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Clinical Analysis Between Interlocking IM Nail and Plate Fixation in the Treatment of Humeral shaft Fractures
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Soo Chan Lee, Beom Koo Lee, Do Hyun Moon, Jin Hong Ko, Hong Gi Park, Ki Dong Kang, Hyoung Il Kim
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J Korean Soc Fract 1997;10(3):621-627. Published online July 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.3.621
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- Most of the humeral shaft fractures have been treated conservatively. If operation is indicated, most surgeons used to perform an open reduction and internal fixation with plate &Treatment of the Humeral Shaft Fracture in Adult screws. But, when open reduction and internal fixation is carried out, the periosteum and soft tissue attachments must be stripped off from the bone and operative time becomes longer. Interlocking IM nailing is an attractive procedure which does not disrupt or strip off periosteum and soft tissue at the fracture site, decrease the chance of infection and allow early exercise.
Authors compare the clinical result of humerus shaft fracture which were treated by plate fixation in 25 patients and interlocking IM nailing in 16 patients who were treated at the orthopedic depaunent, Joong Ang Gil Hospital from Feb. 1992 to Jan. 1995.
1. The average time of operation in interlocking IM nail was 65 minutes and that of plate fixation was 95 minutes.
2. The average time for bone union was about 14.4 weeks in interlocking IM nail and 14.2 weeks in plate fixation.
3. The complications of interlocking IM nail were 1 case of postoperative radial nerve palsy, 1 case of delayed union, 1 case of nonunion and 3 cases of pain and stiffness of shoulder.
4. the complications of plate fixation were 1 case of infectioin, 1 case of delayed union, 3 cases of nonunion, 1 case of metal failure, 2 cases of postoperative radial nerve palsy and 2 cases of pain and stiffness of elbow.
In conclusion, the interlocking IM nailing is an attractive procedure or the treatment of the humeral shaft fractures.
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A Comparison of Unlearned IM-nailing with Reamed IM-nailing in Tibial Shaft Fracture
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Su Chan Lee, Bum Gu Lee, Do Hyun Moon, Jin Hong Ko, Hong Ki Park, Ki Dong Kang, Sang Kyoo Choi
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J Korean Soc Fract 1997;10(2):295-302. Published online April 30, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.2.295
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- Recently, there is seen frequently the tibial fracture due to the increased traffic accident and the high industry. Rigid intramedullary nailing is the method of choice in tibial shaft fracture, early weight bearing and joint motion.
Between Jan.1993 and Dec. 1994, we treated 93 tibial shaft fractures with reamed intramedullary nails(55 cases) & unlearned intramedullary nails(38 cases).
We analyzed the effects of these two methods, and the following results were obtained.
1. Of 93 fractures, 32 fractures were open and 61 fractures were closed.
2. The most common cause was traffic addicent. Among the 93 cases, 60 cases were male and 33 cases were female, the most common age were ranged from 30-39 year, involving 36 cases.
3. The mean durations of the bone union were 19.7 weeks in closed fracture with treated by reamed nail and 22.1 weeks in closed fracture with unlearned.
The mean duration of the bone union were 24.5 weeks in open fracture with reamed and 22.4 weeks in open fracture with unlearned.
The complications of intramedullary nail are angular deformity, infection, delayed and nonunion, and screw breakage.
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Management of Unstable Proximal Tibial Fractures Using the Ilizarov
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Hong Gee Park, Beom Goo Lee, Soo Chan Lee, Do Hyun Moon, Jin Hong Ko, Ki Dong Kang, Hyun Park
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J Korean Soc Fract 1997;10(2):332-337. Published online April 30, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.2.332
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- We reviewed fifteen cases of unstable tibial fractures treated with Ilizarov method from May 1995 to May 1996.
We attained satisfactory bony union in all cases without bone graft(Average time 19 weeks).
There were numbers of complications, such as pin tract infection, angular deformity and joint ankylosis but its were soluble and careful management & numbers of minor surgery were needed to prevent & solve such complications. Post-op immediate weight bearing and ROM exercise were possible and showed no difficulty in getting mainteance of reduction & fracture healing, and serious joint ankylosis waa not developed.
