Journal of Musculoskeletal Trauma

Proximal Femoral Nail(PFN) for Femur Intertrochanteric Fracture: Dong Kyu Shin, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Chang Hyuk Choi, Kyung Min Kim; J Korean Soc Fract 2002;15(3):328-335. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.328

PURPOSE
This prospective study was performed to evaluate the usefulness and the risk of the Proximal Femoral Nail(PFN) for internal fixation of the femur intertrochanteric fracture.
MATERIALS AND METHOD
We operated 26 consecutive intertrochanteric fracture patients with PFN from June 2000 to May 2001 and analysed the operation time, bleeding loss, union rate, union time, failure of fixation and complications. We also evaluated the clinical result with the recovery of ambulatory function and functional recovery score.
RESULTS
Mean operation time was 72 minutes and mean transfusion amount was 0.54 unit. 24 cases progressed to union until 4 months uneventfully and remaining 2 cases also progressed to union within 6months without further operation. There was no failure of fixation. Mean fracture site impaction was 4.4mm and among the 11 unstably reduced cases 3 showed overimpaction(> 10mm). Clinically mean loss of ambulation ability was 1.4 grade. Last follow Skovoron functional recovery score was 72.2. We removed laterally protruded hip pin and femur neck screws in two cases because of irritation on the lateral trochanteric area skin. But there was no significant complications such as intraoperative or postoperative fractures and femoral head cut out.
CONCLUSION
The findings from this study indicate that, compared with other methods, PFN is useful and reliable choice for the femur intertrochanteric fracture treatment in the terms of less complications and equal or better results.

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GS Hip Nail versus Affixus Hip Fracture Nail for the Intramedullary Nailing of Intertrochanteric Fractures
Seungcheol Kwon, Minjae Lee, Heeyeon Lee, Jihyo Hwang
Journal of Clinical Medicine.2023; 12(21): 6720. CrossRef
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
Treatment of Intertrochanteric Fractures Using the Compression Hip Nail
Je-Min Yi, Kye Young Han, Keun Woo Kim, Chang Hyun Ryu
Hip & Pelvis.2014; 26(3): 166. CrossRef
Unstable Intertrochanteric Fracture Treated with ITST: A Comparative Study between Groups with and without Comminution of Greater Trochanter
Kyung-Sub Song, Sang-Ho Lee, Seong-Hun Jeong, Su-Keon Lee, Sung-Ha Hong
Journal of the Korean Fracture Society.2014; 27(1): 36. CrossRef
Treatment of Unstable Pertrochanteric Fractures with a Long Intramedullary Nail
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Dae Jung Huh
Hip & Pelvis.2013; 25(1): 51. 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
Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails
Il Ho Park, Jong Kyoung Won, Kye Young Han
Hip & Pelvis.2012; 24(2): 117. CrossRef
Operative Treatment with Gamma 3 Nail in Femur Intertrochanteric Fracture
Ki-Do Hong, Jae-Chun Sim, Sung-Sik Ha, Tae-Ho Kim, Yoon-Ho Choi, Jong-Hyun Kim
Journal of the Korean Fracture Society.2011; 24(1): 7. CrossRef
The Comparison between ITST™ (Intertrochanteric/Subtrochanteric) & DHS (Dynamic Hip Screw) in Unstable Femur Intertrochanteric Fracture
Ho-Seung Jeon, Byung-Mun Park, Kyung-Sub Song, Hyung-Gyu Kim, Jong-Ju Yun
Journal of the Korean Fracture Society.2009; 22(3): 131. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)
Kee-Byoung Lee, Byung-Taek Lee
Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef

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Ambulatory Recovery after Fixation of Intertrochanteric Fracture with Gamma nail in the Elderly: Dong Kyu Shin, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Chang Hyuk Choi, Sang Bong Go; J Korean Soc Fract 2000;13(4):771-778. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.771

Abstract PDF

PURPOSE
This study was performed to evaluate the ambulatory recovery after fixation of intertrochanteric fracture of elderly patients with Gamma nail and to analyze the factors to affect the recovery.
MATERIALS AND METHODS
we evaluated the ambulatory result of 64 cases of intertrochanteric fracure which were fixed with gamma nail and rehabilitated with early weight bearing protocol regardless of reduction state. We analysed the result with statisical method and tried to find the important factor for better ambulatory recovery.
RESULTS
Only 21 patients were able to recover to preinjured level of ambulation and mean loss of ambulation ability was 1.31 according to our evaluation protocol. Stastically the age and early weight bearing walking exercise was affecting factor for better recovery of ambulation and the rate of complication caused by early weight bearing was not significant.
CONCLUSION
Fixation with Gamma nail and early weight bearing rehabilitation protocol was good choice for elderly intertrochanteric fracture without the risk of major complication.

