Journal of Musculoskeletal Trauma

Operative Treatment of Intra-articular Calcaneal Fractures by Posterior Approaeh: Youn Soo Kim, Ckoong Seo Park, In Tak Chu, Hyoung Min Kim, Jae Duk Ryu; J Korean Soc Fract 1992;5(2):191-198. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.191

Abstract PDF: In contrast to the extra-articular calcaneal fractures, the treatment of intra-articular fractures is very difficult and the final result is not always satisfactory, because it has not only difficulties in the identification of the exact fracture pattern and an anatomical reduction of the fracture fragments, but also no principle of ideal treatment. Today, numerous controversies remain regarding the treatment of intra-articular calcaneal fractures, which include the need of reduction, the method of reduction, the surgical approach. the method of fixation, and the need of bone graft. We propose the posterior approach and longitudinal buttress screw fixation for the treatment of intra-articular calcaneal fractures. The posterior approach allows excellent visualization of the posterior facet of subtalar joint, and the longitudinal screw buttresses the posterior facrt fracture fragment of calcaneus. From Dec. 1990 to May 1992, 17 intra-articular calcaneal fractures out of 15 patients were treated by our surgical method and followed up (average, 9.2 months) in 12 cases out of 10 patients (2 bilateral cases). Seven cases were tongue type fractures and five were joint do- pression type. Operations were performed 5 to 15 days after accident(average, 92 days). Bone graft was performed only 3 cases. At last follow-up, there was no pain in 8 cases. intermittant dull pain in 3, and resting pain in 1. The Bohlers angle at post-accident and last follow-up were 5.9 and 30.7 in tongue type : 10.6 and 32.6 in joint depression type. The reduction of the fracturr fragments was maintained well and secondary deformities were not developed in all cases. Based on these findings in this study, most of the intra-articular calcaneal fractures can be reduced anatomically by posterior approach, and fracture fragment maintained by longitudinal buttress screw fixation.

53 View
0 Download

Intra-Articular Fractures of the Calcaneus: ORIF via Lateral Approac: Ik Dong Kim, Jo Chul Ihn, Poong Taek Kim, Byung Chul Park, Young Goo Lyu, Il Hyung Park, Sung Jung Kim; J Korean Soc Fract 1992;5(2):199-204. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.199

Abstract PDF: The os calcis is one of the most commonly injured tarsal bone and fractures involving the subtalar joint may cause serious and persistent disabilities. We treated 12 intra-artlcular calcaneal fractures in 11 patients from June, 1998 to April, 1992 by plate fixation after lateral approach. The Sanders fracture classification system was applied to out study which classify the fractures according to the number of the fractured segments and direction of the fracture lines after computerized axial tomography of the posterior facetal joint. The follow-up evaluation included questioning the patient about pain during activity and rest, the ability to walk and stand, range of subtalar motion and ability to return to work according to the assessment sheet for calcaneal fractures of Creighton Nebraska Health Foundationl We experienced 8 excellent and 2 good results among 12 cases and there was little complication.

91 View
0 Download

Open Reduction and Interrial Fixation of Displaeed Intraartieular Fractures of Calcaneus: Eun Kyoo Song, Dong Hyun Ryang; J Korean Soc Fract 1992;5(2):205-211. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.205

Abstract PDF: Nine displaced intraarticular fractures of the calcaneus involving subtalar joint in six patien ts were treated by open reduction and internal fixation with plate at department of orthopedic surgery, chonnam university hospital from April 1990 to October 1991. The clinical and radiographic results were analysed after follow-up from five to twenty three months. 1. Of 9 fractures, 7 fractures were joint depression type and 2 fractures were tongue type by Essex-Lopresti classification.2. The operations were performed though lateral approach in 8 cases and medial approach in 1 case. 3. At final follow-up 12 months in average the assessments of results by Salama and Rowe unit system showed satisfactory results in 89% and 67%, respectively. 4. The averge Bohler angle was -6.1 before operation and increased to 16.4 at final follow up. 5. The common complication were pain around ankle and heel, subtalar arthritis and cal-caneal deformlty etc.

40 View
0 Download

Fracture & Dislocation of Tarso-metatarsal Joint: Eung Shick Kang, Ho Jung Kang, Ick Hwan Yang, Dong Wha Lee; J Korean Soc Fract 1992;5(2):212-218. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.212

