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Volume 16(4); October 2003
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Original Articles
Surgical Treatment of Unstable Pelvic Bone Fracture Involving Sacroiliac Joint
Myung Ho Kim, Hee Gon Park, Moon jib Yoo, Jin Woo An
J Korean Soc Fract 2003;16(4):433-440.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.433
AbstractAbstract PDF
PURPOSE
To evaluate the results of surgical method using plate and screws in the treatment of unstable pelvic bone fracture involving Sacroiliac Joint.
MATERIALS AND METHOD
Authors reviewed 21 patients treated by surgical method from 1998 to 2002. Mean follow-up period was 15 months (12~24 month). Male were 16 and female were 5. We used plate and screws in 18 cases, just screws in 3 cases. We classified the type of fracture by Tile's classification and evaluated the results with Moon's criteria that based on reduction state in simple x-ray and patient's subjective satisfaction.
RESULTS
We got the bony union in all cases. By Moon's criteria, 10 cases were good, 7 cases were fair and 4 cases were poor. In 17 cases (80.9%), we got the results over fair. Mean weight bearing exercise periods were 6.4 weeks. There were 2 infection and 2 sacroiliac arthritis after operation.
CONCLUSION
As a method of surgical treatment on unstable pelvic bone fracture involving sacroiliac joint, we recommend open reduction and internal fixation with plate and screws and it may has particular advantages in early ambulation and satisfactory functional outcome.
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Factors Predisposing to Complications After Internal Fixation of Femoral Neck Fracture
Sang Won Park, Chang Yong Hur, Jong Ryoon Baek, Seong Jun Park
J Korean Soc Fract 2003;16(4):441-446.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.441
AbstractAbstract PDF
PURPOSE
To analyze the factors predisposing to complications after internal fixation of femoral neck fracture.
MATERIALS AND METHODS
We reviewed retrospectively the results of percutaneous internal fixation of femoral neck fracture using multiple pinning, in 52 cases who were treated from Jan. 1996 to Dec. 2001. Relationship between the complications and several factors such as the age, sex, time interval from injury to operation, Garden stage, Singh index, internal fixation device and state of redction were analyzed.
RESULTS
The functional results by Lunceford criteria were excellent in 23 cases (44%), good in 15 cases (29%), fair in 2 cases (3.8%) and poor in 12 cases (23.1%). The avascular necrosis of the femoral head were occured in 14 cases (26.9%). Among these, 1 case of non-union, 2 cases of mal-union were accompanied. No stastically significant relationship between the age, sex, time interval from injury to operation, Garden stage, Singh index, internal fixation device, state of redction and complication. However, there was 4 times higher complication rate in Garden stage 3 or 4 group than its rate in Garden stage 1 (odds ratio 3.889), and 3 times higher complication rate in non-anatomical reduction group (odds ratio 3.22).
CONCLUSION
Factors predisposing to complications after internal fixation of femoral neck fracture seemed to closely relate with Garden stage and state of reduction.

Citations

Citations to this article as recorded by  
  • Bipolar Hemiarthroplasty for the Femoral Neck Fractures in Elderly Patients
    Woong-Kyo Jeong, Sang-Won Park, Soon-Hyuck Lee, Jong-Hoon Park, Suk-Ha Lee, Ji-Hoon Kang, Gi-Won Choi, Won Noh
    Journal of the Korean Fracture Society.2008; 21(1): 8.     CrossRef
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The Importance of Position of the Distal Fragment in Intertrochanteric Fracture of the Femur using Compression Hip Screw
Jong Deuk Rha, Hyun Soo Park, Young Bong Park, Chang Suk Lim, Seung Woo Kim
J Korean Soc Fract 2003;16(4):447-455.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.447
AbstractAbstract PDF
PURPOSE
We reviewed the amount of impaction and the change of neck shaft angle of intertrochanteric fracture of the femur which were treated with compression hip screw according to the fracture type and the displaced state of the distal fragment.
MATERIALS AND METHODS
There were 50 patients who had at least six months follow up, 13 men, and 37 women who were treated from January 1995 to December 2000. We have analysed the amount of impaction (measurement of the ratio between screw length and screw outside barrel length) and the change of neck shaft angle according to the fracture type and the displaced state of the distal fragment. The results were assessed statistically.
RESULTS
The fracture healing was achieved in about 13 weeks. There were 36 stable fracture types and 14 unstable fracture types by Evans classification. The most common osteoporotic singh index was grade II. The mean impaction amount of the fracture site was 5.4 mm and the mean neck shaft angle change was 1.5degrees of varus angulation. The mean tip apex distance was 32 mm. There was no case of lag screw penetration into the joint. There was significant difference in result according to the displaced state of the distal fragment. The amount of impaction was less in cases that anatomically reduced or got the posterolateralization of the distal fragment.
CONCLUSION
The results of our study indicate that the anatomical reduction and posterolateralization of the distal fragment could reduce the amount of impaction and the change of neck shaft angle. We advise that the position of the distal fragment in intertrochanteric fracture of the femur is very important to reduce the failure.

