Journal of Musculoskeletal Trauma

Complications in the Use of Interlocking Intramedullary Nailing for the Femoral Fractures: Sung Kwan Hwang, Jae Beum Han; J Korean Soc Fract 1995;8(1):1-12. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.1

Abstract PDF: A retrospective review was undertaken in 31 patient with femoral fracture which had complication after undergoing the closed reduction and internal fixation using interlocking intramedullay nail. The technical complexity associated with the locking nail introduces a new set of complications. This article discusses these problems and suggests means to avoid certain difficulties. The results were as follws; 1 Intraoperative complications were new fracture near the original fracture site(3 cases), Iatrogenic femur neck fracture(1 case), pudendal nerve neuropraxia(1 case). 2. Postoperative complications were delayed union(13 cases), limb shortening(4 cases), nonunion(3 cases), infection(3 cases), distal screw breakage(3 cases), nail breakage(1 case), proximal screw breakage(1 case), and angulation(1 case). 3. At final follow up, the major complications were 11 cases(13.4%) but, bone union was achived in all cases except 3 case, union rate was 96.4%. 4. Highly developed operative technique and postoperative management were necessary to diminish complications.

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Treatment of Infected Nonunion of Femoral Fracture: Chil Soo Kwon, Young Uck Kim, Byung Hyun Jung, Kyeong Seog Kong; J Korean Soc Fract 1995;8(1):13-21. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.13

Abstract PDF: There are many difficult problems in the treatment of inferted nonunions of the femur, e.g, eradication of infection and osseous union even in the presence of devastating infection. To solve these diffcult problems, various methods were tried including thorugh debridement and rigid internal nxation or external fixation, and bone graft. Recently, large bone defect due to resection of infected bone was treated excellently using llizarov external fixator. Authors treated 13 cases of infected nonunions of femur with Ilizarov external fixator from september 1989 to July 1994. The results were as follows. 1. Among 13 cases of infected nonunion of femoral fracture, 1 case was treated with internal fixation and others with external fixation, and obtaned bone union in all cases. 2. Mean number of previous surgery in other hospital was 3.2(1-5) times and mean number of surgery in our hospital was 2.5(1-5) times. 3. Lengthening(including length of internal bone transport) was performed from 2.5cm to 22cm. 4. Duration of treatment was from 4 months to 27 months(Mean : 11 months). In conclusion, infected femoral nonunion in very selective cases could be treated with retention of internal fixation (Exchange of nail, or plate and screws). But converison to external fixator should be well prepared in most cases. Infected nonunion could be managed in staged surgery with use of modular external fixator like llizarov external fixator. Management of infection, malposition, and shortening could be controlled more safely and more definitely with the ring external fixator.

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A Clinical Experience of Surgical Treatment for Type C of AO Classification of Supracondylar Fractures of the Femur: Yung Khee Chung, Jung Han Yoo, Myung Ryool Park, Baek Yong Song, Yong Wook Park, Jun Tae Kim; J Korean Soc Fract 1995;8(1):22-30. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.22

Abstract PDF: The treatment of supracondylar fractures of the femur remains many problem because of its complications. Particularly, the type C fracture of AO classification causes the traumatic arthritis, limitation of motion, shortening, as well as angular deformity, especially varus. In the past, there has been a reluctance toward treatment of supracondylar fractures of the frmur with internal fixation. But, recently, a trend toward internal fixation has become evident and good results has been reported by several authors. We studied 9 cases of type C of AO classification of supracondylar fracture of the femur at our hospital from January,1989 to February, 1993. The longest follow up was 49 months and the shortest was 12 months, the average being 22.2 months And the results were as follows 1. Age distribution was between 29 and 60 years old, and the ratio between male and females was 5:4. The most common cause of injury was traffic accident. 2. Seven patients were associated with injuries of other parts and the most frequent associated fracture was patellar fracture and the most common associated injury was cerebral contusion. 3. The average time of clincal union was 22 weeks in operative treatment and 13 weeks in conserv alive treatment. 4. In type C AO classification, 6 out of 9 cases treated by anatomical reduction and early motion achieved good to excellent results(50%), but all type C3 fractures is healed in slightly varus position. 5. In conclusion, type C3 of the supracondylar fracture of femur should be reduced to the neutral or slightly valgus position, or the ends of distal cancellous screws should be penetrated the medial femoral cortex because of progressing varus deformity after operation.

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The Treatment of the Supracondylar-Intercondylar Fracture of the Femur: Joo Tae Park, Gil Yeong Ahn, Il Hyun Nam, Jung Kyu Ji; J Korean Soc Fract 1995;8(1):31-38. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.31

Abstract PDF: Although not as common as femoral shaft fracture, supracondylar-intercondylar fracture of the femur present considerable challanges in management. Because supracondylar-intercondylar fracture is frequently accompanied by severe soft tissue damage, comminution and intraarticular extension of fracture, it can produce some disability of the knee joint, So recently, early anatomical reduction, rigid internal fixation and early rehabilitation was recommended. The authors analyzed twenty cases of supracondylar-intercondylar fracture that treated at the Department of Orthopaedic Surgery of Pohang Saint Marys hospital from March, 1990 to December, 1993. The object of this study is to evaluate the corelation between the rigid internal fixation and early rehabilitation, The average follow up period was 18.3 months(form 14 to 27 months,) The results were as follows; 1, Among the twenty cases, male was more common than female and the prevalent age was 4th decade(50%). 2. The most common cause of injury was trafnc accident in 15 cases(75%). 3. During 1st 3weeks after operation, we started active R.0.M. exercise by using Thomas splint with Pearson attatchment and long leg brace with ischial weight bearing was applied from 3months to 6months (averge 4.2 months). We permit partial bearing Sweets after operation, 4. According to Schatzker and Lambert criteria, excellent were 16 cases, good 3 cases, feir 1 case. 5. We obtained satisfactory by rigid internal fixation and early rehabilitation.