Abstract PDF: The fracture and dislocation of tarso-metatarsal joint is rare injury, but if it occurs, as-sociated soft tissue injury is so severe according to its cause of injury. We reviewed 19 patients of fracture and dislocation of tarso-metatarsal joint who were treated in patient service, during the perlod, from April, 1981 to March, 1991 at our hospital. The results were as follows; 1. Fifteen patients (75%) among the 19 patients were injured due to traffic accident and the associated injury was so severe. 2. Nine cases were treated with percutaneous pinning, closed redoclion with cast immobilization in 2 cases and open reduction with multiple pinning in 8 cases. Three cases needed free vasculariaed flap for its extensive soft tissue injury and, one case was taken below knee amputation for its associatrd severe injury. 3. Anatomical reduction was achieved in 15 cases and iss results were as follows: good in 4 cases. fair in 10 cases and poor in one case Anatomical reduction was not achieved in 3 cases and the results were as follows : fair in one case and poor in 2 cases. 4. Eight cases which were treated with open reduction with multiple pinning had the results as follows: good in one. fair in 6 cases and the remaining one case had taken below knee amputation Seven cases which were treated with closed reductlon and cast immobiliza- cases and poor in 3 cases. 5. The patients who were achieved anatomical reduction had better results than who were not achieved anatomical reduction, Buy the results of all patients were not so satisractory. That is because of the point that the Lisfranc joint injury had associated with severe soft tissue injuries. We concluded that early and active intervention and anatomical reduction should be achieved for the better results.

94 View
0 Download

Injuries of the Tarsometatarsal Joint: Chong Il Yoo, Jeung Tak Suh, Kuen Tak Suh, Yong Jin Kim, Hui Taeg Kim, Kie Bong Wang; J Korean Soc Fract 1992;5(2):219-226. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.219

Abstract PDF: Because of the anatomical configuration of the tarsornetatarsal joints with their strong ligmanet connections, the injries in this regicon are rare. But the injury is associated with a high potential for chronic disability.Authors reviewed and clinically analysed 18 cases of tarsometatarsal joint injuries which were followed more than one year at the orthopedic department of Pusan National University durging the period from January 1986 to December 1990. The results were as follows ; 1. The incidence was higher in male and young active age group. 2. The most common cause of the injury was traffic accident (50.0%). 3. Tarsal and metatarsal fractures were commonly combined (61.1%) 4. The most frequent injury type by Hardcastles classification was total inconjgrulty type (55.5%). 5. Overall result estimated by Hardcastles criteria was good in 5 cases (27.8%), fair in 8 cases (44.4%), and poor in 5 cases (27.8%). 6. The causes of poor resulted cases were severe crushing injury, inadequate anatomical reduction, delayed treatment due to combind injury and loss of medial longitudinal arch. 7. Late complications such as traumatir arthrltis, paln and foot deformity were seen more than half of the cases.

88 View
0 Download

A Clinical Study of Operative Treaenent for the Ankle Fractures: Sang Won Park, Young Soe Byun, Kwang Suk Lee, Jong Woong Park, Suk Ha Lee; J Korean Soc Fract 1992;5(2):227-235. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.227

Abstract PDF: The ankle is a complex, weight bearing joint and its injury results in a severe functional disturbance of complex anatomical characteristics. It is very important to understand the mechanism of the trauma in order to make defenite diagnosis and proper treatment. The authors analysed 92 cases(92 patients) of the ankle fractures which were operated in Orthopedic Department, Korea University Hospital from Sept. 1980 to Dec. 1991. The results obtained were as follows ; 1. Of the 92 cases, male was 61 cases(66.3%), female was 31 cases(33.7%) and average age of the patients was 39.9 years. 2. The causes of the injury were slipping down, traffic accident, sports injuries and falling down in orders. 3. Open fractures were 12 cases(13.0%) and closed fractures were 80 cases(87%). 4. The most common type of the ankle fracture was supination-external rotation type(32 cases, 34.8%) and next was pronation-external rotation type(26 cases, 28.3%), according to the classification of Lauge-Hansen. 5. The associated fractures with ankle fracture were 26 cases (28.3%). 6. The best result was supination-adduction type and the worst result was pronation dorsiflexion type, when assessed according to the criteria of Meyer. 7. There were 11 cases of complications(12.0%), in which 6 cases of traumatic arthritis, 4 cases of malunlon and 1 case of nonunion. 8. The accurate reduction and rigid internal fixation to the fracture of lateral malleolus of dlstal fibula and tibiofibular diastasis was important in the treatment of the ankle fractures.

46 View
1 Download

A Clinical Study of the Childrens Anltle Fracture: Seung Gyun Cha, Won Suck Lee, Kyoung Hoon Kim, Woo Tae Lee, Jin Hak Kim, Jae Sung Lee; J Korean Soc Fract 1992;5(2):236-243. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.236

Abstract PDF: The injuries of ankle in children occur mostly at the bony structure rather than ligamentous one, and some injuries of the growth plate may result in the arrest of entire growth an these may result to leg length discrepancy or deformity. Accurate treatment under the knowledge of injury mechanism is very important. We have reviewed 30 cases of childrens ankle fracture treated our clinics from Jan. 1987 to Dec. 1990. The results are as follows; 1. Traffic accident was most common cause of injury (50.0%). 2. According to Dias & Tachdjian classification, Supination-Invertion type was most common (11 cases). 3. The treatments performed were closed reduction & cast immobilization for 11 cases (36.7%), closed reduction & percutaneous pinning for 3 cases (10.0%), and open reduction & internal fixation for 16 cases(53.3%). 4. Among open reduction & internal fixation group, only 1 case(pronation-eversion-external rotation type) show angular deformaity. 5. For the prevention of complications, accurate reduction and adequate fixation was desired.

