Journal of the Korean Fracture Society最新文献

{"title":"Pelvis/Acetabular Fractures in the Elderly: When and How to Fix?","authors":"K. Park, C. Oh, Joon-Woo Kim","doi":"10.12671/JKFS.2018.31.3.102","DOIUrl":"https://doi.org/10.12671/JKFS.2018.31.3.102","url":null,"abstract":"Financial support: None. Conflict of interests: None. Owing to the increase in life expectancy, the incidence of osteoporotic fracture of the pelvis and acetabulum is increasing. Fractures in the elderly population is different from those in younger patients. Pelvic ring and acetabular fractures in geriatric patients are more likely the result of low-energy trauma, but the outcomes are generally poorer than those of the younger population. Multiple management options are available, but no intervention has become the standard of care for these fractures in the elderly. A treatment strategy should be established depending on the state of the individual patient. Regardless of whether nonsurgical or surgical treatment is selected, early ambulation should be considered to avoid the complications associated with prolonged immobilization.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129965164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Extramedullary Reduction in Unstable Intertrochanteric Fracture: A Biomechanical Study Using Cadaver Bone","authors":"Young-Chang Park, Soon-Phil Yoon, K. Yang","doi":"10.12671/JKFS.2018.31.3.79","DOIUrl":"https://doi.org/10.12671/JKFS.2018.31.3.79","url":null,"abstract":"Financial support: None. Conflict of interests: None. Purpose: To prevent excessive sliding and subsequent fixation failures in unstable intertrochanteric fractures with posteromedial comminution, extramedullary reduction through overlapping of the anteromedial cortices of both proximal and distal fragments as a buttress has been introduced. The purpose of this study was to compare the biomechanical properties between two reduction methods– intramedullary reduction and extramedullary reduction–in treating unstable intertrochanteric fractures with posteromedial comminution (AO/OTA classification 31-A2.2). Materials and Methods: Eight pairs of frozen human cadaveric femora were used. The femora of each pair were randomly assigned to one of two groups: the intramedullary reduction group or the extramedullary reduction group. A single axial load-destruction test was conducted after cephalomedullary nailing. Axial stiffness, maximum load to failure, and energy absorbed to failure were compared between the two groups. Moreover, the pattern of mechanical failure was identified. Results: The mean axial stiffness in the extramedullary reduction group was 27.3% higher than that in the intramedullary reduction group (422.7 N/mm vs. 332.0 N/mm, p=0.017). Additionally, compared with the intramedullary reduction group, the mean maximum load to failure and mean energy absorbed to failure in the extramedullary group were 44.9% and 89.6% higher, respectively (2,848.7 N vs. 1,966.5 N, p=0.012 and 27,969.9 N·mm vs. 14,751.0 N·mm, p=0.012, respectively). In the intramedullary reduction group, the mechanical failure patterns were all sliding and varus deformities. In the extramedullary reduction group, sliding and varus deformities after external rotation were noted in 3 specimens, sliding and varus deformities after internal rotation were noted in 3 specimens, and medial slippage was noted in 2 specimens. Conclusion: In unstable intertrochanteric fractures with posteromedial comminution, the biomechanical properties of extramedullary reduction are superior to those of intramedullary reduction. Anteromedial cortex could be the proper buttress, despite a comminuted posteromedial cortex. It could help enhance the stability of the bone-nail construct.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129964030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Options of Osteoporotic Vertebral Compression Fractures","authors":"Yu Mi Kim, Tae Kyun Kim, D. Shim, K. H. Lim","doi":"10.12671/JKFS.2018.31.3.114","DOIUrl":"https://doi.org/10.12671/JKFS.2018.31.3.114","url":null,"abstract":"Financial support: This study was supported grant in 2018 from Wonkwang University. Conflict of interests: None. This paper reviews previous studies on the treatment of osteoporotic vertebral compression fractures in elderly patients to determine what factors should be considered for successful treatment. In osteoporotic vertebral compression fractures, the primary treatment is conservative treatments. Other treatments include osteoporosis treatment, pain control, orthosis, and physical therapy. Recently, percutaneous catheterization or balloon plasty is performed for rapid pain recovery and early ambulation. Percutaneous catheterization or balloon posterior plasty is effective in reducing pain and improving the activity ability. Surgical treatment should be considered in cases of nonunion or osteonecrosis, dent, deformation, and spinal cord compression after conservative treatment has failed. In surgical treatment, posterior spinal fixation and vertebroplasty are more advantageous in terms of the amount of bleeding, operation time compared to the anterior approach, but the most appropriate method should be selected through the patient’s condition and understanding of each surgical method.