Journal of Musculoskeletal Trauma

Operative Treatment of Traumatic Humeral Shaft Fracture: Comparision of Interlocking IM Nailing and Plate Fixation by Posterior Approach: Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Ho Sup Song; J Korean Fract Soc 2005;18(2):93-99. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.93

PURPOSE
To compare the results and complications of interlocking IM nailing and plate fixation by posterior approach in the treatment of traumatic humeral shaft fracture MATERIALS AND METHODS: From March 1997 to March 2003, 49 patients undergone operation due to traumatic humeral shaft fracture. Follow-up was over one year. 28 patients operated with interlocking IM nailing initially and 21 operated with plate fixation by posterior approach prospectively. Statistics were compared using clinical and radiological outcomes and complications.
RESULTS
Radiologically, bone union was observed after an average of 14.3 weeks in IM nailing, and 11.7 weeks in plate fixation. So plate fixation showed earlier bone union (p=0.012). Nonunion occurred in 4 cases (14.3%) operated with IM nailing, and 1 case (4.8%), that was open shaft fracture, with plate fixation. Nonunion occurred more frequently when operated by IM nailing. 6 cases showed limitation of shoulder movement due to damage of the rotator cuff by IM nail entry site. 1 case showed radial nerve palsy, and 1 case showed axillary nerve palsy in the case of IM nailing. Also, secondary surgery due to complications was operated in 9 cases (32.1%) in IM nailing and 1 case (4.8%) in plate fixation (p=0.03).
CONCLUSION
In the case of traumatic humeral shaft fracture plate fixation by posterior approach was more useful than IM nailing in the decrease of complications and bone union. Such approach is thought to be an excellent method for anatomic reduction and nerve exploration in the case of open and comminuted fracture which accompany nerve injuries

Citations

Citations to this article as recorded by

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
Minimally Invasive Anterior Plating of Humeral Shaft Fractures
Hyun-Joo Lee, Chang-Wug Oh, Do-Hyung Kim, Kyung-Hyun Park
Journal of the Korean Fracture Society.2011; 24(4): 341. CrossRef
Result of Interlocking Intramedullary Nailing for Humeral Shaft Fracture Evaluation of Post-operative Shoulder Function
Seung Rim Park, Tong Joo Lee, Ryuh Sub Kim, Kyoung Ho Moon, Dong Seok You
Journal of the Korean Fracture Society.2007; 20(2): 166. CrossRef

112 View
0 Download
3 Crossref

Minimal Open Reduction and Interlocking IM Nailing of Comminuted Humeral Shaft Fracture: Comparison between Plate Internal Fixation: Kyeong Jin Han, Soo Ik Awe, Tae Young Kim, Shin Young Khang; J Korean Soc Fract 2002;15(4):573-580. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.573

Abstract PDF: PURPOSE
We compared the functional and radiological results after the minimal open reduction and interlocking IM nailing and LC-DCP plate internal fixation for the comminuted humeral shaft fractures.
MATERIALS AND METHODS
Fourteen plates(LC-DCP) and eighteen interlocking IM nail(AO unreamed IM nail) were applied after open reduction for 32 comminuted fractures of the humeral shaft between March 1997 and December 2001. They were followed up for a minimum 9 months after surgery and the radiological and functional results were evaluated.
RESULTS
The average fracture healing time was 13.2 weeks and union rate was 85.7% for plate internal fixation. The average fracture healing time was 12.4 weeks and union rate was 94,4% for interlocking IM nail. The average functional scores according to American Shoulder and Elbow Surgeon 's (ASES) shoulder score(Total 52 points) was 44 points for plate internal fixation and 47 points for interlocking IM nailing respectively.
CONCLUSION
Minimal open reduction and interlocking IM nailing is better method with good functional and radiological results than plate internal fixation for the comminuted humeral shaft fractures.

