Journal of Musculoskeletal Trauma

Multiple Pinning in Femoral Neck Fractures: Kuen Tak Suh, Taek Geon Lee, Chang Il Yoo; J Korean Soc Fract 1997;10(4):727-737. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.727

Abstract PDF: The incidence of femoral neck fracture has steadily increased with lengthening of the average life span. The end results of treatement have been improving with the development of internal fixation devices. However, the anatomic characteristics of femoral neck has made the complications of nonunion and avascular necrosis as a common result. Authors analysed 47 patients, with over 2 years follow-up on an average, who were more than twenty years old and treated with multiple Knowles pins or cannulated screws during the period from February 1988 to February 1994. Following results were obtained. 1. Among 47 patients, 23 cases(49%) were male and 24 cases(51%) were female. The highest incidence was found in the sixth decade. 2. The most common cause of femoral neck rracture was slip down(55%). 3. According to the Gardens classification, the displaced fracture(Garden stage III and IV) was more common (68%), and according to the anatomic classification, transcervical type was the most common (40%). 4. Among 47 patients, there were 1 case of nonunion(7%) and 2 cases of avascular necrosis of femoral head(13%) in the nondisplaced fractures(15 cases), compared to 6 cases of nonunion(19%) and 8 cases of avascular necrosis of femoral head(25%) in the displaced fractures(32 cases). There were 4 cases of nonunion(15%) and 5 cases of avascular necrosis of femoral head(19%) among the 26 patients treated with multiple Knowles pins, compared to 3 cases of nonunion(14%) and 5 cases of avascular necrosis of femoral head(28%) among the 21 patients treated with cannulated screws. 3 cases of nonunion(10%) and 4 cases of avascular necrosis of femoral head(13%) were developed among 30 cases in which acceptable reduction was achieved after closed reduction. 4 cases of nonunion(24%) and 6 cases of avascular necrosis of femoral head(35%) were developed among 17 cases in which poor reduction was achieved. 11 cases(42%) were complicated among 26 cases below Singh index grade 3 and 6 cases(29%) were complicat among 21 cases above Singh index grade 4. 5. Factors that may affect the success of treatment in femoral neck fracture are not the type of internal fixation device used, but rather anatomic site of fracture, the degree of displacement, degree of osteoporsis and accuracy of reduction.

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Comparison of Hemiarthroplasty and Compression Hip Screw on Elderly Unstable Intertrochanteric Fractures: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Sang Hoon Ko, Ki Woong Lee; J Korean Soc Fract 1997;10(4):738-745. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.738

Intertrochanteric fractures of the femur usually occur in the elderly and osteoporotic patients. These appear to be increasing in frefuence and are usually unstable. Sixthy two cases were treated ai our hospital from September 1993 through October 1995. 29 elderly patients underwent bipolar hemiarthroplasty and 33 patients underwent internal fixation with compression hip screw(C.H.S). The results were as follows ; 1. Functional results according to hip rating scale of Merle D,Aubiigne was superior in bipolar group. 2. The incidence of postoperative complications was much fewer in bipolar group than in compression hip screw group. 3. In casees of definite osteoporosis with Singhs index below 3 and Evans unstable type frartures, the incidence of mechanical complications was increased, especially in compression hip screw group. 4. There was no siginificant difference between 2 groups in operative time and blood loss.

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Fixation of Greater Trochanter Using an AO Trochanteric Reattachment Device (AO TRD) in Arthroplasty for Intertrochanteric Femur Fracture of Elderly Patients
Weon-Yoo Kim, Young-Yul Kim, Jae-Jung Jeong, Do-Joon Kang
Hip & Pelvis.2013; 25(4): 274. CrossRef
Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -
Chae-Hyun Lim, Young-Yool Chung, Jeong-Seok Kim, Chung-Young Kim
Hip & Pelvis.2013; 25(1): 44. CrossRef
Hip Arthroplasty Using Collarless Polished Tapered Stem -Minimum 2 Years Follow-up Results-
Yerl-Bo Sung, Jung-Yun Choi, Su-Chan Oh
Hip & Pelvis.2012; 24(1): 18. CrossRef
Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients
Sung-Hwan Kim, Soo-Won Lee, Gyu-Min Kong, Mid-Um JeaGal
Hip & Pelvis.2012; 24(1): 45. CrossRef
Cemented Bipolar Hemiarthroplasty for Intertrochanter Fracture in Elderly Patients - Minimum 2-Years Follow-up Results -
Sung Kwan Hwang, Dong Hyun Kang, Tae Yeon Cho, Chang Ho Yi
Hip & Pelvis.2010; 22(3): 209. CrossRef

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Fracture around Hip Joint Combined with Ipsilateral Femoral Shaft Fracture: Sung Kwan Whang, Jung Ho Rha, Jin Rok Oh, Young Hyun Park; J Korean Soc Fract 1997;10(4):746-754. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.746

Abstract PDF: Fracture around hip joint combined with ipsilateral femoral shaft fracture is relatively uncommon injury and usually result from high-energy trauma. In many of cases, this fracture accompanies with multiple fractures and may be unrecognized the fracture around hip joint. The mechanism of this fracture is that the force on knee joint breaks femoral shaft, and then, when adductive position of femoral shaft, the remained force dislocates hip joint or breaks acetabulum, when abductive position of the shaft, the force breaks femoral neck or intertrochanter. The treatment methods of this fracture are many, but there is no choice of treatment. So, when we select method of treatment, we must consider patients all situations(patients age, pattern of fracture, qulality of bone, ability of surgeon, etc.). The purpose of this study is to make the algorithim of the selection of treatment method for rracture around hip joint combined with ipsilateral femoral shaft fracture. We reviewed 37 cases of fracture around hip joint combined with iplilateral femoral shaft fracture from Febrary 1978 to June 1996. The minimal follow-up period was 1 year. From the review, we made the algorithm of the selection of treatment method for fracture around hip joint combined with ipsilaterl femoral shaft fracture.

