Journal of Musculoskeletal Trauma

Treatment of Open Type-III Tibial Shaft Fractures -Comparison Between Ilizarov External Fixation and Secondary Intramedullary Nailing-: Hoon Kim, Woo Dong Nam, Ki Chan Ahn, Seung Seok Seo, Young Chang Kim, Jang Seok Choi, Young Goo Lee; J Korean Soc Fract 1998;11(1):191-197. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.191

Abstract PDF: Open type III tibial shaft fractures have a high incidence of complication and a poor outcome. The most usual method of stabilization is by external fixation, but there are several complications as infection, delayed union and nonunion. We tried to compare the results of Ilizarov external fixation cases with the case of secondary intramedullary nailing after temporary Ilizarov fixation. There was no significant difference in the union time of Ilizarov external fixation and secondary intramedullary nailing after temporary Ilizarov fixation. But the patients were more comfortable in the secondary intramedullary nailing. In conclusions, secondary intramedullary nailing after temporary Ilizarov fixation is the useful method in the treatment of open type III tibial shaft fractures.

The Treatment and Complications of Ipsilateral Fracture of the Femur and tibia: Kyu Min Kong, Ki Chan Ahn, Sung Seok Seo, Young Chang Kim, Jang Seok Choi, Young Goo Lee; J Korean Soc Fract 1997;10(3):556-561. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.556

Abstract PDF: Ipsilateral fracture of the femur and tibia is difficult to treat because it is often comminuted and combined with severe soft tissue injury. And The result of treatment is poor in most cases. The thirty-four cases were treated at Pusan Paik Hospital from March, 1992 to February, 1995. The result were as follows; 1. The bony union time was shorter in the intramedullary nailing than other methods. 2. There were less complications in the group of used intramedullary nailing than other methods. 3. The intramedullary nailing was relatively good treatment method for ipsilateral fracture of the femur and tibia.

Treatment using Intramedullary Fixation for Open Tibial Diaphyseal Fractures: Young Goo Lee, Jnng Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seung Seok Seo, Sang Hun Ha; J Korean Soc Fract 1996;9(3):583-592. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.583

Abstract PDF: This fractures of tibial shaft are common and open injuries are frequently accompanied due to its anatomical characteristics. External fixation was widely used for treatment of open fractures of tibia, but recently internal fixation combined with appropriate debridement and antibiotics has been reported, with more comfortness and less secondary operations. We analysed 33 cases of open tibial diaphyseal fractures treated using intramedullary fixation devices. The results were as follows. 1. The methods of fixation were Ender nail, 15 cases, and interlocking nail, 18 cases. And 17 cases out of 18 interlocking nail were unlearned one. 2. The Ender nail was used in 5 cases for open type I fracture, 7 type II, 2 type III-a and 1 type III-b, And the interlocking nail was used in 9 cases for type 1, 7 type II, 1 type IIIa and 1 type III-b. The average operation time was 55 minutes for Ender nail, while 14 minutes for interlocking nail. 3. The Ender nailing group has 6 complications;one case superficial infection, one deep infection, one delayed union, one nonunion and two angulation deformities. The interlocking nailing group has also 6 complications;one case superficial infection, two deep infections, one delayed union, one nonunion and one peroneal nerve palsy. 4. The average union period was 18.4 weeks in Ender nail and 19.1 weeks in interlocking nail.

Interlocking Medullary Nailing in Severe Comminuted Fracture of the Femoral Shaft: Young Goo Lee, Jang Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seong Seok Seo, Young Jae Kim; J Korean Soc Fract 1996;9(1):105-111. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.105

Abstract PDF: The interlocking medullary nail widens the range of the indication for medullary osteosynthesis of the femoral shaft fractures. Twenty one cases with the comminuted fracture of the femoral shaft were reviewed, which had been treated by closed or or semi-open IM nailing at the Department of Orthopedic Surgery, Pusan Paik Hospital from March 1991 to December 1993. The results were as follows 1. The period of fracture union was 22.1 weeks in Winquist-Hansen Grade III,27.4 weeks in Grade IV , 19.6 weeks in segmental. And its period was 22.6 weeks in closed and 26.2 weeks in semi-open IM nailing. 2. The result of closed interlocking medullary nailing was better and complications were less than semi-open interlocking medullary nailing. 3. The severely comminuted femoral shaft fractures were unstable and there were the risk of shortening, rotation and inadequate reduction. Therefore, when the closed interlocking medullary nailing did not gain the anatomical reduction, it was altemative method to perform semi-open interlocking medullary nailing. From above result, we conclude that closed interlocking medullary nailing or semi-open interlocking medullary nailing seems to be a favorabel method for treatment of severe comminuted femoral shaft fracture.

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