Journal of Musculoskeletal Trauma

The Percutaneous Pinning of the Displaced Supracondylar Fracture of the Humerus using Skin Traction: In Heon Park, Kyung Won Song, Sung Il Shin, Jin Young Lee, Seung Yong Lee, Won Seok Oh; J Korean Fract Soc 2004;17(2):65-69. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.65

PURPOSE
The purpose of this study was to evaluate a new treatment method, which was using intraoperative skin traction and Steinmann(S)-pin for anatomically reduction by gentle manipulation to treat the displaced supracondylar fracture of the humerus with percutaneous pinning.
MATERIALS AND METHODS
Clinical analysis was performed on thirty displaced supracondylar fractures (Gartland type III) of the humerus patients with a minimal three month follow up, who were treated percutaneous pinning after reduction with by intraoperative skin traction and S-pin. Clinical results were analyzed according to the Flynn grading system.
RESULTS
According to the Flynn grading system, excellent results were obtained in 12 cases (43%), good in 14 case (47%), fair in 4 cases (10%), poor in 0 cases (0%) and we obtained all satisfactory results. There was one case which was reoperated for closed reduction and percutaneous pinning repeatedly due to reduction loss and no case with conversion to open reduction.
CONCLUSION
To avoid the forceful manipulation, gentle closed reduction and percutaneous pinning using intraoperative skin traction and S-pin especially for rotational correction in the displaced supracondylar fracture of the humerus is considered to be useful method because showed satisfactory results.

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Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique
H.-Y. Lee, S.-J. Kim
The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef

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Clinical Outcome of Surgical Treatment of Distal Humerus Intercondylar Fractures Through the Transolecranon Approach Combined with Anterior Transposition of the Ulnar Nerve: Kwang Hyun Lee, Seong Pil Lee, Kyu Tae Hwang, Joo Hak Kim; J Korean Fract Soc 2004;17(2):70-75. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.70

Abstract PDF: PURPOSE
To analyze the clinical outcomes of surgical treatment of distal humerus intercondylar fractures through the transolecranon approach combined with anterior transposition of the ulnar nerve.
MATERIALS AND METHODS
Eight patients who had distal humerus intercondylar fractures were included in this study and underwent operative treatment through the transolecranon approach for sufficient operative field with anterior transposition of the ulnar nerve and fixed with reconstruction plate.
RESULTS
The results were evaluated using Riseborough and Radin rating criteria. Seven cases of eight cases were achieved good results with flexion contracture less than 30 degrees and forward flexion more than 115 degrees. However, one case was acheived poor result with 40 degrees of flexion contractue and 70 degrees of forward flexion. There were no the compressive ulnar neuropathy.
CONCLUSION
We found the transolecranon approach and anterior transposition of the ulnar nerve a viable option for surgical treatment of the distal humerus intercondylar fractures

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Treatment in Distal Humerus Fracture with Anatomical Y Plate: Eun Sun Moon, Sung Man Rowe, Jong Keun Seon, Myung Sun Kim, Seong Beom Cho; J Korean Fract Soc 2004;17(2):76-82. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.76

Abstract PDF

PURPOSE
To evaluate the clinical results of this modified anatomical Y-plate in treatment of distal humerus fracture and factors that affect the results.
MATERIALS AND METHODS
From April 1991 to January 2002, 40 cases (16 male, 24 female) of distal humeral fractures were treated using a modified anatomical Y plate. The patient's age, gender, pain, range of motion, instability, function, bone union, and complication were recorded.
RESULTS
At the operation, the mean age of patients is 49.5 years (12~74 years) and mean follow up period is 18 months (13~82 months). In the range of motion, mean flexion is 122.1 degrees (75~140 degrees) and mean flexion contracture is 11.4 degrees (0~30 degrees). Results by Morrey's functional evaluation include 15 excellent, 23 good and 2 fair cases. There are 2 excellent and 5 good cases in patients of supracondylar fracture which didn't involve the articular surface (A2, A3 type of AO classification), and 13 excellent, 18 good and 2 fair cases in patients of intracondylar fracture which involve the articular surface (B2, C1, C2, C3 type). But there is no statistical significance in results between two groups. There are 3 excellent, 3 good cases in 6 open fracture and 2 excellent, 6 good and 1 fair case in 9 patients with multiple trauma. The patient's age, gender, open fracture, multiple trauma, and intraarticular fracture did not affect the results.
CONCLUSION
Satisfactory results can be obtained if the modified anatomical Y-plate is used to treat a distal humerus fracture, regardless of many factors affecting the results.

