Femur intramedullary nailing can be one of the most predictable procedures in orthopedic traumatology. The advantage of this method is that the fracture site does not have to be widely exposed for reduction, which can minimize soft tissue damage. For this reason, the incidence of complications related to hematoma has been rare. We experienced only one case of sciatic nerve palsy due to hematoma after intramedullary nailing; the patient was receiving an anticoagulant therapy. Therefore, we report this case with literature review.
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Ipsilateral Foot Drop After Leg Traction on Fracture Table for Mid-Shaft Femur Fracture Nailing: A Rare Case Report Jehad A Alzahrani, Ahmed A Alabdali, Mohammed O Albariqi Cureus.2023;[Epub] CrossRef
PURPOSE To report the method of anatomical reduction and its maintenance by percutaneous wiring reduction in minimally invasive plate osteosynthesis for distal tibial fractures. MATERIALS AND METHODS 17 cases that were diagnosed oblique, spiral or transverse fracture of distal tibia from August 2007 to February 2010 and were able to anatomically reduce by the method of percutanous wiring reduction in minimally invasive plate osteosynthesis were included in this study. Mean age was 50, and mean follow up period was 18 months. We investigated the period until bone union was achieved, degree of angulation angle, and complications. For postoperative evaluation, Olerud and Molander ankle score and VAS pain score in daily living were checked. RESULTS The mean varus/valgus angulation after bone union on AP radiograph was 0.9 degrees and the mean anterior/posterior angulation on lateral radiograph was 2.0 degrees The mean Olerud and Molander ankle score was 89.4, and mean pain score due to walk adjacent to metal plate was 0 points. CONCLUSION By the method of percutaneous wiring reduction in distal tibial fracture, anatomical reduction is easily acquired, and only by wire itself, reduction could be maintained, so that without additional manual reduction, plate could be easily fixed.
PURPOSE To find out the efficiency of two staged operation of patients with high energy proximal tibia fracture with severe soft tissue damage, the first step being external fixation, and the second, internal fixation with plates. MATERIALS AND METHODS The study group was the 42 patients who had followed for one year out of a group of 56, performed the first step external fixation and the second step internal fixation with plates retrospectively, from March 2003 to March 2007. The average age of the study group was 51.4, 26 men, and 16 women participating in this study. The average time of follow up was 32 months. In the final follow up, investigations of the radiological assessments and functional abilities of the bony fusion were carried out along with the complications of the soft tissue. RESULTS The duration after the first step external fixation until second step internal fixation to be performed was 14.9 (6~40) days in average. The final bone fusion took about 15 weeks, and according to the final follow up, the range of motion of the knee was around 110.8 degrees (6.2~117 degrees). In 31 cases, only the internal fixation was performed, while in 11 cases, soft tissue reconstruction was carried out with the internal fixations. As for the complications there were 2 cases of deep soft tissue infection, 2 cases of nonunion, 1 case of malunion and 1 case of knee joint stiffness. CONCLUSION In cases of proximal tibia fracture with severe soft tissue damage, external fixation was important to secure the safety of the fracture, carry forward the anatomical alignment, plan the soft tissue safety and manage the wound to decrease the number of microbial in the next operation, which is the internal fixation with plates.
Dislocation of the metatarsophalangeal joint is rare due to the stability of the ligaments and soft tissue surrounding the joint. The authors have experienced lateral dislocation of the first metatarsophalangeal joint, which required surgery, accompanied by complete injuries of medial collateral ligament and capsule, contributing to medial stability, differing from posterior dislocation with intersesamoid complex rupture, with a review of the relevant literature and previous reported cases.
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Dislocation of the first metatarsophalangeal joint concomitant with Lisfranc joint dislocation in a 45-year-old man Kanoko Mizumoto, Tadashi Kimura, Makoto Kubota, Mitsuru Saito BMJ Case Reports.2021; 14(6): e243004. CrossRef
Rare Lateral Dislocation of the First Metatarsophalangeal Joint: A Case Report and Review of the Literature Amir Reza Vosoughi, Pascal F. Rippstein The Journal of Foot and Ankle Surgery.2017; 56(2): 375. CrossRef
PURPOSE To evaluate the clinical results of minimally invasive percutaneous plate osteosynthesis using a periarticular plate (Zimmer, Warsaw, IN, USA) for distal tibia fractures. MATERIALS AND METHODS 27 patients with distal tibia fractures were treated operatively by minimally invasive percutaneous plate osteosynthesis. The patients were followed for at least 1 year. The duration for bone union, complications after the surgery, the amount of skin irritation at the site of plate insertion was evaluated using the VAS score and the Olerud and Molander ankle score. The average age of the patients was 56 years old (range, 30~81 years) with an average follow up period of 21 months (range, 12~30 months). RESULTS The average time from trauma to surgery was 6 days (range, 2~19 days). 10 cases showed an associated distal fibular fracture. The average time for bone fusion was 14 weeks (range, 8~40 weeks) with 1 case of angular deformity with more than 5 degrees. The amount of skin irritation due to the periarticular plate resulted in a VAS score of 2.2 points. Evaluation of the ankle function test showed an average of 90.2 points, resulting in satisfactory. CONCLUSION The periarticular plate used in minimally invasive percutaneous plate osteosynthesis for distal tibia fractures was concluded to give a firm fixation of the fracture site as bony fusion could be acquired without any callus formation, and few skin irritation due to plate has seem to be an advantage.
