Journal of Musculoskeletal Trauma

Surgical Treatment of Displaced Acetabular Fractures - focused on Complications after open reduction -: Chung Nam Kang, Jong Oh Kim, Kong Uk Kim, Yeong Do Koh, Byeong Geun Kim; J Korean Soc Fract 1998;11(3):477-486. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.477

Abstract PDF: Management of displaced fractures of the acetabulum represents one of the greatest challenges in fracture surgery. The results had been proved to be successful after anatomical reduction and stable internal fixation. The purpose of this study is to analyze the clinical results and complications of open reduction of the displaced acetabular fractures to minimize the complications, and to present suggestions for the treatment of these fractures. We reviewed our experience with 23 displaced acetabular fractures which had been treated by open reduction to evaluate the clinical results and complications. The results were as follows; 1. The most common type of elementary fractures was posterior wall fractures according to Letournel's classification. 2. Excellent or good results were obtained in 88% among the satisfactory reduction group, and it means that accurate reduction was the most reliable factors contributing to successful clinical outcomes. 3. Complications were 1 deep infection, 2 ectopic bone formation, 1 intraarticular hardware, and 1 chondrolysis. 4. In the treatment of displaced acetabular fractures, careful initial assessment using radiograph, angiogram and 3-D CT, appropriate selection of surgical approach and accurate surgical clinical outcome and minimize the complication rate.

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Treatment of Unstable Intertrochanteric Fractures of the Femur - Comparative analysis of the postero-medial fixation with or without additional screw -: Jin Hong Ko, Bum Gu Lee, Do Hyun Moon, Young Sung Kim; J Korean Soc Fract 1998;11(3):487-494. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.487

Abstract PDF: An unstable intertrochanteric fracture lacks continuity of the bone cortex on the opposing surfaces of the proximal and distal fragments. This cortical deficit is due to either comminuti- On on the medial aspect of the neck(calcar-region) or a large and separate posterior trochan-teric fragment. Treatment of unstable intertochanteric fracture have taken method to restore bony contact medially and posteriorly by anatomical reduction or displacement osteotomy. The authors analyzed the 60 unstable intertrochanteric fractures treated by anatomic reduction and internal fixation with a compression hip screw from January 1990 to December 1995. We made a comparative analysis of the postero-medial fixation with additional screw(Group I) and no fixation group(Group II). We tried to find the difference of operation time, blood loss, union time, weight bearing time, neck-shaft angle, sliding length of lag screw and complication rate in two groups. The results were obtained as follows: 1. The mean union time was 11.5 weeks in the Group I and 12.7 weeks in the Group II (p>0.05). 2. The mean weight bearing time was 6.1 weeks in the Group I and 8.3 weeks in the Group II (p<0.05). 3. The decrease of neck-shaft angle was 2.3 degree in the Group I and 5.2 degree in the Group II(p<0.05). 4. The sliding length of lag screw was 5.8mm in the group I and 11.2mm in the group II(p< 0.05). 5. The lower complication rate was obtained in the group I than in the Group II, but two groups showed no significance by statistical analysis. In conclusion, the postero-medial fixation with additional screw in the treatment of unstable intertrochanteric fracture of the femur are suggested that medial cortical stability can be gained and early weight-bearing can be allowed.

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A Clinical Comparative Study of Reamed and Unreamed Nail of Femoral Shaft Fracture: Hyung ku Yoon, Kwang Pyo Jeon, Kyung Hun Kang, Jin Il Kim, Dong Soo Kim, Young Kwan Koh; J Korean Soc Fract 1998;11(3):495-500. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.495

The purpose of this study is to verify the clinical efficacy of unreamed nails compared to reamed nails. The cases of 31 parients in whom 32 fractures of the femoral shaft had been treated by intramedullary nailing with reamed or unreamed nails were prospectively reviewed. Reamed nailing was done for 17 cases, and unreamed nailing was done for 15 cases. The following results were obtained. 1. According to Winquist-Hansen classification, type 1 was 9 cases, type 2,3,4 were 4,2,2 cases 2. The average operation time was 70.5 minutes in reamed group, and 62.5 minutes in unreamed group(p-value=0.638). the average bleeding amount was 450ml in reamed group, and 218ml in unreamed group(p-value=0.000). 3. The mean times to partial weight bearing and full weight bearing were 4.4 weeks, 7.7 weeks in reamed group retrospectively, and 7.2 weeks, 13.7 weeks in unreamed group(p-walue=0.039,0.002). 4. The mean union time was 15.2 weeks in reamed group, and 17.7 weeks in unreamed group(p-value=0.237). 5. According to Denker's functional classification, 15 cases were excellent, 1 case was satisfactory, 1 case was very poor in reamed group, and 13 cases were wxcellent, 1 case was satisfactory, 1 case was poor in unreamed group(p-value=0.545).

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Bursting Fracture of the Proximal Femur during Insertion of Unreamed Femoral Nail for Femur Shaft Fracture - A Case Report -
Ji Wan Kim, Seong-Eun Byun, Won-Hyuk Oh, Jung Jae Kim
Journal of the Korean Fracture Society.2010; 23(2): 227. CrossRef

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Analysis of Metal Failures for the femur Shaft Fractures: Kyung Jin Song, Hwang Jik Kim, Jeong Ryul Kim, Joo Hong Lee, Byung Yun Hwang; J Korean Soc Fract 1998;11(3):501-508. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.501