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Comparative study of a Y- anatomical and innovative locking plate versus double plate for supracondylar humeral fracture
Hugo Barret, Romain Ceccarelli, Paul Vial D’Allais, Matthias Winter, Michel Chammas, Bertrand Coulet, Cyril Lazerges
Orthopaedics & Traumatology: Surgery & Research.2023; 109(5): 103380. CrossRef
Étude comparative d’une plaque verrouillée anatomique et innovante en Y par rapport à 2 plaques à 90 degrés pour la prise en charge des fractures supra condyliennes de l’humérus
Hugo Barret, Romain Ceccarelli, Paul Vial d’Allais, Matthias Winter, Michel Chammas, Bertrand Coulet, Cyril Lazerges
Revue de Chirurgie Orthopédique et Traumatologique.2023; 109(5): 648. CrossRef
Double Parallel Plates Fixation for Distal Humerus Fractures
Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk-Jin Lee, Joon Oh Lee, Kyu-Won Oh, Hyun Sik Gong
Journal of the Korean Fracture Society.2010; 23(2): 194. CrossRef

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Lateral Approach for Internal Fixation of the Distal Humeral Shaft Fractures: Seung Koo Rhee, Joo Yup Lee, Yoo Joon Suh, Joon Ho Lee, Nong Kyoum Ahn; J Korean Fract Soc 2004;17(2):83-89. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.83

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PURPOSE
To investigate the efficacy and advantages of the lateral approach for internal fixation of the distal humeral shaft fractures.
MATERIALS AND METHODS
Twelve patients with distal humeral shaft fractures who underwent open reduction and internal fixation using plate and screws by lateral approach from January, 1997 to May, 2002 were investigated. Postoperative results after a minimum 1 year follow-up were assessed using union rate, elapsed time to union, postoperative complications such as iatrogenic radial nerve palsy, range of motion of the elbow joint. Clinical outcomes were evaluated with Mayo elbow performance scoring system.
RESULTS
Union was achieved in all cases. The average time to union was 9 weeks (range, 7~12 weeks). Four cases of preoperative radial nerve palsy were revealed as contusion of the intact nerve and resolved completely by three months. The mean elbow range of motion was from 5 to 138 degrees. The average Mayo elbow performance score was 91 points; 9 cases ranked as excellent and 3 as good.
CONCLUSION
Distal humeral shaft fractures can be treated successfully through open reduction and internal fixation using plate and screws. Lateral approach is recommended to stabilize distal humeral shaft fractures without compromising the range of motion of the elbow, and to protect or explore the injured radial nerves easily

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Modified anterolateral approach for internal fixation of Holstein–Lewis humeral shaft fractures
Ho Min Lee, Young Sung Kim, Suk Kang, Min Young Lee, Jong Pil Kim
Journal of Orthopaedic Science.2018; 23(1): 137. CrossRef
Posterior Dual Plating for Distal Shaft Fractures of the Humerus
Chul-Hyun Cho, Kwang-Yeung Jeong, Beom-Soo Kim
Journal of the Korean Fracture Society.2017; 30(3): 117. CrossRef

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The Clinical Results in Compression Plate Fixation with Autogenous Cancellous Bone Graft for Humerus Diaphyseal Nonunion: Kwang Hyun Lee, Seong pil Lee, Hyung Jong Kim, Bong Geun Lee, Joo Hak Kim; J Korean Fract Soc 2004;17(2):90-94. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.90

Abstract PDF: PURPOSE
A The purpose of this retrospective study was to evaluate the results of compression plating and autogenous iliac bone graft in the management of humeral diaphyseal nonunion.
MATERIALS AND METHODS
Twenty patients who underwent the surgical treatments between May. 1998 and May. 2002 were included in this study. Nine of them are males and the others are females. The average age of them, when they was on operation, was 45 years. The symptoms lasted 23 months on average. They have been followed up for 33 months at an average. Treatment of nonunion consisted of resecting the atrophic nonunion, shortening the bone, apposing bleeding diaphyseal surface. Rigid fixation was then achieved using a compression plate and autogenous bone graft.
RESULTS
Solid bony union was achieved in all patients. In one patient, the bone was not healed at the first operation of plating and autogenous bone graft, but achieved union after the use of intramedullary nailing. In another patient, because of infected nonunion, we achieved union after several surgical debridement and stabilization by internal fixation.
CONCLUSION
This study documents that compression plate fixation with autogenous cancellous bone graft is a viable option with predictable and satisfactory results for humerus diaphyseal nonunion.

