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Reduction of Pediatric Forearm Diaphyseal Fractures by Pin Leverage Technique.

Soo Hong HAN ; Duck Yun CHO ; Hyung Ku YOON ; Byung Soon KIM ; Sung Hoon KANG ; Tae Hyung KIM

Journal of the Korean Fracture Society.2004;17(1):59-63. doi:10.12671/jkfs.2004.17.1.59

PURPOSE: Although the majority of children's forearm diaphyseal fractures may be treated conservatively with closed reduction and cast immobilization, unstable or irreducible fractures are usually treated by surgical management. Authors performed percutaneous pin leverage reduction technique for irreducible displaced diaphyseal fractures. The aim of this study is to determine the efficacy of pin leverage technique in pediatric forearm diaphyseal fractures MATERIALS AND METHODS: In this retrospective study, we reviewed 22 cases of forearm diaphyseal fractures reduced by percutaneous pin leverage technique between 1997 and 2002. We analyzed radiographs, operation time, hospital stay and immobilization period, range of motion, postoperative complications and functional results by Thomas. RESULTS: Average length of follow up was 28 months with mean age of 10.5 years. All fractures in this series healed less than 2 degrees of diaphyseal angulation. Average operation time including anesthesia was 42 minutes and hospital stay was 4.6 days. Time to union was 49.6 days in average and range of motion and functional results were satisfactory in all cases except one case of congenital radioulnar synostosis. There was one case of superficial pin track infection as complication. CONCLUSION: In operative treatment of children's diaphyseal fractures of forearm bones, percutaneous pin leverage reduction technique is a good alternative method prior to open reduction in case of difficult closed reduction.
Anesthesia ; Child ; Follow-Up Studies ; Forearm* ; Humans ; Immobilization ; Length of Stay ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies ; Synostosis

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Clavicle Fracture in Newborn.

Kyeong Seop SONG ; Byeong Mun PARK ; Young Hun KANG

Journal of the Korean Fracture Society.2004;17(1):55-58. doi:10.12671/jkfs.2004.17.1.55

PURPOSE: The purpose of this study is to identify the incidence of clavicle fracture in birth trauma associated with delivery, fetal presentation, birth weight and to identify the difference of the prognosis of clavicle fracture when immobilization was performed or not. MATERIALS AND METHODS: Among the 12,738 live births from March 1996 to December 2000, we reveiwed retrospectively the medical records and radiographs of 39 cases of clavicle fracture which were followed for more than 6 months. Statistical analysis was measured P-value. Except 11 cases that diagnosis was delayed, 27 cases were treated with figure of 8-bandage, and 1 case, which was combined with humerus fracture, was treated with long arm cast. RESULTS: Among 39 cases infants of clavicle fracture, 36 cases (0.57%) were delivered through vaginal delivery, 3 cases (0.04%) through ceasarean section. Fetal presentations were cephalic presentation in 29 cases, shoulder dystocia in 8 cases, breech presentation in 2 cases. The mean birth weight was 3.8 kg, the high prevalence (8.5%) was identified on large birth weight infants more than 4 kg (p<0.05). The fracture site was proximal portion in 12 cases, middle portion in 27 cases and right clavicle in 24 cases, left clavicle in 13 cases and both clavicle in 1 case. The combined injuries were the brachial plexus palsy (2 cases), skull fracture (1 case) and cephalhematoma (1 case). Finally all cases of clavicle fracture were shown radiographically bony union within 3 weeks. CONCLUSION: The newborn clavicle fractures were remarkably low incidence in cesarean section delivery and were easily neglected, and were detected accidentally on simple chest X-ray that was performed for upper respiratory infection. As a conclusion, it is necessary of screening test through careful physical examination and X-ray interpretation.
Arm ; Birth Weight ; Brachial Plexus ; Breech Presentation ; Cesarean Section ; Clavicle* ; Diagnosis ; Dystocia ; Female ; Humans ; Humerus ; Immobilization ; Incidence ; Infant ; Infant, Newborn* ; Labor Presentation ; Live Birth ; Mass Screening ; Medical Records ; Paralysis ; Parturition ; Physical Examination ; Pregnancy ; Prevalence ; Prognosis ; Retrospective Studies ; Shoulder ; Skull Fractures ; Thorax

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Ankle Syndesmotic Injury.

Keun Bae LEE

Journal of the Korean Fracture Society.2007;20(3):282-290. doi:10.12671/jkfs.2007.20.3.282

No abstract available.
Ankle Injuries* ; Ankle*

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Posterior Thigh Compartment Syndrome as a Result of Pseudoaneurysm of the Popliteal Artery in the Distal Femoral Fracture: A Case Report.

