Journal of Musculoskeletal Trauma

Flexible Intramedullary Nail Fixation of Pediatric Femoral Shaft Fracture: Suk Kyu Choo, Byung Jik Kim, Hyun Wook Chung; J Korean Fract Soc 2005;18(1):60-64. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.60

Abstract PDF: PURPOSE
To traditional treatment of pediatric femoral shaft fracture has been a traction and spica cast application. But flexible intramedullary nail fixation has been introduced as an alternative to other treatment modalities. With this in mind, we analyzed the clinical and radiologic results of flexible intramedullary nail fixation of pediatric femoral shaft fractures.
MATERIALS AND METHODS
We analyzed 12 patients (13 cases) who were treated with flexible intramedullary nail and followed up for at least 6 months at the department of Orthopedic Surgery, Inje University Ilsan Paik Hospital since May, 2002.
RESULTS
In all 12 patients (13 cases) involving 1 case with reoperation because of reduction failure, average duration of bone union was 12.6 weeks. There were no considerable complications except mild post-op knee pain and limitation of motion.
CONCLUSION
In spite of relatively short term study, a flexible intramedullary nail fixation seems to be a useful method without serious complications on pediatric femoral shaft fracture. However, in big or older pediatric patients, interlocking intramedullary nail fixation may be a better choice rather than a flexible nail fixation because of it's insufficient stability.

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Operative Treatment of the Clavicular Fracture with Cannulated Screw: Byung Jik Kim, Suk Kyu Choo, Jin Hwan Kim, Sang Min Lee, Dong Soo Kim; J Korean Soc Fract 2003;16(4):555-562. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.555

Abstract PDF: PURPOSE
To investigate the utility of cannulated screw in operative treatment of the clavicular fracture.
MATERIALS AND METHODS
From December 1999 to December 2002, 23 patients with clavicular fracture were underwent operative treatment with cannulated screw. Their mean age was 40.1 years and the sites of fracture were 16 cases in middle 1/3, 7 cases in lateral 1/3, 12 cases were comminnuted fracture. The clinical and radiological results were evaluated.
RESULTS
According to the Kang's criteria, the clinical results were excellent in 18 cases (78.3%), good in 4 cases (17.4%) and fair in 1 case. Radiologically, all cases showed bone union and the average time was 7.9 weeks. Complications such as infection, nonunion, metal failure has not been observed.
CONCLUSION
Open reduction and internal fixation with cannulated screw could be considered as an alternative method of treatment in clavicular fracture, when indications for primary surgical treatment are presents.

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External Fixation of Displaced Proximal Humeral Fracture: Suk Kyu Choo, Byung Jik Kim, Jin Hwan Kim, Seung Yeub Suk, In Hwan Hwang; J Korean Soc Fract 2002;15(3):379-384. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.379

Abstract PDF: PURPOSE
Proximal humerus fractures are relatively frequent and have variable treatment mothods. It is important to resolve union of the fracture site, good range of motion and function through the early ambulation in treatment results. We will know whether it is recommendable treatment or not and analyze the results of treatment on the effectiveness of the external fixator in two or three part fractures of the proximal humerus fractures.
MATERIALS AND METHODS
From May, 1999 to April, 2001, 8 cases in 8 patients were treated by external fixator on the proximal humerus fractures. Mean age was 44.7yrs(11 to 68 yrs), two part fracture 6 cases, three part fracture 2 cases in fracture classification by Neer. We treated 3 cases with ring external fixator, 4 cases with monoplane external fixator. We referred chart and radiographics to patients and assessed the results by Neer 's shoulder function table through final follow-up or phone call.
RESULTS
In all cases, we obtained bone union without neuroparalysis, neurovascular injury, avascular necrosis and other complications. Mean bone-union time was 7 weeks(5 to 12 weeks). Final functional assessments are excellent or good in 7 cases, poor in 1 case.
CONCLUSION
We obtained comfortable results after we performed external fixation on proximal humerus fracture and bone union was acquired and removed external fixator at 7 weeks through early ambulation. We think procedure has brief, low soft tissue damage, high stability and motily. Thus we think it is recommendable treatment on the displaced proximal humerus fractures.

