Journal of Musculoskeletal Trauma

Operative Treatment of Intraarticular Fractures of the Distal Raidus: Jong Keon Oh, Seung Woo Suh, Woo Nam Moon, Sung Joon Hong; J Korean Soc Fract 1996;9(1):1-7. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.1

Abstract PDF: The intraarticular fracture of the distal radius is one of the most common fractures in the orthopaedic field and physicians have considered the results of the treatment to be favorable. But recently investigations into the pathomechanics of these injuries highlight the peoblems of arthritis, pain, swelling, weakness, limited ranges of motion and instability associated with nonanatomic reduction of both intraaetocular fragments and their associated ligaments. So the treatment of intraarticular fractures of the distal radius has been altered into more aggressive pattern using the open reduction and internal fixation, open reduction or closed reduction and internal fixation, closed reduction and percutaneous pinning. The authors reviewed 37 cases(34 patients)of intraarticular fractures of the distal radius treated using operative methods from February 1989 to May 1994 in the department of orthopaedic surgery, Ansan Hospital, Korea University: We analyzed the correlation between the radiologic parameters(articular conguity, radial height loss, adial angulation, palmar angulation)and the end results.

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Open Reduction & Internal Fixation for The Nonunion of Scaphoid Fracture: Eung Shick Kang, Ho Jeong Kang, Keun Soo Lee; J Korean Soc Fract 1996;9(1):8-14. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.8

Scaphoid fracture is the most common carpal bone fracture and at least 5% of acute fractures of the scaphoid fail to unite after conservative treatment. The failures have been attributed to delay in beginning treatment, inadequate immobilization, displacement of fragments, instability due to ligamentous injury, and inadequate blood supply of the proximal fragment. Previously, some authors reported several kinds of treatment mordality for nonunion of scaphoid. Of all the techniques that have been introduced, we have used open reduction and internal fixation (O/R & I/F) with autogenous iliac bone graft(AIBG). We reviewed the 10 cases of patients who underwent O/R & IT with K-wire or Herbert screw and A1BG from Jan 1985 to Aug 1994. The results were as follow 1.Among 10 cases, 9 cases were male and 1 case was female, and all cases were right hand, and most common age group was twenties (70%). 2.The most common cause of injury was falling with outstretched hand in 8 cases. 3.In the previous treatment, 8 cases had non-specific treatment and 2 cases had cast immobilization. 4.In the operation method, open reduction and internal fixation (O/R & IT) with K-wire combined with autogenous iliac bone graft (AIBG) for 8 cases, and O/R & I/F with Herbert screw combined with AIBG for I case and O/R & I/F with Herbert screw without bone graft for 1 case. 5-After operation, average duration of cast immobilization was 2.8 months (2.5months-3months). 6.All patients had a bony union with average duration 6.2 months (3months- 10months).

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Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture
Jae Kwang Kim, Jong Oh Kim, Seung Yup Lee, Nam Hoon Do
Journal of the Korean Fracture Society.2009; 22(2): 104. CrossRef

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Surgical Treatment of Scaphoid Nonunion: Jae Ik Thim, Taek Sun Kim, Sung Jong Lee, Suk Ha Lee, Chang Moo Yoo, Kil Joo Han; J Korean Soc Fract 1996;9(1):15-23. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.15

Abstract PDF

The scaphoid fracture is the most common fracture of the carpal bone in young men and has high incidence of nonunion. Many methods of treatment for nonunion of the carpal scaphoid have been described; bone grafting, screw fixation, pulsed electromagnetic field and cast, percutaneous pinning and Herbert screw fixation. Two of the commonest methods of treatment are Matti-Russe procedure and Herbert screw fixation and this paper compares these two surgical treatments. At the Department of Orthopaedic Surgery, Korea Veterans Hospital, from October 1988 to October 1994, 11 cases of the scaphoid nonunion had been treated by Matti-Russe procedure only (4 cases), Matti-Russe procedure with K-wire (2 cases) and Bone graft with Herbert screw fixation (5 cases) and followed up more than 1 year. The results were as follows; 1. Among 11 cases, 10 cases were male and 1 case was female and the range of age was 19-46 years (Mean 26.2 years). 2. The sites of fracture were confined to the waist in 9 cases (82%) and prox 1/3 in 2 cases (18%). 3. The treatment methods were Matti-Russe only in 4 cases, Matti-Russe procedure with K-wire in 2 cases and Bone graft with Herbert screw fixation in 5 cases. 4. Postoperative cast immobilization was done for 16.5 weeks in the cases treated by Matti-Russe procedure and for 4 weeks in the cases treated by Bone graft with Herbert screw fixation. 5. The union rate was 91 % after postoperative 4 months (Mean 4.1 months). 6. The results of treatment were excellent in 7 cases (64%), good in 3 cases (27%) and fair in 1 case(9%). Therefore the Matti-Russe procedure and Bone graft with Herbert Screw fixation are good procedures in the treatment of scaphoid nonunion. But, Bone graft with Herbert screw fixation is more useful in young men because of short periods of immobilization and early returning to work.

