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Treatment of Intertrochanteric Fracture of the Femur with Ender Nail in the Elderly Patients with High Risk of Anesthesia.

Ju yong SHIN ; Duk Hwan KHO ; Dong Ok KIM ; Dong Heon KIM

Journal of the Korean Fracture Society.2004;17(2):202-207. doi:10.12671/jkfs.2004.17.2.202

PURPOSE: To evaluate the usefulness of IM Ender nail in treating femoral intertrochanteric fractures with high risks including cardiovascular disease, pulmonary disease, liver cirrhosis, cerebrovascular disease, metastatic cancer, and skin problem at hip joint region. MATERIALS AND METHODS: Thirty-five patients of pre-existing diseases and femoral intertrochanteric fractures treated with Ender nailing, January 1990 to November 1997. Under the c-arm guided, closed reduction and internal fixation were performed using Ender nails, We analized operation time, blood loss, bone union, ambulation time and complications RESULTS: Mean operation time was 55 minutes, mean blood loss was 120 ml, mean radiological bone union was 12 weeks and average of partial weight bearing was 6.9 days. Postoperative complications were gastrointestinal discomfort in 3 cases, superficial wound infection in 1 case, knee pain in 7 cases, inguinal pains in 5 cases, distal migration of nails in 3 cases, varus deformity in 2 cases, proximal migration of nail with nonunion in 1 case. CONCLUSION: The intramedullary ender nail is useful method in treating femoral intertrochanteric fractures in high risk patients of anesthesia and blood loss or skin problem at hip joint region.
Aged* ; Anesthesia* ; Cardiovascular Diseases ; Congenital Abnormalities ; Femur* ; Hip Fractures ; Hip Joint ; Humans ; Knee ; Liver Cirrhosis ; Lung Diseases ; Postoperative Complications ; Preexisting Condition Coverage ; Skin ; Walking ; Weight-Bearing ; Wound Infection

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Clinical Applications of Autologous Cultured Osteoblasts: Case Report.

Seok Jung KIM ; In Young OK ; Cheong Ho CHANG ; Young Sik KIM ; Jae Deog JANG ; Won Jong BAHK ; Joo Hyung LEE

Journal of the Korean Fracture Society.2004;17(2):197-201. doi:10.12671/jkfs.2004.17.2.197

We treated 3 cases of fracture and 1 case of avascular necrosis of femoral head using autologous cultured osteoblasts injection. The stromal cells from the bone marrow were cultured to differentiate to osteoblasts for 4 weeks. The fracture sites of each patients were right ulnar shaft, left radial shaft, and left 5th metatarsal base. All of the fractures showed callus formations after 1 week of osteoblasts injection to the fracture site. After 4 weeks, callus formations were progressed. Avascular necrosis of femoral head was bilateral and both were Ficat stage II. Core decompression and allograft impaction were performed to the left, and core decompression and autologous cultured osteoblasts injection percutaneously after 4 weeks of the decompression operation were done to the right femoral head. CT images of 1 year from the operations showed trabecular bone formation and well maintained femoral head contour of the right femur, but resorption of the grafted bone for the left.
Allografts ; Bone Marrow ; Bony Callus ; Decompression ; Femur ; Head ; Humans ; Metatarsal Bones ; Necrosis ; Osteoblasts* ; Osteogenesis ; Stromal Cells ; Transplants

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Treatment of Vertebral Pseudarthrosis after Compression Fracture.

