Journal of Musculoskeletal Trauma

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; J Korean Fract Soc 2010;23(3):296-302. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.296

Abstract PDF: PURPOSE
To compare the result of treatment between minimally invasive plate osteosynthesis (MIPO) using periarticular plate and intramedullary nailing in treatment of distal tibia fractures.
MATERIALS AND METHODS
28 cases of distal tibia fractures form Jan. 2006 to Mar. 2008 were divided into two group. Minimum follow-up was for 12 month. Group 1 consisted of 14 patients who were treated by MIPO technique and group 2 consisted of 14 patients who were treated by interlocking intramedullary nailing. The results were compared by assessing radiologic and clinical result.
RESULTS
The mean bony union time was 14 weeks (8~17) in group 1 and 15 weeks (11~20) in group 2. Operation time was 58 minutes (55~65) in group 1 and 82.7 minutes (70~100) in group 2. The average angulation in AP view was 1.5 degrees (0~2) in group 1 and 2 degrees (0~5) in group 2, in lateral view was 1.8 degrees (0~4) in group 1 and 2.3 degrees (0~12) in group 2. The average range of motion for dorsi flextion was 17.5 degrees (15~20) in group 1 and 18 degrees (16~20) in group 2, for plantar flextion was 45 degrees (42~50) in group 1 and 44 degrees (42~50) in group 2, which means that there were no severe limitation of motion in all patients, resulting in satisfactory ambulation. There was no post operative complications such as skin irritation problem caused by internal device and no implant failure and superficial wound infection.
CONCLUSION
There were no difference in bony union time, clinical result and anatomical reduction between Group 1 and Group 2 in distal tibia fractures, but operation time was shorter in MIPO than nailing.

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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; J Korean Fract Soc 2008;21(4):286-291. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.286

PURPOSE
To compare the effectiveness between minimally invasive plate osteosynthesis (MIPO) and interlocking IM nailing in the treatment of distal tibia fracture without involvement of ankle joint retrospectively.
MATERIALS AND METHODS
38 patients with distal tibia fracture from Jan. 2004 to Oct. 2005 were divided into two groups. Minimum follow-up was for 12 months. Group MIPO consisted of 18 patients were treated with MIPO and group Nail consisted of 20 patients were treated with interlocking intramedullary nail. The results were compared between two groups by assessing bony union time and operation time. Clinical evaluation was evaluated by Olerud score.
RESULTS
The mean bony union time was 14.4 weeks (12~17 weeks) in group MIPO and 16.7 weeks (13~19 weeks) in group Nail (p=0.011). The mean operation time was 1.05 hours (0.6~1.6 hours) in group MIPO and 0.74 hours (0.4~1.1 hours) in group Nail (p=0.044). The Olerud score was 83.8 (75~100) in group MIPO and was 89.6 (70~100) in group Nail (p=0.075). In Complication, group MIPO showed one metal failure and two skin irritations, group Nail showed three superficial wound infections.
CONCLUSION
MIPO was the shorter bony union time and the longer operation time than the interlocking intramedullary nailing. There were no significant differences between the two groups in clinical results.

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Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures
Ho-Min Lee, Young-Sung Kim, Jong-Pil Kim, Phil-Hyun Chung, Suk Kang, Kaung Suk Jo
Journal of the Korean Fracture Society.2018; 31(3): 94. CrossRef
A Rehabilitation for Ankle Fracture in Korean Medicine: A Report of 4 Cases
Won-Bae Ha, Jong-Ha Lee, Yoon-Seung Lee, Dong-Chan Jo, Jin-Hyun Lee, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2017; 27(4): 171. CrossRef
Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures
Jung-Han Kim, Heui-Chul Gwak, Chang-Rack Lee, Yang-Hwan Jung
Journal of Korean Foot and Ankle Society.2015; 19(3): 86. CrossRef
Intramedullary Nailing of Distal Tibial Fractures with Percutaneous Reduction by Pointed Reduction Forceps
Jae-Kwang Hwang, Chung-Hwan Kim, Young-Joon Choi, Gi-Won Lee, Hyun-Il Lee, Tae-Kyung Kim
Journal of the Korean Fracture Society.2014; 27(2): 144. CrossRef
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
Analysis of the Result Treated with Locking Compression Plate-Distal Tibia and Zimmer Periarticular Locking Plate in Distal Tibia Fracture
Jun-Young Lee, Sang-Ho Ha, Sung-Won Cho, Sung-Hae Park
Journal of the Korean Fracture Society.2013; 26(2): 118. CrossRef

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Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail: Kwang Yul Kim, Moon Sup Lim, Shin Kwon Choi, Hyeong Jo Yoon; J Korean Fract Soc 2008;21(2):157-164. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.157

Abstract PDF

PURPOSE
To evaluate the result of forearm shaft fracture treated by modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA).
MATERIALS AND METHODS
15 patients with fracture of radius, ulna, radio-ulna shaft treated by modified interlocking intramedullary nail from December 2003 to February 2007 were analyzed. Modified interlocking intramedullary nail has paddle blade tip and fluted rod, so the distal screw fixation was not needed but had relatively firm fixation. It has advantages including short operation time, small operation scar. The average follow up period was 8.3 months (range, 5~15 months). We analyzed the results by average union time and the functional results according to Anderson's criteria.
RESULTS
The mean duration of union was 9.8 weeks in radius and 11.4 weeks in ulna. The average range of motion of forearm was 74.6 degree in supination and 72 degree in pronation.. Functional results assessed by Anderson were rated excellet in 12 cases, satisfactory in 3 cases. We found no complications such as delayed union, non-union, neurovascular injury and infection.
CONCLUSION
Modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA) is a viable therapeutic alternative in the management of forearm shaft fracture.

