The Surgical Outcomes of Olecranon Fracture Dislocation of the Elbow / 대한정형외과학회잡지

PURPOSE: The purpose of this study is to evaluate the surgical outcomes of olecranon fracture dislocation in accordance with the direction of the dislocation. MATERIALS AND METHODS: From December 2006 to February 2016, the surgical outcome in patients who had been followed-up for a minimum of 6 months accompanied with olecranon fracture and elbow instability were reviewed retrospectively. We classified olecranon fracture as either the anterior type or the posterior type. Moreover, we evaluated the clinical results by the Mayo elbow performance scores (MEPS) and checked for any associated injury, age, injury mechanism, and complication. RESULTS: Fourteen patients had anterior transolecranon fracture dislocation, with an average age of 46 years. The associated lesions were radial head fractures found in 2 patients (14.3%) and coronoid process fracture found in 5 patients (35.7%). Patients with anterior transolecranon fracture showed an average MEPS of 93.2 (70–100). Eight patients with posterior olecranon fracture dislocation had an average age of 66 years (22–87 years). The associated lesions were radial head fractures in 6 patients (75.0%) and coronoid process fracture in 8 patients (100%). Patients with posterior olecranon fracture dislocation showed an average MEPS of 94.4 (80–100). In comparison with the anterior type, posterior type occurred more frequently in elders and showed a greater association with injuries, such as radial head fracture and coronoid process fracture. However, there was no significant difference between the two groups with respect to the clinical outcome. CONCLUSION: There were differences in frequency of associated injuries and age in accordance with the direction of olecranon fracture dislocation. Moreover, good clinical outcomes were achieved by surgical treatment.

Clinical Results of Open Reduction and Internal Fixation in the Coronal Plane Articular Fracture of the Distal Humerus / 대한정형외과학회잡지

PURPOSE: The purpose of this study is to evaluate the surgical outcomes according to the Ring's classification system in patients with the distal humeral coronal plane articular fracture after treatment with open reduction and internal fixation (OR/IF). MATERIALS AND METHODS: Patients with the distal humeral coronal plane articular fracture treated with OR/IF in the three hospitals were reviewed retrospectively. The patients were evaluated clinically and radiographically according to the Ring's classification system. RESULTS: Eleven patients, including three males and eight female patients, with a mean age of 55 years (15–88 years) were enrolled in this study. Average Mayo elbow performance score was 85 (60–100), four patients had excellent, four had good, and three had fair results. Fracture union was achieved in ten of 11 patients who underwent open reduction and internal fixation. In the analysis of the results according to Ring's classification, patients presenting fracture of the posterior aspect of the lateral column showed worse clinical results than those who did not. It was the same for the patient presenting fracture of the posterior aspect of the trochlea. CONCLUSION: The open reduction and internal fixation provides good clinical and radiologic outcomes for the distal humeral coronal plane articular fracture. Our results suggest that the type of fracture involvement with posterior aspect of trochlear or capitellum can result in poor clinical outcomes.

Fracture of Distal Epiphysis of Femur during Childbirth: 10-Year Follow-Up Report / 대한정형외과학회잡지

Epiphyseal fractures in neonates are rare and difficult to diagnose on simple radiographic images and objective guidelines for treatment have not yet been established. Authors performed conservative treatment for displaced distal femoral epiphyseal fracture detected on 5th day after cesarean section delivery. At 10 years of follow-up, satisfactory functional recovery was observed. Herein, we report on a case of displaced distal femoral epiphyseal birth fracture with literature reviews.

Preoperative Incidence of Deep Vein Thrombosis after Hip Fractures in Korean

BACKGROUND: The purpose of the current study was to investigate the incidence of preoperative deep vein thrombosis (DVT) after hip fractures in Korea. METHODS: In this prospective study, we enrolled 152 Korean geriatric patients who had suffered hip fractures due to a simple fall and were hospitalized between January 2013 and December 2013. There were 52 male and 100 female patients, and their mean age was 78.2 years. There were 96 trochanteric fractures and 56 femoral neck fractures. All patients were examined for DVT: 26 by ultrasonography and 126 by computed tomography venography. The patients having DVT underwent inferior vena cava filter insertion before the surgical intervention. RESULTS: Preoperatively, none of the patients had any signs or symptoms of DVT; however, 4 patients were identified as having asymptomatic DVT. The overall incidence of DVT was 2.6% (4/152). The mean time to arrival at emergency room after injury was 32.6 hours. Mean time elapsed to undergo surgery after hospitalization was 24.9 hours. The average time to hospitalization after injury was 237 hours for patients with DVT versus 27.5 hours for patients without DVT. DVT developed within 72 hours in two of the 137 patients (1.4%) and after 72 hours in two of the remaining 15 patients (13.3%) hospitalized. CONCLUSIONS: While the preoperative incidence of DVT after hip fractures was relatively low (2.6%) in the Korean geriatric population, we confirmed that getting no treatment within 72 hours after injury increased the incidence of DVT. Thus, we conclude from this study that a workup for DVT should be considered in cases where admission or surgery has been delayed for more than 72 hours after injury.

Unusual Cause of Hip Pain: Intrusion of the Acetabular Labrum / 대한고관절학회지

Femoroacetabular impingement and dysplatic hip joint is well known cause of osteoarthritis. In these diseases, labral tear and subsequent cartilage damage is thought to be main pathophysiology of development of osteoarthritis. If there are no known bony abnormalities, we called it as idiopathic osteoarthritis. Normal appearance of acetabular labrum is a continuous, usually triangular structure that attaches to the bony rim of the acetabulum and is completed at the inferior portion by the transverse acetabular ligament over the acetabular notch. A few authors reported intra-articular labrum and its relation to the development of osteoarthritis. But they didn't comment the primary bony abnormality especially acetabulum. We'd like to report x-ray, computed tomogram, magnetic resonance arthrogram and arthroscopic findings of a case had double contour sign of acetabular dome combined with intrusion of acetabular labrum.