Citations

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  • Comparison of Bone Mineral Density in Elderly Patients according to Presence of Intertrochanteric Fracture
    Sang Ho Moon, Byoung Ho Suh, Dong Joon Kim, Gyu Min Kong, Hyeon Guk Cho
    Journal of the Korean Fracture Society.2007; 20(3): 222.     CrossRef
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Analysis of Failures of Union of the Intertrochanteric Femoral Fractures
Sung Soo Kim, Sung Keun Sohn, Myung Jin Lee, Min Soo Kang, Sang Kook Kim
J Korean Soc Fract 2003;16(4):456-464.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.456
AbstractAbstract PDF
PURPOSE
The purpose of this study was to analyze the factors influencing the failure of union in the intertrochanteric femoral fractures.
MATERIALS AND METHODS
Authors divided the patients treated with lag screws into two groups, 9 cases of the non-union group and 46 cases of the union group. And analyzed the preoperative, intraoperative and postoperative factors influencing the union.
RESULTS
Age, displacement in AP film after surgery, displacement of lesser trochanter after surgery, superior or anterior position of lag screw, displacement of lag screw and change of neck-shaft angle were significantly higher in the non-union group. Displacement in AP radiograph after surgery and displacement of lag screw were two significant factors by multivariate logistic regression analysis.
CONCLUSION
In case of intertrochanteric fracture treated with lag screw, the probabilities of union failure are increased when the displacement is more than 5 mm in AP plane postoperatively and the sliding of lag screw is more than 10 mm in follow-up.

Citations

Citations to this article as recorded by  
  • Safety and Effectiveness of the Anchor Augmentation with Bone Cement on Osteoporotic Femoral Fracture: A Systematic Reviews
    So Young Kim
    Journal of the Korean Fracture Society.2019; 32(2): 89.     CrossRef
  • Treatment of Failed Intertrochanteric Fractures to Maintain the Reduction in Elderly Patients
    Soon-Yong Kwon, Hyun-Woo Park, Sang-Uk Lee, Soo-Hwan Kang, Jae-Young Kwon, Jung-Hoon Do, Seung-Koo Rhee
    Journal of the Korean Fracture Society.2008; 21(4): 267.     CrossRef
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Retrograde Nailing in Femur Supracondylar Fracture
Jin Woo Kwon, Sung Ho Shin, Won Ho Cho, Ki Ho Sung, Ki Han Kim, Kyong Tae Sohn, Sang Hoon Lee, Se Won Park, Jong Moon Bae, Tae Woo Kwon
J Korean Soc Fract 2003;16(4):465-473.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.465
AbstractAbstract PDF
PURPOSE
We retrospectively analysed the result of retrograde supracondylar nail fixation in femur supracondylar fractures and evaluate the clinical effectiveness of this method.
MATERIALS AND METHODS
Since October 1998 we have treated 14 supracondylar fractures (AO type: A2-6, A3-1, C1-3 and C2-4) by retrograde intramedullary nailing technique through trans-patellar tendon approach from October 1998 to June 2001 and followed more than 1 year.
RESULTS
Among 14 cases, 5 cases were excellent, 6 good, 3 fair according to Schatzker functional result. The complications were 1 distal locking screw loosening, 1 delayed union and 1 fracture around proximal locking site.
CONCLUSION
Even though the retrograde nailing may damage the knee joint because it is inserted by opening up the joint, it provided the necessary stable fixation with short operation time, low blood loss, minimal soft tissue injury. Thus we believe that retrograde nailing is useful operative technique for the management of supracondylar fracture in osteoporotic, communited fractures, or open fractures.

Citations

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  • Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail
    Moon-Jib Yoo, You-Jin Kim, Jin-Won Lee
    Journal of the Korean Fracture Society.2008; 21(1): 19.     CrossRef
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Minimally Invasive Plate Osteosynthesis for Distal Femoral Fractures
Sung Jung Kim, Chang Wug Oh, In Ho Jeon, Hee Soo Kim, Byung Chul Park, Hee Soo Kyung, Joo Chul Ihn, Ho Sung Jung
J Korean Soc Fract 2003;16(4):474-481.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.474
AbstractAbstract PDF
PURPOSE
We retrospectively reviewed the outcomes and advantages of minimal invasive plating osteosynthesis (MIPO) technique as a new treatment of distal femoral fractures.
MATERIALS AND METHODS
Sixteen supracondylar femoral fractures (15 patients) were treated by MIPO technique and evaluated radiologically and functionally after minimal 1 year follow-up (average; 22 months, range; 13~42 months). There were 9 women and 6 men with a mean age of 46 years old (range 35 to 64 years). Seven fractures were extended into knee joints (AO/OTA type C), and 9 were extraarticular (AO/OTA type A). Five cases were open fractures (type I; 2, type II; 3) according to the Gustilo-Anderson classification. After minimal lateral parapatellar incision and accurate reduction of intra-articular fractures, the supracondylar fractures were fixed by percuatneous plating method without exposure of fracture area. Neer scoring was used for functional evaluation of knee.
RESULT
At a mean of 17 weeks (range 14 to 22), most fractures united without secondary procedures. One case of nonunion had the procedure of bone graft, but there were no other complications including shortening over 1 cm, mal-alignment over 10 degrees, or deep infections. All the cases had good or excellent knee function, and the average range of knee motion was 120.6 degrees.
CONCLUSION
MIPO technique is a worthwhile method of managing distal femoral fractures with good unions and functional recovery.

