Journal of Musculoskeletal Trauma

The Result of Treatment in Fracture of the Proximal Humerus: Man Je Park, Byeong Yeun Seong, Seung Ki Lee, Taek Gun Lee, Sang Yol Shin, Hyung Su Kim; J Korean Soc Fract 2002;15(2):299-306. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.299

PURPOSE
To evalute the anatomical and functional outcome after treatment for proximal humerus fracture according to surgical and conservative treatment and assess the final results according to treatment methods.
MATERIALS AND METHODS
Forty-two cases with follow-up over 12 months were divided into three groups: conservative treatment (Group 1, 20 cases), closed reduction with Rush or percutaneous pin fixation (Group 2, 11 cases), proximal intramedullary interlocking nailing(Group 3, 11 cases). The functional outcome was obtained by modified neer method using self-assessed score paper and the anatomical outcome was obtained by paavolainen method using radiologic film score. Statistics in comparing with the result of each group was analized by variance analysis using Generalized Liner Model and Fisher?s exact test.
RESULT
Anatomical reduction was best obtained in group 3 (p< 0.05) and mean duration of bone union was 10.33 weeks. Functional score was also best obtained in group 3 (p<0.05). Complication was noted in 9 cases. There was only 1 case in group 3. In studing of overall outcome, the group 3 has good result than other groups.
CONCLUSION
Proximal intramedullary interlocking nailing in displaced proximal humerus fracture can be demonstrated as better method for anatomical reduction(p<0.05) than other methods because it can make insertion of locking screw ease with multiple direction for anatomical reduction and can provides a sufficient fixation for early rehabilitation and union , while minimizing complication.

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Does medial support decrease major complications of unstable proximal humerus fractures treated with locking plate?
Woo-Bin Jung, Eun-Sun Moon, Sung-Kyu Kim, David Kovacevic, Myung-Sun Kim
BMC Musculoskeletal Disorders.2013;[Epub] CrossRef
Comparison of Results between Internal Plate Fixation and Hemiarthroplasty in Comminuted Proximal Humerus Fracture
Doo-Sup Kim, Dong-Kyu Lee, Chang-Ho Yi, Jang-Hee Park, Jung-Ho Rah
Journal of the Korean Fracture Society.2011; 24(2): 144. CrossRef

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Interlocking Intramedullary Nailing of the Humerus Shaft Fractures: Ji Ho Lee, Jin Soo Park; J Korean Soc Fract 2000;13(4):982-991. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.982

Abstract PDF: PURPOSE
The purpose of this study is to document the results of the interlocking nailing of the humerus fractures which is still controversial.
MATERIALS AND METHODS
Twenty three cases of interlocking intramedullary nailing was done. 13 nails were inserted through the shoulder, 10 nails through the olecranon fossa. We used a closed technique for the 22 cases of the nailing.
RESULTS
Most patients who had antegrade nailing complained of shoulder pain. The bony union was obtained in 8 patients(61.5%) with antegrade nailing patients, somewhat high rate of nonunion compared to other methods of treatment. Criticism of the procedure is because of the trauma that can occur to the rotator cuff and possible impingement syndrome, which can occur after antegrade insertion. As for the retrograde nailing patients, the union rate was 90%, higher than that of antegrade nailing patients, but without statistical significance. Fracture propagation(3 cases), limitation in elbow extension(1 case) and rotational deformity(1 case) were occurred in retrograde nailing patients.
CONCLUSION
Though interlocking intramedullary nailing are an attractive alternative for humeral fracture stabilization because of the limited surgical exposure, there must be further considerations for the insertion site problems and improvement in bony union rate.

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Interlocking Nailing in Segmental Tibial Fractures: The Problems of the Fractures involving Proximal Portion: Ki Soo Kim, June Young Song, Kwang Soo Shon, Joon Han Kim; J Korean Soc Fract 2000;13(4):912-920. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.912

Abstract PDF: PURPOSE
To analyze the clinical features and treatment results of the tibial segmental fractures with the interlocking nailing. To compare the results between the segmental fractures with (Group I) or without (Group II) involving proximal portion of the tibia.
MATERIALS AND METHODS
We analyzed 16 patients, 16 cases of the tibial segmental fractures treated with the interlocking nailing between April 1993 and November 1998.
RESULTS
We obtained solid bone union for all cases and relatively good clinical results. The average bone union time was 20.6 weeks. The functional results were excellent in 7 cases, good in 6 cases and fair in 3 cases. There were 8 cases of malunion. The comparison between Group I and Group II revealed no remarkable differences for bone union time, functional results and complications. But the tendency of the malunion was more higher in Group I.
CONCLUSION
For segmental tibial fractures, interlocking nailing showed good clinical results. We propose that open reduction and internal fixation should be done before interlocking nailing of the fractures involving proximal portion of the tibia.

