Journal of Musculoskeletal Trauma

Han Jun Lee

16 Articles

Modified Tension Band Wiring Combined with Anti-Gliding Loop Augmentation Technique for the Treatment of Comminuted Patellar Fracture: Technical Note and Report of Early Results: Technical Note: Han Jun Lee, Jae Jun Yang, Ho Joong Jung, Hyoung Seok Jung; J Korean Fract Soc 2013;26(4):321-326. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.321

Abstract PDF: In order to investigate the feasibility of a modified tension band combined with anti-gliding loop augmentation technique for the treatment of comminuted patellar fracture, 21 patients with comminuted patellar fracture were enrolled in this study. After the modified tension band wiring of patellar fracture, a cerclage wire was passed around the patella. Anti-gliding loops were made on the bending sites of Kirshner-wires. A knot was tied using both ends of the anti-gliding loops, and the cerclage wire was tightened using proximal knots. Bone union was achieved at 4.5+/-1.5 months postoperatively without nonunion. The Lysholm score was 87.1+/-2.8, and the range of motion of the knee was 2.1degrees+/-3.4degrees to 132.2degrees+/-6.5degrees at the last follow-up. The modified tension band combined with anti-gliding loop augmentation technique might be considered an alternative modification of modified tension band wiring for the treatment of comminuted patellar fracture.

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Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients: Han Jun Lee, Jong Won Kim, Jae Sung Lee, Jae June Yang, Woo Young Hwang; J Korean Fract Soc 2010;23(3):276-281. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.276

PURPOSE
To evaluate clinicoradiological outcomes after cementless bipoloar hemiarthroplasty in elderly patients with femoral intertrochanteric fractures.
MATERIALS AND METHODS
From March 2006 to February 2008, 28 patients-all in patients greater than 80 years of age, classified unstable intertrochanteric fractures in Evans classification-were followed for more than 1 year. 24 patients were women and 4 patients were men. The mean age of the patients was 84.6 years, the mean follow-up period was 16.3 months. Harris hip score, postoperative inguinal and thigh pain, Parker and Palmer mobility score were analyzed clinically. The radiological results were assessed using various radiological indicies including bone-union, fit and alignment change of femoral stem and vertical subsidence.
RESULTS
The average Harris hip score was 82.9, Parker and Palmer mobility score preoperative 8.0 changed to 5.2 postoperatively. More than moderate pain was presented in 1 case. There were no cases of varus deformity or osteolysis. All stems were stable without significant alignment change or subsidence except 1 case of periprosthetic fracture. There were no dislocation, thromboembolism, death during operation or hospital days.
CONCLUSION
In elderly patients, cementless bipolar hemiarthroplasty is good treatment method of unstable intertrochanteric fracture and short-term clinicoradiological outcomes proved to be satisfactory.

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The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures
Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim
Hip & Pelvis.2014; 26(2): 99. CrossRef

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Long Term Follow up Results of the Operative Treatment of the Acromioclavicular Joint Dislocation with a Wolter Plate: Ki Ser Kang, Han Jun Lee, Jae Sung Lee, Jae Yoon Kim, Yong Beom Park; J Korean Fract Soc 2009;22(4):259-263. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.259

Abstract PDF

PURPOSE
To evaluate the long-term clinical and radiological results of the operative treatment of the acromioclavicular dislocation with a Wolter plate. MATERIALS AND METHODS: We reviewed clinical and radiological data of twenty patients (mean age: 37 years) who underwent the operative treatment of acromioclavicular joint dislocation using a Wolter plate from September, 1999 to December, 2002 with minimum of five years follow-up (average 6 years 7 months). The clinical outcomes of twenty patients were evaluated by UCLA scoring and radiological results of fifteen patients with available radiograph were evaluated by Zanca view and stress view. RESULTS: The mean UCLA score was mean 33 points (range, 27~35) at final follow up. By clinical evaluation, twelve cases (60%) were excellent, six cases (30%) were good and two cases were poor (10%). By radiological evaluation, eight cases (54%) were excellent (without displacement), five cases (33%) were good (displacement <5 mm) and two cases (13%) were poor (displacement >5 mm). Erosive change in acromioclavicular joint was seen in poor case. CONCLUSION: Wolter plate fixation may be a useful modality for treating acromioclavicular joint dislocation. Great care should be taken to make the hook hole at the appropriate position during operation for long-term prognosis.