80 View
0 Download

A Clinical Study for the Complications Following Treatment of Children Ankle Injury: Sung Jon Kim, Jae Lim Cho, Tai Seung Kim, Hyun Kyu Jang; J Korean Soc Fract 1992;5(2):244-252. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.244

Abstract PDF: The childrens ankle injury is different from that of adults in terms of the possibilities of injury to growth plate and influence to growth. Therefore accurate reduction under the knowledge of prognosis of the injured growth plate is very important. Many authors agree that the prognosls of injured growth plate is dependent on the injury type, the age of the patient at the onset of injuries, the method and accuracy of reduction. and whether the injuries open or closed. We treated 45 cases of children ankle injuries from August 1983 to June 1991 and evaluated the cases of eight children who had a injury loading to complication. Most of them had had a Salter-Harris type II or type III injury of the distal end of the tibia. Initially all the cases were treated with accurate reduction of thr physis as much as possible, but six of them developed growth disturbance including physeal arrest, temporary cessation of the growth and growth retardation, while two did growth stimulation.

102 View
0 Download

A Clinical Study of the Ankle Fracture with Diastnsis: Ik Dong Kim, Jo Chul Ihn, Pong Tnk Kim, Byung Chul Park, Young Goo Lyu, Il Hyung Park, Chang Hyuk Choi; J Korean Soc Fract 1992;5(2):253-259. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.253

Abstract PDF: The ankle fracture with diastasls of distal tibiofibular joint is caused by an axial loading force with concomitant external rotation and associated with severe ankle fracture in addition to talai subluxation due to rupture of the distal tibiofibular syndesmosis. In order to restore the normal ankle mortise, operative anatomical reduction and temporary stabilization of the syndesmosis is mostily required until early ligament healing is present. Twelve cases among ninety-six cases of the ankle fracture were associated with diastasis and treated in the Department of Orthopedic Surgery, Kyungpook National University Hospital during the period from January, 1988 to May, 1991. We analysed these cases according to injury mechanism, radiographic criterion, the patterns of associated medial and lateral injury and treatment result. The results obtained were as follows; 1. The incidence of trauma was most frequent in 5th decade(5 cases). 2. Diastasls was produced by 3 mechanism according to Lauge-Hansen classification : (pronalion-external rotation : 7, Suplnatlon-external rotation : 3, pronation-Abduction;2). 3. All were associated with fibular fracture : proximal fibular fracture was most common (7cases). 4. All had disruption of the medial structures (medial ligament rupture 3, medial malleolusfracture 9). 5. Although the cases were small, there seems no significant differences between transfixation group and unfixation group when accurate anatomical restoration of the distal tibiofibular syndesmosis was achieved.

44 View
0 Download

A Clinieal Study of the Tibial Pilon Fractures: Cheol Kwak, Sung Seok Soe, Hyun Duk Yoo, Young Chang Kim, Jang Seok Choi, Young Ku Lee; J Korean Soc Fract 1992;5(2):260-267. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.260

Abstract PDF: Intraarticular fractures of the distal tibia, the so-called pilon tibial fracture, usually resultfrom a torsional injury, a motor vehicle accident, or a fall from a height. The management of these fractures has been notoriously difficult due to the comminution of the distal tibia, articular incongruity, and asscociat ed soft-tissue trauma. The best results of treatment reported for this fracture, have followed early open reduction and rigid internal fixation to restore length, recon struction of the plafond, primary cancellous bone-grafting, butress plate on tibia, early motion and prolonged non weight-bearing. The purpose of this study was to examine the experience of the Pusan Paik Hospital between 1986 and 1991 as it relates to the treatment of 20 pilon fractures and to correlates the Clinical fesults with fracture type. They were followed post-operatively for an average of 22.3 months. The results were as follows 1. The most frequent type of the fraEture was type III according to Ruedl and Allgowe Classification. 2. Open reduction and internal fixation in cases type II & III has showed better resulis than those treated conservatively. 3. The fibula fracture fixed internally with a plate first often makes re construction of the distal tlbia easier. 4. The most often complication was the ankle joint pain.

97 View
0 Download

A Clinical Study of the Tibial Plafond Fractures: Seung Gyun Cha, Won Suek Lee, Kyoung Hoon Kim, Jin Hak Kim, Jin Yong Jung, Jae Sung Lee; J Korean Soc Fract 1992;5(2):268-274. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.268

Abstract PDF: The tibial plafond fractures result from an axial compression and rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displacement, it is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws, basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The author analysed the 22 cases of the tibial plafond fractures in 22 patients, which were treated at the department of orthopedic surgery in Dai Han hospital. From january 1989 to january 1991. The longest duration of follow up was 2 years and 6 months and shortest one was 7 months, and the average was 14 months The results were as follows ; 1. Among the 22 patients, male were 17 and female was five. 2. The major causes of injury were a fall from a height. 3. Regardless of the method of treatment the type I and II were In good and fair result, but the type III were fair in 4 cases and poor in 2 cases, other 5 cases were in good result. 4. It is important to remind the basic steps in reconstruction appllied in an indivisual case especially in type III. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, early motion of the ankle joint is possible. The early motion reduces stiffness of the ankle and will yeild the most satisfying rusult. But the anatomic reduction of ankle joint is difficult to be obtained in each case especlally in type III and may consider an ankle fusion.

