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The Operative Treatment of Nonunions of Midshaft Clavicular Fractures: Reconstruction Plate Fixation and Bone Grafting
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Young Soo Byun, Chan Hoon Yoo, Hyug Su An, Seong Gun Moon, Dong Ju Shin, Jun Woo Park
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J Korean Soc Fract 2003;16(2):222-229. Published online April 30, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.2.222
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The purpose of this study is to present our experience with open reduction, 3.5-mm reconstruction plate fixation, bone-grafting, and postoperative early mobilization for nonunions of midshaft clavicular fractures. MATERIALS AND METHODS Sixteen patients were treated operatively for nonunions of the midshaft of the clavicle from 1997 to 2001. Ten nonunions were atrophic and six were hypertrophic. Nonunion had been present for an average of 6.5 months. The operative technique included removing the fibrous tissue from the nonunion site and opening the medullary canal, reduction of the fracture and fixation with a 3.5-mm reconstruction plate, and bone-grafting. Postoperative mobilization started within one week. RESULTS The average duration of follow-up was 22.0 months. All fractures were united in an average of 10.0 weeks. All patients had full range of motion of the ipsilateral shoulder, but 3 out of 6 patients who were more than 50 years old complained occasional pain in the ipsilateral shoulder at the final follow-up examination. There were no major complications of postoperative infection, metal failure of the plate, loss of fixation, nonunion, and refracture after removal of the implant. CONCLUSION The technique of open reduction, reconstruction plate fixation, and bone-grafting is a safe and reliable method to allow early rehabilitation by stable fixation and to predict a high rate of union for nonunions of midshaft clavicular fractures.
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Unstable Trochanteric Fractures of the Femur Treated with a Condylar Blade Plate
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Young Soo Byun, Chan Hoon Yoo, Jun Mo Nam, Young Ho Cho, Dong Ju Shin
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J Korean Soc Fract 2002;15(3):320-327. Published online July 31, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.3.320
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This study evaluates the effectiveness of the condylar blade plate for internal fixation of unstable trochanteric fractures of the femur. MATERIALS AND METHODS Twenty six unstable trochanteric fractures of the femur (AO classification, 9 type A2 and 17 type A3) were treated by condylar blade plate fixation. Osteoporosis was found in 14 cases. Fractures were operated on the average 7th day after trauma and cancellous bone graft was performed in 3 fractures with severe comminution. Results were evaluated by operating time, time of fracture healing, complications, and function of the hip and walking ability at the final follow-up assessment. RESULTS Operating time was 123 minutes on average. All fractures were united in an average of 14.0 weeks. Complications at the fracture site were a heterotopic ossification and a refracture. Motion of the hip was limited moderately in a case with heterotopic ossification and mildly in 5 cases. Two patients used a cane and 2 patients revealed a mild limp. CONCLUSION Although the condylar blade plate is technically difficult to apply, it provides stable fixation to obtain good results with less complications for unstable trochanteric fractures of the femur, especially even in the presence of osteoporosis.
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Citations
Citations to this article as recorded by 
- Helical Blade Locking Sleeve Disassembly Following Failed Femur Intertrochanter Fracture - A Case Report -
Soon Ho Huh, Hong-Man Cho, Ji-Yeon Park Journal of the Korean Fracture Society.2021; 34(3): 112. CrossRef - Excessive Sliding of the Helical Blade and the Femoral Neck Fracture after Insertion of Proximal Femoral Nail Anti-Rotation for Type A2 Intertrochanteric Fractures - A Case Report -
Bong-Ju Park, Hong-Man Cho, Ju-Han Kim, Woo-Jin Sin Journal of the Korean Fracture Society.2013; 26(2): 151. CrossRef - A Case Report of Unique Complications of PFNA Penetration of the Blade into the Hip Joint
Se-Ang Jang, Young-Ho Cho, Young-Soo Byun, Hun-Sik Cho, Sung Choi, Hyun-Seong Yoo Hip & Pelvis.2011; 23(4): 318. CrossRef
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Treatment of Trochanteric Fractures of the Femur with Compression Hip Screw-Analysis of Factors associated with Failure of Fixation-
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Chan Hoon Yoo, Hong Tae Kim, Young Soo Byun, Jun Mo Nam, Young Ho Cho, Seong Gun Moon
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J Korean Soc Fract 2002;15(3):312-319. Published online July 31, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.3.312
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This study was performed to analyze the significant factors that may affect failure of fixation in trochanteric fractures of the femur treated with the compression hip screw. MATERIALS AND METHODS From May 1995 to July 2000, the authors analyzed 97 cases of trochanteric fracture of the femur treated with the compression hip screw and followed more than one year. We classified the fracture type by Jensen 's method. We used Singh index for the degree of osteoporosis. In the post-operative radiograph, we checked neck-shaft angle, state of reduction, position of the lag screw within the femoral head, tip-apex distance, and sliding distance of the lag screw. The relationship between these factors and failure of fixation was statistically analyzed. RESULTS There were 17 cases (17.5%) of failure of fixation ; 15 cases (15.4%) of excessive sliding of the lag screw, 1 case (1%) of cutting out of the lag screw, and 1 case (1%) of valgus malunion. There were significant relationships between failure of fixation and old age over 80, unstable fracture, telescoping reduction, anterior or medial displacement of the distal fragment, and anterior placement of the lag screw within the femoral head. CONCLUSION Accurate reduction and avoidance of the placement of the lag screw in the anterior part of the femoral head were important factors to prevent failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.
