Journal of Musculoskeletal Trauma

Repeated Metal Breakage in a Femoral Shaft Fracture with Lateral Bowing: A Case Report: Dong Soo Kim, Yong Min Kim, Eui Sung Choi, Hyun Chul Shon, Kyoung Jin Park, Byung Ki Cho, Ji Kang Park, Hyun Cheol Lee, Kyung Ho Hong; J Korean Fract Soc 2012;25(2):136-141. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.136

Fractures of the femoral shaft with marked bowing face some obstacles in fixation of the fracture such as difficulty in insertion of the intramedullary nail (IM nail) or exact contouring plate. Locking compression plates (LCP) are an option to manage this problem. However, we experienced consecutive breakage of LCP twice and IM nail once in an 80-year-old female. Finally, union of the fracture was achieved after fixation of the IM nail and additional plate together. Fractures of the femur shaft with marked bowing are thought to have different biomechanical properties; therefore, we present this case with a review of the literature.

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Comparative analysis of operation time and intraoperative fluoroscopy time in intramedullary and extramedullary fixation of trochanteric fractures
Milan Mitkovic, Sasa Milenkovic, Ivan Micic, Predrag Stojiljkovic, Igor Kostic, Milorad Mitkovic
Vojnosanitetski pregled.2022; 79(2): 177. CrossRef
Pre-operative planning for fracture fixation using locking plates: device configuration and other considerations
Alisdair R. MacLeod, Pankaj Pankaj
Injury.2018; 49: S12. CrossRef
Letter: Repeated Metal Breakage in a Femoral Shaft Fracture with Lateral Bowing - A Case Report -
Hae Seok Koh
Journal of the Korean Fracture Society.2012; 25(3): 240. CrossRef

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The Fate of Butterfly Fragments in Extremity Shaft Comminuted Fractures Treated with Closed Interlocking Intramedullary Nailing: Ki Chan An, Yoon Jun Kim, Jang Suk Choi, Seung Suk Seo, Hi Chul Gwak, Dae Won Jung, Dong Woo Jeong; J Korean Fract Soc 2012;25(1):46-51. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.46

Abstract PDF

PURPOSE
For conservative treatment of shaft fractures, the butterfly fragments that were somewhat larger in the closed intra-medullary (IM) nailing. The results of treatment were monitored using radiography separately for the weight-bearing femur and non-weight-bearing humerus.
MATERIALS AND METHODS
27 from Group I and 31 from Group II. In the two groups, the displacement and angulation changes in the fragments, and the degree of improvement of these two factors, were compared using follow-up radiography.
RESULTS
The mean angulation of fragments in Groups I and II were 9.2degrees and 9.6degrees, and the mean degree of displacement of the fragments in Groups I and II were 16.7 mm and 21.2 mm, respectively. Follow-up radiography showed that the above factors improved in both groups. The degree of displacement was significantly lower in the normal cases than in the complicated cases (p=0.001).
CONCLUSION
Displacement and angulation gradually improved in both groups. It was found that the degree of displacement after the initial reduction is more important than the influence of anatomical position or weight bearing. This indicates that care should be taken when inserting IM nails to prevent displacement or angulation.

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Risk Factors for Failure of Nonsurgical Management of Ulnar Shaft Fractures
Carew C. Giberson-Chen, Cassandra M. Chruscielski, Dafang Zhang, Philip E. Blazar, Brandon Earp
The Journal of Hand Surgery.2025; 50(4): 497.e1. CrossRef
The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study
Giovanni Vicenti, Massimiliano Carrozzo, Vincenzo Caiaffa, Antonella Abate, Giuseppe Solarino, Davide Bizzoca, Roberto Maddalena, Giulia Colasuonno, Vittorio Nappi, Francesco Rifino, Biagio Moretti
International Orthopaedics.2019; 43(1): 193. CrossRef
Reply to “Letter to the Editor on: The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study”
Giovanni Vicenti, Massimiliano Carrozzo, Davide Bizzoca, Biagio Moretti
International Orthopaedics.2019; 43(6): 1545. CrossRef
Letter to the Editor on “The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study”
Shih-Jie Lin, Kevin Liaw, Tsan-Wen Huang
International Orthopaedics.2019; 43(6): 1543. CrossRef
The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study
Giovanni Vicenti, Massimiliano Carrozzo, Vincenzo Caiaffa, Antonella Abate, Giuseppe Solarino, Davide Bizzoca, Roberto Maddalena, Giulia Colasuonno, Vittorio Nappi, Francesco Rifino, Biagio Moretti
International Orthopaedics.2018;[Epub] CrossRef
Comparison of the Result of the Intramedullary Nail Fixation and Plate Fixation in Humeral Shaft Fracture with Butterfly Fragments
Duk-Hwan Kho, Hyeung-June Kim, Byoung-Min Kim, Hyun-Ryong Hwang
The Korean Journal of Sports Medicine.2016; 34(2): 120. CrossRef
Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn
The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef

