Journal of Musculoskeletal Trauma

Bone scintigraphy after multiple pinning of femoral neck fractures: Kee Haeng Lee, Youn Soo Kim, Chang Hoon Jeong, Suk Ku Han, Hyoung Min Kim, Jun Seok Kim; J Korean Soc Fract 2001;14(4):567-574. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.567

Abstract PDF: PURPOSE
To determine the value of bone scintigraphy in predicting avascular necrosis following femoral neck fracture, and to analyze of relationship between pintract sign (increased radioactivity along the pins) and avascular necrosis after multiple pinning of femoral neck fracture.
MATERIALS AND METHODS
We analyzed 20 femoral neck fractures, which were fixed with cannulated screws(14 cases) or Knowles pins(6 cases). The follow-up period was longer than 18 months, and bone scintigraphy was carried out at postoperative 3 weeks, 3 months interval to 1 year, 6 months interval to 2 years, and then every 1 year.
RESULTS
There were 14 cases with positive pin-tract sign and increased uptake of femoral head on bone scintigraphy performed at the postoperative 3 weeks, and I case with positive pin-tract sign and partially decreased uptake of femoral head. None of them developed avascular necrosis. There was I case with negative pin-tract sign and partially decreased uptake of femoral head, which showed increased uptake later and didn't develop avascular necrosis. There were 4 cases with negative pin-tract sign and generally decreased uptake of the femoral head, and all of them developed avascular necrosis.
CONCLUSION
Bone scintigraphy is a useful method predicting the avascular necrosis following femoral neck fracture, and pin-tract sign may be an early postoperative sign indicating that there is little possibility of development of avascular necrosis.

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Treatment of Intertrochanteric Fractures of Femur Using Intramedullary Hip-Screw: Phil Hyun Chung, Chung Soo Hwang, Suk Gang, Dong Ju Chae, Jong Pil Kim, Joon Han Kim; J Korean Soc Fract 2001;14(4):575-583. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.575

Abstract PDF: PURPOSE
We analyze the results of the treatment of intertrochanteric fractures by using intramedullary hip screw.
MATERIALS AND METHODS
We reviewed 34 patients of intertrochanteric fracture who were treated by using of intramedullary hip screw from March 1998 to February 2000, and we classified the fractures by Evans system. 26 cases were treated by closed reduction and internal fixation; 8 cases were by open reduction and internal fixation. We analyzed fracture figure and stability, amount of sliding of lag screw, the change of femur neck-shaft angle, postoperative activity and postoperative complication RESULTS: Bony union was obtained in average 14.3 weeks. Gap of fracture site was formed in 2 cases and crack on entry area of nail was formed in 1 case. Postoperative wound infection occurred in laces and delayed union occurred in 1 case. The change of femur neck-shaft angle showed an average decrease 1.7 degree in stable fractures, 3.5 degree in unstable fractures. Lag screw was sided an average 1.0 mm in stable fractures, 2.6 mm in unstable fractures. Postoperative mobility were analyzed by score of Parker and Palmer, and showing from 7.6 score pretrauma to 3.37 score postoperation in 1 month, 5.0 score postoperation in 3 months, 7.48 score postoperation in 6 months and 7.5 score postoperation in one year.
CONCLUSION
Intramedullary hip screw in intertrochanteric fractures reduced the collapse by processing union of fracture site due to the less decreases of femur neck shaft angle and the shortening by sliding of lag screw

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Comparison Study between Internal Fixation with Compression Hip Screw and Bipolar Hemiarffiroplasty in Unstable Intertrochanteric Fracture: You Sung Suh, Sai Won Kwon, Ho Won Jung, Jong Seok Park, Byung Ill Lee; J Korean Soc Fract 2001;14(4):584-591. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.584

Abstract PDF: PURPOSE
To define the appropriate treatment of unstable intertrochanteric fracture for aged patients by conducting a clinical and roentgenographical comparative analysis of internal fixation with compression hip screw and primary bipolar hemiarthroplasty.
MATERIALS AND METHODS
38 patients aged 65 or above with intertrochanteric fracture of Singh index below grade III or bone mineral density(BMD) -3.0 who had both severe osteoporosis and unstable fracture, from the period of January 1995 to January 2000. The 38 patients had either internal fixation with compression hip screw(18 cases, Group I) or primary bipolar hemiarthroplasty(20 cases, Group II), and were followed-up for at least one year afterwards. To prevent postoperative complication, early ambulation was permitted as early as possible to both groups.
RESULTS
The average age was 76(range 65-87) for Group I and 79.8(range 78-92) for Group II, respectively. 19 patients were diagnosed to have I-c fracture, following Evans Classification. 35 cases(92.1%) were given grade III or below according to the preoperative Singh index, while all cases showed severe osteoporosis with average bone density of -4.26(-6.95 ~ -2.54). 60% of Group II were given very good or above diagnosis following Merle d'AubignÃ¨'s postoperative functional outcome, compared with 16.7% of Group I, thus showed statistic difference of p=0.006. The average for postoperative Harris hip score was also higher with 77 points(range 43-95) for Group I than with 86 points(range 57-94) for Group II, thus showed statistic difference of p=0.0216.
CONCLUSION
For aged patients with unstable intertrochanteric fracture, primary bipolar hemiarthroplasty is considered to have better clinical and roentgenographical results, and able to decrease local and general complications, compared with internal fixation with compression hip screw.

