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14 "Ipsilateral fracture"
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Case Reports
Major Limb Replantation of Lower Leg Amputation with Ipsilateral Distal Femoral Comminuted Fracture in Old Age: A Case Report
Tae Young Ahn, Seung Joon Rhee, Sang Ho Kwak, Hyo Seok Jang, Sang Hyun Lee
J Korean Fract Soc 2019;32(4):227-231.   Published online October 31, 2019
DOI: https://doi.org/10.12671/jkfs.2019.32.4.227
AbstractAbstract PDF
The development of microsurgical techniques has also increased the success rate of replantation surgery. This paper reports the results of limb replantation performed on a lower extremity amputation that was associated with crush amputation and an ipsilateral comminuted fracture in and elderly patient. A 68-year-old female presented with a right distal tibia amputation due to a traffic accident. At that time, with a comminuted fracture in the distal femoral condyle, simple wound repair was recommended, but the caregivers strongly wanted replantation. Three years after surgery, normal walking was possible without a cane and the patient was satisfied with the function and aesthetics. What used to be contraindicated in limb replantation in the past are now indications due to the development of microsurgical techniques, surgical experience, and postoperative rehabilitation treatment. If the patient is willing to be treated, good results in contraindications can be obtained.
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Ipsilateral Femoral Segmental and Tibial Fractures : A Case Report
Oog Jin Sohn, Chul Hyun Park, Sang Keun Bae
J Korean Fract Soc 2009;22(3):193-196.   Published online July 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.3.193
AbstractAbstract PDF
The ipsilateral femoral segmental and tibial fractures seldom occur such as traffic accidents needed high energy mechanisms. For these fractures, surgical stabilization and early mobilization of joint produce can be the best clinical outcomes. We have experienced a case of ipsilateral femoral segmental and tibial fracture and gained good clinical results with surgical treatment. We have reported here on this case and included a review of the relevant literature.

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  • Clinical Outcome after Treatment of Tibia Segmental Fracture with Intramedullary Nailing and Minimal Invasive Plate Osteosynthesis
    Jun Young Lee, Hyung Seok Park, Dong Hyuk Cha
    Journal of the Korean Fracture Society.2020; 33(3): 142.     CrossRef
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Original Articles
Instability of Knee Associated with Ipsilateral Femoral and Tibial Shaft Fractures
Whan Yong Chung, Woo Suk Lee, Woo Sik Kim, Yong Chan Kim, Taek Soo Jeon, Sun Hong Kim, Ji Hyuk Lim, Young Su Lim
J Korean Fract Soc 2005;18(2):136-143.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.136
AbstractAbstract PDF
PURPOSE
To establish the incidence, type and significance of knee instability in patients with ipsilateral femoral and tibial shaft fracture, comparing with the patients with femoral shaft or tibial shaft fracture alone.
MATERIALS AND METHODS
Two hundreds and seventy-nine consecutive patients were retrospectively reviewed from February 2000 to April 2004. They were composed of 80 patients with femoral shaft fracture alone, 176 patients with tibial shaft fracture alone and 23 patient with ipsilateral femoral and tibial shaft fracture. We evaluate the instability of knee based on physical examinations, plain stress films and MRI. We analyze incidence and period to diagnosis of instability, period to complete bony union and Hospital for Special Surgery (HSS) knee score respectively.
RESULTS
There were 6.3% of knee instability in femoral shaft fracture alone, 9.7% in tibial shaft fracture alone and 30.4% in ipsilateral femoral and tibial shaft fracture. The average period to diagnosis of instability, average period to complete bony union and average HSS knee score were 9.2 months, 4.7 months and 65 points in femoral shaft fracture alone, 9.1 months, 4.2 months and 69 points in tibial shaft fracture alone, 8.7 months, 5.3 months (femur), 4.7 months (tibia) and 57 points in ipsilateral femoral and tibial shaft fracture respectively.
CONCLUSION
We should consider MRI to evaluate the knee instability in patient with ipsilateral femoral and tibial shaft fracture at the time of injury and make a plan early about the treatment of knee instability.
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Difficulties in the treatment for ipsilateral concomitent femoral neck & shaft fractures
Chang Wug Oh, Shin Yoon Kim, Hee Soo Kyung, Joo Chul Ihn, Hyung Tae So, Jong Min Lee, Ho Wook Wee
J Korean Soc Fract 2001;14(2):152-158.   Published online April 30, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.2.152
AbstractAbstract PDF
PURPOSE
This retrospective study was performed to know the difficulties and efficient methods of treatment after several types of operations for ipsilateral femoral neck and shaft fracture.
