Journal of Musculoskeletal Trauma

Missed Fractures in Severely Injured Patients: Hee Gon Park, Jae Sung Yoo, Hyung Suk Yi; J Korean Fract Soc 2014;27(2):113-119. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.113

PURPOSE
The purpose of this study is to analyze anatomic distributions, diagnostic methods, and prognosis of missed fractures in patients with severe injury.
MATERIALS AND METHODS
A review of single-institutional medical records between January 2001 and May 2012 identified 58 patients with 62 delayed diagnoses of fractures among 4,643 severely injured patients older than 20 years with Injury Severity Scores higher than 16. We evaluated combined injuries, location of fractures, diagnostic methods, and reasons for missed diagnosis at initial exam.
RESULTS
Among 62 missed fractures, there were eight cases of spine fracture, 10 cases of peri-shoulder joint fracture, eight cases of upper extremity fracture, 10 cases of pelvis of acetabulum fracture, and 26 cases of lower extremity fracture. Head injury was the most common concomitant injury (23 cases). Initially missed fractures were most commonly discovered by official reading by radiologists. The most common reasons for misdiagnosis were the use of improper radiologic study and missed-reading of proper radiologic studies.
CONCLUSION
In order to prevent misdiagnosis of fractures in patients with severe injury, meticulous physical examination with suspicion of fractures should come first. In addition, obtaining proper radiologic study and thorough evaluation of radiologic images are important to decreasing the rates of missed fracture diagnoses. In addition, thorough surveillance for ipsilateral fractures is important in extremities with identified fractures.

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Neglected upper-extremity fractures at a severe trauma center in the Republic of Korea
Dong Hee Kim, Seung Soo Han, Sang Hyun Lee
Archives of Hand and Microsurgery.2023; 28(4): 233. CrossRef

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Results of Use of Compression Hip Screw with Trochanter Stabilizing Plate for Reverse Oblique Intertrochanteric Fracture: Byung Woo Min, Kyung Jae Lee, Gyo Wook Kim, Ki Cheor Bae, Si Wook Lee, Du Han Kim; J Korean Fract Soc 2014;27(2):120-126. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.120

Abstract PDF: PURPOSE
The aim of this study was to analyze the use of a compression hip screw with a trochanter stabilizing plate for treatment of reverse oblique intertrochanteric fractures.
MATERIALS AND METHODS
We reviewed the results of 33 cases of reverse oblique intertrochanteric fracture treated with a compression hip screw with a trochanter stabilizing plate from January 2000 to December 2012 which were followed-up for more than one year. We evaluated postoperative bone union period, change of neck-shaft angle, sliding of hip screw, and other complications.
RESULTS
Of 33 patients, satisfactory reduction was achieved in 28 patients. Five patients had an unsatisfactory reduction, with two cases of excessive screw sliding, one of broken metal, one of varus deformity, and one of internal rotation deformity. We performed corrective osteotomy in varus and internal rotation deformity and partial hip replacement in a case of excessive screw sliding. Bone union was achieved in 29 patients, and the average bone union period was 19.2 weeks.
CONCLUSION
We consider that a compression hip screw with a trochanteric stabilized plate is a good option for treatment of reverse oblique intertrochanteric femoral fractures. However, adequate fracture reduction and ideal implant placement are a basic necessity for successful treatment.

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Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome: Seong Cheol Moon, Chul Hee Lee, Jong Hoon Baek, Nam Su Cho, Yong Girl Rhee; J Korean Fract Soc 2014;27(2):127-135. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.127

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the radiologic and clinical outcomes after tension band wire fixation of Neer type II distal clavicle fractures.
MATERIALS AND METHODS
Twenty-six patients with Neer type II distal clavicle fractures who underwent tension band wire fixation from March 2002 to May 2011 were included in the study. Fifteen cases were classified as Neer type IIa and 11 cases as type IIb. The postoperative mean follow-up period was 14.3 months. Clinical and radiologic evaluation was performed at two weeks, six weeks, three months, six months, and 12 months postoperatively.
RESULTS
Bony union on X-rays was observed at an average of 11.7 weeks (range 8-20 weeks) postoperatively. The overall visual analogue scale score for pain was 1.23+/-2.75 postoperatively. The overall postoperative University of California at Los Angeles score increased to 33.5+/-2.15 from the preoperative score of 21.6+/-1.91 (p<0.05).
CONCLUSION
Among various methods of treatment for Neer type II distal clavicle fracture, K-wire and tension band fixation was used and relatively satisfactory radiological and clinical results were obtained. This surgical method yields excellent clinical results, owing to its relatively easy technique, fewer complications, and allowance of early rehabilitation.

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Clinical and Radiologic Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Kirschner's Wire Transfixation and Locking Hook Plate Fixation
Yong Girl Rhee, Jung Gwan Park, Nam Su Cho, Wook Jae Song
Clinics in Shoulder and Elbow.2014; 17(4): 159. CrossRef

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Ankle Fracture Associated with Tibia Shaft Fractures: Ji Wan Kim, Hong Joon Choi, Dong Hyun Lee, Young Chang Kim; J Korean Fract Soc 2014;27(2):136-143. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.136

