Journal of Musculoskeletal Trauma

Analysis of Low-Energy Trochanter Fracture Using the Multiplanar Computed Tomography Image: Application for Intramedullary Nail Fixation: Gu Hee Jung, Sung Keun Heo, Hyun Je Seo; J Korean Fract Soc 2015;28(3):155-162. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.155

Abstract PDF: PURPOSE
The purpose of this radiologic study was to evaluate the geographic patterns of low-energy trochanteric fractures using multiplanar computed tomography (CT) images for application of intramedullary nailing.
MATERIALS AND METHODS
In this study, 117 trochanteric fractures (stable fracture, 39 cases, unstable fractures, 78 cases) sustained from simple slip-down were assessed. The mean age was 78.4 years (range, 60-96 years). Multiplanar CT images were assessed for evaluation of geographic features of trochanteric fracture, and the fracture exit and geographic patterns were analyzed.
RESULTS
The medial and lateral exit of the trochanteric fracture showed no statistical difference by age, bone density, and comorbid disease. The exit was located at an average distance of 10.2 mm (range, 1.0-22.2 mm) from the tip of the greater trochanter (GT), and the medial exit, average distance of 8.1 mm (range, 0.0-18.3 mm) from the tip of the lesser trochanter. It was also found that there was no comminution around the anteromedial cortex of the fracture, and its contact loss was from fracture deformity.
CONCLUSION
Because of no comminution, the contact restoration of the anteromedial cortex resulted in correction of fracture deformity and reduction. Trochanteric nailing by GT tip could be fixed through the proximal fragment of the fracture because the lateral exit is placed at an average distance of 10.2 mm from the GT tip.

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A Comparison of Quality of Life Using Short Form 36 between Femoral Shaft Fracture and Tibia Shaft Fracture Treated with Antegrade Nailing: Sangbong Ko, Hojin Chang; J Korean Fract Soc 2015;28(3):163-168. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.163

PURPOSE
We sought to compare the quality of life between two similar groups of patients; one group who sustained an isolated femoral shaft fracture, and the other group who sustained an isolated tibial shaft fracture.
MATERIALS AND METHODS
From February 1995 to July 2010, two groups of 168 patients who underwent implant removal operations after intramedullary nailing for an isolated femoral shaft fracture or an isolated tibial shaft fracture were enrolled. Short Form 36 (SF-36) questionnaires were completed at the final follow-up visit. Data analysis was performed by another physician not otherwise involved with clinical evaluation or the surgeries.
RESULTS
Patients ranged in age from 18 to 37 years old. The two groups had similar characteristics, including age, gender ratio, body weight, smoking, and mean follow-up period (all p>0.05). No significant difference in functional outcome using SF-36 was observed between the groups except in the domain of physical functioning (PF) where femoral shaft fracture patients had a slightly higher score (p=0.002).
CONCLUSION
Femoral shaft fracture patients and tibial shaft fracture patients who underwent intramedullary nailing and subsequent implant removal after fracture union with similar epidemiological characteristics had similar functional outcomes using the SF-36 survey, except in the domain of PF, where femoral shaft fracture patients had a slightly better outcome.

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Health‐related quality of life outcomes after surgical treatment of atypical femur fractures: a multicenter retrospective cohort study
Jonathon Spanyer, Lauren A. Barber, Harrison Lands, Alexander Brown, Mary Bouxsein, Marilyn Heng, Madhusudhan Yakkanti
JBMR Plus.2021;[Epub] CrossRef

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Additional Hinged External Fixation in Complex Elbow Injury: Tong Joo Lee, Taek Ho Hong, Nak Chul Kim; J Korean Fract Soc 2015;28(3):169-177. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.169

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the use of hinged external fixation in management of complex elbow injury.
MATERIALS AND METHODS
We retrospectively reviewed clinical outcomes in 10 patients with elbow dislocation and associated fractures of both the radial head and the coronoid process from January 2007 to December 2013. All ten patients were treated by hinged external fixation after open reduction and internal fixation. The indication for use of a hinged external fixator was persistent instability after fixation of the fractures. Early mobilization was started at 1 week (6.5 days) after surgery. The external fixator was removed at 6 weeks after surgery. Cassebaum classification and Mayo elbow performance score were used for clinical and functional evaluation. The follow-up period was at least 1 year.
RESULTS
At the last follow-up, the average further flexion was 127degrees, and the average flexion contracture was 16degrees. The average pronation was 83degrees and the average supination was 78degrees. By the Cassebaum classification after 1 year follow-up, patients were classified as 4 excellent, 4 good, and 2 poor. According to the Mayo elbow performance score, the average score was 87 points (65-100 points) with 3 excellent, 6 good, and 1 fair. Stability was restored in all patients at the last follow-up. There was no case of nonunion and the average union period was 11.5 weeks.
CONCLUSION
This study advocated the additional use of a hinged external fixator in the treatment of complex elbow instability, especially when fixation of fractures and repair of soft tissues were not sufficient. Providing adequate stability and allowing early motion, additional external fixation could improve the functional outcome.