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Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture
Jae Kwang Kim, Jong Oh Kim, Seung Yup Lee, Nam Hoon Do
Journal of the Korean Fracture Society.2009; 22(2): 104. CrossRef

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The Result of Osteosynthesis of Scaphoid with Matti-Russe Technique and Herbert Screw: Duck Yun Cho, Young Gil Hahm, Myoung Hyoung Lee; J Korean Soc Fract 1996;9(1):24-32. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.24

Abstract PDF: Fracture of scaphoid are second most common fractures of wrist, and about 1/6 of these fractures proceed to nonunion. The most widely used surgical procedure of scaphoid nonunion has been Matti-Russe procedures,and Hebert screw is a recently introduced fixation device as a means of rigid internal fixation promoting union and decreasing immobilization time. Authors have managed 15 cases of scaphoid nonunion with Mtti-Russe bone grafting technique and herbert screw, and accomplished satisfactory results: The union rate Was 96.6%, the average time to union was 17.1 weeks, and according to Maudsleys assessment criteria, we obtained 7 cases of excellnt, 6 good, and 2 fair results. Despite of its technical demand and lack of the number and study material, Matti-Russe bone grafting technique with Herbert screw fixation seems efficient and reliable method of treatment.

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A Clinical Study of Fracture of Distal Radius: Pitfall of Treatment of Intraarticularly comminuted fracture: Chong Hoon Park, Won Yoo Kim, Jin Hyung Sung, Kyong Ho Yoo, Jin Yiung Kim; J Korean Soc Fract 1996;9(1):33-41. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.33

Abstract PDF: The fracture of the distal radius was first described as the fracture of the radius with dorsally eisplaced fragment within distal 1.5 inch at 1814 by Abraham Calles.since that, according to feature of fractures, many classifications have been introduced. Although there are many kinds of msthod in treatment of fracture of the distal radius, we find difficulty in selecting adequate method of treatment of intraarticularly comminuted fracture of the distal radius.And recently the intraarticularly comminuted fracture is occasionally recognized as nit a simple fracture but a complicated fracture because of postraumtic arthritrs, malunion, nonunion,and stiff hand after treatment.So,we retrospectively reviewed thirty-eight cases which were treated by several methods for 5 year from Jan.1990 to Dec. 1994 at the our hospital. The results were as follows. 1.In general, the incidence was mare higher in male, but the older in age, the more incidence in female. 2.The most common catse as a single cause of injury was a traffic accident. 3.By the point system for subjective evaluation and objective evaouation of Gartland and Werley, the excellent or good result were represented at the extraarticular fractures or undisplaced inraarticaular fracture among Collesfracture, Bartons Chauffeurs, Smiths, and lunste load fracture, which had been treated by sugar-tongs splint or percutaneous pinnongs after the closed reduction. And the excellent result was especially showed at the volar Bartons jractures which had been managed by the plate fixation after the open reduction. But the poor result was represented at the intraarticularly comminuted fractures of the distal radius, which had been treated by percutaneoys pinning(2 cases)or only external fixation without an additional fixation(4 cases) after the closed reduction. In conclusiln, the investigatir thought that the anatomical reduction, more secure fixation, and sometimes bone grafting in treating the intraarticylarlycomminuted fracture of the distal radiuw were essential fir having satisfactory clinical result.

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Lunate dislocation and perilunte dislocation with or without fracture: Won Jong Bahk, Jong Min Sohn, Nam Gee Lee, Seung Key Kim, Young Joo Park, Han Chang; J Korean Soc Fract 1996;9(1):42-49. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.42

Abstract PDF: The lnate dislocation and perilunte dislocation with or without fracture, occupying about 10% of carpal injury, might b classified as a same category of injury resulted from similar mechanim. Initial diagnosis was missed often. In case of failure of closed reduction, open reduction and internal fixation will be necessary. The authors analyzed retrospectively 15 patients with lunate dislocation and perilunate dislication without fracture(Group A)and perlunate dislication with scaphoid fracture(Group B) who were treated from 1989 to 1994 at our hespital. The follow-up periods were 7 months to 60 months with mean of 23.2 months. The results were as follows. 1.Group A were 2 cases of anterior dislication of lunate and 8 cases of perilunate dislocation Group B were 5 cases of transscaphoid perilunate fracture-dislocation. The direction of perilunar dislocation with or without scaphoid fracture was posterior in all cases. 2.The causes of injury were fall from height in 7 cases, slip in 3 cases, traffic accident in 3 cases and crushing injury in 2 cases. 3.The overall clinical results by modified Green and OBriens clinical score were excellent in 4 cases(26.7%), good in 4 cases (26.7%),fair in 4 cases(26.7)and poor in 3 cases(20%). 4.9 out of 10 cases (90%) in Group A and 3 out of 5 cases(60%) in Group B were superior to fair. Early treatment within 3 days injury was performed in 11 cases (7 in Group A,4 in Group B), The average point was 85 and 70, respectively and there was no statisticat significance between two groups(P>0.05). Treatment was delayed beyond two weeks after injury due to missed initial diagnosis and open wound in 4 cases(3 in Group A,1 in Grdup B). The final tesults were 1 case of good, 1 case of fair, 1 case of poor in Group a, and 1 case of poor in Group B. There was no statistical significance between the early treatment cases and delayed treatment cases(P>0.05). In conclusion, ounate and perilunate dislocation without scaphoid fracture can be treated by early operation to get and maintain the anatomical reduction. The authors thought that the presence of scaphoid fracture, nonanatomic reduction and delay in treatment are poor prognostic factors.