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Chondrodiatasis of the Distal Femur: Report of 2 cases: Kwang Jin Rhee, Chan Hee Park, Jin Sun Jeong, Cheol Se Ahn; J Korean Soc Fract 1995;8(1):39-45. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.39

Abstract PDF: Chondrodiatasis is a limb lengthening technique involving slow, controlled, symmetric epiphyseal distraction. The technique has significant advantages over other correction methods that involves osteotomies. We have used this methods with other surgical technique to lengthen limbs in 2 children with leg-length discrepancies or with angular deformities. Shortely after initial lengthening, the growth plate seemed maintain its function. But, several years later, the growth plate fused. In spite of many report that chondrodiatasis having many complications, there was no special complications in our cases. In the absence of definite proof, we decide to use this technique clinically almost during the last two years of the growth period.

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Treatment of Intertrochanteric Fractures of Femur in Elderly Patients over 65 Years Old: Young Sun Koh, Chang Moo Yu, Suk Ha Lee, Sung Jong Lee, Taik Sun Kim, Jae lk Shim; J Korean Soc Fract 1995;8(1):46-53. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.46

Abstract PDF: The incidence of intertrochanteric fracture of femur is increasing because of increasing number of old-aged people. The goal in the treatment of an elderly patient with an intertrochanteric fracture is to restore the patient to his prefracture activity as soon as possible. The purpose of this report is to review of the difficulty of treating the intertrochanteric fracture of femur in elderly patients. The authors treated 213 cases of intertrochanteric fracture from Jan,1980 to Dec.1993. We analyzed the clinical result of 73 cases intertrochanteric fracture with minimum 1 year follow up retrospectively. The results were as follows. 1. The degrees of osteoporosis by Singh index were 27 cases in Grade III, 22 Cases in Grade II,14 cases in grade IV,5 cases in Grade I and 5 cases in Grade V. 2. By Tronzo classification of fracture, the most common type was 38 cases in type III, 17 cases in type II and 8 casesintype V. 3. The operation method were compression hip screw(38 cases), Jewett nail (12 cases), Ender nail(17 cases), multiple pinning (5 cases), and primary kerniarthoplasty(3 cases). 4. Average bony union time was 13.2 weeks in compression hip screw group, 14.5 weeks in Jewett nail group,14.7 weeks in Ender nail group and 15.4 weeks in multiple pinning group.

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Treatment of Intertrochanteric Fractures of Femur in Elderly Patients over 65 Years Old: Yoo Seong Seo, Hyung Suk Choi, Sang Gi Kim, Byung Joon Shin, Soo Kyun Rah, Chang Uk Choi; J Korean Soc Fract 1995;8(1):54-60. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.54

Abstract PDF: The ipsilateral femur fracture after hip arthroplasty is rare, but serious complication. And its treatment is difficult and controversial. We experienced 6 patients who had the hip arthroplasty complicated by an ipsilateral femur fracture in postoperative period at the Department of Orthopaedic Surgery, Soonchunhyang Univesity from February 1990 to December 1993. The Type 1 fracture was 1 case, and 2 Type IV-A, and 1 Type IV-3, and 2 Type V according to AAOS classification. Bony union and satisfactory clinical results were achieved in all 6 cases.

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Treatment of Femoral Neck Fractures in the Elderly Patiene: Chung Nam Kang, Kwon Jae Roh, Yeo Hon Yun, Dong Jun Kim, Cheol Min Kim; J Korean Soc Fract 1995;8(1):61-67. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.61

Abstract PDF: We analyzed 41 femoral neck fractures in 40 elderly patients aged over 65 years. All of them were treated by surgery and followed for average 22 months (range, 14 to 52 months) at the Ewha Womans University Hospital from 1988 to 1992. Of these, 15 cases were treated with internal fixation and 26 cases with endoprosthetic or total hip replacement arthroplasty For the level of fractures the most common features were subcapital, that were moderately to severely (Gardens stage III or IV) displaced. In the internal fuation group the results were unsatisfactory in the cases of subcapital type, moderate to severe (Gardens stage III or IV) displacement, Pauwels type III and those with osteoporosis (below stage III in Singh index). Our short term follow-up results showed that the prosthetic replacement group were generally superior in that they were not affected by the types of fractures and the degree of osteoporosis.