40 View
0 Download

Clinical Results of the Nonunion of Tibia: Chung Nam Kang, Jin Man Wang, Kwen Jae Roh, Yeo Hon Yun, Han Chul Kim; J Korean Soc Fract 1992;5(2):275-281. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.275

Abstract PDF: Tibia is anatomically predisposed to an open fracture because of inadequate covering of soft tissue, and fracture of tibial shaft is more frequently complicated by nonunion than any oter fractures. Although the methods of treatment for nonunion are varied, tibial fractures failed to heal within expected time can constitute a major orthopedic problem. Twenty-six patients of the nonunion of tibia were treated at the Department of Orthopedic Surgery, Ewha Womans University Hospital from January 1983 to December 1990, and were analysed. The results were as follows ; 1. Of twenty-six cases, 21 cases were injured by traffic accident. 2. Most common fracture site & type were middle 1/3 and comminuted fracture. 3. Among fifteen cases of open fracture, seven were Gustilo Type I injury 4. Seventeen cases were associated with injury of other part of the body. 5. Hypertrophic type nonunion were treated intramedullary nailing with fibular osteotomy and then early weight bearing, and these union and satisfactory results were obtained. 6. Atrophlc type nonunion were treated plate and screws with bone graft, and also satisfactory results were obtained.

80 View
0 Download

Treatment of the Tibia Fractures with Unreamed Intramedullary Interlocking Nailing: Jae Won You, Dong Min Shin, Young Bne Pyo; J Korean Soc Fract 1992;5(2):282-288. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.282

Abstract PDF: The intramedullary interlocking nailing for the fractured tibia has been used in selected cases of fresh diaphyseal fracture, but the indication has been expended considerably with modern technical improvement. The authors analyzed 28 cases of fresh fractures of the tibia, who were treated with unlearned intramedullary interlocking nailing in out hospital between May 1990 to Oct. 1991, average follow-up was 12 months ranged from 8 to 22 months and we obtained the following results. 1. The most common causes of the injury were traffic accident(19 cases). 2. Mostly associated injury was ipsilateral fibular fracture(24 cases). 3. We used unlearned intramedullary interlocking nail in all cases and dynamic and static interlocking were done in 12 cases and 16 cases respectively. 4. The average bony union was demonstrated radiographlcally at 16 weeks. 5. The complications were deep infection(1 case), delayed union(2 cases), angular deformity (4 cases), superficial infection(3 cases), limitation of knee joint ROM(3 cases) and shorte ning of leg length(2 cases). 6. In case of the treated for method of unlearned nailing, it is not difficut to insert the nail, and we obtained good bony union, decresed operation time and bleeding. The authors concluded that unlearned intramedullary interlocking nailing is useful method to treat the tibla fracture.

56 View
0 Download

Interlocking Intramedullary Nailing with Transfixing Serew for Femur Shaft Fracture: Sung Kwan Hwang, Woo Yong Yi; J Korean Soc Fract 1992;5(2):289-299. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.289

Abstract PDF: Despite advances in fracture management. the long bone fracture have high rate of morbidity. Recently interlocking intramedullary nailing have gained increasing attention and accepta- nce as a treatment modality for femoral shaft fracture. Early proper fixation of long bone fractures is needed for early mobiliaation of the patient to facilitate pulmonary care and to prevent secondary complications due to prolonged bed rest and traction We treated twenty-eight patients of femur shaft fracture using interlocking intramedullary nails and transfixing screws. All twenty-eight fractures were nailed in static fashion initially. Twelve patients were randomly chosen and they were changed from statlc fixation to dynamic fixation at average 16 weeks after surgory. The purpose of this study was to compare the bone healing rates, clinical results, and postoperative complication between the static fixation group and dynamiaation group. The results were as follows ; 1. According to Winqulst-Hansen classification : 9 cases were type I : 7 cases, type II : 6 cases, type III : 4 cases, type IV and : 2 cases, type V. 2. All sixteen fractures, treated by static fixation achieved bony union(mean union time : 21 weeks). 3. Of twelve fractures with dynamization, eleven fractures were united (mean union time, 19 weeks). 4. Postoperative complications were limb shortening (4 cases : mean 0.7cm), nail breakage (1 case) and nonunion(1 case). We consider interlocking intramedullary nailing is the treatment of choice for closed or open femoral shaft fractures and dynamization is not an essential procedure for fracture healing.