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Importance of maintenance medial buttress in treatment of supra-condylar and inter-condylar(T-condylar) fracture of the femur: Seung Ho Yune, Kwang Jin Rhee, Chan Hee Park, Ki Yong Byun, Sang Yong Lee, Seung Kwon Rho; J Korean Soc Fract 1996;9(1):50-58. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.50

Abstract PDF

Recently, treatment of supracondylar and intercondylar(T-condylar) fracture of the femur has been changed from conservative treatment to do open reduction and internal fixation. Principles of anatomical reduction, rigid internal fixation and early knee joint exercise are recommended, but there are many difficulties and problems to get anatomial reduction and rigid internal fixation. we observed 3 cases of malunion & nonunion that were treated by ORIF. In these cases, there is a failure in restoring medial buttress of distal femur due to inadequate reduction and internal fixation. Dynamic condylar screw(DCS) or blade plate were usually used through lateral approach and laterally applying method can not always restore the medial buttress of the fracture site. In these cases, early exercise and early weight bearing have to be postponed,and the results were poor. So we want to emphasize the principles in open reduction and internal fixation of the supra-and inter-condylar fracture fo the femur. To get anatomecal reduction is very important, but if is not possible in severely comminuted fractures, we have to try to maintain medial buttress by another methods such as double plating(to add a medial auxiliary buttress plate to lateral internal fixation) or auxiliary external fixations instead of medial anatomical contact.

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Medial Plating of Distal Femoral Fracture with Locking Compression Plate-Proximal Lateral Tibia: Cases' Report
Se-Ang Jang, Young-Soo Byun, In-Ho Han, Dongju Shin
Journal of the Korean Fracture Society.2016; 29(3): 206. CrossRef
The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Kwang-Hee Park, Yoon-Ho Choi
Journal of the Korean Fracture Society.2009; 22(4): 246. CrossRef

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Operative Treatment of the fractures of the Distal Femur: Jeung Tak Suh, seung Wook Kim, Chong Il Yoo; J Korean Soc Fract 1996;9(1):59-67. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.59

Abstract PDF

Fractures of the distal femur which include supracondylar and intercondylar injuries are difficult to manage. Usually combined with high energy trauma, there are severe soft tissue damage, comminu tion, intra-articular fracture, and injury to the quadriceps mechanism lead to unsatisfactory results in many cases, regardless of the treatment. The goals of treatment are to achieve fracture union and to restore early knee motion. Before 1960, preferred method of menagment was primarily traction alone or combination with a cast. During the last two decades, as technology and implants have been improved, most traumatologists have advocated some form of internal fixation in the managment of distal femur fractures. Surfaces, restorative treatment requires achieving the following goals;anatomic reduction of joint surfaces, restoration of limb length and alignment, rigid fixation, and eatly knee range of motion. Author reviewed and clinically analysed 42 cases of the fractures which were followed more than one year at the orthoedic department of Pusan National Universty Hospital during the period from January 1987 to December 1993. The results were as follows; 1.The incidence was higher in active young age group. 2.The most common cause of the injury was traffic accident with high energy rauma(59.5%) and the most frequent injury type by Mullwes classification was C type(59.5%) 3.Overall result estimsted by schatzkers criteria was excellent in 10 cases(28.6%), good in 4 cases(40.0%), faur in 6 cases(17.1%) and poor in 5 cases(14.3%). 4.The causes of poor resulted cases were open fractures, fracture with articular comminution and inadequate anatomical reduction. 5.Rigid internal fixation permits early functional rehabilitation of the patient and decrease the incidence of malunion, nonunion and loss of fixation.

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Fractures of the distal femur in elderly patients: retrospective analysis of a case series treated with single or double plate
Dae Jin Nam, Min Seok Kim, Tae Ho Kim, Min Woo Kim, Suc Hyun Kweon
Journal of Orthopaedic Surgery and Research.2022;[Epub] CrossRef

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Result of 29 consecutive patients with the distal femiral fracture: Analysis of the result treated with AO DCS(dynamic condylar Screw) Supracondylar nail, May anatomical plate: Weon Yoo Kim, Jin Hyung Sung, Chong Hoon Park, Jeong Soo Park, Jin Yong Kim; J Korean Soc Fract 1996;9(1):68-75. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.68

Abstract PDF: Twenty-nine cases of the surgically treated distal femoral fracture were analyzed to compare internal fixatorw (AO DCS,Supracondylar nail, May anatomical plate),who were treated at Department of orthopaedic surgery, Taejon Saint Marys hospital from Jan. 1992 to Jun. 1994. The cases were classified according to AO classification and minmum 12 months(average:22.4 monthw) follow up. Following results were obtained: 1.Male was more common than female, age distrbution was between 16 and 77 years old(average 40.4), abd the most common cause of the fracture was traffic accident. 2.The most comon type C by AO classification(type A 11 cases, type B 1 case, type C 17 cases). 3.According to Schatzkers criteria in the clincal result, type A,B were better resykt than type C, and severe soft tissue damage, comminution and joint involvement lead to unsatisfactory results. 4.Supracondylar nail was inadequate implant due to inferior clinical result(1 excellent, 2 good and 3 poor). 5.DCS had more sateafactory result than other internal fixators(supracondylar nail, May anatomical plate). Based on the observations, the better results depend on the amount of initial trauma, early anatomical reduction, rigid internal fixation and exercise of the knee joint.

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The Gamma Nail for Unstable Peritrochanteric Fractures: Hong Jun Han, Hee Jun Yu; J Korean Soc Fract 1996;9(1):76-80. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.76

Abstract PDF

The Gamma nail was designed to treat unstable intertrochanteric and subtochanteric fractures with the theoretical advantages of a load-sharing compinent which could be implanted by a semi-closed procedure. We report a retrospective study of 27 unstable peritrochanteric fractures treated by the Gamma nail. Gamma nail were implanted with an average duration of anesthesia of 84 minutes and little intra-operative bleeding by a semi-closed technique. Complications were few, and clinically not implant except one case of femoral shaft fracture at the distal end of the nail which healed well fter treatment with Gamma nail and circlage wiring.