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Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures Sung-Kyu Kim, Keun-Bae Lee, Keun-Young Lim, Eun-Sun Moon Journal of the Korean Fracture Society.2011; 24(1): 33. CrossRef
Anatomically Percutaneous Wiring Reduction in Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures Young-Mo Kim, Chan Kang, Deuk-Soo Hwang, Yong-Bum Joo, Woo-Yong Lee, Jung-Mo Hwang Journal of the Korean Fracture Society.2011; 24(3): 230. CrossRef
Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture Oog Jin Shon, Dae Sung Kim Journal of the Korean Fracture Society.2010; 23(1): 42. CrossRef
PURPOSE To find out the consequences of the surgical treatment of acromioclavicular joint dislocation, using modified Phemister technique with Mersilene tape augmentation. MATERIALS AND METHODS We chose 26 patients who were able to follow up 1 year or more among the patients who were diagnosed as acromioclavicular joint dislocation in our hospital through February 2001 to March 2003 and took modified Phemister surgery with Mersilene tape augmentation. Patients with clavicle fracture were excluded. Evaluation of the surgical results was done with the condition or pain, function, range of motion by using Imatani evaluation system, and preoperative, postoperative and last follow up radiographs. RESULTS Most of the cases showed satisfactory result. Clinical evaluations were 16 excellent (62%), 10 good (38%), radiological evaluations were 14 excellent (54%), 10 good (38%), 2 fair (8%), and no poor group. On the final follow up six cases showed vertical translation, but none had clinical symptoms. Seven cases showed a little inflammation at where pin were inserted, but after the removal of the pin, the inflammation was gone. CONCLUSION The modified Phemister surgery for acromioclavicle dislocation is simple, but we can obtain strong fixation, and there is no burden of the removal of the metal plate, or complication of re- dislocation after the removal of the pin, so it is thought as a very effective surgery.
PURPOSE To evaluate the effectiveness of a blocking screw in intramedullary nailing at the tibia proximal shaft fracture. MATERIALS AND METHODS 63 tibia proximal shaft fractures from January 2000 to December 2002 treated with only intramedullary nailing were referred to as group I, and 8 fractures from January 2003 to December 2003 treated with both intramedullary nailing and the blocking screw were referred to as group II. Retrospective studies were done for group I and II. The incidence of nonunion and the postoperative angular alignments were compared. Malalignment was defined as an angle of 5 degrees anteroposteriorly or mediolaterally. RESULTS There were 7 nonunion (11%) in group I in compare with none in group II. There were 21 angular malalignments (33%) in group I and 1 in group II (12%) and most of them had valgus deformity or anterior anglulation. No complications were directly due to the use of the Blocking screw. CONCLUSION The technique of the blocking screw used to be one of the option for proximal tibial nailing at tibial proximal shaft fracture helps to overcome angular malalignments of bones.
PURPOSE To analyse the comparative clinical results between adults with multiple injury including the clavicular shaft fracture and only clavicular shaft fracture who had supportive care through retrospective aspect. MATERIALS AND METHODS We had 48 adult patients in this hospital with simple fracture and multiple injury including the clavicular shaft whom we were able to evaluate at least more than a year. 12 of 48 patients were with only clavicular shaft fracture and the rest of them were with multiple injury. We classified patients into two groups those who had fracture with displacement for group A (A1 for the cases with over 50% of fracture surface contact rate and A2 for less than 50% from the images of simple X-ray) and those who had comminuted fracture for B. We compared the time of bone union, nonunion rate of only clavicular fractures and multiple injury, clinical results for patients who had supportive care with retrospective aspect. RESULTS A1 (7 cases), A2 (4 cases), B (1 case) were prevalent in the group of only clavicular shaft fracture and A1 (8 cases) and A2 (16 cases) and B (12 cases) were prevalent in the group of multiple injury. For the cases with supportive care, we could find 1 nonunion case (8%) and 11 union cases on average 2.91 months in the group of only clavicular shaft fracture and 7 nonunion cases (19%) and 29 union cases on average 3.58 months in the group of multiple injury. The best clinical results had occurred in 8 cases (67%) of only clavicular shaft fracture group and 19 cases (53%) of multiple injury group. We could find out the union from all 8 nonunion cases that took operation afterward. CONCLUSION Although the choice of treatment of clavicular fracture is supportive care, but multiple injury including the clavicular fracture is a high-energy injury, so the possibility of comminuted and displacement is high, so that nonunion rate is high. The possibility of early surgery must be considered seriously.