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Treatment of unstable pertrochanteric fracture of the femur using compression hip screw and plate with 6 or more holes: Jeong Woung Lee, Chi Weon Lee, Doo Hoon Sun, Myung Sang Moon; J Korean Soc Fract 2001;14(4):592-600. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.592

Abstract PDF: PURPOSE
The objectives of this study are to observe and report the clinical results of the treatment of unstable pertrochanteric femur fracture extending into subtrochanter or shaft of the femur using compression hip screw and plate with 6 or more holes.
MATERIALS AND METHODS
Between February 1993 and December 1997, 39 patients were treated surgically for unstable pertrochanteric femur fracture. 26 patients who have been followed up over twelve months were included in this study. Surgery was performed within 2 weeks after injury, except one patient who had combined head injury. The fracture was fixed internally with compression hip screw and plate with 6 or more holes, and additional fixations were also performed with Cable wire, interfragmentary screw and Knowles pin. The result was analyzed radiographically and clinically for blood loss, surgery time, bony union period and complication. Average estimated blood loss was 910 cc. Average surgery time was one hundred ten minutes. The complications occurred in 7 cases (27%) ; 1 nonunion, 2 screw loosening and 4 cases of superficial wound infection. There was no case of lag screw penetration to the femoral head or metal failure. The bony union was obtained at average 22 weeks.
CONCLUSION
With use of the compression hip screw and long plate with 6 or more holes for stable internal fixation, we obtained satisfactory results for unstable pertrochanteric femur fracture extending into subtrochanter or shaft of the femur.

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Usefulness of Interlocking Compression Nail in Treatment of Femoral Shaft Stable Fracture: Keun Bae Lee, Sung Taek Jung, Eun Sun Moon, Eun Kyoo Song, Kwang Cheul Jeong; J Korean Soc Fract 2001;14(4):601-608. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.601

Abstract PDF: PURPOSE
The goal of our study was to evaluate the usefulness and results of the Interlocking Compression Nail in femoral shaft stable fractures.
MATERIALS AND METHODS
The 87 patients, 88 cases, who were underwent internal fixations with interlocking compression nail for the stable fracture of the femoral shaft were evaluated. The majority of the causes of injury was traffic accident and the majority of location of the fractures was middle one thirds. The classification of the fracture using Winquist-Hansen classification showed that grade 0 were 23 cases(26.1%), grade 1, 47 cases(53.4%) and grade 2, 18 cases(20.5%). We used ICnail(Osteo, Switzerland) that can actively compress the fracture gap, maximum 10mm.
RESULTS
We used active compression in 63 cases(71.6%) and the mean length of compression was 2.3mm(range 1-5mm). The bone union was seen in 63 cases(71.6%) at postoperative 4 months and in 87 cases(98.9%) at postoperative 6 months. There was one case of delayed union, but there were no nonunion, infection, leg length discrepancy, and angular or rotational deformity, disturbing the daily activity.
CONCLUSION
The interlocking compression nail can reduce the fracture gap easily and effectively using compression screw by active interfragmentary compression. Thereby promote fracture healing and postoperative stability at the fracture site can be obtained, so early weight bearing is possible. Especially, this is recommendable useful method for femoral shaft stable fracture.

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Ipsilateral Femoral Neck and Shaft Fracture: Secondary Avascular Necrosis of Femoral Head: Sung Taek Jung, Keun Bae Lee, Taek Lim Yoon, Sang Don Shim, Myung Seon Kim; J Korean Soc Fract 2001;14(4):609-615. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.609

Abstract PDF: PURPOSE
To evaluate the prognostic variables that influence the incidence of complication such as avascular necrosis of femoral head, nonunion of neck after the treatment of ipsilateral femoral neck and shaft fracture by the results and long term follow up. MATERIAL AND METHODS: We studied the 18 cases of 17 patients that could be follow up over 2 years among the patients received the treatment of ipsilateral femoral neck and shaft fracture from 1987 to 1998. The average follow up duration was 54.3 months (24-120) and all patients was men. The average age was 38.2 yrs(20-60). Fifteen cases of femoral neck fracture were treated with multiple pinning and 3 cases with the compression hip screw, 12 cases of femoral shaft fracture were treated with DCP, 5 cases by interlocking IM nailing and 1 case, open fracture, by external fixator. We evaluated the bone union and complication such as avascular necrosis of femoral head and nonunion.
RESULTS
For femoral neck fracture, resection arthroplasty was performed in 1 case and nonunion in 1 case. Bone union was obtained at average 4 months in 16 cases of femoral neck fracture, at 9 months in all cases of shaft fracture. The avascular necrosis of femoral head in 5 cases included 1 case of nonunion was found at minimal 20 months to maximal 59 months follows up.
DISCUSSION
All prognostic variables of the ipsilateral femoral neck and shaft fracture, that is the Garden stage, Pauwels classification, delayed time to operation. had no statistical correlation with complication. Whenever possible the patients should be followed for a minimum 5 years to rule out avascular necrosis of femoral head.

