Journal of Musculoskeletal Trauma

Surgical Treatment of Femoral Nonunion: Hyun Sik Gong, Hee Joong Kim, Han Soo Kim, Goo Hyun Baek, Sang Hoon Lee, Sang Rim Kim, Moon Sang Chung, Young Min Kim; J Korean Soc Fract 1999;12(1):1-5. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.1

Femur is one of the most frequent sites of nonunion and femoral nonunion imposes many complications secondary to repeated surgical procedures and immobilizations. Many kinds of treatment options have been used and studied for comparison, but still the classical principle is rigid fixation, bone grafting, and adequate postoperative immobilization. In this study, the results of surgical treatment for femoral nonunion were analyzed. From July 1995 to August 1997, a total of 14 cases of femoral nonunion were treated surgically at the department of Orthopedic Surgery of the Seoul National University Hospital. All cases were treated by autogenous bone graft and internal fixation. For internal fixation, plate and screws were used in 10 cases and intramedullary nail in 3 cases and compression hip screw in 1 case. Postoperatively, hip spica cast was applied in 8 cases, cast brace in 2 cases and long leg splint in 1 case. In the other 3 cases, no additional support was adopted. In all cases, clinical union was achieved at postoperative 5 months in average. There was no significant complication except one case of marked limited motion in knee followed by hip spica cast.

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Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing
Sung-Soo Kim, Sung-Keun Sohn, Chul-Hong Kim, Myung-Jin Lee, Lih Wang
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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Treatment of Femoral Neck Fracture by Osteosynthesis: Won Yong Sohn, Hong Chul Lim, Seung Joo Jeon, Ky Sung Kim; J Korean Soc Fract 1999;12(1):6-12. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.6

Abstract PDF: We reviewed respectively the results of treatment of femotal neck fracture using ostesoynthetic methods, in 29 patients who were treated at the Department of Orthopedic Surgery, Guro hospital, Korea university, from January 1991 to December 1995. 20 cases were stabilized by cannulated hip screw, 6 cses by compression hip screw and 3 cases by Knowles pin. With the average follow up of 26 months (12-45 months), we analtzed the cauwe of injury with age, fracture types by Gardens method, the accuracy of reduction by Gardens alignment index and the functional results of the hip by Harris hip score and walking capacity. The adequacy of reduction by Gardens alignment index were as follows: anatsmical in 14, acceptable in 12 and poor in 3 cases. The fnetional results by Harris hip score and walking capacity were as follows : excellent in 21, good in 3, fair in 2 and poor in 3 cases. Complications after treatment of femoral neck fracture were one case of AVN, one case of non-union and two cases of combination of AVN and non-union. All these complications were developed in displaced femoral neck fracture with poor quality of reduction and directly correlated with initial displacement of fracture and reversely correlated with adequacy of reduction. Our concluwions are treatment of femoral neck fracture using osteosynthesis is favorable in young age regardless of intial displacement and in old age without osteoporosis and displacment and satisfactory results are produced from acceptable to anatomical reduction of fracture.

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Ipsilateral Fractures of Femoral neck and Shaft: Byeong Hwan Kim, Sung Keun Sohn, Soo Jin Park; J Korean Soc Fract 1999;12(1):13-20. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.13

Abstract PDF: Ipsilateral fractures of the femoral neck and shaft are uncommon injuries with the difficulties in diagnosis and treatment. The femoral neck fracture of this injury is commonly missed on initial evaluation. The overlooked femoral neck fracture may lead to higher risk of complications such as avascular necrosis of the femoral head, nonunion and coxa vara. The authors reviewed nine cases of ipsilateral femoral neck and shaft fracture treated in our clinic from June 1990 to March 1997, and average follow-up period was 39 months(range, 16 to 97 months). The results obtained were as follows ; 1. The cause of injury was traffic accident and one femoral neck fracture was missed initially. 2. The most common site of femoral neck fracture was basicervical in 7 cases and that of shaft fractures was middle 1/3 shaft in 6 cases. 3. Two cases were treated with femoral reconstruction nail, seven with multiple neck pinning and dynamic compression plate for shaft fracture. 4. There were complication such as 2 cases of delayed union of femoral shaft, 1 case of nonunion of femoral shaft. 5. It should be treated with anatomical and rigid internal fixation in femoral neck fracture having first priority.

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Plate augmentation for the nonunion of femur shaft fractures after interlocking intramedullary nail fixation: Ki Soo Kim, Ju O Kim, Hyun Guyn Jung, Byoung Oh Jung; J Korean Soc Fract 1999;12(1):21-27. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.21

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Ten patients with nonunions of femoral shaft fractures were treated with plate augmentations and bone grafts. The patients sustained comminuted femoral shaft fractures and were fixed with interlocking intramedullary nails. Eight of the ten patients were inserted by closed technique and two were open. We followed the patients and waited for average 11.6 months, and during that periods, six of the ten patients received several procedures to facilitate union. But nails alone could not provide enough stability for the fracture unions. We exposed the nonunion sites, left the nails in situ, and applied additional plates with bone grafts. All nonunions were vascular and hypermobile, which could be corrected after plate applications. The patients were followed for at least 1 year(average 2.7 years), and all achieved radiologic solid unions after 7.7 months(average). No complications were noted. We believe that we can apply additional plates without removing previously inserted intramedullary nails for the hypermobile femoral shaft nonunions.