PURPOSE To evaluate the factor of fixation failure in association of the early controlled weight bearing exercise after using a compression hip screw (CHS) for unstable intertrochanteric fracture of femur in old ages. MATERIALS AND METHODS Between May 1998 and February 2002, 8 cases of fixation failure of CHS among the 80 patients were evaluated. We compared gender, age, fracture type with a matched group that fixation failure was not noted. During operation, we performed valgus nailing of compress lag screw and compressed fracture gap with a bolt as soon as possible. The patients were encouraged partial weight bearing 4~5 days after operation and compaired immediate postoperative and postoperative 2 weeks x-ray films about degree of slippage or varus angulation of femur. RESULTS In 5 cases, cut-out of the lag screw were found. In 3 cases, plate fracture and fixation failure were found. Relation between timing of partial weight bearing and fixation failure was not significant (p=0.146). But in 5 cases of failure, they continued weight bearing in spite of excessive slippage of the lag screw. CONCLUSION Early controlled partial weight bearing exercise after operation of intertrochanteric fracture of the femur were reported good for functional recovery in old ages. But, excessive slippage of the lag screw or varus angulation of proximal femur were found on follow up period, patient teaching and control of ambulation is strongly recommended.
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Treatment of Failed Intertrochanteric Fractures to Maintain the Reduction in Elderly Patients Soon-Yong Kwon, Hyun-Woo Park, Sang-Uk Lee, Soo-Hwan Kang, Jae-Young Kwon, Jung-Hoon Do, Seung-Koo Rhee Journal of the Korean Fracture Society.2008; 21(4): 267. CrossRef
PURPOSE To analogize the result of the test through explaining the correlation of bone mineral density (BMD) test value between proximal femur and lumbar spine. MATERIALS AND METHODS It is based on 59 cases who visited the out-patient department. They were classified into two groups by age, group I (55~59 yr) and II (60~64 yr). Then we evaluated the average and the degree of correlation between the two groups and analyzed the correlation of the two sites according to the T & Z-score through the regression analysis. RESULTS In T-score, the correlation between L (independent variable, lumbar) and H (dependent variable, femur) indicated that L = 0.751 xH -0.195 for group I and L = 0.912 xH+0.31 for group II. In Z-score, the correlation was L = 0.647 xH -0.656 for group I and L = 0.897 xH -0.481 for group II. CONCLUSION It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part.
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A Novel Method for Estimation of Femoral Neck Bone Mineral Density Using Forearm Images from Peripheral Cone Beam Computed Tomography Kwanmoon Jeong, Hoon Ko, Chang-Hoon Lee, Myeung Lee, Kwon-Ha Yoon, Jinseok Lee Applied Sciences.2016; 6(4): 113. CrossRef
The Correlation Analysis and Correction factor of BMD in Forearm and Lumbar with DXA Man-Seok Han The Journal of Digital Policy and Management.2013; 11(12): 551. CrossRef
The Correlation Analysis of BMD in Proximal Femur and Spine with Dual Energy X-ray Absorptiometry Man-Seok Han, Dong-Heon Cho Journal of the Korea Society of Computer and Information.2012; 17(9): 165. CrossRef
PURPOSE To evaluate the radiologic and functional results of treatment in proximal tibial plateau fracture using lateral submeniscal approach, which is a relatively minimally invasive approach to tibial condylar articular surface. MATERIALS AND METHODS Twenty three cases of tibial plateau fracture which treated with submeniscal approach were analyzed with one year follow up. The results were evaluated by immediate postoperative radiographic and Hohl's clinical evaluation. RESULTS Tibial articular surface could be in operation field and the articular surface could be restored the anatomically by elevating the depressed articular surface and bone graft to the empty space. The postoperative radiography showed that most cases (91%) could be reduced adequately (within 2 mm). The clinical evaluation by Hohl's criteria revealed excellent 7 cases (30%), good 12 cases (52%), fair 3 cases (13%), and one poor case (4%). CONCLUSION Submeniscal approach can identify the articular surface and intraarticular soft tissues with minimal incision, and allows anatomical reduction, sufficient bone graft, rigid plate fixation and soft tissue treatment, therefore it is one of the good approach in treatment of proximal tibial plateau fracture.
