Journal of Musculoskeletal Trauma

Comparison of Quality of Life between Before and After Orthopaedic Implant Removal Surgery: Sang Bong Ko, Seung Bum Chae; J Korean Fract Soc 2016;29(2):101-106. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.101

Abstract PDF: PURPOSE
The purpose of this study is to determine whether or not a patient's results are improved after removal of an internal fixative from a patient with no related symptoms.
MATERIALS AND METHODS
This prospective study included 87 patients who agreed to participate in the study and satisfied the criteria for selection and exclusion of patients who underwent the operation for removal of internal fixative due to broken bones from March 1st, 2004 to December 31st, 2011 at Daegu Catholic University Medical Center. The average replication period was 27 months (12-64 months) and the average age at the time of the operation for removal was 41.5 years (21-75 years) for 55 males and 32 females. The quality of life for all patients was evaluated using Short Form 36 (SF-36) surveys before the operation for removal and after a minimum of one year.
RESULTS
After an orthopedic operation for removal of internal fixative, physical health status showed statistically significant improvement (p=0.001); however mental health status did not (p=0.411). A satisfaction test for the subjective surgery written by patients indicated an improvement of subjective health status in 52.9% after the surgery for removal but with no difference in 29.9% compared to preoperation.
CONCLUSION
In case of an operation for removal of internal fixative for patients with no related symptoms with internal fixatives used for treatment of fractures showing agglutination opinions, an improvement was observed in physical health status, not in mental health status. When surgery for removal of internal fixative is performed for patients without related symptoms, consideration that subjective satisfaction of patients shows an improvement only in 52.9% will be helpful.

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Usefulness of the Additional K-Wire Fixation and Suture for Reinforce the Treatment of Distal Clavicle Fracture Using Modified Tension Band Wiring: Seung Bum Chae, Chang Hyuk Choi, Dong Young Kim; J Korean Fract Soc 2016;29(2):107-113. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.107

PURPOSE
We attempted to evaluate the clinical results of modified tension band wiring (MTBW) with additional K-wire fixation and suture for distal clavicle fracture.
MATERIALS AND METHODS
Fifty-nine patients with a distal clavicle fracture from May 2009 to December 2013 treated with MTBW were enrolled in this study. Their fracture types were type 2, 12; and type 3, 33; type 4, 8; and type 5, 6 according to Craig classification group II; average age was 47.2 years with a mean follow-up period of 27.9 months. The operations were performed within a mean of 3.1 days a fter t rauma. The c linical results were evaluated u sing University of California at Los Angeles scores (UCLA), American Shoulder and Elbow Surgeons scores (ASES) and Korean Shoulder Society scores (KSS) at 1 year after surgery.
RESULTS
Radiographic bone union was achieved at a mean of 3.7 months after the operation. In the last observation, their range of motion was forward flexion 159.0Â°, external rotation 59.8Â°, and internal rotation 4.3 points, and there were 2 cases of nonunion. Each average functional score was UCLA 31.3 points, KSS 91.6 points, and ASES 93.0 points.
CONCLUSION
For the surgical treatment of distal clavicle fractures, MTBW with additional K-wire fixation and suture is a useful technique allowing early range of motion exercises, minimizing soft tissue damage, and preserving the acromio-clavicular joint.

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Treatment Results for Unstable Distal Clavicle Fractures Using Hybrid Fixations with Finger Trap Wire and Plate
Jeong-Seok Yu, Bong-Seok Yang, Byeong-Mun Park, O-Sang Kwon
Journal of the Korean Orthopaedic Association.2022; 57(2): 135. CrossRef
Comparison of Locking Compression Plate Superior Anterior Clavicle Plate with Suture Augmentation and Hook Plate for Treatment of Distal Clavicle Fractures
Jun-Cheol Choi, Woo-Suk Song, Woo-Sung Kim, Jeong-Muk Kim, Chan-Woong Byun
Archives of Hand and Microsurgery.2017; 22(4): 247. CrossRef

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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; J Korean Fract Soc 2016;29(2):114-120. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.114

