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Volume 13(2); April 2000
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Original Articles
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Treatment of Displaced Lateral Condylar Fracture of the Humerus in Children
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Jong Sup Shim, Sung Min Kim
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J Korean Soc Fract 2000;13(2):201-207. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.201
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- PURPOSE
: We tried to define the complications related to the degree of injury and the treatment modalities in surgically treated lateral condylar fracture of the humerus in children.
MATERIAL : We experienced 42 children under 15 years of age who were diagnosed lateral humeral condylar fracture and treated by operation. The follow up periods were from 6 months to 39 months, average 15.2 months. There were 4 cases of Milch type I fracture and 38 cases of Milch type II fractures. According to the displacement, there were 9 cases of stage I fracture, 20 cases of stage II fracture, and 13 cases of stage III fracture. The age distribution was from 1.5yrs. to 13yrs.(average ; 5.2years) and there were 26 male children and 16 female children.
METHOD
: 6 cases of stage I fracture and 2 cases of stage II fracture were treated by maunal reduction and percutaneous K-wire fixation. 3 cases of stage I fracture revealed incongruency of articular surface, 18 cases of stage II fractures and 13 cases of all stage III fracture were treated by open reduction and percutaneous K-wire fixation.
RESULT
: There 13 cases of lateral bony hypertrophic(30.9%), 4 cases of minimal limitation of elbow joint motion(9.5%), 3 cases of hypertrophic skin scar(7.1%), 2cases of pin tract infection(4.8%), one case of slight decrease of carrying angle(2.4%). Howerer there was no serious complication such as nonunio or cubitus valgus. Limitation of elbow joint motion occurred significantly higher in Milch type I fracture(2 cases, 50%) than Milch type II fracture(2 cases, 5.3%)(p<0.05). Lateral bony hypertroph occurred significantly higher in open reduction(12cases, 35.3%) than in manual reduction(one case, 12.5%)(p<0.05). Also lateral bony hypertrophy occurred higher in moderate and severe displaced fractures(stage II and III ; 12cases, 36.4%) than in minimal displaced fractures(stage I ; one cases, 11.1%)(p<0.05).
CONCLUSION
: In the displaced lateral humeral condylar fractures in children, the serious complications can be avoided through selecting adequate treatment modality. In the case of open reduction, the possibility, the possibility of lateral bony hypertrophy should be minded.
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Clinical Study of Pin Fixation of Suprecondylar Fracture of the Humerus in Children
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Jun Kwang Park, Tae Hyun Yoon, Young Lae Moon, Kwang Kim
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J Korean Soc Fract 2000;13(2):208-215. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.208
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- PURPOSE
: The supracondylar fracture of the humerus is the most common elbow injury in children. They are commonly treated with closed reduction and percutaneous pin fixation. We measured the stability of supracondylar fractures, fixed with different configuration of pins, according to the each type of supracondylar fractures.
MATERIAL AND METHOD : We reviewed 42 supracondylar fractures of the humerus in children that were treated with percutaneous pon fixtion from 1988 to 1997. The follow up period ranged from 1.5 to 41 months. The patient's average age was 9.2 years. The most common cause of injury was fall down injury in thirty three. The extension type is the most common, accounting for 95% of cases. We compared the initial post-op films with the follow up films which was checked at 2-3weeks later to establilish the stability by assessing the anterior beak prominence of the proximal fragment on lateral radiograph.
RESULT
: There were 8 cases of Type II-A (hyperextension post cortext intact AP, lateral appearance), 10 cases of Typer II-B (displaced/ angulated with osseous contact AP, lateral appearance) and 24cases of Type III(completely displaced AP, lateral appearance). The greatest stability was achieved with two crossed pons placed from the medial and lateral condyles. Final failure of the fixation occurred in two cases of the group II-B, fixed with only two lateral pins.
CONCLUSION
: The two crossed pins which were placed from the medial and lateral condyles provided the greatest stability of the fracture fragment. When we treat the type II-B pattern fracture (displaced/ angulated with osseous contact AP, lateral appearance), we must check the rotational stability after lateral pin fixation. If the fracture is unstable, we must fix the fracture with additional medial crossed pin fixation.
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Radiologic Pattern of Trochlear Ossification Center
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Jin Woo Kwon, Seung Ho Shin, Won Ho Cho, Woo Se Lee, Chun Ho Kim
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J Korean Soc Fract 2000;13(2):216-221. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.216
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: The trochlear secondary ossification center may be variable in number, shape and size, thus it can be considered as fracture. The purpose of this study is to evaluate radiographic analysis of normal trochlear secondary ossification center.
METHOD
AND MATERIAL : We reviewed the 100 cases of normal elbow radiographs and classified the numbers and shapes of trochlear sencondary ossification center.
RESULT
: The number of trochear secondary ossification center was that one was 72 cases(72%), two 19 cases(19%), three 9 cases(9%). The shape of trochlear ossification center which has only one ossification center was classified as round was 11cases(15.3%), elliptical 24 cases(33.3%), irregular37(51.4%).
CONCLUSION
: The radiographic finding of trochlear secondary ossification center is variable in number, size and shape, thus authors concluded that fragmentation or bizzare shape of trochlea in painless elbow must be considered as secondary ossification center.
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Primary Bipolar Hemiarthroplasty for the Treatment of Unstable Intertrochanteric Fractures in Elderly Patients
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You Sung Suh, Sung Tae Kim, Soo Jae Yim, Yon Il Kim, Soo Kyoon Rah, Chang Uk Choi
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J Korean Soc Fract 2000;13(2):222-229. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.222
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: The purpose of this paper was to present the clinical and roentgenographic results were obtained with bipolar hemiarthroplasty as a primary treatment for comminuted unstable intertrochanteric fracture in elderly patients with severe osteoporosis. The goal of this treatment is early ambulation with early weight bearing to prevent the complications such as a deep vein thrombosis, pulmonary embolism, pneumonia or atelectasis, and pressure sore.
