Journal of Musculoskeletal Trauma

Surgical Techniques for Percutaneous Reduction by Towel Clips and Percutaneous Intramedullary Fixation with Steinmann Pins for Clavicle Shaft Fractures: Ki Do Hong, Jae Chun Sim, Sung Sik Ha, Tae Ho Kim, Jong Hyun Kim, Jong Seong Lee; J Korean Fract Soc 2012;25(1):31-37. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.31

PURPOSE
To report the clinical results of surgical treatment of clavicle shaft fracture by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation.
MATERIALS AND METHODS
This study reviewed the results of 80 cases of clavicle shaft fracture treated by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation with Steinmann pins from January 2002 to August 2010, after follow-up for 12 months or more. We evaluated the clinical results, such as union time and complications.
RESULTS
Bone union was evident in all cases and the mean time for bone union to appear on radiological findings was 10.3 weeks. Using Kang's criteria, 78 of the 80 patients (97.5%) showed good results and there were no severe complications.
CONCLUSION
Percutaneous reduction with towel clips and the percutaneous intramedullary pin fixation method showed good results for treating clavicle shaft fracture.

Citations

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Additional fixation using a metal plate with bioresorbable screws and wires for robinson type 2B clavicle fracture
Woo Jin shin, Young Woo Chung, Seon Do Kim, Ki-Yong An
Clinics in Shoulder and Elbow.2020; 23(4): 205. CrossRef
A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture
Seong-Ho Yoo, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Yeong-Joon Kim, Gyu-Taek Park, Chang-Hun Kwack
Journal of the Korean Orthopaedic Association.2017; 52(1): 1. CrossRef

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Flexible Intramedullary Pin Fixation of Both Forearm Bone Fractures in Children: Young Jin Sohn, Yong Woon Shin, Hyung Jin Chung, Sang lim Lee, Jae Kwang Yum, Yerl Bo Sung, Jong Kuk An, Eul O Choi; J Korean Fract Soc 2006;19(2):271-276. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.271

Abstract: PURPOSE
To evaluate the efficacy of Flexible intramedullary pin fixation in pediatric forearm diaphyseal fractures.
MATERIALS AND METHODS
In this retrospective study, we reviewed 15 cases of forearm diaphyseal fractures operated using flexible intra-medullary nail fixation technique between January 2000 and December 2004. Of these 15 children, there were 11 boys and 4 girls with an average age of 11.6 years (range, 7~15 years). The implants were introduced in the distal radius and proximal ulna in all patients. An average duration of fixation was 5.3 months in the radius, 4.7 months in the ulna. After operation, all patient were applied with a long arm cast and the duration of immobilization was 5.2 weeks (range, 4~6 weeks) on average.
RESULTS
All fractures in this series healed with normal range of supination (average 80.0) and pronation (average, 71.6 degrees). Average operation time including anesthesia was 123 minutes and hospital stay was 5.4 days. Time to union was 8.4 weeks on average. Range of motion and functional results were satisfactory in all cases. There were one case of incomplete ulnar nerve injury and two cases of refracture which were treated conservatively without any permanent complication.
CONCLUSION
Flexible intramedullary pin fixation technique is a good method in case of unstable displaced fracture and difficult or failed closed treatment.

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Surgical Treatment of Type II distal clavicle end Fracture: Phil Hyun Chung, Suk Kang, Dong Joo Chae, Jong Pil Kim, Sang Ho Lee; J Korean Soc Fract 2002;15(2):106-113. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.106

Abstract PDF: PURPOSE
Many authors have supported open reduction and internal fixation of type II distal clavicle fractures because of high rates of nonunion and delayed union after conservative treatment. Authors analyzed thirty-nine cases of type II distal clavicle fractures which had been treated operatively and reviewed the result of operative treatment retrospectively.
MATERIALS AND METHODS
We evaluated 39 unstable distal 1/3 clavicular fractures with operative treatment from May 1992 to December 1999 and followed up for at least 1 year. According to the classification of Rockwood, type IIa was 28cases and IIb was 11 cases. We treated all the cases by open reduction, such as transacromial pin fixation in 27 cases, and plate and screws with or without bone graft in 12 cases. The operative method was chosen in operative field.
RESULT
We analyzed the results in term of the time to radiologic union, functional evaluation, and complications. Average time to union was 8.5 weeks in the cases of transacromial pin fixation and 12.7 weeks in the cases using plate and screws with or without bone graft. Functional results was evaluated by classification of functional results by Kona et al. In cases of transacromial pin fixation, excellent result was 13 cases and good was 14 cases. In cases of plate and screws, excellent result was 4 cases, good 6 cases, fair 1 case, and poor was 1 case. The complications of transacromial pin fixation were 4 cases of pin site infection and 1 case of pin migration. But, neither nonunion nor deep infection was appeared. The complication of plate and screws was 2 cases of metal failure in which were fixated by only two cortical screws on distal fragment.
CONCLUSION
We concluded that minimal open reduction and transacromial pin fixation is thought to be good method in treatment of distal 1/3 clavicular fracture in regard to the time to union, functional results, and complications.

