Journal of Musculoskeletal Trauma

Biomechanical Analysis of Korean Radiolucent Carbon/Graphite Ring Fixator: In Ho Choi, Jun kyung Kim, Kui won Choi, Chin Youb Chung, Tae Joon Cho, Ki Seok Lee; J Korean Soc Fract 2000;13(1):1-12. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.1

PURPOSE
The mechanical stiffness of Korean radiolucent carbon/graphite ring fixator(KRCRF) was analyzed and compared with those of conventional stainless steel Ilizarov system and the Smith- Nephew carbon fiber circular external fixator.
MATERIALS AND METHODS
The transfixing olive pins of the circular fixator on the acryl pylon were assembled in 90degrees- 90degrees and 135degrees- 45degrees configuration, respectively. And the fixator-pylon model was loaded with Instron model No. 8500 in three testing modes: axial compression, anteroposterior(AP) bending and lateral bending.
RESULTS
As compared with stainless steel Ilizarov fixator, the KRCRF was significantly more stiff on the axial compression test regardless of the ring size(140 mm and 200 mm diameters) and transfixation configuration. But, it was less stiff on the anteroposterior(AP) and lateral bending tests. When compared with the Smith-Nephew carbon fiber circular external fixator, the KRCRF was generally more stiff on the axial compression, AP and lateral bending tests regardless of the ring size(140 mm and 180 mm diameters) and configuration, except the AP bending stiffness in 90degrees- 90degrees configuration and lateral bending stffness in 135degrees- 45degrees configuration on the 180 mm diameter frame.
CONCLUSION
Considering the radiolucency, weight and biomechanical stffness, we think that the KRCRF is an excellent substitute for the imported circular fixators made of stainless steel or carbon/graphite.

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A Study on the Development of the Off-Line Software for Regulating the 6 D.O.F. Circular Fixator
Bum-Seok PARK, In-Ho CHOI, Jin-Woo KIM, Seung-Yeol LEE, Chang-Soo HAN
JSME International Journal Series C.2006; 49(4): 1123. CrossRef

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Ilizarov Treatment of Nonunions with Bone Defect in the Tibia: Soo Bong Hahn, Hong Jun Park, Kee Hong Song; J Korean Soc Fract 2000;13(1):13-19. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.13

Abstract PDF: PURPOSE
To analyze the clinical results and complications of internal transport by Ilizarov for defect nonunion of tibia MATERIALS AND METHODS: We performed a retrospective review of 24 patients undertaken internal transport by Ilizarov for defect nonunion of tibia from January 1991 to December 1997. There were 21 males and 3 females with a mean age of 33.4 years(range, 17-64 years). On average, the size of bone defect measured 7.9 cm(range, 2-17 cm). Bone defects were gradually closed by progressive internal transport. After internal transport, bone grafts on 14 docking sites were performed because of delayed union. Soft tissue defects were treated with secondary closures(6 cases), skin grafts(4 cases), and flaps(4 cases).
RESULTS
According to Paley and Catagni's classification, bone results were excellent in 19 cases, good in 4 cases, and poor in 1 case. Functional results were excellent in 2 cases, good in 21 cases, and poor in 1 case. According to Paley's classification, the complications were developed as follows; Problems were pin site infections(12 cases), joint contractures(9 cases), and distraction gap delayed consolidations(3 cases). Obstacle was absent. Complication was refracture(1 case). The average distraction consolidation index was 39.4 days/cm. The average percentage transport was 139.7 %.
CONCLUSION
The application of Ilizarov to defect nonunion of the tibia is effective, but correct technique and careful follow-up is required.

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Treatment of Comminuted Fractures of Femur & Tibia with Ilizarov Apparatus: Soo Bong Hahn, Hong Jun Park, Hui Wan Park, Sung Hun Kim; J Korean Soc Fract 2000;13(1):20-29. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.20

Abstract PDF: PURPOSE
To evaluate the effectiveness of Ilizarov external fixator for the treatment of unstable closed or open comminuted femoral and tibial fractures, especially those with severe soft tissue injury by clinical and radiological analysis.
MATERIALS AND METHODS
Fifty six consecutive femoral or tibial fractures were treated using Ilizarov external fixator between May 1991 and August 1998 and followed up for minimum 12 months upto 36 months with the average of 16 months. All of them consisted of comminuted or segmental fractures. And thirty five cases of them were open fractures. There were nine Type I, seventeen Type II, five Type IIIA, and four Type IIIB fractures. Primary closure was performed for Type I and II fractures. Split-thickness skin graft (5 cases) and free vascularized flap (3 cases) were used for severe soft tissue defects.
RESULTS
All fractures healed within the average of 7.7 months (from minimum 3 months to maximum 24 months). Bone grafts were performed in 39 cases. Bony union was obtained in all the cases with Ilizarov method. The most common complication, the adjacent joint contracture was developed in 21 cases (37.5%). Pin site infection in 12 cases (21.4%), delayed union in 3 cases (5.4%), angulation deformity in 2 cases (3.6%) were developed.
CONCLUSION
The Ilizarov external fixation technique is one of the effective methods in the management of unstable closed or open comminuted femoral or tibial fractures.

