Clinical and Radiologic Outcomes of AO Type C1, 2 Distal Radius Fractures Treated with Percutaneous Pinning or Volar Locking Plating

PURPOSE: To compare clinical and radiological results between closed reduction followed by percutaneous K-wire fixation and volar locking compression plate fixation in the treatment of AO type-C1, 2 fractures of the distal radius. MATERIALS AND METHODS: The subjects of this study were 61 patients who had a AO type-C1,2 fracture of the distal radius treated from March 2006 to January 2010, and were followed up for over 12 months. Clinical evaluations included disabilities of arm, shoulder and hand score (DASH) score, patient-rated wrist evaluation questionnaires (PRWE) score, the Grip strength, and the range of joint motion at the last follow-up, and radiological assessment included the presence of bony union, the dorsal tilt angle of the radius, the inclination of the radius, and the radial shortening. RESULTS: The range of joint motion, the grip strength, DASH and PRWE demonstrated no significant difference between the two groups. Radiological results revealed that the patients treated with percutaneous K-wire fixation showed greater radial shortening than those treated with locking compression plate fixation. CONCLUSION: Although clinical results are similar between volar locking plating and percutaneous pinning in the treatment of AO C1, 2 distal radius fractures, volar locking plating is more effective in preventing radial shortening during fracture healing.

Comparative Study of Posterior Lumbar Interbody Fusion with Posterolateral Fusion in Degenerative Lumbar Spinal Disorders

STUDY DESIGN: A retrospective study. OBJECTIVES: The authors found that problems such as axial pain, donor site pain, loss of reduction, loosening or failure of fixation materials occurred relatively frequently after posterolateral fusion. For this, we had views on the ideas that the problems could be improved by an operation that fused vertebral bodies. Furthermore, we performed posterior lumbar interbody fusion and wanted to know the results. SUMMARY OF LITERATURE REVIEW: We performed posterior lumbar inter-body fusion as an alternative, due to complications of autoiliac bone graft that has complications, such as donor site pain. MATERIALS AND METHODS: Sixty patients with single segment degenerative lumbar disease were treated with decompression, pedicle screws fixation, and spinal fusion. The patients were followed-up for more than 2 years. Thirty patients, who had undergone posterolateral fusion with autologous iliac bone graft, were classified as the "group 1". The second 30 patients, who underwent posterior lumbar interbody fusion with cage and local bone graft, were classified as the "group 2". The operation time, blood loss, fusion rate, lumbar lordotic angle, segmental angle were compared between the 2 groups. The clinical outcomes were evaluated by Kim's functional evaluation scale. RESULTS: The operation time was shorter in group 2 (142.74 minutes vs 171.64 minutes), there was a statistical difference between the 2 groups. Intraoperative blood loss was more in group 2 (563.40 vs 551.78 mL), but total blood loss, including postoperative drained blood was less in group 2. The bony fusion rate was 90% in group 1, 97% in group 2. For the lumbar lordotic angle, the last outcome was less than the preoperative value. There was no statistical difference between the 2 groups. The segmental angle in group 1, the last outcome was less than the preoperative value. The segmental angle in group 2 was maintained the value through pre-operation to post-operation. Clinical outcomes were satisfactory in group 1 (96.67%) & in group 2 (100%). In group 1, 7 patients experienced pain at the iliac graft donor site. In group 2, there were 2 cases of retroposition of the cage. CONCLUSIONS: In the posterior lumbar interbody fusion group, operation time was shorter, total blood loss was less than in the posterolateral fusion group. Restoration and maintenance of the segmental angle in sagittal and coronal radiographs showed better outcomes, axial pain and iliac donor site pain were less. It is the authors' position that posterior lumbar interbody fusion is an alternative operation to supplement the faults of posterolateral fusion.

Osteochondroma of 12th Thoracic Vertebra: A Case Report

STUDY DESIGN: Cases report OBJECTIVES: We report 1 case of relatively rare osteochondroma that was in thoracic spine. SUMMARY OF LITERATURE REVIEW: Osteochondroma is one of the most common benign tumor in bone, consist of 40%, but, rare in spine area occupying only 2%. We report a case of osteochondroma that was in the 12th vertebra of thoracic spine, that had severe right flank pain. We performed en bloc excisional biopsy of the bony mass. MATERIALS AND METHODS: A fourty seven-year-old male complained right flank pain. He had mass of 12th thoracic costovertebral junction and underwent open excision and biopsy. RESULTS: The preoperative pain disappeared and any signs of recurrence were not found on the follow up performed at 1 year. CONCLUSIONS: The painful osteochondroma of thoracic spine is treated successfully by surgical technique.