Journal of Musculoskeletal Trauma

Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult: Yong Woon Shin, Yerl Bo Sung, Jeong Yoon Choi, Minkyu Kim; J Korean Fract Soc 2011;24(4):313-320. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.313

PURPOSE
To evaluate the union time and nonunion rate after intramedullary nailing of femoral shaft fracture in adult, we would like to analysis the operation techniques, comminution, contact surface and displacement.
MATERIALS AND METHODS
We reviewed retrospectively 53 patients undergoing femoral intramedullary nailing at least 2 years postoperatively and analysised the union time and nonunion rate by operation techniques, comminution, contact surface and displacement. Patients were operated by either antegrade or retrograde intramedullary nailing.
RESULTS
There were no differences in nonunion rate, the duration of bony union between antegrade and retrograde intramedullary nail groups. Significant differences were found in the duration of bony union between the Winquist and Hansen type I, II and the type III, IV (p<0.05). There were significant differences in the duration of bony union among simple, comminuted, and segmental fracture groups (p<0.05).
CONCLUSION
The union time is affected by not operation techniques and fracture displacement, but Winquist-Hansen classification and number of fracture fragments in intramedullary nailing of adult femoral shaft fracture.

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Extra-capsular proximal femoral fractures: a cohort comparison of union and complication rates after ballistic versus blunt trauma
Jordan Cook Serotte, Kevin Chen, Julia Nascimben, Jason Strelzow
European Journal of Orthopaedic Surgery & Traumatology.2025;[Epub] CrossRef
Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
Hip & Pelvis.2014; 26(2): 107. CrossRef
Augmentative Locking Plate Fixation for the Treatment of Femoral Nonunion after Intramedullary Nailing
Ki-Chul Park, Chul-Woong Kim, Kyu-Tae Hwang, Ye-Soo Park
Journal of the Korean Fracture Society.2013; 26(4): 268. CrossRef

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Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults: Sanglim Lee, Hee Sung Lee, Yerl Bo Sung, Jae Kwang Yum; J Korean Fract Soc 2009;22(1):30-38. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.30

Abstract PDF

PURPOSE
To evaluate the usefulness of interlocking intramedullary nailing for operative treatment of forearm shaft fractures in adults.
MATERIALS AND METHODS
Thirteen forearm shaft fractures in 12 patients were fixated with 13 Acumed forearm intramedullary rods (ulna: 8, radius: 5). The average age was 36.7 years and mean follow-up period was 15.2 months. The union time was measured when there was no tenderness over the fracture site and the bridging callus was evident in at least two sides of the cortex. The range of motion of the joint and the rotation of the forearm was measured and the functional results were evaluated with Grace and Eversmann's rating system.
RESULTS
Radiologic union was observed at 11.8 weeks postoperatively in 11 cases out of 13. No limitation of motion was observed. Nine had excellent or good functional results. In one Galeazzi fracture, radial shaft became displaced after nailing and should be re-stabilized with plate. Proximal interlocking screws were improperly inserted in one ulnar nail. Implants were removed in 7 cases. Removal guide screw was broken while removing the intramedullary nail in one case of ulnar shaft fracture.
CONCLUSION
Interlocking intramedullay nailing might be a treatment option for the middle 1/3 shaft fractures of the adult forearm bone with favorable results.

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Comparison of minimally invasive plate osteosynthesis (MIPO) and open reduction and internal fixation (ORIF) for the treatment of radial shaft fractures: a retrospective study
Hyun-Tak Kang, Yang-Hoon Jo, Hong-Je Kang
BMC Musculoskeletal Disorders.2025;[Epub] CrossRef
Distal blocking screw augmentation in ulnar intramedullary nail fixation of adult forearm diaphyseal fractures
Yong Woo Kim, Sang Ki Lee, Young Sun An
Journal of Orthopaedic Surgery.2024;[Epub] CrossRef
Comparison of Bending Strength among Plate, Steinmann Pin, and Headless Compression Screw Fixations for Proximal Ulnar Shaft Fracture in Sawbones
Jinyoung Han, Jin Rok Oh, Jaewoong Um
Archives of Hand and Microsurgery.2020; 25(4): 267. CrossRef

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Management of Open Tibial Fractures: Role of Internal Fixation: Yerl Bo Sung; J Korean Fract Soc 2007;20(4):349-354. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.349

Abstract PDF: No abstract available.

