• 대한족부족관절학회지
• /
• 제20권3호
• /
• pp.131-134
• /
• 2016

Purpose: This study aimed to evaluate the outcomes, including the complications, of open reduction and internal fixation using a headless cannulated compression screw for a fifth metatarsal base fracture. Materials and Methods: We retrospectively investigated 11 patients with 5th metatarsal base fracture who were treated with a headless cannulated compression screw. The mean follow-up period was 13 months (8~15 months), and the mean age was 46.5 years (21~70 years). We analyzed the patients' sex, age, time to union, amount of fracture displacement, and complications. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was used for clinical assessment. Results: The average amount of displacement decreased significantly from 3.4 mm (2.1~5.2 mm), preoperatively, to 0.4 mm (0~1.3 mm), postoperatively (p<0.001). The average bone union time was 54.1 days (41~68 days). There were no complications, such as a metal failure, irritation, and loss of a reduction. The mean AOFAS midfoot score was 97.7 (90~100) at 6 months, postoperatively. Conclusion: We suggest that a headless cannulated compression screw for 5th metatarsal base fracture is a useful and alternative method for a firm fixation without complications.

• Clinics in Shoulder and Elbow
• /
• 제14권1호
• /
• pp.94-98
• /
• 2011

목적: 견갑골 전방 관절와 분쇄 골절에 대해 관절경하 정복 및 AO 무두 압박 나사를 이용하여 골편을 고정한 증례를 보고하고자 한다. 대상 및 방법: 31세 남자로 내원 2주 전 추락 후 발생한 좌측 견관절의 전방 관절와 분쇄 골절에 대하여 관절경하에서 골절을 정복한 후, 표준 전상방 삽입구를 통해 1.1 mm K 강선을 가이드핀으로 삽입하고 AO 무두 압박 나사로 골편을 고정하였다. 결과: 수술 후 12개월째 견관절의 운동 범위는 정상 범위로 회복 되었으며, 골절은 유합을 얻었고 일상 생활에 불편감은 없었다. 결론: AO 무두 압박 나사는 나사의 길이가 다양하여 작은 관절와 골편에 사용하기 적합하고, 가이드 핀의 길이가 상대적으로 짧으나 1.1 mm K 강선으로 대체가 가능하며, 나사 돌리개 (screw driver)나 천공기 (drill bit) 등의 동반 기구의 길이가 길어 비교적 깊은 위치의 견갑과 골절의 고정에 사용하기 편리하여 관절경적 고정술 시 유용하게 이용할 수 있을 것으로 생각된다.

• Journal of Korean Neurosurgical Society
• /
• 제60권5호
• /
• pp.498-503
• /
• 2017

Objective : The purpose of the present study was to compare inter-fragmentary compression pressures after fixation of a simulated type II odontoid fracture with the headless compression Herbert screw and a half threaded cannulated lag screw. Methods : We compared inter-fragmentary compression pressures between 40- and 45-mm long 4.5-mm Herbert screws (n=8 and n=9, respectively) and 40- and 45-mm long 4.0-mm cannulated lag screws (n=7 and n=10, respectively) after insertion into rigid polyurethane foam test blocks (Sawbones, Vashon, WA, USA). A washer load cell was placed between the two segments of test blocks to measure the compression force. Because the total length of each foam block was 42 mm, the 40-mm screws were embedded in the cancellous foam, while the 45-mm screws penetrated the denser cortical foam at the bottom. This enabled us to compare inter-fragmentary compression pressures as they are affected by the penetration of the apical dens tip by the screws. Results : The mean compression pressures of the 40- and 45-mm long cannulated lag screws were $50.48{\pm}1.20N$ and $53.88{\pm}1.02N$, respectively, which was not statistically significant (p=0.0551). The mean compression pressures of the 40-mm long Herbert screw was $52.82{\pm}2.17N$, and was not statistically significant compared with the 40-mm long cannulated lag screw (p=0.3679). However, 45-mm Herbert screw had significantly higher mean compression pressure ($60.68{\pm}2.03N$) than both the 45-mm cannulated lag screw and the 40-mm Herbert screw (p=0.0049 and p=0.0246, respectively). Conclusion : Our results showed that inter-fragmentary compression pressures of the Herbert screw were significantly increased when the screw tip penetrated the opposite dens cortical foam. This can support the generally recommended surgical technique that, in order to facilitate maximal reduction of the fracture gap using anterior odontoid screws, it is essential to penetrate the apical dens tip with the screw.

• 대한족부족관절학회지
• /
• 제17권2호
• /
• pp.106-114
• /
• 2013

Purpose: Posteroanterior screw fixation is biomechanically stronger than anteroposterior screw fixation. However, there are few literature about the correlation between clinical results and more strength by posteroanterior fixation. This study was performed to evaluate the clinical outcomes of the accelerated rehabilitation following anterior open reduction and posterior percutaneous screw fixation for displaced talar neck fractures. Materials and Methods: Eighteen cases were followed up for more than 1 year after posteroanterior fixation using headless compression screw for talar neck fractures. The clinical evaluation was performed according to American Orthopaedic Foot and Ankle Society (AOFAS) score and Hawkins criteria. As radiographic evaluation, the degree of fracture displacement, period to union, and occurrence rate of complications such as avascular necrosis through MRI were measured. Results: The AOFAS score was average 90.4 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the Hawkins criteria. Therefore, 16 cases(88.8%) achieved satisfactory results. The degree of fracture displacement had improved significantly from preoperative average 5.6 mm to 1.2 mm immediate postoperatively, and maintained to 1.1mm at the last follow-up. All cases achieved bone union, and the period to union was average 12.4 weeks. There were 3 cases of avascular necrosis of talar body and 2 cases of post-traumatic arthritis. Conclusion: Anterior open reduction and posterior percutaneous headless screw fixation seems to be an effective surgical method for displaced talar neck fractures, because of the possibility of accurate restoration of articular surface, fixation strength enough to early rehabilitation, and needlessness of hardware removal.

• 대한족부족관절학회지
• /
• 제16권4호
• /
• pp.247-256
• /
• 2012

Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using mini-open sinus tarsi approach for displaced intraarticular calcaneal fractures. Materials and Methods: We studied 18 cases (16 patients) of intraarticular calcaneal fractures who were treated with sinus tarsi approach by same surgeon. The mean age of patients was 44.8 years, and mean follow-up period was 17.2 months. The measurement of B$\ddot{o}$hler angle, Gissane angle, the degree of articular surface depression, and the period to union were performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: B$\ddot{o}$hler angle and Gissane angle had improved significantly from preoperative average $9.8^{\circ}$, $117.6^{\circ}$to average $22.4^{\circ}$, $113.4^{\circ}$ immediate postoperatively, and had maintained to average $21.8^{\circ}$and $114.2^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 5.2 mm to 1.2 mm at the last follow-up. All cases achieved bone union, and the period to union was average 10.5 weeks. AOFAS score was average 86.2 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the CNHF scale. Therefore, 16 cases (88.8%) achieved satisfactory results. Conclusion: The minimally invasive sinus tarsi approach using headless compression screw seems to be an effective surgical method for displaced intraarticular calcaneal fractures, because of the possibility of accurate restoration of articular surface and the low risk of postoperative soft tissue complications.