1.Revision Total Knee Arthroplasty in the Treatment of Periprosthetic Fracture around the Knee.
Kang Il KIM ; Kye Youl CHO ; Donggeun KANG
Journal of the Korean Fracture Society 2011;24(4):382-387
No abstract available.
Arthroplasty
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Knee
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Periprosthetic Fractures
2.Periprosthetic Fracture after Hook Plate Fixation in Neer Type II Distal Clavicle Fracture: A Report of 3 Cases.
Kyung Yong KIM ; Joon Yub KIM ; Won Bok LEE ; Myong Gon JUNG ; Jeong Hyun YOO ; Joo Hak KIM
Journal of the Korean Fracture Society 2016;29(1):55-60
Hook plate fixation is a treatment method for the displaced distal clavicle fracture with favorable results regarding bone union and shoulder function, however possible complications include impingement syndromes, subacrormial erosions, acromial fractures, and periprosthetic fractures. In this report, we observed 3 cases of periprosthetic fracture after hook plate fixation. All cases of periprosthetic fractures were initiated at the medial end screw holes. The causes of these periprosthetic fractures appeared to be the off centered fixation of medial end screws near the anterior or posterior cortex which were specific during operations with hook plates with more than 6 holes and the increased stress on the medial end screw by over-reduced or inferiorly reduced position of the distal end of the clavicle by the hook plate.
Clavicle*
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Periprosthetic Fractures*
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Shoulder
3.Periprosthetic Fracture after Locked Plating in the Osteoporotic Long Bone Fracture.
Ki Chul PARK ; Hong Sik KIM ; Jeong Han OH
The Journal of the Korean Orthopaedic Association 2012;47(3):222-226
The locking plate is used for osteoporotic long bone fracture because of the ability to affect a lock between the plate and locking screws that prevents reduction loss, angular deformity and axial deformity. However, it has been reported that locked plating can increase the periprosthetic fracture risk in osteoporotic bone compared with conventional plating. We report 3 cases of periprosthetic fracture after the use of locked plating in osteoporotic long bone fracture and a review of the relevant literatures.
Congenital Abnormalities
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Fractures, Bone
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Periprosthetic Fractures
4.Short Humeral Stems in Shoulder Arthroplasty
Clinics in Shoulder and Elbow 2018;21(2):105-110
Since the introduction of shoulder arthroplasty by Neer in 1974, the design of not only the glenoid component but also the humeral component used in shoulder arthroplasty has continually evolved. Changes to the design of the humeral component include a gradually disappearing proximal fin; diversified surface finishes (such as smooth, grit-blasted, and porous coating); a more contoured stem from the originally straight and cylindrical shape; and the use of press-fit uncemented fixation as opposed to cemented fixation. Despite the evolution of the humeral component for shoulder arthroplasty, however, stem-related complications are not uncommon. Examples of stem-related complications include intraoperative humeral fractures, stem loosening, periprosthetic fractures, and stress shielding. These become much more common in revision arthroplasty, where patients are associated with further complications such as surgical difficulty in extracting the humeral component, proximal metaphyseal bone loss due to stress shielding, intraoperative humeral shaft fractures, and incomplete cement removal. Physicians have made many attempts to reduce these complications by shortening the stem of the humeral component. In this review, we will discuss some of the limitations of long-stem humeral components, the feasibility of replacing them with short-stem humeral components, and the clinical outcomes associated with short-stemmed humeral components in shoulder arthroplasty.
Arthroplasty
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Humans
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Humeral Fractures
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Periprosthetic Fractures
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Shoulder
5.Periprosthetic Fractures after Total Elbow Replacement.
