Journal of Musculoskeletal Trauma

Fracture Healing Process: Kyu Hyun Yang; J Korean Soc Fract 1995;8(2):318-322. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.318

Abstract PDF: No abstract available.

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Epiphyseal Injury of Long Bones: Review of Structure and Function of the Growth Pate: Won Hwan Oh, Jong Sup Shim; J Korean Soc Fract 1995;8(2):323-331. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.323

Abstract PDF: No abstract available.

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Operative Treatment of Intertrochanteric Fractures of the Femur in Elderly Patiene: Sang Won Park, Seung Beom Hahn; J Korean Soc Fract 1995;8(2):332-339. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.332

Abstract PDF: There are many problems in the treatment of the intertrochanteric fractures due to oslteoporosis and unstable pattern of fractures in elderly patients and determined by quality of the bone, geometry of the fragments, reduction of the fragments, type of the implant and its placements. The authors analysed the 52 patients of the intertrochanteric fracture over 60 years old age who were operatively treated with compression hip screws and followed more than 1 year at Department of Orthopaedic Surgery, Korea University Hospital from Mar. 1986 to Dec.1992 in order to evaluate the results and prognostic factors. The results obtained were as follows: 1. According to Tronzo classification, the most common type was 3 in 27 cases(52%). 2. Among the fifty two cases, the patients having osteoporosis below grade 3 of Singh index was 30 cases(58%). In osteoporotic group(Singh index 1-3), unstable type fracture were more common(70%). 3. The most common pattern of reduction was anatomical reduction in 23 cases(66%), and medialization(9 cases), varus reduction(6 cases), valses refection(3 cases) in order of frequency. 4. The sliding length of lag screw was 7.8mm in average, 16.5mm in complicated cases, and 4.1 mm in uncomplicated cases. 5. The complications were developed in 13 cases(257o), and progressive varus deformity was most common in 9 cases. The complication rate had statiscally significant correlation with type of fracture, osteoporosis, pattern of reduction and sliding length of the lag screw. 6. The prognostic factors of the intertrochanteric fractures of the femur in elderly patients were fracture type, pattern of the reduction, position of the lag screws.

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Treatment of Distal 1/3 Fracture of Tibia by Intramedullary Nailing: Eun No Lee, Chang Moo Yu, Suk Ha Lee, Sung Jong Lee, Taik Seon Kim, Jae Ik Shim; J Korean Soc Fract 1995;8(2):340-346. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.340

Abstract PDF: Recently, there is seen frequently the tibial fracture due to the increased traffic accident and the high energy trauma, and this fracture has many problems in a treatment because of nonunion, malunion, angular deformity, shortening and infection. In the treatment of distal 1/3 fracture of tibia. interlocking intramedullary nailing has been popularized because it enables preservation of the range of motion of the joint, early weight bearing and early bony union. Between Jan. 1988 and Dec. 1993 intramedullary nailing of the tibial fracture has been perfomed in 41cases, of which 38 cases were acute fractures and 3 cases were nonunion with folow up of more than one year. The results were as follows; 1. Closed nailing technique was accomplished in 38 cases and 3 were opened. 2. The mean fracture healing period was 18.6 weeks and each mean fracture healing time was 19 weeks in Brooker nail and 18.5 weeks in interlocking nail, and so there was no significant difference in bone union time between two devices. 3. According to the functional classification of Klemm and Borner, out of 41 cases,26 were excellent,8 were good,5 were fair and 2 were poor. 4. The complications were infection in 4 cases, delayed union in 2 cases, angular deformity in 1 case and partial ankylosis of knee in 1 case. 5. In the cases associated with soft tissue injury and comminuted fracture of distal 1/3 of lower leg, Blocker nail was considered an useful treatment when distal interlocking screw fixation was not appropnate.

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The Treatment of Infected Nonunions of the Tibia by the Methods of Ilizarov: Chil Soo Kwon, Yong Uck Kim, Byung Hyun Jung, Kyung Seog Shin; J Korean Soc Fract 1995;8(2):347-353. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.347