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Treatment of Humerus Fracture using Ilizarov External Fixator: Suk Myun Ko, Myung Gu Kim, Ryuh Sup Kim, In Suk Oh, Joung Yoon Lee, Hyeok Chae Jeong; J Korean Soc Fract 2000;13(1):30-37. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.30

Abstract PDF

PURPOSE
Recently, the incidence of humerus fracture not allowing open reduction and internal fixation has been increased with increment of traffic accident and industrial accident. But, there have been a few reports in the use of Ilizarov external fixator. The purpose of this study is to report the authors'experience with Ilizarov external fixation for the treatment of the patients with fractures of the humerus.
MATERIALS AND METHODS
From June 1996 to July 1998, we reviewed sixteen patients with humeral fracture who were treated by the Ilizarov external fixator. Three fractures were in the middle third of the shaft; two, in the proximal third; two, in the distal third; seven, in the proximalmiddle; two, in the middle-distal. The fractures that were located within the joint of the shoulder or the elbow were excluded. Five fractures had been open and six had been associated with multiple trauma. Two had been initially treated by open reduction and internal fixation but failed : one, because of infection; the other, because of loss of fixation. We performed the Ilizarov external fixator procedure in the case of soft tissue trauma so severe that internal fixation was impossible, and in the case of the comminution too extensive and severe for internal fixation.
RESULTS
The average time to radiologic union was 12.7 weeks. According to Stewart and Hundley's functional assessment system, excellent or good results were obtained in 14 cases. There was no poor result.
CONCLUSION
Although the Ilizarov external fixator was a technically demanding procedure, it was a good method comparing with any other operative methods for the treatment of fractures of the humerus not allowing the open reduction and internal fixation.

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Contributing Factors of Radial Nerve Palsy Associated with Humeral Shaft Fracture
Tae-Soo Park, Joon-Hwan Lee, Tai-Seung Kim, Kwang-Hyun Lee, Ki-Chul Park
Journal of the Korean Fracture Society.2008; 21(4): 292. CrossRef

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Mechanical Properties of External Fixator according to Its Arrangement and Structure: Hong Jun Han, Byung Chang Lee, Yeung Jin Kim, Byung Soo Jin, Gun Hyee Lee; J Korean Soc Fract 2000;13(1):38-45. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.38

Abstract PDF: PURPOSE
To obtain the accurate knowledge of the fundamental mechanical properties of the external fixator affected by variations in arrangements and structures. We used newly developed external fixator, Anyfix, universal testing machine and plastic padding bone model which had similar structural properties to human tibia. The measured performance for seven different configurations of external fixators was its ability to control the motion of the bone fragment at the fracture site. Based on a unit of applied load, the corresponding displacement measured at the fracture site was used to described the stiffness of the fixation device for each load. Three stiffness moduli can be determined as axial stiffness, anterior posterior bending stiffness and lateral bending stiffness.
RESULTS
In basic configuration, all three stiffnesses for unilateral two plane external fixator showed marked increase than those for unilateral one plane model. Axial compression stiffness and bending stiffness were increased when ring component were located far from the fracture site. In modified configuration, all three stiffnesses were increased when the number of pin was increased and small sized ring was used.
CONCLUSION
The stiffness of the external fixator can be substantially increased by using unilateral two plane, locating the ring at far portion from the fracture site, using a small sized ring and increasing the number of pins.

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Three-Dimensional Computed Tomography of Acetabular Fractures: Poong Taek Kim, Joo Chul Ihn, Chang Wug Oh, Seung Hoon Oh; J Korean Soc Fract 2000;13(1):46-51. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.46

Abstract PDF: PURPOSE
In the evaluation of acetebular fractures, conventional radiography is limited by distortion, magnification, and overlap of fracture fragments. Computed tomography(CT) has already been shown to be superior in this field. The purpose of this paper was to use 3D reformations for classification of acetabular fractures and planning of operation.
MATERIALS AND METHODS
From July 1994 to December 1998, we reviewed 40 acetabular fractures. We evaluated fractures as plain X-ray(inlet & outlet view, AP view, obturator foramen & illiac wing view), axial CT with 3 mm slices, and 3D reformations. We classified fractures by classification of Letournel.
RESULTS
32 cases of 40 cases were displaced fractures, We recognized fracture easily in 3D reformations. 12 cases were posteior wall fracture. 9 cases were both column frctures. We interpretated both column fractures difficultly in plain X-ray, but we had many informations about rotation & displacement of fracture fragment by 3D reformations. Undisplaced fracture was 8 cases. We interpretated undisplaced fracture difficultly in 3D reformations and distinguished difficultly from normall 3D reformations.
CONCLUSION
3D reformations were useful for analysis of complex displaced fracture but not useful for analysis of undisplaced fracture. Acetabular internal oblique view was useful for analysis of quadrilateral space & posterior wall fractures. Acetabular external view was useful for decision of surgical approach.

