Journal of Musculoskeletal Trauma

The Shortening and Rotational Deformity after Closed Intramedullary Nailing of Femur Shaft Fracture: According to Winquist-Hansen classification: Dong Eun Shin, Dong Hoon Lee, Chang Soo Ahn, Ki Shik Nam; J Korean Fract Soc 2007;20(4):297-301. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.297

PURPOSE
This study evaluated the shortening and rotational deformity after closed intramedullary nailing of femur shaft fracture according to Winquist-Hansen classification type.
MATERIALS AND METHODS
This study was based on 98 cases who received cloased intramedullary fixation about their femur shaft fractures between January 2000 and October 2005 with minimum 12 months follow up. The rotational deformity was analysed by Yang's method (45 cases) preoperatively and postoperatively, and the shortening by orthoradiogram (55 cases). Furthermore we analysed other complications, for example nonunion, infection, and metal failure.
RESULTS
We found more than 15 degrees anteversion difference of both femurs in 10 cases. Among them, 9 cases were classified to type 3, 4. According to Winquist-Hansen classification, rotational deformity ranged from 3.7Â° (Type 1) to 8.9Â° (Type 4). More than 2 cm leg length discrepancy (LLD) was found in 9 cases, all of them were classified as Winquist-Hansen classification type 3, 4. In the type 1, LLD was checked as 3.2 mm and type 4, 14.2 mm.
CONCLUSION
To prevent the shortening and rotational deformity after intramedullary fixation of Winquist-Hansen classification type 3, 4 femur shaft fracture, intraoperatively the exact contralateral femoral anteversion and length should be checked.

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The Fate of Butterfly Fragments in Extremity Shaft Comminuted Fractures Treated with Closed Interlocking Intramedullary Nailing
Ki-Chan An, Yoon-Jun Kim, Jang-Suk Choi, Seung Suk Seo, Hi-Chul Gwak, Dae-Won Jung, Dong-Woo Jeong
Journal of the Korean Fracture Society.2012; 25(1): 46. CrossRef
Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture
Sang Ho Ha, Jun Young Lee, Sang Hong Lee, Sung Hwan Jo, Jae Cheul Yu
Journal of the Korean Fracture Society.2009; 22(4): 225. CrossRef

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Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann Pin: Sung Sik Ha, Jae Chun Sim, Ki Do Hong, Jae Young Kim, Jung Ho Kang, Kwang Hee Park; J Korean Fract Soc 2007;20(3):233-238. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.233

Abstract PDF

PURPOSE
To evaluate the results between open reduction and internal fixation with the plate and percutaneous reduction by towel clip and intramedullary fixation with Steinmann pin for clavicle shaft fractures in adult.
MATERIALS AND METHODS
We have studied the results in 33 cases with the plate, 35 cases with the Steinmann pin among total 68 cases of clavicle shaft fracture. The patients were followed up over a period of at least 12 months. The final postoperative outcome was analyzed with the clinical outcomes using Kang's criteria, radiological union time and operation time.
RESULTS
The clinical outcome that was good or excellent according to the Kang's criteria showed a distribution of 88% in the group using the plate with 29 cases out of total 33 cases, 91% in the group using the Steinmann pin with 32 cases out of total 35 cases. The mean radiological union time was 8.9 weeks in the group using the plate, 9.1 weeks in the group using Steinmann pin. The mean operation time was 72 minutes in the group using the plate, whereas was 18 minutes in the group using Steinmann pin.
CONCLUSION
In the treatment of adult clavicle shaft fracture, two groups did not show a significant statistical difference in clinical and radiological outcomes. However, the operation time and postoperative functional recovery was significantly shorter and faster in the group using Steinmann pin. Additionally economic and cosmetic aspect was more satisfactory in the group using Steinmann pin.

