Journal of Musculoskeletal Trauma

Surgical Fitness for Trochanteric Fracture in Elderly: Prospective Study: Gu Hee Jung, Jong Seo Lee, Sung Gun Heo, Jae Do Kim, Hyun Ik Cho; J Korean Fract Soc 2014;27(4):261-266. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.261

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the risks of undergoing intramedullary nailing with minimum surgical optimization (fast-track) for geriatric trochanter fracture due to fall from a standing height.
MATERIALS AND METHODS
From May 2006 to August 2013, 48 fractures were enrolled in fast-track, and were an average age of patients was 77.6 years (range, 62-97 years). They underwent primary testing for anesthesia, including basic body fluid test, arterial blood, electrocardiography, and chest radiographs. The time from visit to surgery was 28.9 hours (range, 1-96 hours).
RESULTS
During hospitalization, there was one case of stress-induced cardiac arrest; however, other complications, infection, and 30-day mortality did not occur. According to preoperative classic test, the average albumin was 3.45 g/dl, blood sugar, 169 mg/dl, blood urea nitrogen, 20.5 mg/dl, Cr, 1.5 mg/dl, Na, 135.3 mEq/L, and K, 4.21 mEq/L. The average PaCO2 of arterial blood was 37.6 mmHg.
CONCLUSION
We found that the fast-track for trochanteric fracture due to slip-down was relatively safe, and could be considered as a therapeutic approach.

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Treatment of Type IIIb Open Tibial Fractures: Seong Yeon Lim, Il Jae Lee, Jae Ho Joe, Hyung Keun Song; J Korean Fract Soc 2014;27(4):267-273. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.267

PURPOSE
The purpose of this study is to evaluate the outcome of treatment for patients with Type IIIb open tibial fractures.
MATERIALS AND METHODS
This study targeted 35 adult patients for whom follow-up was possible over one year after undergoing surgical treatment. There were 29 males and six females with an average age of 45 years.
RESULTS
Fracture location was proximal in 10 cases, midshaft in 13 cases, and the distal part of the tibia in 12 cases. An average of 10 days was observed for definitive fixation with soft tissue coverage of the injury. The mean time to radiographic union was 27 weeks. Sixteen cases (45.7%) of complications were observed. Three cases of superficial infection, two cases of deep infection, four cases of partial flap necrosis, three cases of mal-alignment, three cases of joint stiffness, and one case of hardware breakage were observed. The mean lower extremity functional scale score was 68.5 and the factors influencing the clinical results were severity of open wound (p=0.000) and occurrence of complications (p=0.000) according to results of multiple regression analysis.
CONCLUSION
In treatment of Type IIIb open tibial fractures, good clinical results can be expected provided that complications are prevented through proper reduction, firm fixation, early soft tissue reconstruction, and early rehabilitation.

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Effect of Korean Medicine Treatments in Patients with Proximal Tibia Fracture: A Retrospective Observational Study
Jung Min Lee, Eun-Jung Lee
Journal of Korean Medicine Rehabilitation.2020; 30(3): 141. CrossRef

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Modified Stoppa Approach in Acetabular Fractures: Ji Wan Kim, Young Chang Kim; J Korean Fract Soc 2014;27(4):274-280. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.274

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the clinical results of modified Stoppa approach in acetabular fractures.
MATERIALS AND METHODS
Twelve patients who underwent surgery using the modified Stoppa approach for acetabular fractures were enrolled. There were 10 cases of isolated acetabular fracture, two cases of acetabular fracture combined with pelvic ring injury. There were two cases of anterior column fracture, nine cases of both column fracture, and one case of T-type fracture according to Letournel classification. The clinical outcomes were evaluated from Harris hip score (HHS) at postoperative one year and complications. The radiologic result was evaluated according to Matta criteria; anatomical, imperfect, and poor.
RESULTS
According to the radiological results, there were eight cases of anatomical, three cases of imperfect, and one case of poor reduction. The average HHS was 82.5 and 10 patients had excellent or good results. The other two patients had poor results due to lumbosacral plexopathy and poor reduction, respectively. The complication included one case of incomplete sciatic nerve palsy, which was recovered at postoperative three months.
CONCLUSION
Internal fixation of acetabular fractures using the modified Stoppa approach had satisfactory clinical and radiological outcomes. The modified Stoppa approach can be a useful option for acetabular fractures with appropriate indication and anatomical information.

