Journal of Musculoskeletal Trauma

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

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 Î”Kyphotic 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 1.7Â°Â±1.2Â° vs PPSF 5.9Â°Â±3.2Â°, 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

1,208 View
20 Download
1 Crossref

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

Abstract 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.

279 View
1 Download

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

Abstract 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 NÂ·mm vs. 14,751.0 NÂ·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
Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs
Aytek Hüseyin Çeliksöz, Büşra Tokmak, Ali Okan Tarlacık, Servet Igrek
Scientific Reports.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; 38(4): 220. 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

519 View
3 Download
17 Crossref

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

Abstract 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

454 View
3 Download
1 Crossref

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

Abstract 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 (9â€“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 (12.5â€“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.

355 View
0 Download

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

Abstract 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

979 View
27 Download
4 Crossref

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

Abstract 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.

664 View
2 Download

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

Abstract 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

Displacement of an anterior pelvic ring fracture after L5, S1, and iliac screw fixation: a case report
Euijin Cho, Joonghyuk Kim, Hyeongyu Lim, Kyeol Han, Yonghun Pee, Junhong Min, Il-Tae Jang, Jeesoo Jang
Journal of Korean Society of Geriatric Neurosurgery.2025; 21(1): 24. CrossRef
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

697 View
4 Download
4 Crossref

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

Abstract 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.

361 View
1 Download

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

Abstract 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

Is dorsal cortex drilling necessary for distal radius fractures treated with a volar locking plate? A comparative study of near-cortex-only and far-cortex drilling
Chul Hong Kim, Sung Yoon Jung, Hyeon Jun Kim, Si-Hyun Park
Journal of Trauma and Injury.2025; 38(3): 248. CrossRef
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

515 View
1 Download
2 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; 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

Abstract 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.

442 View
0 Download

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

Abstract 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

565 View
4 Download
1 Crossref

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

Abstract 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.

Citations

Citations to this article as recorded by

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

757 View
1 Download
3 Crossref

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

Abstract 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.

Citations

Citations to this article as recorded by

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

563 View
0 Download
1 Crossref

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

Abstract 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.

561 View
6 Download

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

Abstract 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.

Citations

Citations to this article as recorded by

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

619 View
3 Download
2 Crossref

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

Abstract 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.

Citations

Citations to this article as recorded by

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

570 View
0 Download
7 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; 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

Abstract 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.

Citations

Citations to this article as recorded by

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

586 View
0 Download
2 Crossref

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

Abstract 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.

Citations

Citations to this article as recorded by

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

795 View
3 Download
3 Crossref

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

Abstract

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.

Citations

Citations to this article as recorded by

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

480 View
0 Download
1 Crossref

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

Abstract: 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.

269 View
0 Download

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

Abstract

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.

Citations

Citations to this article as recorded by

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

455 View
0 Download
6 Crossref

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

Abstract

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.

Citations

Citations to this article as recorded by

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

481 View
0 Download
3 Crossref

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

Abstract

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

Citations to this article as recorded by

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

476 View
0 Download
1 Crossref

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

Abstract: 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.

334 View
0 Download

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

Abstract 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

Citations to this article as recorded by

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

568 View
3 Download
3 Crossref

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

Abstract 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

Citations to this article as recorded by

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

523 View
8 Download
1 Crossref

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

Abstract 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.

342 View
0 Download

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

Abstract 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.

Citations

Citations to this article as recorded by

The lesser trochanter “Sling fixation technique” in proximal intramedullary nailing of unstable intertrochanteric fractures: A polymer-based cerclage wiring
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

569 View
11 Download
9 Crossref

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

Abstract 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

Citations to this article as recorded by

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

496 View
0 Download
10 Crossref

Relevancy of Posterior Column Injury and Dural Tear in Unstable Burst Fracture: Ye Soo Park, Kee Hun Son, Ki Chul Park, Il Hoon Sung, Jae Lim Cho; J Korean Fract Soc 2005;18(1):65-68. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.65

Abstract PDF

PURPOSE
To analyze the pattern of posterior column injury in unstable burst fractures and to predict the possibility of dural injury.
MATERIALS AND METHODS
Retrospective review was carried out on 22 patients of unstable burst fracture from Nov. 1996 to Sep. 2003. The pattern posterior column injury was analyzed by simple x-ray, CT and MRI findings. In simple x-ray, authors analyzed laminar fracture, posterior facet injury, inter-spinous widening and inter-spinous malalignment, posterior bony injury by CT, posterior inter-spinous ligament injury and dural tear by MRI. The statistical analysis was performed using Mann-Whitney test and Chi-square test.
RESULTS
There were 13 men and 9 women, and mean age was 41 years-old (18~65). The level of injury showed 15 cases in T12-L2, 6 in L3, 3 L4. In simple x-ray, findings were showed 13 cases (59.1%) in laminar fracture, 7 (31.8%) in posterior facet injury, 16 (72.7%) in inter-spinous widening and 8 (36.4%) in inter-spinous malalignment. In CT, findings were showed 13 (59.1%) in laminar fracture, 10 (45.5%) in posterior facet injury, 9 (40.9%) in transverse process fracture. In MRI, findings were showed 18 (81.8%) in posterior inter-spinous ligament injury and were not showed dural tear. The combined cases of posterior bony and ligamentous injury was 6 (27%) and 5 of 6 showed dural tear and the analysis of dural tear and radiologic findings was showed positive correlation (p=0.004).
CONCLUSION
Posterior ligament injury was more frequent than bony injury in unstable burst fracture. Among the posterior bony injuries, dural tear was more frequent in facet injury. Authors confirmed all dural tear with operation. In cases of posterior bony injury combined with ligamentous injuries, the possibility of dural tear was significantly higher than that of single structural injury (p=0.004).

