional results according to clinical evaluation scoring system by Green and O'Brien and osteoarthritis grade according to arthritic grading system by Knirk and Jupiter.
RESULTS
Excellent and good results were rated in 17 cases (77%) of all cases. At last follow-up the mean loss of radial length, radial inclination and volar tilt were 1.4 mm, 1.0o, and 1.4o respectively. Also 7 patients had grade I, 1 patient grade II, and 1 patient grade III arthritis.
CONCLUSION
We think that percutaneous K-wire reduction-fixation and external fixation is useful treatment method for the unstable intra-articular distal radius fracture. But severely comminuted AO type C3 fractures would need additional treatments such as open reduction and bone graft to acquire and maintain the articular reduction for better results.

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  • Management of Comminuted Intra-articular Fractures of the Distal Radius: Arthroscopically Assisted Reduction and Pin Fixation Supplemented with External Fixation
    Jong-Pil Kim, Hyun-Jin Yu
    The Journal of the Korean Orthopaedic Association.2009; 44(2): 233.     CrossRef
  • Comparison of Outcomes for Unstable Distal Radius Intraarticular Fractures - T-locking Compression Plate versus External Fixator -
    Chul-Hyun Cho, Su-Won Jung, Sung-Won Sohn, Chul Hyung Kang, Ki-Cheor Bae, Kyung-Jae Lee
    Journal of the Korean Fracture Society.2008; 21(1): 51.     CrossRef
  • Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
    Chul Hyun Cho, Ki Choer Bae, Doo Hyun Kwon
    Journal of the Korean Fracture Society.2008; 21(3): 220.     CrossRef
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The Treatment of Unstable Proximal Humerus Fracture Using Locking Plate
Eun Sun Moon, Myung Sun Kim, Kyung Soon Park, Jae Yoon Chung, Keun Bae Lee
J Korean Fract Soc 2006;19(2):193-200.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.193
AbstractAbstract
PURPOSE
The purpose of this study was to determine the results of internal fixation with locking plate system for the unstable proximal humerus fracture.
MATERIALS AND METHODS
Sixteen cases of unstable proximal humerus fracture were treated using locking plate system between September 2004 and June 2005. Average age of the patients was 55.6 years (range, 22 to 78), male was four patients, female was twelve. The clinical outcomes were evaluated by using Neer's evaluation criteria and Constant socring system. We analyzed the radiological results by bony union time and Paavolainen method. All data was analyzed statistically.
RESULTS
According to Neer's evaluation ciriteria, eleven cases (69%) showed excellent or satisfactory results and according to Constant scoring system, twelve cases (75%) showed excellent or good result. Twelve cases (75%) showed good results by Paavolainen method. In all cases, bony union was obtained in average 12.8 weeks after operation. There were two complications; one screw irritation and one screw loosing.
CONCLUSION
The patients treated using locking proximal humerus plate could exercise earlier due to good initial stability. And the clinical and radiological results were relatively good. The treatment of unstable proximal humerus fracture with locking plate system was considered as a good method.