39 View
0 Download

Treatment of Intertrochanterie fracture of the Femur with Ender Nails in the Elderly Patients: Seong Taek Kim, Ki Soo Kim, Yeub Kim, Seung Hee Koh, Yong Soo Choi, Sang Tae Park; J Korean Soc Fract 1992;5(2):300-308. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.300

Abstract PDF: The incidence of intertrochanteric fracture of the femur in the elderly patient has been increased progresslvely due to the prolongation of Korean average life span and improvement of the medical survice. The mortality. however, in these elderly patients is relatively high. Rigid internal fixation of intertrochanteric fracture with early mobilization of the patient has in recent years reduced the mortality and morbidity. From September 1984 to August 1991, the authors had treated with Ender nails for 126 cases of intertrochanteric fracture. From 109 cases followed more than six months, the clincal results were as follows. 1. The average age was 74.8 years. 2. 73 cases (67%) were unstable fractures and 36 cases (33%) were stable fractures by Evans classification. The most common type was type 3 (35.8%) by the Tronzo classification, A2 type(55.1%) by the AO classification. 3. The main indication were stable fracture, unstable fracture over 70 years old, high anesthe tic resk, severe osteoporosis and wound at greater trochanter. 4. Intraoperatlve complications were experienced in 37 cases(33.9%). The improper entry hole site was most common. 5. Postoperative complications occured in 57 cases(52.3%) and more frequently in unstable fractures(57.5%). The most common complication was knee joint pain in 45 cases (41.3%) 6. Recently, patients who had Ender nails with Knowles pins showed good results in the presence of severe osteoporosis or unstable fracture.

51 View
0 Download

A Clinical Study on Open Fracture of the Shaft of the Ulna and Radius in Adults: Sung Joon Kim, Il Yong Choi, Kwang Hyun Lee, Do Gyoung Lee; J Korean Soc Fract 1992;5(2):309-318. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.309

Abstract PDF: We reviewed 55 cases of open fracture of the forearm bones had been treated by conservative treatment or open reduction and intramedullary nailing or internal fixation with dynamic compression plate and analyzed the results by wound management and methods of treatment.The results were obtained as follows ;1. In the type I,II and type III-A open fractures, primary closure of the wound was reliable method of treatment. 2. The non-union rate was 44% in the positive culture test and 14.8% in the negative culture test. 3. Immediate internal fixation with dynamic compression plate was reliable method in the treatment of the type I, II open fractures.

38 View
0 Download

Supracondylar Osteotomy for Cubitus Vnrus Deformity by Using Plate in Adults: Hyun Ki Yoon, Sung Seok Soe, Young Ku Lee; J Korean Soc Fract 1992;5(2):319-324. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.319

Abstract PDF: Cubitus varus deformity is the most common complication of supracondylar fractures of the humerus in children. For the correction of this deformity, three basic types of osteotomies were known. Among them, the lateral closing wedge osteotomy is the easiest, safest and the most stable method. After osteotomy, the methods of fixation are plate fixation, crossed kirschner wires, staple, and French techniques. Between 1987 and 1991, 15 corrective supracondylar osteotomy of the humerus in adults were perromed at department of orthopaedic surgery inje University, Paik hoshpital Pusan, Korea. All were fixed with plate and screws. From this small series of retrospective study, the authors concluded that plate fixation is good method for the prevention of complication after osteotomy and results are satisfactory.

84 View
0 Download

Clinical Analysis of Supracondylar Fracture of the Humerus in Children: Bu Hwan Kim, Kyo Seog Shin, Jae Hyek Kim, Doo Jeong Kim; J Korean Soc Fract 1992;5(2):325-333. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.325

Abstract PDF

Supracondylar fracture of the humerus is the most common fracture of the elbow in children. There are many controversies about the methods of treatent. We analysed 41 cases of supracondylar fractures of the children from Jan. 1988 to Dec. 1990 according to the types of the fracture and methods of the treatment. The results were as follows . 1. Boys were more vulnerable to injury than girls by the ratio of 2.4 : 1, and all fractures were extension type. 2. The most common associated injuries were nerve injuries and all of them recovered spontaneously There were 2 cases of radial nerve palsies in patient with posteromedial displacements of distal fragments. 2 cases of median nerve palsies and 2 cases of ulnar nerve palsied with posterolateral displacements. 3. There were 30 cases of Excellent, 9 cases of Good and 2 cases of Fair results by the Flynn criteria. Only 7 cases showed limitation of elbow joint motion over 5 degrees after treatment. 4. We believe that percutaneous pinning was the choice procedure for treatment of displaced supracondylar fractures. The higher the severity, the poorer the result in Holmberg classification. 5. We used posterior approaches of 12 cases among 14 cases of open rdductions for anatomi. cal reduction of the fractures. We havent found and problem concerning the posterior approaches except some degrees of elbow joint motion limitations.