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Anatomical Reduction of All Fracture Fragments and Fixation Using Inter-Fragmentary Screw and Plate in Comminuted and Displaced Clavicle Mid-Shaft Fracture
Kyoung Hwan Koh, Min Soo Shon, Seung Won Lee, Jong Ho Kim, Jae Chul Yoo
Journal of the Korean Fracture Society.2012; 25(4): 300. CrossRef
Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?
Jae-Kwang Yum, Yong-Woon Shin, Hee-Sung Lee, Jae-Gu Park
Journal of the Korean Fracture Society.2011; 24(2): 138. CrossRef

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Pediatric Forearm Bone Fractures Treated with Flexible Intramedullary Nail: Suk Kyu Choo, Jin Hwan Kim, Hyung Keun Oh, Dong Hyun Kim; J Korean Fract Soc 2007;20(2):190-195. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.190

Abstract PDF: PURPOSE
To determine the usefulness of flexible intramedullary fixation in pediatric forearm diaphyseal fractures.
MATERIALS AND METHODS
We reviewed 22 cases of forearm diaphyseal fractures treated with flexible intramedullary nail and K-wire. The radiographic assessment was based on the time to union, maintenance of reduction and angular deformity. The functional outcome was assessed with the range of motion and complications at last follow up.
RESULTS
Average length of follow up was 13.9 months with mean age of 10.8 years and the time to union was 5.2 weeks. There were no angular deformity and fuctional results were excellent in all cases. There were 5 cases of soft tissue irritation of nail insertion site as post operative complication which was resolved after nail removal.
CONCLUSION
Flexible intramedullary for pediatric forearm bone fractures is an effective and safe method which gives a good functional outcome.

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Bouquet Pin Intramedullary Nail Technique of the 5th Metacarpal Neck Fractures: Myung Ho Kim, Moon Jib Yoo, Jong Pil Kim, Ju Hong Lee, Jin Won Lee; J Korean Fract Soc 2007;20(1):64-69. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.64

Abstract PDF

PURPOSE
To evaluate radiologic and clinical results of bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture.
MATERIALS AND METHODS
Between April, 2005 and February, 2006, 17 patients treated by bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture were evaluated. All patients were reviewed clinically and radiologically after operation.
RESULTS
All of 17 cases of fractures were completely united. In the anteroposterior radiographs, the average of preoperative angulation was corrected from 34.4Â° to 5.2Â°. Also, in the oblique radiographs, radiographic results of angulation correction were satisfactory which was corrected from 44.2Â° to 11.7Â°. Although, the averages of difference between postoperative and final follow-up angulations were 1.5Â° in the anteroposterior radiographs and 0.9Â° in the oblique radiographs, they were not statistically different. All patients were excellent clinically except 1 patient who has moderate joint stiffness after operation.
CONCLUSION
Selecting of appropriate patients who is indicated, bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture could be a good treatment method without complications.

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Percutaneous retrograde intramedullary single wire fixation for metacarpal shaft fracture of the little finger
Soo-Hong Han, Seung-Yong Rhee, Soon-Chul Lee, Seung-Chul Han, Yoon-Sik Cha
European Journal of Orthopaedic Surgery & Traumatology.2013; 23(8): 883. CrossRef
Treatment of 5th Metacarpal Neck Fracture Using Percutaneous Transverse Fixation with K-Wires
Jae-Hak Jung, Kwan-Hee Lee, Yong-Ju Kim, Woo-Jin Lee, Sung-Hyun Choi
Journal of the Korean Fracture Society.2012; 25(4): 317. CrossRef
Antegrade Intramedullary Prebent K-wire Fixation for the 5th Metacarpal Neck Fracture
Tae-Hyung Kim, Bo Hyeon Kim, In-Ho Jung, Dong-Hyun Kim
Journal of the Korean Fracture Society.2011; 24(1): 67. CrossRef
Percutaneous Retrograde Intramedullary Pin Fixation for Isolated Metacarpal Shaft Fracture of the Little Finger
Soo Hong Han, Hyung Ku Yoon, Dong Eun Shin, Seung Chul Han, Young Woong Kim
Journal of the Korean Fracture Society.2010; 23(4): 367. CrossRef

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Treatment of Humeral Shaft Fracture with Retrograde Flexible Nail: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Young Sung Kim, Sung Pock Park, Kwang Uk An; J Korean Fract Soc 2006;19(3):340-345. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.340

