Journal of Musculoskeletal Trauma

Treatment of Unstable Distal Radius Fracture: Myung Chul Yoo, Yong Girl Rhee, Keun Young Lee, Dong Kee Ahn; J Korean Soc Fract 1988;1(1):11-19. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.11

Abstract PDF: The unstable distal radius fractures result in various residual disability, and the instability can be recognized by the presence of much comminution, severe dorsal angulation or extensive intraarticular involvement. It is disfficult to reduce the fracture fragments and immobilize it with classical closed rduction and cast immobilization. So many authors have tried to reduce it with invasive methods and apply supplementary fixztion. Clinical and radiological analysis was made in 29 patients of unstable distal radius fracture who treated in Kyung Hee University Hospital from Jan. 1983 to Dec, 1987. The results were as following; 1. The unstable distal radius fractures were 24% of the distal radius fractures which were treated with admission. 2. In prevalence, male was mostly young men, but female was mostly old women. 3. The most frequent Frykman type was VIII(48.3%), but it could not represent the degree of comminution and displacement sufficiently. 4. Most of the patients treated by conservative method showed poor results. But operative treatment made it possible to align the fragment anatomically, restore the congruity of articular surface and prevent the collapse of reduction, so satisfactory results were obtained. 5. The unstable factures with large cortical defect or severe comminution required internal fixation for anatomical reduction and at the same time required additional external fixation to prevent the collapse and shortening of the distal radius.

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A Clinical Experience of Limited Wrist Arthrodesis (Radioscapholunate arthrodesis): Yung Khee Chung, Jung Han Yoo, Baek Yong Song; J Korean Soc Fract 1988;1(1):20-23. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.20

Abstract PDF: The principle of treatment in patient with fracture involving articular surface is necessary for anatomical reduction, rigid fixation and early motion. However, on the occasion of the unsatisfactory results such a post-traumatic arthritis of the wrist joint, in 1981, Watson and coworkers reported the good results by limited wrist arthrodesis for relief of pain and allowance of some range of motion. Recently, we have experienced two cases of post-traumatic arthritis of the wrist joint which was treated by limited wrist arthrodesis, especially, radioscapholunate arthrodesis with good results.

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A Clinical Study of complicated Fractures in the Hand: Eung Shick Kang, Hyung Kon Kim; J Korean Soc Fract 1988;1(1):24-35. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.24

Abstract PDF: Fractures of the metacarpals and phalanges are the most common fractures in the skeletal system. Because these fractures are so common, they are considered as minor injuries frequently and treated in improper methods in many cases. As a result, complications such as malunion, stiffness, nonunion, traumatic arthritis, and infection may develop and cause severe functional disability and economic loss. The authers reviewed 138 cases of fractures of the hand and 20 complicated cases which were admitted and treated in the department of orthopedic surgery, Severance hospital from 1983 to 1987. 1. Fractures occured more commonly in man(81.9%) than woman, and more commonly in the second decade(32.6%). 2. The most common cause was the machinary injury(42.8%), the traffic accident was the second(34.8%). 3. Open fractures occured in 57 cases(41.3%), and the cases with multiple fractures were 54(39.1%). 4. The most frequently fractured bone was the metacarpal(44.6%), especially metcarpal neck, then the proximal phalanx(33.0%), middle phalanx(12.7%), distal phalanx(9.7%) in decreasing frequency. 5. The most frequent associated injuries were dislocation and subluxation(45.8%), tendon injury was the second(28.8%). 6. Complications were found in 20 cases(14.5%), and malunion and stiffness occured most frequently. 7. The incidence of malunion was 7.5% of all fractures. Malunion occured most frequently in metacarpal fractures(10.9%) and angulatory deformity was most common(55.0%). 8. Stiffness occured in 12 cases(8.7%). The most common sites were distal and proximal interphalangeal joints(33.3%, respectively). 9. Traumatic arthritis occured in 8 cases, which were all intraarticular fractures. The metacarpophallangeal joint was the most common site(50.0%). 10. Nonunion occured in 3.0% of the all fractures and was most common in proxiaml phalangeal fractures(4.5%). The bone graft and internal fixation were carried out in 2 cases, and the results were good. 11. Infection occured in 6 cases(4.3%) and confined to pin tract and soft tissue. They were treated well with conservative treatment.

