PURPOSE To evaluate the usefulness of the retrograde intramedullary nailing for the treatment of segmental femoral shaft fracture including distal part. MATERIALS AND METHODS We reviewed 15 patients of segmental femoral fracture, who had treated with retrograde intramedullary nailing and followed-up more than 1 year from January 2003 to October 2007. There were 10 men, 5 women, and the mean age was 45 years old. There were associated fracture in 10 cases. We evaluate the time for union, non-union and malunion by radiologic finding and functional assessment by Sanders' criteria. RESULTS The mean time of union was 21 weeks. There was one delayed union in proximal fracture site. There was no shortening more than 1.5 cm, no angular deformity more than 10 degrees, no postoperative infection or instability. According to Sanders' criteria, there were excellent clinical results in 9 cases, good results in 5 cases and fair result in 1 case. CONCLUSION The retrograde intramedullary nailing can be a useful method for treatment of segmental femoral shaft fracture including distal part.
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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 evaluate the effectiveness of a mini T-plate fixation in clavicle lateral end fractures. MATERIALS AND METHODS We reviewed eleven cases of calvicle lateral end fracture which were treated with open reduction and internal fixion with mini T-plate from May 2000 to December 2004. The follow up period was 12 months minimum. The radiologic result, pain and shoulder function were evaluated by the ASES shoulder score. RESULTS All cases showed satisfactory results. Seven cases (63%) were excellent, and four (37%) cases were good. There were no fair or poor results. All cases showed radiologic union by the fifteenth week. No complications such as metal breakage, limited motion, infections were seen. CONCLUSION This study demonstrates that using a mini T-plate fixation which is easy and induces no injury of acromiocalvicular joint, contributes to provide stable fixation in clavicle lateral end fractures.
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Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome Seong Cheol Moon, Chul Hee Lee, Jong Hoon Baek, Nam Su Cho, Yong Girl Rhee Journal of the Korean Fracture Society.2014; 27(2): 127. CrossRef
The Surgical Outcomes of Clavicle Lateral End Fractures Fixed with the Oblique T Locking Compession Plate Seung-Oh Nam, Young-Soo Byun, Dong-Ju Shin, Jung-Hoon Shin, Chung-Yeol Lee, Tae-Gyun Kim Journal of the Korean Fracture Society.2011; 24(1): 41. CrossRef
Comparison of Results of Tension Band Wire and Hook Plate in the Treatment of Unstable Fractures of the Distal Clavicle Chul-Hyun Park, Oog-Jin Shon, Jae-Sung Seo Journal of the Korean Fracture Society.2011; 24(1): 55. CrossRef
PURPOSE To evaluate the usefulness of early range of motion exercise by using 90degrees knee flexion splint after open reduction and internal fixation in fracture of distal femur. MATERIALS AND METHODS We reviewed twenty-six cases of distal femur fractures which were treated with open reduction and internal fixation from February 2002 to November 2003. One group (group A) were treated by using 30degrees knee flexion splint, the other group (group B) were treated by using 90degrees flexion and full extension splint alternativley by post-operative 1 week. The follow up period was minimally 12 months. The range of motion and Schatzker and Lambert criteria were evaluated. RESULTS The mean period to gain 90degrees knee flexion was 11.4 (7~14) weeks in group A, and 6.6 (3~8) weeks in group B. Mean range of motion was 94.7degrees (average flexion contracture 9.5degrees ) in A group and 108.7degrees (average flexion contracture 6.3degrees ) in B group at 12 weeks follow-up. According to Schatzker and Lambert criteria, excellent result was achieved in 10 cases (38%), good result in 13 cases (50%), fair result in 3 cases (12%). CONCLUSION This study demonstrates that alternative splinting at extension and 90degrees flexion contribute to early recovery of range of motion in distal femur fractures treated with internal fixation.
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Treatment of Femur Supracondylar Fracture with Locking Compression Plate Seong Ho Bae, Seung Han Cha, Jeung Tak Suh Journal of the Korean Fracture Society.2010; 23(3): 282. CrossRef
PURPOSE To evaluate indications and effectiveness of intramedullary K-wire fixation for distal radial fractures. MATERIALS AND METHODS Twenty one fractures of distal radius treated with intramedullary K-wire fixation from April 2001 to September 2002 were evaluated. The mean age was 67.8(range 46~82). Severely comminuted intra-articular fractures and Barton's fractures were excluded. One or two K-wires were added percutaneously. To assess the functional result, we used Green and O'Brien score system. The radiographic assessment included a scoring system based on measurements of radial length, radial inclination, volar tilt and step-off of the radial articular surface. RESULTS Average follow up period was 13.5 months. In functional result, excellent and good result were obtained in 18 cases (86%). In radiologic result, mean loss of radial length, radial inclination and volar tilt were 0.9 mm, 1.4degrees, 0.9degrees, respectively. CONCLUSION The advantages of intramedullary K-wire fixation were relatively simple procedure, low occurrence of soft tissue complications and early wrist motion. Intramedullary K-wire fixation was good to maintaining reduction in osteoporotic bone.