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Ambulatory Ability & Mortality Study after Intertrochanteric Fractures of the Femur in Geriatric Patients: Bong Gee Park, Beom Koo Lee, Do Hyun Moon, Jin Hong Ko, Young Gue Go; J Korean Soc Fract 1997;10(4):755-760. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.755

Abstract PDF: Intertrochanteric fractures are common in older age group. But still many patients suffer from high morbidity and mortality and decreased ambulation levels, because of accompanying general weak- ness and various senile diseases. From January 1991 to February 1995, we treated 46 patients older than 65 years with intertrochanteric fractures of femur. A retrospective study was performed to determine which Pre- and postinjury factors were predictive of mortality and ambulatory capacity 1 year after operation. Potential causative factors included age, gender, prefracture ambulatory ability, postoperative ambulatory ability, associated medical problem, fracture type, degree of osteoporosis, American. Society of Anesthesiologists rating of operative risk, interval between injury and operatiorl. This retrospective study were analyEed with following results ; 1. Mortality was releated to prefracture ambulatory ability, postoperative ambulatory ability, ASA risk, interval between injury and operation, which were statistically significant. 2. Eighteen(39%) patients maintained their prerfacture ambulatory ability at a poslinjury 1 year ; Twenty-eight(61%) patients lost some degree of ambulatory ability.

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Osteofibrous Dysplasia of The Femoral Shaft: Chung Soo Hwang, Phil Hyun Chung, Dong Ju Chae, Jung Yong Hong, Seung Hun Lee; J Korean Soc Fract 1997;10(4):761-765. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.761

Abstract PDF: Osteofibrous dysplasia is a rare benign fibrosseous lesion that occurs predominantly in children. It is almost always occurs in the tibia, occasionally in both tibia and fibula or only in the fibula. It is distinguished from fibrous dysplasia by the osteoblastic rimming of the bony trabeculae and the presence of lamellar bone and radiographically by its cortical location rather than medullary location. We are now reporting a case of an eleven-year-old male patient who had a osteofibrous dysplasia of the femoral shaft with pathological fracture.

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Traumatic Bilateral Anterior and Posterior Dislocations of the Hips with a Unilateral Acetabular Posterior Column Fracture (Thompson and Epstein type IV): A Case Report: Young Sik Lee, Jung Dae Oh, Jin Tae Choi, Gyeong Rin Lim; J Korean Soc Fract 1997;10(4):766-771. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.766

Abstract PDF: A rare case of traumatic bilateral anterior and posterior dislocations of the hips occurred by passenger traffic accident . The right hip was dislocated posterosuperior to the right acetabulum with a linear acetabular posterior column tracture(Thompson and Epstein type IV) and left hip was dislocated anteroinferior to the left acetabulum(modified classification of Epstein type II A). The dislocations were successfully reduced by the Bigelows method for the right hip and the reverse Bigelows method for the left hip, and 4 weeks of Bucks traction was applied. He was able to return to full activity after 4 months. There was no sign of avascular necrosis at 3 years and 11 months follow-up.

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Traumatic Fracture - Dislocation of the Hip: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Sang Hoon Ko, Jae Doo Yoo, Joo Seok Eom, Dong Wook Lee; J Korean Soc Fract 1997;10(4):772-777. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.772

Abstract PDF: Traumatic dislocation or fracture-dislocation of the hip is relatively uncommon, but high velocity accidents have increased its incidence in recent years. The purpose of this study was to review the result of the treatment and to evaluate the prognostic factor. We retroprospectively reviewed 28 patients with traumatic fracture-dislocation of the hip between October, 1993 and March, 1996. 21 were males and 7 females. The mean age was 33.5 years(range, 11 to 67 years). Average follow-up was 18 months(range, 13 to 28 months). Exellent or good results were obtained in 19 patients(68%) by the criteria of Epstein. The complications were followings 2 cases of avascular necrosis and 1 case of osteoarthritis. Factors associated with a good prognosis included an early reduction, low level of initial trauma, abscence of associated injury.