MATERIALS AND METHODS
: Twenty consecutive patients who were more than seventy years old with severe osteopotosis and had an comminuted unstable intertrochanteric fractures were treated by primary bipolar hemiarthtoplasty from January 1995 through January 1998 at the Department of Orthopaedic Surgery of Soonchunhyang University Hospital. If there were fractured at the lesser or the greater, a circlage wire or Dall-Miles system (trochanter cable grip system) was passed through the lesser and the greater trochnater to permit its subsequent fixation to the medial and the lateral side of the femoral component. The functional results were judged according to the hip rating scale of Merle d' Aubigne.
RESULTS
: The mean age at operation was 79.8(70 to 92) years old. The most common type according to the Evans classification system was I -d(10 cases, 50%). Singh index was case(5%) of Grade I , 7 cases(35%) of Grade II, 10 cases(50%) of Grade III and 2 cases(10%) of Grade IV. The mean bone mineral density(BMD) was -4.24(-6.95 - -3.17). The functional results in 75% of the patients were rated as excellent, very good, or good and in 25% as fair, poor, or bad.
CONCLUSION
: Primary bipolar hemiarthroplasty for the treatment of comminuted unstable intertrochanteric fractures in elderly patients with severe osteoporosis could return these patients to their pre-injury level of activity quickly, thus obviating the postoperative complications caused by immobilization.
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Citations
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- A STUDY OF PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY OF HIP IN ELDERLY PATIENTS WITH OSTEOPOROTIC, UNSTABLE INTERTROCHANTERIC FRACTURE
Maheshwar Lakkireddy, Radhakrishna Rapaka, Naveen Gouru, Shivaprasad Rapur
Journal of Evidence Based Medicine and Healthcare.2015; 2(35): 5447. CrossRef
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Knee Fractures and Ligament Injuries Associated with Ipsilateral Femoral Shaft Fractures: Mechanism of Injury, Site of th Knee Fracture and Ligament Injury
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Dong Ju Chae, Phyl Hyun Chung, Won Suk Chae
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J Korean Soc Fract 2000;13(2):230-235. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.230
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: To establish the incidence and type of knee fractures, injury of knee ligament associated with ipsilateral femoral shaft fractures. What is the most common mechanism of these combined injuries? MATERIALS AND METHODS : From March 1995 to February 1999, evaluation of one hundred and twenty consecutive patients with fracture of the femoral shaft showed fractures and injuries of the ligaments of the ipsilateral knee in thirty-five(29%) of them. Of those thirty-five, nineteen patients had injured their knees and femoral shaft fractures by the dashboard injury. Twelve injuries were caused in a motor cycle accident, and two patients occurred in pedestrians struck by cars. Two injuries were caused by falls.
RESULTS
: There were twenty fractures of th knee and fifteen injuries of the ligament. Seventeen of the twenty fractures were in the patella, two in the bicondyle of the proximal tibia and one in the lateral condyle of the proximal tibia. Eleven of seventeen fractures of the patella were open fractures. Of fifteen injuries of the ligament, there were six posterior cruciate ligament tears (including 2 partial tears and 1 avulsion fracture), three posterior cruciate ligament tears with medial or lateral collateral ligament disruption , three anterior cruciate ligament tears(2 tibial spine fractures and 1 partial tear), two lateral collateral ligament disruptions and one medial collateral ligament tear. The locations of femoral shaft fracture were proximal in four patients, middle in thirty, and distal in one patient.
CONCLUSION
: We conclude that there is a high incidence of ipsilateral fracture of the patella and posterior cruciate ligament tears in patients with femoral shaft fractures. The dashboard injury is the most common mechanism of the ipsilateral knee fractures and ligament tears with femoral shaft fractures.
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Malalignment of Tibial Fracture Following Interlocking Intramedullary Nailing
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Seung Wook Yang, Hyung Taek Park, Kuen Tak Suh
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J Korean Soc Fract 2000;13(2):236-243. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.236
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Abstract
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: The purpose of this study was to evaluate the incidence and the factors that influence on malalignment following interlocking nailing for tibial fracture.
MATERIALS AND METHODS
: The authors analysed 59 patients, 60 cases tibial fracture treated with interlocking intramedullary nailing from 1993 to 1997 about nail insertion site, nail entrance angle and fracture type with roentegenogram. Malalignment was defined as 5 degree or more angular deformity in varus-valgus, 10 degree or more angular deformity in anterior-posterior plane.
RESULTS
: Malalignment was found in 15 cases out of 60(25%). We found malalaignment in 7 cases out of 11(64%)in proximal fracture, 6 cases out of 29(21%) in middle fracture, 2 cases out of 20(10%) in distal fracture(p<0.001). Correlation between nail insertion site or medial entrance angle and angular deformity was higher in proximal fractures. In midshaft wedge fractures, direction of main fragment influenced on the axial alignment.
CONCLUSION
: Centromedullary nail orientation is required to prevent malalignment after interlocking intramedullary nailing. Precise selection of nail insertion site and nail entrance angle under the C-arm control in proximal tibial fracture is necessary. Fracture type and fragment direction must be considered during tibial nailing in comminuted tibial fracture.
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Ilizarov/Hybrid-Ring External Fixation in the Management of Tibial Plafond Fractures
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Chang Wug Oh, Byung Chul Park, Joo Chul Ihn, Sung Jung Kim, Hee Soo Kim, Saeng Guk Lee
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J Korean Soc Fract 2000;13(2):244-251. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.244
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: To evaluate the results of the treatment of distal tibial fracture using ring or hybrid ring external fixator and to compare the results according to the influencing factors.