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Treatments of the Nonunion of Femoral Shaft Fractures after Interlocking Intramedullary Nailing: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Jae Sang Park; J Korean Fract Soc 2004;17(2):95-102. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.95

Abstract PDF: PURPOSE
To investigate and analyze the clinical result in the treatment of aseptic nonunion of femoral shaft fracture after interlocking intramedullary nailing MATERIALS AND METHODS: We reviewed 23 cases of aspetic nonunion of femoral shaft fracture after interlocking intramedullary nail from March 1995 to February 2003 and follow up more than one year. 8 cases were treated by metal exchange, 3 cases by autogenous bone graft and the rest 12 cases by metal exchange and bone graft on the basis of fracture gap and type of nonunion. We evaulated nonunion type, union time and clinical result. Those patients were treated by interlocking intramedullary nail with or without bone graft. Union were accepted when the radiographic evidences showed bridging callus on both end of femoral shaft fracture with clinical evidences showing abscence of pseudomotion or pain.
RESULTS
All patients were united by one operation. Average union time were 4.8 months in metal exchange group, 3.9 months in metal exchange with autograft bone graft group, and 4.3 months in bone graft group. 15 patients (65.2%) showed hypervascular nonunion including 7 Elephant foot types (46.7%) and 8 oligotrophic types (53.5%), and 8 patients (34.8%) showed avascular nonunion according to Weber-Brunner classification CONCLUSION: Based on our analysis on clinical outcome and stability of nonunion occuring after initial interlocking intramedullary nailing in femoral shaft fracture, interlocking intramedullary nailing with bone graft made early ambulation possible and promoting returning to normal daily life much earlier, thus based on this data, we recommend interlocking intramedullary nailing for treating femoral shaft fracture along with bone graft.

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Treatment of Distal Femoral Shaft and Supracondylar Fracture with aRetrograde Intramedullary Nailing: Sang Hong Lee, Jun Young Lee, Sang Ho Ha, Hong Moon Sohn, Kwang Chul Lee; J Korean Fract Soc 2004;17(2):103-109. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.103

Abstract PDF

PURPOSE
Retrograde intramedullary nailing has been recommended as one of the treatment options for the distal femoral fracture, particularly in patients who are obese, are pregnant, has sustained ipsilateral femoral neck fracture, have multiple injuries. However there are some disadvantage such as post-arthrotomy infection, knee joint stiffness. This paper is to evaluate the result and complication of treatment of distal femoral fracture with a retrograde intramedullary nailing.
MATERIALS AND METHODS
We reviewed 13 cases (distal femoral shaft fracture: 6 cases, supracondylar fracture: 7 cases) of the distal femoral fracture who had been treated with retrograde intramedullary nailing and follow up for more than 12 months from January 1999 to December 2001. The rate of bony union, range of motion of the knee, complications were evaluated.
RESULTS
The mean duration of bony union was 20 weeks (range, 16~25 weeks). A case of delayed union was developed. In 4 cases of 13 cases showed posterior angulation below 6 degree, which did not need further treatment. According to Saunder's criteria, excellent result was achieved in 8 patients, good result in 5 patients, respectively.
CONCLUSION
This study showed good clinical and radiological results of union with retrograde intramedullary nailing at the distal femoral fracture and ipsilateral multiple fracture

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Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef
Axial Malalignment after Minimally Invasive Plate Osteosynthesis in Distal Femur Fractures with Metaphyseal Comminution
Jae-Ho Jang, Gu-Hee Jung, Jae-Do Kim, Cheung-Kue Kim
Journal of the Korean Orthopaedic Association.2011; 46(4): 326. CrossRef

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Treatment of Supracondylar-Intercondylar Femoral Fractures with a Retrograde Intramedullary Nailing: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Yong Jin Jeon; J Korean Fract Soc 2004;17(2):110-116. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.110

Abstract PDF

PURPOSE
We analyzed the cases of supracondylar-intercondylar femoral fracture treated with retrograde intramedullary nail and report the clinical results and its usefulness.
MATERIALS AND METHODS
We reviewed 17 cases of supracondylar-intercondylar femoral fracture that had been treated with retrograde intramedullary nail and each of patients had been followed up for a minimum one year. Post-operative functional assessment was performed using a scale developed by Sanders et al. The evaluation scale assesses range of motion, pain, walking ability, return to work, and alignment and shortening as measured on radiograph.
RESULTS
According to functional assessment of Sanders et al, there were 6 excellent, 9 good, 1 fair, and 1 poor results, that is, 94% showed above excellent results. Bony union was obtained in average 5 months after operation. The post-operative complications were varus deformity in 1 case, wound infection in 1 case, stiffness of knee joint in 1 case, and metal failure in 1 case.
CONCLUSION
The treatment of supracondylar-intercondylar femoral fracture with retrograde intramedullary nail is one of the good surgical options for clinically preferable results with the advantages in early joint motion and early ambulation.