MATERIALS AND METHODS
Thirteen cases (12 patients) with ipsilateral femoral neck and shaft fracture at the mean age of 36.6(range 21-51), have been followed up over the minimum of one year. All the patients suffered from motor vehicle accidents(11 in dash-board injury), and most of patients associated with multiple injuries including other fractures. All of femoral neck fracture were same type in basicervical area and 4 of them were missed initially. According to the classification of femoral shaft fractures, middle 1/3 fracture was most common in 10 cases and type C in 8 cases. In neck fractures, all cases were treated with multiple pinning, but in shaft fractures, 6 were treated by open plating, 5 by closed antegrade nailing, and 2 by retrograde nailing.
RESULTS
The mean union period was 12.1 weeks in neck fractures and 9.9 months in shaft fractures. In complications, there were 1 case of nonunion and 1 case of avascular necrosis in neck fractures, and 8 of delayed union, 3 of nonunion, and 2 of malunion, in shaft fractures. The methods of treatment had no influence on the results of this injury, but we had 1 failure in antegrade nailing prior to operation of neck fracture.
CONCLUSION
After operation of ipsilateral femoral neck and shaft fracture, the shaft fracture needed longer time of union and had many problems in spite of different methods. We suppose that many problems in shaft are affected not only by characteristic mechanism of injury, but also by multiple associated injury.

Citations

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  • Treatment for Concurrent Ipsilateral Femoral Neck and Shaft Fractures Using Reconstruction Nail with Temporary K-Wires
    Sang-Joon Lee, Sang Hong Lee, Sang Ho Ha, Gwang-Chul Lee
    Journal of the Korean Fracture Society.2015; 28(1): 23.     CrossRef
  • 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
    Journal of the Korean Fracture Society.2007; 20(2): 135.     CrossRef
  • Retrograde Intramedullary Nailing for the Treatment of Ipsilateral Femoral Shaft and Neck Fracture
    Chang-Wug Oh, Jong-Keon Oh, Shin-Yoon Kim, Ki-Bong Cha, In-Ho Jeon, Byung-Chul Park, Woo-Kie Min, Tae-Gong Kim
    The Journal of the Korean Orthopaedic Association.2007; 42(3): 380.     CrossRef
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Surgical Treatment of Ipsilateral Fracture of the Femur and Tibia("Floating Knee")
Eu Sub Chung, Ki Sik Hong, Seung Soo Hwang
J Korean Soc Fract 1998;11(4):825-832.   Published online October 31, 1998
DOI: https://doi.org/10.12671/jksf.1998.11.4.825
AbstractAbstract PDF
Ipsilateral fractures of the femur and tibia is also called "Floating knee", It is the term applied to the flail knee joint segment resulting from a fracture of the shaft or adjacent metaphysis of the ipsilateral femur and tibia. The principles of the treatment is focussed to the rigid fixation and early restoration of the knee function. Authors reviewed 24 patient in which were treated surgical management from January 1991 to June 1998. The results were as following : 1. The patient who had both diaphyseal fractures had better clinical result than metaphyseal fractures. And the metaphyseal fractures associated with intraarticular fractures were worse than other metaphyseal fractures. 2. At the last follow up, the excellent and good results were achieved in 71% of the patients treated with internal fixation of both fractures and 60% of the patient with external fixation of the tibia, but all of the patient with wxternal fixation of the femur were poor result by Karlstrom and Olerud criteria.