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Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults
Sanglim Lee, Hee-Sung Lee, Yerl-Bo Sung, Jae-Kwang Yum
Journal of the Korean Fracture Society.2009; 22(1): 30. CrossRef

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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; J Korean Fract Soc 2007;20(2):166-171. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.166

Abstract PDF

PURPOSE
To evaluate the post-operative functional reduction of the shoulder joint and the impacting factors to post-operative shoulder joint function in interlocking IM nailing treatment of humeral shaft fracture.
MATERIALS AND METHODS
From April 1999 to August 2004, 35 patients (35 cases) whom admitted to hospital for humeral shaft fracture and treated using interlocking intramedullary nail were followed up for more than 1 year. 1 year post-operative shoulder joint function were evaluated using American Shoulder Elbow Surgery Scale (ASES). Pre-operative shoulder joint pain, radiologically degenerative change and extent of nail protrusion were evaluated, and each factor was correlated with function of the shoulder joint.
RESULTS
33 cases out of 35 cases showed union and average union period was 12 weeks. Complications consisted of 2 cases of nonunion, 1 case of infection, 1 case of loosening of distal fixing screw, 1 case of radial nerve palsy and 1 case of axillary nerve palsy. Shoulder joint function 3 months after operation : mean ASES score 78.2, 12 months after operation : mean ASES score 89.6. Pre-operative shoulder joint pain and nail protrusion showed to be statistically related to shoulder joint function.
CONCLUSION
If the operation leaves no protrusion of intramedullary nail, it can be concluded to be relatively safe and effective.

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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
Plain Radiograph Analysis of the Distal Humerus Posterior Bowing That May Affect Interlocking Intramedullary Nailing for Humerus Shaft Fracture
Jaekwang Yum, Kyunghwan Boo, Minkyu Sung, Jiseok Jang
Journal of the Korean Orthopaedic Association.2015; 50(1): 31. 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
Surgical Treatment of Pathologic Humeral Fracture
Ho Jung Kang, Byoung Yoon Hwang, Jae Jeong Lee, Kyu Ho Shin, Soo Bong Hahn, Sung Jae Kim
Journal of the Korean Fracture Society.2010; 23(2): 187. 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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Interlocking Intramedullary Nail in Distal Tibia Fracture: Oog Jin Shon, Sung Min Chung; J Korean Fract Soc 2007;20(1):13-18. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.13

Abstract PDF

PURPOSE
To evaluate the effectivity of interlocking intramedullary nailing for distal tibia fracture and prognostic factor to bone healing.
MATERIALS AND METHODS
From April 2000 to June 2005, 21 cases who had distal tibia fracture were treated by interlocking intramedullary nail were analyzed. The duration of follow-up was more than 1 year. We evaluated clinical results by IOWA ANKLE rating system and union time by simple X-ray. Furthermore, we estimated prognostic factor to union time.
RESULTS
The bone union was achieved at average 18.5 weeks. At the last follow-up, there was no non-union and infection. Average IOWA ANKLE rating score was 91.3 point. The union time was delayed in open and segmental fracture at initial fracture. And severe soft tissue injury in open fracture revealed bad result.
CONCLUSION
We concluded that interlocking intramedullary nail is effective method for treatment of the distal tibial fractures. And, adequate soft tissue management is important to bone healing and clinical outcome.

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Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures
Jung-Han Kim, Heui-Chul Gwak, Chang-Rack Lee, Yang-Hwan Jung
Journal of Korean Foot and Ankle Society.2015; 19(3): 86. CrossRef

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Wedge Tibial Shaft Fractures Treated with Interlocking IM Nailing: Sang Jun Song, Hyung Ku Yoon, Soo Hong Han, Hyung Kun Park, In Seok Lee; J Korean Fract Soc 2006;19(3):322-328. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.322

Abstract: PURPOSE
To investigate the bone union time of patients treated with interlocking intramedullary nailing in wedged tibial shaft fracture and to evaluate the factors that influence this result.
MATERIALS AND METHODS
32 patients treated with interlocking intramedullary nailing for wedge tibial shaft fracture were reviewed with a follow-up period of more than 1 year. Radiographic results were assessed with diameter (%) and length (mm) of wedge fragment, pre and postoperative displacement (mm) of wedge fragment. We also checked the bone union time of the main fragment and the wedge fragment (paired t-test). We investigated the bone union time acocording to the diameter, length of wedge fragment, pre and postopertvie displacement (correlation analysis).
RESULTS
Bone union time of the main fragments averaged 15.3 weeks (6~53 weeks) and that of wedge fragment averaged 24.2 weeks (8~64 weeks) (p=0.005). There was no correspondence between wedge fragment diameter and bone union time (p=0.681), but the bone union time of wedge fragment increased in proportion to its diameter (r2=0.747, p=0.031). There was no correspondence between preoperative displacement of wedge fragment and bone union time (p=0.574), but the bone union time increased in proportion to postoperative displacement of wedge fragment (r2=0.730, p=0.001).
CONCLUSION
Wedge fragments need longer time for bone union than main fragments in interlocking intramedullary nailing for wedge tibial shaft fractures. We need to pay attention to the displacemet of fragments in treating tibial shaft fractures with large wedge fragment.