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Neglected Unilateral Subluxation of Facet Joint in Lumbar Spine of Multiple Trauma Patient: A Case Report: Ye Soo Park, Min Kun Kim, Jae Lim Cho; J Korean Soc Fract 2000;13(1):52-55. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.52

Abstract PDF: Unilateral dislocation or subluxation of a facet in lumbar spine is extremely rare, so it has been often neglected. The mechanism of injury is hyperflexion and distraction forces. As for the treatment of lumbar facet dislocation and subluxation, open reduction and internal fixation by the posterior approach has been recommended because the injuries are resistant to closed reduction and they may cause chronic instability. We report a case of neglected unilateral subluxation of facet joint in lumbar spine of multiple trauma patient, which was treated by open reduction and internal fixation with posterolateral fusion. In the multiple trauma patients, it is mandatory to the meticulous diagnosis and treatment.

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Comparison of Bipolar Hemiarthroplasty and Compression Hip screw on Treatment of Elderly Unstable Intertrochanteric Fractrues: Ik Su Choi, Su In Roh, Dae Yeon Kim, Keun Il Lee, Seung Chan Ko; J Korean Soc Fract 2000;13(1):56-63. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.56

Abstract PDF: PURPOSE
To evaluate and compare the clinical outcomes of bipolar hemiarthroplasty and compression hip screw on elderly with unstable intertrochanteric fractures We evaluated the clinical results of 65-year or older elderly patients with unstable intertrochanteric fractures between Jan. 1993 to Dec. 1997. 23 patients underwent compression hip screw treatment and 19 patients were treated with bipolar hemiarthroplasty. Functional evaluation was conducted at 3, 6 and 12 month after the operation by hip rating scale of Merle d'Aubigne. Complications, time to weight bearing and hospitalization period were also investigated.
RESULTS
For the bipolar hemiarthroplasty group, functional scale of good or above were seen in 74%, 72% and 67% of the group at 3 months, 6 months and 12 months. However in the compression hip screw group, the good or above results were shown in 57%, 52% and 43% of the group, thus showing a functional deterioration as time progresses. Comparing the overall clinical outcome, the bipolar hemiarthroplasty group showed better results, complication occurred in 26 cases of compression hip screw group and 8 cases of bipolar hemiarthroplasty group, showing better outcomes in the bipolar hemiarthroplasty group.
CONCLUSION
Comparing the length of hospital stay, time to weight bearing, complication and functional superiority of the treatment for elderly unstable intertrochanteric fractures, the bipolar hemiarthroplasty showed superior clinical outcomes than the compression hip screw. Moreover, patients with more unstable fractures and more severe osteoporosis showed better clinical results with bipolar hemiarthroplasty.

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Muller Type C Intercondylar Fractures of Femur : Comparative Analysis by Surgical Approach: Hong Geun Jung, Myung Ho Kim, Moon Jib Yoo, Suk Joo Yoo, Sung Churl Lee, Jin Young Park, Sang Hyuk Min; J Korean Soc Fract 2000;13(1):64-73. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.64

Abstract PDF: PURPOSE
The purpose of this study is to compare the functional results of Muller type C intercondylar fractures treated by 2 different surgical approaches : lateral and extensile approach.
MATERIALS AND METHODS
The study is based on 20 patients 21 knees of Muller type C intercondylar fractures. Two surgical approaches, i.e. 13 cases with lateral and 8 cases with extensile approach were used. The functional evaluation of results was done with criteria by Schatzker and Lambert. Excellent and good was grouped superior while fair and failure was grouped inferior.
RESULTS
Comparative analysis by surgical approach showed that among total 10 cases of C2 fractures, 6 cases(85.7%) of lateral approach and 2 cases(66.7%) of extensile approach were categorized in inferior group. Among the 8 cases in type C3 fractures, 3 cases treated surgically using the lateral approach showed fair and failure results and 3 cases(60%) of the remaining 5 cases using the extensile approach showed good results.
CONCLUSION
There was no significant result difference between lateral and extensile approach in type C2 fractures, but in C3 fracture, cases with extensile approach showed better results. Therefore the extensile approach should be recommended in C3 intercondylar fractures with intra-articular comminution.

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Interlocking Compression Nails for the Treatment of Acute Tibial Shaft Fractures: Sang Wook Bae, Ho Yoon Kwak; J Korean Soc Fract 2000;13(1):74-80. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.74

Abstract PDF: PURPOSE
To evaluate the differences between interlocking compression nail and ordinary compression nail in the treatement of acute tibial shaft fractures ,ATERIALS AND METHODS: From March, 1995 to November, 1998, 67 patients were treated with intramedullary nail for the acute tibial shaft fractures. Among them, 27 cases treated with interlocking compression nails and 22 cases, with ordinary interlocking nails were analyzed in terms of average union time, complications and functional results.
RESULTS
One tibial shaft treated with interlocking compression nail failed to unite. Average union time was 14.4 weeks in the group treated with interlocking compression nails, 14.2 weeks, with ordinary interlocking nails. Functional results were graded as excellent and good in 85% in the group treated with interlocking compression nails, 90%, with ordinary compression nails.
CONCLUSION
There was no difference in the treatment results between the groups treated with interlocking compression nails and ordinary interlocking nails.

