Journal of Musculoskeletal Trauma

The Result of Open Reduction and Mini-Plate Fixation for Displaced Talar Neck Fracture: Woong Chae Na, Sang Hong Lee, Jun Young Lee, Sang Jun Lee, Boseon Kim; J Korean Fract Soc 2015;28(4):215-222. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.215

PURPOSE
We evaluated the complications, radiological and clinical results after operative treatment using a mini-plate for fixation of displaced talar neck fractures.
MATERIALS AND METHODS
There were 20 cases of displaced talar neck fractures from May 2006 to December 2011; we performed a retrospective chart review of 15 patients treated by open reduction and internal fixation using a mini-plate who had more than 2 years of follow-up. According to Hawkin's classification, there were 7 cases of type II fractures and 8 cases of type III fractures. During postoperative 12-16 weeks we checked magnetic resonance imaging. The assessment of clinical results was based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.
RESULTS
Mean union period was 11.6 weeks (10-15 weeks). Nonunion and malunion did not occur in all cases. The mean AOFAS score was 88.2 points (80-97 points). There were 5 cases of avascular necrosis. Of these, there were 3 cases of body collapse and 4 cases of post-traumatic arthritis. In the statistical analysis, there was no correlation between the elements including gender, Hawkin's classification and union rates and clinical results.
CONCLUSION
Mini-plate fixation of a displaced talar neck fracture is thought to be a good technique, with a low rate of malunion and also showed satisfactory results in radiological and clinical assessment.

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Outcome of Type 3 Talar Neck Fractures by Means of Medial Malleolar Osteotomy and Large Distractor
Sung Hae Park, Jun Young Lee, Jung Woo Lee
Journal of the Korean Orthopaedic Association.2019; 54(1): 45. CrossRef
The Measurement of Normal Talus in Korean Cadaver
Dong-Jun Ha, Heui-Chul Gwak, Jeon-Gyo Kim, Jung-Han Kim, Chang-Rak Lee, Young-Jun Kim, Jeong-Han Lee, Byung-Ho Ha, Ui-Cheol Kim
Journal of Korean Foot and Ankle Society.2016; 20(4): 163. CrossRef

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Clinical Outcomes of Fasciotomy for Acute Compartment Syndrome: Ji Yong Park, Young Chang Kim, Ji Wan Kim; J Korean Fract Soc 2015;28(4):223-229. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.223

Abstract PDF: PURPOSE
The purpose of this study is to evaluate clinical outcomes and complications after fasciotomy in acute compartment syndrome.
MATERIALS AND METHODS
Seventeen cases diagnosed as compartment syndrome and underwent fasciotomy from January 2011 to February 2015 were evaluated retrospectively. We investigated the causes and regions of acute compartment syndrome, the methods of wound management, the necessity of skin graft, and the complications including amputation and infection.
RESULTS
According to the causes of acute compartment syndrome, there were 7 fractures, 1 traumatic hematoma, 6 reperfusion injury, and 3 rhabdomyolysis. The regions of acute compartment syndrome were 3 cases of thigh, 10 cases of leg, and 3 cases of foot. One case had acute compartment syndrome involving thigh, leg, and foot. Of 17 cases, 3 cases died due to reperfusion injury and one case with severe necrosis of soft tissues underwent amputation. Among the 13 cases excluding 4 cases with death or amputation, 3 cases underwent split thickness skin graft. Shoelace technique and/or vacuum-assisted closure (VAC) was used for 9 cases, and wound closure without skin graft was achieved in all except one case, while 2 cases required skin graft among 4 cases without shoelace technique or VAC. There were 2 cases of infection.
CONCLUSION
Acute compartment syndrome caused by reperfusion injury had poor outcomes. Shoelace technique and/or VAC were useful for management of wound after fasciotomy.

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The Usefulness of Poller Screw with Antegrade Nailing in the Initial Treatment of Infraisthmal Femur Shaft Fracture: Jeong Hyun Yoo, Hyoung Soo Kim, Chang Geun Kim, Ho Il Kwak, Sang Heon Song; J Korean Fract Soc 2015;28(4):230-236. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.230

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the radiologic and clinical outcomes after intramedullary nailing with Poller screw insertion at initial stage in infraisthmal femur shaft fractures.
MATERIALS AND METHODS
Seven consecutive patients (7 femurs) treated with antegrade intramedullary nailing with Poller screw insertion for the infraisthmal femur shaft fracture were reviewed retrospectively. There were 4 male and 3 female patients. Mean age was 46.1 years (20-72 years). Operative time including Poller screw insertion, time for union, malalignment, and range of motion were evaluated.
RESULTS
All 7 cases had primarily healed successfully. Mean time for radiologic union was 19.1 weeks (16-24 weeks) postoperatively. One case had 5 degree valgus malalignment. One case of 15 mm shortening was reported and he required shoe lift orthosis. All cases had a full range of motion in hip and knee joint.
CONCLUSION
Antegrade intramedullary nailing with Poller screw insertion is useful in the initial treatment of infraisthmal femur shaft fracture, because it could provide additional stability. An additional 20 minutes were required but a Poller screw should be considered according to the anatomic location of a femur shaft fracture.

