Journal of Musculoskeletal Trauma

Surgical Treatment of Displaced Intra-articular Fracture of the Calcaneus using a Y-plate: Han Jun Lee, Soo Yong Kang, Jong Won Kim; J Korean Soc Fract 2002;15(4):433-438. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.433

PURPOSE
To investigate the results of surgical treatment of displaced intra-articular fracture of the calcaneus using a Y-plate.
MATERIALS AND METHOD
We have studied 22 patients who underwent surgical treatment of displaced intra-articular fracture of the calcaneus in our hospital from March, 1998 to August, 2000. The fractures were identified according to Eastwood classification, there were 8 cases of type I, 10 cases of type II and 4 cases of type III. The axial and Bohler angle of lateral views were compared preoperative and postoperative period. Functional evaluation was measured by Carr 's method.
RESULT
The average Bohler angle before the operation was 5 degrees and after the operation it has been up to 28 degrees. In functional evaluation, 3 cases were excellent, 15 cases were good, and 4 cases were fair.
CONCLUSION
Fixation using a Y-plate can be used easily for restoration of anatomical dimension of the calcaneus in the operative treatment of displaced intra-articular fracture. It could be helpful for firmer fixation of the posterior facet.

Citations

Citations to this article as recorded by

Joint-Sparing Surgical Management of Sanders IV Displaced Intra-Articular Calcaneal Fractures
Thomas S. Roukis
Clinics in Podiatric Medicine and Surgery.2019; 36(2): 251. CrossRef
Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef
Treatment of Displaced Intra-articular Calcaneal Fractures Using a F-plate
Kyu Hyun Yang, Jae Bong Chung, Han Kook Yoon, Si Young Park, Hang Seob Yoon
Journal of the Korean Fracture Society.2007; 20(1): 1. CrossRef

116 View
0 Download
3 Crossref

Operative Treatment of Intraarticular Calcaneal Fractures Combined with Multiple Injuries using Closed Reduction and Cannulated Screw Fixation: Dae Moo Shim, Tae Kyun Kim, Soo Uk Chae, Seok Hyun Kweon; J Korean Soc Fract 2002;15(4):439-445. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.439

Abstract PDF: PURPOSE
To evaluate the radiological and clinical results of closed reduction and cannulated screw percutaneous fixation of intraarticular calcaneal fractures combined with multiple injuries.
MATERIALS AND METHODS
We reviewed 15 cases of 13 patients intraarticular calcaneal fractures combined with multiple injuries which were treated with closed reduction and cannulated screw percutaneous fixation between June 1998 to June 2001 and minimum follow up period of 12 months(12-27 months). The results were based on the assessment criteria of Salama and the analysis of Bohler 's angle, states of subtalar joint and deformities of calcaneus. Based on the Sanders classification, there were 2 cases(13%) of type I, 9 cases(60%) of type II and 4 cases(27%) of type III.
RESULTS
The preoperative Bohler 's angles were between 5 degrees to 35 degrees, postoperative Bohler 's angles were between 15 degrees to 45 degrees and the last follow up Bohler 's angles were between 15 degrees to 40 degrees . The postoperative complication of subtalar arthritis were developed in 5 cases and deformities of calcaneus were developed in 4 cases. Based on the assessment criteria of Salama, the functional results were excellent in 2 cases, good in 8 cases, fair in 3 cases, and poor in 2 cases.
CONCLUSION
The closed reduction and cannulated screw percutaneous fixation of intraarticular calcaneal fractures combined with multiple injuries was thought to be a useful method of treatment at the state of not delayed operating time and not position changing.

36 View
0 Download

Open Reduction using Lateral Approach in Displaced Intra-articular Fracture of Calcaneus: Kyung Jin Song, Keun Ho Yang, Joo Hong Lee; J Korean Soc Fract 2002;15(4):446-454. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.446

Abstract PDF: PURPOSE
This study was designed to investigate the usefulness of lateral approach for accurate reduction and rigid internal fixation in comminuted intra-articular fractures of calcaneus.
MATERIALS AND METHOD
Twenty patients(21 cases) who had intra-articular fracture of calcaneus and underwent an open reduction and internal fixation using lateral approach were enrolled. Using Essex-Lopresti classification, all cases were intra-articular fracture, which joint depression type was 17 cases and 4 of severe comminuted tongue type. We compared the preoperative and postoperative change of B o h l e r 's angle and clinical results were analyzed using Paley and Halls evaluation protocol and scoring system.
RESULTS
The average B ohler 's angle was restored from 2.8 to 25.1 after operations and clinical results classified 4 well, 12 good, 4 fair, 1 poor cases. Postoperative complications were 2 cases of wound dehiscence, 1 of infection and one had sural nerve injury. Late complications included 3 cases of limitation of motion of ankle that disturb usual activity, 3 of sustained pain and 2 of traumatic arthritis and 2 cases had 2 complications at the same patients.
CONCLUSION
The lateral approach is valuable for the comminuted intra-articular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint, and also with little morbidity of neurovascular injury.

55 View
0 Download

Avulsion Fracture of the Calcaneal Tuberosity: 2 Cases Report: Woo Sik Kim, Kwang Kyun Kim; J Korean Soc Fract 2002;15(4):455-458. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.455

Abstract PDF: Fractures of the calcaneus have received much attention because a large number involve the subtalar joint. Avulsion fracture of the tuberosity of the calcaneus is rare injury, and it is reported that the avulsion of the calcaneal tuberosity accounted for less than 1 % of these injuries. We have experienced two cases of avulsion of the calcaneal tuberosity and report these cases.