Abstract: PURPOSE
To evaluate and report the clinical and radiological results of the intramedullary fixation by retrograde flexible nail in the humeral shaft fracture.
MATERIALS AND METHODS
From July 2002 to May 2005, seventeen cases who had the humeral shaft fracture were treated with the intramedullary fixation by retrograde flexible nail. Fifteen cases were followed up and the clinical and radiological results were analyzed.
RESULTS
All of the cases had satisfactory fracture union, and none of the patient had limitation in shoulder or elbow joint movement, and shoulder or elbow joint pain, and average ASES was 42.86 point. There was 1 case of delayed union, and 3 cases of distal nail displacement. Another severe complications were not occurred.
CONCLUSION
Intramedullary fixation by retrograde flexible nail is one of the effective method in the humeral shaft fracture without nerve or vessel injuries, and also can avoid the complication of wide soft tissue incision or rotator cuff injury.

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Intramedullary Fixation in the Fracture of the Shaft of the Clavicle by Threaded Kirschner Wire: Jae Kwang Yum, Se Jin Park; J Korean Fract Soc 2005;18(2):89-92. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.89

Abstract PDF: PURPOSE
To evaluate and report the clinical result of the intramedullary fixation by threaded Kirschner wire in the clavicle shaft fracture.
MATERIALS AND METHODS
From May 2000 to April 2004, twenty patients who had the fracture of the shaft of the clavicle were treated by the intramedullary fixation with threaded Kirschner wire. Thirteen patients were followed up and the clinical and radiological results were analyzed.
RESULTS
All of the cases had satisfactory fracture union but there were four cases of skin irritation signs by the tip of threaded Kirschner wire. In one case, the Kirschner wire was bent at the fracture site with malunion. According to the clinical scoring system of Kang et al, eight cases were excellent and five cases were good.
CONCLUSION
Authors think that intramedullary fixation with threaded Kirschner wire in the fracture of the shaft of the clavicle is one of a good operative method because of small operative incision, easy operative method, satisfactory fracture union and easy removability of the implant.

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Intramedullary Fixation of Clavicle Fracture Percutaneously Reduced By Towel Clip: Ki Do Hong, Sung Sik Ha, Nam Sik Chung, Jae Cheon Sim, Gyoung Ho Kim; J Korean Fract Soc 2004;17(4):328-332. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.328

Abstract PDF

PURPOSE
To investigate the utility of surgical treatment of clavicle shaft fracture using a percutaneous towel clip reduction and intramedullary fixation.
MATERIALS AND METHODS
This study was conducted for total 16 cases of patients who had no neurovascular injury and a few comminuted bone fragment among patients with clavicle shaft fracture from January 2002 to July 2003. The method of operation was percutaneous towel clip reduction and intramedullary fixation. The clinical and radiological results were evaluated.
RESULTS
Radiologically, 15 cases showed bone unions and the average time was 9.1 weeks. According to Kang's criteria clinically, there were 14 cases which were more than an excellence. One case substituted open reduction and nailing fixation due to a medial migration of K-wire and re- displacement of fracture even in 1 week. However, there wasn't any other major complication.
CONCLUSION
Due to its having no additional injury to soft tissues, no scar formations, and its short operation time, percutaneous towel clip reduction and intramedullary fixation will be very useful as one of the treatments of clavicular shaft fracture if it follows correct surgical indications.

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Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Jung-Ho Kang, Kwang-Hee Park
Journal of the Korean Fracture Society.2007; 20(3): 233. CrossRef

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A Comparison of Treatment between Plate Fixation and Antegrade Intramedullary Fixation of the Humeral Shaft Fractures: Jung Ryul Kim, Joo Hong Lee, Byung Yun Hwang; J Korean Soc Fract 1999;12(1):119-125. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.119