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Treatment of the Open Tibial Fractures with Unreamed AO Intramedullary Nail: Bum Soo Kim, Sung Do Cho, Yong Sun Cho, Soon Woo Hong, Hyung Jin Cho, Ki Yong Kim; J Korean Soc Fract 2000;13(1):81-86. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.81

Abstract PDF: PURPOSE
To evaluate the results of open tibial fractures treated with unreamed AO intramedullary nail MATERIALS AND METHODS: Among the patiens of open tibial fractures who were treated with unreamed AO intramedullary nail from January 1993 to August 1998, the authors reviewed 34 patients whose follow-up was possible for more than one year. Fourteen patients were treated with AO external fixator after meticulous debridement, followed by unreamed AO intramedullary nailing, and the other 20 patients were treated with primary unreamed AO intramedullary nailing after debridement. The authors evaluated the results by the union time and the presence of complication.
RESULTS
The average union time was 26.3 weeks. There was no significant difference of union time and complications between the patients who were treated with AO exteranl fixator followed by unreamed AO intramedullary nailing and the patients who were treated primarily with debridement and unreamed AO intramedullary nailing. However there was high incidence(21%) of interlocking screw breakage.
CONCLUSION
With meticulous debridement and close observation of the wound, the open tibial fractures can be effectively treated with unreamed AO intramedullay nailing. Unreamed intramedullary nailing of open tibial fractures immediately after trauma can be recommended in selected cases.

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Ender Nailing of Tibial Shaft Fractures: In Young Ok, Yang Guk Chung, Tec Soo Kim; J Korean Soc Fract 2000;13(1):87-95. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.87

Abstract PDF

PURPOSE
Though Ender nailing in tibial shaft fractures is a good method of treatment, there were several reports about complications such as angulation or shortening. Most of those complications were associated with improper surgical technique and might be avoidable. So, we analyzed the results of tibial Ender nailing in view of the complications and their contributing factors. MATERIAL AND METHOD: Thirty-five tibial shaft fractures were treated with Ender nailing and followed up for 12 to 51 months. We evaluated the bony union, angulation, shortening, proximal migration of nail and infection, and analyzed the results in association with the type and the location of fractures, the number and the length of nails and the divergency of distal tip of nails.
RESULTS
Average bony union time was 18.5 weeks and there were 2 delayed unions, 2 nonunions, 5 angulations, 1 shortening, 3 soft tissue irritations by proximal tips of nails, 1 proximal migrations of nails and one nail breakage. Most of them were associated with technical faults such as few number, short length or insufficient divergency of nails. According to the type of fractures, the highest rate of complications was seen in segmental fractures.
CONCLUSION
Performed by proper surgical technique based on detailed fracture analysis, most of the complications of Ender nailing for tibial shaft fractures might be avoidable. Therefore, Ender nailing is one of the useful alternatives for tibial shaft fractures.

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Manoeuvring Distal Tibial Shaft Fractures with Ender’s Nailing: Case Series
Aditya Pundkar, Chandrashekar Kulkarni
Journal of Datta Meghe Institute of Medical Sciences University.2023; 18(3): 481. CrossRef

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Results of Judet Quadricepsplasty in Knee Stiffness: Kuhn Sung Whang, Ki Chul Park, Kyung Sik Kim; J Korean Soc Fract 2000;13(1):96-102. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.96

Abstract PDF

PURPOSE
: We performed this study to evaluate the proper indication and complication of the Judet quadricepsplasty in the stiff knee.
MATERIALS AND METHODS
: Authors analyzed 15 cases in 14 patients treated by Judet quadricepsplasty from July 1990 to may 1998. There were 9 male and 5 female with an average age of 32.0 years. The average follow-up was 3 years 7 months. Causes of stiff knee sere femoral distal fracture in 7 cases, femoral midshaft fracture in 5 cases, tuberculosis osteomyelitis in 3 cases. The average interval between injury and quadricepsplasty was 1 year 10 months. We check the preoperative and last follow up range of motion in involved knee, and check the postoperative and last follow up extension lag and complication.
RESULTS
: By the Judet' classification, last follow up results were shown to be 5 cases in excellent, 5 cases in good, 5 cases in poor. Complications were patella fracture in 3 cases, infection in 1 case, femoral artery rupture in 1 case, and these 5 cases were shown to be poor results. Three patella fractures were arisen at the insertion of Quadriceps muscle. Infection was secondary type by the hematoma results from inappropriate hemostasis. Femoral artery rupture was arisen by the severe fibrosis at the surrounding arteries and tissues results from chronic infection due to long term application of Ilizarov apparatus. In the excellent and good results, average preoperative range of motion were 36.0 degrees, average last follow up range of motion were 96..5 degrees, average flexion gain were 60.5 degrees. Postperative extension lag were 16.5 degrees in 7 cases(70%), but last follow up extension lag were 8.7 degrees in 4 cases(40%).
CONCLUSION
: Judet quadricepsplasty was excellent method to solve the extra-articular stiff knee in the proper indication. Inappropriate indication were thought to severe intra-articular adhesion, severe osteoporosis of patella, severe fibrosis in the medial aspect of distal thigh. Postoperative early ROM exercise using CPM were thought to improve the range of motion of involved knee.