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Triradiate Approach in Surgical Treatment of Complex Fracture of Acetabulum: Kang Il Kim, Kyung Hoi Koo, Bun Joong Kang, Hyung Bin Park, Sun Chul Hwang, Soon Taek Jeong, Hae Ryong Song, Se Hyun Cho; J Korean Soc Fract 2001;14(4):616-622. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.616

Abstract PDF: PURPOSE
To determine the advantages of triradiate approach in complex acetabular fractures, the results were reviewed for 24 patients who had open reduction and internal fixation of complex acetabular fractures with a triradiate approach.
MATERIALS AND METHODS
Twenty four patients were followed for a mean of 3 years after the operation. All patients with complex fractures of the acetabulum were treated with open reduction and internal fixation using Y-shaped triradiate incision, osteotomy of the greater trochanter, and arthrotomy of the hip joint. In 13 patients the fracture was fixed with reconstruction plates and in I 1 patients the fracture was fixed with the plates and wires.
RESULTS
All fractures united and no patient required subsequent total hip replacement arthroplasty. Four patients had heterotopic ossification without serious limitation of motion of the hip and one patient had grade IV lesion as defined by Brooker et al, which limited motion of the hip enough to impair function. Six patients showed posttraumatic arthritis at the latest radiograph. The overall clinical result was excellent for 7 hips, good for 13, and fair for 4 as defined by d' Aubigne and Postel. The radiological result was excellent for 13 hips, and good for 6 as defined by Matta. One femoral head necrosis was observed at the latest follow-up.
CONCLUSION
A triradiate approach provides a good extra and intraarticular access to complex fracture of the acetabulum, which facilitates an accurate reduction, rigid fixation, removal of loose osteochondral fragments and management of labial injury, without increased morbidity of the hip joint.

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Comparison of the Unloading Effect of the Lower Limb Casts: Ju O Kim, Sang Moon Yoo, Han Ki Lim, Seung Jun Choi; J Korean Soc Fract 2001;14(4):623-627. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.623

Abstract PDF: PURPOSE
We compared and evaluated the unloading effect and the availability of four different types of lower limb casts.
MATERIALS AND METHODS
The subjects were ten healthy men who had no gait disturbances, neuromuscular disorder, and deformities of lower extremities. The mean age was 25.2years(22-29) and the mean weight was 62.6kg(53.9-69.1). The trials consisted of patellar tendon bearing(PTB) casts, short leg casts, long leg extension casts, and long leg 30Â° flexion casts. In each experiment, ten sets of measurements were taken with all subjects wearing four different types of lower limb casts and walking on a flat surface indoors. The load cell was placed on the sole of the foot and wrapped with casts so that we could measure the pressure of the sole during gait. The percentage of load reduction was calculated by comparing pressure of the soles and the bottom of the casts.
RESULTS
The unloading effects of the PTB, the short leg, the long leg extension, and the long leg 30Â° flexion casts were 23.8%, 19.5%, 25.5%, 27.9% of the loading. No significant difference of unloading effect was demonstrated between each four different types of lower limb casts(P>0.05).
CONCLUSION
Notwithstanding the clinical success of the lower limb casts in below knee fractures, the unloading effect of the casts was limited and any type of the casts did not show better unloading effects.

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Prevention of Fracture During Removal of ILMN in Tibia Fracture: Bu Hwan Kim, Myoung Hee Choi, Sang Hun Yi, Mu Jung Heo; J Korean Soc Fract 2001;14(4):628-631. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.628

Abstract PDF: PURPOSE
Sometimes we experience refracture of tibia during removal of ILMN after complete union of fracture. We evaluated surgical technique in order to know how we can avoid the fracture of posterior cortex of tibia during removal of ILMN.
MATERIALS AND METHODS
From Jan. 1993 to Dec. 1999, we removed 86 cases of ILMN used for tibia fracture. Among them, 40 cases of Ace titanium ILMN were removed. We compared the fracture rate of tibia during removal of Ace titanium ILMN.
RESULTS
The refracture rate during removal of Ace titanium ILMN was 17.2% (5/29cases) previously, but after careful "slow and steady" removal of nail, the refracture rate was reduced to 0%(0/11 cases, P<0.05).
CONCLUSION
Take some cares during removal of ILMN is important to reduce the fracture rate of tibia during removal of Ace titanium ILMN.

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Comparison of External Fixation and Interlocking IM Nail in Open Tibial Fractures: Hyung Jin Chung, Duck Kyu Kim, Yerl Bo Sung, Jong Guk Ahn; J Korean Soc Fract 2001;14(4):632-642. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.632

Abstract PDF: PURPOSE
To compare and analyze the results of the treatment based on the method of treatment between interlocking IM nail and external fixation of type II, III A, and III B open fractures of the tibia] shaft.
MATERIALS AND METHODS
A clinical analysis was performed on 57 cases of type II, III A, and III B open fractures of tibial shaft from January 1994 to October 1999 those studies are followed at least 1 year or more. The results was analyzed according to complications and functional results based on operative methods of types of open fractures.
RESULTS
In aspect of delayed union and nonunion, interlocking IM nail indicate a great results(p = 0.036) in type II. In angulation, interlocking IM nail marks an outstanding results in case of type II. There is no difference between interlocking IM nail and external fixation in infection. But, the delay of operation after injury increase the possibilities of infection.
CONCLUSION
At present, especially in type m, external fixation was preferred. But, interlocking IM nail has a good results in aspect of complications. Therefore unreamed intramedullary nailing for open tibia shaft fractures is a good treatment method to be recommended.

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IIizarov Method of Tibial Plafond Fracture: Myung Hwan Son, Byung Chul Kim, Nam Wook Kang, Min Yong Kim; J Korean Soc Fract 2001;14(4):643-650. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.643

Abstract PDF: PURPOSE
To report the result and the advantage of Ilizarov device when treating the tibial plafond fractures described as difficult to manage.
MATERIALS AND METHODS
We retrospectively reviewed 10 cases of tibial plafond fractures treated with Ilizarov device form March 1996 to October 1999. If necessary, limited internal fixation was combined and the mean follow-up time was 11 months. The clinical and the radiological results were evaluated after operation.
RESULTS
The objective clinical results were classified as good (4 cases), fair (5 cases), and poor (1 case). The average union time was 13 weeks and there were ankle pain, wound infection and traumatic arthritis after opertion, but severe complications such as osteomyelitis and nonunion were not appeared.
CONCLUSION
For tibial plafond fractures, Ilizarov device minimize the soft tissue injury and combined limited internal fixation improve the result.

