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Ender nailing For Intertrochanteric Fracture of the Femur in the Elderly patients
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Hak Yeong Jeong, Seung Wook Yang, Seung Joon Shin, Hyeong Joon Seung
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J Korean Soc Fract 1998;11(4):745-753. Published online October 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.4.745
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 Abstract
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- The principle of treatment of intertrochanteric fracture is early operation and early rehabilitation. The morbidity and mortality associated with intertrochanteric fracture are remained high because the elderly patient generally have a reduced tolerance for prolonged bed rest, lengthy operation and blood loss. Since Ender introduced the concepts of multiple flexible intramedullary nailing in 1970, Ender nailing has been mostly used in intertrochanteric fracture of the elderly patient, but it has been rarely used for unstable fracture. The authors analysed 87 cases of intertrochanteric fractures of femur over 60 years old, treated with Ender nailing during period from July, 1998 to October, 1996. The results were as follows : 1. Among 87 cases, 70 cases were female and average age was 75.3 years old. 2. The common complications were knee pain and LOM(10%) and distal migration of nails(3%). 3. These complications were reduced by careful bending of nails, fanning of nails in femoral head, stacking of medullary canal and accurate placement of portal hole. 4. 10 patients died within 1 year(Mortality rate : 11%). 5. Thirty-six(47%) patients maintained their prefracture ambulatory ability at a postoperative 1 year ; Fourty-one(53%) patients lost some degree of ambulatory ability. 6. In unstable intertrochanteric fracture, we can achieved good results by Ender nailing in valgus reduction.
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Fracture-Separation of The Distal Humeral Epiphysis
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Hak Yeong Jeong, Seung Wook Yang, Jae Woong Shim, Seung Joon Shin, Jeong Tae Kim
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J Korean Soc Fract 1998;11(3):650-657. Published online July 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.3.650
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Abstract
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- A fracture-separation of the distal humeral epiphysis in children is an extremely rare injury and presents problems in diagnosis, radiographic interpretation and management. From June 1992 to December 1996, Authors experienced the 5 cases of Salter - Harris type II injury of the distal humeral epiphysis at Department of Orthopedic Surgery, Pusan Maryknoll General Hospital. The patient were followed up from one year nine months to three years four months. The two cases were treated by closed reduction and percutaneous K-wire fixation and the three cases by open reduction and internal fixation with K-wires.
There were 4 cases of complication seldom reported following fracture-separation of the distal humeral epiphysis. This complications consist of 4 dissolutions of trochlea, which is one, frank avascular necrosis of trochlea. In 3 cases with open reduction developed the cubitus varus & dissolution of trochlea. We speculate that this complications results from avascular necrosis of distal end of humerus. Attention to change of carrying angle and radiographic change of distal humeral end are important in detection of complication & evaluation of etiology of dissolution of distal humeral end.
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