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A Modified Thompson Quadricepsplasty for Extension Contracture Resulting From Femoral and Periarticular Knee Fractures
Mohammad H. Ebbrahimzadeh, Ali Birjandi-Nejad, Said Ghorbani, Mohammad Reza Khorasani
Journal of Trauma: Injury, Infection & Critical Care.2010; 68(6): 1471. CrossRef

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Arthroscopic Reduction and Percutaneous Cannulated Screw Fixation for Longitudinal Fractures of Patella: Jung Han Yoo, Yung Khee Chung, Yong Wook Park, Jin Sub Kim, Deuk Soo Jun, Ho Jin Lee; J Korean Soc Fract 2000;13(1):103-108. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.103

Abstract PDF: A variety of surgical modalities for fractures of patella have been described. We used arthroscopic reduction and percutaneous screw fixation for six cases of longitudinal fracture of patella. Ages of the patients ranged from 25 to 33 years. the postoperative regimen was one week long leg splint for reducing the pain, followed by continuous passive range of motion exercise of the knee including active one and quadriceps strengthening exercise until the full range of motion was gained, with progressive partial to full weight bearing with crutches. The follow-up period was from 12 to 54 monhts. Results were assessed subjectively and objectively with retrograde study. The full range of knee motion was recovered from 20 to 35 days postoperatively, The radiographic bone union was achieved from 31 to 42 days. And all patient had good results according to Lysholm and Gillquist scoring system. We had no experience of complication except one which is prominence of screw end. So, we believed that the arthroscopic reduction and percutaneous cannulated screw fixation for longitudinal fractures of patella is the useful surgical method.

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Avulsion Fracture of The Medial Meniscus: A Case Report: Hyoung Soo Kim, Seung Rim Park, Joon Soon Kang, Woo Hyeong Lee, Kil Seok Ko; J Korean Soc Fract 2000;13(1):109-112. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.109

Abstract PDF: Post-traumatic meniscal ossicle due to avulsion fracture of medial meniscus was very rare. They were often associated with meniscal tear, but caused symptoms without a tear, by mass effect from protruding meniscal contour. so it had to be differential diagnosised with free loose body in the knee joint. We experienced a symptomatic meniscal ossicle due to post-traumatic avulsion fracture of the posterior horn of medial meniscus, and managed with open reduction, internal fixation with screw and washer after arthroscopic examination. We report a rare case of meniscal ossicle in detail with literature

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Surgical Treatment of Symptomatic Clavicular Nonunion: Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Hong Gweon Han; J Korean Soc Fract 2000;13(1):113-119. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.113

Abstract PDF: PURPOSE
: The nonunion after mid-shaft clavicular fracture is predisposed by refracture, interposition of the soft tissue, complete displacement of the fracture fragment and bony defect with comminuted fracture by the high-energy trauma. Symptomatic nonuions may need surgical treatment. The purpose of this study is to assess the functional and radiological results of the surgical treatment of the symptomatic nonunion of the clavicle.
MATERIALS AND METHODS
: We reviewed 10 cases of symptomatic clavicular nonunions managed with surgical treatment from January, 1994 to May, 1997. The age at operation ranged from 26 to 60 years old( average 46.5 years ). The average length of follow-up was 1.7 years( range, 1 to 3 years ). According to the scoring system of Rowe, the function of the shoulder was evaluated.
RESULTS
: All cases were united and radiologic union was obtained at 10.2 weeks on average after surgery. On functional result. average score on pain was 9.9 (3-12), average score on stability was 24.5 (20-25), average score on function was 21.0 (10-25). In motion, average score on abduction and forward flexion was 11.0 (7-15), average score on internal and external rotation were 3.8 (3-5), 3.3 (0-5). According to the scoring system of Rowe, excellent in 6 cases, good in 3 cases, fair in 1 case and the average of the total score were 83.8.
CONCLUSION
: We concluded that open reduction and internal fixation by plate or intramedullary device with autogenous bone graft could provide the relief of symptom and effective results of shoulder of shoulder function in the symptomatic nonunion of the clavicle

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Dual Plate Osteosynthesis for Distal Humeral Fractures: Chang Wu Oh, Hee Soo Kyung, Pook Taek Kim, Il Hyung Park, Yeong Chul Choi; J Korean Soc Fract 2000;13(1):120-125. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.120

Abstract PDF: PURPOSE
: The purpose of this pater was to evaluate results of double plate osteosynthesis in distal humerus fractures. MATERIAL AND METHOD : From June1995 to August 1998, we reviewed 22 distal humerus fractures. According to the type of fractures(AO classification), 6 and 16 cases were type A and C respectively. According to surgical approach, transolecranon approach was done in 12 cases and triceps split approach in 10 cases. We fixed intercondylar fracture with lag screw and supracondylar fracture with dual plate(2 reconstruction plates or 1 reconstruction plate + 1/3 tubular plate) as right angle. Rehabilitation was started just after postoperative 24 hours with posterior splint, and then increase activity and frequency.
RESULTS
: Average union time was 11.5 weeks. Overall functional results according to the classification of Jupiter and Cassebaum were excellent, good, fair, poor in 8, 10, 3, 1 cases, respectively. According to the age, patients under 50-year-old group revealed slightly superior functional. According to the type of fracture, surgical approach, interval between injury and approach, there were no statistically significant difference between group(p>0.05). There were 5 cases with complications. 1 case was mental failure, 3 cases were ulnar palsy, and 1 case was transient radial nerve palsy.
CONCLUSION
: We consider dual plate osteosynthesis in distal humerus fractures as a good treatment modality, even in type C fractures and old age patients.