In conclusions, Ilizarov method is an excellent treatment in getting reduction, maintenance of reduction, early ambulation and fracture healing in the cases of unstable tibia fractures.
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Arthroscopic Management of the Tibial Condylar Fractures
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Do Hyun Moon, Beom Koo Lee, Jin Hong Ko, Ki Dong Kang, In Seok Oh, Young Kab Shin
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J Korean Soc Fract 1997;10(2):324-331. Published online April 30, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.2.324
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- The tibial condylar fracture is a fracture of the proximal end of the tibia, involving as they do weight-bearing articular sufaces and frequently accompanied by soft tissue injuries and menisci present a variety of problems in the treatment and prognosis.
We performed reduction of the depressed articular fragment under mornitoring of arthroscopy and under the control of image intensifier and fixed with cannulated cancellous screws and accompanied by bone graft in 7 cases of the 11 cases.
The results were satisfactory Arthroscopy bridges the advantage of accurate reduction and fixation without extensive operative exposure.
In addition, arthroscopy allows through lavage, removal of loose fragment and accurate of associated intraarticular pathology.
Since extensive exposure is avoided, rapid recovery with reduced pain and early full ROM us achieved in patients managed arthroscopically.
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Citations
Citations to this article as recorded by  - Arthroscopically Assisted Reduction and Internal Fixation of Intra-Articular Fractures of Tibial Plateau
Jeung Tak Suh, Jae Min Ahn, Tae Wan Kim, He Myung Cho
Journal of the Korean Orthopaedic Association.2012; 47(2): 96. CrossRef
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Operative Tleatment of the Lateral Condyle Fractures of the Humerus in Children
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Bum Gu Lee, Do Heun Moon, Jin Hong Ko, Su Chan Lee, Hong Ki Park, Ki Dong Kang, Young Kim
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J Korean Soc Fract 1996;9(4):1096-1103. Published online October 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.4.1096
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- Fracture of the lateral humeral condyle is a relatively common injury in children.
The standard treatment of Jakobs type II and III fractures is open reduction and internal fixation The treatment of Jakobs type I fractures is more controversial.
Authors performed clinical and radiological analysed of fifty-two patients of lateral condylar fracture of the humerus who have been treated with open reduction and internal fixation.
They were followed up from one year to five years and two months.
The results were as follows; 1. The age incidence was confined from 3 years to 12 years.
2. There were 14 cases(26.9%) of Milch type I, 38 cases(73.8%) of Milch type II and according to Jakobs stage, 20 cases were stage I, 23 cases were stage II, 9 cases were stage III.
3. All cases were treated by open reduction and Internal fixation.
4. In 5 cases were lateral condyle overgrowth of the humerus, 2 cases were limited ROM of elbow joint. and 2 cases pin site loosening and superficial wound infections observed. And this complications did not resutt in significant clinical disabilites.
5. Respectively, according to the criteria of Hardacre 41 cases(78.8%) were excellent, 11 cases (21.1%) were good, and there was no poor case.
6. The fracture type and stage of displacement did not effect the flnal results. the complications, the complications are due to inaccurate reduction or insecure fixation.
Therefore, open anatomical reduction and stable internal fixation is required to avoid complications, even in stage I displaced fractures.
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Problems and complication after Interlocking Intramedullar Nailing for Femoral Shaft Fracture
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In Suk Oh, Do Hyun Moon, Jin Hong Ko, Ki Dong Kang, Si Hwan Kim
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J Korean Soc Fract 1996;9(3):547-556. Published online July 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.3.547
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- Fracture of the femoral shaft, is among most common fractures in orthopaedics, with its aspect becomming more complex. Since the introduction of Kuncher Nail, closed rodding techinque and locking nail system were followed with additional feature of preventing shortening and rotation as well as allowing early weight bearing and joint motion. With their wide application, we met many problems during the operative procedure due to delicient concept and technique.
We have checked the possible problems during and after the procedure of interlocking nailing for the femoral fractures in 65 cases.
