Owing to the increase in life expectancy, the incidence of osteoporotic fracture of the pelvis and acetabulum is increasing. Fractures in the elderly population is different from those in younger patients. Pelvic ring and acetabular fractures in geriatric patients are more likely the result of low-energy trauma, but the outcomes are generally poorer than those of the younger population. Multiple management options are available, but no intervention has become the standard of care for these fractures in the elderly. A treatment strategy should be established depending on the state of the individual patient. Regardless of whether nonsurgical or surgical treatment is selected, early ambulation should be considered to avoid the complications associated with prolonged immobilization.
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Effect of Korean Medicine Treatments for Pain Reduction in Patients with Hip Fracture : A Retrospective Observational Study Nam Hoon Kim, Min Seok Oh Journal of Physiology & Pathology in Korean Medicine.2020; 34(5): 263. CrossRef
The incidence of malunion in the long bone with has been reduced because of the advancements in surgical technique. However, nonunion or malunion are still observed in mechanical axis deformation of the lower limb, resulting in the overload of cartilage and instability of the joint, requiring surgical correction. Preoperative planning for malunion is very important, and accurate evaluation of the deformity is essential. Herein, we describe the indications of corrective osteotomy, choice of patients, and various surgical methods for the treatment of malunion of the long bone.
PURPOSE With the increase in the old age population, proximal humerus fractures have been increasing recently. However, complications after operative treatment, such as fixation failure, are common because of osteoporosis. We treated proximal humerus fractures in patients with osteoporosis conservatively, and evaluated the radiographic and functional results by analyzing the factors affecting the results. MATERIALS AND METHODS Nineteen out of 30 cases for whom the clinical follow-up was over 1 year were included in this retrospective study. There were 17 females and 2 males, and the mean age was 73.2 years. The causes were slip from a short height (18 cases) and a minor car accident (1 case). We evaluated the union period, nonunion, malunion and the Constant score and analyzed several factors affecting the functional result, such as age, fracture pattern, and malunion. RESULTS Seventeen cases (89.5%) obtained union within 12.8 weeks on average. Neck-shaft angle was 125.3degrees on average, with seven cases of malunion. The Constant score was 84.1 on average, and there were excellent scores in 11 cases, good scores in 4 cases, and fair scores in 2 cases. Fracture pattern, neck-shaft angle, or malunion did not affect the functional outcome, and elderly patients showed poorer shoulder function. CONCLUSION Proximal humeral fractures with osteoporosis may achieve a high rate of bony union when treated with conservative methods. Despite the common occurrence of malunion, a satisfactory functional outcome may be expected.
A study of functional outcome of humeral shaft fracture treated with anterior bridge plating Nishant V. SHIVADE, Nitin PATIL, Paresh PATIL, Sapan VORA, Jaykumar K Minerva Orthopedics.2021;[Epub] CrossRef
Comparing the Use of Single and Double Interlocking Distal Screws on a Polarus Intramedullary Nail for Humeral Shaft Fractures Hee Seok Yang, Jeong Woo Kim, Hong Je Kang, Jung Hyun Park, Yong Chan Lee, Kwang Mee Kim Clinics in Shoulder and Elbow.2015; 18(2): 91. CrossRef
Polarus Intramedullary Nail for Proximal Humeral and Humeral Shaft Fractures in Elderly Patients with Osteoporosis Youn-Soo Hwang, Kwang-Yeol Kim, Hyung-Chun Kim, Su-Han Ahn, Dong-Eun Lee Journal of the Korean Fracture Society.2013; 26(1): 14. CrossRef
PURPOSE We evaluated the efficacy and results of minimally invasive anterior plating for humeral shaft fracture. MATERIALS AND METHODS Twenty-two cases of humeral shaft fracture were reviewed, including 8 cases of type A, 8 of type B and 6 of type C (AO/OTA classification). There were three open fractures. The fracture was fixed with MIPO (minimally invasive plate osteosynthesis) technique under C-arm guide. A locking compression plate was located in anterior aspect of the humerus with at least three screws fixed in each fragment. Radiologic and functional results were evaluated. RESULTS In 20 of 22 cases, bony union was achieved with the mean period of 17.5 weeks, including 2 cases of delayed union. There were 2 cases of nonunion, which needed the further operative procedure. Except one case of distal 1/3 fracture, all cases showed satisfactory elbow and shoulder function with the mean Mayo elbow score of 17.4 and mean UCLA shoulder score of 97.3. In complication, there was one case of radial nerve palsy due to improper traction, but it was completely improved after 3 months. Otherwise, there was no complication including infection. CONCLUSION Anterior MIPO for humeral shaft fracture may be another option of operative methods with high union and low complication rate.