Abstract PDF: The purpose of this investigation was to analyze the causes of the metal failures, and to suggest reasonable methods that can prevent metallic failures in the treamtnet of femur shaft fractures. There were 27 metal failures in 25 patient who underwent internal fixation for the femur shaft fracture between May of 1990 and May of 1996. We analyzed the causes of injury, fracture site, associated injury and used implants for the femur shaft fractures. And also analyzed the interval since operation to metal failure, method of treatment, and complications following surgery for the metallic failures. There were 13 stainless steel DCP(dynamic compression plate), 4 titanium LC(low contact)-DCP, 7 interlocking IM(intramedullary) nails, 2 Dutscher nails, and 1 anatomical plate. The metal failure occurred on average 6.1 months after internal fixation. Eight stainless steel DCP, 4 LC0DCP and 1 anatomical plate failed at the empty hole located at the fracture site. With interlocking IM nail, 4 cases of failure occurred at the proximal 1/3 of femur and other 3 cases showed failure on distal interlocking hole in distal femoral shaft fractures. All failures developed at the fracture site in kuntscher nail. For the treatment of metal failures, we used stainless steel DCP in 12 cases, interlocking IM nail in 7 cases, Kuntcher nail in 2 cases, Ender nail in 1 case, dual plate in 1 case, and external fixation in 2 cases. Autogenous cancellous iliac bone graft applied in 20 cases for the augmentation of frcture site or to fill the defect area. There were 2 cases of re-failure, 2 chronic osteomyelitis, 1 fracture site infection, 2 delayed union and knee joint ankylosis in 1 case. Accurate preoperative evaluation of fracture site, fracture pattern and proper implant selection will be essential for the prevention of metal failures. Minimal soft tissue dissection, anatomical reduction and rigid internal fixation will be necessary for the satisfactory outcome in the treatment of femur shaft fractures. Augmentation with autogenous cancellous bone graft should be followed after internal fixation for the comminuted fractures or bony defect over the fracture site. Postoperative rehabilitation program should be individualized according to the preoperative fracture pattern, used implant, and fracture stability.

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Iigament Injuries of the Knee Joint Combined with Ipsilateral Femoral Shaft Fracture: Jin Hyung Sung, Choang Whan Han, Jae Duk Ryu, Weon Jin Cha, Jin Young Kim; J Korean Soc Fract 1998;11(3):509-513. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.509

Abstract PDF: Most fractures of the shaft of the femur are caused by high-energy trauma. It would be expected that in many cases the ipsilateral knee ligaments are subjected to severe stress. In these days, early diagnosis and proper treatment of combined ligament injury in ipsilateral femoral shaft fracture become to be important and are possible by arthroscope and MRI. We retrospectively reviewed a series of 97 patients with 97 fractures of the femoral shaft from March 1995 to December 1997. demonstrable ipsilateral knee ligament laxity was present in 10(11.3 per cent) of these patients. There were 7 males and 8 left femur fractures. Eight of them were injured by traffic accident. Ten patients were followed for an average months. PCL injuries were five cases and ACL and MCL injuries were two cases each and posterolateral instability was one case. Early diagnosis was possible in MCL and ACL cases but diagnosis was dilayed to average 10 months post-accidentally in PCL injuries. MCL injuries and one ACL injuries were treated conservatively and one ACL and one PCL avulsion fracture were treated with pull-out suture technique and another 4 PCL injuries were treated with reconstruction using bone patella tendon bone, From this study, we advocate careful asessment of the knee, especially PCL injury in all cases of fracture of the femur caused by high-energy trauma.

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A Clinical Analysis of Distal Fracture of the Femur with DCS Fixation & Early Exercise: Soo Jae Yim, Dong Jin Kim, Seung Ryul Yoon; J Korean Soc Fract 1998;11(3):514-521. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.514

Abstract PDF

Fracture of the distal femur is not as common as femoral shaft or hip fracture. A widening medullary canal, thin cortex, osteopenia make open reduction and internal fixation difficult, enen for an experienced surgeon, The surgical treatment for supracondylar femoral fractures has a better outcome becuse of improved implants, fixation technique and preoperative planing during the past two decades. We reviewed 33 cases of fractures of the distal femur at Soon Chun Hyang Gumi Hospital from June, 1992 to March, 1996 with minimum 12 months follow up. Following results were obtained. 1. In age distribution, fourth decade was most frequent. 2. The most common cause of these fractures was traffic accident. 3. The most common fracture type was type C by Muller classification. 4. Complication were as follows : pain, knee joint stiffness, bursitis, skin infection etc 5. The satisfactory results could be obtained by the open reduction and rigid internal fixation followed by early R.O.M. exercise of knee joint.

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Bone Union Time of Simple Distal Femur Fractures in the Elderly according to Fracture Gap after Treated with Minimally Invasive Plate Osteosynthesis
Young Ho Cho, Sangwoo Kim, Jaewook Koo
Journal of the Korean Fracture Society.2023; 36(4): 133. CrossRef

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Interlocking Intramedullary Nailing for the Treatment of Segmental Fractures of the Femur: Kyung Jin Song, Hwang Jik Kim, Jeong Yul Kim, Joo Hong Lee, Byung Yun Hwang; J Korean Soc Fract 1998;11(3):522-527. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.522

Abstract PDF: Segmental femoral fractures are unusual injury caused by a severe force and associated with marked demage to the soft tissue, especially the quardriceps muscle. Intramedullary nailing is the most common treatment modality for the segmental femur fractures with high union rate and few complications. The purpose of this study is to evaluate the results of surgical treatment with interlocking intramedullary nailing for the segmental femoral fractures. We analyzed 23 consecutive segmental femoral fractures with static interlocking nail from May, 1989 to Feburary, 1997. Major associated injuries were sustained in 18 cases. There were 19 closed and 4 open fractures. Eighteen cases(78.3%) were done by closed technique and 5 cases(21.7%) were done by open technique. All fractures united at an average of 25.9 fractures. There were 3 malunion, 1 shortening(18mm) and stiffness of knee, 1 delayed union, and 1 limited motion of the knee. delayed union was treated by dynamization and autogenous bone graft, and additional intervention for union was unnecessary for the other problems. Although interlocking intramedullary nailing for the segmental femoral fracture is a techniqually demanding procedure, we recommand that it is the treatment of choice for closed and open(open type I) segmental fractures of the femur.