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Refracture of Forearm Bone after Plate Removal: Sung Keun Sohn, Byeong Hwan Kim, Sang Ki Lee; J Korean Soc Fract 2000;13(1):132-138. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.132

Abstract PDF

PURPOSE
: To evaluate the results of operative treatment for intercondylar fracture of the distal humerus in adults.
MATERIALS AND METHODS
: From February 1994 to June 1998, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 12 of them were treated by open reduction and internal fixation(dual plate for 8, screw & K-wire for 4) and 3 of them by open reduction & Ilizarov fixation. Open or closed fracture and AO classification of fracture were considerd as a prognostic factor. The functional results were analyzed by Jupiter's critera.
RESULTS
: There were 2 excellent, 2 good in C1 type, one excellent, 2 good, one fair and 2 poor in C2 type, and one excellent, 2 good, 2 poor in C3 type. And there were one good and one poor in 2 open fractures and 4 excellent, 5 good, one fair and 3 poor in closed fractures. The average range of motion of the elbow joint was 85 degrees(30 degrees-115 degrees). Overall results show excellent and good in 67%(10 of 15) and poor in 27%(4 of 15).
CONCLUSION
: It's not easy to get satisfactory results in treatment for intercondylar fracture of the distal humerus We suggest that more efforts are needed to get anatomical reduction, rigid internal fixation and early joint motion in interconylar fracture of the distal humerus.

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Refractures of the Upper Extremity in Children
Hui Wan Park, Ick Hwan Yang, Sun Young Joo, Kun Bo Park, Hyun Woo Kim
Yonsei Medical Journal.2007; 48(2): 255. CrossRef

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The Additional Use of External Fixator after Percutaneous K-Wire Fixation for Intra-articular fractures of The Distal Radius: Chang Woo Kim, Ja Seong Gu, Gi Tae Jeong, Su Yeong Jeon, Tae Hoon Jeong, Jang Won Hur, Yeon Park; J Korean Soc Fract 2000;13(1):139-145. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.139

Abstract PDF: PURPOSE
: To evaluate the role of the additional external fixator in maintenance of reduction with was known as an important prognostic factor for the treatment of intra-articular distal radius frctures. MATERIAL AND METHOD : Thirty cases of unstalbe intra-articular fractures of the distal radius, which were treated by operative method, were classified by Frykman's method and grouped in two(group A and B). The group A was treated by closed reduction and percutaneous K-wire fixation and long arm cast immobilization. The group B was treated by treated by closed reduction and percutaneous K-wire fixation with use of additional external fixator. The end results were evaluated by the Demerit Point Rating System(by Sarmiento) & radiologic evaluation(radiologic index : radial length, radial tilt, volar tilt) RESULTS : By the Demerit point rating system, excellent and good results were rated by 45.5% in group A and 75% in group B and poor results were found in 3 cases which were Frykman type VII or VIII in group A. Radiologically, radial length loss was rated by 11%, radial tilt loss by 10.8% and volar tilt loss by 47% in group A and 3.1%, 6.8%, 29% each in group B(p<0.05).
CONCLUSION
: We think that additional use of external fixator, after percutaneous K-wire fixation, may have an important role in maintenance of reduction and group prognosis for the treament of intra-articular distal radius fractures.

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Open Reduction and AO Miniscrew Fixation of Displaced Radial Head Fractures in Adults: Jae Do Kang, Kyung Chil Jung, Chi Wook Kyoung; J Korean Soc Fract 2000;13(1):146-151. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.146

Abstract PDF: PURPOSE
: To analyze the results of open reduction and AO miniscrew fisation in displaced radial head fractures in adults. Materials & Methods : We analyzed 10 cases of displaced radial head fractures who were operated with open reduction and AO miniscrew fixation from January 1996 to March 1998. All of the fractures were classified in the Mason classification. The functional rating index was used in follow-up assessment.
RESULTS
: Average flexion was 143.5degrees, and the mean fixed flexion deformity was 3.5 degrees. The average elbow score was 95.6 points Good or excellent results were achieved in 100%. No patient had evidence of valgus instability.
CONCLUSION
: We concluded that open reduction and internal fixation in Mason type II and reparable Mason type III radial head fractures gives satisfactory range of motion and stability in the elbow joint. We suggest that anatomical reduction of fracture fragments, rigid fixation, early mobilization and proper implant placement are important for the restoration of the elbow function

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Lag Screw Fixation for the Multiple Spiral Metacarpal Fractures: Jong Woong Park, Sung Kon Kim, Jung Ho Park, Joon Seok Hong, Jae Hun Kim; J Korean Soc Fract 2000;13(1):152-157. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.152

