Journal of Musculoskeletal Trauma

Treatment of the Femoral Fracture Using Sirus(R) Nail: A Comparison of Complication according to the Entry Potal: Young Yool Chung, Dong Hyuk Choi, Dae Hyun Yoon, Jung Ho Lee, Ji Hun Park; J Korean Fract Soc 2015;28(2):103-109. Published online April 30, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.2.103

Abstract PDF: PURPOSE
The purpose of this study is to analyze the clinical results of fixation using Sirus(R) nail in patients with femoral subtrochanteric and shaft fracture and the difference in the frequency of complications according to the entry portal.
MATERIALS AND METHODS
From July 2006 to August 2013, at least 1-year clinical follow-up, we retrospectively analyzed 36 cases with femoral subtrochanteric (15 cases) and shaft fracture (21 cases) who underwent surgery using Sirus(R) nail. We reviewed the records of operation time, intra-operative amounts of bleeding and complications. At last follow-up, we reviewed clinical results by Ray-Sanders criteria and analyzed the periods of bone union on the radiograph. We also measured changing of the femoral neck-shaft angle in the subtrochanteric fractures and angulation in the shaft fractures, respectively. Considering anatomical variation of the trochanter and fracture position of subtrochanteric and femoral shaft, entry points were divided into subgroups, and the clinical results were compared.
RESULTS
The mean Ray-Sanders score was 27.4, 27 cases (75.0%) were good or excellent. The mean periods of bone union was 21.1 weeks in 31 cases. The mean neck-shaft angles were 135.7o preoperatively, 130.2o postoperatively. The mean angulation of the femur was 24.4o preoperatively, 2.4o postoperatively in patients of femoral shaft fractures. Despite no statistical significance, greater trochanter tip entry point and lateral entry point had a higher rate of frequency than medial entry point, with respect to the occurrence of iatrogenic fracture and malalignment.
CONCLUSION
Using Sirus(R) nail for femoral subtrochanteric and shaft fractures showed good clinical and radiographic results and a high rate of union. Medial entry point yielded slightly better results in the occurrence of iatrogenic fracture and malalignment, compared to greater trochanter tip entry point and lateral entry point.

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Minimally Invasive Plate Osteosynthesis for Humeral Proximal or Distal Shaft Fractures Using a 3.5/5.0 Metaphyseal Locking Plate: Hyoung Keun Oh, Suk Kyu Choo, Jung Il Lee, Dong Hyun Seo; J Korean Fract Soc 2012;25(4):305-309. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.305

PURPOSE
Our study aimed to investigate the clinical and radiological results of humerus proximal or distal shaft fractures treated with minimally invasive plate osteosynthesis (MIPO) using a 3.5/5.0 metaphyseal locking plate.
MATERIALS AND METHODS
We reviewed the clinical and radiographic records of 17 patients with humeral proximal or distal shaft fractures who had undergone 3.5/5.0 metaphyseal locking plate osteosynthesis with a minimally invasive technique. We evaluated the results with respect to the anatomical reduction and union of the humerus shaft fracture through radiologic studies. We also evaluated the clinical results using the motion of shoulder and elbow functional outcome, American Shoulder and Elbow Surgeons (ASES) score, Mayo elbow performance score (MEPS), and postoperative complications.
RESULTS
Complete union was achieved in all cases. The mean union time was 14.2 weeks. According to the functional outcome rated by the ASES score and MEPS, 15 cases were considered excellent and 2 cases were good. There were no cases of surgically-related complications like metal failure, loss of anatomical reduction, or postoperative nerve injuries.
CONCLUSION
Using a 5.0 metaphyseal locking plate for humerus shaft fracture has the limitation that difficulties can arise in achieving sufficient screw fixation for small bony fragments. The 3.5/5.0 metaphyseal locking plate used in MIPO for humerus 1/3 proximal or distal shaft fractures was concluded to give good clinical and radiologic results.