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Survival and Functional Outcomes after Hip Fracture among Nursing Home Residents
Hong Man Cho, Kyujung Lee, Woongbae Min, Yong Suk Choi, Hyun Suk Lee, Hyoung Jin Mun, Hye Young Shim, Da Geon Lee, Mi Joung Yoo
Journal of Korean Medical Science.2016; 31(1): 89. CrossRef

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Use of Gamma Nail in Peritrochanteric Fractures of the femur : A comparative study of Asian-Pacific type with Standard-European type: Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Chang Hyuk Choi, Dong Kyu Shin, Young Joon Youn; J Korean Soc Fract 1999;12(4):786-791. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.786

Abstract PDF: PURPOSE
: The mismatch of the Standard Gammd nail(SU) in oriental people led to the modification of the delign of its femoral shaft component and use of the Asian-Pacific type(AP). We compared the clinical results of 2 groups of femoral peritrochanteric fractures treated with each type of Gamma nail.
MATERIALS and METHODS
: 65 cases of peritrochanteric fractures of the femur(AP 24 cases, SU 42 cases) were studied with regard to operation time, union time and complications. The cases in each group were similar in fracture pattern, degree of osteoporosis and time interval between trauma and operation.
RESULTS
There were no significant differencef between two groups in operation time, intraoperative blood loss, and union time. Lateral cortical fracture and nail breakage were not observed in AP group but lag screw cutout was more frequent in AP group(8%) than in SU group(2%), but other complications were similar in type and frequency between two groups.
CONCLUSION
: AP Camma nail showed somewhat improved matching with the configuration of Korean femora, but further modification of the design might be needed to solve remained problems such as nail protrusion above trochanter.

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Treatment of communited & Segmental Femoral shaft Fracture by using Interlocking nailing: Comparison between Closed and Open techniques: Chang Hyuk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Ho Sun Chang; J Korean Soc Fract 1999;12(3):516-522. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.516

Abstract PDF: When femoral shaft fracture with severe communition and segmentation result from violent force, they are frequently associated with severe soft tissue damage. Treatment of this unstable fracture need the rigid fixation in order to prevent shorting and rotational loading. In terms of this advantages, interlocking nailing technique was widely used with open and closed methods. In the cases of fractures that having large fragments and wide displacement, closed technique has disadvantage of difficulties in anatomic reduction and its maintenance. Nineteen femoral shaft fractures had been treated by these techniques alternatively at our hospital between Feburary 1994 and Feburary 1997 and had been followed for more than 12 months. Among the 19 cases, closed techniques were 11 cases and open 8 cases. We evaluated the results of two treatment methods in terms of the bone union time, complications and functional results. Mean duration of the bone union time was 24.2 weeks in closed interlocking nailing, 24.5 weeks in open. There was no difference between the bone union time and the operation techniques(p-value>0.05). And complications were delayed union in two cases. In conclusion, in the cases of severe comminuted and segmental femoral shaft fractures especially with posteromedial fragment, open technique was more useful than closed technique, in terms of anatomic restoration and getting functional recovery afford to preinjury level of work.

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Closed Interlocking Nailing for Femoral Shaft Fracture -Comparison of results according to fracture comminution and site-: Sang Wook Lee, Koing Woo Kwun, Shin Kun Kim, Chang Hyuk Choi, Ho Sun Chang; J Korean Soc Fract 1998;11(3):528-532. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.528

Abstract PDF

To compare of result according to fracture comminution and fracture site, we reviewed retrospectively 68 femoral shaft fractures treated by closed interlocking intramedullary nailing. The Winquist-Hansen classification was used to categorize the degree of comminution, and fracture site was categorized to three parts as proximal 1/3, middle 1/3, and distal 1/3. The results were analized and compared in each categorized group The average bone union time was delayed in more severely comminuted fracture and in distal 1/3 fracture compared to proximal 1/3 or middle 1/3. Varus angulation deformity was occurred more frequently in proximal 1/3 and severely comminuted fracture group, and posterior angulation deformity was occured more frequently in distal 1/3 fracture group. All but one case showed good functional results regardless of fracture comminution, fracture site and development of malalignment.