MATERIALS AND METHODS
: The authors analized 30 patients, 31 cases of distal tibial fracture who were treated by Ilizarov ring external fixator or hybrid ring external fixator at our hospital from May 1996 to August 1998 and were followed up over 1 year. The type of distal tibial fractrue were classified according to AO group, type A was 7 cases, and type C was 24(C1:5, C2:4, C3:15)cases. Restoration of articular surface of the distal tibia was performed through closed method or minimal invasive technique by minimal internal fixation with K-wire or screw. Then fixation of th distal tibia was done by ring external with multiple transfixing wire. Connection to the tibial shaft was done by Ilizarov ring external fixator(15 cases), or mono-external fixator(Dyna-Extor, 16 cases).
RESULTS
: By Tornetta's assessment of functional results, excellent was 5, good 19, fair 4 and poor 3cases. According to AO classification, the functional results of type A, 7cases were all above good results, among 24 cases of type C, 4cases of C1, 2 cases of C2, and 11 cases of C3 were above good results and there was no statistical difference between the results and the fracture type(P=0.024). One of 3 cases of poor functional results was open type C3 fracture and was complicated with osteomyelitis and refracture, and others two cases type C2 fracture which were complicated with malunion.
CONCLUSION
: The authors had a good results without soft tissue complication after the treatment of distal tibial fracture patients by Ilizarov ring external fixator or hybrid ring external fixator.
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Citations
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- Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator
Suk Kyu Choo, Kyung Wook Nha, Hyoung Keun Oh, Dong Bong Lee
Journal of the Korean Fracture Society.2007; 20(4): 323. CrossRef
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Bilateral Salter-Harris Type II Proximal Tibial Epiphtyseal Fracture: A Case
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Byung Ill Lee, Hoon Choi, You Sung Suh, You Il Kim, Soo Kyoon Rah, Chang Uk Choi
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J Korean Soc Fract 2000;13(2):252-257. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.252
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Abstract
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- An uncommon fracture of the proximal tibial epophysis can be classified into 5 types based in the mechanism of injury and the relationship of the fracture line to the physeal plate. The separation extends along the physeal plate and then through a portion of the metaphysis, Salter-Harris type II is the most common physeal fracture. We experienced a very rare case of bilateral flexion type Salter-Harris type II fracture of the proximal tibia, which was treated by long leg cast. At six weeks fusion is complete at the proximal tibial epiphyses of both knees, and the range of motion is full at follow-up six months
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Treatment of the Distal Femoral Fracture with Anatomical Bone Plate
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Sung Ho Hahn, Bo Kyu Yang, Seung Rim Yi, Shun Wook Chung, Je Oh Lee
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J Korean Soc Fract 2000;13(2):258-266. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.258
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Abstract
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: In this paper, we have intended to evaluate the types of fracture of the distal femur treated with anatomical bone plate, simple and user's friendly apparatus and to assess their clinical results.
MATERIALS AND METHODS
: We retrospectively reviewed 21 cases in 20 patients who were followed up over 1 year among the patients that had distal femoral fractures treated with anantomical bone plate. We analysed their fracture types in AO classification and assessed clinical results according to Neer system. The average duration of follow-up was 30 months(range, 14months to 49 months).
RESULTS
: Ont of twenty-one cases, twelve were A type(A1, 3 cases;A2, 4cases;A3, 5 cases)and nine were C type(C1, cases;C2, 4cases; C3, 3 cases). But B type was none.
CONCLUSIONS
: This study demonstrate that the operation with anatomical bone plate is not only simple and user's friendly technique but also widely appleicable method to treat A and C types of the distal femoral fractures.
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- 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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Medullary Canal Widening Effect on Insertion of Tibial Intramedullary Nail bent anteriorly at distal portionJong Min Sohn
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Hyung Kwan Kim, Juhae Jahng, Dae Hyun Baek, Nan Kyoung Ha, Hyuk Je Lee
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J Korean Soc Fract 2000;13(2):267-271. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.267
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Abstract
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: We have studied medullary canal widening effect on anteroposterior plane by intramedullary nails with distal anterior bend in the surgical treatment of tibial fracture and signified the clinical importance of the effect.
MATERIALS AND METHODS
: Ineramedullary tibial nails with distal anterior bend, Russell-Taylor(R)and AIMTMtibial nails were compared and the amount of medullary canal widening was calculated mathematically using the length and angle of distal anterior bend of the nails. the length and angle of distal anterior bend of Russell-Taylor(R)and AIMTMtibial nails were 64mm, 3 and 47.5mm, 5 , respectively.
RESULTS
: The amount of medullary canal widening on anteroposterior plane by Russell-Taylor(R)and AIMTM tibial nails were 2.81mm and 3.26 mm more than the nail diameter, respectively.
CONCLUSION
: On insertion of tibial nails with distal anterior bend, the medullary canal widening effect on anteroposterior plane by the nails should be carefully considered. We think it will be better to insert these nails with unreamed technique or to insery smaller diameter nails after minor reaming and forceful blow should be avoided especially when the nail passes down through the isthmic portion of the tibial diaphysis to prevent the fracture of isthmic portion.
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Treatment of Articular Fracture of the Distal Tibia (Pilon Fracture) with Limited Open Reduction and External Fixator
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Hui Taek Kim, Moon Bok Song
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J Korean Soc Fract 2000;13(2):272-280. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.272
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Abstract
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: To evaluate the usefulness of the treatment method of limited open reduction for the articular surface and combined. external fixation in a tibial pilon fracture.
MATERIALS AND METHODS
: We reviewed 15 cases of pilon fracture treated by the combined internal and external fixation method. The fracture was classified by Ruedi and Allgower's classification: 3 cases of type I , 7 cases of type II and 5 cases of type III. The result was analyzed by Ovadia and Beals' radiologic, subjective and objective criteria of assessment.