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Interlocking Intramedullary Nailing in the Distal Metaphyseal Fractures of the Tibia: Sang Jun Song, Duck Yun Cho, Hyung Ku Yoon, Dong Eun Shin, Jae Hwa Kim, Tae Hyung Kim; J Korean Fract Soc 2005;18(3):275-280. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.275

Abstract PDF

PURPOSE
To evaluate the clinical and radiographic results of interlocking intramedullary nailing for the distal metaphyseal fractures of the tibia and to identify the usefulness of the interlocking intramedullary nailing.
MATERIALS AND METHODS
Thirty four patients who underwent interlocking intramedullary nailing for distal metaphyseal fractures of the tibia were reviewed with a follow-up period of more than 2 years. Clinical result was assessed using the Olerud score and this score was marked as percentage of prefracture state. Radiographic results were assessed with varus-valgus angle, anterior-posterior angle, and bone union time. We checked the cases of complication and need for additional surgery after interlocking intramedullary nailing.
RESULTS
Clinically, Olerud score averaged 92.1% (76~100%). Radiographically, average varus-valgus angle was 1.6+/-2.9 degrees and average antero-posterior angle was 0.8+/-3.3 degrees. Bone union time averaged 18.7 weeks. As complications, there were one deep infection and two breakages of distal interlocking screw. In additional surgery, there were 1 debridement and soft tissue flap, and one dynamization of nail at postoperative 12 weeks.
CONCLUSION
Interlocking intramedullary nailing is one of safe and reliable method for distal metaphyseal fractures of the tibia, considering less soft tissue injury, possibility of early range of motion exercise, high bone union rate, and low complications rate.

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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

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Treatment of Comminuted Femoral Shaft Fracture by Interlocking Intramedullary Nailing: Comparision of results between open reduction with cerclage wiring and closed reduction: Jeung Tak Suh, Hyoung Lok Roh, Jeung Il Kim, Chong Il Yoo; J Korean Fract Soc 2005;18(1):6-11. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.6

Abstract PDF: PURPOSE
To compare of results between open interlocking intramedullary nailing combined with cerclage wiring and closed interlocking intramedullary nailing in treatment of femoral shaft comminuted fracture, we reviewed retrospectively 62 femoral shaft fractures.
MATERIALS AND METHODS
We reviewed retrospectively 62 femoral shaft comminuted fractures, who had been followed up for a minimum one year including Winquist-Hansen classification II, III, IV from January 1996 to December 2002. The group I include the patients who treated with closed interlocking intramedullary nailing. The group II include the patients who treated with open interlocking intramedullary nailing combined with cerclage wiring.
RESULTS
The average bone union time was 18.6 weeks in group I, 27.6 weeks in group II. The complication included 3 delayed unions, 1 nonunion and shortening of more than two centimeters in 1 patents in group I. In group II, The complication included 2 infections, 7 delayed unions and 3 nonunions.
CONCLUSION
We can use open interlocking intramedullary nailing with cerclage wiring in some femur shaft comminuted fractures, but there are many problems and complications. So we must consider it carefully before using this method.

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The Effect of Fibular Malreduction on Ankle Joint after Tibial Interlocking IM Nailing of Tibial and Fibular Fractures: Dong Eun Shin, Duck Yun Cho, Hyung Ku Yoon, Jin Soo Lee, Yoon Seok Lee, Hyoung Jun Kim; J Korean Fract Soc 2005;18(1):29-35. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.29

Abstract PDF

PURPOSE
To investigate the effect of fibular malreduction on ankle joint after tibia interlocking IM nailing of tibial and fibular fractures according to type of fibular fractures at preoperation.
MATERIALS AND METHODS
Thirty-nine patients who had ipsilateral tibiofibular fracture were analyzed clinically and radiographically. The talocrural angle and the distance from joint line to the tip of fibular were measured on both ankle standing AP view. The difference of angle and distance of both ankle were analyzed by paired t-test and correlation between defference and AOFAS score by Spearman correlation coefficients.
RESULTS
The difference of The talocrural angle and the distance from joint line to the tip of fibular of both ankle was statistically significant (p<0.05). The correlation between this difference and AOFAS score was statistically insignificant (p>0.05).
CONCLUSION
In tibia interlocking IM nailing of tibia and fibula fracture, malreduction of fibula could cause the change of ankle joint.

