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Treatment of unstable pertrochanteric fracture of the femur using compression hip screw and plate with 6 or more holes
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Jeong Woung Lee, Chi Weon Lee, Doo Hoon Sun, Myung Sang Moon
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J Korean Soc Fract 2001;14(4):592-600. Published online October 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.4.592
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 Abstract
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The objectives of this study are to observe and report the clinical results of the treatment of unstable pertrochanteric femur fracture extending into subtrochanter or shaft of the femur using compression hip screw and plate with 6 or more holes.
MATERIALS AND METHODS
Between February 1993 and December 1997, 39 patients were treated surgically for unstable pertrochanteric femur fracture. 26 patients who have been followed up over twelve months were included in this study. Surgery was performed within 2 weeks after injury, except one patient who had combined head injury. The fracture was fixed internally with compression hip screw and plate with 6 or more holes, and additional fixations were also performed with Cable wire, interfragmentary screw and Knowles pin.
The result was analyzed radiographically and clinically for blood loss, surgery time, bony union period and complication.
Average estimated blood loss was 910 cc. Average surgery time was one hundred ten minutes. The complications occurred in 7 cases (27%) ; 1 nonunion, 2 screw loosening and 4 cases of superficial wound infection.
There was no case of lag screw penetration to the femoral head or metal failure.
The bony union was obtained at average 22 weeks.
CONCLUSION
With use of the compression hip screw and long plate with 6 or more holes for stable internal fixation, we obtained satisfactory results for unstable pertrochanteric femur fracture extending into subtrochanter or shaft of the femur.
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Surgical Treatment for Tibial Condyle Fracture of the Proximal Tibia
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Won Tae Choi, Bo Yel Choi, Chul Hyung Lee, Eui Soon Kim, Jeong Woung Lee, Doo Hoon Sun, Myung Sang Moon
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J Korean Soc Fract 2001;14(2):291-297. Published online April 30, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.2.291
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To evaluate the results of operative treatment for tibial condyle fracture of the proximal tibia.
MATERIAL AND METHODS: From March 1995 to June 1999, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 10 of them were treated by open reduction and internal fixation(plate & screw for 8, screw & K-wire for 2) and 5 of them by closed reduction and Ilizarov fixation. Preoperative prognostic factors were considered as the fracture type of Schatzker classification, associated injury, and closed or open fracture. Functional outcome was evaluated results by Blokker`s criteria.
RESULTS
According to Schatzker classification, type III were 4 cases, type IV were 6 cases, and type V were 5 cases. At last follow up, average range of motion was 115degrees (Internal fixation was 110degrees, External fixation was 130degrees) The results was according to Blokker`s criteria, 11 cases(73%) had satisfactory acceptable results, among 4 cases(27%) of non-acceptable criteria.
CONCLUSION
For treatment of tibia condyle complicated communited fracture, we are able to consider that rigid internal fixation with anatomical reduction and external fixation for early range of motion.
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Comparison of radial head excision and open reduction & internal fixation for comminuted radial head & neck fracture
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Jae Gune Jun, Chul Hyung Lee, Sung Jun Han, Sang Seon Lee, Won Tae Choi, Ho Rim Choi, Jeong Woung Lee
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J Korean Soc Fract 2001;14(1):106-112. Published online January 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.1.106
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Abstract
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The goals of the present study were to compare of radial head excision and open reduction k internal fixation for comminuted radial head & neck fracture.
MATERIALS AND METHODS
From march 1993 to February 1999, Patients with fracture of radial head (Mason type III) who were treated at Dae-Jeon Sun General hospital were enrolled in the study. The average duration of follow up was 3 years and 3 months. Six patients(Group A) were treated with radial head excision and fourteen patients(Group B) were treated with open reduction and internal fixation.
RESULTS
By functional rating index(modified After B.F. Morrey et al), in Group A, the results were classified as excellent(1 patient), good(No patient), fair(2 patients), and poor(3 patients), and in Group B, excellent(4 patients), good(5 patients), fair(3 patients), and poor(2 patients).
CONCLUSION
We concluded clinically to obtain better outcome in group which were treated with open reduction and internal fixation than radial head excision. Therefore, though the treatment of choice for Mason type III radial head fracture was total excision, in consideration of complication, procedure to preserve radial head was desirable. We must give careful consideration to possibility of open reduction and decision of radial head excision.
