Is Distal Locking Constantly Necessary When Intertrochanteric Femur Fracture Is Stably Fixed in the Distal Area with Intramedullary Hip Nail? / 대한정형외과학회잡지

PURPOSE: The purpose of this study is to investigate the constant necessity of distal locking when intertrochanteric fracture was treated with an intramedullary hip nail. MATERIALS AND METHODS: From April 2010 to June 2013, 47 stable intertrochanteric fractures (AO/OTA 31-A1) were treated with second generation intramedullary hip nailing. They were followed-up for more than 12 months. In the first group of 18 cases distal locking was used, and in the second group of 29 cases, distal locking was not used. We compared the radiologic and clinical results of the two groups. RESULTS: Comparison of the two groups of patients showed no difference in terms of radiological and functional results. Postoperative thigh pain developed in eight cases (17%). A statistically difference was observed between isthmic diameter and used nail diameter (Fisher exact test, p=0.01) for postoperative thigh pain. In logistic regression analysis, the difference between isthmic diameter and used nail diameter was the most statistically significant factor in development of postoperative thigh pain (p=0.04, odd ratio=27.75). CONCLUSION: Our results suggested that the second generation intramedullary hip nail may be successfully implanted without distal interlocking in 31-A1 intertrochanteric femur fracture when the reduction status was satisfactory and stable fixation of the distal area was estimated by less than 3 mm difference between isthmic diameter and used nail diameter.

Arthroscopic Treatment of Delayed Patella Infera / 대한정형외과학회잡지

Patella infera (baja) is a rare condition that can result from several etiologies including trauma around the knee. Risk factors include scar tissue formation in the retropatella fat pad, extensor mechanism dysfunction, immobilization in extension position of the knee joint, etc. Unawareness and delayed recognition are known to be associated with long-term disability. In this condition, arthroscopic treatment is generally recommended only for early cases. In this report, we present a case with reasonable outcome of delayed patella infera treated by arthroscopic treatment. Prudent arthroscopic debridement of the responsible scar tissue and accelerated rehabilitation therapy is necessary for achievement of a successful outcome.