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The Operative Treatment of Nonunions of Midshaft Clavicular Fractures: Reconstruction Plate Fixation and Bone Grafting
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Young Soo Byun, Chan Hoon Yoo, Hyug Su An, Seong Gun Moon, Dong Ju Shin, Jun Woo Park
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J Korean Soc Fract 2003;16(2):222-229. Published online April 30, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.2.222
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 Abstract
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- PURPOSE
The purpose of this study is to present our experience with open reduction, 3.5-mm reconstruction plate fixation, bone-grafting, and postoperative early mobilization for nonunions of midshaft clavicular fractures.
MATERIALS AND METHODS
Sixteen patients were treated operatively for nonunions of the midshaft of the clavicle from 1997 to 2001. Ten nonunions were atrophic and six were hypertrophic. Nonunion had been present for an average of 6.5 months. The operative technique included removing the fibrous tissue from the nonunion site and opening the medullary canal, reduction of the fracture and fixation with a 3.5-mm reconstruction plate, and bone-grafting. Postoperative mobilization started within one week.
RESULTS
The average duration of follow-up was 22.0 months. All fractures were united in an average of 10.0 weeks. All patients had full range of motion of the ipsilateral shoulder, but 3 out of 6 patients who were more than 50 years old complained occasional pain in the ipsilateral shoulder at the final follow-up examination. There were no major complications of postoperative infection, metal failure of the plate, loss of fixation, nonunion, and refracture after removal of the implant.
CONCLUSION
The technique of open reduction, reconstruction plate fixation, and bone-grafting is a safe and reliable method to allow early rehabilitation by stable fixation and to predict a high rate of union for nonunions of midshaft clavicular fractures.
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Treatment of Trochanteric Fractures of the Femur with Compression Hip Screw-Analysis of Factors associated with Failure of Fixation-
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Chan Hoon Yoo, Hong Tae Kim, Young Soo Byun, Jun Mo Nam, Young Ho Cho, Seong Gun Moon
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J Korean Soc Fract 2002;15(3):312-319. Published online July 31, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.3.312
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Abstract
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- PURPOSE
This study was performed to analyze the significant factors that may affect failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.
MATERIALS AND METHODS
From May 1995 to July 2000, the authors analyzed 97 cases of trochanteric fracture of the femur treated with the compression hip screw and followed more than one year. We classified the fracture type by Jensen 's method. We used Singh index for the degree of osteoporosis. In the post-operative radiograph, we checked neck-shaft angle, state of reduction, position of the lag screw within the femoral head, tip-apex distance, and sliding distance of the lag screw. The relationship between these factors and failure of fixation was statistically analyzed.
RESULTS
There were 17 cases (17.5%) of failure of fixation ; 15 cases (15.4%) of excessive sliding of the lag screw, 1 case (1%) of cutting out of the lag screw, and 1 case (1%) of valgus malunion. There were significant relationships between failure of fixation and old age over 80, unstable fracture, telescoping reduction, anterior or medial displacement of the distal fragment, and anterior placement of the lag screw within the femoral head.
CONCLUSION
Accurate reduction and avoidance of the placement of the lag screw in the anterior part of the femoral head were important factors to prevent failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.
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