Citations

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  • The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture
    Seong-Jun Ahn, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Seong-Ho Yoo, Kwan-Taek Oh
    Journal of the Korean Fracture Society.2013; 26(4): 314.     CrossRef
  • Treatment of Distal Femur Fracture with Minimally Invasive Locking Compression Plate Osteosynthesis
    Ki-Chul Park, Kyu-Sung Chung, Joon-Ki Moon
    Journal of the Korean Fracture Society.2012; 25(1): 13.     CrossRef
  • Axial Malalignment after Minimally Invasive Plate Osteosynthesis in Distal Femur Fractures with Metaphyseal Comminution
    Jae-Ho Jang, Gu-Hee Jung, Jae-Do Kim, Cheung-Kue Kim
    Journal of the Korean Orthopaedic Association.2011; 46(4): 326.     CrossRef
  • Surgical Treatment of AO Type C Distal Femoral Fractures Using Locking Compression Plate (LCP-DF, Synthes®)
    Kap-Jung Kim, Sang Ki Lee, Won-Sik Choy, Won-Cho Kwon, Do Hyun Lee
    Journal of the Korean Fracture Society.2010; 23(1): 20.     CrossRef
  • What is an Ideal Treatment?
    Chang-Wug Oh
    Journal of the Korean Fracture Society.2008; 21(4): 347.     CrossRef
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Arthroscopic-Assisted Reduction and Internal Fixation of Patella Fractures
Sang Hun Ko, Sung Do Cho, Hwa Yeop Na, Woo Suk Kim, You Young Jeong, Chang Yeul Kwag, Bum Soo Kim
J Korean Soc Fract 2003;16(4):482-489.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.482
AbstractAbstract PDF
PURPOSE
The aim of this study is to report the clinical effectiveness of arthroscopic-assisted reduction and internal fixation of patella fractures.
MATERIALS AND METHODS
We analyzed fifteen patella fractures, which had been operated by using an arthroscopic-assisted technique from January, 2000 to April, 2003 at our hospital. After clinical follow-ups for at least 1 year, clinical analyses had been done by using the Cincinnati Knee Rating System Score, Lysholm Score Scale, and radiological findings.
RESULTS
In our study group, the Cincinnati Knee Rating System scores were from 80 to 100, with a mean of 89.9. The Lysholm Scoring Scale scores ranged from 81 to 100 with a mean of 90.8 for the same group. Radiologically, we obtained complete anatomical reduction of articular surfaces in 80 percent of cases. Arthroscopic-assisted reduction for patella fractures brought clinically satisfactory results that are accurate articular surface reduction, early recovery of motion range, knee joint stability and minimal soft tissue damage, etc.
CONCLUSION
The operative treatment for patella fractures using arthroscopic-assisted reduction is an effective alternative method to open reduction.