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Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent: Kun Bo Park, Hoon Park, Hyun Woo Kim, Hui Wan Park, Jae Young Roh; J Korean Fract Soc 2010;23(2):206-212. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.206

Abstract PDF: PURPOSE
To evaluate the results of interlocking humeral nail for femur shaft fractures through the greater trochanter in older children and adolescent.
MATERIALS AND METHODS
Eleven femoral shaft fractures in ten patients were selected. They were consisted of 9 boys and 1 girl. Two patients had osteogenesis imperfecta and one patient had a simple bone cyst as an underlying disease. 7 cases were right side and 4 cases were left side. The mean age at the time of operation was 12 years and 7 months (8 years 11 months~15 years 7 months). The mean follow-up period was 21 months and interlocking humeral nail was inserted at the greater trochanter in all patients.
RESULTS
All patients had a complete bony union without any complication such as infection, nonunion, leg length discrepancy and metal failure. Avascular necrosis of femoral head and coxa valga were not developed in all patients.
CONCLUSION
Intramedullary nailing through the greater trochanter using interlocking humeral nail is effective and safe treatment for the femoral shaft fracture in older children and adolescents.

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The Treatment of IM Nailing of Femoral Shaft Fracture: Piriformis Fossa versus Trochanteric Entry Portal: Hyun Kook Youn, Oog Jin Shon, Dong Sung Han; J Korean Fract Soc 2008;21(3):200-206. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.200

Abstract PDF: PURPOSE
To compare the results of IM nailing of femur shaft fractures using trochanteric and piriformis fossa entry portal.
MATERIALS AND METHODS
37 patients were treated with IM nail using Trochanteric (Trochanter group: TG, n=17) and piriformis fossa entry portal (piriformis group: PG, n=20) and were followed from February 2004 to 2007. The outcomes were assessed based on the clinical and radiographic findings.
RESULTS
The functional result, ROM and union time were similar in both groups. The alignment was similar in both groups but PG showed variable alignment in proximal 1/3. Incision was larger in PG (PG=8.7 cm, TG=5.8 cm, p<0.05) and there was a difference between overweight and normal weight group. Operative time was 95 minutes in PG, 87 minutes in TG (p>0.05), there was statistically significant difference in overweight groups (PG=125 minutes, TG=90 minutes, p<0.05). Blood loss was 313 cc in PG, 268 cc in TG and less in TG in overweight patients (p<0.05). There was 5.7degrees of varus angulation in PG, 2 nonunion cases in both groups.
CONCLUSION
The femoral nail specially designed for trochanteric insertion resulted in high union rates, low complication rates similar to conventional nail and the trochanteric nail can be the alternative choice especially in proximal femur fracture and overweight patients.

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The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation: Se Dong Kim, Oog Jin Sohn, Byung Hoon Kwack; J Korean Fract Soc 2008;21(2):117-123. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.117

