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The Clinical Resuts of Bipolar Hemiarthroplasty in Old Age-Femoral Neck Fracture vs. Intertrochanteric Fracture-
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Dong Heon Kim, Kyu Cheol Shin, Byeong Chun Chang, Dae Sul Kang
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J Korean Soc Fract 1999;12(3):509-515. Published online July 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.3.509
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- The peritrochanteric fracture remains one of the most common and potentially devastating injuries in the geriatric population. The goal of treatment is early ambulation to prevent the complications such as pressure sore, pneumonia, deep vein thrombosis, pulmonary embolism and long time hospitalization by open reduction and internal fixation or closed reduction and internal rotation. In femoral neck fracture, many surgeons agree on the bipolar hemiarthroplasty but there is controversy about that treatment in intertrochanteric fracture. We have tried to assess the clinical outcome of bipolar hemiarthroplasty for the intertrochanteric fracture as compared with femoral neck fracture in old age. Ninty-five bipolar hemiarthroplasties were performed at our hospital, between January 1991 and February 1996. We selected 65 patients who had been followed for at least one year. Forty of sixty-five patients had femoral neck fractures and twenty-five of them intertrochanteric fractures.
The results were as follows: 1. Regardless of using the cement, the partial weight bearing ambulation time after operation was 10.3 days in femoral neck fracture, 19.5 days in intertrichanteric fracture.
2. At one year follow-up the average Modified Harris Hip Score was 88.9 in femoral neck fracture, and 87.5 in intertrochanteric fracture.
3. Postoperative complications in case of femoral neck fracture included thigh pain in 4 patients, heterotopic ossification in 1, intraoperative fractures of the femoral shaft in 2, leg length inequality in 1 and dislocations after bipolar hemiarthroplasties in 3. And those in case of intertrochanteric fractures were thigh pain in 2 patients, heterotopic ossifications in 2, intraoperative fractures of the femoral shaft in 2 and dislocation after bipolar hemiarthroplasty in 1.
4. There were no statistically significant differences in the clinical functional score and complications between intertrochanteric and femoral neck fracture groups, therefore bipolar hemiarthroplasty can be recommended as one of the treatment of intertrochanteric fracture as well as femoral neck fracture in the elderly patient.
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The Treatment of the Proximal Tibia Fracture -Comparison of the Variable Method of Fixation-
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Dong Heon Kim, Kyu cheol Shin, Kyeong Soon Kim, Byeong Chun Chang, Dae Sul Kang
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J Korean Soc Fract 1998;11(2):442-448. Published online April 30, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.2.442
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- The treatment of proximal tibial fracture is an area of great controversy. Because open and comminuted fractures are common, selection of fixation method of the proximal tibial fracture is more difficult than any other fractures. Many authors reported high rate of malunion and loss of reduction. The purpose of this study is to compare the results of the proximal tibial fractures depending on the fixation method. We evaluated the records of 35 patients (36 fractures) who had been treated with intramedullary nailing, plate and screws and external fixation from January 1989 to January 1996. The mean period of follow-up was 12months. Of the 36 fractures, 8 fractures were with intramedullary nailing, 12 fractures with plate and screws, 16 fractures with external fixator. In intramedullary nailing groupp, the average time of bony union was nineteen weeks (16-27), in plate and screws fixation group twenty three weeks (18-31) and in external fixation group 22 weeks (19-29). The complications of intramedullary nailing group were 3 nonunions, 1 delayed union, 1 varus deformity, 2 anterior angulations and 2 cases of deep wound infection. The complications of plate and screws group were 1 nonunion, 3 delayed union, 1 deep wound infection, 2 superficial infections and in most fractures partial stiffiness of knee joint. The complications of external fixator group were 1 nonunion, 1 delayed union, 1 deep wound infection, 6 pin tract infections and 3 cases of knee joint stiffness. In our cases, if there is open wound higher than Gustilo grade III-B and severe comminuted fracture initially, the external fixation is more preferred for wound management and also more advantageous method for the patients who got a multiple trauma in abdomen, chest and head injuries. In closed fractures and Gustilo grade I, II open fractures, intramedullary nailing is considered to be more preferable method. But the anatomy of proximal tibia made nailing these fractures technically difficult. In conclusion, we consider each method of fixation is useful fixation method of the proximal tibial fractures, but each method should be selected advertently depending on the severity of soft tissue injury and the degree of comminution of the fractures.
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Treatment of Femoral Shaft Fracture with Intramedullary Nailing: A Comparison of Ender Nailing with Interlocking Intramedullary Nailing
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Sung Tae Lee, In whan Jeong, Dong Heon Kim, Kyu Cheol Shin, Moon Koo Lee
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J Korean Soc Fract 1996;9(2):409-415. Published online April 30, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.2.409
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Abstract
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- The rigid internal fixation of the femoral shaft fracture with intramedullary nailing enables early joint motion and reduces morbidity.
The authors reviewed the results of 38 patients treated with Ender nailing(22 casses) and interlocking intramedullary nailing(16 cases) between March 1989 and March 1994.
The resuls were as follows.
1. The average bony union time in Ender nailing(18.9 weeks) was similar to interlocking intramedullary nailing(18.7 weeks).
2. The average time to acHieve full range of motion of the knee was shorter in intramedullary nailing (10.2 weeks) than in Ender nailing(13.5 weeks).
3. Interlocking intramedullary nailing required shorter time to achieve full weight Ender nailing.
4. The average operation time was shorter in Ender nailing(55 mins.) than in interlocking intramedullary nailing(100 mins).