88 View
0 Download

Modified Tension Band Wiring using Cortical Screw for Displaced Medial Malleolar Fractures: Jong Oh Kim, Sang Hun Ko; J Korean Soc Fract 2002;15(4):459-464. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.459

Abstract PDF: PURPOSE
To evaluate the clinical results of minimal incision and modified tension band wiring using 3.5mm cortical screw in the treatment of ankle fracture including displaced medial malleolar fractures MATERIALS AND METHODS: From March 1997 to May 2001, 77 patients were treated by modified tension band wiring using minimal incision about 4cm for medial malleolar fracture.
RESULTS
According to Lauge-Hansen classification, there were 47 supination-external rotation type fractures (61%), 14 supination -adduction type fractures (18.2%), 10 pronation-external rotation type(12.9%), 6 pronation-abduction type fracture(7.8%). The average time to union was 12.5weeks. In the functional outcome (according to Meyer and Kumler), 71 patients(92%) showed excellent results.
CONCLUSION
We concluded that modified tension band wiring using cortical screw proved effective fixation method in the treatment of the displaced medial malleolar fracture. The merits of this procedure are minimal incision about 4cm and preservation of blood supply on suprafracture area due to not injuried periosteum, stable fixation and early range of motion of joint, simple procedure and reduced surgical time.

33 View
0 Download

The Study for the Factors Affecting the Radiological Outcome of the Displaced Ankle Fracture over the Elderly: Hong Gi Park, Lee Hyuk Jung; J Korean Soc Fract 2002;15(4):465-469. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.465

Abstract PDF: OBJECT: This study investigated to know the factors affecting the radiological results of the ankle fracture after open reduction and internal fixation over the age 60 years. PATIENTS & METHOD: Open reduction and internal fixation on patient with closed displacement ankle fracture over the age 60 years were studied in 51 cases. Statistical analysis by t-test was used to assess the factors affecting to the post-operation radiological results among the age, sex, classification of fracture, the degree of fracture displacement, bone fragility between anatomical reduction group and non-anatomical reduction group in average 16 months, RESULTS: There are statistical significance(p<0.05) of the sex and bone fragility in post-operation radiological results.
CONCLUSION
The radiological results in old age with ankle fracture is affected by sex and bone fragility in open reduction & internal fixation.

89 View
0 Download

Unreamed interlocking nailing in tibia fracture: You Sung Suh, Young Il Cho, Ho Won Jung, Yeon Il Kim; J Korean Soc Fract 2002;15(4):470-476. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.470

Abstract PDF: PURPOSE
To evaluate of clinical results and malunion according to nail insertion site and early ambulation after unreamed interlocking intramedullary nailing for the treatment of tibial fractures, MATERIALS AND METHODS: We reviewed 46 tibial fractures that were treated with unreamed static intramedullary nailing prospectively from March 1997 to May 2001. Nail insertion site and angulation of fracture site were reviewed by radiograph. All of 46 cases, ambulation was started at postoperative 2 weeks, and then clinical outcomes were reveiwed RESULTS: In all 46 cases, union was achieved at average 18.2 weeks clinically and average 19.4 weeks radiographically. There is no significant difference in angulation according to nail insertion site, i,.e. after central/medial/lateral insertion, outcome was 2 . 4 5 degrees +/-2 . 1 7 / 2 . 2 2 degrees +/-1 . 8 4 / 1 . 7 3 degrees +/-1.33(p; 0.705) in last follow up anterioposterior view, and 1.81 degrees +/-1 . 1 3 / 2 . 6 7 degrees +/-1 . 6 2 / 2 . 0 0 degrees +/-1.64(p; 0.320) in last follow up lateral view. No breakage of intramedullary nails and no stiffness on adjacent joints.
CONCLUSION
We confirmed that unreamed interlocking nailing in tibial fractures is one of the effective method for low recurrence of malunion and early ambulation

80 View
0 Download

Result of Fibular Fixation Using Screw in Ankle Fracture: Chung Soo Han, Yang Sun Im, Sun Teak Cheong; J Korean Soc Fract 2002;15(4):477-482. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.477

Abstract PDF

PURPOSE
To compare the use of screw only fixation with lateral one-third tubular plate fixation of non-comminuted oblique fracture of the lateral malleous and report the advantages of screw only fixation MATERIALS AND METHODS: From January 1996 to January 2000, we had operated 44 cases of non-comminuted oblique fractures of the lateral malleous (Denis-Weber type B, Lange-Hausen classification supination-external rotation injury). All cases had a follow-up period of over 6 months. There were 21 cases of cortical or bone screw fixation (group I) and 23 cases of one third tubular plate fixation (group II). Radiologic and clinical outcome parameters were used to compare group I with group II.
RESULTS
There were no significant difference in bone union rate and period between group I and group II (group I : 92 days, group II : 89 days). All cases of both groups recovered a complete range of motion after cast off. There was 1 case superficial infection in group II.
CONCLUSION
The radiologic and clinical results and complications between screw only fixation and one-third tubular plate fixation at non-comminuted lateral fibular fracture have no difference. The advantage of screw only fixation at non-comminuted lateral malleolar fracture is a small incision, short operation time and decreased patient 's complaints as compared with a similar group of patients treated by fixation with a lateral one third tubular plate fixaiton.

