PURPOSE: To evaluate and report the clinical and radiological results of the intramedullary fixation by retrograde flexible nail in the humeral shaft fracture. MATERIALS AND METHODS: From July 2002 to May 2005, seventeen cases who had the humeral shaft fracture were treated with the intramedullary fixation by retrograde flexible nail. Fifteen cases were followed up and the clinical and radiological results were analyzed. RESULTS: All of the cases had satisfactory fracture union, and none of the patient had limitation in shoulder or elbow joint movement, and shoulder or elbow joint pain, and average ASES was 42.86 point. There was 1 case of delayed union, and 3 cases of distal nail displacement. Another severe complications were not occurred. CONCLUSION: Intramedullary fixation by retrograde flexible nail is one of the effective method in the humeral shaft fracture without nerve or vessel injuries, and also can avoid the complication of wide soft tissue incision or rotator cuff injury.
Elbow Joint ; Humans ; Rotator Cuff ; Shoulder

PURPOSE: We are reporting the result of comminuted midshaft fractures of clavicle treated by reconstruction plate fixation and PDS augmentation easily fixing butterfly fragments with minimal soft tissue dissection. MATERIALS AND METHODS: We reviewed 42 cases of operatively treated displaced comminuted midshaft fractures of clavicle at our hospital from March, 2001 to May 2004 whom were followed up for more than one year after the operation. According to Robinson classification, we grouped simple fractures as group A, and comminuted fractures as group B. Internal fixation using reconstruction plate has been chosen for type A fracture. Type B has been treated by reconstruction plate fixation with PDS augmentations. Shoulder function, union time and complications has been studied according to the fracture type retrospectively. RESULTS: All cases had complete bone union with average union time of 8.6 weeks for type A and 8.9 weeks for type B. Weitzman functional evaluation did not show significant differences. CONCLUSION: PDS augmentation in comminuted midshaft fracture of clavicle easily fix the butterfly fragments with least soft tissue damage and lessen the bone graft. Therefore it considered to be one of the available treatment methods for comminuted midshaft fracture of clavicle.
Butterflies ; Classification ; Clavicle* ; Fractures, Comminuted ; Retrospective Studies ; Shoulder ; Sutures* ; Transplants

PURPOSE: To review clinical and radiological results after open reduction and internal fixation with T plate for unstable distal clavicle fractures. MATERIALS AND METHODS: From July. 1999 to December 2002, nine patients with distal clavicle Neer type II fractures were treated by open reduction and internal fixation with T plate. The bony union was confirmed by plain radiography. The clinical results were analyzed according to the classification by Kona et al. RESULTS: Average time to fracture union was 8 weeks in all cases. The functional results were as follows: excellent in 7 cases and good in 2 cases. Screw loosening occurred in one case, but bony union was achieved. CONCLUSION: We recommend T plate fixation as another treatment method for unstable distal clavicle fractures.
Classification ; Clavicle* ; Humans ; Radiography

PURPOSE: To investigate the bone union time of patients treated with interlocking intramedullary nailing in wedged tibial shaft fracture and to evaluate the factors that influence this result. MATERIALS AND METHODS: 32 patients treated with interlocking intramedullary nailing for wedge tibial shaft fracture were reviewed with a follow-up period of more than 1 year. Radiographic results were assessed with diameter (%) and length (mm) of wedge fragment, pre and postoperative displacement (mm) of wedge fragment. We also checked the bone union time of the main fragment and the wedge fragment (paired t-test). We investigated the bone union time acocording to the diameter, length of wedge fragment, pre and postopertvie displacement (correlation analysis). RESULTS: Bone union time of the main fragments averaged 15.3 weeks (6~53 weeks) and that of wedge fragment averaged 24.2 weeks (8~64 weeks) (p=0.005). There was no correspondence between wedge fragment diameter and bone union time (p=0.681), but the bone union time of wedge fragment increased in proportion to its diameter (r2=0.747, p=0.031). There was no correspondence between preoperative displacement of wedge fragment and bone union time (p=0.574), but the bone union time increased in proportion to postoperative displacement of wedge fragment (r2=0.730, p=0.001). CONCLUSION: Wedge fragments need longer time for bone union than main fragments in interlocking intramedullary nailing for wedge tibial shaft fractures. We need to pay attention to the displacemet of fragments in treating tibial shaft fractures with large wedge fragment.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Tibia

PURPOSE: To evaluate the pattern of meniscal tear according to the type of the tibial plateau fracture of Schatzker. MATERIALS AND METHODS: Sixty two cases of tibial condyle fracture treated between the period of 1994 and 2003 were evaluated. The fracture type was classified according to Schatzker. The pattern and extent of the meniscus tear were compared with the fracture classification. Statistical analysis was made with the Fisher's exact test. RESULTS: Meniscus tear was noted in 29 cases out of 62 fractures (46.8%). The twenty cases of minimally displaced fractures treated conservatively showed no meniscal tear. Of 18 cases of the most common type I fracture 2 (11.2%) had a meniscus tear. Of 16 type II fractures 12 (75%) had a meniscus tear. The type III fracture showed the highest prevalence of meniscus tear (76.9%, 10/13). There was statistically significant relationtionship between the type of fractures and the rate of meniscus tear (p<0.0001). CONCLUSION: The meniscus tear frequently occurred in tibial plateau fractures in Schatzker type II and III. Associated meniscus tears should be born in mind when those types of fracture are encountered.
Classification ; Prevalence*