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Nonunion after Interlocking Intramedullay Nailing in Tibia Segmental Fractures
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Jin Hong Rhee, Jeong Woung Lee, Jae Yong Cho, Sang Won Bae, Seog Hyun Yoon, Ju Youn Lee
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J Korean Soc Fract 1997;10(2):309-315. Published online April 30, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.2.309
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Abstract
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- Tibial segmetnal fracture, usually caused by strong external force has recently been increased in frequency because of increased traffic accident. This type of fracture has been well known to be very difficult to manage on reduction and maintenance of reduction, and also that it has high rate of complications such as delayed union, nonunion, infection and etc., because of high incidence of open fracture and association with other injury. For the management of this type fracture there are various methods from conservative care to operative treatment such as internal or external fixation. We analyzed nonunion of 8 cases who underwent interlocking intramedullary nailing for tibia segmental fracture. The results were as follows ; 1. Interlocking intramedullary nailing for the treatment of tibia segmental fractures were done in 29 cases(76.31%) out of total 38 tibia segmental fractures.
2. Nonunion occurred in 8 out of 29 cases(27.6%).
3. Nonunion occurred at the distal fracture site in 7 cases and both proximal and distal fracture site in 1 case.
4. Nonunion occurred in 4 cases of open fractures, 3 cases of closed fractures with compartment syndrome.
5. Nonunion occurred in 5 cases of Melis type IV, fracture, 2 cases of type I and 1 case of type II fracture.
Although the interlocking intramedullary nailing is thought to be good method for the tibia segmental fracture, our study showed relatively high rate of nonunion especially, at the distal fracture site, in case of open fracture, associated with compartment syndrome and Melis Type IV fracture. On the basis of this study we recommend that closer attention should be paid to the method of treatment, fracture type, severity of comminution, open or closed fracture, degree of soft tissue injury, and fracture site.
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Citations
Citations to this article as recorded by  - Funciones entre dendroides (abanicos) que (no) preservan (no)contractibilidad
José G. Anaya, Félix Capulín, Mónica Sánchez Garrido
Revista Integración.2021;[Epub] CrossRef - Outcomes and Analysis of Factors Affecting Bone Union after Interlocking Intramedullary Nailing in Segmental Tibia Fractures
Sang Soo Park, Jun-Young Lee, Sang-Ho Ha, Sung-Hae Park
Journal of the Korean Fracture Society.2013; 26(4): 275. CrossRef
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Treatment of the humeral shaft fracture with interlocking intramedullary nail
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Seok Beom Kim, Jeong Woung Lee, Won Tai Choi
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J Korean Soc Fract 1996;9(1):170-176. Published online January 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.1.170
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Abstract
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- In general, fracture of the shaft of the humerus is treated non-operative or by operative methods.
The accepted treatment of the Isolated low-energy humeral shaft fracture is non-operative method.
However, the fracture of the humerus that are associated with high energy, significant communition, unstable fracture patterns, or fractures that have been difficult to reduce or maintain reduction have been difficult to treat or maintain reduction have been difficult to treat by non-operative method.
This has led to the use of operative intervention for the treatment of the humeral shaft fracture. The use of open technique with plate and screw is difficult due to potential injury of the neurovascular structure, increased risk of the infection and extensile exposure of the fracture site.
Intramedullary nailing has advantages over other techniques of internal fixation and has been used to maintain the alignment and length of humerus.
Especially, hiornechanically locked intramedullary nailing has the theoretical advantage of providing a weight shearing device and a ability to decrease the effect of rotational shear at the fracture site.
This would increase the inherent stability at the fracture site and thus promote union.
Authors performed interlocking intramedullary nailing for 35 cases of humeral shaft fracture from July-1993 until May-1995.
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Fracture of the Capitellum of the Bumerus: Report of 4 cases
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Sang Deug Lim, Ho Young Sun, Jeong Woung Lee, Young Seug Yoon, Deok Young Yoon
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J Korean Soc Fract 1995;8(2):439-444. Published online April 30, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.2.439
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- Fracture of the capitellum is intraarticular fractures that occured rarely about the elbow. It is usually caused by a fall on the outstretched upper extremity with the radial head impacting against the anterior portion of the lateral humeral condyle. We reviewed 4 patients with capitellum fracture of the humerus treated by open reduction and internal fixation from Aug. 1990 to Mar 1993. The isolated capitellum fractures were in 2 cases, associated radial head fracture in 1 rase, associated humeral lateral condyle fracture in 1 case. The case combined comminuted fracture of the humeral lateral condyle was fair, others were good result.
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