Citations

Citations to this article as recorded by

A Rehabilitation for Ankle Fracture in Korean Medicine: A Report of 4 Cases
Won-Bae Ha, Jong-Ha Lee, Yoon-Seung Lee, Dong-Chan Jo, Jin-Hyun Lee, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2017; 27(4): 171. CrossRef

105 View
0 Download
1 Crossref

Screw breakage in tibial interlocking nailing: Hyung Bin Park, Bun Jung Kang, Hae Ryong Song, Kyong Hoi Koo, Soon Taek Jeong, Se Hyun Cho; J Korean Soc Fract 2002;15(4):483-488. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.483

Abstract PDF

PURPOSE
The aims of this study were to investigate the prevalence and the causes of screw breakage in tibia nailing.
MATERIALS AND METHODS
Between 1995 and 2000, eighty-two tibial diaphyseal fractures were treated with interlocking nails. The loss of follow-up was 7 cases. We retrospectively reviewed seventy-five cases. We investigated the rate and location of metal failure and evaluated the fracture pattern, the presence of distraction after nailing and union abnormality.
RESULTS
Screw breakage was identified in seven cases (9.3%) and most frequently occurred on the second proximal locking screw. Screw breakage occurred in AO type B or C type fractures, fracture site distraction after nailing, open fracture, delayed union and nonunion.
CONCLUSION
The main cause of screw breakage is unstable bone to bone contact on the fracture site caused by comminution or distraction. The open fracture, delayed union, and nonunion also contributing factors for screw breakage. For preventing screw breakage, it is necessary to avoid fracture site distraction and delay full weight bearing in cases having unstable fracture site contact.

Citations

Citations to this article as recorded by

Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques
Oog-Jin Shon, Ji-Hoon Shin, Chul-Wung Ha
Journal of the Korean Fracture Society.2013; 26(1): 50. CrossRef

103 View
0 Download
1 Crossref

The results of Operative Treatment in the Proximal Tibial Plateau Fracture: Kyung Jin Song, Keun Ho Yang, Joo Hong Lee; J Korean Soc Fract 2002;15(4):489-496. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.489

Abstract PDF: INTRODUCTION: The purpose of this study was to analyze the results, prognosis and complications in the treatment of proximal tibia plateau fractures, and to suggest the guideline for the proper management in the difficult cases of tibial plateau fractures.
MATERIALS AND METHODS
We have analyzed 27 cases, which surgically treated during recent five years with average 36.6 months follow-up. Patients ranged in age from 24 to 83 years at the time of hospitalization, consisting of 19 males(70.4%) and 8 females(29.6%). The type of fracture by Schatzker classification revealed in type I 3 cases(11.1%), type II 1 case(3.7%), type III 0 case(0%), type IV 3 cases(11.1%), type V 1 case(3.7%) and type VI 19 cases(70.4%). The associated injury occurred in 22 cases(81.5%), most of them were ipsilateral fibular, ipsilateral femoral and radioulnar fractures. The results were evaluated by Blokker 's criteria.
RESULTS
Screw fixation was done in 4 cases(18%) and plate fixation in 23 cases(85.2%), and bone grafting was done in 10 cases(37.0%). There were 10 postoperative complications with 3 cases of knee ankyosis, 3 cases of angular deformity, 3 cases of infection, and 1 case of traumatic arthritis. According to Blokker 's criteria, 22 cases(81.5%) had satisfactory results.
CONCLUSIONS
Accurate anatomical reduction and rigid internal fixation of the proximal tibial plateau fracture enabled early motion and normalization of injured soft tissues, and also provided functional improvement of the knee.

43 View
1 Download

Treatment of the Nonunion of Femur Shaft Fractures after Interlocking Intramedullary Nailing: Keun Bae Lee, Eun Sun Moon, Eun Kyoo Song, Jin Choi, Sung Taek Jung; J Korean Soc Fract 2002;15(4):497-503. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.497

Abstract PDF

PURPOSE
We analyzed the results of treatment for the nonunion of femur shaft fractures after interlocking intramedullary(IM) nail fixation. MATERIALS & METHODS: Thirty-three patients who underwent interlocking IM nailing due to femur shaft fractures from May, 1990 to July, 2000 and followed up for more than one year were evaluated retrospectively. Mean age at the time of operation was 40 years(Range, 19-68). 27 cases were men and 6 cases were women. By Weber and Brunner classification of the nonunion, hypervascular type were 10 cases(30%), avascular type 21cases(64%), mixed type 2 cases(6%). Infected type among the avascular type of nonunion were 5 cases(23%). Results were evaluated with bone union by treatment methods and complications.
RESULTS
According to the causes and types of nonunion, we performed IM nail exchange in seven cases, IM nail exchange and bone grafting in eleven cases, external fixation in five cases, compression plating and bone grafting in three cases, and only cancellous bone grafting in seven cases. Radiographical union was achieved in 19 weeks, 17 weeks, 20 weeks, 16 weeks and 15 weeks respectively. There 's no statistically significant difference between treatment methods. There are no cases of nonunion, malunion and infection.
CONCLUSION
The selection of appropriate treatment method by the cause and type of each nonunion is very important to achieve the bony union in the treatment for the nonunion of femur shaft fractures after interlocking intramedullary nailing.

