Journal of Musculoskeletal Trauma

Dae-Hyun Park

3 Articles

Paradoxical hypertrophy as a cause of femoral insufficiency fractures analyzed through differences in force application in Korea: three case reports: Yong-Uk Kwon, Dae-Hyun Park, Hyoung-Gu Kang; J Musculoskelet Trauma 2026;39(2):174-180. Published online April 23, 2026; DOI: https://doi.org/10.12671/jmt.2025.00388

Abstract PDF: Previous studies have extensively examined the association between femoral insufficiency fractures and prolonged bisphosphonate therapy. However, alternative etiologies remain insufficiently characterized. This study aimed to analyze nonpharmacologic factors associated with femoral insufficiency fractures, with particular emphasis on paradoxical cortical hypertrophy and altered biomechanical load distribution. We reviewed three cases of femoral insufficiency fracture that were surgically treated at our institution between January 2018 and January 2022. None of the patients had a history of bisphosphonate use. Clinical histories—including underlying comorbidities, prior surgical procedures, and radiographic findings—were evaluated. Serial radiographs obtained before and after fracture occurrence were analyzed to characterize fracture morphology and associated cortical changes. Case 1 involved a patient with posttraumatic hip synostosis; case 2 involved a patient with osteogenesis imperfecta; and case 3 involved a patient who had previously undergone intramedullary nailing for an intertrochanteric fracture. Lateral femoral bowing and cortical hypertrophy preceded fracture development in two cases, whereas focal cortical hypertrophy at the distal locking screw site was observed in the third case. No history of bisphosphonate therapy was identified in any patient. Fractures developed at sites characterized by increased cortical remodeling and abnormal load concentration. Femoral insufficiency fractures can occur in the absence of bisphosphonate therapy. Paradoxical cortical hypertrophy and altered biomechanical force distribution appear to be important contributing factors. Level of evidence: IV.

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Operative Positioning Technique for an Intertrochanteric Fracture in a Patient with an Ipsilateral Above-the-Knee Amputation - Technical Note -: Dae-Hyun Park, Yong-Uk Kwon, Dong-Seok Kim; J Korean Fract Soc 2021;34(4):137-141. Published online October 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.4.137

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A 45-year-old man with a remote history of a left above-the-knee amputation presented to the emergency department with left hip pain after a mechanical fall. This case was an operative challenge because commonly used intraoperative traction methods could not be applied to a patient with an above-the-knee amputation. We describe a rarely utilized surgical technique of applying traction to an amputated extremity via a Steinmann pin during closed reduction and internal fixation of an intertrochanteric fracture.

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Periprosthetic Femur Fractures in Osseointegration Amputees
Jason Shih Hoellwarth, S. Robert Rozbruch
JBJS Case Connector.2022;[Epub] CrossRef

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Physeal distraction for physeal bar detachment in a 10-year-old boy in Korea: a case report: Yong-Uk Kwon, Dae-Hyun Park, Dong-Yun Lee; Received April 16, 2026 Accepted July 2, 2026 Published online September 16, 2026; DOI: https://doi.org/10.12671/jmt.2026.00178

Abstract: A 10-year-old boy developed a posterolateral distal femoral physeal bar (bar-to-physis ratio, 14.91%) with progressive genu valgum 6 months after fixation of a Salter-Harris type II fracture; the mechanical axis deviation (MAD) had increased to 21.3 mm. Because resection of small bars can still be followed by substantial risks of recurrence and reoperation, distraction epiphysiolysis was selected to disrupt the bar while preserving the growth plate rather than excising it. After removal of the fixation screws, distraction screws were placed in the epiphysis and metaphysis and connected to an external fixator, and distraction was performed at 1 mm/day and continued at outpatient visits (total, 9.5 mm). At 3 months, computed tomography showed that the bar had decreased to 3.01%, and 2-year magnetic resonance imaging demonstrated only multifocal partial closure (<10%) without recurrence of a confluent bar. Over 3 years, the mechanical axis gradually realigned (MAD decreased to 4.6 mm) with near-equal limb length (limb-length discrepancy, 0.1 mm), consistent with preserved longitudinal growth, whereas the mechanical lateral distal femoral angle changed little (80.2° to 82.0°). A bench test of six synthetic femur constructs showed a mean construct yield load of 74.74 N, a construct characteristic that does not represent the force transmitted to the physis in vivo. This case suggests that distraction epiphysiolysis may disrupt a small physeal bar and support gradual realignment while preserving limb length. Level of evidence: V.

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