Seoung Jun LEE

Journal of the Korean Fracture Society.2007;20(3):277-281. doi:10.12671/jkfs.2007.20.3.277

Compartment syndrome of the thigh is a rare condition and usually occurs in the anterior compartment. It is frequently caused by muscle injury, femur fracture, muscle overuse and vessel injury, but there have been few reports about posterior thigh compartment syndrome caused by pseudoaneurysm of the popliteal artery after fixation of distal femoral fracture with the retrograde intramedullary nail. We report a case of posterior thigh compartment syndrome caused by pseudoaneurysm of the popliteal artery, and report the clinical progression and result of our case.
Aneurysm, False* ; Compartment Syndromes* ; Femoral Fractures* ; Femur ; Popliteal Artery* ; Thigh*

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Vertically Unstable Fracture of the Pelvis Combined with Anterior Dislocation of the Hip Joint: A Case Report.

Kap Jung KIM ; Ha Yong KIM ; Dae Suk YANG ; Won Sik CHOY

Journal of the Korean Fracture Society.2007;20(3):272-276. doi:10.12671/jkfs.2007.20.3.272

Pelvic fractures result from high energy trauma and often associated with concomitant injuries. But, vertically unstable pelvic fractures combined with anterior dislocation of the hip is far less common. The traumatic dislocation of the hip is a true orthopedic emergency and it should be considered that a femoral head can be exposed to deteriorized vascularity. We report a case of vertically unstable pelvic fractures combined with traumatic anterior dislocation of the hip joint with the review of the literature.
Dislocations* ; Emergencies ; Head ; Hip Joint* ; Hip* ; Orthopedics ; Pelvic Bones ; Pelvis*

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Compatibility of Self-setting DBM-CP Composites in Percutaneous Kyphoplasty.

Jung Hee LEE

Journal of the Korean Fracture Society.2007;20(3):266-271. doi:10.12671/jkfs.2007.20.3.266

PURPOSE: To analyze the physical properties of demineralized bone matrix (DBM) and self-setting calcium phosphate cement (CPC) composite for its compatibility to percutaneous kyphoplasty. MATERIALS AND METHODS: According to tap volume method, DBM was mixed with CPC in variable ratio 0%, 20%, 30%, 40% and 50%. Distilled water was used as a hardening fluid. Its properties, including injectability, mold applicability, setting time and its behavior, maximum temperature, and mechanical strength, were analyzed. RESULTS: The DBM-CP composites has a good injectability and mold applicability, a maximum temperature of less than 5oC, a initial setting time of 3 to 10 minutes. The outer surface of DBM-CP composites showed their even distribution in optical microscopy. Injectability, mold applicability and compressive strength were in inverse proportion to the amounts of DBM. CONCLUSION: This study suggests that the DBM-CP composites has a good injectability and mold applicability with a low setting temperature and even distribution of compound. Therefore this composite might be used as a substitute of PMMA in kyphoplasty.
Bone Matrix ; Calcium ; Compressive Strength ; Fungi ; Kyphoplasty* ; Methods ; Microscopy ; Polymethyl Methacrylate ; Water

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Risk Factors of New Compression Fractures in Adjacent Vertebrae after Percutaneous Vertebroplasty.

Myung Ho KIM ; Sang Hyuk MIN ; Suk Ha JEON

Journal of the Korean Fracture Society.2007;20(3):260-265. doi:10.12671/jkfs.2007.20.3.260

PURPOSE: To evaluate the risk factors related to the development of new fractures in adjacent vertebrae after vertebroplasty. MATERIALS AND METHODS: The study was conducted on 46 patients in whom 296 patients were performed during last 9 years. We were especially concerned with the restoration rate of vertebral height and kyphotic angle and estimated them on simple X-ray films. RESULTS: In patients experienced subsequent vertebral fractures and no subsequent vertebral fractures after vertebroplasty, the mean height restoration rate of treated vertebra were 16.7% and 7.07%, and the kyphotic angle difference were 2.53 degree and 4.2 degree. The greater degree of height restoration of the vertebral body, especially in middle vertebral height and the lesser degree of kyphotic angle difference increased the risk of adjacent vertebral fracture risk. This results were available statistically (all p<0.05, Logistic regression test, SPSS 13.0). CONCLUSION: It may be thought that the vertebral body height restoration rate will become risk factor of adjacent vertebral fractures.
Body Height ; Fractures, Compression* ; Humans ; Logistic Models ; Risk Factors* ; Spine* ; Vertebroplasty* ; X-Ray Film

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The Amount and Related Factors of Reduction Loss in Distal Radius Fracture after Treatment by Kapandji Technique.