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The Angular Deformity of Interlocking Nailing in Tibial Fractures: Hwa Jae Jeong, Kyung Chul Kim, Jae Yeul Choi, Bon Seop Koo, Jung Hee Oh; J Korean Soc Fract 2000;13(4):905-911. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.905

Abstract PDF: PURPOSE
We studied the relationship between angular deformity and possibly contributing factors in the treatment of tibial fractures with interlocking nailing.
MATERIALS AND METHODS
Intramedullary nailing of the tibia was performed on 49 cases and were followed for the minimum of 12 months. We analyzed relationship between angular deformity and postoperative tibial alignment, operative technique and other factors.
RESULTS
Of the 49 cases, 19(38%) were angulated. Angular deformity was seen in 60%, 51.8% and 11.8% in the proximal, distal and middle third of tibial fractures respectively. With AO classification, Group A,B,C were angulated in 32.4%, 55.6%, 66.7%. In group A, 43.8% of spiral fractures, 28.6% of oblique fractures and 14.3% of transverse fractures were angulated. The cases combined with fibular fracture showed higher incidence of angular deformity than the cases with intact fibula. The opening of fracture and the nail insertion site were not significant to angular deformity.
CONCLUSION
Angular deformity of interlocking nailing in tibial fractures were more common in proximal, comminuted and spiral fractures. Precise attentions to operative technique i. e. accurate anatomical reduction and centromedullary nail orientation are recommended to prevent angular deformity. In proximal third tibial shaft fractures where muscles and patellar tendon has deforming force on fracture fragment, authors believe that use of interlocking nailing must be limited with fracture pattern.

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Effects of Fibular Fixation for Interlocking Nailing of Distal Tibiofibular Fractures: Sang Ho Moon, Phil Hyun Chung, Chung Soo Hwang, Dong Ju Chae, Beom Kim; J Korean Soc Fract 2000;13(2):296-302. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.296

Abstract PDF: PURPOSE
: To compare redioiogic results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures.
MATERIALS AND METHODS
: From April 1993 to February 1999, 26 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 61 fractures fixed with nails only. Average age of patients was 41.8 years. These two groups were compared by frequency of malalignment, degree of postoperative angulation, angulation according to comminution, angulation according to fracture configuration. The statistical analysis was evaluated by t-test.
RESULTS
: Fibular fixation group had no malalignment while non-fixations had angulation of 1.2+/-1.1 degree and non-fixation had 3.0+/-2.1. So fixation had lessor angulation than non-fixation significantly(p=0.004). In lateral rediographs, each had 1.3+/- 1.1, 2.8+/-2.3 degree and showed significant difference(p=0.027). In type I and II fractures of Winquist-Hansen classification, fixation group showed lesser degree of angulation in A-P plane significantly(p=0.008) but no significant difference in lateral plane. In type III and IV, no significant difference in both planes. According to configuration of fractures, transverse and spiral fractures showed no significant differences but oblique configurations had significant differences in A-P plane(p=0.002) CONCLUSION : Interlocking intramedullary nail with fibular fixation has the advantage in maintenance of alignment during insertion of nail in distal tibiofibular fractures, especially in Winquist-Hansen classification type I and II and oblique fractures in anteroposterior plane, so it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

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Treatment of communited & Segmental Femoral shaft Fracture by using Interlocking nailing: Comparison between Closed and Open techniques: Chang Hyuk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Ho Sun Chang; J Korean Soc Fract 1999;12(3):516-522. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.516

Abstract PDF: When femoral shaft fracture with severe communition and segmentation result from violent force, they are frequently associated with severe soft tissue damage. Treatment of this unstable fracture need the rigid fixation in order to prevent shorting and rotational loading. In terms of this advantages, interlocking nailing technique was widely used with open and closed methods. In the cases of fractures that having large fragments and wide displacement, closed technique has disadvantage of difficulties in anatomic reduction and its maintenance. Nineteen femoral shaft fractures had been treated by these techniques alternatively at our hospital between Feburary 1994 and Feburary 1997 and had been followed for more than 12 months. Among the 19 cases, closed techniques were 11 cases and open 8 cases. We evaluated the results of two treatment methods in terms of the bone union time, complications and functional results. Mean duration of the bone union time was 24.2 weeks in closed interlocking nailing, 24.5 weeks in open. There was no difference between the bone union time and the operation techniques(p-value>0.05). And complications were delayed union in two cases. In conclusion, in the cases of severe comminuted and segmental femoral shaft fractures especially with posteromedial fragment, open technique was more useful than closed technique, in terms of anatomic restoration and getting functional recovery afford to preinjury level of work.