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Retrograde Intramedullary Nailing or the Treatment of Segmental Femoral Shaft Fracture Including Distal Part
Jong-Ho Yoon, Byung-Woo Ahn, Chong-Kwan Kim, Jin-Woo Jin, Ji-Hoon Lee, Hyun-Ku Cho, Joo-Hyun Lee
Journal of the Korean Fracture Society.2009; 22(3): 145. CrossRef

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The Treatment of Patellar Fracture with Modified Tension Band Wiring, using Cannulated Screws: Chul Won Ha, Jong Il Sun; J Korean Fract Soc 2004;17(2):117-121. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.117

Abstract PDF

PURPOSE
We have followed up the patients of the patellar fracture who had been treated with modified tension band wiring using cannulated screws. Since we have seen excellent clinical results, we would like to show the practical use of this operative method.
MATERIALS AND METHODS
We analyzed the operation time, the time elapsed for union, and complications of 9 cases of the patellar fracture who were treated with this operative method at our hospital recently.
RESULTS
Mean operation time (from the incision to the skin suture) was 68.3 min (40~120 min) and mean time elapsed for union was 9.7 weeks (8~12 wks). Mean time for full range of motion was 1 week in 5 cases of transverse fracture, 3 weeks (2~4 wks) in 3 cases of comminuted fracture. We found no complications like limitation of range of motion of the knee, loss of the reduction, irritation and migration of the hardware, and infection.
CONCLUSION
This surgical technique provides stable fixation, allowes early motion excercise by minimizing injury to extensor mechanism and accompanies reduced rate of complications such as loss of the reduction, irritation or displacement of the hardware

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Evolution in the Management of Patella Fractures
Mahak Baid, Sid Narula, Jonathan R. Manara, William Blakeney
Journal of Clinical Medicine.2024; 13(5): 1426. CrossRef
Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef
Treatment of Transverse Patellar Fracture with Cannulated Screws
Jung-Man Kim, Ju-Seok Yoo, Yong-Jin Kwon, Jang-Ok Cheon
Journal of the Korean Fracture Society.2007; 20(2): 149. CrossRef

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The Efficacy of MRI in Tibial Plateau Fractures: Hyoun Oh Cho, Kyoung Duck Kwak, Dae Hwan Lim, Sang Min Ahn, Kyung Ku Kang; J Korean Fract Soc 2004;17(2):122-132. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.122

Abstract PDF

PURPOSE
To analysis the efficacy of MRI in assessing fracture configuration and frequency of associated soft tissue injuries in tibial plateau fractures.
MATERIALS AND METHODS
In the plain films and MRI of 47 cases with tibial plateau fractures,every fracture was classified by findings on plain film and MRI respectively according to the Schatzker system and they were compared with each other. The degree of displacement and depression of the fracture fragments were measured on plain film and MRI.
RESULTS
MRI was more accurate in determining the classification of the fracture and measuring the displacement and depression of fragments. Fracture classifications were changed in 12 cases. Especially in Schatzker VI cases, articular step off over 2 mm and articular fragments over 2X2 cm were revealed in detail by MRI. Evidence of internal derangement of the knee was found in 38 (80.8%) cases.
CONCLUSION
Most of the cases with acute tibial plateau fracture were commonly associated with ligamentous and meniscal injuries. MRI can aid in accurate evaluation of tibial plateau fracture patterns and decision of treatment plan.

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Evaluation of the Patterns of Fractures and the Soft Tissue Injury Using MRI in Tibial Plateau Fractures
Ji-Yong Chun, Hee-Gon Park, Sung-Su Hwang
Journal of the Korean Fracture Society.2007; 20(4): 302. CrossRef

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Treatment of Proximal Shaft Fracture of Tibia with Intramedullary Nail: Analysis According to AO Classification and the Poller Screw: Chang Wug Oh, Sung Jung Kim, In Ho Jeon, Hee Soo Kyung, Byung Chul Park, Joo Chul Ihn, Kyung Hoon Kim, Yun Kee Woo; J Korean Fract Soc 2004;17(2):133-137. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.133

Abstract PDF

PURPOSE
This was a retrospective study to evaluate the results of intramedullary nailing in proximal shaft fracture of tibia. We analyzed those results according to AO classification and Poller screw.
MATERIALS AND METHODS
Thirty-three proximal tibial shaft fractures (32 patients) were followed for more than one year. In AO classification, there were 6 cases of type A, 14 cases of type B, and 13 cases of type C. We used Poller screws in 14 operations. We evaluated translation, angulation and nonunion after surgeries.
RESULTS
Twenty-eight cases (85%) were united primarily, but nonunions occurred in 5 cases. Malalignment (angulation>5degree or translation>5 mm) was found in 14 cases (42%). In Poller screw used and non-used groups, the malalignment was respectively showed in 2 cases (14%) and 12 cases (63%). According to AO classification, nonunion was found in only type B with 5 cases (36%).
CONCLUSION
Intramedullary nailing of proximal shaft fracture of tibia showed relatively lower rate of primary union. Especially, when initial fractures have a butterfly fragment, it showed the higher rate of nonunion. Moreover, the malalignment rate was relatively higher, yet it is possible to reduce the rate of malalignment by using Poller screw.

