Journal of Musculoskeletal Trauma

Treatment of Comminuted Distal Radius Fracutures with External Skeletal Fixation: Hee Joong Kim, Mood Sang Chung; J Korean Soc Fract 1990;3(1):3-9. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.3

Abstract PDF: Thirteen cases of comminuted distal radius fractures were treated with external skeletal fixation from January 1985 to June 1989. Those cases were reviewed with special respect to the loss of reduction during immobilization. All fractures were healed with no remarkable complications and with minimal loss of redunction(average 1.1 mm loss in radial length). We think that the results suggest that external skeletal fixation is a simple and reliable method to prevent the recollapse of the reduced comminuted distal radius fractures.

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Treatment of Old Distal Radioulnar Dislocation: A Preliminary Report: Kwon Ick Ha, Sung Ho Hahn, Min Young Chung, Bo Kyu Yung, Seung Rim Lee; J Korean Soc Fract 1990;3(1):10-15. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.10

Abstract PDF: Dislocations of the distal radioulnar joint without fracture are more common than would be expected from the literature and most of these injuries are not diagnosed when seen initially. Several chronic problems may befall the distal radioulnar joint-loss of forearm rotation, chronic pain and arthritis, and a great many surgical procedures have been devised to relieve them. Six patients were treated with resection of ulnar head (Darrach Operation)in 3 cases, ligamentous stabilization(Hui and Linscheid Operation)in 3 cases, and we found more satisfactory results in the latter.

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A Clinical Observation for the Fracture of Proximal Phalanx of the Great Toe(So Called Safety shoes-Fracture): Bong Yeol Lim, Hee Young Cheong, Dong Bai Shin, Young Hwa Ahn; J Korean Soc Fract 1990;3(1):16-21. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.16

Abstract PDF: The heavy labours have been using the safety shoes widespreadly in recent years and the incidence of the toe injuries have been significantly reduced largely due to the increased effectiveness of the steel toe cap in the safety shoes. When heavy material fall over the foot dorsum wearing safety shoes, toe cap was rotated backward and tapped the proximal phalanx of the great toe, and so the displaced fracture of the proximal phalanx occurred largely by distraction. We have reviewed 67 cases among 80 cases, which resulted in many complication such as delayed union, nonunion, and malunion etc... So we suggest the method of treatment and the modification of toe cap in safety shoes.

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Open reduction and Internal Fixation of Calcaneus Fractures by Staples and Screws: Myung Ku Kim, Soo Ill Kang, Kang Hyun Lee, Chan Soo Park, Jae Woo Ryuh; J Korean Soc Fract 1990;3(1):22-33. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.22

Abstract PDF: Clacaneal fractures involving subtalar joint can be associated with prolonged and severe disability. Many different methods have been tried for the treatment in order to search for better results. From October 1987 to October 1989, five cases of calcaneal fractures involving subtalar joint were treated by open reduction and internal fixation, and the results were as follows: 1. The causes of fractures of the calcaneus were fall from a height in all five cases. 2. The medial approach was used usually and, when the anatomical reduction was impossible by medial approach only, the lateral approach was combined. 3. The average Bohlers angle was 4.6 before reduction and 24.6 after open reduction. The Bohlers angle was increased to average 20 4. Satisfactory results were botained in all but one, who was not followed up for over 1 year. 5. The open reduction and internal fixation through the medial approach was valuable treatment method of the intraarticular calcaeal fracture.

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Operative Treatment of Ankle Fractures: Sang Ho Ha, Sang Hong Lee, Dong Min Shin, Young Ju Chung, Keun Ho Park; J Korean Soc Fract 1990;3(1):34-39. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.34

Abstract PDF: The ankle is the most congrous joint in the lower extremity, bearing up to five times the body weight. Many clinical studies of ankle fractures have proven that good results depend upon an antomic reduction of the fracture. There remains, however, controversy as to the best method of obtaining this goal. More recently there has been interest in anatomic reduction & authors analysed 58 cases of ankle fractures treated operatively at Chosun University Hospital from january 1981 to December 1988. 1. The result of treatment was good or exellent in 49 cases(84.5%) of clinical results in 51 cases(87.9%) of radiological result, according to the criteria of Meyer. 2. Operative treatment affords the most predictable way to carry out an absolutely anatomic reduction of fractures & a low complication rate. 3. Most of the unsatisfactory group were severe displacement, commivuted fracture due to high violence.