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Closed Interlocking Nailing for Femoral Shaft Fracture -Comparison of results according to fracture comminution and site-: Sang Wook Lee, Koing Woo Kwun, Shin Kun Kim, Chang Hyuk Choi, Ho Sun Chang; J Korean Soc Fract 1998;11(3):528-532. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.528

Abstract PDF

To compare of result according to fracture comminution and fracture site, we reviewed retrospectively 68 femoral shaft fractures treated by closed interlocking intramedullary nailing. The Winquist-Hansen classification was used to categorize the degree of comminution, and fracture site was categorized to three parts as proximal 1/3, middle 1/3, and distal 1/3. The results were analized and compared in each categorized group The average bone union time was delayed in more severely comminuted fracture and in distal 1/3 fracture compared to proximal 1/3 or middle 1/3. Varus angulation deformity was occurred more frequently in proximal 1/3 and severely comminuted fracture group, and posterior angulation deformity was occured more frequently in distal 1/3 fracture group. All but one case showed good functional results regardless of fracture comminution, fracture site and development of malalignment.

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Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef

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Clinical Study on Operative Technique and Management of Tibial condylar Fractures: Su Chan Lee, Beom Koo Lee, Do Hyun Moon, Jin Hong Ko, Young Kyu Kim, Hong Ki Park, Jun MO Jung, Hyun Park; J Korean Soc Fract 1998;11(3):533-539. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.533

Abstract PDF: We reviewed fifteen cases of tibial condylar fractures, especially, Schatzker type VI treated with hybrid method from January 1995 to May 1997. We attained satisfactory bony union in all cases. There were not serious complications such as deep wound infection and severe angular deformity, but partial ankylosis. After operation, the patients could do knee motion exercise immediately and had no difficulty in getting maintenance of reduction and fracture healing. In conclusions, the hybrid method is an excellent treatment in soft tissue care, maintenance of reduction, and early ambulation and fracture healing in the cases of tibial condylar fractures.

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The Treatment of Infected Nonunion of Femur after Open Reduction and Internal Fixation: Hee Soo kyung, Joo Chul Ihn, Byung Chul Park, Yong Goo Kim; J Korean Soc Fract 1998;11(3):540-545. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.540

Abstract PDF: Infected nonunion developed after open reduction and internal fixation is one of the serious complications among the treatments of fracture of long bone. It is very difficult to eliminate the infection, to correct the deformity and defect at the same time obtaining union. All six cases were male, the average of age was 34 years old from 21 to 49. Five cases were closed fracture and one was open fracture. For the primary internal implant, five cases were plate and one was intramedullary nail. About the 6 cases of infected nonunion of femur from June, 1994 to October, 1996, we performed the following procedure : after removal of internal fixation, extensive debridememt, complete sequestrectomy, firm fixation with Ilizarov external fixator, compression at fracture site and early autogenous cancellous bone graft. We obtained following results : 1. The average duration of infection was 7.8 months, average duration of bone union was 5.8 months. Average duration of follow-up was 17.5 months. 2. The average shortening of leg was 1.4cm. 3. According to classification of Paley and Catagni, the bone results were excellent in all cases, functional results were excellent in 4 cases and fair in 2 cases. 4. In conclusion, firm fixation with Ilizarov fixator, sequestrectomy, early autogenous cancellous bone graft and compression is one of the good treatment modalities of infected nonunion of the femur.

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Intramedullary Nailing Treatment for Segmental TibialFractures: In Heon Park, Kee Byoung Lee, Kyung Won Song, Jin Young Lee, Eung Joo Lee, Byung Koo Jooe; J Korean Soc Fract 1998;11(3):546-551. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.546

Abstract PDF: Fracture of the tibia is the most common fracture of the long bone and due to its anatomical property, significantly high rate of complication has been reported during and after treatment. Various ways of surgical treatment have been tried with reasonable satisfaction. Recently, closed intramedullary nailing under the image intensifier has been widely performed with good results. However, segmental tibial fractures are more difficult than ordinary tibial shaft fracture in terms of reduction and fixation. Its treatment has been rather challenging for average orthopedic trauma surgeons. Particularly, segmental tibial fractures are commonly combined with extensive soft tissue injury, comminution as well as displacement resulted in poor blood supply especially in its middle segment. In this paper we are reporting our experience with intramedullary nailing treatment for 13 segmental tibial fractures in 13 patients. 13 cases with segmental fracture of tibia were reviewed, which were treated at the Deparment of Orthopaedic Surgery, Kang-Dong Sacred Hospital of Hallym University for 6 years from January 1990 to December 1996 with more than 1 year follow up period. All cases were caused by traffic accident and four were open fractures. Patients were 19-60 years of age (average 44) with male to female ratio of 1.6:1. The fractures were closely reduced and intramedullary nailed under the image intensifier control. Two cases were added with limited skin opening of the displaced fragments for reduction. Seven cases were reenforced an additional immobilization such as long leg splint or cast or externl fixator postoperatively. Melis type I fractures were most frequent in our series. All fractures were healed within a 1 year and average union period was 167 days (proximal fracture-144 days, distal fracture-190 days). Complications were a case of chronic osteomyelitis and one deep vein thrombosis and 4 case of delayed union, which were treated by reoperation with bone grafts. Displacing most proximal fragment was most troublesome to manage during and after operation. We tried intracortical screws fixation between proximal and middle segments with satisfactory bony union without displacement for a case. Carefully planned intramedullary nailing with or without some modification of the most proximal and shoryt segment seems to be recommendable way of treatment for the most segmental fractures of the tibia.