Citations

Citations to this article as recorded by

Lumbar Spine Fracture
Seung-Wook Back, Hyun-Joong Cho, Ye-Soo Park
Journal of the Korean Fracture Society.2011; 24(3): 277. CrossRef
Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures
Ki-Chan An, Dae Hyun Park, Yong-Wook Kwon
Journal of the Korean Fracture Society.2011; 24(3): 256. CrossRef

376 View
2 Download
2 Crossref

Fixation Failure of Unstable Intertrochanteric Fracture of the Femur Using Compression Hip Screw: Sang Won Park, Soon Hyuck Lee, Jong Ryoon Baek, Sung Jun Park, Jong Won Chung; J Korean Fract Soc 2005;18(1):1-5. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.1

Abstract PDF: PURPOSE
To investigate the factors which influence on the fixation failure after the compression hip screw fixation for unstable intertrochanteric fractures.
MATERIALS AND METHODS
Eighty-two patients of unstable intertrochanteric fracture of A2 and A3 type who had underwent operation with compression hip screw were evaluated at least 1 year follow-up in regard to the age, degree of osteoporosis, fracture type, diastasis of fragment, sliding of lag screw, position of lag screw and status of reduction.
RESULTS
73 patients out of 82 patients had the union and 9 patients showed fixation failure. The results of fixation failure were 6 cases of migration of lag screw and 3 cases of cut-out of lag screw. There were statistically significant correlations between fixation failure and A2.3 and A3 type. The fixation failure group showed increased medial migration of medial cortex of proximal and distal fragment, which is significantly correlated with fixation failure. There were little statistical significant correlations between age, degree of osteoporosis, status of reduction, position of lag screw, sliding of lag screw and fixation failure.
CONCLUSION
Another alternative fixation method and technique have to be considered for unstable A2-3 or A3 type because compression hip screw fixation only is very insufficient with high failure rate.

324 View
1 Download

Surgical Treatment of Unstable Pelvic Bone Fracture Involving Sacroiliac Joint: Myung Ho Kim, Hee Gon Park, Moon jib Yoo, Jin Woo An; J Korean Soc Fract 2003;16(4):433-440. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.433

Abstract PDF: PURPOSE
To evaluate the results of surgical method using plate and screws in the treatment of unstable pelvic bone fracture involving Sacroiliac Joint.
MATERIALS AND METHOD
Authors reviewed 21 patients treated by surgical method from 1998 to 2002. Mean follow-up period was 15 months (12~24 month). Male were 16 and female were 5. We used plate and screws in 18 cases, just screws in 3 cases. We classified the type of fracture by Tile's classification and evaluated the results with Moon's criteria that based on reduction state in simple x-ray and patient's subjective satisfaction.
RESULTS
We got the bony union in all cases. By Moon's criteria, 10 cases were good, 7 cases were fair and 4 cases were poor. In 17 cases (80.9%), we got the results over fair. Mean weight bearing exercise periods were 6.4 weeks. There were 2 infection and 2 sacroiliac arthritis after operation.
CONCLUSION
As a method of surgical treatment on unstable pelvic bone fracture involving sacroiliac joint, we recommend open reduction and internal fixation with plate and screws and it may has particular advantages in early ambulation and satisfactory functional outcome.

388 View
1 Download

Treatment of Unstable Intertrochanteric Femoral Fracture with the AO/ASIF Proximal Femoral Nail (PFN): Do Hyun Moon, Jang Seok Choi, Geon Beom Kim, Jin Won Kim, Ki Tae Kim; J Korean Soc Fract 2003;16(2):136-142. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.136

Abstract PDF

PURPOSE
To review the clinical and radiographic results of the treatment of unstable intertrochanteric femoral fractures with a proximal femoral nail (PFN).
MATERIALS AND METHODS
We reviewed 47 unstable intertrochanteric femoral fracture cases that had been treated with a PFN operatively. The clinical and radiographic results and complications were analyzed. The mean age was 76.8 years old (62~96 years old) and the mean duration of follow-up was 15 months (12~24 months).
RESULTS
The postoperative walking ability was regarded as satisfactory when the patient could walk alone using an walking frame without others aids and satisfactory results was achieved in 43 cases (91.5%). In all cases the radiologic bone union was obtained. The average sliding of femoral neck screw was 3.0 mm and the average change of neck-shaft angle was 2.6 degree. There were three cases of postoperative complication which were including 1 case of cut-out of femoral neck screw, local superficial infection in 1 case and pain complaints over trochanteric area in 1 case.
CONCLUSION
The PFN is an useful implant for the treatment of unstable intertrochanteric femoral fracture because of the simplicity of the surgical technique and the low level of the complications encountered.