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A Comparison of Using Closed Interlocking Nailing versus Plate Fixation in Humeral Shaft Comminuted Fractures: Dong Gyu Lee, Woo Dong Nam, Jang Seok Choi; J Korean Soc Fract 1999;12(1):126-134. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.126

Abstract PDF: The purpose of this paper is to compare the results, complication, advantages and disadvantages of treatment with closed interlocking intramedullary nail with those with plate in humeral shaft comminuted fractures. The authors have reviwed 25 cases of humeral shaft comminuted fractures, which were treated with closed interlocking intramedullary nail in 14 cases and plate in 11 cases, from November 1992 to May 1996. The results were as follows: 1. The average time of operation in closed interlocking nailing was 72 minutes and that of plate fixation was 104 minutes. 2. The average time for bone union was 14.7 weeks in closed interlocking nailing and 14.9 weeks in plate fixation. 3. The complications of closed interlocking nailing were 2 cases of delayed union, 1 case of nonunion, 1 case of postoperative radial nerve palsy and 3 cases of pain and stiffness of shoulder. 4. The complications of plate fixation were 1 case of delayed union, 2 cases of nonunion, 1 case of postoperative radial nerve palsy, 1 case of stiffness of shoulder. 5. Excellent and good functional results rated by Stewart and Hundley were 12(85%) cases in closed interlocking nailing and 8(73%) cases in plate fixation. We concluded that closed interlocking nailing is one of the better useful method of treatment in humeral shaft comminuted fractures but, the procedures should be performed exactly.

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Use of Interlocking Intramedullary Nail in Treatment of Delayed Union or Nonunion of the Long Bone Fractures: Suk Kyu Choo, Byung Jik Kim, Han Suk Ko, Jeong Gook Seo, Jin Gu Kim, Jun Woo Chang; J Korean Soc Fract 1998;11(4):761-768. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.761

Abstract PDF

Of the several nonoperative and operative options described for the treatment of delayed union and nonunion of the long bone, interlocking nailing with reaming offect of internal splint, autogenous bone graft and early return to a normal way of life. The purpose of this study is to evaluate the usefulness and complication of intramedullary(IM) naling with reaming by retrospective method. We treated 34 patients with delayed union or nonunion of the tibia, femur, and humerus by interlocking nailing with reaming between January 1992 and December 1996. The results were as follows ; 1. Of the 34 cases, there were 13 tibia fracture, 17 femur fracture, 4 humerus fracture. Half of them were ununited and another half were delayed in fracture healing. 2. Previous methods of treatment were conservative treatment in 2 cases, external fixator in 2, plate & screws fixation in 8, Ender nail in 2, Kuntscher nail in 2 and interlocking nail in 7 among 24 cases of cloed fracture and external fixator in 8 and interlocking nail in 2 among 10 cases of open fracture. 3. Twenty-five patients were treated with closed nailing and 9 were treated with open nailing. Iliac bone graft was performed at 3 cases and fibulotomy was performed at 1 case. 4. Union was obtained in 33 cases and 1 case needed additional bone grafting to achieve union. 5. Postoperative complications were one nonunion, two evtry site pain, one screw breakage, one heterotopic ossification, and one postoperative infection. Interlocking nailing with reaming was associated with a high union rate(97%) in our eries. The authors believe that IM nailing with reaming is a useful option for treatment of delayed or nonunion of the long bone fracture.