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the usefulness of computed tomography (CT) for spiral tibia shaft fracture by analyzing associated distal tibia intra-articular fractures diagnosed by CT only which met the indication of surgical fixation and were fixed.
MATERIALS AND METHODS
Ninety-five spiral tibia shaft fractures with preoperative ankle plain radiographs and CT were analyzed retrospectively. The incidence and type of associated distal tibia articular fractures were evaluated by reviewing ankle plain radiography and CT. The number of fractures diagnosed by CT that correspond with the indication of fixation and that were actually fixed were analyzed.
RESULTS
Among 95 spiral tibia shaft fractures, 62 cases (65.3%) were associated with distal tibia intra-articular fracture. There were 37 cases of posterior malleolar fracture, 5 cases of avulsion fracture of the distal anterior tibiofibular ligament, 5 cases of medial malleolar fracture, and 15 cases of complex fracture. Among 52 posterior malleolar fractures including complex fracture, 20 cases were diagnosed by ankle plain radiograph. Of these 20 cases, 16 posterior malleolar fractures (80.0%) met the indication of surgical fixation, and 14 cases were actually fixed with a screw. Among 32 posterior malleolar fractures diagnosed by CT only, 26 cases (81.3%) met the indication of surgical fixation and 18 cases (56.3%) were fixed by screw.
CONCLUSION
Approximately 50% of associated fractures were diagnosed by CT only and more than 80% of associated posterior malleolar fractures met the indication of surgical fixation and among these fractures, 18 cases (56.3%) were actually fixed by screw. This result suggests that CT is useful in diagnosis and treatment of distal tibia intra-articular fracture associated with spiral tibia shaft fracture.

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Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures
Young Sung Kim, Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Soon Young Park
Journal of the Korean Orthopaedic Association.2021; 56(4): 317. CrossRef

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Hypoesthesia after Open Reduction and Plate Fixation of Clavicular Midshaft Fractures: Correlation with Plate Location and Clinical Features of Hypoesthesia: Seong Hun Kim, Joon Yub Kim, Kyoung Hwan Koh, Myung Gon Jung, Jae Ho Cho; J Korean Fract Soc 2016;29(2):121-127. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.121

Abstract PDF: PURPOSE
The aim of this study is to evaluate the correlation between the location of the plate and the incidence of clavicular hypoesthesia and the clinical features of patients with clavicular hypoesthesia after open reduction and internal fixation of clavicular midshaft fractures.
MATERIALS AND METHODS
Seventy-eight patients who underwent open reduction and plate fixation for clavicle midshaft fractures between March 2013 and October 2014 were assessed for eligibility. The total clavicular length (A), the distance to the medial end of the plate from the sternoclavicular joint (B), and the distance to the lateral end of the plate from the sternoclavicular joint (C) were measured. Correlation between the location of the clavicular plate and the incidence of clavicular hypoesthesia was evaluated. In addition, the severity, and recovery of hypoesthesia were evaluated. Patient satisfaction, pain visual analogue scale were evaluated regarding hypoesthesia.
RESULTS
The incidence of hypoesthesia was 32.1% (25/78 patients). No correlation was observed with respect to the location of the clavicular plate and the incidence of clavicular hypoesthesia (p=0.666 at the medial end, p=0.369 at the lateral end). Recovery from hypoesthesia was observed in 23 out of 25 patients (p=0.008). Patient satisfaction and pain showed negative correlation with the incidence of hypoesthesia (p=0.002 and p=0.022).
CONCLUSION
There was no correlation between clavicular hypoesthesia and the plate location. Although most cases of hypoesthesia were recovered, we should try to avoid hypoesthesia due to the negative 'correlation' with patient satisfaction and pain.

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A Comparative Study of TRIGENâ„¢ INTERTAN Nail (InterTAN) and Proximal Femoral Nail Antirotation 2 (PFNA2) in the Patients with Intertrochanteric Fractures: Jae Hoon Jang, Jeung Il Kim, Um Ji Kim, Nam Hoon Moon; J Korean Fract Soc 2016;29(2):128-136. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.128

