Journal of Musculoskeletal Trauma

Effect of the Ultrasound and LASER in the fracture healing in rabbits: Jun Young Yang, Kwang Jin Rhee, June Kyu Lee, Deuk Soo Hwang, Hyun Dae Shin, Jun ho Lee; J Korean Soc Fract 2001;14(3):305-312. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.305

Abstract PDF: PURPOSE
To study the effectiveness of the ultrasound and LASER on the fracturehealing in rabbits.
MATERIALS AND METHODS
This study was performed on rabbits using the Hi-Tech 2000 (Ultrasound+LASER) which was made in our institute. After anesthesia of the rabbit, the shaft of tibia was fractured with Gigli saw under aseptic condition, and then intramedullary nailing using K-wire was performed. We evaluated left tibia as control and right tibia as experimental. we applicated ultrasound and LASER from 7 days after operation and sacrificed at 3 weeks and 5 weeks after operation. Gross findings, simple radiologic findings, and histologic findings were evaluated by modified Zorlu scoring system. With use of T-test of SAS system ( level of significance, P < 0.05 ), difference between left and right tibia were evaluated to be determined the effect of ultrasound and LASER on the fracture-healing.
RESULTS
At postoperative 3 weeks, differences were noted in 4 cases but we could detect no significant difference between left and right side. At postoperative 5 weeks, differences were noted 6 cases and significant difference was noted.
CONCLUSIONS
Seeing this results, ultrasound and LASER treatment was effective in fracture healing. However we think that additional studies for accurate quantitative and qualitative analysis, biomechanical test in callus, microangiographic study and clinical research to determine the effectiveness of ultrasound and LASER in clinical field are needed.

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Treatment of pelvic bone fracture involving the sacrum and sacroiliac joint: Hui Taek Kim, Kyo Min Son, Sang Jin Cheon, Chong Il Yoo; J Korean Soc Fract 2001;14(3):313-322. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.313

PURPOSE
To evaluate the usefulness of early posterior internal fixation(I/F) by cannulated cancellous screw(CCS) in unstable pelvic bone fractures involving the sacrum and sacroiliac joint.
MATERIALS AND METHODS
Sixteen cases were evaluated retrospectively. Classification according to the injury mechanism, using Young's criteria, was as follows: 7 anteroposterior compression, 4 lateral compression, 4 vertical shear and 1 combined mechanism. With respect to treatment, 9 cases were treated by combined anterior external fixation(E/F) and posterior I/F with CCS(7 cases) and transiliac rod(2 cases). Five cases were treated by anterior E/F only, and 2 cases were treated without surgery. We analyzed clinical results using Matta's criteria, and radiologic abnormalities.
RESULTS
The management by posterior I/F with CCS and transiliac rod including anterior E/F has shown superior clinical results(7 satisfactory, 2 unsatisfactory) over the management by only anterior E/F(1 satisfactory, 4 unsatisfactory) or conservative methods(2 unsatisfactory). The rate of malunion and nonunion was also low in the former method in the radiographic analysis.
CONCLUSION
Posterior I/F using CCS is an excellent surgical procedure in the treatment of unstable pelvic bone fracture due to its lessened invasiveness, early applicability, simple surgical technique and its direct effects on the prevention of several complications.

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Measurement of Optimal Insertion Angle for Iliosacral Screw Fixation Using Three-Dimensional Computed Tomography Scans
Jung-Jae Kim, Chul-Young Jung, Jonathan G. Eastman, Hyoung-Keun Oh
Clinics in Orthopedic Surgery.2016; 8(2): 133. CrossRef
Management of sacral fractures associated with spinal or pelvic ring injury
Ye-Soo Park, Seung-Wook Baek, Hong-Sik Kim, Ki-Chul Park
Journal of Trauma and Acute Care Surgery.2012; 73(1): 239. CrossRef
Upper Sacral Morphology Related to Iliosacral Screw Fixation in Korean
Jung-Jae Kim, Chul-Young Jung, Hyoung-Keun Oh, Byoung-Se Yang, Jae-Suck Chang
Journal of the Korean Fracture Society.2007; 20(2): 115. CrossRef

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The Effectiveness of Bone Scintigraphy of Femur neck fracture: Sang Won Park, Seung Beom Han, Soon Hyuck Lee, Woong Kyo Chung, Seung Yong Wang; J Korean Soc Fract 2001;14(3):323-330. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.323

