Journal of Musculoskeletal Trauma

The Angular Deformity of Interlocking Nailing in Tibial Fractures: Hwa Jae Jeong, Kyung Chul Kim, Jae Yeul Choi, Bon Seop Koo, Jung Hee Oh; J Korean Soc Fract 2000;13(4):905-911. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.905

Abstract PDF: PURPOSE
We studied the relationship between angular deformity and possibly contributing factors in the treatment of tibial fractures with interlocking nailing.
MATERIALS AND METHODS
Intramedullary nailing of the tibia was performed on 49 cases and were followed for the minimum of 12 months. We analyzed relationship between angular deformity and postoperative tibial alignment, operative technique and other factors.
RESULTS
Of the 49 cases, 19(38%) were angulated. Angular deformity was seen in 60%, 51.8% and 11.8% in the proximal, distal and middle third of tibial fractures respectively. With AO classification, Group A,B,C were angulated in 32.4%, 55.6%, 66.7%. In group A, 43.8% of spiral fractures, 28.6% of oblique fractures and 14.3% of transverse fractures were angulated. The cases combined with fibular fracture showed higher incidence of angular deformity than the cases with intact fibula. The opening of fracture and the nail insertion site were not significant to angular deformity.
CONCLUSION
Angular deformity of interlocking nailing in tibial fractures were more common in proximal, comminuted and spiral fractures. Precise attentions to operative technique i. e. accurate anatomical reduction and centromedullary nail orientation are recommended to prevent angular deformity. In proximal third tibial shaft fractures where muscles and patellar tendon has deforming force on fracture fragment, authors believe that use of interlocking nailing must be limited with fracture pattern.

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Remodelling of Angular DeforMity after Femoral Shaft Fractures in Children: Young Bae Pyo, Sang Ho Ha, Hong Moon Sohn; J Korean Soc Fract 1998;11(1):116-122. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.116

Abstract PDF: The common sequelae after femoral shaft fractures in children are leg-length discrepancy, angular deformity and rotational deformity. Overgrowth after the conservative management of fractures has been clearly defined, and it has been reported that rotational deformities can remodel. The importance of angular deformity after fracture is less clear although it has been reported as many as 40% of cases. So, authors reviewed 15 children (16 cases) with unilaterral femoral shaft fractures who had more than 10 degrees angular deformity after conservative treatment and observed the remodelling of deformity both at the fracture site and the physes. after average follow up of 34 months, the results were as follows 1. The average correction was 84% of the initial angular deformity; the physes contributed more than the fracture site. 2. The anterior angulation remodelled better than the varus angulation. 3. Younger children remodelled better and the magnitude of the angulation influenced the degree of remodelling.

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Supracondylar Closing Wedge Osteotomy for Posttraumatic Angular Deformity of Distal Humerus: Methods for Reducing Secondary Deformity: Sung Soo Kim, Sung Keun Sohn, Chul Hong Kim; J Korean Soc Fract 1996;9(3):706-714. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.706

Abstract PDF: The angular deformity of distal humerus is one of the most frequent complication of supracondylar fracture in growing children. The deformity rarely limits function, but corrected by patients request due to cosmetic problem. Many orthopedic surgeons have suggested various operation methods but with high incidence of complications related to these operations, also we often experience secondary deformity after inaccurate osteotomy. Therefore to identify desirable operative method to reduce secondary deformity, a retrospective study of 17 patients operated with angular deformity following distal humerus fracture was carried out in which replanning with isosceles triangle method was done in all cases. The following results were obtained. 1. The complications were two cases of metal failure and one of non union. 2. The basic requirement of closing wedge osteotomy without secondary deformity was that:the center line of isosceles triangle whose apex angle should be identical to the deformity angle and be placed on the concave apex of deformity, should overlap the transverse bisector of hurnerusforearm axes. In inevitable cases, the disparity should be minimized to alleviate secondary deformity. 3. The translation was calculated by the equation of T=Dxsin Î±(T:translation, D:proximal or distal migration of the point of contact of humerus-forearm axes, Î±:angle of the deformity). In conclusion, we think that the deformity may be corrected safely and easily using minute preoperative planning with application of above principle.

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Application of the Ilizarow technique to the complications of tibial open fracture report of two cases: Eun Kyoo Song, Ju Chull Jeung, Sung Man Rowe, Hyung Soon Kim; J Korean Soc Fract 1991;4(2):332-339. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.332

Abstract PDF: No abstract available.

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