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Clinical Application of Wrist Arthrography after Trauma: Kwon Ick Ha, Sung Ho Han, Min Young Chung, Hee Joong Kim, Tae Won An; J Korean Soc Fract 1988;1(1):36-42. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.36

Abstract PDF: One of the greatest diagnostic challenges that faces both orthopedic surgeons and the radiologists is the patient with a subacute or chronic wrist injury who has no obvious clinical or radiographic abnormality to explain the pain. The wrist arthrography is used to evalute structures that can not be seen on plain radiography. These structures include the synovium, the intraarticular ligaments and the articular cartilage including the triangular fibrocartilage. The most inportant indication is persistent pain or limitation of motion after trauma. We think that the wrist arthrography is to be used widly. We collected and analized the results of wrist arthrographies performed in 33 patients with traumaic painful wrist.

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Clinical Study of the Trans-Scaphoid Perilunar Dislocation: Moon sang Chung, Choon Seong Lee, Se IL Suk; J Korean Soc Fract 1988;1(1):43-53. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.43

Abstract PDF

It is possible to diagnose trans-scaphoid perlunar dislocation(TSPD) with simple anteroposterior and lateral roetgenograms, But, there are many cases in which we make a wrong diagnosis as simple scaphoid fracture or perilunar dislocation. Most of the 7 cases among the 11 cases who visited Seoul Natioinal University Hospital from 1981 to 1987 were delayed 3 or more weeks because they were misdiagnosed as simple fracture, sprain or dislocation. It is important to identify the relationship of scaphoid with capitate or radius with simple lateral roetgerogran and we nust suspect accompanying perilunar dislocation if there is rotationary deformity in scaphoid fracture. We consider open reduction and internal fixation is better than closed reduction as treatment of TSPD because scaphoid fracture is easy to displace due to instability of fracture fragments in most cases. And we also suggest it is better to try open reductioin and internal fixation first than salvage operation as initral tratment of old fractures, if there is no osteoporosis and resorption of scaphoid fragment.

Citations

Citations to this article as recorded by

Treatment of Anchor Suture with Kirschner Wires Fixation for Chronic Perilunate Dislocation
Gab-Lae Kim, Yoon-Suk Hyun, Sung-Il Shin, Jung-Seob Park, Kyul Han, Sung-Yup Hong
Journal of the Korean Society for Surgery of the Hand.2014; 19(4): 200. CrossRef
Surgical Treatment of the Perilunate Dislocation and the Lunate Dislocation with Dorsal Approach
Soo-Hong Han, Jin-Myoung Dan, Dong-Hoon Lee, Young-Woong Kim
Journal of the Korean Fracture Society.2011; 24(4): 347. CrossRef

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Treatment of Unstable Thoracic and Lumbar Spine Fracture with Harrington SSI(Segmental Spinal Instrumentation): Se IL Suk, Choon Ki Lee, Chong Suh Lee; J Korean Soc Fract 1988;1(1):54-63. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.54

Abstract PDF: This is a retrospective clinical and roentgenographic study to measure the correction of deformity and rigidity of Harrington SSI in the stabilization of unstable thoracic and lumbar spine fractures. 35 patients with unstable thoracic and lumbar spine fracture were treated with Harrington SSI from Feb. 1985 to Mar. 1987 in SNUH and 29 patients were followed up for more than 1 year, average 15.6 months. At final follow up of these 29 patients, 73.1% of patents gained neurologic improvment. Measurement of correction of anterior, middle and posterior coumn height, local kyphosis and anteroposterior offset were 29.7%, 5.2%, 31.2%, 12.8Â° and 5.3mm and loss of correction of these were 6.5%, 0.1%, 5.8%, 3.1Â° and 1.1m.