Citations

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  • Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases
    Ji-Hye Geum, Hyeon-Jun Woo, Jong-gyu Kim, Jung-Han Lee
    Journal of Korean Medicine Rehabilitation.2020; 30(4): 203.     CrossRef
  • Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
    Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
    Journal of the Korean Fracture Society.2014; 27(3): 206.     CrossRef
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Meniscal Injuries with Tibial Plateau Fractures
Yong In, Won Jong Bahk, Oh Soo Kwon, Chae Gwan Kong, Ju Young Kim
J Korean Soc Fract 2003;16(4):490-495.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.490
AbstractAbstract PDF
PURPOSE
The purpose of this study is to evaluate by arthroscopy the incidence of meniscal injury and the result of its treatment in fractures of the tibial plateau.
MATERIALS AND METHODS
From March 2000 to July 2002, twenty-three patients with tibial plateau fractures were examined and treated by arthroscopy before reduction of the fractures. Following the classification by Schatzker, there were 3 pure cleavage fractures (type I), 7 with cleavage and depression (type II), 4 with pure central depression (type III), one medial condyle fracture (type IV) and 8 with meta-diaphyseal fractures (type VI). Meniscal injuries were treated by meniscectomy or meniscal repair. Second look arthroscopy for patients treated with meniscal repair were performed at 6 months after operation or at time of the fixative removal.
RESULTS
Thirteen knees (56%) were found to have meniscal injuries. There were 11 lateral meniscal tears, eight of which were periphral and repaired. There were 3 complex lateral meniscal tears which required partial meniscectomy. The five medial meniscal tears were required all partial meniscectomy. Six of the eight patients who were repaired the meniscal tears evaluated by second look arthroscopy. Five patient showed complete healing and one showed incomplete healing.
CONCLUSION
Every effort should be made to repair the meniscal tears in tibial plateau fractures.
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Lateral Submeniscal Approach in the Treatment of Tibial Condyle Fracture
Weon Yoo Kim, Jin Young Kim, Woo Sung Choi, Yong Hwan Kim, Bum Sung Lee, Young Mo Kim, Chang Whan Han
J Korean Soc Fract 2003;16(4):496-503.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.496
AbstractAbstract PDF
PURPOSE
To evaluate the radiologic and functional results of treatment in proximal tibial plateau fracture using lateral submeniscal approach, which is a relatively minimally invasive approach to tibial condylar articular surface.
MATERIALS AND METHODS
Twenty three cases of tibial plateau fracture which treated with submeniscal approach were analyzed with one year follow up. The results were evaluated by immediate postoperative radiographic and Hohl's clinical evaluation.
RESULTS
Tibial articular surface could be in operation field and the articular surface could be restored the anatomically by elevating the depressed articular surface and bone graft to the empty space. The postoperative radiography showed that most cases (91%) could be reduced adequately (within 2 mm). The clinical evaluation by Hohl's criteria revealed excellent 7 cases (30%), good 12 cases (52%), fair 3 cases (13%), and one poor case (4%).
CONCLUSION
Submeniscal approach can identify the articular surface and intraarticular soft tissues with minimal incision, and allows anatomical reduction, sufficient bone graft, rigid plate fixation and soft tissue treatment, therefore it is one of the good approach in treatment of proximal tibial plateau fracture.
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Treatment of Segmental Fractures Associated with Periarticular Fracture of the Tibia by Ilizarov External Fixator
Jung Ryul Kim, Moon Ki Choi, Kwang Bok Lee, Jong Hyuk Park, Ju Hong Lee, Jun Mo Lee, Kyung Jin Song, Byung Yun Hwang
J Korean Soc Fract 2003;16(4):504-510.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.504
AbstractAbstract PDF
PURPOSE
We analyzed the results and complications of the treatment of segmental fractures of the tibia associated with periarticular fracture by using Ilizarov external fixator.
MATERIALS AND METHODS
We reviewed 17 patients of segmental fractures of the tibia were treated by Ilizarov external fixator and were followed for a minimum one year. There were twelve closed fractures, three type 3A, and two type 3B open fractures. According to Melis classification, there were five type I, four type II, and eight type III. All closed fractures were reduced and fixed with Ilizarov external fixator within seven days. Open fractures were performed immediate wound irrigation and radical debridement and fixed with Ilizarov external fixator. Autogenous iliac bone graft was done in five severe comminuted fractures. Average time in bone graft was 7.5 weeks after operation. We analyzed bony union time according to configuration and site of the fractures, results of the treatment, and complications. The functional outome was assessed with rating system of Tucker.
RESULTS
In all cases, bony union was obtained, and average union time was 20.5 weeks. According to modified Melis classification, our results showed no difference between each criteria with respect to bony union and there was no difference bony union time between proximal and distal fracture site. There were two leg-length discrepancy less than 2 cm, one partial ankylosis of the knee joint, and ten pin tract infections. The functional results was excellent in 11 cases, good in 5 cases, and fair in one case.
CONCLUSION
Ilizarov external fixator can be useful method for the treatment of segmental fractures of the tibia associated with juxtaarticular fracture in respect of bony union and functional results.
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Treatment of Infected Nonunion of Long Bone Shaft: Comparison between Fixation by Antibiotic-cement Loaded Intramedullary Nailing and Fixation by Antibiotic-cement Loaded External Monofixator
Ki Ho Nah, Seong Jin Park, Suk Ku Han, Hyun Suk Song, Nam Yong Choi
J Korean Soc Fract 2003;16(4):511-518.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.511
AbstractAbstract PDF
PURPOSE
To evaluate the surgical results between fixations by antibiotic-cement loaded intramedullary nailing and antibiotic-cement loaded external monofixator in the treatment of infected nonunion of long bone shaft with mild bone loss and shortening of less than 1 cm.
MATERIALS AND METHODS
Among the 15 cases of infected nonunion of long bone shaft, 6 cases treated with fixation by antibiotic-cement coated intramedullary nailing and 3 cases treated with fixation by intramedullary nailing along with antibiotic-cement beads insertion were divided as group I (n=9), and other 6 cases treated with fixation by external monofixator along with antibiotic-cement beads insertion were divided as group II (n=6). There was no difference between the two groups in the degree of infection in the laboratory data and clinical feature and degree of bone loss and shortening. Male was in 7 and 5 patients, average age of the patients was 34.8 (26~53) and 37.2 (20~63) years old and average follow-up period was 15.9 (12~35) and 19.3 (15~41) months in group I and II respectively.
RESULTS
Among the nine cases of group I, 3 cases were newly convereted into fixation by antibiotic-cement coated intramedullary nailing at average 9.5 weeks. Radiologic union was gained at the average of 26 weeks from the time of initial nail fixation. Infection was responsive at 6.1 weeks by laboratoey data. Knee ROM of more than 100 degrees was gained in all case and average shortening was 9.2 mm in the last follow-up. And external rotation deformity of more than 5 degrees was noted in 1 case. Among the six cases of group II, radiologic union was gained at 14 weeks in 1 case without converting to internal fixation, and the other 5 cases were converted to antibiotic cement loaded intramedullary nailing at average 12.5 weeks because of delayed uinon or angulation deformity, and radiologic union was gained at average 44 weeks from the time of fixation by external fixator. Infection was responsive at 10.2 weeks by laboratoey data. Knee ROM of more than 100degrees was gained in 5 cases, and average shortening was 11.8 mm in the last follow-up.
CONCLUSION
In the treatment of infected nonunion of long bone shaft with mild bone loss and shortening of less than 1 cm, the fixation by intramedullary nailing with the use of antibiotic-cement prefers to the fixation by external monofixator with the use of antibiotic-cement in the velocity of union, control of infection, and in the clinical aspects such as alignment, early ambulation and joint stiffness.
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Surgical Treatment of Internal Malleolar Fracture of the Ankle: Rush Rod Versus Plate Osteosynthesis
Hak Jun Kim, Kwon Ick Ha, Jae Ik Shim, Taik Seon Kim, Jeong Ro Yoon, Young Bae Kim, Woo Seung Lee, Jae Young Chang
J Korean Soc Fract 2003;16(4):519-525.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.519
AbstractAbstract PDF
PURPOSE
We evaluated the results between the methods of open reduction and internal fixation using plate and screws and the methods of closed reduction and fixation with rush pin in lateral malleolar fractures.
MATERIALS AND METHODS
We analysed the 33 fractures of lateral malleolus which had been treated by open reduction and internal fixation using plate and screws or closed reduction and fixation with rush pin from January 1995 to January 2002 and had been observed over 1 year. The 33 patients were observed for the comparison of radiologic and clinical results in according to the measure of McLennan and Ungersma.
RESULTS
Among the 33 cases, 15 cases were treated by open reduction and internal fixation with plate, and 18 cases were treated by closed reduction and Rush rods fixation. In according to the measure of McLennan and Ungersma, good radiologic result was 60% (9 cases) and excellent clinical result was 27% (4 cases) in plate fixation, and good radiologic result was 61% (11 in 18 cases) and excellent clinical result was 39% (7 in 18 cases) in Rush rods fixation.
CONCLUSION
In ankle fractures of elderly patients who have soft tissue problems and osteoporotic bony quality, radiologic and clinical results of internal fixation of distal fibula were relatively same between fixation with plate and screws and Rush rods. Therefore, closed reduction and internal fixation with Rush rods is one of the good treatment modalities of distal fibular fracture.
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Usefulness of CT Scan in Treatment of Calcaneal Fracture
Hak Jun Kim, Kwon Ick Ha, Jeong Ro Yoon, Jae Ik Shim, Taik Seon Kim, Young Bae Kim, Woo Seung Lee, Jae Hyuck Choi
J Korean Soc Fract 2003;16(4):526-533.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.526
AbstractAbstract PDF
PURPOSE
Accurate fracture classification is difficult because of its complex bony architecture and there is no definitive treatment modality according to fracture pattern or classification. We evaluated the fracture pattern using simple radiography and CT scan simultaneously and then the result according to treatment modalities and fracture classification.
MATERIALS AND METHODS
We evaluated 24 patients (26 cases) who suffered intraarticular calcaneal fracture were treated with closed reduction and axial pinning or open reduction and plate fixation. There were had taken CT scan. Fractures were classified with two different manner using both plain radiography and CT scan. Essex-Lopresti classification was made with plain radiography and Sanders classification was made with CT scan. Radiographic results were measured of preoperative and postoperative Bohler angle on plain x-ray. 16 patients (17 cases) were analyzed for clinical outcomes by Salama's criteria focused on pain, patients' satisfaction, walking abilities and usage of orthosis.
RESULTS
Mean followed-up period was 6 years (range 1~8.8 years). 8 cases were classified into tongue type intraarticular calcaneal fractures by plain radiography and 9 cases into joint depression type. According to Sanders classification by CT scan, 5 cases were classified into type IIA, 1 case IIC, 4 cases type IIIA, 4 cases IIIB and 3 case type IV. 12 fractures were reduced by closed reduction and axial fixation and 5 cases by open reduction and internal fixation. There was no correlation between clinical outcomes and treatment modality but there was linear correlation between clinical outcomes and postoperative Bohler angle (correlation coefficient = 0.04). In 8 cases of tongue type by plain radiography, sanders type IIC was only 1 case which calcaneal tuberosity connected to articular facet but articular involvements were observed in remaining cases.
CONCLUSION
Accurate eavaluation of articular facet in calcaneal fracture by CT scan is necessary to determining to select the treatment option.