Abstract PDF

PURPOSE
To evaluate the effectiveness of bone scintigraphy using 99mTc-methylene diphosphonate(99mTc-MDP) for prediction of viability of femoral head in femur neck fracture that have been treated with osteosynthesis.
MATERIALS AND METHOD
Thirty two patients were included in this study who underwent preoperative and postoperative bone scintigraphy using 99mTc-MDP following femur neck fracture. The uptake of istope was estimated visually as either normal or reduced compared with the opposite side. The complications as avascular necrosis and non-union were checked and compared with the preoperative and postoperative bone scintigraphy and the predictive values of positive and negative scintigraphy were calculated.
RESULTS
Among thirty-two patients, bone union occured in nineteen patients except 12 avascular necrosis and 1 non-union. Average bone union peried was 4.4 months and 50% was occured between 3 and 6 months. In seventeen patients who showed reduced isotope uptake, twelve patients developed complications and predictive value of positive scintigraphy was calculated as 0.76. In fifteen patients shown normal isotope uptake, none developed complications and predictive value of negative scintigraphy was calculated as 1.00.
CONCLUSION
Preoperative bone scintigraphy using 99mTc-MDP was useful method to evaluate the viability of femoral head following femur neck fracture and to choose the treatment modality of displaced femur neck fracture especially in elderly person.

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Bipolar Hemiarthroplasty for the Femoral Neck Fractures in Elderly Patients
Woong-Kyo Jeong, Sang-Won Park, Soon-Hyuck Lee, Jong-Hoon Park, Suk-Ha Lee, Ji-Hoon Kang, Gi-Won Choi, Won Noh
Journal of the Korean Fracture Society.2008; 21(1): 8. CrossRef

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Treatment of Peritrochanteric Fracture of Femur with Angulated Blade Plate: Myung Chul Yoo, Yoon Je Cho, Kang Il Kim, Young Soo Chun, Chang Hyeok Kwon, Dong Jin Shin; J Korean Soc Fract 2001;14(3):351-357. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.351

Abstract PDF: PURPOSE
To clarify the efficacy of angulated blade plate fixation in the treatment of complex peritrochanteric fracture of femur.
MATERIALS AND METHODS
Thirty peritrochanteric fractures treated with angulated blade plate, with a follow-up period of more than twelve months, were included. There were twenty subtrochanteric fractures and ten intertrochanteric fractures in which compression hip screw could not be applied due to comminution of trochanteric area. Average age was fifty six years(range, 17 to 76). Average follow-up period was 22.4 months(range, 12 to 31).
RESULTS
Average time to bony union for those fractures that healed primarily was 5 months. Solid union occurred in all cases with two malunion. Infection, implant failure, femoral head protrusion was not occurred.
CONCLUSION
Angulated blade plate can be a useful alternative for the fixation of comminuted peritrochanteric fracture if appropriate fixatives are not available.

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Lateral Insufficiency Fracture of the Femur caused by Osteopenia & Varus angulation after Hip Arthroplasty: Case Report: Myung Sik Park, Yong Min Kim; J Korean Soc Fract 2001;14(3):358-363. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.358

Abstract PDF: Lateral femoral insufficiency fracture in total hip arthroplasty occur due to osteopenia and varus positioning of the femoral component. The presentation of these fractures usually involves the insidious onset of unexplained thigh or groin pain. The insufficiency fracture generally occur at the level of the femoral stem tip on the lateral cortex of the femur. Recommended treatment involves revision to a long stem femoral component. This is the first report of lateral femoral insufficiency fracture simply regarded as periprosthetic fracture of the femur.

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Surgical Treatment for Nonunion of Femoral Shaft Fractures: Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Young Bae Kim, Jong Ro Yoon, Eui Sang Seol, Kwang Yeol Park, Dae Woong Kang; J Korean Soc Fract 2001;14(3):364-370. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.364

Abstract PDF: PURPOSE
The purpose of this study is to analyze the clinical and radiological result of surgical treatment for femoral shaft nonunion.
MATERIALS AND METHODS
From January 1993 to December 1999, 21 cases of femoral shaft nonunion were treated surgically and followed for an average of 15 months. We analyzed initial cause of injuries, classification of fractures, and cause of nonunion in clinically and radiologically. The authors analyzed the average time to union and results after surgical treatment by rigid internal fixation with interlocking intramedullary nail and autogenous bone graft.
RESULTS
The mean duration of bony union was 22 weeks and bony union achieved in 18 cases(85.7%) of 21 cases. The complications were shortening of leg length and limping gait in 2 cases, partial limitation of knee joint in 2 cases, superficial infection in 2 cases.
CONCLUSION
Rigid internal fixation with interlocking intrameduallary nail and bone graft is useful method of treatment for femoral shaft nonunion according to cause and type of nonunion.