Abstract PDF

PURPOSE
The purpose of this study was to evaluate the efficacy of the surgical treatment through the comparison of LC-DCP (Limited Contact-Dynamic Compression Plate) versus LCP (Locking Compression Plate) fixation in the plate augmentation for the nonunion of femur shaft fractures after intramedullary nail fixation.
MATERIALS AND METHODS
Twenty-four patients with the nonunion of femur shaft fractures after intramedullary nail fixation who underwent plate augmentation were evaluated from Mar. 2001 to Sept. 2005. The group with LC-DCP augmentation was done bicortical screw fixation and the group with LCP was done monocortical fixation.
RESULTS
There was one case of nail breakage in LC-DCP group, but sound bony union were achieved uneventfully in all the cases of both group. LCP fixation was slightly superior to LC-DCP fixation in view of the bony union time, operating time, postoperative Hb down, amount of postoperative transfusion, but there was no statistical difference (p>0.05). CONCLUSION: We got the satisfactory results after monocortical LCP augmentation as well as bicortical LC-DCP fixation and have concluded that monocortical LCP fixation was an effective treatment option for nonunion of femur shaft fracture occurred after Intrmedullary nail fixation.

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Delayed Union and Nonunion: Current Concepts, Prevention, and Correction: A Review
Kristin M. Bowers, David E. Anderson
Bioengineering.2024; 11(6): 525. CrossRef
RETRACTED ARTICLE: An experimental study on stress-shielding effects of locked compression plates in fixing intact dog femur
Xinwen Zhao, Wensen Jing, Zhe Yun, Xun Tong, Zhao Li, Jiajia Yu, Yaohui Zhang, Yabin Zhang, Zhixue Wang, Yanhua Wen, Heping Cai, Jun Wang, Baoan Ma, Haien Zhao
Journal of Orthopaedic Surgery and Research.2021;[Epub] CrossRef
The Treatment of IM Nailing of Femoral Shaft Fracture: Piriformis Fossa versus Trochanteric Entry Portal
Hyun Kook Youn, Oog Jin Shon, Dong Sung Han
Journal of the Korean Fracture Society.2008; 21(3): 200. CrossRef

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Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing: Sung Soo Kim, Sung Keun Sohn, Chul Hong Kim, Myung Jin Lee, Lih Wang; J Korean Fract Soc 2007;20(2):141-148. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.141

Abstract PDF

PURPOSE
To analyze the causes and the clinical results of treatment for the nonunion of femur shaft fractures that occurred after interlocking intramedullary nail fixation.
MATERIALS AND METHODS
We reviewed 19 cases of aseptic nonunion of femur shaft fracture in 174 patients after interlocking IM nailing from March 1999 to February 2004 and followed up for more than one year. First we investigated the factors causing nonunion. For operative options, two methods about exchange nailing and exchange nailing with bone graft were performed. Finally clinical results were analyzed with bone union rate by treatment methods and compared with the nonunion factors statistically.
RESULTS
According to the causes and types of nonunion, we performed larger IM nail change in 10 cases and IM nail change with bone graft in 9 cases. Bone union was achieved in all cases. Average bone union period were 18.5 weeks in exchange group and 16.1 weeks in exchange with bone graft group. There are significant difference between treatment methods statistically (p<0.05). Compared with the nonunion factors, initial open fracture and smoking groups showed late union rate statistically.
CONCLUSION
Based on our analysis, IM nail change is a useful method for nonunion after initial IM nailing in femoral shaft fracture, and additional bone graft that according to the radiologic pattern and stability, especially the fracture gap is also a useful option for nonunion treatment.

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Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing
Suenghwan Jo, Gwang Chul Lee, Sang Hong Lee, Jun Young Lee, Dong Hwi Kim, Sung Hae Park, Young Min Cho
Journal of the Korean Fracture Society.2019; 32(2): 83. CrossRef
Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef
Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture
Sang Ho Ha, Jun Young Lee, Sang Hong Lee, Sung Hwan Jo, Jae Cheul Yu
Journal of the Korean Fracture Society.2009; 22(4): 225. CrossRef

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The Incidence of Infection in Interlocking Intramedullary Nailing after Skeletal Traction of Distal Femur: Hyuk Woo Nam, Seung Woo Suh, Hae Reong Song, Jun Gyu Moon, Jun Ho Wang, Chan Eung Park, Jae Hyuk Yang; J Korean Fract Soc 2005;18(1):12-16. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.12