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":"14 24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130998441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of the Results between Internal Fixation and External Fixation in AO C Type Distal Radius Fractures","authors":"Yoon-Min Lee, H. Lee, Seok-Whan Song, Jae-Hoon Choi, Jong-Tae Park","doi":"10.12671/JKFS.2018.31.3.87","DOIUrl":"https://doi.org/10.12671/JKFS.2018.31.3.87","url":null,"abstract":"Financial support: None. Conflict of interests: None. Purpose: The purpose of this study was to evaluate the radiological and clinical results of plate fixation and external fixation with additional devices for treating distal radius fracture in AO type C subtypes, and propose a treatment method according to the subtypes. Materials and Methods: Two hundred and one AO type C distal radius fracture patients were retrospectively reviewed. Eighty-five patients in group 1 were treated with volar or dorsal plate, and 116 patients in group 2, were treated with external fixation with additional fixation devices. Clinical (range of mtion, Green and O’Brien’s score) and radiological outcomes were evaluated. Results: At the 12-month follow-up, group 1 showed flexion of 64.4, extension of 68.3, ulnar deviation of 30.6, radial deviation of 20.8, supination of 76.1, and pronation of 79.4 in average; group 2 showed flexion of 60.5, extension of 66.9, ulnar deviation of 25.5, radial deviation of 18.6, supination of 73.5, and pronation of 75.0 in average. The mean Green and O’Brien score was 92.2 in group 1 and 88.6 in group 2. The radial height of group 1 and group 2 was 11.6/11.4 mm; radial inclination was 23.2/ 22.5; volar tilt was 11.6/ 8.7; and the ulnar displacement was 1.27/0.93 mm. Conclusion: Judicious surgical techniques during device application and tips for postoperative management during external fixation can produce similar clinical results compared with internal fixation patients.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125422610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clay-Shoveler's Fracture in an 18-Year-Old Cheerleader: A Case Report","authors":"Il-Yeong Hwang, Sun Jae Park, Jae-Ryong Cha","doi":"10.12671/JKFS.2018.31.2.57","DOIUrl":"https://doi.org/10.12671/JKFS.2018.31.2.57","url":null,"abstract":"Financial support: None. Conflict of interests: None. Clay-Shoveler’s fracture refers to a fracture that is solely developed on the spinous process of the cervical spine or the thoracic vertebrae. This fracture rarely occurs during sporting activities. In this case, an 18-year-old female developed the fracture on the spinous process of the 7th cervical spine and 1st thoracic vertebrae due to the repetitive practice of cheerleading. The patient’s pain was improved by wearing a support device and taking an anti-inflammatory analgesic drug and muscle relaxant. Her case is being followed-up at the outpatient department.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126068496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Difficult Is It to Surgically Treat AO-C Type Distal Humerus Fractures for Inexperienced Orthopedic Surgeons?","authors":"S. Yoo, Suk-Woong Kang, Moo-Ho Song, Young Jun Kim, H. Bae","doi":"10.12671/JKFS.2018.31.2.45","DOIUrl":"https://doi.org/10.12671/JKFS.2018.31.2.45","url":null,"abstract":"Financial support: None. Conflict of interests: None. Purpose: Twenty early surgical management cases of distal humerus type-C fractures were analyzed. Materials and Methods: This study analyzed 20 early patients, who received surgical management of distal humerus type-C fractures, and could be followed-ups for more than one year between March of 2013 and May of 2015. The operative time, bone union time, and elbow range of motion were analyzed. The Mayo’s functional score was used to evaluate their postoperative function. The primary and secondary complications of each patient immediately after each of their surgery were also reviewed. Results: All patient groups achieved bone union within an average