• Title/Summary/Keyword: Proximal fracture

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Surgical Treatment of the Fifth Metatarsal Base Fracture Using Multiple Kirschner Wires (다발성 Kirschner 강선을 이용한 제 5중족골 기저부 골절의 수술적 치료)

  • Kim, Jihyeung;Kim, Jang Woo;Lee, Jeong Ik;Kim, Sang Kil;Rhee, Seung Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.24-28
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    • 2014
  • Purpose: The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires (K-wires) for the fifth metatarsal base fracture. Materials and Methods: We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distance of fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visual analog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) mid-foot score at six months postoperatively. Results: In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bony union in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantly decreased after surgery. The average AOFAS score was 95 at six months postoperatively. Conclusion: Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a K-wire into the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.

Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years (65세 이상의 상완골 근위부 골절 환자에서 다축 각안정 잠김 압박 금속판을 이용한 내고정술)

  • Lee, Ki-Won;Choi, Young-Joon;Ahn, Hyung-Sun;Kim, Chung-Hwan;Hwang, Jae-Kwang;Kang, Jeong-Ho;Choo, Han-Ho;Park, Jun-Seok;Kim, Tae-Kyung
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.25-31
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    • 2012
  • Purpose: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated. Materials and Methods: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle. Results: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head. Conclusion: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

Proximal Tibia Fracture after Proximal Tibia Autograft Harvest

  • Kim, Jin-Kak;Song, Jong-Hyeop;Lee, Kyungbum;Cho, Jae-Woo;Moon, Ki-Ho;Yeo, Do-Hyun;Kim, Beom-Soo;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.247-252
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    • 2017
  • Bone-grafting procedures are common in orthopedic trauma surgeries. There are only few reports on the morbidity after proximal tibia harvesting. Here, we report an experience of complication after proximal tibia harvesting while treating subtrochanteric femoral osteomyelitis.

Surgical Treatment of Maisonneuve Fracture Accompanied by Tillaux-Like Fracture: A Case Report (Tillaux 골절과 유사한 골절이 동반된 Maisonneuve 골절 환자의 수술적 치료: 증례보고)

  • Gab-Lae Kim;Seung-Jin Lee;Jung Hyun Cho
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.3
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    • pp.111-113
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    • 2024
  • Tillaux fractures, a rare type corresponding to Salter-Harris type 3, are observed in approximately 3% of pediatric ankle fractures. They are known to occur primarily via a supination-external rotation mechanism. Maisonneuve fractures, on the other hand, are proximal fibula fractures involving injury on syndesmosis, deltoid ligament, or medial malleolus fracture, occurring via a pronation-external rotation mechanism. These two types of fractures occur through different mechanisms of injury. In this study, a nine-year-old female pediatric patient presented to the outpatient department with ankle pain following a fall from a trampoline and was diagnosed with concurrent Tillaux-like fracture and Maisonneuve fractures. Surgical treatment was performed, resulting in successful recovery.

Treatment of Deformity in Polyostotic Fibrous Dysplasia Using Interlocking Intramedullary Nailing (다발성 섬유성 골이형성증 변형에 대한 나사못 맞물림 골수정을 이용한 치료)

  • Lee, Kwang-Suk;Oh, Jong-Keon;Koo, Ja-Seong
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.249-253
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    • 1995
  • The fibrous dysplasia is a progressive and disabling condition that lead to deformity, especially weight bearing bones. The morbidity that is associated with the polyostotic fibrous dysplasia is the recurrent fracture and deformity. Various methods of treatment had been failed to control this problem. We used osteotomy and reconstruction nailing for polyostotic fibrous dysplasia occured in the proximal part of right femur with varus deformity and reconstruction nailing in left femur without osteotomy, and interlocking intramedullary nailing in right tibia to prevent pathologic fracture. These methods brought a good result of bone union and full weight bearing ambulation after 1 year and 6 month follow up. We think these methods are useful methods to control refracture and deformity, so we reported this case with bibliographic reviews.

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Tension Band Sutures Using a Washer for a Proximal Humerus Fracture

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong;Yang, Jae-Hoon;Kim, Dong-Kyu;Kim, Joung-Hun
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.161-161
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    • 2009
  • To prevent distraction and varus deformity between the humeral head and shaft, tension band sutures placed between the head of the interlocking screw and the rotator cuff, and we recommend using nonabsorbable sutures. We describe our simple procedure to overcome these difficulties in tension band suturing after reducing a proximal humerus fracture to maintain the reduction.

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Fifth Metatarsal Stress Fracture (운동선수의 제5 중족골 피로골절)

  • Lee, Kyung-Tai;Park, Young-Uk;JeGal, Hyuk;Kim, Jun-Beom
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.87-93
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    • 2012
  • Fractures located at the metaphyseal/diaphyseal junction at the base of the fifth metatarsal were first described by Sir Robert Jones in 1902. However, ever since, there has been disagreement and debate regarding the diagnosis, classification, pathomechanics, the incidences, and potential causes of delayed unions and nonunions, and the optimal method of treatment. It appears to be widely agreed that proximal fractures of the metaphyseal/diaphyseal region of the fifth metatarsal are prone to delayed union or even nonunion. Several classifications of proximal fifth metatarsal stress fractures have been devised. Torg et al. classified fractures involving the proximal part of the diaphysis of the fifth metatarsal into three types. The Torg classification is a good grading system that can be used to determine the type of surgery needed as well as for the prediction of prognosis. The ''plantar gap'' might add to the decision-making process for surgery and improve the prediction of patient prognosis. In addition, the new classification using 'plantar gap' might be used for classification of fifth metatarsal stress fracture. Fifth metatarsal stress fractures can be treated conservatively or surgically, and excellent results have been reported for surgery with rapid recovery in athletes. Intramedullary screw fixation has become a popular form of fixation for fifth metatarsal stress fractures. Bone grafting presents the problems of a longer recovery time and additional skin incision for harvesting. The modified tension band wiring is an useful and simple option for surgical treatment of challenging fifth metatarsal stress fractures.