Eun Sun MOON ; Myung Sun KIM ; Il Kyu KONG

Journal of the Korean Fracture Society.2007;20(3):252-259. doi:10.12671/jkfs.2007.20.3.252

PURPOSE: To evaluate the amount and related factors of reduction loss in distal radius fracture after treatment by Kapandji technique. MATERIALS AND METHODS: From September 2004 to May 2006, 44 cases (43 patients) of distal radius fractures were treated by Kapandji technique. Fracture were classified with AO classification and volar tilt, radial inclination, and radial length were measured in preoperative, immediate, postoperative radiographs. Also the amount and related risk factors of reduction loss were analyzed. In addition, the radiological results at last follow up were evaluated using modified Lidstrom scoring system. RESULTS: There was significantly more reduction loss of volar tilt in the patients with AO type C comparing with other fracture types, but the patients who were treated using three k-wire fixations including intrafocal K-wires showed significantly more reduction loss of volar tilt also. Overall radiological results at last follow up showed that excellent was 50% in cases with dorsal comminution, but, the other cases 90%. In addition, excellent was 70% in type A cases, but, in type C 44%. CONCLUSION: Kapandji technique percutaneous pinning is the one of effective treatment options for distal radius fracture. But, type of fracture, total number of K-wires, and presence of dorsal cortical comminution showed the significant relation with postoperative reduction loss of volar tilt and overall radiological results at last follow up.
Classification ; Follow-Up Studies ; Humans ; Radius Fractures* ; Radius* ; Risk Factors

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Comparison of LC-DCP versus LCP for Internal Fixation of Humeral Shaft Fractures in Elderly Patient.

Chang Yong HUR ; Won Yong SHON ; Jun Gyu MOON ; Sang Hwan HAN ; Jae Young HONG ; Sung Kang CHUN

Journal of the Korean Fracture Society.2007;20(3):246-251. doi:10.12671/jkfs.2007.20.3.246

PURPOSE: To compare outcomes of humeral shaft fractures fixed with locking compression plate and those fixed with dynamic compression plate in elderly patients. MATERIALS AND METHODS: Nineteen consecutive elderly patients with a fracture of the humeral diaphysis were evaluated retrospectively. Ten patients had been fixed with LC-DCP, and nine had been fixed with LCP. Radiological and clinical results were compared and comparison of implants was done. RESULTS: Loosening of the plate occurred in one case each from the LCP group and the LC-DCP group. The rest of the patients achieved union uneventfully without any complications. Union rate, clinical score and hardware were not significantly different between the two groups. One patient who developed loosening in the LC DCP underwent reoperation whereas one patient with loosening in the LCP was successfully managed conservatively. CONCLUSION: Principle of fracture fixation was more important than plate selection in humeral shaft fracture of elderly patient.
Aged* ; Diaphyses ; Fracture Fixation ; Humans ; Humerus ; Osteoporosis ; Reoperation ; Retrospective Studies

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The Surgical Outcomes for Isolated Greater Tuberosity Fracture of Proximal Humerus.

Eun Sun MOON ; Myung Sun KIM ; Young Jin KIM

Journal of the Korean Fracture Society.2007;20(3):239-245. doi:10.12671/jkfs.2007.20.3.239

PURPOSE: To evaluate the adequate surgical methods and postoperative rehabilitation by analyzing the outcome of surgical treatment for isolated greater tuberosity fracture of proximal humerus. MATERIALS AND METHODS: Ten patients who allowed at least 1 year follow up after the surgical treatment of isolated greater tuberosity fractures were evaluated. Their mean age was 52.3 years (range, 28~67) and mean follow up duration was 23.8 months (range, 12~36). We choosed the different approaches and fixation methods according to size, location and presence of comminution of the fragment, and combined injury. The rehabilitation programs were indivisualized and we evaluated the clinical outcomes using UCLA and Constant scoring system. RESULTS: According to the UCLA scoring system, 5 cases were excellent, 3 cases were satisfactory, and 2 cases were unsatisfactory. By the Constant scoring system, 8 cases were excellent and 2 cases were good. The average bony union time was 7.6 weeks (range, 6~8) except the 2 cases of revision surgery. Two cases were operated using cannulated screws alone, 3 cases using only nonabsorbable sutures and 5 cases using cannulated screws and nonabsorbable sutures. One out of two revision cases was developed from the negligence of preoperative shoulder anterior dislocation with rupture of subscapularis, and the other was caused by improper immobilization of the fracture site postoperatively. CONCLUSION: Not only the adequate surgical approaches and the fixation methods according to the size and comminution of fragment, but also the identification of combined injuries were very important in the surgical treatment for the isolated greater tuberosity fracture. And we considered that the adequate postoperative rehabilitation and proper protection based on the intraoperative fixation stability play an important role for the better clinical and radiological outcomes.
Dislocations ; Follow-Up Studies ; Humans ; Humerus* ; Immobilization ; Malpractice ; Rehabilitation ; Rupture ; Shoulder ; Sutures

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