113 View
0 Download

The Fate of Large Butterfly Fragments in Femoral Shaft Comminuted Fractures Treated withClosed Interlocking Intramedullary Nailing: Keun Bae Lee, Jae Yoon Chung, Eun Sun Moon, Eun Kyoo Song, Kwang Cheul Jeong; J Korean Soc Fract 2002;15(4):504-510. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.504

Abstract PDF: PURPOSE
To evaluate the radiographic changes and union of large butterfly fragments after closed interlocking IM nailing for femoral shaft comminuted fractures.
MATERIALS AND METHODS
The objects of this study were 23 cases(15 males, 8 females) of femoral shaft comminuted fractures with butterfly fragments larger than 5cm and with the follow up period of 12 months or more from June 1995 to June 2000. We assessed the size, the degrees of displacement and angulation of the large butterfly fragments at preoperatively, one day, one month and three month postoperatively and evaluated the union at four month and six month postoperatively.
RESULTS
The size of the fragments was 8.4cm (5.0-13.0) in average. The distance between the fragment and shaft was 15.9cm preoperatively and 10.1, 7.7, 6.8cm at one day, one month and three month postoperatively. In 13 cases of angulation over 5 degrees, it changed from 19.6 degrees preoperatively to 13.9 degrees , 8.4 degrees , 5 . 9 degrees at one day, one month and three month postoperatively. There is no increase in angulation.The union was completed at 4 months in 13 cases (56.5%) and at 6 months in all except one case of delayed union, in which we did not do any further procedure until the union was achieved.
CONCLUSION
In femoral shaft comminuted fractures with displaced large butterfly fragments treated with closed interlocking IM nailing, the distance and angulation of fragments decreased gradually and even the fragments were inverted or largely displaced and angulated the fragments were united. So the caution must be given not to displace the fragments intraoperatively and to keep anatomical position of the fragments by active exercise and hydrostatic pressure of the muscles of thigh postoperatively. Then the open reduction and internal fixations of the fragments will not be necessary.

79 View
0 Download

Comparative Analysis of Interlocking IM Nailing and LC-DCP fixation in the Treatment of Distal Tibial Fracture: Hwa Yeop Na, Young Jun Park, Sang Hoon Ko, Wahn Sub Choe, Young Sang Lee, Kyung Dong Yoon; J Korean Soc Fract 2002;15(2):152-158. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.152

Abstract PDF

PURPOSE
To compare the clinical results between interlocking IM nailing and LC-DCP fixation in the treatment of distal tibial shaft fracture.
MATERIALS AND METHODS
From August 1998 to August 2001, 23 patients were treated by interlocking IM nail and 15 patients were treated by LC-DCP for distal tibial shaft fracture.
RESULTS
Accoding to Robinson classification, there were 12 type 1 fractures (52.1%) and 11 type 2a fractures (47.8%) in the interlocking IM nailing group, and 4 type 1 fractures (26.7%), 8 type 2a fractures (53.4%) and 3 type 2c fractures (20.07%) in the LC-DCP fixation group. The average time to bony union was 16 weeks in the patients treated with interlocking IM nail and 12 weeks in the patients treated with LC-DCP. In the functional outcome (according to Klemm and Borner), 18 patients treated (78.2%) with interlocking IM nail showed satisfactory results and 13 patients (86.6%) treated with LC-DCP had satisfactory results.
CONCLUSION
We concluded that more satisfactory results could be obtained with LC-DCP fixation compared with interlocking IM nailing in the treatment of the distal tibial fracture.

