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Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation
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Ui Seoung Yoon, Jin Soo Kim, Jae Sung Seo, Jong Pil Yoon, Seung Yub Baek
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J Korean Fract Soc 2010;23(3):270-275. Published online July 31, 2010
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DOI: https://doi.org/10.12671/jkfs.2010.23.3.270
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To analyze the causes of fixation failure of compression hip screw and evaluate outcomes of hip arthroplasty for reconstruction. MATERIALS AND METHODS We reviewed 108 femoral intertrochanteric fractures that underwent compression hip screw between January 1997 and December 2007. Failure group (group I) contained 28 cases who had hip arthroplasty for failed compression hip screw and the control group (group II) contained 80 cases who had successive compression hip screw. We analyzed the causes of failure of compression hip screw and evaluated the results of hip arthroplasty for reconstruction. RESULTS In group I, 21 cases (75%) were unstable fractures. Group II, 14 cases (17%) were unstable fractures. Tip-apex distance was 26.5 (18~35) mm in group I and 18.6 (8~22) mm in group II. Lateral wall fracture of greater trochanteric area was combined in 24 cases (85.7%) in group I and 9 cases (11.3%) in group II. Harris Hip Score improved from 33.5 (22~43) points to 84.2 (75~93) points after salvage hip arthroplasty. CONCLUSION We considered the causes of failed compression hip screw to be fracture instability, increased tip-apex distance and presence of lateral wall fracture of greater trochanter. Hip arthroplasty was found to be a useful method for failed compression hip screw.
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Internal Fixation for Femoral Neck Fracture in Patients between the Ages of Twenty and Forty Years
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Ui Seoung Yoon, Jin Soo Kim, Hak Jin Min, Jae Seong Seo, Jong Pil Yoon, Joo Young Chung
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J Korean Fract Soc 2010;23(1):1-5. Published online January 31, 2010
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DOI: https://doi.org/10.12671/jkfs.2010.23.1.1
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To retrospectively analysis of results of operatively treatment for femoral neck fracture occurred in twenties to thirties. MATERIALS AND METHODS 20 patients were selected whom we were able to follow up at least 2 years after internal fixation for femoral neck fracture in twenties to thirties from 1998 to 2005. Mean age was 32.2 (21~39) and average follow up period was 26.3 (24~45) months. According to preoperative X-ray, there were 6 cases for Garden classification stage I, 10 for stage II and 4 for stage III, and 7 cases for subcapital fracture, 9 for transcervical fracture, 4 for basicervical fracture. In all cases, operations were performed within 12 hours after the injury. The operations were done after satisfying reduction with the Garden alignment index, with three cannulated screws for internal fixation. Postoperative results were analyzed by clinical symptoms and radiological examinations during follow up periods. RESULTS In immediately postoperative radiological examination, satisfying anatomical reduction with Garden alignment index was obtained in all cases, and unions were obtained within 4.5 months after the operation (3~6 month). Avascular necrosis of femoral head occurred in 7 cases of all patients (35.0%). The average time of occurrence of avascular necrosis of femoral head after operation was 10.7 months (9~15 months). Avascular necrosis was occutted 5 (31.3%) in fracture without displacement (Garden stage I, II), 2 (50.0%) in fracture with displacement (Garden stage III) and 4 in subcapital fracture, 3 in transcervical fracture. CONCLUSION The incidence of avascular necrosis of femoral head after the operation for displaced and nondisplaced femoral neck fracture between twenties and forty years was no significant difference.
