Journal of Musculoskeletal Trauma

Original Articles

Medullary Canal Widening Effect on Insertion of Tibial Intramedullary Nail bent anteriorly at distal portionJong Min Sohn: Hyung Kwan Kim, Juhae Jahng, Dae Hyun Baek, Nan Kyoung Ha, Hyuk Je Lee; J Korean Soc Fract 2000;13(2):267-271. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.267

Abstract PDF: PURPOSE
: We have studied medullary canal widening effect on anteroposterior plane by intramedullary nails with distal anterior bend in the surgical treatment of tibial fracture and signified the clinical importance of the effect.
MATERIALS AND METHODS
: Ineramedullary tibial nails with distal anterior bend, Russell-Taylor(R)and AIMTMtibial nails were compared and the amount of medullary canal widening was calculated mathematically using the length and angle of distal anterior bend of the nails. the length and angle of distal anterior bend of Russell-Taylor(R)and AIMTMtibial nails were 64mm, 3 and 47.5mm, 5 , respectively.
RESULTS
: The amount of medullary canal widening on anteroposterior plane by Russell-Taylor(R)and AIMTM tibial nails were 2.81mm and 3.26 mm more than the nail diameter, respectively.
CONCLUSION
: On insertion of tibial nails with distal anterior bend, the medullary canal widening effect on anteroposterior plane by the nails should be carefully considered. We think it will be better to insert these nails with unreamed technique or to insery smaller diameter nails after minor reaming and forceful blow should be avoided especially when the nail passes down through the isthmic portion of the tibial diaphysis to prevent the fracture of isthmic portion.

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Pitfalls in Treatment of Lateral Malleolar Frcture with Plate and Screws: Jong Min Sohn, Ju Hae Jahng, Nan Kyung Ha, Dae Hyun Baek, Hyoung Gwan Kim, Bong Heon Hyun; J Korean Soc Fract 1998;11(4):900-905. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.900

The goal in treatment of ankle fracture is the restoration of normal ankle function. Although controversy still exists over the best method of treatment, recent ariticles emphasize importance of the anatomic reduction of fibula and the benefits of early mobilization when adequate fixation is accomplished. When we fix fracture of lateral alleolus with plte and screws, the distal screws should engage the medial cortex of the fibula but not protrude into the talofibular joint. Because the penetration of screws into ankle joint may be the cause of postoperative pain and opst-traumatic arthritis. This article has reviewed a series of 36 ankle fractures, treated from March 1993 to January 1997, using plate and screws. In order to analyse the influence of the penetration of screws into the ankle joint, all fractures were classified according to the penetrating length of screw from medial cortex of lateral malleolus. Thse with the end of the screw protnided more than 2mm into joint were clssified group I, those with less than 2mm groupp II, those with no engagement group III. The results obtained from this study were as follows: 1. According to clinical and radiolgraphic assessment of the results of the treatment, open reduction and internal fixation using plate and screws in treatment of lateral malleous was a satisfactory method. The excellent or good results were achieved in 28 patients among the 36 patients (77.8%). 2. Average time of bony union was not different significally among the three groups. 3. The gain of full range of motion was delayed in group I. 4. Patients of group I complained persistent pain and discomfort more frequently than the other groups. 5. In the treatment of lateral malleolar fracture, the distal screws should engage the medial cortex of fibula to gain firm fixation,but should not protrude more than 2mm into the ankle joint.

Citations

Citations to this article as recorded by

Features of Lateral Malleolar Fractures in Elderly Patients and Clinical Outcome of Locking Compression Plate Fixation
Seok-Min Hwang, Hong-Geun Jung, Hyung-Jin Chung, Joon-Sang Eom, Dong-Oh Lee, Jung-Hyun Cho, Jong-Tae Park
Journal of the Korean Orthopaedic Association.2016; 51(1): 77. CrossRef

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