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The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation
Se Dong Kim, Oog Jin Sohn, Byung Hoon Kwack
Journal of the Korean Fracture Society.2008; 21(2): 117. CrossRef
Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing
Sung-Soo Kim, Sung-Keun Sohn, Chul-Hong Kim, Myung-Jin Lee, Lih Wang
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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Results and Problems of open Intramedullary Nailing of Femoral Shaft Fracture: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Jae Doo You, Kyoung Soo Kim; J Korean Soc Fract 1999;12(1):28-34. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.28

Abstract PDF: The intramedullary nailing is one of the most available methods in treatment of femoral shaft fracture. The closed intramedullary nailing is known to be the best method of treatment of femur shaft fracture, but it is not always available in cases of deficit of equipment, severe associated injury, and some fracture pattern. The open intramedullary nailing has advantage of easily obtaining anatomical reduction but it increases the risk of infection, the incidence of delayed union and additional operations inevitably. We reviewed 33 cases of open intramedullary nailing in femur shaft fracture from September 1994 to September 1997. The results were as follows : 1. The average union time was 27.3 weeks. 2. Location of fractures was middle one-thirds in most cases, and Winquist-Hansen classification type II was the most common. 3. The complication included 8 delayed unions, 3 nonunions, 2 infections, shortening of more than two centimeters in 3 patients. 4. In 4 cases, we did open intramedullary nailing with bone graft initially, but all of them has complication as delayed union and nonunion. We can use open intramedullary nailing method in some femur shaft fractures, but there are many problems and complications. So we must consider it carefully before using this method.

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Role of Dynamization in the Interlocking Nailing for Fractures of Femur: Sung Churl Lee, Suk Joo Lyu; J Korean Soc Fract 1999;12(1):35-39. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.35

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Interlocking screws have extended the use of intramedullary nail into comminuted, unstable fractures, from subtrochanteric to supracondylar region of the femoral fractures. But it is still controversial whether dynamization is necessary in the course of treatment. Forty-nine femoral fractures treated with interlocked intramedullary nailing were investigated. Static nailing was converted to dynamic one in 33 femurs with removal of the proximal or distal locking screws. The rest were kept in static nailing. In 19 out of 33 cases with dynamization, there was average 6.0mm of telescoping after dynamization. Average 3.8mm of telescoping was seen in 15 out of 25 cases with removal of the distal locking screws while average 14.3mm in 4 out of 8 cases with removal of the proximal locking screws. There were 4 cases of breakage of distal locking screws without dynamization. Union was achieved in 45 fractures of the 49 cases. Dynamization improves fracture healing by reducing fracture gap and increasing axial compression. Dynamization is necessary in selected cases, especially fractures with a large fracture gap after static nailing and fractures that failed in filling the fracture gap even after some time postoperatively, and it is even more necessary in order to prevent breakage of locking screws in such cases.

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“Chair”–“Boat” Conformational Transition of Cyclohexanone during the Oxidation of Cyclohexane
S. V. Puchkov, Yu. V. Nepomnyashchikh
Журнал физической химии.2023; 97(8): 1155. CrossRef
Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn
The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef

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Combined Injuries of Pubic Ramus Fracture : The Role of Computerized Tomography: Choong Gil Lee, Jin Woo Kwon, Kyoung Tae Sohn, Seung Ho Shin, Jun Wook Park; J Korean Soc Fract 1999;12(1):40-46. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.40

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Pelvic fractures in general can be divided into two major types, based on the amount of energy involved : low-energy mechanisms are usually fractures of individual bones of the pelvic ring and high-energy mechanisms results in more severe injury to the pelvic ring, generally producing pelvic ring disruption. Pelvic fractures resulting from low-energy mechanism are usually fractures of individual bones of the pelvic ring that do not damage the true integrity of the ring structure. These include avulsion fractures, isolated fractures of the sacrum, and iliac wing fracture. Computerized tomography permits confirmation of findings noted on plain film and delineates injury to the posterior ring. It facilitates subclassifying the fracture according to degree of severity, as in the Young classification. The purpose of this study is to evaluate the role of CT, which is to identify the combined injuries of pubic ramus fractures. The sacrum impacted fracture and sacroiliac joint injury are often unidentified and diagnosed as an isolated fracture to the pubic ramus. The 42 cases of pubic ramus fractures on conventional radiography were simultaneously performed CT from June 1996 to February 1998. The results of associated injuries were as follows. 1. In 34 cases (81%) posterior pelvic ring injuries (sacral fractures 28 cases, anterior sacroiliac joint widening 6 cases) were observed. 2. CT was very useful to diagnose the posterior pelvic injury and to determine the mechanisms of injury.