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Yvascular Injuries Associated with Fracture and Dislocastion of the Knee: Sung Joon Kim, Il Yong Choi, Jae Lim Cho, Soo Tai Chung; J Korean Soc Fract 1990;3(1):40-45. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.40

Abstract PDF: Injury of the popliteal artery associated with fracture and dislocastion of the knee is uncommon, But, when the fracture and dislocation of the knee occurs, it frequently associated with vascular injuries, and vascular injury can be a very serious one because of ischemia that necessitates amputation. Sixteen vascular injuries combined by fractures and dislocation of the knee between March, 1985 and February, 1989 have been reviewed and the results are as follows. 1. There were 11 cases of proximal tibial fracture, 2 cases of distal femoral fracture and 3 cases of knee dislocation. 2. The site of injury which is proximal to insertion of the soleus muscle were 15 cases. 3. There were contusion in 11 cases, rupture in 4 cases and laceration in 1 case. 4. One of the 2 cases(50%) that were treated within 12 hours after injury survived, while two to 10 cases(20%) that were treated after 24 hours following injury survived. 5. The open reduction and internal fixation was done in 5 cases, the skeletal traction in 1 case, and cast immobilization in 10 cases. 6. Finally, the B-K amputation was done in 4 cases, A-K amputation in 6 cases, knee disarticulation in 2 cases.

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Tension band wiring and Modified tension band wiring in the Operative Treatment of Patella Fracture: Sang Ho Ha, Sang Hong Lee, Dong Min Shin, Young Bae Pyo; J Korean Soc Fract 1990;3(1):46-52. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.46

Abstract PDF: The authors report a clinical experience of 25 patients having patellar fracture who were treated with tension band wiring or modified tension band wiring from January 1984 to December 1988, at the Department of Orthopedic Surgery, Cho-Sun University Hospital. The results were as follows. 1. Out of 25 cases were treated by modified tension band wiring and remaining 5 cases were treated by tension band wiring. 2. The mean fracture healing period was 5.8 weeks in cases of modified tension band wiring and 6.8 weeks in tension band wiring. 3. Fixation by tesion band priciple has given acceptable results in comminuted fractures and transverse fractures both.

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Operative Treatment on Fracture of Distal Third of Femoral Shaft: Ki Hong Choi, Chung Nam Kang, Jin Man Wang, Kwon Jae Roh, Kang Deuk Koh; J Korean Soc Fract 1990;3(1):53-61. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.53

Abstract PDF: The fracture of distal third of femoral shaft difficult to choose method of treatment and timing of wt. bearing because of increrment of communited fracture, anatomic characteristics and complication such as metal faulure, shortening and angulation. After analysis of 52 cases of fracture of distal third femoral shaft treated operatively in the Department of Orthopaedic Surgery, Ewha Womans University Hospital during 5.5yrs from. Jan. 1984 to June 1989 except pathologic fracture, the following results were obtained. 1. By Reis and Hirschberg classification, type I, II and III fracture wore seen in 16 patients (31%), 12 patients(23%) and 24 patients(46%) respectively. 2. The rate of complication was 29%(15 cases) with 46%(7 cases) of the complication related to the nature of the implant. 3. Among the 7 cases of metal faulure, four cases was caused by early wt. bearing and uncarefulness of patients in type III fracture.

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Supracondylar Fracture of the Femur Treated by Ender Nail: Yong Ju Kim, Suk Woong Yoon, Bum Goo Lee, Sung Il Shin; J Korean Soc Fract 1990;3(1):62-70. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.62

Abstract PDF: The supracondylar fracture of the femur is very difficult to treat regardless of whether non-surgical of surgical methods are selected. Recent advance of device for internal fixation such as AO angle plate and Judet plate improved the result of the operative treatment. But the operative technizue is difficult and in elderly patient rigid fixation can not be obtained due to osteoporsis and comminution of the fracture. So intramedullary nailing such as Zickel supracondylar element were treated with the Ender anil with distal screw in Red Cross Hospital from September 1987 to December 1988. Ender nailing appear to be a promising treatment of the supracondylar fracture of the femur, especially elderly patient, because the operaive technique is easy, blood loss is minimal and fixation is adequate to allow early exercise of the knee.