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Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA)
Myung-Sik Park, Young-Jin Lim, Young-Sin Kim, Kyu-Hyung Kim, Hong-Man Cho
Journal of the Korean Fracture Society.2009; 22(2): 91. CrossRef
Treatment of Senile Osteoporotic Intertrochanteric Fracture using Proximal Femoral Nail
Dong-Hui Kim, Sang-Hong Lee, Young-Lae Moon, Jun-Young Lee, Kun-Sang Song
Journal of the Korean Fracture Society.2007; 20(3): 215. CrossRef

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Causes and Treament of Nonunion of the Femur Shaft: Moon Gu Choi, Hyoung Min Kim, Youn Soo Kim, Kee Haeng Lee, Hong Hua Song, Young Joo Park; J Korean Soc Fract 1996;9(1):81-87. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.81

Abstract PDF: The causes of nonunion of the femur shaft could be divided as fracture itself and iatrogenic. And also the methods of treatment are controversial. From Dec. 1988 to Jan. 1995. We analyzed 21 cases of nonunion of the femur shaft. The period of follow up was from 1 year to 4 year 7 month (average time 2 years). The causes of the nonunion were fracture itself in 1 case, inadequate fixation in 17 cases, and early weight bearing in 3 cases. Seventeen of 21 were plate fixation cases and 4 or 21 were intramedullary-nailing cases. Metallic failures were seen in 15 cases. Cancellous bone graft was done in all cases. Cancellous bone graft only without other additional fixation were done in two cases, plate fixation were done in 8 cases, and intramedullary nailing were done in 11 cases. Additional narrow plate fixations were done in 9 cases, which 3 cases were done with plate fixation and 6 cases were done with intramedullary nailing. Partial weight bearing were done 2.5 months in which case cancellous bone graft only, plate fixation and intramedullary nailing cases, were done 2 months in the case of narrow additional plate with intramedullary nailing. Authors concluded that stable internal fixation was very important and additional narrow plate fixation was good alternative method in the treatment of nonunion of the femur shaft.

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Classification of Femoral Neck Fractures: Soo Ho Lee, Ewy Ryong Chung, Hyung Sun Ahn, Jae Suk Chang, Key Yong Kim; J Korean Soc Fract 1996;9(1):88-96. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.88

Abstract PDF: The authors have reviewed 45 cases of femoral neck fractures from January 1991 to September 1994 with special reference to fracture classification. Follow-up periods for these cases were more than 1 year for all of these cases. The results were as follows: 1. AO classification of femoral neck fractures is better than Garden's classification in its simplicity and less inter-observer variations. 2. AO classification of femoral neck fractures is better than Garden's classification in predicting healing complications of internal fixation of femoral neck fractures. 3. Another factors predicting healing complications are the accuracy of reduction and the postoperative bone scintigraphy. With the above results, we concluded that AO classification of femoral neck fractures seems to be useful in clinical application to femoral neck fractures together with Garden's classification.

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Metal Failure in Treatment of Fracture of Femoral Shaft: S R Park, H S Kim, K H Moon, J S Kang, W H Lee, S R Shin; J Korean Soc Fract 1996;9(1):97-104. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.97

Abstract PDF: Treatments of choice for femoral shaft fracture in adult patients are plate and screws, and intramedullary nailing. Through this active treatment, early motion exercise and early weight bearing can be obtained. However, the frequency of metal failure has increased also and has become a problem in treatment of the fracture. The authors clinically analysed the metal failure in 13 cases after fixation of femoral shaft fracture, during last 7 years since from February 1988 to January 1995. We obtained the following results; 1. The interval between initial operation and metal failure was 6.8 months on average, ranging from 2 to 13 months, and the most common site of the metal failure was previous fracture site. 2. The most common cause of metal failure was dificiency of medial buttress(8 cases, 61.5%) and the most common method of the treatment was intramedullary fixation with interlocking nail and bone graft. 3. To avoid metal failure, accurate reduction of fracture, adequate immobilization and adequate postoperative management was necessary.

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Interlocking Medullary Nailing in Severe Comminuted Fracture of the Femoral Shaft: Young Goo Lee, Jang Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seong Seok Seo, Young Jae Kim; J Korean Soc Fract 1996;9(1):105-111. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.105

Abstract PDF: The interlocking medullary nail widens the range of the indication for medullary osteosynthesis of the femoral shaft fractures. Twenty one cases with the comminuted fracture of the femoral shaft were reviewed, which had been treated by closed or or semi-open IM nailing at the Department of Orthopedic Surgery, Pusan Paik Hospital from March 1991 to December 1993. The results were as follows 1. The period of fracture union was 22.1 weeks in Winquist-Hansen Grade III,27.4 weeks in Grade IV , 19.6 weeks in segmental. And its period was 22.6 weeks in closed and 26.2 weeks in semi-open IM nailing. 2. The result of closed interlocking medullary nailing was better and complications were less than semi-open interlocking medullary nailing. 3. The severely comminuted femoral shaft fractures were unstable and there were the risk of shortening, rotation and inadequate reduction. Therefore, when the closed interlocking medullary nailing did not gain the anatomical reduction, it was altemative method to perform semi-open interlocking medullary nailing. From above result, we conclude that closed interlocking medullary nailing or semi-open interlocking medullary nailing seems to be a favorabel method for treatment of severe comminuted femoral shaft fracture.