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Deep-learning-based pelvic automatic segmentation in pelvic fractures
Jung Min Lee, Jun Young Park, Young Jae Kim, Kwang Gi Kim
Scientific Reports.2024;[Epub] CrossRef

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Management of Acetabular Fracture: Myung Sik Park, Hyung Ju Park; J Korean Soc Fract 1999;12(1):47-55. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.47

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Acetabular fractures are relatively uncommon, but frequency is becoming increasingly with the increase of automobile accident. Undisplaced acetabular fractures have a good prognosis, but major displaced acetabular fractures have always given rise to difficulty and have a problem if fractures are not accurately evaluated, classified and reduced anatomically. The priciples of treatment are to restore the fractured acetabulm to its normal anatomy, to maintain and restore the function and accordingly early joint motion to promote healing and to prevent joint adhesion. However, the treatment of displaced fracture of acetabulum has been controversal. Judet, Pennal and Matta advocated open reduction and internal fixation for displaced fracture of acetavbulum. But, Watson Jones and Crenshaw reported that closed reduciton such as traction was used, good result could be obtained. The authors studied the sex and age distribution, classification according to roentgenographic findings, associated injuries, methods of treatment and prognosis among 67 patients who were admitted to the department of Orthopedic Sugery of Chonbuk National University Hospital under diagnosis of acetabular fracture and we evaluate the usefulness of spring plate for posterior wall fracture of acetabulum. The results were as follows, 1. The prevalant age was fourth decade and the cause of injury was traffic accident in the majority. The most common type of fracture was posterior wall fracture and the second was transverse fracture by Letournel classification 2. The complications were posttraumatic arthritis in 21%, ectopic ossification, peroneal nerve palsy and wound infection. The prognosis of the total hip arthroplasty for complicated traumatic arthritis was relatively poor than others. 3. Satisfactory results by clinical criteria(by Postel) of operative treatment were 71% and conservative treatment 46%. In the majority of displaced acetabular fractures, open reduction and internal fixation was recommended. If surgery is attempted, it is essential to achieve an anatomical reduction and firm fixation by fully understanding the pathologic anatomy and by choosing an appropriate approach fixation device. We can make a satisfactory results by the treatment with spring plates in the comminuted posterior column fractures or posteior wall fractures that was difficulty in the treatment by simple plates.

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Spectroscopic studies and evanescent optical fibre wave sensing of Cu2+ based on activated mesostructured silica matrix
Othman Belhadj Miled, Clément Sanchez, Jacques Livage
Journal of Materials Science.2005; 40(17): 4523. CrossRef

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Review of Guide to Medical Certificate issued by Korean Medical Association: Bu Hwan Kim, Jong In Im, Yong Kyun Im, Uk Nam; J Korean Soc Fract 1999;12(1):56-60. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.56

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Doctors have some difficulties in deciding the duration of expected treatment for certain trauma patient in issuing medical certificate because of rarity of references about the medical certificate. In 1996, Korean Medical Association published Guide to Medical Certificate which helped many doctors in their practice of certificate issuing. But in reviewing the contents of the book, we would like to point out a few problems for amendment in next issue.

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PARK Formula Can Replace "Guide to Medical Certificate" Published by Korean Medical Association in Deciding the Treatment Duration
Chan Yong Park, Kwang Hee Yeo, Sora Ahn
Journal of Trauma and Injury.2018; 31(2): 58. CrossRef
Ethical aspects for the rules and procedures for issuing medical certificates
Byung-In Choe, Gwi-Hyang Lee
Journal of the Korean Medical Association.2014; 57(7): 594. CrossRef

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Femoral Fracture Malalignment following Interlocking Intramedullary Nailing: Yeub Kim, Yong Beom Jeon, Gi Jung Joo, Hae Ryong Hur; J Korean Soc Fract 1999;12(1):61-68. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.61