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PURPOSE To assess the result of staged minimally invasive plate osteosynthesis (MIPO) for distal tibial fracture with an open wound or injured soft tissue. MATERIALS AND METHODS In 20 patients (mean age, 47.8 year-old) with distal tibial fractures, there were 4 type A fractures and 16 type C fractures based on the AO classification system. Eight of the 20 patients had open fractures. MIPO was performed on average 23.9 days after bridging external fixation. At the final follow-up, we assessed the radiological results of bone union and alignment. Functional results were also evaluated by measuring the degrees of ankle motion and the American Orthopedic Foot & Ankle Society (AOFAS) scores. RESULTS Seventeen of 20 cases (85%) achieved primary union at an average of 21.3 weeks. There were 3 cases of nonunion requiring a bone graft. The mean AOFAS score was 88.5 (range, 67~92) and the average range of ankle motion was 49.2degrees (plantarflexion: 37.4degrees, dorsiflexion: 11.8degrees). Complication included 2 cases of minor mal-alignment, 1 case of claw toe and 1 case of peroneal neuropathy. Patients over the age of 60 had lower functional results. Additional factors did not affect the final results. CONCLUSION Staged MIPO may achieve satisfactory results in distal tibial fractures with soft tissue compromise, decreasing deep infections and soft tissue complications.
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PURPOSE To assess the affecting factors of results after the operation of Crescent fracture-dislocation in sacro-iliac joint. MATERIALS AND METHODS In 19 patients (mean age, 47.4 year-old) of open reduction and internal fixation for Crescent fracture-dislocation, there were seven type I, 9 type II, and 3 type III fractures according to Day's classification. We assessed affecting factors of radiological and functional results, such as patients' ages, surgical approaches, the fixation extent of pelvic ring, and fracture patterns. RESULTS Seventeen of 19 cases united at 14.5 weeks in average, and 2 non-unions occurred with the fixation failure of posterior ring. Satisfactory results were 14 and 15 in radiological and functional evaluation, respectively. In complications, three cases of leg length discrepancy were from an imperfect reduction and two fixation failures. Surgical approach did not show any difference of results, but all cases of unsatisfactory reduction occurred from posterior ring fixation through the anterior approach. Fixation of both rings seemed to have satisfactory results, comparing to posterior ring only. Older patients over 60 year-old had more complications and a tendency to show an unsatisfactory result. CONCLUSION In operative treatment of Crescent fracture-dislocation of sacro-iliac joint, it is better to fix both anterior and posterior rings. But, caution is needed to prevent complications in old-aged patients.
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Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques Chul-Hyun Park, Chul-Wung Ha, Sang-Jin Park, Min-Su Ko, Oog-Jin Shon Journal of the Korean Fracture Society.2013; 26(2): 112. CrossRef
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PURPOSE To assess the results of staged MIPO (Minimally Invasive Plate Osteosynthesis) for proximal tibial fractures with compromised soft tissue. MATERIALS AND METHODS Eighteen proximal tibial fractures (AO 41:9 cases, AO 42:9 cases) included this study. Ten were open fractures. After temporary external fixation until soft tissue healed (mean 27.3 days), MIPO was performed secondarily without bone graft. We assessed the bony union and knee function, and affecting factors of the results were investigated. RESULTS All fractures united at 20 weeks (range, 11~32) except 1 case. Mean range of knee flexion was 134.4degrees and mean IOWA knee score was 89.1. There were 2 superficial and 2 delayed deep infections from open fractures (grade II:1 case, grade III:3 cases), although they healed after implant removal. Open fractures seem to influence the infection rate. Otherwise, there was no related factor affecting the results. CONCLUSION MIPO after temporary external fixation can provide favorable results in proximal tibial fractures with soft tissue injuries, but attention of delayed infection should be paid in open fractures.