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The Risk Factors Associated with Nonunion after Surgical Treatment for Distal Fibular Fractures
Jun Young Lee, Kwi Youn Choi, Sinwook Kang, Kang Yeol Ko
Journal of Korean Foot and Ankle Society.2018; 22(3): 95. CrossRef

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Augmentation Plate Fixation for the Management of Long-bone Nonunion after Intramedullary Nailing: Kee Haeng Lee, Hyoung Min Kim, Chan Woong Moon, Youn Soo Kim, Won Sik Nam; J Korean Fract Soc 2004;17(3):265-270. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.265

Abstract PDF

PURPOSE
The aims of this study were to determine the effectiveness of the treatment using augmentation plate fixation for nonunion of long bone fracture after interlocking intramedullary nailing MATERIALS AND METHODS: Thirteen patients with nonunion of the long bone fracture after interlocking intramedullary nailing who underwent augmentation plate fixation were evaluated; followed up for more than 1 years. We evaluated five patients with nonunion of the humerus, three of the tibia and five of the femur. Twelve of thirteen patients were carried out autogenous cancellous bone graft and augmentation plate fixation was performed without removal of intramedullary nail for all patients.
RESULTS
For the cause of nonunion, seven patients were by iatrogenic factors such as insecure fixaton and six patients were by fracture itself such as severe comminution and open fracture. Bone union was achieved in thirteen patients all and the average bony union time was 4.2 months (ranged from 3 to 5.5 months) for the humerus, 6.4 months (ranged from 4 to 8.5 months) for the tibia and 7.3 months (ranged from 5.5 to 9 months) for the femur. There were no complications such as reoperation, infection or plate failure.
CONCLUSION
TAugmentation plate fixation is effective treatment option for the management of long bone fracture nonunion after intramedullary nailing.

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Augmentation Plate Fixation for the Treatment of Femoral and Tibial Nonunion After Intramedullary Nailing
Ali Birjandinejad, Mohammad H. Ebrahimzadeh, Hosein Ahmadzadeh-Chabock
Orthopedics.2009; 32(6): 409. CrossRef
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
Journal of the Korean Fracture Society.2008; 21(2): 117. CrossRef

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Treatments of the Nonunion of Femoral Shaft Fractures after Interlocking Intramedullary Nailing: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Jae Sang Park; J Korean Fract Soc 2004;17(2):95-102. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.95

Abstract PDF: PURPOSE
To investigate and analyze the clinical result in the treatment of aseptic nonunion of femoral shaft fracture after interlocking intramedullary nailing MATERIALS AND METHODS: We reviewed 23 cases of aspetic nonunion of femoral shaft fracture after interlocking intramedullary nail from March 1995 to February 2003 and follow up more than one year. 8 cases were treated by metal exchange, 3 cases by autogenous bone graft and the rest 12 cases by metal exchange and bone graft on the basis of fracture gap and type of nonunion. We evaulated nonunion type, union time and clinical result. Those patients were treated by interlocking intramedullary nail with or without bone graft. Union were accepted when the radiographic evidences showed bridging callus on both end of femoral shaft fracture with clinical evidences showing abscence of pseudomotion or pain.
RESULTS
All patients were united by one operation. Average union time were 4.8 months in metal exchange group, 3.9 months in metal exchange with autograft bone graft group, and 4.3 months in bone graft group. 15 patients (65.2%) showed hypervascular nonunion including 7 Elephant foot types (46.7%) and 8 oligotrophic types (53.5%), and 8 patients (34.8%) showed avascular nonunion according to Weber-Brunner classification CONCLUSION: Based on our analysis on clinical outcome and stability of nonunion occuring after initial interlocking intramedullary nailing in femoral shaft fracture, interlocking intramedullary nailing with bone graft made early ambulation possible and promoting returning to normal daily life much earlier, thus based on this data, we recommend interlocking intramedullary nailing for treating femoral shaft fracture along with bone graft.

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Interlocking Intramedullary Nailing for Treating Most Distal Tibial Fracture: In Heon Park, Kyung Won Song, Sung Il Shin, Jin Young Lee, Seung Yong Lee, Tae Hyoung Kim, Jeong Hun Cha; J Korean Soc Fract 2003;16(3):356-362. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.356

Abstract PDF

PURPOSE
We analyzed the result of treatment for most distal extraarticular tibial fracture using interlocking intramedullary nail.
MATERIALS AND METHODS
From January 1999 to April 2002, 8 patients who had most distal tibial fracture were treated by interlocking intramedullary nailing. The duration of follow-up was more than 12 months. The mean age was 41.5 years old. There were 5 males and 3 females. During follow-up period, we evaluated the bone union, range of motion of knee and ankle joint and gait pattern.
RESULTS
The average distance from fracture line to ankle joint line was 1.1 cm. The bone union was achieved at average 18.6 weeks. At the last follow-up, there was no limited motion on knee. But at one case, ankle range of motion was limited from 5 degree extension to 35 degree flexion. There was no gait disturbance.
CONCLUSION
Interlocking intramedullary nailing can be recommendable and useful in the most distal tibial fractures.