Sang Myung LEE ; Jae Chul PARK ; Seok Whan SONG ; Jong Min PARK ; Ji Hyun RYU ; Seung Koo RHEE ; Yoon Min LEE
Journal of the Korean Society for Surgery of the Hand 2010;15(3):107-111
PURPOSE: To analyze clinical presentation and results of the treatment of periprosthetic fractures occurring after total elbow replacement (TER). MATERIALS AND METHODS: Eleven patients who had periprosthetic fractures after TER were examined. The locations and the causes of periprosthetic fractures were evaluated. The periprosthetic fractures were classified using Mayo classification. Stable fractures were treated conservatively, and unstable fractures were treated by open reduction and internal fixation. Revision operation was conducted if implant loosening was observed. End results after treatment were evaluated based on Mayo elbow performance score (MEPS) and radiologic examinations. RESULTS: Most fractures occurred at the humeral site(82%), and Type B2 periprosthetic fracture was most frequently observed(64%). Radiographic union was observed at a mean of 26 weeks after the treatment. No statistically significant differences were observed between preoperative and postoperative elbow active motions. According to the MEPS, the results were rated as excellent in three patients, good in five, fair in one and poor in two. CONCLUSION: A periprosthetic fracture after TER likely occurrs at humeral site and it is highly related with loosening of the implant. Although union tends to be delayed and complications occur frequently, relatively fair results can be obtained with appropriate treatment.
Arthroplasty, Replacement, Elbow
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Elbow
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Humans
;
Periprosthetic Fractures
6.Undetected Incomplete Stress Fracture in the Proximal Femur of a Patient with Paget's Disease: A Case Report.
Hong Kyun KIM ; Jung Han YOO ; Yong Wook PARK ; Jin Soo PARK ; Kyu Cheol NOH ; Kook Jin CHUNG ; Min Young JO ; Ji Hyo HWANG
Journal of the Korean Hip Society 2011;23(1):60-65
Paget disease is a well-documented skeletal disease and it has an increased rate of tissue breakdown due to the excessive turnover of osteoblasts and osteclasts. Stress fracture is one of the most common complications in the late phase of Paget disease, but the clinical presentation of incomplete pathologic fracture is rare and this is an important clue to plan the treatment. We experienced a case of Paget's disease in a 74 year old woman with a periprosthetic fracture from the undetected, imcomplete stress fracture in the proximal femur.
Female
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Femur
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Fractures, Spontaneous
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Fractures, Stress
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Humans
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Osteoblasts
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Periprosthetic Fractures
7.Periprosthetic Atypical Femoral Fracture-like Fracture after Hip Arthroplasty: A Report of Three Cases.
Kyung Jae LEE ; Byung Woo MIN ; Hyung Kyu JANG ; Hee Uk YE ; Kyung Hwan LIM
Hip & Pelvis 2015;27(3):187-191
Atypical femoral fractures are stress or insufficient fractures induced by low energy trauma or no trauma and have specific X-ray findings. Although the American Society for Bone and Mineral Research has excluded periprosthetic fractures from the definition of an atypical femoral fracture in 2013, this is still a matter of controversy because some authors report periprosthetic fractures showing specific features of atypical fractures around a well-fixed femoral stem. We report 3 cases of periprosthetic femur fractures that had specific radiographic features of atypical femoral fractures in patients with a history of prolonged bisphosphonate use; we also review relevant literature.
Arthroplasty*
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Femoral Fractures
;
Femur
;
Hip*
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Humans
;
Periprosthetic Fractures
8.Plate Designed for Wiring ( CHO Plate ).