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Adhesion of External Iliac Vessels Found in a Modified Stoppa Approach to Acetabular Fracture in a Patient with a History of Previous Abdominal Surgery
Seong-Tae Kim, Seungyup Shin, Hohyoung Lee, Seong Man Jeon
Journal of the Korean Orthopaedic Association.2022; 57(1): 68. CrossRef
Anterior Approach for the Acetabular Fractures
Jae Youn Yoon, Jae-Woo Cho, Ji Wan Kim
Journal of the Korean Fracture Society.2019; 32(3): 157. CrossRef
Reduction Technique of Dome Impaction Using the Modified Stoppa Approach: A Technical Note
Ji Wan Kim, Yong Min Seo, Hyo-Seok Jang
Journal of the Korean Fracture Society.2017; 30(3): 131. CrossRef
Biological fixation of pelvic ring and acetabular fractures: a pilot study with anatomical validation
Abdelfattah Mohamed Fathy Saoud, Ahmed Mohamed Sallam, Ahmed Mohamed Morsey
Current Orthopaedic Practice.2017; 28(3): 303. CrossRef
Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture
Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong
Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef

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Analysis of Missed Fractures in Polytrauma Patients: Ki Chul Park, Hyun Uk Kim; J Korean Fract Soc 2014;27(4):281-286. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.281

Abstract PDF: PURPOSE
The purpose of this study is to determine the frequency of missed fractures in severe multiple trauma patients and to analyze any differences in treatment plan, after whole body bone scan.
MATERIALS AND METHODS
From September 2012 to December 2013, 49 patients were confirmed to have multiple trauma with an injury severity score (ISS) of 16 or higher. Whole body bone scan was performed at an average of 15.7 days (7-25) after injury. Missed fractures were diagnosed according to physical examination and additional radiologic reports. Locations and patterns of missed fractures were analyzed. We evaluated any differences in treatment plan after the diagnosis of missed fractures.
RESULTS
Missed fractures were diagnosed in 14 patients (16 cases) on the whole body bone scan. The most frequent location was the knee (three cases), followed by rib, clavicle, carpal bone, and foot. Seven cases were occult fractures, five cases were undisplaced fractures and four cases were displaced fractures. Conservative treatment was administered in 15 patients and surgery was necessary in one patient.
CONCLUSION
Delayed or missed diagnosis of fractures occurred frequently in patients of multiple trauma with a high ISS. Whole body bone scan appears to be effective in finding missed fractures in the whole body. Definitive assessment should be supplemented after initial trauma care in order to reduce the rate of missed fractures.

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Comparison of Greater Trochanter Versus Piriformis Entry Nail for Treatment of Femur Shaft Fracture: Jong Hee Lee, Jong Hoon Park, Si Yeong Park, Seong Cheol Park, Seung Beom Han; J Korean Fract Soc 2014;27(4):287-293. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.287

Abstract PDF: PURPOSE
The purpose of this study was to compare the clinical outcome of femoral shaft fracture treatment with intramedullary nailing performed using a greater trochanter and a piriformis entry nail.
MATERIALS AND METHODS
A total of 57 patients treated by antegrade nailing for a femoral shaft fracture between January 2008 and April 2013 were included in this study. We evaluated postoperative radiographs of 57 femoral shaft fractures stabilized with femoral intramedullary nailing at a single institutional center. The cases included 25 piriformis fossa entry nails and 32 greater trochanter entry nails. Outcome measures included the alignment, union rate and duration of union, complications, operation time, intra-operative bleeding, and a pain rating scale.
RESULTS
The alignment, union rate, and duration of union did not differ significantly between the groups with piriformis fossa and trochanteric nailing. In addition, no significant differences regarding complications and operation time were observed between the two groups. Less intra-operative bleeding was observed in the trochanteric nailing group. This difference was statistically significant (p=0.044).
CONCLUSION
Use of a femoral nail specially designed for the trochanteric insertion resulted in equally high union rates, duration of union, and low complication rates. Thus, greater trochanter entry nails were similar to conventional antegrade femoral nailing through the piriformis fossa.

