According to the Letournel classification, a transverse fracture is the only elementary fracture pattern that breaks both the anterior and posterior border of the innominate bone. A transverse acetabular fracture separates the innominate bone into two segments: the iliac segment and the ischiopubic segment. Therefore, minimally displaced transverse fractures can be stabilized by purchasing both segments with a large-diameter single screw. Although it is not a stable internal fixation construct compared with plates and screws, it provides sufficient stability to promote early mobilization and early weight-bearing while minimizing the risk of secondary displacement and preventing secondary complications associated with prolonged bed rest and immobilization. The authors successfully treated a case of minimally displaced transverse acetabular fracture with percutaneous column fixation using a retrograde fashion of a single anterior column screw. This report discusses the case with a literature review and deliberates the usefulness of the procedure.

Some structures should be noted in the modified Stoppa approach for the treatment of acetabular fractures. Among them, the external iliac vessels should be protected with special care during surgery. If there is any history of previous abdominal surgery or a delay in surgery, it is predicted that the intra-abdominal adhesion will be severe. In this case, thorough preparation and caution are required before surgery because a dangerous situation may arise due to blood vessel damage during surgery. On the other hand, there are no specific reports on these cases. The authors report a case of severe adhesion of the external iliac vessels with a history of previous abdominal surgery.

The lesser trochanteric fracture is commonly found amongst intertrochanteric fractures, where pseudoaneurysm of the femoral artery is a rare complication. A pseudoaneurysm could develop due to the penetration injury of the artery by the bone fragment during occurrence of the fracture, or by the insertion of screws during the surgical procedure. Minimal complication is seen when the lesser trochanter is not fixed during the intertrochanteric fracture surgery. However, in the current case, the authors experienced appearance of a delayed pseudoaneurysm of the deep femoral artery caused by migration of the lesser trochanter, which was successfully treated by excision.

An irreducible ankle dislocation is a rare injury. The cause is a dislocation of the distal fibula anteriorly or posteriorly or the insertion of soft tissue, such as the deltoid ligament or posteromedial tendon. The tibialis posterior tendon can be dislocated through distal tibiofibular diastasis and prevent reduction of the ankle joint. The authors experienced anterolateral ankle fracture dislocation with a diastasis of the distal tibiofibular joint, and reduction was impossible because of impingement of the tibialis posterior tendon dislocated anteriorly through the distal tibiofibular diastasis. This paper reports the treatment of this injury.

Purpose: A retrograde intramedullary nail is commonly used to treat femoral shaft and distal femur fractures. The authors analyzed the treatment results and the factors affecting the period of bone union for thirty-five patients treated with a retrograde intramedullary nail. Materials and Methods: Thirty-five patients who could be followed up for more than twelve months after the treatment with retrograde intramedullary nailing were analyzed retrospectively. The treatment results and the relationship between the period of bone union and the patient’s age, sex, comminution of fracture, presence of open fracture, location of the fracture, and accompanying fractures were evaluated. Results: The average bone union time was 4.50 months. The period of bone union was unaffected by the age, sex, location, and presence of open fractures but was affected by the presence of comminution and accompanying fractures. Conclusion Retrograde intramedullary nailing is effective for distal and shaft of fractures of the femur. The period of bone union is affected by the presence of comminution and accompanying fractures.

The lesser trochanteric fracture is commonly found amongst intertrochanteric fractures, where pseudoaneurysm of the femoral artery is a rare complication. A pseudoaneurysm could develop due to the penetration injury of the artery by the bone fragment during occurrence of the fracture, or by the insertion of screws during the surgical procedure. Minimal complication is seen when the lesser trochanter is not fixed during the intertrochanteric fracture surgery. However, in the current case, the authors experienced appearance of a delayed pseudoaneurysm of the deep femoral artery caused by migration of the lesser trochanter, which was successfully treated by excision.

Purpose: This study examined the factors influencing the telescoping of the spiral blade after surgery with the proximal femoral nail antirotation II (PFNA II) for intertrochanteric fracture patients. Materials and Methods: Between January 2017 and January 2022, the degree of telescoping of the spiral blade was measured in 178 patients who underwent surgery with PFNA II for intertrochanteric fractures. Several variables were investigated, including the patient's sex, age, neck shaft angle of the nail, number and horizontal length of the posteromedial bone fragment, degree of osteoporosis in the normal hip, AO Foundation/Orthopaedic Trauma Association classification, tip apex distance, position of the spiral blade in the femoral head, and the reduction status of whether the proximal bone fragment had been adequately reduced into the intramedullary canal of the distal femur. These factors were analyzed statistically to determine their impact on the telescoping of the spiral blade. Results: The transverse size of the bone fragment and the reduction state of the fracture significantly influenced the telescoping of the spiral blade after surgery. Conclusion Inadequate reduction of the proximal bone fragment inside the distal intramedullary cavity must be avoided to prevent excessive telescoping of the spiral blade following intertrochanteric fracture surgery. In addition, in cases where the transverse size of the posteromedial bone fragment is substantial, consideration should be given to either fixing the posteromedial fragment or delaying weightbearing during rehabilitation.