1. With poor selection of implant, long, short and small nail were used in 5, 3 & 2 cases, respectively.
2. In the process of operation, inlet error, angular & rotational deformity, femoral neck fracture, failure (or loossening) of distal screws were 2,10, 1, and 4 cases, respectively.
3. A New fragment was made in 7 cases(11%) durinbg surgery, especially medial side and distal to the fracture line.
4. Post-operative deep infection were developed in 2 cases.
5. Post-operative metal failure and delayed(or non) union was 1 and 7(11%) cases, delayed union (or nonunion) occured in 3 cases(20%) after open reduction while following closed reduction in 4 cases(8%).
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Citations
Citations to this article as recorded by - Iatrogenic Femur Proximal Shaft Fracture during Nailing Using Lateral Entry Portal on Femur Shaft Fracture
Hong Moon Sohn, Gwang Chul Lee, Chae Won Lim
Journal of the Korean Orthopaedic Association.2014; 49(4): 272. CrossRef
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Management of open Supracondylar Fractures of Femur using the Ilizarov Method
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Bum Ku Lee, Do Hyun Moon, Jin Hong Ko, Soo Chan Lee, Ki Dong Kang, Jong Seob Park
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J Korean Soc Fract 1996;9(3):567-573. Published online July 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.3.567
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- It is extremely difficult to treat to the comminuted open fractures of supracondyle of femur Internal fixation with plates and screw or intramedullary nailing of open fracture is high risk of infection and circulatory compromising at the fracture site. External fixation reduces the risk of infection and permits easy access for wound care, early mobilizatioll of joints and weight bearing.
We reviewed nine cases of open supracondylar fractures of femur treated with Ilizarov method from February 1993 to December 1995 and obtained the following results.
1. The average time of bony union was 2 weeks. According to AO classification, the average time of bony union was 22.7 weeks in type A and 29.3 weeks in type C. According to classification of Gustilo and Anderson, the average time of bony union was 21 weeks in type II,27.3 weeks in type Illa and 30 weeks in type IIIb.
2. The Neers criteria was based on the final functional and anatomical rating for supracondylar fracture of femur. According to this criteria, excellent was 1 case, satisfactory in 7 cases and unsatisfactory in 1 case.
3. The complications were divided into problem, obstacle and complication;Problem in 9 cases, bstacle in 5 cases and complication in 3 cases.
We conculded the Ilizarov technique is a useful method in management of the severe comminuted fractures and extensive soft tissue injury of the supracondylar fractures of femur.
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A Treatment of Fracture of the Neck of the Talus
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In Suk Oh, Do Hyun Moon, Jin Hong Ko, Ki Dong Kang, Si Hwan Kim
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J Korean Soc Fract 1996;9(2):369-375. Published online April 30, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.2.369
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- A fracture of the tatar nock if relatively rare, but it is generally regarded as a serious traumatic lesion of the ankle, because of the poor outcome after treatment. The talus has a special anatomical, functional and vascular characteristics. So the complications with avascular necrosis and nonunion and degenerative joint diseases are frequent.
We reviewed 19 cases who treated at ChungAng Gil General Hospitai from January, 1990 to August, 1994 and studied the incidence of complications and important factors in achieving good results.
The follow up period was at least 12 months.
The results were as follows; 1. Of the 18 cases, there were 18 males and 2 females, and most were third and fourth decades(67%).
2. The main cause were a fall down injury(44%), with sudden hyperextension as its mechanism.
3. According to Hawkins classification, type I, type II & type III were 6,8 & 4 cases, respectively.
4. The accompanying ipsilateral peri-ankle involvement were observed in 44%.
5. As for the method of treatment, C/R with cast immobilization were performed in 6 cases of type I while O/R and I/F with screw & Steinmann pin done on others.
6. As for the complications, AVN, skin necrosis, traumatic arthritis and infection were 3, 1,2 and 1 cases, respectively.
: Excellent in 9 cases, good in 6, fair in 1, poor in 2.
Consequently we think, in the treatment of displaced neck fracture and dislocation of talus, it is important to decompress the soft tissue early with concomitant anatomical reduction & internal fixation to get a satisfactory results.
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