Journal of Musculoskeletal Trauma

Development of a Computer-assisted Surgery System for Screw Fixation of the Sacro-iliac Joint: Jin Sup Yeom, Won Sik Choy, Ha Yong Kim, Whoan Jeang Kim, Jong Won Kang, Yeongho Kim, Hyungmin Kim, Donghyun Seo, Seok Lee, Jae Bum Lee, Namkug Kim, Cheol Young Kim; J Korean Soc Fract 2003;16(1):1-7. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.1

Abstract PDF: PURPOSE
The purposes of this study were to develop a computer-assisted surgery system for percutaneous screw fixation of the sacro-iliac joint and to evaluate its accuracy.
MATERIALS AND METHODS
We have developed a navigation system composed of an optical tracking device (Polaris, Northern Digital, Canada) and a personal computer. The registration error and target localization error at hybrid registration were measured using a phantom. The errors were measured 30 times for each. Sixteen 6.5 mm cannulated screws were inserted into four plastic bone models (Sawbones, USA), and the accuracy was evaluated.
RESULTS
The registration error was 0.76 +/-0.33 mm, and the target localization error was 1.43 +/-0.42 mm. All of the 16 screws were inserted well across the sacro-iliac joint, and there was neither penetration of the cortical bones nor collision between screws or washers.
CONCLUSION
The accuracy of the developed system was similar to existing ones, and its usefulness and helpfulness was proven with screw insertion into plastic bone models.

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Treatment of Unstable Intertrochanteric Fractures in Elderly Patients: Comparison between DHS and Additional TSP: Sang Won Park, Jong Ryoon Baek, In Seok Moon; J Korean Soc Fract 2003;16(1):9-14. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.9

PURPOSE
The purpose of this study was to compare the results by only Dynamic HIP Screw(DHS) with those by DHS and additional Trochanter Stabilizing Plate(TSP) in the operative treatments of unstable intertrochanteric fractures.
MATERIALS AND METHODS
From January 1998 to December 2000, twenty-five cases of unstable intertrochanteric fractures in the patient over 70 years old were reviewed with minimal follow up of one year. Ten cases(group I) were treated with DHS and additional TSP. Fifteen cases(group II) were treated with only DHS. The cases were analyzed according to the type of fracture by AO classification, the cause of trauma, the age of patient. We evaluated the sliding of lag screw, the change of neck-shaft angle and lateral displacement of greater trochanter by comparison of last follow up radiographs with immediate postoperative radiographs.
RESULTS
The degree of sliding of lag screws was average 8.57 mm in group I and average 14.75 mm in group II(P=0.04). The change of neck-shaft angle was average 3.81 degree in group I and average 3.93 degree in group II(P>0.05). There was a significant difference between group I(0 case) and group II(14 cases) in lateral displacements of greater trochanter. In group II, the degree of lateral displacement of greater trochanter was average 6.41 mm.
CONCLUSION
We consider that additional TSP is more effective method for reducing excessive sliding of lag screw and lateral displacement of greater trochanter than only using dynamic hip screw in the treatment of unstable intertrochanteric fracture.

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A Comparison of Clinical Results between Compression Hip Screw and Proximal Femoral Nail as the Treatment of AO/OTA 31-A2.2 Intertrochanteric Femoral Fractures
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, In Hwa Back, Kyeong Soo Eom
Journal of the Korean Orthopaedic Association.2016; 51(6): 493. CrossRef
The Comparison between ITST™ (Intertrochanteric/Subtrochanteric) & DHS (Dynamic Hip Screw) in Unstable Femur Intertrochanteric Fracture
Ho-Seung Jeon, Byung-Mun Park, Kyung-Sub Song, Hyung-Gyu Kim, Jong-Ju Yun
Journal of the Korean Fracture Society.2009; 22(3): 131. CrossRef

