The Relationship between Superior Disc-Endplate Complex Injury and Correction Loss in Young Adult Patients with Thoracolumbar Stable Burst Fracture

BACKGROUND: To determine the relationship between superior disc-endplate complex injury and correction loss after surgery in a group of young adult patients with a stable thoracolumbar burst fracture. METHODS: The study group was comprised of young adult patients who had undergone short-segment posterior fixation and bone grafting under the diagnosis of a stable thoracolumbar burst fracture from March 2008 to February 2014. Follow-up was available for more than 1 year. Before surgery, magnetic resonance imaging was performed to determine injury to the anterior longitudinal ligament, posterior longitudinal ligament, and superior and inferior intervertebral discs and endplates. Correction loss was evaluated by the Cobb angle, intervertebral disc height, upper intervertebral disc angle, vertebral wedge angle, and vertebral body height. RESULTS: No significant relation was noted between correction loss and an injury to the anterior longitudinal ligament, posterior longitudinal ligament, inferior intervertebral disc/endplate, and fracture site, whereas an injury to the superior endplate alone and superior disc-endplate complex showed a significant association. Specifically, a superior intervertebral disc-endplate complex injury showed statistically significant relation to postoperative changes in Cobb angle (p = 0.026) and vertebral wedge angle (p = 0.047). CONCLUSIONS: A superior intervertebral disc-endplate complex injury may have an influence on the prognosis after short-segment fixation in young adult patients with a stable thoracolumbar burst fracture.

The Changes in Patient Pattern for Pediatric Supracondylar and Lateral Condylar Humeral Fractures / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to compare the changes in patients pattern retrospectively for pediatric supracondylar and lateral condylar humeral fractures. MATERIALS AND METHODS: We retrospectively studied 335 pediatrics treated operatively for supracondylar and lateral condylar fracture from March 1993 to February 2013. The pediatrics were divided depending on the 10-year time period: those who received treatment from March 1993 to February 2003 as group I, and those who received treatment from March 2003 to February 2013 as group II. By each group, the differences in age, gender, cause, season of incidence, whether the time of incidence was a weekend, and education level of the parents were compared and analyzed. RESULTS: Fractures in group I were mainly due to slip down and fall down, but sports injury was the main cause of fractures in group II. There were 112 cases and 121 cases of supracondylar fractures, and 65 cases and 37 cases of lateral condylar fracture in groups I and II. Significant differences were found in the incidence of lateral condylar facture (p=0.009). In terms of the education level of the parents, the number with high school or under decreased significantly from group I to group II, from 71 cases to 45 cases (p=0.040). CONCLUSION: The supracondylar fracture does not show any significant difference according to the time lapse in the age and cause of incidence. However, the incidence of lateral condylar fracture shows a decreasing trend which may be related to the decrease of the incidence of slipping and falling, and the improvement in the parent's education level.