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Analysis of the Operative Treatment of Ipsilateral diaphyseal Fractures of the Humerus and Forearm
Jung Ryul Kim, Kyung Jin Song, Sung Jin Kim, Jun Mo Lee, Byung Yun Hwang
J Korean Soc Fract 1998;11(1):34-40.   Published online January 31, 1998
DOI: https://doi.org/10.12671/jksf.1998.11.1.34
AbstractAbstract PDF
Twenty-six adults who had concomitant ipsilateral shaft fracture of the humerus and forearm were managed with operative treatment. The mean age was 41 years (range 20 to 55 years), and the mean follow-up was 3.3 years (range 1.5 to 6 years). We reviewed initial soft tissue injury, presence of open fracture, and evaluted radiologic bone union. The functional outcome assessed with rating system of Lange and Foster, which is based on terms of fracture healing and functional restoration of the upper extremity. Overall rate of union for the humerus was 88.4 per cent, for the radius was 82.6 per cent and for the ulna 84.2 percent. We found no difference in average time to union between the treatment group with regard to open reduction and plate fixation or intramedullary nailing in the humerus and forearm bones (P>0.1, Wilcoxon signed rank test). But radiologic evaluation revealed a significant correlation between presence of open fracture and average time to union. The functional result was good in 12 cases (46%), fair in 6 cases(23%), and poor in 8 cases (31 %) according to Lange and Foster criteria. There were four nonunions of the humerus, three of the radius, and three of the ulna. Infection occurred three patients. Other complications were high radial nerve palsy in one case and above elbow amputation in one case. The results following injury were affected both by the severity of the initial trauma and by the treatment given. Best chance for a functional outcome will result from stable fixation of both the humeral and the forearm components.

Citations

Citations to this article as recorded by  
  • Classic Floating Elbow in Adults: A Case Series
    Chul-Hyun Cho, Kyung-Keun Min
    Clinics in Shoulder and Elbow.2015; 18(1): 8.     CrossRef
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The Treatment and Complications of Ipsilateral Fracture of the Femur and tibia
Kyu Min Kong, Ki Chan Ahn, Sung Seok Seo, Young Chang Kim, Jang Seok Choi, Young Goo Lee
J Korean Soc Fract 1997;10(3):556-561.   Published online July 31, 1997
DOI: https://doi.org/10.12671/jksf.1997.10.3.556
AbstractAbstract PDF
Ipsilateral fracture of the femur and tibia is difficult to treat because it is often comminuted and combined with severe soft tissue injury. And The result of treatment is poor in most cases. The thirty-four cases were treated at Pusan Paik Hospital from March, 1992 to February, 1995. The result were as follows; 1. The bony union time was shorter in the intramedullary nailing than other methods. 2. There were less complications in the group of used intramedullary nailing than other methods. 3. The intramedullary nailing was relatively good treatment method for ipsilateral fracture of the femur and tibia.
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Treatment with an Interlocking Nail for Ipsilateral Fracture of the Femur and Tibia
Sang Soo Kim, Churl Hong Chun, Dong Churl Kim, Sang Hoon Cha
J Korean Soc Fract 1996;9(3):541-546.   Published online July 31, 1996
DOI: https://doi.org/10.12671/jksf.1996.9.3.541
AbstractAbstract PDF
Concomitant ipsilateral femoral and tibial fractures present a challenging therapeutic problem. They are generally caused by high-energy trauma, primarily motor-vehicle accidents, and the associated injuries frequently develop. Also the complications much as delayed union, non-union, malunion and stiffness of the knee are more prevalent in patients with this combination of fractures than in patients with an isolated femoral or tibial fractures. The interlocking nail system has many advantages about among the many treatment methods of isolated long bone fractures, but the surgical technique is very difficult at the concomitant ipsilateral femoral and tibial fractures. The purpose of this study has been to review the surgical technique and to grasp an easy reduction method at that fractures. We routinely perform the interlocking nail for the ipsilateral femoral and tibial fractures in order to promote early motion of the knee in 14 patients from 1989 to 1995. Local complications included 1 case of femoral metal failure, and 2 cases of nonunion treated by bone graft. At the last follow up examination, at an average of 13 months after injury, the mean range of motion of the knee was 130 degrees. Over-all, a good or excellent functional result was achieved in about 93% of the patients according to the criteria suggested by Karlstr m and Olerud. In conclusion, the best results were achieved when both fractures were stabilized surgically with the interlocking nail system.