Abstract PDF

Chronic infection of the shaft of tibia is one of the most perplexing dilemmas in orthopedic surgery. Difficult or resistant infection usually require more radical debridement of the septic bone and soft tissue in addition to application of stable fixation to enhance soft-tissue healing and bony union. The application of Ilizarov is possible to correct deformities, regenerate new bone tissue without the use of bone grafts, progressirely lengthen the extremity and allow weight bearing during the treatment period. Application of Ilizarov were preformed on eigtheen patients with infected nonunion of tibia between November 1989 February 1993. The result were as follows; 1. There were 16 males and 2 females with an average age of 39 years. 2. Fifteen of 18 patients had infected tibial nonunion associated with bone loss. 3. Two of 15 patients had infected nonunions associated with hemicircumferential bone loss. These tibiae were treated by hemicircumferential corticotomy and partial bone transport. 4. Twelve of 15 patients had an average 6.6cm of segmental bone loss. These were treated by coitictomy and internal bone transport. 5. The mean duration of treatment was 10.3 months. 6. The application of Ilizarov technique to diaphyseal infected nonunion and segmental defect is very encouraging. It may prove to be an excellent technique for further management of resisitant diaphyseal infection of bone.

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Bone Transport Over the Intramedullary Nail for Defects of Long Bone
Jae-Young Roh, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Byung-Chul Park, Woo-Kie Min, Joon-Woo Kim, Chang-Hyun Cho
Journal of the Korean Fracture Society.2008; 21(1): 37. CrossRef

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A Clinical Analysis on Treatment of Tibial Fractures Using Ex-Fi-Re External Fixator: Soo Kyun Rah, Dae Ik Kim, Chang Uk Choi; J Korean Soc Fract 1995;8(2):354-360. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.354

Abstract PDF: Since Malgaigne described a external fixators in 1853, it were widely used for open and communited fractures. Modern external fixators such as modified Hoffman, Denham and of hofix external fixators are commonly applied because it could obtain rigid fixation and compression of fracture site. Most of external fixators used only as a fixator after reduction, however new extemal fixator(Ex-F-Re) by Osteo is consists of two units, which are the correction and fixation units. This device is possible to manipulate fracture fragments under the complete control of stability and to obtain more rigid fixation and compression of fracture site. Among the 16 cases of tibial fractures treated with Ex-Fi-Re external fixator device from June 1992 to June 1993, 14 casrs had minimum 1 year follow up and the following results were obtained. 1. Among 14 cases,7 were open fractures,4 were closed periarticular communited fractures and 3 were infected nonunion of tibia. 2. Among 11 cases of fracture and 3 cases of infected nonunion, nonunion was happened in each one case. 3. Average bony union period was 24.4 weeks in fracture group and 44 weeks in infected nonunion group. 4. Ex-Fi-Re external fixator was very rigid fixator, easy to use, and possible to manipulate fracture fragments under the complete control of stability.

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The Treatment of Tibial Infected Nonunion by the Ilizarov Method: Chang Yeul Yang, Kyung Soo Choi, Young Ki Lee; J Korean Soc Fract 1995;8(2):361-369. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.361

Abstract PDF: The goal of treatment in infected nonunion include the elimination of infection, complete bony union and prevention of bony defects and deformity. Twenty patients with infected nonunion were treated using ilizarov external fixator from January 1992 to August 1993. The results were summarized as follows, 1. The main causes of infection were mixed infection in all cases and main causative agents were pseudomonas and staphylococcus. 2. Ninteen cases of infected nonunion were achieved bony union and one case was failed. The mean time to union was 10.6 months. The healing index averaged 51.3 days. 3. The bone results were excellent in sixteen cases, good in three and poor in one. The functional results were excellent in seven cases, good in eight and fair in five. 4. We experienced 35 complications, five were joint ankylosis. one was nonunion and we could solve the rest of complications with conservative treatment and minor surgery. 5. There were no problems in getting the bony union at bony distraction site in all cases. But, there were numbers of problem at the docking site such as autogenous bone graft, nonunion. So, it is important to wide resection of infected necrotic tissue and early bone graft. 6. We could solve the poor soft tissue problem with acute shortening method of bone.

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Overall Review of the Treatment of Tibial Fracture by Endernailing: Technical Consideration of Ender Nailing on Tibial Fracture: Hyung Ku Yoon, Kwang Pyo Jeon, Dae Eun Jung, Ho Seung Jeon, Dae Young Jaang; J Korean Soc Fract 1995;8(2):370-377. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.370

Abstract PDF: Fractures of the tibia are one of the most common injury encountered by orthopaedic surgeons and their treatments are considered to be difficult due to serious complications. Many treatment modalities were introduced. Among them, Ender nailing is considered one of the useful modality because it is a relatively simple and, 3ess invasive procedure Authors analized 123 tibial fractures treated with Endr nails from Feb. 1986 to Feb. 1992 to solve the problems during Ender nailing. The follow up ranged from 12months to 51 months with an average of 11 months. The results are as follows; 1. Among 123 patients,93 cases are male and 30 cases are female. Traffic accident is the most common cause of injury. 2. Average interval from injury to operation is 9 days and average 2.1 Ender nails are used. The mean duration of the bone union is 19.1 weeks. 3. To prevent knee joint pain, more distal medial and lateral portal of entry and more posteriorly located lateral portal of entry were used. 4. To provide stability of distal 1/3 fracture,3 or more nails are introduced with fanning in AP and lateral plane. 5. to provide stability of the comminuted fractures, convexities of at least 2 nails are located at the comminuted site. 6. To prevent rotation of the middle fragments of segmental fractures, technique of temporary Steinmann pin fixation for handling the middle fragment during operation were used.

