Journal of Musculoskeletal Trauma

Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures: Jin Young Han, Ki Youn Kwon; J Korean Fract Soc 2020;33(1):1-8. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.1

PURPOSE
This study compared the clinical and radiological results between two groups of patients with percutaneous fixation or conventional fixation after hardware removal.
MATERIALS AND METHODS
The study analyzed 68 patients (43 open fixation and 43 percutaneous screw fixation [PSF] 25) who had undergone fixation for unstable thoracolumbar fractures. The radiologic results were obtained using the lateral radiographs taken before and after the fixation and at the time of hardware removal. The clinical results included the time of operation, blood loss, time to ambulation, duration of the hospital stay and the visual analogue scale.
RESULTS
The percutaneous pedicle screw fixation (PPSF) group showed better results than did the conventional posterior fixation (CPF) group (p<0.05) in regard to the perioperative data such as operation time, blood loss, and duration of the hospital stay. There were no significant differences in wedge angle, local kyphotic angle, and the Î”Kyphotic angle on the postoperative plane radiographs between the two groups (p>0.05). There were no significant differences in the wedge angle and local kyphotic angle after implant removal (p>0.05) between the two groups as well. However, there were significant differences in the segmental montion angle (p<0.001), and the PPSF group showed a larger segmental motion angle than did the CPF group (CPF 1.7Â°Â±1.2Â° vs PPSF 5.9Â°Â±3.2Â°, respectively).
CONCLUSION
For the treatment of unstable thoracolumbar fractures, the PPSF technique could achieve better clinical results and an improved segmental motion angle after implant removal within a year than that of the conventional fixation method.

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A Comparison of 2 Surgical Treatments for Thoracolumbar Burst Fractures: Temporary Osteosynthesis and Arthrodesis
Halil Ibrahim Süner, Rafael Luque Pérez, Daniel Garríguez-Pérez, Marta Echevarría Marín, Jose Luis Pérez, Ignacio Domínguez
World Neurosurgery.2022; 166: e419. CrossRef

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Surgical Treatment of Pediatric Intra-Articular Proximal Phalangeal Head Fracture of the Big Toe: Yeun Soo Kim, Geunwu Gimm, Il ung Hwang, Goo Hyun Baek, Jihyeung Kim; J Korean Fract Soc 2020;33(1):9-15. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.9

Abstract PDF: PURPOSE
Pediatric intra-articularproximal phalangeal head fractures of the big toe are very rare and few studies on this have been published. The purpose of this study is to present the diagnostic approach and surgical management of these extremely rare fractures, which might be easily underestimated or misdiagnosed.
MATERIALS AND METHODS
The study retrospectively reviewed all the patients who were diagnosed as intra-articular proximal phalangeal head fracture of the big toe and who underwent surgical intervention in our institution. The size of the bony fragment and hallux valgus interphalangeus angle were measured on the preoperative X-rays. The size and rotation of the osteochondral fragment, the presence of avascular necrosis, ligamentous injury and soft tissue entrapment were assessed on the preoperative magnetic resonance images (MRIs). The radiologic and functional evaluation were performed at 1 year postoperatively.
RESULTS
The average size of the bony fragments measured on the X-rays was 4.1 mm in width and 2.3 mm in length. Two cases showed hallux valgus interphalangeus. Preoperative MRI was performed in four cases and the average size of any osteochondral lesion was 5.3 mm in width, 3.9 mm in length, and 4.7 mm in height. Rotation of the osteochondral fragment was observed in one patient, and soft tissue entrapment was noted in two patients. Postoperatively, successful bony union was achieved in all the patients and the average time to union was 74.4 days.
CONCLUSION
Intra-articular proximal phalangeal head fractures of the big toe are very rare and often neglected due to incomplete ossification in the pediatric population. It is important to suspect the presence of this intra-articular fracture and to appropriately implement further evaluation. Nonunion of chronic cases as well as acute fractures can be successfully treated through open reduction and internal fixation using multiple K-wires.