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Treatments of the delayed Union or Nonunion of Tibial Shaft Fracture Fixed with Interlocking IM nail: Yong Bum Park, chung Soo Hwang, Phil Hyun Chung, Suk Kang, Dong Joo Chae, Han Chul Kim, Sang Ho Moon, Jong Phil Kim, Dae Jin Kim; J Korean Soc Fract 1998;11(3):552-559. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.552

Abstract PDF: Interlocking intramedullary nailing has been the first choice treatment of most tibial shaft fractures because its rigidity of fixation allows early ROM and weight bearing. Although most interlocking nailing procedures are performed with closed reduction that preserve periosteal blood supply, delayed union or nonunion is often occurs. so secondary procedures, such as bone graft, dynamization, nail exchange, are necessary to achieve fracture healing. We analyzed 25 cases of delayed union or nonunion from 432 tibial shaft fractures fixed initially with static interlocking intramedullary nailing since January 1990 till January 1996. Overall incidence of delayed union or nonunion is 5.8%(25/432). Secondary procedures included mainly iliac bone graft or dynamization. Average time to achieve bone union after secondary procedure is 6.1 months. The more distracted or displaced fracture ends after interlocking nailing or the more comminuted fracture fragments led to the more delayed bone union. Careful attention to minimize distraction or displacement during interlocking nailing is necesary to decrease the incidence of delayed union or nonunion. And appropriate procedures should be performed when delayed union or nonunion is predicted, which result in success in most cases.

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Treatment of Type IIIB Open Tibial Shaft Fractures: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Doo Koh, Jae Doo You, Jong Keon Oh, Young Seuk Kim; J Korean Soc Fract 1998;11(3):560-566. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.560

Abstract PDF

In general, severe open fractures of the tibial shaft have been treated initially with external fixation. However, despite many refinements in this technique, it has been associated with numerous complications, including problems at the sites of pins, non-union, delayed union, malunion, and infection. The purpose of this retrospective study is to analyze the results in a consecutive series of patients. There were 8 males and 2 females with an average age of the 44.9 years(range, 26-64 years). The mean follow up period was 23.2 nibtgs(range, 34-120 days). Free flap procedures were performed on all patients. The average time between removal of the fixator and intramedullary nailing was 16.5 days(range, 11-26 days). Indication of conversion to nailing was abscence of any serous discharge, reddness or local heating around pin-sites and normal renge of laboratory data. All 10 fractures had united with additional bone graft in 7 cases. The most frequent complications were delayed union in 7 cases and infection(superficial infection: 6 cases, osteomyelitis: 1 case) after IM nailing. We concluded that pin-tract infection is the major cause of infection after IM nail, but duration of external fixation and time interval(between removal of external fixator and nailing) are not isolated factors.

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Study on Instant Fish Cake Noodle Manufacturing Techniques Using Ultra-fine Powdered Kelp
Yoo-Jin Park, Se-Jong Kim, Myung-Ryun Han, Moon-Jeong Chang, Myung-Hwan Kim
Food Engineering Progress.2019; 23(3): 217. CrossRef
Treatment of Type IIIb Open Tibial Fractures
Seong Yeon Lim, Il Jae Lee, Jae Ho Joe, Hyung Keun Song
Journal of the Korean Fracture Society.2014; 27(4): 267. CrossRef

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Treatment of Unstable Open Tibial Fractures with Ilizarov System: Won Sik Choy, Kwang Won Lee, Ha Yong Kim, In Sung Hwang; J Korean Soc Fract 1998;11(3):567-575. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.567

Abstract PDF: The treatment of open comminuted tibial shaft fractures have a high incidence of complications and often result in poor outcomes. General principles of treatment are accepted throughout most surgeons, which include aggressive debricdement, antibiotics, early stabilization, early soft tissue coverage, and prophylactic bone graft. But, recently there is a controversy on the bony stabilization methods; one group of authors favors external fixator, and the other group favors unreamed interlocking intramedullary nail. In this paper, we carried out retrospective study of the 42 cases of open comminuted tibial shaft fractrues managed with Ilizarov external fixator (minimum follow up of one year(average: 2.8 years)). The purpose of this study is to evaluate the results of treatment with an Ilizarov method for the patients with open comminuted tibia fractures (open type III-A and more by Gustilo and Anderson classification and, type B and more by AO classification). The results were as follows; 1. It has taken 7.4 months to achieve bony union with relatively delayed healing time for the diaphyseal fractures and fractures with higher energy injury on AO classification). The results were as follows; 1. It has taken 7.4 months to achieve bony union with relatively delayed healing time for the diaphyseal fractures and fractures with higher energy injury on AO classification. 2. Forty eight additional operations were needed for 27 patients; 24 bone grafts for 19 atients, 1 case of bone marrow injection, 4 cases of corticotomy and bone transport, 4 cases of sequestrectomy, 3 cases of internal fixation with plate, 2 cases of IM nailings, and 2 cases of Ilizarov correction in operating room. 3. Following complications were resulted in; delayed union 14 cases, nonunion 1 case, superficial infection 2 cases, deep infection 8 cases, chronic osteomyelitis 3 cases, refracture 2 cases, knee stiffness 6 cases, ankle stiffness 5 cases, subtalar stiffness 8 cases, lateral angulation 4 cases, anteroposterior angulation 4 cases, and leg length discrepancy 5 cases. 4. Twenty patients, at the final follow-up, could walk without limping and live their life with no activity limitation. 5. At the final follow-up, 19 patients complained intermittent pain on fracture sites, knees or feet and ankles. We could conclude that the Ilizarov external fixator can be a stabilizer of choice for the open comminuted (Gustilo type III and more than AO type B) tibial shaft fractures of which fracture line extended over the proximal or distal metaphysis.

