Journal of Musculoskeletal Trauma

A Skeletal Traction on the Radiolucent Table in Closed Intramedullary nailing of Femoral Fracture: Eun Woo Lee, Han Jun Lee, Kee Hyun Lee, Ho Sun Jin; J Korean Fract Soc 2005;18(3):244-249. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.244

Abstract PDF: PURPOSE
To evaluate the clinical results of femoral shaft fracture treated by Intramedullary (IM) nailing through skeletal traction compared with manual traction on a radiolucent table.
MATERIALS AND METHODS
Thirty cases with femoral shaft fracture treated with closed IM nailing from January 2000 to June 2002 were divided into two groups; fifteen fractures reduced by manual traction (Group A) and fifteen fractures reduced by skeletal traction (Group B) on a radiolucent table. The number of people participated in the operations, operation and radiation exposure time, and post-operative complications were evaluated.
RESULTS
The number of people participated in the operations was five in Group A and four in Group B. The average operation time was 116 minutes and 82 minutes (p<0.001). The radiation exposure time was 2.8 minutes and 1.2 minutes (p<0.001). However, there was no significant difference in the post-operative complications such as shortening or lengthening of bone between two groups.
CONCLUSION
There was no significant difference in the operative outcome between two groups. However, skeletal traction has positive effects of reducing the operation time, radiation exposure time, and number of people participating in the operations. Also, regarding the consistent traction power, skeletal traction is the better treatment modality in maintaining the alignment and length of femoral bone than manual traction.

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Modified Tension Band Technique With Looped Pin: Eun Woo Lee, Han Jun Lee, Tae Ho Kim; J Korean Fract Soc 2005;18(1):48-53. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.48

PURPOSE
Fixation of fracture using modified tension band is a very useful treatment method, but loss of fixation caused by loosening of K-wires still remain problem. So we have studied the usefulness of modified tension band with looped pin in order to prevent loss of internal fixation.
MATERIALS AND METHODS
From September 1999 to June 2002, we had treated 40 patients with this technique, including 16 patella, 8 olecranon, 8 distal clavicle fractures in which three were nonunion fractures, 5 ankle fractures and 3 acromioclavicular joint separations. We looped the pin which has been used for ring external fixator, in line with its long axis.
RESULTS
After mean postoperative follow-up of 20 months, there were no loosening of looped pin in all cases and we obtained satisfactory results of functional evaluation. There were no complications of nonunion or metallic irritation.
CONCLUSION
We concluded that modified tension band with looped pin could prevent displacement of internal fixation, and reduce the subsequent complications. Especially in elbow and shoulder joint that the displacement of fixation pin occured frequently, It was considered as very useful operative technique.

Citations

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Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins
Kyung-Hag Lee, Yohan Lee, Young Ho Lee, Bong Wan Cho, Min Bom Kim, Goo Hyun Baek
Journal of Orthopaedic Surgery.2019;[Epub] CrossRef
Nanostructured ATO Anodes Produced by RF Magnetron Sputtering for Li-Ion Batteries
O. Cevher, U. Tocoglu, H. Akbulut
Acta Physica Polonica A.2015; 127(4): 1065. CrossRef

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Anatomical Assessment of the Proper Insertion Site for a Tibial Nailing: Soo Yong Kang, Eun Woo Lee, Ki Ser Kang, Han Jun Lee, Ho Joong Jung, Pyeong Ho Jeong; J Korean Fract Soc 2004;17(2):142-147. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.142

Abstract PDF

PURPOSE
To investigate the proper insertion site for a tibial intramedullary nail in the Korean.
MATERIALS AND METHODS
Forty volunteers without trauma below knee joint were studied to determine relationship between central axis of medullary canal and lateral tibial spine, patellar tendon and the proper insertion site, and to evaluation changes of proper insertion site during rotation of knee and effective diameter.
RESULTS
The proper insertion site located average 4.3+/-0.9 mm medial to the lateral tibial spine. The proper insertion site was in the medial 1/3 of patellar tendon in 6 knees, middle 1/3 of patellar tendon in 20 knees, and lateral 1/3 of patellar tendon in 14 knees. The proper insertion site might be changed two times in internal rotation more than in external rotation. The effective diameter was more narrow in medial slope than in lateral slope at proximal tibia.
CONCLUSION
The study indicates the ideal insertion site of tibial nail is the medial aspect of the lateral tibial spine in Korean. To reduce the mal-reduction from a improper insertion site, lateral insertion site might be safer than medial one. However, individual variations in the relationship between the patellar tendon and tibial medullary canal should be considered.