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Clinical outcomes of bending versus non-bending of the plate hook in acromioclavicular joint dislocation
Min Su Joo, Hoi Young Kwon, Jeong Woo Kim
Clinics in Shoulder and Elbow.2021; 24(4): 202. CrossRef
Clinical Comparison of Two Types of Hook Plate in Surgical Treatment of Acromioclavicular Dislocation - AO Hook Plate and Wolter Plate -
Jea-Yeol Choi, Eugene Kim, Haw-Jae Jeong, Jin Whan Ahn, Hun-Kyu Shin, Se-Jin Park, Seung-Hee Lee, Jae-Wook Lee, Kyu-Bo Choi
The Journal of the Korean Shoulder and Elbow Society.2012; 15(2): 123. CrossRef

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Radiologic Analysis and Treatment of Posterior Malleolar Fractures of the Ankle: Jae Sung Lee, Soo Yong Kang, Han Jun Lee, Young Bong Ko; J Korean Fract Soc 2009;22(2):98-103. Published online April 30, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.2.98

Abstract PDF

PURPOSE
The purpose of this study was to classify posterior malleolar fractures according to the position of fragments and to analyze radiologic features of each type.
MATERIALS AND METHODS
We analyzed forty-six patients of ankle fractures involving a posterior malleolus who were treated between January 2004 and December 2007. The posterior malleolar fractures were categorized into three types (posterolateral, posteromedial, shell) based on the major fracture line. In each type, we analyzed amount of displacement, involvement of articular surface, existence of subluxation and osteochondral impacted fragments.
RESULTS
The forty-six patients were categorized into three types: Posterolateral (PL) type (33 cases, 72%), Posteromedial (PM) type (8 cases, 17%), shell type (5 cases, 11%). Of the 8 cases with PM type, 7 cases showed displacement more than Grade II, 4 cases showed subluxation of ankle joint, and 3 cases showed osteochondral impacted fragment. Average involvement of articular surface of PM type is 35% (15~65%).
CONCLUSION
Posterior malleolar fractures with medial extension tended to have adverse effect on ankle stability and Preoperative CT scan is essential for evaluation of fracture type and determination of appropriate surgical approach.

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Treatment of Isolated Posterior Malleolus Fracture in the Ankle
Ji Hoon Kim, Seong Mu Cha, Dae Yeon Jo, Jin Soo Suh
Journal of the Korean Orthopaedic Association.2014; 49(1): 29. CrossRef

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The Effect of COX-2 Inhibitor on the Expression of MMP-13 during Early Fracture Healing Phase in Rats: Ki Ser Kang, Han Jun Lee, Jae Sung Lee, Ho Sung Ryu; J Korean Fract Soc 2009;22(1):45-50. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.45

Abstract PDF: PURPOSE
This study investigated the effect of COX-2 inhibitor on the expression of MMP-13 in the healing process of fracture. MATERIAL AND METHODS: Adult Sprague-Dawley rats were divided into two groups of twenty five rats each. Unilateral femoral shaft fractures were created artificially under displacement in all two groups. COX-2 inhibitor was only given to the experimental group from the postoperative day 1. At 2 weeks after fracture the rats were sacrificed and the callus from each group was used for histologic examination and real time RT-PCR for MMP-13 expression.
RESULTS
Histologically, proliferation of osteoblasts and formation of osteoid was less abundant in the experimental group. In real time RT-PCR, the mean expression of MMP-13 is 2.84+/-2.50 in the control group compared with 1.16+/-1.05 in the experimental group.
CONCLUSION
In the early stage of fracture healing, COX-2 inhibitor suppress the expression of MMP-13.

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The Treatment of Posterolateral Malleolar Fractures using Percutaneous Reduction Technique: Jae Sung Lee, Han Jun Lee, Jae Hyun Yoo, Hee Chun Kim; J Korean Fract Soc 2009;22(1):19-23. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.19

Abstract PDF: PURPOSE
To evaluate the usefullness of the percutaneous reduction technique with K-wire that could reduce the displaced posterolateral fracture fragment which persisted even after an anatomical reduction of the lateral malleolar fracture.
MATERIALS AND METHODS
From January 2004 to December 2006, we reviewed 72 patients who underwent surgical treatment for their trimalleolar fractures. We estimated the clinical and radiological results of 5 cases treated by percutaneous reduction technique with K-wire when more than the distal tibial articular step-off was left after reduction of the lateral malleolar fracture. The method of reduction starts with temporary fixation of lateral malleolar fracture followed by checking ankle radiographic image to confirm the accuracy of reduction. In case of incomplete reduction of the posterior fragment, a K-wire is inserted into the posterior fragment and pushed downward to the ankle joint level, and then lag screws were inserted.
RESULTS
The average articular involvement by the posterolateral fracture fragment was 30.2%. The average step-off after reduction of the lateral malleolar fracture was 3.7 mm. At the final follow up, step-off was less than 2 mm in all cases. In clinical results by Baird and Jackson score, 3 out of 5 cases were excellent, other 2 were good.
CONCLUSION
Percutaneous reduction technique for posterolateral fragment using the K-wire is relatively easy. This technique may be useful when the posterolateral fragment is large (more the 25% of articular surface) and not severely comminuted.