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Open Source-Based Surgical Navigation for Fracture Reduction of Lower Limb
Sanghyun Joung, Jaeyeong Park, Chul-Woo Park, Chang-Wug Oh, Il Hyung Park
Transactions of the Korean Society of Mechanical Engineers A.2014; 38(5): 497. CrossRef

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Treatment of Proximal Tibial Non-union after IM Nailing in Conjunction with Anterior Buttress Plating: Han Jun Lee, Young Uk Park; J Korean Fract Soc 2004;17(2):138-141. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.138

Abstract PDF

PURPOSE
We investigated the results of autologous bone grafting and anterior buttress plating for non-union occurred in junction between metaphysis and diaphysis of tibia after intramedullary nailing technique.
MATERIALS AND METHODS
We reviewed six patients who suffered from non-union of proximal tibia for a minimum follow up of one year. The interval was 6 months in average between first and second surgery. The mean follow up period was 15 months in average. The surgical method was autologous bone grafting and anterior buttress plating without removal of previous nail.
RESULTS
In all patients, the tenderness and pain of non-union sites were passed at a postoperative one month. Radiologic bone union was achieved in all patients at 18 weeks in average, range from 11 weeks to 20 weeks. The complication was superficial infection in one patient without deleterious effect on union.
CONCLUSION
The described method in this study could be a good alternative technique for the treatment of proximal tibial non-union due to failed intramedullary nailing.

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Cause and Treatment of Extraarticular Proximal Tibial Nonunion
Sung Soo Kim, Sung Keun Shon, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Lih Wang, Im Sic Ha
Journal of the Korean Fracture Society.2008; 21(4): 279. CrossRef

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Anatomical Assessment of the Proper Insertion Site for a Tibial Nailing: Soo Yong Kang, Eun Woo Lee, Ki Ser Kang, Han Jun Lee, Ho Joong Jung, Pyeong Ho Jeong; J Korean Fract Soc 2004;17(2):142-147. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.142

Abstract PDF

PURPOSE
To investigate the proper insertion site for a tibial intramedullary nail in the Korean.
MATERIALS AND METHODS
Forty volunteers without trauma below knee joint were studied to determine relationship between central axis of medullary canal and lateral tibial spine, patellar tendon and the proper insertion site, and to evaluation changes of proper insertion site during rotation of knee and effective diameter.
RESULTS
The proper insertion site located average 4.3+/-0.9 mm medial to the lateral tibial spine. The proper insertion site was in the medial 1/3 of patellar tendon in 6 knees, middle 1/3 of patellar tendon in 20 knees, and lateral 1/3 of patellar tendon in 14 knees. The proper insertion site might be changed two times in internal rotation more than in external rotation. The effective diameter was more narrow in medial slope than in lateral slope at proximal tibia.
CONCLUSION
The study indicates the ideal insertion site of tibial nail is the medial aspect of the lateral tibial spine in Korean. To reduce the mal-reduction from a improper insertion site, lateral insertion site might be safer than medial one. However, individual variations in the relationship between the patellar tendon and tibial medullary canal should be considered.

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Three-dimensional analysis of the intramedullary canal axis of tibia: clinical relevance to tibia intramedullary nailing
Sang Jun Song, B. O. Jeong
Archives of Orthopaedic and Trauma Surgery.2010; 130(7): 903. CrossRef
Three Dimensional Analysis for the Intramedullary Canal Axis of the Proximal Tibia: Clinical Relevance to Total Knee Arthroplasty
Sang Jun Song, Choong Hyeok Choi
The Journal of the Korean Orthopaedic Association.2007; 42(3): 345. CrossRef

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Grade III Tibia Open Fractures Treated with Unreamed Tibial Nailing: Chang Wug Oh, Hee Soo Kyung, Do Heon Kim, Il Hyung Park, Poong Taek Kim, Joo Chul Ihn, Yeon Ki Woo, Jung Yup Lee; J Korean Fract Soc 2004;17(2):148-152. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.148

Abstract PDF

PURPOSE
This is a retrospective study to analyze the results of unreamed intramedullary nailing in grade III tibial open fracture.
MATERIALS AND METHODS
Twenty-nine Gustilo-Anderson grade III tibial open fractures fixed with unreamed tibial nail were followed more than one year. Primary union rate, union time, infection, conversion to external fixation, ankle and knee function according to different grade of open, fracture level, AO classification, and muscle flap were evaluated.
RESULTS
Primary union was achieved at sixteen fractures. There were three delayed union that achieved union twenty week after primary operation. And eight undergone secondary bone grafts which were done after inflammation sign subcided. Complications about infection were in five cases. Two cases were unable to maintain internal fixation due to deep infection, and three of superficial infection were treated with repeated debridement and antibiotics use.
CONCLUSION
In grade III tibial open fracture, unreamed nailing with early soft tissue reconstruction and early prophylactic bone graft can be a good treatment.