RESULTS
: The results were 12 good and 3 fair in the radiologic evaluation; 1 excellent, 9 good, 3 fair and 2 poor in the objective evaluation; and 5 good, 8 fair, 2 poor in the subjective evaluation. The mean duration of the bony union was 6.5 months (5-11 months). The most common complication was the limitation of the ankle joint. Intra-articular arthroscopic adhesiolysis and extra-articular soft tissue release were helpful to increase the range of motion of the ankle joint.
CONCLUSION
: This technique provides a satisfactory result in the anatomical reduction of the articular fracture, in the management of the soft tissue problem particularly in open fracture, and permits early motion of the ankle joint in the pilon fracture.
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Treatment Using Unreamed Intramedullary Nailing for Open Tibial Fractures
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Chang Wug Oh, Hee Soo Kyung, Joo Chul Ihn, Byung Chul Park, Hyung Jin Park
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J Korean Soc Fract 2000;13(2):281-288. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.281
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Abstract
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: this paper was to evaluate the treatment results in the viewpoint of bone union, union time, and complications including infection of unreamed nailing of pen tibial fractures.
MATERIALS AND METHODS
: We reviewed 46 open tibial shaft fractures that were treated with unreamed tibial nail. AO unreamed tibial nail was inserted after reduction under image intensifier control, Considering factors were severity of open wound, type and location of fractures.
RESULTS
: Average union time of open fractures was 21.3 weeks, nonunion rate was 2/46(4%). Average union tiome were 24.1, 19.7, 24, 24, 20 weeks in open grade I , II, IIIa, IIIb, IIIc fractures. According to the type of fractures, average union time were 20.4, 23.6, 25.7 weeks and nonunion rate were 0/22, 1/18, 1/6 in type A, B, C fractures. According to the level of fractures, average union time were 24.0, 20.0, 24.1 weeks in proximal, middle, and distal fractures. There was no signficant differences in average period of radiologic union, infection rate and nonunion rate according to fracture level, open grade, but longer union time and higher nonunion rate were observed in complex and comminuted fractures(p<0.05).
CONCLUSION
: With adequate soft tissue treatment, the unreamed intramedullary nailing can be a good treatment modality for open tibial shaft fractures, even to grade IIIB.
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Delayed Diagnosed Thrombosis Associated with Closed Fractures Around the Knee
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Byung Moon Park, Hyung Koo Yoon, Kwang Pyo Jeon, Kyung Hoom Kang, Jin Il Kim, Dong Soo Kim, Yong Jae Lee
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J Korean Soc Fract 2000;13(2):289-295. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.289
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Abstract
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: The goal of this study is to decrease the chance of the lower limb loss resulting from the delayed diagnosis of arterial thrombosis after first operation in a patient of the closed fractures around the knee by early diagnosis and proper management via studying several prognostic factors.
MATERIALS AND METHODS
: We have reviewed 8 cases of delayed diagnosed arterial thrombosis patient who was follow up for 1 year or more March 1987 to February 1997, retrospectively. We have followed ip the clinical results.
RESULTS
: The amputation rate was 50%(4/8), and among associated injuries, tibial or peroneal nerve palsy was combined in 75%(6/8). The time interval from initial trauma to diagnosis was significantly different between amputation group(77hours) and non amputation group(34.25hours). Better results were obtained in cases who had early diagnosis and treated with end to end anastomosis than vein graft.
CONCLUSION
: It is very important that the vascular status should be assessed not only at the first examination but also repeatedly over the ensuing hours and days with caution, even though there was absence of ischemic sign.
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Effects of Fibular Fixation for Interlocking Nailing of Distal Tibiofibular Fractures
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Sang Ho Moon, Phil Hyun Chung, Chung Soo Hwang, Dong Ju Chae, Beom Kim
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J Korean Soc Fract 2000;13(2):296-302. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.296
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: To compare redioiogic results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures.
MATERIALS AND METHODS
: From April 1993 to February 1999, 26 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 61 fractures fixed with nails only. Average age of patients was 41.8 years. These two groups were compared by frequency of malalignment, degree of postoperative angulation, angulation according to comminution, angulation according to fracture configuration. The statistical analysis was evaluated by t-test.
RESULTS
: Fibular fixation group had no malalignment while non-fixations had angulation of 1.2+/-1.1 degree and non-fixation had 3.0+/-2.1. So fixation had lessor angulation than non-fixation significantly(p=0.004). In lateral rediographs, each had 1.3+/- 1.1, 2.8+/-2.3 degree and showed significant difference(p=0.027). In type I and II fractures of Winquist-Hansen classification, fixation group showed lesser degree of angulation in A-P plane significantly(p=0.008) but no significant difference in lateral plane. In type III and IV, no significant difference in both planes. According to configuration of fractures, transverse and spiral fractures showed no significant differences but oblique configurations had significant differences in A-P plane(p=0.002) CONCLUSION : Interlocking intramedullary nail with fibular fixation has the advantage in maintenance of alignment during insertion of nail in distal tibiofibular fractures, especially in Winquist-Hansen classification type I and II and oblique fractures in anteroposterior plane, so it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.
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Opreative Treatment of Intra-articula T or Y
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Young Kyu Kom, Gi Serk Eom
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J Korean Soc Fract 2000;13(2):303-310. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.303
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Abstract
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: To evaluate the results after rigid fixation for intraarticular distal humerus fractures and determine the prognostic factors influencing outcome.
MATERIALS AND METHODS
: Twenty-two patients were managed with the rigid fixation using dual plate or one plate combined with cannulated screw. According to the M ller's classification, eleven cases were classified as type C1; five, as type C2; and six, as type C3. Based on the age, the patients were divided into two groups as a guideline of 50 years so that the number of the patients was 11 cases respectively.
RUSULTS : By the rating scale from Aitken and Rorabeck, excellent or good results were 90% in type C1, 80% in type C2 and 66% in type C3. All patients who were under 50 years of age obtained excellent or good results, and group who were older than 50 showed 64% good results.
