Journal of Musculoskeletal Trauma

Original Articles

Three-Dimensional Analysis of the Morphological Features in the Femur of Atypical Fracture and Practical Implications of Intramedullary Nailing: Yong Uk Kwon, Kyung-Jae Lee, Joo Young Choi, Gu-Hee Jung; J Korean Fract Soc 2020;33(2):87-95. Published online April 30, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.2.87

Abstract PDF: Purpose
This study analyzed the morphological features of the contralateral femur without an atypical fracture by constructing a three-dimensional model with an actual size medullary canal.
Materials and Methods
Lateral and anterior bowing of the shaft were measured for 21 models, and the shape of the medullary canal was analyzed. To eliminate the projection error, the anteroposterior (AP) femur was rotated internally to the extent that the centerline of the head and neck, which is the ideal position of cephalomedullary nail screw, was neutral, and the lateral femur matched the medial and lateral condyle exactly.
Results
The lateral bowing and anterior bowing was an average of 5.5° (range, 2.8°-10.7°; standard deviation [SD], 2.4°) and 13.1° (range, 6.2°-21.4°; SD, 3.2°), respectively. In the area where lateral bowing increased, the lateral cortex became thicker, and the medullary canal was straightened. On the lateral femur, the anterior angle was increased significantly, and the diameter of curvature averaged 1,370.2 mm (range, 896-1,996 mm; SD, 249.5 mm).
Conclusion
Even if the anterolateral bowing increases in the atypical femur, the medullary canal tends to be straightened in the AP direction. So, it might be considered as a reference to the modification of an intramedullary nail to increase the conformity.

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Three-Dimensional Computed Tomography of Acetabular Fractures: Poong Taek Kim, Joo Chul Ihn, Chang Wug Oh, Seung Hoon Oh; J Korean Soc Fract 2000;13(1):46-51. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.46

Abstract PDF: PURPOSE
In the evaluation of acetebular fractures, conventional radiography is limited by distortion, magnification, and overlap of fracture fragments. Computed tomography(CT) has already been shown to be superior in this field. The purpose of this paper was to use 3D reformations for classification of acetabular fractures and planning of operation.
MATERIALS AND METHODS
From July 1994 to December 1998, we reviewed 40 acetabular fractures. We evaluated fractures as plain X-ray(inlet & outlet view, AP view, obturator foramen & illiac wing view), axial CT with 3 mm slices, and 3D reformations. We classified fractures by classification of Letournel.
RESULTS
32 cases of 40 cases were displaced fractures, We recognized fracture easily in 3D reformations. 12 cases were posteior wall fracture. 9 cases were both column frctures. We interpretated both column fractures difficultly in plain X-ray, but we had many informations about rotation & displacement of fracture fragment by 3D reformations. Undisplaced fracture was 8 cases. We interpretated undisplaced fracture difficultly in 3D reformations and distinguished difficultly from normall 3D reformations.
CONCLUSION
3D reformations were useful for analysis of complex displaced fracture but not useful for analysis of undisplaced fracture. Acetabular internal oblique view was useful for analysis of quadrilateral space & posterior wall fractures. Acetabular external view was useful for decision of surgical approach.

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