Citations

Citations to this article as recorded by

A Comparison of the Results between Intramedullary Nailing and Minimally Invasive Plate Osteosynthesis in Distal Tibia Fractures
Chul-Hyun Park, Chi-Bum Choi, Bum-Jin Shim, Dong-Chul Lee, Oog-Jin Shon
Journal of the Korean Orthopaedic Association.2014; 49(4): 285. CrossRef
Comparative Study Using of Treatment with Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Interlocking Intramedullary Nailing in Distal Tibia Fractures
Chang Hwa Hong, Jong Seok Park, Sang Seon Lee, Soo Ik Awe, Woo Jong Kim, Ki Jin Jung
Journal of the Korean Fracture Society.2010; 23(3): 296. CrossRef
A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures
Kee-Byung Lee, Si-Young Song, Duek-Joo Kwon, Yong-Beom Lee, Nam-Kyou Rhee, Jun-Ha Choi
Journal of the Korean Fracture Society.2008; 21(4): 286. CrossRef
Comparative Study of Intramedullary Nailing and Plate for Metaphyseal Fractures of the Distal Tibia
Hoon Jeong, Jae-Doo Yoo, Young-Do Koh, Hoon-Sang Sohn
Journal of the Korean Fracture Society.2007; 20(2): 154. CrossRef

120 View
0 Download
4 Crossref

The Comparison of the Using of Plate Fixation and Interlocldng IM Nailing in Humeral Shaft Fracture: Myung Hwan Son, Byung Chul Kim, Nam Wook Kang, Min Yong Kim; J Korean Soc Fract 2001;14(4):720-725. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.720

Abstract PDF: PURPOSE
This study was to evaluate the results and the usefulness of the plate fixation and the interlocking IM nailing for the humeral shaft fractures.
MATERIALS AND METHODS
We have reviewed thirty cases of humeral shaft fractures, which were treated with plate fixation in seventeen cases and interlocking IM nailing in thirteen cases in period of February 1993 to May 1999. The Russel-Taylor nails were used in all cases for interlocking IM nailing. The clinical and the radiological results were evaluated after operation.
RESULTS
The average union time was 14.5 weeks for the plate fixation and 15.2 weeks for the interlocking IM nail respectively. There were two cases of wound infection and one case of radial nerve injury for the plate fixation, and two cases of rotator cuff injury on the shoulder were found after the interlocking IM nailing.
CONCLUSION
Interlocking IM nailing is a relatively simple procedure with low rate of infection and radial nerve injury, but rotator cuff injury is a considerable problem after operation.

40 View
0 Download

Treatments of the delayed Union or Nonunion of Tibial Shaft Fracture Fixed with Interlocking IM nail: Yong Bum Park, chung Soo Hwang, Phil Hyun Chung, Suk Kang, Dong Joo Chae, Han Chul Kim, Sang Ho Moon, Jong Phil Kim, Dae Jin Kim; J Korean Soc Fract 1998;11(3):552-559. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.552

Abstract PDF: Interlocking intramedullary nailing has been the first choice treatment of most tibial shaft fractures because its rigidity of fixation allows early ROM and weight bearing. Although most interlocking nailing procedures are performed with closed reduction that preserve periosteal blood supply, delayed union or nonunion is often occurs. so secondary procedures, such as bone graft, dynamization, nail exchange, are necessary to achieve fracture healing. We analyzed 25 cases of delayed union or nonunion from 432 tibial shaft fractures fixed initially with static interlocking intramedullary nailing since January 1990 till January 1996. Overall incidence of delayed union or nonunion is 5.8%(25/432). Secondary procedures included mainly iliac bone graft or dynamization. Average time to achieve bone union after secondary procedure is 6.1 months. The more distracted or displaced fracture ends after interlocking nailing or the more comminuted fracture fragments led to the more delayed bone union. Careful attention to minimize distraction or displacement during interlocking nailing is necesary to decrease the incidence of delayed union or nonunion. And appropriate procedures should be performed when delayed union or nonunion is predicted, which result in success in most cases.