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Polarus Intramedullary Nail for Proximal Humeral and Humeral Shaft Fractures in Elderly Patients with Osteoporosis
Youn-Soo Hwang, Kwang-Yeol Kim, Hyung-Chun Kim, Su-Han Ahn, Dong-Eun Lee
Journal of the Korean Fracture Society.2013; 26(1): 14. CrossRef

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Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture: Chang Wug Oh, Jong Keon Oh, Woo Kie Min, Shin Yoon Kim, Seung Hoon Baek, Byung Chul Park, Hyung Soo Ahn, Tae Gong Kim; J Korean Fract Soc 2007;20(2):135-140. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.135

Abstract PDF

PURPOSE
To compare retrospectively the antegrade and retrograde nailing in the management of ipsilateral femoral neck and shaft fractures.
MATERIALS AND METHODS
Thirty-two patients (thirty-three injuries) were included in this study. Mean age of patients was 38 years-old in the antegrade nailing group (16 injuries) and 44 years-old in the retrograde nailing group (17 injuries). We compared the union of fractures and complications between two groups, and investigated the influencing factors.
RESULTS
Femoral shaft fracture was united in 10 cases (63%) of antegrade group and 12 cases (71%) of retrograde group, at 28.2 and 27.3 weeks respectively. Nonunion was more prevalent in Winquist-Hansen III and IV (5 in antegrade nailing, 3 in retrograde nailing) than I and II. Femoral neck fracture was united with 1 case of nonunion in each group. Nonunion developed from Garden stage IV, but fractures of Garden stage I and II united regardless of methods.
CONCLUSION
In ipsilateral femoral neck and shaft fractures, the kinds of methods did not affect the results of shaft fractures. Minimally displaced neck fractures also were not influenced by kinds of methods, but retrograde nailing may have a benefit in fixing the displaced neck fractures

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Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants
J. D. Cnossen, Esther M. M. Van Lieshout, Michael H. J. Verhofstad
Archives of Orthopaedic and Trauma Surgery.2023; 143(10): 6229. CrossRef
Retrograde Intramedullary Nailing or the Treatment of Segmental Femoral Shaft Fracture Including Distal Part
Jong-Ho Yoon, Byung-Woo Ahn, Chong-Kwan Kim, Jin-Woo Jin, Ji-Hoon Lee, Hyun-Ku Cho, Joo-Hyun Lee
Journal of the Korean Fracture Society.2009; 22(3): 145. CrossRef
The Treatment of IM Nailing of Femoral Shaft Fracture: Piriformis Fossa versus Trochanteric Entry Portal
Hyun Kook Youn, Oog Jin Shon, Dong Sung Han
Journal of the Korean Fracture Society.2008; 21(3): 200. CrossRef

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Lateral Approach for Internal Fixation of the Distal Humeral Shaft Fractures: Seung Koo Rhee, Joo Yup Lee, Yoo Joon Suh, Joon Ho Lee, Nong Kyoum Ahn; J Korean Fract Soc 2004;17(2):83-89. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.83

Abstract PDF

PURPOSE
To investigate the efficacy and advantages of the lateral approach for internal fixation of the distal humeral shaft fractures.
MATERIALS AND METHODS
Twelve patients with distal humeral shaft fractures who underwent open reduction and internal fixation using plate and screws by lateral approach from January, 1997 to May, 2002 were investigated. Postoperative results after a minimum 1 year follow-up were assessed using union rate, elapsed time to union, postoperative complications such as iatrogenic radial nerve palsy, range of motion of the elbow joint. Clinical outcomes were evaluated with Mayo elbow performance scoring system.
RESULTS
Union was achieved in all cases. The average time to union was 9 weeks (range, 7~12 weeks). Four cases of preoperative radial nerve palsy were revealed as contusion of the intact nerve and resolved completely by three months. The mean elbow range of motion was from 5 to 138 degrees. The average Mayo elbow performance score was 91 points; 9 cases ranked as excellent and 3 as good.
CONCLUSION
Distal humeral shaft fractures can be treated successfully through open reduction and internal fixation using plate and screws. Lateral approach is recommended to stabilize distal humeral shaft fractures without compromising the range of motion of the elbow, and to protect or explore the injured radial nerves easily

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Modified anterolateral approach for internal fixation of Holstein–Lewis humeral shaft fractures
Ho Min Lee, Young Sung Kim, Suk Kang, Min Young Lee, Jong Pil Kim
Journal of Orthopaedic Science.2018; 23(1): 137. CrossRef
Posterior Dual Plating for Distal Shaft Fractures of the Humerus
Chul-Hyun Cho, Kwang-Yeung Jeong, Beom-Soo Kim
Journal of the Korean Fracture Society.2017; 30(3): 117. CrossRef