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Double-Plating in the Comminuted Supracondylar Fracture of the Distal Femur: Taek Rim Yoon, Sung Taek Jung, Hyoung Yeon Seo; J Korean Soc Fract 1997;10(4):778-784. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.778

Abstract PDF: Supracondylar fracture of femur is not well suited to internal fixation. A wide canal, a thin cortex, comminution and compound wound make open reduction more difficult. Especially, type C2 and C3 on AO classification is problematic. The cases of nine patients who had type C2 or C3 fracture including three open fractures and deficient medial-cortical buttress were reviewed. Stable fixation was achieved with the lateral condylar buttress plate. Additional stabilization with a medial plate and bone graft from the iliac crest was applied in all nine patients. At an average duration of follow-up nineteen months(range from twelve to forty-eight months), all of the fracture had healed. Evaluation of the functional outcome revealed two excellent, three good and four fair results. In three patient, less than 90 degree of flexion of the knee was present and in six, the arc of flexion was limited to between 90 and 110 degrees. One patient had two centimeter shortening, one had medial screw loosening which need not additional fixation. The results of our study suggest that, for the treatment of patients who have a difficult fracture in whom stable fixation of the distal part of the femur cannot be achieved with a condylar buttress plate because of medial cortical communition, a short distal condylar fragment, or loss of metaphyseal bone, double-plating is indicated.

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A Comparison of Plate Fixation with Intramedullary Nailing in Humeral Shaft Fracture: Kwang Won Lee, Kyou Hyeun Kim, Ha Yong Kim, Young Sik Min, Hwan Jung Kim, Won Sik Choy; J Korean Soc Fract 1997;10(4):785-792. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.785

Abstract PDF: We evaluated prospectively ninety-two patients out of 130 humeral shaft fractures requiring surgical stabilization from January 1991 to December 1995. Among them, thirty-one patients received open reduction and internal fixation with plate & screws(PLT). Thirty-one patients received closed reduction & antegrade intramedullary nail fixation(IMN). Thirty patients received closed reduction & antegrade and retrograde endernail fixation(EN). Average follow-up period was 20.7 months. Eleven patients had primary radial nerve palsies. The higher incidence of nonunion was found on IMN(42%), and EN(20%), than PLT(8%). We concluded that the result of IMN was not superior to that of PLT or EN.

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Proximal Humeral Fracture with Epiphyseal Plate Injury: Sung Kwan Hwang, Jin Rok Oh, Jung Ho Rah, Ki Ho Kim; J Korean Soc Fract 1997;10(4):793-800. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.793

Abstract PDF: Proximal humerus fracture with epiphyseal plate injury does not cause the growth disturbances and deformity of humerus in comparison with other fracture of epjphyseal plate. The explanation about this phenomenon is that the fracture occurs microscopically in maturing Bone near provisional calcifying zone, another explanation is that the epiphyseal plate in proximal humerus greatly contribute the longitudinal growth of humerus and has trimendous remodelling potential. In this study, we experienced the 25 cases of proximal humeral epiphyseal injury from January, 1991 to June, 1997 We analyzed the growth disturbance and deformity of the proximal humeral epiphyseal plate in regard to age, fracture type, treatment method of the 15 cases with 3 years follow-up among the 25 cases. This fracture is most common in the age of 13 to 16, 11 cases among total 15 cases(75 percent). Most common fracture type is type II by Salter-Harris classification, 14 cases among total 15 cases, 3 cases is type IV by Neer-Horowitz classification, where, manual reduction was impossible because of interposition with biceps tendon between fracture fragments. There was no impairment of motion, growth distrubance and deformity in all cases. We concluded there is no direct correlation with patient age, the degree of fracture, displacement, treatment method in view of gorwth disurbance and deformity.

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Treatment of Chronic Uncontrolled Infected Nonunion of Femur and Knee with the Ilizarov Instrument: 3 cases reports: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suck Ha Lee, Hyung Gon Jee; J Korean Soc Fract 1997;10(4):801-811. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.801

Abstract PDF: We analysed three cases, repectively. The first case was chronic uncontrolled infected nonunion of femur due to open type III fracture which had been operated unsuccessfully at least 5 times. The second case was a infected nonunion and shortening of leg due to infecton of soft tissue surgery and then after knee arthrodesis. The third case was result from the total knee arthroplasty failure and then after knee arthrodesis. Ilizarov instrument was applied to this case for the knee joint arthrodesis. All cases showed bony union after average 14.6 months. The exact bony lengthening in the two cases after treatment was 11cm and 13cm and the healing index was 49.Odays/cm and 50.8days/cm The complications included the pin tract infection in all three cases and pin breakage in 2 of the cases. We achieved bony lengthening and bony union with relief of infection in 3 cases of chronic uncontrolled infected nonunion of femur treated with extensive saucerizaton and fixation using the Ilizarov instrument. These are the results of our treatment of chroic uncontrolled infected nonunion of femur using the Ilizarov instrument.

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Infected non-union of the Tibia: Kwon Ik Ha, Seung Ho Kim, Kyoung Ho Yoon, Sang Ho Moon; J Korean Soc Fract 1997;10(4):812-815. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.812

Abstract PDF: There are two major problems in the management of infected non-union of the tibia: how to treat the infection; and how to obtain bony union. The previous treatment as debridement and antibiotic therapy often failed. Multiple hospitalization, many operative procedures, and prolonged treatments with parenteral antibiotics cause not only functional disability but also economic hardship and loss of self-esteem. The authors reviewed a case of infected non-union of the tibia who has received 12 operations and prolonged intravenous antibiotic therapy. It is suggested that if appropriate drainage, complete excision of necrotic tissues and rigid fixation is provided, prolonged intravenous antibiotic therapy seems to be unnecessary.