Citations

Citations to this article as recorded by

Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteic Fractures in the Elderly
Byung-Hak Kim, Young-Yool Chung, Sung-Chang Ki, Dae-Hyun Yoon, Ji-Hoon Ryu
Journal of the Korean Orthopaedic Association.2011; 46(5): 399. CrossRef
Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision
Se Dong Kim, Oog Jin Sohn, Jae Ho Cho
Journal of the Korean Fracture Society.2008; 21(1): 1. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)
Kee-Byoung Lee, Byung-Taek Lee
Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef
Treatment of Intertrochanteric Fracture with Proximal Femoral Nail
Dae Joong Kim, Sung Chan Ki, Young Yool Chung
Journal of the Korean Fracture Society.2007; 20(1): 40. CrossRef

463 View
0 Download
4 Crossref

Treatment of Unstable Intertrochanteric Fractures in Elderly Patients: Comparison between DHS and Additional TSP: Sang Won Park, Jong Ryoon Baek, In Seok Moon; J Korean Soc Fract 2003;16(1):9-14. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.9

Abstract PDF

PURPOSE
The purpose of this study was to compare the results by only Dynamic HIP Screw(DHS) with those by DHS and additional Trochanter Stabilizing Plate(TSP) in the operative treatments of unstable intertrochanteric fractures.
MATERIALS AND METHODS
From January 1998 to December 2000, twenty-five cases of unstable intertrochanteric fractures in the patient over 70 years old were reviewed with minimal follow up of one year. Ten cases(group I) were treated with DHS and additional TSP. Fifteen cases(group II) were treated with only DHS. The cases were analyzed according to the type of fracture by AO classification, the cause of trauma, the age of patient. We evaluated the sliding of lag screw, the change of neck-shaft angle and lateral displacement of greater trochanter by comparison of last follow up radiographs with immediate postoperative radiographs.
RESULTS
The degree of sliding of lag screws was average 8.57 mm in group I and average 14.75 mm in group II(P=0.04). The change of neck-shaft angle was average 3.81 degree in group I and average 3.93 degree in group II(P>0.05). There was a significant difference between group I(0 case) and group II(14 cases) in lateral displacements of greater trochanter. In group II, the degree of lateral displacement of greater trochanter was average 6.41 mm.
CONCLUSION
We consider that additional TSP is more effective method for reducing excessive sliding of lag screw and lateral displacement of greater trochanter than only using dynamic hip screw in the treatment of unstable intertrochanteric fracture.

Citations

Citations to this article as recorded by

A Comparison of Clinical Results between Compression Hip Screw and Proximal Femoral Nail as the Treatment of AO/OTA 31-A2.2 Intertrochanteric Femoral Fractures
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, In Hwa Back, Kyeong Soo Eom
Journal of the Korean Orthopaedic Association.2016; 51(6): 493. CrossRef
The Comparison between ITST™ (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
Journal of the Korean Fracture Society.2009; 22(3): 131. CrossRef

528 View
1 Download
2 Crossref

Surgical treatment using external fixator for unstable intra-articular fracture of distal radius: Chul Hong Kim, Byeong Hwan Kim, Sung Won Lee, Wook Kim; J Korean Soc Fract 2003;16(1):83-90. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.83

Abstract PDF: PURPOSE
To analyze the results of surgical treatment using external fixator for unstable intra-articular fracture of distal radius. MATERIAL AND METHODS: We investigated 38 cases of distal radius fracture from Mar. 1990 to Dec. 2000. The patients were followed up for average 18 months postoperatively. We compared the results of 22 cases, treated with open reduction and internal fixation(ORIF) to the results of 16 cases, treated with ORIF and external fixation. We evaluated the results of the mean loss of radial length, radial inclination, volar tilt and traumatic arthritis according to demerit point rating system above the Fernandez classification IV.
RESULTS
According to demerit point rating system, excellent to good results were obtained in 72.7% at ORIF and external fixator, compared to 43.8% at case of ORIF only. In the last follow up, the mean loss of radial length was 0.6mm in case of ORIF, but 0.4 mm in case of ORIF and external fixator, the mean loss of radial inclination was 2.3 and 1.5 degrees, the mean loss of volar tilt was 2.5 and 2.2 degrees, respectively (p < 0.05). Postoperative complications were developed in 9 cases. Malunion was in 4 cases of ORIF and external fixator, in 2 cases of ORIF. Metacarpal bone fracture was in 1 case of ORIF and external fixation. Traumatic arthritis was in 2 cases of ORIF.
CONCLUSION
Open reduction and internal fixation combined with external fixation was thought to be a better method than open reduction and internal fixation for the treatment of unstable intra-articular fractures of the distal radius of the Fernandez classification IV and IV, because that was more comfortable and convenient to patients and was useful to prevent late displacement.

