Journal of Musculoskeletal Trauma

Nonunion of the Fracture of Distal One-third of Femoral Shaft treated by Interlocking Intramedullary Nailing: Su Chan Lee, Min Ho Song; J Korean Soc Fract 1999;12(2):259-266. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.259

The twelve nonunions of distal one-third fracture of femoral shaft after interlocking intramedullary nailing were teated with reaming and exchange nailing with a larger-sized nail, or reaming and exchange nailing with a larger-sized nail added with poller screw fixation. All the femoral nonunion were caused by insecure fixation of the intramedullary nailing, in which a instability of the fracture sites was verified in all cases during operation. The six of them were treated with reaming and exchange nailing. A simultaneous bone graft was performed in one of them to repair the bony defect. The other six of them were treated with reaming and exchange nailing added with poller screw fixation. The result were as follows: 1. In six cases that treated with reaming and exchange nailing, patients walked bearing full weight on the extremity with mild aching at the fracture site within 3 months and not obtained a bony union until a 12 months. 2. In one case that treated with reaming and exchange nailing added with poller screw fixation, patient walked bearing full weight on the extremity with mild aching at the fracture site within 3 months and not obtained a bony union until a 12 months. 3. In five cases that treated with reaming and exchange nailing added with poller screw fixation, patient walked bearing full weight on the extremity without aching at the fracture site within 3 months and obtained a bony union within a average of 7 months. From our experience, etiology of nonunions of distal one-third fractures of femoral shaft is thought insecure fixation of the intramedullary nailing due to wide intramedullary canal. We have found reaming and exchange nailing with poller screw fixation is more helpful treatment that reaming exchange nailing as treatment for those fractures.

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Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing
Sung-Soo Kim, Sung-Keun Sohn, Chul-Hong Kim, Myung-Jin Lee, Lih Wang
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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Clinical Study on Operative Technique and Management of Tibial condylar Fractures: Su Chan Lee, Beom Koo Lee, Do Hyun Moon, Jin Hong Ko, Young Kyu Kim, Hong Ki Park, Jun MO Jung, Hyun Park; J Korean Soc Fract 1998;11(3):533-539. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.533

Abstract PDF: We reviewed fifteen cases of tibial condylar fractures, especially, Schatzker type VI treated with hybrid method from January 1995 to May 1997. We attained satisfactory bony union in all cases. There were not serious complications such as deep wound infection and severe angular deformity, but partial ankylosis. After operation, the patients could do knee motion exercise immediately and had no difficulty in getting maintenance of reduction and fracture healing. In conclusions, the hybrid method is an excellent treatment in soft tissue care, maintenance of reduction, and early ambulation and fracture healing in the cases of tibial condylar fractures.

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A Comparison of Unlearned IM-nailing with Reamed IM-nailing in Tibial Shaft Fracture: Su Chan Lee, Bum Gu Lee, Do Hyun Moon, Jin Hong Ko, Hong Ki Park, Ki Dong Kang, Sang Kyoo Choi; J Korean Soc Fract 1997;10(2):295-302. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.295

Abstract PDF: Recently, there is seen frequently the tibial fracture due to the increased traffic accident and the high industry. Rigid intramedullary nailing is the method of choice in tibial shaft fracture, early weight bearing and joint motion. Between Jan.1993 and Dec. 1994, we treated 93 tibial shaft fractures with reamed intramedullary nails(55 cases) & unlearned intramedullary nails(38 cases). We analyzed the effects of these two methods, and the following results were obtained. 1. Of 93 fractures, 32 fractures were open and 61 fractures were closed. 2. The most common cause was traffic addicent. Among the 93 cases, 60 cases were male and 33 cases were female, the most common age were ranged from 30-39 year, involving 36 cases. 3. The mean durations of the bone union were 19.7 weeks in closed fracture with treated by reamed nail and 22.1 weeks in closed fracture with unlearned. The mean duration of the bone union were 24.5 weeks in open fracture with reamed and 22.4 weeks in open fracture with unlearned. The complications of intramedullary nail are angular deformity, infection, delayed and nonunion, and screw breakage.