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A Clinical Analysis of the Tibial Pilon Fractures with Open Reduction: Joo Tae Park, Gil Yeong Ahn, Young Shik Shin, Young Tae Lee; J Korean Soc Fract 1997;10(4):816-822. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.816

Abstract PDF

A Pilon fracture, which is defined as a comminuted intra-articular fracture of distal tibia, violates the articular region and the metaphysis with occasional extension into the diaphysis, and renders the bone difficult to restore to its anatomic shape. Now there is wide consensus that more aggressive surgical treatment is needed to fulfill better result in such complex fracture. The authors analized 22 cases of pilon fracture of distal tibia that treated by the prinicple of anatomical reduction, rigid internal fixation and early rehabilitation at the Department of Orthopaedic Surgery, Pohang St. Marys Hospital from March 1989 to October 1995. The average follow up period was 54 months(from 16 to 90 months). The results were as follows ; 1. We obtained bone union in all cases and average union period was 19 weeks(from 12 to 26 weeks). 2. The most frequent type of fractures was type III(12 cases . 55%) according to Ruedi and Allgower classification. 3. According to the clinical results that classified by the criteria of the Ovadia and Beals subjective evaluation classification, type I and II were excellent and good, and type III excellent in 5 cases, good in 4 cases, fair in 1 case and poor in 2 cases. 4. The most important variables that influenced in the clinical result were the type of fracture and severity of soft tisuue injury.

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Comminuted Pilon Fractures: Comparative Outcome Analysis according to Surgical Techniques
You-Jin Kim, Hong-Geun Jung, Joo-Hong Lee, Woo-Sup Byun, Sung-Tae Lee
Journal of the Korean Fracture Society.2007; 20(1): 6. CrossRef

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Results of Operative Treatment in Fracture of the Proximal Tibial Plateau: Yong yeun Kim, Dong Chul Lee, Jong Chul Ahn; J Korean Soc Fract 1997;10(4):823-831. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.823

Abstract PDF

The tibial plateau fractures commonly result from high energy trauma such as traffic accidents or falls, and it is can produce the disability of the knee joint because it is frequently accompanied by the soft tissue injury such as ligaments and menisci. Even if accurate anatomical reduction and rigid internal fixation with early motion can decrease the complications, recent study show unacceptable results from 20 to 40 persents of cases. We have analysed 44 cases of tibial condylar fracture which were treated with operative method at Yeungnam University Hospital from Feb. 1990 to Apr. 1996. The results were as follows : 1. The type of fracture by Schatzker classification revealed in type 17 cases(16%) type II 4 cases (9%), the III 8 cases(18%), type IV 5 cases(11%), type V 13 cases(30%), type VI 7 cases(16%), and the main causes of injury were traffic accident(35 cases;80%), and fall(6 cases). The associated injury occured in 30 cases(68%) . Half of them (57%) were ipsilateral fibular fracture in 9 cases, ipsilateral patellar fracture in 8 cases, and ipsilateral femoral fracture in 8 cases. 2. The Clinical evaluation by Hohl criteria revealed in 76.8 scores fair in average in 44 cases, those were excellent in 2 cases(5%), good in 27 cases(62%) and poor in 5 cases(11%). The Subjective evaluation of the patients were more than good in 13 cases(29%), and less than fair in 31 cases (71%). The clinical averge score according to the type of fracture by Hohl evaluation were 79 in type I, 81 in type II, 81 in type III, 74 in type IV, 84 in type V and 72 in type VI. 3. The clinical results according to the adeqacy of reduction of depressed joint surface after operation were more than good(score>80) when the anatomic or adequate reduction of joint surface were performed. 4. The most complication was limitation of motion in 11 cases(25%), the other complications showed angular deformity in 6 cases(15%), infection in 5 cases, traumatic arthritis in 5 cases, and pernoneal palsy in 4 cases.

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Second-look arthroscopy after surgical treatment of Schatzker type II plateau fractures through the lateral submeniscal approach
Han-Jun Lee, Ho-Joong Jung, Eui-Chan Chang, Jae-Sung Lee, Hyoung-Seok Jung
Archives of Orthopaedic and Trauma Surgery.2014; 134(4): 495. CrossRef
Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures
Jae-Sung Lee, Yong-Beom Park, Han-Jun Lee
Journal of the Korean Fracture Society.2008; 21(2): 124. CrossRef

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Surgical Treatment of Tibial Plateau Fracture: Validity of Arthroscopy: Shin Kang Cho, Jung Dae Oh, Young Sik Lee, Jin Tae Choi, Gyeong Hin Lim; J Korean Soc Fract 1997;10(4):832-842. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.832

Abstract PDF

Twenty tibial plateau fractures were surgically treated by means of the double images of the arthroscopy and the image intensifier. The purpose of this attempt was (1) obtaining more anatomical reduction of articular margin, (2) preventing knee joint from the surgical dissection and (3) simultaneous diagnosis & management of the combined meniscus and ligament injuries. Three aims of this study are searching for (1) the indications of the arthroscopic surgery for the libial plateau fractures, (2) the techniques of the arthroscopic surgery for reduction and fixation and (3) the techniques for reducing the risk of the arthroscopic surgery. As a result, we can obtain more anatomical reduction and excellent or good functional knee score after follow-up study of a mean of 1 year and 9 months. There is no complication with regard to arthroscopic surgery. But anatomical reduction of the bicondyle fractures with severe articular and metaphyseal comminution was technically difficult. So, the other technique as if open reduction will be needed.