Citations

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  • Open Intramedullary Nail with Tension Band Sutures & Lock Sutures on Proximal Humeral Three-part Fracture
    Jin-Oh Park, Jin-Young Park, Sung-Tae Lee, Hong-Keun Park
    Journal of the Korean Fracture Society.2007; 20(1): 45.     CrossRef
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Comparative Study of Bipolar Hemiarthroplasty and Second Generation Intramedullary Nailing on Treatment of Elderly Unstable Peritrochanteric Femoral Fractures
Ho Hyun Yun, Gil Yeong Ahn, Il Hyun Nam, Gi Hyuk Moon, Jae Wook Lee, Jae Cheol Kim
J Korean Fract Soc 2006;19(2):128-134.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.128
AbstractAbstract
PURPOSE
To evaluate and compare the clinical and radiological outcome of bipolar hemiarthroplasty and second generation intramedullary nailing for elderly unstable peritrochanteric femoral fracutre.
MATERIALS AND METHODS
From January 2000 to July 2004, 56 elderly unstable peritrochanteric fractures were treated with a bipolar hemiarthroplasty (34 cases) or a ITST intramedullary nailing (22 cases). The fractures were classified using the OTA/AO classification. The clinical results were evaluated by walking capability, hip joint pain, and thigh pain. The radiological results were evaluated on the basis of the radiographs at follow-up.
RESULTS
In bipolar hemiarthroplasty group, The mean operation time was 134 minute, the mean blood loss was 648 ml. In intramedullary nailing group, The mean operation time was 103 minute, the mean blood loss was 386 ml. There were no different walking ability between prefracture and postoperative state in 22 cases (65%) of bipolar hemiarthroplasty group, 18 cases (80%) of intramedullary nailing group respectively. There were 5 cases (14%) hip joint pain in bipolar hemiarthroplasty group and 4 cases (18%) thigh pain in ITST intramedullary nailing group postoperatively.
CONCLUSION
Comparing the operation time, blood loss, and walking ability, ITST intramedullary nailing group show superior clinical outcomes than bipolar hemiarthroplasty group. However, The effort for decreasing postoperative thigh pain might be required.
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The Treatment of Unstable Intertrochanter Fracutures of Femur: Comparison between Proximal Femoral Nail and Dynamic Hip Screw
Kyun Chul Kim, Hun Kyu Shin, Kyung Mo Son, Chun Seok Ko
J Korean Fract Soc 2005;18(4):369-374.   Published online October 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.4.369
AbstractAbstract PDF
PURPOSE
To analyze the results between PFN (Proximal Femoral Nail) and DHS (Dynamic Hip Screw) on the operative treatment of unstable intertrochanteric fractures retrospectively.
MATERIALS AND METHODS
35 cases of unstable intertrochanteric fractures (grouped 24 patients with DHS and 11 patients with PFN) who were taken the operations from Jan. 2001 to Mar. 2002 were analysed regarding to union state, union time, operation time, sliding length of lag screws, blood loss, postoperative complications and functional recovery scores by Sk?vron with ANOVA and multivariate linear regression.
RESULTS
The means of union time were 17.9 weeks (DHS) and 17.0 weeks (PFN), sliding length of lag screws were 3.9 mm (DHS) and 2.1 mm (PFN), perioperative blood losses were 743 cc (DHS) and 736 cc (PFN), operation time were 93.4 minutes (DHS) and 102 minutes (PFN), and the functional recovery scores by Sk?vron were 71.8% (DHS) and 76.8% (PFN), respectively. The results of our study indicate that there were not statistically significant differences between PFN and DHS groups in treatment of unstable intertrochanteric fractures (p>0.05). But, there was less sliding of lag screws in PFN group in statistical significance (p<0.05).
CONCLUSION
Authors think that PFN is one of the useful implants in treating unstable intertrochanteric fractures of the femur in regarding to sliding.

Citations

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  • Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures with an Effective Wiring Technique
    Jae-Hwi Nho, Gi-Won Seo, Tae Wook Kang, Byung-Woong Jang, Jong-Seok Park, You-Sung Suh
    Hip & Pelvis.2023; 35(2): 99.     CrossRef
  • Comparison of the Gamma Nail and the Dynamic Hip Screw for Peritrochanteric Fracture
    Seok Hyun Kweon
    Hip & Pelvis.2011; 23(2): 124.     CrossRef
  • The Efficiency of Additional Fixation of the Alternative Bone Substitute in Unstable Intertrochanteric Fractures of Femur Treated with Gamma Nail
    Jong-Oh Kim, Young-One Ko, Mi-Hyun Song
    Journal of the Korean Fracture Society.2011; 24(1): 1.     CrossRef
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The Treatment of Unstable Intertrochanteric Fractures with Dynamic Hip Screw and Trochanter Stabilizing Plate
Sang Won Park, Soon Hyuck Lee, Dae Hee Lee, Jong Won Chung, Gi Won Choi
J Korean Fract Soc 2005;18(4):359-363.   Published online October 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.4.359
AbstractAbstract PDF
PURPOSE
To analyze the effect of treatment of unstable intertrochanteric fractures with dynamic hip screw and additional trochanter stabilizing plate.
MATERIALS AND METHODS
Among twenty three cases of unstable intertrochanteric fractures treated with DHS and additional TSP between January 2002 to December 2004, seventeen cases over sixty years old were reviewed with minimal follow up of one year. We analyzed the type of fracture by AO classification, the age of patient, sex, the cause of trauma in seventeen cases. We evaluated the lag screw slippage, the change of neck-shaft angle and lateral displacement of greater trochanter, the period of union by comparison of last follow up radiographs with immediate postoperative radiographs. The fixation failure is defined that displacement of lag screw tip is more than 3 mm or cut out of the screw from the femoral head.
RESULTS
The period of union was average 12.8 weeks. The lag screw slippage was average 8.22 mm. The change of neck-shaft angle was average 2.66 degree. No lateralization of greater trochanter was noted in twelve cases, but five cases showed average 0.8 mm (range: 0.5~1 mm) of lateral displacement of greater trochanter. There was not fixation failure.
CONCLUSION
In unstable intertrochanteric fracture, the addition of a TSP to the dynamic hip screw can decrease a change of neck shaft angle, a lag screw slippage, and prevent lateral displacement of greater trochanter.