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Treatment of Nonunion of the Tibia Fracture: Dong Heon Kim, Kyu Cheol Shin, Hee Cheol Park, Ju Yong Shin; J Korean Soc Fract 1996;9(1):112-118. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.112

Abstract PDF: Nonunion after tibia fracture is a relatively common problem. The cases of nonunion have been known open and comunited fracture, extensive soft tissue injury, interposition of the soft tissue, distarbance of the blood supply and inadequate fixation. A number of methods stimulating union have born described. These include fibular osteotomy followed by weight-bearing in a cast, autogenous boone graft with or without additional stabilization, internal or external fixation with compression, open or closed IM nailing and even electromagetic stimulation. In this paper we carried out retrospective study of the 24 nonunion of the tibia fracture which were treated at the Department of Orthopeadic Surgery, Kon-Kuk University Hospital from March 1990 to March 1995. The results were as follows: 1. Among 24 cases of monunions, 16cases(66.6%) were communited fractures and 18cases(75%) were open fractures. 2. Hypervascular nonunion were 12cases and avascular nonunion were 12cases. Previous methods of treatinent were conservative treatment in 6cases of closed fracture and were treated with Ender nailing, multiple K-wire fixation, Ilizarolr external fixation, monofixator external fixation in 1 Bcases of open fractures. 3. The average duration from injury to dignosis of nonunion was 7 months tweets.(Range 5 months to 24months) 4. Tibial nonunion were treated with plate and screw with bone graft(Bcases), Interlocking IM nail ing(14cases), and nizarov external fixation with bone graft(teases). 5. The average time of union was 23weeks in all patients: 24 weeks in the case of plate and screw with bone graft. 20 weeks in the case of interlocking IM nailing. 28 weeks in the case Ilizarov external fixation with bone graft. 6. The main complications were joint stiffness due to long-term cast irnrnobiliBation in the case of plate and screw with bone graft, LROM of joint contracture and external pin site in the case of Ilizarov external fixation with bone graft, deep infection Icase and knee joint pain teases due to proximal nail protrusion in the case of Interlocking IM nailing.

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The Ilizarov Method for the Treatment of Open Intraarticular Fractures around the Knee Joint: Clinical Analysis of 6 Cases: Chang Hyouk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Yong Joo Kim; J Korean Soc Fract 1996;9(1):119-128. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.119

Abstract PDF: There are many difficulties in treating open intraarticular fracture around the knee joint because of its combined neurovascular injury and comminution of fracture site. The difficulties lie in choosing a fixation method, postoperative care, and analyzing the results of the treatment. Recently there is growing preference in using Ilizarov apparatus. The merits of Ilizarov in fracture treatment are early weight bearing and easy compression and distraction. In cases of this study, difficulties were subclassified into problems, obstacles. and complications. Six cases of open intraarticular fracture around the knee joint were treated from Mar., 1993 to Aug.,1994 and the average follow up period was twenty months and the results were as follows: 1. Of the six patients, there were five males and one female patients. 2. The cause of the fractures was traffic accident in five and crushing injury in one. 3. Of the six cases, five cases were combined femoral and tibial fractures and one case was only femoral condylar fracture. 4. In follow up study, there was thirty cases of difficulties such as pin site problem, pain, limitation femotion, and nonunion etc. 5. Of the seventy-four wires, pin site problem occurred at twenty pins but open wounds were cured without infection evidence. 6. The results were poor in all cases. 7. The Ilizarov technique requires adequate implantation and management to reduce an overall complication rate and improve functional results.

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Treatment of the Ipsilateral fracture of Femur and Tibia in Children: Jong Seok Park, Yoon Sik Kim, Hee Kwon, Jun Min Song, Soo Kyun Rah, Chang Uk Choi; J Korean Soc Fract 1996;9(1):129-136. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.129

Abstract PDF: Sixteen cases of fracture of the femur and tibia on the same leg in children below 16 year age were treated in Soonchunyang Univ. Hospital during the period 1988-1993. We studied all of these patients, classified by LettsNew classification of pediatric floating knee, retrospectively with analysis of treatment and results. The results were as follows; 1. Among the 16 cases,14 cases were male(88%), and 10 cases(63%) were at their first decade and 6 cases(37%) were at second decades. 2. The main cause of injury was traffic accident;15 cases(94%). 3. The most common concomitant injury was fracture in other site;5 cases(31%). 4. Among the 9 cases of conservative treatment, limping and leg length inequality were occurred in 6 cases(61%), and malunion in 5 cases(56fo). 5. Among the 7 cases of operative treatment, limping was occurred in 1 cases(14%), leg length inequality was in 2 cases(29%), and malunion in 3 cases(43%). 6. Among the 10 cases at first decade, limping was occurred in the 6 cases(75%) out of 8 cases of conservative treatment, but it was not occurred in 2 cases of operative treatment. According to the results, we suggest that at least one fracture should be rigidly fixed in all cases.

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Lateral Condyle Fracture of Tibia Treated by Open Reduction and Internal Fixation: Jong Min Sohn, Ju Hai Chang, Dong Heon An, Soo An Park; J Korean Soc Fract 1996;9(1):137-145. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.137

Abstract PDF: Tibial condyle fracture involving articular surface can produce some disabilities of the knee because they are usually accompanied with the injuries of the ligaments and menisci. Though recent studies suggest that anatomical reduction and rigid fixation of the fracture followed by early knee mobilization have improved clinical end results, the results were not always successful. The lateral condyle fracture is more often in the incidence than the medial one. This is due to the physiologic valgus of the knee, the weaker trabeculation under the lateral tibial plateau, and the increased frequency of valses injuries as the knee is protected medially by the contralateral side. Eighteen lateral condyle fractures of the tibia treated by open reduction and internal fixation at the Our Lady of Mercy Hospital from June 1991 through February 1995 were analized. The results are as follows. 1. The patients were 13 males and 5 females, mean age was 39.2 years and mean follow up-period was 19.2 months. 2. The most common cause was motor vehicle accident(8 cases,44.4%). 3. The most frequent type of fracture was split(8 cases,44.4%) by Rasmussens lateral condyle fracture classification and the next was split-compression(6 cases,33.3%). 4. According to Blokkers criteria,15 cases(83.3%) had satisfactory results. Among 3 cases of unsatisfactory results, 1 developed secondary degenerative change, 1 had valgus instability and 1 secondary degenerative change and mild valgus instability. It is thought that the most important factor influencing results was the anatomical reduction of the articular surface, rigid fixation and early joint mobilization.