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Management of Open Fracture
Gu-Hee Jung
Journal of the Korean Fracture Society.2010; 23(2): 236. CrossRef
Management of Open Tibial Fractures: Role of Internal Fixation
Yerl-Bo Sung
Journal of the Korean Fracture Society.2007; 20(4): 349. CrossRef

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Analysis for the Factors Influencing Bone Union in Segmental Tibial Shaft Fractures Treated with Interlocking Intramedullary Nailing: Kyung Jin Song, Kwang Bok Lee, Byung Yun Hwang; J Korean Fract Soc 2004;17(2):153-159. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.153

Abstract PDF

PURPOSE
To find the factors influencing bone union in segmental tibial shaft fractures treated with interlocking intramedullary nailing, and to find the special attentions during operation based on this factors.
MATERIALS AND METHODS
This retrospective study made to investigate the medical records and plain radiograms of 32 patients who treated with interlocking intramedullary nailing. We statistically analyzed the correlation between bone union time and factors influencing bone union, including fracture site, fracture pattern, Melis type, open fracture, nail diameter, reaming, postoperative gap, postoperative angulation.
RESULTS
The factors that showed the significant difference statistically were fracture site, Melis type, open fracture, postoperative gap, postoperative angulation. The factors that showed no significant difference statistically were fracture pattern, nail diameter, reaming.
CONCLUSION
We recommend that surgeons should be considered the site and type, open fracure in preoperative stage. During operation, try to reduce it accurately without angulation and gap if possible. And so, the careful planing of treament can be expected with a high rate of union and a low rate of complication.

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Outcomes and Analysis of Factors Affecting Bone Union after Interlocking Intramedullary Nailing in Segmental Tibia Fractures
Sang Soo Park, Jun-Young Lee, Sang-Ho Ha, Sung-Hae Park
Journal of the Korean Fracture Society.2013; 26(4): 275. CrossRef

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Biomechanical Analysis of Hybrid External Fixation for the Distal Tibial Fractures: A FEM Study: Duk Young Jung, Boug Ju Kim, Seok Bae Ryu, Jong Keon Oh; J Korean Fract Soc 2004;17(2):160-166. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.160

Abstract PDF: PURPOSE
To analyze the biomechanical effects of different frame configurations of the hybrid external fixators for distal tibial fractures on the frame stiffness and stress distribution with a finite element method (FEM).
MATERIALS AND METHODS
Five configurations were simulated: Group I: two wires with convergence angle of 60degrees, Group II: 3rd wire on a bisector axis of the group I. Group III: two wires with 30degrees. Group IV: 3rd wire on a bisector axis. Group V: two wires with 30degree and a half pin on the distal articular fragment. Each group was simulated under compression, torsion, anterior-posterior and lateral-medial bending load. Stiffness, stress and deformation values were calculated.
RESULTS
The overall stiffness was increased by 15~30% with the addition of a third wire, and by 150~400% with a anteromedial half pin on the articular fragment. The half pin decreased the stress level of the frame by about 43% and the deformation of the 5/8 ring by about 30%.
CONCLUSION
The addition of a half pin on the articular fragment is not only a method of increasing the stiffness but also a way of decreasing the stress concentration and the deformation of the frame.

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Mechanical Properties of F Plate in Intraarticular Calcaneal Fractures: Kyu Hyun Yang, Young Hee Park, Jung Hoon Won, Dae Ya Kim; J Korean Fract Soc 2004;17(2):167-172. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.167

Abstract PDF

PURPOSE
We evaluated the mechanical properties of F plate fixation comparing with Y plate and a screw fixation for the intraarticular calcaneal fractures using synthetic bones.
MATERIALS AND METHODS
Using 12 synthetic calcaneal bones, newly designed F plate was compared with the Y-plate, most commonly used, regarding the change of Bohler angle and the displacement of the thalamic fragments of the calcaneus after axial compressive loading by Instron 6022.
RESULTS
Y plate fixation lost 8degrees of Bohler angle in average after axial compressive load and 2.6degrees in F plate fixation. Thalamic fragments were displaced 1.72 mm in average in Y plate fixation group and 0.73 mm in F plate fixation group.
CONCLUSION
F plate offered more firm fixation than Y plate in the intraarticular calcaneal fracture in the aspect of maintaining the Bohler angle and preventing displacement of the thalamic fragments of calcaneus against axial compressive loading.