Abstract PDF: We compared the clinical and radiographic outcomes between plate fixation and antegrade interlocking intramedullary fixation for humeral shaft fractures requiring operative intervention. Through retrospective, radomized comparative study, a total sixty adult patients have been reviewed. Thirty patients were treated with plate fixation, thirty another patients were treated with antegrade interlocking intramedullary fixation. Average follow-up time was two year and five months(range, one to four years). Average time to union was 10.8 weeks in plate fixation group and 16.9 weeks in intramedullary fixation group. Overall rate of union was 100% in plate fixation group and 90 % in intramedullary fixation group. According to Stewart and Hundleys functional assessment system, excellent or good results were obtained 29 cases(97%) in plate fixation group, 24 cases(80%) in interlocking intramedullary fixation group. In the plate group, only one fracture had deep infection but in the nail group, nine fractures had complications : three with nonunion, three with shoulder pain and limited ROM, two with intraoperative comminution and one with postoperative radial nerve palsy. There were some technical problems in antegrade intramedullay nailing such as difficulty proximal locking, failed expanlion of distal locking, iatrogenic fracture and distraction between fracture fragment. We concluded that the results after plate fixation have been shown to be preferable with respect to clinical and functional outcomes. In our study, the majority of circumstance requiring internal fixation, plate fixation is proferred and antegrade intramedullary fixation must be used in inevitable situation such as multiple trauma patients, fracture with overlying burns, patients with osteoporotic bone, pathologic fractures and segmental tractures.

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The Operative Treatment of the shaft Fractures of the Forearm Bone: Operative Comparison in Intramedullary Fixation to Plate Fixation on Treatment of the Both Forearm Bone Fracture: Chung Nam Kang, Jong Ho Kim, Dong Wook Kim, Young Do Gho, Jae Doo You, Jong Keon Oh, Jin Chang; J Korean Soc Fract 1998;11(1):63-69. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.63

Abstract PDF

Diaphyseal fractures of the radius and ulna present high incidence of malunion and nonunion because of difficulty in reduction and maintenence of two mobile, parallel ones in the presence of the pronating and supinating muscles which exert angulatory as well as well as rotational forces. The author divided the traceable patients into two groups, the one was the group treated with AO compression plates and the other one was the roup treated with Rush pin in radius and AO compression plate in ulna, and compared the results in the aspect of healing time and functional results. The results were as follows; 1.Those two groups were demographically similar. 2.The immobilization period and the radiologic bone union time did not differentiate two groups significantly. 3.In plate group, one nonunion, one nerve injury and two superficial wound infection were occurred. 4.Between the two operative methods selected alternatively, immobilization period, radiologic bone union and fuctional results were not different significantly, but the Rush pinning method was preferred due to simple operation technique, small operation scar, short operation time, a little blood loss, a few complication.

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Shaft Fractures of Both Forearm Bones: The Outcomes of Surgical Treatment with Plating Only and Combined Plating and Intramedullary Nailing
Sang Bum Kim, Youn Moo Heo, Jin Woong Yi, Jung Bum Lee, Byoung Gu Lim
Clinics in Orthopedic Surgery.2015; 7(3): 282. CrossRef
Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults
Sanglim Lee, Hee-Sung Lee, Yerl-Bo Sung, Jae-Kwang Yum
Journal of the Korean Fracture Society.2009; 22(1): 30. CrossRef

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Treatment using Intramedullary Fixation for Open Tibial Diaphyseal Fractures: Young Goo Lee, Jnng Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seung Seok Seo, Sang Hun Ha; J Korean Soc Fract 1996;9(3):583-592. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.583

Abstract PDF: This fractures of tibial shaft are common and open injuries are frequently accompanied due to its anatomical characteristics. External fixation was widely used for treatment of open fractures of tibia, but recently internal fixation combined with appropriate debridement and antibiotics has been reported, with more comfortness and less secondary operations. We analysed 33 cases of open tibial diaphyseal fractures treated using intramedullary fixation devices. The results were as follows. 1. The methods of fixation were Ender nail, 15 cases, and interlocking nail, 18 cases. And 17 cases out of 18 interlocking nail were unlearned one. 2. The Ender nail was used in 5 cases for open type I fracture, 7 type II, 2 type III-a and 1 type III-b, And the interlocking nail was used in 9 cases for type 1, 7 type II, 1 type IIIa and 1 type III-b. The average operation time was 55 minutes for Ender nail, while 14 minutes for interlocking nail. 3. The Ender nailing group has 6 complications;one case superficial infection, one deep infection, one delayed union, one nonunion and two angulation deformities. The interlocking nailing group has also 6 complications;one case superficial infection, two deep infections, one delayed union, one nonunion and one peroneal nerve palsy. 4. The average union period was 18.4 weeks in Ender nail and 19.1 weeks in interlocking nail.