Abstract PDF

PURPOSE
The insertion site of K-wire for skeletal traction is proximal part of tibia or distal part of femur. However, people prefer proximal tibia over distal femur due to lower risk of infection rate when change to interlocking IM nailing is needed. We evaluated the infection rate of interlocking IM nailing.
MATERIALS AND METHODS
Fourty-seven patients were included in this study who underwent interlocking IM nailing due to femur shaft fracture. Traction was applied at the distal femur in 19 cases and proximal tibia in 10 cases before interlocking IM nailing. No skeletal traction was applied to the remaining 18 cases. Thirty-eight patients were male and 9 were female. The average age at the time of surgery was 36.7 years old (range, 15~17 years). The average traction period was 9.5 days (range, 3~33 days) and the average followed-up period was 17.2 months.
RESULTS
In the distal femoral traction group, 8 cases of superficial pin tract infection developed, but no case of deep infection such as osteomyelitis occurred. In the proximal tibia traction group, 2 cases of superficial pin tract infection developed, but no case of deep infection occurred. In the group that received no skeletal traction before interlocking IM nailing, no case of infection developed.
CONCLUSION
In femur shaft fracture, the distal femoral skeletal traction followed by interlocking IM nailing of femur, compared to proximal tibia skeletal traction, did not increase the risk of deep infection such as osteomyelitis.

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Rectus femoris muscle atrophy and recovery caused by preoperative pretibial traction in femoral shaft fractures-comparison between traction period
D.-G. Shim, T.-Y. Kwon, K.-B. Lee
Orthopaedics & Traumatology: Surgery & Research.2017; 103(5): 691. CrossRef

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Treatment of the Nonunion of Femur Shaft Fractures after Interlocking Intramedullary Nailing: Keun Bae Lee, Eun Sun Moon, Eun Kyoo Song, Jin Choi, Sung Taek Jung; J Korean Soc Fract 2002;15(4):497-503. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.497

Abstract PDF

PURPOSE
We analyzed the results of treatment for the nonunion of femur shaft fractures after interlocking intramedullary(IM) nail fixation. MATERIALS & METHODS: Thirty-three patients who underwent interlocking IM nailing due to femur shaft fractures from May, 1990 to July, 2000 and followed up for more than one year were evaluated retrospectively. Mean age at the time of operation was 40 years(Range, 19-68). 27 cases were men and 6 cases were women. By Weber and Brunner classification of the nonunion, hypervascular type were 10 cases(30%), avascular type 21cases(64%), mixed type 2 cases(6%). Infected type among the avascular type of nonunion were 5 cases(23%). Results were evaluated with bone union by treatment methods and complications.
RESULTS
According to the causes and types of nonunion, we performed IM nail exchange in seven cases, IM nail exchange and bone grafting in eleven cases, external fixation in five cases, compression plating and bone grafting in three cases, and only cancellous bone grafting in seven cases. Radiographical union was achieved in 19 weeks, 17 weeks, 20 weeks, 16 weeks and 15 weeks respectively. There 's no statistically significant difference between treatment methods. There are no cases of nonunion, malunion and infection.
CONCLUSION
The selection of appropriate treatment method by the cause and type of each nonunion is very important to achieve the bony union in the treatment for the nonunion of femur shaft fractures after interlocking intramedullary nailing.

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Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing
Suenghwan Jo, Gwang Chul Lee, Sang Hong Lee, Jun Young Lee, Dong Hwi Kim, Sung Hae Park, Young Min Cho
Journal of the Korean Fracture Society.2019; 32(2): 83. CrossRef

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Long Term Results of Retrograde Nailing in Adult Femoral Shaft Fractures: Yerl Bo Sung, Soo Chul Park, Jong Kuk Ahn, Jae Kwang Yum, Hyung Jin Chung, Jin Ho Kim, Seung Taek Song, Yong Taek Han; J Korean Soc Fract 2002;15(3):356-362. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.356