Citations

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  • Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation
    Ui Seoung Yoon, Jin Soo Kim, Jae Sung Seo, Jong Pil Yoon, Seung Yub Baek
    Journal of the Korean Fracture Society.2010; 23(3): 270.     CrossRef
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The Compression Hip Screw with Trochanter Stabilizing Plate for Internal Fixation of Unstable Intertrochanteric Fractures
Jin Ho Cho
J Korean Fract Soc 2005;18(3):221-226.   Published online July 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.3.221
AbstractAbstract PDF
PURPOSE
To evaluate trochanter stabilizing plate and compression hip screw can prevent excessive impaction and cutting-out in unstable intertrochanteric fractures.
MATERIALS AND METHODS
One hundred twenty-one patients with intertrochanteric fractures were treated between December 1999 and March 2002. Of the patients, twenty-four patients were treated with an additional TSP on the CHS. Nineteen patients were followed for more than six months. The fractures were classified according to the AO classification. Impactions of compression lag screw were measured immediate postoperatively and postoperatively three months later on simple radiographs. Functional results were followed Salvati-Wilson assessment score at postoperative six months later.
RESULTS
The group consisted of seven men and twelve women, and the mean age was 73 years. Two were classified as A2.2, six A2.3, one A3.2, and ten A3.3 fractures. Mean impaction was 5.4 mm (range 1.8 to 11.4 mm). Functional results were excellent in 32% and good in 53%. Eighteen patients had healed after operation. One complication required a bipolar hemiarthroplasty due to cutting-out of lag screw.
CONCLUSION
In three-part and four-part intertrochanteric fractures with lateral cortex breakage or vertical fracture in greater trochanter, the addition of TSP to CHS can prevent abductor muscle weakness due to fracture impaction, limb shortening and additional lateral cortical fracture. It also helps early weight bearing and bone healing.
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Note
New Wiring Method for Lesser Trochanter Fixation in Unstable Intertrochanteric Fractures: Technical Note
Joong Myung Lee, Jeong Hee Lee, Churl Woo Lee, Hyun Min Kim
J Korean Fract Soc 2005;18(2):209-212.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.209
AbstractAbstract PDF
In unstable femoral trochanteric fracture, we usually used transversing K-wires through the lesser trochanter to achieve an anatomical reduction, and using sliding hip screws. However, in patients with comminuted lesser trochanter or osteoporosis, an intrusion of the wire into the lesser trochanter and/or iatrogenic intertrochanteric fractures were often resulted. Those who were not familiar with a technique of puncturing two holes through the lesser trochanter might have had to face some difficulties. In order to overcome aforementioned drawbacks, the authors had quite satisfactory results by employing the method of passing each of two wires above and below the iliopsoas muscle, and they were twisted posteriorly and then anteriorly; and finally they were pulled together posteriorly. Through this technique, both firm fixation of the lesser trochanter and more stable bony union were obtained.