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Treatment of Isolated Lateral Malleolar Fractures Using Locking Compression Plate Fixation and Tension Band Wiring Fixation: Woojin Shin, Seondo Kim, Jiyeon Park; J Korean Fract Soc 2020;33(1):16-21. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.16

Abstract PDF: PURPOSE
The purpose of this study was to compare the clinical and radiological outcomes of locking compression plate (LCP)-screw fixation and tension band wiring (TBW) fixation in isolated lateral malleolar fractures.
MATERIALS AND METHODS
From May 2016 to August 2018, 52 patients with isolated lateral malleolar fracture were retrospectively reviewed. They were divided into 30 cases of the LCP fixation group (Group I) and 22 cases of the TBW fixation group (Group II). The clinical and radiological results of those groups were compared. Pearson chi-square tests and independent t-tests were used in the statistical analysis.
RESULTS
The mean length of the surgical incision was 8.3 cm in Group I and 4.9 cm in Group II. Radiological union was obtained at a mean of 8.4 weeks in both groups. The mean American Orthopaedic Foot and Ankle Society score was 90 (range, 85â€“97) and 92 (range, 85â€“100) in Groups I and II, respectively, at the last follow up.
CONCLUSION
Both the LCP-screw and TBW techniques revealed excellent results in isolated lateral malleolar fractures. The tension band technique may be a fine alternative method of fixation in the treatment of isolated lateral malleolar fracture.

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Brachial Plexus Neuropathy after Revision of Clavicular Fracture Nonunion: A Case Report: Youngwoo Kim, Suk Kyu Choo, Neunghan Jeon; J Korean Fract Soc 2020;33(1):22-26. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.22

Abstract PDF: We performed a revisionary open reduction and internal fixation for treating nonunion of the mid-shaft of the left clavicle with an autogenous cancellous bone graft. On postoperative day 4, the patient presented with neurologic deficits in the left upper extremity. We removed the implant and made a superior angulation to decompress the brachial plexus. At 6 months postoperatively, callus bridging and consolidation were visible and all hand and elbow functions were fully recovered. Our case suggests that brachial plexus neuropathy may be caused by stretching and compression after reduction and straightening of the nonunion site around adhesions or scar tissue. Therefore, care should be taken whether there are the risk factors that can cause brachial plexus neuropathy when revision surgery is performed for treating nonunion of a clavicle shaft fracture.

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Concurrent Posterolateral Corner Injury Associated with a Schatzker Type 2 Tibial Plateau Fracture: A Case Report: Jae Cheon Sim, Choong Won Jung, Tae Seok Nam; J Korean Fract Soc 2020;33(1):27-31. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.27

Abstract PDF: Isolated posterolateral corner (PLC) injury associated with a Schatzker type 2 fracture is a very rare combination of injuries. A male who was driving a motor vehicle was injured after a collision accident. The plain radiographs and computed tomography scans of the knee showed a Schatzker type 2 fracture of the tibial plateau, mostly in the anterolateral portion of tibial plateau, and an avulsion fragment on the fibular tip. Magnetic resonance imaging showed no injury to cruciate ligaments, medial collateral ligament, or any meniscal injury. We performed an open reduction operation and internal fixation for treating the fracture. Six months later, he complained of instability. At 11 months later after initial operation, we performed the second operation for stabilizing the PLC. We present here a rare case of an isolated PLC injury associated with a Schatzker type 2 fracture. We discuss the mechanism of injury and review similar cases.