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Bilateral Subtrochanteric fracture After Pin Removal in Slipped Capital Femoral Epiphysis: A Case Report: Sung Joon Kim, Il Young Choi, Tai Seung Kim, Chung Kyu Choi; J Korean Soc Fract 1995;8(1):68-71. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.68

Abstract PDF: Subtrochanteric fracture of the femur has been infrequently reported after pin removal that is second operation for slipped capital femoral epiphysis and that fracture is a serious complication. We report a case of subtrochanteric fracture of the femur occured after pin removal that had been inserted for fixation of slipped capital femoral epiphysis. Its treatment was open reduction with condylar blade plate and screws. We recommend insertion of fewer pins and longer pins at higher level, early pin removal, avoidance of repeated insertion and use of cannulated pin screw instead of Knowles pin for prevention of subtrochanteric fracture after pin removal.

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Treatment of the Supracondylar Fractures of the Femur with an Interlocked Intramedullary Nail: Dong Min Shin, Sang Ho Ha, Hyung Chull Mun; J Korean Soc Fract 1995;8(1):72-78. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.72

Abstract PDF: The purpose of this paper is to report the technical problems, indications and contraindications of treatment by interlocked intramedullary nail in supracondylar fracture of the femur. The authors analyEed 5 cases of femoral supracondylar fractures in patients who were treated by interlocked intramedullary nailing. All 5 cases treated with interlocked intramedullary nail were obtained primary bone union. According to Neers criteria, excellent result was achieved in 1 patient, satisfactory and unsatisfactory results in 2 patients, respectively. In conclusion, we consider that interlocked intramedullary nail fit as follows: 1. Type A of AO classification. 2. In case of more proximally located fracture. 3. Supracondylar fracture of the femur with severe communited fracture of the ipsilateral femora diaphyses but unfit as follows; 1) Supracondylar fracture of the femur with severe osteoporosis. 2) In case of more distally located fracture. 3) Type C of AO classification.

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Selective Arterial Thrombolysis with Urokinase in Popliteal Arterial Occlusion Developed after Total Hip Replacement Arthroplasty: Seung Koo Rhee, Kee Yong Ha, Nam Gee Lee, Jong Bum Park; J Korean Soc Fract 1995;8(1):79-83. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.79

Abstract PDF: A 60 year old patient with a sudden thromboembolic occlusion of ipsilateral popliteal artery on four days after the total hip replacement (THR) were treated with high-dose urokinase by direct intraarterial selective infusion. The cause of arterial occlusion after THR was not clear, but it was thought to be caused by spontaneous thrornboembolism in an elderly patient accompanied with diffuse arteriosclerosis, and this multifocal arteriosclerosis was caused not to perform the vein graft immediately. The initial infusion therapy with 4,000 IU/min for 2 hours of urokinase was failed but the second trial with same doses of urokinase in another 2 hours was succeed with complete clot lysis. Then 500,000 IU/24 hours of urokinase was infused again, and total 1,500,000 IU/28 hours was used in this patient. But massive internal bleeding from the operation site, hip joint, for more than 1,400 co was leaked because of bleeding tendency induced by extensive use of urokinase within short duration, and minor toe amputations should be performed on 2 weeks after thrombolysis because of distal migration of small thromboembolic particles. It was suggested that the peripheral arterial occlusion resulting from thromboembolism after joint replacement, especially in an elderly patient with diffuse arteriosclerosis, could develop, and it could be successfully treated with an initially high-dose urokinase regimen if it is detected earlier, rather than vein graft or amputation.

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Operative Treatment of Proximal Humeral Fracture using Inlay Graft of Fibular Allograft Combined with Plating: Duck Yun Cho, Eun Sung Koh, Myong Hyoung Lee; J Korean Soc Fract 1995;8(1):84-92. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.84

Abstract PDF

Fracture of the proximal humerus occurs more frequently in older individuals who may have advancing osteoporosis, causing the bone to weaken, even with minimal force. And, most proximal humeral fractures respond satisfactory to conservative treatment. But, operative treatment is reconmended in the case that poor results are anticipated by the severe displacement and comminution. In older patient with proximal humerus fracture, there was some problem such as osteoporosis, absorption of cancellous bone, cystic formation, and weakness of the mechanical support, and it has difficulties in rigid fixation and early ROM. Four cases of displaced fracture of the proximal humerus in older patients over 50-year-old Treated by using plate & inlay fibular allograft from Apr. 1991 to Dec. 1993 were analized clinically and radiologically. The following results were obtained. 1. The results of these patients were rated by the Neers functional criteria. Of four cases, three cases had excellent results, one case had satisfactory. 2. There was no allograft related complications, such as infection & graft rejection. So, in treatment of proximal humerus fracture at old individuals, open reduction and internal fixation with plating and inlay graft using fibular allograft was very useful method, and it resulted in rigid fixation, early ROM. and good functional result.

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Citations to this article as recorded by

Allogeneic Inlay Cortical Strut Grafts for Large Cysts or Post-curettage Cavitary Bony Defects
Yang-Guk Chung, Yong-Koo Kang, Chol-Jin Kim, An-Hi Lee, Jeong-Mi Park, Won-Jong Bahk, Hyun-Ho Yoo
The Journal of the Korean Bone and Joint Tumor Society.2011; 17(2): 73. CrossRef

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Clinical Study for Humerus Intercondylar Fracture in Adult: Hyung Ku Yoon, Kuk Rwan Oh, Kyung Hoon Kang, Jin Il Kim, Kye Sung Lee; J Korean Soc Fract 1995;8(1):93-100. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.93

Abstract PDF: The intercondylar fracture of distal humerus in adult is difficult to treat. Because it is difficult to obtain accurate anatomical reduction atd rigid internal fixation due to comminution and intraarticular components. The authors review the 13 cases of intercondylar fracture of the distal humerus in adult that were treated at the orthopaedic department of Sung Ae Hospital, from JAN 1988 to JUN 1992, and the result are as follows: 1. It was frequently occured in 3rd and 4th decades active male and old female over 60 years old. 2. We think that cast hinge elbow brace is recommendable method for improvement of elbow ROM through early active motion. 3. For accurate anatomical reduction and rigid internal fixation, transolecranon approach is recommended for the suffcient exposure of the articular surface.