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Comparison of Time to Operation and Efficacies of Ultrasound-Guided Nerve Block and General Anesthesia in Emergency External Fixation of Lower Leg Fractures (AO 42, 43, 44) Chan Kang, Sang-Bum Kim, Youn-Moo Heo, You-Gun Won, Byung-Hak Oh, June-Bum Jun, Gi-Soo Lee The Journal of Foot and Ankle Surgery.2017; 56(5): 1019. CrossRef
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PURPOSE To evaluate the results of bone transport using external fixator over an intramedullary nail for defects of long bone. MATERIALS AND METHODS We treated 14 cases of bone defect after chronic osteomyelitis or trauma of tibia (12 cases) and femur (2 cases) using this method. The mean age of index procedure was 46.9 years, and all of them had follow-up study for a mean of 3 years. After the corticotomy and insertion of intramedullary nail, bone transport was done by external fixators. Then, the segment was moved and bone graft was done at docking site. RESULTS The mean transported amount was 5.8 cm, and the external fixator was removed after 141 days. The mean external fixation index was 25.6 days/cm. Primary union of distraction and docking site was achieved in all, but one had failure in union of docking site. According to the Mekhail's functional criteria, there were 5 excellent, 6 good, and 3 fair results. Among 15 complications, there were 2 major complications with residual sequelae, and they were 1 recurred osteomyelitis and 1 flexion contracture of knee. CONCLUSION Bone transport using external fixator over an intramedullary nail, can successfully solve defects of long bone. Since this method can remove external fixators earlier than the conventional method, it has fewer complications and makes patients to return to daily life earlier.
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Treatment for Bone Defect of Open Tibial Fractures by Using Intramedullary Nail Fixation with Autogenous Iliac Bone Graft Hyub Sakong, Ki Cheor Bae, Chul Hyun Cho, Kyung Jae Lee, Eun Seok Son, Du Han Kim Journal of the Korean Fracture Society.2012; 25(4): 288. CrossRef
PURPOSE To compare retrospectively the antegrade and retrograde nailing in the management of ipsilateral femoral neck and shaft fractures. MATERIALS AND METHODS Thirty-two patients (thirty-three injuries) were included in this study. Mean age of patients was 38 years-old in the antegrade nailing group (16 injuries) and 44 years-old in the retrograde nailing group (17 injuries). We compared the union of fractures and complications between two groups, and investigated the influencing factors. RESULTS Femoral shaft fracture was united in 10 cases (63%) of antegrade group and 12 cases (71%) of retrograde group, at 28.2 and 27.3 weeks respectively. Nonunion was more prevalent in Winquist-Hansen III and IV (5 in antegrade nailing, 3 in retrograde nailing) than I and II. Femoral neck fracture was united with 1 case of nonunion in each group. Nonunion developed from Garden stage IV, but fractures of Garden stage I and II united regardless of methods. CONCLUSION In ipsilateral femoral neck and shaft fractures, the kinds of methods did not affect the results of shaft fractures. Minimally displaced neck fractures also were not influenced by kinds of methods, but retrograde nailing may have a benefit in fixing the displaced neck fractures
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Retrograde Intramedullary Nailing or the Treatment of Segmental Femoral Shaft Fracture Including Distal Part Jong-Ho Yoon, Byung-Woo Ahn, Chong-Kwan Kim, Jin-Woo Jin, Ji-Hoon Lee, Hyun-Ku Cho, Joo-Hyun Lee Journal of the Korean Fracture Society.2009; 22(3): 145. CrossRef
The Treatment of IM Nailing of Femoral Shaft Fracture: Piriformis Fossa versus Trochanteric Entry Portal Hyun Kook Youn, Oog Jin Shon, Dong Sung Han Journal of the Korean Fracture Society.2008; 21(3): 200. CrossRef
PURPOSE To evaluate the conformity of the anatomically pre-shaped LCP-PT to the tibias of the Korean adult and to identify radiological guidelines to assist intraoperative assessment of correct alignment. MATERIALS AND METHODS 30 adult femur obtained from the Korean adult cadaver were used. A nine or eleven-hole LCP-DF was applied to the lateral surface of the tibia according to the contour. Then the distance from the inner surface of the plate to the lateral condyle was measured at the sites of mismatch. The angle between the most proximal screw and the articular surface was measured with the image intensifier. RESULTS The LCP-PT showed good conformity to the tibia in general. The distance from the inner surface of the plate to the lateral condyle was 3.5mm in average (range 0~9). The angle between the most proximal locking screw and the joint line was 1.16 degrees in average (range 0~7 degree). CONCLUSION The LCP-PT showed good conformity to the tibia in general. Malposition of the most proximal screw which is not paralleling to the joint line may herald a coronal plane malalignment.