348 View
0 Download

Primary Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fracture of the femur in Elderly patients: Jong Min Sohn, Ju Hae Jahng, Nan Kyung Ha, Seong Tae Cho, Kwang Young Choi; J Korean Soc Fract 2003;16(1):37-44. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.37

Abstract PDF

PURPOSE
The purpose of this study was to evaluate the effectiveness and advantage of bipolar hemiarthroplasty in treatment of unstable femoral intertrochanteric fracture in elderly patients.
MATERIALS AND METHODS
We reviewed 93 patients and followed up more than one year. Group I(n=34, Singh index <3 with more than 70 year old) were treated by bipolar hemiarthroplasty. Group II(n=20) with same condition were treated by compression hip screw. Group III(n=39, Singh index >4 with more than 70 year old) were treated by compression hip screw.
RESULTS
Group I and III patients showed satisfactory result over than good by merle D 'Aubigne hip rating scale. Among Group II(n=20), 16 cases showed under 'poor 'according to functional scale. Complication was 1 cases in group I, 19 cases in group II and 8 cases in group III.
CONCLUSION
We suggest bipolar hemiarthroplasty as first choice of treatment for osteoporotic elderly patients with unstable intertrochanteric fracture, especially who have combined medical problems or poor general condition.

Citations

Citations to this article as recorded by

Analysis of Missed Fractures by Bone Scan in Elderly Hip Fracture Patients with Osteoporosis
Tae Hun Lee, Yeong Hyun Lee, Seo Won Kang
Journal of the Korean Fracture Society.2024; 37(3): 144. CrossRef

703 View
1 Download
1 Crossref

Common Modes of Fixation Failure with a Sliding Hip Screw encountered Unstable Intertrochanteric Fracture: Byung Soon Kim, Duck Yun Cho, Hyung Ku Yoon, Dong Eun Sin, Soo Hong Han, Jae Hwa Kim, Dong Jun Kim; J Korean Soc Fract 2003;16(1):15-21. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.15

Abstract PDF

The purpose of this study was to evaluate the common modes of fixation failure in unstable intertrochanteric fractures , related risk factors and the prevention of fixation failure. Between 1995 and 2001, 44 patients who had sustained an unstable intertrochanteric fractures were assigned to be treated with a sliding hip screw. Men in 14 cases ( 32% ), women in 30 cases ( 68% ) , the average age at the operation was 65(22-90) years and the average duration of follow up was 12(8-22) months. We classified the fracture patterns with Evans system and used Singh 's index for osteoporosis. And we examined the common modes of fixation failure with postoperative X-ray. The fixation failure in unstable intertrochanteric fracture was 8 cases (18.2 % ); varus collapse of the proximal fragment with cutout of the lag screw was 3 cases (6.8%), varus collapse of the proximal fragment with excessive sliding of the lag screw was 4 cases (9.1%) and loss of fixation of the plate-holding screws was 1 case (2.3%). The authors think that inadequate anatomical reduction of comminuted posteromedial fragment and severity of osteoporosis are main causes of fixation failure. During operation for unstable intertrochanteric fractures, the most important point is accurate reduction of posteromedial fragment and the intramedullary hip screw like proximal femoral nail ( PFN ) may be considered to avoid fracture of lateral cortex that enter the lag screw, causing fixation failure.

Citations

Citations to this article as recorded by

The Antero-medial Cortex Overlapped Reduction of Unstable Intertrochanteric Fractures
Chae-Geun Kim, Suc-Hyun Kweon, Hong-Jun Han, Jae-Seon Hwang
Hip & Pelvis.2013; 25(4): 280. CrossRef

519 View
2 Download
1 Crossref

External fixation of distal radius fracture: Deok Weon Kim, Moon Ki Kim; J Korean Soc Fract 2002;15(2):258-263. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.258

Abstract PDF: PURPOSE
In the treatment of an unstable intraarticular distal radius fracture, we report the result of a retrospective study of reduction maintaining effect of external fixation.
MATERIALS AND METHODS
During the period from May 1996 to May 1999, 19 patients 20 cases with AO type C2, C3 distal radius fracture were treated by external fixation and followed-up for 2 years or longer. Six had AO type C2 fracture, and fourteen type C3. We evaluated immediate postoperative & follow-up radiological evaluation by volar tilt, radial inclination, radial length difference. As combined treatment, additional reduction maintaining effect of bone graft or internal fixation was evaluated also.
RESULT
Mean reduction loss of 2 years or longer follow-up after external fixation was volar tilt 7.2 degrees, radial inclination 4.3 degrees, radial length 3.1 mm. As additional reduction maintaining effect, internal fixation had statistically significant effect(p <0.05)-especially radial length maintenance, but bone graft not significant.
CONCLUSIONS
In unstable intraarticular distal radius fracture, after open reduction or bone graft etc. for intraarticular anatomic reduction, we consider external fixation or combined internal fixation for reduction maintenance.