111 View
0 Download

Clinical Analysis Between Interlocking IM Nail and Plate Fixation in the Treatment of Humeral shaft Fractures: Soo Chan Lee, Beom Koo Lee, Do Hyun Moon, Jin Hong Ko, Hong Gi Park, Ki Dong Kang, Hyoung Il Kim; J Korean Soc Fract 1997;10(3):621-627. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.621

Abstract PDF: Most of the humeral shaft fractures have been treated conservatively. If operation is indicated, most surgeons used to perform an open reduction and internal fixation with plate &Treatment of the Humeral Shaft Fracture in Adult screws. But, when open reduction and internal fixation is carried out, the periosteum and soft tissue attachments must be stripped off from the bone and operative time becomes longer. Interlocking IM nailing is an attractive procedure which does not disrupt or strip off periosteum and soft tissue at the fracture site, decrease the chance of infection and allow early exercise. Authors compare the clinical result of humerus shaft fracture which were treated by plate fixation in 25 patients and interlocking IM nailing in 16 patients who were treated at the orthopedic depaunent, Joong Ang Gil Hospital from Feb. 1992 to Jan. 1995. 1. The average time of operation in interlocking IM nail was 65 minutes and that of plate fixation was 95 minutes. 2. The average time for bone union was about 14.4 weeks in interlocking IM nail and 14.2 weeks in plate fixation. 3. The complications of interlocking IM nail were 1 case of postoperative radial nerve palsy, 1 case of delayed union, 1 case of nonunion and 3 cases of pain and stiffness of shoulder. 4. the complications of plate fixation were 1 case of infectioin, 1 case of delayed union, 3 cases of nonunion, 1 case of metal failure, 2 cases of postoperative radial nerve palsy and 2 cases of pain and stiffness of elbow. In conclusion, the interlocking IM nailing is an attractive procedure or the treatment of the humeral shaft fractures.

55 View
0 Download

Problems and complication after Interlocking Intramedullar Nailing for Femoral Shaft Fracture: In Suk Oh, Do Hyun Moon, Jin Hong Ko, Ki Dong Kang, Si Hwan Kim; J Korean Soc Fract 1996;9(3):547-556. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.547

Abstract PDF

Fracture of the femoral shaft, is among most common fractures in orthopaedics, with its aspect becomming more complex. Since the introduction of Kuncher Nail, closed rodding techinque and locking nail system were followed with additional feature of preventing shortening and rotation as well as allowing early weight bearing and joint motion. With their wide application, we met many problems during the operative procedure due to delicient concept and technique. We have checked the possible problems during and after the procedure of interlocking nailing for the femoral fractures in 65 cases. 1. With poor selection of implant, long, short and small nail were used in 5, 3 & 2 cases, respectively. 2. In the process of operation, inlet error, angular & rotational deformity, femoral neck fracture, failure (or loossening) of distal screws were 2,10, 1, and 4 cases, respectively. 3. A New fragment was made in 7 cases(11%) durinbg surgery, especially medial side and distal to the fracture line. 4. Post-operative deep infection were developed in 2 cases. 5. Post-operative metal failure and delayed(or non) union was 1 and 7(11%) cases, delayed union (or nonunion) occured in 3 cases(20%) after open reduction while following closed reduction in 4 cases(8%).

Citations

Citations to this article as recorded by

Iatrogenic Femur Proximal Shaft Fracture during Nailing Using Lateral Entry Portal on Femur Shaft Fracture
Hong Moon Sohn, Gwang Chul Lee, Chae Won Lim
Journal of the Korean Orthopaedic Association.2014; 49(4): 272. CrossRef

112 View
0 Download
1 Crossref

Treatment of Nonunion of the Tibia Fracture: Dong Heon Kim, Kyu Cheol Shin, Hee Cheol Park, Ju Yong Shin; J Korean Soc Fract 1996;9(1):112-118. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.112