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Operative Results in AO Type C3 of Tibial Pilon Fracture: Limited Internal Fixation and Hybrid External Fixation: Byeong Yeon Seong, dong Seong Park, seung Jun Park, Sang Wook Kim, Taek Geon Lee; J Korean Soc Fract 1998;11(3):576-584. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.576

Abstract PDF: The intraarticular fractures of the distal tibia has been the most difficult problem due to severe comminution of itself, little bone mass and poor circulation of soft tissue. Recently limited internal fixation with hybrid external fixation has been reported to provide a good clinical results for the severely commnuted or open pilon fractures as a AO type C3. From February 1994 to February 1996, the authors analyzed the clincal and radiological results of 2 year follow-up in 7 cases of the AO type C3 pilon fractures who were treated with combination of limited internal fixation and hybrid externalfixation. 6 cases had good or excellent clinical and radiological results without any serious complications such as skin sloughs, skin infection, malunion and nonunion, but one case had a nonunion who were treated with internal fixation and autogenous iliac bone graft. We believe that the combination of limited internal fixation and hybrid external fixation that does not cross the ankle joint, provides the good clinical results in AO type C3 pilon fractures by early ankle joint motion.

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Comparative analysis for syndesmotic Fixation vs Non-syndesmotic Fixation of distal Tibiofibular Diastasis: Duk Uong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk ha Lee, Dong ki Lee, Yeon Sik Yu, Jae Yeon Moon; J Korean Soc Fract 1998;11(3):585-590. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.585

Abstract PDF: The ankle fracture with diastasis of distal tibiofibular jointis caused by an axial loading force with concomitant external rotation or other force. Many surgeons have treated this injuries by rigid fixation medial and lateral malleoli with syndesmotic fixation. But recently, syndesmotic fixation is not required to maintain the syndesmotic fixation on ankle fracture. seventy-five patients of ankle fracture with syndesmotic injury treated at Korea veterans Hospital from Jan. 1990 to Dec. 1996 were analysed in clinical and radiological aspect. The syndesmotic fixation was not necessary if the both medial and lateral injury was rigidly stabilized by fixation or ligament repair.

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Treatment of Intraarticular Calcaneal Fractures using Ilizarov Exteranl Fixation: Byeong Yeon Seong, Dong Seong Park, Seung Jun Park, Sang Wook Kim; J Korean Soc Fract 1998;11(3):591-596. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.591

Abstract PDF

Open reduction and internal fixation (ORIF) is gaining in popularity as method of choice for the treatment of displaced intraarticular calcaneal fracture since diagnosis and classification of computed tomography have become routine. But early weight-bearing cannot be allowed by convertional ORIF, and delayed weight-bearing may contributed to heel had pain and dystrophy. We performed combined technique of limited internal fixation and Ilizrov external fixation to ten-cases of displaced intraarticular calcaneal fractures, between February 1994 and February 1996. The follow-up period in this study was at least two years. This method can provide not only anatomical reduction, but also stable fixation. None of patients complained of heel pad pain, which was attributed to the desensitization of the heel by early weight-bearing. None of patients went on to late collapse of the posterior facet. clinical results were rated as excellent in six, good in three, and fair in one case. Pin-track infection, complicated operative technique, cumbersomeness and expensiveness of the external fixator itself were shortcomings of this method. We consider this method as one of options for the treatment of displaced intraarticular calcaneal fracture.

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A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture
Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 13. CrossRef

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A Clinical study of the Tibial Plateau Fracture: Hyung Seok Kim, Ki do Hong, Sung Sik Ha, Beom Soo Kim; J Korean Soc Fract 1998;11(3):597-604. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.597

Abstract PDF

The tibial plateau fracture often produce some disabilities of the knee joint because it is the intraarticular fracture and often associated with soft tissue, ligament and meniscal injury. The authors analyzed 42 cases of the Tibial Plateau fractures, which were treated at the department of orthopaedic surgery, Seoul Adventist Hospital from 1992 to 1997, to know the releationship between the type of fracture, the methods of treatment, and the results. The results were summerized as follows; 1. The most common fracture type by Schatzker classification was type I(18 case 42.9%). 2. Sixteen cases among of 42 cases were treated with conservative treatment, and 26 cases were treated with operative method 3. The clinical result according to Blokker method, acceptable were 34 cases (81.0%) and unacceptable were 8 cases (19.0%) 4. The complications were limitation of range of motion(4 case), peroneal nerve palsy(2 case), posttraumatic arthritis(1 case), wound infection(1 case).

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Coating and Intergrowth of NaX Molecular Sieve Films on Porous Ceramic Paper for Membranes
Ik Jin Kim, Hae Jin Lee
Key Engineering Materials.2007; 280-283: 891. CrossRef
Effects of Seeding on Large Crystal Growth of NaX Zeolite by Continuous Crystallisation
Ik Jin Kim, Hae Jin Lee, Panagiotis Tsiakaras
Key Engineering Materials.2007; 280-283: 861. CrossRef

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The Acute surgical Treatment in Superior Peroneal Retinacular Injury in Ankle: Suk Goo Han, Nam Yong Choi, In Tak Choo, Sung Jin Park, Young Mok Kang, In Ju Lee; J Korean Soc Fract 1998;11(3):605-610. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.605

Abstract PDF: The superior peroneal retinacular injury in ankle is often diagnosed as an ankle sprain and treated conservatively because of normal bony contour in type 1,2 injury according to Eckery's classification and small bony fragment with early union, evenly displaced in type 3. But its complications such as peroneal tendinitis and recurrent subluxation or dislocation of peroneal tendons sometimes develop late. Compared to peroneal tendinitis, the surgical treatment method for recurrent subluxation or dislocation of peroneal tendons is known superor to conservative method in results. And many reconstructive methods have been reported. In spite of their good results, harmfulness to normal structures, recurrences and technical difficulties may be a problem. So we perfomed 10 cases of acute surgical repair in superior peroneal retinacular injuries in ankle from March 1993 to February 1997 and prospectively analysed their clinical and radiological results with complications. Preoperative radiological diagnosis was done by plain films, peroneal tenography with computed tomography and also postperatively evaluated with plain films and peroneal tenography. 1. The most common cause of injury was sports(6 cases) including ski injury(4 cases) and average age of the patient was 29(17-56) years. 2. 4 cases of bony avulsion(type 3) were fixed with mini-screws and mean duration of bony union was 3.6 months. 3. The incidental subluxation or dislocation of peroneal tendons was not found intraoperatively and postoperatively. 4. All patients are able to participate in active exercise postoperatively except one patient who complains of lateral ankle discomfort due to peroneal tendinitis. In conclusion, acute surgical repair of superior peroneal retinacular injury in ankle is a recommended method to prevent it's complications such as peroneal retinacular injury in ankle is a recommended method to prevent it's complications such as peroneal tendinitis and subluxation or dislocation of peroneal tendons especially, in young and active patients.