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Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures
Jung-Han Kim, Heui-Chul Gwak, Chang-Rack Lee, Yang-Hwan Jung
Journal of Korean Foot and Ankle Society.2015; 19(3): 86. CrossRef
Interlocking Intramedullary Nail in Distal Tibia Fracture
Oog Jin Shon, Sung Min Chung
Journal of the Korean Fracture Society.2007; 20(1): 13. CrossRef

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Treatment of Distal Tibial Fractures by Interlocking Intramedullary Nailing: Jung Ryul Kim, Hyung Suk Lee, Moon Ki Choi, Kwang Bok Lee, Jong Hyuk Park, Jun Mo Lee; J Korean Soc Fract 2003;16(3):348-355. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.348

Abstract PDF

PURPOSE
To analyze the result of treatment for distal tibial fractures by interlocking intramedullary nailing.
MATERIALS AND METHODS
Eighteen patients who underwent interlocking intramedullary nailing for distal tibial fracture were followed up for more than one year. We analyzed the fracture configuration, presence of fibular fracture, angular deformity and bone union by follow-up radiograph, and complications. The functional results were assessed by Baird's ankle scoring system.
RESULTS
According to Robinson classification, there were 4 type I fractures, 12 type IIA fractures, and 2 type IIB fractures. All cases were combined with fibular fracture. The mean union period of 18 cases were 21.9 weeks. There were three complications with 3 cases of valgus deformity. In functional outcome according to Baird's ankle scoring system, 15 patients (83%) showed satisfactory results.
CONCLUSION
We concluded that interlocking intramedullary nailing is effective method for the treatment of the distal tibial fractures. However, to avoid valgus deformity of the distal tibia when combined distal fibular fracture, fibular reduction and rigid fixation should be needed.

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Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques
Oog-Jin Shon, Ji-Hoon Shin, Chul-Wung Ha
Journal of the Korean Fracture Society.2013; 26(1): 50. CrossRef
Interlocking Intramedullary Nail in Distal Tibia Fracture
Oog Jin Shon, Sung Min Chung
Journal of the Korean Fracture Society.2007; 20(1): 13. 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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Nail Breakage after Femoral Interlocking Intramedullary Nailing: Suk Kang, Phil Hyun Chung, Dong Ju Chae, Jong Pil Kim, Joon Han Kim, Sung Pock Park, Jae Sang Park; J Korean Soc Fract 2002;15(3):363-370. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.363

Abstract PDF

PURPOSE
We analyze the clinical causes and precautions of nail breakage followed by femoral intramedullary nailing MATERIALS AND METHODS: We reviewed 12 cases of nail breakage followed by the femoral intramedullary nailing from Jan. 1993 to Feb. 2001 and for each cases, we analyzed used nail diameter, patient weight and used nail, time to nail breakage and configuration of non-union. We classified fracture site at the time of trauma as proximal 1/3, middle 1/3, distal 1/3, and evaluated gap of fracture site, displacement of fragment after surgery, location and treatment of broken nail on each part, and analyzed the causes of nail breakage RESULTS: The average time of nail breakage was 8.1 months and distal 1/3 fracture were major as 6 cases. Those were mainly comminuted fracture of Winquist-Hansen type II. After surgery, gap of fracture site and displacement of fragment were mostly observed in middle 1/3 fracture and, in the part of middle 1/3, the site of nail breakage took place in fracture site. Especially in the distal 1/3 fracture, nail breakage happened usually in distal first locking screw hole. The causes of nail breakage were inadequately small diameter of nail inserted into the isthmic portion of medullary canal in proximal fracture, inaccurate reduction of fracture site in middle fracture, and the use of short length of nail and its mechanical damage caused by inaccurate insertion of distal locking screw in distal fracture.
CONCLUSION
To prevent nail breakage while femoral intramedullary nailing, in proximal fracture, adequate diameter of nail has to be inserted into the isthmic portion of medullary canal. In middle fracture, the accurate reduction of fracture site will be necessary, and the case of distal fracture, enough length of nail has to be used and especially it is important not to cause mechanical injury with the accurate insertion of distal locking screw in nail

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Comparison of our self-designed rotary self-locking intramedullary nail and interlocking intramedullary nail in the treatment of long bone fractures
Bailian Liu, Ying Xiong, Hong Deng, Shao Gu, Fu Jia, Qunhui Li, Daxing Wang, Xuewen Gan, Wei Liu
Journal of Orthopaedic Surgery and Research.2014;[Epub] 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 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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Comparison between Ender Nail and Interlocking Nail in The Treatment of Infra-isthmic Tibial Shaft Fracture: Seung Wook Yang, Moo Ho Song, Hyung Taek Park, Sun Jin Choi; J Korean Soc Fract 2001;14(4):651-659. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.651