Abstract PDF: Interlocking intramedullary nailing has become a common method of treatment for femoral shaft fractures in adults. But sometimes the malalignment of the femoral fracture results in pain, limb length discrepancy, and traumatic osteoarthritis of the knee, etc. Therefore, it is very important to know what makes the malalignment after the femoral shaft fractures. We performed CT scan in 46 patients who had femoral shaft fractures, treated by interlocking intramedullary nailing at the orthopaedic department of the Kwanaiu Verterans Hospital. There were thirty-five men and eleven women, and their mean age was 36 years at the time of the operation. We measured the rotational deformity of both femurs by the CT scanning and the angulation deformity by plain radiographs in forty-six patients. We also compared the amount of the angulation and rotational deformity according to the type or the site of fracture, the degree of comminution, the time from injury to operation and the associated injury. Average angulation deformity was 2.7degrees in sagittal plane and 2.5degrees in coronal plane. Average rotational deformity wat 10.2degrees Fourteen patients(30%) had angulation more than 5degrees Ten patients(22%) had rotational deformity more than 15degrees Angulation deformity was severe significantiy at proximal 1/3 fracture, segmental fracture and severely comminuted fracture group. But because there was no significant difference of rotational deformity according to the level of fracture, the amount of comminution, and associated injury, increased rotational deformity seems to be resulted from the preoperative traction and the intraoperative technique. Therefore, we must determine the accurate entry point of intrameduiiary nailing and reduce the fracture accurately by intraoperative ultrasonography or fluoroscopy.

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Interlocking Intramedullary Nailing for the Treatment of Segmental Tibial Shaft Fractures: Kyung Jin Song, Young Keun Lee, Jeong Yeul Kim, Byung Yun Hwang; J Korean Soc Fract 1999;12(1):69-75. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.69

Abstract PDF: The treatment of segmental tibial shaft fractures poses many problems because of the serious damage to the surrounding soft tissue that usually occurs from the high-energy trauma, and the results are often unsatisfactory following lots of complications like non-union, delayed union, malunion, and infection We studied to evaluate the treatement results of interlocking intramedullary nailing for the segmental tibial shaft fractures. Twenty-two cases of segmental tibial shaft fractures were reviewed and we analyzed the results of surgical treatement in the viewpoint of bony union times, complication and its final outcome. The range of follow-up was 12 months to 68 months with mean 38 months follow-up. Most of the patients were between forty and sixty years, and average age was 47 years. Associated injury was incurred in nineteen cases with various musculoskeletal symptoms and signs. According to Meils classification, 8 were Type I, 1 was Type II and 3 were Type IV of the 12 closed fractures. Of the 10 open fractures, 4 were Type, 2 were Type II, 3 were Type IV, and 1 demonstrated multisegmental fractures. All of the closed fractures were united well except only one infected nonunion. The average time to union was 21.6 weeks with range from 16 to 26 weeks. The healing was tlowest in Type IV and fastest in Type I fractures. There was no significant difference in the healing time between the distal and proximal fractures. Of the 10 open fractures, each one of open type I fracture and open type II fractures did not united because of infected nonunion. The average time to union was 26.4 weeks with range from 16 to 38 weeks for the remaining 8 open fractures. The healing was slowest in Type IV and fastest in Type I fractures. There were 3 cases of infected nonunion, 1 case of delayed union of the proximal fracture and 1 case of valgus deformity of distal fracture. The infection was controlled and bone union obtained with removal of the nail and reaming, curettage and antibiotic bead wire, and plating with bone graft. We recommand that wherever poslible, interlocking intramedullary nailing can be used for the closed or open type I and II segmental tibial shaft fractures. And a high rate of union and a low rate of complication can be expected with this treatment modality.

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The Problems of Locked Intramedullary Nailing in the Proximal Shaft Fractures of the Tibia: Jin Woo Kwon, Kyoung Tae Sohn, Seung Ho Shin, Jae Il Kim; J Korean Soc Fract 1999;12(1):76-82. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.76

Abstract PDF: Proximal shaft fractures of the tibia have a high incidence of complication and often result in poor outcomes. Plate fixation and locked intramedullary nailing are the most common methods of treatment, but now the latter is more popular because of soft tissue problem, osteomyelitis etc.. The purpose of this study is to evaluate the results of locked intramedullary nailing in the treatment of proximal shaft fractures of the tibia and to draw a conclusion that what type of fracture patterns are the appropriate indication of nailing. We analyzed 18 proximal shaft fractures of the tibia which were treated by locked intramedullary nailing from October 1991 to March 1997 and followed more than 12 months. The results were as follows ; The complications were occurred in 12 cases(66.6%); 4 cases of delayed or non-union, 8 of angular deformity, 1 of leg length discrepancy. Delayed or non-unions were caused by fracture site comminution and bone defect. 5 anterior angular deformities were due to the pulling of the knee extensor mechanism and 3 valgus deformities were due to medially located entry portal. In conclusion, since locked intramedullary nailing in proximal tibial fractures causes a high incidence of complications, it is recommended in transverse or undisplaced fractures. And plate fixation and bone graft will be recommended in comminuted or displaced oblique fractures, if soft tissue condition is permitted.