Citations

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  • Physiological Characteristics and Anti-Obesity Effect of Lactobacillus plantarum K6 isolated from Kimchi
    Seulki Kim, Sang-Dong Lim
    Journal of Milk Science and Biotechnology.2017; 35(4): 221.     CrossRef
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Complications after Vertebroplasty of Treatment for Compression Fracture with Osteoporosis
Hee Gon Park, Myung Ho Kim, Moon Jib Yoo, Sung Chul Lee, Jin Young Park, Woo Yeon Hwang, Jin Woo An
J Korean Soc Fract 2003;16(4):534-540.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.534
AbstractAbstract PDF
PURPOSE
To evaluate the complications of percutaneous vertebroplasty using PMMA (polymethylmethacrylate) in the treatment of osteoporotic compression fractures.
MATERIALS AND METHODS
Authors reviewed 113 patients treated by percutaneous vertebroplasty from 1998 to 2001. After treatment, Simple x-ray and computed tomography were done of methods for analysis of complication, especially bone cement leakage.
RESULTS
In each case, we injected bone cement (PMMA) in one vertebra, average amount is 5.6 cc. The complications were 39 cases (34.5%): 1 case was dead by hemothorax, 1 case was arrhythmia, 12 cases were intercostals neuralgia, 7 cases were back pain, 2 cases were mild dyspnea, 14 cases were abdominal pain and 2 case were injection site pain. In follow-up x-ray and CT, bone cement (PMMA) leakage were 45 cases (39.8%).
CONCLUSION
Bone cement (PMMA) leakage can be cause of complications in vertebroplasty. We try to avoid the complication of bone cement leakage.