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Common Modes of Fixation Failure with a Sliding Hip Screw encountered Unstable Intertrochanteric Fracture: Byung Soon Kim, Duck Yun Cho, Hyung Ku Yoon, Dong Eun Sin, Soo Hong Han, Jae Hwa Kim, Dong Jun Kim; J Korean Soc Fract 2003;16(1):15-21. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.15

Abstract PDF

The purpose of this study was to evaluate the common modes of fixation failure in unstable intertrochanteric fractures , related risk factors and the prevention of fixation failure. Between 1995 and 2001, 44 patients who had sustained an unstable intertrochanteric fractures were assigned to be treated with a sliding hip screw. Men in 14 cases ( 32% ), women in 30 cases ( 68% ) , the average age at the operation was 65(22-90) years and the average duration of follow up was 12(8-22) months. We classified the fracture patterns with Evans system and used Singh 's index for osteoporosis. And we examined the common modes of fixation failure with postoperative X-ray. The fixation failure in unstable intertrochanteric fracture was 8 cases (18.2 % ); varus collapse of the proximal fragment with cutout of the lag screw was 3 cases (6.8%), varus collapse of the proximal fragment with excessive sliding of the lag screw was 4 cases (9.1%) and loss of fixation of the plate-holding screws was 1 case (2.3%). The authors think that inadequate anatomical reduction of comminuted posteromedial fragment and severity of osteoporosis are main causes of fixation failure. During operation for unstable intertrochanteric fractures, the most important point is accurate reduction of posteromedial fragment and the intramedullary hip screw like proximal femoral nail ( PFN ) may be considered to avoid fracture of lateral cortex that enter the lag screw, causing fixation failure.

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The Antero-medial Cortex Overlapped Reduction of Unstable Intertrochanteric Fractures
Chae-Geun Kim, Suc-Hyun Kweon, Hong-Jun Han, Jae-Seon Hwang
Hip & Pelvis.2013; 25(4): 280. CrossRef

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Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Unstable Intertrochanteric Fractures in Elderly Patients: Duk Hwan Kho, Kyou Hyeun Kim, Ju Young Shin, Sin Woo Lim, Dong Heon Kim; J Korean Soc Fract 2003;16(1):22-28. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.22

Abstract PDF

PURPOSE
The purpose of this paper is to analyze the operating time, timing of ambulation, functional results and complications using the calcar replacement stem for the severely comminuted unstable intertrochanteric fractures in the elderly patients.
MATERIALS AND METHODS
From August 1991 through January 2001, 20 elderly patients over the 75 year old patients had undergone bipolar hemiarthroplasty with calcar replacement stem for the treatment of unstable intertrochanteric fractures.
RESULTS
The mean operating time was 45 minutes and mean Harris Hip Score was 84.7. Ambulation with walker was started at post-operative 8 days and full weight bearing was 6.9 weeks, each. Complications were 2 cases of wound infection, 1 case of severe thigh pain and 1 case of dislocation.
CONCLUSION
Early ambulation, functional restoration and decrease of the complications with bipolar hemiarthroplasty using calcar replacement stem for severely comminuted unstable intertrochanteric fractures in elderly patients, therefore this methods seems to be one of the effective treatments.

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Pre- and Perioperative Risk Factors of Post Hip Fracture Surgery Walking Failure in the Elderly
YoungJi Ko
Geriatric Orthopaedic Surgery & Rehabilitation.2019;[Epub] CrossRef
A STUDY OF PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY OF HIP IN ELDERLY PATIENTS WITH OSTEOPOROTIC, UNSTABLE INTERTROCHANTERIC FRACTURE
Maheshwar Lakkireddy, Radhakrishna Rapaka, Naveen Gouru, Shivaprasad Rapur
Journal of Evidence Based Medicine and Healthcare.2015; 2(35): 5447. CrossRef
Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients
Sung-Hwan Kim, Soo-Won Lee, Gyu-Min Kong, Mid-Um JeaGal
Hip & Pelvis.2012; 24(1): 45. CrossRef