period of 16.4 weeks. Based on the Mayo functional score, 6, 10, and 4 patients scored excellent, good, and fair, respectively. The average range of motion was a flexion contracture of 14.5 with a follow-up improvement averaging 120.7. Six patients received nine revision operations due to major and minor complications. Two patients received revision fixation from an inadequate fixating power, and another patient received an ulnar nerve transposition. Other complications included olecranon osteotomy site displacement, superficial operational site infection, and pin loosening. Conclusion: Distal humerus fractures of the AO-C type can cause a range of complications and has a very high rate of revision due to its difficult nature of surgical manageability. Therefore, it is imperative for a surgeon to expect various complications beforehand and a careful approach to their postoperative rehabilitation is essential.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127882037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational Simulation of Multiple Cannulated Screw Fixation for Femoral Neck Fractures and the Anatomic Features for Clinical Applications","authors":"J. Jeong, Gu-Hee Jung","doi":"10.12671/JKFS.2018.31.2.37","DOIUrl":"https://doi.org/10.12671/JKFS.2018.31.2.37","url":null,"abstract":"Financial support: None. Conflict of interests: None. Purpose: To identify the anatomic features for clinical applications through a computational simulation of the fixation of three cannulated screws for a femoral neck fracture. Materials and Methods: Thirty cadaveric femurs underwent computed tomography and the images were transferred to the Mimics program, resulting in three-dimensional proximal femur models. A three-dimensional scan of the 7.0 mm cannulated screw was performed to enable computerized virtual fixation of multiple cannulated screws for femoral neck fractures. After positioning the screws definitively for cortical support, the intraosseous position of the cannulated screws was evaluated in the anteroposterior image and axial image direction. Results: Three cannulated screws located at the each ideal site showed an array of tilted triangles with anterior screw attachment and the shortest spacing between posterior and central screws. The central screw located at the lower side was placed in the mid-height of the lesser trochanter and slightly posterior, and directed toward the junction of femoral head and neck to achieve medial cortical support. All the posterior screws were limited in height by the trochanteric fossa and were located below the vastus ridge, but the anterior screws were located higher than the vastus ridge in 10 cases. To obtain the maximum spacing of the anterior and posterior screws on the axial plane, they should be positioned parallel to the cervical region nearest the cortical bone at a height not exceeding the vastus ridge. Conclusion: The position of cannulated screws for cortical support were irregular triangular arrangements with the anterosuperior apex. The position of the ideal central screw in the anteroposterior view was at the mid-height of the lesser trochanter toward the junction of the femoral head and neck, and the anterior and posterior screws were parallel to the neck with a maximal spread just inferior to the vastus ridge.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129887302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting Posterior Angulation in Retrograde Intramedullary Nailing for Distal Femoral Fractures","authors":"Hohyoung Lee, Jinsil Jeong, Min-Su Kim, Bum Soo Kim","doi":"10.12671/JKFS.2018.31.2.50","DOIUrl":"https://doi.org/10.12671/JKFS.2018.31.2.50","url":null,"abstract":"Financial support: None. Conflict of interests: None. Purpose: To analyze the factors that cause a posterior angulatory deformity in the retrograde intramedullary nailing of distal femoral fractures. Materials and Methods: Fifty-five patients with distal femur fractures who were treated with retrograde intramedullary nailing were enrolled in this study. They were followed-up for at least one year postoperatively. The posterior angulatory deformity was evaluated according to the fracture location, pattern, and insertion point and the insertion point was compared with the ideal point derived from the radiographs of 100 normal adults. The correlation between the posterior angulation and the entry point of the nail was analyzed. Results: The posterior angulation was similar in terms of the fracture location; a meaningful difference was noted among the fracture patterns (p=0.047). The posterior angulation was significantly greater when the entry point was located more posteriorly, accepting a malreduced state (p=0.012). Conclusion: Posterior angulation was smaller in the transverse fracture and the posterior location of the entry point from the apex of the Blumensaat’s line increased the posterior angulation.