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Bipolar Clavicular Dislocation: A Case Report: Han Jun Lee, Jae Sung Lee, Young Bong Ko; J Korean Fract Soc 2008;21(4):316-319. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.316

Abstract PDF

Bipolar clavicular dislocation is simultaneous dislocation of both poles of the clavicle (mainly an anterior dislocation of the sternoclavicular joint and a posterior dislocation of acromioclavicular joint) and rarely reported. We report a case of bipolar claviclular dislocation after a seat belt injury and describe its presumed mechanism and treatment with a review of literature.

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Case of the Month #177: Bipolar Clavicular Dislocation: Radiologic Evaluation of a Rare Traumatic Injury
Michael P. Loreto, Dawn Pearce
Canadian Association of Radiologists Journal.2012; 63(2): 156. CrossRef
Clavicle Midshaft Fracture with Acromioclavicular Joint Dislocation: A Case Report
Chul-Hyun Cho, Chul-Hyung Kang, Soo-Won Jung, Hyuk-Jun Seo
Journal of the Korean Fracture Society.2009; 22(4): 297. CrossRef

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Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures: Jae Sung Lee, Yong Beom Park, Han Jun Lee; J Korean Fract Soc 2008;21(2):124-129. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.124

Abstract PDF: PURPOSE
To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation.
MATERIALS AND METHODS
We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test.
RESULTS
There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score.
CONCLUSION
The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.

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A Skeletal Traction on the Radiolucent Table in Closed Intramedullary nailing of Femoral Fracture: Eun Woo Lee, Han Jun Lee, Kee Hyun Lee, Ho Sun Jin; J Korean Fract Soc 2005;18(3):244-249. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.244

Abstract PDF: PURPOSE
To evaluate the clinical results of femoral shaft fracture treated by Intramedullary (IM) nailing through skeletal traction compared with manual traction on a radiolucent table.
MATERIALS AND METHODS
Thirty cases with femoral shaft fracture treated with closed IM nailing from January 2000 to June 2002 were divided into two groups; fifteen fractures reduced by manual traction (Group A) and fifteen fractures reduced by skeletal traction (Group B) on a radiolucent table. The number of people participated in the operations, operation and radiation exposure time, and post-operative complications were evaluated.
RESULTS
The number of people participated in the operations was five in Group A and four in Group B. The average operation time was 116 minutes and 82 minutes (p<0.001). The radiation exposure time was 2.8 minutes and 1.2 minutes (p<0.001). However, there was no significant difference in the post-operative complications such as shortening or lengthening of bone between two groups.
CONCLUSION
There was no significant difference in the operative outcome between two groups. However, skeletal traction has positive effects of reducing the operation time, radiation exposure time, and number of people participating in the operations. Also, regarding the consistent traction power, skeletal traction is the better treatment modality in maintaining the alignment and length of femoral bone than manual traction.

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Modified Tension Band Technique With Looped Pin: Eun Woo Lee, Han Jun Lee, Tae Ho Kim; J Korean Fract Soc 2005;18(1):48-53. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.48

Abstract PDF

PURPOSE
Fixation of fracture using modified tension band is a very useful treatment method, but loss of fixation caused by loosening of K-wires still remain problem. So we have studied the usefulness of modified tension band with looped pin in order to prevent loss of internal fixation.
MATERIALS AND METHODS
From September 1999 to June 2002, we had treated 40 patients with this technique, including 16 patella, 8 olecranon, 8 distal clavicle fractures in which three were nonunion fractures, 5 ankle fractures and 3 acromioclavicular joint separations. We looped the pin which has been used for ring external fixator, in line with its long axis.
RESULTS
After mean postoperative follow-up of 20 months, there were no loosening of looped pin in all cases and we obtained satisfactory results of functional evaluation. There were no complications of nonunion or metallic irritation.
CONCLUSION
We concluded that modified tension band with looped pin could prevent displacement of internal fixation, and reduce the subsequent complications. Especially in elbow and shoulder joint that the displacement of fixation pin occured frequently, It was considered as very useful operative technique.

