Journal of Musculoskeletal Trauma

Computed Tomography Image Analysis of the Fusion Site of Subtalar Arthrodesis for Traumatic Arthritis after a Displaced Intraarticular Calcaneal Fracture: Hong Gi Park, Jae Ang Sim, Han Soul Kim, Byung Hoon Lee; J Korean Fract Soc 2019;32(3):121-127. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.121

Abstract PDF: PURPOSE
The study examined the fusion site and characteristics of the subtalar arthrodesis after intraarticular calcaneal fractures using computed tomography.
MATERIALS AND METHODS
The clinical results and computed tomographic analysis of the fusion site were reviewed in 18 patients who were followed-up for a minimum of six months after undergoing subtalar arthrodesis due to traumatic arthritis caused by an intra-articular calcaneal fracture from December 2012 to April 2017.
RESULTS
An evaluation of clinical results after subtalar arthrodesis revealed statistically significant improvements. In all cases, arthritis was found in the injured articular surface, which was displaced superolaterally from the initial primary fracture line of the calcaneus. Six months after arthrodesis, the subtalar fusion rate was 80.0% (16/20). Of these, 14 cases had a cannulated screw inserted in the uninjured site that is medial to the primary fracture line. Joint fusion was observed on the uninjured articular surface in 17 cases (85.0%).
CONCLUSION
Joint fusion was initially achieved at the uninjured posterior facet after subtalar arthrodesis due to traumatic arthritis caused by a displaced intra-articular calcaneal fracture. This suggests that meticulous surgical techniques and cannulated screw positioning at the uninjured site will promote joint fusion.

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Paratricipital Approach for AO/OTA Type C2 Intra-Articular Fracture of Distal Humerus: Chul Hyung Lee, Doo Hun Sun, Deukhee Jung, Chung Han An; J Korean Fract Soc 2019;32(3):128-134. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.128

Abstract PDF: PURPOSE
The aim of this study was to determine the outcomes of fixation of AO/OTA type C2 fractures among intra-articular fractures of the distal humerus using the paratricipital approach (side to side retraction of the triceps).
MATERIALS AND METHODS
From June 2008 to January 2018, 12 patients underwent an open reduction and internal fixation with the paratricipital approach and were followed-up for more than 10 months after surgery. According to the AO/OTA classification, type C2 fractures were chosen among the intraarticular distal humerus fractures. An extended posterior incision was used over the olecranon in the prone position, preserving the insertion site of the triceps brachii muscle. The fracture site was exposed by retracting the muscle side-to side through a dissection of the medial and lateral intermuscular septum of the triceps brachii muscle. The therapeutic results were assessed by the anatomical reduction of the articular surface and integrity of the metaphyseal contour in postoperative simple radiographs, complications, such as neuropathy or non-union, and the Mayo elbow performance score (MEPS) were checked to estimate the functional outcome.
RESULTS
In the postoperative simple radiographs, no case showed more than 1 mm step-off and the disrupted contour of the distal humerus was recovered to normal alignment in most cases. The range of elbow joint motion in the last follow-up was 133.8Â° on average with a mean flexion contracture of 5.0Â°. The clinical results depending on the MEPS were excellent, except for two cases, which were good. Neuropathy of the ulnar nerve was observed in one patient, which was resolved after metal removal.
CONCLUSION
The paratricipital approach is useful technique in AO/OTA type C2 intra-articular distal humerus fractures that provides sufficient exposure of the surgical field, without injury to the triceps brachii muscle and postoperative complications associated with the trans-olecranon approach.

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Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures in Elderly Patients: Comparison of the Minimally Invasive Approach and Extensile Lateral Approach: Hong Ki Park, Jae Yoon Ko, Seung Kwan Lee, Jong Min Baik; J Korean Fract Soc 2019;32(3):135-142. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.135

