PURPOSE To evaluate the usefulness of proximal femoral nail in the treatment of intertrochanteric fracture. MATERIALS AND METHODS The authors investigated the classificaton of fracture, operation time, the amount of intraoperative and postoperative bleeding, the amount of transfusion, postoperative ambulation status, bone union time and the complication among 45 cases who were treated with proximal femoral nail from Jan. 2001 to June 2002. RESULTS The mean operation time was 116 minutes, and the amount of bleeding was 524 ml in average. The amount of intraoperative transfusion was 1.4 pints and that of postoperative transfusion was 1.1 pints. The complications were the intraoperative penetration of antirotational screw through the femoral neck in 2 cases, separation of the fracture fragment while inserting the nail in 4 cases, irritation of skin by retropulsion of antirotation screw in 2 cases, and penetration of antirotation screw through femoral head in 1 case. CONCLUSION Proximal femoral nail was effective for the treatment of intertrochanteric fracture, however the surgeon should be carful about collision of the insertion handle against pelvis when the fracture line coincides with the insertion point of nail, especially in obese patients.
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Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture - Chae-Hyun Lim, Young-Yool Chung, Jeong-Seok Kim, Chung-Young Kim Hip & Pelvis.2013; 25(1): 44. CrossRef
Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails Il Ho Park, Jong Kyoung Won, Kye Young Han Hip & Pelvis.2012; 24(2): 117. CrossRef
Results of the Proximal Femoral Nail-Antirotation (PFNA) in Patients with an Unstable Pertrochanteric Fracture Yerl-Bo Sung, Sung-Il Jo The Journal of the Korean Hip Society.2011; 23(1): 39. CrossRef
Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture Jong Min Lim, Jeung Il Kim, Jong Seok Oh, Kuen Tak Suh, Jae Min Ahn, Dong Joon Kang Journal of the Korean Fracture Society.2010; 23(4): 360. CrossRef
Treatment of Intertrochanteric Fracture: Comparison of Proximal Femoral Nail and Proximal Femoral Nail A Jung Ho Park, Jong Woong Park, Joon Ho Wang, Jae Wook Lee, Jung Il Lee, Jae Gyoon Kim Journal of the Korean Fracture Society.2008; 21(2): 103. CrossRef
Treatment of Intertrochanteric Fracture with Proximal Femoral Nail Dae Joong Kim, Sung Chan Ki, Young Yool Chung Journal of the Korean Fracture Society.2007; 20(1): 40. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN) Kee-Byoung Lee, Byung-Taek Lee Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef
PURPOSE We report our experience of treatment of peritrochanteric fractures with newly designed proximal femoral nail. MATERIALS AND METHODS We have studied 24 cases of the peritrochanteric fractures using PFN between Jun. 2001 and Aug. 2002 excluding 3 cases (1 case expired due to ARF and pulmonary complication, 2 cases were loss of follow-up). The mean age was 69.6 years and the mean duration of follow-up was 12 months. RESULTS The mean medial cortical displacement of postoperative roentgenogram was 4.6mm, the mean anterior cortical displacement of postoperative roentgenogram was 4.1 mm, the mean degree of sliding of lag screw between postoperative and last follow-up roentgenogram was 1.2 mm. Neck-shaft angle was average 3.3degrees varus angulation (from postoperative average 131.1degrees to last follow-up average 127.8degrees). Allowed to begin weight-bearing at 1 week postoperatively, the mean union time was 10 weeks and all cases showed bony union and there were no evidence of delayed union or nonunion. Perioperatve complications were pulmonary embolism, DVT, varus deformity, 2 thigh pains, and so on. CONCLUSION We obtained satisfactory results in treatment of the femoral trochanteric fractures using PFN in point of early ambulation, excellent union rate and minimal complication.