Citations

Citations to this article as recorded by

Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing
Suenghwan Jo, Gwang Chul Lee, Sang Hong Lee, Jun Young Lee, Dong Hwi Kim, Sung Hae Park, Young Min Cho
Journal of the Korean Fracture Society.2019; 32(2): 83. CrossRef

72 View
0 Download
1 Crossref

The Fate of Large Butterfly Fragments in Femoral Shaft Comminuted Fractures Treated withClosed Interlocking Intramedullary Nailing: Keun Bae Lee, Jae Yoon Chung, Eun Sun Moon, Eun Kyoo Song, Kwang Cheul Jeong; J Korean Soc Fract 2002;15(4):504-510. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.504

Abstract PDF: PURPOSE
To evaluate the radiographic changes and union of large butterfly fragments after closed interlocking IM nailing for femoral shaft comminuted fractures.
MATERIALS AND METHODS
The objects of this study were 23 cases(15 males, 8 females) of femoral shaft comminuted fractures with butterfly fragments larger than 5cm and with the follow up period of 12 months or more from June 1995 to June 2000. We assessed the size, the degrees of displacement and angulation of the large butterfly fragments at preoperatively, one day, one month and three month postoperatively and evaluated the union at four month and six month postoperatively.
RESULTS
The size of the fragments was 8.4cm (5.0-13.0) in average. The distance between the fragment and shaft was 15.9cm preoperatively and 10.1, 7.7, 6.8cm at one day, one month and three month postoperatively. In 13 cases of angulation over 5 degrees, it changed from 19.6 degrees preoperatively to 13.9 degrees , 8.4 degrees , 5 . 9 degrees at one day, one month and three month postoperatively. There is no increase in angulation.The union was completed at 4 months in 13 cases (56.5%) and at 6 months in all except one case of delayed union, in which we did not do any further procedure until the union was achieved.
CONCLUSION
In femoral shaft comminuted fractures with displaced large butterfly fragments treated with closed interlocking IM nailing, the distance and angulation of fragments decreased gradually and even the fragments were inverted or largely displaced and angulated the fragments were united. So the caution must be given not to displace the fragments intraoperatively and to keep anatomical position of the fragments by active exercise and hydrostatic pressure of the muscles of thigh postoperatively. Then the open reduction and internal fixations of the fragments will not be necessary.

52 View
0 Download

The Significance of Posterior Cortex in Complicated Femoral Neck Fractures which were Internal Fixated: You Sung Suh, Seok Bong Jung, Soo Jae Yim, Jong Seok Park, Byung Ill Lee; J Korean Soc Fract 2002;15(4):511-518. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.511

Abstract PDF: PURPOSE
When a surgeon carries out an operative treatment on a patient who has fractures of the femoral neck, he decides to do either the internal fixation for bony union or the aggressive treatment according to his experience and preparation, not according to the objective standard. The aim of this retrospective study is to prepare a guideline for the operative method.
MATERIALS AND METHODS
We analyse possible factors of the patient who has nonunion, avascular necrosis and loss of fixation after doing internal fixation in femoral neck fractures RESULTS: In this treated case of femoral neck, the appearance of complications are influenced by the maintenance of internal fixation, shape of fractures, osteoporosis, and the position of fixations; but in the complicated cases without the loss of fixation, the shape of fractures always have posterior cortical communition.
CONCLUSION
When we choose between simple fixation and aggressive treatments in cases of fractures of the femoral neck, we must treat according to the patient 's condition, displacement of the fracture, operative technique and existence of a posterior cortical comminuted fracture.

79 View
0 Download

Impacted Cancellous Allograft and Quadratus Femoris Pedicle Bone Graft of Femoral Neck Fracture Nonunion: Soo Jae Yim, Seung Han Woo; J Korean Soc Fract 2002;15(4):519-525. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.519

Abstract PDF: PURPOSE
The aim of this study was attempted to evaluate the effects of impacted cancellous allograft and quadratus femoris pedicle bone graft in the management of nonunion of femur neck fracture.
MATERIALS AND METHODS
Between March 1998 and April 1999, 5 patients, rating from 36 to 45 years of age, were treated with impacted cancellous allograft and quadratus femoris pedicle bone graft and all cases were nonunion with displaced transcervical fracture whose primary treatment had been done with closed reduction and multiple pinning. The duration of follow-up was from 36 months to 48 months and the mean follow-up period was 40 months. Clinical evaluation was done according to Lunceford functional results and radiologically bone union was evaluated by 3 monthly X-ray check.
RESULTS
After follow-up from 36 months to 48 months, all cases resulted in the bone union. Four cases, radiologically bone union was progressed during 14 weeks, and the other, obtained at 6 months. All cases, at 18 months, radiologically complete bone union was obtained. Clinical result was above fair results and no one complaints pain and instability.
CONCLUSION
For patients with nonunion of femoral neck fracture, impacted cancellous allograft and quadratus femoris pedicle bone graft was provide a good result of union.