PURPOSE: To evaluate the effectiveness. analyze the result after retrograde intramedullary (IM) nailing in femoral shaft fracture MATERIALS AND METHODS: Thirty-four femoral shaft fracture (32 patients) were operated with retrograde IM nail and followed the result for more than 18 month from march 2001 to march 2003. There were 6 of femoral mid shaft fractures and 28 of distal femur fractures. According to AO classification, there were 1 of A1, 1 of A2, 2 of A3, 2 of C1 in femoral mid shaft fracture and 11 of A1, 7 of A2, 7 of A3, 1 of B1, 2 of C1 in distal femur fracture. They included 5 open fracrures. By Gustilo classification there were 3 of type I, 2 of type II. Through radiologic study we evaluated the time of union, nonunion, malunion. And in clinical evaluation we checked knee function in 18 month after operation. RESULTS: It took 16 weeks (range 12~20 weeks) for average bone uion period. 30 cases out of 34 cases had the bone union but 4 cases showed nonunion. There were not any complication except 3 cases of screw migration. Full rage of motion was gained in 29 cases. However knee stiffness occurred in 5 cases. The knee function through knee score was assessed by showing 28 of excellent, 1 of good, 5 of poor. CONCLUSION: Even though the retrograde intramedullary nailing may have some defect to be able to damage to knee joint in operating, It can be useful surgical technique for femoral shaft fracture in such as ipsilateral fracture or multiple fracture, poor general condition, and so on.
Classification ; Femoral Fractures* ; Femur ; Fracture Fixation, Intramedullary ; Knee ; Knee Joint ; Rage

PURPOSE: To evaluate the usefulness of a 2 holes side plate dynamic hip screw for the treatment of stable intertrochanteric fracture of the femur. MATERIALS AND METHODS: Between January 2000 and September 2004, 46 patients with intertrochanteric fracture of the femur were treated with 2 hole side plate dynamic hip screw (Group 1, 25 cases) or 4 hole side plate dynamic hip screw (Group 2, 21 cases). The mean age of the patient was 70 years, with a mean follow-up duration of 13 months. The time for operation, surgical incision length, blood loss, time for union, the sliding distance, change in the femoral neck-shaft angle and patient's walking ability were evaluated. RESULTS: The mean operation time and mean incision length were shortened, and mean blood loss was decreased in Group 1 (p<0.01). There was no statistical difference in the union time, the mean change in the femoral neck-shaft angle and the mean sliding distance of the lag screw at the last follow-up. The mean mobility score of the Parker and Palmer was 8.0 points before the fracture and 7.2 points at the last follow-up. CONCLUSION: Two-hole side plate dynamic hip screw is a useful device, in terms of the operation time, morbidity of operation site, satisfactory union rate and functional recovery of the patient in treatment of elderly patients with stable intertrochanteric fractures of the femur.
Aged ; Femur ; Follow-Up Studies ; Hip Fractures* ; Hip* ; Humans ; Walking

PURPOSE: To evaluate the radiographic, clinical results and the complications between who had intertrochanteric fracture, treated with the ITST or the PFN. MATERIALS AND METHODS: We selected each 30 patients of intertrochanteric fracture which were treated with ITST or PFN from July 2002 to November 2005. We evaluated the radiographic results by follow-up radiography and the clinical results with the mobility score of Parker and Palmer, Salvati and Wilson hip function scoring system and Jensen index. RESULTS: The mean distance of lag screw sliding was 4.1 mm at the ITST group and 6.6 mm at the PFN group. Decrease of mobility score of Parker and Palmer, Salvati and Wilson hip function score were similar. Patients complaint pain over lateral thigh area in 5 cases (ITST group) and 8 cases (PFN group). CONCLUSION: The ITST nail and PFN were seen good results in treatment of stable and unstable intertrochanteric fracture.
Femur* ; Follow-Up Studies ; Hip ; Hip Fractures* ; Humans ; Radiography ; Thigh

PURPOSE: To evaluate the factors which influence on the fixation failure after internal fixation using multiple cannulated screws in the patients with femoral neck fracture. MATERIALS AND METHODS: Ninty-six patients (male: 63, female: 33) who underwent closed reduction and internal fixation of femoral neck fracture between Feb. 1994 and Jun. 2002 with use of multiple cannulated screws. The mean age was 68 years (17~90) and mean follow-up period was average 50 months (36 months~6 years). The fixation failure was defined by change in fracture position above 10 mm, change in each screws position above 5%, backing above 20 mm, or perforation of the head, respectively. They were evaluated with the age, gender, fracture type, accuracy of reduction, placement of screws, posterior comminution and also studied the risk factors which influenced nonunion and the development of avascular necrosis. RESULTS: Twenty-four patients out of 96 patients had radiographic signs of fixation failure. The incidence of nonunion in the fixation failure group was 41% (10/24) and AVN was 33% (8/24). There were statistically significant correlations between fixation failure and nonunion and that posterior comminution, poor reduction and improper placement of the screws were the major factors contributing to nonunion. CONCLUSION: In case of femoral neck fracture of internal fixation using multiple cannulated screws, posterior comminution, poor reduction and improper placement of the screws were the major factors contributing to nonunion and fixation failure.
Female ; Femoral Neck Fractures* ; Femur Neck* ; Follow-Up Studies ; Head ; Humans ; Incidence ; Necrosis ; Risk Factors

No abstract available.
Fractures, Open