Abstract PDF: PURPOSE
To compare the clinical results between Ender nail and interlocking nail in the treatment of infra-isthmic tibial shaft fracture.
MATERIALS AND METHODS
The authors analyzed 44 cases of infra-isthmic tibial shaft fracture treated with Ender nail(23 cases) as a group 1 or interlocking nail(21 cases) as a group 2 from 1994 to 1998. Fracture type was divided by AO classification, and measured the fracture level, the time of bone union and angular deformity was checked with roentgenograms. The functional results were compared using the criteria by Klemm and Borner.
RESULTS
Distal end of fracture line from ankle joint shows no difference between two groups(P>0.05). Mean operation time was 96 minutes in group 1 and 140 minutes in group 2(P<0.05). Mean intraoperative blood loss was 103cc in group 1 and 254cc in group 2(P<0.05). Mean bone union time was 19.26 weeks in group 1 and 24.81 weeks in group 2. There was no significant difference between two groups in the angulation(P>0.05) and the functional results by Klemm and Borner.
CONCLUSION
Ender nail is a good method of treatment in infra-isthmic tibial fracture when isthmic portion of tibia is too narrow, or insertion of distal interlocking screws were too difficult to insert because of the severe soft tissue injury. The stability of fixation can be strengthened with a three point fixation as fanning of the nails in the distal fragments using more than 3 nails selecting a 1cm longer nail than the ordinary nail length for diaphyseal fracture.

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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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The Effect of Dynamization in Tibia Fracture: Jin Woo Kwon, Seung Ho Shin, Won Ho Cho, Woo Se Lee, Ki Ho Sung; J Korean Soc Fract 2001;14(1):52-59. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.52

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the effect of dynamization which was done for the treatment of delayed union or persisting fracture gap after interlocking intramedullary nailing, by radiographic and physical examination.
MATERIALS AND METHODS
We analyzed 22 cases these were treated with dynamization from 247 cases of tibia shaft fracture treated initially with static interlocking intramedullary nailing from February l990 to May 2000 and were followed up more than lyear. The result of dynamization was classified as 3 groups and we divided each results 3 categories that is effective result, uncertain result and ineffective result. Group A is cases that achived ultimate union with shortening of fracture gap and was 10 cases. Group B is that achieved ultimate union but fracture gap did not reduced and was 10 cases. Group C is that showed ultimate non-union and was 2 cases.
RESULTS
The result is that dynamization was effective only 4 cases of group A. 6 cases of group A and 4 cases of group B showed instability(radiolucent halo around nail, hypertrophied callus and leg pain), and 6 cases of group B showed no shortening of fracture gap, thus these were classified as uncertain result. Group C(2 cases) showed non-union, classified as ineffective.
CONCLUSION
Dynamization caused instability in most tibia fractures except simple mid-shaft fracture. So in the comminuted fractures and distal or proximal l/3 oblique fractures, other procedures such as bone graft, refixation should be considered rather than dynamization.

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Malalignment of Tibial Fracture Following Interlocking Intramedullary Nailing: Seung Wook Yang, Hyung Taek Park, Kuen Tak Suh; J Korean Soc Fract 2000;13(2):236-243. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.236

Abstract PDF: PURPOSE
: The purpose of this study was to evaluate the incidence and the factors that influence on malalignment following interlocking nailing for tibial fracture.
MATERIALS AND METHODS
: The authors analysed 59 patients, 60 cases tibial fracture treated with interlocking intramedullary nailing from 1993 to 1997 about nail insertion site, nail entrance angle and fracture type with roentegenogram. Malalignment was defined as 5 degree or more angular deformity in varus-valgus, 10 degree or more angular deformity in anterior-posterior plane.
RESULTS
: Malalignment was found in 15 cases out of 60(25%). We found malalaignment in 7 cases out of 11(64%)in proximal fracture, 6 cases out of 29(21%) in middle fracture, 2 cases out of 20(10%) in distal fracture(p<0.001). Correlation between nail insertion site or medial entrance angle and angular deformity was higher in proximal fractures. In midshaft wedge fractures, direction of main fragment influenced on the axial alignment.
CONCLUSION
: Centromedullary nail orientation is required to prevent malalignment after interlocking intramedullary nailing. Precise selection of nail insertion site and nail entrance angle under the C-arm control in proximal tibial fracture is necessary. Fracture type and fragment direction must be considered during tibial nailing in comminuted tibial fracture.

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Treatment of open Tibial Shaft Fractures with Unreamed Interlocking Intramedullary Nailing: Jeung Tak Suh, Byung Guk Park, Chong Il Yoo; J Korean Soc Fract 1999;12(3):568-576. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.568

Abstract PDF: Severe open fracture of the tibia have a high incidence of complications and a poor outcome. The most usual method of stabilization was by external fixation, but the advent of small diameter interlocking intramedullary nails has introduced a new option. From the June 1992 to December 1997, 55 cases of open tibial shaft fracture were treated with unreamed interlocking intramedullary nailing at the department of orthopedic surgery, Pusan National University Hospital. The purpose of this study is to evaluate its result and complications. Mean age was 31, mostly male. The main cause of trauma was traffic accidents(30 cases, 55%) and fracture sites consisted of mid 1/3 portion over 75%. According to the Gustilo & Anderson classification 8 type I(15%), 22 type II(40%), 15 type IIIA(27%) and 10 type IIIB(18%) were shown. Union time was 28.3 weeks on an average and union rate was 98%. There were 5 cases(9%) of delayed union, 2 cases(4%) of deep infection and 1 case(2%) of chronic osteomyelitis. In conclusion unreamed interlocking intramedullary nailing can be the first choice treatment in the treatment of open tibia shaft fractures with low postoperative infection.