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Treatment of Childrens Ankle Fractures: Byeong Mun Park, Soo Bong Hahn, Hyun Woo Kim, Won Young Lee; J Korean Soc Fract 1995;8(2):378-385. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.378

Abstract PDF: Childrens ankle fractures induce angular deformity, limb-length discrepancy, or incongruity of the joint surface unless anatomical reduction of the epiphsyeal plate and articular surface have failed. We made a retrospective study for the result of 20 cases of childrens ankle fractures which had been treated at Yonsei University College of Medicine from Jan. 1989 to June 1993. The age ranged from 6 to 15 years and the mean was 11.8 years old. Most of them had got traffic accident (14 cases, 70%). According to the Dias and Tachdj inns classification, pronation-eversion-external rotation injuries were 9 cases(45%) and supination and inversion inju.ies were 7 cases(35%). According to the Salter-Harris classification, type II were 13 cases(65%) and type III were 6 cases(30%). Sixteen cases were treated by gentle closed reduction and plaster cast. Four cases were treated by open reduction and internal fixation. Among the cases which had underwent closed reduction, 2 cases of angular deformity, one case of angular deformity with limb length discrepancy and one case of incongruity of joint surface were found. One case was treated with Ilizarov external fixation for the correction of angular deformity.

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Dislocation of First Metatarsophalangeal and farsornetatarsal Joint: Case Report: Chung Soo Hwang, Yong Min Kim, Hyung Ho Oh, Young Un An, Jong Pil Kim; J Korean Soc Fract 1995;8(2):386-390. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.386

Abstract PDF

Dislocation of first metatarsophalangeal joint is a rare condition. Anatomically, the head of first metatarsal is stabilized by various soft tissue structures associated with the sesamoid bones. When the metatarsal head was entrapped underneath the sesamoid complex, it might be impossible to gain reduction via closed method. We experienced a case of dorsal dislocation of first metatarsophalangeal joint and associated dislocation of larsornetatarsal joint in a 32 year old man who was injured by ftll from height. Closed reduction fEiled even under spinal anesthesia. Open reduction via medial approach revealedbuttonholingof the metatarsal head under the sesamoid complex, which had made colsed reduction impossible. Concerning about the rarity and anatomical characteristic of these injuries, we report this case with reviewing of the literatures.

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Lateral Dislocation of the First Metatarsophalangeal Joint: A Case Report
Yeong-Sik Yun, Young-Mo Kim, Kyung-Cheon Kim, Pil-Sung Kim
Journal of the Korean Fracture Society.2008; 21(4): 312. CrossRef

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Modified Technique of Essex-Lopresti Axial Fixation for Calcaneal Fracture: Woo Koo Junng, Byung Seol Kim, Kee Joon Na; J Korean Soc Fract 1995;8(2):391-398. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.391

Abstract PDF: In Essex-Lopresti conventional method, a heavy Steinmann pin is introduced into the cancellous part of tongue fragment and with knee flexed,the fracture is reduced by lifting upward on the pin. However it is hard to restore the anatomical position in the body of calcaneus because the tip of pin, positioned on cancellous part of tongue fragment, could not make adequate force on distal fragment especially in the case of osteoporosis or aged patients. Authors made one modification that the tip of pin was introduced from the upper tuberosity through the fracture site into the plantar cortical surface of posterior fragment and the fragment was lifted superiorly It was easy to reduce fracture by the lever arm effect, which made counter forces on anterior and posterior fragments against mechanism of fracture simultaneously. The authors had treated the 35 cases of 31 patients with displaced intra-articular calcaneal fractures using the modified techique of Essex-Lopresti axial fixation at Seoul Eul-Ji General Hospital from April 1989 to January 1993 and analyzed 31 cases of 21 patients after the follow-up from 12 months to 38 months (mean 16.5 months). The results were as follows; 1. Among 31 cases, 22 were tongue type and 9 were comminuted fracture with the joint depression. 2. Bohlers angle was changed from -5.4 in average preoperatively to 30.5 in average postoperatively. 3. according to Rowe evaluations, the clinical results were evaluated as excellent in 9, good in 13, fair in 7, poor in 2 cases. 4. Two poor cases were the joint depression type, which showed decreased Biihlers angle during follow up period. 5. In 7 cases, traumatic arthritis was developed on subtalar joint radiologically but there was no clinical need of subtalar fusion clinically 6. One case required the excision of traumatic bony spur. 7. There was no operative infection.

