Journal of Musculoskeletal Trauma

Treatment of Wide Gap Non-Unions in Lower Extremities: Doohoon Sun, Byeong Seop Park, Taehyeon Jeon, Seung Koo Rhee; J Korean Fract Soc 2017;30(1):1-8. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.1

Abstract PDF: PURPOSE
To analyze the end results of the treatment for patients with wide gap non-unions of the long bones in the lower extremities.
MATERIALS AND METHODS
A total of 62 cases of wide gap unions, with a mean age of 38 years, were included for analysis. Study cohort included six children under the age of seven years. The average size of established bone defect was 7 cm (4-23 cm). Bone defects under 7 cm were treated with plating and various bone grafts, and those over 7 cm were managed with vascularized fibular graft (VFG), distraction-osteogenesis, tibial strut, plating and etc. Two boys with a defect of the whole tibia but with an intact fibula were treated with tibialization of intact fibula and with rotation-plasty of the leg. Their end results were evaluated by the time of bony union in accordance with the treatment of defect size of the long bone as well as their age.
RESULTS
Bony unions were obtained for an average period of at least 27 months. Fifty-one cases showed an average leg-length discrepancy of 2.8 cm, and 11 cases showed no leg-length discrepancy. The VFG, distraction-osteogenesis, and tibial cortical-strut graft and plating were the most effective methods for non-unions of wide, long bone defections (>7 cm). The prognosis was more favorable in children, muscular femur, and in cases with tibial defect but intact fÃ bula.
CONCLUSION
Various bone union techniques should be considered carefully, considering the ages of patients and the size of bone defects. Due to severe physical and mental disabilities of patients during the long-treatment period, specialized orthopedic doctors for trauma and mental care were necessary.

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The Cause of Primary Reduction Failure in Hip Dislocation with or without Hip Fracture: Hee Gon Park, Yong Eun Shin, Sung Hyun Kim; J Korean Fract Soc 2017;30(1):9-15. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.9

PURPOSE
A rapid and accurate reduction is important for hip dislocated patients to avoid various potential complications, including avascular necrosis of the femoral head. We analyzed hip dislocation cases, ones that particularly failed during the primary reduction trial.
MATERIALS AND METHODS
Eighty-seven patients with hip dislocation, who visited the emergency department between January 2007 and September 2015, were retrospectively analyzed. Of them, 68 patients were successfully treated in the first closed reduction trial, and the remaining 19 patients were unsuccessful. Of the 19 unsuccessful first trial, 12 patients were successfully treated in the second closed reduction; however, in the remaining 7 patients, open reduction was performed in the operation room with general anesthesia. Every closed reduction was practiced by at least 2 orthopedic doctors, and open reduction was performed by a single senior author.
RESULTS
The rate of first reduction failure was higher, with statistical significance, in patients aged under 50 years, male gender, and those with combined around hip fractures, including femoral head and acetabular fracture (p<0.05). In particular, the presence of impacted fracture fragment in the hip joint and large size of the impacted fracture fragment was highly related to the failure of second closed reduction trial requiring open reduction. Conversely, the method of reduction, Thompson-Epstein classification, Pipkin classification were not related to the failure of closed reduction statistically (p>0.05).
CONCLUSION
To evaluate the patients with hip dislocation, realizing the type of dislocation, presence of accompanied fracture, location and size of fracture fragment, age, as well as gender of patients is important. If the fracture fragment is impacted in the hip joint and the size of the fragment is large, then the operative treatment is considered, rather than the repetitive trial of closed reduction by constraint.

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Traumatic obturator dislocation of the hip joint: About 2 cases and review of the literature
Z.F. Zengui, O. El Adaoui, M. Fargouch, O. Adnane, Y. El Andaloussi, M. Fadili
International Journal of Surgery Case Reports.2022; 93: 106983. CrossRef

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A Comparison of Results between AO Hook Plate and TightRope for Acute Acromioclavicular Joint Dislocation: Yong Gun Kim, Ho Jae Lee, Dong Won Kim, Jinmyoung Dan; J Korean Fract Soc 2017;30(1):16-23. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.16