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Ipsilateral Fractures of the Femur and Tibia
Hyoun Oh Cho, Kyeong Duck Kwak, Sung Do Cho, Cheol Soo Ryoo, Jang Ho Oh
J Korean Soc Fract 1996;9(2):416-423.   Published online April 30, 1996
DOI: https://doi.org/10.12671/jksf.1996.9.2.416
AbstractAbstract PDF
Concomitant ipsilateral femoral and tibial fractures are generally caused by high energy trauma with high incidence of associated injuries and complications. Twenty-seven cases of ipsilateral fractures of the femur and tibia in 25 adults from 1990 through 1994 were reviewed and the patients were grouped according to the type of fracture and the method of treatment. Nine femoral fractures(33%) and 19 tibial fractures(70%) were open. All but one femoral fractures and 23 tibial fractures were treated operatively with plate and screws, intramedullary nail and external fixator. Local complications include 14 delayed or non-onions, 3 deep infections, 1 compartment syndrome and 2 below-the-knee amputations. Over-all, a good or excellent functional result was achieved in 20 cases(74%). More use or rigid external fixation is recommended in the management of the tibial fracture, combined with internal fixation of the femoral fracture. Examination of the ipsilateral knee suggested that with the "floating knee injuries", disruption of ligaments is a common occurance and should always by suspected.
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Treatment of the Ipsilateral fracture of Femur and Tibia in Children
Jong Seok Park, Yoon Sik Kim, Hee Kwon, Jun Min Song, Soo Kyun Rah, Chang Uk Choi
J Korean Soc Fract 1996;9(1):129-136.   Published online January 31, 1996
DOI: https://doi.org/10.12671/jksf.1996.9.1.129
AbstractAbstract PDF
Sixteen cases of fracture of the femur and tibia on the same leg in children below 16 year age were treated in Soonchunyang Univ. Hospital during the period 1988-1993. We studied all of these patients, classified by LettsNew classification of pediatric floating knee, retrospectively with analysis of treatment and results. The results were as follows; 1. Among the 16 cases,14 cases were male(88%), and 10 cases(63%) were at their first decade and 6 cases(37%) were at second decades. 2. The main cause of injury was traffic accident;15 cases(94%). 3. The most common concomitant injury was fracture in other site;5 cases(31%). 4. Among the 9 cases of conservative treatment, limping and leg length inequality were occurred in 6 cases(61%), and malunion in 5 cases(56fo). 5. Among the 7 cases of operative treatment, limping was occurred in 1 cases(14%), leg length inequality was in 2 cases(29%), and malunion in 3 cases(43%). 6. Among the 10 cases at first decade, limping was occurred in the 6 cases(75%) out of 8 cases of conservative treatment, but it was not occurred in 2 cases of operative treatment. According to the results, we suggest that at least one fracture should be rigidly fixed in all cases.
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Treatment of Ipsilateral Fracture of the Femur and Tibia
Dong Heon Kim, Kyu Cheol Shin, Bo Hyeon Kim
J Korean Soc Fract 1995;8(3):620-627.   Published online July 31, 1995
DOI: https://doi.org/10.12671/jksf.1995.8.3.620
AbstractAbstract PDF
The floating knee describes the fail knee joint segment resulting from fractures of the shafts or adjacent metaphyses of the ipsilateral femu. and tibia. It usually is associated with majo. soft tissue damages, open fractures, and other site injuries. The methods of treatment have been controversal. The key point of the treatment is focussed to the early restoration of the knee function. The floating knee in 24 patients were treated by surgical management from March 1988 to December 1994. The results were follows: 1. Average bone union time in femur was 20 weeks and in tibia was 18 weeks. Difference of the result of the treatment between the interlocking nail and Ender nail was not significant. 2. At the last follow up, the excellent and good results were 83% by Karlstrom and Olerud criteria, and the first group using the intrarneduallary nail achieved best result. 3. The most common complication was loss of the range of motion of the knee and loss of the range of motion of the knee was 0 to 45 degrees(the average 1 degrees).
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Treatment of Ipsilateral Fracture of the Femur and Tibia("Floating Knee")
Soo Bong Hahn, Gang Hee Koh
J Korean Soc Fract 1995;8(3):488-496.   Published online July 31, 1995
DOI: https://doi.org/10.12671/jksf.1995.8.3.488
AbstractAbstract PDF
Concomitant ipsilateral femoral and tibial fractures present a challenging therapeutic problem. They are generally caused by high-energy trauma, primarily motor-vehicle accidents, and the local trauma to the soft tissue is often extensive. We retrospectively reviewed 48 cases of the ipsilateral fracture of femur and tibia from March 1983 to March 1993 and analyzed the clinical and functional results. The results were as follows. 1. The most common site of fracture was middle one-third and the most common type of the fracture was comminuted in both femur and tibia. 2. The most common associated injury was concomitant fracture and dislocation of other sites(28 cases) and fat embolism was developed in 4 cases and compartment syndrome was developed in 3 cases. 3. Satisfactory reults were achieved in 72% of the patients treated with internal fixation of both fracture, 63% of the patient with internal fixation for the femur and 43% of the patients managed conseuatively.