The purposes of this study are to make an operative treatment option of thoracolumbar burst fractures by the degree of initial kyphotic deformity or by the degree of initial loss of anterior vertebral height. We analyzed sixty-three cases of one segmental thoracolumbar bursting fractures treated surgically by posterior or posterolateral fusion with short segmental transpedicular screws fixation method using Diapason or CD from January, 1992 to October, 1996. Indications of operative treatment were that the degree of initial kyphotic deformity was above 15degreesor initial loss of anterior vertebral height was above 30%. Minimum follow-up period was 12 months and the results were as follows : 1. Entirely, mean kyphotic angle was 21.6degreesinitially, 11.3degreespostoperatively and 14.2degrees at the end of follow-up. Mean anterior vertebral height was 59.6% initially, 83.8% postoperatively and 80.8% at the end of follow-up. So 10.3degrees , 24.2% was corrected postoperatively and loss of correction was 2.9degrees , 3% at the end of follow-up. 2. In the respect of the degree of initial kyphotic deformity, when compared above 30degrees with below 30degrees , loss of correction was 7.3degrees , 1.4degrees at the end of follow-up respectively and this result had significant difference between these two groups statistically. 3. In the respect of initial loss of anterior vertebral height, when compared above 55% with below 55%, loss of correction was 7.7%, 2.2% at the end of follow-up respectively and this result had significant difference between these two groups statistically. 4. In the respect of time interval from injury to operation, when compared within 2 weeks with after 2 weeks, respectively loss of correction was 1.7-2.2degrees , 3-3.9% and 4.1degrees , 6.7% at the end of follow-up and this results had significant difference between these two groups statistically. These data suggested if initial kyphotic angle is below 30degrees or initial loss of anterior vertebral height less than 55%, short segmental transpedicular screw fixation provide sufficient stability but if initial kyphotic angle is above 30degrees or initial loss of anterior vertebral height is above 55%,additional anterior interbody fusion may be considered.
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Efficiency of Implant Removal for Treatment of the Thoraco-lumbar Unstable Fractures - Multi Segments Fixation ยท Single Segment Fusion - Heui-Jeon Park, Young-Jun Shim, Wan-Ki Kim, Tae-Yeon Cho, Sung-Min Kwon Journal of Korean Society of Spine Surgery.2011; 18(3): 103. CrossRef
Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level Jeong-Gook Seo, Jong-Ho Park, Jeong-Seok Moon, Woo-Chun Lee Journal of the Korean Fracture Society.2009; 22(1): 39. CrossRef
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Relationships between Posterior Ligament Complex Injury and Plain Radiograph in Thoracolumbar Spinal Fracture Heui-Jeon Park, Phil-Eun Lee, Byung-Ho Lee, Myung-Soon Kim Journal of Korean Society of Spine Surgery.2005; 12(2): 140. CrossRef
We treated 26 cases(25 patients) olecranon fractures operatively with Kirschner wire and tension band wiring technique from January 1993 to December 1995. The Kirschner wire fixation methods in our study were either bicortical fixation(15 cases) or intramedullary fixation(11 cases). We retrospectively reviewed clinical results according to Mayo elbow performance index and starting time of full range of motion(ROM) exercise. We analyzed relationship between the cli9nical results of the cases with cast immobilization and those without cast immobilization. We also compared Kirschner wire fixation methods in the respect of clinical results, full ROM exercise starting time and complications. The results were as follows. 1. Clinical results were excellent or good in 25 cases(96%) according to Mayo elbow performance index. Full ROM exercise starting time was within 2weeks in 10 cases, between 2-3weeks in 11 cases, between 5-6weeks in four cases and after 6weeks in one case. Full ROM exercise starting time was significantly different(P=0.016) with clinical results statistically and there was statistically high significant difference(P=0.0025) between clinical results and cast immobilization or not. 2. Clinical results of bicortical fixation group was ont significantly different frmo those of intramedullary fixation group and there was no significant difference between full ROM exercise starting time and Kirschner fixation methods statistically. 3. The most frequent complications were decreased ROM and loosening of the Kirschner wire. There were decreased ROM In 10 cases and loosening of the Kirschner wire in 6 cases in all cases. We encountered more higher incidence of complications related to intramedullary fixation method. The clinical results and full ROM exercise starting time of bicortical fixation group were not significantly different with those of intramedullary fixation group statistically. But more early exercise, more better clinical results and more less complications was produced in bicortical fixation group. So we thought bicortical fixation method is better than intramedullary fixation method.
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Double Tension Band Wiring for Olecranon Fractures Suk Kang, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Jin Wook Chung, Jong Pil Kim Journal of the Korean Fracture Society.2008; 21(2): 130. CrossRef