Journal of Musculoskeletal Trauma

Sang Yong Lee

2 Articles

Treatment of Unstable Intertrochanteric fracture of the femur in Elderly Patients: Deuk Soo Hwang, Cheol Se Ahn, Sang Yong Lee; J Korean Soc Fract 1996;9(2):376-383. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.376

Abstract PDF: Intertrochanteric fractrures in elderly are a frequent problem and are becoming more common as the population of elderly people in the population increase. The treatment of unstable intertrochanteric fracture present a challenging problem. Severe comminution in elderly osteoporotic patients renders internal fixation difficult and precipitate varus malpositioning after internal fixation. We analysed 48 unstable intertrochanteric fractures in 48 elderly patient (58 to 91 yeared, mean age : 78 years) with advanced osteoporosis (grade III or more by Singh et al., and by BMD) between May, 1990 to March, 1995 ; Nineteen had been treated with an anatomical reduction with dynamic hip screw(DHS). In addition to DHS fixation, additional circumferential wiring was done in 1 cases, adjunctive methylmethacrylate bone cement fixation in head and neck was done 2 cases. We classified lag screw fixation alone group as DHS , lag screw fixation and additional oircurnferential wire reinforcement group as DHS II. Twenty had been treated with an anatomical reduction with gamma nail. Another nine that had severe comminuted fracture had been treated with bipolar hemiarthroplasty. In DHS II and gamma nailing group, operation time was longer and amount of transfusion after postoperative period was much than DHS I group. In DHS fixation group, lag screw fixation and additional tircurnferential wire reinforcement of posteromedial fracture fragment group was more favor result than lag screw fixation alone. Nonunion developed in two cases of adjunctive methylmethacrylate fixation with DHS, and malunion(external rotation) developed in two cases of DHS fixation group. We concluded that better result are obtained when posteromedial fracture fragment reduced with circumferential wiring with DHS. In addition to anatomical reduction of fragment, encouraging early postoperative ambulation also contribute to good prognosis. A number of the patients who had fear for weight bearing after 3 month postoperatively compromise ambulation on further follow up. In severely commented fracture that was not able to get stable reduction or in patient necessary for early weight bearing, hemiarthroplasty permit to early ambulation, but it also have many disadvantage.

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Importance of maintenance medial buttress in treatment of supra-condylar and inter-condylar(T-condylar) fracture of the femur: Seung Ho Yune, Kwang Jin Rhee, Chan Hee Park, Ki Yong Byun, Sang Yong Lee, Seung Kwon Rho; J Korean Soc Fract 1996;9(1):50-58. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.50

Recently, treatment of supracondylar and intercondylar(T-condylar) fracture of the femur has been changed from conservative treatment to do open reduction and internal fixation. Principles of anatomical reduction, rigid internal fixation and early knee joint exercise are recommended, but there are many difficulties and problems to get anatomial reduction and rigid internal fixation. we observed 3 cases of malunion & nonunion that were treated by ORIF. In these cases, there is a failure in restoring medial buttress of distal femur due to inadequate reduction and internal fixation. Dynamic condylar screw(DCS) or blade plate were usually used through lateral approach and laterally applying method can not always restore the medial buttress of the fracture site. In these cases, early exercise and early weight bearing have to be postponed,and the results were poor. So we want to emphasize the principles in open reduction and internal fixation of the supra-and inter-condylar fracture fo the femur. To get anatomecal reduction is very important, but if is not possible in severely comminuted fractures, we have to try to maintain medial buttress by another methods such as double plating(to add a medial auxiliary buttress plate to lateral internal fixation) or auxiliary external fixations instead of medial anatomical contact.

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Medial Plating of Distal Femoral Fracture with Locking Compression Plate-Proximal Lateral Tibia: Cases' Report
Se-Ang Jang, Young-Soo Byun, In-Ho Han, Dongju Shin
Journal of the Korean Fracture Society.2016; 29(3): 206. CrossRef
The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Kwang-Hee Park, Yoon-Ho Choi
Journal of the Korean Fracture Society.2009; 22(4): 246. CrossRef

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