PURPOSE
As the functional demands for activities in elderly patients are increasing according to their life extension, the need for surgical treatment is also increasing in elderly patients with displaced intra-articular calcaneal fractures. In addition to the extensile lateral approach (ELA), which is a surgical procedure that showed good results on intra-articular calcaneal fractures, the minimally invasive approach (MIA) also showed an outstanding result. This study compared the radiological and clinical results of intraarticular calcaneus fractures in elderly patients in two groups: ELA and MIA.
MATERIALS AND METHODS
Thirty patients aged over 65 years with intra-articular calcaneus fractures, who could be followed-up more than 14 months, were included in this study. Thirteen patients of the MIA group and 17 patients of the ELA group were analyzed retrospectively using radiological and clinical assessments.
RESULTS
No significant difference in union time, posterior facet reduction accuracy, subtalar osteoarthritis frequency, Bohler angle, calcaneal width, American Orthopaedic Foot and Ankle Society score, visual analogue scale score, 36-item short form survey, and foot function index was observed between the two groups. The p-value of the average height of the calcaneus correction, average length of calcaneal correction, and average loss of correction length were <0.001, 0.005, and 0.015, respectively. The incidence of complications, including soft tissue necrosis and bone infection, were 23.1% in the ELA group and none in the MIA group.
CONCLUSION
The clinical outcomes were similar in the two groups. The degree of reduction of fracture showed a better result in the MIA group than the ELA group. Furthermore, there were no complications in the MIA group, whereas the ELA group showed some complications.

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Clinical and Radiological Outcomes of ‘Blocking Kirschner Wire Technique’ in Displaced Intra-Articular Calcaneal Fractures via the Extended Sinus Tarsi Approach
Jeong-Kil Lee, Chan Kang, Sang-Bum Kim, Gi-Soo Lee, Jung-Mo Hwang, Byung-Kuk An
Journal of the Korean Orthopaedic Association.2021; 56(3): 224. CrossRef

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Ulnar Insufficiency Fractures in Patients on Prolonged Bisphosphonate Therapy: A Case Report: Kyu Min Kong, Yong Uk Kwon, Young Kyung Min, Doo Yeol Kim; J Korean Fract Soc 2019;32(3):143-147. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.143

Abstract PDF

Atypical fractures associated with prolonged bisphosphonate (BP) therapy rarely occur outside the femur, and the diagnostic criteria, appropriate treatment principles, and fixation methods for atypical ulnar fractures have not been established. The authors experienced the use of internal fixation with a metal plate and a new internal fixation method with an intramedullary nail in the treatment of an atypical ulnar fracture in a patient who had been on BP therapy for 10 to 20 years. This paper reports findings along with a review of the relevant literature.

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Treatment of Atypical Ulnar Fracture Associated with Bisphosphonate Therapy: A Case Report
Dong-Soo Kim, Ji-Kang Park, Eui-Sung Choi, Ho-Seung Jeong, Seok-Hyun Hong, Byung-Hyun Ahn
Journal of the Korean Fracture Society.2020; 33(2): 101. CrossRef

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Principles for Management of Periprosthetic Acetabular Fractures after Hip Arthroplasty: Chan Woo Park, Hyoung Keun Oh, Woo Suk Lee, Youn Soo Park, Seung Jae Lim; J Korean Fract Soc 2019;32(3):148-156. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.148

Abstract PDF

Periprosthetic acetabular fracture (PAF) is an uncommon complication following hip arthroplasty. However, as the number of people needing hip prostheses continues to rise, the absolute number of PAF is expected to increase as well. These fractures may occur either intraoperatively or postoperatively. Postoperative fractures can be caused by traumatic events or by pathologic conditions related to periacetabular osteolysis. The management of PAF usually depends on the degree of displacement and the stability of the acetabular component. While most of non-displaced fractures can be managed nonoperatively by protected weight bearing, displaced fractures with unstable implants require surgical intervention, which is often technically challenging. This review summarized the latest findings on the epidemiology, the diagnosis, the classification, and the treatment of PAF.

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Treatment of Periprosthetic Femoral Fractures after Hip Arthroplasty
Jung-Hoon Choi, Jong-Hyuk Jeon, Kyung-Jae Lee
Journal of the Korean Fracture Society.2020; 33(1): 43. CrossRef

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Anterior Approach for the Acetabular Fractures: Jae Youn Yoon, Jae Woo Cho, Ji Wan Kim; J Korean Fract Soc 2019;32(3):157-164. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.157

Abstract PDF

In the surgical treatment of acetabular fractures, the anterior approach is used widely for anterior column fractures with or without posterior column fractures. This paper reviews the anterior approach for the anatomical reduction and rigid fixation of acetabular fractures: traditional ilioinguinal approach, modified Stoppa approach, and new Pararectal approach.

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Adhesion of External Iliac Vessels Found in a Modified Stoppa Approach to Acetabular Fracture in a Patient with a History of Previous Abdominal Surgery
Seong-Tae Kim, Seungyup Shin, Hohyoung Lee, Seong Man Jeon
Journal of the Korean Orthopaedic Association.2022; 57(1): 68. CrossRef

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