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Results of the Proximal Femoral Nail-Antirotation (PFNA) in Patients with an Unstable Pertrochanteric Fracture Yerl-Bo Sung, Sung-Il Jo The Journal of the Korean Hip Society.2011; 23(1): 39. CrossRef
Proximal Femoral Nail Antirotation and Proximal Femoral Nail in Intertrochanteric Fractures Sung Soo Kim, Chul Hong Kim, Jin Hun Kang, Dong Hoon Han, Yong Seung O Journal of the Korean Orthopaedic Association.2011; 46(5): 392. CrossRef
The Comparison between ITSTâ„¢ (Intertrochanteric/Subtrochanteric) & DHS (Dynamic Hip Screw) in Unstable Femur Intertrochanteric Fracture Ho-Seung Jeon, Byung-Mun Park, Kyung-Sub Song, Hyung-Gyu Kim, Jong-Ju Yun Journal of the Korean Fracture Society.2009; 22(3): 131. CrossRef
Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA) Myung-Sik Park, Young-Jin Lim, Young-Sin Kim, Kyu-Hyung Kim, Hong-Man Cho Journal of the Korean Fracture Society.2009; 22(2): 91. CrossRef
Operative Treatment with ITST in Femur Trochanteric Fracture Ki-Do Hong, Jae-Chun Sim, Sung-Sik Ha, Jae-Young Kim, Jung-Ho Kang, Kwang-Hee Park Journal of the Korean Fracture Society.2008; 21(4): 274. CrossRef
Treatment of Intertrochanteric Fracture: Comparison of Proximal Femoral Nail and Proximal Femoral Nail A Jung Ho Park, Jong Woong Park, Joon Ho Wang, Jae Wook Lee, Jung Il Lee, Jae Gyoon Kim Journal of the Korean Fracture Society.2008; 21(2): 103. CrossRef
Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision Se Dong Kim, Oog Jin Sohn, Jae Ho Cho Journal of the Korean Fracture Society.2008; 21(1): 1. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN) Kee-Byoung Lee, Byung-Taek Lee Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef
PURPOSE To assess the evaluation of prognostic factors according to union time after unreamed femoral nailing. MATERIALS AND METHODS From Mar. 1998 to Mar. 2002, 53 cases of bone healing were analyzed among the fifty-nine femoral shaft fractures were treated with unreamed femoral nail (AO, UFN) and had been followed for more than 12 months. Clinical bone healing time was analyzed by Kempf's method and were evaluated prognostic factors according to union time. RESULTS Mean duration of the bone healing time was 18.7 weeks. According to Denker's classification, functional results were seen over satisfactory at all cases. Bone healing time was more faster at the low communition group than high communition group at 18.1 weeks. At the middle portion, bone healing time was fastest. Closed reduction cases were more faster than open reduction cases at 17.9 weeks. Bone healing time was faster that fracture was more close distance from isthmic portion. Bone healing time was not influenced age, isthmic ratio, operation time, associated injury. CONCLUSION All cases were unioned within 5 months without severe complication. That was seen faster bone healing time, in that low communition, more close distance of fracture from the isthmic portion, closed reduction method.
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Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef
PURPOSE To present a clinical experience of the insufficiency fractures of the femoral shaft associated with osteoporosis MATERIALS AND METHODS: From January 1995 to December 2002, four patients (8 cases, four females) more than 1-year follow up were reviewed retrospectively. The mean age was 61 years (range, 55 to 73). Medical records and roentgenograms were reviewed. RESULTS The fractures were bilateral. Plain film revealed fracture line in six among seven cases excluding 1 displaced fracture at initial presentation. All cases presented osteoporosis, anterolateral bowing of the femur, and hot spot in bone scan. Five cases (four displaced, one impending displaced fracture) underwent interlocking intramedullary nailing and all five of them manifested no evidence of delayed union. The preoperative thigh and knee joint pain improved postoperatively. CONCLUSION Femoral shaft insufficiency fracture could occur rarely in patients with anterolateral bowing of the femur and postmenopausal osteoporosis. Careful history taking, radiography and bone scan are necessary, and bone scan is helpful for early diagnosis. Once diagnosed as the insufficiency fracture with fracture-related symptoms, prophylactic nailing may be necessary lest complete displaced fracture should occur.
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PURPOSE To emphasis an effectiveness of the Ilizarov circular external fixator in treatment of the complicated segmental fractures of the tibia MATERIALS AND METHODS: We had analyzed 15 cases in 14 persons, treated from November 1993 to March 2000. We analyzed several considering factors including age, etiology, type of fracture, number of the segmentation, associated injuries, open or closed fracture, healing time, additional bone graft, clinical results and complications. RESULTS The mean period of follow up was 22 months. The mean age was 45 years. The etiology was traffic accident in 13 persons. Open fracture were 11 cases (73%). Associated injuries were noted in 8 persons (53%). The number of segmentation were three segments in 9 cases (60%) and four segments in 6 cases (40%). Additional manipulations after first application were needed in 10 cases (67%). Bone graft were performed in 5 fracture site (9.8%), proximal fracture site in two and distal in two, middle in one. Mean period of application of external fixator for healing was 8.1 Months. Procedures for soft tissue injuries performed in 3 cases including two split thickness skin graft and distant flap surgery. The results were graded as excellent in 5 cases, good in 2 cases, fair in 1 cases, poor in 7 cases. Limitation of motion in ankle joint was major cause of poor results CONCLUSION: We considered that ilizarov circular external fixator is one of effective treatment modality in treatment of the complicated segmental tibia fractures.