PURPOSE Fractures of the acetabulum remain a major challenge to the orthopedic surgeons. Although the operative treatment for the complex fractures is preferred, inaccurate reduction and then incongruity of the hip joint lead to serious complication such as premature osteoarthritis. We evaluated the results of surgical and conservative treatment for acetabular fractures. MATERIALS AND METHODS From January 1996 to March 2001, we reviewed 55 cases retrospectively. Posterior wall fracture (13 cases) was the most common by Letournel's classification and followed by both column fracture (10 cases). Causes of injuries included 41 cases of traffic accident and 8 cases of falling down. We divided the cases into an operation group (28 cases) and conservative group (27 cases) and evaluated the results as excellent, good, fair or poor according to Matta's clinical and radiological grade criteria. RESULTS Anatomical or satisfactory reduction was obtained in 22 cases of operative group and clinical results were excellent in 7 cases, good in 13 cases. Conservative group revealed excellent and good clinical results in 15 of 27 cases. CONCLUSION In cases of the displaced complex fractures, posterior wall fracture with instability and displaced fractures involving the weight bearing dome of the acetabulum, open reduction and internal fixation after accurate evaluation of the fracture pattern could allow earlier ROM exercise and have the result in better prognosis.
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Clinical Results of Surgical Treatment of Acetabular Fractures according to Quality of Reduction Sang-Hong Lee, Min-Kyu Shin, Sueng-Hwan Jo The Journal of the Korean Orthopaedic Association.2007; 42(2): 153. CrossRef
PURPOSE To analyze children with displaced supracondylar fractures of the humerus that were treated by immediate closed reduction and then maintained by lateral percutaneous K-wire fixation. MATERIALS AND METHODS 70 cases of supracondylar fractures of the humerus(5 type I, 19 type II, 46 type III) were treated, 14 fractures(5 type I, 7 type II, 2 type III) with cast, 49 fractures(12 type II, 37 type III) with lateral percutaneous pinning, 7 fractures(7 type III) with open reduction and internal fixation. The K-wire were removed after averaging 6.2 weeks of operation in out patient clinic. The follow-up period ranged from 6 months to 28 months, averaging 13 months. RESULT By Flynn's functional and cosmetic criteria, 47 fractures(95.9%) among 49 fractures, treated with immediate closed reduction and lateral percutaneous pinning, resulted in satisfactory criteria. Only one fracture was reoperated due to reduction loss. CONCLUSION Immediate closed reduction and lateral percutaneous K-wire fixation appears to be safe and reliable option for the treatment of supracondylar fractures of the humerus in children.
In the treatment of ankle f1racture, anatomical reduction and restoration of ankle mortise is very important. But tranf-syndesmotic screw fixation for syndesmosis seperation is dependent on the condition in operation field. The purpose of this study is to analyse the radiographic and clinical relults. to evaluate the need for trans-syndesmotic screw fixaition, and to know the effectiveness of radiogrphic landmarks for diagnofis of the syndesmosis separation, retrospectively. The patients were divided into two groups. The Croup I(25cases) were treated with trant-syndetmotic screw and group II(42 cases) were treated without trans-syndesmotic screw fixation .
The clinical results were excellent in 13, good 9 in group I and excellent in 19, good in 17 in group II. The radiographic results were excellent in 6, good in 8 in group I and excellent in 23, good 14 in group II. In the radiographic findings, the false negative result of tibiofibular overlap was 15.6%(M: 20.8%, F: 10.4%), tibiofibular clear space was 16.8%(M: 21.6%, F: 11.9%) and ratio of tibiofibular overlap to fibular width was 14.2%(M: 14.9%, F: 13.6%).
There was no siginificant statsitical difference in the ratio of tibiofibular overlap to fibular width between male and female.
We consider that the ratio of tibiofibular overlap to tibiofibular width are more reliable diagnostic criteria for syndemosis separation than the tibiofibular overlap and tibiofibular clear space. Trans-syndesmotic tcrew fixation is not alswaya required to maintain the integrity of the tibiofibular syndesmosis if the diastasis was satisfactorily reduced with rigid fixation.
There are many methods to treat the humeral shaft fracture. Various types of hulneral shaft fracture in multiple trauma patients were treated by intrarnedullary stabilization with Rush nail.
We reviewed twenty two patients who were treated with Rush nail in Masan Samsung Hospital from August. 1990 to May.1995. The purpose of this study is to report the results and kilow whether Rush nailing is recommendable in multiple trauma patients.
The results virere as follows: 1. The most common type of fracture was comminuted with large displaced fragment type (11 cases,47.8%), most common site was distal one third of shaft(10 cases,43.5%).
2. The average operation time was about 40 minutes.
3. The average time of radiological bone union was about 14 weeks.
4. Complications were 5 cases of mild joint stiffness (2 cases in shoulder and 3 cases in elbow),5 cases of nonunion, 5 cases of angulation deformity(average 7 degree) and 2 cases of nail migration.
We had satisfactory functional outcome rated by Stewart and Hundly. In spite of some complication, we think that Rush nailing can be applied safely and effectively to humeral shaft fractures associated with multiple injury.