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Arthroscopically-Assisted Reduction and Internal Fixation of Intra-Articular Fractures of the Lateral Tibial Plateau
Juhan Kim, Dong Hwi Kim, Jae-Hwan Lim, Hyunwoong Jang, Young Wook Kim
Journal of the Korean Orthopaedic Association.2019; 54(3): 227. CrossRef
Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating
In-Jung Chae, Sang-Won Park, Soon-Hyuck Lee, Won Noh, Ho-Joong Kim, Seung-Beom Hahn
Journal of the Korean Fracture Society.2009; 22(4): 252. CrossRef

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Clinical and Radiologic Analysis of Occult Osseous Lesion on Magnetic Resonance Imaging in Acute Knee Injury: Seung Key Kim, Jong Hun Lee, Nam Gee Lee, Chang Beom Park, Han Chang; J Korean Soc Fract 1997;10(4):843-850. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.843

Abstract PDF: Bone bruise or occult osseous lesion on magnetic resonance imaging was focused on the indirect sign of acute anterior cruciate ligament injury. But there were few reports which compared the location of bone bruise with the injured structure. The purposes of this study were to identify the common pattern of location of bone bruise, and to analyze the relationship between the location and injured structure or mechanism of injury. The authors reviewed 76 magnetic resonance imaging studies of the knee from March 1993 to May 1994 which show the sign of bone bruise in acute knee injury within six weeks. The mean age of the patient was 26.3 years and the main cause of injury was traffic accident. The final diagnosis was 20 cases of isolated medial collateral ligament injury, 17 cases of isolated anterior cruciate ligament injury, 16 cases of combined anterior cruciate and medial collateral ligament injury, 7 cases of meniscus injury, 6 cases of combined posterior cruciate and medial collateral ligament injury, 5 cases of isolated posterior cruciate ligament injury, 2 cases of patella dislocation, 1 case of lateral collateral ligment injury, and 2 cases of undiagnosed knee injury. In isolated MCL injuries, bone bruises were all confined to the lateral compartment. In isolated injury of ACL, the most common pattern of location of bone bruises were lateral tibial plateau and lateral femoral condyle(47.1%). In combined ACL and MCL injury, the most common pattern of location was lateral tibial plateau, only(43.8%). Bone bruise on MRI may be easy to detect during interpretation and we can obtain much information to decide the diagnosis and prognosis.

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Severe Comminuted and Displaced Patellar Fracture Treated by Partial or Total Patellectomy: Kuen Tak Suh, Taek Geon Lee, Weon Wook Park, Chong Il Yoo, Kyu Yeol Lee, Bu Hwan Kim; J Korean Soc Fract 1997;10(4):851-859. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.851

Abstract PDF: The results of partial and total patellectomy as a treatment for severe comminuted and displaced patellar fracture were assessed retrospectively with the use of clinical criteria and radiologic findings. Sixteen patients treated with patellectomy(four total and twelve partial patellectomies) were followed up for an average of 3 years 4 months and valuated. According to the Bostmans fracture classification, there were type I In 5 cases(31%), type II in 7 cases(44%), and type III in 4 cases(25%). The results of the patellectomy were relatively good since excellent result was shown in 11(69%) among 16 cases. The comparison between partial and total patellectomy was difficult because the fracture patterns treated by these techniques were different. In this study, the result of the partial patellectomy was better than that of the total patellectomy, but their difference was not statisticaliy significant(P>0.05). The results of the study indicated that partial or total patellectomy could be one of the effective treatment methods for severe comminuted and displaced patellar fracture. However total patellectomy should be recommended only when the entire patella was too severely comminuted to function as a part of the extensor mechanism of the knee.

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Interlocking Intramedullary Nail Fixation for Tibiotalocalcaneal Fusion(2 cases): Young Ki Chung, Jung Han Yoo, Sung Il Shin, Yong Wook Park, Dong Cheol Pyo; J Korean Soc Fract 1997;10(4):860-865. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.860

Abstract PDF: Multiple fixation techniques for tibiotalocalcaneal arthrodesis have been introduced. The interlocking intramedullary nailing for tibiotalocalcaneal osteoarthritis with osteoporosis permits excellent internal fixation. We had two retrograde interlocking intramedullary nail fixation for tibiotalocalcaneal arthrodesis. One patient is chronic infectious osteoarthritis of the ankle and subtalar joints. And the other is non-union of the distal tibia with arthrofibrosis of the ankle and subtalar joints. Two patients also had osteoporosis due to long immobilization. The follow up period were 12 and 22 months respectively. The leg and foot is aesthetically pleasing and the musculature around the ankle and foot is maintained in the normal balanced position after the tibiotalocalcaneal fusion. So, we believed that the interlocking intramedullary nailing is an excellent treatment method for tibio talocalcaneal arthritis with osteoporosis.