Abstract PDF

PURPOSE
The purpose of our study is to compare the radiographic and clinical outcomes with respect to acromioclavicular (AC) joint dislocation depending on the surgical method: Hook plate (HP) versus TightRope (TR).
MATERIALS AND METHODS
Between May 2009 and May 2012, 51 patients with Rockwood type III-V lesions received clinical and radiographic follow-up. Patients were divided into two groups according to the surgical methods (HP: n=32; TR: n=19). Radiological follow-up included comparative coracoclavicular distance (CCD) measurements as a percentage of the uninjured shoulder. For clinical follow-up, a standardized functional shoulder assessment with the Constant score, University of California at Los Angeles (UCLA) score, and Korea shoulder score (KSS) were carried out.
RESULTS
Comparing the functional results, no differences were observed between the two groups (Constant score: HP, 78.5; TP, 81.4; UCLA score: HP, 29.2; TP, 29.9; KSS: HP, 79.2; TP, 80.7). Time to restoration of the range of motion (ROM) above shoulder level was longer in the HP group than in the TR group. However, the ROM at 1 year postoperation and final follow-up revealed similar results between the two groups. The AC joints were well reduced in both groups, the CCD increased to 44.7% in the HP group and to 76.5% in the TR group at the final follow-up; however, no one was significantly superior to the others. Furthermore, there were 8 cases (25.0%) and 5 cases (26.3%) of AC joint arthritis in the HP group and TR group, respectively. However, the observed AC joint arthritis has a poor correlation between clinical symptom and radiological results in both groups.
CONCLUSION
Both HP and TR fixation could be a recommendable treatment option in acute unstable AC joint dislocation. Both groups showed excellent radiologic and functional results at the final visit. Moreover, there was no significant difference in statistics, except for the time to restoration of ROM above shoulder level.

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Arthroscopic Treatment of Acromioclavicular Joint Dislocations
Du-Han Kim, Chul-Hyun Cho
Journal of the Korean Orthopaedic Association.2023; 58(5): 384. CrossRef
Combination of Clavicular Hook Plate with Coracoacromial Ligament Transposition in Treatment of Acromioclavicular Joint Dislocation
Aikebaier Tuxun, Ajimu Keremu, Pazila Aila, Maimaitiaili Abulikemu, Zengru Xie, Palati Ababokeli
Orthopaedic Surgery.2022; 14(3): 613. CrossRef

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Decompressive Sacral Foraminotomy for Nerve Root Injury during Conservative Treatment of Sacral Fracture: A Case Report: Jung Gil Lee, Jae Hyuk Shin, Kwon Kim, Sang Min Choi, Moon Soo Park, Ho Guen Chang; J Korean Fract Soc 2017;30(1):24-28. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.24

Abstract PDF: A 35-year-old woman visited the emergency department for a pedestrian traffic accident. Severe tenderness was noted at the posterior sacrum area, without open wound or initial neurologic deficit. Fracture of the left sacral ala extended to the S1 foramen, anterior acetabulum, and pubic ramus. Two weeks after the injury, she presented aggravating radiculopathy with the weakness of the left great toe plantar flexion. The S1 nerve root was compressed by the fracture fragments in the left S1 foramen. Decompressive S1 foraminotomy was performed. The postoperative follow-up computed tomography scan showed successful decompression of the encroachment, and the patient recovered well from the radiculopathy with motor weakness. She was able to resume her daily routine activity. We suggest that early decompressive sacral foraminotomy could be a useful additional procedure in selective sacral zone II fractures that are accompanied by radiculopathy with a motor deficit.

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Pediatric Cartilaginous Tibia Eminence Fracture Overlooked on Plain Radiograph: A Report of Two Cases: Seong Eun Byun, Yunseong Choi, Wonchul Choi; J Korean Fract Soc 2017;30(1):29-34. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.29

Abstract PDF: In children with open physis, avulsion fracture of the tibia eminence, as an anterior cruciate ligament (ACL) injury, is more commonly observed than an ACL rupture. Pure cartilaginous avulsions of the ACL tibia insertion seldom occurs. In such case, cartilaginous lesion is frequently overlooked or misdiagnosed on plain radiograph and may result in a less favorable treatment outcome. We report two cases of cartilaginous tibia eminence fractures of the children that were initially overlooked from plain radiographs, and then diagnosed by magnetic resonance imaging, which was ultimately treated by arthroscopyassisted headless compression screw fixation.

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Arthroscopic Assisted Bioabsorbable Screw Fixation for Radial Head Fractures: A Report of Two Cases: Bong Ju Park, Ki Yong An, Yong Suk Choi; J Korean Fract Soc 2017;30(1):35-39. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.35

Abstract PDF

Most radial head fractures occur as the result of low-energy mechanisms, such as a trip or fall on the outstretched hand. These fractures typically occur when an axial load is applied to the forearm, causing the radial head to hit the capitellum of the humerus. Good results are shown with nonsurgical treatments for Mason type 2 fractures. However, if there is a limitation of elbow joint exercise or displacement of more than 2 mm, an operative treatment should be considered. We treated two patients with arthroscopic assisted bioabsorbable screw (K-METâ„¢; U&I Corporation, Uijeongbu, Korea) fixation for radial head fractures to prevent complications of open reduction and minimize radiation exposure.