Citations

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  • A Review of Korean Medicine Treatment for Managing the Thoracolumbar Compression Fractures: A Retrospective Observational Study
    Min-Jin Cho, Jiyun Lee, Myeong-Jong Lee, Hojun Kim, Kyungsun Han
    Journal of Korean Medicine Rehabilitation.2023; 33(4): 109.     CrossRef
  • Clinical and radiological outcomes of denosumab and teriparatide treatment in elderly patients with osteoporotic spinal compression fracture without vertebroplasty
    Joo Young Jung, Byoung Hun Lee, Jong Young Lee, Hong Jun Jeon, Byung Moon Cho, Su Yeon Kim, Se Hyuck Park
    Journal of Korean Society of Geriatric Neurosurgery.2021; 17(2): 69.     CrossRef
  • A Retrospective Clinical Survey of Vertebral Compression Fractures
    Ji Hye Oh, Yun Kyu Lee, Jae Soo Kim, Hyun Jong Lee, Sung Chul Lim
    Journal of Acupuncture Research.2018; 35(4): 219.     CrossRef
  • Survival Analysis of Conservative Treatement in Osteoporotic Vertebral Fracture
    Young Do Koh, Jong-Oh Kim, Rag Gyu Kim, Dae Youn Kim, Nam-Ki Kim, Dong Jun Kim
    Journal of Korean Society of Spine Surgery.2012; 19(4): 138.     CrossRef
  • Factor Analysis Affecting the Leakage of Bone Cement After Vertebroplasty
    Jae-Hoon Kim, Kyung-Jin Song, Tai-Seung Kim, Jae-Lim Cho, Ye-Soo Park
    Journal of Korean Society of Spine Surgery.2010; 17(1): 13.     CrossRef
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MRI Findings of Posterior Ligament Complex Injury in Thorcolumbar Bursting Fractures
Young Do Koh, Yeo Heon Yun, Hoon Jeong
J Korean Soc Fract 2003;16(4):541-547.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.541
AbstractAbstract PDF
PURPOSE
To investigate the MR findings of structures injured in the burst fractures of thoracolumbar spine.
MATERIALS AND METHODS
Twenty-one patients who had thoracolumbar burst fractures with posterior ligament complex injury on MRI were studied. For the evaluation of stability of fractures, we used the scheme described by Oner et al. We identified the state of posterior ligament complex on surgery.
RESULTS
The MRI findings of ALL were state 1 in four, state 2 in fourteen, and state 3 in three. Those of PLL were state 1 in twelve, state 2 in six, and state 3 in three. The findings of posterior ligament complex were state 2 in one, state 3 in three, and state 4 in seventeen. The endplate state 1 was in four, state 2 in six, state 3 in seven, and state 4 in four. The disc state 1 was in twelve, state 2 in six, state 3 in two, state 4 in one. The vertebral body involvement state was 1 in four, state 2 in nine, and state 3 in eight. The injuries of posterior ligament complex were confirmed intraoperatively in all twenty-one patients.
CONCLUSION
We recommend the use of MRI to evaluate stability of fractures and state of posterior ligament complex in thoracolumbar burst fractures.
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The Treatment of Acromioclavicular Dislocation Comparison Study between Bosworth Screw and Wolter Plate Technique
Jae Do Kang, Kwang Yul Kim, Hyung Chun Kim, Kyung Chil Jung, Mun Sup Lim, Jin Hyung Kim, Seong Joo Lee
J Korean Soc Fract 2003;16(4):548-554.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.548
AbstractAbstract PDF
PURPOSE
Acromioclavicular joint dislocation are frequently seen and various operation treatment modalities have been suggested. The purpose of this study is to compare the clinical results of two operative methods, Bosworth screw procedure and Wolter plate technique.
MATERIALS AND METHODS
We have analysed 30 patients with acromioclavicular dislocations, which had been treated by Bosworth screw & Wolter plate technique from June 1996 to February, 2002 with minimal 1 year follow up. All patients were assessed clinical and radiological results by ASES Score and UCLA Score.
RESULTS
Using the Shoulder evaluation scheme of ASES and UCLA Score at the one year follow up examination, 93.4% of the patients had excellent results in Wolter plate group. In Bosworth screw group, 4 complications such as loosening of the screw, or breakage of screw were seen. 2 complicated patients were over 40 years old and then conversions to Wolter plate operation was needed and obtained good results.
CONCLUSION
Bosworth procedure has a merit not to damage acromioclavicular joint, but the technique is difficult, sometimes may be encountered loss of fixation due to overcorrection and anterior displacement of the clavicle. However, Wolter plate implant provides enough stability for active postoperative physiotheraphy, and hence accelerates rehabilitation. Therefore, this technique is thought to be a good modality in the treatment of acute acromioclavicular seperation.
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Operative Treatment of the Clavicular Fracture with Cannulated Screw
Byung Jik Kim, Suk Kyu Choo, Jin Hwan Kim, Sang Min Lee, Dong Soo Kim
J Korean Soc Fract 2003;16(4):555-562.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.555
AbstractAbstract PDF
PURPOSE
To investigate the utility of cannulated screw in operative treatment of the clavicular fracture.
MATERIALS AND METHODS
From December 1999 to December 2002, 23 patients with clavicular fracture were underwent operative treatment with cannulated screw. Their mean age was 40.1 years and the sites of fracture were 16 cases in middle 1/3, 7 cases in lateral 1/3, 12 cases were comminnuted fracture. The clinical and radiological results were evaluated.
RESULTS
According to the Kang's criteria, the clinical results were excellent in 18 cases (78.3%), good in 4 cases (17.4%) and fair in 1 case. Radiologically, all cases showed bone union and the average time was 7.9 weeks. Complications such as infection, nonunion, metal failure has not been observed.
CONCLUSION
Open reduction and internal fixation with cannulated screw could be considered as an alternative method of treatment in clavicular fracture, when indications for primary surgical treatment are presents.
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Surgical Treatment of Fractures of the Distal Radius in Patients Older Than 65 Years
Jeung Tak Suh, Dae Woong Kim, Chong Il Yoo
J Korean Soc Fract 2003;16(4):563-569.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.563
AbstractAbstract PDF
PURPOSE
To analyze the results of surgical treatment of the displaced distal radius fractures in elderly patients over 65 years old who were treated with percutaneous K-wire fixation only and percutaneous K-wire fixation with external fixation. MATERIAL AND METHOD: We evaluated 24 cases of the distal radius fracture in patients older than 65 years from January 1998 to December 2001. The patients were followed up at least 12 months postoperatively. We compared the surgical results of 14 cases, treated with percutaneous K-wire fixation only with the surgical results of 10 cases, treated with percutaneous K-wire fixation with external fixation. We evaluated the functional results according to demerit point system and the radiographic results (radial length, radial inclination, volar tilt).
RESULTS
According to demerit point system, the mean score of demerit point was 9.9 in the group of percutaneous K-wire fixation and 5.3 in the group of percutaneous K-wire with external fixation respectively (p<0.05). In radiographic results, the percent of the mean loss of radial length, radial inclination and volar tilt were 23.2%, 12% and 41.7% in the group of percutaneous K-wire fixation and 11%, 5.9% and 27.4% in the group of percutaneous K-wire with external fixation respectively (p<0.05).
CONCLUSION
Percutaneous K-wire with external fixation showed better functional and radiographic results than percutaneous K-wire fixation only for the treatment of the displaced distal radius fractures in elderly patients older than 65 years and percutaneous K-wire with external fixation is thought to be a one of the most effective treatment of the displaced distal radius fractures in elderly patients.