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The Effect of Temporary K-wire Fixation in the Plate Fixation for Displaced Intra-articular Calcaneal Fracture
Kiwon Young, Jin Su Kim, Jinseon Moon
Journal of Korean Foot and Ankle Society.2014; 18(3): 119. CrossRef
Treatment of Displaced Intra-articular Calcaneal Fractures Using a F-plate
Kyu Hyun Yang, Jae Bong Chung, Han Kook Yoon, Si Young Park, Hang Seob Yoon
Journal of the Korean Fracture Society.2007; 20(1): 1. CrossRef

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Avulsion Fracture of Calcaneus in Diabetic Patients: Sung Jin Park, Nam Yong Choi, In Tak Chu, Suk Ku Han, Ki Ho Nah, Hyun Seok Song, Jung Ho Kim; J Korean Fract Soc 2004;17(2):173-176. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.173

Abstract PDF

Avulsion fracture of the calcaneal tuberosity is an uncommon injury. Usually it occurs from indirect trauma, and can be seen in old patients with osteoporosis or in patients with diabetic neuropathy. Follow-up studies showed fracture healing in most cases, but skeletal deformity may develop in some cases. Therefore we should do plain X-ray evaluations in diabetic patients with foot and ankle pain, even though there have been no definite trauma history. Four cases of calcaneus avulsion fracture were treated operatively in diabetic patients, and reported.

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Avulsion Fracture of Calcaneal Apophysis in an Adolescent Gymnast : A Case Report
Youn Moo Heo, Whan Young Chung, Sang Bum Kim, Cheol Yong Park, Jin Woong Yi
Journal of the Korean Fracture Society.2009; 22(4): 288. CrossRef

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Treatment for Intractable Infected Nonunion of Lower Extremity in Elderly People using External Fixator: Seung Jun Park, Jong Sup Shim, Sung Kee Shin; J Korean Fract Soc 2004;17(2):177-183. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.177

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PURPOSE
To introduce and report the results of treatment of old patients' infected nonunion using external fixator.
MATERIALS AND METHODS
Nine patients more than 60 years old were included in the study. Four cases had combined medical problems of diabetes, hypertension, and vascular disorder. We used Ilizarov fixator in eight cases and uni-lateral external fixator in one. All patients were treated with debridement, broad sequestrectomy, segmental resection, bone graft and compression of fracture site about 1~1.5 cm. We evaluated the final results by functional result and complication according to the criteria of Paley.
RESULTS
Average length discrepancy was 1.7 cm before operation by initial bone loss and final follow-up shortening was average 2.6 cm. Mean duration of fixtor removal was 5.2 months. We acquired bony union lastly in 8 cases. Final functional result was 3 excellent, 2 good, 2 fair and 2 poor. Among them, 2 good, 1 fair and 1 poor cases had medical problem.
CONCLUSION
In old patients, compression of nonunion site and early joint motion using external fixator seemed to be very useful in the treatment of intractable infected nonunion of lower extremity and in minimizing duration of treatment.

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Treatment of Infected Nonunion
Sang-Ho Ha
Journal of the Korean Fracture Society.2007; 20(2): 206. CrossRef

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Bone & Soft Tissue Injuries Diagnosed by Magnetic Resonance Imaging in Thoracolumbar Fractures: Yong Min Kim, Dong Soo Kim, Eui Seong Choi, Hyun Chul Shon, Kyoung Jin Park, Gi Seok Han, Jae Jung Jeong, Kyoung Il Jeong, Yung Sung Kim; J Korean Fract Soc 2004;17(2):184-190. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.184

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PURPOSE
To assess diagnostic efficacy of the MRI in thoracolumbar fractures, especially in changes of bone and soft tissue which cannot be documented by other diagnostic tools.
MATERIALS AND METHODS
Among 85 patients managed for thoracolumbar fractures between January 1997 and June 2003, MRI was performed in 30 patients to get more informations. Plain X-ray, CT and MRI of these cases were reviewed retrospectively by two orthopaedic spine surgeons and one radiologist to investigate the informations which only MRI could afford.
RESULTS
14 (46.7%) among 30 patients had occult fractures of vertebrae other than main fracture which had not been diagnosed as fractured. Besides 6 patients who showed distraction of posterior structure on plain X-ray, injury of posterior ligament complex was confirmed by MRI in 12(40%) patients. Additionally, MRI visualized other soft tissue injuries such as intramuscular and subcutaneous hematoma, changes of the spinal cord and intervertebral disc. In 16 among 30 patients, informations achieved from MRI were the most important factors in deciding treatment modality.
CONCLUSION
MRI seems to be efficient in visualizing not only soft tissue injury such as ligament but also occult fractures of additional vertebra in thoracolumbar fractures, therefore MRI seems to be an important diagnostic tool in decision of treatment modalities, especially in cases of uncertain stability.