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Case Analysis for Complications in Fracture Treatment: I H Chung, Y Y Won, C H Jeon, J I Ahn, B M Park, B S Bim; J Korean Soc Fract 1995;8(2):399-406. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.399

Abstract PDF: The authors analysed 220 patients(225 cases) of complications including implant failure and refracture in fracture treatment which had been requested for medical consulta!ion by the Korean Automobile, Fire & Marine Insurance Co., Ltd. from July 1984 to December 1992. The results were as follows: 1. The patients were consisted of 178(81%) males and 42(19%) females. 2. The average age of patients was 36.9 years. 3. There were 140(60%) cases of femur,63(29%) cases of tibia and 12(5%) cases of humerus. 4. The most common previous mode of treatment was plate and screw fixation (183 cases,83%). 5. There were 171(78%) cases of metal flilure,14 cases of secondary factlue and 14 cases of efracture. 6. Among the causes of complications, improper postoperative care (156 cases,71%) was the most common causes of complications. 7. It is recommended that in the operative treatment of fracture, orthopaedic surgeon should obey the AO principles and proper postoperative care and also consider the conservative treatment as a good counter part of the operative treatment.

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Open Reduction & Internal Fixation of Long Bone Fracture in Osteopetrosis Patient: Bu Hwan Kim, Jong In In, Woo Seong Choi; J Korean Soc Fract 1995;8(2):407-412. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.407

Abstract PDF

Bone quality in osteopetrosis patient is very hard but brittle and easily fractured by triviat trauma. In case of pathological fractures in osteopetrosis patient, most of the fractures are treated by conservative treatments. But some long bone fractures are difficult to treat conservatively. A few surgeons treated the fracture by open reduction and internal fixation(ORIF) and they came to agree that ORIF of fractures were very difficult technically. We tried plate and screw fixation for a subtrochanteric fracture of femur in a 20-year-old osteopetrosis patient who have already had 4 previous long bone fractures. 1. We changed drill bit everytime for every screw hole penetration and it took about 2 minutes for a hole. 2. ORIF is adventageous in fracture of suitable location in osteopetrosis patient.

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Triple Osteotomy for Hallux Valgus in Patient with Osteopetrosis - A Case Report -
Seung Do Cha, Hyung Soo Kim, Jeong Hyun Yoo, Jai Hyung Park, Joo Hak Kim, Joo Won Joh
The Journal of the Korean Orthopaedic Association.2008; 43(6): 808. CrossRef

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Treatment of the distal radius fractures with open reduction and internal fixation: Eung Shick Kang, Kyoo Ho Shin, Sang Wook Lee; J Korean Soc Fract 1995;8(2):413-418. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.413

Abstract PDF: Treatment of displaced or comminuted intra-articular fractures of distal radius is often difficult and demanding. Emphasis has been on achieving and maintaining an anatomical reduction of the fragments by open reduction and internal fixation. We analyzed twenty nve cases of intra-articular fracture of distal radius treated with open reduction and internal fixation from January 1989 to December 1993 by the method of Gartland and Werley (clinical) and Lidstrom(radiologic) The results of this study were as follows. 1. 84% of the patients had satisfactory results on the basis of the subjective criteria of minimal deformity, absence of pain, and good strength. 2. 88% of the patients had satisfactory results on the basis of radiologic and clinical evaluation. 3. When the intra-articular step-off exceeded 2mm, the results were only fair. 4. If one cannot achieve and maintain a articular step-off of 2mm or less, open reduction of the fracture should be considered.

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Divergent Dislocation of elbow with Ipsilateral CollesFracture: Report of One Case: Sung Joon Kim, Kuhn Sung Whang, Jong Sun Leem, Oh Jae Kwon; J Korean Soc Fract 1995;8(2):419-422. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.419

Abstract PDF: Divergent dislocation of divergent elbow is very rare and this in jury has been reported only 7 cases in English literatures. This injury was affected in the disruption of all three joints of elbow, such as the radiocapitellar, the ulnotrochlear and the proximal radioulnarjoint. According to Stimsons classification, there are two types ; anteroposterior and mediolateral. We experienced a case of the divergent dislocation of elbow with ipsilateral Collesfracture which were treated by closed reduction and cast immobilization. We obtained satisfactory result.