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The proximal femoral nail for intertrochanteric fracture of the femur: Young Wan Moon, Dong Hyun Suh, Shin Taeg Kang, Duck Joo Kwon, Yong Nam Ji, Kee Byoung Lee; J Korean Soc Fract 2003;16(1):29-36. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.29

Abstract PDF

PURPOSE
To evaluate the treatment results of geriatric intertrochanteric fractures using a proximal femoral nail.
MATERIALS AND METHODS
From April 2001 to Feburary 2002, 71 cases of the intertrochanteric fractures were treated with proximal femoral nail(PFN), more often in communited fractures involving lesser trochanter, transverse or reverse oblique intertrochanteric fracture. We evaluated the bone union time, neck-shaft angle, lag screw sliding by follow up radiographs, operation time, blood loss and complications.
RESULTS
The average age was 77.5 years old, the mean duration of follow-up was 9 months and the mean duration of bone union was 13.8 weeks. The average neck-shaft angle on immediate postop. x-ray was 131.9 +/-5.21 degrees and 129.9 +/-6.04 degrees at last follow up and the average lag screw sliding was 4.21 +/-4.13 mm. The average operation time was 61 minute and blood loss was 0.67 pints(134cc). Intraoperative complications were inadequate reduction in one case, difficulty in distal transfixing in one case and drill bit failure in one case and postoperative complications were loss of neck-shaft angle (more than 5 degree) in 12 cases, femur neck fracture in 2 cases and intraarticular cutting out of femur neck screw in one case.
CONCLUSIONS
The use of the proximal femoral nail could be appropriate for the fixation of communited or reverse oblique intertrochanteric fracture in elderly, osteoporotic patients for early ambulation, preventing shortening and rotation deformity, and reducing operation time and blood loss.

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Treatment of Intertrochanteric Fractures Using the Compression Hip Nail
Je-Min Yi, Kye Young Han, Keun Woo Kim, Chang Hyun Ryu
Hip & Pelvis.2014; 26(3): 166. CrossRef
Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails
Il Ho Park, Jong Kyoung Won, Kye Young Han
Hip & Pelvis.2012; 24(2): 117. CrossRef
Proximal Femoral Nail Antirotation and Proximal Femoral Nail in Intertrochanteric Fractures
Sung Soo Kim, Chul Hong Kim, Jin Hun Kang, Dong Hoon Han, Yong Seung O
Journal of the Korean Orthopaedic Association.2011; 46(5): 392. CrossRef
Results of the Proximal Femoral Nail-Antirotation (PFNA) in Patients with an Unstable Pertrochanteric Fracture
Yerl-Bo Sung, Sung-Il Jo
The Journal of the Korean Hip Society.2011; 23(1): 39. CrossRef
Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture
Jong Min Lim, Jeung Il Kim, Jong Seok Oh, Kuen Tak Suh, Jae Min Ahn, Dong Joon Kang
Journal of the Korean Fracture Society.2010; 23(4): 360. CrossRef
Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA)
Myung-Sik Park, Young-Jin Lim, Young-Sin Kim, Kyu-Hyung Kim, Hong-Man Cho
Journal of the Korean Fracture Society.2009; 22(2): 91. CrossRef
Treatment of Intertrochanteric Fracture: Comparison of Proximal Femoral Nail and Proximal Femoral Nail A
Jung Ho Park, Jong Woong Park, Joon Ho Wang, Jae Wook Lee, Jung Il Lee, Jae Gyoon Kim
Journal of the Korean Fracture Society.2008; 21(2): 103. CrossRef
Treatment of Intertrochanteric Fracture with Proximal Femoral Nail
Dae Joong Kim, Sung Chan Ki, Young Yool Chung
Journal of the Korean Fracture Society.2007; 20(1): 40. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)
Kee-Byoung Lee, Byung-Taek Lee
Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef

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Primary Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fracture of the femur in Elderly patients: Jong Min Sohn, Ju Hae Jahng, Nan Kyung Ha, Seong Tae Cho, Kwang Young Choi; J Korean Soc Fract 2003;16(1):37-44. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.37

Abstract PDF

PURPOSE
The purpose of this study was to evaluate the effectiveness and advantage of bipolar hemiarthroplasty in treatment of unstable femoral intertrochanteric fracture in elderly patients.
MATERIALS AND METHODS
We reviewed 93 patients and followed up more than one year. Group I(n=34, Singh index <3 with more than 70 year old) were treated by bipolar hemiarthroplasty. Group II(n=20) with same condition were treated by compression hip screw. Group III(n=39, Singh index >4 with more than 70 year old) were treated by compression hip screw.
RESULTS
Group I and III patients showed satisfactory result over than good by merle D 'Aubigne hip rating scale. Among Group II(n=20), 16 cases showed under 'poor 'according to functional scale. Complication was 1 cases in group I, 19 cases in group II and 8 cases in group III.
CONCLUSION
We suggest bipolar hemiarthroplasty as first choice of treatment for osteoporotic elderly patients with unstable intertrochanteric fracture, especially who have combined medical problems or poor general condition.

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Analysis of Missed Fractures by Bone Scan in Elderly Hip Fracture Patients with Osteoporosis
Tae Hun Lee, Yeong Hyun Lee, Seo Won Kang
Journal of the Korean Fracture Society.2024; 37(3): 144. CrossRef

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Retrograde Intramedullary Nail for Femoral Shaft Fracture with Limited Indications: Sung Jung Kim, Chang Wug Oh, Joo Chul Ihn, Hee Soo Kim, In Ho Jeon, Hee Soo Kyung, Il Hyung Park, Kyung Hoon Kim; J Korean Soc Fract 2003;16(1):45-51. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.45

Abstract PDF

PURPOSE
This is a retrospective study to analyze the results after retrograde intramedullary(IM) nailing in femoral shaft fractures with limited indications.
MATERIALS AND METHODS
Twenty-four femoral shaft fractures(21 patients) were operated with unreamed IM nail(Unreamed femoral nail, SynthesR) in a retrograde method and were followed for more than 1 years. There were 16 men and 5 women, and the mean age at index operation was 41 years (range 18-76 years). In Winquist-Hansen classifications, there were 10 of type I, five of type II, three of type III, and six of type IV. All the patients had associated fractures or injuries, and there were eight ipsilateral tibia fractures, five ipsilateral proximal femoral fractures(including neck and trochanter), four ipsilateral pelvic or acetabular fracture, three bilateral femoral fractures, and one ipsilateral knee injury according to the used indications. In radiological study, we evaluated the time for union, non-unions and malunion, and clinical evaluation with Neer 's criteria was done.
RESULTS
Most fractures(87.5%) were primarily united cases, and the mean time for union was 15.8 weeks(range 12-20 weeks). Three cases of delayed union or nonunion were developed, but a shortening over 1cm or malunion over 10 degrees angular deformity were not found. Evaluating the knee functions, the Neer score was 86.9 in average and all the cases were above satisfactory grade. The average range of knee motion was 120.2 degrees, and the mild knee pain was developed in three cases.
CONCLUSION
The retrograde IM nailing can be a useful option for femoral shaft fractures with limited indications, including ipsilateral fractures of other areas or multiple fractures.