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Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins
Kyung-Hag Lee, Yohan Lee, Young Ho Lee, Bong Wan Cho, Min Bom Kim, Goo Hyun Baek
Journal of Orthopaedic Surgery.2019;[Epub] CrossRef
Nanostructured ATO Anodes Produced by RF Magnetron Sputtering for Li-Ion Batteries
O. Cevher, U. Tocoglu, H. Akbulut
Acta Physica Polonica A.2015; 127(4): 1065. CrossRef

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The Usefulness of Non-operative Treatment of Distal Radius Fracture in Elderly Patients: Ki Ser Kang, Han Jun Lee, Sang Hak Lee; J Korean Fract Soc 2004;17(4):345-349. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.345

Abstract PDF: PURPOSE
To disclose the correlation between the functional and radiologic results of the treatment of distal radius fracture in elderly patients by non-operative versus operative treatment.
MATERIALS AND METHODS
From January 1995 to December 2000, 36 patients, more than 60 years old with fractures of distal radius were treated and followed up for more than one year. We classified them using the Fernandez classification and evaluated functional and radiological results according to the subjective point system of Cole & Obletz and objective evaluation by Scheck.
RESULTS
In functional result, excellent to good results were obtained in 12 cases (71%) in the non-operative group and 14 cases (74%) in the operative group, there were no evidence of statistical difference between two groups (p>0.05). In radiographic results, mean radial inclination, loss of radial length and volar tilt were 13degree, 12.3 mm, 7.2degrees in the non-operative goup and 5.2degrees, 5.1 mm, 3.3degrees in the operative group on last follw-up radiographs, there were evidence of statistical difference between two groups (p<0.05).
CONCLUSION
Operative treatment is radiographically better result in distal radius of elderly patients but functional satisfaction is not significantly related with radiographic result. When we decide the treatment of elderly patients, non-operative treatment can be useful method, considering with patient's age and activity status.

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Treatment of Proximal Tibial Non-union after IM Nailing in Conjunction with Anterior Buttress Plating: Han Jun Lee, Young Uk Park; J Korean Fract Soc 2004;17(2):138-141. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.138

Abstract PDF

PURPOSE
We investigated the results of autologous bone grafting and anterior buttress plating for non-union occurred in junction between metaphysis and diaphysis of tibia after intramedullary nailing technique.
MATERIALS AND METHODS
We reviewed six patients who suffered from non-union of proximal tibia for a minimum follow up of one year. The interval was 6 months in average between first and second surgery. The mean follow up period was 15 months in average. The surgical method was autologous bone grafting and anterior buttress plating without removal of previous nail.
RESULTS
In all patients, the tenderness and pain of non-union sites were passed at a postoperative one month. Radiologic bone union was achieved in all patients at 18 weeks in average, range from 11 weeks to 20 weeks. The complication was superficial infection in one patient without deleterious effect on union.
CONCLUSION
The described method in this study could be a good alternative technique for the treatment of proximal tibial non-union due to failed intramedullary nailing.

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Cause and Treatment of Extraarticular Proximal Tibial Nonunion
Sung Soo Kim, Sung Keun Shon, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Lih Wang, Im Sic Ha
Journal of the Korean Fracture Society.2008; 21(4): 279. CrossRef

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Anatomical Assessment of the Proper Insertion Site for a Tibial Nailing: Soo Yong Kang, Eun Woo Lee, Ki Ser Kang, Han Jun Lee, Ho Joong Jung, Pyeong Ho Jeong; J Korean Fract Soc 2004;17(2):142-147. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.142

Abstract PDF

PURPOSE
To investigate the proper insertion site for a tibial intramedullary nail in the Korean.
MATERIALS AND METHODS
Forty volunteers without trauma below knee joint were studied to determine relationship between central axis of medullary canal and lateral tibial spine, patellar tendon and the proper insertion site, and to evaluation changes of proper insertion site during rotation of knee and effective diameter.
RESULTS
The proper insertion site located average 4.3+/-0.9 mm medial to the lateral tibial spine. The proper insertion site was in the medial 1/3 of patellar tendon in 6 knees, middle 1/3 of patellar tendon in 20 knees, and lateral 1/3 of patellar tendon in 14 knees. The proper insertion site might be changed two times in internal rotation more than in external rotation. The effective diameter was more narrow in medial slope than in lateral slope at proximal tibia.
CONCLUSION
The study indicates the ideal insertion site of tibial nail is the medial aspect of the lateral tibial spine in Korean. To reduce the mal-reduction from a improper insertion site, lateral insertion site might be safer than medial one. However, individual variations in the relationship between the patellar tendon and tibial medullary canal should be considered.