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Comparison between Ender Nail and Interlocking Nail in The Treatment of Infra-isthmic Tibial Shaft Fracture: Seung Wook Yang, Moo Ho Song, Hyung Taek Park, Sun Jin Choi; J Korean Soc Fract 2001;14(4):651-659. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.651

Abstract PDF: PURPOSE
To compare the clinical results between Ender nail and interlocking nail in the treatment of infra-isthmic tibial shaft fracture.
MATERIALS AND METHODS
The authors analyzed 44 cases of infra-isthmic tibial shaft fracture treated with Ender nail(23 cases) as a group 1 or interlocking nail(21 cases) as a group 2 from 1994 to 1998. Fracture type was divided by AO classification, and measured the fracture level, the time of bone union and angular deformity was checked with roentgenograms. The functional results were compared using the criteria by Klemm and Borner.
RESULTS
Distal end of fracture line from ankle joint shows no difference between two groups(P>0.05). Mean operation time was 96 minutes in group 1 and 140 minutes in group 2(P<0.05). Mean intraoperative blood loss was 103cc in group 1 and 254cc in group 2(P<0.05). Mean bone union time was 19.26 weeks in group 1 and 24.81 weeks in group 2. There was no significant difference between two groups in the angulation(P>0.05) and the functional results by Klemm and Borner.
CONCLUSION
Ender nail is a good method of treatment in infra-isthmic tibial fracture when isthmic portion of tibia is too narrow, or insertion of distal interlocking screws were too difficult to insert because of the severe soft tissue injury. The stability of fixation can be strengthened with a three point fixation as fanning of the nails in the distal fragments using more than 3 nails selecting a 1cm longer nail than the ordinary nail length for diaphyseal fracture.

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The effects of the fibular stabilization in the treatment of distal tibio-fibula fracture: Kyung Jin Song, Gyu Hyung Kim, Myung Sik Park, Byung Yun Hwang; J Korean Soc Fract 2001;14(4):660-667. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.660

Abstract PDF: PURPOSE
The purpose of this study was to analyze the effect of fibula stabilization on reduction and union time of tibial fracture, and change in ankle mortise in the treatment of distal tibiofibular fracture.
MATERIALS AND METHODS
We reviewed 23 cases with distal tibiofibula fracture; 10 cases were stabilized and 13 cases were not stabilized for the fibula fracture with reduction and stabilization for the tibia fracture. We analyzed the initial and last follow-up radiograph, and clinical functional outcome.
RESULTS
There were significant differences in the tibiofibular clear space and tibiofibular overlap between two groups and there were somewhat significant differences in the union time of the tibial fracture and ROM of ankle and pain of fracture site or ankle between two groups. But there were no significant differences in talo-crural angle and gap of tibial fracture site between two groups. Moreover, such factors as initial displacement, soft tissue damage, comminution of fracture were affected the union time and prognosis of a tibial fractures.
CONCLUSION
Fibular stabilization group was effective in the maintenance of ankle mortise but there was no difference in the functional outcome. Analysis for much more cases and long term follow-up will be necessary for the precise evaluation of the treatment results.

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Complications after treatment of tibial Non fracture: Ki Do Hong, Sung Sik Ha, Hyun Jong Cha; J Korean Soc Fract 2001;14(4):668-676. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.668

Abstract PDF: PURPOSE
Aim of this study was to find the treatment and preventive method of the complication occurred after treatment of tibial pilon fracture. MATERIAL AND METHODS: 10 cases of complication, which has required the unplanned operative treatment among 25 cases of tibial pilon fracture from 1994 to 1999 were analyzed rertrospectively according to the Ruedi-Allgower classification, open or closed fracture, isolated or polytrauma , type of complication, type of procedure, primary or delayed wound closure.
RESULTS
There were 1 type I, 3 type II, and 6 type III Ruedi-Allgower fracture type, 3 open fracture, 7 isolated and 3 polytrauma. 6 required plastic surgery procedure such as pedicle flap or full thickness skin graft and 7 required orthpaedic procedure such as osteotomy, cancellous bone graft, metal removal and currettage, debridement of ankle.
CONCLUSION
The complications after treatment of tibial pilon fracture are classified to intraoperative, early and late postoperative complication. Intraoperative complication include penetration of the joint by screw and inadequate reconstitution of the articular surface which can be avoided by taking intraoperative roetgenograms, early complication include wound necrosis which can be minimized by good soft tissue technique, late complication include nonunion, joint stiffness and posttraumatic arthritis can be treated by osteotomy, cancellous bone graft and anatomic reduction with early motion.

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Treatement of Diastasis of the Distal Tibiofibular Syndesmosis: Woo Chun Lee, Han Suk Ko, Cheol Lee, Ki Heon Nam, Kang Hoon Ko, Jong Deuk Rha; J Korean Soc Fract 2001;14(4):677-684. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.677

Abstract PDF: PURPOSE
To investigate the indication of transfixation of distal tibiofibular syndesmosis.
MATERIALS AND METHODS
Twenty-two patients were surgically treated for diastasis of the distal tibiofibular syndesmosis and followed for more than one year. The decision to transfix the syndesmosis was made according to the result of intraoperative stress test.
RESULTS
In patients with bimalleolar fracture, good or excellent clinical results were obtained in all patients, and no widening of the medial clear space and I mm or no widening of the tibiofibular clear space was observed. In patients with deltoid ligament tear, good or excellent results were obtained in five patients, and the medial clear space was widened more than 1mm in three patients and tibiofibular clear space was widened 2mm or more in four patients.
CONCLUSION
We believe that transyndesmotic fixation is not required if anatomical bimalleolar fracture fixation is achieved, and in patients who have deltoid ligament rupture, it may be better to transfix the syndesmosis regardless of the level of fibular fracture.