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Postoperative Infection in the Closed Fractures of the Long Bone: Hyoun Oh Cho, Kyoung Duck Kwak, Sung Do Cho, Bab Jae Lee, Il Jong Yang; J Korean Soc Fract 1997;10(4):866-871. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.866

Abstract PDF: Operative treatment for closed fractures of the long bone has many advantages including early restoration of function by stable fixation, but has untoward problems including postoperative infection. The authors reviewed 19 cases of postoperative infection for closed long bone fracture during the period from January, 1990 to December, 1995 and analyzed about clinical, radiologic, pathologic findings and found causes of infection. Most cases were associated with multiple fractures of major bones or injuries to the vital organs and delayed over 48 hours after injury to operation. Operation time was prolonged due to the simultaneous operations for multiple fractures and associated open fractures at the same time. Staphylococcus aureus was the most frequent offending organism. Irregular resorption of plate-bone interface with resultant gap between the plate and bone, on the radiographic follow up, may indicate postoperative infection.

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Surgical Management of the Proximal Tibial Shaft Fractures - A Comparison of Plate Fixation and Interlocking Intramedullary Nailing -: Ki Soo Kim, Yong Soo Choi, Chul Hun Choi, Jin Ho Yang; J Korean Soc Fract 1997;10(4):872-878. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.872

Abstract PDF: The treatment of proximal tibial shaft fractures is an area of great controversy. The purpose of this study was to make the comparison between the results of the plate fixation and those of the interlocking nailing, and to identify the effects of the location of the nail bend on the reduction of the proximal tibial shaft fractures. From June 1991 to May 1995, we performed the plate fixation in 12 cases and interlocking nailing in 16 cases for the proximal tibial shaft fracture. We subdivided the interlocking nailing group into two groups: Group A had the fractures within the posterior bending length of the nail in 8 cases, Group B had the fractures over the posterior bending length of the nail in 8 cases. The results were as follows; The most common type of fractures was the Winquist-Han son type III, 9 cases(75%), in the plate fixation group, and the segmental fracture, 10 cases(62.5%), in the interlocking nailing group. In the plate fixation group, autogenous bone graft were used in 7 cases (58.3%), primary in 5 cases and secondary in 2 cases. The interlocking nailing group had a tendency to cause the surgical problems during the nailing such as angular deformity in 3 cases, displacement of the fracture in 2 cases, extension of the fracture in one case, need an open reduction in one case and unstable fixation in one case. The surgical problems were associatied with the incorrect entry point and the fractures within the posterior bending length of the nail (Group A). Clinically excellent and good results, according to Klemm and Borner criteria, were obtained in 12 cases(100%) of the plate fixation group and 13 cases(81.3%) of the interlocking nailing group. the fair results were associtated with the angular deformity in the Group A. In conclusion, the preoperative planing must carefully consider such as the type of fracture, technical familarity, and understanding of the implants and instrumentations ofr the successful treatment of the proximal tibial shaft fractures. The plate fixation is preferable method for the fractures within the posterior bending length of the nail(Group A).

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Application & Use of an Ilizarov Technique for the Pilon Fracture: Jin Hong Ko, Beom Koo Lee, Do Hyun Moon, Sung We; J Korean Soc Fract 1997;10(4):879-885. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.879

Abstract PDF: A pilon fracture, which is defined as a comminuted intraarticular fracture of distal tibia, violates the articular region and the metaphysis with occasional extension into the diaphysis, and renders the bone difficult to restore to its anatomic shape. The best known treatment of the pilon fracture is, as recommended by A-O group. In the treatments of the fractures with severe comminution or with significant open soft tissue injury aggressive tries for internal fixation with plate and screws in the distal tibia will result in inevitable stripping of the soft tissue and the periosteum. Therefore, dangers of the delayed union, nonunion, soft tissue necrosis and infection will be increased. The authors treated 14 cases by the Ilizarov external fixation technique for treatment of pilon fracture of the tibia. The average duration of external fixation was thirteen weeks. The results were as follows. v1. Such techniques are especially useful in those injuries with extensive aricular communition and in the open pilon fracture with significant soft tissue compromise. 2. The average duration of external fixation was 13 weeks and the time to clinical union averaged 16.4 weeks. 3. In case of accurate reduction, the better clinical result was obtained.

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Treatment Using Unreamed Intramedullary Nailing for Open Tibial Fractures: In Heon Park, Ki Byung Lee, Kyung Won Song, Jin Young Lee, Seung Yong Lee; J Korean Soc Fract 1997;10(4):886-891. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.886

Abstract PDF: Intramedullary nailing has become the most popular fixation method in the treatment of the tibial shaft fractures because it affords most rigid fixation of fracture via closed method which makes early rehabilitation possible. Unlearned interlocking nails offer the advantages of loss damage to the intramedullary blood supply, so infectious rate was lower in open fractures compared with reamed nails. We have analyzed 34 cases of 30 patients who performed unlearned interlocking intramedullary nail for open tibial fractures. The results were as follows : 1. The classification of the open fracture was 12 cases Gustilo-Anderson Type I, 20 cases Type II, 2 case Type III. 2. Bony union occured an average of 18 weeks postoperatively. 3. The complication were 4 cases of nonunion, 1 case of deep infection, and 1 case of screw loosening. In conclusion, unlearned intramedullary nailing is a good alternative method for the management of Type I, II open tibial fracture.