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Operative Treatiment with Open Reduction and Heterogenous bone graft to the Acute Displaced Intra-articular Calcaneus Fractures: Moon Jib Yoo, Suk Joo Lyu, Sung Churl Lee, Hong Geun Jung, Soon Haeng Kwon, Jeong Wan Kim, Myung Ho Kim; J Korean Soc Fract 1998;11(3):611-616. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.611

Abstract PDF: The calcaneus is the most frequently fractured tarsal bone. Although there were many reports of treatment using variable methods, but no definite general agreement to the treatment method of the intra-articular calcaneus fracture. From May. 1995 to Apr. 1997, 14 displaced intra-articular fractures of the calcaneus in 12 patients underwent open reduction and heterogenous bone graft (Lubboc, TRANSPHYTO S.A., France) at the Dept. of Orthopaedic Surgery, Dankook University Hospital The fractures were 13 joint depression type and 1 tongue type fractures according to the classification of Essex-Lopresti. The average follow-up was 20 months and clinical assessment underwent by Clinical Assessment Rating system of Hutchinson and Huebner; we got a satisfactory results for the treatment of displaced intra-articular calcaneus fracture by open reduction and heterogenous bone graft. We didn't need harvesting autograft by use of heterogenous bone graft into bone defect site instead of autograft. Our purpose of using heterogenous bone were filling of defect and internal fixation. We used minimal skin incision and minimal internal fixation device, so reduced complications such as wound edge necrosis and peroneal entrapment caused by entensile appraoch. There were no posterior facet depression and decreased B hler angle for 1 year follow up.

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Delayed Hemolytic Transfusion Reaction in Treatment of Multiple Fracture: Ye Yeon Won, Byoung Hyun Min, Weon Ik Lee, Myeong Ryeol Song; J Korean Soc Fract 1998;11(3):617-622. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.617

Abstract PDF: This is a case report of delayed hemolytic transfusion reaction due to Anti-Le*b and Anti-JK*b in treatment of multiple fracture. The patient was a 14 year-old boy and had no history of transfusion or blood products. The patient underwent open reduction and internal fixtion for fracture of supracondyle of femur with massive blood transfusion. Abnormal finding of ABO incompatibility was not found as usual method. The patient developed a marked fall in hemoglobin and hematocrit value and a marked hyperbilirubinemia at 8 day after surgery, which suggested hemolytic anemia and jaundice. After the evaluation of this hemolytic anemia and jaundice, we found the anti-Le*b antibody and Anti-Jk*b antibody. A delayed hemolytic transfusion reaction represents an infrequent, but potentially hazardous complication of blood transfusion. The phenomenon usually oringinates from exposure to a blood group antigen by prior transfusion or pregnancy. delayed appearance of isoantibodies, first detected 4 to 14 days after the transfusion of apparently compatible blood, has been detected by the authors.

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Internal Bone Transport for Treatment of Infected Non-union of Long Bone: Han Suk Ko, Byung Jik Kim, Young Lim, Jeong Gook Seo, Jin Ku Kim, Dong Hun Lee; J Korean Soc Fract 1998;11(3):623-628. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.623

Abstract PDF: Infected nonunion of long bone frequently accompanies with bone loss, because of the outcome of initial trauma or iatrogenic result from sequestra resection. In this study, infected and ununited long bone fracture was treated with internal bone transport technique which was first discribed by G.A. Ilizarov. There were eleven tibial and two femural nonunion. The mean number of admission was 2.8 times; mean number of operation was 8 times; mean duration of average healing index was 1.95 month/cm. All infections were cured and all nonunions were united. Functional result was excellent in 5 cases (of 13 cases), good in 5, fair in 2, and 1 had poor result. Many complication had been observed. All had infection of pin site and pain at least one time, 5 had stiff knee, 9 had stiff ankle, early consolidation(1), delay consolidation(3), tibiofibular synostosis(5), nerve injury(1), refracture after union(1), angular deformity over 5 degree(7), rotational deformity over 10 degree(2).

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Diffrences of Bone Mineral Density between Osteoporotic Group with or without Compression Fracture of the Spine: Eu Sub Jung, Young Ki Lee, Seung Ill Baek; J Korean Soc Fract 1998;11(3):629-633. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.629

Abstract PDF

Osteoporosis is the metabolic bone disease and the bone is easily fracture by minimal stress due to decreased bone mass. It gets to attract more and more interest due to surprisingly high incidence and prevalence as well as its complications, fracture. We compared the bone mineral density between 45 osteoporotic patients group with compression fractures of the spine, 105 osteoporotic patients group without fractures and 45 normal control group using dual energy X-ray absorptiometry. We obtained following results. 1. There are statistically no significant differences between bone mineral density of the osteoporotic group with compression fracture of the spine and bone mineral density of the osteoporotic group without fractures. 2. Height and weight had statistically significant correlation with bone mineral density of the lumbar spine anteroposterior view, lateral view and Ward triangle. 3. Fracture threshold of the lumbar spine anteroposterior view, lateral wiew and Ward triangle are 0.884g/cm2, 0.694g/cm2 and 0.514g/cm2 according to 90percentile, 0.979g/cm2, 0.732g/cm2, 0.545g/cm2 according to 95percentile.