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Intraoperative Fracture of the Tibia Associated with Removal of the Interlocking Intramedullary Nail: Report of 5 cases: Chan Hoon Yoo, Young Soo Byun, Hong Tae Kim, Hyun Min Kim, Yeon Min Park, Soo Yeol Jeon; J Korean Soc Fract 1999;12(3):538-542. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.538

Abstract PDF

We have experienced five cases of intraoperative fracture of the tibia assoicated with removal of ACE interlocking tibial nail. All fractures occured in young patients whose ages ranged from eighteen to twenty-nine years(mean, 24 years). We think the main reason of the fracture was characteristic design of ACE nail such as prominent distal angulation and posterior longitudinal slot. The other factors were age of the patient, material of the nail and timing of removal of the nail. In conclusion, we advise caution in the removal of the ACE reamed interlocking intramedullary tibial nail in young patient.

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Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report
Ji-Hwan Kim, Seung-Oh Nam, Young-Soo Byun, Han-Sang Kim
Journal of the Korean Fracture Society.2015; 28(1): 71. CrossRef

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Interlocking Intramedullary Nailing for the Treatment of Segmental Tibial Shaft Fractures: Kyung Jin Song, Young Keun Lee, Jeong Yeul Kim, Byung Yun Hwang; J Korean Soc Fract 1999;12(1):69-75. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.69

Abstract PDF: The treatment of segmental tibial shaft fractures poses many problems because of the serious damage to the surrounding soft tissue that usually occurs from the high-energy trauma, and the results are often unsatisfactory following lots of complications like non-union, delayed union, malunion, and infection We studied to evaluate the treatement results of interlocking intramedullary nailing for the segmental tibial shaft fractures. Twenty-two cases of segmental tibial shaft fractures were reviewed and we analyzed the results of surgical treatement in the viewpoint of bony union times, complication and its final outcome. The range of follow-up was 12 months to 68 months with mean 38 months follow-up. Most of the patients were between forty and sixty years, and average age was 47 years. Associated injury was incurred in nineteen cases with various musculoskeletal symptoms and signs. According to Meils classification, 8 were Type I, 1 was Type II and 3 were Type IV of the 12 closed fractures. Of the 10 open fractures, 4 were Type, 2 were Type II, 3 were Type IV, and 1 demonstrated multisegmental fractures. All of the closed fractures were united well except only one infected nonunion. The average time to union was 21.6 weeks with range from 16 to 26 weeks. The healing was tlowest in Type IV and fastest in Type I fractures. There was no significant difference in the healing time between the distal and proximal fractures. Of the 10 open fractures, each one of open type I fracture and open type II fractures did not united because of infected nonunion. The average time to union was 26.4 weeks with range from 16 to 38 weeks for the remaining 8 open fractures. The healing was slowest in Type IV and fastest in Type I fractures. There were 3 cases of infected nonunion, 1 case of delayed union of the proximal fracture and 1 case of valgus deformity of distal fracture. The infection was controlled and bone union obtained with removal of the nail and reaming, curettage and antibiotic bead wire, and plating with bone graft. We recommand that wherever poslible, interlocking intramedullary nailing can be used for the closed or open type I and II segmental tibial shaft fractures. And a high rate of union and a low rate of complication can be expected with this treatment modality.

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Interlocking Intramedullary Nailing for the Treatment of Segmental Fractures of the Femur: Kyung Jin Song, Hwang Jik Kim, Jeong Yul Kim, Joo Hong Lee, Byung Yun Hwang; J Korean Soc Fract 1998;11(3):522-527. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.522

Abstract PDF: Segmental femoral fractures are unusual injury caused by a severe force and associated with marked demage to the soft tissue, especially the quardriceps muscle. Intramedullary nailing is the most common treatment modality for the segmental femur fractures with high union rate and few complications. The purpose of this study is to evaluate the results of surgical treatment with interlocking intramedullary nailing for the segmental femoral fractures. We analyzed 23 consecutive segmental femoral fractures with static interlocking nail from May, 1989 to Feburary, 1997. Major associated injuries were sustained in 18 cases. There were 19 closed and 4 open fractures. Eighteen cases(78.3%) were done by closed technique and 5 cases(21.7%) were done by open technique. All fractures united at an average of 25.9 fractures. There were 3 malunion, 1 shortening(18mm) and stiffness of knee, 1 delayed union, and 1 limited motion of the knee. delayed union was treated by dynamization and autogenous bone graft, and additional intervention for union was unnecessary for the other problems. Although interlocking intramedullary nailing for the segmental femoral fracture is a techniqually demanding procedure, we recommand that it is the treatment of choice for closed and open(open type I) segmental fractures of the femur.