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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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Long Term Results of Retrograde Nailing in Adult Femoral Shaft Fractures: Yerl Bo Sung, Soo Chul Park, Jong Kuk Ahn, Jae Kwang Yum, Hyung Jin Chung, Jin Ho Kim, Seung Taek Song, Yong Taek Han; J Korean Soc Fract 2002;15(3):356-362. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.356

Abstract PDF

PURPOSE
Antegrade intramedullary nailing of the femur is effective method of treatment for patients with femoral shaft fractures. But retrograde IM nailing is another effective method, especially in femoral shaft fractures concomitant with ipsilateral femoral neck, intertrochanteric fractures, acetabular fracture, multiple fracture and obesity, pregnancy, traumatic arthrotomy of the knee joint, bilateral femur fractures, and floating knee injuries are also indicated. The purpose of this study is to verify the effectiveness of retrograde IM nailing after long-term follow-up by retrospective evaluation.
MATERIALS AND METHODS
A retrospective review of the medical charts and X-rays about 37 patients who were operated by retrograde nailing and all patients were minimally followed up about 2 years. Results were evaluated radiologically for screw breakage, nail migration, nonunion and clinically for knee ROM limitation, infection.
RESULTS
The results were as follows; 1) union was achieved at on average of 17 weeks. 2) Full range of knee motion was gained in 33/37 cases. Knee-stiffness occurred in 4 cases, Severity of initial trauma might affect such results but not, retrograde nailing 3) 2 complications were found nonunion and delayed union. 4) There were not postoperative infection and femoral shortening. There were distal screw breakage in 4 cases but, the others were not migrated.
CONCLUSION
Retrograde IM nailing of femoral fracture is an effective method in selected cases such as ipsilateral femoral neck fractures, floating knees, post-TKRA femoral fracture and so on. If retrograde IM nailing is operated by skillful surgeon and appled to absolute indication, the result is no significant difference of antegrade IM nail such as bone union, nonunion and postoperative infection. Nevertheless, operation time is shorter and blood loss lesser. Significant knee problems related to this technique could not be identified for 2 years followed up.

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Factors Affecting the Period of Bone Union When Treating Femoral Fractures with a Retrograde Intramedullary Nail
Bum-Soo Kim, Seong-Tae Kim, Seungyup Shin, Seong Man Jeon
Journal of the Korean Orthopaedic Association.2021; 56(4): 326. CrossRef
Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef

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Comparison of External Fixation and Interlocking IM Nail in Open Tibial Fractures: Hyung Jin Chung, Duck Kyu Kim, Yerl Bo Sung, Jong Guk Ahn; J Korean Soc Fract 2001;14(4):632-642. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.632

Abstract PDF: PURPOSE
To compare and analyze the results of the treatment based on the method of treatment between interlocking IM nail and external fixation of type II, III A, and III B open fractures of the tibia] shaft.
MATERIALS AND METHODS
A clinical analysis was performed on 57 cases of type II, III A, and III B open fractures of tibial shaft from January 1994 to October 1999 those studies are followed at least 1 year or more. The results was analyzed according to complications and functional results based on operative methods of types of open fractures.
RESULTS
In aspect of delayed union and nonunion, interlocking IM nail indicate a great results(p = 0.036) in type II. In angulation, interlocking IM nail marks an outstanding results in case of type II. There is no difference between interlocking IM nail and external fixation in infection. But, the delay of operation after injury increase the possibilities of infection.
CONCLUSION
At present, especially in type m, external fixation was preferred. But, interlocking IM nail has a good results in aspect of complications. Therefore unreamed intramedullary nailing for open tibia shaft fractures is a good treatment method to be recommended.