CONCLUSION
: Rigid fixation using dual plate and early mobilization using functional brace were considered to be a good method for intraarticular distal humerus fractures. And, this study revealed that comminution of fracture and age became an important factors in achieving the desire results.
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- Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus
Ji-Kang Park, Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho
Journal of the Korean Fracture Society.2012; 25(2): 129. CrossRef
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Treatments of the Tibial Condylar Fractures
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Taik Seon Kim, Jae Ik Shim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yu, Hong Man Cho
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J Korean Soc Fract 2000;13(2):311-319. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.311
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Abstract
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: In the proximal tibial condylar fractures, the authors analyzed the treatment results clinically and radiologically, after arthroscopically assisted accurate anatomical reduction of articular surface and rigid internal fixation with early mobilization.
MATERIALS AND METHODS
: We reviewed 56 cases of tibial condylar fracture that were treated at our the orthopaedic department between January 1990 and December 1996 and the follow-up period was 1 year above. According to Schatzker's classifications, we classified the type of fracture and we analyzed the results by average union time and Porter's criteria after accurate anatomical reduction of articular surface and rigid assisted redcution of articular surface and internal fixation.
RESULTS
: According to Schatzker's classification, Type I 15cases, TypeII 14cases, TypeIII 6 cases, TypeIV 7cases, TypeV 3cases, TypeVI 11cases, Associated soft tissue injuries were total 22cases the were MCL injuries 12 cases, lateral meniscal injuries 6 cases. The average union time was 15.5 weeks and by Porter's criteria, 56 cases, of which 39 cases(71%) had an good result.
CONCLUSION
: we considered that good results can be obtained by assistant use of arthroscopy and rigid internal fixation with early mobilization, that accurate diagnosis and appropriate treatments of accampaning injuries according to the type of fractures, and accurate anatomical reduction of articualr surface.
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Intramedullary Nailing of Femoral Shaft Fractures : Comparison between with and without the Fracture Table
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Jung Jae Kim, Yong Gab Jeong, Kwang Hwan Jung, Soo Sung Park, Eu Gene Kim
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J Korean Soc Fract 2000;13(2):320-326. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.320
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Abstract
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: To evaluate and compare the efficacy of intramedullary nailin(IMnailing) between using radiolucent plane table in lateral position and using fracture table in supine position for femoral shaft fractures.
MATERIALS AND METHODS
: Consecutive 62 cases of the fresh fractures of femoral shaft treated with intramedullary nailing were divided into 2 groups; 31 cases on the fracture tables and the other 31 cases with the lateral position on the radiolucent plane table, and we analysed the difference the length of anesthetic time, preparation and draping time, operative time, postoperative complications between the two groups.
RESULT
: There was statistically significant decrease in the length of anesthetic time, operative time in the former group, but no difference in the postoperative complication(Wilcoxon test).
CONCLUSION
: Lateral position on radiolucent plane table with the traction device for intramedullary nailing for femoral shaft fracture considered to be generally accepted not only to the limited cases which fracture tables are not available but also to general cases.
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- The PFNA Nail for Pertrochanteric Fracture of the Femur without Fracture Table
Jeoung Ho Kim, Sang Hong Lee, Kwang Chul Lee, Sung Won Cho
Journal of the Korean Fracture Society.2011; 24(3): 217. CrossRef
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126
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Comparison of Intramedullary Nailing and Plate Fixation for the Treatment of Nonunion of the Long Bone Fracture on Lower Extermities
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Jong Seok Park, Jae Hoon Lee, Hee Kwon, Jae Eung Yoo, Joon Min Song, Yeon Il Kim, Chang Uk Choi
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J Korean Soc Fract 2000;13(2):327-333. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.327
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Abstract
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- PURPOSE
: Under the principle of rigid fixation and bone graft, we analyzed and compared the clinical results in the treatment of nonunion of long bone fractures using plate fixation and intramedullary nailing with or without bone graft.
MATERIALS AND METHODS
: We used 19 cases of plate fixation and 19cases of intramedullary nailing with or without bone graft for the treatment of the nonunion of long bone from Mar. 1994 through Feb. 1997. We analyzed and compared the clinical results of plate fixation and intramedullary nailing with bone graft in the treatment of nonunion of fracture.
RESULTS
: The mean bone union time according to nonunion type in case of plate fixation was 22.6 weeks in the hypertrophic type and 16.4 weeks in the atropic type(p<0.005). In case of intramedullary nailing was 20.4 weeks in the hypertrophic type and 15.3 weeks in the atropic type(p<0.05). According to the bone graft in case of plate fixation, 20.8 weeks in the autogenous bone graft and 19.3 weeks in the combination of autogenous bone graft and allo-bone graft(p>0.05). In case of intramedullary nailing, 16.9 weeks in the autogenous bone graft and 22.7 weeks that dosen't bone graft. According to the radioligical bone union time was 20.1 weeks in the plate fixation and 18.7 weeks in the intramedullary nailing(p>0.05).
CONCLUSION
: There was on significant difference according to the method of fixation, but the treatment of nonunion of long bone in lower extremities using intramedullary nailing will be good because of early ROM exercise and weight bearing ambulation than plate fixation. Although the type of nonunion is hypertrophic in the case of intramedullary nailing, bone graft is helpful to promote bony union.
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Periprosthetic Femur Fracture due to Unrecognized Surgical Instrument Left in the Medullary Canal : A case report
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Ui Seoung Yoon, Keun Woo Kim, Yong Hoon Kim, Hak Jin Min, Kook Hyeung Cho, Min Sup Lee, Sang Rim Kim
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J Korean Soc Fract 2000;13(2):334-337. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.334
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Abstract
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- Postoperative periprosthetic fracture of the femur after hip arthroplasty is a serious complication that can be difficult to treat. Moreover, it has become more common in recent years, as the cases of hip arthroplasty and revisonal hip arthroplasty increase. We have experienced a postoperative periprosthetic fracture of th femur probably caused by a surgical instrument left in the medullary canal during hip arthroplasty. We report this case with reference to other related articles.