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Complication Folloing Operative Treatment in Complete Acromioclavicular Joint Dislocation: Sung Kwan Hwang, Jae In Ahn, Heui Jeon Park, Zi Hoan Cha; J Korean Soc Fract 1988;1(1):64-70. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.64

Abstract PDF: The conservative treatment such as plinting, bandaging and harnessing in the partial disrupton of the acromioclavicular joint(Grade II or less) has been successuful, but many surgeons prefer to operative treaments for complete A-C dislocation(Grade III). Though more than 55 operative methods of treatment were reported in the literature, they could be divided into four categories: 1) acromioclar reduction and acromioclavicular fixation, 2) acromicoclavicular reduction, coracoclavicular ligament repair, and coracoclavicular fixation, 3) distal clavicle excision, and 4) muscle transfers. Among numerous operative methods, we used Weaver-Dunn technic, A-O tension Band technic, and Modified bosworth technic in total 28 cases of complete A-C dislocation from March 1984 to June 1988 at the Yonsei University Wonju College of Medicine, Wonju Christian Hospital. In most cases, excellent or good results were obtained, but we stillfound swveral postperative complications. We experienced neither deep wound infection nor osteomyelitis. All 6 cases had fixation-related complications. After close examination of operation notes and X-rays, following suggestions were considered. 1. Reduce every A-C joint anatomically before inserting K-wires through A-C joints. 2. Start shoulder motion several days after operation to provide enough time form healing of deltoid and trapezius muscles. 3. Surgenous play a major role to prevent commplications such as malposition of fixatives and incomplete A-C joint reduction

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Acase of Fatigue Fracture of the Interlocking nail in the Treatment of Fracture of the Femoral Shaft: Ki Hong Choi, Chung Nam Kang, Jin Man Wang, Kwon Jae Roh; J Korean Soc Fract 1988;1(1):71-75. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.71

Abstract PDF: Closed intramedullary nailing with or without interlocking screws has been a widely accepted method for the fixation of fracture of the femora shaft. Certain complex fractures in which now are commonly treated by dynamic or static locking of the nail by using screws. Interlocking nail introduces the potential for high concentration of stress at both its proximal and its distal end. This paper describes a patient who had at fatigue fracture of the distal part of interlocking nail in the treament of fracture of the femoral shaft.

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A Clinical Study of Femoral Neck Fracture Over Age of 50 Years: Hui Wan Park, Jun Seop Jahng, Koon Soon Kang, Kyung Hoon Kang; J Korean Soc Fract 1988;1(1):76-85. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.76

Abstract PDF: We clinically analysed 125 fractures of femoral neck which had been operated at the Department of Orthopedic Surgery, Yonsei University College of Medicine from January 1976 to December 1985. Of there, 45 fractures were treated with internal fixation, 43 fractures with primary hemiathroplasty, 37 freactures with total hip replacement arthroplasty. The criteria for internal fixation was fracture that could be reduced satisfactorilly and the age of the patients were under 65 years. The criteria for primary hemiarthroplasty was in elderly patient over 65 years, displaced, comminuted subcapital of trascervical fractures, irreducible fractures, pathological fractures and patients having generalised disease or senile psychosis. The criteria for total hip replacement arthroplasty was neglected fractured paients with significant medical problems and patients who had previous hip disease such as degenerative arghritis or rheumatoid arthritis. Following results were obtained. 1. Subcapital type(75%) according to anatomical classification and Graden type III,IV(80%) according to displacement were the most common type, respectively. 2. In cases of internal fixation, accurate medial cortical contact was required and redis-placement and collapse of fragments were prevented by supplementary fixation. 3. The overall rate of osteoporosis was reported to be 85%(below Singh index IV) in our series. The study should be directed not only on the fracture treatment but also on the prevention of refracture via the study of osteoporosis. 4. Good functional end results were obtained in 77% of the internal fixation group and primary hemiarthroplasy group. Internal fixation may be advantageous for femur neck fracture of elderly than arthroplasty in view of biomechanical status of hip joint.

