Flexible Intramedullary Pin Fixation of Both Forearm Bone Fractures in Children

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.

Treatment of Tibial Fracture by Interlocking Intramedullary Nailing / 대한정형외과학회잡지

The intramedullary nailing for the tibial fracture has been used in selected cases of fresh diaphyseal fracture and nonunion. However, with modern technical improvement such as image intensifier and interlocking, the indications have been expanded considerably. Interlocking intramedullary nailing has been popularized because it enables preservation of the range of motion of the joint, early weight bearing and early bony union. Between August, 1989 and July, 1991 interlocking nailing in the tibial fracture has been performed for 53 cases with follow up more than one year. The results were as follows; 1. All were treated with closed nailing and static locking was performed as a principle. Only three cases needed dynamization of the 47 patients treated with static locking nailing. 2. The union rate was 96.296 and mean period of fracture union was 15.2 weeks. 3. In the distal one third of fracture, rigid fixation could be achieved by adjusted length by cutting the distal end. 4. In 7 proximal tibial fractures, 4 fractures were accompanied with complications such as nonunion, angulation deformity and shortening. Therefore, interlocking nail is inadequate treatment of proximal unstable fractures. 5. In the delayed and nonunion treated by interlocking nailing, bony union was achieved in all 3 cases without bone graft and cast immobilization.

Suppurative Arthritis of the Hip Joint in Coma Patient: Two Cases / 대한정형외과학회잡지

Suppurative arthritis of the hip joint is a rare disease in adult, but the disease is a serious condition to be left many complications. So the most important point in management of the suppurative arthritis of the hip joint is the early diagnosis and treatment. Recently we have experienced two cases of suppurative arthritis of the hip joint which was occurred in coma patients. Difficulties of the suppurative arthritis of the hip joint in coma patient are the detection and management. The supposed cause of the suppurative arthritis of the hip joint is probably a puncture of the repeatead femoral puncture.

A Clinical analysis of the Fracture of the Humeral Shaft / 대한정형외과학회잡지

The humerus is anatomically and phyelologically unique, such as, firstly, it is a non weight bearing bone, secondly, it has greatest range of motion, thirdly, when at rest while the person is standing, the axis of bone hangs vertically and is influenced by gravity, and conservative methods usually used in treatment. However, in the event of closed reduction failure, open fracture, multiple fracture, and old age, operative method may be employed. Authors reviewed and analzed 84 humeral shaft fractures which had been treated at the Department Orthopedic Surgery, Paik Hospital from Dec. 1979 to May 1988. The results were as follows : l. Among the 84 patients, male were 63 and female were 21. 2. The major causes of injury were a traffic accident. 3. The most frequent type and site of fracture was comminuted and middle one third. 4. The incident of radial nerve injury was 17 cases. 5. Of 84 cases, 22 cases were treated conservatively and 62 cases operatively. 6. The most common complication was non-union of 14 cases, of which 10 cases were treated with plate and bone graft and 4 cases with only bone graft.