Abstract PDF

PURPOSE
Antegrade intramedullary nailing of the femur is effective method of treatment for patients with femoral shaft fractures. But retrograde IM nailing is another effective method, especially in femoral shaft fractures concomitant with ipsilateral femoral neck, intertrochanteric fractures, acetabular fracture, multiple fracture and obesity, pregnancy, traumatic arthrotomy of the knee joint, bilateral femur fractures, and floating knee injuries are also indicated. The purpose of this study is to verify the effectiveness of retrograde IM nailing after long-term follow-up by retrospective evaluation.
MATERIALS AND METHODS
A retrospective review of the medical charts and X-rays about 37 patients who were operated by retrograde nailing and all patients were minimally followed up about 2 years. Results were evaluated radiologically for screw breakage, nail migration, nonunion and clinically for knee ROM limitation, infection.
RESULTS
The results were as follows; 1) union was achieved at on average of 17 weeks. 2) Full range of knee motion was gained in 33/37 cases. Knee-stiffness occurred in 4 cases, Severity of initial trauma might affect such results but not, retrograde nailing 3) 2 complications were found nonunion and delayed union. 4) There were not postoperative infection and femoral shortening. There were distal screw breakage in 4 cases but, the others were not migrated.
CONCLUSION
Retrograde IM nailing of femoral fracture is an effective method in selected cases such as ipsilateral femoral neck fractures, floating knees, post-TKRA femoral fracture and so on. If retrograde IM nailing is operated by skillful surgeon and appled to absolute indication, the result is no significant difference of antegrade IM nail such as bone union, nonunion and postoperative infection. Nevertheless, operation time is shorter and blood loss lesser. Significant knee problems related to this technique could not be identified for 2 years followed up.

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Factors Affecting the Period of Bone Union When Treating Femoral Fractures with a Retrograde Intramedullary Nail
Bum-Soo Kim, Seong-Tae Kim, Seungyup Shin, Seong Man Jeon
Journal of the Korean Orthopaedic Association.2021; 56(4): 326. CrossRef
Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef

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Treatment of femoral diaphyseal fractures in children: Comparison between conservative treatment and retrograde flexible intramedullary nailing: Chang Wug Oh, Byung Chul Park, Joo Chul Ihn, Hyung Tae Soh, Seung Hoon Baek; J Korean Soc Fract 2002;15(2):292-298. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.292

Abstract PDF: PURPOSE
To compare clinical outcomes and complications between pediatric patients with femoral shaft fracture who had undergone conservative treatment and retrograde flexible intramedullary nailing.
MATERIALS AND METHODS
51 cases of 46 pediatric patients who had femoral shaft fracture were retrospectively studied. Hip spica cast was applied 3~6 weeks after traction in 24 cases of conservative treatment group and closed reduction and internal fixation with flexible nails were performed in 27 cases.
RESULT
Neither pain, limitation of joint motion, nor nonunion was reported in both groups. In radiologic evaluation, 4 cases of angulation more than 10 degrees were observed in conservative treatment group and none of surgical treatment group. In leg length discrepancy(LLD) over 10 mm, there was none in surgical treatment group, but 4 cases were seen in the conservative group. Two cases of limping were observed only in the conservative group. Mean time to weight bearing was earlier in surgical treatment group(7.5 weeks) than that in the conservative group(10.8 weeks).
CONCLUSION
As treatment of pediatric femoral shaft fracture, retrograde flexible intramedullary nailing had less complications such as LLD and angulation and enabled earlier rehabilitation than conservative treatment.

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The Efficacy of Dynamization of Static Interlocking Intramedullary Nailing as A Trial Leading to Bony Union of Femur Shaft Fracture: Byung Soon Kim, Duck Yeon Cho, Hyung Ku Yoon, Soo Hong Han, Jin Yong Kim, Yong Wook Kim; J Korean Soc Fract 2002;15(2):138-145. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.138