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Analysis of result of operative treatment for distal radius fracture
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Jae Yul Choi, Kyung Chul Kim, Kyung Ho Kim
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J Korean Soc Fract 2000;13(2):338-342. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.338
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Abstract
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- PURPOSE
: This study was performed to compare and analyze the result of operative treatment of each type of distal radius fracture.
MATERIALS AND METHODS
: From June 1995 to December 1998, operative treatment for 78 cases of distal radius fracture were performed. According to Fernandez classification of distal radius fracture, there were 31 Type III fractures, 28 Type I fractures. Mean follow up period was 23months and result was assessed according to scoring system of Sarmiento et al.
RESULT
: Excellent to good result were obtained 71.4% in Type I, 100% in Type II, 77.4% in Type III, 100% in Type IV, 50% in Type V.
CONCLUSION
: We obtained good result for Type I, II, III, IV with several operative method but complex method for Type V was not satisfactory.
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Citations
Citations to this article as recorded by

- Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate
Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef - Comparison of Operative Management in Distal Radius Fractures Using 3.5 mm Versus 2.4 mm Volar Locking Compression Plates
Sung-Sik Ha, Tae-Ho Kim, Ki-Do Hong, Jae-Chun Sim, Jong Hyun Kim
Journal of the Korean Fracture Society.2011; 24(2): 156. CrossRef
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Femoral Trochanteric Fracture Treated with Ender Nails in Elderly Patients
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Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yu, Eui Sang Seil
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J Korean Soc Fract 2000;13(2):343-351. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.343
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Abstract
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: To analyze the clinical and radiological result of femoral trochanteric fractures treated by using Ender nails in elderly patients.
MATERIAL AND METHODS :Sixty seven patients of femoral trochanteric fractures treated at Korean Veterans Hospital from 1993 to 1997 were included in this study. Under the C-arm guided, closed reduction and internal fixation with Ender nails was done within one week. According to Kyle classification, we classfied type I in 12case, type II in 20cases, type III in 25cases, typeIV in 20 cases and analyzed duration of bone union, ambulatory ability and postoperative complication.
RESULT
: The duration of union was from 14 weeks to 17 weeks and the mean was about 15.5 weeks. Thirty seven(60.7%) patients maintained their prefracture ambulatory ability at a postoperative 1 year and twenty four(39.3%) patient lost some degree of ambulatory ability. Postoperative complications were the knee pain and the limitation of the motion of the knee in 10 cases(14.9%), external rotation deformity in 7 cases(10.4%), distal migration of nails in 4 cases(5.9%), proximal migration of nails in 2 cases(2.(%), nonunion in 2 cases(2.9%).
CONCLUSION
: We conclude that the treatment by using Ender nails is one of the proper methods in elderly femoral trochanteric fracture with associated medical complication.
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Posterior Short Segment Instreumntation and Fusion for the Unstable Thoracolumbar Spine Fracture: A Comparative Study
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Ki Tack Kim, Gyu Pyo Hong, Dae Woo Hwang, Sang Un Lee, Sang Wook Bae
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J Korean Soc Fract 2000;13(2):352-360. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.352
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Abstract
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- INTRODUCTION : In treating of acute unstable thoracolumbar spine fractures, current trend is a toward short segment instrumentation to spare the motion segments. Many authors reported the result of short instrumentation and fusion, but there have been few reports about the effect of additional screw fixation at fractured vertebra in posterior short segment instrumentation and fusion. Therefore, the objective of this study is to compare the results of treatment between with/without screw fixation at the fractured vertebra in posterior short segment pedicle screw fixation.
MATERIAL AND METHODS : Twenty-three patients with unstable thoracolumbar spine fractures were treated with posterior short segment instrumentation and fusion. Eleven cases classified into group A were not fixed at the fractured vertebre. They were followed up to average 45 months(24-79). Twelve cases classified into group B were treated with screw fixation at the injured vertebra and followed up to average 38 months(14-78). Authors evaluated the radiologic assessment, such as wedge angle of fractured body, local kyphotic angle and wedge index(the ratio of anterior body height to posterior body height), the neurologic assessment by Frankel grade system and functional assessment by Denis system.
RESULTS
: There was no complication resulted from additional pedicle screw fixation at fractured level. In rediologic assessment, wedge angle were measured at preoperative, postoperative and last follow-up time as follows; in group A, 22.2degrees -11.3degrees -14.1degrees and in group B, 19.5degrees -8.8degrees -9.8degrees . The local kyphotic angle measured were 17.9degrees -7.0degrees -14degrees in group A and 17.1degrees -6.3degrees -7.9degrees in group B. The wedge index were 42.9%-22.6%-28.5% in group A and 40%-19.5%-22.4% in group B. At last follow-up time, eight eases showed Frankel grade E and three cases showed grade D in group A, and all cases of group B were Frankel E. Denis pain score were satisfctory in all of both group and Denis work score were also satisfactory in two group except one case of group A.
CONCLUSIONS
: Additional screw fixation at fractured verteba did not cause any complication. There was no significant difference in reduction rate between two groups(P>0.05), but group B showed better maintenance of correction of kyphotic deformity than that of group A(P<0.05). In conclusion, it seems that additional screw fixation at fractured level may be better method in maintaining asgittal alignment and decreasing the risk collapsing of body.
Randomized Controlled Trial
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Effect of Early Active and Weight bearing in Rigid Fixation of Ankle Fracture
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Kyoo Seog Shin, Jong Soom Kim, Dong Wha Lee, Jung Seok Kim
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J Korean Soc Fract 2000;13(2):361-367. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.361
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Abstract
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: Because of the risk of redisplacement after operative treatment of ankle fracture, postoperative immobilization in a plaster cast without weight bearing has often been used. Early weight bearing, however, would no doubt facilitate rehabilitation for many patients and fulfills one of the most important aims of internal fixation. In our study, we compared the clinical and radiological results of cast immobilizatiom with late weight bearing and early weight bearing with ankle exercise.