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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
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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Treatment of the Femoral Shaft Fractures using Unreamed Interlocking Intramedullary Nail: Sung Taek Jung, Eun Sun Moon, Moon Lee; J Korean Soc Fract 1998;11(2):471-476. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.471

Abstract PDF: The current trend in the use of the unreamed intramedullary nail to avoid the increased damage to the intramedullary blood supply may be theoretically attractive for femoral shaft fracture stabilization but little clinical and radiological attention was reported. We have evaluated the results of treatment of femoral shaft fracture with unreamed interlocking intramedullary nail. Thirty-eight femoral fractures have been followed for more than twelve months were included in this study. Most of the fractures were the result of moderate to high-energy trauma. Thirty-three cases were fresh closed fracture and five were open fractures. Winquist-Hansen type I fracture (16 cases) were most common and healing period was shorter than other type. Healing occurred in 35 cases and mean healing period was 18.7 weeks with a range of 11 to 32 weeks. Postoperative complications were delayed union in 3 cases. We concluded that unreamed interlocking nailing for femoral shaft fracture seems to be a useful method with low complication rate.

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Treatment of the Femoral Shaft Fracture by Interlocking Intramedullary Nailing: Sung Joon Im, Sung Jin Kim, Dae Sang Yoo, Ho Sik Sung; J Korean Soc Fract 1998;11(1):181-190. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.181

Abstract PDF: Femoral shaft fractures result from high energy trauma such as traffic accident or falls, and it is frequently accompanied by multiple fractures and several other organ injuries. Intramedullary nail is the effective device available for patient with appropriate fracture of the femoral shaft, and it may also prevent several complications, such as infections and delayed union that can be caused by periosteum and soft tissue injury. Rigid internal fixaton of the femoral shaft fracture with interlocking intramedullary nails presents a significant advance in the management of unst-able fractures and provides longitudinal and rotational stability as well as early joint motion and weight bearing. This procedure has been used with wide popularity because it is possible simultaneously to preserve the range of motion and to obtain the bone union. The purpose of this sutdy is to evaluate the differences of the functional results and duration of the bone union based on Winquist-Hansen classification. Also we analyzed the causes of the complications and results of the treatment. Forty one cases of the femoral shaft fractures were treated with interlocking intramedullary nailing during the period from January 1993 to June 1995 over 12 months follow up. The results were as follows: 1. Among 41 cases of the femoral shaft fractures, static nailings were used in 34 cases and 7 cases with dynamic nailings, then bone union was achieved at 18 weeks for static mode and 15 weeks for dynamic mode respectively. 2. Intraoperative complications were new fractures near the original fracture site(2 cases) and femur neck(1 case). 3. Postoperative complications were delayed union(4 cases), metal failre(1 case), limb shortening(1 case) and distal screw breakage(1 case). 4. Delayed union developed in 4 cases with static mode, but bone union was achieved at average of 22 weeks after changing to dynamic mode at 15 weeks. 5. Functional results were assessed by Karlstrom and Olerud criteria and 80% of the patients were in excellent and goood results.

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Surgical Management of the Proximal Tibial Shaft Fractures - A Comparison of Plate Fixation and Interlocking Intramedullary Nailing -: Ki Soo Kim, Yong Soo Choi, Chul Hun Choi, Jin Ho Yang; J Korean Soc Fract 1997;10(4):872-878. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.872

Abstract PDF: The treatment of proximal tibial shaft fractures is an area of great controversy. The purpose of this study was to make the comparison between the results of the plate fixation and those of the interlocking nailing, and to identify the effects of the location of the nail bend on the reduction of the proximal tibial shaft fractures. From June 1991 to May 1995, we performed the plate fixation in 12 cases and interlocking nailing in 16 cases for the proximal tibial shaft fracture. We subdivided the interlocking nailing group into two groups: Group A had the fractures within the posterior bending length of the nail in 8 cases, Group B had the fractures over the posterior bending length of the nail in 8 cases. The results were as follows; The most common type of fractures was the Winquist-Han son type III, 9 cases(75%), in the plate fixation group, and the segmental fracture, 10 cases(62.5%), in the interlocking nailing group. In the plate fixation group, autogenous bone graft were used in 7 cases (58.3%), primary in 5 cases and secondary in 2 cases. The interlocking nailing group had a tendency to cause the surgical problems during the nailing such as angular deformity in 3 cases, displacement of the fracture in 2 cases, extension of the fracture in one case, need an open reduction in one case and unstable fixation in one case. The surgical problems were associatied with the incorrect entry point and the fractures within the posterior bending length of the nail (Group A). Clinically excellent and good results, according to Klemm and Borner criteria, were obtained in 12 cases(100%) of the plate fixation group and 13 cases(81.3%) of the interlocking nailing group. the fair results were associtated with the angular deformity in the Group A. In conclusion, the preoperative planing must carefully consider such as the type of fracture, technical familarity, and understanding of the implants and instrumentations ofr the successful treatment of the proximal tibial shaft fractures. The plate fixation is preferable method for the fractures within the posterior bending length of the nail(Group A).