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Fracture of the Os Peroneum with Rupture of the Peroneus Longus Tendon: A Case Report: Yong Hoon Kim, Keun Woo Kim, Hak Jin Min, Eui Seong Yoon, Hee Oh Kim, Jae Seong Suh; J Korean Soc Fract 2001;14(4):685-688. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.685

Abstract PDF

Os peroneum is one of the normal sesamoids in the foot and it can be insertion of peroneus longus tendon. We report a case of as peroneum fracture with complete tear of peroneus longus tendon. This case was finally diagnosed in operation and treated by suture with peroneus brevis tendon and short leg cast.

Citations

Citations to this article as recorded by

Painful Os Peroneum Syndrome Presenting as Lateral Plantar Foot Pain
Seon Jeong Oh, Young Hoon Kim, Sun Ki Kim, Min-Wook Kim
Annals of Rehabilitation Medicine.2012; 36(1): 163. CrossRef

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Peritalar Dislocations or Fracture-Dislocations: Seung Koo Rhee, Hwa Sung Lee, Jong Bum Park, Jin Wha Chung, Eui Yong Um, Whi Ju Whang; J Korean Soc Fract 2001;14(4):689-697. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.689

Abstract PDF: PURPOSE
To find the proper way and timing of treatment for minimizing the posttraumatic complication of peritalar dislocation or fracture-dislocation.
MATERIALS AND METHODS
We reviewed total 12 cases of peritalar dislocation or fracture-dislocation that consist of 9 cases of subtalar joint dislocations, I case of talonavicular joint dislocation and 2 cases of talar fracture-dislocations. Closed reduction was performed for subtalar dislocation without suturing the torn ligaments. The average follow up period was 25 months.
RESULTS
Of 9 subtalar dislocations, 8 cases presented acceptable results. But 1 case of a 28-year-old male patient with prolonged heavy sports activity history presented pain and mild limping. The other 3 cases of talo-navicular joint dislocation and talar fracture-dislocations presented acceptable results except one complaining of scar contracture.
CONCLUSION
Complications such as early skin necrosis or neurovascular damage could be prevented by early closed reduction for peritalar dislocations or fracture dislocations, and the repair of torn ligaments of ankle joint in peritalar dislocations did not affect the end results.

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Correlation of the Clinical Outcome and Radiographic Measurement of the Calcaneal Fractures: Dong Eun Shin, Jin Yong Kim, Dong Bae Shin, Yong Jung Kim, Soo Hong Han, Young Je Soung; J Korean Soc Fract 2001;14(4):698-705. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.698

Abstract PDF

PURPOSE
To evaluate the prognostic factors associated with the clinical outcome, which analysed with use of the Pearson correlation method in AOFAS score and radiographic measurement between normal and the affected site after operative treatment of the calcaneal fractures.
MATERIALS AND METHODS
We evaluated 13 patients(13 cases) who had unilateral calcaneal fractures. At the latest follow-up, we calculated the mean differences of the Bohler angle, gissane angle, heel height, calcaneal width, calcaneal length, talocalcaneal angle, talar declination angle, subtalar incongruity between normal and affected site on the lateral view of ankle and tangential view of the calcaneus. And then the correlation between radiographic measurement and the clinical outcome analysed by Pearson correlation method.
RESULTS
Heel height(correlation coefficient = 0.827, p-value<005) and subtalar incongruity(correlation coeffidient = -0.764, p-value<0.05) were closely correlated with the clinical outcome and the B hler angle showed lower correlation coefficiency(correlation coefficiency = 0.470, p-value : 0.104) compare to the heel height.
CONCLUSION
We suggested that restoration of the heel height and subtalar incongruity was significantly correlated to the clinical outcome after operative treatment of the calcaneal fractures.

Citations

Citations to this article as recorded by

The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures
Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Sueng Hwan Jo
Journal of the Korean Fracture Society.2007; 20(3): 227. CrossRef

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The Surgical Treatment of Distal Clavicle Fractures: Eun Sun Moon, Jong Wook Jung, Gwang Cheul Jeong; J Korean Soc Fract 2001;14(4):706-713. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.706

Abstract PDF: PURPOSE
To evaluate and analyze the clinical and radiological result of surgical treatment for distal clavicular fractures.
MATERIALS AND METHODS
From Jan. 1995 to May. 2000, eighteen cases of distal clavicle fractures were treated operatively. Among them, fifteen cases with more than 12 months follow-up were analyzed retrospectively. In Neer classification, type I was 1 case and 14 cases were type II. We performed closed reduction in 4 cases and open reduction in 11 cases. We treated with Steinman pin in I case, K-wires in 6 cases and coracoclavicular screw(Bosworth technique) in 6 cases. One case was treated with coracoclavicular screw due to screw loosening which was used in primary operation. Another case was treated by internal fixation with plate and K-wire due to delayed union after conservative treatment of segmental fracture. Mean follow up period was 18 months(12~62 months). Clinical results was evaluated by Kona s criteria.
RESULTS
Radiological evidence of solid union was detected within 10 weeks in 13 cases. Clinical results were satisfactory in 13 cases (excellent in 10 cases and good in 3 cases). In K-wire fixation, all six cases were demonstrated excellent result. In coracoclavicular screw fixation, four of six cases were excellent, one was good and one was fair. Poor result was noted in one case of Steinmann pin fixation due to nonunion and limitation of range of motion. SUMMARY: Surgical treatment of distal claviclular fracture would obtain satisfactory clinical result with early range of motion exercise and reduce the complications such as nonunion and sustained pain.