359 View
0 Download

The Evaluation of Clinical and Radiographic Prognostic Factors for the Surgically Treated Unstable Ankle Fractures: Hong Geun Jung, Hee Kon Park, Moon Jib Yoo, Tai Won Kim; J Korean Soc Fract 2002;15(2):216-225. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.216

Abstract PDF

PURPOSE
The purpose of this study is to analyze the clinical and radiographic prognostic factors which may affect the postoperative clinical results of the unstable ankle fractures.
MATERIALS AND METHODS
This study is based on 75 unstable ankle fractures treated by open reduction and internal fixation from May 1994 to August 2000, with a minimum follow-up period of 12 months(range : 13 months-7 years 3 months). The 75 patients were average 40.5 years old with male: female ratio of 52:23. Based on Lauge-Hansen classification, the supination-external rotation type was the most common with 42 (56.0%) cases. The clinical results was assessed by American Orthopaedic Foot and Ankle Society(AOFAS) functional scale. The sex, age, side of injury, body weight, trauma-operation interval, operation time, cause of injury as the possible postoperative clinical prognostic factors and fracture type, anatomical reduction of fracture, preoperative medial clear space, postoperative medial clear space, talo-crural angle, talar tilt, tibio-fibular clear space, tibio-fibular overlap space as the possible radiographic prognostic factor were statistically analyzed RESULT: Postoperative AOFAS functional scale was average 81.0 points with 23(30.7%) cases excellent, 17(22.7%) good, 18(24.0%) fair and 17(22.7%) cases poor results. The age, the operation time(p<0.001) and the anatomical reduction of fracture(p<0.005) were found to be statistically significant factors affecting the prognosis. The other clinical and radiographic factors did not significantly affect the clinical results.
CONCLUSION
The surgically treated unstable ankle fractures in patients whose age was above 41 years old or operation time exceeding 90 minutes or unsatisfied anatomical reduction of fractures showed significantly poor clinical results.

Citations

Citations to this article as recorded by

Analysis of Bone Mineral Density of Ankle Fracture Patients
Tae Hyung Kim, Jae Hyung Lee, Seung-Hwan Park
Journal of the Korean Orthopaedic Association.2021; 56(4): 334. CrossRef

505 View
1 Download
1 Crossref

Closed Reduction and Percutaneous Fixation in the Treatment of Proximal Humerus Fractures: Seung Ju Jeon, Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Hyung Sam Kim; J Korean Soc Fract 2002;15(2):173-180. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.173

Abstract PDF: PURPOSE
This is a retrospective study to analyze the functional results of closed reduction and percutaneous fixation of displaced unstable proximal humerus fractures.
MATERIALS AND METHODS
We report 23 patients, 20 with 2-part and 3 with 3-part proximal humerus fractures that can be reduced closed but remain unstable in which percutaneous fixation was performed. The fixation methods were multiple pinning in 10, multiple cannulated screw fixation in 8, Rush pin fixation in 3 and Rush pin combined with other methods in 2. The functional rusults were analyzed with Neer,scriteria.
RESULTS
The functional rusults were excellent in 14, satisfactory in 4 and unsatisfactory in 5. No significant difference was not noted in the long term follow-up results according to the fixation methods but Rush pin resulted in impingement and displacement of greater tuberosity.
CONCLUSION
Closed reduction and percutaneous fixation is a useful alternative to open reduction and internal fixation for the displaced 2-part or 3-part proximal humerus fractures that can be reduced closed but remain unstable.

262 View
0 Download

The Neccessity of Additional Supporting Fixation for the Unstable Intertrochanteric Fractures of the Femur in the Elderly: Hyoun Oh Cho, Kyoung Duck Kwak, Soo Min Sohn, Cheol Ho Kang, Seung Il Whang, Sang Min An, Do Young Lee; J Korean Soc Fract 2001;14(1):23-29. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.23

Abstract PDF: PURPOSE
This study was designed to assess the necessity of additional supporting fixation to the traditional internal fixation for unstable intertrochanteric fractures of femur.
MATERIALS AND METHODS
Seventy two cases of unstable intertrochanteric fractures (modified Boyd-Anderson type III, IV) in the elderly were reviewed, which were internally fixed with Dynamic Hip Screw. 48 cases were treated with Dynamic Hip Screw only(Group I) and 24 cases with Dynamic Hip Screw and additional trochanteric supporting plate(Group II). In 13 cases with weak femoral cortx, we added wiring to the side plate. We measured neck-shaft angle, degrees of displacement of greater trochanteric fragment, slippage of hip screw on plain radiographs.
RESULTS
Varus change in neck-shaft angle, displacement of greater trochanteric fragment and slippage of hip screw revealed 7.3Â°, 5.4 mm, and 10.7 mm respectively in group I, while 2.1Â°, 0.1 mm and 3.8 mm respectively in group II. There were no pullout of cortical screws.
CONCLUSION
Internal fixation with additional trochanteric supporting plate to the conventional Dynamic Hip Screw was effective in unstable intertrochanteric fractures of the femur in the elderly. Added wiring to the side plate was also helpful in weak femoral cortex.