Citations

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  • Osteoporotic Distal Radius Fracture-conservative Treatment
    Seok-Whan Song
    Journal of the Korean Fracture Society.2008; 21(1): 81.     CrossRef
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Correlation Analysis of BMD in Proximal Femur and Spine
Jun Young Yang, Young Mo Kim
J Korean Soc Fract 2003;16(4):570-576.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.570
AbstractAbstract PDF
PURPOSE
To analogize the result of the test through explaining the correlation of bone mineral density (BMD) test value between proximal femur and lumbar spine.
MATERIALS AND METHODS
It is based on 59 cases who visited the out-patient department. They were classified into two groups by age, group I (55~59 yr) and II (60~64 yr). Then we evaluated the average and the degree of correlation between the two groups and analyzed the correlation of the two sites according to the T & Z-score through the regression analysis.
RESULTS
In T-score, the correlation between L (independent variable, lumbar) and H (dependent variable, femur) indicated that L = 0.751 xH -0.195 for group I and L = 0.912 xH+0.31 for group II. In Z-score, the correlation was L = 0.647 xH -0.656 for group I and L = 0.897 xH -0.481 for group II.
CONCLUSION
It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part.

Citations

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  • A Novel Method for Estimation of Femoral Neck Bone Mineral Density Using Forearm Images from Peripheral Cone Beam Computed Tomography
    Kwanmoon Jeong, Hoon Ko, Chang-Hoon Lee, Myeung Lee, Kwon-Ha Yoon, Jinseok Lee
    Applied Sciences.2016; 6(4): 113.     CrossRef
  • The Correlation Analysis and Correction factor of BMD in Forearm and Lumbar with DXA
    Man-Seok Han
    The Journal of Digital Policy and Management.2013; 11(12): 551.     CrossRef
  • The Correlation Analysis of BMD in Proximal Femur and Spine with Dual Energy X-ray Absorptiometry
    Man-Seok Han, Dong-Heon Cho
    Journal of the Korea Society of Computer and Information.2012; 17(9): 165.     CrossRef
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A Clinical Study about Postoperative Wound Complications In Liver Cirrhotic Patients
Seung Woo Suh, Seok Hyun Lee, Jun Kyu Moon, Young Jin Roh, Chang Woo Seok
J Korean Soc Fract 2003;16(4):577-584.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.577
AbstractAbstract PDF
PURPOSE
This study undertaken to evaluate the postoperative wound complications between Child class A liver cirrosis patients and Child class B liver cirrhosis patients.
MATERIALS AND METHODS
In a retrospective study from 1998 to 2003, fifteen patients who underwent surgical intervention for fractures were evaluated the period of wound healing, hopital day, infection, wound complications (swelling, hematoma formation, wound discharge).
RESULTS
The cases of wound complication are 6/15 (40%), in which Child class A LC patients are two (14%), and Child class B LC patients are four (50%). The cases of wound Infection are 2/15 (13%), in which Child class A LC patient is one (14%), and Child class B LC patient is one (12.5%). The average of hospital day is 28 days.
CONCLUSION
The clinical results of postoperative complications is associated with Child classification, but the ralationship between postoperative wound infection and Child classification is not observed. We thought that careful wound management needs in liver cirrhosis patients.
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Treatment of Completely Displaced Supracondylar Fracture of Humerus in Children
Bu Hwan Kim, Mu Jung Heo, Won Jun Hwang
J Korean Soc Fract 2003;16(4):585-591.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.585
AbstractAbstract PDF
PURPOSE
We performed a retrospective study of completely displaced supracondylar fracture of humerus in children to evaluate the result of primary open reduction and internal fixation for this injuries, and also to know whether it is recommendable or not for such injuries.
MATERIALS AND METHODS
For 5 years duration from March '96 to Feb. '01, we treated 58 cases of completely displaced supracondylar fractures of humerus in children. Among them we performed primary open reduction and internal fixation of this fracture in 14 cases. We followed up those cases more than 18 months and evaluated the results by Flynn et al. and Mark et al. criteria.
RESULTS
Eleven of them resulted in excellent grading by both Flynn and Mark criteria. Three cases not involved in excellent grading proved to be good result by Mark criteria. But by Flynn criteria, 2 cases showed good results and the other one proved to be fair. In all cases, the patient and parents were satisfied cosmetically and functionally. Only in one case, the recorded grading was different, fair by Flynn and good by Mark criteria.
CONCLUSION
Primary open reduction and internal fixation in the treatment of completely displaced and not easily reduced supracondylar fracture of humerus in children resulted excellent and good results with few complications, and patients were satisfied with the results functionally and cosmetically. So we recommend proceeding to primary open treatment and internal fixation for these difficult fractures with low threshold to open reduction.

