Journal of Musculoskeletal Trauma

Failure of Removal of Stripped Locking Screw after Locking Compression Plating: Sung Jin Kim, Kyung Jae Lee; J Korean Fract Soc 2011;24(2):169-173. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.169

PURPOSE
The purpose of this study was to evaluate the incidence and possible causes of stripped locking screws that make difficult to remove the locking compression plate. We also tried to find the useful methods to remove the stripped locking screws.
MATERIALS AND METHODS
Between May 2005 and January 2009, 84 patients who underwent operations for removal of locking compression plate were included in this study. We removed 298 3.5-mm locking screws and 289 5.0-mm locking screws in these patients. We retrospectively investigated the incidence and possible causes of stripped locking screws and evaluated the pros and cons of the methods that we have used to remove the stripped locking screws.
RESULTS
17 out of 298 3.5-mm locking screws (5.7%) and 2 out of 289 5.0-mm locking screws (0.7%) were encountered with difficulties by hexagonal driver during removal because of the stripping of the hexagonal recess. First we used the conical extraction screw for all the stripped locking screws and only 3 screws were removed successfully. We removed 3 screws by cutting the plate around the stripped locking screw and twisting the plate with the screw and we removed 1 screw by the use of hallow reamer after cutting the plate. Twelve screw shafts were left except grinding of screw head by metal-cutting burr. There was one iatrogenic re-fracture in whom we have used with hallow reamer.
CONCLUSION
At the time of locking compression plate removal, difficulties of locking screw removal due to the stripping of the hexagonal recess should be expected and surgeon must prepare several methods to solve this problem.

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An inexpensive and rapid method for removal of multiple stripped locking screws following locking plating: A case report
Won Ro Park, Jae Hoon Jang
International Journal of Surgery Case Reports.2019; 57: 134. CrossRef

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2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures: Sung Jin Kim, Chul Hyun Cho; J Korean Fract Soc 2011;24(2):151-155. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.151

Abstract PDF

PURPOSE
To evaluate outcomes 2.4 mm volar locking compression plate for treatment of unstable distal radius fractures.
MATERIALS AND METHODS
We retrospectively analyzed the results in 22 cases, which were treated by 2.4 mm volar locking compression plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results.
RESULTS
All cases had bony union. The mean Mayo wrist performance score was 85.23. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 6.04 mm to 9.68 mm, radial inclination from 15.61degrees to 19.61degrees, volar tilt from -13.73degrees to 7.66degrees and intraarticular step-off from 0.79 mm to 0.33 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured 0.86 mm, radial inclination 0.41degrees, volar tilt 0.54degrees and intraarticular step-off 0.02 mm (p>0.05). Postoperative complication included that flexor pollicis longus and 2nd flexor digitorum profundus were ruptured in 1 case.
CONCLUSION
Treatment of unstable distal radius fractures using a 2.4 mm volar locking compression plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.

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Treatment of the Communited Distal Radius Fracture Using Volar Locking Plate Fixation with Allogenic Cancellous Bone Graft in the Elderly
Je Kang Hong, Chang Hyun Shin
Journal of the Korean Fracture Society.2015; 28(1): 8. CrossRef

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Tibial Condyle Fracture Treated by Osteosynthesis with a Buttress Plate: Duck Yun Cho, Sung Jin Kim, Gun Yeon, Young Yoo Kim, Sung Joon Im, Chun Hee Won; J Korean Soc Fract 2000;13(4):868-876. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.868

Abstract PDF: PURPOSE
We analyzed the anatomical results of operative treatment in acetabular fractures according to fracture pattern and surgeon's experience. MATERIAL AND METHODS: From December, 1993 to December, 1999, 100 cases of acetabular fractures operated by single surgeon were analyzed. Fracture configuration was classified by Letournel's method. The anatomical results were classified by Matt' s criteria and Claude Martimeau score.
RESULTS
There were 36 elementary fractures(anterior column type: 4 cases, posterior wall type: 29 cases, transverse type: 3 cases) and 64 complex fractures(posterior wall and posterior column type: 4 cases, anterior and posterior hemitransverse type: 8 cases, transverse and posterior wall type: 16 cases, T type: 6 cases, both column type: 30 cases). According to Matta's criteria, all elementary fractures were seen anatomic or satisfactory results however, eleven cases of combined fracture were seen unsatisfactory results. Mean Claude Martimbeau's score was 6.1 point. Elementary fracture was 7.5 point and combined fracture was 5.4 point. Both column fracture was 4.4 point and it was the lowest point among the fractures. In both column fracture, the improvement of surgeon's skill made more good anatomical results. There were four cases of infection and 2 cases of nerve injury.
CONCLUSION
In operative treatment of acetabular fractures, complexity of fracture demands more appropriate surgical approach and skillful surgeon,

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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

Abstract 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.

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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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Treatment of the Femoral Shaft Fracture by Interlocking Intramedullary Nailing: Sung Joon Im, Sung Jin Kim, Dae Sang Yoo, Ho Sik Sung; J Korean Soc Fract 1998;11(1):181-190. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.181

Abstract PDF: Femoral shaft fractures result from high energy trauma such as traffic accident or falls, and it is frequently accompanied by multiple fractures and several other organ injuries. Intramedullary nail is the effective device available for patient with appropriate fracture of the femoral shaft, and it may also prevent several complications, such as infections and delayed union that can be caused by periosteum and soft tissue injury. Rigid internal fixaton of the femoral shaft fracture with interlocking intramedullary nails presents a significant advance in the management of unst-able fractures and provides longitudinal and rotational stability as well as early joint motion and weight bearing. This procedure has been used with wide popularity because it is possible simultaneously to preserve the range of motion and to obtain the bone union. The purpose of this sutdy is to evaluate the differences of the functional results and duration of the bone union based on Winquist-Hansen classification. Also we analyzed the causes of the complications and results of the treatment. Forty one cases of the femoral shaft fractures were treated with interlocking intramedullary nailing during the period from January 1993 to June 1995 over 12 months follow up. The results were as follows: 1. Among 41 cases of the femoral shaft fractures, static nailings were used in 34 cases and 7 cases with dynamic nailings, then bone union was achieved at 18 weeks for static mode and 15 weeks for dynamic mode respectively. 2. Intraoperative complications were new fractures near the original fracture site(2 cases) and femur neck(1 case). 3. Postoperative complications were delayed union(4 cases), metal failre(1 case), limb shortening(1 case) and distal screw breakage(1 case). 4. Delayed union developed in 4 cases with static mode, but bone union was achieved at average of 22 weeks after changing to dynamic mode at 15 weeks. 5. Functional results were assessed by Karlstrom and Olerud criteria and 80% of the patients were in excellent and goood results.

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