289 View
0 Download

Percutaneous K-wire fixation for Unstable Fracture of distal radius: Chol Yong Jung, Young Chan Son, Jun Bum Bae, Moon Do Choi; J Korean Soc Fract 2000;13(4):996-1002. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.996

Abstract PDF: PURPOSE
To evaluate the clinical validity of the percutaneous K-wire fixation in applying to unstable extraarticular fracture of distal radius of patients who are older than 50 years. MATERIAL AND METHODS: The validity of K-wire fixation was examined, using subjective study of Cole and Oblelz and objective study of Scheck, on the 20 cases of unstable extraarticular fracture of distal radius of patients older than 50 years, who were treated with percutaneous K-wire fixation and followed up more than 1 year, out of 160 patients with distal radius fracture, treated in the department of orthopedic surgery of our hospital from January 1994 to August 1998.
RESULTS
The result was examined with subjective study of Cole and Oblelz and objective study of Scheck. Combined judgement was made by adding up the scores of both objective and subjective study. 5 excellent cases and 12 good cases were brought forth by subjective study. Objective study achieved the result of average 18 degree of radial angle, 9.8mm of radial length and 3.6 degree of volar angle. Combined judgement achieved a good result of 3 excellent cases, 14 good cases and 3 fair cases.
CONCLUSION
Percutaneous K-wire fixation is expected to be a simple, less invasive, more effective and valuable operation method in the treatment of extraarticular fracture of distal radius with severe comminution

244 View
0 Download

The Result Of Surgical Treatment Of The Femur Unstable Intertrochanteric Fracture Using Compression Hip Screw: Analysis Of Effect Of Degree Of Force On Trauma And Degree Of Osteoporosis: Ki Do Hong, Sung Sik Ha, Sang Weon Park; J Korean Soc Fract 2000;13(4):795-803. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.795

Abstract PDF: PURPOSE
To analyise the effect of degree of force on trauma and degree of osteoporosis in femoral unstable intertrochanteric fracture's result of treatment using compression hip screw.
MATERIALS AND METHODS
From January 1993 to December 1997, 55 patients who were operated with compression hip screw and followed up for more than 1 year were devided into high and low energy injured group by the mechanism of the trauma and also devided low(gradeIV,V,VI) and high grade osteoporosis group(gradeI,II,III) by Singh's index. We analize and compare the result of treatment in each groups.
RESULTS
The averrage rate of mechanincal complication was 24%. The mechanical complication rate of the high grade osteoporosis group(34%) was higher than low grade osteoporosis group(9%)(p<0.05). The average subsidence of compression screw was 9.9mm and it shows significant difference between low(7.8mm ) and high grade osteoporosis group(11.5mm )(p<0.05). The average increased varus deformity of neckshaft angel during follow up was 3.8degrees and it shows singnificant defference between high energy injuried group(4.6degrees ) and low energy injuried group(2.7degrees)(p<0.05). No difference was seen in each groups for time of bone union(p>0.05). In view of functional recovery by Clawson's method, no difference between pre-injury and postoperative state was seen in 7 cases(22%) in high grade osteoporosis group and 13 cases(57%) in low grade osteoporosis group, thus worse functional recovery was seen in high grade osteoporosis group.
CONCLUSIONS
We observed higher mechanical complication rate, more compression screw subsidence and worse functional recovery in high grade osteoporosis group and more varus deformity in high energy injured group. Thus we need more attension to treatment and follow up in high energy injured, severe osteoporotic unstable intertrochanteric fracture.

342 View
1 Download

Effect of Trochanter Stabilizing Plate in Unstable Intertrochanteric Fracture: Youn Soo Park, Kye Young Han, Hyung Gun Kim; J Korean Soc Fract 2000;13(4):779-787. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.779

Abstract PDF

PURPOSE
The purpose of this study is to investigate the effectiveness of trochanter stabilizing plate (TSP) with compression hip screw(CHS) on the reduction stability, fracture union and sliding of lag screw in unstable intertrochanteric fracture. MATERIAL AND METHOD: From October 1997 to March 1999, 32 cases(group 1) and 20 cases(group 2) who could be followed for more than 1 year were treated with TSP (group 2) and CHS only (group 1) due to unstable intertrochanteric fractures. And two groups were compared clinically and radiologically.
RESULTS
Operation time was longer in group 2 and hospital stay was longer in group 1. Preoperative functions were better in group 1(7.00 points) than in group 2(6.47 points). When postop. function was compared with preop. function, group 1 showed differences on the three months follow-up and six months follow-up. Whereas group 2 only showed difference on the three months follow-up but not on the six months follow-up. There was no difference in the incidence of lag screw sliding. However, there were differences in the extent of sliding between group 1(ave.4.88mm) and group 2(ave.2.88mm) with three months follow-up and six months follow-up (group 1: ave 5.42mm and group 2: ave. 3.03mm). There was a significant difference between group 1(12cases) and group 2(0 case) in greater trochanter lateralization, but shaft medialization between group 1(17cases) and group 2(10cases) showed no difference. Loss of neck-shaft angles between group 1(9cases) and group 2(3cases) were not significantly different. Due to loss of reduction, one case in group 1 was reoperated.
CONCLUSION
Application of TSP is not a difficult procedure and reduce excessive sliding of lag screw. And early fuctional recovery without adverse effect of bone healing is possible. So in unstable intertrochanteric fracture, additional use of TSP is effective.

