Journal of Musculoskeletal Trauma

Lih Wang

5 Articles

Treatment of Periprosthetic Femoral Fractures Following Total Knee Arthroplasty: Lih Wang, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Jin Soo Hwang, Sun Hyo Kim; J Korean Fract Soc 2014;27(1):42-49. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.42

PURPOSE
The purpose of this study is to compare the treatment results of fracture fixations by using two minimal invasive techniques for patients with periprosthetic femoral fractures following total knee arthroplasty.
MATERIALS AND METHODS
We reviewed 36 patients (5 males, 31 females) of periprosthetic femoral fractures whom were treated surgically between January 2005 and January 2011. Mean patient age was 68.9 years (range, 43 to 81 years) old and the follow-up period averaged 41 months (range, 18 to 72 months). Nineteen patients were treated with minimal invasive locking plate fixations (group I) and 17 patients with retrograde intramedullary nailing (group II). Clinical and radiological outcomes in each group were comparatively analyzed.
RESULTS
Successful bone unions occurred in all patients and the mean time to bone union was 3.7 months in group I and 4.2 months in group II. There were no statistical differences between the two groups according to mean operative time and mean intraoperative blood loss. There were also no statistical differences between two groups according to clinical outcomes but the valgus deformity was apparent in group II and radiological outcomes revealed significant differences between the two groups.
CONCLUSION
For the treatment of periprosthetic femoral fractures after total knee arthroplasty, two minimal invasive techniques have shown good clinical results. However, the minimal invasive plate fixation showed better results in the radiological alignments.

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The Result of Treatment of Femoral Periprosthetic Fractures after Total Knee Arthroplasty
Jun-Beom Kim, In-Soo Song, Dong-Hyuk Sun, Hyun Choi
Journal of the Korean Orthopaedic Association.2014; 49(6): 446. CrossRef

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Cause and Treatment of Extraarticular Proximal Tibial Nonunion: Sung Soo Kim, Sung Keun Shon, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Lih Wang, Im Sic Ha; J Korean Fract Soc 2008;21(4):279-285. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.279

Abstract PDF: PURPOSE
To analyze the factors affecting the nonunion of extraarticular proximal tibial fracture and the outcome of nonunion treatment.
MATERIALS AND METHODS
We investigated 51 cases of extraarticular proximal tibial fractures from June 2002 to May 2006. The nonunion rate was assessed in relation to several risk factors and the treatment outcome of nonunion using plate fixation with bone graft was assessed by Klemm and BOrner functional rating system.
RESULTS
6 cases of nonunion (11.8%) was noted among 51 cases, and the risk factors examined, OTA A3 comminuted fracture was associated with a high nonunion rate with statistical significance and initial bone graft had a significant effect in bone healing. Excellent and good results were obtained in 5 cases (83.3%) and bone union was achieved in all nonunion cases.
CONCLUSION
Comminution was found to be an important factor affecting the nonunion in extraarticular proximal tibial fracture, and bone graft in primary operation could reduce the chance of nonunion. Accurate plate fixation with bone graft is a reliable option in nonunion treatment.

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Classification and Treatment of Unstable Intertrochanteric Fracture according to the Existence of Posterior Fragment : Preliminary Report: Lih Wang, Sung Keun Shon, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Chul Won Lee, Sung Soo Kim; J Korean Fract Soc 2008;21(2):110-116. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.110

Abstract PDF

PURPOSE
To predict the feature and stability of intertrochanteric fractures with posterior fragment using preoperative 3D computed tomography and to investigate the importance of the posterior fragment in treatment of unstable intertrochanteric fracture.
MATERIALS AND METHODS
15 cases of unstable fractures with posterior fragment which were treated with nail only between October 2006 to August 2007 were classified into 2 groups: study group (5 cases with cannulated screw fixation of posterior fragment) and control group (10 cases without cannulated screw fixation). The average difference of neck-shaft angle, neck screw sliding distance and the complications in the two groups were compared retrospectively after a follow up of at least 3 months.
RESULTS
The average difference of neck-shaft angle in study and control group was 3.8 and 7.5 degree (p>0.05), respectively. The average difference of neck screw sliding distance was 1.6 and 6.6 mm (p<0.05), respectively. Complication which required reoperation was not noted in study group and complications of 3 cases about neck screw lateral protrusion, proximal migration and Z-effect phenomenon were noted in control group.
CONCLUSION
The recognition and fixation of the posterior wall was found to be an important predictive factor in unstable intertrochanteric fracture treatment.