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  • Comparison of Floating Knee according to Presence of Knee Joint Injury
    Eau-Sup Chung, Jong Hyuk Park, Hee Rack Choi, Joo Hong Lee, Kwang-Bok Lee
    Journal of the Korean Fracture Society.2012; 25(4): 277.     CrossRef
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Femoral Shaft Fracture Associated with Ipsilateral Femoral Neck or Intertrochanteric Fracture
Kyoo Ho Shin, Yun Pei Kung, Jun Seop Jahng
J Korean Soc Fract 1995;8(3):480-487.   Published online July 31, 1995
DOI: https://doi.org/10.12671/jksf.1995.8.3.480
AbstractAbstract PDF
The segmental fracture of the femur usually was caused by severe force and often accompanied with marked damage of the soft tissue and associated fractures of the other bones. Treatment of the segmental fracture is almost always required operation, and the interest lies in deciding on what operating methods to use and the technical difficulty involed with each method. From Jan. 1986 to Dec. 1993, 29 patients were treated for femoral neck or intertrochanteric fractures which accompanied with ipsilateral femoral shaft fractures at Severance Hospital, Yonsei University College of Medicine, 16 cases were intracapsular (femoral neck) and 13 cases were extracapsular (intertrochanter) hip fractures. We analysed the union time and complications of the 21 cases which were followed over one year. The following results were obtained: 1. For the group of ipsilateral femoral neck and shaft fracture, the knee injury was the most common associated injury (66.7%). 2. For the group of ipsilateral intertrochanter and femoral shaft fracture, the knee injury was not so frequent than the previous group (11.1 to). 3. The ipsilateral femoral neck and shaft fracture was induced by a longitudinal force, which was parallel with femoral shaft and through the knee, and accompanied with a lateral force. But the ipsilateral intertrochanter and femoral shaft fracture may be induced by a different mechanism, a direct transverse force towards the proximal femur. In conclusion. the ipsilateral intertrochanteric and femoral shaft fracture should be distinguished from the ipsilateral femoral neck and shaft fracture, because of the associated injury pattern and different mechanism of the injury.
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Ipsilateral Fractures of the Hip Joint and Femoral Shaft
Sang Won Park, Soon Hyuck Lee, Jung Ho Park, Hong Kun Lee
J Korean Soc Fract 1990;3(1):88-95.   Published online May 31, 1990
DOI: https://doi.org/10.12671/jksf.1990.3.1.88
AbstractAbstract PDF
Ipsilateral fractures of the hip joint and femoral shaft, which generally occur by severe trauma, are frequently associated with multiple fractures and other injuries. Initially overlocked femur neck fracture may lead unpredicted complications, and femoral shaft fractures, usually comminuted, could be complicated with malunion, infection, limb shortening and limited ROM of knee joing. It is difficult to determine the type of fixation device and priority of fracture in treatment according to the variation of the site and pattern of fracture. Eleven pateints with ipsilateral fractures of hip joint and femoral shaft were treated at Korea university Haehwa hospital from Jan. 1984 to Oct. 1988. Among them, nine pateints were followed up more than twelve months. There were eight male and one female. The ages ranged from twenty-two to fifty-three years, the average being 37.6 years. Seven cases caused by traffic accident and fall down trauma in two cases. 1. The levels of hip joint fractures were 6 femoral neck, 1 basal neck-intertrochanteric, and 2 intertrochanteric region. 2. The levels of femoral shaft fractures were 3 proximal one-third and 6 middle one-third. 3. Eight fractures of the femoral shaft except one were comminuted or segmented. 4. Six patients has other fractures or organ injuries. 5. All nine pateints had operation. In six patients with femoral neck and shaft fractures, the femoral shaft fractures were first reduced and fixed, and femoral neck fractures were stabilized later, In three pateints with femoral shaft and basal neck or intertrochanteric fractures, both fractures reduced and fixed simultaneously. 6. Several devices were used according to the site and patterns of fractures. 7. There were complications in three cases:one coxa vara, limb shortening, and infection, knee joint sitffness, and avascular necrosis in one case.
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