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Fracture-separation of the Distal Humeral Epiphysis: A Case Report: Kwon lck Ha, Sung Ho Hahn, Bo Kyu Yang, Chi Hong Kim, Tae Sung Kim; J Korean Soc Fract 1995;8(1):101-105. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.101

Abstract PDF: The fracture-separation of the distal humeral epiphysis is considered to be a rare injury. It presents problems in diagnosis, radiologic interpretation and management. It is frequently misdiagnosed as a dislocation of the elbow or a fracture of the lateral humeral condyle because the cartilagenous distal portion of the humerus in the children is not visible on roentgenograms. A knowledge of when the ossification centers appear about the elbow is absolutely necessary in the diagnosis of the elbow injury. We experienced 1 case, a 22 month-old girl with Salter-Harris type I[ injury of the distal humeral epiphysis.

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Clinical study of Supracondylar Fractures of the Humerus in Children: Sung Keun Sohn, Kyu Yeol Lee, Byeong Hwan Kim; J Korean Soc Fract 1995;8(1):106-115. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.106

Abstract PDF: The supracondylar fracture of the humerus is the most common elbow fracture in children. There are much controversies for the treatment and variable and frequent complication such as cubitus varus and joint stiffness, etc. For the period of 3 years and 10 months from Mar. 1990 to Dec. 1993, 62 patients with supracondylar fracture of humerus were admitted and treated at the Department of Orthopaedic surgery, College of Medicine, Dong-A University Among them,34 patients who were followed up more than 6 months were reviewed retrospectively. The results are as follows 1. The average age was 6.4 years and sex ratio of male to female was 3.9:1. 2. The extension type was 79.4%, and flexion type was 20.6%. The ratio of left to right was 1.43:1 3. The most common cause of injury is fall from a height in 18 cases (52.9%). 4. The mean duration of bone union was 42.3 days. 5. According to the Holnlberg classification, 3 cases belong to group I(8.8%), 9 to Group II(26.5%),10 to Group III (29.4%), and 12 to Group IV(35.3%). 6. By Flynns criteria, the satisfactory results was in 31 cases(91.2%), and unsatisfactory in 3 cases (6.3%). In Holmberg classification, the higher severity, the higher joint stiffness made the prognosis worse. 7. In conclusion, we believe that percutaneous pinning was a simple, effective method for treatment of displaced supracondylar fractures of the humerus, and the accurate anatomical reduction was required to prevent cubitus varus deformity, which is one of the most serious complication.

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Treatment of Lateral Humeral Condylar Fractures in Children using Closed K-wire Fixation and Intraoperative Arthrogram: Chung Soo Hwang, Kyung Chul Kim, Phil Hyun Chung, Suk Kang, Eung Nam Cha, Yong Min Kim, Young Un An, Min Hyo Park; J Korean Soc Fract 1995;8(1):116-125. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.116

Abstract PDF: Lateral condylar fracture of humerus is the secondly most common elbow injury in childhood. Compared to the most common supracondylar fracture which is fracture of metaphysis around olecranon fossa, lateral condylar fracture is intraarticular, epiphyseal injury and easily displaced by extensor muscle pull. Therefore, lateral condylar fractures are reduced and fixed more frequently by open method than supracondylar fractures are. In spite of affording more accurate reduction, however, open treatment of fracture can be complicated by infection, avasular necrosis, disfiguring scars, etc. So, it is more desirable that accurate reduction and rigid fixation can be achieved by closed method. Sine July 1992, We manged 10 children with lateral condylar fractures of elbow using closed reduction, percutaneous K-wire fixation and intraoperative arthrogram for confirming the reduction status of articular margin. The fractures united and K-wires were removed within postop. 7 weeks(mean) in all cases. The patients were followed up for from 9 months to 2 years and 2 months postoperatively, revealed no great differences in carrying angle, range of motion and physical activity compared with contralateral elbow. Radiologic evaluation showed no definite complications except mild spur formation. Closed reduction and fixation followed by intraoperative arthrogram seemed tobe one of the useful method in the management of lateral humeral condylar fractures in children, especially in mildly displaced cases.