47 View
0 Download

A Slipped Capital Femoral Epiphysis following Ipsilateral Femoral Subtrochanteric fracture: A Case Report: In Young OK, Yang Soo Kim, Yong jin Kwon; J Korean Soc Fract 2002;15(4):526-530. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.526

Abstract PDF

It was known that the etiologies of slipped capital femoral epiphysis(SCFE) were trauma, hormonal or endocrine disorder, genetic factor, radiation, renal osteodystrophy which render the epiphyseal plate susceptible to displacement. We report the case of a 6 year old boy who had SCFE following malunion of the ipsilateral subtrochanteric fracture. The alteration of shear force on epiphyseal plate can be one of the contributing factors in SCFE.

Citations

Citations to this article as recorded by

Delayed slipped capital femoral epiphysis after orif for subtrochanteric femur fracture
Zied Mansi, Mohsen Chamakh, Ltifi Atef, Wajdi Chermiti, Haggui Ali, Gazzah Wael
International Journal of Surgery Case Reports.2024; 118: 109593. CrossRef
Slipped capital femoral epiphysis following a delbet type 3 intertrochanteric fracture fixation
Babak Mirzashahi, Mohammad Moshirfar, Alireza Moharrami
Archives of Trauma Research.2022; 11(2): 97. CrossRef

95 View
0 Download
2 Crossref

The Prefracture Factors on The Hip Fracture in Elderly: Jong Oh Kim, Yeo Hon Yoen, Young Do Ko, Jae Doo Yoo, Jun Mo Chung, Han Cheon Bang, Kyu Bok Kang; J Korean Soc Fract 2002;15(4):531-537. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.531

Abstract PDF

PURPOSE
We studied the co-relation on the causes of the hip fracture through the analysis of a relevance on the etiological factors as increased incidence according increasing old ages.
MATERIALS AND METHODS
Total 158 cases that treated on the hip fracture from 2001 Jan. to 2002 May were studied. The parameters were age, gender, smoking, obesity, type of fracture, place of fracture, other comorbidity, activity of daily living, bone marrow densitometry, hardness of floor, orientation, injury energy. And then, we analysis of difference between femur neck fracture and femur intretrochanter fracture and between stable femur intertrochanter fracture and unstable femur intertrochanter fracture.
RESULTS
The incidence of the femoral intertrochanteric fracture was larger significantly than that of the femoral neck fracture in the older than 80(p < 0.001). On the comparison of the pre-fractural activity of daily living, the group revealed lower activity had larger incidence of femoral intertrochateric fracture(p < 0.001). Also, the femoral intertrochanteric fracture was more larger in osteoporosis patient group(p < 0.005), and lower energy trauma(P<0.05). In a unstable femoral intertrochanteric fracture, 21 cases(77.7%) of total 27 cases were belong to the group of the activity of daily living scale below C(p < 0.05), 24 cases of 27 cases were belong to the osteoporosis patient who was estimated below -3.0 on T-score(p < 0.001).
CONCLUSION
In the hip fracture of the elderly patients, the femoral intertrochanteric fracture is more prevalance rather than the femoral neck fracture on the cases of older patient more than 80 year-old, lower activity of daily living scale, lower T-score less than -3.0 on BMD, lower energy trauma. Also, in femur intertrochanter fracture, unstable fracture is more common in low daily activity and osteoporosis

Citations

Citations to this article as recorded by

The Daily Life Functions of Elderly Peritrochanteric Fracture Patients after Surgical Treatment
Dae Moo Shim, Tae Kyun Kim, Jong Yun Kim, Duk Hwa Choi, Joung Suk Lee, Seong In Lee
Journal of the Korean Fracture Society.2012; 25(1): 8. CrossRef
The Usefulness of Hip to Thigh Ratio as an Anthropometric Indicator for the Incidence of Hip Fracture
Jin Park, Kyu Hyun Yang, Seong Hwan Moon
Journal of the Korean Fracture Society.2009; 22(1): 1. CrossRef
Minimally Invasive Two-Incision Total Hip Arthroplasty for Treating Acute Displaced Femoral Neck Fractures in Active Elderly Patients
Chang-Ich Hur, Taek-Rim Yoon, Kyung-Soon Park, Sang-Gwon Cho, Ji-Hyeon Yim
The Journal of the Korean Orthopaedic Association.2008; 43(5): 643. CrossRef

108 View
1 Download
3 Crossref

The Cause of the Nonunion of the Mid-clavicle Fractures: Jung Ro Yoon, Jae Ik Shim, Taek Seon Kim, Sung Jong Lee, Young Bae Kim, Hack Jun Kim, Kuk Whan Ahn, Jae Young Chang, Myung Pyo Hong; J Korean Soc Fract 2002;15(4):538-544. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.538

Abstract PDF: PURPOSE
Because the prognosis of the mid 1/3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare.However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion.
MATERIALS AND METHODS
We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients 'chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury.
RESULTS
15 of the 63cases had developed nonunion.. The average 8.6mm(2mm-17mm) shortening and average 9.7mm(2-22mm) in the union patients. The average 14.5mm(3mm-37mm) shortening and average 17.3mm(4-25mm) in the nonunion patients. We found that initial shortening > or =1 8 m m ( Fisher's exact test, p <0.01) and initial displacement > or =16mm(Chi-square test, p <0.01) at the fracture site were siinificantly associated with the development of nonunion.
CONCLUSION
The conservative treatment with figure-8-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several weeks, osteosynthesis should be considered.