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Three-dimensional analysis of the intramedullary canal axis of tibia: clinical relevance to tibia intramedullary nailing
Sang Jun Song, B. O. Jeong
Archives of Orthopaedic and Trauma Surgery.2010; 130(7): 903. CrossRef
Three Dimensional Analysis for the Intramedullary Canal Axis of the Proximal Tibia: Clinical Relevance to Total Knee Arthroplasty
Sang Jun Song, Choong Hyeok Choi
The Journal of the Korean Orthopaedic Association.2007; 42(3): 345. CrossRef

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Surgical Treatment of Displaced Intra-articular Fracture of the Calcaneus using a Y-plate: Han Jun Lee, Soo Yong Kang, Jong Won Kim; J Korean Soc Fract 2002;15(4):433-438. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.433

Abstract PDF

PURPOSE
To investigate the results of surgical treatment of displaced intra-articular fracture of the calcaneus using a Y-plate.
MATERIALS AND METHOD
We have studied 22 patients who underwent surgical treatment of displaced intra-articular fracture of the calcaneus in our hospital from March, 1998 to August, 2000. The fractures were identified according to Eastwood classification, there were 8 cases of type I, 10 cases of type II and 4 cases of type III. The axial and Bohler angle of lateral views were compared preoperative and postoperative period. Functional evaluation was measured by Carr 's method.
RESULT
The average Bohler angle before the operation was 5 degrees and after the operation it has been up to 28 degrees. In functional evaluation, 3 cases were excellent, 15 cases were good, and 4 cases were fair.
CONCLUSION
Fixation using a Y-plate can be used easily for restoration of anatomical dimension of the calcaneus in the operative treatment of displaced intra-articular fracture. It could be helpful for firmer fixation of the posterior facet.

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Joint-Sparing Surgical Management of Sanders IV Displaced Intra-Articular Calcaneal Fractures
Thomas S. Roukis
Clinics in Podiatric Medicine and Surgery.2019; 36(2): 251. CrossRef
Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef
Treatment of Displaced Intra-articular Calcaneal Fractures Using a F-plate
Kyu Hyun Yang, Jae Bong Chung, Han Kook Yoon, Si Young Park, Hang Seob Yoon
Journal of the Korean Fracture Society.2007; 20(1): 1. CrossRef

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Treatment of Transolecranon Fracture-Dislocation of the Elbow: Soo Yong Kang, Han Jun Lee, Jung Nam Han, Kyoung Hwan Kim; J Korean Soc Fract 2001;14(1):99-105. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.99

Abstract PDF: PURPOSE
We conducted this study to discriminate transolecranon fracture-dislocation of the elbow from the anterior Monteggia lesion and to validate the differences of method of treatment.
MATERIALS AND METHOD
From March, 1998 to May, 1999, 3 cases of the transolecranon fracture-dislocation of the elbow were treated by open reduction and internal fixation.One of the three patients had simple oblique fracture of the olecranon combined with capitellum fracture and two had complex comminuted fracture of the olecranon. Functional outcome was assessed with elbow performance rating system of Broberg and Morrey.
RESULTS
At a minimum follow-up of 12 months, overall outcome was rated as exellent in two patients, fair in one. Average bone union peoriod was three months.
CONCLUSION
Stable restoration of the accurate contour and dimension of the trochlear notch of the olecranon and early ROM exercise will lead to good result in transolecranon fracture-dislocation cases.

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A Simplified Technique of Distal Locking Screw Fixation of Interlocking Nail: Young Bok Jung, Ki Ser Kang, Boo Sup Kim, Han Jun Lee, Whui Jae Jin; J Korean Soc Fract 1995;8(1):248-253. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.248

Abstract PDF: Failure to determine distal femoral screw hole position can sometimes prolong operating time for placing interlocking screw and increased radiation hazard. We attempted to assess progress in the insertion of distal locking screw with target device. Insertion method of distal locking screw in femoral nail that uses target device improved the accuracy of distal screw placement and reduced the radiation exposure. The authors analyzed 30 patients(33 cases) of the femur shaft fractures that treated by interlocking IM nailing using target divice in the Department of Orthpaedic Surgery, Chung-Ang university from August 1990 to July 1994. Among these patients, except 6 cases, all of the distal femoral drill holes attempted were successfully made with the first pass of a dirll without image intensiner monitoring. Compared with the commonly used free-hand method, our target divice assisted screw placement offer a reduction in the amount of time and radiation exposure to insert distal locking femoral screws.

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