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Results of cross pinning fixation for supracondylar fracture of the humerus in children: considering adequate reduction and instability: Jong Hun Jee, Bong Soon Chang, Seung Baik Kang, Choong Hee Won, Eui Seong Choi; J Korean Soc Fract 1998;11(4):985-993. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.985

Abstract PDF: The supracondylar fracture of the humerus is the most common fracture of the elbow in children. New trends of treatment is that if satisfactory reduction is achieved by manual reduction, medial and lateral cross percutaneous pin fixation is better than others for stable fixation. Among many complications, cubitus varus deformity most commonly results from inaccurate reduction and failure in maintenance of fixation. The obliquity of the fracture, together with internal rotation, causes angular deformity. The angulation and coronal rotation, or tilting of distal fragment, often cause the deformity and limitation of motion of elbow. The porty-two Gartland type II, III supracondylar fractures of the humerus were treated by losed reduction or open reduction with percutaneous pinning or internal fixation from May 1993 to December 1995. The results were as follows; 1. the frequency of difference above 5degree in Baumann's angle was relatively high if fracture line is oblique on lateral roentgenogram or medial column comminution is present, that means unstable reduction. 2. In average, 2.7 pins were needed for reduction and maintenance of stability at this time. 3. Even though a few degree of rotation(5mm), translation(2-4mm) and angulation(5-10degree) were present at immediate reduction, carrying angle and Baumann's angle of follow-up period were often remained about the similar values compared with healthy side. If acceptable intraoperative carrying angle was achieved and a few degree of rotation, translation and angulation were permitted after reduction, varus deformity and limitation of motion of elbow were rerely caused. so repeating forceful manual reduction for anatomical reduction must be avoided because the final results may become progressively remodelled to normal.

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Multiple Knowles Pin Fixations of the Femoral Neck Fractures in Adults under 60 Years of Age: Sang Won Park, Kwang Suk Lee, Dae Gon Wie; J Korean Soc Fract 1996;9(4):859-868. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.859

Abstract PDF: Femoral neck fracture is more common in elderly even by minor trauma because of osteoporosis. In young adults, though the incidence is low, have a poor prognosis because of high incidence of non-union and aseptic necrosis. The treatment method of the femur neck fracture is widely divided into internal fination and replacelnent arthroplasty But there is still contrversies present in the treatment methods. The object of this study is to observe the relationships between the clinical outcomes and the age, the degree of displacement. the type of reduction, the time of operation and the bone density in the femoral neck fractures treated with mulliple Knowles pin fitation. The authors analyzed 29 cases of femoral neck fractures in adults under 60 years of age, who were treated with multiple pih (ixation and followed up more than 1 yearduration The results obtained were as follows; 1. The union of femoral neck fracture occured in 19 cases(65.5%) among the 19 cases and the mean duration of union was 4.8 months. 2. The complications were 8 cases(21.6%) of avascular necrosis, 2 cases(6.9%) of non-union, 2 cases of malunion and 1 case of post-traumatic arthritis. 3. The functional results by Lunceford criteria were satisfactory in 17 cases (58.6%). 4. In the patient group which were no avascular necrosis and non-union showed 89.5% of satisfactory functional end result. 5. There was a relationship between the complications such as avascular necrosis and non-union, and age of the patient, bone density, degree of initial displacement and type of reduction. But the duration between the injury and operation did not influence the complication rate. According to the above results, we concluded that multiple Knowles pin fination in femoral neck fracture is simple and safe method, and one of salvaging method of femoral head in adults under 60 years of age.

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Treatment of Supracondylar Fracture of Humerus in Children: Conservative vs Operative Treatment: Jong Min Sohn, Ju Hai Chang, Dong Heon An, Seung Pyo Eun, Han Seok Son; J Korean Soc Fract 1996;9(3):695-705. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.695

Abstract PDF: Supracondylar fracture of the humerus is the most common fracture around the elbow joint in children, especially in the age from 4 to 9. 97% of the fractures are extension type and there are many problems in management such as the method of reduction and maintenance of reduction, Volkmanns ischemia, neurovascular injuries, cubitus varus or valgus deformity, and myositis ossificans etc. Currently the methods of treatment of supracondylar fracture include open reduction and pin fixation, closed reduction and percutaneous pin fixation, and closed reduction and immobilization by splint. 134 children with supracondylar fracture of humerus, conservatively 49 cases and operative 85 cases, were treated from January 1991 to October 1995 and were followed up for at least 6 months. We analyBed the type of fracture, method of treatment and results and concluded that accurate reduction, minimizing soft tissue injury and maintenance of reduction are important factors for gaining good results.

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