48 View
0 Download

Internal fixation with K-wires for the clavicular shaft fractures in young women: Do Young Kim, Yong Wook Park, Gun Il Im, Chang Kyun Lim, Sang Soo Lee, Hyun Chul Park; J Korean Soc Fract 2002;15(4):545-550. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.545

Abstract PDF: PURPOSE
To know the advantages and disadvantages of this procedure by analyzing the results of internal fixation with K-wires for clavicular shaft fractures in young women.
MATERIALS AND METHODS
Twelve patients were followed for more than 1 year after the operation. All patients were female and average age was 28 years with average follow-up of 14 months. All cases were displaced fractures of the middle third with tenting of the skin and 2 cases were type 1 open fractures. After the operation, we investigated time to union, changes of K-wire, scar and disadvantages periodically.
RESULTS
There was no nonunion and time to union averaged 11.8 weeks. Migration and bending of the K-wires occured in one case. The length of surgical scar was about 4cm and the K-wires were easily removed under local anesthesia. But all patients complained of frequent radiographic evaluation, relatively long period of immobilization and irritation of the K-wires on medial part of the clavicle.
CONCLUSION
We think that internal fixation with the K-wires is one of the effective treatment options for the clavicular shaft fractures in young women.

41 View
0 Download

Double Tension Band Osteosynthesis in Supracondylar Fractures of the Humerus: Ho Jung Kang, Hong Hee Kim, Dong Joon Shim, Soo Bong Hahn, Eung Shick Kang; J Korean Soc Fract 2002;15(4):551-557. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.551

Abstract PDF: PURPOSE
This study evaluated the clinical result of supracondylar fractures of the humerus treated with double tension band osteosynthesis.
MATERIALS AND METHODS
From October 1992 to September 2001, 14 patients with supracondylar fractures of the humerus were treated by method of double tension band osteosynthesis. Eleven fractures were the results of slipped down injury and two traffic accidents and one direct trauma. All fractures were classified according to the AO fracture classification (A2; 2, A3; 1, C1; 6, C2; 3, C3; 2). There were 5 males and 9 females with average age of 51.6 years (range 15 to 88). Olecranon osteotomy was performed in 4 patients with severe comminuted fractures. Postoperative immobiliza-tions were required for an average of 20.6 days and consolidations were noted after an average of 10.1 weeks. Before operation, bone marrow density studies were performed in five fractures above 65 years. Average T-score of the patients were -3.65 on femur neck and -2.97 on lumbar spine. All patients were re-examined after an average of 16.4 months.
RESULTS
Union and consolidation was achieved in all 14 patients with no secondary displacement. In range of motion, eight patients judged their results as excellent and four as good. Ten patients had no pain and four had only occasional discomfort. Early removal of K-wires was performed in one patient because irritation of one side K-wires were develop. Sensory change of the ulnar nerve was noted in two patients. Anterior transposition of ulnar nerve was performed in one patient and the other was improved spontaneously. Skin necrosis was developed in one patient but was healed after pin removal and conservative care.
CONCLUSION
The advantages of double tension band wiring are an easier and faster procedure, less periosteal and muscle damage, and more symmetrical compression than double plating. Therefore, in the commiuted osteoporotic fracture with poor tolerance for internal fixation with the plate or the simple supracondylar fractures in young age, double tension band osteosynthesis can provide sufficient and secure stability to allow early functional exercise.

80 View
0 Download

Comparison study between valgus and varus type in Neer 's 3 and 4 part proximal humerus fracture: Chang Hyuk Choi, Koing Woo Kwon, Shin Kun Kim, Sang Wook Lee, Dong Kyu Shin, Seung Jin Lee; J Korean Soc Fract 2002;15(4):558-565. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.558

Abstract PDF: PURPOSE
We reclassified three- and four-part proximal humerus fractures by Neer ' s classification into valgus & varus type, and compared the results of these groups. MATERIALS & METHODS: 21 cases classified as three- and four-part fracture in Neer 's classification were treated surgically and followed for 12 months. We reclassfied the 21cases valgus and varus type fractures, according to angulation of fractures, facing of humeral head, and dominant displaced tuberosity. Functional evaluation was done by UCLA shoulder rating scale.
RESULTS
Neer 's three- and four-part proximal humerus fractures could be reclassified based on angulation, facing of humeral head, and dominant tuberosity displacement. The functional results according to UCLA shoulder rating scale were good or excellant in 8 of 9 cases of valgus type(89%), and at 4 in 10 cases of varus type(40%). The clinical result of the valgus type was better than that of the varus type.
CONCLUSION
Based on reclassification system of proximal humerus fractures, clinical results and radiographic findings including angulation, facing of head, and dominant tuberosity displacement showed close relationship. Neurovascular complication were more frequent in the varus type. Therefore, careful evaluation including surgical approach and soft tissue status should be considered in the varus type of complex proximal humerus fracture.