Abstract PDF: PURPOSE
To evaluate the efficacy of dynamization of static interlocking intramedullary nailing as a trial leading to bony union of femur shaft fracture, delayed union of femur shaft fracture underwent dynamization were investigated. MATERIALS & METHODS: Between april 1995 and December 2000, 162 patients were treated static interlocking intramedullary nailing, 14 patients were selected who had underwent dynamization. The average age was 39 years old (range 24 to 61), they were 11 men and 3 women. The type of fractures were two communited, seven segmental and five simple fractures. Dynamization were done by removal of proximal or distal interlocking screw. We defined complete bony union as radiological and clinical bony union. Also we measured leg length discrepancy and angulation by radiologic parameters.
RESULTS
Of the 14 patients who showed delayed union, 7 patients were noted successful bony union by dynamization, and of the 7 patients who failed union by dynamization, 6 patients were noted bony union by supportive operative treatments(bone graft : 4 patients, nail exchanging : 1 patient, both method 1 patient). One patient was seen nonunion state because of patient's refusal of treatment. 7 patients who were noted successful bony union by dynamization had 2 degrees~6 degrees(average 4.14 degrees) varus-valgus angulation and 4 degrees~9 degrees(average 6 degrees) AP angulation, and 3 of the 7 patients showed leg length discrepancy(LLD) greater than 2 cm. The other 7 patients had 2 degrees~5 degrees(average 3.57 degrees) varus-valgus angulation and 3 degrees~7 degrees(average 5 degrees) AP angulation, and 2 of the 7 patients showed LLD greater than 2cm. Of the 14 patients, 5 patients showed limping.
CONCLUSION
Dynamization of intramedullary nainling is a simple and valuable method for improving bony union of femur shaft fracture in the case of delayed union. But if the delayed unions are seen due to large bone defect, supportive operative treatments (bone graft, nail exchanging etc.) to avoid significant complica-tion(shortening and angulation) is needed.

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Surgical Treatment for Nonunion of Femoral Shaft Fractures: Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Young Bae Kim, Jong Ro Yoon, Eui Sang Seol, Kwang Yeol Park, Dae Woong Kang; J Korean Soc Fract 2001;14(3):364-370. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.364

Abstract PDF: PURPOSE
The purpose of this study is to analyze the clinical and radiological result of surgical treatment for femoral shaft nonunion.
MATERIALS AND METHODS
From January 1993 to December 1999, 21 cases of femoral shaft nonunion were treated surgically and followed for an average of 15 months. We analyzed initial cause of injuries, classification of fractures, and cause of nonunion in clinically and radiologically. The authors analyzed the average time to union and results after surgical treatment by rigid internal fixation with interlocking intramedullary nail and autogenous bone graft.
RESULTS
The mean duration of bony union was 22 weeks and bony union achieved in 18 cases(85.7%) of 21 cases. The complications were shortening of leg length and limping gait in 2 cases, partial limitation of knee joint in 2 cases, superficial infection in 2 cases.
CONCLUSION
Rigid internal fixation with interlocking intrameduallary nail and bone graft is useful method of treatment for femoral shaft nonunion according to cause and type of nonunion.

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Treatment of the Femoral Shaft FracturesUsing Unreamed Interlocking Intramedullary Nail: Chang Wook Oh, Joo Chul Ihn, Poong Taek Kim, Shin Yoon Kim, Hee Soo Kyung, Chung Hyun Lee; J Korean Soc Fract 2000;13(4):832-836. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.832

Abstract PDF: PURPOSE
To evaluate the usefulness of unreamed nailing inthe treatment of femoral shaft fractures.
MATERIALS AND METHODS
Between March 1996 and June 1998, unreamed nailing with closed method was done for 74 patients with 82 femoral shaft fractures. The main indications for this treatment were multiple injury or isolated femoral fracture above Winquist type II. The influence of Winquist- Hansen classification, anatomical location, and open injury over bone union and the influence of injury severity score over general complication including fat embolism were investigated.
RESULTS
Primary union occurred in 76 cases(93%) with 6 cases of nonunion and 10(12%) of delayed union, and mean time to union was 27 weeks. In open fractures, the union time was delayed(32 weeks) rather than closed fracture. In Winquist classification, there was no stastical importance on time to union, but nonunion was most common in Winquist type IV. Anatomical location has no influence on time to union. In the view point of multiple injury, the group above 18 points(31 patients) in injury severity score had none of fat embolism, but the group below 18 points(43 patients) had 2 patients.
CONCLUSION
The treatment of femoral shaft fractures by unreamed nailing had longer time to union with higher rate of delayed union, and we think that the theoretical advantage of decreasing pulmonary complications is controversial.