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116580922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonsurgical Treatment of a Distal Radius Fracture: When & How?","authors":"Y. Shin, J. Yoon, J. Kim","doi":"10.12671/JKFS.2018.31.2.71","DOIUrl":"https://doi.org/10.12671/JKFS.2018.31.2.71","url":null,"abstract":"Financial support: None. Conflict of interests: None. Distal radius fractures are a common upper extremity fracture and a considerable number of patients have a stable fracture. In the treatment of distal radius fractures, there is considerable disagreement regarding the need for a strict anatomical restoration with operation in elderly patients. Therefore, nonsurgical treatment is a still important treatment option in distal radius fractures. The radiological parameters of before or after manual reduction are important for deciding whether to perform operation or not. The radiological parameters include dorsal angulation of the articular surface, radial shortening, extent of dorsal comminution, intra-articular displacement, concomitant ulnar metaphyseal fracture, shear fracture, and fracture-dislocation of the distal radio-ulnar joint. In addition, clinical situations of patients, including age, activity level, underline disease, and recovery level, which the patients wish should be considered, comprehensively. For the duration of a splint or cast, three to four weeks are recommended in impacted or minimally displaced fractures and five to six weeks in displaced fractures. After reduction of the displaced fractures, patients should undergo a radiologicical examination every week to check the redisplacement or deformity of the fracture site until two or three weeks post trauma. Arm elevation is important for controlling fracture site swelling and finger exercises, including metacarpophalangeal joint motion, are needed to prevent hand stiffness. Active range of motion exercise of the wrist should be initiated immediately after removing the splint or cast.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":" 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132075946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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)","authors":"Jae Woo Park, O. Shon, Seung Wan Lim","doi":"10.12671/JKFS.2017.30.4.192","DOIUrl":"https://doi.org/10.12671/JKFS.2017.30.4.192","url":null,"abstract":"Financial support: None. Conflict of interests: None. Purpose: The aim of this study was to investigate the utility of percutaneous wiring in the reduction of reverse oblique trochanteric fractures (AO classification 31-A3.3) by analyzing the treatment results with or without the use of percutaneous wiring. Materials and Methods: Thirty-five cases from January 2008 to August 2014 that could be followed-up for at least one year were selected among patients with unstable trochanteric fractures who underwent either internal fixation or open reduction. Seventeen patients underwent surgery with percutaneous wire fixation but another 18 patients underwent surgery without it. All patients received a closed reduction and internal fixation with an intramedullary nail. The factors evaluated were as follows: the length of operation, loss of blood, length of in-hospital stay, lower limb function scale, return to preinjury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, time taken for bone attachment, quality of post-operative reduction, and complications. Results: No significant difference in the mean operative time, loss of blood, length of in hospital stay, lower limb function scale, return to pre-injury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, and quality of postoperative reduction was observed between the two groups. A significant difference was noted in the time taken for bone attachment (p=0.032). Bone attachment took 13.3 weeks (9-17 weeks) on average when fixed with percutaneous wiring and no patient was found to have any complications. When treated without percutaneous wiring, however, bone attachment took 17.8 weeks (12.5-28.0 weeks) on average and three cases resulted in delayed union. Conclusion: Percutaneous wiring is a recommended treatment option for patients with an unstable trochanteric fracture.","PeriodicalId":436464,"journal":{"name":"Journal of the Korean Fracture Society","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121852438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}