51 View
0 Download

Closed percutaneous K-wire stabilization for fractures of the proximal humerus: Dong Wha Lee, Kyoo Seok Shin, Jei Bum Kim; J Korean Soc Fract 2002;15(4):566-572. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.566

Abstract PDF: PURPOSE
The purpose of this study is to analyze the result and complications of treatment using percutaneous K-wire stabilization for fractures of the proximal humerus. MATERIALS & METHOD: To be eligible for the study, total 12 patients of displaced two, three or four part fractures of the proximal humerus were treated, 10 females and 2 males with a mean age of 52 years (range 18-76 year). Reduction was obtained by longitudinal traction combined with posterior pressure on the humeral shaft. After reduction, minimum two 2.5mm terminal threaded pin or smooth tip K-wire was inserted.
RESULTS
Union rate of 83.3% was observed at an average 2.7 months. Range of motion of shoulder was 125 degrees of forward flexion, 114 degrees of abduction. Patients of 83.3% had good or excellent functional result. Four patients had a mild, superficial pin tract infection associated with loosening of the pin. The infections resolved with removal of pin and oral antibiotics. Valgus deformity was developed in a patient however the patient subsequently had a good functional result and nonunion were developed in two cases.
CONCLUSION
The technique of closed reduction and percutaneous pinning is quite demanding procedure, although it may appear to be deceptively simples. The good indications for the use of this procedure seems to patients with severe comminuted fractures, old age with osteoporosis. For the more rigid fixation, terminally threaded pins should be used, not smooth pin.

39 View
0 Download

Minimal Open Reduction and Interlocking IM Nailing of Comminuted Humeral Shaft Fracture: Comparison between Plate Internal Fixation: Kyeong Jin Han, Soo Ik Awe, Tae Young Kim, Shin Young Khang; J Korean Soc Fract 2002;15(4):573-580. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.573

Abstract PDF: PURPOSE
We compared the functional and radiological results after the minimal open reduction and interlocking IM nailing and LC-DCP plate internal fixation for the comminuted humeral shaft fractures.
MATERIALS AND METHODS
Fourteen plates(LC-DCP) and eighteen interlocking IM nail(AO unreamed IM nail) were applied after open reduction for 32 comminuted fractures of the humeral shaft between March 1997 and December 2001. They were followed up for a minimum 9 months after surgery and the radiological and functional results were evaluated.
RESULTS
The average fracture healing time was 13.2 weeks and union rate was 85.7% for plate internal fixation. The average fracture healing time was 12.4 weeks and union rate was 94,4% for interlocking IM nail. The average functional scores according to American Shoulder and Elbow Surgeon 's (ASES) shoulder score(Total 52 points) was 44 points for plate internal fixation and 47 points for interlocking IM nailing respectively.
CONCLUSION
Minimal open reduction and interlocking IM nailing is better method with good functional and radiological results than plate internal fixation for the comminuted humeral shaft fractures.

104 View
0 Download

Ideal Placement of the Herbert/Whipple Screw in Scaphoid Fracture: A Model Study: Jae Doo Yoo, Jong Oh Kim, Yeo Hon Yun, Young Do Koh, Su Young Bae, Jeong Joon Lee; J Korean Soc Fract 2002;15(4):581-586. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.581

Abstract PDF: PURPOSE
To evaluate optimal placement of the Herbert/Whipple screw in scaphoid fracture.
MATERIALS AND METHODS
Forty eight models molded from four cadaver scaphoids were used for this study. Using the Herbert/Whipple jig, the guide wire was placed distal to proximal into each scaphoid with twelve method which were four entry points and three target points. Guide wire placement was then evaluated with three planes in the proximal, middle, distal planes and distance from the nearest cortex.
RESULTS
The most concentric position in the proximal plane was D5, in the middle plane C10. As distal entry point, the most concentric position in proximal plane was C. There were no statistical concentric, as middle, distal plane, and proximal entry point, CONCLUSION: The most ideal placement were D5 in proximal fractures of the scaphoid, C5 in distal fractures. In waist fractures of the scaphoid, there were relatively safe, except A0 and D0. The position of entry points was more important than that of target points for ideal screw placement.

38 View
0 Download

Treatment of Displaced Supracondylar Fracture of the Humerus in Children -Open Reduction with Minimal Incision of the Manually Irreducible Fracture: Kyeong Jin Han, Soo Ik Awe, Eung Suck Park, Shin Young Khang; J Korean Soc Fract 2002;15(4):587-594. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.587

Abstract PDF

PURPOSE
We evaluated the results of the displaced supracondylar fractures in children treated by closed reduction and cast immobilization, closed reduction and crossed K-wires fixation or open reduction with minimal incision and crossed K-wires fixation.
MATERIALS AND METHOD
We retrospectively reviewed the results after 1 year of the treatment of 71 extension-type fractures (Gartland type II - 19 cases, type III - 52 cases) of supracondylar humeral fractures in children under age of 8 years. Closed reduction was impossible in 20 cases (1 type II, 19 type III) and we performed open reduction with minimal incision and cross percutaneous pinning. We measured Baumanns angle and range of motion of elbow and evaluated the results by Flynns criteria.
RESULT
By Flynns criteria, 91.5 % of satisfactory (excellent, good) results in cosmetic factor and 97.2 % in functional factor. The result of closed reduction and percutaneous pinning is more excellent in functional factor and that of the minimal open reduction and percutaneous pinning in cosmetic factor but over all satisfactory results were similar.
CONCLUSION
The treatment of the displaced supracondylar humeral fractures in children needs accurate and delicate reduction and firm fixation to prevent deformity and to preserve function of the elbow. Open reduction with minimal incision instead of general incision for the manually irreducible supracondylar humeral fractures would be a reliable and convenient method for the treatment of supracondylar humeral fractures in children.

