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Effect of Additional Medial Locking Plate Fixation and Autogenous Bone Graft for Distal Femur Nonunion after Lateral Locking Plate Fixation
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Ho Min Lee, Jong Pil Kim, In Hwa Baek, Han Sol Moon, Sun Kyo Nam
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J Korean Fract Soc 2024;37(1):30-38. Published online January 31, 2024
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DOI: https://doi.org/10.12671/jkfs.2024.37.1.30
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- Purpose
This study examined the outcomes of additional medial locking plate fixation and autogenous bone grafting in the treatment of nonunions that occurred after initial fixation for distal femoral fractures using lateral locking plates.
Materials and Methods
The study involved eleven patients who initially underwent minimally invasive lateral locking plate fixation for distal femoral fractures between January 2008 and December 2020. The initial procedure was followed by additional medial locking plate fixation and autogenous bone grafting for clinically and radiographically confirmed nonunions, while leaving the stable lateral locking plate in situ. A clinical evaluation of the bone union time, knee joint range of motion, visual analog scale (VAS) pain scores, presence of postoperative complications, and functional evaluations using the lower extremity functional scale (LEFS) were performed.
Results
In all cases, bone union was achieved in an average of 6.1 months after the secondary surgery. The range of knee joint motion, weight-bearing ability, and VAS and LEFS scores improved at the final follow-up compared to the preoperative conditions. All patients could walk without walking assistive devices and did not experience pain at the fracture site. On the other hand, three patients complained of pain in the lateral knee joint caused by irritation by the lateral locking plate; hence, lateral hardware removal was performed. One patient complained of mild paresthesia at the anteromedial incision site.
Severe complications, such as deep infection or metal failure, were not observed.
Conclusion
For nonunion with stable lateral locking plates after minimally invasive lateral locking plate fixation of distal femur fractures, additional medial locking plate fixation and autogenous bone grafting, while leaving the lateral locking plate intact, can achieve successful bone union.
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Usefulness of Percutaneous Cannulated Screws with Tension Band Wiring for Minimally Displaced Fractures of the Patella
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Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Eun Woo Bae
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J Korean Fract Soc 2022;35(4):142-150. Published online October 31, 2022
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DOI: https://doi.org/10.12671/jkfs.2022.35.4.142
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To evaluate the usefulness of percutaneous cannulated screws with tension band wiring (PC-STBW), a minimally invasive surgical technique, compared to conservative treatment for a minimally displaced patella transverse fracture.
Materials and Methods
The subjects included patients from 2010 to 2019 with transverse patella fractures, who were diagnosed as minimally displaced fractures, and were followed up for at least 1 year. Of these, 61 patients who were treated with cylinder casts were classified as Group A, and 53 patients who were treated with PCSTBW were classified as Group B. The clinical evaluation was carried out by evaluation of the radiographic bone union and calculation of the Bostman knee score. Any complications observed were investigated.
Results
All patients in both groups showed no further displacement of the fracture gap, and the bone union was achieved in all cases. The functional evaluation of the knee joint measured at the 8- and 12-week follow-up showed superior results in Group B wherein subjects were treated with surgery, and similar results were seen in both groups during the 6 months and 1-year follow-up. One case in Group A suffered the complication of knee stiffness.
Conclusion
For the treatment of minimally displaced transverse patellar fractures, both conservative treatment and PCSTBW showed similar good results at the 6-month and one-year follow-up. However, the PCSTBW technique showed superior clinical results in the early stage follow-up within 12 weeks.
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Results of Single Small Incision Minimally Invasive Plate Osteosynthesis in the Treatment of the Distal Radius Fractures
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Young Sung Kim, Jong Pil Kim, Phil Hyun Chung, Ho Min Lee, Bo Sung Go
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J Korean Fract Soc 2020;33(2):72-80. Published online April 30, 2020
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DOI: https://doi.org/10.12671/jkfs.2020.33.2.72
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This study compared minimally invasive plate osteosynthesis (MIPO) using a single small skin incision and conventional open volar locking plate fixation (OP) for distal radius fracture to identify outcome difference.
Materials and Methods
Forty-three patients who underwent MIPO using a single small skin incision or OP for distal radius fractures were evaluated retrospectively. Of the patients, 21 were treated with MIPO using a single small skin incision and 22 with the OP method through the conventional volar approach. The postoperative radiographic results and clinical outcomes at the final follow-up in each group were compared.
