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Original Articles
- Problems in the use of Compression Hip Screw in the Treatment of Hip Fractures
- Myung Sang Moon, In Ju Lee, Nam Yong Choi, Dong Soo Choi
- J Korean Soc Fract 1990;3(1):96-102. Published online May 31, 1990
- DOI: https://doi.org/10.12671/jksf.1990.3.1.96
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Abstract
PDF - Though compression hip screw system has many advantages over the other fixation devices in the treatment of hip fractures, surgeons were frequently encountered by the intraoperative and postoperative complications leading to poor result. In reviewing out series of hip fractures treated with this device, between January 1983 and December 1988, serious complications developed in 5 cases, Additionally, three cases who were referred to our hospital during the same period were included in this study. The authors analyzed these 8cases, and found that the complications could have been prevented in using compression hip screw system for the treatment of hip fractures. The purpose of this paper is to re-emphasize the importance of 1) strict application of indication, 2) familiarity with surgical technique and handing instruments, 3) radiologic examination during surgery, 4) good postoperative care.
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- Pitfalls and Complications in the Use of Interlocking Intramedullary Nailing for the Femoral Fractures
- Sung Kwan Hwang, Jong Seon Yoon
- J Korean Soc Fract 1990;3(1):71-78. Published online May 31, 1990
- DOI: https://doi.org/10.12671/jksf.1990.3.1.71
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Abstract
PDF
- The introduction of percutaneously inserted transfixing interlocking screws increase the stabization potential of the intramedullary nail. The use of interlocking system extend the indications for closed intramedullary nailing. However, the added technical complexity, related with the locking screws, introduces a new errors and pitfalls. Among 32 patients who had closed interlocking I.M. nailing for 32 femoral fractures, 7 patients showed intra-or-postoperative complications. Six patients had intraoperative complication : four patients(new fracture near the fracture site) ; one patient(femur neck fracture), and one patient(failure of distal locking). Two patients experienced postoperative complication :one deep infection and another, proximal migration of nail. All 7 patients had pitfalls and complications related with operative techniques for interlocking I.M nailing. After careful analysis of the pitfalls and complications, following suggestions were considered. 1. To reduce the new fracture near the fracture site, insert the nail through an entry portal of trochanteric fossa centered over the axis of the femoral medullary canal. 3. Avoid repeated awling and placing the entry portal too far medially, which can result in iatorogenic fracture of the femur neck. 4. After distal screw insertion, the correct position of the screw in the screw hole should be confirmed on AP and lateral view. 5. Adequate preoperative and postoperative use of antibiotics were seriously considered in case of open fractures.
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