PURPOSE To evaluate the results of fracture fixation between using Proximal Femoral Nail and using Proximal Femoral Nail A and to analyze the effectiveness of proximal femoral nail A. MATERIALS AND METHODS We reviewed 32 patients who suffered from intertrochanteric fracture in our hospital, which were 19 cases of PFN and 13 cases of PFNA. Retrospectively we evaluated mean operation time, amount of bleeding, beginning of ambulation, average union period, changes of neck shaft angle and complication on set of telephone interview and OPD. We also evaluated postoperative capability of function and mobility using 'Social function score' and 'Mobility score'. RESULTS PFNA showed shorter mean operation time, less bleeding, shorter average union period, earlier ambulation and less change of neck shaft angle than PFN. Although they didn't show statistical difference, postoperative capability of function and mobility showed statistical and mathematical difference on each group. CONCLUSION PFNA showed better results of postoperative function and mobility and less complications than PFN. So treatment using PFNA is better method than that of PFN.
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Treatment of the Proximal Femoral Fracture Using the New Design Cephalomedullary Nail: Prospective Outcomes Study Young Ho Roh, Joseph Rho, Kwang Woo Nam Journal of the Korean Fracture Society.2019; 32(1): 35. CrossRef
Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail Jae-Cheon Sim, Tae-Ho Kim, Ki-Do Hong, Sung-Sik Ha, Jong-Seong Lee Journal of the Korean Fracture Society.2013; 26(1): 37. CrossRef
Comparative Study of Proximal Femoral Nail Antirotation and Zimmer Natural Nail for the Treatment of Stable Intertrochanteric Fractures Jee-Hoon Kim, Oog-Jin Shon Journal of the Korean Fracture Society.2013; 26(4): 305. CrossRef
Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture Kwang-Jun Oh, Sung-Tae Lee, Suk-Ha Lee, Jin-Ho Hwang, Min-Suk Kang Journal of the Korean Fracture Society.2010; 23(1): 6. CrossRef
Treatment of the Unstable Intertrochanteric Fracture with Proximal Femoral Nail Antirotation: Comparison with Compression Hip Screw with Trochanteric Stabilizing Plate Tae-Ho Kim, Jong-Oh Kim, Seung-Yup Lee, Geon-Ung Yun Journal of the Korean Fracture Society.2010; 23(4): 353. CrossRef
Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture Jong Min Lim, Jeung Il Kim, Jong Seok Oh, Kuen Tak Suh, Jae Min Ahn, Dong Joon Kang Journal of the Korean Fracture Society.2010; 23(4): 360. CrossRef
PURPOSE To evaluate prospectively the results of early active exercise after open Bankart repair of traumatic anterior shoulder instability. MATERIALS AND METHODS From January, 2001 to June, 2003, 26 patients who were followed up at least 1 year after open Bankart repair for traumatic anterior shoulder instability were evaluated. Average age was 23.9 years old (range, 19~43) with 24 males and 2 females. We evaluated them using the functional shoulder scores (modified Rowe score, ASES score), range of motion, VAS pain scale, patient's subjective satisfaction and return to unlimited daily living activity. RESULTS The shoulder functional scores increased significantly. At last follow up, the final range of motion were flexion in average 5° deficit in comparison to normal side, external rotation in average 10o deficit, and internal rotation in T9. The patient's subjective satisfaction was good in 2l patients (81%). Return to unlimited daily activity was possible in 23 patients (88.5%), and 19 patients (73%) rejoined to sports activity before injury. There were complications including anterior recurrent subluxation in 1 case, weakness of subscapularis muscle in 1 case. CONCLUSION In traumatic anterior shoulder instability, early active range of motion exercise after open Bankart repair does not decrease shoulder stability. Early exercise can be useful for returning to previous level of sports activity in young active patients.
We report an unusual case of Kirschner wire migration from the proximal humerus into the thoracic cavity and diaphragm which induced pneumothorax and hemoperitoneum. An 81-year-old woman admitted to the emergency room due to sudden onset of dyspnea. X-rays showed pneumothorax and old proximal humerus fracture fixed with rush pins and K-wires. One of K-wires was seen on the diaphragm level at posterior gutter of chest wall. Through the abdomen, K-wire was removed from the diaphragm and a chest tube was inserted. The potential for K-wires to migrate must be recognized, and frequent postoperative radiographic studies have to be performed for the early detection of loosening and migration. It appears that if K-wires are used for fixation of proximal humerus, the lateral ends must be bent to prevent medial migration, and when the desired therapeutic goals have been achieved, these pins have to be susbsequently removed as soon as possible.