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Surgical Treatment of the Unstable Fractures of the Proximal Humerus: Consideration of Surgery-related Problems and Complications: In Kim, Young Kyun Woo, Ju Hae Chang, Hyung Min Kim, Yong Sik Kim, Soon Yong Kwon, Yang Su Kim; J Korean Soc Fract 1995;8(1):126-139. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.126

Abstract PDF: Authors reviewed and analyzed the 96 cases of the unstable proximal humerus fracture surgically managed in the department of orthopaedic surgery of Catholic University Medical College from 1981 to 1993. Analysis dealt with the fracture classification, the clinical assessment, surgical method and related complication, operative result. The overall results were as follows 1. According to the classification by Neer (1970),46 cases were 2 part fracture, 16 cases 3 part fracture,24 cases 4 part fracture,8 cases fracture -dislocation and 2 cases head splitting fracture; of 8 cases of fracture-dislocation,2 cases(3part-1/4part-1) were the iatrogenic displaced cases during manual reduction of 2 part fracture-dislocation. 2. The surgical methods were as follows; for fracture fixation of 80 cases, buttress T-plate in 48 cases, Rush pin and wire in 9 cases, cancellous screw and wire in 8 cases, Steinmann pin and wire 8 cases, Seidle nail in 3 cases, Herbert screw and wire in 1 case and Steinmann pin in 1 case were used respectively. Herbert screw was used in 6 cases for major or supplementary fixation. And joint replacement in 16 cases(14 hemiarthroplasty/2 total arthroplasty ) were performed. 3. The Operative results were analyzed with postoperative radiograph 1) Of 80 cases of open reduction; adequate reduction in 51 cases, inadequate reduction in 21 cases(varus-9, valgus-4, malreduction of greater tuberosity-4, highly located implant-3, excessive shortening-1), insufacient fixation in 5 cases, joint penetration of screw in 2 cases, iatrogenic shaft fracture in 1 case. 2) Of 16 cases joint replacement; adequate replacement in 12 cases, improper fixation or management of greater tuberosity in 3 cases, inappropriate retrotorsion of humeral component in 1 case. 4. Functional assessment by Neers method was done as follows: Of 80 cases open reduction group, excellent and satisfactory results in 59 cases, unsatisfactory and failure results in 21 cases. of 16 cases joint replacement group, satisfactory results in 10 cases and unsatisfactory results in 6 cases. 5. Complications occurred as follows: 1) Of 80 cases of open reduction; malunion with joint stiffness 26 cases, impingement in 4 cases, fixation loss in 3 cases, axillary nerve palsy, distant pin migration and avascular necrosis of humeral head in each 1 case. 2) Of 16 cases of joint replacement; joint stiffness in 7 cases, loosening of humeral component in 4 cases, nonunion of greater tuberosity and axillary nerve in each 1 case.

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Change of Carrying Angle in Fracture of the Lateral Humeral Condyle in Children: The New Radiologic Carrying Angle Measuring Method: Jung Yoon Lee, Sung Keun Sohn, Keyong Taek Kim, Sung Soo Kim, Dong Man Park; J Korean Soc Fract 1995;8(1):140-151. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.140

Abstract PDF

The lateral condyle fracture of humerus in children is the second most common fracture among the elbow fractures. In dealing with this fracture, we have frequently encountered the various complications due to physeal plate and intraarticular involvement. Change of the carrying angle is one of the common complications, but many authors reported different results about the change of carrying angle. Also, it is too difficult to measure the carrying angle during the early stage of the treatment because of cast immobilization, motion limitation of elbow, and wide variations of radiologic carrying angle according to elbow position changes. We performed this study to find the more stable and predictable new radiologic measuring method about the carrying angle, and then analysed the factors affecting the changes of canying angle of the 23 patients of the lateral condyle fractures of the humerus in children who were treated and followed up more than twelve months at the Department of Orhopaedic Surgery, Dong-A University Hospital from May 1990 to April 1993. The results were as follows. 1. Carrying angles by Beals method showed variable values according to the elbow positions, but A-angles by the new measuring method were relatively stable regardless of the elbow positons. 2. Increase of clinical carrying angle was 3 cases, decrease was 9 cases, and ranges of clinical carrying angle change were from -7 degress to 14 degrees. Increase of A-angle was 7 cases, decrease was 4 cases, and ranges of A-angle change were from -10 degrees to +10 degrees. 3. The change of canying angle showed no correlation with Jacob stage, follow up duration, metaphyseal height and interval between injury and treatment. But the incidence and the amount of carrying angle change were increased according to the increased age at injury(r=0.62, P<0.01). 4. There were statistical significant correlation(r=-0.65, p<0.01) and regression between the change of canying angle and A-angle : Y=-0.99X+0.56(Y:change of clinical canying angle,X; A-angle change), (r2=0.42, P<0.01).

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Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture
Yoon Hae Kwak, Dong Jou Shin, Kun Bo Park
Journal of the Korean Fracture Society.2010; 23(1): 90. CrossRef

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Percutaneous Pinning & External Fixation In the Treatment of Proximal Humerus Fracture: Jeong Ho Park, Sung Woon Choi, Young Chan Son, Young Gi Hong, Jeong Hwan Son, Jae Do Kim; J Korean Soc Fract 1995;8(1):152-158. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.152

Abstract PDF: The management of displaced fractures of the proximal humerus is still under debate and the need to evaluate alternative methods has been emphasised. We treated the displaced, unstable 2-part or 3-part fractures by percutaneous pinning or external fixation after closed reduction to reduce the complications of open reduction such as soft tissue contracture, articular stiffness, neurovascular injury and potential non-union. In this paper, we analysed 8 cases of proximal humeral fractures treated by percutaneous pinning and external fixation from Sep. 1992 to Mar. 1994. The results were excellent ; 3 cases, satisfactory; 3 cases, and unstisfactory; 2 cases but no ftilures by the criteria for evaluation of Neer. We concluded that percutaneous pinning or external fixation of displaced, unstable 2-part or 3-part fractures is one of the good methods of treatment.

