Journal of Musculoskeletal Trauma

Treatment Results of Reamed Exchange Nailing in Aseptic Nonunion of Tibial Shaft Fracture: Yongjin Cho, Jun Young Lee, Jehong Ryu, Hyoung Tae Kim, Jong Jin Moon; J Korean Fract Soc 2023;36(4):125-132. Published online October 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.4.125

Abstract PDF: Purpose
Intramedullary nailing is used widely for treating tibial diaphysis fractures because of its relatively rigid internal fixation, which allows weight bearing, resulting in rapid bone healing and functional recovery. This study evaluated the results of exchange nailing in treating aseptic nonunion of tibial shaft fractures.
Materials and Methods
From November 2015 to December 2021, a retrospective study was conducted on patients who had undergone intramedullary nailing for tibial diaphysis fractures. Among them, this study focused on patients diagnosed with nonunion and who underwent exchange nailing. Twenty patients with a minimum follow-up period of at least 12 months were included in the study.
Results
The mean ages of patients were 60 years (range, 30-79 years). Of the 20 cases in which exchange nailing was performed, bone union was achieved in 18 cases (90.0%), and the mean period was 23 weeks (range, 14-46 weeks). Among the 18 cases of bone union, one case exhibited delayed union and achieved union without additional treatment after 46 weeks, while two cases of nonunion failed to achieve union and were lost to follow-up until the final assessment.
Conclusion
Reamed exchange nailing performed on aseptic nonunion after intramedullary nailing for tibial diaphysis fractures had satisfactory clinical outcomes.

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Atypical Fracture-Like Insufficiency Fracture of the Tibia with Prolonged Bisphosphonate Drug: A Case Report: Min Jung Park, Su Jin Lee, Jin Hwa Kam, Yun Tae Lee, Ju Hyung Yoo, Hyun Cheol Oh, Joong Won Ha, Yung Park, Sang Hoon Park, Seong Hoon Kim, Han Kook Yoon; J Korean Fract Soc 2017;30(3):137-141. Published online July 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.3.137

Atypical femoral fracture related to a long-term bisphosphonate therapy has commonly been reported; however, a fracture at the site other than the femur has rarely been reported to date. Herein, we report a case of a patient on long-term bisphosphonate therapy who presented atypical tibial insufficiency fracture at the anterolateral aspect of diaphysis, without trauma. We, for the first time in Korea, present this case with a literature review.

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Atypical Femoral Fracture Occurring at a Proximal Screw Insertion Site after Plate Removal in a Distal Femoral Fracture
Jin Woo Jin, Sung Jin Shin, Jong Min Jeon
Journal of the Korean Orthopaedic Association.2024; 59(4): 314. CrossRef

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Intramedullary Nailing in Distal Tibial Meta-Diaphyseal Fracture: Kee Cheol Park, Young A Cho, Young Ho Kim, Tae Soo Park, Ye Soo Park, Il Hoon Sung, Kuhn Sung Whang; J Korean Soc Fract 2003;16(2):201-207. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.201

Abstract PDF: PURPOSE
This study was undertaken in order to evaluate the efficiency of the closed intramedullary nailing in 18 cases of distal tibial fractures.
MATERIALS AND METHODS
From May 1999 to June 2001, eighteen patients were treated by closed intramedullary nailing for distal tibial meta-diaphyseal fracture. According to Robinson classification, there were 7 type 1 fractures, 7 type 2A fractures, 1 type 2B fractures, and 2C type fractures. The mean distance between distal end of fracture and tibial plafond was 2.6+/-1.1 cm (0~5 cm). We evaluated both clinical and radiographic parameters.
RESULTS
Plate fixation of distal fibular fracture was performed in 7 cases. Poller screw was used in 4 cases which showed malalignment after insertion of nail. The mean score was 92.5 point by Blaird ankle scoring system. All patients got the bone union at average of 20 weeks (12~40 weeks). One patient had a antecurvatum deformity of 9 degrees.
CONCLUSION
Intramedullary nailing for distal tibial fractures is one of the safe and reliable method for managing these injuries.

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Treatments of the Malunited Tibial Shaft Fracture: Taik Seon Kim, Jae Ik Shim, Sung Jong Lee, Suk Ha Lee, Yeon Sik Yu, Young Bae Kim, Kwang Yeol Park; J Korean Soc Fract 2000;13(4):897-904. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.897

Abstract PDF: PURPOSE
The malunited diaphyseal tibia fractures result in tibial shortening, angular deformities, gait disturbance, development of joint pain, etc. The authors analyzed the results of treatment consist of corrective osteotomy for diaphyseal malunion with internal or external fixation.
MATERIALS AND METHODS
The authors reviewed 18 cases of tibial diaphyseal malunion treated in Korea Veterans Hospital between January 1992 and December 1998. Mean follow-up period was 4.2 years. The preoperative deformities were varus, anterior or posterior bowing and shortening. The preoperative symptoms were knee joint pain, ankle joint pain, and gait disturbance. Corrective osteotomy was done on the site of malunion in all cases. Fixation were done with IM nailings(13 cases), plates(3 cases) and Ilizarov external fixator. We analyzed the unions radiologically and the knee pains with HSS score.
RESULTS
All malunions were successfully corrected. Mean duration of union was 4.5 month. In the coronal plane, preoperative varus deformity(mean 16.5degrees varus) was corrected to 3degrees of valgus. In the saggital plane, anterior and posterior bowing was corrected to neutral. In 15 cases of the patient with knee joint pain, the mean HSS score was improved from 69 preopertively to 82 postoperatively.
CONCLUSION
The correction of tibia diaphyseal malunion had good results by osteotomy at the malunited site and firm internal or external fixation. And it also improved knee joint pain significantly.

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Treatment of the Fractures of the Humeral Shaft with the Non-reamed True/Flex Humerus Rod: Dong Chul Lee, Jae Sung Seo, Sang Don Kim; J Korean Soc Fract 1994;7(1):122-130. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.122

Abstract PDF: Recently, surgical intervention of the fractures of the humeral shaft was increased due to the severe trauma occuring in the traffic accident and industrial accident, even if closed treatment was appropriate in the humeral diaphysis. In order to obtain the early mobilization prevention of the nonunion and joint stiffness, rigid fixation of the fracture is needed. To reduce the complication of the open reduction (nonunion, infection, radlal neue palsy), closed intramedullary nail fixation techlnques without opening the fracture site were used. Eight cases of the fractures of the humeral shaft were treated with nonreamed True/Flex humerus rod system(intramedullary fixation) between Nov.1992 and Apr.1993. And the obtained results were as follows. 1. The normal healing cases were S and its average healing time Is post-op. 9.2 weeks. There were nonunion in 1 case and delayed union in 2 cases. 2. The causes of the injury were traffic accident in 6 cases fall down in 1 case, belt injury in 1 case. 3. The causes of the nonunion and delayed union were as follows distraction(by inappropriate selection of the rod and physical treatment) in 2 cases, insufficient immobilzation in 1 cases. 4. The True/Flex humerus rod seemed to recommand to the patients with multiple, open, segmental fractures and poor qeneral condition.

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