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the incidence of ankle injury in ipsilateral tibial shaft fractures and to assess the risk factors for ankle injury associated with tibial shaft fractures.
MATERIALS AND METHODS
Sixty patients with tibial shaft fractures were enrolled in this retrospective study. The incidence and characteristics of ankle injury were evaluated, and fracture classification, fracture site, and fracture pattern of the tibial shaft fractures were analyzed for assessment of the risk factors for ankle injury combined with tibial shaft fractures.
RESULTS
Ankle injury occurred in 20 cases (33%). There were four cases of lateral malleolar fracture, four cases of posterior malleolar fracture, two cases of distal tibiofibular ligament avulsion fracture, and 10 cases of complex injury. Fourteen cases (70%) of 20 cases of ankle injury were diagnosed from x-ray films, and the other six cases were recognized in ankle computed tomography (CT). Ankle injury occurred in 45.1% of distal tibial shaft fractures and found in 41.4% of A type, but there was no statistical significance. Ankle injury was observed in 54% of cases of spiral pattern of tibial shaft fracture and the incidence was statistically higher than 19% of cases of non-spiral pattern tibial shaft fracture.
CONCLUSION
Ankle injury was observed in 33% of tibial shaft fractures; however, only 70% could be diagnosed by x-ray. Ankle injury occurred frequently in cases of spiral pattern of tibial shaft fracture, and evaluation of ankle injury with CT is recommended in these cases.

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Usefulness of Computed Tomography on Distal Tibia Intra-Articular Fracture Associated with Spiral Tibia Shaft Fracture
Seong-Eun Byun, Sang-June Lee, Uk Kim, Young Rak Choi, Soo-Hong Han, Byong-Guk Kim
Journal of the Korean Fracture Society.2016; 29(2): 114. CrossRef

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Intramedullary Nailing of Distal Tibial Fractures with Percutaneous Reduction by Pointed Reduction Forceps: Jae Kwang Hwang, Chung Hwan Kim, Young Joon Choi, Gi Won Lee, Hyun Il Lee, Tae Kyung Kim; J Korean Fract Soc 2014;27(2):144-150. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.144

Abstract PDF: PURPOSE
The purpose of this study is to analyze the radiographic and clinical results of intramedullary nailing after percutaneous reduction using pointed reduction forceps for spiral or oblique fractures of the distal tibia. The benefit of percutaneous reduction using pointed reduction forceps in anatomical reduction and maintenance was assessed.
MATERIALS AND METHODS
From January 2005 to December 2009, 47 cases of distal one-third tibial fracture were managed by intramedullary nailing using pointed reduction forceps. Thirty-eight cases were spiral fracture and nine cases were oblique fracture. In all cases, the percutaneous reduction was achieved using pointed reduction forceps under fluoroscopy control. While maintaining the reduction with the pointed reduction forceps, the intramedullary nail was inserted. The pointed reduction forceps were removed after insertion of proximal and distal inter-locking screws. Alignment was evaluated with anterior-posterior and lateral radiographs taken immediately post-operation and at the time of union.
RESULTS
At immediate post-operation, the mean displacement of valgus and anterior angulation was 0.57degrees and 0.24degrees, respectively. That of valgus and anterior angulation at bone union was 0.37degrees and 0.16degrees, respectively. The average duration of bone union was 16.1 weeks.
CONCLUSION
Intramedullary nailing with percutaneous reduction using pointed reduction forceps for distal tibial fractures was an easy and effective method for achievement of accurate alignment intra-operatively. Accurate alignment was successfully maintained until bone union.

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Surgical Correction and Osteosynthesis for Cranial Displaced Pelvic Nonunion: Technical Note and Two Cases Report Regarding Anterior Correction and Osteosynthesis Following Posterior Release: Kwang Cheon Choi, Ji Yoon Ha, Weon Yoo Kim; J Korean Fract Soc 2014;27(2):151-156. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.151

Abstract PDF: Nonunion of an unstable pelvic fracture with cranial displacement pelvic surgery is technically difficult due to a large amount of bleeding and the risk of nerve damage. In addition, surgical correction of leg length discrepancy by reduction of a dislocated sacroiliac joint is in high demand. Nevertheless, when a patient is strongly disabled by a pelvic deformity, surgical correction may be necessary. Two patients with pelvic deformity were treated successfully by surgical correction and osteosynthesis.

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Laminoplasty for Treatment of Transverse Sacral Fracture: A Case Report: Young Soo Jang, Jak Jang, Sung Ju Bae, Chan Il Bae, Sung Bae Park; J Korean Fract Soc 2014;27(2):157-161. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.157

Abstract PDF: The transverse sacral fracture is rare; however, if it accompanies neurological injury or instability, difficult surgical treatment may be necessary. We performed surgical decompression and laminoplasty in a patient with neurological deficits and anterior displacement of S2 on S1. The patient showed a successful clinical outcome by neurological improvement.

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Pulmonary Embolism Complication after Surgical Treatment of Patella Fracture: A Case Report: Yong Beom Kim, Hyung Suk Choi, Dong Ill Chun, Jung Moo Seo, Byung Ill Lee; J Korean Fract Soc 2014;27(2):162-166. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.162

Abstract PDF: Deep vein thrombosis and pulmonary embolism are serious and fatal complications in orthopedic surgery. Most cases of symptomatic pulmonary embolism in knee surgery have been reported after total knee arthroplasty, but rarely after patella fracture. We report on a case of symptomatic pulmonary embolism after surgical treatment of a patella fracture in a 42-year-old female patient.

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Statistical Consideration for Improving Quality of Medical Study: Hyonggin An; J Korean Fract Soc 2014;27(2):167-172. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.167

Abstract PDF

No abstract available.

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Controlled Drinking Behaviors Among Korean American and Korean Male Workers
Younkyoung Kim, John Lowe, OiSaeng Hong
Nursing Research.2021; 70(2): 114. CrossRef

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Current Concepts in Management of Pilon Fracture: Jun Young Lee, Sang Joon Lee; J Korean Fract Soc 2014;27(2):173-184. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.173

Abstract PDF: No abstract available.

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