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Treatment of difficult Nonunion by Modified Dual Onlay graft: Sang Soo Kim, Ju O Kim, Dae Moo Shim, Bong Joo Park, Young Jin Choe; J Korean Soc Fract 1988;1(1):86-90. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.86

Abstract PDF: For the difficult nonunion, such as large bone defect, severe osteoporosis, nonunion with repeated operations, or nonunion at the metaphyses, authors performed modified dual onlay bone graft. One side was appied wiht plate for the stabilization of the nonunion site and the other side with cortical bone from tibia for the osteogenecity. We performed this operation in five cases and all of them had good results. This method is believed to be superior in its stronger stabilization and less donor site problem, however, with sufficient osteogenecity, to the original dual onlay graft. Moreover, even to the metaphyseal area, plate can be contoured to the bone shape, which makes this operation applicable to all areas of bone.

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Clinical Study on the Fractures of the Femoral Neck in Children: Nyung Sik Park, Young Ok Cha; J Korean Soc Fract 1988;1(1):91-101. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.91

Abstract PDF: The femoral neck fracture in children is rare and occurred by severe trauma and the treatment method & prognosis anre different from adult, and it is difficult to treat due to frequent complication, which is so called unsolved fracture. Twelve cases of childrens femoral neck fracture were treated at Chon buk National University Hospital from July, 1981 to May, 1988 were analysed clinically and radiologically and following results were obtained. 1. The commonest ang was between the age of 14 and 16 years and the ratio of boys & girls was 2:1. 2. The main cause of fracture was traffic accident(6 cases) and fall down was 5 cases and slip down was 1 case. 3. According to the Delbet & Colonas classification, the transcervical fracture was most common type and displaced fracture was 8 cases. 4. Associated injuries were extremity fracture(3 cases), etc. 5. Seven cases were treated by open reduction and internal fixation and five cases by cast immobilization after skin or skeletal traction. 6. The most common complication was coxa vara(5 cases) & other complications were avascular necrosis of femoral head(3 cases), premature epiphyseal closure(3 cases) and nonunion(2 cases). 7. According to Ratliffs assessment of results, eight cases were good, two fair & two poor. 8. Secondary operation(muscle pedicle bone graft, corrective subtrochanteric valgus osteotomy) was done in three cases and showed one good result, one fair result and one poor result.

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The Clinical Signifiance of Bone Scan in Fracture Diagnosis: Joon Young Kim, Young An Choi, Byoung Kuk Noh, Bo Seuk Kong; J Korean Soc Fract 1988;1(1):102-108. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.102

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Most of fracture is easily diagnosed by simple roentgenological studies. However, certain fracture, especially rib and spine are not well definable in scout film desite the suspicious clinical findings. For these cases, we can confirm the fracture by use of whole body bone scan, CT scan and M.R.I We performed Tc bone scan and found out 27 cases of the definite fracture that were considered contusion at initial roentgenological studies from March 1987 to April 1988. We present the following results: 1. In general, the incidence of positive findings on bone scan is higher by the 7 days after trauma. 2. The bone scan is especially valuable for detection of occult rib and spine fracture. 3. It is necessary to perform the interval bone scan in the case of clinically suspicious fracture even if negative initial bone scan.

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The Comparison of Bone Scan and MRI in Osteoporotic Compression Fractures
Jung-Hoon Kim, Jong-In Kim, Bo-Hoon Jang, Jung-Gook Seo, Jin-Hwan Kim
Asian Spine Journal.2010; 4(2): 89. CrossRef

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