Journal of Musculoskeletal Trauma

Treatment of the Proximal Humeral Fractures: Se Il Suk, Sang Hoon Lee, In Joon Kim, Min Jong Park; J Korean Soc Fract 1989;2(1):1-8. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.1

Abstract PDF: Thirty-four patients with proximal humeral fratures were treated at department of orthopedic surgery, college of medicine, Seoul National University between 1978 and March, 19 99. They were followed up between six months and three and half years with average of 1.2 years. Mean age was 52.9 years and traffic accidents was the most common cause of injury. According to the Neers classification, there were seven one-part(20%), sixteen two-part(48%), seven three-part(20%) and four four-part(12%) fractures or fracture-dislocations. The methods of treatment and its results were analyzed according to the Neers classificatioin and they were summarized as follows; 1. Seven one-part fractures were treated conservatively and showed satisfactory results in all. 2. Sixteen two-part fractures were treated conservatively except tow old cases and showed satisfactory results except one. 3. Seven three-part fractures were tried to be reduced by closed means but unacceptable five cases were treated by open reduction. They showed satisfactory results except one. 4. Four four-part fractures were treated by open reduction in two, by prosthesis in headsplitting and severely comminuted cases. They showed satisfactory results except one.

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A Clinical Study of Proximal Humeral Fractures: Kwon Jae Roh; J Korean Soc Fract 1989;2(1):9-17. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.9

Abstract PDF: Most proximal humeral fractures respond satisfactory to simple conservative treatment. It is only the occasional displaced fracture or fracture-dislocation that demands special treatment and judgment. We analyzed the 32 cases of proximal humeral fractures treated at the Department of Orthopaedic Surgery of Ewah University Hospital during the period from January, 1984 to December, 1987. The result was as follows; 1. The age distribution was even but there was some prevalance at 7th decades of female. 2. The most common cause of fractures was traffic accident. 3. According to the Neers classification, group I was in 15 cases(46.9%) and group II was in 11 cases(34.4%) 4. According to the Neers criteria for evaluation of the result was satisfactory in cases of conservative treatment. In cases of group III fractures treated with open reduction, the result after 6 months from injury was worse due to the prolonged preperative immobiliz aton but after one year, all were satisfactory. 5. the complication was nonunion in 1 case, malunion in 1 case and joint stiffness in 3 cases.

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A Clinical Study of Proximal Humeral Fractures and Fracture-Dislocations: Chong Il Yoo, Jeung Tak Suh, Kuen Tak Suh, Wan Joo Hong; J Korean Soc Fract 1989;2(1):18-28. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.18

Abstract PDF: A study was made of 39 cases of proximal humeral fractures and fracuture dislocations in adults who had been hospitalized and treated at the Department of Orthopedic Surgery, Pusan National University Hospital, from March 1983 to August 1988. Analysis was based on the age, sex distribution, causes, classification of fracture, associated injuries, treatments, results of treatment and complications. The results obtained were as follows; 1. the age of the patients ranged from 15 to 82 years with a mean of 46.8 years the highest incidence was in the fifth decades and male were affected more frequently than female. 2. The main cause of the fractures was traffic accident 20(51.3%) and the others were slip-down 10(25.6%), fall from a height 8(20.5%) and direct blow 1(2.6%) 3. According to Neers classification, 2-part fracture 28(71.8%) was the most common type and followed by 1-part fracture, head-splitting or head-fragmented fracture, 3-part fracture and 4-part fracture in the order of frequency. 4. Among the 39 cases, 25 cases(64.1%) were treated conservatively an 14 cases(35.9%) operatively. 5. The most common complication was joint stiffness. 6. The results of the cases were rated by the Neers numerical system. Of 39, 14 cases (35.9%) were excellent, 21 cases(53.8%) satisfactory, and 4 cases(10.3%) poor. Most of the poor results were the cases that were immobilized for a long time because of severe comminution, associated injury or poor general condition. It was thought important to allow early motion of joint to obtain a good functional result.

