Journal of Musculoskeletal Trauma

Fatigue Fracture of the Interlocking Nail in the Treatment of Femoral Shaft Fractures: Jung Ryul Kim, Jin Ho Yoon; J Korean Soc Fract 2003;16(2):163-168. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.163

Abstract PDF: PURPOSE
To analyze clinical and mechanical factors of the fatigue fracture of the intramedullary nail in the treatment of the femoral shaft fractures and to consider preventive methods of fatigue fracture.
MATERIALS AND METHODS
We reviewed 12 patients of fatigue fractures of the intramedullary and were followed for a minimum one year. The site of fatigue fracture of the intramedullary nail was at fracture site in 10 cases, just proximal to proximal locking hole in one, and the most proximal of two distal locking holes in one. We analyzed type and diameter of broken nail, time from injury to fatigue fracture, causes of metal failure, and treatment results.
RESULTS
Intramedullary nails which had fatigue fracture were reamed AO nail in four cases, Grosse-Kempf nail in four, Russel-Taylor nail in three, and long Gamma nail in one. Time to fracture of implant was average 13.6 months (range, 6~30 months). All cases were treated by intramedullary nailing, and additional autogenous bone grafting was done in three cases. At an average duration of follow-up of 7.5 months (range, 5 to 10 months), all of the fractures had healed.
CONCLUSION
To prevent fatigue fracture of intramedullary nail, closed obervation for bony union, progressive weight bearing, and augmentation with autogenous bone grafting for comminuted fracture site should be needed.

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Fatigue Fracture of the Distal femur Shaft: A Case Report: Seung Gyun Cha, Kyoung Hoon Kim, Jong Ho Jang, Sang Jun Lee; J Korean Soc Fract 1997;10(4):979-982. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.979

Abstract PDF: A fatigue(stress) fracture begins as a gradual localized dissolution of bone as a result of repeated submaximal and generally unaccustomed stresses which may or may not result in a complete fracture. The most common sites of fatigue fracture are tibia, metatarsal area. We experienced peculiar faligue fracture in professional bowler. So we review the fatigue fracture article and reporte 1 case of fracture in distal part of femur with clinical and radiological findings.

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Fatigue Fracture of the Interlocking Nail in the Treatment of the Distal Part of the femoral Shaft Fractures: Won Sik Choy, Hwan Jung Kim, Kwag Won Lee, Young Sik Min, Ha Yong Kim, Moon Ho Shon; J Korean Soc Fract 1997;10(3):522-528. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.522

Abstract PDF: Closed intramedullary nailing with or without interlocking screws has been a widely accepted method for the fixation of fractures of the femoral shaft. The design of the interlocking nail introduces the potiential for high stress concentrations at the proximal and distal holes. The authors experienced six cases of metal failure of the interlocking nail in the treatment of fractures of the distal part of the femoral shaft from February 1992 to March 1995. The predisposing factors to fatigue fracture of the interlocking nail were studied. In all patients, the fracture of femur was five centimeters or less from the more proximal of the two distal screw-holes. The risk of fatigue failure may be minimized by using nails that have a larger diameter, by using nails long enough to be driven down to the subchondral area of the knee joint and by avoiding early weight-bearing.

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Femoral Fatigue Fracture in Soldier: Jae Hyung Lee, Sung Ku Kang, Chul Joen Kim, Nok Soo Kim, Byung Chul Moon, Jong Oh Kim; J Korean Soc Fract 1996;9(4):907-913. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.907

Abstract PDF: Fatigue fracture are commonly seen in military personnel, especially at basic training c enter, and have been noted in athletes, ballet dancers, laborers, and even pregnant woman. This type of injury is usually encountered in the metatarsal shaft. however in rare cases. fatigue fracture in the femoral shaft was reporied. The purpose of this article is to call attention to the impouanre of early diagnosis of fatigue fracture of the shaft of the femur so that displacement, which may lead to the necessity for surgical intervention, may be prevented. The following clinical results were obtained by analysis of 6 cases of femoral fatigue fractures experienced in the departmert of orthopedic surgery, Capital Armed Forces General Hospital from January 1993 to April 1996. 1. A series off femoral fatigue fractures are reported in the miliiary recruits. 2. The average age was 21 years and all patients sex were male. 3. All the patients were peculiarly army recruits, whose average body heights were 170.3 centimeters and body weights were 61.6 Kilograms. 4. All the patients had previously led a sedentary life styie, with very little physical activity of any kind, including walking. 5. The site of predilection in the femoral shaft was distal one-third, occuring in 5(83.3%) of the cases. The site of other one case was middle one-third of the shaft. 6. The main cause of the fatigue fractures was marching on hard roads, and other cause was playing football. 7. Most of femoral fatigue fractures were classified as grade II, showing periosteal readion on both cortices. 8. All soldiers were treated by immediate stoppage of physical activity, with no plaster immobilization except a displaced fatigue fracture.

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Fatigue Fracture of the Distal Femur in Adolescence: A case Report: Nam Hong Choi, Young Sun Song, Ho Min Lee; J Korean Soc Fract 1996;9(3):809-813. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.809

Abstract PDF: Fatigue fractures have been described in almost every bone in the body, but they are more common in the bones of the lower extremities. Fatigue fractures are seen mainly in military personnel especially at basic training center, athletes, ballet dancers, laborers, and even pregnant woman. But they rarely developed at the distal femur of adolescent. We report a case of fatigue fracture of the distal femur in adolescent who was associated with neithor trauma nor sports activity.

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Acase of Fatigue Fracture of the Interlocking nail in the Treatment of Fracture of the Femoral Shaft: Ki Hong Choi, Chung Nam Kang, Jin Man Wang, Kwon Jae Roh; J Korean Soc Fract 1988;1(1):71-75. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.71

Abstract PDF: Closed intramedullary nailing with or without interlocking screws has been a widely accepted method for the fixation of fracture of the femora shaft. Certain complex fractures in which now are commonly treated by dynamic or static locking of the nail by using screws. Interlocking nail introduces the potential for high concentration of stress at both its proximal and its distal end. This paper describes a patient who had at fatigue fracture of the distal part of interlocking nail in the treament of fracture of the femoral shaft.

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