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Treatment of rotational malalignment after interlocking intramedullary nailing of femur : Report of a case: Suk Kyu Choo, Byung Jik Kim, Byung Hee Min; J Korean Soc Fract 1999;12(4):833-836. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.833

Abstract PDF: Rotational malalignment after IM nail of femur is a common problem and if the deformity is great, may cause pain, limitation of motion, even require corrective osteotolny later. The rotational malalignment of femur is not easy to find out during operation because prominant landmarks is lack. We experienced 25 years old male patient with 45 of internal malalignment of femur after IM nail at other hospital. The patient was treated by corrective osteotomy at the fracture site and exchange nailing, but we confronted the obstacle that was remained rotatonal unstability after slotted nailing, and we have to use additional plate fixation. This problem can be prevented by using rigid unslotted nail.

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Use of Interlocking Intramedullary Nail in Treatment of Delayed Union or Nonunion of the Long Bone Fractures: Suk Kyu Choo, Byung Jik Kim, Han Suk Ko, Jeong Gook Seo, Jin Gu Kim, Jun Woo Chang; J Korean Soc Fract 1998;11(4):761-768. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.761

Abstract PDF

Of the several nonoperative and operative options described for the treatment of delayed union and nonunion of the long bone, interlocking nailing with reaming offect of internal splint, autogenous bone graft and early return to a normal way of life. The purpose of this study is to evaluate the usefulness and complication of intramedullary(IM) naling with reaming by retrospective method. We treated 34 patients with delayed union or nonunion of the tibia, femur, and humerus by interlocking nailing with reaming between January 1992 and December 1996. The results were as follows ; 1. Of the 34 cases, there were 13 tibia fracture, 17 femur fracture, 4 humerus fracture. Half of them were ununited and another half were delayed in fracture healing. 2. Previous methods of treatment were conservative treatment in 2 cases, external fixator in 2, plate & screws fixation in 8, Ender nail in 2, Kuntscher nail in 2 and interlocking nail in 7 among 24 cases of cloed fracture and external fixator in 8 and interlocking nail in 2 among 10 cases of open fracture. 3. Twenty-five patients were treated with closed nailing and 9 were treated with open nailing. Iliac bone graft was performed at 3 cases and fibulotomy was performed at 1 case. 4. Union was obtained in 33 cases and 1 case needed additional bone grafting to achieve union. 5. Postoperative complications were one nonunion, two evtry site pain, one screw breakage, one heterotopic ossification, and one postoperative infection. Interlocking nailing with reaming was associated with a high union rate(97%) in our eries. The authors believe that IM nailing with reaming is a useful option for treatment of delayed or nonunion of the long bone fracture.

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Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing
Sung-Soo Kim, Sung-Keun Sohn, Chul-Hong Kim, Myung-Jin Lee, Lih Wang
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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Internal Bone Transport for Treatment of Infected Non-union of Long Bone: Han Suk Ko, Byung Jik Kim, Young Lim, Jeong Gook Seo, Jin Ku Kim, Dong Hun Lee; J Korean Soc Fract 1998;11(3):623-628. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.623

Abstract PDF: Infected nonunion of long bone frequently accompanies with bone loss, because of the outcome of initial trauma or iatrogenic result from sequestra resection. In this study, infected and ununited long bone fracture was treated with internal bone transport technique which was first discribed by G.A. Ilizarov. There were eleven tibial and two femural nonunion. The mean number of admission was 2.8 times; mean number of operation was 8 times; mean duration of average healing index was 1.95 month/cm. All infections were cured and all nonunions were united. Functional result was excellent in 5 cases (of 13 cases), good in 5, fair in 2, and 1 had poor result. Many complication had been observed. All had infection of pin site and pain at least one time, 5 had stiff knee, 9 had stiff ankle, early consolidation(1), delay consolidation(3), tibiofibular synostosis(5), nerve injury(1), refracture after union(1), angular deformity over 5 degree(7), rotational deformity over 10 degree(2).

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Surgical Treatment of Comminuted Distal Radius Fracture using External Fixators: Suk Kyu Choo, Byung Jik Kim, Han Suk Ko, Young Lim, Jeong Gook Seo, Jae Kie Shin; J Korean Soc Fract 1996;9(2):303-310. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.303

Abstract PDF: Comminuted fractures of distal radius are usually unstable and complex injuries, which require prolonged treatment and often result in some degree of permanent disability. Previous treatment was mainly closed reuction and cast immobilization, and operative treatment of accurate open reduction, internal fixation and bone graft when needed. But recently ligamentotaxis of the fracture using external fixation device has been widely employed. Which could be followed up for 12 cases of comminuted fractured of distal radius operated with external fixators, more than 1 year, during the period of September 1990 to September 1994 at Seoul Paik Hospital was reviewed. According to Frykmalls classification, the most common type was type VIII (7 cases, 58.3%). There was 1 open fracture, and 7 combined injuries of ipsilateral upper extremity. According to AO classification, 9 cases(75%) were type C2 and C3. The most common cause was failing down from a height(6 cases). Additional limited internal fixation was done in 5 cases, all 12 cases were treated external fixators. Results were defined with modified Gartland & Werleys demerit pointing system, exellent was 6 cases(50fr), good wa,i 4 cases(33.3F)), poor was 2 cases. Surgical treatment using external fixators and/or limited open reduction was good Inethod for comminuted distal radius.

