J Korean Fract Soc.  2013 Jan;26(1):81-91. 10.12671/jkfs.2013.26.1.81.

Updated Basic Principles of Internal Fixation of Fracture

• Shon OJ
• Kim JW
• Kim BJ

• KMID: 1431724
• DOI: http://doi.org/10.12671/jkfs.2013.26.1.81

Abstract

No abstract available.

Figure

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  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).

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  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.

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  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.

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  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.

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  Fig. 5 Expert nailing system.

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  Fig. 6 Angular stable locking system (ASLS).

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  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).

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  Fig. 8 Collinear reduction clamp can be used for reduction. (A) Instrument. (B, C) Intraoperative use.

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  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.

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  Fig. 10 (A) Spiral fracture of shaft in a 28-year-old female. (B) Reduction was performed with polar screw (arrow).

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  Fig. 11 3-dimensional C-arm.

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