PURPOSE To evaluate the outcomes of patients with comminuted subtrochanteric femoral fractures using minimally invasive plate osteosynthesis (MIPO) technique. MATERIALS AND METHODS Twelve patients with a mean age of 38.2 years, who sustained comminuted subtrochanteric femoral fractures, were treated using MIPO technique. All patients suffered these fractures either from traffic accidents (6) or falls from height (6). Average follow-up was 4.3 years (range, 29~78 months). Patients were assessed radiographically and clinically with regards to time to union, malunion, and complications. According to the Seinsheimer's classification, there were 1 type III, 7 type IV, and 4 type V. Type C fractures were ten according to AO-OTA classification. RESULTS Union was achieved in 7 of 12 cases, in an average of 23.4 weeks (range, 12~42 weeks). Three definite non-unions with implant failures, needed the procedure of implant change and bone graft. In other two patients, early bone graft was performed for anticipated nonunion of comminuted area. The most common complication was metal failures (2 plate failures and 3 screw breakages). Limb length shortening of 1.5 cm occurred in one patient, and external rotation malunion of 15 degrees was noted in one patient. No patients developed infection. CONCLUSION Preserving biology of the fracture fragments, the use of MIPO technique using DCS has proven to be less successful in comminuted subtrochanteric fractures, comparing to fractures in other areas. To avoid mechanical failure, the careful and protective weight bearing is needed until the callus-bridging is seen in the commniuted area.
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Minimally Invasive Plate Osteosynthesis for Femoral Mid-Diaphyseal Fractures Hyoung-Keun Oh, Suk-Kyoo Choo, Jong-In Kim, Sung-Jong Woo Journal of the Korean Fracture Society.2013; 26(2): 140. CrossRef
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What is an Ideal Treatment? Chang-Wug Oh Journal of the Korean Fracture Society.2008; 21(4): 347. CrossRef
We have treated thirteen complex plateau fractures involving both condyles with one of the following conditions with the use of the combined anterior and posterior approaches in a modified supine position. Associated PCL avulsion fracture, displacement of major fracture plane dominantly at the back, large coronal fracture fragment involving medial or lateral condyles. A patient is placed on an operation table in supine position with a bump under the contralateral buttock. The well leg is placed in a lithotomy position and the injured leg is placed over a sterilized Mayo stand separately. For the posterior approach the table was tilt toward the injured side with the hip abducted and rotated externally. With a modified patient's positioning we were able to use combined anterior and posterior approaches simultaneously for the management of certain complex plateau fractures without changing the draping.
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Current Concepts in Management of Tibia Plateau Fracture Sang Hak Lee, Kang-Il Kim Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef
PURPOSE To report the difficulties in the process of locking head screw removal due to the stripping of the hexagonal recess of the screw head. MATERIALS AND METHODS We have removed 113 5.0-self tapping locking head screws and 202 3.5-self tapping locking head screws from 34 patients with fracture healing and 5 patients complicated with infection. All of the operations were done by one surgeon. All the screws were placed with the use of torque limiting attachment or driver. RESULTS All of 113 5.0-self tapping locking head screws were removed without difficulties with an usual manner. 21 out of 202 3.5-self tapping locking head screws were removed with many difficulties due to the stripping of the hexagonal recess. 3 screws were removed successfully with the use of conical extraction screw. 12 screws were taken out by further stripping and destruction of the screw head. In 6 situations where the only one screw was left stripped, the plate was bent around the stripped screw and then it was removed by turning the plate as a handle. One screw was removed with the partial breakage of the near cortex upon lifting the plate after failed attempt of using conical extraction screw. CONCLUSION Although we have followed the guidelines at the time of insertion we have experienced difficulties in the removal of 3.5 locking head screws due to the stripping of the hexagonal recess. Care should be taken at the time of removal of the locking plate especially for the 3.5 locking screws.