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Pitfalls and Complications in the Use of Interlocking Intramedullary Nailing for the Femoral Fractures: Sung Kwan Hwang, Jong Seon Yoon; J Korean Soc Fract 1990;3(1):71-78. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.71

Abstract PDF: The introduction of percutaneously inserted transfixing interlocking screws increase the stabization potential of the intramedullary nail. The use of interlocking system extend the indications for closed intramedullary nailing. However, the added technical complexity, related with the locking screws, introduces a new errors and pitfalls. Among 32 patients who had closed interlocking I.M. nailing for 32 femoral fractures, 7 patients showed intra-or-postoperative complications. Six patients had intraoperative complication : four patients(new fracture near the fracture site) ; one patient(femur neck fracture), and one patient(failure of distal locking). Two patients experienced postoperative complication :one deep infection and another, proximal migration of nail. All 7 patients had pitfalls and complications related with operative techniques for interlocking I.M nailing. After careful analysis of the pitfalls and complications, following suggestions were considered. 1. To reduce the new fracture near the fracture site, insert the nail through an entry portal of trochanteric fossa centered over the axis of the femoral medullary canal. 3. Avoid repeated awling and placing the entry portal too far medially, which can result in iatorogenic fracture of the femur neck. 4. After distal screw insertion, the correct position of the screw in the screw hole should be confirmed on AP and lateral view. 5. Adequate preoperative and postoperative use of antibiotics were seriously considered in case of open fractures.

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Compression Fixation Using a Condyla Plate for Subtrochanteric Fractures: Ik Dong Kim, Poong Taek Kim, Byung Chul Park, Young Wook Choi, Young Gu Lyu, Young Duk Jo; J Korean Soc Fract 1990;3(1):79-87. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.79

Abstract PDF: No abstract available.

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Ipsilateral Fractures of the Hip Joint and Femoral Shaft: Sang Won Park, Soon Hyuck Lee, Jung Ho Park, Hong Kun Lee; J Korean Soc Fract 1990;3(1):88-95. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.88

Abstract PDF: Ipsilateral fractures of the hip joint and femoral shaft, which generally occur by severe trauma, are frequently associated with multiple fractures and other injuries. Initially overlocked femur neck fracture may lead unpredicted complications, and femoral shaft fractures, usually comminuted, could be complicated with malunion, infection, limb shortening and limited ROM of knee joing. It is difficult to determine the type of fixation device and priority of fracture in treatment according to the variation of the site and pattern of fracture. Eleven pateints with ipsilateral fractures of hip joint and femoral shaft were treated at Korea university Haehwa hospital from Jan. 1984 to Oct. 1988. Among them, nine pateints were followed up more than twelve months. There were eight male and one female. The ages ranged from twenty-two to fifty-three years, the average being 37.6 years. Seven cases caused by traffic accident and fall down trauma in two cases. 1. The levels of hip joint fractures were 6 femoral neck, 1 basal neck-intertrochanteric, and 2 intertrochanteric region. 2. The levels of femoral shaft fractures were 3 proximal one-third and 6 middle one-third. 3. Eight fractures of the femoral shaft except one were comminuted or segmented. 4. Six patients has other fractures or organ injuries. 5. All nine pateints had operation. In six patients with femoral neck and shaft fractures, the femoral shaft fractures were first reduced and fixed, and femoral neck fractures were stabilized later, In three pateints with femoral shaft and basal neck or intertrochanteric fractures, both fractures reduced and fixed simultaneously. 6. Several devices were used according to the site and patterns of fractures. 7. There were complications in three cases:one coxa vara, limb shortening, and infection, knee joint sitffness, and avascular necrosis in one case.

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Problems in the use of Compression Hip Screw in the Treatment of Hip Fractures: Myung Sang Moon, In Ju Lee, Nam Yong Choi, Dong Soo Choi; J Korean Soc Fract 1990;3(1):96-102. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.96

Abstract PDF: Though compression hip screw system has many advantages over the other fixation devices in the treatment of hip fractures, surgeons were frequently encountered by the intraoperative and postoperative complications leading to poor result. In reviewing out series of hip fractures treated with this device, between January 1983 and December 1988, serious complications developed in 5 cases, Additionally, three cases who were referred to our hospital during the same period were included in this study. The authors analyzed these 8cases, and found that the complications could have been prevented in using compression hip screw system for the treatment of hip fractures. The purpose of this paper is to re-emphasize the importance of 1) strict application of indication, 2) familiarity with surgical technique and handing instruments, 3) radiologic examination during surgery, 4) good postoperative care.