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Treatment of Tibial Eminence Fracture: Taik Seon Kim, Jae Ik Shim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yoo, Won Gyu Yang; J Korean Soc Fract 1999;12(1):83-89. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.83

Abstract PDF: Fracture of tibial intercondylar eminence has a clinical importance in aspect of associated ligament injury, limited range of motion and joint instability The purpose of this study is to evaluate the intercondylar eminence fracture and to compare the results of treatment by method of arthroscopic reduction and pull-out suture with results of conservative treatment. The results were evaluated with Mayers and Mckeevers criteria of result and instability. 23 cases of avulsion fracture of tibial intercondylar eminence were reviewed. Most common type was type II Most common cause was traffic accident. Closed reduction and cast immobilization was performed in 12 cases, of which 10 cases had above good result initially, reduction with pull-out suture by arthroscopy was performed in 11 cases, of which 10 cases had above good refult. Type III B fracture were reduction with minimal arthrotomy because of the arthroscopic reduction was difficult. 2 cases of instability were in type III A and type III B. An instability case of type III A was treated non-operatively and the other of type III B was treated pull-out suture. 1 case of extension limitation was in type II which waf treated non-operatively because of multiple injury.

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Arthroscopically-Assisted Reduction and Fixation in Fractures of the Tibial Condyle: Jung Su Hwang, Han Chul Kim, Yong Soon Kim; J Korean Soc Fract 1999;12(1):90-97. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.90

Abstract PDF: Fractures of the tibial condyle are characterized that often involve the articular surfaces and frequently associated with soft tissue injuries such as collateral ligament, cruciate ligament and menisci of the knee. The author analyzed 12 cases of tibial condyle fractures, which were surgically treated by reduction of depressed articular surface under assist of arthroscopy and then fixed with cannulated cancellous screws and accompanied by bone graft under the control of image intensifier in 9 cases of the 12 cases. The purpose of this study are (1) obtaining accurate reduction of the depressed articular surface, (2) preventing knee joint from the surgical wide dissection, (3) not only bony problems but also combined menisci and ligament injuries were diagnosis and management. We can obtain more anatomical reduction and excellent or good functional knee score since extensive exposure is avoided. There is no complication with regard to arthroscopic surgery and rapid recovery with reduced pain and early full ROM are obtained after follow-up study of a mean of 1 year.

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Unilateral Facet dislocation of Lumbosacral Junction: a case report: Bu Hwan Kim, Jong In Im, Yong Kyun Im, Chang Hoon Ryu; J Korean Soc Fract 1999;12(1):98-102. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.98

Abstract PDF: Unilateral lumbosacral facet dislocation is very rare. In a review of literatures, only 14 cases have been documented. We could not find any report about this unusual injury in Korea. The mechanism of injury is hyperflexion and rotation. In general, attention is drawn to the association of fractured transverse process as an important clue to diagnosis. Attempts at closed reduction are futile, and the treatment of choice is open reduction and internal fixation with lumbosacral fusion.

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Treatments of Intraarticular Calcaneal Fracture: Based on CT Classification and Comparison of Treatments: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Ju Sik Park; J Korean Soc Fract 1999;12(1):103-112. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.103

Abstract PDF: The treatment modality of the displaced intraarticular calcaneal fractures is still controversial. The objectives of this study are to classify intraarticular fractures based on computed tomography and to compare the treatment results according to the classification and to consider the influence of Bohler angle to the prognosis of this injuries. From October 1989 to March 1997, 62 fractures(58 patients) who had been treated after calcaneal CT(computed tomography) were selected. The interval between the trauma and the last follw-up was mean 3.3 years(1.1-5.2 years). They had been treated with one of the three methods, that is, open reduction and internal fixation(OR/IF), Essex Lopresti or simple cast immobilization. The fracture was classified as type I(non-displced), type I(two part or split), type III(three part or split depression), type IV (four part or highly comminuted) based on CT according to Sanders et. al. The calcaneal scoring system proposed by Kerr et. al. was applied to the assessment of the treatment results, which may be more appropriate for non-parametric statistical test. The type I fractures had been treated only with cast immoobilization with or without manual reduction and all of the 4 cases(100%) have shown favorable(excellent or good) results. The OR/IF group(favorable results for 15 of 18 cases(83.3%) in type II and for 11 of 13(84.6%) in type III) have shown better results than those of other two group(P<0.05). The results between other two groups, that is, Essex-Lopresti operation group(favorable results for 4 of 8 cases(50%) in type II and for 1 of 3(33.3%) in type III)and cast immobization(2 of 5 cases(40%) in type II and for 0 of 2(O%) in type III) have made no significant differences(p>0.5). In type IV, there were no significant differences among the results of the three methods(p>0.1) and worse results than type II, III (p <0.05) probably due to difficulty in reduction of highly comminuted articular facets. The Bohler angle has given no significant influence to the final results(p>0.1). In conclusion, OR/IF has shown better results than closed modalities in the treatment of displaced intraarticular calcaneal fractures and may be the primary choice of treatment for these fractures. We have used Kruskal-Wallis H test and its approximation to chi-square distribution for comparison of three groups and Mann-Whitney U test and its approximation to normal distribution for two groups and have been aided by the computer program, SPSS in statistical calculations. The p-value was 0.05.