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Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture
Chang-Wug Oh, Jong-Keon Oh, Woo-Kie Min, Shin-Yoon Kim, Seung-Hoon Baek, Byung-Chul Park, Hyung-Soo Ahn, Tae-Gong Kim
Journal of the Korean Fracture Society.2007; 20(2): 135. CrossRef
Retrograde Intramedullary Nailing for the Treatment of Ipsilateral Femoral Shaft and Neck Fracture
Chang-Wug Oh, Jong-Keon Oh, Shin-Yoon Kim, Ki-Bong Cha, In-Ho Jeon, Byung-Chul Park, Woo-Kie Min, Tae-Gong Kim
The Journal of the Korean Orthopaedic Association.2007; 42(3): 380. CrossRef

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Hybrid External Fixation and Limited Internal Fixation for Severe Open Tibial Shaft Fractures: Hong Jun Han, Soo Uk Chae, Ul Oh Jeung; J Korean Soc Fract 2003;16(1):52-58. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.52

Abstract PDF: PURPOSE
To evaluate the radiographic and clinical results of severe open tibial shaft fracture treated by hybrid external fixation and limited internal fixation.
MATERIALS AND METHODS
We reviewed 25 patients open tibial shaft fracture(> or =Gustillo classification type II) which were treated with hybrid external fixation(AnyFixR) that was invented by authors and limited internal fixation between June 1998 to June 2001. 20 males and 5 females were minimum follow up period of 12 months(12-27 months). The mean age was 45 old years(11-72 old years). The results were based on the assessment radiographical analysis with duration of bony union, delayed union including of states of nonunion and malunion, clinical analysis with pain, joint range of motion, wound infection and skin & soft tissue coverage. All fractures were classified according to the Gustilo classification, there were 6 cases of type II, 9 cases of type IIIa and 10 cases of type IIIb. The cause of injury, there were 18 cases of motor vehicle accident, 5 cases of direct trauma and 2 cases of fall from height.
RESULTS
In twenty-five cases, fifteen had union, the average time of bone union was 6.8 months and additional bone graft without change of external fixator performed in ten cases, but one case have failed and then change of intramedullary nail with bone graft. In the group of bone graft, bone union was completed at mean 8.7 months. According to the clinical analysis, no pain in the fracture site, in complications, there were 2 cases of mild joint range of motion that has acceptable result and 2 cases of wound infection were treated with effective antibiotics theraphy and wound dressing. Five cases need to coverage of the open wound, 3 cases were flap operation and each case were muscle transfer, skin graft without change of external fixator.
CONCLUSION
The use of hybrid external fixation and limited internal fixation in severe open tibial shaft fracture to be successful for the stabilization of fracture and subsequent plastic and/or orthopaedic procedure for muscle and skin coverage, bone grafting are more easily accomplished without change of external fixator.

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The role of posterior malleolar fragments in ankle pain after trimalleolar fractures: Su Young Bae, Dong Hoon Sihn; J Korean Soc Fract 2003;16(1):59-66. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.59

Abstract PDF

PURPOSE
There are some criticisms of indication for internal fixation of the posterior malleolar fragments in trimalleolar fractures. We tried to find out clinical and radiologic factors which affect on a clinical outcome of trimalleolar fractures.
MATERIALS AND METHODS
Thirty three patients who were treated for trimalleolar fractures and given anatomical reduction of lateral and medial malleolus were included. We divided patients into two groups, a group without the pain and the other group with the pain. Preoperative and postoperative lateral plain radiographic films were used to estimate fragment size, post-reduction gap and step off. By reviewing the medical records, other factors such as the time of ankle motion, weight loading and whether posterior malleolus was fixed. or not were stucdied. A clinical outcome was evaluated by AOFAS(American Orthopaedic Foot and Ankle Society) scaling system. We performed statistical analysis using Logistic regression analysis and Chi-square test on each factors.
RESULTS
There was no definite difference between two groups on the functional outcome. There was one case showing limited ankle motion. Seven patients were involved in the group with the pain and 23 in the group without the pain. The remnant fracture gap and step off of joint surface statistically showed the meaningful corellation with the pain but a fragment size and a surgical fixation, time of motion and weight loading did not show any significances.
CONCLUSION
We doubt the significance of the size of posterior malleolar fragment. We concluded that anatomical reduction of posterior malleolus is the most significant factor of a clinical outcome regardless of the size or internal fixation, especially the pain after trimalleolar injuries.