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A STUDY OF ANATOMICAL CONFIGURATION OF LATERAL TIBIAL CONDYLE USING MR AXIAL IMAGE: Sung Do Cho, Yong Sun Cho, Bum Soo Kim, Tae Woo Park, So Gu Lew, Su Young Jung; J Korean Soc Fract 2001;14(3):398-403. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.398

Abstract PDF: PURPOSE
To evaluate the anatomical configuration of the lateral tibial condyle using the MR axial images and to present the proper configuration of the head of the buttress plate that fit the lateral tibial condyle of Korean MATERIALS AND METHODS: With 110 MR axial images of the knee joint of male and female, we calculate the ratio of the maximal height of the arc of the l ateral tibial condyle to the length of the line between the end point of the arc of the lateral tibial condyle(the ratio of convexity) and the angle of the peak point of arc of the lateral tibial condyle(the angle of convexity), the absolute value of the difference of the angle of the end point of the arc(the value of symmetry) of that. then we evaluate the head of 3 the buttress plates with same methods and then compare with the result of the lateral tibial condyle.
RESULTS
The ratio and angle of convexity of Korean were average 0.216/49.04(total), 0.203/49.35(male), 0.235/50.36(female), and the value of symmetry were average 5.68(total), 5.76(male), 5.56(female). the ratio and angle of convexity of the head of buttress plate were average 0.177/43.21(EGIRE), 0.114/25(AO), 0.101/23.83(Solco) and the value of the symmetry were 1.643(EGIRE), 0.75(AO), 1.5(Solco). the ratio of convexity was correlated with age, height, and weight but angle of convexity was not correlated with weight.
CONCLUSION
The anatomical configuration of the lateral tibial condyle of Korean did not fit that of the head of the buttress plates and it would be necessary to make a new plate that fit the lateral tibial condyle for Korean.

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Treatment of Tibial Condylar Fractures Using the Ilizarov External Fixator: Dong Wha Lee, Kyoo Seog Shin, Jong Soon Kim, Yong Whee Kim, Jin Ho Seok; J Korean Soc Fract 2001;14(3):404-411. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.404

Abstract PDF: PURPOSE
The aim of this study is to report results of treatment of tibial condylar fracture using the Ilizarov external fixator. MATERIALS & METHOD: 21 Cases of tibial condylar fracture, which were operatively treated with Ilizarov external fixator were evaluated clinically & radiographically. All patients were followed for at least 1 years.
RESULTS
Primary bony union was achieved in 15 cases(71.4%) and bony union after secondary operative procedure was obtained in 6 cases(28.6%). The fracture was united within 6 months except 2 cases. As complications, pin irritation was observed in 6 cases and Joint stiffness in 1 case, delayed union in 1 cases, nonunion in 1case CONCLUSION: We could obtain satisfactory clinical results with using of Ilizarov external fixator in treating of tibial condylar fractures. The good indications for the use of Ilizarov external fixator seems to be high energy tibial condylar fracture difficult to fixation with other method. In cases of bony defect or severe comminuted fractures, we shall obtain better outcome when bone graft is performed.

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Treatment of Open Tibial Fracture with Repofix External Fixator: Ho Choi, Hoon Kim, Neung cheol Shin, Sang Ho Shin, Dong Soo Han; J Korean Soc Fract 2001;14(3):412-418. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.412

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the results of treatment of open tibial fracture with Repofix external fixator by clinical and radiological assessement. MATERIAL AND METHODS: 24 cases of open tibial fracture, who had been treated with Repofix external fixator from Oct. 1995 to June 1999, were evaluated about distribution of gender, age, cause of injury, fracture site and pattern, and assessed bony union time and complication.
RESULTS
The mean period of application of external fixator was 12.3 weeks and we kept PTB cast until bony union for average 11.5 weeks. According to Gustilo-Anderson's classification, the mean bony union time was 21.7 w e e k s ( type I ), 36 weeks(type II) and 39 weeks(type III), simple fracture was 22 weeks, comminuted fracture was 32 weeks(p<0.05). Complications were pin site infection(9 cases), delayed union(3 cases), nonunion(1 cases) and focal skin necrosis(1 case). There was no loss of motion about joint.
CONCLUSION
Repofix external fixator, which has the advantages of accurate reduction without extension of wound and decreases motion limitation of neighboring joint, is alternative useful appratus for open tibial fracture.