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The Supracondylar Osteotomy for the Angular Dformity followed by a Fracture Around the Elbow: Soo Ill Kang, Kang Hyung Lee, Chan Su Park, Myung Ku Kim, Myung Seon Kim; J Korean Soc Fract 1990;3(1):103-109. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.103

Abstract PDF: The fracture around the elbow is frequent in the children. The cubitus varus and cubitus valgus deformities are the common late complications of the elbow fracture. The reason of correction for these problem is not the elbow fuction, but the cosmetic problem of tardy ulnar nerve palsy. We performed five supracondylar osteotomies that are modification of Milch osteotomy from Mar, 1988 to Jan, 1989 of which four cases were cubitus varus and one case was cubitus valgus at In Chon Christian Hospital. The results were as follows; 1. the cubitus varus deformities were four cases and the cubitus balus deformity was one. 2. The injuries were supracondylar fractures of the humerus for the cubitus varus and lateral condyle fracture of the humerus for the cubitus valgus. 3. The result was excellent by modified Milch osteotomy with derotation in the case of rotational deformity. 4. In adult, the bone healing was promoted by deepening the triangular shaped notch in the Milch osteotomy by widening the contact surface.

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Inferior Subluxation of the Humeral Head After Trauma to the Shoulder: In Kim, Seung Koo Rhee, Yang Kim, Kee Haeng Lee; J Korean Soc Fract 1990;3(1):110-118. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.110

Abstract PDF: Since 1980, we have treated twelve patients who had antero-inferior subluxation of humeral head after acute trauma to the shoulder or to the proximal part of the humerus, of both. the diagnosis of subluxation was based on clinical and radiographic examination. To evaluate the rdiological features, and also to clarify the mechanism as well as the treatment for this subluxation, we have been analysed and the following results were obtained. 1. The careful radiographic interpretation, especially standing neutral shoulder AP and lateral films, was quite important to find the hidden soft tissue injuries which it could be caused the subluxation of humeral head after acute trauma to the shoulder. 2. The incidences of subluxation was 24.5%, 12 cases out of the total 49 cases. 3. The subluxation was frequently frequently developed in adduction type of fracture, avulsion fracture of the greater tuberosity and in women with over the 40 of their ages. 4. Intial subluxation of humeral head after trauma might be caused by the rupture of capsule of rotator cuff, and late subluxation may be developed by the loss of damaged muscle tone or direct muscle damage due to intial or sugical trauma. 5. Except the results of the nerve damage after trauma or surgery, the subluxation could be recovered by average 22 day after the first recognition of subluxation with hte vigorous isometric biceps setting exercise immediately after trauma. 6. Isometric biceps seetting exercise was the most important basic step for the every injuries aroud the shoulder joint.

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Treatment of the Complete Separation of Acromioclavicular Joint by Coracoclavicular Wiring: Chang Uk Choi, Yon Il Kim, Young Ho Kim, Min Ku Lee; J Korean Soc Fract 1990;3(1):119-126. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.119

Abstract PDF: Complete dislocation of the acromioclavicular joint is not a common jnjury. But there are many methods of treating for complete separation of acromioclavicular joint. From February, 1988 to March, 1989 at Soonshunyang university hospital, 14 pateints with complete acromioclavicular separation(Allmans type3) had been treated sugically by coraco-clavicular wiring. The results are follows. 1) The most common cause of injury is fraffic accident. 2) Ages in peak incidence are 3rd and 4th decades. 3) The shoulder pain and the limitation of external rotation, which are well known problem of transacromioclavicular fixation cant be found and the functional result were excellent in 12 cases good in 1 case and fair 1 case 4) We consider that over reduction and anatomical reduction of acromioclavicular joint may be prevent complications and obtain excellent results. 5) We can Prevent the anterior displacement of clvicle from the acromion and bony erosion by passing the wire loop through the drill hole on the center of clavicle which direction is from superior to inferior portion.

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