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Treatment of Isolated Posterior Malleolus Fracture in the Ankle
Ji Hoon Kim, Seong Mu Cha, Dae Yeon Jo, Jin Soo Suh
Journal of the Korean Orthopaedic Association.2014; 49(1): 29. CrossRef
Treatment of the Posterior Malleolar Fracture Using Posterior Approach
Hyun Wook Chung, Dong Hwan Kim, Si Hoon Yoo, Jin Soo Suh
Journal of the Korean Fracture Society.2010; 23(1): 50. CrossRef
Radiologic Analysis and Treatment of Posterior Malleolar Fractures of the Ankle
Jae Sung Lee, Soo Yong Kang, Han Jun Lee, Young Bong Ko
Journal of the Korean Fracture Society.2009; 22(2): 98. CrossRef

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Surgical Treatment for Fractures of the Talus: Ho Rim Choi, Jang Geun Lee, Hun Hwi Choi, Sung Woo Choi; J Korean Soc Fract 2003;16(1):67-73. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.67

Abstract PDF: PURPOSE
To evaluate the clinical results and develope guidelines for surgical treatment of talus fracture.
MATERIALS AND METHODS
Among the 60 cases that were treated during March 1990 to November 2000, 34 cases were treated operatively and followed up for more than one year( range: 1 4.4 years ). They were analyzed retrospectively with questionnaire directly or by telephone interview, radiograms and medical records. Clinical results were evaluated by Hawkins 'scoring system.
RESULTS
25 out of 34 cases showed satisfactory results. Unisatisfactory results were seen in cases that we couldn 't achieve anatomical reduction due to severe communition, and also in case of delayed treatment due to associated trauma and soft tissue injury. Six out of 8 cases that showed no Hawkins 'sign developed avascular necrosis. However, satisfactory results were achieved through conservative treatment.
CONCLUSION
Satisfactory results could be achieved through early anatomical reduction and rigid internal fixation followed by aggressive rehabilitation. There was no differences in clinical results either by the surgical approach or method of internal fixation. Avascular necrosis was not essentially related to the clinical results.

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Functional Evaluation of Wrist According to Changes of Length after Operation in Fracture of Both Bones of Forearm: Seung Suk Seo, Ki Yong Kim, Jang Seok Choi, Young Chang Kim, Jae Keun Park; J Korean Soc Fract 2003;16(1):74-82. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.74

Abstract PDF: PURPOSE
To evaluate the relationship between the length changes of both forearm bones and function of wrist. To know permitted length discrepancy for good wrist function after operation in fracture of both bones of forearm MATERIALS AND METHODS: From Jan. 1995 to Dec. 2000, 21 cases were followed over 1 year, were treated with compression plate and screws due to fracture of both bones of forearm in our hospital. Mean duration of follow-up was 3 years 6 months. The postoperative length difference was compared to preoperative or unaffected side in roentgenography. Four groups were defined to A, B, C and D by postoperative length difference ; < or =1mm, 1 2mm, 2 3mm, and >3mm for comparison. The function of wrist joint was evaluated with the Anderson 's classification and Mayo modified wrist score.
RESULT
Group A were 11 cases(52.3%), B 5 cases(23.8%), C 4 cases(19.0%) and D 1 case(4.8%). By the Anderson 's classification, the number of Excellent were 11 cases(52.3%), Good 7(33.3%), Fair 3(14.3%). In the group of the length difference lesser than 2mm, the number of Excellent were 11, and Good 5. The Mayo modified wrist score was 75.15 in the group of the length difference lesser than 2mm, that was higher than 61.15 in the group of more than 2mm.
CONCLUSION
To obtain a good wrist function after operative treatment of fracture of both bones of forearm the length discrepancy of both bones should be lesser than 2mm.