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Clinical Study on treatment of Mid-clavicular Non-union with Semitubular Plating and Bone Graft: Ik Dong Kim, Poong Taek Kim, Byung Chul Park, Young Wook Choi, Sang Bock Lee; J Korean Soc Fract 1989;2(1):29-33. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.29

Abstract PDF: We reviesed 4 patients with clavicular non-union who were treated by internal fixation with semitubular plate and iliac bone graft from Jan. 1984. to Oct. 1988. All 4 Patients had fractures at middle 1/3 of the clavicle. We have defined a non-united clavicular fracture as one that has not demonstrated healing at post-trauma 4 months. All 4 patients had symptoms due to non-union. All 4 patients were treated with semitubular plating and bone graft and achieved good union by average 9.8 weeks post-operatively and symptoms were disappeared. We might conclude that symptomataic non-union of the mid-clavicle could be treated with operative method and rigid internal fixation with semitubular plating and bone graft will be excellent method.

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Popliteal Artery Injuries Associated with Trauma Around the Knee: Myung Chul Yoo, Chung Soo Han, Kye Lim Lee, Moon Hwan Lee; J Korean Soc Fract 1989;2(1):34-41. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.34

Abstract PDF: Between Jan. 1980 and Dec. 1987, 47 cases in 44 patients with politeal artery injury associated with trauma around the knee joint were managed at Department of Orthopaedic Surgery, KMC. Authors analysed the diagonstic methods, operations with its results and prognostic factors, and the results were as follows: 1. The incidence was 3%(44/1473) from Jan. 1980 to Dec. 1987 2. 14 cases of 19 cases, who underwent the vascular surgery, were survived(74%) and further amputations were applied to failed 5 cases. 3. Doppler flowmeter was considered as very useful diagnostic tool because of simplicity, safety, and accuracy, therefore angiography was not necessary in all cases. 4. The length of ischemic time and the amount of associated soft tissue damage were considered as important prognostic factors. 5. Vein graft was considered as good operative technique, but thrombectomy alone was not enough method for politeal artery injury. 6. ligament repair was not always necessary in treatment of popliteal artery injury associated dislocation of knee. 7. Prophylatic decompression was necessary in all cases after vascular surqery and fibulectomy fasciotomy was considered as outstanding technique.

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Conservative Treatment of Ligamentous Injury of Knee in Head Trauma Patients: Joon Young Kim, Young An Choi, Young Chul Choi, Bo Seok Kong; J Korean Soc Fract 1989;2(1):42-48. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.42

Abstract PDF: Operative treatment has been used in unstable ligamentous imjury of knee joint. We experienced three cases of ligamentous injury of knee that was accompained with head trauma and other organ injury. Despite of sugical candidate, we did only conservative treatment due to poor general condition and difficulty of anesthesia. The result was realtively better than we expected. We reported these cases.

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A Clinical Study on the Tibial Condylar Fracture: Jae Young Cheon, Hak Yoon Kim, Sang Won Park, Hong Kun Lee; J Korean Soc Fract 1989;2(1):49-59. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.49

Abstract PDF: The tibial condylar fracture involving articular surface of the proximal tibia is common in traffic accidents. In the tibial condylar fracture, the injuries of soft tissue such as ligaments and menisci are frequently accompanied and the weight bearing surface are involved, too. So significant disability of the knee joint often results from the tibial condylar fracture. The fifty cases of the tibial condylar fracture treated at the orthopaedic department of Korea Univerity Hospital from January, 1982 to December, 1986 have been followed for 1 to 3 year The results obtained were sa follows: 1. among the fifty patients, the ratio of sex was 2.1:1 as male predoninant, and the prevalent age distributions were in the 3rd and 6th decade. 2. The most common cause of injury was traffic accident in 32 cases(64%). Second in frequency were falls in 7 cases(14%). 3. The laterality of injury was left in 29 cases(58%), right in 21 cases(42%). The locations of injury were lateral condyle in 34 cases(64%), medial condyle in eight cases(16%) and bicondyles in eight cases(16%). 4. According to the Hohls classification, the most common was type III in nineteen cases (38%). 5. The most common associated injuries were ipsilateral fibular fracture in 15 cases(30%) and ligament injury in 15 cases(30%) especially frequnt in type II and III. Among the ligament injuries, the medial collateral ligament tearing was eight cases(53%) as predominant. 6. Fifteen cases(30%) were treated by cast immobilization, two cases(4%) by skeletaltraction. Thirty-three cases(66%) were treated by operative method. 7. Thirty-seven cases(74%) revealed the rating of acceptable group according to Robertscriteria.