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Treatment with bone block transfer of coracoacromial ligment in acromioclayicular injury: Byung Chang Lee, Sang Soo Kim, Dae Moo Shim, Sang Do Cha; J Korean Soc Fract 1996;9(1):146-153. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.146

Abstract PDF: Several studies have shown the effectiveness of reconstruction of acromioclavicular ligament with coracoacromial ligament in treating the Grade III acromioclavicular joint injury. One of these is a bone block transfer of coracoacromial ligament into the medullary canal of the clavicle to prevent occasional pullout of the transfered ligament. Eleven cases with complete acromioclavicular dislocation(acute 3, chronic 8) were treated by this method. We modified slightly the original method described by Shoji et at. to increase the success rate. Failure of coracoclavicular reconstruction occurred in two cases. All except one patient regained nearly painlefs range of shoulder motion. One patient showed severe restriction of shoulder abduction and definite deformity. In functional evaluation by the Weitzman criteria, five were excellent, four good, one fair, and one poor. Radiologic results for restoration of coracoclavicular interval showed marked improvement but were not consistent with clinical results. Main technical problems were harvesting bone block and fixation of ligament. To obtain good osseus healing without pull out of transferred ligament, we found that preservation of bone ligament junction and careful harvest of full thickness acromiai bone block was important.

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Treatment of acromioclavicular dislocation by a Phemister method: Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Sung Soo Kim, Hyung Hwan Lee; J Korean Soc Fract 1996;9(1):154-160. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.154

Abstract PDF: Acromio-clavicular joint dislocation occurs when both acromioclavicular and coracoclavicular ligaments are ruptured and brings to deformity, arthralgia and limitation of motion of the shoulder joint. The treatment of complete acromioclavicular dislocation is controversial, and both of the conservative and surgical treatment are reported to be relatively successful. But, conservative treatment have many disadvantages and now rarely advocated. Recently, there are increasing tendencies to treat the acromioclavicular dislocatioll with anatomical reduction of acromioclavicular joint and rigid internal fixation for early movement of shoulder Joint. We report the results of 16 cases of acute acromioclavicular dislocation treated with Phemister or modified Phemister method. The results are as follows. 1. Among 16 cases,14 cases were males and 9 cases were belong to 3rd decade and 4th decade. 2. The most common cause of injuries was slip down. 3. Postoperative difference in coracoclavicular distance on radiogram was 0.1 mm on average. 4. Clinical results were excellent in 14 cases, good in 1 case and acceptable in 1 case. 5. Complications were redislocation in 1 case and K-wire migration in 1 case, but there was no arhritic changes on the affected A-C joint.

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A Comparison of the Using of Plate fixation and Ender nailing in Humeral Shaft Fractures: Ig Gon Kim, Jae Hyek Kim, Chul Hyun Eim, Soo Dong Baek; J Korean Soc Fract 1996;9(1):161-169. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.161

Abstract PDF: The humerus is anatomically and physiologically unique bone: firstly, it is a non-weight bearing bone; secondly, it has greatest range of motion; thirdly, while the person is standing, the axis of bone hangs vertically and is influenced by gravity, and conservative methods are usually used in treatment. However. in the cases of closed reduction failure, open fracture, multiple fracture, and old age etc, operative methods may be employed. This decision should be based on the type, location of fracture. the presence of concomittent injuries, the age, and the general condition of the patient. When open reduction and internal fixation is carried out, the periosteum and soft tissue attachment is stripped off and operative time is longer Flexible Ender nailing is a simple procedure which does not disrupt or strip off periosteum and soft tissue at the fracture site, and decreases the chance of infection and allows early exercise. Authors carried out fixation in 28 patients and Ender nailing in 24 patients having humeral shaft fractures who were treated at the orthopedic department, Hae Dong hospital from March, 1990 to February, 1994.

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Treatment of the humeral shaft fracture with interlocking intramedullary nail: Seok Beom Kim, Jeong Woung Lee, Won Tai Choi; J Korean Soc Fract 1996;9(1):170-176. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.170

Abstract PDF: In general, fracture of the shaft of the humerus is treated non-operative or by operative methods. The accepted treatment of the Isolated low-energy humeral shaft fracture is non-operative method. However, the fracture of the humerus that are associated with high energy, significant communition, unstable fracture patterns, or fractures that have been difficult to reduce or maintain reduction have been difficult to treat or maintain reduction have been difficult to treat by non-operative method. This has led to the use of operative intervention for the treatment of the humeral shaft fracture. The use of open technique with plate and screw is difficult due to potential injury of the neurovascular structure, increased risk of the infection and extensile exposure of the fracture site. Intramedullary nailing has advantages over other techniques of internal fixation and has been used to maintain the alignment and length of humerus. Especially, hiornechanically locked intramedullary nailing has the theoretical advantage of providing a weight shearing device and a ability to decrease the effect of rotational shear at the fracture site. This would increase the inherent stability at the fracture site and thus promote union. Authors performed interlocking intramedullary nailing for 35 cases of humeral shaft fracture from July-1993 until May-1995.

