Journal of Musculoskeletal Trauma

Single Percutaneous Retrograde Anterior Column Screw Fixation in a Minimally Displaced Transverse Acetabular Fracture - A Case Report -: Seungyup Shin, Jinkyu Park, Sungho Lee; J Korean Fract Soc 2023;36(2):57-61. Published online April 30, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.2.57

Abstract PDF: According to the Letournel classification, a transverse fracture is the only elementary fracture pattern that breaks both the anterior and posterior border of the innominate bone. A transverse acetabular fracture separates the innominate bone into two segments: the iliac segment and the ischiopubic segment. Therefore, minimally displaced transverse fractures can be stabilized by purchasing both segments with a large-diameter single screw. Although it is not a stable internal fixation construct compared with plates and screws, it provides sufficient stability to promote early mobilization and early weight-bearing while minimizing the risk of secondary displacement and preventing secondary complications associated with prolonged bed rest and immobilization. The authors successfully treated a case of minimally displaced transverse acetabular fracture with percutaneous column fixation using a retrograde fashion of a single anterior column screw. This report discusses the case with a literature review and deliberates the usefulness of the procedure.

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Factors Affecting Posterior Angulation in Retrograde Intramedullary Nailing for Distal Femoral Fractures: Hohyoung Lee, Ji Ho Jeong, Min Su Kim, Bum Soo Kim; J Korean Fract Soc 2018;31(2):50-56. Published online April 30, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.2.50

Abstract PDF: PURPOSE
To analyze the factors that cause a posterior angulatory deformity in the retrograde intramedullary nailing of distal femoral fractures.
MATERIALS AND METHODS
Fifty-five patients with distal femur fractures who were treated with retrograde intramedullary nailing were enrolled in this study. They were followed-up for at least one year postoperatively. The posterior angulatory deformity was evaluated according to the fracture location, pattern, and insertion point and the insertion point was compared with the ideal point derived from the radiographs of 100 normal adults. The correlation between the posterior angulation and the entry point of the nail was analyzed.
RESULTS
The posterior angulation was similar in terms of the fracture location; a meaningful difference was noted among the fracture patterns (p=0.047). The posterior angulation was significantly greater when the entry point was located more posteriorly, accepting a malreduced state (p=0.012).
CONCLUSION
Posterior angulation was smaller in the transverse fracture and the posterior location of the entry point from the apex of the Blumensaat's line increased the posterior angulation.

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Treatment of Periprosthetic Femoral Fractures Following Total Knee Arthroplasty: Lih Wang, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Jin Soo Hwang, Sun Hyo Kim; J Korean Fract Soc 2014;27(1):42-49. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.42

PURPOSE
The purpose of this study is to compare the treatment results of fracture fixations by using two minimal invasive techniques for patients with periprosthetic femoral fractures following total knee arthroplasty.
MATERIALS AND METHODS
We reviewed 36 patients (5 males, 31 females) of periprosthetic femoral fractures whom were treated surgically between January 2005 and January 2011. Mean patient age was 68.9 years (range, 43 to 81 years) old and the follow-up period averaged 41 months (range, 18 to 72 months). Nineteen patients were treated with minimal invasive locking plate fixations (group I) and 17 patients with retrograde intramedullary nailing (group II). Clinical and radiological outcomes in each group were comparatively analyzed.
RESULTS
Successful bone unions occurred in all patients and the mean time to bone union was 3.7 months in group I and 4.2 months in group II. There were no statistical differences between the two groups according to mean operative time and mean intraoperative blood loss. There were also no statistical differences between two groups according to clinical outcomes but the valgus deformity was apparent in group II and radiological outcomes revealed significant differences between the two groups.
CONCLUSION
For the treatment of periprosthetic femoral fractures after total knee arthroplasty, two minimal invasive techniques have shown good clinical results. However, the minimal invasive plate fixation showed better results in the radiological alignments.