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Subsequent Hip Fracture in Osteoporotic Hip Fracture Patients
Sang Ho Lee, Tong Joo Lee, Kyu Jung Cho, Sang Hyun Shin, Kyoung Ho Moon
Yonsei Medical Journal.2012; 53(5): 1005. CrossRef

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Treatment of Supracondylar Fracture of the Humerus in Children: by Early Closed reduction & K-Wire Fixation: Jong Sup Shim, Won Hwan Oh; J Korean Soc Fract 1998;11(3):634-643. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.634

Abstract PDF: We treated supracondylar fracture of the humerus in children by early closed reduction and K-wires fixation using two lateral parallel K-wires for partially displaced fractures(Gartland Ib, II) and three K-wires,two lateral and one additional medial crossed K-wire for type III fractures. This study is to analyze our method for the treatment of supracondylar fracture of the humerus in children. Sixty-two fractures(4 type Ib, 20 type II and 38 type III) underwent K-wires fixation after closed reduction of the fracture from October 1994 to April 1997 were included in this study. The patients age ranged from 2 years and 2 months to 12 years and 7 months, averaging 6 years and 2 months. All the fractures were treated within 24 hours after arrival in the hospital. After general anesthesia, each fracture was reduced manually and fixed by K-wires under fluoroscopic control. Two lateral parallel K-wire were used for fixation of all type Ib and II fractures. We tried to keep the gap between two K-wires be 1 cm or more. In type III fractures, fractures were fixed by two parallel lateral K-wires and followed by one medial crossed K-wire. The K-wires were removed after averaging 3.2 weeks after operation in out patient clinic. The follow-up period ranged from 6 months to 34 months. averaging 14 months. By Flynn's functional and cosmetic criteria, 37 fractures (97.4%) among 38 type III fractures resulted in satisfactory criteria. All of the type I and II fractures (100%) resulted in satisfactory criteria. In conclusion, our decision is considered as safe and reliable option for the treatment of supracondylar fractures of the humrus in children.

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Spontaneous Correction of Angular Deformity after femoral Shaft Fracture in children: Eu Sub Chung, Jong Bone Lee, Boyung Ho Lee; J Korean Soc Fract 1998;11(3):644-649. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.644

Abstract PDF

Remodeling of long bones in children after posttraumatic deformity was accomplished by two distinctive mechanisms that axially oriented compression forces will slow physeal growth and simillarly oriented tensile forces tend to enhance physeal growth, which occur at the fracture site and physis. We reviewed 17 childrens with unilateral fractures of femoral shaft who had an angular deformity after union of 10degreewere selected and measured by C-T scans. The average correction rate was 84.9% of the initial deformity and was no relation between the remodeling rate and degree of malunion. The correction of angulation, only 25% had occurred at the fracture site and 75% at physis. Under the 10 years old, malunion as much as 23degreein any plane will remodel enough to give normal alignment of the joints surfaces.

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Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture
Suk Kang, Jong Pil Kim, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Sang Ho Lee, Jin Wook Chung
Journal of the Korean Fracture Society.2007; 20(4): 339. CrossRef

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Fracture-Separation of The Distal Humeral Epiphysis: Hak Yeong Jeong, Seung Wook Yang, Jae Woong Shim, Seung Joon Shin, Jeong Tae Kim; J Korean Soc Fract 1998;11(3):650-657. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.650

Abstract PDF: A fracture-separation of the distal humeral epiphysis in children is an extremely rare injury and presents problems in diagnosis, radiographic interpretation and management. From June 1992 to December 1996, Authors experienced the 5 cases of Salter - Harris type II injury of the distal humeral epiphysis at Department of Orthopedic Surgery, Pusan Maryknoll General Hospital. The patient were followed up from one year nine months to three years four months. The two cases were treated by closed reduction and percutaneous K-wire fixation and the three cases by open reduction and internal fixation with K-wires. There were 4 cases of complication seldom reported following fracture-separation of the distal humeral epiphysis. This complications consist of 4 dissolutions of trochlea, which is one, frank avascular necrosis of trochlea. In 3 cases with open reduction developed the cubitus varus & dissolution of trochlea. We speculate that this complications results from avascular necrosis of distal end of humerus. Attention to change of carrying angle and radiographic change of distal humeral end are important in detection of complication & evaluation of etiology of dissolution of distal humeral end.

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Operative Treatment of Clavicle Fracture: Bu Hwan Kim, Jong In Im, Uoung Kyun Yim, Jung Ju Kim; J Korean Soc Fract 1998;11(3):658-664. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.658

Abstract PDF

Clavicle fracture is one of the most common fractures and can be treated by conservative methods with a high rete of union and operative treatment itself was rearded as a cause of nonunion. But recently, we experienced some cases of delayed or nonunion following conservative treatment especially in high energy trauma patient. So we tried to treat 35 cases of clavicle fractures by open reduction and internal fixation with or without bone graft and analyzed the results. Results were as following. 1. The functional results were excellent in 16 cases(45.7%), good in 13 cases(37.1%), fair in 4 cases(11.4%) and poor in 1 case(0.28%), except 1 case of initial brachial plexus injury. 2. Of the 34 cases (except 1 case of nonunion), average time to union was 8.2 weeks in Knowles pin fixation and 8.4 weeks using plate with or without bone graft. Knowles pin fixation and 8.4 weeks using plate with or without bone graft. In the treatment of flesh clavicle fracture for early rehabilitation especially in young patients, open reduction and internal fixation is thought to be good method.

