Updated Basic Principles of Internal Fixation of Fracture

Oog-Jin Shon; Ji-Wan Kim; Beom-Jung Kim

doi:10.12671/jkfs.2013.26.1.81

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Shon, Kim, and Kim: Updated Basic Principles of Internal Fixation of Fracture

Review Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2013; 26(1): 81-91.

Published online: 17 January 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.1.81

Updated Basic Principles of Internal Fixation of Fracture

Oog-Jin Shon, M.D., Ji-Wan Kim, M.D.^*, Beom-Jung Kim, M.D.

Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Korea.

^*Department of Orthopaedic Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Address reprint requests to: Oog-Jin Shon, M.D. Department of Orthopedic Surgery, Yeungnam University Medical Center, 170, Hyeonchung-ro, Nam-gu, Daegu 705-717, Korea. Tel: 82-53-620-3640, Fax: 82-53-628-4020, ossoj@med.yu.ac.kr

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figures and Tables

Fig. 1

Various kinds of minimally invasive osteosynthesis (MIO).

(A) Minimally invasive plate osteosynthesis (MIPO).

(B) Minimally invasive nail osteosynthesis (MINO).

(C) Minimally invasive screw osteosynthesis (MISO).

(D) Minimally invasive external fixator osteosynthesis (MIEFO).

Fig. 2

Fracture of the distal lower leg in a 45-year-old man.

(A) Anteroposterior view of the lower leg demonstrating the distal fracture.

(B) It was treated by conventional plating of the distal fibula and locking compression plate (LCP) osteosynthesis of the distal tibia using a minimally invasive plate osteosynthesis (MIPO) technique.

(C) After implant removal 10 months after injury.

Fig. 3

Fracture of the lower leg in a 31-year-old man.

(A) Multiple injured male with open wound of both lower extremities caused by pedestrian traffic accident. Metaphyseal comminuted fracture of tibia, fibula.

(B) Because the compromised soft tissue did not allow open reduction, consolidation was attempted with the initially applied external fixator.

(C) After 2 weeks, lateral plate fixation of the distal tibia using the minimally invasive plate osteosynthesis (MIPO) technique was performed and free flap was applied.

Fig. 4

Open fracture of the lower leg in a 38-year-old man caused by a traffic accident.

(A) Metaphyseal comminuted fracture of tibia, fibula.

(B) A contaminated fracture fragment was removed, consolidation was attempted with the initially applied external fixator. An antibiotic containig cement bead was inserted in dead space.

(C) After 2 weeks, cement bead was removed, osteotomy & external fixation of distal tibial fragment was performed for bone transport and skin graft was applied.

(D) After 6 weeks, bone transport was done. External fixator was removed and fragment was fixed with previous locking compression plate (LCP).

(E) After 12 weeks, internal fixation, and bone graft was performed using autogenous iliac bone.

Fig. 5

Expert nailing system.

Fig. 6

Angular stable locking system (ASLS).

Fig. 7

Lateral entry nail of proximal femur.

(A) Spiral fracture of the femoral shaft in a 25-year-old male.

(B) Nailing was performed with A2FN (Expert Asian Femoral Nail, AO).

(C) Simple fracture of the femoral shaft in a 37-year-old female.

(D) Nailing was performed with Sirus nail (Zimmer).

Fig. 8

Collinear reduction clamp can be used for reduction.

(A) Instrument.

(B, C) Intraoperative use.

Fig. 9

Periarticular wiring can be used for reduction.

(A) Instrument.

(B) Intraoperative use.

(C) Subtrochanteric fracture of femur in a 58-year-old female.

(D) Reduction was performed using wring and nailing was done.

(E) Follow-up x-rays 6 months after surgery showed good fracture healing with callus formation.

Fig. 10

(A) Spiral fracture of shaft in a 28-year-old female.

(B) Reduction was performed with polar screw (arrow).

Fig. 11

3-dimensional C-arm.

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