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Posterior Cortical Fracture of Tibia during Tibial Interlocking Intramedurally Nail Extraction : A report of 3 cases: Jae Sung Seo, Jin Young Hong; J Korean Soc Fract 1997;10(4):892-896. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.892

Abstract PDF: We have experienced three cases of posterior cortical fracture of tibia during the removal of interlocking intramedullary nail which was made of titanium alloy with the prominent distal angulation. And we observed the distal translation of entry point in one case. The main reason of posterior tibial cortical fracture can be explained by the following statements : (a) prominent distal angulation increases cross sectional surface of nail in medullary canal at the time of extraction and (b) the distal translation of entry point increases the interface of posterior cortex at the time of extraction. In conclusion, we advise caution in the extraction of tibial nail of distally translated entry point which have a prominent distal angulation.

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Treatment of Surgical Neck Fracture and Fracture Dislocation in Proximal Humerus: Sung Ill Baek, Eea Sub Chung; J Korean Soc Fract 1997;10(4):897-903. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.897

Abstract PDF: The management of the two part surgical neck fracture, three part fracture and fracture-dislocation of proximal humerus is still under debate. Various method of internal fixation have been reported but none of these methods have been consistently successful. The purpose of this study is to analyze the result of open reduction and internal fixation surgical neck fracture, three-part fracture and fracture-dislocation in proximal humerus. From Janunary. 1991 to July 1996, fifteen patiens were reviewed and the result were summerized as follows. 1. There were 8 two-part surgical neck fracture, 3 three-part fracture, 4 three-part fracture-dislocalion. 2. The results were analyzed accroding to scoring system of Neer; the excellent or satis-factory results were seen in 11 cases, but unsatisfactory results were seen in 4 cases. 3. Complication occured as follows; joint disability in 4 cases, high positioning of plate in 1 case of joint disability. 4. We concluded that T-plate offers satisfpctory reduction and good stability at high risk of joint disability. Early mobilization is required in the prevenion of joint disability of shoulder.

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Operative Treatment of the Humeral Shaft Fracture: Suk Woong Yoon, Tae Sung Hwang, Bo Keun Jeon; J Korean Soc Fract 1997;10(4):904-911. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.904

Abstract PDF: Most humeral shaft fractures can be managed nonoperatively. Recently improved results have been reported after internal fixation of the humeral shaft fractures, followed by early elbow and shoulder motion. Authors carried out True/Flex intramedullary nail in 14 patients and interlocking intramedullary nail in 12 patients and plate & screw fixation in 18 patients who sustained humerus shaft fracture between February 1992 and August 1996. We compared the operative results of intramedullary nailing and plate and screw fixation in humeral shaft fractures which was follow-up from 12 months to 21 months. The results were as follows ; 1) The mean union time was at 16.5 weeks in True/Flex group, at 16 weeks in interlocking nail group, and at 15.7 weeks in plate fixation group. 2) The complications such as angulation(3 cases), rotation(1 case), limitation of shoulder motion(2 cases), and delayed union(1 case) were observed in True/Flex group. Angulation(1 case), rotation(1 case), limitation of shoulder motion(3 cases), and nonunion (1 case) in interlocking nail group. Angulation (1 case), limitation of elbow motion(2 cases), nonunion(1 case), soft tissue infection(2 cases), and iatrogenic radial nerve palsy (2 cases) were developed in plate fixation group.

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Supracondylar Osteotomy in Cubitus Valgus by Posterior Approach and Internal Fixation with Y-plate: Eun Sun Moon, Jae Hyung Park, Hyoung Yeon Seo; J Korean Soc Fract 1997;10(4):912-917. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.912

Abstract PDF: Cubitus valgus may arise as the sequele of a number of different condition for example, a premature epiphysiodesis of the lateral condylar physis, nonunion or malunion of the lateral condylar fracture, rarely supracondylar fracture of the humerus. Cubitus valgus has more functional loss of extension and possibly the late development of a tardy ulnar nerve paralysis and less significant cosmetic effect. Authors treated the 7 patients who had cubitus valgus developing as a sequele of nonunion of the lateral condyle of the humerus, by the medial closed wedge osteotomy and internal fixation with the lateral arm cut anatomical Y-plate through posterior approach. Five males and two females were followed average 19 months(range 5 to 37 months). A mean age at the time of the operation was 17.1 years(range 13 to 25 years). Symptoms of tardy ulnar nerve palsy was shown in 5 patients. Two patients were treated due to disappearing cosmetic problem. The carrying angle was mean valgus 31 (range 22~50) preoperatively. The carrying angle was changed from mean valgus 9.6(range 3-15) immediate postoperatively to valgus 9(range 3-14) followed state. The duration of external immobilization after operation was mean 4.1 weeks(range 3-5 weeks). Range of motion of the elbow was fully recovered in 6 cases. The neurologic deficit of the tardy ulnar nerve palsy was fully recovered in all five patients. The result of supracondlar osteotomy was excellent in 4 cases(57.1%), good in 2 cases(28.6%) and poor in 1 case(14.3%). In conlusion, internal fixation with the lateral arm cut anatomical Y-plate after medial closed wedge osteotomy through the posterior approach can be recommanded as a method of treatment for the cubitus valgus.