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Does cerclage wiring interfere with fracture healing of osteosynthesis in comminuted midshaft clavicle fractures? A multicenter study
Hyo Jin Lee, Yong Bok Park, Chang Heon Shim, Young Min Noh
Orthopaedics & Traumatology: Surgery & Research.2021; 107(8): 103091. CrossRef
Comparison of Plate Versus Threaded K-wire for Fixation of Midshaft Clavicular Fractures
Young-Jin Ko, Chul-Hyun Park, Oog-Jin Shon, Jae-Sung Seo
Journal of the Korean Fracture Society.2012; 25(2): 123. CrossRef
Surgical Techniques for Percutaneous Reduction by Towel Clips and Percutaneous Intramedullary Fixation with Steinmann Pins for Clavicle Shaft Fractures
Ki-Do Hong, Jae-Chun Sim, Sung-Sik Ha, Tae-Ho Kim, Jong-Hyun Kim, Jong-Seong Lee
Journal of the Korean Fracture Society.2012; 25(1): 31. CrossRef
Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?
Jae-Kwang Yum, Yong-Woon Shin, Hee-Sung Lee, Jae-Gu Park
Journal of the Korean Fracture Society.2011; 24(2): 138. CrossRef
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

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Treatment of Supracondylar or Intercondylar Fracture of Humerus in Adult: Byung Ho Lee, Sang Ho Ha, Sun Jin Choi; J Korean Soc Fract 1998;11(3):665-671. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.665

Abstract PDF: Distal humerus fracture, particularty those that involve the articular surface, in adult has remained one of the most difficult of all fractures to manage. The goal of this study is to analyze clinical result according to fracture pattern and method of treatments and to recognize complicating factor affecting prognosis. Nonoperatively managed intraarticular fractures are likely to have compromised functional outcome. Open anatomic reduction and stable fixation secure enough to permit early functional, pain-free motion of the elbow showed best result. Stable fixation of fracutre is achieved with use of single or dual plates with additional lag screws depending on the fracture pattern. When there is segmental articular fragments, interfragmentary bipolar threaded screw(Herbert screw) may be useful. autogenous cancellous bone grafting is sometimes advisable when the diaphyseal portion of the fracture is comminuted. Transolecranon approach affords excellent surgical exposure of the joint surface for fracture with comminuted intra-articular component and there was no postoperative complication.

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Operative Treatment of Olecranon Fractures Using Tension Band Wiring: Hyun Dae Shin, Kwang Jin Rhee, June Kyu Lee, Joon Uoung Uang, Young Mo Kim, Mun Jong Lee, Jin Soo Kim; J Korean Soc Fract 1998;11(3):672-682. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.672

Abstract PDF

We treated 26 cases(25 patients) olecranon fractures operatively with Kirschner wire and tension band wiring technique from January 1993 to December 1995. The Kirschner wire fixation methods in our study were either bicortical fixation(15 cases) or intramedullary fixation(11 cases). We retrospectively reviewed clinical results according to Mayo elbow performance index and starting time of full range of motion(ROM) exercise. We analyzed relationship between the cli9nical results of the cases with cast immobilization and those without cast immobilization. We also compared Kirschner wire fixation methods in the respect of clinical results, full ROM exercise starting time and complications. The results were as follows. 1. Clinical results were excellent or good in 25 cases(96%) according to Mayo elbow performance index. Full ROM exercise starting time was within 2weeks in 10 cases, between 2-3weeks in 11 cases, between 5-6weeks in four cases and after 6weeks in one case. Full ROM exercise starting time was significantly different(P=0.016) with clinical results statistically and there was statistically high significant difference(P=0.0025) between clinical results and cast immobilization or not. 2. Clinical results of bicortical fixation group was ont significantly different frmo those of intramedullary fixation group and there was no significant difference between full ROM exercise starting time and Kirschner fixation methods statistically. 3. The most frequent complications were decreased ROM and loosening of the Kirschner wire. There were decreased ROM In 10 cases and loosening of the Kirschner wire in 6 cases in all cases. We encountered more higher incidence of complications related to intramedullary fixation method. The clinical results and full ROM exercise starting time of bicortical fixation group were not significantly different with those of intramedullary fixation group statistically. But more early exercise, more better clinical results and more less complications was produced in bicortical fixation group. So we thought bicortical fixation method is better than intramedullary fixation method.

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Double Tension Band Wiring for Olecranon Fractures
Suk Kang, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Jin Wook Chung, Jong Pil Kim
Journal of the Korean Fracture Society.2008; 21(2): 130. CrossRef

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Operative Treatment of Type II Distal Clavicle Fractures: Jung Ho Park, Kyung Wook Rha, Seung Woo Suh, Sung Kon Kim; J Korean Soc Fract 1998;11(3):683-689. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.683

Abstract PDF

Type II clavicle fractures have been associated with high rates of nonunion and delayed union. Many authors have supported open reduction and internal fixation of these fractures. Authors analyzed twelve cases of type II distal clavicle fractures which had been treated operatively at department of orthopaedic surgery, Korea university, Ansan and Guro Hospitals from May 1991 to September 1997 and reviewed the result of operative treatment retrospectively. The results were as follows; 1. Among the 12 cases, male was 8, fenale was 4 and the average age of them was 25.6 years. 2. According to the classification by Neer and Rockwood, type IIa was 5 cases and IIb was 7 cases. 3. We treated all the cases operatively, such as C/R with transacromial K-wire fixation in 6 cases, O/R with transacromial K-wire fixation in 4 cases, O/R with coracoclavicular screw fixation in 2 cases. 4. The average follow-up period was 17 months. The functional results were evaluated with Kona classification and showed excellent in 10 cases, good in 2 cases. In conclusion, the operative treatment revealed good functional results in all cases. Authors recommend early operative treatment in type II distal clavicle fractures.

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Treatment of Distal Clavicle Fracture Using Hook Plate
Su-Han Ahn, Hyeong-Jo Yoon, Kwang-Yeol Kim, Hyung-Chun Kim, In-Yeol Kim
Journal of the Korean Fracture Society.2011; 24(1): 48. CrossRef
Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle
Kyeong-Seop Song, Hyung-Gyu Kim, Byeong-Mun Park, Jong-Min Kim, Sung-Hoon Jung, Bong-Seok Yang
Journal of the Korean Fracture Society.2009; 22(1): 24. CrossRef

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