Young Do KOH ; Hoon JEONG

Journal of the Korean Fracture Society.2004;17(2):191-196. doi:10.12671/jkfs.2004.17.2.191

PURPOSE: To clarity the features of vertebral pseudarthrosis and to evaluate the efficacy of posterior instrumentation and fusion in treatment of it. MATERIALS AND METHODS: Twelve patients with severe back pain and intravertebral pseudarthrosis showing vacuum phenomenon were treated by in situ posterior instrumentation and fusion. The kyphotic angle of pre- and post-treatment was measured on a lateral radiograph. MRI was performed in all patients. The intravertebral instability was confirmed from the dynamic lateral view. The pain level was assessed both before and after the treatment using a visual analog scale. The kyphotic angle at last follow up was also checked. RESULTS: In eight cases, intravertebral instability was shown at the clefts in flexion-extension radiographs. MRI showed that the cleft was low intensity on the T1- weighted image and high intensity on the T2-weighted image. The pre-and postoperative mean kyphotic angles were -18.3degrees and -8.5degrees respectively. The preoperative average pain score was nine and postoperative four. At last follow up the mean kyphotic angle was -16.6degrees CONCLUSION: The cleft with intravertebral vacuum phenomenon and magnetic resonance findings of low intensity on the T1-weighted scans and high intensity on the T2-weighted scans suggests that the cleft is a pseudarthrosis associated with avascular necrosis of the vertebral body. The posterior instrumentation and fusion provides satisfactory pain relief in patient with vertebral pseudarthsosis.
Back Pain ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Magnetic Resonance Imaging ; Necrosis ; Pseudarthrosis* ; Spine ; Vacuum ; Visual Analog Scale

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Lateral Condylar Fracture of the Humerus in Children: Is the Closed Pinning Saticfactory?.

Kwang Soon SONG

Journal of the Korean Fracture Society.2012;25(2):163-168. doi:10.12671/jkfs.2012.25.2.163

No abstract available.
Humerus

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Operative Treatment of Humerus Shaft Fracture: Conventional Open Plating or Minimally Invasive Plate Osteosynthesis.

Hyun Joo LEE ; Chang Wug OH

Journal of the Korean Fracture Society.2012;25(2):155-162. doi:10.12671/jkfs.2012.25.2.155

No abstract available.
Humerus

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Ipsilateral Distal Radius and Scaphoid Fractures Associated with Posteromedial Dislocation of the Elbow Joint: A Case Report.

Jin Wan KIM ; Young Chul KO ; Chul Young JUNG ; Il Soo EUN ; Young Jun KIM ; Chang Kyu KIM

Journal of the Korean Fracture Society.2012;25(2):150-154. doi:10.12671/jkfs.2012.25.2.150

Arm injuries occurring from high energy injuries such as falls or traffic accidents can be accompanied by wrist and elbow injuries. Monteggia fracture, Galeazzi fracture, and Essex-Lopresti fracture-dislocation are known some examples of such injuries. However, there are no reports on the dislocation of the elbow occurring from a distal radius fracture accompanied by scaphoid fracture, and there is nothing published about its prognosis. The authors report on the treatment and outcomes of a case of a 42-year-old male who had a distal radius and scaphoid fracture associated with posteromedial dislocation of the elbow on the same side of his arm along with a literature review.
Accidents, Traffic ; Adult ; Arm ; Arm Injuries ; Dislocations ; Elbow ; Humans ; Male ; Monteggia's Fracture ; Prognosis ; Radius ; Radius Fractures ; Wrist

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Delayed Brachial Artery Occlusion after Humeral Shaft Open Fracture: A Case Report.

Chul Hyun CHO ; Ki Cheor BAE ; Kyung Jae LEE ; Si Wook LEE

Journal of the Korean Fracture Society.2012;25(2):146-149. doi:10.12671/jkfs.2012.25.2.146

Although vascular injury after humeral fracture is very rare, it is a complication that has serious sequelae. It has been associated with proximal humeral fracture or shoulder dislocation in adults and humeral supracondylar fracture in children. However, delayed brachial artery occlusion after humeral shaft fracture has never been reported worldwide. Nevertheless, delayed brachial artery occlusion after humerus shaft fracture has the potential to cause serious complications in the short term as well as long term; therefore, it is essential to provide accurate diagnosis and prompt treatment. We report a case of delayed brachial artery occlusion after humeral shaft open fracture that was successfully treated with early diagnosis as well as effective treatment.
Adult ; Brachial Artery ; Child ; Early Diagnosis ; Fractures, Open ; Humans ; Humeral Fractures ; Humerus ; Shoulder Dislocation ; Shoulder Fractures ; Vascular System Injuries

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Delayed Foreign-body Reaction of Ankle Fracture Treated with a Biodegradable Plate and Screws: A Case Report.