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Nonunion after open reduction and internal fixation of clavicle fractures: Jeung Tak Suh, Jung Sub Lee, Sung Jong Choi; J Korean Soc Fract 2001;14(4):714-719. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.714

Abstract PDF: PURPOSE
To report our experiences of treatment with reviewing literatures and articles about the fractures of plate and nonunion after open reduction and internal fixation of clavicle fracture.
MATERIALS AND METHODS
9 cases among 104 cases of clavicle fractures of reoperation due to the fractures of plate or nonunion after open reduction and internal fixation were included. Treatment results were analyzed after 5 months in regard to fracture site pain, gross deformities, limitation of movement of shoulder, discomfortness of casual activity, and patients' personal satisfaction.
RESULTS
According to the criteria of Kang et al 9 cases were classified into excellent 2 cases, good 4 cases, fair 2 cases, poor 1 case. All cases showed bone union average 14.4(12-26) weeks after reoperation. 3 cases of complications were 3 limitation of movement of shoulder, I superficial wound infection.
CONCLUSION
In operative treatment of clavicle fracture more than three screws in both side of fracture line shoulder be fixated and early exercise of shoulder motion seemed to be needed. In cases of less than three screws fixated, additional external protection is thought be necessary.

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The Comparison of the Using of Plate Fixation and Interlocldng IM Nailing in Humeral Shaft Fracture: Myung Hwan Son, Byung Chul Kim, Nam Wook Kang, Min Yong Kim; J Korean Soc Fract 2001;14(4):720-725. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.720

Abstract PDF: PURPOSE
This study was to evaluate the results and the usefulness of the plate fixation and the interlocking IM nailing for the humeral shaft fractures.
MATERIALS AND METHODS
We have reviewed thirty cases of humeral shaft fractures, which were treated with plate fixation in seventeen cases and interlocking IM nailing in thirteen cases in period of February 1993 to May 1999. The Russel-Taylor nails were used in all cases for interlocking IM nailing. The clinical and the radiological results were evaluated after operation.
RESULTS
The average union time was 14.5 weeks for the plate fixation and 15.2 weeks for the interlocking IM nail respectively. There were two cases of wound infection and one case of radial nerve injury for the plate fixation, and two cases of rotator cuff injury on the shoulder were found after the interlocking IM nailing.
CONCLUSION
Interlocking IM nailing is a relatively simple procedure with low rate of infection and radial nerve injury, but rotator cuff injury is a considerable problem after operation.

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Intraarticular Soft Tissue Injuries in Fractures of the Distal Radius: A Descriptive Arthroscopic Study: Seok Beom Lee, Chang Beom Lee; J Korean Soc Fract 2001;14(4):726-732. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.726

Abstract PDF

PURPOSE
The aim of this study was to determine prevalence of the associated intraarticular soft tissue lesions with fractures of the distal radius by arthroscopic evaluation of the wrist joint and thus to avoid poor outcome after the conventional treatment. MATERIAL AND METHOD: Medical records, radiographs and arthroscopic findings of 27 patients with fractures of the distal radius that underwent arthroscopic procedures were reviewed . Relationships between fracture pattern and associated lesions of the triangular fibrocartilage complex (TFCC), scapholunate and lunotriquetral ligaments were investigated.
RESULTS
71% of fractures of the distal radius were associated with soft tissue lesions. Among those, tear of the triangular fibrocartilage complex was the most prevalent (47%). Associated lesions such as TFCC, scapholaunate and lunotriquetral lesion were more common with inraarticular fracture, while severe nature of the lesion that neccessiated pinning and/or arthroscopic repair was more common with extraarticular fractures of the distal radius.
CONCLUSION
Incidence of the associated soft tissue lesions in this study were comparably high with the latest publications. The authors suggest strongly that wrist arthroscopy should accompay any procedure for fractures of the distal radius, if it is to be done under anesthetic control, to get more favorable outcome.

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Arthroscopic Repair for Traumatic Peripheral Tear of Triangular Fibrocartilage Complex
Seung-Ju Jeon, Chan-Sam Moon, Ho-Seung Jeon, Haeng-Kee Noh, Sung-Hwan Kim
Journal of the Korean Fracture Society.2007; 20(4): 330. CrossRef

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Scapholunate Dissociation Associated with Intra-articular Fractures of Distal Radius: Bon Seop Koo, Kyung Chul Kim, Hun Kyu Shin, Jin Heon Kwak; J Korean Soc Fract 2001;14(4):733-738. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.733

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the risk factors in the occurrence of scapholunate dissociation in relation to the intra-articular fracture of distal radius.
MATERIALS AND METHODS
We performed a retrospective evaluation of 170 cases of the fractures. Average age was 52 years(range, 24-85 years). We reviewed both medical records and radiographic films and analyzed the data according to age, width of the medullary cavity of the third metacarpal bone and fracture morphology.
RESULTS
Nine cases(5.3%) of scapholunate dissociation, mean age of 56 years, all had widened medullary cavity, radial styloid process fracture with radial displacement, a vertical fracture line invading articular surface, depression of scaphoid facet(6 cases) and lunate facet(3 cases). Degree of fracture displacement was not significant.
CONCLUSION
In distal radius intra-articular fracture which occurred in old patient with widened metacarpal medulla and had a radially displaced radial styloid fracture, an articular surface involving vertical fracture line and a depression of scaphoid or lunate facet, we should be careful in the concurrence of scapholunate dissociation.