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Metal failure after compression plate fixation in femoral shaft fracture: Sung Ho Han, Bo Kyu Yang, Chi Hong Kim, Tae Won Ahn, Dong Hyun Kim; J Korean Soc Fract 1998;11(4):732-737. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.732

Abstract PDF: Intramedullary nailing is one of the most available method in the treatment of femoral shaft fracture. Recemtly compression plate is not widly used. Inapproriate technique using compression plate lead to metal failure. The purpose of this study is to analyz the clinical feature, cause and treatment of metal ailure in femoral shaft fracture. We analyzed 6 cases of metal failure from Jan. 1990. to Dec. 1996 and obtained the following results. 1. Type of fracture were Winquist-Hansen Type I in 1 case, Type-II 3 cases, Type III 2 cases. 2. The interval between initial poeration and metal failure was 11 months on average, ranging from one to twenty months. 3. Metal failure occurred as plate breakage in 4 cases, plate bending and loosening in 2 cases. 4. Cause of metal failure after compression plate fixation presumed to be comminuted fracture in 5 cases, early weight bearing in 3 cases, remaining bone defect in 4 cases, inadequate surgical technique in 4 cases and empty plate hole in 4 cases. 5. Treatment of metal failure after compression plate fixation were intramedullary nailing with bone graft in all cases. Accturate preoperative evaluation of fracture site, fracture pattern, and appropiate selection of metal device necessary for the prevention of metal failure.

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Spontaneous Correction of Angular Deformity after femoral Shaft Fracture in children: Eu Sub Chung, Jong Bone Lee, Boyung Ho Lee; J Korean Soc Fract 1998;11(3):644-649. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.644

Abstract PDF

Remodeling of long bones in children after posttraumatic deformity was accomplished by two distinctive mechanisms that axially oriented compression forces will slow physeal growth and simillarly oriented tensile forces tend to enhance physeal growth, which occur at the fracture site and physis. We reviewed 17 childrens with unilateral fractures of femoral shaft who had an angular deformity after union of 10degreewere selected and measured by C-T scans. The average correction rate was 84.9% of the initial deformity and was no relation between the remodeling rate and degree of malunion. The correction of angulation, only 25% had occurred at the fracture site and 75% at physis. Under the 10 years old, malunion as much as 23degreein any plane will remodel enough to give normal alignment of the joints surfaces.

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Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture
Suk Kang, Jong Pil Kim, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Sang Ho Lee, Jin Wook Chung
Journal of the Korean Fracture Society.2007; 20(4): 339. CrossRef

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Consumptive Coagulopathy Secondary to a Traumatic False Aneurysm of Deep Femoral Artery: Duke Whan Chung, Hwi Joong Yoon, Chang Moo Yim, Young Soo Chun, Hyun Ju Park; J Korean Soc Fract 1998;11(1):85-90. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.85

Abstract PDF: A case of consumptive coagulopathy due to pseudoaneurysm, which occured as a complication of intramedullary nailing, was rarely reported. Pseudoaneurysm of peripheral artery is presented with pulsating mass and may show extrinsic indentations of the adjacent bone. The coagulopathy and bleeding responded to surgical elimination of the fistula and aneurysm. Diffuse intravascular coagulopathy or consumptive coagulopathy is infrequently associated with pseudoaneurysm of deep femoral artery. Laceration of major arteries are more common in open than in closed fractures. They usually occur only when a major artery is in close proximity to bone as complications to frractures. Diffuse intravascular coagulopathy or consumptive coagulopathy is characterized clinically by excessive bleeding, ecchymosis and petechiae and by laboratory evidence of a disease in the numbers of platelets and amount of fibrinogen and an increase of fibrin degradation products with prolonged prothrombin and partial thromboplastin times. When the two coexist, they create a difficult clinical problem that reuires optimal medical and surgical treatments. If the appropriate treatment was delayed, serious complication such as sepsis or death could be occured. Prompt recongnition through appropriate laboratory tests and early surgical intervention was indicated essentially. We are reporting one case of coagulopathy associated with pseudoaneurysm of deep femoral artery that presented to the broad clinical picture.

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The use of partridge cerclene system for the treatment of femurshaft fracture during and after the replacement arthroplasty of the hip 6 cases report: Hyung Soo Kim, Jeong Gook Seo, Jin Hyok Kim, Byung Jik Kim; J Korean Soc Fract 1991;4(2):312-319. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.312

Abstract PDF: No abstract available.

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