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Outcomes of dynamic hip screw augmented with trochanteric wiring for treatment of unstable type A2 intertrochanteric femur fractures
Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam
Injury.2017; 48: S72. CrossRef
Additional Fixations for Sliding Hip Screws in Treating Unstable Pertrochanteric Femoral Fractures (AO Type 31-A2): Short-Term Clinical Results
Su Hyun Cho, Soo Ho Lee, Hyung Lae Cho, Jung Hoei Ku, Jae Hyuk Choi, Alex J Lee
Clinics in Orthopedic Surgery.2011; 3(2): 107. CrossRef

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Midterm Results of Treatment with a Retrograde Nail for Periprosthetic Fractures of the Femur Following Total Knee Arthroplasty: Kyung Taek Kim, Jin Hun Kang, Lih Wang, Jae Sung Hwang; J Korean Fract Soc 2007;20(4):309-314. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.309

Abstract PDF: PURPOSE
To analyze the midterm results of the treatment with a retrograde nail for periprosthetic fractures of the femur following total knee arthroplasty.
MATERIALS AND METHODS
Between Jan 1998 and Jan 2004, 11 cases in 11 patients were treated for the periprosthetic fractures following total knee arthroplasty. The mean follow-up was 42.0 (30~98) months and the mean age was 66.0 (57~79) years old. 2 were males and 9 patients were females. In all cases, retrograde nailing was done for the periprosthetic fractures. Postoperative range of motion, HSS knee rating score, femorotibial angle, the time required for union, complications were evaluated.
RESULTS
Postoperative range of motion was 103.6Â° degrees on an average, HSS knee rating score was 83.5 points on an average at the last follow up. The mean angulation on radiograph was valgus 6.3Â°. The mean time required for union was 4 months. One had a newly fracture line at proximal part of supracondylar fracture, but there was no significant in clinical course. There was no prostheses required revision.
CONCLUSION
It appears that retrograde nail is a reliable surgical technique for periprosthetic fractures of the femur following total knee arthroplasty with low complication rate. The midterm results in our study showed that none of the prostheses required revision.

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Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing: Sung Soo Kim, Sung Keun Sohn, Chul Hong Kim, Myung Jin Lee, Lih Wang; J Korean Fract Soc 2007;20(2):141-148. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.141

Abstract PDF

PURPOSE
To analyze the causes and the clinical results of treatment for the nonunion of femur shaft fractures that occurred after interlocking intramedullary nail fixation.
MATERIALS AND METHODS
We reviewed 19 cases of aseptic nonunion of femur shaft fracture in 174 patients after interlocking IM nailing from March 1999 to February 2004 and followed up for more than one year. First we investigated the factors causing nonunion. For operative options, two methods about exchange nailing and exchange nailing with bone graft were performed. Finally clinical results were analyzed with bone union rate by treatment methods and compared with the nonunion factors statistically.
RESULTS
According to the causes and types of nonunion, we performed larger IM nail change in 10 cases and IM nail change with bone graft in 9 cases. Bone union was achieved in all cases. Average bone union period were 18.5 weeks in exchange group and 16.1 weeks in exchange with bone graft group. There are significant difference between treatment methods statistically (p<0.05). Compared with the nonunion factors, initial open fracture and smoking groups showed late union rate statistically.
CONCLUSION
Based on our analysis, IM nail change is a useful method for nonunion after initial IM nailing in femoral shaft fracture, and additional bone graft that according to the radiologic pattern and stability, especially the fracture gap is also a useful option for nonunion treatment.

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Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing
Suenghwan Jo, Gwang Chul Lee, Sang Hong Lee, Jun Young Lee, Dong Hwi Kim, Sung Hae Park, Young Min Cho
Journal of the Korean Fracture Society.2019; 32(2): 83. CrossRef
Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef
Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture
Sang Ho Ha, Jun Young Lee, Sang Hong Lee, Sung Hwan Jo, Jae Cheul Yu
Journal of the Korean Fracture Society.2009; 22(4): 225. CrossRef

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