PURPOSE We retrospectively analysed the result of retrograde supracondylar nail fixation in femur supracondylar fractures and evaluate the clinical effectiveness of this method. MATERIALS AND METHODS Since October 1998 we have treated 14 supracondylar fractures (AO type: A2-6, A3-1, C1-3 and C2-4) by retrograde intramedullary nailing technique through trans-patellar tendon approach from October 1998 to June 2001 and followed more than 1 year. RESULTS Among 14 cases, 5 cases were excellent, 6 good, 3 fair according to Schatzker functional result. The complications were 1 distal locking screw loosening, 1 delayed union and 1 fracture around proximal locking site. CONCLUSION Even though the retrograde nailing may damage the knee joint because it is inserted by opening up the joint, it provided the necessary stable fixation with short operation time, low blood loss, minimal soft tissue injury. Thus we believe that retrograde nailing is useful operative technique for the management of supracondylar fracture in osteoporotic, communited fractures, or open fractures.
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Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail Moon-Jib Yoo, You-Jin Kim, Jin-Won Lee Journal of the Korean Fracture Society.2008; 21(1): 19. CrossRef
PURPOSE The purpose of this study was to analyse the result of operative treatment in ipsilateral femur neck and shaft fracture. MATERIALS AND METHODS Eleven cases of ipsilateral femur neck and shaft fractures were operated and followed more than 1 year. There were 11 men and the mean age at index operation was 38 years (range 22~54). In neck fracture there were 3 of type I, 6 of type II, and 1 of type III according to Garden classification, shaft fractures were located at middle 1/3(7 cases), at distal 1/3(4 cases). We evaluate the operation time, union time, nonunion, malunion, and clinical evaluation with pain and joint stiffness. RESULTS In neck fractures treatment methods were 8 of multiple pinning, 2 of reconstruction nail and 1 of CHS, in shaft fractures 2 of DCP, 7 of retrograde nailing (3 Ender nail, 4 interlocking nail). The mean operation time was 180 minutes in reconstruction nail, 220 minutes in multiple pinning and DCP and 200 minutes in multiple pinning and retrograde nailing. The mean time for shaft union was 5 months. The complications were 1 case of neck reduction loss during operation in reconstruction nailing group, 2 of aseptic necrosis of femur head, 2 of shaft nonunion in retrograde nailing group, 1 of persistant pain around knee in Ender nailing group. CONCLUSION The author think that reconstruction nail fixation is technically difficult, thus neck and shaft fracture be fixed individually. Neck fracture can be fixed first without difficulty and shaft fracture should be fixed rigidly due to comminution.
Femur is one of the most frequent sites of nonunion and femoral nonunion imposes many complications secondary to repeated surgical procedures and immobilizations. Many kinds of treatment options have been used and studied for comparison, but still the classical principle is rigid fixation, bone grafting, and adequate postoperative immobilization. In this study, the results of surgical treatment for femoral nonunion were analyzed. From July 1995 to August 1997, a total of 14 cases of femoral nonunion were treated surgically at the department of Orthopedic Surgery of the Seoul National University Hospital. All cases were treated by autogenous bone graft and internal fixation. For internal fixation, plate and screws were used in 10 cases and intramedullary nail in 3 cases and compression hip screw in 1 case. Postoperatively, hip spica cast was applied in 8 cases, cast brace in 2 cases and long leg splint in 1 case. In the other 3 cases, no additional support was adopted. In all cases, clinical union was achieved at postoperative 5 months in average. There was no significant complication except one case of marked limited motion in knee followed by hip spica cast.
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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
In the adolescent gymnasts, recent studios have shown that wrist is particularly vulnerable to chronic stress. In the immature skeleton, growth plate is especially vulnerable to acute or chronic trauma since the joint capsule and ligamentous structures are strong.
The purpose of this study is to report the frequency, finding of radiologic abnormalities and the type of sports to cause wrist pain.
The authors examined 26 adolescent gymnasts, 20 males and 6 females. The age range was 11 years 10 months to 17 years 5 months for males and 11 years 9 months to 34 years 4 months for females.
The results were as follows; 1. The radiologic abnormalities were found in 23 cases(88%), 19 males and 4 females.
2. Wrist pain was most frequently csused by pommel horse exercise in males and by floor exercise in females.
3. Among 23 cases, 18 showed widening of distal radial growth plates and irregularities of the margins of the growth plate(15 cases were bilateral). Widening of distal ulna growth plates were combineti in six cases, ulna styloid process fracture in 3 cases and radial styloid process fracture in 1 case.
4. Among 23 cases, 5 cases showed widening of distal radial metaphysis and increased ulnar tilting.
Negative electric charge is known to induce osteoblastic activity in bone. Therefore, electrical stimulation can be used clinically to promote more active new bone formation in the fracture site. Among many methods in the treatment of fracture nonunion, electrical stimulation can be emplyed as one of the useful methods, which is less of noninvasive and rather simple.
We experienced 10 cases of fracture nonunion managed with EST without surgery in the Department of Orthtopedic Surgery of Seoul National University Hospital from September 1980 to March 1987. Of these, 6 cases were managed with semiinvasive direct current method and resulted in union of all cases. 4 cases were managed with nonivasive capacitively coupled electric field method and resulted in union iin 3 cases but in1 case, nonunion persisted till 22 months follow-up. In the 9 cases of satisfactory results, union time varied from 2 months to 9 months with mean of 4 months.
No remarkable complication was found in these cases.
In conclusion, electrial sitmulation therapy is thought to be one of the useful and hopeful methods in the treatment of fracture nonunion cases in which surgery is not absolutely indicated.
Thirty-four patients with proximal humeral fratures were treated at department of orthopedic surgery, college of medicine, Seoul National University between 1978 and March, 19 99. They were followed up between six months and three and half years with average of 1.2 years. Mean age was 52.9 years and traffic accidents was the most common cause of injury. According to the Neers classification, there were seven one-part(20%), sixteen two-part(48%), seven three-part(20%) and four four-part(12%) fractures or fracture-dislocations.
The methods of treatment and its results were analyzed according to the Neers classificatioin and they were summarized as follows; 1. Seven one-part fractures were treated conservatively and showed satisfactory results in all.
2. Sixteen two-part fractures were treated conservatively except tow old cases and showed satisfactory results except one.
3. Seven three-part fractures were tried to be reduced by closed means but unacceptable five cases were treated by open reduction. They showed satisfactory results except one.
4. Four four-part fractures were treated by open reduction in two, by prosthesis in headsplitting and severely comminuted cases. They showed satisfactory results except one.