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Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing
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Suenghwan Jo, Gwang Chul Lee, Sang Hong Lee, Jun Young Lee, Dong Hwi Kim, Sung Hae Park, Young Min Cho
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J Korean Fract Soc 2019;32(2):83-88. Published online April 30, 2019
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DOI: https://doi.org/10.12671/jkfs.2019.32.2.83
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Abstract
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This study examined the outcomes of exchange nailing for the hypertrophic nonunion of femoral shaft fractures treated with intramedullary nailing as well as the factors affecting the treatment outcomes. MATERIALS AND METHODS From January 1999 to March 2015, 35 patients, who had undergone intramedullary nailing with a femoral shaft fracture and underwent exchange nailing due to hypertrophic nonunion, were reviewed. This study investigated the time of union and complications, such as nonunion after exchange nailing, and analyzed the factors affecting the results. RESULTS Bone union was achieved in 31 cases (88.6%) after exchange nailing and the average bone union period was 22 weeks (14–44 weeks). Complications included persistent nonunion in four cases, delayed union in one case, and superficial wound infection in one case. All four cases with nonunion were related to smoking, three of them were distal shaft fractures, and one was a midshaft fracture with underlying disease. CONCLUSION Exchange nailing produced satisfactory results as the treatment of hypertrophic nonunion after intramedullary nailing. Smoking is considered a factor for continuing nonunion even after exchange nailing. In the case of a distal shaft, where the intramedullary fixation is relatively weak, additional efforts are needed for stability.
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Arthroscopic Assisted Intra-Articular Reduction and Internal Fixation of Tibia Plateau Fracture
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Dong Hwi Kim, Gwang Chul Lee, Kwi Youn Choi, Sung Won Cho, Sang Ho Ha
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J Korean Fract Soc 2013;26(3):191-198. Published online July 31, 2013
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DOI: https://doi.org/10.12671/jkfs.2013.26.3.191
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Abstract
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We evaluated the results of arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window along with any additional bone grafts. MATERIALS AND METHODS From March 2006 to March 2009, twelve patients with arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures over 5 mm in depression and displacement on the articular surface in computed tomography (CT) were enrolled in this study. We reduced or removed the depressed fracture fragment using freer without making a cortical window. Then, we accomplished internal fixation by a cannulated screw. All cases have not received bone graft. Both the postoperative clinical and radiological results were evaluated by the Rasmussen system. RESULTS The fractures were healed completely in an average of 9 (range from 7 to 12) weeks. According to Rasmussen classification, we obtained satisfactory clinical results as excellent in 8 cases, good in 3 cases, and fair in 1 case; and radiological results were excellent in 7 cases and good in 5 cases. CONCLUSION We consider that arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window and any additional bone grafts is are a useful methods for attaining satisfactory results.
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Citations
Citations to this article as recorded by 
- Current Concepts in Management of Tibia Plateau Fracture
Sang Hak Lee, Kang-Il Kim Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef
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