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A Retrospective Comparative Study of Internal Fixation with Reconstruction Plate Versus Anatomical Locking Compression Plate in Displaced Intercondylar Fractures of Humerus: Tong Joo Lee, Young Tae Kim, Dae Gyu Kwon, Ju Yong Park; J Korean Fract Soc 2014;27(4):294-300. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.294

Abstract PDF: PURPOSE
To analyze the clinical result of a conventional reconstruction plate (CRP) fixation and locking compressive plate (LCP) fixation on the surgical treatment of an adult's displaced intercondylar fracture of humerus.
MATERIALS AND METHODS
A total of 40 patients enrolled in the study were treated between August 2002 and May 2012. Fixation with a CRP was performed in 20 patients (group A) and anatomical locking compression plate fixation was performed in 20 patients (group B). The clinical and functional evaluation was performed according to the Mayo elbow performance score and Cassebaum classification of elbow range of motion (ROM), disabilities of the arm, shoulder and hand score.
RESULTS
The Mayo elbow functional evaluation scores, eight cases were excellent, 10 cases were good, and two cases were fair in group A, and 12 cases were excellent, seven cases good, and one case fair in group B; both groups showed satisfactory results. The durations of attaining 90 to 120 degrees of the ROM of joints postoperatively were 8.3 days on average (6 to 15 days) in group A and 5.5 days on average (5 to 9 days) in group B, demonstrating a significant difference between the two groups (p=0.04). Although the correlations of clinical results according to the difference of bone mineral densities (BMDs) were not statistically significant between the two groups (p=0.35), loss of fixation occurred due to loosening of screws in two patients with low BMDs in whose operations reconstruction plates were used.
CONCLUSION
The use of locking compressive plate on the surgical treatment of an diaplaced intercondylar fracture of humerus have a good clinical results because that permits early rehabilitation through good fixation and reduces the complications such as loosening of screws.

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The Efficacy of Preserved Posterior Cortex in the Treatment of Infected Nonunion of the Tibia: Hyoung Min Kim, Il Jung Park, Youn Tae Roh, Byung Min Kang, Hyun Jin Lee, Jae Young Lee; J Korean Fract Soc 2014;27(4):301-307. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.301

Abstract PDF: PURPOSE
We studied the efficacy of preserved posterior cortex connecting to adjacent muscle or periosteum during wide debridement in the treatment of infected nonunion of the tibia.
MATERIALS AND METHODS
From January 2001 to May 2011, 12 cases of infected nonunion of the tibia with segmental defect larger than 4 cm after wide debridement were selected. The selected cases were categorized according to two groups; group 1 with preserved posterior cortex in the segmental defect site - six cases, group 2 without posterior cortex - six cases. The results were compared by assessing the size of bone defect, the interval between wide debridement and bone reconstruction, bony union time, complications, and clinical results.
RESULTS
The mean length of bone defect of group 1 was 7.6 cm (range 4.3-11.0 cm) and that of group 2 was 6.4 cm (range 4.0-12.0 cm). The interval between wide debridement and bone reconstruction was 10.0 weeks (range 5-18 weeks) for group 1, and 12.1 weeks (range 0-24 weeks) for group 2. The time for bony union of group 1 was 6.2 months (range 5-7 months), and that of group 2 was 10.8 months (range 7-18 months). In group 2, there were two cases of fatigue fracture and two cases of docking site nonunion after distraction osteogenesis.
CONCLUSION
The preserved posterior cortex after wide debridement of infected nonunion of the tibia helps bony union and reduces the treatment period.

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The Pattern of Occurrence of Fractures in Children and Adolescents and Its Managements Based on the Database of the Health Insurance Review and Assessment Service: Yong Wook Kwon, Soon Hyuck Lee, Hyun Woo Kim, Jin Ho Hwang; J Korean Fract Soc 2014;27(4):308-314. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.308

Abstract PDF

PURPOSE
The purpose of this article is to report on the pattern of medical process and relative frequencies of fractures in children and adolescents.
MATERIALS AND METHODS
The authors retrospectively analyzed the database of the health insurance review and assessment service regarding children and adolescents under 20 years old treated from 2008 to 2010. Newly registered numbers of fractures in children and adolescents according to sex, month, institution, and anatomical location were also reviewed.
RESULTS
A total of 1,893,416 fractures occurred during three years; approximately 630,000 cases were treated during one year (approximately 562 cases among 10,000 people during one year). During one year, the most fractures occurred in June and the least in February. Senior general hospital consisted of 5.72%, 12.30% in general hospital, 19.28% in hospital, and 62.70% in clinics. Among the fracture sites, 0.05% were cervical fractures, 0.91% in sternum and thoracic vertebra, 1.35% in lumbar vertebra and pelvis, 12.79% in shoulder and upper extremities, 26.87% in lower extremities, 38.10% in wrist and hand, 1.01% in femur, 10.40% in lower extremities including ankle, and 8.52% in foot excluding ankle. The maximal incidence was age 14 years in male and 12 years in female.
CONCLUSION
The authors reviewed the pattern of medical process and relative frequencies of fractures in children and adolescents.