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Treatment of humeral shaft fracture by interlocking IM nail: Byung Jik Kim, Jung Gook Seo, Suk Kyu Choo, Yoon Seong Yoon; J Korean Soc Fract 1994;7(2):642-647. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.642

Abstract PDF: The ideal treatment for humeral shaft fractures has been a topic of discussion for long times. Conventionally conservative methods like hanging arm cast, coaptation splint and functional brace were used. The operative treatment included plate and screws, intramedullary rods were used. The many known advantage of interlocking nails used in femur and tibia fractures were recently applied to humeral shaft fracture. Among them Seidel nail developed by Dr. Seidel in 1989 was inserted by splitting the rotator cuff and distal locking by expanding the distal tip of the nail through a long screw driver. This study is a preliminary report of first 10 cases of humeral shaft fracture which was internally fixed with Seidel nail during the period of September 1992 to September 1993. The findings are as follows. 1. 9 out of 10 cases(90%) achieved union. 2. Average union time was 10 weeks. 3, According to Neers shoulder functional score, 8 patients(80%) achieved either satisfactory or excellent shoulder function postoperatively. 4. 2 complications occurred. One nonunion and one distal fixation failure. Since fixation of humeral shaft fracture, by Seidel nail can achieve high union rate and good shoulder function, it should be considered as one of many methods to treat humeral shaft fracture.

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Early experience with Dall-Miles cable grip system at femur fracture after hip arthroplasty: 3 case report: Jin Hwan Kim, Suk Kyu Joo, Byung Jik Kim; J Korean Soc Fract 1994;7(2):465-470. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.465

Abstract PDF: The femur fracture after hip arthroplasty is rare, but serious complication. So, its treatment is difficult and controversial. Nonunion and loosening of hip arthroplasty are common at this problem and badly affected to hip joint function. We have experienced 3 cases with Dall-Miles cable grip system at femur fracture after hip arthroplasty. Dall-Miles cable grip system provides rigid fixation including greater trochanter. The results was good at early experience and necessary to long term follow up.

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Comparison between Intramedullary and Plate Fixation for Subtrochanteric Fracture of the Femur: Han Suk Ko, Byung Jik Kim, Suk Kyu Choo, Jae Sung Choi; J Korean Soc Fract 1994;7(2):352-363. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.352

Abstract PDF: Management of subtrochanteric fractures of the femur is difficult because it occurs in bone that is predominantly cortical and high stress concentrates in this region. The subtrochanteric fracture is difficult for the accurate reduction and maintenance because many of these fractures are cmminuted from high velocity trauma and its proximal fragment is severely displaced by adjacent strong muscles pooling. Therefore, as a rule we prefer to treat subtrochanteric fractures by operative means if possible. Many internal fixation devices have been recomended for use in subtrochanteric fractures and their selection should be based on the individual fracture anatomy. In recent years, generally accepted two methods are intramedullary nailing and plate fixation. We have reviewed our experience using the intramedullary fixation on 14 cases of subtrochanteric femur fracture and compared the result with those of 14 cases of plate fixation. All the 28 cases were treated at the Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University in the period from March 1988 to March 1993. Intramedullary fixation were implanted with shorter operating time, smaller incisions, and less intraoperative bleeding. The intramedullary fixation group had a shorter covalescence and earlier full weight-bearing but no significant difference in fracture union rate with plate fixation group. We conclude that with careful surgical technique, the intramedullary fixation was a more suitable method for the treatment of the subtrochanteric femoral fractures.

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The use of partridge cerclene system for the treatment of femurshaft fracture during and after the replacement arthroplasty of the hip 6 cases report: Hyung Soo Kim, Jeong Gook Seo, Jin Hyok Kim, Byung Jik Kim; J Korean Soc Fract 1991;4(2):312-319. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.312

Abstract PDF: No abstract available.

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