PURPOSE The purpose of this study was to evaluate the factors influencing the results for the treatment of the Schatzker type VI tibial plateau fractures. MATERIALS AND METHODS Twenty-two cases of the 21 patients in Schatzker type VI tibial plateau fractures were analyzed. Treatment results were analyzed according to the type of fracture (open vs closed), method of operative treatment, angulation more than 5 degree and status of infection. The functional results was evaluated by Hohl's functional criteria. Student t-test was used for the statistical analysis. RESULTS Functional outcome demonstrated 5 excellent, 8 good, 6 fair and 3 poor results. There was no significant difference in the treatment results between type of fracture, method of operative treatment and status of infection. Among 9 cases with angular deformity of more than 5 degree, 2 showed excellent or good result and 7 showed fair or poor result (p<0.05). There was no significant difference between rate of postoperative infection and the mean period of the clinical bone union (p=0.66). CONCLUSION Accurate anatomical reduction and rigid fixation is essential for the treatment of Schatzker type VI tibial plateau fractures for the prevention of the angular deformity. And early weight bearing exercise should be controlled for the prevention of loss of reduction and loss of alignment leading to angular deformity.
PURPOSE Conservative treatment of displaced ipsilateral compound fractures of clavicle and scapula neck or gleonoid cavity, causing a floating shoulder, cannot expect satisfactory results in all of them. We reviewed 9 operative cases of floating shoulders and analyzed the results with review of literature. MATERIALS AND METHODS Nine patients with floating shoulders were operated from July 1996 to August 2000 were reviewed. Patient's age was in average 38.3 years old. Associated injuries were 4 cases of rib fractures and 1 case of humerus shaft fracture. Other injuries included 3 hemothorax, 2 pneumothorax, 1 brachial plexus injury, and 1 ulnar nerve injury. Operation for both clavicle and scapula fracture was done in 6 cases, and surgery was done for only clavicle in 3 cases. Internal fixation for clavicle was done with 3.5 mm AO reconstruction plate in 4 cases and Dynamic Compression Plate in 5 cases. RESULTS Clinical results by Hardegger method showed 7 cases of excellent, 1 case of good, and 1 case of poor. Complications include 2 cases of limitation of motion of shoulder joint and one case of residual pain. CONCLUSION Floating Shoulder is caused by high-energy trauma, therefore initial assessment of associated injuries should be done carefully. In evaluating the articular surface of the glenoid and positions of the fracture fragment, CT evaluation is very useful in planning the surgical treatment. Clinical results after surgery can give satisfactory results.
PURPOSE This is a retrospective study to analyze the functional results of closed reduction and external fixation of unstable fractures of the proximal humerus. MATERIALS AND METHODS Ten unstable proximal humerus fractures were managed with closed reduction and external fixation in which other operative methods are not proper due to comminution, osteoporosis or poor general condition of patients. 4 cases of 2-part and 6 cases of 3-part fracture were included. Radiologically union of fracture, malunion and the evdence of avascular necrosis of humeral head were assessed and the functional results were analyzed with Neer scoring system. RESULTS Radiologically all fractures were healed but in 2 cases malunion was resulted because of reduction loss in proximal fragment. Pin site infection was developed in 7 cases and oral antibiotics were needed. The functional results were excellent in 4, satisfactory in 3 and unsatisfactory in 3 cases. 2 cases with malunion and one case with lack of postoperative cooperation resulted in functionally unsatisfactory. CONCLUSION External fixation is an alternative method in the treatment of unstable proximal humerus fractures in which open reduction or percutaneous pinning are not proper due to comminution, osteoporosis or poor general condition of patient.