Citations

Citations to this article as recorded by

Surgical Treatment of Femoral Unstable Intertrochanteric Fractures in Elderly Patients -Comparative Study between Compressive Hip Screws and Additional Trochanteric Stabilizing Plates-
Kap Jung Kim, Dae Suk Yang, Sang Ki Lee, Won Sik Choy, Kyoung Wan Bae
Journal of the Korean Fracture Society.2011; 24(4): 295. CrossRef
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
Journal of the Korean Fracture Society.2010; 23(2): 161. CrossRef

397 View
2 Download
2 Crossref

Prognosis of early internal fixation in unstable pelvic fractures: Jang Yeol Lee, Do Hun Moon, Gun Beom Kim; J Korean Soc Fract 2000;13(4):741-748. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.741

Abstract PDF

PURPOSE
This study was conducted to analyze the clinical prognosis of early internal fixation in unstable pelvic fracture. MATERIAL AND METHOD: We analyzed the sixteen patients. The average age of the patients was 34 years(range, 21-64 years). They were followed up for average 21 months. The sixteen pelves were classified by Tile ; Type B 3 cases, Type C 13 cases. Nine patients(56%) had the associated injuries. In 13 patients(81%), internal fixation were performed within 3 weeks after the injury. Fixation was accomplished by the plates and screws. We assessed the functional, radiological results and postoperative complications.
RESULTS
Fourteen(88%) patients were fully ambulatory, had no limp, did not need assistive devices. Fifty percents of the patients had returned to the previous jobs and 31% had to change the jobs. On radiolograph, there were 14 excellent and 2 good reduction. Three postoperative complications happened ; two superficial infections and one lumbar neuropathy, which resolved spontaneously. Three patients with associated injuries, who had delayed fixation, appealed gait disturbance and chronic pain.
CONCLUSION
early internal fixation of unstable pelvic ring fractures may be expected to yield satisfactory functional success and radiologic results in the majority of patients

Citations

Citations to this article as recorded by

Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint
Kwang-Jun Oh, Jin-Ho Choi
Journal of the Korean Fracture Society.2013; 26(3): 184. CrossRef
Surgical Fixation of Sacroiliac Joint Complex in Unstable Pelvic Ring Injuries
Kwang-Jun Oh, Seok-Min Hwang
Hip & Pelvis.2012; 24(2): 139. CrossRef
Operative Treatment of Unstable Pelvic Ring Injury
Sang Hong Lee, Sang Ho Ha, Young Kwan Lee, Sung Won Cho, Sang Soo Park
Journal of the Korean Fracture Society.2012; 25(4): 243. CrossRef
Crescent Fracture-dislocation of Sacroiliac Joint: Affecting Factors of Operative Results
Hee-Soo Kim, Chang-Wug Oh, Poong-Taek Kim, Young-Soo Byun, Joo-Woo Kim, Byung-Chul Park, Woo-Kie Min, Hyun-Joo Lee
Journal of the Korean Fracture Society.2009; 22(2): 71. CrossRef

526 View
0 Download
4 Crossref

Posterior Short Segment Instreumntation and Fusion for the Unstable Thoracolumbar Spine Fracture: A Comparative Study: Ki Tack Kim, Gyu Pyo Hong, Dae Woo Hwang, Sang Un Lee, Sang Wook Bae; J Korean Soc Fract 2000;13(2):352-360. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.352

Abstract PDF: INTRODUCTION : In treating of acute unstable thoracolumbar spine fractures, current trend is a toward short segment instrumentation to spare the motion segments. Many authors reported the result of short instrumentation and fusion, but there have been few reports about the effect of additional screw fixation at fractured vertebra in posterior short segment instrumentation and fusion. Therefore, the objective of this study is to compare the results of treatment between with/without screw fixation at the fractured vertebra in posterior short segment pedicle screw fixation. MATERIAL AND METHODS : Twenty-three patients with unstable thoracolumbar spine fractures were treated with posterior short segment instrumentation and fusion. Eleven cases classified into group A were not fixed at the fractured vertebre. They were followed up to average 45 months(24-79). Twelve cases classified into group B were treated with screw fixation at the injured vertebra and followed up to average 38 months(14-78). Authors evaluated the radiologic assessment, such as wedge angle of fractured body, local kyphotic angle and wedge index(the ratio of anterior body height to posterior body height), the neurologic assessment by Frankel grade system and functional assessment by Denis system.
RESULTS
: There was no complication resulted from additional pedicle screw fixation at fractured level. In rediologic assessment, wedge angle were measured at preoperative, postoperative and last follow-up time as follows; in group A, 22.2degrees -11.3degrees -14.1degrees and in group B, 19.5degrees -8.8degrees -9.8degrees . The local kyphotic angle measured were 17.9degrees -7.0degrees -14degrees in group A and 17.1degrees -6.3degrees -7.9degrees in group B. The wedge index were 42.9%-22.6%-28.5% in group A and 40%-19.5%-22.4% in group B. At last follow-up time, eight eases showed Frankel grade E and three cases showed grade D in group A, and all cases of group B were Frankel E. Denis pain score were satisfctory in all of both group and Denis work score were also satisfactory in two group except one case of group A.
CONCLUSIONS
: Additional screw fixation at fractured verteba did not cause any complication. There was no significant difference in reduction rate between two groups(P>0.05), but group B showed better maintenance of correction of kyphotic deformity than that of group A(P<0.05). In conclusion, it seems that additional screw fixation at fractured level may be better method in maintaining asgittal alignment and decreasing the risk collapsing of body.