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Operative Treatment of Pediatric Distal Forearm Bothbone Fracture: Sang Uk Lee, Changhoon Jeong, Il Jung Park, Jaeyoung Lee, Seman Oh, Kyung Hoon Lee, Sanghyun Jeon; J Korean Fract Soc 2015;28(4):237-244. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.237

Abstract PDF: PURPOSE
Pediatric patients with distal forearm bothbone fractures of surgical indication were treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna at our institution. The purpose of this study is to evaluate clinical and radiological results.
MATERIALS AND METHODS
From February 2012 to June 2014, we retrospectively evaluated 16 out of 18 cases with distal forearm bothbone fractures treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna with at least 1-year follow-up. The average age at operation was 9.1 years (7-13 years).
RESULTS
Adequate reduction for both radius and ulna was achieved for all cases, and none of the cases showed re-displacement until the last follow-up. Mean 6.6 weeks lapsed until bony union was observed for the radius. For the ulna, the mean was 6.5 weeks. All patients gained full wrist range of motion at the last visit.
CONCLUSION
For pediatric distal forearm bothbone fractures, intrafocal Kapandji reduction and internal fixation with Kirschner wire for radius and reduction and internal fixation with a flexible intramedullary nail for ulna is the technique for handy reduction. Use of this technique can prevent re-displacement during the union process and achieve excellent clinical and radiologic results.

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Salvage Therapy from Traumatic Ischemic Finger Necrosis via Prostaglandin E1 Assisted Conservative Treatment: A Case Report: Jae Hyuk Shin, Ho Guen Chang, Cheol Jung Yang, Jungtae Ahn; J Korean Fract Soc 2015;28(4):245-249. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.245

Abstract PDF: Prostaglandin E1 (PGE-1) is a potent vasodilator, which also inhibits platelet aggregation, affects the blood flow viscosity, and fibrinolysis. The compound also excerts anti-inflammatory effects by inhibiting the monocyte and neutrophil function. PGE-1 has been widely administered following microvascular flap surgery, along with perioperative antithrombotic agents such as low molecular weight heparin or aspirin, showing excellent results. We report a case showing successful salvage recovery from post-traumatic ischemic necrosis of the finger via PGE-1 assisted conservative treatment.

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Iatrogenic Subtrochanteric Fractures Related to the Surgical Error: Two Cases Report: Kook Jin Chung, June Young Jeon, Hyun Woo Na, Ji Hyo Hwang; J Korean Fract Soc 2015;28(4):250-255. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.250

Abstract PDF

Iatrogenic fracture is not popular and might be recognized as a malpractice. Surgical error related to iatrogenic fracture which has occurred after an operation can be detected only by a surgeon. Stress riser fracture is another form of iatrogenic fracture also known as a Young's modulus fracture. As the majority of surgical related stress riser fractures can be preventive, the accurate prevalence is not known. The majority of fractures occurred in the weight bearing bones such as femur and tibia. The subtrochanter area is the most stress concentrated area in the human body, thus it is a common area for occurrence of stress riser iatrogenic fractures. We experienced 2 cases of stress riser iatrogenic fractures, which are related to technical errors, thus we report cases with literature review.

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Mechanical and Physical Characteristics Analysis of Radius Trauma Plate by EBM Additive Manufacturing
Kwun-Mook Lim, Sung-Jun Park
Journal of the Korean Society of Manufacturing Technology Engineers.2020; 29(2): 147. CrossRef

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Reconstruction of a Traumatic Soft Tissue Defect: Jong Woong Park; J Korean Fract Soc 2015;28(4):256-265. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.256

Abstract PDF

Soft tissue defect combined with an open fracture is a very challenging problem to the orthopaedic surgeon. Many complicated open fractures remain with soft tissue defect, chronic osteomyelitis, and sometimes terminate with major limb amputation. Soft tissue defect should be reconstructed as soon as possible, particularly when the bone, tendon, or neurovascular structures are exposed. Exposure for longer than a week significantly increases the risk of secondary infection and tissue necrosis. For the simple soft tissue defect, negative pressure wound closure technology has been introduced and many superficial wounds have been treated successfully using this method. For the more complicated wounds, many kinds of local flaps, pedicled flaps, muscle and fascisocutaneous flaps can be indicated according to the characteristics of the wounds. The free flaps including free vascularized bone graft can be considered as a final choice for the most difficult wound problems. In this article, various reconstruction strategies for soft tissue defect after traumatic open fracture are reviewed.

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New proposal for skin grafts on tendon-exposed wounds
Jung Hwan Um, Dong In Jo, Soon Heum Kim
Archives of Plastic Surgery.2022; 49(01): 86. CrossRef
Soft Tissue Reconstruction for Open Tibia Fractures
Young-Woo Kim, Ho-Youn Park, Yoo-Joon Sur
Archives of Hand and Microsurgery.2020; 25(3): 207. CrossRef

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Surgical Treatment of Malunion and Nonunion after Pelvic Bone Fracture: Byung Woo Min, Kyung Jae Lee; J Korean Fract Soc 2015;28(4):266-272. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.266

Abstract PDF: Regardless of the efforts of several treatments after pelvic bone fracture, as many as 5% of all pelvic fractures result in malunion or nonunion of the pelvis. These complications can cause disabling symptoms, including pain, instability, and gait disturbance, which can decrease life quality of patients and increase socioeconomic problems. Therefore concerns regarding the treatment of malunion and nonunion after pelvic bone fracture are increasing. We report our experience and surgical management for pelvic malunion and nonunion.

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