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An inexpensive and rapid method for removal of multiple stripped locking screws following locking plating: A case report Won Ro Park, Jae Hoon Jang International Journal of Surgery Case Reports.2019; 57: 134. CrossRef
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Pitfalls and Complications in the Application of the Locking Plate Jong-Keon Oh Journal of the Korean Fracture Society.2007; 20(4): 355. CrossRef
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Management of Fractures of Distal Tibia by Minimally Invasive Plate Osteosynthesis through an Anterior Approach Gu-Hee Jung, Jae-Do Kim, Jae-Ho Jang, Sung-Keun Heo, Dong-won Lee Journal of the Korean Orthopaedic Association.2010; 45(6): 473. CrossRef
Two-staged Delayed Minimally Invasive Percutaneous Plate Osteosynthesis for Distal Tibial Open Fractures Jung Hwan Yang, Seok Hyun Kweon, Jeung Woo Kim, Jin Young Park, Hyun Jun Kim, Chul Min Lim Journal of the Korean Fracture Society.2008; 21(1): 24. CrossRef
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PURPOSE To evaluate the conformity of the anatomically pre-shaped LCP-DF to the femurs of the Korean adult. MATERIALS AND METHODS 67 adult femur obtained from the Korean adult cadaver were used. An eleven-hole LCP-DF was applied to the lateral surface of the distal femur according to the contour. Then the distance from the inner surface of the plate to the cortex was measured at the sites of mismatch. The angle between the distal most screw and the articular surface was measured. RESULTS Mismatch was found at the level of proximal 4~5 holes of the plate with an average distance of 9.58 mm (0~18) at the tip of the plate. Otherwise, the overall conformity of the LCP-DF was excellent. The distal most screws are positioned such that the joint line is 3 degrees of valgus to this screw in average (range 0~18). CONCLUSION It may be necessary to consider to bend the plate in case of mismatch at the tip especially for the plate longer than 9-hole plate. The angular relation between the distal most screw and the joint line can assist the judgement for the coronal plane alignment.
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Comparison of Results of Minimally Invasive Plate Osteosynthesis according to Types of Locking Plate in Distal Femoral Fractures Oog Jin Shon, Moon Soo Kwon, Chul Hyun Park Journal of the Korean Fracture Society.2012; 25(4): 269. CrossRef
Repeated Metal Breakage in a Femoral Shaft Fracture with Lateral Bowing - A Case Report - Dong Soo Kim, Yong Min Kim, Eui Sung Choi, Hyun Chul Shon, Kyoung Jin Park, Byung Ki Cho, Ji Kang Park, Hyun Cheol Lee, Kyung Ho Hong Journal of the Korean Fracture Society.2012; 25(2): 136. CrossRef
Axial Malalignment after Minimally Invasive Plate Osteosynthesis in Distal Femur Fractures with Metaphyseal Comminution Jae-Ho Jang, Gu-Hee Jung, Jae-Do Kim, Cheung-Kue Kim Journal of the Korean Orthopaedic Association.2011; 46(4): 326. CrossRef
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Pitfalls and Complications in the Application of the Locking Plate Jong-Keon Oh Journal of the Korean Fracture Society.2007; 20(4): 355. CrossRef
PURPOSE To know biomechanical differences in methods of limb lengthening between using monolateral external fixator and using external fixator over an intramedullary nail. MATERIALS AND METHODS In acryl rods, saw-bone, and cadeveric bone, we created two lengthening models of using monolateral external fixator and using external fixator over an intramedullary nail. The axial compression test was done on the site of osteotomy for lengthening. To fix the models, half pins of 5 mm in diameter and nails of 9 mm in diameter were used. Using MTS (Material Test System) machine, we evaluated the differences of axial stiffness according to the presence of an intramedullary nail or the numbers of half-pins which were fixed at each side of osteotomy. RESULTS Lengthening over an intramedullary nail, comparing to monolateral external fixator only, increased the axial stiffness by 1.1~1.2 times in acryl rods, 1.2~1.6 times in saw bones, and 15.6~15.9 times in cadeveric bones when the same numbers of half-pins were used. In saw bone and cadaveric bone, the group of two half pins in lengthening over an intramedullary nail was stiffer than the group of three pins in lengthening with monolateral external fixator. CONCLUSION In the distraction of the limb, the addition of an intramedullary nail may increase the axial stiffness of the frame of monolateral external fixator. In lengthening over an intramedullary nail, it is enough to distract the bone with fixing two half pins at each sides of osteotomy.