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Salter-Harris Type IV Physeal Fracture of the Distal Radius: A Case Report: Young Soo Byun, Hong Tae Kim, Kyoung Hoon Hyun, Jun Mo Nam, Young Ho Cho; J Korean Soc Fract 2001;14(4):739-744. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.739

Abstract PDF: Physeal fractures in children are the most common in the distal radius. In the distal radius Salter-Harris type II physeal fractures occur predominantly, while type IV physeal fractures are quite rare. For type IV physeal fractures, open reduction and internal fixation are usually indicated to align both the physis and the articular surface. Growth arrest can be developed by premature physeal closure depending on multiple factors, particularly the severity of trauma. We treated a type IV physeal fracture of the distal radius with open reduction and internal fixation in an 11-year-old boy, but growth arrest with gross deformity and painful motion limitation of the wrist occurred. The deformity in external appearance was nearly corrected and symptoms were improved by surgical shortening of the ulna 3 years after injury, and the final result was satisfactory.

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Operative treatment of Radial neck fractures in Children: Ho Jung Kang, Jae Hoon Jun, Kye Wook Song, Soo Bong Hahn, Eung Shick Kang; J Korean Soc Fract 2001;14(4):745-752. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.745

Abstract PDF: OBJECTS: Radial neck fractures are uncommon in children, and most cases were treated by conservative treatment or manual reduction. But if proximal fragment is angulated more than 30 degrees, and displaced more than 30%, operative treatment is needed. Operative treatment is also needed in cases of closed reduction failure or in type IV of Salter-Harris classification. If open reduction is not performed, limitation of motion, altered carrying angle and radiologic change occur. We retrospectively analyzed 12 patients who had operative treatment for radial neck fractures in children.
MATERIALS AND METHODS
From April 1996 to December 1998, 12 patients with radial head fracture, were admitted to our hospital and were treated by operation. The average age of 9 years and 6 months (range 5 years 11 months to 14 years). Falling down was most common cause of injury. Seven cases were treated by open reduction and 5 cases by closed reduction. On open reduction group, 3 cases were fixed by Kirschner wire and 4 cases fixed by mini-screw. On closed reduction group, 3 cases were reduced percutaneously using steinmann pin, 1 case reduced using curet, and I case was fixed with Kirschner wire.
RESULTS
Ten cases were evaluated as good or excellent by criteria for judging results of radial neck fracture by Tibone and Stortz. Three cases had complication of heterotopic ossification, two cases had complication of limitation of motion. and one case had complication of pin loosening.
CONCLUSION
The operative treatment for radial neck fracture in children, improved the results of physical examination and roentgenographic evaluation. So operative treatment is needed for radial neck fracture in children which are more than 30 degrees angulation, more than 30% displacement and with displaced epiphyseal plate injury.

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Treatment of Supracondylar Fracture of the Humerus in Children: by Immediate Closed Reduction & Lateral Percutaneous K-Wire Fixation: Byung Woo Ahn, Chong Kwan Kim, Jeong Hwan Kim, Chae Ik Chung, Jae Kyu Park, Young O Kim, Jong Ho Yoon; J Korean Soc Fract 2001;14(4):753-761. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.753

Abstract PDF: PURPOSE
To analyze children with displaced supracondylar fractures of the humerus that were treated by immediate closed reduction and then maintained by lateral percutaneous K-wire fixation.
MATERIALS AND METHODS
70 cases of supracondylar fractures of the humerus(5 type I, 19 type II, 46 type III) were treated, 14 fractures(5 type I, 7 type II, 2 type III) with cast, 49 fractures(12 type II, 37 type III) with lateral percutaneous pinning, 7 fractures(7 type III) with open reduction and internal fixation. The K-wire were removed after averaging 6.2 weeks of operation in out patient clinic. The follow-up period ranged from 6 months to 28 months, averaging 13 months.
RESULT
By Flynn's functional and cosmetic criteria, 47 fractures(95.9%) among 49 fractures, treated with immediate closed reduction and lateral percutaneous pinning, resulted in satisfactory criteria. Only one fracture was reoperated due to reduction loss.
CONCLUSION
Immediate closed reduction and lateral percutaneous K-wire fixation appears to be safe and reliable option for the treatment of supracondylar fractures of the humerus in children.

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Operative treatment of fracture of medial epicondyle of humerus in children: Ho Jung Kang, Yong Min Cheon, Kye Wook Song, Eung Shick Kang, Hui Wan Park; J Korean Soc Fract 2001;14(4):762-768. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.762

Abstract PDF: PURPOSE
We investigated injury mechanism, clinical feature, treatment, and prognosis in fracture of medial epicondyle of humerus in children. MATERIAL AND METHOD: From April 1997 to April 2000, 10 fractures of medial epicondyle of humerus treated by operative method and followed up for minimum 12 months were analyzed retrospectively.
RESULTS
The injury mechanism includes slip down with elbow outstretched in 8 case, throwing ball in one case, arm wrestling in other one case. Ulnar nerve symptom at the distal region of fracture site was noted in one case. 2 cases had elbow dislocation at the time of trauma. Fractured fragment displaced more than 5mm in 9 cases and fractured fragment incarcerated in elbow joint in one case. Open reduction and internal fixation was done with medial approach. The mean period of cast immobilization was 6 weeks postoperatively and after removal of cast, gentle exercise of range of motion was started. After operation and postoperative follow up, in all case except one, the full range of motion of elbow joint was recovered and there were no Unar nerve symptom and valgus instability in affected elbow joint.
CONCLUSION
The indication of operation for fracture of medial epicondyle of humerus is controversial, yet. We had done open reduction and internal fixation for medial epicondyle of humerus only in case of displacement of fractured fragment more than 5mm and incarceration in elbow joint after manual reduction, ulnar nerve symptom. In 90 percents of all case, the result was satisfactory.