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  • 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
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Nancy Nail Fixation for Femur Shaft Fracture in Children
Ki Do Hong, Sung Sik Ha, Nam Sik Chung, Jae Cheon Sim, Jae Young Kim
J Korean Soc Fract 2003;16(4):592-599.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.592
AbstractAbstract PDF
PURPOSE
To investigate, the radiologically, the duration of bone union, angular formation, leg length discrepancy, other complications and mean hospital stay after Nancy nail fixation has been performed in children with femoral shaft fracture, and also to inquire into the clinical validity of such procedure. MATERIAL AND METHOD: Included in this study were 12 patients who had been treated with the Nancy nail fixation for the femoral shaft fracture and then followed up for a year or more. The age distribution ranged from 4 to 12 years with mean age 7.2 years. After the fracture was reduced under an imaging intensifier, 2 or 3 Nancy nails were pinned onto the medial and lateral femur distally.
RESULTS
The average duration for complete union was 9.9 weeks. Any angular formation over 5 degrees was notfound. Leg length discrepancy ranged from 2 mm shortening to 12 mm overgrowth with a mean value of 2.8 cm. In one case, with overgrowth over 10 mm or more, there was no gait disturbance. In all cases, There was neither infection, delayed union, nor any motion disturbance. A nail was moved distally in one case and skin irritation was evident in another case. The mean hospital stay was 17.3 days.
CONCLUSION
Nancy nail fixation in pediatric femoral shaft fracture relatively has less complications and is a safe surgical procedure. In addition, it helps in reducing hospital stay.

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  • Comparison of Flexible Intramedullary Nailing with External Fixation in Pediatric Femoral Shaft Fractures
    Do-Young Kim, Sung-Ryong Shin, Un-Seob Jeong, Yong-Wook Park, Sang-Soo Lee, Keun-Min Park
    The Journal of the Korean Orthopaedic Association.2008; 43(1): 30.     CrossRef
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Fixation Failure of Compression Hip Screw in Unstable Intertrochanteric Fracture of Femur
Deuk Soo Hwang, Sang Goo Kwak, Young Mo Kim, Dae Chul Nam, Ui Pyo Hong
J Korean Soc Fract 2003;16(4):600-604.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.600
AbstractAbstract PDF
PURPOSE
To evaluate the factor of fixation failure in association of the early controlled weight bearing exercise after using a compression hip screw (CHS) for unstable intertrochanteric fracture of femur in old ages.
MATERIALS AND METHODS
Between May 1998 and February 2002, 8 cases of fixation failure of CHS among the 80 patients were evaluated. We compared gender, age, fracture type with a matched group that fixation failure was not noted. During operation, we performed valgus nailing of compress lag screw and compressed fracture gap with a bolt as soon as possible. The patients were encouraged partial weight bearing 4~5 days after operation and compaired immediate postoperative and postoperative 2 weeks x-ray films about degree of slippage or varus angulation of femur.
RESULTS
In 5 cases, cut-out of the lag screw were found. In 3 cases, plate fracture and fixation failure were found. Relation between timing of partial weight bearing and fixation failure was not significant (p=0.146). But in 5 cases of failure, they continued weight bearing in spite of excessive slippage of the lag screw.
CONCLUSION
Early controlled partial weight bearing exercise after operation of intertrochanteric fracture of the femur were reported good for functional recovery in old ages. But, excessive slippage of the lag screw or varus angulation of proximal femur were found on follow up period, patient teaching and control of ambulation is strongly recommended.

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  • Treatment of Failed Intertrochanteric Fractures to Maintain the Reduction in Elderly Patients
    Soon-Yong Kwon, Hyun-Woo Park, Sang-Uk Lee, Soo-Hwan Kang, Jae-Young Kwon, Jung-Hoon Do, Seung-Koo Rhee
    Journal of the Korean Fracture Society.2008; 21(4): 267.     CrossRef
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