Results
All patients achieved bone union in the MIPO and OP groups. No significant differences in the bone union time, alignment, range of motion, QuickDASH, or pain score were observed. On the other hand, the size of the incision was significant: 23 mm in the MIPO group and 55 mm in the OP group (p<0.001).
Conclusion
MIPO technique using a single small incision showed similar satisfactory radiographic and functional outcomes compared to conventional OP for distal radius fractures. The MIPO technique using a single small incision offered advantages, including cosmetic benefits and minimal soft tissue damage, is recommended, particularly in young women and high functional demand patients.
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Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures
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Ho Min Lee, Young Sung Kim, Jong Pil Kim, Phil Hyun Chung, Suk Kang, Kaung Suk Jo
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J Korean Fract Soc 2018;31(3):94-101. Published online July 31, 2018
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DOI: https://doi.org/10.12671/jkfs.2018.31.3.94
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Abstract
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This study compared the radiological and clinical results of minimally invasive plate osteosynthesis (MIPO) and intramedullary nailing (IMN) of distal tibial fractures, which were classified as the simple intra-articular group and extra-articular group.
MATERIALS AND METHODS
Fifty patients with distal tibial fractures, who could be followed-up more than 12 months, were evaluated. Group A consisted of 19 patients treated with MIPO and group B consisted of 31 patients treated with IMN. The results of each group were analyzed by radiological and clinical assessments.
RESULTS
The mean operation times in groups A and B were 72.4 minutes and 65.7 minutes, respectively. The mean bone union times in groups A and B were 16.4 weeks and 15.7 weeks, respectively. The bone union rate in groups A and B were 100% and 93%, respectively. The ranges of ankle motion were similar in the two groups at the last follow-up. The mean American Orthopaedic Foot and Ankle Society score was similar: 90.1 in group A and 90.5 in group B. The radiological and clinical results were similar in the intra and extra-articular groups. In groups A and B, two cases of posterior angulation and five cases of valgus deformity of more than 5° were encountered.
CONCLUSION
Both MIPO and IMN achieved satisfactory results in extra-articular AO type A and simple articular extension type C1 and C2 distal tibia fractures.
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Citations
Citations to this article as recorded by  - Intramedullary Nailing versus Minimally Invasive Plate Osteosynthesis for Distal Tibia Shaft Fractures: Retrospective Comparison of Functional and Cosmetic Outcomes
Kahyun Kim, In Hee Kim, Geon Jung Kim, SungJoon Lim, Ji Young Yoon, Jong Won Kim, Yong Min Kim
Journal of Korean Foot and Ankle Society.2023; 27(3): 93. CrossRef
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A Comparison between Compression Hip Screw and Intramedullary Nail for the Treatment of AO/OTA A2.2 Intertrochanteric Femoral Fracture
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Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Jong Hyun Kim
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J Korean Fract Soc 2013;26(1):44-49. Published online January 31, 2013
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DOI: https://doi.org/10.12671/jkfs.2013.26.1.44
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Abstract
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To compare the result between the compression hip screw (CHS) and intramedullary (IM) nail for the treatment of AO/OTA A2.2 intertrochanteric fracture.
MATERIALS AND METHODS
We retrospectively reviewed 95 cases of AO/OTA A2.2 intertrochanteric fracture, which were treated with CHS or IM nail by one surgeon from March 1994 to December 2009. One group was treated with CHS (Group I, 28 cases) and the other was treated with IM nail (Group II, 67 cases). We evaluated the mean operation time, the amount of bleeding and transfusion, hospital duration, radiological results and the clinical outcome with the mobility score of Parker and Palmer.
RESULTS
Radiologically, the tip-apex distance, change of neck-shaft angle, and union time were not significantly different between both groups (p>0.05). Clinically, the mean operation time, the amount of bleeding and transfusion, hospital duration and the mobility score were not significantly different (p>0.05). The post-operative complications were lag screw slippage over 25 mm (1 case) and loosening of device (1 case) in group I. In group II, there were perforation of the femoral head (1 case), nail breakage (1 case) and deep infection (1 case).
CONCLUSION
There was no significant differences that are clinical and radiological results in the treatment of AO/OTA A2.2 intertrochanteric fracture, using CHS and IM nail.