PURPOSE To evaluate results regarding pain relief, spinal stabilization, and complication after treatment with percutaneous vertebroplasty. MATERIALS AND METHODS 108 patients (12 men, 96 women; aged 42~84 years) underwent 156 percutaneous injections of surgical cement into a vertebra (vertebroplasty) with fluoroscopic guidance in 119 procedures. All patients had severe pain,osteoporotic fractures and had failed medical therapy. Immediate and long-term pain response, spinal stability, and complications were evaluated. Assessment criteria were the changes over time (Days 3, 30, 90, 180) in visual analogue scale (VAS: 0~100 mm) and McGill-Melzack scoring system. The height of vertebral body was checked at three portions (anterior, middle, posterior) with lateral view of plain radiographs. RESULTS A statistically significant decrease of both VAS and McGill-Melzack scoring system was observed at Day 3. The results were also significant at Days 30, 90, and 180 both scales. We observed no adverse event, but 26 vertebral fractures had occured in the adjacent level during 12 months of follow-up. The leakage of cement was observed in 57 vertebral bodies (36.5%). But there was no neurological symptoms associated with cement leakage. The vertebral body height was increased after vertebroplasty. CONCLUSION Vertebroplasty is safe and effective, and have a useful role in the treatment of painful osteoporotic vertebral compression fractures that do not respond to conventional treatments. Continuous management of osteoporosis and patient education is mandantory to prevent subsequent fracture of the adjacent vertebral bodies.
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Comparison of Outcomes of Conservative Treatment, Early Vertebroplasty, and Delayed Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures Se-Hyuk Im, Young-Joon Ahn, Bo-Kyu Yang, Seung-Rim Yi, Ye-Hyun Lee, Ji-Eun Kwon, Jong-Min Kim Journal of Korean Society of Spine Surgery.2016; 23(3): 139. CrossRef
The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture Young-Do Koh, Jong-Seok Yoon, Sung-Il Kim Journal of the Korean Fracture Society.2008; 21(1): 57. CrossRef
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PURPOSE The purpose of this study is to identify the incidence of clavicle fracture in birth trauma associated with delivery, fetal presentation, birth weight and to identify the difference of the prognosis of clavicle fracture when immobilization was performed or not. MATERIALS AND METHODS Among the 12,738 live births from March 1996 to December 2000, we reveiwed retrospectively the medical records and radiographs of 39 cases of clavicle fracture which were followed for more than 6 months. Statistical analysis was measured P-value. Except 11 cases that diagnosis was delayed, 27 cases were treated with figure of 8-bandage, and 1 case, which was combined with humerus fracture, was treated with long arm cast. RESULTS Among 39 cases infants of clavicle fracture, 36 cases (0.57%) were delivered through vaginal delivery, 3 cases (0.04%) through ceasarean section. Fetal presentations were cephalic presentation in 29 cases, shoulder dystocia in 8 cases, breech presentation in 2 cases. The mean birth weight was 3.8 kg, the high prevalence (8.5%) was identified on large birth weight infants more than 4 kg (p<0.05). The fracture site was proximal portion in 12 cases, middle portion in 27 cases and right clavicle in 24 cases, left clavicle in 13 cases and both clavicle in 1 case. The combined injuries were the brachial plexus palsy (2 cases), skull fracture (1 case) and cephalhematoma (1 case). Finally all cases of clavicle fracture were shown radiographically bony union within 3 weeks. CONCLUSION The newborn clavicle fractures were remarkably low incidence in cesarean section delivery and were easily neglected, and were detected accidentally on simple chest X-ray that was performed for upper respiratory infection. As a conclusion, it is necessary of screening test through careful physical examination and X-ray interpretation.
PURPOSE Although the majority of children's forearm diaphyseal fractures may be treated conservatively with closed reduction and cast immobilization, unstable or irreducible fractures are usually treated by surgical management. Authors performed percutaneous pin leverage reduction technique for irreducible displaced diaphyseal fractures. The aim of this study is to determine the efficacy of pin leverage technique in pediatric forearm diaphyseal fractures MATERIALS AND METHODS: In this retrospective study, we reviewed 22 cases of forearm diaphyseal fractures reduced by percutaneous pin leverage technique between 1997 and 2002. We analyzed radiographs, operation time, hospital stay and immobilization period, range of motion, postoperative complications and functional results by Thomas. RESULTS Average length of follow up was 28 months with mean age of 10.5 years. All fractures in this series healed less than 2 degrees of diaphyseal angulation. Average operation time including anesthesia was 42 minutes and hospital stay was 4.6 days. Time to union was 49.6 days in average and range of motion and functional results were satisfactory in all cases except one case of congenital radioulnar synostosis. There was one case of superficial pin track infection as complication. CONCLUSION In operative treatment of children's diaphyseal fractures of forearm bones, percutaneous pin leverage reduction technique is a good alternative method prior to open reduction in case of difficult closed reduction.
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