Woo Shin CHO ; Jun O YOON ; Soo Ho LEE ; Kyoung Min NOH ; Yong Gab JEONG
The Journal of the Korean Orthopaedic Association 1998;33(5):1460-1467
Although intramedullary nailing is mostly used in the management of fractures in the long bone shaft, plate fixation is still alternative option in periprosthetic or metaphyseal fractures. For the rigid fixation during plating, sometimes we need wiring. Many surgeons experience slippage of wire resulting in loss of rigid fixation because plate and wire is so slippery and the diameter of bone is changing by level especially in the metaphyseal area. Wiring plate(CHO plate) was designed to prevent slippage. This plate has transverse holes for wires between screw holes on traditionally used dynamic compression plate. Sixteen fractures of long bone shaft were fixed with wiring plate and 11 cases which were followed up for more than one year were evaluated. There were periprosthetic fractures(4 cases), spiral or butterfly fractures(4 cases) and fractures of poor bone quality(two cases of malignancy and one case of osteoporosis). Nine cases were successfully reduced and the healed without loss of fixation. In two cases, delayed union and nonunion were observed due to wire breakage with plate loosening. Preliminarily, wiring plate fixation can be used for the periprosthetic fracture and one of alternative option in butterfly or spiral fracture and fracture in osteoporotic bone or pathologic fracture.
Butterflies
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Fracture Fixation, Intramedullary
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Fractures, Spontaneous
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Periprosthetic Fractures
9.Periprosthetic Fracture after Proximal Humeral Intramedullary Nail, Treated by Functional Bracing: A Case Report.
Jae Hyuk SHIN ; Ho Guen CHANG ; Young Woo KIM ; Nam Kyou RHEE ; Yong Bok PARK ; Yong Kuk KIM
Journal of the Korean Fracture Society 2011;24(2):185-190
Periprosthetic fracture following a proximal humeral intramedullary (IM) nailing is rarely reported neither for its occurrence nor for its treatment. Proximal humeral IM nail (Acumed, LLC, Hillsboro, OR, USA) has been increasingly reported of its successful treatment outcomes, yet there is paucity of data describing its complications. Here we report a 26 year-old female patient, who sustained a proximal humerus fracture which was initially successfully treated by proximal humeral IM nail, and was complicated by a periprosthetic fracture distal to the nail tip at postoperative 4 months. Serial application of U-shaped coaptation splint, hanging cast, and functional bracing resulted in satisfactory clinical outcome. Periprosthetic fracture after proximal humerus IM nail can occur by a low energy injury, which need to reminded in treating young and sports-active patients.
Braces
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Female
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Humans
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Humerus
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Nails
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Periprosthetic Fractures
;
Splints
10.Risk Factors Related to Modular Femoral Stem Failures in Revision Hip Arthroplasty.
Jong Hyuk PARK ; Myung Sik PARK ; Do Yeon KIM
Hip & Pelvis 2012;24(2):87-93
PURPOSE: The purpose of this study was to analyze failure rates and causes of hip arthroplasty revisions associated with the use of cementless modular femoral stems. MATERIALS AND METHODS: This study comprised 93 patients(100 hips) that were followed up for more than two years after revision involving modular femoral stem arthroplasty. The clinical results were evaluated using the Harris Hip Score and the radiologic results were evaluated using leg length discrepancy, subsidence and bone formation assessments. We analyzed the relationship between the number of hip surgeries performed and the bone deficiencies and failures observed. Preoperative femoral bone deficiencies were described by Paprosky Grade; Grade I or II were identified in 24 hips, IIIa in 4 hips, IIIb in 28 hips and IV in 3 hips. RESULTS: We observed 80 hips with aseptic loosening, 10 hips with infection after previous revision, 8 hips with periprosthetic fractures and 2 hips with dislocations. Clinical results improved from a preoperative score of 42 (HHS) to a postoperative mean score of 81.5. The cause of early failure in 4 hips was identified as femoral stem subsidence, and the cause of late failure in 3 hips was due to infection. According to the comparison analysis, there was no statistical significance between femoral bone deficiency (P=0.727) and application of cement (P=0.087), but hips with previous revision surgery showed a higher rate of failure (P=0.024). CONCLUSION: Cementless modular stems produced satisfactory results. The main cause of failure was subsidence. A significant risk factor for failure was hips which had undergone previous revision surgery.
Arthroplasty
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Dislocations
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Hip
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Leg
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Osteogenesis
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Periprosthetic Fractures
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Risk Factors