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Closed Interlocked intramedullary nailing of the humerus shaft Fracture: Bu Bwan Kim, Jong ln Yim, Hee Yeong Chung, Joon Young Park; J Korean Soc Fract 1996;9(1):177-184. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.177

Abstract PDF: The interlocked intramedullary nailing of humerus shaft fracture has been used as a available method because of the advantages, including relatively simple procedure, stable fixation method, and allowing early ROM and low complication. The authors have reviewed 24 cases of humerus shaft fractures, which were treated with closed interlocked intramedullary nailing from Mar. 1992 to Feb. 1994 at Dae-Dong General Hospital. The results were as follows; 1. Twenty four patients treated with intramedullary nailing revealed primary bone union and the average time for bone union was about 8.5 weeks. 2. There was no serious post operative complication such as nonunion, infection, rotatory deformity, metal failure of nail or interlocking screw. 3. According to the Stewart & Hundley classification of result, excellent, good and fair were observed in 21 cases(87%). 4. To prevent the impingement syndrome and rotator cuff injury, the proximal end of the nail was countersunk but the deeper the insertion, the more difficult the removal.

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Treatment of A-C joint dislocation with cannulated screw fixation under local anesthesia: Bu Hwan Kim, Jong In Yim, Deog Jeong Kang; J Korean Soc Fract 1996;9(1):185-192. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.185

Abstract PDF: In 1941, Bosworth used noncannulated coracoclavicular lag screw to Oeat acute A-C joint dislocation. In 1989, Tsou fixed coracoclavicular joint with percutaneous cannulated screw under general anesthesia in the treatment of acute A-C joint complete dislocations. We tried to treat 10 cases of acute A-C joint dislocations with cannulated screw fixation of C-C joint under local anesthesia, so we report the results with review of literatures. The results were as follows 1. Results of treatment were good in 7 cases, fair in 2 cases, and poor in 1 case by Weaver and Dunn evaluation criteria. 2. The operations were done under local anesthesia, but in two cases operation ended under general anesthesia due to discomfort of the patients. 3. In skeletally thin patient, it was very difficult to make accurate hole and we experienced an iatrogenic fracture of clavicle and coracoid process. This technique is not recommendable in skeletally thin patient. 4. Operation took 42 minutes on average(from 30 minutes to 105 minutes) though it took more time in the early cases. 5. We had several complications in 3 patients. Misdirection of screw(1 case), screw loosening and pull out(1 case), subluxation of A-C joint after removal of screw(2 cases), and iatrogenic fracture of clavicle and coracoid process(1 case) but no case of metal breakage or infection.

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The Treatment of the Intra-articular Fracture of Distal Radius: Joo Tae Park, Gil Yeong Ahn, Il Hyun Nam, Gyun Hwan Kim; J Korean Soc Fract 1996;9(1):193-199. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.193

Abstract PDF: Althougn not as common as the intra-articular fracture of distal radius, if present considerable challanges in management. Because the intra-articular fracture is frequently accompanied by comminution and intra-articular extension of fracture, it can produce rome disability of the wrist joint. Now there are wide consensus that more aggressive surgical treatments are needed in such complex fracture to fulfill the better results. So recently, anatomical reduction, rigid internal fixation and early rehabilitation was recommended. The authors analized sixteen causes of intra-articular fracture of distal radius that were treated with open reduction and internal fixation at the Department of Orthopedic Surgery of Pohang St, Marys Hospital from March,1990 to December,1993. The object of this study is to evaluated the correlation between the rigid internal fixation and early rehabilitation. The average follow up period was 18.3 months(from 14 to 21 month) The result were as follows, 1. Among 1st 2 weeks after operation, long arm cast was applied. During 2nd 2 weeks, monster cast was applied. At 4 weeks, we started R.O.M.exercise and additional night splint was applied during 4 weeks. 2. The radiological union was achieved at all cases and the average time of union was 9.5 months. 3. According the Cole and Obletz criteria, excellent were 11 cases, good 3 cases, fair 2 cases. 4. We obtained satisfactory result by rigid internal fixation and early rehabilitation.

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Clinical Evaluation for the Tibial Pilon Fractures: Kyung Jin Song, Joo Won Jung, Joo Bong Lee, Myung Sik Park, Byung Yun Bwang; J Korean Soc Fract 1996;9(1):200-204. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.200

Abstract PDF

Treatment for the tibial Pilon fractures involving ankle joint must be the most challenging one in the long bone fractures following lots of complications. We analyzed fourteen patients those who underwent surgical treatment for distal tibia fracture extending through the tibial plafond into the ankle joint. Under the Ruedi and Allgower classification two were in type I, two were in type II and ten were in type III. The Mean follow-uP Period was four years ranging from two to seven years. The purpose of this paper is to evaluate the treatment results of tibia Pilon fractures and analyBe the causes of complications. In surgical treatment method, we tried early open reduction and rigid internal fixation as far aas possible in the closed pilon fracture. We assessed the function under the objective and sutjective criteria of Ovadia and Beals. Two out of two in type I, one out of two in type II and four out of ten in type III Pilon fractures obtained good functional outcome. There were 3 wound infections, 1 malunion with reflex sympathetic dystrophy and 2 traumatic osteoarthritis as a complication. Type I and type II Pilon fractures proved to be amenable to open reduction, restoration of anatomic position, and stable internal fixation with early joint exercise. Nonanatomic reduction, unstable fixation, infection, and secondary arthrosis were associated in type III Pilon fractures with poor functional outcome after surgical treatment.