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Treatment of Ipsilateral Femoral Neck and Shaft Fractures: Jung Ryul Kim, Hyung Suk Lee, Myung Sik Park, Hee Chul Yu, Doo Hyun Yang; J Korean Soc Fract 2003;16(3):327-333. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.327

Abstract PDF: PURPOSE
To analyse the result of the treatment of ipsilateral femoral neck and shaft fractures and to consider effective method of the treatment.
MATERIALS AND METHODS
Seventeen patients with ipsilateral femoral neck and shaft fractures were treated from January 1992 to January 1999 and followed up more than 2 years. Radiologic bony union between each treatment method, complication were analysed. The functional results assessed with Iowa hip rating system and Swiontkowski system.
RESULTS
In femoral neck fractures, bony union was obtained in all cases, average 12 weeks. In femoral shaft fractures, bony union was obtained in all but one case. There was no statistical association bony union time between each treatment method (p>0.05). By Iowa hip rating system, nine hips had an excellent result; eight, a good result. According to rating system of Swiontkowski, the result was excellent in nine, good in six, fair in one, and poor in one.
CONCLUSION
We concluded that early diagnosis of all injuries was needed. To avoid further vascular damage of femoral head, early anatomical reduction of the femoral neck fracture should be performed. And then, shaft fracture was fixed with implants which were most appropriate for that combination of fractures.

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Treatment of Type IIIB Open Tibial Shaft Fractures: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Doo Koh, Jae Doo You, Jong Keon Oh, Young Seuk Kim; J Korean Soc Fract 1998;11(3):560-566. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.560

Abstract PDF

In general, severe open fractures of the tibial shaft have been treated initially with external fixation. However, despite many refinements in this technique, it has been associated with numerous complications, including problems at the sites of pins, non-union, delayed union, malunion, and infection. The purpose of this retrospective study is to analyze the results in a consecutive series of patients. There were 8 males and 2 females with an average age of the 44.9 years(range, 26-64 years). The mean follow up period was 23.2 nibtgs(range, 34-120 days). Free flap procedures were performed on all patients. The average time between removal of the fixator and intramedullary nailing was 16.5 days(range, 11-26 days). Indication of conversion to nailing was abscence of any serous discharge, reddness or local heating around pin-sites and normal renge of laboratory data. All 10 fractures had united with additional bone graft in 7 cases. The most frequent complications were delayed union in 7 cases and infection(superficial infection: 6 cases, osteomyelitis: 1 case) after IM nailing. We concluded that pin-tract infection is the major cause of infection after IM nail, but duration of external fixation and time interval(between removal of external fixator and nailing) are not isolated factors.

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Study on Instant Fish Cake Noodle Manufacturing Techniques Using Ultra-fine Powdered Kelp
Yoo-Jin Park, Se-Jong Kim, Myung-Ryun Han, Moon-Jeong Chang, Myung-Hwan Kim
Food Engineering Progress.2019; 23(3): 217. CrossRef
Treatment of Type IIIb Open Tibial Fractures
Seong Yeon Lim, Il Jae Lee, Jae Ho Joe, Hyung Keun Song
Journal of the Korean Fracture Society.2014; 27(4): 267. CrossRef

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The Clinical Results of Unreamed Interlocking Intramedullary Nailing for Tibial Fractures: Young Ho Kwon, Hyun Mok Yang; J Korean Soc Fract 1997;10(3):569-574. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.569

Abstract PDF: Recently interlocking intramedullary nailing is used widely for the management of tibial shaft fractures. We evaluated any differences in healing time and complications associated with reamed and unlearned tibial interlocking intramedullary nailing. Between January 1991 and February 1996 we performed a retrospective trial on 62 patients with tibial shaft fractures comparing the reamed with unlearned interlocking nailing. The mean time to union for patients with unlearned intramedullary nail was 18.5 weeks(13 to 32 weeks) which was significantly less(P<0.05) than the 21.7 weeks(16 to 36 weeks) for reamed group. The complications of the reamed interlocking intramedullary nailing were three delayed unions (9.3%), three superficial infections(9.3%), and two cases of knee joint or ankle joint LOM(6.2%). The complications of the unlearned interlocking intramedullary nailing were four delayed unions(13.9%), three angular deformities(10.3%), three screw breakages(10.3%), and one superficial infection(3.4%). Unlearned interlocking intramedullary nailing is better for the tibial shaft comminuted fractures with small diameter, unstable tibial isthmus fractures, pelytraurnatized patient and some type of open fractures.