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Minimal Surgical Treatment of the Tibial Pilon Fracture: Min Young Chung, Chang Woo Kim, Joon Kwon Jung, Eun Hwan Bae, Ho Keun Park, Seong Ho Park, Jang Won Hur; J Korean Soc Fract 1999;12(1):113-118. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.113

Abstract PDF: The goals of the treatment of pilon fracture include to restore a normal anatomy and functional level of uninjured state. We analysed the clinical outcomes of the treatment of pilon fractures with calcaneal traction and percutaneous intramedullary nailing in the fibula (group A, 12 cases), or open reduction and internal fixation (group B, 11 cases) in 23 cases between April 1994 and March 1997. All of the patients were followed for at least one year (average, 18 months; range, 12 to 24 months). Fifteen patients were male (group A, 8; group B, 7), and eight were female (group A, 4; group B, 4). Falling-down injury is the most common cause and automobile accident is the second. According to the R.. uedi and Allg.. ower classification, type II fractures were most common. In the group A, two of the 12 fractures were type I, six were type II, and four were type III, and in the group B, two of the 11 fractures were type I, six were type II, and four were type III. According to the criteria of Mast and Teipner, in the group A, six were good result and six were fair, and in the group B, four were good, five were fair, and two were poor. A nonunion with wound infection and a malunion developed in the group B. The results in the group A were better than those in the group B in clinically, we propose the minimal surgical treatment is useful treatment option of pilon fracture.

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A Comparison of Treatment between Plate Fixation and Antegrade Intramedullary Fixation of the Humeral Shaft Fractures: Jung Ryul Kim, Joo Hong Lee, Byung Yun Hwang; J Korean Soc Fract 1999;12(1):119-125. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.119

Abstract PDF: We compared the clinical and radiographic outcomes between plate fixation and antegrade interlocking intramedullary fixation for humeral shaft fractures requiring operative intervention. Through retrospective, radomized comparative study, a total sixty adult patients have been reviewed. Thirty patients were treated with plate fixation, thirty another patients were treated with antegrade interlocking intramedullary fixation. Average follow-up time was two year and five months(range, one to four years). Average time to union was 10.8 weeks in plate fixation group and 16.9 weeks in intramedullary fixation group. Overall rate of union was 100% in plate fixation group and 90 % in intramedullary fixation group. According to Stewart and Hundleys functional assessment system, excellent or good results were obtained 29 cases(97%) in plate fixation group, 24 cases(80%) in interlocking intramedullary fixation group. In the plate group, only one fracture had deep infection but in the nail group, nine fractures had complications : three with nonunion, three with shoulder pain and limited ROM, two with intraoperative comminution and one with postoperative radial nerve palsy. There were some technical problems in antegrade intramedullay nailing such as difficulty proximal locking, failed expanlion of distal locking, iatrogenic fracture and distraction between fracture fragment. We concluded that the results after plate fixation have been shown to be preferable with respect to clinical and functional outcomes. In our study, the majority of circumstance requiring internal fixation, plate fixation is proferred and antegrade intramedullary fixation must be used in inevitable situation such as multiple trauma patients, fracture with overlying burns, patients with osteoporotic bone, pathologic fractures and segmental tractures.

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A Comparison of Using Closed Interlocking Nailing versus Plate Fixation in Humeral Shaft Comminuted Fractures: Dong Gyu Lee, Woo Dong Nam, Jang Seok Choi; J Korean Soc Fract 1999;12(1):126-134. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.126

Abstract PDF: The purpose of this paper is to compare the results, complication, advantages and disadvantages of treatment with closed interlocking intramedullary nail with those with plate in humeral shaft comminuted fractures. The authors have reviwed 25 cases of humeral shaft comminuted fractures, which were treated with closed interlocking intramedullary nail in 14 cases and plate in 11 cases, from November 1992 to May 1996. The results were as follows: 1. The average time of operation in closed interlocking nailing was 72 minutes and that of plate fixation was 104 minutes. 2. The average time for bone union was 14.7 weeks in closed interlocking nailing and 14.9 weeks in plate fixation. 3. The complications of closed interlocking nailing were 2 cases of delayed union, 1 case of nonunion, 1 case of postoperative radial nerve palsy and 3 cases of pain and stiffness of shoulder. 4. The complications of plate fixation were 1 case of delayed union, 2 cases of nonunion, 1 case of postoperative radial nerve palsy, 1 case of stiffness of shoulder. 5. Excellent and good functional results rated by Stewart and Hundley were 12(85%) cases in closed interlocking nailing and 8(73%) cases in plate fixation. We concluded that closed interlocking nailing is one of the better useful method of treatment in humeral shaft comminuted fractures but, the procedures should be performed exactly.

