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Treatment with an Interlocking Nail for Ipsilateral Fracture of the Femur and Tibia
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Sang Soo Kim, Churl Hong Chun, Dong Churl Kim, Sang Hoon Cha
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J Korean Soc Fract 1996;9(3):541-546. Published online July 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.3.541
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 Abstract
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- Concomitant ipsilateral femoral and tibial fractures present a challenging therapeutic problem. They are generally caused by high-energy trauma, primarily motor-vehicle accidents, and the associated injuries frequently develop. Also the complications much as delayed union, non-union, malunion and stiffness of the knee are more prevalent in patients with this combination of fractures than in patients with an isolated femoral or tibial fractures.
The interlocking nail system has many advantages about among the many treatment methods of isolated long bone fractures, but the surgical technique is very difficult at the concomitant ipsilateral femoral and tibial fractures. The purpose of this study has been to review the surgical technique and to grasp an easy reduction method at that fractures.
We routinely perform the interlocking nail for the ipsilateral femoral and tibial fractures in order to promote early motion of the knee in 14 patients from 1989 to 1995.
Local complications included 1 case of femoral metal failure, and 2 cases of nonunion treated by bone graft. At the last follow up examination, at an average of 13 months after injury, the mean range of motion of the knee was 130 degrees. Over-all, a good or excellent functional result was achieved in about 93% of the patients according to the criteria suggested by Karlstr m and Olerud.
In conclusion, the best results were achieved when both fractures were stabilized surgically with the interlocking nail system.
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The IliBarov Technique in the Treatment of Nonunions of Long Bone
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Hong Jun Han, Dae Moo Shim, Sang Hoon Cha
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J Korean Soc Fract 1995;8(1):254-261. Published online January 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.1.254
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Abstract
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- Orthopaedic surgeons have employed many different techniques for the management of nonunion of long bone. But, nonunion of long bone continued to challenge ouhopaedic surgeons.
We used llizarov apparatus for the chronic infected nonunions or nonunions with large bone defect to achieve union, to correct deformity, to eradicate infection and to eliminate bone defect. Twenty-eight patients were treated for nonunions of long bone with llizarov apparatus by the same surgeon between 1990 March and 1992 August.
Followings are the summary of the results.
1. 21 patients achieved solid bony union. The average duration of application of apparatus was 10.12 months.
2. 8 patients with less than 2cm shortening were treated by monofocal compression osteosynthesis, with an average healing time of 6.3 months. None of these 8 cases had infection.
3. 14 patients with infection and less than 2cm bone defect were also treated by monofocal compression osteosynthesis, with an average healing time of 8.7 months.
4. 6 patients with more than 2cm shortening or bone defect were treated by bone lengthening or bone transport. The average length gain was 5.6cm.
5. We have not any significant complications with llizarov method. The most common complication was a superficial pin tract infection in 12 patients(43%).
6. If the bony defect was not large, it was thought to be better to change B, or B, type nonunion to B, type to improve bony contact and healing.
We find ourselves capable of solving increasingly more difficult problems with a level of sucess rarely, if ever, achieved with other conventional method.
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