MATERIAL AND METHODS : Forty-two patients, who had ankle fractures treated with rigid internal fixation between February 1996 and January 1998, were randomly assigned to either cast immobilization with weight bearing (n=20) or ankle exercise with early weight bearing (n=22). Radiologic follow-up was performed for the evaluation of redisplacement and clinical results between the two groups were compared.
RESULT
: No postoperative redisplacement was present in either group. After at least 1 year follow-up, no significant differences were found between the two groups in clinical results by Meyer's criteria.
CONCLUSION
: We concluded that postoperative early ankle exercise and weight bearing in rigid fixation of ankle fracture may be useful.
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- Rehabilitation for ankle fractures in adults
Sharon R Lewis, Michael W Pritchard, Roses Parker, Henry KC Searle, Paula R Beckenkamp, David J Keene, Chris Bretherton, Chung-Wei Christine Lin
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
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Original Articles
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Posttraumatic avascular necrosis of talus
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Soo Bong Hahn, Hong Jun Park, Kee Hong Song
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J Korean Soc Fract 2000;13(2):368-374. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.368
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Abstract
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: We performed this study in order to analyze the clinical results and complications of posttraumatic avascular necrosis of talus MATERIALS AND METHODS : We performed a retrospective review of 19 patients undertaken treatment of talus fracture from September 1996 to September 1998. There were 11 males and 8 females with an a mean age of 21.4 years(range, 10-52years).
RESULTS
: In one case, there was soft tissue defect and bone maceration on dorsum of left foot due to crushing injury by traffic accident. The patient was treated with debridement and skin graft. In trauma 5 months, equinus deformity and stiffness of ankle was noted. Posttraumatic avascular necrosis of talus was noted at magnetic resonance imaging. But, there was neither collapse of talar dome nor pain. Therefore, heel cord lengthening and correction of equinus by hinged Ilizarov with distraction was done. In follow-up(1 year 3 months), avascular necrosis was improved and good ambulation without pain was possible. In another case, open reduction and internal fixation for talar neck fracture(Hawkins typeIII)was performed. In trauma 9 months, there were severe degenerative arthritis of peritalar joint, severe ankle pain, and severe avascular necrosis with collapse of talus. Therefore, dead bone resection and ankle arthrodesis with autoiliac bone graft were performed using Ilizarov external fixator. In follow-up(trauma day 1 year 11 months), good ambulation in 90degreesankle fusion state without pain was possible.
CONCLUSION
: In the treatment of talus fracture, periodic physical and radiologic examination is important for early detection of posttraumatic avascular necrosis and early management.
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The Effect of External Distractor on Recovery of B hler angle in Displaced Intraarticular Calcaneal Fractures
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Deuk Soo Hwang, Kwang Jin Rhee, June Kyu Lee, Jung Hee Choi
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J Korean Soc Fract 2000;13(2):375-381. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.375
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Abstract
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: We had studied the results retrospectively in displaced intraarticular calcaneal fractures treated with internal fixation by screw for thalamic portion and percutaneous pinning by K-wire using minimal Ollier's lateral approach, so we had reported good results, but recovery of B hler angle loss was difficult technically. So, we used intraoperative external distractor combined with previous our method.
MATERIALS AND METHODS
: We analysed retrospectively B hler angle and clinical results on 12 cases with clcaneal fracture, who underwent an operation for displaced intraarticular calcaneal fracture by using external distractor from January 1997 to August 1998. B hler angle were measured at preoperative, postoperative and last follow-up X-ray. Surgical technique is through minimal Ollier's lateral approach, reduced and fixed with screw of displaced posterior facet and used intraoperative external distractor for restoring of deperssed calcaneal tuberosity and then did percutaneous pinning with K-wire. RESULTS : In the previous our reports, the mean preoperative and postoperative B hler angle were -0.9degrees, 19.1degreeseach other and the mean recovery of B hler angle was 20.1degrees. After we use the intraoperative external distractor, the mean preoperative and postoperative B hler angle were 0.92degrees, 26.0degreeseach other and the mean recovery of B hler angle is 26.9degrees. It is nearly normal range of korean's B hler angle (31.1degrees+/-0.4 degrees). Also there is no complication such as intraoperative calcaneal tuberosity fracture and soft tissue injury(skin necrosis, neurovascular injury).
CONCLUSION
: We obtained enough restoration of B hler angle to normal range by using our previous method combined with intraoperative external distractor.
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Analysis and Clinical Study on Fracture Dislocation of the Talus
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Ye Yeon Won, Chang Hoon Jeon, Jae In Ahn, Seung Jun Choi, Jung Mo Lee
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J Korean Soc Fract 2000;13(2):382-389. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.382
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Abstract
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: Talar fractures are uncommon and so surgeon's experience in the treatment of the talar fracture is limited. This study was undertaken to evaluate the incidence, associated injuries, complications of talar fracture and results of treatment.
MATERIALS AND METHODS
: Authors experienced 15 cases of the talar fractures treated at Ajou university Hospital from 1995 to 1998 with minimal 1 year follow-up period and obtained following result.
RESULTS
: Of 15 cases, fall down injury was the most common cause of injury(11/15). 4 ipsilateral medial malleolar fractures, 2 lateral malleolar fractures and other associated injury was occured. According to the Hawkins' classification 5 cases in type I , 1 cases in typeII, 2 cases in typeIII were observed. 2 posttraumatic arthritis, 1 skin necrosis, 1 avascular necrosis, were observed as complications but nonunion was not observed.
CONCLUSIONS
: We suggest that early and accurate anatomical reduction and rigid internal fixation of the fracture dislocation of the talus canprevent complications such as acascular necrosis, posttraumatic arthritis.