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The Result of Treatment of Femoral Periprosthetic Fractures after Total Knee Arthroplasty
Jun-Beom Kim, In-Soo Song, Dong-Hyuk Sun, Hyun Choi
Journal of the Korean Orthopaedic Association.2014; 49(6): 446. CrossRef

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Treatment of Humeral Shaft Fracture with Retrograde Intramedullary Nail: Ki Bum Choi, Soo Hwan Kang, Yoon Min Lee, Seok Whan Song, Youn Jun Kim; J Korean Fract Soc 2013;26(4):299-304. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.299

Abstract PDF

PURPOSE
The purpose of this study was to report the outcome of treatment of humeral shaft fracture with retrograde intramedullary nail of advanced insertion opening.
MATERIALS AND METHODS
From April 2005 and August 2012, 22 patients with a humeral shaft fracture were treated by a single surgeon using the technique of retrograde intramedullary nail at Department of Orthopedic Surgery, Yeouido St. Mary's Hospital (Seoul, Korea). To avoid causing fractures at the insertion site, the entry point was more distally located than conventionally, and was extended proximally to include the proximal marginal cortex of the olecranon fossa. The outcome was evaluated clinically and radiologically.
RESULTS
The mean period of achievement of bony was 5.8 months (4-11 months). Additional fixations were needed in one patient with intraoperative lateral condylar fracture and 2 patients with postoperative nonunion. There were no limitations of movement or pain in the shoulder joint, and 8 cases had a 6.5degrees flexion contracture on average.
CONCLUSION
This retrograde intramedullary fixation technique using a distal entry portal near the olecranon fossa is particularly useful in humeral shaft fractures without a neurovascular injury. The risk of an intraoperative fracture (supracondylar fracture or fracture around the entry portal) can be decreased using this treatment. We recommend this technique because of the safety and the satisfactory outcome.

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HEALING PATTERN OF INTERLOCKED INTRAMEDULLARY NAILED HUMERAL SHAFT FRACTURE
Myung-Sang Moon, Dong-Hyeon Kim, Min-Geun Yoon, Sang-Yup Lee
Journal of Musculoskeletal Research.2016; 19(04): 1650018. CrossRef

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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; J Korean Fract Soc 2010;23(4):367-372. Published online October 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.4.367

Abstract PDF

PURPOSE
To evaluate the anatomic and functional outcome of retrograde intramedullary single wire fixation for metacarpal shaft fractures of the little finger.
MATERIALS AND METHODS
hirty one consecutive patients with closed metacarpal shaft fractures of the little finger who have been treated with retrograde intramedullary single wire fixation were evaluated. Fracture union and angulation were analyzed radiologically, and clinical evaluations were performed including range of motion, DASH score and complications.
RESULTS
Fracture union was achieved in all cases and callus formation was obvious at postoperative 41 days. Average angulation of fracture site was 3degrees in the coronal plane and 1.2degrees in the sagittal plane at the last follow up and no measurable metacarpal shortening was observed. Mean TAM was 253degrees and DASH score was 2.6. There were two cases of pin migration as intermediate complications.
CONCLUSION
Closed reduction with subsequent percutaneous retrograde K-wire fixation produced good radiological and functional results. We recommend this minimally invasive technique which provides adequate fixation of displaced little finger metacarpal shaft fractures with good functional results and low morbidity.

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The Treatment Outcomes of the Metacarpal Shaft and Neck Comminuted Fractures Using Modified Percutaneous Retrograde Intramedullary Kirschner Wire Fixation
Seok Woo Hong, Young Ho Lee, Min Bom Kim, Goo Hyun Baek
Archives of Hand and Microsurgery.2018; 23(3): 175. CrossRef

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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; J Korean Fract Soc 2009;22(3):145-151. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.145

Abstract PDF

PURPOSE
To evaluate the usefulness of the retrograde intramedullary nailing for the treatment of segmental femoral shaft fracture including distal part.
MATERIALS AND METHODS
We reviewed 15 patients of segmental femoral fracture, who had treated with retrograde intramedullary nailing and followed-up more than 1 year from January 2003 to October 2007. There were 10 men, 5 women, and the mean age was 45 years old. There were associated fracture in 10 cases. We evaluate the time for union, non-union and malunion by radiologic finding and functional assessment by Sanders' criteria.
RESULTS
The mean time of union was 21 weeks. There was one delayed union in proximal fracture site. There was no shortening more than 1.5 cm, no angular deformity more than 10 degrees, no postoperative infection or instability. According to Sanders' criteria, there were excellent clinical results in 9 cases, good results in 5 cases and fair result in 1 case.
CONCLUSION
The retrograde intramedullary nailing can be a useful method for treatment of segmental femoral shaft fracture including distal part.