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The Effect of Dynamization After Static Intelocking Intramedullary Nailing: Kyoo Seog shin, Jong Soon Kim, Kong Wha Lee, Jin Hwan Seo; J Korean Soc Fract 1998;11(2):262-268. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.262

Abstract PDF: We had investigated the effect of dynamization in static interlocking intramedullary nailing for the long bone fracture of the femur and tibia treated in Bongseng Memorial Hospital for last 3 years (from Jan. 1994 to Jan. 1997) Total 62 patients (37 tibia, 28 femur) were treated, 35 cases were reamed at operaion and 27 cases not reamed. following results were obtained; 1. In all except 24 fractures, the static interlocking intramedullary nail was preserved without dynamization and got to mean union time of 17.2 weeks (femur) and 6.4 weeks (tibia). 2. The 24 patients (14 femur, 10 tibia) did not show callus formation and complained of vague pain in fracture site at 20 weeks after static mode. In those cases, we tried dynamization as a initial treatment modality. 3. The success rate after dynamization was about 87%. 4. The interval between nailing and dynamization did not affect the success rate. 5. Dynamization could be done day surgery.

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Posterior Cortical Fracture of Tibia during Tibial Interlocking Intramedurally Nail Extraction : A report of 3 cases: Jae Sung Seo, Jin Young Hong; J Korean Soc Fract 1997;10(4):892-896. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.892

Abstract PDF: We have experienced three cases of posterior cortical fracture of tibia during the removal of interlocking intramedullary nail which was made of titanium alloy with the prominent distal angulation. And we observed the distal translation of entry point in one case. The main reason of posterior tibial cortical fracture can be explained by the following statements : (a) prominent distal angulation increases cross sectional surface of nail in medullary canal at the time of extraction and (b) the distal translation of entry point increases the interface of posterior cortex at the time of extraction. In conclusion, we advise caution in the extraction of tibial nail of distally translated entry point which have a prominent distal angulation.

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Interlocking Intramedullary Nail Fixation for Tibiotalocalcaneal Fusion(2 cases): Young Ki Chung, Jung Han Yoo, Sung Il Shin, Yong Wook Park, Dong Cheol Pyo; J Korean Soc Fract 1997;10(4):860-865. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.860

Abstract PDF: Multiple fixation techniques for tibiotalocalcaneal arthrodesis have been introduced. The interlocking intramedullary nailing for tibiotalocalcaneal osteoarthritis with osteoporosis permits excellent internal fixation. We had two retrograde interlocking intramedullary nail fixation for tibiotalocalcaneal arthrodesis. One patient is chronic infectious osteoarthritis of the ankle and subtalar joints. And the other is non-union of the distal tibia with arthrofibrosis of the ankle and subtalar joints. Two patients also had osteoporosis due to long immobilization. The follow up period were 12 and 22 months respectively. The leg and foot is aesthetically pleasing and the musculature around the ankle and foot is maintained in the normal balanced position after the tibiotalocalcaneal fusion. So, we believed that the interlocking intramedullary nailing is an excellent treatment method for tibio talocalcaneal arthritis with osteoporosis.

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The Clinical Results of Unreamed Interlocking Intramedullary Nailing for Tibial Fractures: Young Ho Kwon, Hyun Mok Yang; J Korean Soc Fract 1997;10(3):569-574. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.569

Abstract PDF: Recently interlocking intramedullary nailing is used widely for the management of tibial shaft fractures. We evaluated any differences in healing time and complications associated with reamed and unlearned tibial interlocking intramedullary nailing. Between January 1991 and February 1996 we performed a retrospective trial on 62 patients with tibial shaft fractures comparing the reamed with unlearned interlocking nailing. The mean time to union for patients with unlearned intramedullary nail was 18.5 weeks(13 to 32 weeks) which was significantly less(P<0.05) than the 21.7 weeks(16 to 36 weeks) for reamed group. The complications of the reamed interlocking intramedullary nailing were three delayed unions (9.3%), three superficial infections(9.3%), and two cases of knee joint or ankle joint LOM(6.2%). The complications of the unlearned interlocking intramedullary nailing were four delayed unions(13.9%), three angular deformities(10.3%), three screw breakages(10.3%), and one superficial infection(3.4%). Unlearned interlocking intramedullary nailing is better for the tibial shaft comminuted fractures with small diameter, unstable tibial isthmus fractures, pelytraurnatized patient and some type of open fractures.

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Treatment of Distal Tibial Fractures by Interlocking Intramedullary Nailing: Bu Hwan Kim, Joung In Yim, Hee Yeong Chung, Jung Ju Kim; J Korean Soc Fract 1997;10(2):316-323. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.316

Abstract PDF: Intramedullary rigid nailing has been used to treat diaphyseal fracture of tibia, but with improvement of practical technical ideas, especially development of interlocking transverse screw, the indication of intramedullary nailing for tibial fracture became expanded to the fractures occurred 3cm proximal to the ankle joint. We treated 34 distal tibial fractures from Mar. 1992 to Feb. 1995 and followed up at least more than one year. The results of treatment were as follows ; 1. Time for union was 11.3 weeks in closed fracture group and 19 weeks in open group. 2. According to the functional classification of Klemm and Borner, excellent and good results were obtained in 30 cases(94.1%). 3. Complications developed in 7 cases which include ankle motion limitation, angular deformity, delayed union.

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