Citations

Citations to this article as recorded by

The Effect of Rotational Deformities on Cubitus Varus for Supracondylar Humerus Fractures in Children
Hyun Dae Shin, Kyung Cheon Kim, Dong Kyu Kim, Woo Yong Lee
Journal of the Korean Orthopaedic Association.2010; 45(5): 373. CrossRef
Natural regeneration offraxinus mandshuricaandF. rhynchophyllain the natural deciduous forest
Ji Hong Kim, Hee Moon Yang, Sung Kee Kang
Forest Science and Technology.2010; 6(1): 1. CrossRef

105 View
0 Download
2 Crossref

Clinical Investigation of the Proximal Humerus Fracture: Chang Ju Lee, Won Ho Cho, Ho Guen Chang, Soo Joong Choi, Byung Il Min, Yong Jee Park; J Korean Soc Fract 1992;5(2):334-341. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.334

Abstract PDF: Proximal humerus fractures respond satisfactorily to conservative treatment, but in old age group, there are difficulties in managing it. So we analyzed 42 cases of proximal humerus fractures according to age and the method of treatment. The results were as follows; 1. Eighteen one part fractures were treated conservatively except one case and show satisfactory result except one. 2. Fifteen two-part fractures were treated by open reduction except one case and show satisfactory result except one. 3. Six three-part fractures were treated by open reduction in all cases and show satisfactory result except one. 4. Three four-part fractures were treated by open reduction or total shoulder arthroplastT 2. respectively in two ceses and show satisfactory result except one. 5. In old age group. loosenings of plate and screws were found in 2 cases. 6. In young age group, loosening of plate and screws was not found. 7. Tension band wire was not related loosening of wire in all cases.

91 View
0 Download

Operative Treatment of Three Part Fraetures of the Proximal Humerus Following AO/ASIF Principle: Key Yong Kim, Choon Sung Lee, Sung Il Bin; J Korean Soc Fract 1992;5(2):342-347. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.342

Abstract PDF: The three part fractures of proximal humerus are not uncommon and the management is still under debate. For the good functional result, rigid internal or external fixation and early ROM exercise is mandatory. From Oct, 1989 to Oct, 1991, the results of treatment of 13 cases of proximal humerus 3-part fractures exclusively treated by internal fixation following the principles of the AO/ASIF group were analyzed at the Department of Orthopedic Surgery, Asan Medical Center. The results were as follows ; 1. The major cause of injury was traffic accident(9 out of 13 cases). 2. The associated injuries were brachlal plexopathy(1), rib fractures(1) and femur fractures (1). 3. The types of fractures were type B(7 cases), and type C(6 cases) according to AO/ASIF classification. 4. Open reduction and internal fixation was performed with T plate and tension band wiring, if necessary. 5. The excellent results were 4 cases and satisfactory results were 5 cases according to Neer criterla.

76 View
0 Download

Treatment for Two-part Fracture of the Humerus Surgieal Neck by Ender Nailing: Choong Gil Lee, Jin Woo Kwon, Soo Yong Kim, Kyung Tae Son; J Korean Soc Fract 1992;5(2):348-355. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.348

Abstract PDF: There is no consensus on the best way to treat complicated fractures of the proximal humerus. We treated two-part surgical neck fractures which were not suitable for conservative method by semi-open reduction and Ender nailing with addition of cancellous bone graft. This method provided good three-point fixation and then early ROM exercise was possible even in case of osteoporotic or severely comminuted surgical neck fractures. Between June 1989 and February 1992, Ender nailinss were performed for two-part surgical neck fractures, and among those cases 16 were followed for more than 1 year. The results of study were as follows ; 1. All cases were treated by seml-open reduction and Ender nailing with additional cancelous bone graft. 2. Ender nails were inserted through retrograde entry in all cases. 3. Complications developed in 3 cases ; one case of proximal migration of Ender nail and two of shooter joint partlal stiffness. 4. The mean duration of radiologic bone union was postoperative 9 weeks. 5. According to Neer criteria 11 cases were good, 3 fair and 2 poor results.

85 View
0 Download

Clinical Study of Nonunion of Clavicle in Adult: Dae Yong Han, Ik Hwan Yang, Jo Hyung Lee; J Korean Soc Fract 1992;5(2):356-364. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.356

Abstract PDF

Although the clavicle is one of the most commonly fractured bone, nonunion is rare. The authors experienced 15 cases of clavicle nonunion in adult who were admitted and treated at the Department of Orthopedic Surgery of Severance Hospital during period from January 1983 to December 1990 (eight years). This study focused on the predisposing factors in relation to nonunion of clavicle and the analysis of the results after operative treatment The results of analysis wire as follows ; 1. Predisposing factors of nonunion were primary operative treatment with inadequate fixation, middle 1/3 of clavicle, severe associated injury and initial gross displacement of fracture fragment. 2. Among the 15 patients, 14 patients were treated with plate and screw fixation and autogenous iliac bone graft. One patient was treated by metal removal due to infected nonunion. 3. Using a rating scale of excellent(no apparent fractors), good(one factor), fair(two factors), poor(more than three factors), the result showed, 12 excellent, 1 good, and 2 poor 4. Amonf the is opeTative treatment, there was only one case of complication which was metal failure. It was concluded that symptomatic nonunion of the clavicle could be treated by operation. and the procedure of choice seemed to be rigid internal fixation with plate and bone graft.