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Bioabsorbable Screws Used in Hallux Valgus Treatment Using Proximal Chevron Osteotomy
Woo-Jin Shin, Young-Woo Chung, Ki-Yong An, Jae-Woong Seo
Journal of Korean Foot and Ankle Society.2018; 22(4): 181. CrossRef

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Impaired Bone Healing Metabolic and Mechanical Causes: Sam Guk Park, Oog Jin Shon; J Korean Fract Soc 2017;30(1):40-51. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.40

Abstract PDF

Non-union is one of the most devastating complications after fracture fixation. It usually results in prolonged treatment duration and unpredictable results. We reviewed the literature to identify recent information regarding the following: risk factors of nonunion; mechanical risk factors, including fracture gap width and stability, osteonecrosis and healing mechanism, osteoporotic fracture and fixation method, the characteristics of fracture, soft tissue injury, local infection, and multiple fractures; as well as the metabolic risk factors, including age, comorbidities, smoking, alcoholism, and medications. The technique and devices for fracture treatment have been developed, and treatments of nonunion are evolving according to the enhancement of our understanding of nonunion. Clinicians should refer to the risk factors and advancements while developing a treatment plan.

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Evaluating the Stability of Locking Screw on Locking Compression Plate According to Various Screw Insertion Angles
Jin Woong Yi, Jong Un Kim, A. Yoon Kim, Byung Hak Oh, Ju Yong Ahn, Ki Sik Tae
International Journal of Precision Engineering and Manufacturing.2022; 23(7): 789. CrossRef
Experimental Study ofDohongsamul-tang(Taohongsiwu-tang) on Fracture Healing
Hyun Ju Ha, Min-Seok Oh
Journal of Korean Medicine Rehabilitation.2020; 30(2): 47. CrossRef
Effect of Pahyeolsandong-tang (Poxiesanteng-tang) in Tibia Fracture-induced Mice
Woo-Suk Shin, Kira Parichuk, Yun-Yeop Cha
Journal of Korean Medicine Rehabilitation.2020; 30(4): 1. CrossRef
The Clinical Effects of Complex Korean Medicine Treatment in Patient with Delayed Union of the 4th Toe Distal Phalanx Fracture
Kyungtae Park, Hee-Ra Shin, Sung-Hu An, Seung-Ryong Yeom, Young-Dal Kwon
Journal of Korean Medicine Rehabilitation.2019; 29(4): 143. CrossRef
Outcomes following Treatment of Geriatric Distal Femur Fractures with Analyzing Risk Factors for the Nonunion
Soo-young Jeong, Jae-Ho Lee, Ki-Chul Park
Journal of the Korean Fracture Society.2019; 32(4): 188. CrossRef

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Treatment Strategy of Infected Nonunion: Hyoung Keun Oh; J Korean Fract Soc 2017;30(1):52-62. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.52

Abstract PDF

The management of infected nonunion is based on a detailed evaluation of patients, the involved bone and soft tissues, stability of fixation, and type of bacterial pathogens. Preoperative surgical planning and strategies for each step is mandatory for the successful treatment of infected nonunion. The radical debridement of infected tissues, including the unstable implant, is one of the most important procedures. Adequate soft tissue coverage should be considered for the appropriate management of infection; a reconstructive procedure and stable skeletal stabilization by internal or external fixation is also necessary later. A restoration of bone defects and bony union can be accomplished with bone grafting, distraction osteogenesis, vascularized fibular grafting, and induced membrane technique.

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Systematic Diagnosis and Treatment Principles for Acute Fracture-Related Infections
Jeong-Seok Choi, Jun-Hyeok Kwon, Seong-Hyun Kang, Yun-Ki Ryu, Won-Seok Choi, Jong-Keon Oh, Jae-Woo Cho
Journal of the Korean Fracture Society.2023; 36(4): 148. CrossRef
The Antibiotic Cement Coated Nail and Masquelet Technique for the Treatment of Infected Nonunion of Tibia with Bone Defect and Varus Deformity: A Case Report
Min Gu Jang, Jae Hwang Song, Dae Yeung Kim, Woo Jin Shin
Journal of the Korean Fracture Society.2022; 35(1): 26. CrossRef

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