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Clinical Comparison in Intramedullary Fixation to Plate Fixation on Treatment of the Both Forearm Bone Fractures: Seog Yeong Jeong, Ung Moon, Soo Jae Yim, Seung Ryeol Yoon, Soo Kyun Rah, Chang Uk Choi; J Korean Soc Fract 1995;8(4):893-901. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.893

Abstract PDF

The diaphyseal fractures of radius and ulnar have many problems like nonunion, malunion and functional disturbance with conservative treatment. Therefore, open anatomical reduction and rigid internal fixation have been widely used. The plate fixation has been employed in most both forearm bone fractures and the intramedullary pinning usually used in cases of the open fractures, comminuted types, multiple fractures or poor general conditions. Seventeen patients were treated with semitubular plate and eighteen cases by the closed or open reduction and intramedullary fixation with Rush pin(the operation methods were decised alternatively) were followed up more than one year at Soonchunhyang Gumi Hospital from June 1988 to Nov. 1992 and the results were compared and analyzed clinically. 1. Those two groups were demographically similar. 2. The operation time was 65 minites in Rush pin group, 85.6 minutes in plate group and the blood loss was 37.1cc in Rush pin group,85.3cc in plate group. 3. The immobilization period and the radiologic bone union time did not differentiate two groups significantly. 4. In plated group, one nonunion and one radius refracture after union(plate removed state) were occurred. 5. Between the two operatio methods selected alternatively, immobilization period, radiologic bone union and functional results were not different significantly, but the Rush pinning method was preferred due to simple operation technique, small operation scars, short operation time, a little blood ioss, a few complications.

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Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture
Yong Chan Lee, Hong Je Kang
Journal of the Korean Society for Surgery of the Hand.2015; 20(4): 168. CrossRef
Pediatric Forearm Bone Fractures Treated with Flexible Intramedullary Nail
Suk Kyu Choo, Jin Hwan Kim, Hyung Keun Oh, Dong Hyun Kim
Journal of the Korean Fracture Society.2007; 20(2): 190. CrossRef

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Comparison between Intramedullary and Plate Fixation for Subtrochanteric Fracture of the Femur: Han Suk Ko, Byung Jik Kim, Suk Kyu Choo, Jae Sung Choi; J Korean Soc Fract 1994;7(2):352-363. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.352

Abstract PDF: Management of subtrochanteric fractures of the femur is difficult because it occurs in bone that is predominantly cortical and high stress concentrates in this region. The subtrochanteric fracture is difficult for the accurate reduction and maintenance because many of these fractures are cmminuted from high velocity trauma and its proximal fragment is severely displaced by adjacent strong muscles pooling. Therefore, as a rule we prefer to treat subtrochanteric fractures by operative means if possible. Many internal fixation devices have been recomended for use in subtrochanteric fractures and their selection should be based on the individual fracture anatomy. In recent years, generally accepted two methods are intramedullary nailing and plate fixation. We have reviewed our experience using the intramedullary fixation on 14 cases of subtrochanteric femur fracture and compared the result with those of 14 cases of plate fixation. All the 28 cases were treated at the Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University in the period from March 1988 to March 1993. Intramedullary fixation were implanted with shorter operating time, smaller incisions, and less intraoperative bleeding. The intramedullary fixation group had a shorter covalescence and earlier full weight-bearing but no significant difference in fracture union rate with plate fixation group. We conclude that with careful surgical technique, the intramedullary fixation was a more suitable method for the treatment of the subtrochanteric femoral fractures.

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