Journal of Musculoskeletal Trauma

Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture: Chang Wug Oh, Jong Keon Oh, Woo Kie Min, Shin Yoon Kim, Seung Hoon Baek, Byung Chul Park, Hyung Soo Ahn, Tae Gong Kim; J Korean Fract Soc 2007;20(2):135-140. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.135

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

Citations

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Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants
J. D. Cnossen, Esther M. M. Van Lieshout, Michael H. J. Verhofstad
Archives of Orthopaedic and Trauma Surgery.2023; 143(10): 6229. CrossRef
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

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A Biomechanical Advantage of the Lengthening with an External Fixator Over an Intramedullary Nail: An Experimental Study in Saw Bones and Cadeveric Bones: Chang Wug Oh, Poong Taek Kim, Hae Ryong Song, Jong Keon Oh, Hyung Soo Ahn, Byung Chul Park, Byung Guk Min, Sung Ki Park, Young Heon Sohn; J Korean Fract Soc 2005;18(3):335-340. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.335

Abstract PDF: 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.

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Management of Ipsilateral Femur and Tibia Fractures, with Retrograde and Antegrade Nailings from the Knee: Chang Wug Oh, Jong Keon Oh, Woo Kie Min, In Ho Jeon, Hyung Soo Ahn, Hee Soo Kyung, Poong Taek Kim, Jung Ho Noh; J Korean Fract Soc 2005;18(2):131-135. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.131

Abstract PDF

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

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Treatment of Intertrochanteric Fractures using Gamma Nail: Joo Chul Ihn, Byung Chul Park, Sin Yoon Kim, Hyung Soo Ahn; J Korean Soc Fract 1994;7(2):588-596. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.588

Abstract PDF

Surgical fixation, early weight bearing and bony union remain a challange in the treatment of intertrochanteric femur fractures, especially if the fractures are comminuted or unstable. We have experienced 18 cases of intertrochanteric femur fracture that were treated using Asian Gamma nails(Gamma AP) in Kyungpook National University Hospital in period from Feb. 1993 to Oct. 1993. Early full weight bearing was encouraged and this seemed to be beneficial for old patients. All fractures were healed securely and many patients(15/18) could be painless ambulatory regardless of fracture configuration(9 fractures classified as unstable). Major complications included screw cut-out(2 cases), lateral cortical fracture(1 cases) and delayed union(1 case). In this early experience, the Gamma nail appears to be useful internal fixator for intertrochanteric femur fractures and it allows early ambulation regardless of the fracture configuration with excellent clinical results.

Citations

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Surgical Treatment of Femoral Unstable Intertrochanteric Fractures in Elderly Patients -Comparative Study between Compressive Hip Screws and Additional Trochanteric Stabilizing Plates-
Kap Jung Kim, Dae Suk Yang, Sang Ki Lee, Won Sik Choy, Kyoung Wan Bae
Journal of the Korean Fracture Society.2011; 24(4): 295. CrossRef
Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone
Haw Jae Jung, Jae Yeol Choi, Hun Kyu Shin, Eugene Kim, Se-Jin Park, Yong Taek Lee, Gwang-Sin Kim, Jong-Min Kim
Journal of the Korean Fracture Society.2007; 20(4): 291. CrossRef

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Treatment of Intertrochanteric Fractures using Gamma Nail: Joo Chul Ihn, Byung Chul Park, Sin Yoon Kim, Hyung Soo Ahn; J Korean Soc Fract 1994;7(2):580-587. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.580

Abstract PDF: Surgical fixation, early weight bearing and bony union remain a challange in the treatment of intertrochanteric femur fractures, especially if the fractures are comminuted or unstable. We have experienced 18 cases of intertrochanteric femur fracture that were treated using Asian Gamma nails(Gamma AP) in Kyungpook National University Hospital in period from Feb. 1993 to Oct. 1993. Early full weight bearing was encouraged and this seemed to be beneficial for old patients. All fractures were healed securely and many patients(15/18) could be painless ambulatory regardless of fracture configuration(9 fractures classified as unstable). Major complications included screw cut-out(2 cases), lateral cortical fracture(1 cases) and delayed union(1 case). In this early experience, the Gamma nail appears to be useful internal fixator for intertrochanteric femur fractures and it allows early ambulation regardless of the fracture configuration with excellent clinical results.

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