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Subtrochanteric Fracture in Osteopetrosis: Yerl Bo Sung, Kook Jin Chung, Sung Wook Won, Jin Ho Kim, Hyung Jin Chung, Jae Kwang Hwang, Jae Kwang Yum, Jong Guk Ahn; J Korean Soc Fract 2000;13(3):440-444. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.440

Abstract PDF: Osteopetrosis is a rare inheritable skeletal disorder caused by a defective remodeling mechanism. The resultant bone of these children is dense, brittle and susceptible to fracture. We report a case of the subtrochanteric fracutre in osteopetrosis.

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Results of Treatment of Fracture-Dislocations of Elbow: Dong Soo Kim, Soon Ho Hwang, Chil Soo Kwon, Jong Kuk Ahn, Byung Hyun Jung, Yerl Bo Sung, Jae Kwang Yum, Hyung Jin Chung; J Korean Soc Fract 2000;13(1):178-185. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.178

Abstract PDF: PURPOSE
: This study analyzed clinical and biomechanical data from patients with elbow fracture dislocation to correlate long-term objective result with the specific injury type and treatment rendered. This can provide a basis for the management of this difficult injuries.
MATERIALS AND METHODS
: Fifteen patients with elbow dislocation were studied from October, 1992 to October, 1997 in Sang-Gye Paik Hospital. The average duration of follow up was 4.2 years.
RESULTS
: On the basis of an objective functional grading score that included elements of pain, motion, strength, and stability, the results were excellent in five(33%), good in five(33%), fair in one(7%), poor in four(27%). Prolonged immobilization greater than four weeks was associated with poor results. The results were closely related to the combined injuries and duration of immobilization. In case of radial head fractures, the best result was obtained in patients with Mason type II fractures treated by open reduction and internal fixation using Herbert screw and early complete radial head excision. SUMMARY AND CONCLUSION : The most common combined injury is radial head fracture. Early complete radial head excision and encouraging early ROM had more satisfactory result than delayed radial head excision or internal Fixation for Mason type III fracture.

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Compartment Syndrome Complicating Avulsion Fractures of the Tibial Tubercle: Yerl Bo Sung, Jin Hyok Kim, Hyung Jin Chung, Dong Soo Kim, Byung Hyun Jung, Jong Guk Ahn, Chil Soo Kwon, Kook Jin Chung, Bong Gyun Kang; J Korean Soc Fract 1999;12(2):284-289. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.284

Abstract PDF: Avulsion of the tibial tubercle is an uncommon physeal injury. Complications from this fracture have rarely been reported and seldom affect the long-term outcome. Three adolescent boys who sustained avulsion fracture of the tibial tubercle, were complicated by compartment syndrome and treated at Inje University Sang-Gye Paik Hospital from September 1989 to February 1995. Injury to the soft tissue surrounding the tibial tubercle avulsion may be more extensive than is usually appreciated. The anatomy of the proximal tibia and the tibial tubercle with nearby branches of the anterior tibial recurrent artery suggest a predisposing factor for the development of compartment syndrome. So, compartment syndrome should be added to the list of possible complications of this type of fracture.

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Displaced fracture of the base of the second metacarpal into velar side: Yerl Bo Sung, Sung Soo Kim; J Korean Soc Fract 1997;10(4):945-948. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.945

Abstract PDF: Fracture of the base of the second metacarpal bone is usually undisplaced or minimallly displaced. There were some reports of traumatic avulsion fracture of the extensor carpi radialis longus from the base of the second metacarpal. In most cases, the fragments were displaced into dorsal side However, there is noreport uf displaced fracture of the base of the second metacarpal into volar side in English papers. We are reporting a case in which the fragment was displaced into volar side.