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Comparative study between operative and conservative treatment in 3 part and 4 part fracture of the proximal humerus
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Chang Hyuk Choi, Kwoing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Dong Kyu Shin, Bum Jin Park
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J Korean Soc Fract 2000;13(2):390-396. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.390
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Abstract
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: Majority of 3-part and 4-part fracture of proximal humerus had been treated by surgical methods. However, Surgical treatment might be inappropriate due to the medical status or combined injures if the patients. Therefore, we compared the operative treatment with the conservative treatment in 3-part and 4-part fracture of proximal humerus.
MATERIALS AND METHODS
: Among the 39 cases of 3-part(30) and 4-part(9) fracture of proximal humerus, 22 cases(57%) were treated by conservative methods and 17 cases(43%) were treated by operative methods with T-plate, wire, arthroplasty and screw.
RESULTS
: Among 30 cases of 3-part fracture of proximal humerus, according to the Neer's functional criteria, 12cases(60%) had excellent or satisfactory result in conservative treatment and 7cases(70%) had excellent or satisfactory result in operative treatment. In 9 cases of 4-part fracture of proximal humerus, 2 cases(100%) had poor result in conservative treatment, and 5 cases(71%)had excellent or satisfactory result in operative treatment.
CONCLUSION
: There was no difference in functional result according to the treatment modality in 2-part fracture(p>0.05). but in 4-part fracture, we prefer to treat by operative methods due to avascular necrosis at humeral head and poor functional result with conservative treatment.
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A Clinical Analysis of Treatment of the Fracture of the Proximal Humerus
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Sang Won Park, Soon Hyuck Lee, Seung Bum Han, Byung Taek Lee
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J Korean Soc Fract 2000;13(2):397-405. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.397
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Abstract
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: Fracture of proximal humerus is adjacent to shoulder joint which has an almost global range of motion, thus respond satisfactorily to conservative treatment, but displaced fracture needs accurate diagnosis and proper treatment. We analyzed the type of treatments and results of proximal humeral fractures MATERIALS AND METHODS : Fifty nine cases of fractures of the proximal humerus which were treated from January 1992 to February 1998 were analyzed according to Neer's classification.
RESULTS
: Among the 59 cases, 26 cases were treated conservatively, 19 cases(73.1%) had excellent or satisfactory results and 33 cases were treated operatively, 23 cases(69.7%) had excellent or satisfactory results. All one-part fractures(6 cases) were treated conservatively and had excellent or satisfactory results. but in three-part fracture(17 cases), 3 cases(42.8%) who were treated conservatively and 7 cases(70.0%) who were treated operatively had excellent or satisfactory results and no significant difference was shown according to method of operation All four-part fractures(3 cases) were treated operatively, and only 1 cases(33.3%) had satisfactory results.
CONCLUSION
: We can treat conservatively or operatively in one-part or two-part fractures but consider the percutaneous pin fixation or minimal soft tissue dissection in three-part fractures.
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Closed Reduction and Percutaneous Pinning in Displaced Surgical Neck Fracture of the Proximal Humerus
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Ju Hong Lee, Gyu Hyung Kim
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J Korean Soc Fract 2000;13(2):406-413. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.406
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Abstract
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: to appreciate the effectiveness of th closed reduction and percutaneous pinning(CRPP) in reducible but unstable displaced surgical neck fracture of the humerus.
MATERIALS AND METHODS
: reviewed 30 patients(19 cases in CRPP and 11 cases in ORIF) with at least 1 year follow-up, comparing clinical union time, elapse time for surgery and clinical results using UCLA end-result scoring system in two froups and determining prognostic factors in CRPP.
RESULTS
: Clinical union was seen 8.4 weeks in CRPP and 11.2 weeks in ORIF. The difference between two groups in the clinical results was not significant. Lower UCLA score in CRPP correlated with the increment in age(p<0.05), but not with sex and metaphyseal comminution. Elapse time for surgery was taken average 38minutes in CRPP and average 95 minutes in ORIF. The postoperative complications in CRPP were 1 in nonunion, 4 in stiffness and 4 in pin loosening, most of them were occurred in female over sixty.
SUMMARY : CRPP is a useful alternative and may be primarily applicable method in respect of comparable results to ORIF, minimal soft tissue damage and shorter surgical time. However, in cases of female with sixty or more, ORIF would be preferred because of poor bone quality, less compliant, and frequent joint stiffness.
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Functional Results of Olecranon Fracture-Dislocation According to the Methods of Internal Fixation
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Won Sik Choy, Yong Bum Park, Kwang Won Lee, Whoan Jeang Kim, Ha Yong Kim, Jae Hun An, Chang Soo Ryu
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J Korean Soc Fract 2000;13(2):414-420. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.414
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Abstract
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- PURPOSE
: This study was performed to compare the functional results according to the methods of internal fixation in olecranon fracture-dislocation.
MATERIALS AND METHODS
: Authors retrospectively analyzed in 13 adult patients with olecranon fracture-dislocation (Colton II D) who were treated by internal fixation from January 1991 to June 1998. Functional results were assessed by Broberg and Morrey system and radiographic results were analyzed in terms of articular step-off, articular gap and reduction loss.
RESULTS
: In regard to functional assessment, all oblique fractures treated with plate and screw showed 100% of satisfactory result whereas those treated with tension bands showed 33.4% of satisfactory result. Comminuted fractures treated with plate and screw showed 40% of satisfactory result whereas all two treated with tesion bands resulted in unsatisfactory result. In regard to radiologic assessment, three oblique fractures treated with plate and screw result whereas those treated with tension bands resulted in fair result. Comminuted fractures treated with plate and screw resulted in three fair, two poor radiologic results whereas those treated with tension bands resulted in one fair, one poor result.
CONCLUSION
: Plate and screw fixation can obtain more satisfactory functional and radiologic results than tension bands in oblique and comminuted olecranon fracture-dislocation