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Unreamed interlocking nailing in tibia fracture
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You Sung Suh, Young Il Cho, Ho Won Jung, Yeon Il Kim
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J Korean Soc Fract 2002;15(4):470-476. Published online October 31, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.4.470
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 Abstract
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- PURPOSE
To evaluate of clinical results and malunion according to nail insertion site and early ambulation after unreamed interlocking intramedullary nailing for the treatment of tibial fractures, MATERIALS AND METHODS: We reviewed 46 tibial fractures that were treated with unreamed static intramedullary nailing prospectively from March 1997 to May 2001. Nail insertion site and angulation of fracture site were reviewed by radiograph. All of 46 cases, ambulation was started at postoperative 2 weeks, and then clinical outcomes were reveiwed RESULTS: In all 46 cases, union was achieved at average 18.2 weeks clinically and average 19.4 weeks radiographically. There is no significant difference in angulation according to nail insertion site, i,.e. after central/medial/lateral insertion, outcome was 2 . 4 5 degrees +/-2 . 1 7 / 2 . 2 2 degrees +/-1 . 8 4 / 1 . 7 3 degrees +/-1.33(p; 0.705) in last follow up anterioposterior view, and 1.81 degrees +/-1 . 1 3 / 2 . 6 7 degrees +/-1 . 6 2 / 2 . 0 0 degrees +/-1.64(p; 0.320) in last follow up lateral view. No breakage of intramedullary nails and no stiffness on adjacent joints.
CONCLUSION
We confirmed that unreamed interlocking nailing in tibial fractures is one of the effective method for low recurrence of malunion and early ambulation
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Comparison Study between Internal Fixation with Compression Hip Screw and Bipolar Hemiarffiroplasty in Unstable Intertrochanteric Fracture
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You Sung Suh, Sai Won Kwon, Ho Won Jung, Jong Seok Park, Byung Ill Lee
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J Korean Soc Fract 2001;14(4):584-591. Published online October 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.4.584
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Abstract
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- PURPOSE
To define the appropriate treatment of unstable intertrochanteric fracture for aged patients by conducting a clinical and roentgenographical comparative analysis of internal fixation with compression hip screw and primary bipolar hemiarthroplasty.
MATERIALS AND METHODS
38 patients aged 65 or above with intertrochanteric fracture of Singh index below grade III or bone mineral density(BMD) -3.0 who had both severe osteoporosis and unstable fracture, from the period of January 1995 to January 2000. The 38 patients had either internal fixation with compression hip screw(18 cases, Group I) or primary bipolar hemiarthroplasty(20 cases, Group II), and were followed-up for at least one year afterwards. To prevent postoperative complication, early ambulation was permitted as early as possible to both groups.
RESULTS
The average age was 76(range 65-87) for Group I and 79.8(range 78-92) for Group II, respectively. 19 patients were diagnosed to have I-c fracture, following Evans Classification. 35 cases(92.1%) were given grade III or below according to the preoperative Singh index, while all cases showed severe osteoporosis with average bone density of -4.26(-6.95 ~ -2.54). 60% of Group II were given very good or above diagnosis following Merle d'Aubignè's postoperative functional outcome, compared with 16.7% of Group I, thus showed statistic difference of p=0.006. The average for postoperative Harris hip score was also higher with 77 points(range 43-95) for Group I than with 86 points(range 57-94) for Group II, thus showed statistic difference of p=0.0216.
CONCLUSION
For aged patients with unstable intertrochanteric fracture, primary bipolar hemiarthroplasty is considered to have better clinical and roentgenographical results, and able to decrease local and general complications, compared with internal fixation with compression hip screw.
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