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Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases
Ji-Hye Geum, Hyeon-Jun Woo, Jong-gyu Kim, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2020; 30(4): 203. CrossRef

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Operative Treatment of Intraarticular Calcaneus Fractures with extensile lateral approach: Dong Kyu Shin, Yong Woon Kim; J Korean Soc Fract 2001;14(3):440-449. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.440

Abstract PDF: PURPOSE
Through the analysing intraarticular calcaneal fractures operated with extensile lateal approach and lateral plate fixation we tried to find the factors related to the result and to prove the usefulness of this treatment method. MATERIAL AND METHOD: We reviewed 50 intraarticular calcaneal fractures which were treated with this method between July 1995 and December 1998. We analysed the relationship between the fracture type and the accuracy of posterior facet reduction and between the accuracy of reduction and the clinical result. We also analysed the complication rate.
RESULT
We gained anatomical reduction in 64% among all cases. There was significant relationship statistically between the Sanders fracture type and accuracy of reduction(p=0.001). There were also significant relationship statistically between the Sanders fractrure type and the clinical result(p=0.045) and between the accuracy of reduction and clinical result(p=0.001). It was also possible to regain the calcaneal height, width and Bohler angle through this treatment method. There was only one wound complication which was skin necrosis and was treated with dressing and finally skin graft.
CONCLUSION
Sanders classification was very useful and reasonable for this kind of fracture. The accuracy of reduction of posterior facet was very important to clinical result. This treatment method for the calcaneal fracture was useful in the term of regain of anatomical components of calcaneus such as posterior facet congruency, calcaenal height, width and Bohler angle with acceptable rate of serious complication.

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Treatment of the Clavicular Shaft Fractures with K-wires: Ho Choi, Hoon Kim, Neungcheol Shin, Dongsoo Han; J Korean Soc Fract 2001;14(3):450-455. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.450

Abstract PDF: PURPOSE
We report the results of treatment of the clavicular shaft fractures with Kwires.
MATERIALS AND METHODS
We treated 25 cases of clavicular shaft fractures with Kwires from June, 1998 to March, 2000 and analyzed the union period, functional results and complications.
RESULTS
Clinical union period was 3.2 weeks, radiologic union period was 8.3 weeks. The functional results were excellent or good in 21 cases(84 %) and there was no delayed or nonunion.
CONCLUSION
In the treatment of the clavicular shaft fractures, intramedullary fixation with K-wires is thought to be simple and effective method.

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Modified Phemister Operation for Acromioclavicular Dislocation: Jin Yung Park, Gun Nam Kim, Byung Sam Min, Moon Jib Yoo; J Korean Soc Fract 2001;14(3):456-462. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.456

Abstract PDF: PURPOSE
To evaluate the clinical results after modified Phemister operation for complete dislocation of acromioclavicular joint.
MATERIALS AND METHODS
Thirty-seven cases of Fifty-three cases complete dislocation of acromioclavicular joint which were treated modified Phemister operation, follow up for at least one year, were evaluated. After operation, applied Kenny-Howard brace for six weeks and removed the inserted pins at ten to twelve weeks postoperatively. The ROM exercise was started at postoperative six weeks and meticulous ROM exercise was begun at pin removal. The clinical results were evaluated with range of movement, comparision of the coracoclavicular distance after surgery with that of follow up, and complications.
RESULTS
The range of motion were forward elevation 150 degree, external rotation 71 degree, external rotation at 90 degree abduction 77 degree, and internal rotation T8. The comparision of coracoclavicular distance after surgery(0,6mm) with that of follow up(1.0mm) showed no significant ligament laxity. The complication were subluxation in 2 cases, heterotrophic calcification in 3cases, broken K-wire in 2cases, pin site infection in 7cases and distal clavicle osteolysis in 3cases, which were healed at follow up radiographically.
CONCLUSION
To prevent of redislocation of acromioclavicular joint, we tried to insert the pin during relatively long period for sufficient healing of ruptured coracoclavicular ligament. Although immobilization period was relatively long period, clinical results were good.

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The Result of Modified Bankart Operation with Suture Anchor in Traumatic Recurrent Anterior Dislocation of Shoulder Joint: Kwang Suk Lee, Jung Dae Seo, Kwang Jun Oh, Seung Joon Lee, Seung Yong Wang; J Korean Soc Fract 2001;14(3):484-490. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.484

Abstract PDF

PURPOSE
The purpose of this study was to evaluate the clinical result of modified Bankart operation repairing the Bankart lesion with capsular shifting using suture anchor in traumatic recurrent anterior dislocation of shoulder joint MATERIALS AND METHODS: All of the cases were treated with modified Bankart operation. The inferior and superior capsular flaps were advanced to the anterior aspect of glenoid neck and fixed with three suture anchors in 30 degrees abduction and external rotation of shoulder joint. Especially the inferior 1/3 capsular flap was sutured over the superior 2/3 capsular flap. We used the grading system of Rowe and Zarins as measuring function, pain, stability, range of motion of shoulder joint.
RESULT
The clinical results were excellent in 80%, good in 20%. The mean loss of motion at follow up study was 2% of flexion and 7% of external rotation.
CONCLUSION
This operative technique is useful in repairing the Bankart lesion and gaining adequate capsular tension. And the using of suture anchor could save the operation time.