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Treatment of Acromioclayicular Dislocation-Comparative Study between Operative and Conservative Method: Young Su Lee, Min Ki Kim; J Korean Soc Fract 1997;10(4):918-924. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.918

Abstract PDF: There has been considerable controversy as to the method of treatment of acromioclavicular joint especially in grade III injury. We treated 27 cases of the complete dislocation of acromioclavicular dislocation with operative method(15 cases) and conservative method(12 cases) from October 1989 to November 1995. The purpose of this study is to compare the clinical and radiological result of two treatment method. The average follow up period was thirty nine months and the result as follows. 1. Of the 27 cases, there was 18 male and 9 female patients, and peak incidence was in 3rd and 4th decades(51%). 2. The most common causes of the injury was traffic atcident(49%). 3. The functional results were similiar to all treatment modalities, and coracoclavicular interval ratio was well manintained regardless of treatment. 4. Complication rate was more lower in the group of conservative treatment. 5. The conservative treatment was proven to be a valuable method for acromioclavicular dis- location except in a few situations.

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Isolated Fracture Dislocation of the Tarsal Navicular: Case report: Bum Soo Kim, Sung Do Cho, Yong Sun Cho, Tae Woo Park, Chang Sung So; J Korean Soc Fract 1997;10(4):925-928. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.925

Abstract PDF

Isolated fracture dislocation of the tarsal navicular bone is a very rare injury. The mechanism of injury of this fracture dislocation is known as a horiBontal or axial load in plantar flexed foot. Anatomical reduction using closed or open methods is recommended for displaced navicular fractures to achieve a satisfactory result and early mobilization of the foot is required to get a good range of motion at the tarsal joint. Authors report one case of isolated fracture dislocation of the tarsal navicular which was treated with closed reduction and percutaneous K-wire fixation.

Citations

Citations to this article as recorded by

Fractures of the Tarsal Bone
Young Hwan Park, Hak Jun Kim, Soo Hyun Kim
Journal of the Korean Fracture Society.2016; 29(4): 276. CrossRef

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Attritional Rupture of the Flexor Tendons after Malunion of Distal Radial Fracture : Report of One Case: Jae Do Kang, Kwang Yul Kim, Sang Hun Ko, Hyung Chun Kim, Kyeong Chil Jung, Moon Sub Yim; J Korean Soc Fract 1997;10(4):929-933. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.929

Abstract PDF: There are a few of reports of delayed rupture of flexor tendon around the wrist and hand by attrition. Only 4 cases of delayed flexor tendon rupture of finger except rupture of flexor pollicis longus after Cellos fracture were reported until now. Several causes of the delayed rupture of the tendon around the wrist and hand were reported by many authors. Cellos fracture is one of the cause of the attritional rupture. But the frequency of the attritonal rupture of the flexor tendon was only one-third of the extensor tendons. Furthermore, flexor tendons of the finger were less commonly affected than that of the thumb by their anatomical features. We would like to report a very rare case of delayed rupture of flexor digitorum profundus on 73 year old male patient by attrition on the bony spur which was formed by malunion of distal radial fracture about 10 years ago. They were treated by direct repair for ring finger and free tendon graft with flexor digitorum sublimis of middle finger for little finger. After 1 year follow up, range of motion and flexion power were recovered to nearly normal.

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Functional Outcome after Operative Treatment of the Fractures of the Forearm Both Bones: Jung Ryul Kim, Kyung Jin Song, Joo Won Jung, Jun Mo Lee, Byung Yun Hwang; J Korean Soc Fract 1997;10(4):934-939. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.934

Abstract PDF

Twenty-seven adults who had a closed fracture of both bones of the forearm were managed with plate in twenty-four radial and twenty-three ulnar fracture. and with intramedullary nailing in three radial and four ulnar fractures. And were followed for a mean three years and two months(range, one year to six years). Standard anterioposterior and lateral radiographs were made of both forearms, and evaluated bone union that was qualified by measurement of the amount and location of the maximum radial bow in the relation to the contralateral normal ram. The functional outcome was assessed with rating system of Anderson, which is based on union of the fracture and rotation to the forearm, also with measurement of grip strength. Overall rate of union for the radius was 92.5 per cent and for the ulna 96.2 per cent. Average time to union was 10.4 weeks in the radius and 10.3 weeks in the ulna. Twenty-three patients(84%) had an excellent, good, or acceptible functional results, according to the criteria of Anderson. At follow-up, the mean and standard error for motion of the elbow from 64.0+/-4.1 of pronation to 74.3+/-4.2 supination. Seventeen patients(63%) had a grip strength that was more than 80 per cent of that of the contralateral side. Mean maximal radial bow was 15.1+/-0.4 millimeter and mean location of radial bow was 61.2+/-1.1 per cent in the normal arm. There was good or excellent rotation of the forearm, the rotation was close to where it was in the normal extremity. When five radial and three ulnar transverse fractures which were treated with less than five-hole plate, radiographic union was delayed(mean 13.3 weeks) and less satisfactory restoration of the function were obtained. However eleven radial and nine ulnar transverse fractures which were treated with more than six-hole plate were all united(mean 10.2 weeks) and acceptible restoration of the function were obtained Overall, there were three nonunions(two radial and one ulnar fracture), and one infection. Restoration of the normal radial bow was related to functional outcome. A good functional result was associated with restoration of the normal amount and location of the radial bow. Plating with more than six cortex secured by screws on each side of the fracture, provided a successful method for obtaining union and optimum function after fractures of the foream.

Citations

Citations to this article as recorded by

Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail
Kwang-Yul Kim, Moon-Sup Lim, Shin-Kwon Choi, Hyeong-Jo Yoon
Journal of the Korean Fracture Society.2008; 21(2): 157. CrossRef

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