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Closed Reduction and Percutaneous K-wire Fixation in Supracondylar Fractures of the Humerus in Children: Soon Hyuck Lee, Jung Ho Park, Young Soo Byun; J Korean Soc Fract 1995;8(2):423-429. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.423

Abstract PDF: We evaluated the clinical results of the closed reduction and percutaneous K-wire fixation for supracondylar fracture of the humerus in thirty patients who were treated from Jan 1990 to Nov 1993. We analyzed the relationships between non-anatomical reduction and occurrence of varus deformity in displaced supracondylar fractures of the humerus in children. The following results were obtained: 1. There were twenty-two males and eight females, twelve cases of type IIB and eighteen cases of type IIIfractures by Gartland classification. Posteromedial displacement and fractures through the olecranon fossa were most common pattern. 2. After closed reduction, eleven rotations and three medial displacements of distal fragment, and three angular deformities of medial cortex were observed in eleven cases. 3. Radiologically, the differences of carrying angle compared with normal side were decreased in twenty-one cases, no changes in three cases, and increased in six cases. 4. Two cubitus varus deformities were developed in decreased cases more than six degrees of carrying angle with residual rotation and medial displacement. 5. We obtained relatively good results in supracondylar fracture of the humerus in children treated by closed reduction and percutaneous K-wire fixation with grossly normal carrying angle.

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Clinical analysis of fractures around the elbow joint in adults: Duck Yun Cho, Joong Myung Lee, Hee Chun Kim, Hyeong Jin Kim; J Korean Soc Fract 1995;8(2):430-438. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.430

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The fractures around the elbow joint in adults are relatively rare in comparision with that in children, but the late complications are more common in adult. So, it is important to select the appropriate early management to prevent the late sequelae. Complications are joint contracture, persistant pain, nonunion, deformity, neurologic symptom, infection. etc. Among them limited range of joint motion is the main problem. We, authors have clinically and radiologically analyBed 48 cases of fracture around the elbow joint in adults over the age of 20 years, treated at the Department of Orthopaedic Surgery in National Medical Center from January 1984 through December 1993. The results are as follows: 1. The age incidence was higher in active young persons and the male to female ratio was 3:2. 2. The most common cause of the injury was slip-down(46%), followed by traffic accident(29fo), falling, and athletic injury. 3. In total 48 cases, olecranon fractures were 29 cases, fractures of distal humerus 13 cases, radial head fractures 5 cases, and multiple fractures (including olecranon, radial head and intercondyle) was 1 case, Among them. open fractures were 5 cases. 4. Closed reduction with cast immobilization or K-wire fixation was performed in 8 cases, and open reduction and internal fixation was performed in 37 cases. In 3 cases. radial head resection was done. 5. The most common complication was limited range of the joint motion (9cases), followed by nerve injury(3 cases), infection(3 cases) and nonunion(1 cases). 6. Development of limited range of joint motion was increased in case of old age over 60 years(33%), open fracture(60%), longer immobilization period over 6 weeks(27%). Though fracture around the elbow joint in adult is reletively rare. it frequently results in limitation of the joint motion and has poor prognosis For prevention of limitation of joint motion, rigid fixation and shortening of immobilization period and early rehabilitation are necessary.

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Treatment of Ulnar Olecranon Fracture Using Acutrak Screw
Hyungchun Kim, Kwangryul Kim, Moonsup Lim, Youngil Park, Inhwan Hwang, Jihoon Lee
Journal of the Korean Fracture Society.2009; 22(4): 270. CrossRef

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Fracture of the Capitellum of the Bumerus: Report of 4 cases: Sang Deug Lim, Ho Young Sun, Jeong Woung Lee, Young Seug Yoon, Deok Young Yoon; J Korean Soc Fract 1995;8(2):439-444. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.439

Abstract PDF: Fracture of the capitellum is intraarticular fractures that occured rarely about the elbow. It is usually caused by a fall on the outstretched upper extremity with the radial head impacting against the anterior portion of the lateral humeral condyle. We reviewed 4 patients with capitellum fracture of the humerus treated by open reduction and internal fixation from Aug. 1990 to Mar 1993. The isolated capitellum fractures were in 2 cases, associated radial head fracture in 1 rase, associated humeral lateral condyle fracture in 1 case. The case combined comminuted fracture of the humeral lateral condyle was fair, others were good result.

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