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Outcomes of Severe Comminuted Distal Radius Fractures with Pronator Preserving Approach: Seung Hyun Cho, Hong Gi Park, Deuk Soo Jun, Jae Ang Sim, Young Hak Roh, Yong Cheol Yoon, Jong Ryoon Baek; J Korean Fract Soc 2015;28(3):178-185. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.178

Abstract PDF

PURPOSE
We investigate the outcomes of treatment of patients with severe comminuted distal radius fractures with volar plate fixation using a pronator-preserving approach.
MATERIALS AND METHODS
Fourteen patients with severe comminution of the distal radius fractures for whom anatomical reduction of the fractures was deemed difficult to achieve with traditional approaches were enrolled. The gender ratio was 8 males to 6 females, and the average age of the patients was 64.9 years. According to the AO/OTA classification of fractures, 2 patients had 23-A3 fractures, 7 patients had 23-C2, and 5 patients had 23-C3. Radial length, radial inclination, and volar tilt were measured for radiologic evaluation. Modified Mayo wrist score (MMWS) was used for clinical outcome.
RESULTS
Bony union was achieved in all 14 patients without signs of complications. The average time-to-union was 4.3 months (3-6 months). The radiological findings at the final follow-up were as follows: the average radial inclination was 20.5degrees; the average volar tilt, 7.57degrees; and the average radial length, 11.8 mm. At the final follow-up, the results of the MMWS were 'Fair' in 1 patient, 'Good' in 4, and 'Excellent' in 9.
CONCLUSION
We propose that a pronator-preserving approach is an effective treatment for severe comminuted distal radius fracture.

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Use of Miniplate for Severe Comminuted Metadiaphyseal Fractures of the Distal Radius
Jong-Ryoon Baek, Yong-Cheol Yoon, Seung Hyun Baek
Journal of the Korean Fracture Society.2019; 32(4): 204. CrossRef

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Comparison of Treatment Methods in Gartland Type III Pediatric Supracondylar Humeral Fracture: Lateral Entry Pin versus Crossed-Pin Technique: Young Hoon Jo, Tai Seung Kim, Dong Yun Kim; J Korean Fract Soc 2015;28(3):186-193. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.186

Abstract PDF: PURPOSE
The aim of this study was to compare the results of the lateral entry pin technique and the crossed pin technique in treatment of Gartland type III humerus supracondylar fracture.
MATERIALS AND METHODS
Seventeen patients (group I) underwent surgery using the lateral entry pin technique, and 33 patients (group II) underwent surgery using the crossed pin technique for Gartland type III humerus supracondylar fracture in Hanyang University Seoul Hospital between January 2011 and January 2014. Maintenance of reduction was compared between the 2 surgical techniques by measuring changes in Baumann angle and lateral humerocapitellar angle after surgery and after pin removal in groups I and II. In addition, the final carrying angle and level of loss of functional movement were measured for comparison of clinical results between the 2 groups. Occurrence of ulnar nerve palsy in the 2 groups was also examined.
RESULTS
The mean Baumann angle and lateral humerocapitellar angle changes were 3.3degrees and 3.7 in group I and 3.1degrees and 3.4degrees in group II, respectively. No statistically significant differences were found between the 2 groups. Clinical results showed that the changes in the final carrying angle and range of motion were 2.9degrees and 2.6degrees in group I and 2.6degrees and 3.0degrees in group II, respectively, indicating no significant differences between the 2 groups. In terms of nerve damage, 1 patient in group II had temporary iatrogenic ulnar nerve palsy.
CONCLUSION
The lateral entry pin technique may be regarded as an appropriate treatment that reduces the risk of iatrogenic ulnar nerve palsy and provides satisfactory results in Gartland type III humerus supracondylar fracture patients.

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Extraction of Misplaced Endcap during Tibia Intramedullary Nailing by 'Fish-Hook' Technique: Technical Note: Se Hyeok Yun, Jae Hyuk Yang; J Korean Fract Soc 2015;28(3):194-197. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.194

Abstract PDF: Endcap placement after intramedullary nailing can be cumbersome. Misplacement of the endcap which may be difficult to extract may occur. In this report, a simple Kirschner wire device with 'fish-hook' technique may ease the procedure without further violating bony or soft tissues.

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Mangled Extremity: Salvage versus Amputation: Ki Chul Park, Hyun Joong Cho; J Korean Fract Soc 2015;28(3):198-204. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.198

Abstract PDF: No abstract available.

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Management of Long Bone Fractures with Severe Bone Defect: Jae Woo Cho, Jinil Kim, Han Ju Kim, Jong Keon Oh; J Korean Fract Soc 2015;28(3):205-214. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.205

Abstract PDF

No abstract available.

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Treatment Strategy of Infected Nonunion
Hyoung-Keun Oh
Journal of the Korean Fracture Society.2017; 30(1): 52. CrossRef

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