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Interlocking Intramedullary Nailing in the Treatment of the Tibial Shaft Fractures: Comparative Study between Reamed and Unreamed Nailing: Jae Hoon Lee, Kyung Jin Song, Byung Yun Hwang; J Korean Soc Fract 1996;9(4):993-1001. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.993

Abstract PDF: Interlocking intramedullary nailing has been popularized by its many advantages in the fracture treatment of long bone compared with the other fixatives. The purpose of this paper was to evaluate the treatment results in the viewpoint of bone union, complication and functional outcomes of the interlocking intramedullary nailing between reamed and unlearned technique in the treatment of tibial shaft fractures. We reviewed 64 tibial shaft fracture that were treated at our hospital from May 1990 to February 1995 with interlorking intramedullary nailing that composed 36 reamed, and 28 unlearned cases. These included 33 open fractures and 34 closed fractures. There was no significant di florences in average prriod of radiologic union, complications and in the functional outcomes between the two treatment grovps(P<0.05). Unlearned interlocking intramedullary nailing in the tibial shaft fractures must be a goof treatment modality by its simplicity, shorter operation time, less probability in pulmonary and throrrlboembolic complications and less comprormised medullary blood supply, especially in patients with multiple trauma or open fractures.

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A Comparison of the Using of Plate fixation and Ender nailing in Humeral Shaft Fractures: Ig Gon Kim, Jae Hyek Kim, Chul Hyun Eim, Soo Dong Baek; J Korean Soc Fract 1996;9(1):161-169. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.161

Abstract PDF: The humerus is anatomically and physiologically unique bone: firstly, it is a non-weight bearing bone; secondly, it has greatest range of motion; thirdly, while the person is standing, the axis of bone hangs vertically and is influenced by gravity, and conservative methods are usually used in treatment. However. in the cases of closed reduction failure, open fracture, multiple fracture, and old age etc, operative methods may be employed. This decision should be based on the type, location of fracture. the presence of concomittent injuries, the age, and the general condition of the patient. When open reduction and internal fixation is carried out, the periosteum and soft tissue attachment is stripped off and operative time is longer Flexible Ender nailing is a simple procedure which does not disrupt or strip off periosteum and soft tissue at the fracture site, and decreases the chance of infection and allows early exercise. Authors carried out fixation in 28 patients and Ender nailing in 24 patients having humeral shaft fractures who were treated at the orthopedic department, Hae Dong hospital from March, 1990 to February, 1994.

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A Treatment of Humeral Shaft Fracture with Closed Interlocking Nailing: Kun Yung Lee, Myung Sik Park, Keun Kwon Kang; J Korean Soc Fract 1995;8(1):159-166. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.159

Abstract PDF: The ideal treatment of acute fractures of the humeral shaft remains controversial. It is generally accepted that conservative treatment is best for isolated closed fractures of the humerus shaft. But recently, in case of surgical management, intramedullary nailing treatment has reported good results. Authors have analysed 20 cases of the humeral shaft fractures treated with closed intramedullary nailing at the department of orthopedic surgery, Lee-Rha general hospital from June 1991 to December 1993 with minimal 1 year follow up. The results were as follows 1. In the 20 cases, the age between 20 and 40 years old was taken place 60% and the most common cause of injury was traffic accident (75%) 2. It was worthwhile to define the relationship between union time and Winquist-Hansen classification which used in femoral shaft fracture. And the average bone union time was 8 weeks except 3 cases, especially delayed union was found in type 3 of Winquist-Hansen classification. But 2 cases were united after 9 monthes follow up without secondary procedure. 3. Problem in Seidel nailing was flilure of expansion of distal portion and in Russel-Taylor nailing was impairement of internal rotation of shoulder and delayed union due to iatrogenic distraction at the fracture level during operation. In according to the above results to treat the humeral shaft fracture, closed intramedullary inter-locking nailing was satisfactory enough to obtain bone union and early recovery of shoulder motion. Also, the Winquist-Hansen classification is useful guide to find the bone union time in the treatment of humeral shaft fracture with interlocking nail.

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