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A Treatment of Humeral Shaft Fracture with Closed Interlocking Nailing: Kun Yung Lee, Myung Sik Park, Keun Kwon Kang; J Korean Soc Fract 1995;8(1):159-166. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.159

Abstract PDF: The ideal treatment of acute fractures of the humeral shaft remains controversial. It is generally accepted that conservative treatment is best for isolated closed fractures of the humerus shaft. But recently, in case of surgical management, intramedullary nailing treatment has reported good results. Authors have analysed 20 cases of the humeral shaft fractures treated with closed intramedullary nailing at the department of orthopedic surgery, Lee-Rha general hospital from June 1991 to December 1993 with minimal 1 year follow up. The results were as follows 1. In the 20 cases, the age between 20 and 40 years old was taken place 60% and the most common cause of injury was traffic accident (75%) 2. It was worthwhile to define the relationship between union time and Winquist-Hansen classification which used in femoral shaft fracture. And the average bone union time was 8 weeks except 3 cases, especially delayed union was found in type 3 of Winquist-Hansen classification. But 2 cases were united after 9 monthes follow up without secondary procedure. 3. Problem in Seidel nailing was flilure of expansion of distal portion and in Russel-Taylor nailing was impairement of internal rotation of shoulder and delayed union due to iatrogenic distraction at the fracture level during operation. In according to the above results to treat the humeral shaft fracture, closed intramedullary inter-locking nailing was satisfactory enough to obtain bone union and early recovery of shoulder motion. Also, the Winquist-Hansen classification is useful guide to find the bone union time in the treatment of humeral shaft fracture with interlocking nail.

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Treatment of the Fractures of the Humeral Shaft with the Interlocking Nail: Jong Seok Park, Yo Sub Wee, Moon Ryul Park, Joon Min Song, Jae Uk Kwon, Soo Kyun Rah; J Korean Soc Fract 1995;8(1):167-172. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.167

Abstract PDF: The humeral shaft fracture was managed by conservative treatment conventionally. But recently tendency of surgical treatment has been increased. The use of closed intramedullary interlocking nail was recently applied to humeral shaft fracture. The retrospective review was undertaken of 17 patients with humeral shaft fractures treated with the use of closed intramedullary nail during the period of April,1992 to Februaty,1994. The findings are as follows. 1. All were treated with closed nailing and static licking was performed. 2. The union was achieved in 16 cases(94%) and average union time was 2.5 minths. 3. There was one radial nerve injury by initial trauma. But there was no post operative radial nerve injury. 4. According to the range of motion scale by Brumback. there were excellent result in 11 cases. good result in 4 cases, poor result in 2 cases.

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Surgical Mangement of the Fracture of the Humeral Shaft: A comparison using of B%ate fixation and Ender nailing: Ki Soo Kim, Young Soo Choi, In Kyu Baik, Se ln Oh; J Korean Soc Fract 1995;8(1):173-180. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.173

Abstract PDF: The treatment of humeral shaft fractures remains controversal. The decision should be based on the type and location of the fracture, The presence of concomitant injuries, and the age and condition of the patient. Auhors reviewed and analyzed plate fixation in 30 patients and Ender nailing in 21 patients having humeral shaft fractures. These patients were treated at the Department of Orthopaedic Surgery, Kwang ju Christian Hospital from January 1988 to December 1993. The results were as follows, 1. Males had a dominant incidence in social active age groups, the major causes of these injuries were traffic accidents. 2. Most of surgical indications were polytrauma patients in Ender nailing groups, while flilure of conseuative management and radial nerve palsy in plate fixation groups, The bony union rate was 80.9% in Ender nailing groups and 100% in plate fixation groups. 3. Among the seven radial nerve palsy sustaining high energy accidents two cases had poor results. Nonunion of the humeral shaft fracture occured in four cases and were associated with insecure fixation, distraction of fracture site and open fracture. these four patients were only in the Ender nailing groups. When surgical management is indicated, internal fixation using plate osteosynthesis combining interfragmentary compression can give good results. Closed intramedullary Ender nailing have advantages and can be performed effectively in selected fractures of the humeral shaft such as polytrauma patients.

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Evaluation of Treatment for Clavicle fracture: Comparision between Conservative Versus Operative Treatment: Kyung Jin Song, Ki Young Chang, Byung Yun Hwang; J Korean Soc Fract 1995;8(1):181-187. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.181

Abstract PDF: There is still controversies in the treatment of clavicle fracture between conservative versus operative treatment. We reviewed one hundred thirth-six patients(141 cases) treated conservatively and operatively since February 1981 to September 1993 at Chonbuk National University Hospital. The mean follow-up was forth-six months ranging from six months to twelve years. Fifty cases treated surgically and ninty-one cases treated conservatively. In the surgical treatment group, mostly treated with intramedullary nailling with K-wires or Steinmann pin and plating with screws, with or without bone graft. We tried to evaluate the result of treatment between these two treatment groups in the viewpoint of criteria of pain, deformity, limitation of motion, subjective symptoms and disturbance of daily activities and also in the viewpoint of complications like nonunion, malunion, motion limitaion, infection and metal failures. The most common complication of the conservative treatment was malunion and nonunion was the most common complication in the operative treatment. Satisfactory results obtained in 89% of operative treatment group in the functional group and 88% of operative treatment group in the functional evaluation scale. Each clavicle fracture should be treated according to their degree of comminution, site of fracture, neurovascular injury, associated injury and doctors experience as which cases can promptly be treated either conservatively or operatively. But we would like insist of surgical treatment for the cases necessitating surgery for the provention of nonunion, malunion and joint stiffness what are common complications in the conservative treatment of clavicle fractures.