OBJECTIVES To evaluate the results and its efficacy of double plating for proximal tibial fractures using minimally invasive percutaneous osteosynthesis (MIPO) technique.
MATERIAL & METHODS: Twenty-three fractures, followed-up more than 1 year, were included in this retrospective study. There were 18 men and 5 women, and the mean age was 53.5 years-old. According to the AO-OTA classification, five were 41A, 13 were 41C, and 5 were 42. There were four open fractures (grade I- three, grade III A-one case). The plates were fixed on the medial and lateral sides of tibia with MIPO technique. Functional and radiographic results were evaluated by the modified Rasmussen system. RESULTS All fractures healed without bone graft, and the mean period for fracture healing was 19.3 weeks (range, 10~32 weeks). All other patients had excellent or good clinical or radiological results, except for two patients of a fair clinical result after a combined injury. Complications included one case of shortening (1 cm) and two cases of mal-alignments (varus less than 10 degrees). There was one case of superficial infection, but no patient showed deep infection. CONCLUSION Double plating using MIPO technique can provide favorable results in the treatment of proximal tibial fractures.
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Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures Jae-Ang Sim, Kwang-Hui Kim, Yong-Seuk Lee, Sang-Jin Lee, Beom-Koo Lee Journal of the Korean Orthopaedic Association.2014; 49(4): 278. CrossRef
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Staged Minimally Invasive Plate Osteosynthesis of Proximal Tibial Fracture Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Woo-Kie Min, Byung-Chul Park, Kyung-Hoon Kim, Hee-Joon Kim Journal of the Korean Fracture Society.2009; 22(1): 6. CrossRef
PURPOSE To review the results in the management of ipsilateral femur and tibia fractures, using femoral and tibial intramedullary nailings with single incision on the knee. MATERIALS AND METHODS We treated 19 cases of ipsilateral femur and tibia fractures (floating knee), and the retrograde femoral nailing and antegrade tibial nailing were done with single incision on the knee. Except one patient of early death, 18 patients were included in this study. The mean age of index procedure was 34.1 years, and all of them had follow-up study for a mean of 2.4 years. The mean injury severity score was 18.8, and 12 patients had other fractures in the lower extremity. RESULTS Primary union was achieved in all, but one patient of femur and two of tibia. The average period for union was 27.6 weeks for femur and 24.5 weeks for tibia. One femoral nonunion occurred due to the metal failure after using short nail, and two tibial nonunion were caused by the bone loss with open tibial fractures. Most patients showed no limitation in knee motion. According to Karlstrom-Olerud criteria, functional results showed 14 excellent, 3 good and 1 acceptable. The protrusion of nail tip into the knee joint made the acceptable result with moderate limitation of knee motion, but it improved after the removal of nail. CONCLUSION CONCLUSION: Simultaneous retrograde femoral and antegrade tibial nailing with single incision on the knee, with an appropriate technique, can achieve the satisfactory result in the management of the ipsilateral femur and tibia fractures.
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Ipsilateral Femoral Segmental and Tibial Fractures: A Case Report Oog Jin Sohn, Chul Hyun Park, Sang Keun Bae Journal of the Korean Fracture Society.2009; 22(3): 193. CrossRef
PURPOSE To retrospectively review the results of internal bone transport in the management of tibial bone defect using ilizarov fixator. MATERIALS AND METHODS We treated 39 cases of tibial bone defect (16 of traumatic bone loss, 23 after treatment of osteomyelitis). The mean age of index procedure was 33.8 years (range, 13~66 years), and all of them had follow-up study for a mean of 3.5 years (range, 1.6~8 years). The mean transported amount was 6.3 cm (range, 2.7~20 cm), and the external fixator was removed after 345 days (range, 120~700 days). The mean external fixation index was 60.3 days/cm (range, 13.1~121.3 days/cm). RESULTS Primary union of distraction and docking site was achieved in all, but two patients had failure in union of docking site. Functional results showed 6 excellent, 19 good, 10 fair, and 4 fair. The patients under age 20 showed better functional outcomes than the others. Among 73 complications (incidence, 1.87 cases/ patient), 27 of major complications with residual sequelae occurred in 20 patients. The residual sequelae were more common in the patients who had the concomitant injuries in the same leg. CONCLUSION Internal bone transport can solve the large amount of tibial bone defect. However, the complications are not uncommon, which might be related to the concomitant injures in the same leg.