Interlocking intramedullary nailing is thought to be a better option than Ender nailing in fixa lion of femur shaft fracture by our study. However, in elderly patients or multiple injured patieilts, Ender nailing can be used advantageously for shorter operation time and technical sim plicity.
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Treatment of Nonunion of the Tibia Fracture
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Dong Heon Kim, Kyu Cheol Shin, Hee Cheol Park, Ju Yong Shin
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J Korean Soc Fract 1996;9(1):112-118. Published online January 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.1.112
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- Nonunion after tibia fracture is a relatively common problem. The cases of nonunion have been known open and comunited fracture, extensive soft tissue injury, interposition of the soft tissue, distarbance of the blood supply and inadequate fixation. A number of methods stimulating union have born described.
These include fibular osteotomy followed by weight-bearing in a cast, autogenous boone graft with or without additional stabilization, internal or external fixation with compression, open or closed IM nailing and even electromagetic stimulation.
In this paper we carried out retrospective study of the 24 nonunion of the tibia fracture which were treated at the Department of Orthopeadic Surgery, Kon-Kuk University Hospital from March 1990 to March 1995.
The results were as follows: 1. Among 24 cases of monunions, 16cases(66.6%) were communited fractures and 18cases(75%) were open fractures.
2. Hypervascular nonunion were 12cases and avascular nonunion were 12cases. Previous methods of treatinent were conservative treatment in 6cases of closed fracture and were treated with Ender nailing, multiple K-wire fixation, Ilizarolr external fixation, monofixator external fixation in 1 Bcases of open fractures.
3. The average duration from injury to dignosis of nonunion was 7 months tweets.(Range 5 months to 24months) 4. Tibial nonunion were treated with plate and screw with bone graft(Bcases), Interlocking IM nail ing(14cases), and nizarov external fixation with bone graft(teases).
5. The average time of union was 23weeks in all patients: 24 weeks in the case of plate and screw with bone graft.
20 weeks in the case of interlocking IM nailing.
28 weeks in the case Ilizarov external fixation with bone graft.
6. The main complications were joint stiffness due to long-term cast irnrnobiliBation in the case of plate and screw with bone graft, LROM of joint contracture and external pin site in the case of Ilizarov external fixation with bone graft, deep infection Icase and knee joint pain teases due to proximal nail protrusion in the case of Interlocking IM nailing.
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The Treatment of Volar Iunate Dislocation and Perilunar Dislocation
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Kyu Cheol Shin, Dong Heon Kim, Ju Yong Shin
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J Korean Soc Fract 1995;8(4):902-913. Published online October 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.4.902
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Abstract
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- The treatment methods of volar lunate dislocation and dorsal perilunar dislocation were introduced variably. We treated 7 cases of volar lunate and dorsal perilunar dislocation by closed reduction and K-wire fixation, open reduction and isolated lunate excision. The 1 case of trans-scaphoid dorsal perilunar dislocation was treated by closed reduction and Herbert screw fixation.
The result were as followed: 1. The early diagnosis and early treatment is the most improtant.
2. The closed reduction and percutaneous pinning has advatage of maintenance of reduction and stability of wrist joint.
3. The advantage of Herbert screw fixation is anatomical reduction of the scaphoid fracture but disadvantage is technical difficulty.
4. In open reduction, we must choose the approach that minimiBe the vascular damage to the lunate from the volar side.
5. The isolated lunate excision is not advised.
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Citations
Citations to this article as recorded by  - Carpal Tunnel Syndrome and Rupture of Flexor Tendon Associated from Neglected Anterior Lunate Dislocation
Young Yool Chung, Young Jae Jang
Journal of the Korean Society for Surgery of the Hand.2015; 20(1): 33. CrossRef - Surgical Treatment of the Perilunate Dislocation and the Lunate Dislocation with Dorsal Approach
Soo-Hong Han, Jin-Myoung Dan, Dong-Hoon Lee, Young-Woong Kim
Journal of the Korean Fracture Society.2011; 24(4): 347. CrossRef - Combined Lunate and Triquetrum Fracture: A Case Report
Joo-Hak Kim, Hyung-Soo Kim, Soo-Tae Chung, Jeong-Hyun Yoo, Seung-Do Cha, Joong-Hyo Lee, Jai-Hyung Park
Journal of the Korean Fracture Society.2008; 21(4): 320. CrossRef
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Treatment of Ipsilateral Fracture of the Femur and Tibia
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Dong Heon Kim, Kyu Cheol Shin, Bo Hyeon Kim
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J Korean Soc Fract 1995;8(3):620-627. Published online July 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.3.620
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- The floating knee describes the fail knee joint segment resulting from fractures of the shafts or adjacent metaphyses of the ipsilateral femu. and tibia. It usually is associated with majo. soft tissue damages, open fractures, and other site injuries. The methods of treatment have been controversal. The key point of the treatment is focussed to the early restoration of the knee function. The floating knee in 24 patients were treated by surgical management from March 1988 to December 1994.
The results were follows: 1. Average bone union time in femur was 20 weeks and in tibia was 18 weeks. Difference of the result of the treatment between the interlocking nail and Ender nail was not significant.
2. At the last follow up, the excellent and good results were 83% by Karlstrom and Olerud criteria, and the first group using the intrarneduallary nail achieved best result.
3. The most common complication was loss of the range of motion of the knee and loss of the range of motion of the knee was 0 to 45 degrees(the average 1 degrees).
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