• Title/Summary/Keyword: Intramedullary fracture fixation

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Surgical Techniques for Percutaneous Intramedullary Fixation with Steinmann Pins for Clavicle Shaft Fractures (쇄골 간부 골절에 대한 경피적 골수강내 금속핀 고정 수술법과 결과 보고)

  • Ha, Sung Sik;Sim, Jae Chun;Sung, Min Chul;Jeon, Jong Hyun;Seo, Yi Rak
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.7-14
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    • 2017
  • Purpose: To report the clinical results from surgical treatment for clavicle shaft fracture by percutaneous intramedullary fixation with Steinmann pins. Materials and Methods: Between January 2004 and June 2014, the medical records of 135 patients who underwent percutaneous intramedullary fixation with Steinmann pins were reviewed. The mean follow-up periods were 15 months. The functional results were evaluated with The Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant score. The clinical results were evaluated with the shortened length of the clavicle, length of surgical wound, operation time and Kang's criteria. Results: The mean bone union period was 11.6 weeks (8-16 weeks). The mean DASH score was 11.8. The mean Constant score was 91.2. The mean shortened length of the clavicle was less than 20 mm. The mean length of surgical wound was 1.2 cm (0.7-1.5 cm). The mean operation time was 18 minutes (10-35 minutes). Using Kang's criteria, 131 out of 135 patients (97.0%) showed good results. Complications included were 3 pin migrations and 2 non-unions. Conclusion: Percutaneous intramedullary fixation with Steinmann pins showed good results for treating clavicle shaft fracture.

Fractures of the dog in Taegu area (대구지방에서 발생한 개의 골절)

  • 김대영;장인호
    • Journal of Veterinary Clinics
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    • v.15 no.1
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    • pp.222-227
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    • 1998
  • This survey was based on the data of one hundred four dogs with 108 case,T of fracture admitted to the veterinary teaching hospital, College of Veterinary Medicine, Kyungpook National University and 24 private small animal hospitals from January, 1995 to Decemberi 1996. The results were analyzed as following criteria; the distribution of fractures causes of fractured age and sexual distributions month of the most frequencel total body weights presence of communicating external wound, extent of damaged direction of fracture line, location of fracture liner fracture managements fixations methods, fixations methods according to location of fracture. The results of survey were as follow: 1. Main distribution of fracture; radius . ulna (23.1%).2. Causes of fracture; road toraffic accident (39.4 T,). 3. Age; over 24 months (27.9%). 4. Sex; male (53.89)), female (46.2%). 5. Month of the most frequence; July (14.4%) 6. Total body weight: 2-5 kg (45.27)). 7. Presence of communicating external wound; closed fracture (94.2%). 8. Extent of damage; complete fracture (92.6%). 9. Direction of fracture line: comminuted fracture (27.8 To). 10. Location of fracture line; diaphysis (62.0%). 11. Fracture management; open reduction (58.3% ). 12. Fixation methods; not treat (22.2%). 13. Fixation methods according to location of fracture; radius ulna-Kirschner wire fixation (45.5%), femur. shaft-intramedullary pinning (71.4%), pelvis-bone plate (53.3%), metacarpus-not treat, Kirschner wire fixation (each 30.8%).

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Comparison between Two Kirschner Wire Fixation and Three Wire Fixation, in Treating of Metacarpal Neck Fracture Using Multiple Retrograde Kirschner Wire Fixation (다발성 역행성 K 강선을 이용한 중수골 경부 골절의 치료에서 2개의 강선과 3개의 강선 사용군의 비교)

  • Kwak, Sang-Ho;Lee, Young Ho;Seo, Gil Joon;Baek, Goo Hyun
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.55-59
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    • 2015
  • Purpose: To compare clinical and radiographic outcomes of between two and three Kirschner wire(K-wire) intramedullary fixation for fractures in the neck of the metacarpal bone. Methods: A single institutional retrospective review identified 28 cases of metacarpal fractures between March 2010 and August 2014. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the neck of the metacarpal bone. The patient groups were divided by the number of K-wire. Outcomes were compared for range of motion of the metacarpophalangeal joint, radiographic parameters, and period until union. Results: The fractures were treated with either 2 Kirschner wire fixation (n=10) or 3 Kirschner wire fixation (n=18). The active range of motion of metacarpophalangeal joint and radiographic result showed no statistically significant difference between the two groups. The mean union period was 5.9 weeks. However, four cases suffered distal head perforation in 2 K-wire fixation group and one case in 3 K-wire fixation group. Conclusion: Multiple retrograde intramedullary Kirschner wire fixation is a good treatment of choice for fractures in the neck of the metacarpal bone. To prevent metacarpal head perforation, it is preferred to use three K-wires than two K-wires.

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Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures (원위 경골 골절에서 금속정 및 금속판 고정술의 결과 비교)

  • Kim, Jung-Han;Gwak, Heui-Chul;Lee, Chang-Rack;Jung, Yang-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.3
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    • pp.86-90
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    • 2015
  • Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

A Case of External Fixation for Humeral Fracture in a Common Buzzard (Buteo buteo) (말똥가리의 상완골 골절에 있어서 외부고정술 일례)

  • Kim Young-jun;Kim Soo-ho;Gwon Min-jeong;Park Cheol-Min;Lee Hang;Shin Nam-shik
    • Journal of Veterinary Clinics
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    • v.21 no.4
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    • pp.409-412
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    • 2004
  • Authors introduce a case of successful orthopedic surgery for humeral fracture of Common buzzard (Buteo buteo). The bird, juvenile male, was rescued due to illegal gun shot in Yeoncheon-Gun, Kyonggi-Do. The external skeletal fixation (ESF) with intramedullary pinning (Tie-in method) using Imex clamps was chosen for this fracture case. The common buzzard was anesthetized with hand made face mask and Isoflurane. In particular, the rescued bird was needed rehabilitating procedures, such as flight training or physical exercise for their survivals in wild habitats. The injured buzzard is successfully recovered without any damage to ligaments and nerves after 6 weeks.