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Surigcal Treatment for Acute Acromioclayicular Joint Dislocation: Nam Yong Choi, In Ju Lee, Moon Ku Choi, Young Chae Lee, Han Jin Kim, Chong Ook Shin; J Korean Soc Fract 1995;8(1):188-192. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.188

Abstract PDF: Thirty-one patients who had a acromioclavicular joint dislocation that were treated by surgical operation, between January 1990 and December 1993 at St. Pauls & Holy Family hospital were analyzed. The results are as follows; 1. There were twenty-five males and six females. The mean age was 33 years, ranging from 17 to 52 years old. 2. Out of thirty-one cases, twenty-six had good to excellent functional results. 3. As regards complication, wire migration occurred in two cases, wire breakage in one case, screw loosening in one, and subluxation following wire or screw removal in four.

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The Treatment of Acromioclayicular Dislocation Comparison Study between Modified Bosworth and Phemister Technique: Kun Yung Lee, Myung Sik Park, Keun Kwon Kang, Myung Kon Nami; J Korean Soc Fract 1995;8(1):193-198. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.193

Abstract PDF: Acromioclavicular joint injuries are frequently seen with increase of traffic & industrial accidents & sports injury recently, There are many procedures which described for the treatment of acromioclavicular dislocation, but there are still controversies concerning the best treatment of the injuries. We have analysed 35 patients with acromioclavicular dislocations had been treated by modified Bosworth & Phemister technique at the department of orthopedic surgery Lee-Rha general hospital from June 1990 to December 1993 with minimal 1 year foll up The authors had obtained following results as modified Phemister technique and modified Bosworth technique treatment for acromioclavicular joint. 1. The complications were as follows: superficial infection at insertion site of k-wire and migration of k-wire in modified Phemister technique and loosening of screw and erosion of clavicle noted in modified Bosworth tecnique. But, there were no specific difference between two groups for pain and motion of shoulder joint. 2. In modified Bosworth technique, it was not necessary to fix the acromioclvicular joint with k-wire and also possible to perform early mobilization of shoulder joint than modified Phemister tecnique.

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The Operative Treatment of the Shaft Fractures of the Forearm Bone: Sang Won Park, Geol Choi; J Korean Soc Fract 1995;8(1):199-205. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.199

Abstract PDF

The reduction and maintenance of the disphyseal fractures of the forearm bone are difficult due to the special rotational movement between two bones. Over the years various methods of operative treatment have been advocated, and good method must be selected as the fracture level, the fracture type, and the patients general condition. From May 1988 to August 1993, the authors have reviewed 50 patients of the forearm shaft fracture except the solitary radius or ulna fracture with minimum 1 year follow up which were treated in Department of Orthopedic Surgery, Korea University Hospital. The results obtained were as follows, 1. The most common cause of injury was the traffic accident(38%) and the next was the fall down(24%). The most frequent level of the fracture was middle one-third(54%) and the most common type of the fracture was transverse fracture(64%). The treatment methods were 32 cases of the compression plate and screw fuation in the radius and ulna, and 18 cases of the compression plate and screw fixation in radius and the intramedullary nailing in ulna. 2. The average duration of the radiological union of compression plate and screw fixation of radius and ulna was 12.5 weeks in radius and 12.1 weeks in ulna, and 12.8 weeks of radius and 15.2 weeks of ulna in cases of compression plate and screw fixation of radius and intramedullary nailing of ulna. 3. According to Grace and Eversmanns evaluation, satisfactory results (Excellent and Good) were 81.5% of compression plate and screw fixation and 83.3.To of compression plate and screw fixation of radius and intramedullary nailing of ulna. 4. Postoperative complication were 2 cases of superFicial wound infection and each 1 case of transient posterior interosseous nerve injury, non-union and non-union with metal failure in compression plate and screw fixation of both radius and ulna, and 1 case of non-union in intramedullary nailing of the ulna.

Citations

Citations to this article as recorded by

Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture
Yong Chan Lee, Hong Je Kang
Journal of the Korean Society for Surgery of the Hand.2015; 20(4): 168. CrossRef

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Operative Treatment of Carpal Scaphoid Fractures with Herbert Screw: Sung Joon Kim, Kuhn Sung Whang, Jong Sun Leem; J Korean Soc Fract 1995;8(1):206-215. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.206

Abstract PDF: Carpal scaphoid fracture is most common in carpal bone injury, but its not easy to diagnose this fracture after affecting the damage, and also is not rane induced avasular neeresis and/or non-union. 13 cases of carpal scaphoid fractures (5 displaced fresh fractures and 8 non-unions) were treated by open reduction and internal fixation with Herbert screw and also cancellous bone graft taking from distal radius were performed on the cases of non-union. The results and conclusions were follows 1. Bony union takes average 11.8 weeks in displaced fresh fractures and average 14.4 weeks in non-unions. 2. By final assessment, excellent result was taken in 10 and good in 3. 3. It might be effective procedure for which cancellous bone was harvested from distal radius of same operative site. 4. Herbert srrew would be one of the good and rigid internal fixation device for the treatment of scaphoid fracture.