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Treatment of the Femur Shaft Fractures using Interlocking Nail: Jong Keon Oh, Soon Hyuck Lee, Seung Woo Suh, Young Soo Byun; J Korean Soc Fract 1997;10(2):289-294. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.289

Abstract PDF: A series of forty patients who had forty femoral shaft fractures that were treated with static interlocking nailing were analyzed to determine the incidence of union of the fracture without planed conversion from static to dynamic intramedullary fixation as a technique to stimulate healing of the fracture. All of the forty cases were nailed using closed method under the guide of a image intensifier. The time to full weight was individualized for each patient and depend on the degree of comminution, the postoperative cortical contact between the major fragments, the presence of bridging callus as seen on follow up x-rays, and the patients mobility according to the associated injuries. Healing occurred in thirty nine(97%) of the forty fractures of the femoral shaft that had been treated with static interlocking nailing without dynamizaton. Only one patient needed conversion from static to dynamic interlocking fixation to promote fracture healing. This patient had a delayed union after closed interlocking nailing of Gustilo type I open midshaft fracture associated with Winquist type II comminution. We concluded that static interlocking nailing for femoral shaft fractures does not seem to inhibit the fracture healing process, and that conversion to dynamic intramedullary fixation is needed only for exceptional cases of delayed union.

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Angulation Deformity Following Interlocking Nailing for Treaeent of Tibia Fracture: Hong Jun Han, Jae Hoon Shin, Jeong Hyu Lee; J Korean Soc Fract 1996;9(4):1002-1008. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1002

Abstract PDF: Intramedullary nailing is often the treatment of choice in the management of fractures in the tibial diaphysis. With the advent of interlocking nailing, the indication for nailing have expanded, recently. One of the most frequent but little discussed complication of tibial nailing is fracture malalignment leading to angular or rotational deformities. This retrospective study was undertaken to access the incidence of aneular malalignment after interlocking nailing for 210 tibiae(208 patients). The results obtained were as follows; 1. The incidence of angular malalignment was 12.4% 2. The incidence of angular malalignment was 15.8% in proximal one third, 4.1% in middle one third,20.7% in distal one third fractures. 3. The most frequent deformity was valgus angulation in distal one third fractures. 4. Angular deformity was developed more frequently in cases of unlearned nailing(18.9%) than reamed nailing(8.4%). 5. Angular deformity was developed more frequently in cases of double level fracture(22.2%) than single level fracture(11.5%).

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The Treatment of Nonunion of Femoral Fractures with an Interlocking Nailing: Churl Hong Chun, Sang Soo Kim, Dong Churl Kim, Hee Jun Yoo; J Korean Soc Fract 1995;8(3):497-504. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.497

Abstract PDF

Nonunion of femoral fractures has continued to challenge orthopaedic surgeons. Interlocking nailing with reaming offers the advantages of stable fixation. adequate alignment, minimum shortening, good rotational control, early weight bearing without external support and high union rate. Between August 1988 and March 1993, 20 patients with nonunion of the femoral fractures were treated by an interlocking nailing with reaming. The types of primary treatment prior to nonunion were plate fixation in 10 patients, conventional intramedullary nailing in 9 patients and external fixation in 1 patient. The purpose of this study was to evaluate the causes of nonunion and analyze the results with interlocking nailing in the management of nonunion of femoral fractures. The radiological examination revealed that formation of the bridge callus took a mean of 3.5 months for the patients who received the plate and screw fixation. On the other hand. it took a mean of 2.4 months for the patients who were treated with conventional intramedullary nailing. When the two groups of patients were combined, it took a mean of 3.2 months. All patients were obtained the complete union in a mean time of 10.4 months after an interlocking nailing. Complications were 1 breakage of distal target screws. 1 pain near the entry of nail and 1 delayed union. Limb shortening was measured by roentgenoscanography and occurred in all patients but not clinically significant.

