Trochanteric entry femoral nails have been widely used for fixation of femoral shaft fractures because of easier identification of the entry point. Young patients usually request removal of the nail after healing of the fracture. We experienced a failure and difficulty in removal of the trochanteric entry nail in two adolescent patients. In the patient in which the nail could be removed with difficulty, dense compact bone was formed through the empty interlocking holes and the nail was held just like a latch. This finding was quite similar to the computed tomography findings of the patient in which the nail could not be removed. In order to remove the nail, the newly formed, dense compact bone in the interlocking holes must be broken and detached from the femur itself. We suggest that dense compact bone through the empty interlocking holes might be a clue for difficult removal of the trochanteric entry nail.
Stress fractures occur when the loads applied to a bone exceed the mechanical resistance and fall into two groups. Fatigue fractures, in which abnormal mechanical stress is applied to a normal bone, and insufficiency fractures, in which fracture occurs when stress of normal activity is applied to a bone that has decreased elastic resistance. Femoral shaft insufficiency fractures are reported rarely in patients with postmenopausal osteoporosis. We report a case of repetitive insufficiency fractures of the femoral shaft in 70 year-old female with marked osteoporosis.
PURPOSE evaluate the effectiveness of minimally invasive plate osteosynthesis (MIPO) in unstable fractures of the distal tibia. MATERIALS AND METHODS From March 2001 to December 2003, 21 cases with unstable fractures of the distal tibia were treated with MIPO technique and followed for at least one year. Eighteen cases were extra-articular and three cases were intra-articular fractures. According to AO classification, six cases were 42-A, four 42-B, one 42-C, seven 43-A, and three 43-C. There was only one case of Gustilo-Anderson type II open fracture. We reviewed the results of fracture healing, axial and rotational deformity, ankle motion, and complications RESULTS: All fractures were healed in an average of 16.1 weeks (range, 11 to 24 weeks). There was only one case of 7-degree posterior angular deformity, but no cases of rotational malalignment. Recovery of ankle motion was satisfactory in all patients within 5-degree loss of motion. Subcutaneous abscess was developed in one case after fracture healing and cured by a drainage with implant removal. CONCLUSION Although MIPO technique is technically more demanding than the traditional open technique, MIPO technique is an effective method for unstable fractures of the distal tibia because it minimizes incidence of soft-tissue compromise and infection and provides good fracture healing.
Citations
Citations to this article as recorded by
Clinical Outcomes of Locking Compression Plate Fixation through Minimally Invasive Percutaneous Plate Osteosynthesis in the Treatment of Distal Tibia Fracture Jae-Sung Yoo, Hyun-Woo Park Journal of the Korean Fracture Society.2012; 25(2): 117. CrossRef
Staged Protocol in Treatment of Open Distal Tibia Fracture: Using Lateral MIPO Oog Jin Sohn, Dong Hwa Kang Clinics in Orthopedic Surgery.2011; 3(1): 69. CrossRef
Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn Journal of the Korean Fracture Society.2010; 23(3): 289. CrossRef
Management of Fractures of Distal Tibia by Minimally Invasive Plate Osteosynthesis through an Anterior Approach Gu-Hee Jung, Jae-Do Kim, Jae-Ho Jang, Sung-Keun Heo, Dong-won Lee Journal of the Korean Orthopaedic Association.2010; 45(6): 473. 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
Basic Principle of the Locking Compression Plate Keun Bae Lee Journal of the Korean Fracture Society.2008; 21(3): 261. CrossRef
Treatment of High-energy Distal Tibia Intraarticular Fractures with Two-staged Delayed Minimal Invasive Plate Osteosynthesis Hong-Moon Sohn, Jun-Young Lee, Sang-Ho Ha, Jae-Won You, Sang-Hong Lee, Kwang-Chul Lee Journal of the Korean Fracture Society.2007; 20(1): 19. CrossRef
Minimally Invasive Plate Osteosynthesis, MIPO Young-Soo Byun Journal of the Korean Fracture Society.2007; 20(1): 99. CrossRef
Minimally Invasive Percutaneous Plate Osteosynthesis Using Periarticular Plate for Distal Tibial Fractures Young Mo Kim, Jae Hoon Yang, Dong Kyu Kim Journal of the Korean Fracture Society.2007; 20(4): 315. CrossRef
PURPOSE To analyze early postoperative complications of calcaneal fractures operated by a lateral extensile approach and to identify risk factors for wound complications. MATERIALS AND METHODS From July 1990 to February 2003, 116 calcaneal fractures in 104 patients were treated by open reduction and internal fixation through a lateral extensile approach. The patient's records were reviewed for early postoperative complications. Statistical analysis was performed to determine significant relationships between predicted variables and the development of wound complications. RESULTS Fourteen fractures (12.0%) developed infection. Ten of them were superficial infection and four were deep infection that required surgical treatment. Eight fractures (6.9%) developed skin necrosis. Six of them were marginal skin necrosis and two were flap necrosis that required surgical treatment. Seven fractures (6.0%) developed sural nerve injury, but their symptoms were improved without additional treatment. Open fracture (p=0.003) and prolonged operating time (p=0.049) increased significantly the rate of wound complications. CONCLUSION The rate of early postoperative complications of calcaneal fractures operated by a lateral extensile approach is high. These complications can be reduced by meticulous treatment of an open wound, reduced operating time within 90 minutes through preoperative planning and skillful technique, and correct incision to avoid damage of the sural nerve.
Citations
Citations to this article as recorded by
Results in Operative Treatment of Open Calcaneal Fracture Ba Rom Kim, Jun Young Lee, Donghyuk Cha Journal of Korean Foot and Ankle Society.2021; 25(3): 133. CrossRef
Bilateral Open Transcalcaneal Fracture with Talonavicular Dislocation - A Case Report - Hun Park, Sung Jin Shin, Sang Rim Kim, Kwang Woo Nam, Sung Wook Choi, Kyu Bum Seo, Jun Young Seo Journal of the Korean Fracture Society.2011; 24(1): 87. CrossRef
Treatment of Intra-articular Calcaneal Fractures Using Minimally Invasive Sinus Tarsi Approach in Diabetic Patients Hong-Moon Sohn, Sang-Ho Ha, Sang-Hong Lee, Jun-Young Lee, Jeong-Ho Kim, Sang-Jun Lee Journal of the Korean Fracture Society.2008; 21(3): 195. CrossRef