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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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Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail: Moon Jib Yoo, You Jin Kim, Jin Won Lee; J Korean Fract Soc 2008;21(1):19-23. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.19

Abstract PDF: PURPOSE
Retrograde intrameullary nail is one of the treatment of periprosthetic supracondylar femoral fracture after total knee replacement (TKR), but all TKRs will not permit to insert a supracondylar nail. Therefore, we have investigated the compatibility of the TKRs with supracondylar nail.
MATERIALS AND METHODS
Using trial femoral component of the 5 used TKRs in Korea and saw bone model, we checked their compatibility and measured the dimensions of the intercondylar notches in both cruciate retaining (CR) and posterior stabilized (PS) type.
RESULTS
Although most CR prostheses had an intercondylar notch large enough to accept a supracondylar nail, in some case, this was not possible due to the notch being situated too far posteriorly. The position of the intercondylar notch is also important factor in the PS prostheses.
CONCLUSION
The notch position, rather than the notch size, was the most important factor in determining nail compatibility with femoral stem.

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Midterm Results of Treatment with a Retrograde Nail for Periprosthetic Fractures of the Femur Following Total Knee Arthroplasty: Kyung Taek Kim, Jin Hun Kang, Lih Wang, Jae Sung Hwang; J Korean Fract Soc 2007;20(4):309-314. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.309

Abstract PDF: PURPOSE
To analyze the midterm results of the treatment with a retrograde nail for periprosthetic fractures of the femur following total knee arthroplasty.
MATERIALS AND METHODS
Between Jan 1998 and Jan 2004, 11 cases in 11 patients were treated for the periprosthetic fractures following total knee arthroplasty. The mean follow-up was 42.0 (30~98) months and the mean age was 66.0 (57~79) years old. 2 were males and 9 patients were females. In all cases, retrograde nailing was done for the periprosthetic fractures. Postoperative range of motion, HSS knee rating score, femorotibial angle, the time required for union, complications were evaluated.
RESULTS
Postoperative range of motion was 103.6Â° degrees on an average, HSS knee rating score was 83.5 points on an average at the last follow up. The mean angulation on radiograph was valgus 6.3Â°. The mean time required for union was 4 months. One had a newly fracture line at proximal part of supracondylar fracture, but there was no significant in clinical course. There was no prostheses required revision.
CONCLUSION
It appears that retrograde nail is a reliable surgical technique for periprosthetic fractures of the femur following total knee arthroplasty with low complication rate. The midterm results in our study showed that none of the prostheses required revision.

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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

Abstract PDF

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

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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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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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Retrograde Intamedullary Nailing for Femoral Fracture: Kyung Won Song, Seung Yong Lee, Sung Il Shin, Jin Young Lee, Gab Lae Kim, Dae Eun Choi, Young Suk Ko, Hyung Suk Oh; J Korean Fract Soc 2006;19(3):314-318. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.314

Abstract

PURPOSE
To evaluate the effectiveness. analyze the result after retrograde intramedullary (IM) nailing in femoral shaft fracture MATERIALS AND METHODS: Thirty-four femoral shaft fracture (32 patients) were operated with retrograde IM nail and followed the result for more than 18 month from march 2001 to march 2003. There were 6 of femoral mid shaft fractures and 28 of distal femur fractures. According to AO classification, there were 1 of A1, 1 of A2, 2 of A3, 2 of C1 in femoral mid shaft fracture and 11 of A1, 7 of A2, 7 of A3, 1 of B1, 2 of C1 in distal femur fracture. They included 5 open fracrures. By Gustilo classification there were 3 of type I, 2 of type II. Through radiologic study we evaluated the time of union, nonunion, malunion. And in clinical evaluation we checked knee function in 18 month after operation.
RESULTS
It took 16 weeks (range 12~20 weeks) for average bone uion period. 30 cases out of 34 cases had the bone union but 4 cases showed nonunion. There were not any complication except 3 cases of screw migration. Full rage of motion was gained in 29 cases. However knee stiffness occurred in 5 cases. The knee function through knee score was assessed by showing 28 of excellent, 1 of good, 5 of poor.
CONCLUSION
Even though the retrograde intramedullary nailing may have some defect to be able to damage to knee joint in operating, It can be useful surgical technique for femoral shaft fracture in such as ipsilateral fracture or multiple fracture, poor general condition, and so on.