Chul Hyun PARK ; Dae Hyun SONG ; Jae Ho CHO

Journal of the Korean Fracture Society.2012;25(2):142-145. doi:10.12671/jkfs.2012.25.2.142

Biodegradable implants made of co-polymers composed of L-lactide, D-lactide, and trimethylene carbonate were used in the present case. To our knowledge, only one reported tissue reaction has been associated with ankle fracture treated with third-generation implants internationally and none yet domestically. We report a delayed foreign-body reaction of ankle fracture treated with a third-generation biodegradable plate and screws. We suggest that ankle fracture patients treated with biodegradable implants should be advised of this possible complication and should be followed for at least 2 years.
Absorbable Implants ; Animals ; Ankle ; Carbon ; Dioxanes ; Foreign-Body Reaction ; Humans

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Repeated Metal Breakage in a Femoral Shaft Fracture with Lateral Bowing: A Case Report.

Dong Soo KIM ; Yong Min KIM ; Eui Sung CHOI ; Hyun Chul SHON ; Kyoung Jin PARK ; Byung Ki CHO ; Ji Kang PARK ; Hyun Cheol LEE ; Kyung Ho HONG

Journal of the Korean Fracture Society.2012;25(2):136-141. doi:10.12671/jkfs.2012.25.2.136

Fractures of the femoral shaft with marked bowing face some obstacles in fixation of the fracture such as difficulty in insertion of the intramedullary nail (IM nail) or exact contouring plate. Locking compression plates (LCP) are an option to manage this problem. However, we experienced consecutive breakage of LCP twice and IM nail once in an 80-year-old female. Finally, union of the fracture was achieved after fixation of the IM nail and additional plate together. Fractures of the femur shaft with marked bowing are thought to have different biomechanical properties; therefore, we present this case with a review of the literature.
Aged, 80 and over ; Female ; Femur ; Humans ; Nails

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Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus.

Ji Kang PARK ; Yong Min KIM ; Dong Soo KIM ; Eui Sung CHOI ; Hyun Chul SHON ; Kyoung Jin PARK ; Byung Ki CHO

Journal of the Korean Fracture Society.2012;25(2):129-135. doi:10.12671/jkfs.2012.25.2.129

PURPOSE: To evaluate the clinical outcomes of operative treatment using a transolecranon approach with a dual locking plate for unstable intercondylar fractures of the distal humerus. MATERIALS AND METHODS: Eighteen patients were followed for more than 1 year after surgical treatment for unstable intercondylar fractures of the humerus. Anterior transpositioning of the ulnar nerve and an early rehabilitation program to allow range of motion (ROM) exercise from postoperative week 1 were used for all cases. The clinical and functional evaluation was performed according to the Mayo Elbow Performance Index and Cassebaum's classification of ROM. RESULTS: The range of elbow joint motion was a flexion contracture mean of 12.8 degrees to a further flexion mean of 119.3 degrees at the final follow-up. The Mayo Elbow Performance Index was an average of 88.5 points. Among the results, 6 were excellent, 9 good, 2 fair, and 1 poor. Therefore, 15 cases (83.3%) achieved satisfactory results. Fourteen cases (77.7%) achieved a satisfactory ROM according to Cassebaum's classification. All cases achieved bone union, and the interval to union was an average of 14.2 weeks. CONCLUSION: Dual locking plate fixation through the transolecranon approach seems to be one of the effective treatment methods for unstable intercondylar fractures of the humerus because it enables the anatomical reduction and rigid fixation of articulation, and early rehabilitation exercise.
Contracture ; Elbow ; Elbow Joint ; Follow-Up Studies ; Humans ; Humerus ; Range of Motion, Articular ; Ulnar Nerve

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