273 View
0 Download

Comparison of Bipolar Hemiarthroplasty and Compression Hip screw on Treatment of Elderly Unstable Intertrochanteric Fractrues: Ik Su Choi, Su In Roh, Dae Yeon Kim, Keun Il Lee, Seung Chan Ko; J Korean Soc Fract 2000;13(1):56-63. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.56

Abstract PDF: PURPOSE
To evaluate and compare the clinical outcomes of bipolar hemiarthroplasty and compression hip screw on elderly with unstable intertrochanteric fractures We evaluated the clinical results of 65-year or older elderly patients with unstable intertrochanteric fractures between Jan. 1993 to Dec. 1997. 23 patients underwent compression hip screw treatment and 19 patients were treated with bipolar hemiarthroplasty. Functional evaluation was conducted at 3, 6 and 12 month after the operation by hip rating scale of Merle d'Aubigne. Complications, time to weight bearing and hospitalization period were also investigated.
RESULTS
For the bipolar hemiarthroplasty group, functional scale of good or above were seen in 74%, 72% and 67% of the group at 3 months, 6 months and 12 months. However in the compression hip screw group, the good or above results were shown in 57%, 52% and 43% of the group, thus showing a functional deterioration as time progresses. Comparing the overall clinical outcome, the bipolar hemiarthroplasty group showed better results, complication occurred in 26 cases of compression hip screw group and 8 cases of bipolar hemiarthroplasty group, showing better outcomes in the bipolar hemiarthroplasty group.
CONCLUSION
Comparing the length of hospital stay, time to weight bearing, complication and functional superiority of the treatment for elderly unstable intertrochanteric fractures, the bipolar hemiarthroplasty showed superior clinical outcomes than the compression hip screw. Moreover, patients with more unstable fractures and more severe osteoporosis showed better clinical results with bipolar hemiarthroplasty.

289 View
0 Download

Treatment of fractures of the Distal Radius with External Fixator: C Y Huh, J R Yoon, H S Ha; J Korean Soc Fract 1999;12(4):995-1002. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.995

Abstract PDF

PURPOSE
: Recently, intraarticular fractures or unstable fractures with severe comminution of the distal radius are increasing in younger ages, which are known to be difficult to treat. We designed this study to evaluate the clinical results and the prognosis of the external fixators for the treatment of the fractures of the distal radius. Material and Method : We reviewed 16 cases of the distal radius fractures, which were treated surgically with the external fixdtors since January 1995 to December 1997. We applied the external fixator with closed reduction and Kirschner-wire fixation in 8 cases, and in the rest of the cases we did minimal open reduction before the application of the exteranl fixator, because it was not enough to reduce the articular fragments in those cases with closed reduction For the analysis of the clinincal results, we used the Demerit point rating system, and for the analysis of the radiologic parameter, we measured radial height, radial inclination, and volar tilting in comparison with the uninjured side from the anteroposterior and the lateral X-ray films which were taken at preoperative, postoperative, and last follow-up period.
RESULTS
In clinical results by Demerit rating point system, 2 cases were excellent, 10 cases were good, 4 cases were fair, and none of the cases was poor. In radiologic results, the average of the radial height was 8.43mm, the average of the radial inclination was 17.68o, and the average of the volar tilting was 3.870.
CONCLUSION
: It is suggested that external fixator is one of the useful modalities in the treatment of the unstable fractures of the distal radius, and we can also improve the results of the intraarticular fractures by using the minimal open reduction technique.

Citations

Citations to this article as recorded by

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
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

482 View
0 Download
2 Crossref

Surgical Treament for Unstable Intra-articular Fracture of the Distal Radius with Rayhack's Transulnar Percutaneous Pinning Technique: Eui Chan Jang, Ho Sung Ryu, Jae Sung Lee, Jung Nam Han; J Korean Soc Fract 1999;12(2):422-428. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.422

Abstract PDF: There has been many treatment modalities in the distal radius fracture. Although there is no doubt that external fixators have a role in the treatment of some highly displaced distal radius fractures, many unstable distal radius fractures may be treated adequately with far less complicated and intrusive percutaneous pinning technique. The purpose of this study was to evaluate indication and effectiveness of Rayhack's transulnar percutaneous pinning technique. Authors reviewed the unstable intra-articular fracture of the distal radius of 15 cases treated with Rayhack's transulnar percutaneous pinning technique between March 1994 and February 1997. At the final follow-up examination, the mean loss of radial length, radial inclination and volar tilt was respectively 0.4mm (3.9%), 2.0 (10.6%), 2.1 (14.7%). Posttraumatic arthritis was occurred in 1 case (11.1%) of less than 1mm residual articular step-off, 2 cases (40%) of more than 1mm and less than 3mm residual articular step-off, 1 case (100%) of more than 3mm residual articular step-off. Distal radioulnar joint synostosis by percutaneous pinning was not found. According to Demerit point rating system, excellent to good results were obtained in 73.3%. Authors suggest that Rayhack's pinning technique can be applied in terms of simple procedure, cost-effectiveness and functional outcome.

277 View
2 Download

Search