Journal of Musculoskeletal Trauma

Kee Byoung Lee

6 Articles

Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN): Kee Byoung Lee, Byung Taek Lee; J Korean Fract Soc 2007;20(1):33-39. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.33

PURPOSE
We analyzed the complications of femoral pertrochanteric fractures treated with proximal femoral nail (PFNÂ®) to reduce the its complications.
MATERIALS AND METHODS
We evaluated the complications among 198 patients who were treated with PFNÂ® from June 2001 to August 2005 in our hospital.
RESULTS
The complications were presented in 28 cases (14.1%). Cut-out of lag screw was in 1 case, cut-out of lag screw and antirotation screw were in 3 cases, cut-out of antirotation screw in 3 cases, of these femoral head fracture was in 1 case. Femoral neck fracture in 1 case, Osteonecrosis of femoral head in 1 case, cortical fracture during the insertion of distal interlocking screw in 1 case, breakage of drill bit intraoperatively in 1 case, fibrous union in 2 case, thigh skin irritation due to screw back-out in 3 cases, periprosthetic fractures in 2 cases, varus collapse more than 10 degrees in 4 cases, superficial and deep infections in 3 cases, breakage of nail in 1 case, varus collapse after PFN removal in 1 case, persistent thigh pain in 1 case. Of all these cases, 9 cases (4.5%) were required reoperation with general or spinal anesthesia. Complications related with screws or fracture reduction were 19 cases (9.6%) and, of these, 17 cases (89.5%) showed increased TAD (tip apex distance) or nonanatomical reduction.
CONCLUSION
To reduce the complications of PFNÂ®, we need to exact surgical technique and anatomical reduction and consider the modification of implant design to prevent of cut-out of screws.

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Proximal Femoral Nail Mechanical Failure: A Case Report and Biomechanical Study
Dimitrios Papanikolopoulos, Christos Kalligeros, Apostolos Polyzos, Vasileios Spitas, Vasileios Soranoglou
Cureus.2022;[Epub] CrossRef
Clinical and radiological outcomes of patients treated with the talon distalfix proximal femoral nail for intertrochanteric femur fractures
Furkan Yapici, Hanifi Ucpunar, Yalkin Camurcu, Necati Emirhan, Oguzhan Tanoglu, Ismail Tardus
Injury.2020; 51(4): 1045. CrossRef
Implant Fracture Analysis of the TFNA Proximal Femoral Nail
Anton Lambers, Bertram Rieger, Alan Kop, Peter D’Alessandro, Piers Yates
Journal of Bone and Joint Surgery.2019; 101(9): 804. CrossRef
Radiographic Outcomes of Osteosynthesis Using Proximal Femoral Nail Antirotation (PFNA) System in Intertrochanteric Femoral Fracture: Has PFNA II Solved All the Problems?
Won Chul Shin, Jung Dong Seo, Sang Min Lee, Nam Hoon Moon, Jung Sub Lee, Kuen Tak Suh
Hip & Pelvis.2017; 29(2): 104. CrossRef
Avascular necrosis of the femoral head following trochanteric fractures in adults: A systematic review
Antonio Barquet, Gabriel Mayora, Joao Matheus Guimaraes, Roberto Suárez, Peter V. Giannoudis
Injury.2014; 45(12): 1848. CrossRef
Anatomical Measurement of Normal Korean Proximal Femur Using Plain Radiography: A Problem when using Proximal Femoral Nail Anti-rotation
Jong-Seok Park, Woo-Jong Kim, Jae-Wan Soh, Byung-Woong Jang, Tae-Heon Kim, You-Sung Suh
Hip & Pelvis.2011; 23(4): 303. CrossRef
PFNA and PFN in Intertrochanteric Fractures - Comparison Study of Sliding -
Suk Kyu Choo, Hyoung Keun Oh, Jun Young Choi
Hip & Pelvis.2010; 22(1): 79. CrossRef

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Vertebroplasty for the Treatment of Painful Osteoporotic Compression Fractures: Young Woo Kim, Ho Guen Chang, Kee Byoung Lee, Yong nam Ji, Yong Beom Lee, Jeong Mo Ku; J Korean Fract Soc 2004;17(1):49-54. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.49