Cut-Through versus Cut-Out: No Easy Way to Predict How Single Lag Screw Design Cephalomedullary Nails Used for Intertrochanteric Hip Fractures Will Fail?

  • Garrett W. Esper;Nina D. Fisher;Utkarsh Anil;Abhishek Ganta;Sanjit R. Konda;Kenneth A. Egol
    • Hip & pelvis
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    • v.35 no.3
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    • pp.175-182
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    • 2023
  • Purpose: This study aims to compare patients in whom fixation failure occurred via cut-out (CO) or cut-through (CT) in order to determine patient factors and radiographic parameters that may be predictive of each mechanism. Materials and Methods: This retrospective cohort study includes 18 patients with intertrochanteric (IT) hip fractures (AO/OTA classification 31A1.3) who underwent treatment using a single lag screw design intramedullary nail in whom fixation failure occurred within one year. All patients were reviewed for demographics and radiographic parameters including tip-to-apex distance (TAD), posteromedial calcar continuity, neck-shaft angle, lateral wall thickness, and others. Patients were grouped into cohorts based on the mechanism of failure, either lag screw CO or CT, and a comparison was performed. Results: No differences in demographics, injury details, fracture classifications, or radiographic parameters were observed between CO/CT cohorts. Of note, a similar rate of post-reduction TAD>25 mm (P=0.936) was observed between groups. A higher rate of DEXA (dual energy X-ray absorptiometry) confirmed osteoporosis (25.0% vs. 60.0%) was observed in the CT group, but without significance. Conclusion: The mechanism of CT failure during intramedullary nail fixation of an IT fracture did not show an association with clinical data including patient demographics, reduction accuracy, or radiographic parameters. As reported in previous biomechanical studies, the main predictive factor for patients in whom early failure might occur via the CT effect mechanism may be related to bone quality; however, conduct of larger studies will be required in order to determine whether there is a difference in bone quality.

Femoral Shaft Fracture in Klippel-Trenaunay-Weber Syndrome Patients - What to Do to Reduce Bleeding Risk: A Case Report

  • Byung-Chan Cho;Byung-Woo Min;Kyung-Jae Lee
    • Hip & pelvis
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    • v.34 no.4
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    • pp.262-268
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    • 2022
  • A fracture of the affected extremity in patients with Klippel-Trenaunay-Weber syndrome can be fatal due to massive bleeding and show poor results. A 42-year-old male presented with an old fracture of the right femoral shaft with metal failure. We planned an operation to remove the previously fixed plate and to perform re-fixation using an intra-medullary nail. Preoperative angiography was performed and the arteriovenous malformations were embolized in order to reduce the risk of bleeding. After angiography, the previously fixed plate was removed. After the operation, a second angiography was performed immediately and the venous malformation was embolized. One week after the first operation, a second operation was performed in order to reduce the fracture and to perform re-fixation using an intramedullary nail. The patient is being followed without major complication over a period of seven years after surgery. We recommend careful planning of preoperative and postoperative angiography and embolization in order to reduce the risk of bleeding in patients with Klippel-Trenaunay-Weber syndrome.

Intramedullary Screw Fixation for Clavicle Shaft Fractures: Comparison of the Anterograde versus the Retrograde Technique

  • Rhee, Yong Girl;Cho, Nam Su;Cho, Sung Whan;Song, Jong Hoon
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.8-14
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    • 2016
  • Background: The purpose of this study was to investigate the difference between two nailing approaches of intramedullary screw fixation, the retrograde nailing versus the anterograde nailing, on the radiological and clinical outcomes in patients with clavicle shaft fractures. Methods: From April 2002 to August 2014, we enrolled a total of 22 patients with clavicle shaft fractures to participate in this study. Twelve patients received retrograde intramedullary nailing and 10 received anterograde nailing. The average duration of follow-up was 12 months. In all the patients, we took follow-up radiographs of the anteroposterior and the axial views to assess the postoperative radiological outcomes. We measured the visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and the range of motion (ROM). Results: Clinically, we did not find a statistically significant difference in the retrograde group and the anterograde group in terms of the duration to bone union, the VAS score the ASES score and the ROMs. Radiologically, we found that the difference in the clavicle shortening of the affected arm and the unaffected arm did not show a statistically significant difference at the immediate postoperative assessment. we found that the difference in the clavicle shortening of the affected arm between the immediate postoperative and the final follow-up value did not show a statistically significant difference. Conclusions: We found that both the retrograde nailing and the anterograde nailing gave a favorable outcome for clavicle shaft fractures. Although we saw evidence of clavicle shortening after intramedullary screw fixation, this was not a factor that influenced clinical outcome.

Stress Analysis of Plate Augumentation for Distal Femur Fracture (대퇴부 원위부 골절에 관한 금속판 보강술의 응력 해석)

  • 김지숙;범현규;양영수
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 1997.10a
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    • pp.816-819
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    • 1997
  • The operation of femoral non-union after IM(Intramedullary) nailing in distally femoral fractures is considered. Augmentive plate fixation is the management of femoral non-union after IM nailing. The purpose of this study is to compare the bending, torsional stiffness and stress distribution of the two operations by the FEM(Finite Element Method). Augmentive plate fixation is better than IM nail fixation. These results conclude that plate augmentation is a useful method for the unstable femoral non-union after interlocking IM nailing.

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