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Surgical treatment using external fixator for unstable intra-articular fracture of distal radius: Chul Hong Kim, Byeong Hwan Kim, Sung Won Lee, Wook Kim; J Korean Soc Fract 2003;16(1):83-90. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.83

Abstract PDF: PURPOSE
To analyze the results of surgical treatment using external fixator for unstable intra-articular fracture of distal radius. MATERIAL AND METHODS: We investigated 38 cases of distal radius fracture from Mar. 1990 to Dec. 2000. The patients were followed up for average 18 months postoperatively. We compared the results of 22 cases, treated with open reduction and internal fixation(ORIF) to the results of 16 cases, treated with ORIF and external fixation. We evaluated the results of the mean loss of radial length, radial inclination, volar tilt and traumatic arthritis according to demerit point rating system above the Fernandez classification IV.
RESULTS
According to demerit point rating system, excellent to good results were obtained in 72.7% at ORIF and external fixator, compared to 43.8% at case of ORIF only. In the last follow up, the mean loss of radial length was 0.6mm in case of ORIF, but 0.4 mm in case of ORIF and external fixator, the mean loss of radial inclination was 2.3 and 1.5 degrees, the mean loss of volar tilt was 2.5 and 2.2 degrees, respectively (p < 0.05). Postoperative complications were developed in 9 cases. Malunion was in 4 cases of ORIF and external fixator, in 2 cases of ORIF. Metacarpal bone fracture was in 1 case of ORIF and external fixation. Traumatic arthritis was in 2 cases of ORIF.
CONCLUSION
Open reduction and internal fixation combined with external fixation was thought to be a better method than open reduction and internal fixation for the treatment of unstable intra-articular fractures of the distal radius of the Fernandez classification IV and IV, because that was more comfortable and convenient to patients and was useful to prevent late displacement.

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Immediate hip spica cast application for femoral shaft fractures in children: Han Yong Lee, Kee Won Rhyu, Jin Young Chung, Mun Ik Sohn, Chang Ki Kim, Yong Koo Kang; J Korean Soc Fract 2003;16(1):91-97. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.91

Abstract PDF

PURPOSE
To evaluate an efficacy of immediate closed reduction and hip spica casting in pediatric patients with femoral shaft fractures.
MATERIALS AND METHODS
27 cases of 27 pediatric patients who had been treated conservatively for the femoral shaft fractures under 10 years of age were retrospectively reviewed. The cases with serious associated injuries were excluded. The hospital stay, duration of traction and hip spica cast, frequencies of plain radiographs, clinical and radiological outcomes at the final follow-up, and financial aspects were evaluated comparatively between the groups of immediate hip spica casting(12 cases) and traction-casting(15 cases).
RESULTS
The patients treated with immediate hip spica casting had a mean hospital stay of 7.8 days, compared with a mean of 25.8 days for those treated with traction and casting. The mean duration of immobilization were 44.2 days in the group of immediate hip spica casting, and 65.1 days in the group of traction and casting. The radiologic examinations were performed 2 times and 6.9 times respectively. The clinical and radiological outcomes at the final follow-up were good in both groups. Insignificant leg length discrepancies were seen in 3 cases each group. The total charges of traction and casting was 2.4 times higher than that of immediate hip spica casting.
CONCLUSION
The immediate hip spica casting seems to be an effective method of treatment in femoral shaft fractures without serious associated injuries under 10 years of age because there are several advantages such as satisfactory result, shortened hospitalization and immobilization, reduction of total charges, and lowered the risk of radiologic exposures.