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Management of the Intraarticular and Periarticular Fracture Using a Herbert bone screw: Clinical analysis of Technical Probleus of Surgery and Complications: In Kim, Young Kyun Woo, Ju Hae Chang, Yong Sik Kim, Seok Whan Song, Soon Yong Kwon, Whan Kun Yoo; J Korean Soc Fract 1995;8(1):216-227. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.216

Abstract PDF: 32 cases of intraarticular and periarticular fractures treated with the Herbert bone screw were analyzed retrospectively by radiographic and functional assessment in the department of orthopaedic surgery of Catholic University Medical College from 1989 to 1994. 1. According to the anatomical distribution, there were various fracture sites as follows: 11 cases of carpal scaphoid, 7 cases of distal humerus, 4 cases of proximal radius, 3 cases of proximal humerus, 3 cases of femoral head,2 cases of distal radius, metacarpal head and medial malleolus in each 1 case. 2. Early and late radiographic assessment showed some complications as follows: 1) Through early radiographic assessment, there were 2 cases of inaccurate reduction of fracture fragment,2 cases of inappropriate fixation (out of bone) and 1 cases of insecure fixation followed by displacement of fracture fragment. 2) Through late radiographic assessment, there were 3 cases of posttraumatic arthritis, 2 cases of avascular necrosis of the osteochondral fracture fragment ; Of 3 cases of posttraumatic arthritis, 2 cases were related to the progressive protrusion of screw head resulting from degenerative thinning of the articular cartilage. Through this study, it was stressed that 1. Fracture personality must be evaluated for the appropriate use of Herbert screw, considering the fracture pattern and sites. 2. The head including a trailing thread must be inserted into the subchondral bone to prevent the protrusion of screw head, being aware of the progressive thinning of cartilage resulting from the inevitable posttraumatic arhritis or avasculsr necrosis of fracture fragment. 3. In the cases of osteochondral fracture deserving the shear force by musculotendinous pulling and joint motion, Herbert screw seems to be undesirable. 4. The Herbert screw is effective method, but needs skill and experience if errors are to be avoided.

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Treatment of Carpal Bone Fracture-Dislocation using the Small-External Fixator and Internal Fixation: Chil Soo Kwon, Young Uck Kim, Byung Hyun Jung, Kyeong Seog Kong; J Korean Soc Fract 1995;8(1):228-233. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.228

Abstract PDF: Authors reviewed 3 cases of carpal bone fracture-dislocation treated with samll-external fixator and internal fixation such as K-wires or screws from October 1991 to March 1993 with above 1 year follow up. The results were as follows; 1. Mean ages were 25 years, all patients were male. 2. The causes of injury were the fall down in 2 cases and the sports injury in 1 case. 3. Cases were a palmar transscaphoid lunate dislocation, a Neglected volar dislocation of lunate, and a doral transscaphoid perilunar dislocation. 4. Advantages are as follows 1) minimize surgical dissection 2) maintenance of reduction is easy 3) ROM: full 4) painless 5) results are excellent We would like to recomment to use the small-external fixator and limited internal fixation instead of other methods for the treatment of carpal bone fracture-dislocation.

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Surgical Treatment of Galezzi's Fracture in Adult: In Suk Oh, Do Hyun Moon, Ju Moon Kim; J Korean Soc Fract 1995;8(1):234-242. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.234

Abstract PDF: Galeazzi's fracture has been defined as a fracture of the distal part of the radial diaphysis that is associated with rupture of the capsule and ligaments of the distal radioulnar joint. This fracture is infrequent and shows the tendency to redisplacement after reduction due to various factors including strong muscles (the brachioradialis, the pronator quadratus, the thumb aHuctors and extensors) and the distal radioulnar joint instability. Because of these factors, the treatment of choice for Galeazzis fracture is open reduction and internal fuation. The authors reviewed the cases of 22 patients with GaleazBis fracture who had been treated surgically form January 1988 to December 1993. The results were as follows 1. There were 18 males and 4 females. The age range was from 19 to 54 years(average, 31 years). 2. The fracture occured mostly at the junction of the middle and distal third of the radial diaphysis in 13 cases(59%). 3. In 16 cases(73%), the fractures were closed and in 6 cases(27%), open. In 17 cases(78%), the fractures were simple and in 5 cases(22%), comminuted. 4. Radiograph signs of the distal radioulnar joint disruption was positive in 86% of the cases. 5. Operative treatment was performed in all cases. Operative treatment resulted in an excellent outcome in 11 cases(50%), a fair outcome in 7 cases(31%) and poor in 4 cases(17%). 6. Among 9 cases. complications were delayed union in 3 cases, subluxation of the distal radioulnar joint in 3 cases, superfical wound infection in 1 case, injury of sensory branch of radial nerve in 1 case and angulation(5 â†‘)in 1 case.

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