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Spinal Canal Migration of a K-Wire Used for Fixation of a Distal Clavicular Fracture Byung-Ill Lee, Yong-Beom Kim, Hyung-Suk Choi, Chang-Hyun Kim, Jung-Woo Ji Journal of the Korean Orthopaedic Association.2013; 48(3): 231. CrossRef
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PURPOSE To know the functional and radiologic results of the operative treatment for the type I and II tibial plateau fractures according to the methods of internal fixations. MATERIALS AND METHODS Twenty-six patients, who had been treated with open reduction and internal fixation for the type 1 or 2 tibial plateau fractures were evaluated. Twelve cases of type 1 fractures were fixated with 1 lag screw in 5, 2 lag screws in 4 and buttress plate in 3. Fourteen cases of type 2 fractures were fixated with 1 lag screw in 4, 2 lag screws in 6 and buttress plate in 4. The criteria of Hohl and Porter was used for the evaluation of the clinical and radiological results. RESULTS There was no significant difference in the clinical result in type 1 and 2 tibial plateau fractures according to the methods of fixations. And the radiological results were not significantly different in both of type 1 and 2 fractures. CONCLUSION If the anatomical reduction of the articular surface can be achieved, the methods of fixation for the type 1 and 2 tibial plateau fractures do not affect the final clinical and radiological results.
PURPOSE The purpose of operative treatment in acetabular fracture is to restore anatomically the disrupted joint surface and prevent post-traumatic arthritis. We analysed the relationship between the types of the fracture, its location, reduction state with the development of post-traumatic arthritis and hip joint function in postoperative period. METHOD & MATERIAL: A clinical analysis was performed on 14 patients, excluding patients with anterior & posterior wall fracture, with displaced acetabular fracture who had been treated by open reduction and internal fixation. All patients had been followed for minimum 1 year in our department from May 1989, to February 1999. RESULTS The type of acetabular fracture was not correlated statistically with posttraumatic arthritis and Harris hip score. The reduction state of acetabular fracture was significantly correlated with post-traumatic arthritis and Harris hip score. The antomic location of acetabular fracture was not correlated statistically with post-traumatic arthritis but correlated with Harris hip score. CONCLUSION Anatomic reduction is more significant factor in postoperative outcome of acetabular fracture than the type of fracture and the anatomic location of fracture.
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Comparative Results of Acetabular Both Column Fracture According to the Fixation Method Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park Hip & Pelvis.2011; 23(2): 131. CrossRef
Cerclage Wiring in Internal Fixation of Displaced Acetabular Fractures Chong-Kwan Kim, Jin-Woo Jin, Jong-Ho Yoon, Sung-Won Jung, Jung-Wook Peang Journal of the Korean Fracture Society.2008; 21(2): 95. CrossRef
Treatment of Acetabular Column Fractures with Limited Open Reduction and Screw Fixation Jung-Jae Kim, Hyoung Keun Oh, Sung-Yoon Kim Journal of the Korean Fracture Society.2007; 20(1): 26. CrossRef
PURPOSE : We evaluated the results after the lag screw fixations using A.O. 2.0mm mini screws for the unstable multiple spiral metacarpal fractures. MATERIALS AND METHODS : thirteen cases of multiple spiral metacarpal fractures were treated with the lag screw fixations using 2.0mm mini cortical screws by the recommended technique of AOASIF. TAM of each digit was measured at the time of last follow up and the result was compared with the contralateral normal digits. We also evaluated the amount of shortening, angulation or rotation at the fracture sites on the last follow-up radiographs. RESULTS : Complete radiological unions were obtained in all of the cases. TAM of the operated digits were above 90% compared with those of the contralateral normal digits except 1 case, which had an another fracture and deep laceration at the distal phalanx and proximal interphalangeal joint during the period of follow up. We could not find any shortening, angulation or rotation at the fracture sites on the last follow-up radiographs. CONCLUSION : When we consider that the goal of treatment of the metacarpal fracture is to obtain full motion of the digit through the early mobilization after injury, we think that the lag screw fixation using 2.0mm mini screw is a good treatment modality in the cases of unstable multiple spiral metacarpal fractures.
Sixty-five Intertrochanteric hip fractures were analyzed radiologically to study the factors affecting postoperati ye stability. Fractures were evaluated by measuring shortening and angulation, collapse of telescoping device when utilized, and migration of the fixation device within the femoral head. Fractures were classified according to their stability preoperatively and the reduction of lessor trochanteric fracture fragment postoperatively. The failure rate and postoperative stability were then compared on terms of severity of osteoporosis, type of fracture, existence of reduction of lestor trochanter fragment. Results indicated that the severity of osteoporosis was not related to the group of fracture, which determines stability of fracture. Regarding the rate of bone union, anatomically reduced groups showed similar rates of bone union(73.8% in average) and degree of sliding of lag screw (4.13mm in average) regardless of fixation of lesser trochanter fragment. On the other hand, malreduced group which failed to obtain anatomical reduction had 26.1% of bone union rates and 10.95mm of sliding of lag screw representing importance of anatomical reduction rather than fixation of lesser trochanteric fracture.
