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Treatment of Tibial Shaft Fracture with Butterfly Fragment using Interlocking Intramedullary Nailing
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Chong Il Yoo, Jeung Tak Suh, Tae Wook Nam
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J Korean Soc Fract 1999;12(4):894-900. Published online October 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.4.894
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 Abstract
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- PURPOSE
: We evaluated the result of tibial fracture with butterfly fragment treated with interlocking intramedullary nailing and union of butterfly fragment.
Material and Method : The thirty tibial fractures with butterfly fragment treated with interlocking intramedullary nailing from 1994 February to 1997 January were followed up more than 12 months. They were clastified by Henleys classification based on the size of fragment and Johner and Wruhs classification cased on the comnlinution and accident mechanism. We evaluated the bone union of tibial fracture and butterfly fragment itself.
RESULTS
The time for bone union was Bl-14.5, B2-16.2, B3-18.8 weeks and Type I-15.2, Type II-17.1 Type III-18.3 weeks. In proximal and distal part of butterfly fragment, the time for bone union was 8.6 and 7.2 weeks in type I, 10.5 and 9.3 weeks in type II, and 11.8 and 10.2 weeks in type III. As the displacement of fragment were classified into 0-5, 5-10, and more than 10mm, the time for bone union was 15.3, 15.0 weeks in type I(no case in more than 10mm), 16.4, 17.5, 18.2 weeks in type II, and 17.7, 18.4, 20.3 weeks in type III.
CONCLUSION
: As the size and comminution of butterfly fragment increased, bony union was delayed. The union of spiral fracture in distal tibia was earlier than others, unrelated to the size of butterfly fragment. For the union of butterfly fragment, the distal part had earlier union than the proximal part. As the displacement of fragment was increased bone union was delayed.
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Ilizarov External Fixation for Severe Open Tibial Shaft fractures in Adults
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Jeung Tak Suh, Tae Wook Nam, Chong Il Yoo
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J Korean Soc Fract 1999;12(3):549-556. Published online July 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.3.549
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Abstract
PDF
- PURPOSE
It is to evaluate and discuss the result of severe open tibial shaft fractures treated by Ilizarov external fixation.
MATERIALS and METHODS
From the January 1992 to July 1997, 34 cases of severe open tibial shaft fracture in adults were treated with Ilizarov external fixator. 20 males and 14 females were followed for at least 1 year.
RESULTS
Fractures were evenly distributed through proximal 1/3 to distal 1/3 and its pattern was mostly comminuted one. According to Gustilo-Anderson classification, it mainly consisted of type IIIa &IIIb(28 cases: 82%). Mean bony union time was 40.2 months. There were 5 cases(15%) of delayed union, 2 cases(6%) of nonunion, 5 cases(15%) of deep infection including 3 cases(9%) of osteomyelitis, 10 cases(29%) of pin tract infection, 4 cases(12%) of malunion and 11 cases(32%) of ankle stiffness.
CONCLUSION
Conclusively, in the first place, for the successful treatment with Ilizarov external fixator, determining appropriate indications is the most important. Secondly, active reconstruction of soft tissue environment and early prophylactic bone graft, if necessary, are also essential to shorten union time. Thirdly, meticulous care of pin site and ankle motion is needed for the prevention of the two most common complications even though they are considered to be minor.
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