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The Efficacy of Dynamization of Static Interlocking Intramedullary Nailing as A Trial Leading to Bony Union of Femur Shaft Fracture
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Byung Soon Kim, Duck Yeon Cho, Hyung Ku Yoon, Soo Hong Han, Jin Yong Kim, Yong Wook Kim
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J Korean Soc Fract 2002;15(2):138-145. Published online April 30, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.2.138
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 Abstract
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- PURPOSE
To evaluate the efficacy of dynamization of static interlocking intramedullary nailing as a trial leading to bony union of femur shaft fracture, delayed union of femur shaft fracture underwent dynamization were investigated.
MATERIALS & METHODS: Between april 1995 and December 2000, 162 patients were treated static interlocking intramedullary nailing, 14 patients were selected who had underwent dynamization. The average age was 39 years old (range 24 to 61), they were 11 men and 3 women. The type of fractures were two communited, seven segmental and five simple fractures. Dynamization were done by removal of proximal or distal interlocking screw. We defined complete bony union as radiological and clinical bony union. Also we measured leg length discrepancy and angulation by radiologic parameters.
RESULTS
Of the 14 patients who showed delayed union, 7 patients were noted successful bony union by dynamization, and of the 7 patients who failed union by dynamization, 6 patients were noted bony union by supportive operative treatments(bone graft : 4 patients, nail exchanging : 1 patient, both method 1 patient). One patient was seen nonunion state because of patient's refusal of treatment. 7 patients who were noted successful bony union by dynamization had 2 degrees~6 degrees(average 4.14 degrees) varus-valgus angulation and 4 degrees~9 degrees(average 6 degrees) AP angulation, and 3 of the 7 patients showed leg length discrepancy(LLD) greater than 2 cm. The other 7 patients had 2 degrees~5 degrees(average 3.57 degrees) varus-valgus angulation and 3 degrees~7 degrees(average 5 degrees) AP angulation, and 2 of the 7 patients showed LLD greater than 2cm. Of the 14 patients, 5 patients showed limping.
CONCLUSION
Dynamization of intramedullary nainling is a simple and valuable method for improving bony union of femur shaft fracture in the case of delayed union. But if the delayed unions are seen due to large bone defect, supportive operative treatments (bone graft, nail exchanging etc.) to avoid significant complica-tion(shortening and angulation) is needed.
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Correlation of the Clinical Outcome and Radiographic Measurement of the Calcaneal Fractures
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Dong Eun Shin, Jin Yong Kim, Dong Bae Shin, Yong Jung Kim, Soo Hong Han, Young Je Soung
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J Korean Soc Fract 2001;14(4):698-705. Published online October 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.4.698
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Abstract
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- PURPOSE
To evaluate the prognostic factors associated with the clinical outcome, which analysed with use of the Pearson correlation method in AOFAS score and radiographic measurement between normal and the affected site after operative treatment of the calcaneal fractures.
MATERIALS AND METHODS
We evaluated 13 patients(13 cases) who had unilateral calcaneal fractures. At the latest follow-up, we calculated the mean differences of the Bohler angle, gissane angle, heel height, calcaneal width, calcaneal length, talocalcaneal angle, talar declination angle, subtalar incongruity between normal and affected site on the lateral view of ankle and tangential view of the calcaneus. And then the correlation between radiographic measurement and the clinical outcome analysed by Pearson correlation method.
RESULTS
Heel height(correlation coefficient = 0.827, p-value<005) and subtalar incongruity(correlation coeffidient = -0.764, p-value<0.05) were closely correlated with the clinical outcome and the B hler angle showed lower correlation coefficiency(correlation coefficiency = 0.470, p-value : 0.104) compare to the heel height.
CONCLUSION
We suggested that restoration of the heel height and subtalar incongruity was significantly correlated to the clinical outcome after operative treatment of the calcaneal fractures.
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Citations
Citations to this article as recorded by  - The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures
Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Sueng Hwan Jo
Journal of the Korean Fracture Society.2007; 20(3): 227. CrossRef
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Result of 29 consecutive patients with the distal femiral fracture: Analysis of the result treated with AO DCS(dynamic condylar Screw) Supracondylar nail, May anatomical plate
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Weon Yoo Kim, Jin Hyung Sung, Chong Hoon Park, Jeong Soo Park, Jin Yong Kim
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J Korean Soc Fract 1996;9(1):68-75. Published online January 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.1.68
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Abstract
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- Twenty-nine cases of the surgically treated distal femoral fracture were analyzed to compare internal fixatorw (AO DCS,Supracondylar nail, May anatomical plate),who were treated at Department of orthopaedic surgery, Taejon Saint Marys hospital from Jan. 1992 to Jun. 1994. The cases were classified according to AO classification and minmum 12 months(average:22.4 monthw) follow up.
Following results were obtained: 1.Male was more common than female, age distrbution was between 16 and 77 years old(average 40.4), abd the most common cause of the fracture was traffic accident.
2.The most comon type C by AO classification(type A 11 cases, type B 1 case, type C 17 cases).
3.According to Schatzkers criteria in the clincal result, type A,B were better resykt than type C, and severe soft tissue damage, comminution and joint involvement lead to unsatisfactory results.
4.Supracondylar nail was inadequate implant due to inferior clinical result(1 excellent, 2 good and 3 poor).
5.DCS had more sateafactory result than other internal fixators(supracondylar nail, May anatomical plate).
Based on the observations, the better results depend on the amount of initial trauma, early anatomical reduction, rigid internal fixation and exercise of the knee joint.
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