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Analysis of Results of External Fixation in the Tibial Shaft Fracture: Sang Soo Kim, Dae Moo Shim, Min Jong Lee, Yong Suk Shim; J Korean Soc Fract 1989;2(1):60-70. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.60

Abstract PDF: The fracture of the tibia shaft is difficult to treat because of high tendency of open fracture and complications such as osteomyelitis, soft tissue defect, delayed union and non-union. To evaluate that external fixation alone can be a final solution on treatment of the tibial fractures of the change of treament mode after external fixation, We studied 50 cases of fractures of the tibia shaft which were treated with external fixation between January 198 4 and June 1988. The results were as follows. 1. Among causes of injury, the traffic accidents were the most common. 2. Among the type of fractures, comminuted fractures were 26 cases(41%) and open fractures 47 cases(92%). By classification of Gustilo and Anderson most cases were open type III(60%). 3. The 4 cases(8%) were treated with external fixation alone and the time to union ave-raged 5.2 months. 4. For the 15 cases(30%), external fixators were removed, then applied cast and the time to union averaged 5.3 months. The 12 cases(24%) were treated with bone grafting and cast after removal of external fixator and the time to union averaged 6.8 months. 5. Among the secondary additional operatioin required after external fixation, bone operations were 34 cases, soft tissue operations 13 cases and comosite operations 3 cases. The bone 5 cases(39%) out of 13 cases of soft tissue operation. 6. The duration of external fixation was 22 days to 248 days, mean 101.6 days. 7. A retrospective evaluation of 50 cases treated external fixation revealed that external fixation was simple, safe and dffective method in the initial stage of fracture treatment but could not be a final Solution.

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Clinical Study of Tibial Shaft Fractures: Soo Kil Kim, Keung Bae Rhee, Sae Jung Oh, Kye Seok Yang; J Korean Soc Fract 1989;2(1):71-81. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.71

Abstract PDF: The tibia has poor soft tissue coverage and poor blood supply in anatomy, but it is the most commonly fractured bone of all the long bones, therefore tibial fractures are much controversy concerning the method of treatment because of frequent complications. The 63 adult patients(67 fractures) with fractures of the shaft of the tibia were treated at the Department of Orthopaedic Surgery, Choong Ang Gil Hospital during the 4 years from Jan. 1984 to Dec. 1987. by the group, the 24 cases(25 fractures) were treated with conservative methods, the 21 cases(23 fractures) were treated with self compression plate & screw fixation and the 18 cases(19 fractures) were treated with Ender nailing. The results obtained were as follows; 1. The average time of bone union was the 17.7 weeks.;the 14.1 weeks in the Ender nailing, the 17.5 weeks in conservative treatment methods, the 21.2 weeks in the compression plate & screws fixation. While hte rate of bone union was the 91.0%.;the 96.0% in conservative treatment method, the 86.9% in the compression plate & srews fixation, the 89.5 in the Ender nailing. 2. In the average time of bone union among the various levels of fractures, middle one third(16.7 weeks) healed more rapidly than the proximal one third(18.4 weeks) and distal one third(18.3 weeks). 3. As to the types and natures of fracture, average time of bone union was longer in open fractures(19.9 weeks) and comminuted fractures(20.6 weeks) than closed fractures(17.0 weeks) and simple fractures(15.5 weeks). 4. By the modified Ellis classification of tibial fractures, average time of bone union was the 16.2 weeks in minor severity, the 18.3 weeks in moderate severity, and the 20.1 weeks in major severity. Therefore the higher the severity, the longer the average time of bone union and the higher the complication. 5. In an intact fibula, tibial fractures healed more rapidly and the complications ocurred in the concomitant fibular fractures. 6. The complication of the tibial fractures were 28 cases, and most important complication were impairment of joint function, malunion and common peroneal nerve injury in conservative method, nonunion and infection in the compression plate and screws fixation, and delayed union in the Ender nailing.

