• Title/Summary/Keyword: Malunited fracture

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Delayed Reduction of Facial Bone Fractures (정복 시기가 지난 안면골 골절의 수술적 교정)

  • Lee, Kyu-Seop;Park, Jae Beom;Song, Seung Han;Oh, Sang Ha;Kang, Nak Heon
    • Archives of Craniofacial Surgery
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    • v.14 no.2
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    • pp.119-123
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    • 2013
  • Except for special situations, it is generally agreed that best results in the treatment of facial fractures is expected if reduction is done within the first 2 or 3 weeks after injury. We reduced facial bone fractures at 4 to 7 weeks after trauma. A 44-year-old female patient underwent open reduction for her right zygomaticomaxillary complex fracture at 7 weeks after injury. A 59-year-old female patient underwent surgery for the right mandible body and left parasymphysis fractures at 4 weeks after injury. Using traditional approaches, granulation tissue and callus were removed from the fracture sites, and malunited fracture lines were separated by a small osteotome. We reduced the displaced fractured zygoma and mandible to their normal anatomical positions and fixed them using titanium plates. No complications such as asymmetry, malunion, malocclusion, or trismus were seen. Unfavorable asymmetric facial contours were corrected, and we obtained good occlusion with favorable bony alignment. The functional and aesthetic outcomes were satisfactory. Through removal the callus and limited osteotomy, a successful approach to the previously fractured line was possible, and an exact correction with symmetry was obtained. This method can be a good option for obtaining good mobility and clinical results in treating delayed facial bone fractures.

Open Reduction and Internal Fixation for Vancouver B1 and B2 Periprosthetic Femoral Fractures: A Proportional Meta-Analysis

  • Byung-Ho Yoon;Seong Gyun Park;Young Hak Roh
    • Hip & pelvis
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    • v.35 no.4
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    • pp.217-227
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    • 2023
  • Purpose: Periprosthetic femoral fracture (PFF) is a common complication after total hip arthroplasty, and open reduction and internal fixation (ORIF) is a common surgical treatment. We conducted a meta-analysis to compare the outcomes of ORIF in patients with different fracture patterns (Vancouver B1 and B2). Materials and Methods: We conducted a systematic search of PubMed, Embase, Cochrane Library and KoreaMed from inception to August 2022. We conducted a pair-wise meta-analysis (with a fixed-effects model) on the 10 comparative studies and a proportional meta-analysis on the data from the 39 articles to determine a consensus. The outcomes were the incidence of reoperations that included osteosynthesis, irrigation/debridement and revision arthroplasty. Results: The pair-wise meta-analysis showed similar outcomes between two groups; the risk of reoperation (odds ratio [OR]=0.82, confidence interval [CI] 0.43-1.55, P=0.542), nonunion (OR=0.49; CI 0.22-1.10, P=0.085) and deep infection (OR=1.89, CI 0.48-7.46, P=0.361). In proportion meta-analysis, pooled prevalence of reoperation was 9% (95% CI, 6-12) in B1 and 8% (95% CI, 2-15) in B2 (heterogeneity between two groups (Q), P=0.772). The pooled prevalence of nonunion was same as of 4% in B1 and B2 (Q, P=0.678), and deep infection was 2% (95% CI, 1-3) in B1 and 4% (95% CI, 2-7) in B2 (Q, P=0.130). Conclusion: ORIF is a feasible treatment for B1 and B2 periprosthetic femoral fractures, with acceptable outcomes in terms of, nonunion and infection. The results of this study would help clinicians and provide baseline data for further studies validating PFF.

Delayed Diagnosis of Volar Dislocation of the Distal Ulna after Treatment of the Radial Shaft Fracture (요골 간부 골절 치료 후 지연 발견된 원위 척골의 전방 탈구)

  • Jeon, Suk Ha;Lee, Sanglim
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.427-432
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    • 2021
  • Delayed treatment of volar dislocation of the distal radioulnar joint can result in wrist pain, limited rotation of the forearm, and degenerative arthritis that could be managed only by salvage procedures. A 24-year-old male patient presented with wrist pain and a loss of forearm rotation after surgery for a radial shaft fracture. The shaft of the radius was fixed with a plate and screws with a volar angulation of 7°. The ulnar head was dislocated volar to the distal radius, and the bone defect in the ulnar head was impacted into the volar rim of the sigmoid notch of the radius, preventing the head from being reduced in the joint. Corrective osteotomy of the malunited radial shaft and sliding osteotomy of the proximal ulnar head were performed to fill the distal bone defect. Pain and range of the forearm rotation were improved at postoperative 19 months.

Ananlysis of Correlation between Functional Leg Length Discrepancy caused by Pelvic tilting and Femur head height difference (골반변위와 대퇴골두 높이차이에 대한 상관성 비교 - Gonstead's Technique을 중심으로 -)

  • Lee, Kyung-Yun;Seo, Jin-Woo;Park, Kwae-Hwan;Park, Min-Jung
    • The Journal of Korea CHUNA Manual Medicine
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    • v.5 no.1
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    • pp.213-222
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    • 2004
  • Objectives : To investigate contributing degree of other factors except pelvic tilting to F.L.L.D by analizing with Gonstead technique on the correlation between femur head height discrepancy on the standing pelvic AP view and F.L.L.D caused by pelvic tilting. Method : We analysed standing pelvis AP X-ray of 70 patients who had visited at the department acupunture and moxibustion in Conmaul oriental medical hospital, during May, 1st, 2004 - July, 30th, 2004, with low back pain or lower extremity pain. We excluded the person with any past history of polio, genetic defect, malunited fracture, growth plate injury, infection and overgrowth attributable to hemangioma, or arteriovenous fistula. Results & Conclusion : The functional leg length discrepancy caused by pelvic tilting and femur head height difference had no statistical difference(p=0.132) but poorly correlated(Pearson ${\nu}=0.05$). In the 94.28% of subjects, the femur head height difference wasn't in accord with F.L.L.D. caused by pelvic tilting. In 47.14% of subjects were expected to have over $3^{mm}$ of leg length discrepancy after pelvic adjustment. The mean of measurement difference between two methods was $3.76{\pm}3.12^{mm}$ and the range was $0{\sim}11.4^{mm}$. Consequently, we must consider not only functional leg length discrepancy caused by pelvic tilting but also anatomical leg length discrepancy, misalignment of ankle, knee or hip joint etc.

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