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Treatment of Comminuted Subtrochanteric Fractures of the Femur by High-Energy Trauma
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Taek Soo Jeon, Woo Sik Kim, Sang Bume Kim, Cheol Mog Hwang, Kyu Tae Kim, Sun Hong Kim
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J Korean Fract Soc 2006;19(2):135-140. Published online April 30, 2006
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DOI: https://doi.org/10.12671/jkfs.2006.19.2.135
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Abstract
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The purpose is to evaluate the effectiveness of open reduction and internal fixation in comminuted subtrochanteric fractures caused by high energy trauma at a non-osteoporotic young age. MATERIALS AND METHODS Of all cases of subtrochanteric fractures caused by high energy trauma under 60 years old from February 2000 to February 2004, we analyzed 16 patients who had severe comminuted fractures (Seinsheimer classification type IV, V). The mean age is 43.5 (31~54) years old. Mean follow-up period was 22 (14~38) months. We tried to reduce anatomically as much as possible and fixed firmly using a compression hip screw in all cases. Additional procedures such as interfragmentary screw fixation, cerclage wiring or lateral stabilization plating were performed in 13 cases. Bone grafting was performed in 8 cases. We evaluated bony union rate, time to union, status of reduction, varus deformity and rate of implant failure using a simple X-ray. We also analyzed the clinical result using the Harris hip score including range of motion, pain and limping gait, so on. RESULTS In all 16 cases, bony union was achieved and the mean time to union was 24 (20~32) weeks. There was no intra-operative complication. Postoperative complications such as loss of reduction, varus deformity, implant failure or infection did not occur. Clinically, the Harris hip score was 98.9 (97~100) points. CONCLUSION Optimal open reduction and firm internal fixation with or without additional fixation was thought to be a recommendable method of treatment for comminuted subtrochanteric fractures of the femur caused by high energy trauma at a young age.
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- Treatment of Subtrochanteric Femur Fractures Using Intramedullary Devices
Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Chong Suk Park, Sang Ho Lee Journal of the Korean Fracture Society.2008; 21(1): 13. CrossRef
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Instability of Knee Associated with Ipsilateral Femoral and Tibial Shaft Fractures
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Whan Yong Chung, Woo Suk Lee, Woo Sik Kim, Yong Chan Kim, Taek Soo Jeon, Sun Hong Kim, Ji Hyuk Lim, Young Su Lim
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J Korean Fract Soc 2005;18(2):136-143. Published online April 30, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.2.136
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Abstract
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To establish the incidence, type and significance of knee instability in patients with ipsilateral femoral and tibial shaft fracture, comparing with the patients with femoral shaft or tibial shaft fracture alone. MATERIALS AND METHODS Two hundreds and seventy-nine consecutive patients were retrospectively reviewed from February 2000 to April 2004. They were composed of 80 patients with femoral shaft fracture alone, 176 patients with tibial shaft fracture alone and 23 patient with ipsilateral femoral and tibial shaft fracture. We evaluate the instability of knee based on physical examinations, plain stress films and MRI. We analyze incidence and period to diagnosis of instability, period to complete bony union and Hospital for Special Surgery (HSS) knee score respectively. RESULTS There were 6.3% of knee instability in femoral shaft fracture alone, 9.7% in tibial shaft fracture alone and 30.4% in ipsilateral femoral and tibial shaft fracture. The average period to diagnosis of instability, average period to complete bony union and average HSS knee score were 9.2 months, 4.7 months and 65 points in femoral shaft fracture alone, 9.1 months, 4.2 months and 69 points in tibial shaft fracture alone, 8.7 months, 5.3 months (femur), 4.7 months (tibia) and 57 points in ipsilateral femoral and tibial shaft fracture respectively. CONCLUSION We should consider MRI to evaluate the knee instability in patient with ipsilateral femoral and tibial shaft fracture at the time of injury and make a plan early about the treatment of knee instability.
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