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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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Percutaneous Interlocking Intramedullary Nailing of Femoral Shaft Fracture with Retrograde Guide Wire Insertion Technique: Ho Seung Jeon, Seung Ju Jeon, Jae Ho Choi, Jong Min Kim, In Kee Cho; J Korean Fract Soc 2006;19(1):104-108. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.104

Abstract: Piriformis fossa is chosen for the entry point of the intramedullary nail insertion for the broken femoral shaft. To evaluate the correct entry point selection, the use of the usual operation table and short skin incision, we tried the percutaneous interlocking intramedullary nailing with retrograde guide wire insertion technique. The guide wire is inserted through the short skin incision on the anterior thigh and comes out through piriformis fossa easily. Through over the guide wire the femoral nail was inserted with only short skin incision. And the trick makes no difference except the convenience compared with the antegrade guide wire insertion technique. It is considered as a useful tip of the intramedullary nailing of the femoral shaft fracture.

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Treatment of the Distal Femur Fracture with Retrograde Intramedullary Nailing: Moon Jib Yoo, Myung Ho Kim, Hee Gon Park, Woo Sup Byun, Ki Choul Kim; J Korean Fract Soc 2005;18(3):238-243. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.238

Abstract PDF

PURPOSE
To evaluate the results and complications of the retrograde intramedullary nailing for the treatment of distal femur fracture.
MATERIALS AND METHODS
Thirty three patients who received retrograde IM nailing for fractures of the distal femur between October 1998 to December 2003. Average age was 53.8+/-17 (17~86) years. The average follow up period was 19.4 (12~36) months. Clinical information included age, sex distribution, associated fracture and fracture was classified by AO classification. Functional result was evaluated by Schatzker's criteria.
RESULTS
The most common cause of injury was traffic accident (60%). The type of fracture were 6 A1 cases, 5 A2 cases, 11 A3 cases, 5 C2 cases, 6 C3 cases by AO classification. Among the 33 cases, 15 cases were excellent, 9 good, 6 fair and 1 failure according to Schatzker's criteria. Average union time was 9.7+/-3.5 months.
CONCLUSION
Treatment of distal femur fracture with retrograde intramedullary nailing was useful due to its minimal invasiveness and early range of motion, more rigid fixation.

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Retrograde Intramedullary Nailing for Periprosthetic Supracondylar Fractures of the Femur after Total Knee Arthroplasty
Hyuk-Soo Han, Kyu-Won Oh, Seung-Baik Kang
Clinics in Orthopedic Surgery.2009; 1(4): 201. CrossRef
Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail
Moon-Jib Yoo, You-Jin Kim, Jin-Won Lee
Journal of the Korean Fracture Society.2008; 21(1): 19. CrossRef
Midterm Results of Treatment with a Retrograde Nail for Periprosthetic Fractures of the Femur Following Total Knee Arthroplasty
Kyung-Taek Kim, Jin-Hun Kang, Lih Wang, Jae-Sung Hwang
Journal of the Korean Fracture Society.2007; 20(4): 309. CrossRef

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Treatment of Supracondylar-Intercondylar Femoral Fractures with a Retrograde Intramedullary Nailing: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Yong Jin Jeon; J Korean Fract Soc 2004;17(2):110-116. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.110

Abstract PDF

PURPOSE
We analyzed the cases of supracondylar-intercondylar femoral fracture treated with retrograde intramedullary nail and report the clinical results and its usefulness.
MATERIALS AND METHODS
We reviewed 17 cases of supracondylar-intercondylar femoral fracture that had been treated with retrograde intramedullary nail and each of patients had been followed up for a minimum one year. Post-operative functional assessment was performed using a scale developed by Sanders et al. The evaluation scale assesses range of motion, pain, walking ability, return to work, and alignment and shortening as measured on radiograph.
RESULTS
According to functional assessment of Sanders et al, there were 6 excellent, 9 good, 1 fair, and 1 poor results, that is, 94% showed above excellent results. Bony union was obtained in average 5 months after operation. The post-operative complications were varus deformity in 1 case, wound infection in 1 case, stiffness of knee joint in 1 case, and metal failure in 1 case.
CONCLUSION
The treatment of supracondylar-intercondylar femoral fracture with retrograde intramedullary nail is one of the good surgical options for clinically preferable results with the advantages in early joint motion and early ambulation.