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Treatment of Intractable Nonunion of the Long Bone with the Invasive Electrical Stimulation: Myung Chul Yoo, Dae Kyung Bae, Yong Girl Rhee, Deok Ho Ahn, Goong Hee Cho; J Korean Soc Fract 1989;2(1):82-90. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.82

Abstract PDF: Nonunion of the long bone is one of the difficult porbloems in orthopaedic surgery. We studied the effect of the electrical stimulation. From July, 1980 to August, 1988, 30 nonunions of the long bones were treated with the invasive type electrical stimulator. The range of follow-up period was from 3 months to 7 years(average, 25 months). The results were as foloowings: 1. The good bony union has occurred in 26 cases(86.7%). 2. The previous infection was in 11 cases and its union rate was 100% 3. The average duration of bone union in over-all cases was 5. months and in previous infeted cases, was 5.5 months. 4. The average duration of bone union in open fracture was 5.5 months and in closed fracture, was 5 months. 5. The invasive electrical stimulation was a good technique to treat the intractable nonunion as the result of long bone fracture.

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Cotrel-Dubousset Pedicular Screw in the Treatment of Unstable Dorsolumbar fracture: comparison with Harrignton SSI: Se Il Suk, Byung Joon Shin, Choon Seong Lee, Myung Chul Lee; J Korean Soc Fract 1989;2(1):91-100. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.91

Abstract PDF: Twenty four patients with unstable dorsolumbar spine fractures were treated with C-D pedicular screw from March 1987 to Dec. 1988 in Seoul National university Hospital and 19 patients were followed-up more than 4 months, average 7.9 months. The results of these 1 9 patients were compared with those treated with Harrington SSI from Feb. 1985 to March 1987 and following conclusions are obtained. 1. The average fixation with C-D pedicular screw was 2 segments. Even the short segments fixation, C-D pedicular screw gave better correction and stability of fractures as compared with Harrington SSI. 2. Anatomical reduction with restoration of normal spinal sagital curvature was possible using C-D pedicular screw. 3. C-D pedicular screw permitted early ambulation with minumum immobilization and slight loss of correction.

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The Calcaneal Trabecular Pattern as an Index of Osteoporosis and the Role of Osteoporosis in Ankle Joint Fractures: Ju O Kim, Hong Jun Han, Young Suk Kim, Sang Soo Kim; J Korean Soc Fract 1989;2(1):101-106. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.101

Abstract PDF: To provide another effective method of surveying osteoporosis, authors introduced the calcaneal trabecular pattern as an index of osteoporosis. We reviewed the roentgenograms of 144 patients with ankle or hip joint fracture. The trabecular pattern in the cacaneum(expressed as the calcaneal index) and that in the upper end of the femur(Singhs index) were well correlated, and both indices have a inverse correlation with age. The calcaneal index did not reveal any correlation with the type of ankle joint fractures, but it was estimated to provide useful information for ankle joint fractures in selection of treatment mode including fixation method and prediction of the prognosis.

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Treatment of Fracture and/or Dislocation of the Tarsometatarsal Joint, using AO Screws: Two cases Report: Yung Khee Chung, Jung Han Yoo, Baek Yong Song; J Korean Soc Fract 1989;2(1):107-112. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.107

Abstract PDF: Fracture and/or dislocations of the tarsometatarsal joint are rare yet carry such a high potential for chronic disability. These injuries have been frequently followed by poor end results by the failure of timely diagnosis, incomplete reduction, or redislocation after inadequate treatment. These disappointing results have made us to give an aggressive approach for thses injuries consisting of open reduction and temporary rigid internal fixation using AO screws.

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