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Result of Early Active Range of Motion Exercise after Bankart Repair of Traumatic Anterior Instability
Haeng Kee Noh, Jong Woong Park, Jung Il Lee, Jung Ho Park
Journal of the Korean Fracture Society.2007; 20(1): 53. CrossRef

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The role of the coronoid process fracture in the elbow dislocation: Yong Girl Rhee, Jae Ryong Cha; J Korean Soc Fract 2001;14(3):491-498. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.491

Abstract PDF

PURPOSE
To evaluate whether the size of the coronoid process fracture influence on elbow instability, to recognize the requirement of surgery and to report the final results after operation.
MATERIALS AND METHODS
We performed the operative treatment for 10 cases among 17 coronoid process fractures with elbow dislocation from December 1995 to January 1999, and evaluated operative cases. According to Reagan & Morrey classification, 3 cases(30%) belong to type I, 4 cases(40%) type II and 3 cases(30%) type III. The major mode of injury was fall down accident(70%) and most common associated injury was radial head fracture(70%). In all case, the elbow was inevitably subluxated when flexed beyond 45degreesregardless the size of the fragment segment. This lead us to performed the fixation of coronoid process fracture and the reconstruction of the ruptured articular capsule. Two patients who had had recurrent posterolateral instability due to severe capsular damage at initial injury and previous excision of the radial head underwent the total elbow replacement.
RESULTS
According to Mayo elbow performance index, results were graded as excellent in 7 cases(70%), good in 1 cases(10%), and at two case of radial head excision had been performed previously, the results had been graded as poor, but after total elbow replacement they were good. At final results, all of them resulted in more than good. Postoperative range of motion averaged 6 degrees in extension and 128 degrees in forward flexion and there was significantly a tendency for less motion of a forward flexion with more involvement of coronoid fragment.
CONCLUSION
In cases of the elbow dislocation, instability of the elbow is correlated with the severity of the damaged articular capsule and ligament regardless of the size of the coronoid process fracture. The early excision of the fractured radial head should be avoided not to run into total elbow replacement.

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Surgical Outcomes after Olecranon Plating with Retrograde Coronoid Process Screw Fixation through the Plate Hole in the Bifocal Fracture of the Proximal Ulna
Seong-Eun Byun, Ho-Jae Lee, Junhyun Kim, Sang-June Lee, Uk Kim, Soo-Hong Han
Journal of the Korean Orthopaedic Association.2016; 51(5): 403. CrossRef

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Selective treatment for completely displaced supracondylar fractures of the humerus in children: Chang Wug Oh, Byung Chul Park, Young Woo Kim; J Korean Soc Fract 2001;14(3):534-540. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.534

Abstract PDF: PURPOSE
This retrospective study was performed to know the clinical results after closed reduction and open reduction for completely displaced supracondylar fractures of distal humerus in children.
MATERIALS AND METHODS
Twenty-eight cases of this injury at the mean age of 6.4 (range 21- 138 months), have been followed up over the minimum of one year. The types according to the position of displacement were 15 in posteromedial, and 13 in posterolateral displacement. There were 4 cases of associated nerve palsies (3;median, 1; radial). We tried the closed reduction (17 cases), but open reduction (11 cases) was indicated in irreducible cases with or without severe swelling. Then, the fractures were stabilized by percutaneous K-wires with lateral (23 cases) or cross pinning (5 cases). The differences of Baumann's angle, humero-ulnar angle, and elbow motion to uninjured side were calculated, and Flynn's criteria was used for evaluation.
RESULTS
All fractures were united without any infection or soft tissue compromise. The symptoms of injured nerve recovered within 8 weeks. According to Flynn's cirteria, results were excellent in eleven, good in 12, fair in 2, and poor in 3. The rates of satisfactory results over good were similiar between closed and open reduction, and the other factors including age and type of displacement were not meaningful. The mean Baumann's angle was 8.7 in closed and 6.6 in open reduction group. None of the patients showed restricted elbow motion above 10 degrees, even in 3 cases of hypertrophic scars in the group of open reduction.
CONCLUSION
The selective use of open reduction in completely displced supracondylar fractures of distal humerus in children, would show results as good as closed reduction.

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