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Comminuted Pilon Fractures: Comparative Outcome Analysis according to Surgical Techniques
You-Jin Kim, Hong-Geun Jung, Joo-Hong Lee, Woo-Sup Byun, Sung-Tae Lee
Journal of the Korean Fracture Society.2007; 20(1): 6. CrossRef

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The Treatment of Tarsometatarsal Fracture-Dislocation: Han Yong Lee, Yong Koo Kang, Bae Seok Koh, Kee Won Rhyu, Jong UK Yhu; J Korean Soc Fract 1996;9(1):205-211. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.205

Abstract PDF: In order to analyze the value of various methods of treatment and to recognize the prognostic factors for tarsometatarsal fracture-dislocation, 16 patients(17 cases) were reviewed. The average follow up was 21 months(range 12 months to 36 months). All cases were classified radiologically by Hardcastles method. There were 3 cases in type A, 12 cases in type B, and 2 cases in type C. Ten cases were treated with open reduction and internal fixation, seven cases were treated with closed reduction and percutaneous pinning. Functional results were evaluated with Hardcastles criteria, 6 had good results and 11 fair. In ten cases treated with open reduction, 3(30%) had good results and 7(70%) fair, whereas 2(28.6%) had good result and 5(71.4%) fair in seven cases treated with closed reduction. When the results were assessed according to the type of injury,6(50%) had good results and 6(50%) fair in type B, whereas all cases had fair results in type A and C. In conclusion, larsornetatarsal fracture-dislocation was more frequently seen in active adult males and associated with other injuries. The anatomic reduction and its maintenance seem to lead to the good results. It was thought that prognosis after anatomic reduction might be dependent on the type of injury.

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A Clinical Analysis of Open Reduction of the Ankle Fracture: Eun Kyoo Song, Go Hun Chung, Dae Yeon Hong; J Korean Soc Fract 1996;9(1):212-219. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.212

Abstract PDF: The ankle is a modified hinge joint consisting of tibial plafond, medial and lateral malleolus, talus and many soft tissue structures, which play important role in weight bearing and walking. Ankle joint injury is determined by patients age, quality of bone, the position of a ankle at trauma, direction and degree, velocity of force. Hence, it is very important to understand the mechanism of trauma in order to make definite diagnosis and proper treatment. The authors analysed 71 cases(66 patients) of the ankle fracture which were admitted and treated in Orthopaedic Department, Chonnam University Hospital from Aug. 1985 to June 1994. The most common type of the ankle fracture was supination external rotation type(17 cases, 23.9%), by the classification of Lauge-Hansen, and type C(30 cases, 42.3%) by the AO classification. According to the criteria of Meyer using the clinical and radiological result, pronation-external rotation type gave the best result and the worst results obtained from pronation-dorsiflexion type. We concluded that classification of Lauge-Hansen & AO were useful in the diagnosis and treatment of ankle fracture and accurate reduction and rigid internal fixation of the lateral malleolus, distal fibula and distal tibiofbular diastasis was important in treatment of the ankle fracture.

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Ipsilateral Momentary Fibular Transfer in an Large Tibia Defect Using Ring Fixator: A Case Report: Hak Sun Kim, Churl Hong Chun, Hye Jung Kim; J Korean Soc Fract 1996;9(1):220-224. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.220

Abstract PDF: Massive segmental bony defect in open tibial fractures are generally treated with conventional bone grafting, free vascularized fibular graft or ring fixator technique. There are corcumstance when conventional bone graft is not adequate. A vascularized fibular graft may be superior to conventional graft, but it is with ring fixator is alternative method. The procedure can be accomplished by transferring the osteotomized part of the fibula to the tibia by means of olive wires. There was a 20-year-old male patient with Gustilo type IIIc open tibial fracture. Soft tissue defect was severe and femoral angiogram was perfomed. Only tibialis posterior artery was patent and peroneal artery was partially damaged. Latissmus dorsi flap was performed for covering soft tissue defect. Since the only patent tibialis posterior artery was already used for latissmus dorsi flap, it was difficult to perform vascularized fibular graft. Also it was technically difficult for us to accomplish a gradual transport using ring fixator because the distal tibia was lost. Thus, the fibular transfer was performed immediately after the ring fixator was applied. Good bony union and fibular hypertophy were obtained even though these two procedure had been done simultaneously.

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Simultaneous Asymmetric Bilateral Traumatic Hip Dislocation: A Cases Report: Byung Ill Lee, Bo Weon Jeong, Jae Eung Yoo, You Sung Suh, Soo Kyun Rah, Chang Uk Choi; J Korean Soc Fract 1996;9(1):225-228. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.225

Abstract PDF

Hip dislocation represents 2 to 5% of all joint dislocations. Bilaterat dislocation of the hip joints is reported about 1.25% of all cases fo hip dislocations and therefore 0.025 to 0.050% of all joint dislocations. Dislocations in which one hip dislocates anteriorly and the other posteriorly are even rarer. Of all traumatic bilateral hip dislocations, bilateral simultaneous anterior and posterior dislocations in 40% of cases. This paper is a case report of a traumatic bilateral anterior and posterior dislocation of hips in a 24 year-old man injured by motor vehicle accident as a passenger. The patient was treated by means of closed reduction, traction and physical therapy. We report such a case.

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Traumatic Bilateral Anterior Hip Dislocation: A Case Report
Sung-Taek Jung, Hyun-Jong Kim, Myung-Sun Kim, Young-Jin Kim, Sang-Kwan Cho
Journal of the Korean Fracture Society.2008; 21(1): 62. CrossRef

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