Abstract PDF

PURPOSE
To evaluate results regarding pain relief, spinal stabilization, and complication after treatment with percutaneous vertebroplasty.
MATERIALS AND METHODS
108 patients (12 men, 96 women; aged 42~84 years) underwent 156 percutaneous injections of surgical cement into a vertebra (vertebroplasty) with fluoroscopic guidance in 119 procedures. All patients had severe pain,osteoporotic fractures and had failed medical therapy. Immediate and long-term pain response, spinal stability, and complications were evaluated. Assessment criteria were the changes over time (Days 3, 30, 90, 180) in visual analogue scale (VAS: 0~100 mm) and McGill-Melzack scoring system. The height of vertebral body was checked at three portions (anterior, middle, posterior) with lateral view of plain radiographs.
RESULTS
A statistically significant decrease of both VAS and McGill-Melzack scoring system was observed at Day 3. The results were also significant at Days 30, 90, and 180 both scales. We observed no adverse event, but 26 vertebral fractures had occured in the adjacent level during 12 months of follow-up. The leakage of cement was observed in 57 vertebral bodies (36.5%). But there was no neurological symptoms associated with cement leakage. The vertebral body height was increased after vertebroplasty.
CONCLUSION
Vertebroplasty is safe and effective, and have a useful role in the treatment of painful osteoporotic vertebral compression fractures that do not respond to conventional treatments. Continuous management of osteoporosis and patient education is mandantory to prevent subsequent fracture of the adjacent vertebral bodies.

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Comparison of Outcomes of Conservative Treatment, Early Vertebroplasty, and Delayed Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures
Se-Hyuk Im, Young-Joon Ahn, Bo-Kyu Yang, Seung-Rim Yi, Ye-Hyun Lee, Ji-Eun Kwon, Jong-Min Kim
Journal of Korean Society of Spine Surgery.2016; 23(3): 139. CrossRef
The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture
Young-Do Koh, Jong-Seok Yoon, Sung-Il Kim
Journal of the Korean Fracture Society.2008; 21(1): 57. CrossRef
Compatibility of Self-setting DBM-CP Composites in Percutaneous Kyphoplasty
Jung Hee Lee
Journal of the Korean Fracture Society.2007; 20(3): 266. CrossRef

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The proximal femoral nail for intertrochanteric fracture of the femur: Young Wan Moon, Dong Hyun Suh, Shin Taeg Kang, Duck Joo Kwon, Yong Nam Ji, Kee Byoung Lee; J Korean Soc Fract 2003;16(1):29-36. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.29

Abstract PDF

PURPOSE
To evaluate the treatment results of geriatric intertrochanteric fractures using a proximal femoral nail.
MATERIALS AND METHODS
From April 2001 to Feburary 2002, 71 cases of the intertrochanteric fractures were treated with proximal femoral nail(PFN), more often in communited fractures involving lesser trochanter, transverse or reverse oblique intertrochanteric fracture. We evaluated the bone union time, neck-shaft angle, lag screw sliding by follow up radiographs, operation time, blood loss and complications.
RESULTS
The average age was 77.5 years old, the mean duration of follow-up was 9 months and the mean duration of bone union was 13.8 weeks. The average neck-shaft angle on immediate postop. x-ray was 131.9 +/-5.21 degrees and 129.9 +/-6.04 degrees at last follow up and the average lag screw sliding was 4.21 +/-4.13 mm. The average operation time was 61 minute and blood loss was 0.67 pints(134cc). Intraoperative complications were inadequate reduction in one case, difficulty in distal transfixing in one case and drill bit failure in one case and postoperative complications were loss of neck-shaft angle (more than 5 degree) in 12 cases, femur neck fracture in 2 cases and intraarticular cutting out of femur neck screw in one case.
CONCLUSIONS
The use of the proximal femoral nail could be appropriate for the fixation of communited or reverse oblique intertrochanteric fracture in elderly, osteoporotic patients for early ambulation, preventing shortening and rotation deformity, and reducing operation time and blood loss.

Citations

Citations to this article as recorded by

Treatment of Intertrochanteric Fractures Using the Compression Hip Nail
Je-Min Yi, Kye Young Han, Keun Woo Kim, Chang Hyun Ryu
Hip & Pelvis.2014; 26(3): 166. CrossRef
Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails
Il Ho Park, Jong Kyoung Won, Kye Young Han
Hip & Pelvis.2012; 24(2): 117. CrossRef
Proximal Femoral Nail Antirotation and Proximal Femoral Nail in Intertrochanteric Fractures
Sung Soo Kim, Chul Hong Kim, Jin Hun Kang, Dong Hoon Han, Yong Seung O
Journal of the Korean Orthopaedic Association.2011; 46(5): 392. CrossRef
Results of the Proximal Femoral Nail-Antirotation (PFNA) in Patients with an Unstable Pertrochanteric Fracture
Yerl-Bo Sung, Sung-Il Jo
The Journal of the Korean Hip Society.2011; 23(1): 39. CrossRef
Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture
Jong Min Lim, Jeung Il Kim, Jong Seok Oh, Kuen Tak Suh, Jae Min Ahn, Dong Joon Kang
Journal of the Korean Fracture Society.2010; 23(4): 360. CrossRef
Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA)
Myung-Sik Park, Young-Jin Lim, Young-Sin Kim, Kyu-Hyung Kim, Hong-Man Cho
Journal of the Korean Fracture Society.2009; 22(2): 91. CrossRef
Treatment of Intertrochanteric Fracture: Comparison of Proximal Femoral Nail and Proximal Femoral Nail A
Jung Ho Park, Jong Woong Park, Joon Ho Wang, Jae Wook Lee, Jung Il Lee, Jae Gyoon Kim
Journal of the Korean Fracture Society.2008; 21(2): 103. CrossRef
Treatment of Intertrochanteric Fracture with Proximal Femoral Nail
Dae Joong Kim, Sung Chan Ki, Young Yool Chung
Journal of the Korean Fracture Society.2007; 20(1): 40. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)
Kee-Byoung Lee, Byung-Taek Lee
Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef

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Treatment of Humeral Shaft Fracture with AO Unreamed Humeral Nail: In Heon Park, Kee Byoung Lee, Kyung won song, Jin Young Lee, Min Choi; J Korean Soc Fract 1999;12(2):429-434. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.429

Abstract PDF: We performed a retrospective study of nine humeral shaft fractures which were treated by interlocking intramedullary nailing, the AO UHN (Unreamed Humeral Nail) system between March 1996 and February 1997 with more than one year of follow up. AO UHN inserted by either antegrade or retrograde technics through limited incisions followed by insertion of 2 proximal and distal Interlocking screws. Compression between fractured fragments was achieved in the non-comminuted and indicated cases. Immediate postoperately, soft shoulder immobilizer was applied and rehabilitation was started with active shoulder motion exercise few days to 1 week postoperately as soon as patient could tolerate pain. Union occurred at average of 13 weeks except one expired case with pathologic fracture due to advanced metastatic cancer. Pain relief and functional restoration were rated as good to excellent in most cases. Interlocking intramedullary nailing using AO UHN for the humeral shaft fractures usually provides immediate stability of the fracture and can be accomplished with a closed technique, minimum morbidity, with a resultant early return of function of the extremity. Therefore we recommend AO UHN for the treatment of the humeral shaft fractures if available without hesitation.

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Intramedullary Nailing Treatment for Segmental TibialFractures: In Heon Park, Kee Byoung Lee, Kyung Won Song, Jin Young Lee, Eung Joo Lee, Byung Koo Jooe; J Korean Soc Fract 1998;11(3):546-551. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.546

Abstract PDF: Fracture of the tibia is the most common fracture of the long bone and due to its anatomical property, significantly high rate of complication has been reported during and after treatment. Various ways of surgical treatment have been tried with reasonable satisfaction. Recently, closed intramedullary nailing under the image intensifier has been widely performed with good results. However, segmental tibial fractures are more difficult than ordinary tibial shaft fracture in terms of reduction and fixation. Its treatment has been rather challenging for average orthopedic trauma surgeons. Particularly, segmental tibial fractures are commonly combined with extensive soft tissue injury, comminution as well as displacement resulted in poor blood supply especially in its middle segment. In this paper we are reporting our experience with intramedullary nailing treatment for 13 segmental tibial fractures in 13 patients. 13 cases with segmental fracture of tibia were reviewed, which were treated at the Deparment of Orthopaedic Surgery, Kang-Dong Sacred Hospital of Hallym University for 6 years from January 1990 to December 1996 with more than 1 year follow up period. All cases were caused by traffic accident and four were open fractures. Patients were 19-60 years of age (average 44) with male to female ratio of 1.6:1. The fractures were closely reduced and intramedullary nailed under the image intensifier control. Two cases were added with limited skin opening of the displaced fragments for reduction. Seven cases were reenforced an additional immobilization such as long leg splint or cast or externl fixator postoperatively. Melis type I fractures were most frequent in our series. All fractures were healed within a 1 year and average union period was 167 days (proximal fracture-144 days, distal fracture-190 days). Complications were a case of chronic osteomyelitis and one deep vein thrombosis and 4 case of delayed union, which were treated by reoperation with bone grafts. Displacing most proximal fragment was most troublesome to manage during and after operation. We tried intracortical screws fixation between proximal and middle segments with satisfactory bony union without displacement for a case. Carefully planned intramedullary nailing with or without some modification of the most proximal and shoryt segment seems to be recommendable way of treatment for the most segmental fractures of the tibia.

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Treatment of Distal Clavicular Fracture with Ruptured Coracoclavicular Ligament by Weaver and Dunn Method: In Heon Park, Kee Byoung Lee, Myung Ryool Park, Jin Young Lee, Kyun Ho Chang; J Korean Soc Fract 1989;2(2):288-291. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.288

Abstract PDF: We reported two patients with fracture of distal clavicle combined with rupture of the coracoclavicular ligament which was treated by Weaver and Dunn method recently. The following results were obtained: 1. The over all recovery were graded good. 2. The Weaver and Dunn nethod is recommendabel for several reasons such as relatively easy surgical procedure, elimination of secondary procedure and degenerative change of the acromioclavicular joint, cosmetic acceptability and early functional recovery.

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