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Operative Tleatment of the Lateral Condyle Fractures of the Humerus in Children: Bum Gu Lee, Do Heun Moon, Jin Hong Ko, Su Chan Lee, Hong Ki Park, Ki Dong Kang, Young Kim; J Korean Soc Fract 1996;9(4):1096-1103. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1096

Abstract PDF: Fracture of the lateral humeral condyle is a relatively common injury in children. The standard treatment of Jakobs type II and III fractures is open reduction and internal fixation The treatment of Jakobs type I fractures is more controversial. Authors performed clinical and radiological analysed of fifty-two patients of lateral condylar fracture of the humerus who have been treated with open reduction and internal fixation. They were followed up from one year to five years and two months. The results were as follows; 1. The age incidence was confined from 3 years to 12 years. 2. There were 14 cases(26.9%) of Milch type I, 38 cases(73.8%) of Milch type II and according to Jakobs stage, 20 cases were stage I, 23 cases were stage II, 9 cases were stage III. 3. All cases were treated by open reduction and Internal fixation. 4. In 5 cases were lateral condyle overgrowth of the humerus, 2 cases were limited ROM of elbow joint. and 2 cases pin site loosening and superficial wound infections observed. And this complications did not resutt in significant clinical disabilites. 5. Respectively, according to the criteria of Hardacre 41 cases(78.8%) were excellent, 11 cases (21.1%) were good, and there was no poor case. 6. The fracture type and stage of displacement did not effect the flnal results. the complications, the complications are due to inaccurate reduction or insecure fixation. Therefore, open anatomical reduction and stable internal fixation is required to avoid complications, even in stage I displaced fractures.

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Surgical Treatment of Intra-articular Fracture of the Os Calcis: Soo Kil Kim, Young Gyu Kim, Bum Gu Lee, Jin Hong Ko, Su Chan Lee, Young Kim; J Korean Soc Fract 1996;9(2):354-365. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.354

Abstract PDF: Intra-articular fractures involving the posterior facet of the subtalar joint are associated with significant and prolonged disability. But, the treatment of choice for displaced intra-articular calcaneal fractures remains controversial. We treated 30 displaced intra-articular fractures of the calcaneus by open 1eduction and internal fixation through the lateral approach with autogenous bone graft at the Department of Orthopaedic Surgery, Choong-ang Gil and Dong Inchon Gil Ceneral Hospital from January 1990 to October 1994 The clinical and radiographic analyses were as follows. 1. Of 26 patients, 20 patients were male and 6 patients were female. 2. The main cause fractures of calcaneus was a fall from a height in 23 cases(88%) and most of associ ated fractures were spine injury in 6 patients. 3. Fracture was classified according to Essex-Lopresti classification. 13 cases were tongue type, 17 cases were joint depression type. 4. Alt Open reduction and internal fixation through the laterl approach with bone graft was performed in joint depression type and tongue type. 5. The preoperative ayerage Bohlers angle was - 5. The postoperative avereage Bohlers angle was -24, Which was increased significantly. 6. Complications were 12 cases ; included heel pad pain in 8 caLes, osteomyelitis and superficial wound infection in 2 cases, transient sensory hypesthesia on the lateral side of the foot in 2 cases. 7. Based on assessement of Salama, the results were excellent in 5 cases, good in 1 Teases, fair in 6 cases, poor in 2 cases.

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Treatment of Unstable Tibial Fracture Using Interlocking Intramedullary Nailing: In Suk Oh, Do Hyun Moon, Jin Hong Ko, Su Chan Lee, Yeoung Hun Jang; J Korean Soc Fract 1995;8(1):269-277. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.269

Abstract PDF: With increasing industrial and traffic accident, tibia fractures by high energy has been increased and their treatment is difficult. There are many controversy concerning the method of treatment, because of many complications, such as malunion, delayed union, nonunion, infection and joint contracture. The use of an intramedullary nail with interlocking bolts, either closed or open thchnique has became an attractive alternative method of treatment for unstable fracture of tibia. From Januaiy, 1987 to December,1992 we treated 63 fractures of the tibia by minipulative reduction and fixation of the fracture fragments with rigid intramedullary nail at Department of Ouhopaedic Surgery Choong-ang Gil Hospital. The following result was obtained. 1) The average time from injury to operation is in closed and open fracture, 6 and 21 days respectively. 2) Of 63 fractures, 60 fractures united and the union rate was 95.2% 3) The average time of bone union was the 19.3 wks : the 17.8 wks in closed fracture ; the 21.6 wks in open fracture ; the 22.3 wks in Non-union. 4) Regardless of amount of comminution, we treated tibial fractures extending from 3 CM distal to the tibial tuberosity to 5 CM above the ankle joint. 5) Static and dynamic interlocking nailing were done 44 and 19 cases respectively. 6) We permitted weight bearing within 2 weeks in butterfly or oblique fracture within 6 weeks in communited or segmental fracture. 7) According to the functional classification of Klemm and 3,orner, among 63 cases, 35 were excellent,20 good,5 fEir and 3 poor.

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