Abstract PDF: PURPOSE
: We evaluated the results after the lag screw fixations using A.O. 2.0mm mini screws for the unstable multiple spiral metacarpal fractures.
MATERIALS AND METHODS
: thirteen cases of multiple spiral metacarpal fractures were treated with the lag screw fixations using 2.0mm mini cortical screws by the recommended technique of AOASIF. TAM of each digit was measured at the time of last follow up and the result was compared with the contralateral normal digits. We also evaluated the amount of shortening, angulation or rotation at the fracture sites on the last follow-up radiographs.
RESULTS
: Complete radiological unions were obtained in all of the cases. TAM of the operated digits were above 90% compared with those of the contralateral normal digits except 1 case, which had an another fracture and deep laceration at the distal phalanx and proximal interphalangeal joint during the period of follow up. We could not find any shortening, angulation or rotation at the fracture sites on the last follow-up radiographs.
CONCLUSION
: When we consider that the goal of treatment of the metacarpal fracture is to obtain full motion of the digit through the early mobilization after injury, we think that the lag screw fixation using 2.0mm mini screw is a good treatment modality in the cases of unstable multiple spiral metacarpal fractures.

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Neurologic recovery of neural injuries associated with supracondylar fractures of the humerus in children: Hyung Ku Yoon, Seoung Ju Jeon, Ho Seung Jun, Kye Nam Cho, Chul Won Kang; J Korean Soc Fract 2000;13(1):158-165. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.158

Abstract PDF: PURPOSE
: The purpose of our study in to determine the incidence of spontaneous recovery from neural injuries associated with supracondylar fractures of the humerus and to assess the results of electromyographic study and nerve conduction velocity. Material & methods : The 160 displaced supracondylar fractures of the humerus which had operation at the Sung Ae general hospital between April 1994 and 1998 were reviewed. Twelve(7.5%) were associated with complete neural injuries involving 16 nerves ; 9 radial, 5 ulnar and 2 median nerves. The mean age was 7.8 years old and boys outnumbered girls by 9 to 3. The follow-up period ranged from 1 year to 5 yeras 2 months. 11 fractures were managed with closed reduction and one with open means. All of the neural injuries were initially managed only by closed observation. At recent follow-up examination, we assessed the motor and sensory neurological status with Seddon's modification, grip strength and two-point discrimination in the autonomous zone. Electromyography(EMG) and nerve conduction velocity(NCV) were performed in 13 nerves of 10 patients who were assessed as complete recovered clinically.
Result
: Spontaneous neurological recovery occurred in 11 patients(15 nerves) at a mean of 2.4 months(range, 2 to 3.5 months.) Clinically, these nerves were assessed as normal. In the EMG and NCVs, 4 of 13 nerves resulted in adnormal findings. 2 radial and 1 ulnar nerve showed mild sensory neuropathy and 1 ulnar nerve showed mild denervation potentials in EMG and slow motor and sensory NCVs.
CONCLUSION
: We think that neural injuries associated with the displaced supracondylar fractures of the humerus tend towards spontaneous recovery within 4 months. And even though the neurologic recoveries are clinically complete, these are not always completely recovered in electromyographic study and nerve conduction velocity.

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Diagnosis and Treatment of the Lateral Condylar Fracture of Humerus Traversing the Capitulum in Children: Kwang Soo Song, Dong Hwa Woo; J Korean Soc Fract 2000;13(1):166-171. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.166

Abstract PDF: PURPOSE
: To emphasize the importance of the oblique view of elbow in diagnosis of the lateral condylar fracture traversing the capitulum to propose an appropriate treatment reducing the complication.
MATERIALS AND METHODS
: We analyzed eight cases of lateral condylar fracture traversing the capitulum among the 192 cases of lateral condylar fracture with preoperative complete roentgenogram and medical record from April, 1992 to September, 1998.
RESULTS
: In seven cases, it was possible to diagnose as lateral condylar fracture of humerus in initial anteroposterior and lateral view, but it had a difficulty to decide whether fracture line traversing the capitulum. The oblique view provided accurate fracture line to diagnose. One case was diagnosed fracture line traversing the capitulum in lateral view. There was no considerable complications at 18 months follow up in average, except one case with malunion that was transferred form other hospital after operation.
CONCLUSION
: To make a diagnosis of the lateral condylar fracture traversing capitulum, the oblique view is helpful. We considered that internal fixation is require because the fragment can be displaced progressively.

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Leg Length Discrepancy after Ender Nail Fixation in Children Femoral Shaft Fracture: Jin Woo Kwon, Seung Ho Shin, Won Ho Cho, Woo Se Lee, Jin Ho Park; J Korean Soc Fract 2000;13(1):172-177. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.172

Abstract PDF: PURPOSE
: The purpose of this study is to evaluate the seg length discrepancy after Ender nail fixation in children's femoral shaft fracture.
MATERIALS AND METHODS
: We reviewed 18 femoral shaft fracture that were treated with Ender nail and studied the relationship between the initial site of fracture, type of fracture and overgrowth. The age of children in this study ranged 6 to 13 years old and the average period of follow-up was 32 months.
RESULTS
: The range of leg length discrepancy was from 6 mm shortening to 16mm lengthening and average 3.4 mm lengthening. Only one patient had shortening, nine patients had limbs of equal length(less than 2 mm) and eight patients had lengthening. The average overgrowth was 1.3 mm in proximal 1/3, 7.0 mm in middle 1/3, 3.0 mm in distal 3/1 fractures. The average overgrowth was 7.3 mm in transverse, 1.3 mm in oblique and 2.3 mm in comminuted fractures.
Conclusions
: We consider closed Ender nailing in children femoral shaft fractures as a good treatment modality in the matter of leg length discrepancy.