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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

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Treatment of Distal Femoral Shaft and Supracondylar Fracture with aRetrograde Intramedullary Nailing: Sang Hong Lee, Jun Young Lee, Sang Ho Ha, Hong Moon Sohn, Kwang Chul Lee; J Korean Fract Soc 2004;17(2):103-109. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.103

Abstract PDF

PURPOSE
Retrograde intramedullary nailing has been recommended as one of the treatment options for the distal femoral fracture, particularly in patients who are obese, are pregnant, has sustained ipsilateral femoral neck fracture, have multiple injuries. However there are some disadvantage such as post-arthrotomy infection, knee joint stiffness. This paper is to evaluate the result and complication of treatment of distal femoral fracture with a retrograde intramedullary nailing.
MATERIALS AND METHODS
We reviewed 13 cases (distal femoral shaft fracture: 6 cases, supracondylar fracture: 7 cases) of the distal femoral fracture who had been treated with retrograde intramedullary nailing and follow up for more than 12 months from January 1999 to December 2001. The rate of bony union, range of motion of the knee, complications were evaluated.
RESULTS
The mean duration of bony union was 20 weeks (range, 16~25 weeks). A case of delayed union was developed. In 4 cases of 13 cases showed posterior angulation below 6 degree, which did not need further treatment. According to Saunder's criteria, excellent result was achieved in 8 patients, good result in 5 patients, respectively.
CONCLUSION
This study showed good clinical and radiological results of union with retrograde intramedullary nailing at the distal femoral fracture and ipsilateral multiple fracture

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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
Axial Malalignment after Minimally Invasive Plate Osteosynthesis in Distal Femur Fractures with Metaphyseal Comminution
Jae-Ho Jang, Gu-Hee Jung, Jae-Do Kim, Cheung-Kue Kim
Journal of the Korean Orthopaedic Association.2011; 46(4): 326. CrossRef

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Retrograde Nailing in Femur Supracondylar Fracture: Jin Woo Kwon, Sung Ho Shin, Won Ho Cho, Ki Ho Sung, Ki Han Kim, Kyong Tae Sohn, Sang Hoon Lee, Se Won Park, Jong Moon Bae, Tae Woo Kwon; J Korean Soc Fract 2003;16(4):465-473. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.465

Abstract PDF

PURPOSE
We retrospectively analysed the result of retrograde supracondylar nail fixation in femur supracondylar fractures and evaluate the clinical effectiveness of this method.
MATERIALS AND METHODS
Since October 1998 we have treated 14 supracondylar fractures (AO type: A2-6, A3-1, C1-3 and C2-4) by retrograde intramedullary nailing technique through trans-patellar tendon approach from October 1998 to June 2001 and followed more than 1 year.
RESULTS
Among 14 cases, 5 cases were excellent, 6 good, 3 fair according to Schatzker functional result. The complications were 1 distal locking screw loosening, 1 delayed union and 1 fracture around proximal locking site.
CONCLUSION
Even though the retrograde nailing may damage the knee joint because it is inserted by opening up the joint, it provided the necessary stable fixation with short operation time, low blood loss, minimal soft tissue injury. Thus we believe that retrograde nailing is useful operative technique for the management of supracondylar fracture in osteoporotic, communited fractures, or open fractures.