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Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture
Suk Kang, Jong Pil Kim, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Sang Ho Lee, Jin Wook Chung
Journal of the Korean Fracture Society.2007; 20(4): 339. CrossRef

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Analysis of Elbow Injuries 'pattern in Children: Soon Hyuck Lee, Jong Woong Park, Sang Won Park, Kwang Suk Lee, Dang Jae Im, Tae Ha Kim, Sang Won Lee; J Korean Soc Fract 2003;16(1):98-103. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.98

Abstract PDF: PURPOSE
The purpose of this report is to describe the pattern of elbow injuries and the incidence of the different fracture types in children.
MATERIALS AND METHODS
The records of 445 in-patient children treated for the elbow injuries for 5 years were reviewed and analyzed statistically.
RESULTS
The average age of 445 children was 6.7 years. The average age of boys(6.9 years) was about 1 year older than girls(5.9 years). The age group of 4 - 7 years is the majority(50%), followed by the age group of 8 - 11 years(22%). The boy to girl ratio was approximately 2:1. The male predominance changed with the age and appeared dramatically in the age group of 12-16 years( 6.7:1 ). Left elbow was injured more frequently(60%). Left side predominance was accentuated in girls compared to boys(69% vs 55%), especially in the age group of 8 - 16 years (80% vs 50%). Thirty percent of the fractures occurred during the summer, followed by 27% the autumn, 26% the spring months and 17% the winter. The most common fracture was the supracondylar fractures of the humerus(52.3%), followed by lateral condylar fractures(25.4%), olecranon fractures(5.3%), radial head fractures(4.8%), medial epicondyle fractures(4.6%), transphyseal fractures(2.8%) and Monteggia fractures(2.2%). Medial condylar fractures(1.1%) and elbow dislocation(0.8%) were rare injuries. The average age was higher in radial head fracture(10.6 years) and medial epicondylar fracture(12.4years). Closed reduction and percutaneous pinning was the method of treatment in more than half(52%). Open reduction was performed in 32%. Sixteen percent was treated by closed reduction and cast immobilization.
CONCLUSION
The incidence and pattern of elbow injuries in children, which needed operative treatment in the majority, occured closely correlated with the amount of injury prone play and the pattern of behavior during the causative accidents.

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The Usefulness of Low-Intensity Ultrasound for Nonunion and Delayed Union: Yeo Heon Yun, Jong Oh Kim, Young Do Ko, Jae Doo Yoo, Jun Mo Jung, Jong Gun Oh, Han Chen Bang, Chang Ho Choi, Myeung cheol Shin; J Korean Soc Fract 2003;16(1):104-111. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.104

Abstract PDF: PURPOSE
To evaluation of usefulness of low-intensity ultrasound for nonunion and delayed union.
MATERIALS AND METHODS
For 5 months, we treated 7 delayed union and 8 nonunion using low-intensity ultrasound. After 5 months, in checked X-ray AP and Lateral view, when cortical bridge formation was done, we through union.
RESULTS
In 7 delayed union, 5 cases-2 femur, tibia, humerus, radius were healed. In 8 nonunion, 3 femur nonunion were healed. Union rate was 71% in delayed union 37.5% in nonunion.
CONCLUSION
we thought that the low-intensity ultrasound has capacity of induction of union and was considered as the method of treatment for delayed union.

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A Bent Intramedullary Interlocking Tibial Nail: A Case Report: Whan Yong Chung, Woo Suk Lee, Dae Hwan Kim; J Korean Soc Fract 2003;16(1):112-115. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.112

Abstract PDF: Broken tibial intramedullary nails caused by secondary trauma have been infrequently reported, but bent intramedullary tibial nail was extremely rare. We describe a rare case of a bent intramedullary tibial nail due to a traffic accident who had previously operated with intramedullary tibial nail.

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Femoral Neck Fracture in Bilateral Above Knee Amputee: A Case Report: Kye Young Han; J Korean Soc Fract 2003;16(1):116-119. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.116

Abstract PDF: Femoral neck fracture is a common fracture in elderly or osteoporotic women. But femoral neck fracture in previously amputed patients is rare, so the guideline of appropriate treatment is rarely discussed. Especially, femoral neck fracture in patients with above knee amputation was more rare. Hereby I report a case of femoral neck fracture occurred to 58-year-old male bilateral above knee amputee with the review of literatures.

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