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Comparison of the Clinical Results Between the Plate Fixation and Intramedullary Nailing for the Diaphyseal Both Forearm Bone Fractures: Hyun Dai Shin, Kwang Jin Rhee, Jun Young Yang, Sung Ho Yun, Mun Jong Lee; J Korean Soc Fract 1999;12(1):135-144. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.135

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The fractures of the forearm bone are common and the forearm has the specific movement of supination and pronation. So, the goal of the treatment of forearm fractures is the recovery of rotatory function of the forearm as well as the function of the elbow and wrist. Surgical treatment usually is not necessory in children under 10 years of age because of remodelling potential and spontaneous correction ability. But, anatomical reduction and rigid fixation is essential in fractures of adult forearm above 15 years of age because of rotational deformity and angulation after forearm fractures may result in serious functional problems of the forearm. The purpose of the our retrospective study is to compare the clinical result between the plate fixation and intramedullary nailing of the diaphyseal both forearm bone fractures in adult. We reviewed 64 patients above 15 ages who had diaphyseal both forearm bone fractures, and were treated with fixation using compression plate or Rush pin. Forty patients were treated with both plates, 7 patients with both Rush pins, and 17 patients with plate and rush pin. Galeazzi or Monteggia fractures were excluded in this study. On final follow up, we performed the radiological analysis and compared the operation interval, immobilization period after operation, bone union time, functional result and complications in these groups. Functional results was more higher in both plate fixation, and complications were high in both intramedullary nailing. In conclusion, both plate fixation is the best treatment method in the diaphyseal both forearm bone fractures in adult. Thus in both forearm bone fractures, both plate fixation is recommended, but if it is not available, at least one bone with plate fixation is necessary

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Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults
Sanglim Lee, Hee-Sung Lee, Yerl-Bo Sung, Jae-Kwang Yum
Journal of the Korean Fracture Society.2009; 22(1): 30. CrossRef
Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail
Kwang-Yul Kim, Moon-Sup Lim, Shin-Kwon Choi, Hyeong-Jo Yoon
Journal of the Korean Fracture Society.2008; 21(2): 157. CrossRef

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Non-operative Treatment of Fracture of Distal Radius in Adults: Sang Won Park, Ki Hoon Kang, Ki Hong Lee; J Korean Soc Fract 1999;12(1):145-152. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.145

Abstract PDF: The authors analysed ninety-five cases of fracture of distal radius in adults with non-operative treatment followed for more than one year at Korea University Hospital from January 1991 to December 1996 to evaluate the clinical results according to the types of fracture by Fernandez classification and the methods of non-operative treatment. The results obtained were as follows ; 1. Methods of treatment were closed reduction and cast immobilization in 51 cases(53.7%) and closed reduction and percutaneous pinning in 44 cases(46.3%). 2. In a group treated with closed reduction and cast immobilization, the results of subjective evaluation were excellent in 3.9%, good in 47.1%, fair in 45.1% and poor in 3.9%, and the results of objective evaluation were good in 42.8%, fair in 36.5%, and poor in 20.7%. 3. In a group treated with closed reduction and percutaneous pinning, the results of subjective evaluation were excellent in 6.8%, good in 54.5%, fair in 29.5% and poor in 9.2%, and the results of objective evaluation were excellent in 15%, good in 46.6%, fair in 35%, and poor in 3.4%. 4. The results of subjective evaluation according to fracture type were excellent and good in 91.3% of type I, 42.1% of type II, and 10% of type III, and the results of objective evaluation were excellent and good in 78.3% of type I, 52.6% of type II, and 3.5% of type III. 5. The results of subjective and objective evaluation were not satisfactory in patients older than seventy years old. Above results suggest that the clinical results of non-operative treatment were not satisfactory in type III, therefore external fixation or operative treatment is recommended.

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Non-operative Treatment of Fracture of Distal Radius in Adults: Sang Won Park, Ki Hoon Kang, Ki Hong Lee; J Korean Soc Fract 1999;12(1):153-161. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.153

Abstract PDF: The authors analysed ninety-five cases of fracture of distal radius in adults with non-operative treatment followed for more than one year at Korea University Hospital from January 1991 to December 1996 to evaluate the clinical results according to the types of fracture by Fernandez classification and the methods of non-operative treatment. The results obtained were as follows ; 1. Methods of treatment were closed reduction and cast immobilization in 51 cases(53.7%) and closed reduction and percutaneous pinning in 44 cases(46.3%). 2. In a group treated with closed reduction and cast immobilization, the results of subjective evaluation were excellent in 3.9%, good in 47.1%, fair in 45.1% and poor in 3.9%, and the results of objective evaluation were good in 42.8%, fair in 36.5%, and poor in 20.7%. 3. In a group treated with closed reduction and percutaneous pinning, the results of subjective evaluation were excellent in 6.8%, good in 54.5%, fair in 29.5% and poor in 9.2%, and the results of objective evaluation were excellent in 15%, good in 46.6%, fair in 35%, and poor in 3.4%. 4. The results of subjective evaluation according to fracture type were excellent and good in 91.3% of type I, 42.1% of type II, and 10% of type III, and the results of objective evaluation were excellent and good in 78.3% of type I, 52.6% of type II, and 3.5% of type III. 5. The results of subjective and objective evaluation were not satisfactory in patients older than seventy years old. Above results suggest that the clinical results of non-operative treatment were not satisfactory in type III, therefore external fixation or operative treatment is recommended.