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Analysis of Computed Tomography Scans for Radiation Safety Management in the Republic of Korea
Min Young Lee, Ji Woo Kim, Ga Eun Oh, Geon Woo Son, Kwang Pyo Kim
Journal of Radiation Protection and Research.2024; 49(3): 141. CrossRef

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Removal Methods for Broken Proximal Femoral Nails Using Ball Tip Guide Wire: Technical Note and Two Cases Report: Bong Ju Park, Hong Man Cho; J Korean Fract Soc 2014;27(4):315-320. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.315

Abstract PDF

Recently, the use of intramedullary nailing for proximal femoral fractures has increased. Breakage of the nail usually occurs at the un-united fracture site, and it is a rare complication of intramedullary nailing of the femur. However, removal of the distal fragment of a broken nail is a challenging problem. Herein, the authors describe the methods used for removal of relatively fixed or strongly fixed broken intramedullary nails in two different cases.

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Breakage of the Tail Portion of the Lag Screw during Removal of Proximal Femoral Zimmer Natural Nail: Report of Two Cases with Technical Notes
Asep Santoso, Ik-Sun Choi, Kyung-Soon Park, Taek-Rim Yoon
Hip & Pelvis.2017; 29(3): 199. CrossRef

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Chronic Osteomyelitis in Distraction Osteogenesis Area of Tibial Shaft: A Case Report: Sanguk Bae, Baekyong Song, Jin Seon Moon; J Korean Fract Soc 2014;27(4):321-326. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.321

Abstract PDF: Distraction osteogenesis with an Ilizarov external fixator is one of the most successful treatment options for large segmental bone defects after extensive debridement of chronic osteomyelitis in the tibial shaft. Its complications include skin irritation, pin tract infection, and non-union due to infection. There are few case reports on chronic osteomyelitis occurring in the distraction osteogenesis area. The authors experienced a chronic osteomyelitis in the distraction osteogenesis area of the tibial shaft and report this case with references.

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Multiple Stress Fractures Related to Low-dose Adefovir Dipivoxil Treatment in a Patient with Chronic Hepatitis B: A Case Report: Chul Hyun Park, Hyo Sae Ahn, Dong Chul Lee; J Korean Fract Soc 2014;27(4):327-331. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.327

Abstract PDF: Stress fractures typically result from repeated abnormal mechanical loading to the bones. In particular, multiple stress fractures may occur in patients with systemic disease, such as rheumatoid arthritis, osteoporosis, or osteoarthritis. Adefovir dipivoxil (ADV), a nucleotide analogue of adenosine monophosphate, very rarely causes severe hypophosphatemia when using a low dosage of 10 mg daily for treatment of chronic hepatitis B. To the best of our knowledge, in English literature, this is the first report of multiple stress fractures in a chronic hepatitis B patient who has been treated with a low dosage of ADV. We think it is important to consider that use of ADV in a patient with chronic hepatitis B could be a risk factor for stress fractures.

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Authorship, Another Research Misconduct: Dong Soo Han; J Korean Fract Soc 2014;27(4):332-337. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.332

Abstract PDF: No abstract available.

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Non-Operative Treatment of Nonunion: Oog Jin Shon, Man Ho Lee, Hyo Sae Ahn; J Korean Fract Soc 2014;27(4):338-347. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.338

Abstract PDF

No abstract available.

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A Novel Triad of Bio-Inspired Design, Digital Fabrication, and Bio-Derived Materials for Personalised Bone Repair
Greta Dei Rossi, Laura Maria Vergani, Federica Buccino
Materials.2024; 17(21): 5305. CrossRef
The Clinical Effects of Complex Korean Medicine Treatment in Patient with Delayed Union of the 4th Toe Distal Phalanx Fracture
Kyungtae Park, Hee-Ra Shin, Sung-Hu An, Seung-Ryong Yeom, Young-Dal Kwon
Journal of Korean Medicine Rehabilitation.2019; 29(4): 143. CrossRef

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