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Citations
Citations to this article as recorded by - A Comparison of Clinical Results between Compression Hip Screw and Proximal Femoral Nail as the Treatment of AO/OTA 31-A2.2 Intertrochanteric Femoral Fractures
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, In Hwa Back, Kyeong Soo Eom
Journal of the Korean Orthopaedic Association.2016; 51(6): 493. CrossRef
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Missed Variation of the Essex-Lopresti Injury Associated with Type-I Monteggia Equivalent Lesion: A Case Report
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Young Sung Kim, Phil Hyun Chung, Suk Kang, Ho Min Lee, Jong Pil Kim
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J Korean Fract Soc 2012;25(3):219-222. Published online July 31, 2012
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DOI: https://doi.org/10.12671/jkfs.2012.25.3.219
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- The authors report the case of a patient with the combination of a Type I Monteggia equivalent lesion and Essex-Lopresti injury. This combination of injury is very rare, and an associated distal radioulnar injury is often missed. We hope our experience illustrates the need to examine the wrist joint carefully and to be aware of the potential for distal radioulnar joint instability in all patients with type I Monteggia equivalent lesions.
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Interlocking Intramedullary Nailing in Distal Tibial Metaphyseal Fractures
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Young Sung Kim, Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Ho Min Lee
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J Korean Fract Soc 2005;18(3):269-274. Published online July 31, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.3.269
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Abstract
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To evaluate and compare the outcome in fracture of distal tibial metaphyseal fractures involving ankle joint and not involving the ankle joint treated by interlocking imtramedullary nailing.
MATERIALS AND METHODS
Twenty six cases of distal tibial metaphyseal fractures treated by interlocking intramedullary nailing whom were able to follow up for more one year were selected and 10 cases involved ankle joint and the rest 16 cases did not. In all cases, more than 2 distal locking screws were inserted after reaming for the nailing, and cannulated screws or K-wires fixation were inserted for 8 cases of fractures involving ankle joint out of 10. We analyzed preoperative fracture type, union time, function of joint, and complications at final follow up.
RESULTS
According to Robinson's classification for distal tibial metaphyseal fractures, there were 9 cases of type I, 7 of 2A, 4 of 2B, 6 of 2C. Union time taken for distal tibial fractures involving ankle were average of 17 weeks (12~20 weeks) and for the fractures not involving ankle joint were average of 19 weeks (12~28 weeks). Klemm and Borner's functional evaluation showed above good in 8 cases (80%) of fracture involving ankle joint and 13 cases (81%) of fracture not involving the ankle joint, and functional evaluation did not show significant differences as well as the complication rate in both group.
CONCLUSION
Interlocking intramedullary nailing is one of the effective methods for treatment of distal tibial metaphyseal fracture involving articular surface of the ankle.
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Citations
Citations to this article as recorded by - Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures
Young Sung Kim, Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Soon Young Park
Journal of the Korean Orthopaedic Association.2021; 56(4): 317. CrossRef - Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures
Ho-Min Lee, Young-Sung Kim, Jong-Pil Kim, Phil-Hyun Chung, Suk Kang, Kaung Suk Jo
Journal of the Korean Fracture Society.2018; 31(3): 94. CrossRef - Intramedullary Nailing of Distal Tibial Fractures with Percutaneous Reduction by Pointed Reduction Forceps
Jae-Kwang Hwang, Chung-Hwan Kim, Young-Joon Choi, Gi-Won Lee, Hyun-Il Lee, Tae-Kyung Kim
Journal of the Korean Fracture Society.2014; 27(2): 144. CrossRef - Comparative Study of Intramedullary Nailing and Plate for Metaphyseal Fractures of the Distal Tibia
Hoon Jeong, Jae-Doo Yoo, Young-Do Koh, Hoon-Sang Sohn
Journal of the Korean Fracture Society.2007; 20(2): 154. CrossRef
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Fatigue Fracture of the Distal Femur in Adolescence: A case Report
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Nam Hong Choi, Young Sun Song, Ho Min Lee
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J Korean Soc Fract 1996;9(3):809-813. Published online July 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.3.809
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- Fatigue fractures have been described in almost every bone in the body, but they are more common in the bones of the lower extremities. Fatigue fractures are seen mainly in military personnel especially at basic training center, athletes, ballet dancers, laborers, and even pregnant woman. But they rarely developed at the distal femur of adolescent.
We report a case of fatigue fracture of the distal femur in adolescent who was associated with neithor trauma nor sports activity.
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