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Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail
Moon-Jib Yoo, You-Jin Kim, Jin-Won Lee
Journal of the Korean Fracture Society.2008; 21(1): 19. CrossRef

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Retrograde Intramedullary Nail for Femoral Shaft Fracture with Limited Indications: Sung Jung Kim, Chang Wug Oh, Joo Chul Ihn, Hee Soo Kim, In Ho Jeon, Hee Soo Kyung, Il Hyung Park, Kyung Hoon Kim; J Korean Soc Fract 2003;16(1):45-51. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.45

Abstract PDF

PURPOSE
This is a retrospective study to analyze the results after retrograde intramedullary(IM) nailing in femoral shaft fractures with limited indications.
MATERIALS AND METHODS
Twenty-four femoral shaft fractures(21 patients) were operated with unreamed IM nail(Unreamed femoral nail, SynthesR) in a retrograde method and were followed for more than 1 years. There were 16 men and 5 women, and the mean age at index operation was 41 years (range 18-76 years). In Winquist-Hansen classifications, there were 10 of type I, five of type II, three of type III, and six of type IV. All the patients had associated fractures or injuries, and there were eight ipsilateral tibia fractures, five ipsilateral proximal femoral fractures(including neck and trochanter), four ipsilateral pelvic or acetabular fracture, three bilateral femoral fractures, and one ipsilateral knee injury according to the used indications. In radiological study, we evaluated the time for union, non-unions and malunion, and clinical evaluation with Neer 's criteria was done.
RESULTS
Most fractures(87.5%) were primarily united cases, and the mean time for union was 15.8 weeks(range 12-20 weeks). Three cases of delayed union or nonunion were developed, but a shortening over 1cm or malunion over 10 degrees angular deformity were not found. Evaluating the knee functions, the Neer score was 86.9 in average and all the cases were above satisfactory grade. The average range of knee motion was 120.2 degrees, and the mild knee pain was developed in three cases.
CONCLUSION
The retrograde IM nailing can be a useful option for femoral shaft fractures with limited indications, including ipsilateral fractures of other areas or multiple fractures.

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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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Long Term Results of Retrograde Nailing in Adult Femoral Shaft Fractures: Yerl Bo Sung, Soo Chul Park, Jong Kuk Ahn, Jae Kwang Yum, Hyung Jin Chung, Jin Ho Kim, Seung Taek Song, Yong Taek Han; J Korean Soc Fract 2002;15(3):356-362. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.356

Abstract PDF

PURPOSE
Antegrade intramedullary nailing of the femur is effective method of treatment for patients with femoral shaft fractures. But retrograde IM nailing is another effective method, especially in femoral shaft fractures concomitant with ipsilateral femoral neck, intertrochanteric fractures, acetabular fracture, multiple fracture and obesity, pregnancy, traumatic arthrotomy of the knee joint, bilateral femur fractures, and floating knee injuries are also indicated. The purpose of this study is to verify the effectiveness of retrograde IM nailing after long-term follow-up by retrospective evaluation.
MATERIALS AND METHODS
A retrospective review of the medical charts and X-rays about 37 patients who were operated by retrograde nailing and all patients were minimally followed up about 2 years. Results were evaluated radiologically for screw breakage, nail migration, nonunion and clinically for knee ROM limitation, infection.
RESULTS
The results were as follows; 1) union was achieved at on average of 17 weeks. 2) Full range of knee motion was gained in 33/37 cases. Knee-stiffness occurred in 4 cases, Severity of initial trauma might affect such results but not, retrograde nailing 3) 2 complications were found nonunion and delayed union. 4) There were not postoperative infection and femoral shortening. There were distal screw breakage in 4 cases but, the others were not migrated.
CONCLUSION
Retrograde IM nailing of femoral fracture is an effective method in selected cases such as ipsilateral femoral neck fractures, floating knees, post-TKRA femoral fracture and so on. If retrograde IM nailing is operated by skillful surgeon and appled to absolute indication, the result is no significant difference of antegrade IM nail such as bone union, nonunion and postoperative infection. Nevertheless, operation time is shorter and blood loss lesser. Significant knee problems related to this technique could not be identified for 2 years followed up.

