Journal of Musculoskeletal Trauma

Torsional Deformity Following Intramedullary Nailing for Treatment of the Tibia Fractures: Ju O Kim, Sung Jun Lee, Yeub Kim, Hae Ryong Huh; J Korean Soc Fract 2000;13(4):928-934. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.928

Abstract PDF: PURPOSE
To determine the incidence and extent of torsional mal-alignment in patients with tibial shaft fractures treated with closed antegrade intramedullary(IM) nailing.
MATERIALS AND METHODS
We measured torsion using CT scanning in 35 patients. Affected tibiae were compared with the normal tibiae.
RESULTS
A torsional difference of 8degrees or more found in 22 cases(63%) as compared with the uninjured side. Only 7 of these cases could be clinically detected and only two patients noted the problem.
CONCLUSION
Torsional mal-alignment occurs in a significant number of tibial fractures treated by closed IM nailing in spited of careful attention to detail. We recommend that torsional mal-alignment be considered as a likely cause for less than optimal result after treatment of the tibial fractures by closed IM nailing and to investigate this further by performing CT scans.

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Femoral Fracture Malalignment following Interlocking Intramedullary Nailing: Yeub Kim, Yong Beom Jeon, Gi Jung Joo, Hae Ryong Hur; J Korean Soc Fract 1999;12(1):61-68. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.61

Abstract PDF: Interlocking intramedullary nailing has become a common method of treatment for femoral shaft fractures in adults. But sometimes the malalignment of the femoral fracture results in pain, limb length discrepancy, and traumatic osteoarthritis of the knee, etc. Therefore, it is very important to know what makes the malalignment after the femoral shaft fractures. We performed CT scan in 46 patients who had femoral shaft fractures, treated by interlocking intramedullary nailing at the orthopaedic department of the Kwanaiu Verterans Hospital. There were thirty-five men and eleven women, and their mean age was 36 years at the time of the operation. We measured the rotational deformity of both femurs by the CT scanning and the angulation deformity by plain radiographs in forty-six patients. We also compared the amount of the angulation and rotational deformity according to the type or the site of fracture, the degree of comminution, the time from injury to operation and the associated injury. Average angulation deformity was 2.7degrees in sagittal plane and 2.5degrees in coronal plane. Average rotational deformity wat 10.2degrees Fourteen patients(30%) had angulation more than 5degrees Ten patients(22%) had rotational deformity more than 15degrees Angulation deformity was severe significantiy at proximal 1/3 fracture, segmental fracture and severely comminuted fracture group. But because there was no significant difference of rotational deformity according to the level of fracture, the amount of comminution, and associated injury, increased rotational deformity seems to be resulted from the preoperative traction and the intraoperative technique. Therefore, we must determine the accurate entry point of intrameduiiary nailing and reduce the fracture accurately by intraoperative ultrasonography or fluoroscopy.

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Treatment of Intertrochanterie fracture of the Femur with Ender Nails in the Elderly Patients: Seong Taek Kim, Ki Soo Kim, Yeub Kim, Seung Hee Koh, Yong Soo Choi, Sang Tae Park; J Korean Soc Fract 1992;5(2):300-308. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.300

Abstract PDF: The incidence of intertrochanteric fracture of the femur in the elderly patient has been increased progresslvely due to the prolongation of Korean average life span and improvement of the medical survice. The mortality. however, in these elderly patients is relatively high. Rigid internal fixation of intertrochanteric fracture with early mobilization of the patient has in recent years reduced the mortality and morbidity. From September 1984 to August 1991, the authors had treated with Ender nails for 126 cases of intertrochanteric fracture. From 109 cases followed more than six months, the clincal results were as follows. 1. The average age was 74.8 years. 2. 73 cases (67%) were unstable fractures and 36 cases (33%) were stable fractures by Evans classification. The most common type was type 3 (35.8%) by the Tronzo classification, A2 type(55.1%) by the AO classification. 3. The main indication were stable fracture, unstable fracture over 70 years old, high anesthe tic resk, severe osteoporosis and wound at greater trochanter. 4. Intraoperatlve complications were experienced in 37 cases(33.9%). The improper entry hole site was most common. 5. Postoperative complications occured in 57 cases(52.3%) and more frequently in unstable fractures(57.5%). The most common complication was knee joint pain in 45 cases (41.3%) 6. Recently, patients who had Ender nails with Knowles pins showed good results in the presence of severe osteoporosis or unstable fracture.

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Femoral subtrochanteric fracture during closed meduallary nailing: two cases report: Yeub Kim, Ki Soo Kim, Seong Taek Kim, Young Youl Chung; J Korean Soc Fract 1991;4(1):119-122. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.119

Abstract PDF: No abstract available.

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