Fractures In Sagittal Plane Research Articles

Sagittal and Coronal Plane Fracture of Talar Body, An Unusual Combination with Medial Malleolus Fracture: A Case Report

Introduction: Fractures of the talus are relatively uncommon injuries with majority of them involving the neck region. Talar body fracture in sagittal plane in combination with medial malleolus fracture is very rare with few cases being reported in the literature earlier. Aims and Objectives: To discuss such an unusual combination in an adolescent, which was treated with open reduction and internal fixation with screws for both talus and medial malleolus. Materials and Methods: A 18-year-old boy with medial malleolus and sagittal plane talus fracture was treated with open reduction and internal fixation. Conclusion: Talar body fractures in the sagittal plane and its combination with medial malleolus fracture are challenging due to its rarity and associated high degree of complications. Surgery should be planned at appropriate time considering the status of surrounding soft tissues and swelling. Proper anatomic reduction and rigid fixation with good surgical technique followed by cast immobilization and non-weight bearing for longer periods (at least 3 months or till radiological union) is the key to a good clinical outcome.

Buttress plating for volar Barton fractures in children: Salter-Harris II distal radius fractures in sagittal plane.

We observed an unusual type of volar Barton fracture in the pediatric age and performed open reduction and internal fixation of the fragment, using the buttress plate in consecutive children. We report the radiological and clinical outcomes after follow-up for at least 3 years. From March 2008 to September 2014, nine consecutive children were treated by buttress plating. Their mean age at the time of injury was 13.1 years. All of the fractures were metaphyseal fractures in the coronal plane and typical Salter-Harris II fractures in the sagittal plane. After accurate reduction of the fragment, a cortical screw was inserted in the proximal area until the maximum compressive force against the fragment was obtained. Then, one or two locking screws were added adjacent to the initial cortical screw. No screw was fixed in the distal fragment. All evaluations were done at least 3 years postoperatively with a mean follow-up of 48.8 months. At final follow-up, the radial inclinations, volar tiltings, and ulnar variances were 23.2°±1.78° (98.7% of contralateral side), 9.4°±2.12° (98.4% of contralateral side), and -1.56±0.88 mm (93% of contralateral side), respectively. All radiological parameters of the distal radius were not significantly different from the contralateral values. The flexion-extension arc was 140.56°±5.27°, and the pronation-supination arc was 165.00°±8.29°. The grip strength was 26.67±5.56 kg. All clinical outcomes except the flexion-extension arc were similar to those of the normal side, with statistical significance. A volar Barton type injury can occur in the pediatric age involving the physis, and the buttress plating that is used in adults is also a useful treatment method. However, there is little information on this injury, and it was difficult to compare treatment outcomes with other methods. Because of the rarity of the injury, a larger, multicenter prospective comparative study is required to further explore appropriate treatment options, long-term outcomes, and complications. Level of Evidence: Therapeutic, Level IV.

A rare combination of sagittal plane fracture of talar body with medial malleolus fracture: Case report and review of literature

Fractures of talus are relatively uncommon injuries with majority of them involving the neck region. Talar body fracture in sagittal plane in combination with medial malleolus fracture is very rare with few cases being reported in the literature earlier. We report such an unusual combination in an adolescent, which was treated with open reduction and internal fixation with screws for both talus and medial malleolus. This was followed by physiotherapy and non-weight bearing till the fracture united.

Unusual ankle fracture: A case report and literature review.

Fractures of the talus are uncommon, and talar body fractures in the sagittal plane are still rarer. The aim of its treatment is urgent anatomic reduction to restore congruency of the ankle and to reduce the risk of avascular necrosis by preserving any remaining blood supply. We report the case of a body talar fracture in sagittal plane associated with fracture of the medial malleolus in a young adult; the mechanism of the fracture was plantar hyperflexion, internal rotation and axial compression. We perform an open reduction and stabilization with two screws for the talus and screw the medial malleolus. At 14 months following the injury patient had good range of movement with little pain. The mechanism is discussed along with a literature review.

しょう骨骨折に対する手術的治療

Twenty-four feet in 19 patients with fractures of the calcaneus treated by the modified Westhues' method were reported. Satisfactory results assessed by Furuoka's criteria were obtained in 75% of the cases at follow-up examination.Some cases of fair or poor results showed decreased Bdhler's tuber-joint angle and or comminuted fractures in sagittal plane.