Dissociation of Polyethylene Liner of the Dual Mobility Acetabular Component after Closed Reduction of Dislocation: A Case Report / 대한고관절학회지

A dual mobility acetabular component has a structure that combines a polyethylene liner and a femoral head, unlike the general design of acetabular cups, making the dissociation of a polyethylene liner highly unlikely. In addition, it increases the range of motion and reduces the possibility of dislocations by increasing a jump distance. A fifty-one-year-old male who had received total hip arthroplasty with the dual mobility acetabular component visited a hospital for a posterior hip dislocation 10 weeks after the operation. At the emergency room, closed reduction was performed and the dislocation was reduced. However, plain imaging test revealed polyethylene liner dissociation after the closed reduction. Revision surgery was performed. We will report a rare case of early dislocation of the dual mobility acetabular component and dissociation of polyethylene liner accompanied with a literature review.

Laminoplasty for Treatment of Transverse Sacral Fracture: A Case Report

The transverse sacral fracture is rare; however, if it accompanies neurological injury or instability, difficult surgical treatment may be necessary. We performed surgical decompression and laminoplasty in a patient with neurological deficits and anterior displacement of S2 on S1. The patient showed a successful clinical outcome by neurological improvement.

Neglected Isolated Lunate Fracture

Isolate fracture of lunate is very rare. The authors reported a neglected fracture of lunate which was founded incidentally after the dorsal wall fracture of triquetrum. Pain reduction and improvement of range of motion was achieved after excising the dorsal fragment of lunate.

A Case of Surgically Treated by Transperitoneal Approach in Delayed Neurological Deficit after Sacral Fracture: A Case Report

This study reviews a case of sacral fracture with delayed onset neurological deficit that showed good results after decompressive surgery. The delayed neurological deficit appeared at 4 weeks after injury and it was treated with anterior decompression through transperitoneal approach. A 23-year-old woman was injured in a car accident and had bilateral pubic rami fractures and fractures of the sacral ala on the right side. She was treated with external fixation devices for approximately four weeks, but complained of pain and numbness. The dorsiflexion and plantalflexion of the right ankle was weakened and graded as grade 2. Preoperative pelvic and sacral radiographs, computed tomography, magnetic resonance imaging and electromyelography, and nerve conduction study were performed to identify the region of neurological deficit, and we decided to implement neurological decompression. By transperitoneal approach, we performed bone curratage and decompression around the region of sacral alar slope and S1 foramen. The pain and numbness of the right foot cleared up. Dorsiflexion and plantalflexion of the right ankle improved to grade 5. Anterior decompression by transperitoneal approach proved to bring satisfactory results in a patient, who presented delayed neurological deficit after sacral fracture.

The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation

PURPOSE: This study was performed to evaluate the results of treating intertrochanteric fracture with proximal femoral nail antirotation (PFNA). MATERIALS AND METHODS: We performed PFNA on 41 intertrochanteric femur fracture patients from May 2008, to August 2010. We analyzed the operation time, blood loss, recovery of ambulatory function, T-score, the tip apex distance (TAD), the sliding distance of the blade, neck-shaft angle, and complications. RESULTS: The mean operation time was 51 minutes and the mean amount of blood loss was 350 ml. The time to ambulation averaged 7.2 days. Thirty-two cases (79%) recovered their previous walking status at 6 months after operation. The average T-score was 3.3 and TAD was 12.3 mm (8.6~27 mm). 35 cases (87%) achieved acceptable reduction. The average amount of PFNA blade sliding was 3.3 mm. The neck-shaft angle was changed 2.6 degrees varus displacement at the final follow-up. There was one case of nonunion due to tuberculosis infection. CONCLUSION: The findings from this study indicate that PFNA is a useful and reliable choice for the treatment of intertrochanteric fracture of the femur.