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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
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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Application of Unlearned Interlocking Nailing for Tibial Shaft Fractures: Hee Kwon, Kyoung Dae Min, Jong Suk Park, Jae Uk Kwon, Soo Byoon Rah, Chang Uk Choi; J Korean Soc Fract 1995;8(1):292-299. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.292

Abstract PDF: Intramedullary nails may be divided into two categories: unlearned and reamed. reaming effectively lengthens the isthmus of the tibia and thereby extends the number of fractures amenable to this technique, but other studies showed that union impairement and infection rates were relatively high because of reaming destroyed the endosteal blood supply, especially open fractures. Unlearned interlocking nails in open fractures offer the advantage of less damage to the intramedullary blood supply Also lower infection rates have been reported in open fracture when compared with reamed nails. We analysed 22 cases of tibial shaft fractures managed with interlocking nailing without reaming and experienced treatment of complications since September 1992. Average follow-up period was 13 months ranged 5 to 17 months and results were as follows: 1) We used an unlearned interlocking nails for tibial open fractures, 14 cases(Gustilo-Anderson type: I.3 cases, II.5 cases, III a 4 cases, III b.2 cases)and closed fractures asscciated with combined injuries, 8 cases. 2) Union occurred an average of 5.2 months postoperatively with a range from three to 14 months. 3) The complications were 2 cases of superficial infection and 5 cases of nonunion(3 cases among the 8 cases of closed fracture and 2 cases among the 14 cases of open fracture. 4) The treatment of nonunion was successful with bone graft, additional screw fixation and reinsertion of reamed nail. 5) We concluded that unlearned interlocking nailing was useful method to treat the open tibial shaft fractures in the selected cases, but undesirable to treat closed tibial shaft fractures because considered less mechanical stability.

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Proximal Femral Fracture During Closed Intramedullary Interlocking Delta Nailing: Phil Hyun Chung, Moon Jib Yoo, Suk Kang, Eung Nam Cha, Yong Min Kim, Jong Won Kim; J Korean Soc Fract 1992;5(2):378-382. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.378

Abstract PDF: Closed intramedullary nailing is a complex technique which usually requires fracture table and image intensifier, so that the patient and surgeon are exposed to the radiation. But this technique affords considerable advantages such as high rate of union, less infection rate and early weight bearing, etc. The main causes of failure or complication of this procedure are inapproprisate entry point and inadequate nail size. These are especially important problems in the patient who is femoral canal diameter is very small (8 or 9mm). The Delta femoral interlocking nails (diameter 10mm and 11mm)were devised for the femurs with narrow canal diameter. However, proximal portion of the Delta nail (about 7cm from the proximal end)is thick (diameter 13mm)to gain strength enough for holding the insertion device and fixation of the interlocking screws. If the insertion point is not correct or proximal reaming is inadequate, iatrogenic proximal femoral fracture may occur during final insertion of the nail. We experienced 2 cases of this complication during fixation of femoral shaft fractures using the Delta nails. We managed thls problem with hip spica cast immobilization in one case, and multiple pinning of femur neck in the other.

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Treatment of the Tibia Fractures with Unreamed Intramedullary Interlocking Nailing: Jae Won You, Dong Min Shin, Young Bne Pyo; J Korean Soc Fract 1992;5(2):282-288. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.282

Abstract PDF: The intramedullary interlocking nailing for the fractured tibia has been used in selected cases of fresh diaphyseal fracture, but the indication has been expended considerably with modern technical improvement. The authors analyzed 28 cases of fresh fractures of the tibia, who were treated with unlearned intramedullary interlocking nailing in out hospital between May 1990 to Oct. 1991, average follow-up was 12 months ranged from 8 to 22 months and we obtained the following results. 1. The most common causes of the injury were traffic accident(19 cases). 2. Mostly associated injury was ipsilateral fibular fracture(24 cases). 3. We used unlearned intramedullary interlocking nail in all cases and dynamic and static interlocking were done in 12 cases and 16 cases respectively. 4. The average bony union was demonstrated radiographlcally at 16 weeks. 5. The complications were deep infection(1 case), delayed union(2 cases), angular deformity (4 cases), superficial infection(3 cases), limitation of knee joint ROM(3 cases) and shorte ning of leg length(2 cases). 6. In case of the treated for method of unlearned nailing, it is not difficut to insert the nail, and we obtained good bony union, decresed operation time and bleeding. The authors concluded that unlearned intramedullary interlocking nailing is useful method to treat the tibla fracture.

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Femoral subtrochanteric fracture during closed meduallary nailing: two cases report: Yeub Kim, Ki Soo Kim, Seong Taek Kim, Young Youl Chung; J Korean Soc Fract 1991;4(1):119-122. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.119

Abstract PDF: No abstract available.

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