• Journal of Trauma and Injury
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• 제36권1호
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• pp.65-69
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• 2023

The surgical approach for humeral implant failure can be challenging due to neurovascular anatomy and the possible necessity of osteosynthesis removal. We present a rare case of humeral nail bending after secondary trauma in a patient with preexistent nonunion of the humerus after intramedullary nailing. During revision surgery, the nail was sawed in half and the distal part was removed, followed by plate osteosynthesis with cable fixation to achieve absolute stability. The patient regained a full range of motion 1 year after surgery, and complete healing of the fracture was seen on imaging.

• 대한족부족관절학회지
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• 제19권4호
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• pp.171-175
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• 2015

Purpose: Tibiotalocalcaneal arthrodesis has been used as a treatment option for severe deformity including Charcot arthropathy, avascular necrosis of the talus, and severe osteoarthritis of the ankle and subtalar joint. The purpose of this study was to evaluate the result of the surgical outcome of tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail. Materials and Methods: Tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail was performed by one surgeon in 36 cases. Clinical and radiological finding was evaluated using assessment of fusion time, 5th metatarsal-tibial angle, possibility of postoperative complication, visual analogue scale for pain and American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: Union was achieved in 33 cases at an average of 23 weeks (11~29 weeks). There were 3 cases of nonunion and 1 case of reoperation. Nail-tibial angle tended to be larger in nonunion cases. AOFAS score showed significantly poor outcome at malalignment (${\geq}5^{\circ}$), negative value of 5th metatarsal-tibial angle. Conclusion: Tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail is considered a useful treatment option for severe destruction and deformity involving ankle and subtalar joint.

• 대한정형외과학회지
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• 제56권2호
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• pp.183-189
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• 2021

슬관절 고정술은 슬관절이 손상되어 재건술을 시행할 수 없는 환자에서 안정적이고 통증이 없는 슬관절을 얻을 수 있는 마지막 선택사항 중 하나이다. 슬관절 고정술에는 외고정 장치, 압박 금속판을 이용한 내고정, 조립형 금속정 또는 이상와로부터 삽입하는 전향적 금속정을 이용한 내고정 등 다양한 방법들이 사용되어 왔다. 다른 선택사항으로 Neff 정, Wichita 정, 또는 Huckstep 정과 같은 짧은 금속정을 이용하기도 한다. 그러나 한국에서는 현재 사용 가능한 상용화된 짧은 금속정이 없다. 이에 저자들은 역행성 대퇴부 골수강 내 금속정을 이용한 슬관절 고정술을 보고하고자 한다.

• 대한족부족관절학회지
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• 제18권4호
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• pp.202-207
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• 2014

Purpose: The purpose of this study was to evaluate the radiological and clinical outcomes of tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail for patients with complex hindfoot problems, including Charcot arthropathy, osteonecrosis of talus, combined arthritis of the ankle and subtalar joint, failure of previous ankle arthrodesis, and failed total ankle arthroplasty. Materials and Methods: Eighteen consecutive patients (10 men and 8 women) with an average age of 54 years (range, 42~72 years) underwent tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail fixation. The mean duration of follow-up was 16 months (range, 12~23 months). Radiological evaluation included assessment of the union status of ankle and subtalar joints. Clinical evaluations included visual analogue scale (VAS) for pain and patient satisfaction, and postoperative complications were analyzed. Results: Radiological union was achieved in 14 ankle joints (77%) and 16 subtalar joints (88%) at an average of 16 weeks (range, 14~40 weeks) and 14 weeks (range, 12~24 weeks), respectively. The preoperative VAS were 4.6 (range, 4~8) at rest and 8.2 (range, 7~10) during walking, and the postoperative VAS were 2.2 (range, 0~3) and 4.6 (range, 4~6), respectively (p<0.05). There were 6 nonunions (4 ankle joints and 2 subtalar joints), 3 tibia fractures, 2 delayed union of ankle joints, and 2 breakage of the implant. Conclusion: Tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail may be considered as a viable option in patients with complex hindfoot problems.

• Journal of Trauma and Injury
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• 제18권1호
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• pp.41-46
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• 2005

Background: We evaluated the clinical and the radiological results of treatment for humeral shaft fractures by using an antegrade intramedullary nail. Methods: Thirty-nine (39) cases of humeral shaft fractures treated with antegrade intramedullary nail were evaluated. Bone union was evaluated with simple radiographic findings, and a functional evaluation was done using the American Shoulder and Elbow Surgeons (ASES) score. Results: The average duration until union was 14.1 weeks. On the functional evaluation using the ASES score, 15 cases were excellent, 19 cases good, 3 cases fair, and 2 cases poor. Conclusion: We conclude that antegrade intramedullary nailing has a good clinical and radiological result for treatment of humeral shaft fractures.

• Journal of Yeungnam Medical Science
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• 제10권2호
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• pp.388-399
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• 1993

1983년 2월부터 1993년 5월까지 저자들이 interlocking IM nail정을 이용하여 치료한 경골 골절을 평균 14개월 추시하여 다음과 같은 결론을 얻었다. 1. 총 38례 중 37례에서 골유합을 이루어 97.3%의 골유합율은 보였으며 평균골유합기간은 18.7주였다. 2. 금속정의 사용 범위는 경골 간부 및 근위부나 원위부 골절에서 만족할 만한 결과를 얻었다. 3. interlocking nail은 심한 분쇄성 골절, 개방성 골절, 골소실이 있는 개방성 골절 동에서 견고한 고정을 얻을 수 있었다. 4. 불유합 및 지연유합된 경우 모두 골유합을 이루어 나사못 맞물림을 이용한 금속정 고정법은 경골 간부 골절에서 훌륭한 치료법으로 생각된다. 5. 가장 중요한 합병증은 Valgus 각형성 2례 및 varus 1례와 심부감염 1례 등이었다. 6. 금속정은 고정력이 견고하여 조기 관절운동 및 보행이 가능하여 관절 강직이나 근위축을 방지할 수 있었다.

• Clinics in Shoulder and Elbow
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• 제18권2호
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• pp.91-95
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• 2015

Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.

• Clinics in Shoulder and Elbow
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• 제18권1호
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• pp.47-51
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• 2015

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2008년도 추계학술대회 논문집
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• pp.199-200
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• 2008

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2007년도 추계학술대회 논문집
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• pp.177-178
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• 2007