Citations

Citations to this article as recorded by

Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique
H.-Y. Lee, S.-J. Kim
The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef

102 View
0 Download
1 Crossref

Neurologic Complications of Elbow Fractures in Children: Suk Kyu Choo, Gyu Won Park; J Korean Soc Fract 2002;15(4):595-600. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.595

Abstract PDF: PURPOSE
We analyzed neurologic complications of the elbow fractures in children and evaluated clinical results of type of fractures, frequency of nerve injuries and displacement of fracture fragments and spontaneous recovery of each nerve injuries.
MATERIALS AND METHODS
We analyzed 17 child-patients (20cases) with nerve injuries who were treated conservatively and follewed up for at least 1 year since December 1999. and we analyzed type of fractures, differences between fracture type and nerve injuries, frequency of each nerve injuries and periods of spontaneous recovery of each nerves.
RESULTS
There were all 148 elbow fractures in children. Children with neurologic complications were 17(20 nerves) and 14 in supracondylar and 3 in medial epicondylar fractures. There were 6 in radial nerve, 8 in ulnar nerve, 3 in median nerve and 3 in anterior interosseous nerve. Both ulnar and median nerve injuries were 3 patients. They were recovered spontaneously and mean periods of recovery was 7.3 weeks, 6.5 weeks in radial nerves, 7.0 in median nerves, 7.6 in anterior interosseous nerves, 7.8 in ulnar nerves and radial nerve recovery was most fast than any others. One patient with ulnar nerve injury who was diagnosed medial epicondylar fracture recovered 2 weeks after excision of nonuioned fragment. Among 14 supracondylar fractures, there was 11 posteromedial displacement, 1 posterolateral and 2 posterior. Most of them was displaced posteromedially.
CONCLUSION
All nerve injuries happened in supracondylar and medial condylar fractures and almost recovered. Nerve injuries in the supracondylar fractures was displaced fractures than nondisplaced simple fractures and displacement of fracture fragment and nerve injuries was not agreed with previous published books or papers. We recommand that observation is the appropriate way to manage these nerve injuries in most cases than immediate operation for excision.

54 View
1 Download

Flexion-type Humerus Supracondylar Fractures in Children: Jae Do Kang, Kwang Yul Kim, Hyung Chun Kim, Moon Sup Lim, Shin Kwon Choi, Hyun Soo Park; J Korean Soc Fract 2002;15(4):601-606. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.601

Abstract PDF: PURPOSE
We investigated the treatment modality and clinical results in flexion-type supracondylar fractures of the humerus in children.
MATERIALS AND METHODS
11 cases of flexion-type supracondylar fractures of the humerus(3 type I, 5 type II, 3 type III) were treated, 3 fractures(3 type I) with extension cast, 6 fractures(5 type II, 1 type III) with two lateral percutaneous K-wire fixation, 2 fractures(2 type III) with open reduction and crossed pin fixation. The K-wire were removed after 4-6 weeks of operation and the follow-up period ranged from 12 months to 26 months, averaging 18 months.
RESULTS
By Flynn 's functional and cosmetic criteria, nine cases were good and excellent results, one case (type III with two lateral percutaneous pin fixation) is fair result.
CONCLUSION
As the same methods of the extension-type supracondylar fractures, the K-wire fixation is useful method in the treatment of flexion-type supracondylar fractures of the humerus in children.

83 View
0 Download

Differential diagnosis and its treatment of gas forming infections: Soo Bong Hahn, Ho Jung Kang, Jin Park; J Korean Soc Fract 2002;15(4):607-613. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.607

Abstract PDF

PURPOSE
To establish the guidelines for the differential diagnosis and proper initial treatment of the gas forming infections through the review of literature and our clinical experiences.
MATERIALS AND METHODS
The radiological findings, clinical course, gram stain, bacterial culture, predisposing factors and treatment of four cases of gas forming infections from January 1994 to August 2001, were retrospectively analyzed.
RESULTS
Three cases diagnosed presumptively as gas gangrene were improved through amputation or disarticulation and intravenous antibiotics. One case diagnosed presumptively as non-clostridial infection was expired due to sepsis in spite of incision, drainage and intravenous antibiotics. In the bacterial culture, two cases were non-clostridial infection, one case was not able to diagnose and one case was clostridial myonecrosis(gas gangrene) CONCLUSION: The gas forming infections are rare but life-threatening. When the proper initial treatment is delayed, the fatal complications may result. So, the presumptive diagnosis through gram stain, clinical course, radiological findings should be made as soon as possible, and according to which, the appropriate initial treatment, such as, surgical debridement, amputation, intravenous antibiotics must be started. The following treatments should be corrected by definitive diagnosis through the bacterial culture.

Citations

Citations to this article as recorded by

Salmonella gas-forming pyomyositis in an immunocompetent patient: a case report and review
Jee Young Lee, Gyu Min Kong
Journal of International Medical Research.2025;[Epub] CrossRef
Type I, II Acute Necrotizing Fasciitis of the Low Extremity
Sang-Jun Song, In Seok Lee, Ju Hwan Chung
The Journal of the Korean Orthopaedic Association.2007; 42(5): 636. CrossRef

98 View
0 Download
2 Crossref

Previous issues