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Treatment of Femoral Neck Fractures with Cannulated Screws
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Chan Hoon Yoo, Hong Tae Kim, Young Soo Byun, Sang Chul Shin, Byung Doo Jang, Kyoung Hoon Hyun
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J Korean Soc Fract 2000;13(3):445-453. Published online July 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.3.445
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This study was performed to evaluate the results of femoral neck fractures in adult treated with cannulated screws and the factors that may affect results. MATERIALS AND METHODS From April 1992 to December 1998, the authors analysed 53 cases of femoral neck fracture treated with cannulated screws and followed more than one year. According to Garden's classification and anatomic location, we classified the fracture type. We used Garden alignment index for the accuracy of reduction and Singh index for the degree of osteoporosis. The clinical results were analysed by Lunceford's assessment. RESULTS According to Lunceford's assessment, the results were good or excellent in 40 cases(75%). Mean bony union time was 16.3 weeks. There were 10 cases(19%) of avascular necrosis of the femoral head, 6 cases(11%) of nonunion and 2 cases(4%) of malunion. There were significant relationship between complication rate and accuracy of reduction(P<0.01), operative delay more than 7 days(P<0.05). CONCLUSION The important factors that may affect the results are accuracy of reduction and interval between injury and time of operation, the others were degree of displacement, anatomic site, degree of osteoporosis. The results of this study indicate that cannulated screw fixation is an effective method for femoral neck fractures in adult.
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Intraoperative Fracture of the Tibia Associated with Removal of the Interlocking Intramedullary Nail: Report of 5 cases
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Chan Hoon Yoo, Young Soo Byun, Hong Tae Kim, Hyun Min Kim, Yeon Min Park, Soo Yeol Jeon
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J Korean Soc Fract 1999;12(3):538-542. Published online July 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.3.538
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- We have experienced five cases of intraoperative fracture of the tibia assoicated with removal of ACE interlocking tibial nail. All fractures occured in young patients whose ages ranged from eighteen to twenty-nine years(mean, 24 years). We think the main reason of the fracture was characteristic design of ACE nail such as prominent distal angulation and posterior longitudinal slot. The other factors were age of the patient, material of the nail and timing of removal of the nail. In conclusion, we advise caution in the removal of the ACE reamed interlocking intramedullary tibial nail in young patient.
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Citations
Citations to this article as recorded by 
- Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report
Ji-Hwan Kim, Seung-Oh Nam, Young-Soo Byun, Han-Sang Kim Journal of the Korean Fracture Society.2015; 28(1): 71. CrossRef
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Surgical Treatment of Comminuted Interior Patellar Pole Fractures by Separate Vertical Wirings: A New Method of Internal Fixation
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Young Soo Byun, Hong Tae Kim, Chan Hoon Yoo, Hyun MiH Kim, Yeon Min Park, Sang Chul Shin
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J Korean Soc Fract 1999;12(3):584-592. Published online July 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.3.584
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- The inferior pole fragments of patellar fractures should be reduced anatomically whenever possible because any resection of the inferior pole fragments results in patella baja and abnormal patellofemoral biomechanics. However, there are still no effective methods of stable fixation for comminuted inferior patellar pole fractures. The purpose of this study is to introduce a new method of internal fixation of separate vertical wirings for comminuted inferior patellar pole fractures and to present the results of the wirings.
Thirteen patients with comminuted inferior patellar pole fracture were treated with 2 to 4 separate vertical wirings, which provided the sufficient strength to allow early motion without loss of reduction during fracture healing. All the fractures were healed in anatomical position and all the patients regained full range of motion of the knee. Loss of fixation occurred in a patient by foiling on the ground, but the fracture was healed by the wirings again. There were no patients with radiographic evidence of posttraumatic osteoarthritis at the final follow-up. Overall result was rated as excellent in all the patients.
The results of this study indicate that separate vertical wirings are an effective method of stable fixation enough to allow early motion without loss of reduction during fracture healing for comminuted inferior patellar pole fractures.
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