Abstract PDF

PURPOSE
The primary purpose of this study was to demonstrate that the TRIGENâ„¢ INTERTAN nail (InterTAN) could show better clinical outcome compared to the proximal femoral nail antirotation 2 (PFNA2) for treatment of intertrochanteric fracture in the elderly.
MATERIALS AND METHODS
Between March 2009 and December 2013, 164 patients with intertrochanteric fractures who met our inclusion and exclusion criteria were enrolled in this study. Evaluation variables, including operation time, blood loss during the operation, incidence of perioperative complications, clinical results at the last follow-up, and radiographic findings were assessed for comparison of the 2 implants.
RESULTS
Intraoperative lateral wall fracture was significantly higher in the PFNA2 group (p<0.05) and tip apex distance was significantly higher in the InterTAN group (p<0.05). Sliding of the proximal fragment at the last follow-up was significantly higher in the PFNA2 group. However, there was no significant difference in union rate, time to union, postoperative complications, and clinical outcomes at the last follow-up between the 2 groups.
CONCLUSION
Based on these data, clinical outcomes at the last follow-up were equivalent between InterTAN and PFNA2.

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Unstable Intertrochanteric Fracture: Do We Know Everything? A Review
Balaji Zacharia, Harshitha Hayavadana Udupa
SN Comprehensive Clinical Medicine.2022;[Epub] CrossRef

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Huge Pseudoaneurysm of Popliteal Artery Following Conservative Treatment of a Distal Femur Fracture: A Case Report: Won Chul Cho, Chong Bin Park, Young Jun Choi, Hyun Il Lee, Hee Jae Won, Jae Kwang Hwang; J Korean Fract Soc 2016;29(2):137-142. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.137

Abstract PDF: A pseudoaneurysm is a contained arterial disruption in the intimal and medial layers of an arterial wall. It may originate from a perforation caused by traumatic or iatrogenic injury or the dehiscence of a surgical anastomosis. Because of its insidious onset and delayed presentation, orthopaedic surgeons should be aware of the possibility of such a lesion after an initial trauma. We report on a case of a delayed huge pseudoaneurysm of the popliteal artery that occurred 11 months after conservative treatment of a supracondylar fracture of the femur in order to keep in mind the possibility of the delayed presentation of vascular injury after a distal femur fracture.

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Current Concepts of Fractures and Dislocation of the Hand: Yong Cheol Yoon, Jong Ryoon Baek; J Korean Fract Soc 2016;29(2):143-159. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.143

Abstract PDF

Fractures and dislocation of the hand is a body injury involving complex structures and multiple functions, which frequently occur as they represent 10%-30% of all fractures. Such fractures and dislocation of the hand should be treated in the context of stability and flexibility; and tailored treatment is required in order to achieve the most optimal functional performance in each patient since deformation may occur if not treated, stiffness may occur with unnecessarily excessive treatment, and both deformation and stiffness may occur coincidently with inappropriate treatment. Stable injuries can be fixed with splintage whereas surgery is actively considered for unstable injuries. In addition, surgeons should keep in mind that as the surgical intervention is done aggressively, aggressive rehabilitation must be followed in correspondence with the surgical intervention. Successful outcome requires effort to prevent any potential complication including nerve hypersensitivity and infection. Finally, it is also important that the patient to know that swelling, stiffness, and pain may last for a long period of time until the recovery of fractures and dislocation of the hand.

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Current Concepts in Management of Phalangeal Fractures
Yohan Lee, Sunghun Park, Jun-Ku Lee
Journal of the Korean Fracture Society.2022; 35(4): 169. CrossRef

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Diagnosis and Management of Ligament Injuries of the Wrist: Ki Tae Na, Joo Yup Lee; J Korean Fract Soc 2016;29(2):160-170. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.160

Abstract PDF: The wrist joint is formed by the distal end of the radius and ulna proximally, and eight carpal bones distally. It has many ligaments to maintain stability of the complex bony structures. The incidence of ligament injuries of the wrist has increased due to sports activities. However, diagnosis and management of these injuries are sometimes difficult because of the anatomic complexity and variable injury patterns. Among them, scapholunate ligament injury and triangular fibrocartilage tears are the two most common injuries resulting in chronic disabling wrist pain. Thorough understanding of the wrist anatomy and physical and radiologic examination is mandatory for proper diagnosis and management of these conditions. This article will briefly discuss the wrist joint anatomy and biomechanics, and review the diagnosis and management of the scapholunate ligament injury and triangular fibrocartilage injury.

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