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Comparison of Results between Minimally Invasive Plate Fixation and Antegrade Intramedullary Nailing of Recon-Type in Low-Energy Injury Distal Femoral Shaft Fractures
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Hong Moon Sohn, Gwangchul Lee, Ba Rom Kim, Jung Soo Oh
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J Korean Fract Soc 2024;37(2):87-94. Published online April 30, 2024
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DOI: https://doi.org/10.12671/jkfs.2024.37.2.87
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 Abstract
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- Purpose
This study compared the outcomes of minimally invasive plate osteosynthesis and antegrade intramedullary nailing for low-energy fracture of the distal femoral shaft.
Materials and Methods
A study was conducted on 30 patients who underwent surgery for low-energy fractures of the distal femoral shaft between January 2016 and April 2022. The study compared 15patients who underwent minimally invasive plate osteosynthesis (Group P) with 15 patients who underwent recon-type antegrade intramedullary nailing (Group N). We evaluated intraoperative blood loss, operative time, C-arm exposure time, bone density, final union status, anatomical reduction, and clinical evaluation. The complications were also examined, and statistical analysis was conducted to compare the two groups.
Results
The blood loss, surgery time, and C-arm time were similar in the two groups. The radiographic assessments and clinical evaluations were also similar in the two groups. The clinical results showed no difference between the groups. Group N had one case of nonunion and one case of delayed union, while Group P had one case of nonunion and one case of peri-prosthetic fracture.
Conclusion
Antegrade intramedullary nailing of the recon-type demonstrated comparable results to minimally invasive plate osteosynthesis. Hence, antegrade intramedullary nailing of the recon-type, which enhances stability by fixing the entire femur and providing additional fixation in the distal portion, is deemed appropriate for treating distal femoral shaft fractures.
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Intra-Articular Alterations after Suprapatellar Nailing in Tibial Shaft Fractures: An Arthroscopic Evaluation
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GwangChul Lee, Sung Hun Yang, Sung Min Jo, Jeong Min Kook
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J Korean Fract Soc 2022;35(4):129-134. Published online October 31, 2022
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DOI: https://doi.org/10.12671/jkfs.2022.35.4.129
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Abstract
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- Purpose
This study attempted to study the intra-articular changes due to intramedullary nailing through the suprapatellar approach by evaluating the joint cartilage damage and presence of foreign bodies through a comparison of the pre- and post-operative status evaluated by knee arthroscopy.
Materials and Methods
This retrospective study analyzed fifteen patients who underwent intramedullary nailing through the suprapatellar approach for proximal tibial shaft fracture from January 2017 to March 2020. The condition of the joint cartilage and the presence of foreign substances in the patellofemoral joint were evaluated. The cartilage status of the patellofemoral joint was evaluated using the International Cartilage Repair Society (ICRS) grading system. Data from the ICRS grading and the visual analogue scale (VAS) scores of the femoral and patellar cartilage were compared to each independent variable surveyed.
Results
All the intra-articular structures before nailing were normal. In all cases after nailing, articular cartilage damage of the patellofemoral joint and intra-articular debris were observed. The average VAS score was 0.6 (0-1) before surgery and 2.27 (0-4) after surgery. There were no statistically significant differences except for the correlation in the diameter of the tibia nail and femoral ICRS grade (p=0.001) and the damage to the cartilage was greater in the femoral cartilage than that to the patella (p=0.001).
Conclusion
Intra-articular damage appears to be unavoidable in suprapatellar nailing. Further research is needed on the long-term effects of intra-articular damage and on methods to reduce this damage.
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Minimal Invasive Plate Osteosynthesis versus Conventional Open Plating in Simple Humeral Shaft Fracture (AO Type A, B1, B2)
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Boseon Kim, GwangChul Lee, Hyunwoong Jang
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J Korean Fract Soc 2017;30(3):124-130. Published online July 31, 2017
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DOI: https://doi.org/10.12671/jkfs.2017.30.3.124
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Abstract
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- PURPOSE
The purpose of this study is to evaluate the efficacy of minimally invasive plate osteosynthesis (MIPO) by comparing the results between open plating and MIPO conducted by simple humeral shaft fractures.
MATERIALS AND METHODS
From September 2010 to February 2015, we evaluated humeral shaft fractures that 26 cases underwent MIPO and 41 cases underwent open plate fixation (OPEN). Operation time, amount of blood loss, and radiative exposure time were examined. Radiographically, bone union time and angulation were compared. At last, UCLA shoulder score and MEPI were used to compare the clinical results of shoulder and elbow and complications were examined.
RESULTS
The average operation time 82±23 minutes in MIPO, 119±20 minutes in OPEN (p=0.007) and amount of bleeding 238±67 ml in MIPO, 303±48 ml in OPEN (p=0.003), radiation exposure time 201±85 seconds in MIPO, 20±5 seconds in OPEN (p=0.000) were statistically significant. Bone union time and angulations, clinical results were not statistically significant. In Complication, iatrogenic radial nerve paralysis occurred 2 cases, nonunion occurred 1 case in MIPO. Nonunion and soft tissue infection occurred 2 cases each in OPEN.
CONCLUSION
MIPO in simple humeral shaft fractures gave us radiologically and clinically satisfactory results, and may be useful by understanding the anatomical knowledge and using appropriate implants and skills.
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Citations
Citations to this article as recorded by  - Outcomes of Arthroscopic Assisted Reduction and Percutaneous Fixation for Tongue-Type Sanders Type II Calcaneal Fractures
Jae Woo Park, Chul Hyun Park
Journal of Korean Foot and Ankle Society.2017; 21(4): 144. CrossRef
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