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Cubitus Varus Resulted from Fracture-Separation of the Distal Humeral Epiphysis: Sung Soo Kim, Sang Hwan Park, Kyoung Sik Hwang; J Korean Soc Fract 2001;14(4):769-775. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.769

Abstract PDF: PURPOSE
We tried to find the cause of cubitus varus after treatment of fracture separation of the distal humeral epiphysis.
MATERIALS AND METHODS
We reviewed 13 cases of fracture-separation of the distal humeral epiphysis. Five cases were treated by open reduction and K-wire fixation, 8 cases were treated by closed reduction and K-wire fixation. Six cases of cubitus varus were evaluated.
RESULTS
With the average 27 months(14-96 months) of follow-up, six of 13 cases showed cubitus varus postoperatively and mean carrying angle was -6.7 degrees(range -3~-15 degrees). None of these cases showed the progression of deformity after then. Among the six cases, five cases were treated with closed reduction, and one case with open reduction. Average age of the cubitus varus cases was 31 months (14-60 months). Among the six cases, four cases were Salter-Hams type I and two cases were type II.
CONCLUSION
Incomplete reduction seems to be the cause of cubitus varus in fracture-separation of the distal humeral epiphysis, so the anatomical reduction is important to prevent the cubitus varus.

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Use of Cancellous Bone Allograft in the Treatment of Long bone Fractures: Keun Bae Lee, Taek Rim Yoon, Jae Yoon Chung, Sung Taek Jung, Jae Joon Lee; J Korean Soc Fract 2001;14(4):776-782. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.776

Abstract PDF

PURPOSE
The goal of our study was to evaluate the usefulness of frozen cancellous bone allograft in the treatment of long bone fractures that had bone defect and nonunion.
MATERIALS AND METHODS
22 cases of long bone fractures(femur and tibia) with severe comminution or bone defect and nonunion were treated by operation using frozen cancellous bone allograft from March 1998 through May 2000. Thirteen were male and nine were female. The average age was 55 years old (range, 17-76 years) and the mean duration of follow-up was 20.1 months(range, 10-37 months). Eleven cases were femoral fractures, 7 cases of tibial fractures, and 4 cases of nonunion. Allografts were achieved from the patients of femoral neck fracture or osteoarthritis of the hip, and cadaveric donors. The specimens were carefully evaluated based on medical history and laboratory examination about the acute or chronic infection, and bloodtransmitted diseases. The results were evaluated by clinically, such as infection, pain at fracture site, immunological rejection and by radiologically union or resorption of allografts.
RESULTS
Radiologically, bone union was obtained in 14 cases(63.6%) at 6 months after operation, in all except two cases(90.9%) at 9 months after operation. Clinically, pain at fracture site, infection, and immunologic rejection were not observed.
CONCLUSION
In the treatment of severe comminuted fracture or nonunion of long bones, cancellous allograft transplantation after strict donor selection and appropriate screening was a good substitution for autograft avoiding of donor site morbidity or limitation in quantity.

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Influence of Process Conditions on the Quality Characteristics of Beef-Bone Broth
Byung-Su Kim, Gye-Won Kim, Jae-Yong Shim
Food Engineering Progress.2014; 18(1): 15. CrossRef

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The Biomechanics of Hybrid External Fixator: Effectiveness of Bar to Ring Connection: Jong Keon Oh, Duk Young Jung, Seong Yong Yoon; J Korean Soc Fract 2001;14(4):783-791. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.783

Abstract PDF: OBJECTIVES
The biomechanical effects of bar to ring connection in a hybrid external fixator have not yet been clearly identified. The purpose of this study was to identify the biomechanical effects of bar to ring augmentation in the hybrid external fixator.
METHODS
Simulated tibial plateau fractures were created using a polyvinylchloride pipe. Groups of simulated periarticular tibia fractures were stabilized with one of six different external fixation constructs with components from one manufacturer. Six frame configurations were tested: a four-ring Ilizarov frame, a hybrid frame without bar to ring augmentation, hybrid frames with three different bar to ring augmentations, a hybrid frame constructed with multiple levels of fixation in the periarticular fragment. A material testing machine was used to apply pure compression, anterior and posterior bending, medial and lateral bending, and torsion. Stiffness values were calculated from the load deformation and torque angle curves RESULTS: The four-ring Ilizarov fixator was the stiffest in all modes of testing. Frame augmentation with three different types of bar-to-ring connection did increase stiffness in all modes of testing. No statistical difference was found between the stiffness of the frames with three different types of bar to ring augmentations. The stiffness of a hybrid frame constructed with multiple levels of fixation in the periarticular fragment was comparable to that of the fixators with bar to ring augmentation.
CONCLUSION
Our results show that the bar to ring augmentation increases the overall stiffness of hybrid external fixators in this periarticular tibia fracture model by 27-76%.

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