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Delayed Rupture of the Extensor Pollicis Longus due to Fracture of the distal radius: A Case Report: Soo Jae Yim, Yeon Cheol Jeong, Seung Ryeol Yoon, Joong Geun Choi, You Sung Suh, Soo Kyun Rah; J Korean Soc Fract 1999;12(1):162-165. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.162

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After distal radius fracture, delayed rupture of extensor pollicis longus is rare. It is known that delayed rupture of extensor pollicis longus tendon result from undisplaced distal radius fracture. We have experienced a case of rupture of the extensor pollicis longus tendon after undisplaced distal radius fracture, and treated with palmaris longus tendon graft. the result were satisfactory without complications.

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Extensor Pollicis Longus Rupture after Distal Radius Fracture
Nam-Young Cho, Chang-Young Seo, Myung-Sun Kim, Ha-Sung Kim, Keun-Bae Lee
Journal of the Korean Fracture Society.2012; 25(1): 52. CrossRef
Flexor Pollicis Longus Tendon Rupture as a Complication of a Closed Distal Radius Fracture - A Case Report -
Do-Young Kim, Eun-Min Seo, Woo-Dong Nam, Seung-Jae Park, Sang-Soo Lee
Journal of the Korean Fracture Society.2011; 24(2): 191. CrossRef

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Fracture-Dislocations of Carpometacarpal joints excluding thumb: A case report: Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Hong Gweon Han; J Korean Soc Fract 1999;12(1):166-169. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.166

Abstract PDF: Fracture-Dislocations of the ulnar carpometacarpal joints is an uncommon injury. The priorities of management of other more extensive injuries often delay definitive treatment. If such a dislocation is diagnosed early, it can be reduced easily by closed means. We reviewed one case of fracture-dislocation of carpometacarpal joints excluding thumb with stable and pain free carpometacarpal joints in one year after closed reduction and internal fixation.

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Fat Embolism Syndrome: Current Concept: Byung Oh Chung, Won Hwan Oh, Jae Gon Seo, Jong Suh Lee, Jong Sup Shim; J Korean Soc Fract 1999;12(1):170-178. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.170

Abstract PDF: No abstract available.

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Treatment of Supracondylar Fractures of the Humerus in Children: Duk Yong Lee, Jae Ik Shim, Taek Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yoen Sik Yu, Young Jin Park; J Korean Soc Fract 1999;12(1):179-186. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.179

Abstract PDF

The supracondylar fracture of the humerus is the most common fracture of the elbow in children and is occasionally associated with significant residual complications such as cubitus varus deformity. Clincal analysis was performed on 32 patients with displaced supracondylar fractures of humerus, who were treated either by closed reduction and percutaneous pinning or by open reduction and internal fixation. The results were as follows : 1. The average age of the children was 6.8 years old in both sexes, and male to female was 21 : 11. 2. The extension type was 26 cases(82%), flexion type was 6 cases(18%) and the left side was more frequently involved. 3. According to Pirone classification, type II was 14 cases, type III 18 cases. 4. There was no significant difference in the mean duration of bony union between the percutaneous group and the open reduction group. 5. Cubitus varus deformity and limitation of elbow motion were more common complications in open reduction group.

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The Effect of Rotational Deformities on Cubitus Varus for Supracondylar Humerus Fractures in Children
Hyun Dae Shin, Kyung Cheon Kim, Dong Kyu Kim, Woo Yong Lee
Journal of the Korean Orthopaedic Association.2010; 45(5): 373. CrossRef

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The Results of the Percutaneous K-wire Fixation for the Supracondylar Fractures of the Humerus in Children: Chil Soo Kwon, Jong Kuk Ahn, Byung Hyun Jeong, Jin Chung, Ho Cheol Rhee; J Korean Soc Fract 1999;12(1):187-193. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.187

Abstract PDF: The cases of 160 patients who had a displaced supracondylar fracture of the humerus were reviewed retrospectively. According to the Flynn's criteria, the results of treatment were excellent 33%, good 53%, fair 10%, poor 4%. No neurovascular complication was appeared. In two cases, cubitus varus deformity was appeared to be related with incorrect reduction. We believe that percutaneous k-wire fixation is excellent method in treatment of the displaced supracondylar fractures in children. There was no significant difference of clinical results among methods of percutaneous K-wire fixation but lateral 2 and medial 1 cross pinning has advantages : easy technique in insertion of lateral 2 pins, biomechanical stability and removal of medial pin in the irritation of ulna nerve without significant influence of stability.

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