Citations

Citations to this article as recorded by

Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Jung-Ho Kang, Kwang-Hee Park
Journal of the Korean Fracture Society.2007; 20(3): 233. CrossRef

103 View
0 Download
1 Crossref

A Clinical Study of Fracture of Neck of the Talus: 6 Cases Report: Kyung Ckul Kim, Sung Joon Im, Bo Seok Kong, Bo Hyeong Bang; J Korean Soc Fract 1992;5(2):365-371. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.365

Abstract PDF: The talus is a important bone because it supports and distributes the body forces above it. The fractures of the talus are not common but the talus is a bone with unique biomechanical features and vascular supply, so the complications with avascular necrosis and tramatic arthritis are frequent and resulting disabilities are so severe that the importance of proper management is emphasized. We analyzed 6 cases of fracture-dislocation of the talus, treated at Koryo General Hospital from 1987 to 1991. The follow up period was at least 12 months. The results were as follows ; 1. Of 6 cases, all were males and almost were 3rd and 4th decade. 2. The causes were traffic accident and fall from height. 3. Associated injuries were fracture of medial malleolus, tibia and Os calcis. 4. According to modified Hawkons classification, type I was 1 case, type II and type III were 2cases and type IV was 1 case. 5. 1 case in type II was treated conservatively, and 5 cases in other types were treated operatively. 6. Complications were skin infection and necrosis in 3 cases, failure of reduction in 2 cases, avascular necrosis in 3 cases and degenerative arthritis in 2 cases. 7. Complications wlth avascular necrosis and degenerative arthritis were treated with fusion of ankle and subtalar joint with external fixator.

40 View
0 Download

Avulsion Fractures of the Tibial Tuberosity: Three Cases Reports: Ho Jung Kang, Koon Soon Kang, Jun Seop Jahng, Young June Park; J Korean Soc Fract 1992;5(2):372-377. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.372

Abstract PDF: The talus is a important bone because it supports and distributes the body forces above it. Avulslon Fractures of the tibial tubercle prior to epiphyseal closure are uncommon. Fractures that are seen most frequently in adolescents. Watson-Jones classified these injuries into three types. The authors treated three cases of the tuberosity fractures. Two adolescent boys were treated with open reduction and screw fixation and K-wire fixation. One adult man was treated with open reduction and circumferential wire fixation. The Osgood-schlatter disease was diagnosed in two patients. There were small flecks of calcification 3 to 4cm proximal to the tubercle in the two adolescent cases. Functional motion was started within six weaks after operation. No early complications occurred, and no later defermities. such as genu recurvatum as reported by Blount, were detected. All patients returned to normal activity in one year after an operation.

95 View
0 Download

Proximal Femral Fracture During Closed Intramedullary Interlocking Delta Nailing: Phil Hyun Chung, Moon Jib Yoo, Suk Kang, Eung Nam Cha, Yong Min Kim, Jong Won Kim; J Korean Soc Fract 1992;5(2):378-382. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.378

Abstract PDF: Closed intramedullary nailing is a complex technique which usually requires fracture table and image intensifier, so that the patient and surgeon are exposed to the radiation. But this technique affords considerable advantages such as high rate of union, less infection rate and early weight bearing, etc. The main causes of failure or complication of this procedure are inapproprisate entry point and inadequate nail size. These are especially important problems in the patient who is femoral canal diameter is very small (8 or 9mm). The Delta femoral interlocking nails (diameter 10mm and 11mm)were devised for the femurs with narrow canal diameter. However, proximal portion of the Delta nail (about 7cm from the proximal end)is thick (diameter 13mm)to gain strength enough for holding the insertion device and fixation of the interlocking screws. If the insertion point is not correct or proximal reaming is inadequate, iatrogenic proximal femoral fracture may occur during final insertion of the nail. We experienced 2 cases of this complication during fixation of femoral shaft fractures using the Delta nails. We managed thls problem with hip spica cast immobilization in one case, and multiple pinning of femur neck in the other.

54 View
0 Download

A Cliniral Experience of Quadratus Femoris Muscle Pedicle Bone Graft in Nonunion and PatHologic Fracture of the Neck of Femur: C U Choi, S K Rah, Y S Seo, S Y Choi, D Y Kim; J Korean Soc Fract 1992;5(2):383-393. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.383

Abstract PDF: In spite of the improvement for the treatment of femoral neck fracture, the incidence of noinion is more than 15%. There are several surgical methods for treating the nonunion of femoral neck fracture, they are:osteosynthesis, osteotomy, prosthetic replacement, total hip arthroplasty, hanging hip and arthrodesis and so forth. The muscle pedicle bone graft method fof the nonunion in femoral neck fracture was designed by Judet (1962) initially. This method is also applied for the patients with nonunion, possibility of nonunion, or avascular necrosis of femoral head. In this paper, the authors reported the results of muscle pedicle bone graft for the three cases of the nonunion in femoral neck fracture, and one case of pathologic fracture at SoonChunHyang Hospital during from April 1988 to August 1990. Two out of the three cases of femoral neck fracture were treated by Richard hip screw and the other was applied by multiple pinning.The cause of nonunion was inaccurate reduction and inadequate position of implant. Mean fracture, 4 days after injury, curretage and muscle pedicle bone grafting were performed. The complication were found leg length shortening and limitation of hip motion but painful walking was not noted. Clinical and radiological, bone union was obtainef at 6 months after the operation In according to Lunceford s assessment, all four cases showed satisfaGtory results.