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    Marco Villano, Matteo Innocenti, Roberto Civinini, Christian Carulli, Alessandro Civinini, Zyad Ayman Taha, Andrea Cozzi Lepri
    Journal of Orthopaedics.2022; 34: 94.     CrossRef
  • Unstable Intertrochanteric Fracture: Do We Know Everything? A Review
    Balaji Zacharia, Harshitha Hayavadana Udupa
    SN Comprehensive Clinical Medicine.2022;[Epub]     CrossRef
  • When to Reduce and Fix Displaced Lesser Trochanter in Treatment of Trochanteric Fracture: A Systematic Review
    Ao-Lei Yang, Wei Mao, Jun-Guo Wu, Yi-Qun He, Hao-Fei Ni, Hai-Long Li, You-Hai Dong
    Frontiers in Surgery.2022;[Epub]     CrossRef
  • Medial wall fragment involving large posterior cortex in pertrochanteric femur fractures: a notable preoperative risk factor for implant failure
    Pengfei Li, Yang Lv, Fang Zhou, Yun Tian, Hongquan Ji, Zhishan Zhang, Yan Guo, Zhongwei Yang, Guojin Hou
    Injury.2020; 51(3): 683.     CrossRef
  • In response
    David J. Ciufo, John P. Ketz
    Journal of Orthopaedic Trauma.2018; 32(9): e382.     CrossRef
  • Three-Dimensional Computed Tomography Reduced Fixation Failure of Intramedullary Nailing for Unstable Type of Intertrochanteric Fracture
    Wei-Yu Li, Kai-Cheng Lin
    Journal of Orthopaedic Trauma.2018; 32(9): e381.     CrossRef
  • Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note
    Joong-Myung Lee, Yongsuk Cho, Junhyun Kim, Dong-Won Kim
    Hip & Pelvis.2017; 29(1): 44.     CrossRef
  • Wiring technique for lesser trochanter fixation in proximal IM nailing of unstable intertrochanteric fractures: A modified candy-package wiring technique
    Gyeong Min Kim, Kwang Woo Nam, Kyu-Bum Seo, Chaemoon Lim, Jiyun Kim, Yong-Geun Park
    Injury.2017; 48(2): 406.     CrossRef
  • Bipolar Hemiarthroplasty with Cementless Femoral Stem for Unstable Intertrochanteric Fractures
    Joong-Myung Lee, Hee-Tae Nam, Sang-Hun Lee
    Journal of the Korean Orthopaedic Association.2012; 47(2): 79.     CrossRef
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Original Article
Minimally Invasive Plate Osteosynthesis in Unstable Fractures of the Distal Tibia
Se Ang Chang, Hyug Soo Ahn, Young Soo Byun, Ji Hwan Kim, Hoon Ho Bang, Do Yop Kwon
J Korean Fract Soc 2005;18(2):155-159.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.155
AbstractAbstract PDF
PURPOSE
evaluate the effectiveness of minimally invasive plate osteosynthesis (MIPO) in unstable fractures of the distal tibia.
MATERIALS AND METHODS
From March 2001 to December 2003, 21 cases with unstable fractures of the distal tibia were treated with MIPO technique and followed for at least one year. Eighteen cases were extra-articular and three cases were intra-articular fractures. According to AO classification, six cases were 42-A, four 42-B, one 42-C, seven 43-A, and three 43-C. There was only one case of Gustilo-Anderson type II open fracture. We reviewed the results of fracture healing, axial and rotational deformity, ankle motion, and complications RESULTS: All fractures were healed in an average of 16.1 weeks (range, 11 to 24 weeks). There was only one case of 7-degree posterior angular deformity, but no cases of rotational malalignment. Recovery of ankle motion was satisfactory in all patients within 5-degree loss of motion. Subcutaneous abscess was developed in one case after fracture healing and cured by a drainage with implant removal.
CONCLUSION
Although MIPO technique is technically more demanding than the traditional open technique, MIPO technique is an effective method for unstable fractures of the distal tibia because it minimizes incidence of soft-tissue compromise and infection and provides good fracture healing.

Citations

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  • Clinical Outcomes of Locking Compression Plate Fixation through Minimally Invasive Percutaneous Plate Osteosynthesis in the Treatment of Distal Tibia Fracture
    Jae-Sung Yoo, Hyun-Woo Park
    Journal of the Korean Fracture Society.2012; 25(2): 117.     CrossRef
  • Staged Protocol in Treatment of Open Distal Tibia Fracture: Using Lateral MIPO
    Oog Jin Sohn, Dong Hwa Kang
    Clinics in Orthopedic Surgery.2011; 3(1): 69.     CrossRef
  • Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures
    Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn
    Journal of the Korean Fracture Society.2010; 23(3): 289.     CrossRef
  • Management of Fractures of Distal Tibia by Minimally Invasive Plate Osteosynthesis through an Anterior Approach
    Gu-Hee Jung, Jae-Do Kim, Jae-Ho Jang, Sung-Keun Heo, Dong-won Lee
    Journal of the Korean Orthopaedic Association.2010; 45(6): 473.     CrossRef
  • Comparative Study Using of Treatment with Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Interlocking Intramedullary Nailing in Distal Tibia Fractures
    Chang Hwa Hong, Jong Seok Park, Sang Seon Lee, Soo Ik Awe, Woo Jong Kim, Ki Jin Jung
    Journal of the Korean Fracture Society.2010; 23(3): 296.     CrossRef
  • A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures
    Kee-Byung Lee, Si-Young Song, Duek-Joo Kwon, Yong-Beom Lee, Nam-Kyou Rhee, Jun-Ha Choi
    Journal of the Korean Fracture Society.2008; 21(4): 286.     CrossRef
  • Basic Principle of the Locking Compression Plate
    Keun Bae Lee
    Journal of the Korean Fracture Society.2008; 21(3): 261.     CrossRef
  • Treatment of High-energy Distal Tibia Intraarticular Fractures with Two-staged Delayed Minimal Invasive Plate Osteosynthesis
    Hong-Moon Sohn, Jun-Young Lee, Sang-Ho Ha, Jae-Won You, Sang-Hong Lee, Kwang-Chul Lee
    Journal of the Korean Fracture Society.2007; 20(1): 19.     CrossRef
  • Minimally Invasive Plate Osteosynthesis, MIPO
    Young-Soo Byun
    Journal of the Korean Fracture Society.2007; 20(1): 99.     CrossRef
  • Minimally Invasive Percutaneous Plate Osteosynthesis Using Periarticular Plate for Distal Tibial Fractures
    Young Mo Kim, Jae Hoon Yang, Dong Kyu Kim
    Journal of the Korean Fracture Society.2007; 20(4): 315.     CrossRef
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