In conclusion, there was no correlationthip between severity of oLteoporosis and type of fracture. And it is suggested that unstabae intertrochanteric fractures accompanied by large lesser trochanteric fracture fragment can be provided stability avoiding major complications such as loosening of implant or collapse of fracture fragment if it is fixed with anatomical reduction of fracture even without the fixation of lesser trochanteric fragment.
Type II clavicle fractures have been associated with high rates of nonunion and delayed union. Many authors have supported open reduction and internal fixation of these fractures. Authors analyzed twelve cases of type II distal clavicle fractures which had been treated operatively at department of orthopaedic surgery, Korea university, Ansan and Guro Hospitals from May 1991 to September 1997 and reviewed the result of operative treatment retrospectively. The results were as follows; 1. Among the 12 cases, male was 8, fenale was 4 and the average age of them was 25.6 years. 2. According to the classification by Neer and Rockwood, type IIa was 5 cases and IIb was 7 cases. 3. We treated all the cases operatively, such as C/R with transacromial K-wire fixation in 6 cases, O/R with transacromial K-wire fixation in 4 cases, O/R with coracoclavicular screw fixation in 2 cases. 4. The average follow-up period was 17 months. The functional results were evaluated with Kona classification and showed excellent in 10 cases, good in 2 cases. In conclusion, the operative treatment revealed good functional results in all cases. Authors recommend early operative treatment in type II distal clavicle fractures.
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Treatment of Distal Clavicle Fracture Using Hook Plate Su-Han Ahn, Hyeong-Jo Yoon, Kwang-Yeol Kim, Hyung-Chun Kim, In-Yeol Kim Journal of the Korean Fracture Society.2011; 24(1): 48. CrossRef
Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle Kyeong-Seop Song, Hyung-Gyu Kim, Byeong-Mun Park, Jong-Min Kim, Sung-Hoon Jung, Bong-Seok Yang Journal of the Korean Fracture Society.2009; 22(1): 24. CrossRef
Authors experienced a rare injury in a 5-year-old girl with Monteggia fracture and concomitant lateral condyle fracture of humerus with radial nerve injury. This combined injury has not been reported in the literature. This unusual fractures were treated by open reduction and K-wire fixation of lateral condyle fracture and transcapitellar K-wire fixation of radial head dislocation. An excellent result was obtained with operative treatment.
The clavicular fractures occur frequently and are treated conservatively, usually. But things are trending toward operative treatment in displaced cases due to nonunion.
From June 1984 to November 1993, 153 patients(156 cases) among 297 patients with the clavicular fractures were analysed at Department of orthopedic surgery, Korea university hospital.
The brief summary of the observations are as follows: 1. among 156 cases, the right side were 72 cases, the left side were 84 cases and both were 3 patients. The most common cause of injury was the the traffic accident and the most frequent site of the fracture was middle one-third.
2. According to the Allmans classification, the fractures were classified in three groups. Group Iwere 113 cases, Group II were 28 cases and Croup III were 15 cases and the average age of each groups were individually 28.7 yeara,35.4 years and 41.4 years respectively.
3. The average duration of the radiological union of the conservative treatment were 9.8 weeks in Group I ,9.7 weeks in Group II and 10.3 weeks in Group III. And of the operative treatment were 10.1 weeks in Group I , 10.1 weeks in Group II and 9.9 weeks in Group III Any difference between the conservative and the operative treatment was not observed.
4. The complications were nonunion in 2 cases, delayed union in 2 cases and refracture in 1 case after conservative treatment, and nonunion in 2 cases, delayed union in 1 case, refracture in 1 case and superficial wound infection in 1 case after operative treatment.
We evaluated the clinical results of the closed reduction and percutaneous K-wire fixation for supracondylar fracture of the humerus in thirty patients who were treated from Jan 1990 to Nov 1993. We analyzed the relationships between non-anatomical reduction and occurrence of varus deformity in displaced supracondylar fractures of the humerus in children.
The following results were obtained: 1. There were twenty-two males and eight females, twelve cases of type IIB and eighteen cases of type IIIfractures by Gartland classification. Posteromedial displacement and fractures through the olecranon fossa were most common pattern.
2. After closed reduction, eleven rotations and three medial displacements of distal fragment, and three angular deformities of medial cortex were observed in eleven cases.
3. Radiologically, the differences of carrying angle compared with normal side were decreased in twenty-one cases, no changes in three cases, and increased in six cases.
4. Two cubitus varus deformities were developed in decreased cases more than six degrees of carrying angle with residual rotation and medial displacement.
5. We obtained relatively good results in supracondylar fracture of the humerus in children treated by closed reduction and percutaneous K-wire fixation with grossly normal carrying angle.
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.