The introduction of the strong clover-leafed nail combined with the principle of reaming out the medullary canal and the development of image intensifiers has been extended the indications of the in tramedullary nailing. In this report, an attempt was made to introduce the method and to verify the indications and advantage of retrograde intramedullary nailing of humeral shaft fractures, as compared with the conventionally accepted methods.
Fracture Fixation, Intramedullary ; Humerus ; Methods

Background: Leg bone fracture is common seen in orthopedic trauma. Currently, the trend of treatment is using a less invasive technique. Especially, with application of C-Arm in surgery, closed Kuntscher nailing technique has made the treatment of leg bone fractures achieving more new improvements. Objectives: To summarize the experiences in the technical implementation process and to assess results of treatment. Subjects and method: A descriptive, retrospective study was conducted on 112 patients was confirmed diagnosed with leg bone fractures (81 males, 31 females, the average aged 29\xb15.3), were operated in Da Nang General Hospital from January, 2004 to June, 2006. All of them were performed with Kuntscher intramedullary nail in tibia without opening fracture cavity, in condition of without C-Arm. Results: The patients with combined injuries included 5 cases of 2 legs fracture, 2 cases of hip fracture, 5 cases of leg fracture in 2 stages, 1 case of collabone fracture. Postoperative observations: no case of infection, patients were discharged after 2-7 days, the average length of hospitalization was 3\xb12.4 days. Complication: 1 case of secondary deviation, no case of any delay to heal bone, broken nails. Recording a case of nail was rise up to cause painfully and synovial capsule inflammation of knee joint. Conclusion: The implementation of this less invasive technique should be orderly done. The most ideal indication was tibial shaft fractures in stage of middle 1/3. Because of a minimally invasive technique so patients were less painful, fracture healing quickly, early mobilization could be set, surrounding joints were not affected.
Tibial Fractures/surgery ; Fracture Fixation ; Intramedullary/ methods ;

OBJECTIVETo discuss the curative effect of bone graft from trochanter with interlocking intramedullary nail for comminute fracture of femur.

METHODSFrom January of 2009 to January of 2010, fifty patients with comminute fracture of femur were treated by the therapy of bone graft from trochanter with interlocking intramedullary nail, included 35 males and 15 females with an average age of 38.4 years old ranging from 28 to 50 years. According to AO/ASIF classification system, there were 15 cases of type B1, 20 of type B2, 8 of type B3, 7 of type C1.

RESULTSAll the patients were followed up for 12 to 24 months, averaged 14.4 months. All the broken femurs knitted in 4 to 6 months, the average period of knit was 5.6 months. The injured legs with normal movement in knees,which had no infection, vascellum-nerve injury and anchylosis in knees. According to Merchan knee rating scale, the results were excellent in 25 cases, good in 20, fair in 3 and poor in 2, and the excellent and good rate was 90%.

CONCLUSIONBone graft from trochanter with interlocking intramedullary nail, which has a virtue of small injury, less blood loss, high rate of bone knit, perfect functional recovery, is a preferable therapy of fresh fracture of femur.

Adult ; Bone Transplantation ; methods ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged

No abstract available.
Female ; Femoral Fractures/*surgery ; Fracture Fixation, Intramedullary/*methods ; Humans ; Male ; Osteoporosis, Postmenopausal/*pathology ; Osteoporotic Fractures/*surgery

PURPOSE: This study evaluated the shortening and rotational deformity after closed intramedullary nailing of femur shaft fracture according to Winquist-Hansen classification type. MATERIALS AND METHODS: This study was based on 98 cases who received cloased intramedullary fixation about their femur shaft fractures between January 2000 and October 2005 with minimum 12 months follow up. The rotational deformity was analysed by Yang's method (45 cases) preoperatively and postoperatively, and the shortening by orthoradiogram (55 cases). Furthermore we analysed other complications, for example nonunion, infection, and metal failure. RESULTS: We found more than 15 degrees anteversion difference of both femurs in 10 cases. Among them, 9 cases were classified to type 3, 4. According to Winquist-Hansen classification, rotational deformity ranged from 3.7° (Type 1) to 8.9° (Type 4). More than 2 cm leg length discrepancy (LLD) was found in 9 cases, all of them were classified as Winquist-Hansen classification type 3, 4. In the type 1, LLD was checked as 3.2 mm and type 4, 14.2 mm. CONCLUSION: To prevent the shortening and rotational deformity after intramedullary fixation of Winquist-Hansen classification type 3, 4 femur shaft fracture, intraoperatively the exact contralateral femoral anteversion and length should be checked.
Classification* ; Congenital Abnormalities* ; Femur* ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Leg ; Methods