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Factors Affecting the Period of Bone Union When Treating Femoral Fractures with a Retrograde Intramedullary Nail
Bum-Soo Kim, Seong-Tae Kim, Seungyup Shin, Seong Man Jeon
Journal of the Korean Orthopaedic Association.2021; 56(4): 326. CrossRef
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 femoral diaphyseal fractures in children: Comparison between conservative treatment and retrograde flexible intramedullary nailing: Chang Wug Oh, Byung Chul Park, Joo Chul Ihn, Hyung Tae Soh, Seung Hoon Baek; J Korean Soc Fract 2002;15(2):292-298. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.292

Abstract PDF: PURPOSE
To compare clinical outcomes and complications between pediatric patients with femoral shaft fracture who had undergone conservative treatment and retrograde flexible intramedullary nailing.
MATERIALS AND METHODS
51 cases of 46 pediatric patients who had femoral shaft fracture were retrospectively studied. Hip spica cast was applied 3~6 weeks after traction in 24 cases of conservative treatment group and closed reduction and internal fixation with flexible nails were performed in 27 cases.
RESULT
Neither pain, limitation of joint motion, nor nonunion was reported in both groups. In radiologic evaluation, 4 cases of angulation more than 10 degrees were observed in conservative treatment group and none of surgical treatment group. In leg length discrepancy(LLD) over 10 mm, there was none in surgical treatment group, but 4 cases were seen in the conservative group. Two cases of limping were observed only in the conservative group. Mean time to weight bearing was earlier in surgical treatment group(7.5 weeks) than that in the conservative group(10.8 weeks).
CONCLUSION
As treatment of pediatric femoral shaft fracture, retrograde flexible intramedullary nailing had less complications such as LLD and angulation and enabled earlier rehabilitation than conservative treatment.

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Retrograde Flexible Intramedullary Nailing of Pediatric Femur Fractures: Chang Wug Oh, Byung Chul Park, Hyung Jin Park; J Korean Soc Fract 2001;14(2):272-277. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.272

Abstract PDF

PURPOSE
This study was designed to evaluate the clinical effectiveness including bone union, leg length discrepancy, after retrograde flexible intramedullary nailing for pediatric femoral fractures. MATERIAL AND METHOD: Nineteen cases (18 patients) with femur fracture at the age of 4 to 10 years (mean age 6.7) have been followed up over the minimum of one year. Under imaging intensifier, the fracture was temporarily reduced with manual traction, and 1 or 2 flexible nails were inserted at medial and lateral side of distal femur above the distal epiphysis. After two weeks of immobilization with long leg splint, joint motion was permitted. At 6-8 weeks, partial weight bearing was permitted, and at 10- 12 weeks, full weight bearing was permitted.
RESULTS
Time to radiologic union averaged 10.9 weeks. Limb length discrepancy ranged from 7mm of shortening to 6mm of overgrowth(mean ; 1.1mm of overgrowth), but there was no severe limb length discrepancy over 10mm. As another complications, there were one case of limited motion of knee joint and one case of broken nail.
CONCLUSION
We found that retrograde flexible intramedullary nailing is a safe, effective treatment for acute femoral shaft fractures in skeletally immature patients.

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Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent
Kun-Bo Park, Hoon Park, Hyun-Woo Kim, Hui-Wan Park, Jae Young Roh
Journal of the Korean Fracture Society.2010; 23(2): 206. CrossRef

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Arthroscopic Treatment of The Tibial Intercondylar Eminence Fractures: Han Chul Kim, Beom Kim; J Korean Soc Fract 2000;13(3):488-493. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.488

Abstract PDF: PURPOSE
To compare operative results between pull-out wiring and retrograde screw fixation for displaced tibial intercondylar eminence fracture.
MATERIALS AND METHODS
From March 1997 to February 1999, authors carried out pull-out wiring in 3 patients and retrograde screw fixation in 5 patients who sustained typeII and typeIII displaced tibial intercondylar eminence fractures follow up for 16 months(mean).
RESULTS
The Union time was mean 7 wk in pull-out wiring and 6.5 wk in retrograde screw fixation. Limitation of knee motion(1 case) developed in retrograde screw fixation group and reoperated for adhesiolysis. Pull-out wiring group were all full motion recovered. Anterior instability(1 case) developed in retrograde screw fixation group and pull-out wiring group had no instability. Operation time for retrograde screw fixation group was mean 98min and pull-out wiring group was 105 min.
CONCLUSION
The outcome of pull-out wiring group were superior to retrograde screw fixation group. It can be stably fixed and allow early motion exercise. Besides, in case of small bony fragment, it is difficult for fixation with screw. And even impossible. In child cases, the multiple percutaneous pinning can lead to good result. So authors believe that pull-out wiring is worthy for tibial intercondylar eminence fracture.

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