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Three-dimensional analysis of the intramedullary canal axis of tibia: clinical relevance to tibia intramedullary nailing
Sang Jun Song, B. O. Jeong
Archives of Orthopaedic and Trauma Surgery.2010; 130(7): 903. CrossRef
Three Dimensional Analysis for the Intramedullary Canal Axis of the Proximal Tibia: Clinical Relevance to Total Knee Arthroplasty
Sang Jun Song, Choong Hyeok Choi
The Journal of the Korean Orthopaedic Association.2007; 42(3): 345. CrossRef

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A Prospective Study of Fractures of the Tibial Shaft Treated with Intramedullary Interlocking Nail : Comparing One versus Two Distal Screws: Eun Woo Lee, Ki Ser Kang, Soo Yong Kang, Eui Chan Jang, Jin Woo Lee; J Korean Soc Fract 1997;10(2):303-308. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.303

Abstract PDF: In non-randomized prospective study, 67 tibial fractures were treated with intramedullary inter-locking nail. Patients were divided into 2 groups based on the number of distal locking screw. Group I was consisted of 33 fractures treated with one distal locking screw Group II was consisted of 34 fractures treated with two distal locking screws. The patients were followed up for an average of 12 months. There was no statistically significant difference between group I and II with regard to total operation time, fracture union time. However fluoroscopic time was significantly longer at group II than group I. Serial radiographs of patients in both group were analyzed for change of hardware and fracture healing postoperatively. No significant difference was found between two groups in fracture union time, hardware failure and complications in proximal and middle tibial fracture. But the angulation and locking screw breakage were significant in group I in distal tibia fracture. We concluded that fracture of the proximal and middle third of the tibia that require interlocking nail can be successfully treated with a single distal locking screw. However, in fractures of the distal one third, two distal locking screws should be required to prevent of angular deformity in sagittal plane and for stablefixaton. The use of a single distal locking screw reduces operation time, radiation exposure, local soft tissue discomfort and cost without compromizing fracture union.

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Thirty-five Degree Internal Oblique Radiographs in Assessment of Tibial Fracture Healing: Eun Woo Lee, Ki Ser Kang, Soo Yong Kang, Jin Woo Lee; J Korean Soc Fract 1996;9(2):475-479. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.475

Abstract PDF: For the assessment of fracture healing, tomogram, computerized sonometry, resonant frequency analysis etc. were introduced recently, but most of orthopedic surgeons depend on plain X-ray and clinical experience. The progress of tibial fracture healing may be difficult to assess through routine radiological examination(AP and lateral). So, we intended to assess the healing of tibial fracture with 35Â° internal oblique view as well as AP and lateral. Five orthopedic surgeons assested the tibial fracture heating with only AP and lateral (group 1), and AP. lateral and 35Â° internal oblique view(group 2) in 45 tibial fractures. In the percent agreement of their assessment, Group 1 was 60% and group 2 was 76%. Group 2 was higher than group 1, especially in IM nailing and bone graft groups.The change of judgement between the two group was 18.7%, and it was higher in the distal tibial fracture, posterolateral bone graft and external device groups. In 11 Cases, the fibular fractures were overlapped with tibiai fracture in laterai view, in which cases 35Â° intelnal oblique view was useful for assessing the tibial fracture healing. We recommand 35Â° internal oblique view for assessment of tibial fracture healing before using more tophisticated and expensive procedure, especialiy in patients with posterolateral bone graft, distal libial fracture and combined fibular fracture, and probably in IM nailing and external device.

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External Fixation and Limited Internal Fixation in AO Type C Pilon Fracture: Report of Five Cases: Eun Woo Lee, Soo Yong Kang, Il Seok Kim; J Korean Soc Fract 1995;8(1):243-247. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.243

Abstract PDF: Techniaue of biologic fixation and external fifation are playing an crucial role in the management of the severe comminuted fracture with soft tissue injuries. To evaluate the treatment of severe pilon fracture by a conbination internal and external fixation, five high Pilon fractures with open or severs soft tissue injries were treated by a medial external fixator with an articulated ankle hinge(EBI) and limited internal flxation. Two AO C2 fractures and three AO C3 fractures were followed for a minimum of 1 year. All fractures united and had good functional results without any serious complication. We believe that external fixation and limited internal fixation using biologic principle is an excellent alternative method in high energy, complex fracture with diaphyseal comminution.

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