226 adult patients (235 fractures) with fractures of the shaft of the tibia were treated at the Department of Orthopaedic Surgery, Soon Chun Hyang College Hospital during the 6 and a half years from January 1975 to June 1981. These were analysed according to the methods of treatment and the results were categorized by the level, type, severity and whether open or closed in an attempt to seek the most suitable method of treatment. The following observations were made: l. Of the 226 cases, nine were bilateral, the total number of fractures being 235. Of these, 173 (73.6%) were treated conservatively, 26 (11.1%) by plate and screw fixation and the remaining 36 (15.3%) by in- tramedullary nailing. 2. There were no differences in the average healing time among the various levels of fractures. However, the upper one third and the lower one third healed more rapidly than the middle one third when treated con- servatively. When treated by intramedullary nailing, the middle one third healed most rapidly. 3. As to the types of freactures, spiral fractures healed most rapidly with 15.3 weeks and segmental fractures healed most slowly with 23.8 weeks. Transverse fractures and spiral fractures healed most rapidly when treated conservatively, oblique fractures healed most rapidly when treated by plate and screw fixation, segmental and comminuted fractures by intramedullary nailing. 4. The healing time was longer and complications were higher in open fractures than in closed ones. 5. Based on the modified Ellis classification of tibial fractures, the higher the severity, the longer the healing time and the lower the primary healing rate. 6. The primary intramedullary nailing group, which were treated within 24 hours of injury, was compared with the delayed intramedullary nailing group. The former showed faster healing and higher primary healing rate than the latter, while the infection rate was higher in the former.
Adult ; Classification ; Clinical Study ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Fractures, Open ; Humans ; Methods ; Tibia ; Tibial Fractures

Fractures of both forearm bones present specific therapeutic preoblems encountered infrequently in the fractures of other shafts of long bones. Although some of these fractures can be treated conservatively, majority of fractures are treated by open reduction and internal fixation for accurate anatomic reduction and rigid fixation. From January 1979 to December 1986, seventy two cases of both forearm bone fractures had been treated by four different methods at the Department of Orthopaedic Surgery, College of Medicine, Ewha Womans University and results were obtained as follows : 1. The most common fractures site was middle third of radius and ulna. 2. Comminuted fx was most common in radius and oblique fracture was most frequent. 3. Eleven cases were treated conservatively and 61 cases were treated by open reduction. Among them, 2 cases were fixed with intramedullary nailing, 36 cases by plating and 23 cases by combined method. 4. The time required for bony union was shorter in group of open reduction and plating than in groups of the other treatment. 5. The functional result was satisfactory in 53 cases(74%) and was best in group of open reduction and plating. 6. Among 5 cases of nonunion, 3 cases were developed in open fractures.
Adult ; Female ; Forearm ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Open ; Humans ; Methods ; Radius ; Ulna

There is much controversy concerning the method of treatment on the tibial fracture because of frequent complications, such as non-union, delayed union and infection. Authors reviewed and analyzed 110 tibial fractures which had been treated at the Department of Orthopedic Surgery, Sung Ae General Hospital from June 1983 to March 1987 by the groups, conservative treatment, open reduction and internal fixation with compression plate and closed flexible intramedullary nailing. The results were as follows :1. In regard to the fracture location, there was no difference in the healing time among the treatment methods. The I.M. nailing group healed 1.5 weeks earlier than other groups in each location. 2. In minor and moderate severity by Ellis, the I.M. nailing group revealed better result, and in major one, the compression plate group showed better result. More complications occured in major severity. 3. Union time among the trestment methods was not affected by the fibular fractures, but most of the complications occured in the concomitant fibular fracture case. 4. In open fracture, the healing time showed no difference among the groups, and was prolonged about 2 weeks than closed fracture. In closed case, the I.M. nailing group showed good result. 5. The cases, which were reduced earlier in the conservative group, and treated within 3 days in the I.M. nailing group revesled better result. 6. The radiological union time from the definite treatment was 15.80 weeks in the conservative treatment group, 15.18 weeks in the compression plate group and 13.92 weeks in the I.M. nailing group.
Clinical Study ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hospitals, General ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

In addition to general charceteristics of tibial fracture, segmental tibial fracture is commonly combined with extensive soft tissue injury, comminution and displacement with poor blood supply in its middle segment. According to recent reports, intramedullary nailing was regarded as the excellent method in the management of this kind of fracture. Twenty-one cases were treated at the department of Orthopaedic Surgery, National Medical Center from January 1980 to December 1987 and following results were obtained; 1. Most common type of fracture was Type I (38.1%). Almost all the fractures were accompanied by open wounds(85.7%) and GIIIB open wounds were 12 cases(57.1%). 2. A verage union time was 31.8 weeks(union rate, 76.2%) and showed marked difference between closed fracture(20.2 weeks) and GIIIB open one(38.6 weeks). 3. Better results were seen in 8 cases of intramedullary nailing(average union time, 24.2 weeks), while all the plating method showed non-union in 3 cases of open wound.
Fracture Fixation, Intramedullary ; Methods ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Wounds and Injuries

The purpose of early reduction and internal fixation of the trochanteric fracture is early mobilization and reducing the complication rate. The morbidity and mortality rates remain high in elderly patients with this type of injury. This is due to reduced tolerance to prolonged bed rest, lenghy operation, and massive soft tissue dissection and blood loss. We feel the Ender method has the advantages of ease performance, decreased operating time, and immediate weight bearing in most cases. Total 23 cases of trochanteric fracture of the femur was treated at the Department of Orthopaedic Surgery of National Medical Center during the period from June, 1985 to December, 1987. The results were as follows : l. Out of 23 patients, 16 patients were female and the mean age was 71 year old. 2. The most common cause was the injury from slip down. 3. By the Tronzo classification, the most common type was type III. (14 cases) 4. The average duration from accident to operation was 4.5 days and average blood loss was 210 ml during operation. 5. The average bony union was obtained in 16.4 wks. 6. For prevention of distal pin migration, we performed circumferential wiring through the eye of distal pin in 6 cases and resulted in no migration until complete bony union.
Aged ; Bed Rest ; Classification ; Early Ambulation ; Female ; Femur ; Fracture Fixation, Intramedullary ; Humans ; Methods ; Mortality ; Weight-Bearing