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Measurement Discrepancy of Sagittal Parameters between Plain Radiography and 3D Computed Tomography in Thoracolumbar and Lumbar Fractures
Dong-Soo Kim, Yong-Min Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Ji-Kang Park, Hyun-Cheol Lee
Journal of the Korean Orthopaedic Association.2012; 47(3): 198. CrossRef
Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures
Ki-Chan An, Dae Hyun Park, Yong-Wook Kwon
Journal of the Korean Fracture Society.2011; 24(3): 256. CrossRef

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Treatment of Vertebral Pseudarthrosis after Compression Fracture: Young Do Koh, Hoon Jeong; J Korean Fract Soc 2004;17(2):191-196. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.191

Abstract PDF: PURPOSE
To clarity the features of vertebral pseudarthrosis and to evaluate the efficacy of posterior instrumentation and fusion in treatment of it.
MATERIALS AND METHODS
Twelve patients with severe back pain and intravertebral pseudarthrosis showing vacuum phenomenon were treated by in situ posterior instrumentation and fusion. The kyphotic angle of pre- and post-treatment was measured on a lateral radiograph. MRI was performed in all patients. The intravertebral instability was confirmed from the dynamic lateral view. The pain level was assessed both before and after the treatment using a visual analog scale. The kyphotic angle at last follow up was also checked.
RESULTS
In eight cases, intravertebral instability was shown at the clefts in flexion-extension radiographs. MRI showed that the cleft was low intensity on the T1- weighted image and high intensity on the T2-weighted image. The pre-and postoperative mean kyphotic angles were -18.3degrees and -8.5degrees respectively. The preoperative average pain score was nine and postoperative four. At last follow up the mean kyphotic angle was -16.6degrees CONCLUSION: The cleft with intravertebral vacuum phenomenon and magnetic resonance findings of low intensity on the T1-weighted scans and high intensity on the T2-weighted scans suggests that the cleft is a pseudarthrosis associated with avascular necrosis of the vertebral body. The posterior instrumentation and fusion provides satisfactory pain relief in patient with vertebral pseudarthsosis.

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Clinical Applications of Autologous Cultured Osteoblasts: Case Report: Seok Jung Kim, In Young Ok, Cheong Ho Chang, Young Sik Kim, Jae Deog Jang, Won Jong Bahk, Joo Hyung Lee; J Korean Fract Soc 2004;17(2):197-201. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.197

Abstract PDF: We treated 3 cases of fracture and 1 case of avascular necrosis of femoral head using autologous cultured osteoblasts injection. The stromal cells from the bone marrow were cultured to differentiate to osteoblasts for 4 weeks. The fracture sites of each patients were right ulnar shaft, left radial shaft, and left 5th metatarsal base. All of the fractures showed callus formations after 1 week of osteoblasts injection to the fracture site. After 4 weeks, callus formations were progressed. Avascular necrosis of femoral head was bilateral and both were Ficat stage II. Core decompression and allograft impaction were performed to the left, and core decompression and autologous cultured osteoblasts injection percutaneously after 4 weeks of the decompression operation were done to the right femoral head. CT images of 1 year from the operations showed trabecular bone formation and well maintained femoral head contour of the right femur, but resorption of the grafted bone for the left.

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Treatment of Intertrochanteric Fracture of the Femur with Ender Nail in the Elderly Patients with High Risk of Anesthesia: Ju yong Shin, Duk Hwan Kho, Dong Ok Kim, Dong Heon Kim; J Korean Fract Soc 2004;17(2):202-207. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.202

Abstract PDF: PURPOSE
To evaluate the usefulness of IM Ender nail in treating femoral intertrochanteric fractures with high risks including cardiovascular disease, pulmonary disease, liver cirrhosis, cerebrovascular disease, metastatic cancer, and skin problem at hip joint region.
MATERIALS AND METHODS
Thirty-five patients of pre-existing diseases and femoral intertrochanteric fractures treated with Ender nailing, January 1990 to November 1997. Under the c-arm guided, closed reduction and internal fixation were performed using Ender nails, We analized operation time, blood loss, bone union, ambulation time and complications RESULTS: Mean operation time was 55 minutes, mean blood loss was 120 ml, mean radiological bone union was 12 weeks and average of partial weight bearing was 6.9 days. Postoperative complications were gastrointestinal discomfort in 3 cases, superficial wound infection in 1 case, knee pain in 7 cases, inguinal pains in 5 cases, distal migration of nails in 3 cases, varus deformity in 2 cases, proximal migration of nail with nonunion in 1 case.
CONCLUSION
The intramedullary ender nail is useful method in treating femoral intertrochanteric fractures in high risk patients of anesthesia and blood loss or skin problem at hip joint region.

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