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Heterotrophic Ossification after Aggressive Rehabilitation in Patients with Trauma: A Case Report: Jae Ang Sim, Yong Cheol Yoon, Seung Hyun Baek; J Korean Fract Soc 2020;33(1):32-37. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.32

Abstract PDF: Heterotrophic ossification (HO) is a reactive disease presenting the formation of mature lamellar bone in soft tissues. It is known to occur following surgery, soft tissue injury, or central nervous system anomalies. However, a definite cause has not yet been clearly addressed. During the process of approach, reduction, and fixation while conducting surgeries, partial injury of soft tissue is inevitable. Additionally, secondary injuries may be caused during the active and passive range of motion exercises that should be done for the recovery of joint motion after surgery. The authors experienced cases of HO that may occur during surgery and rehabilitation after surgery. The authors recognized that special care is required for patients complaining of severe pain during the early stage of rehabilitation immediately after surgery. This study aimed to reaffirm the principles of fracture treatment by reviewing the cases and to investigate the occurrence of HO after fracture surgery.

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Tension Band Wiring Technique for Distal Radius Fracture with a Volar Articular Marginal Fragment: Technical Note: Neunghan Jeon, Jong Keon Oh, Jae Woo Cho, Youngwoo Kim; J Korean Fract Soc 2020;33(1):38-42. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.38

Abstract PDF: Most distal radius fractures are currently being treated with anterior plating using anatomical precontoured locking compression plates via the anterior approach. However, it is difficult to fix the volar articular marginal fragment because these anatomical plates should be placed proximally to the watershed line. There were just a few methods of fixation for this fragment on medical literature. Herein, we introduced a tension band wiring technique for fixation of a volar articular marginal fragment in the distal radius.

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Treatment of Periprosthetic Femoral Fractures after Hip Arthroplasty: Jung Hoon Choi, Jong Hyuk Jeon, Kyung Jae Lee; J Korean Fract Soc 2020;33(1):43-51. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.43

Abstract PDF: Although the incidence of postoperative periprosthetic femoral fractures after hip arthroplasty is expected to increase, these complex fractures are still challenging complications. To obtain optimal results for these fractures, thorough clinical and radiographic evaluation, precise classification, and understanding of modern management principles are mandatory. The Vancouver classification system is a simple, effective, and reproducible method for planning proper treatments of these injuries. The fractures associated with a stable femoral stem can be effectively treated with osteosynthesis, though periprosthetic femoral fractures associated with a loose stem require revision arthroplasty. We describe here the principles of proper treatment for the patients with periprosthetic femoral fractures as well as how to avoid complications.

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Periprosthetic Fractures following Total Knee Arthroplasty: Byung Hoon Lee, Jae Ang Sim; J Korean Fract Soc 2020;33(1):52-61. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.52

Abstract PDF: Recently, as the elderly population increases, the incidence of total knee arthroplasty has increased, with a concomitant increase in the frequency of periprosthetic fractures. To determine the treatment plan for fractures, the treatment method should be determined by the patient's age, osteoporosis, fixation status of the implant, and type of fracture. In recent years, operative treatment with reduction and stable fixation, rather than non-operative treatment, was used to promote early joint movement and gait. On the other hand, it is necessary to select an appropriate operative method to reduce complications of surgery, such as nonunion and infection, and expect a good prognosis. In this review, periprosthetic fractures were divided into femur, tibia, and patella fractures, and their causes, risk factors, classification, and treatment are discussed.

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Corrigendum: Outcomes following Treatment of Geriatric Distal Femur Fractures with Analyzing Risk Factors for the Nonunion: Soo young Jeong, Jae Ho Lee, Ki Chul Park; J Korean Fract Soc 2020;33(1):62-62. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.62; Corrects: J Musculoskelet Trauma 2019;32(4):188

Abstract PDF: The approval number of Institutional Review Board (IRB) was wrong in the article. The IRB approval number should be corrected.

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Corrigendum: Failure of Intramedullary Nailing for Subtrochanteric Atypical Femoral Fractures Caused by Endosteal Cortical Thickening: Young Ho Roh, Kimoon Kang, Hee Joong Kim, Kwang Woo Nam; J Korean Fract Soc 2020;33(1):63-63. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.63; Corrects: J Musculoskelet Trauma 2019;32(4):211

Abstract PDF: The original version of this article contained an error in Financial support.

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