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Results of Treatment of Fracture-Dislocations of Elbow: Dong Soo Kim, Soon Ho Hwang, Chil Soo Kwon, Jong Kuk Ahn, Byung Hyun Jung, Yerl Bo Sung, Jae Kwang Yum, Hyung Jin Chung; J Korean Soc Fract 2000;13(1):178-185. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.178

Abstract PDF: PURPOSE
: This study analyzed clinical and biomechanical data from patients with elbow fracture dislocation to correlate long-term objective result with the specific injury type and treatment rendered. This can provide a basis for the management of this difficult injuries.
MATERIALS AND METHODS
: Fifteen patients with elbow dislocation were studied from October, 1992 to October, 1997 in Sang-Gye Paik Hospital. The average duration of follow up was 4.2 years.
RESULTS
: On the basis of an objective functional grading score that included elements of pain, motion, strength, and stability, the results were excellent in five(33%), good in five(33%), fair in one(7%), poor in four(27%). Prolonged immobilization greater than four weeks was associated with poor results. The results were closely related to the combined injuries and duration of immobilization. In case of radial head fractures, the best result was obtained in patients with Mason type II fractures treated by open reduction and internal fixation using Herbert screw and early complete radial head excision. SUMMARY AND CONCLUSION : The most common combined injury is radial head fracture. Early complete radial head excision and encouraging early ROM had more satisfactory result than delayed radial head excision or internal Fixation for Mason type III fracture.

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Surgical Treatment of the Fracture and Dislocation of the Elbow and Early Controlled Mobilization: Young Kye Kim, Ki Young Kang; J Korean Soc Fract 2000;13(1):186-192. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.186

Abstract PDF: PURPOSE
: To assess the results according to the injury types of fracture-dislocation of the elbow and to evaluate the stability after early controlled mobilization.
MATERIALS AND METHODS
: Twenty-two patients were managed with open reduction and internal fixation, sometimes using the compass hinged external fixator. Most common direction of dislocation was posterior(46%) and most common associated fracture was radial head and neck fracture(36%). patients were treated with various methods regarding the types of fracture and immediate mobilization using the hinged functional brace.
RESULTS
: Of 11 cases associated with radial head fracture. 9 cases had excellent or good results and 2 cases combined with concomitant other fracture had fair results. Of 5 cases associated with olecranon fracture, 2 cases with severe comminuted fracture had fair or poor results. All of 6 cases associated with coronoid or medial condyle fracture had good results. Late instability was not observed in any of 22 cases.
CONCLUSION
: This study revealed that more combined lesion and comminution of the fracture had worse functional results. Late instability from immediate controlled mobilization was not observed.

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Treatment of Periprosthetic Fracture Following Total Elbow arthroplasty: Myung Chul Yoo, Yong Girl Rhee, Yoon Je Cho, Kang Il Kim, Young Lin Cho; J Korean Soc Fract 2000;13(1):193-199. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.193

Abstract PDF

PURPOSE
: To classify the pattern of periprosthetic fracture after total elbow replacement(TER) and introduce the principles of treatment in various fracture patterns.
MATERIALS AND METHODS
: Four patients(1 man and 3 women) were evaluated, who had periprosthetic fractures following total elbow arthroplasty, form July 1997 to October 1998. The incidence of fracture among TERs was 6%(4/62) and the average follow-up period was 1 year 6 months. The locations of periprosthetic fractures were classified according to Hanyu et al. The result were analyzed about the treatment modalities, the period to bony union, elbow motion and complication.
RESULTS
: Type2 and type 3 fractures were treated with closed reduction and hanging splint, whereas type 1 fracture showing loosening of humeral component was treated with revision arthroplasty. Type 4 fracture was treated with open reduction and internal fixation. The period to bone union was 5 months in average. The elbow motion ranged between 7.5degrees to 106.2degrees at the last follow-up. Type 3 showed anterior angulation deformity of 20degrees.
CONCLUSION
: Fracture pattern, stability, and loosing of component should be considered to select treatment modality. In transverse fracture proximal to the humeral stem tip(type 3), open reduction and internal fixation is recommended because of difficulties in maintaining alignment of fracture fragment. Postoperative rehabilitation program is very important to prevent limitation of elbow motion

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Treatment of Periprosthetic Fracture after Total Elbow Replacement Arthroplasty
Hyunseok Seo, Jin-Hyung Im, Joo-Yup Lee
Journal of the Korean Fracture Society.2020; 33(2): 110. CrossRef

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