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Bone Transport Over the Intramedullary Nail for Defects of Long Bone Jae-Young Roh, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Byung-Chul Park, Woo-Kie Min, Joon-Woo Kim, Chang-Hyun Cho Journal of the Korean Fracture Society.2008; 21(1): 37. CrossRef
Minimally Invasive Plate Osteosynthesis to Prevent or Treat the Deformity after Distraction Osteogenesis Chang-Wug Oh, Byung-Chul Park, Il-Hyung Park, Hee-Soo Kyung, Woo-Kie Min, Seung-Hoon Baek, Seung-Kil Baek The Journal of the Korean Orthopaedic Association.2007; 42(6): 764. CrossRef
PURPOSE To report the results of unreamed nailing using a nail with the largest possible diameter for the management of the open tibial shaft fractures. MATERIALS AND METHODS Nineteen patients with open tibial shaft fractures underwent unreamed nailing with the largest possible diameter according to the isthmic diameter measured on preoperative radiography. There were 1 Grade I, 6 Grade II, 9 Grade IIIa, 3 Grade IIIb open fractures. There were 4 type A, 12 type B, 3 type C fractures according to the OTA classification. Fractures were classified as The nail was introduced after gentle passage of a 7 to 8 millimeter-hand reamer. RESULTS Union was obtained in all cases. However 9 (47%) fractures required an additional procedures before union. In 6 cases, dynamization was done. Two of them were required exchange nailing for nonunion, 1 of two gained bony union through additional bone graft. Three of the others had gained union through exchange nailing, bone graft, bone transport respectively. There were one rotational malunion, one superfical and one deep infection. Interlocking screw breakage developed only in one patient. CONCLUSION Our data indicate that unreamed nailing in the management of open tibial fractures is safe and reliable method. Using a tight fitting nail with the largest possible diameter is a safe and effective way to avoid the problems of screw breakage.
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Treatment of Type IIIb Open Tibial Fractures Seong Yeon Lim, Il Jae Lee, Jae Ho Joe, Hyung Keun Song Journal of the Korean Fracture Society.2014; 27(4): 267. CrossRef
Management of Open Tibial Fractures: Role of Internal Fixation Yerl-Bo Sung Journal of the Korean Fracture Society.2007; 20(4): 349. CrossRef
PURPOSE To review the clinical results of eight cases of typeIII coronoid process fractures which were treated operatively. MATERIALS AND METHODS Eight patients with coronoid type III fracture were reviewed retrospectively. All were men with an average age of 33. There were three isolated fractures, two elbow dislocations, two radial head and neck fractures, and one medial collateral ligament rupture. Open reduction and internal fixation through anterior approach with canulated screws was used. The patients were followed up for a mean of 31 months (24 to 60). RESULTS Average active elbow joint motion at the most recent follow up was 105degrees. The average Mayo Elbow Performance Score was 76.9 (50 to 95). There was one excellent result, four good, two fair, and one poor. CONCLUSION Early open reduction and stable internal fixation provided a reliable method for the treatment of type III coronoid process fractures. Any associated ligament injuries to the elbow and fracture comminution were considered as important prognostic factors.
PURPOSE Despite of various treatment methods, proximal tibial fractures are common injuries that may be associated with poor outcomes and high rates of complications. To improve this, percutaneous plating technique was performed in the proximal tibial fractures. MATERIALS AND METHODS Twenty-four proximal tibial fractures (AO 41A; 5, AO 41C; 12, AO 42; 7) were treated by percutaneous plating with either or both sides without bone graft. One was open fracture. RESULTS All fractures were healed. The average time for fracture healing was 16.5 weeks (range, 8~24 weeks). Complications included a 1cm shortened case and two mal-alignments; a 6 degree valgus case and 5 degree varus case. There was one case of superficial infection, which healed after plate removal. But, there was no deep infection. Results were evaluated by modified Rasmussen score system, all patients had excellent or good result. CONCLUSION Minimally invasive percutaneous plating technique can provide favorable results in the treatment of proximal tibial fractures.
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