Abstract PDF: Nonunion after tibia fracture is a relatively common problem. The cases of nonunion have been known open and comunited fracture, extensive soft tissue injury, interposition of the soft tissue, distarbance of the blood supply and inadequate fixation. A number of methods stimulating union have born described. These include fibular osteotomy followed by weight-bearing in a cast, autogenous boone graft with or without additional stabilization, internal or external fixation with compression, open or closed IM nailing and even electromagetic stimulation. In this paper we carried out retrospective study of the 24 nonunion of the tibia fracture which were treated at the Department of Orthopeadic Surgery, Kon-Kuk University Hospital from March 1990 to March 1995. The results were as follows: 1. Among 24 cases of monunions, 16cases(66.6%) were communited fractures and 18cases(75%) were open fractures. 2. Hypervascular nonunion were 12cases and avascular nonunion were 12cases. Previous methods of treatinent were conservative treatment in 6cases of closed fracture and were treated with Ender nailing, multiple K-wire fixation, Ilizarolr external fixation, monofixator external fixation in 1 Bcases of open fractures. 3. The average duration from injury to dignosis of nonunion was 7 months tweets.(Range 5 months to 24months) 4. Tibial nonunion were treated with plate and screw with bone graft(Bcases), Interlocking IM nail ing(14cases), and nizarov external fixation with bone graft(teases). 5. The average time of union was 23weeks in all patients: 24 weeks in the case of plate and screw with bone graft. 20 weeks in the case of interlocking IM nailing. 28 weeks in the case Ilizarov external fixation with bone graft. 6. The main complications were joint stiffness due to long-term cast irnrnobiliBation in the case of plate and screw with bone graft, LROM of joint contracture and external pin site in the case of Ilizarov external fixation with bone graft, deep infection Icase and knee joint pain teases due to proximal nail protrusion in the case of Interlocking IM nailing.

96 View
0 Download

Comparison between Interlocking IM Nail and Ender Nail in the Treatment of Shaft Fracture of the Tibia: Dong Chul Lee, Sang Ho Lee, Se Dong Kim; J Korean Soc Fract 1995;8(4):830-840. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.830

Abstract PDF: The shaft of tibia is prone to the open wounds owing to the subcutaneous location and poor muscular envelope. The open wounds frequently result in the severe complications and major disabilities, such as infection, delayed union and nonunion. The choice of treatment should be considered cautiously. The intramedullary fixation of the shaft has the advantage of early weight bearing as well as relative firm fixation. Sixty four cases of fracture of the tibia shaft were treated with interlocking IM nail(38 cases) or Ender nail(26 cases) from December 1985 to January 1993. 1. The most common causes of the tibia fracture were the pedestrian injury and motorcycle accident. 2. There was no difference in operation time between interlocking IM nail group and 5 weeks in Ender nail group. the average time of operation was about 70 minutes. 3. The mean time of cast support was 2.5 weeks in interlocking IM nail group and 5 weeks in Ender nail group. The mean duration of nonweight bearing was 7.6 weeks in interlocking IM nail group,9.2 weeks in Ender nail group. 4. The mean duration of bone union was 18.7 weeks in interlocking IM nail group,21.4 weeks in Ender nail group. The interlocking IM nail group seemed to obtain earlier bone union(2.5 weeks) than Ender nail group, but there was no significance in statistical analysis in the bone union time between two groups. 5. Angular deformities were found in 3 cases in interlocking IM nail group and 4 cases in Ender nail group, which occured in the communited fracture and both ends fracture of the tibia shaft, segmental fractures. Delayed union was also occured in 5 cases in Ender nail group and 3 cases in interlocking IM nail group.

70 View
0 Download

Delayed Femoral Neck Fracture in Interlocking Intramedullary Nailed Femur: A case report: Sung Man Rowe, Eun Sun Moon, Eun Kyoo Song, Sung Taek Jung; J Korean Soc Fract 1989;2(2):269-273. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.269

Abstract PDF: We report an uncommon complication following interlocking intramedullary nailing of the femur: delayed femoral neck fracture after 5 months of unevenful postoperative course. He was a 47-year-old laborer with good quality of bone, nevertheless he sustained femoral neck fracture after minor fall on the ground. We thought that loss of bone elasticity caused by interlocked nail in the whole femoral shaft including intertrochanteric portion made stress concentration on the femoral neck to develop a fracture with minor magnitude of traumatic force.

80 View
0 Download

Search