33 View
0 Download

The Treatment of Pathologic Troehanterie Fracture of the Femur by Solitary Bone Cyst in Children: Sang Ho Ha, Sang Hong Lee, Byoung Ho Lee; J Korean Soc Fract 1992;5(2):394-399. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.394

Abstract PDF: Generally, pathologic fracture with solitary bone cyst was treated by plaster immobilization to stabilize the fracture site and there-after local steroid injection and curettage and bone graft in the remaining cyst. However, pathologic fracture involving weight bearing bone such as trochanter of the femur showed many complications : coxa, vara, avascular necrosis of femoral head, osteochondritis dissecans if they are treated by conservative method. We treated operatively for two unstable pathologic fractures of the trochanteric region of femur with large solitary bone cyst by primary curettage and autogenous bone graft with internal fixation and obtained satisfactory results.

85 View
0 Download

The Treatment of Infected Large Defect of the Long Bone - Allograft Transplantation and Ilizarov Technique: Duck Yun Cho, Sung Bum Yang, Kwang Chang; J Korean Soc Fract 1992;5(2):400-409. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.400

Abstract PDF: Infected large defect of the long bone have had many obstacles in treatment. It is usually very difficult to obtain union and to correct coexisting infection, deformity, & leg length discrepancy, Allograft transplantation have been traditionally used to treat infected large defect of the long bone. And Ilizarov technique has recently gained popularity as a multifactorial approach to the management of infected large defect of the long bone. We performed allograft transplantation in 5 cases and Ilizarov technique in 6 cases with infected large defect of the long bone at National Medical Center from 1987 through 1991. The results were as follows; 1. In the cases of allograft transplantaton, the average size of the bone defect was 9.6cm (range from 6cm to 3cm) and the average length of leg length discrepancy was 2.4cm (range from 0cm to 4cm). 2. In the six cases of Ilizarov technique, the average size of the bone defect was 2.5cm(range from 0.5cm to 4.5cm) and the average length of leg length discrepancy was 3.7cm(range from 0cm to 7cm). 3. In the cases of allograft transplantation, the bone union was achieved in two cases. Two cases have been followed up for 19 and 26 months each and they showed complete bone union in the proximal side of host-graft junction, but not complete union in the distal side. In one case, developed the osteolysis of the grafted bone due to the infection. After operation, the average length of leg length discrepancy was 1.4cm(range from 0 cm to 2cm). 4. In the cases of Ilizarov technique, bone union was achieved in three cases. One case have been followed up for 15 menths and showed incomplete bone union. In two cases, additional operation was performed due to the nonunion and the fracture between the junction of the proximal bone fragment and the transportated bone fragment in each. So we report our results of diferent two methods of treatment even if limited cases and experiences.

89 View
0 Download

Treatment of Bone Loss by Local Bone Transportation: A report 3 eases: Sung Joon Kim, Kuhn Sung Whang, Hyun Kee Chung, Ye So Park; J Korean Soc Fract 1992;5(2):410-416. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.410

Abstract PDF: We experienced the local bone transportation in 3 cases. with a dynamic axial fixator, which had been effected the large bone defects because of the loss of the bony segment or infected non-union. The 2 patients showed the large femoral bone defect after motorcycle accident and the other patient. The tibial infected nonunion with large bone defect. The two femoral bone defects were treated by callotasis, and the tibial bone defect by chondrodiatasis. The size of bony defects were 12.Ocm and 6.5cm and the amount of bony transportation were 10.Ocm, 9.4cm and 5.9cm in orthoroentgenogram. These local bone transportations induced excellent osteogenesls and it filled up the defects We suggest that local bone transportation might be one of the best ways for the treatment of the large bone defects.

55 View
0 Download

Treatment of Wrist Frarture-Disluation using the Mini-External Fixator and Internal Fixation: Chil Soo Kwon, Young Uek Kim, Jin Hyok Kim, Won Ho Choi; J Korean Soc Fract 1992;5(2):417-425. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.417

Abstract PDF: Authors reviewed 8 cases of wrist fracture-dislocation treated with mini-external fixator and internal fixation form Septmeber 1989 to May 1992 with average 6 months follow up. The results were as follows ; 1. Mean ages were 47 years, most patients were young age. 2. We could achieve good results in intra-articular, communited, displaced fracture and open fracture of the wrist by using the mini-externall fixator and internal fixation. 3. Radial length and inclination was maintained mainly by the external fixator. Articular surface restoration and reconstruction was performed by bone graft and the limited internal fixation. We would like to recommend to use the mini-external fixator and limited internal fixation instead of plate and screws for the intraarticular fractue, displaced, communited farcture and open fracture of the wrist.

38 View
0 Download

Previous issues