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A Clinical Study of the Tibial Pilon Fractures: Chil Soo Kwon, Jong Kuk Ahn, Jin Hyok Kim, Yerl Bo Sung, Hyung Jin Chung; J Korean Soc Fract 1997;10(2):338-345. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.338

Abstract PDF: The pilon fracture result from axial compression and rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displacement. It is managements are closed reduction and plaster immobilization, skeletal traction, fibular stabilization alone, limited open reduction and extemal fixation, primary arthrodesis, and even immediate amputation. Recently limited open reduction and external fixation has been proved to provide good clinical results for the severely comminuted or open pilon fractures. Authors reviewed 20 cases of the pilon fractures. Among them 10 cases were treated with limited open reduction and external fixation from October 1989 to January 1994. The results were as follows : 1. Age distribution was from 14 years to 77 years(mean ; 47 years). 2. Of the 20 cases, male were 14, and female were 6. 3. The cause of injury were tracffic accident in 10 cases, slip down in 6 and fall from a height in 4. 4. The most frequent type of fractures was type III(12 cases : 60%) according to Ruedi and Allgower classification. 5. Limited open reduction and external fixation(10 cases) has shown better results than classic open recduction and internal fixation for severely comminuted or open pilon fractures.

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Fracture of the Distal Radius with Ulnar Nerve Palsy: Chil Soo Kwon, Jong Kuk Ahn, Jin Hyok Kim, Yerl Bo Sung, Jin Ho Cho; J Korean Soc Fract 1997;10(1):171-174. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.171

Abstract PDF

There are several complications of distal radiug fracture such as median nerve injury, malunion nonunion, rupture of EPL, and ischemic contracture. Lesion of ulnar nerve as a complication of fracture of the distal radius are very rare. The authors report 1 case of the distal radius fracture with ulnar nerve palsy. The electromyography & nerve-conduction studies showed incomplete axonotmesis of ulnar nerve on 1 month following injury. A second electromyography & nerve-conduction study two months after injury showed complete recovery of nerve function.

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Ulnar Nerve Palsy Following Closed Fracture of the Distal Radius: A Report of 2 Cases
Chul-Hyun Cho, Chul-Hyung Kang, Jae-Hoon Jung
Clinics in Orthopedic Surgery.2010; 2(1): 55. CrossRef

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Interlocking Intramedullary Nailing of Femoral Shaft Fractures in Adolescents: Chil Soo Kwon, Jong Kuk Ahn, Jin Hyok Kim, Byung Hyun Jung, Yerl Bo Sung, Hyung Jin Jung, Jong Deuk Rha, Woo Chun Lee, Hyun Soo Park, Myung Ho Lee, Bu Maan Kim; J Korean Soc Fract 1996;9(4):914-920. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.914

Abstract PDF: Although treatment of femoral shaft fractures by traction and casting satisfactory in young children, it is less useful in obtaining and maintaining satisfactory alignment in adolescent patients. Residual angulation, malrotation. and leg length inequality is well documented. The options for surgical treatment of femoral shaft fractures in adolescents include extemal fixation, plate fixation, and intramedullary nailing. Surgical treatments carry the-risks of growth plate damage and infection, but these risks are very low. Recently, it is generally anepted that adolescent femoral shaft fractures are preferably treated by intramedullary nailing with care taken to avoid damaging the distal femoral physis. The authors experienced 9 femoral shaft fractures in 8 patients treated with interlocking intramedullary nails from August 1989 to May 1994, and followed up for more than 18 months(range from 18 to 45 months). The results were as follows: 1. There were 6 cases in male, 2 cases in female. Average age at the time of injury was 13 years(range, 11-14). 2. All fractures were united, and the nails were removed at an average 13.3 months after operation: no refracture or femoral neck fracture has since occured. 3. None had angular or rotational malunions, infection and avascular necrosis of femoral head. The average leg-length discrepancy at the last follow-up was 0.5cm(range, 0-1.0cm) and all were clinically acceptable. Coxa valga due to premature closure of trochanteric apophysis was not found. The average femoral neck-shaft angle was 133(130~138) at the last follow-up. So, interlocking intramedullary nailing is a reasonable alternative for the treatment of femoral shaft fracture in adolescents.

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