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- Comparison of Clinical Outcomes for Femoral Neck System and Cannulated Compression Screws in the Treatment of Femoral Neck Fracture
Jae Kwang Hwang, KiWon Lee, Dong-Kyo Seo, Joo-Yul Bae, Myeong-Geun Song, Hansuk Choi Journal of the Korean Fracture Society.2023; 36(3): 77. CrossRef
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Operative Treatment of Olecranon Fractures Using Tension Band Wiring
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Hyun Dae Shin, Kwang Jin Rhee, June Kyu Lee, Joon Uoung Uang, Young Mo Kim, Mun Jong Lee, Jin Soo Kim
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J Korean Soc Fract 1998;11(3):672-682. Published online July 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.3.672
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Abstract
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- We treated 26 cases(25 patients) olecranon fractures operatively with Kirschner wire and tension band wiring technique from January 1993 to December 1995. The Kirschner wire fixation methods in our study were either bicortical fixation(15 cases) or intramedullary fixation(11 cases). We retrospectively reviewed clinical results according to Mayo elbow performance index and starting time of full range of motion(ROM) exercise. We analyzed relationship between the cli9nical results of the cases with cast immobilization and those without cast immobilization. We also compared Kirschner wire fixation methods in the respect of clinical results, full ROM exercise starting time and complications. The results were as follows. 1. Clinical results were excellent or good in 25 cases(96%) according to Mayo elbow performance index. Full ROM exercise starting time was within 2weeks in 10 cases, between 2-3weeks in 11 cases, between 5-6weeks in four cases and after 6weeks in one case. Full ROM exercise starting time was significantly different(P=0.016) with clinical results statistically and there was statistically high significant difference(P=0.0025) between clinical results and cast immobilization or not. 2. Clinical results of bicortical fixation group was ont significantly different frmo those of intramedullary fixation group and there was no significant difference between full ROM exercise starting time and Kirschner fixation methods statistically. 3. The most frequent complications were decreased ROM and loosening of the Kirschner wire. There were decreased ROM In 10 cases and loosening of the Kirschner wire in 6 cases in all cases. We encountered more higher incidence of complications related to intramedullary fixation method. The clinical results and full ROM exercise starting time of bicortical fixation group were not significantly different with those of intramedullary fixation group statistically. But more early exercise, more better clinical results and more less complications was produced in bicortical fixation group. So we thought bicortical fixation method is better than intramedullary fixation method.
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Citations
Citations to this article as recorded by 
- Double Tension Band Wiring for Olecranon Fractures
Suk Kang, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Jin Wook Chung, Jong Pil Kim Journal of the Korean Fracture Society.2008; 21(2): 130. CrossRef
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Recovery of Walking Ability After Operation for Unstable Intertrochanteric fractures of the Femur in Elderly. -Timing on weight Bearing-
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Deuk Soo Hwang, Hyun Tae Jung, Sang Beom Kim, Jin soo Kim
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J Korean Soc Fract 1998;11(2):296-303. Published online April 30, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.2.296
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- Intertrochanteric fracture of the femur frequently occurs in elderly patients with osteoporosis, represent as unstable and comminuted fracture, is the major cause of the morbidity and mortality in old ages. In the past, the goal of treatment of a fracture was to obtain union with little regard early ambulation is thought to be the best treatment modality. Fifty-three patients with unstable intertrochanteric fracture of the femur treated by possible anatomic reduction and internal fixation with compression hip screw were divided two groups and reviewed. In group A, 25 patients were began to bearing partial weight during six to eight weeks after operation. In group B, 28 patients were began to bearing partial weight as soon as possible(during first to third week after operation). The results were as follows; 1. According to Koval's classification, 6 cases(24.0%) in group A and 12 cases(42.9%) in group B maintained their prefracture ambulatory ability at more than 1 year postoperatively. 12 cases(48.0%) in group A, 8 cases(28.6%) in group B lost more than two grade of ambulatory ability. 2. Average loss of neck-shaft angle was 5.87degree in group A and 9.41degree in group B. Also average shortening was 5.2mm in group A and 12.7mm in group B at more than 1 year postoperatively. 3. The complications were two cases of nonunion in group A, two cases of femur fracture around compression hip screw in group B. There was no evidence of nail penetration or metal failure in both group. We concluded that better results are obtained in the respect of recovery of walking ability when partial weight bearing was started in early, even if more malunion was occurred, which is not seemed to be a severe problem for ordinary daily living in elderly.
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Citations
Citations to this article as recorded by 
- A Comparative Study of Bipolar Hemiarthroplasty for Intertrochanteric Fracture: Direct Anterior Approach versus Conventional Posterolateral Approach
Young Yool Chung, Seung-Woo Shim, Min Young Kim, Young-Jae Kim Hip & Pelvis.2023; 35(4): 246. CrossRef - Hemiarthroplasty through Direct Anterior Approach for Unstable Femoral Intertrochanteric Fractures in the Elderly: Analysis of Early Cases
Ji-Hun Park, Young-Yool Chung, Sung-Nyun Baek, Tae-Gue Park Hip & Pelvis.2022; 34(2): 79. CrossRef - 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 - Changes in Patient Pattern and Operation Methods for Intertrochanteric Fractures
Dong-Hui Kim, Sang-Hong Lee, Sang-Ho Ha, Jae-Won You Journal of the Korean Orthopaedic Association.2011; 46(1): 49. CrossRef - 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 Journal of the Korean Fracture Society.2010; 23(3): 276. CrossRef - Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone
Haw Jae Jung, Jae Yeol Choi, Hun Kyu Shin, Eugene Kim, Se-Jin Park, Yong Taek Lee, Gwang-Sin Kim, Jong-Min Kim Journal of the Korean Fracture Society.2007; 20(4): 291. CrossRef
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