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Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef

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Treatment of Acetabular Fractures -Comparison of Conservative Treatment and Surgical Treatment According to AO Comprehensive Classification-: Chang Hyuk choi, Koing Woo Kwun, shin Kun Kim, Sang Wook Lee, seung Hee Kim; J Korean Soc Fract 1998;11(2):288-295. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.288

Abstract PDF: Acetabular fracture is a severe injury associated with other body injuries. they result in permanent disability due to management difficulty and its complications such as traumatic arthritis, avascular necrosis of femoral head, etc.. In order to restore excellent function of hip joint, anatomic reduction and secure internal fixation followed by early mobilization are neccessary. We analysed 21 patients who were diagnosed as type A1 acetabular fracture from Jan. of 1991 to Dec. of 1996, and compared the functional results of conservative treatment method with that of surgical treatment method. The results were as follows. 1. Conservative management was done at 8 cases, and surgical management was done at 13 cases with open reduction and internal fixation. 2. The functional result by Goodwin criteria was all satisfactory in conservative reatment method and 12 cases(92%) in surgical treatment method. 3. Associated injuries were found in 18 cases, among them pelvic bone fracture was the most common fractured site and knee ligament injury was the most common soft tissue injury. 4. In the cases of larger acetabular fragment or in the presence of associated injury and instability after closed reduction, faster rehabilitation was achieved by starting early range of motion exercise and weight-bearing after surgical treatment than classical conservative treatment.

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Surgical Treatment of the Fracture of the Distal Humerus: Chang Hyuk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Soo Il Han, Chang Jin Kang; J Korean Soc Fract 1997;10(1):104-111. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.104

Abstract PDF: The treatment of the fracture of the distal humerus has remained one of the most difficult of all fractures to manage. The goal of treatment, which is the same for other intraarticular fractures, is to reestablish articular congruity, rigid fixation and early active motion as soon as possible. It appears that the use of plates is currently the most acceptable method of fixation. The aim of this study is to clarify the correlation between various fixation methods and functional end results, in order to help in choosing treatment modalities. We reviewed 11 cases of the fractures of the distal humerus treated surgically in Orthopaedic Department of Taegu Hyosung University Hospital between 1992 and 1995. Clinical end results were as follows: 1. Of the 11 cases, there was 6 males and 5 females. Age was from 13 years old to 83 years old and mean age was 46 years old. 2. Muller classification consisted of 4 cases of A2, 1 case of B2, 3 cases of Cl and 3 cases of C2. The mean length of follow up was 15 months. Except for 2 cases of open wound and nonunion, time from injury to surgery was 8 days. Mean period of initial exercise was 4 weeks. 3. All surgical incisions were done with posterior approach; they consisted of 5 cases of dual-contoured plates, 4 cases of plate with screw and 2 cases of K-wires with screw. 4. Mean range of elbow motion was flexion 123 and extension defect 14. There was no limition of pronation and supination compared with the normal side. 5. The functional result by Jupiter criteria was excellent in 5 cases, good in 4 cases, fair in 1 case and poor in 1 case. 6. There were complications in 1 case of plate broken and 1 case of nonunion. 7. In the distal fracture of the humerus, There were 82% of excellent of good result by over-all functional result of Jupiter.

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The Ilizarov Method for the Treatment of Open Intraarticular Fractures around the Knee Joint: Clinical Analysis of 6 Cases: Chang Hyouk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Yong Joo Kim; J Korean Soc Fract 1996;9(1):119-128. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.119

Abstract PDF: There are many difficulties in treating open intraarticular fracture around the knee joint because of its combined neurovascular injury and comminution of fracture site. The difficulties lie in choosing a fixation method, postoperative care, and analyzing the results of the treatment. Recently there is growing preference in using Ilizarov apparatus. The merits of Ilizarov in fracture treatment are early weight bearing and easy compression and distraction. In cases of this study, difficulties were subclassified into problems, obstacles. and complications. Six cases of open intraarticular fracture around the knee joint were treated from Mar., 1993 to Aug.,1994 and the average follow up period was twenty months and the results were as follows: 1. Of the six patients, there were five males and one female patients. 2. The cause of the fractures was traffic accident in five and crushing injury in one. 3. Of the six cases, five cases were combined femoral and tibial fractures and one case was only femoral condylar fracture. 4. In follow up study, there was thirty cases of difficulties such as pin site problem, pain, limitation femotion, and nonunion etc. 5. Of the seventy-four wires, pin site problem occurred at twenty pins but open wounds were cured without infection evidence. 6. The results were poor in all cases. 7. The Ilizarov technique requires adequate implantation and management to reduce an overall complication rate and improve functional results.

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