Journal of Musculoskeletal Trauma

Ankle Fracture: E K Song; J Korean Soc Fract 1995;8(4):727-731. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.727

Abstract PDF: No abstract available.

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Evaluation of ankle fracture: Y S Park; J Korean Soc Fract 1995;8(4):732-735. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.732

Abstract PDF: No abstract available.

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Complications and Its Treatment of Ankle Fractures: In Kim, Seung Ko Rhee, Soon Yong Kwon, Ki Won Kim, Yong Keun Cho, Han Chang, Won Jong Bahk, Nam Kee Lee, Seung Ki Kim; J Korean Soc Fract 1995;8(4):736-746. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.736

Abstract PDF: We have investigated total 294 cases of ankle fractures, which were treated and followed for average 17 months after treatment at St. Marys hospital since 1980, to detect the complications and to define their provoking factors. The results were as follows; 1. Twenty-six cases out of total 294 cases of ankle fracture(8.8%) were complicated clinically and radiologically. 2. Their complications are osteoarthritis(8/26, 31%), diastasis of distal tibio-fibular syndesmosis(9/26, 34.6%), varus ankle deformity(5/26, 19.2%), malunion(6/26, 23%), non-union and ankle instability(each 2/26, 7.7%) in its order, but 14 cases of the 26 cases complained painful limited ankle motion and limp. So, clinical symptoms are not closely related with radiologic changes in complications of ankle fracture. 3. The complications are common in elderly patients over 50 of their ages(12.26, 46%) and in younger patients under 16 of their ages(5/26, 20%). 4. The complications are frequently found in pronation-external rotation injuries(6/61, 1O%), pronation-dorsiflexion(9/14, 64%) and supination-external rotation injuries(8/165, 4.8%) in orders. 5. Malpractice with misuse of instrument(12/26, 46%), mistakes in preoperative evaluation and neglect any ankle fracture or diastasis of syndesmosis(8/26, 30.7%) and severity of injuries(6.26, 23%) are common causes of complications of ankle fractures. 6. Varus ankle deformity due to early epiphyseal closure are shown in 5 cases(5/28, 20%) and three of them are treated with supramalleolar corrective osteotomies and Langenskiolds physolysis In conclusion, the complications of ankle fracture could be reduced by accurate pre-operative evaluation to detect the hidden soft tissue injuries or fracture mechanism and by also anatomic reduction, rigid internal fixation and early ankle motions. childrens ankle fracture will induce angular deformity and limb length discrepancy due to frequent epjphyseal damage, so long-term follow up should be kept in mind until their skeletal growth are ceased.

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Bipolar Hemiarthroplasty for the Treatment of Femoral Neck Fracture in Elderly Patients: Kwon Jae Roh, Dong Wook Kim; J Korean Soc Fract 1995;8(4):747-752. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.747

Abstract PDF: Displaced intracapsular fracture of the hip remains a formidable problem in orthopaedic management despite advances in surgical technique and hardware. Advances in internal fixation have lowered the morbidity from prolonged bed rest and shortened the time of mobilization , however, the incidence of nonunion End avascular necrosis remains high. As a result, prosthetic replacement has been advocated as a solution to this problem. But, sepsis, dislocation and late loosening remain real concoern. So we reviewed the follow-up(range, twelve to sixty months) results of forty bipolar hemiarthroplasty for the displaced femoral neck fracture in elderly patients. The average age of the patients was seventy-four and the common cause of injury was slipped down. In the type of fracture, anatomically subcapital(21), Garden stage IV(19), and Pauwel typeII (21) was the most common. The associated medical conditions were chronic lung disease(10), chronic heart disease(8), diabetes mellitus(7), chronic liver disease(5). Two patients died of hepatoma and liver cirrhosis during the follow-up periods. The results were followed; 1. The most common used prosthesis was Centralign and cement was used in 32 cases. 2. Above 80% wereexcellent or goodin Luncefords criteria and Harris hip score. 3. The complications were transient peroneal nerve palsy(2), intractable thigh pain(2), deep wound infection(1), proximal femoral fracture(1). In conclusion, bipolar hemiarthroplasty seems to be a good alternative to the internal fixation in elderly patients with a displaced femoral neck fracture.

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The Use of Gamma Nail in Peritrochanteric Fractures of the Femur: Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Hyung Hwan Lee; J Korean Soc Fract 1995;8(4):753-759. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.753

Abstract PDF: In old age, trochanteric fracture occurs easily by trivial external force due to osteoprosis and many kinds of treatment has been performed. The goal of treatment in elderly patients with trochanteric fractures is restoration of function to preoperative ambulatory status at the earliest possible time. For this purpose operative treatment is gernerally recommended. The success of operative treatment depends on the stable reduction and secure fixation. Gamma nail is a new intramedullary device which has been applied in the treatment of trochanteric fractures with the benefits of the closed technique such as low blood loss, low risk of infection and short operative time. The implant can be used by the method of static or dynamic. Intraoperative compression of the fracture segments can be achieved by acting on the sliding lag screw and further compression is given by weight bearing. We studied 22 cases of patient who had the trochanteric fracture and treated operatively with gamma-locking nail at the department of orthopaedic surgery, Dong-A university hospital from January 1993 to December 1994. Among 22 cases, 7 cases were stable fracture and 14 cases were unstable fracture by the Evans classification. Mean operation time was 76 minutes and mean blood loss was 303 mf and intraoperative and postoperative complicatins were encountered in 3 cases, femur shaft fracture in 2 casea and lag screw displacement on the femoral head in 1 case. Based on the above results, we have experienced limited utiliBation of the nail because of the mappropriateness between nail and femur itself and non-skillful application technique. We think that if nail shape and assembly for fixating distal screw are improved, Gamma-interlocking nail is a good interraf fixation device which allows early weight bearing ambulation.

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Interlocking Intramedullary Nailing for femoral Shaft Fracture: Closed and Open Nailings: Ju Hai Chang, Jong Min Sohn, Dong Reon An, Sung Tae Kim; J Korean Soc Fract 1995;8(4):760-766. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.760

Abstract PDF: Femoral shaft fractures are caused by violent external forces like motor vehicle or falling down accident and associated with multiple injuries of other parts of the body, so that accurate reduction and rigid fixation is mandatory to ensure early fracture healing and mobilization of patients. Authors thought that the interlocking intramedullary nailing may be one of methods that can provide rigid and stable fixation for the unstable fracture of femoral shaft. Thus this study was carried out to assess the effectiveness of open reduction and interlocking intramedullary nailing to the comminuted unstable femoral shaft fracture. Twenty-seven femoral shaft fractures were treated by closed or open interlocking intramedullary nailing from July 1990 through August 1994 and followed-up at least for 12 months. Closed nailings were 11 and open nailings were 16 cases. Radiological union was obtained at an average of 15 weeks in closed nailing cases and at an average of 21 weeks in open nailing cases. However, comparative anlysis of union times was meaningless because of different fracture patterns in both open and closed nailings. Clinical results by Thoresens classification were excellent in all cases. Complications were 3 iatrogenic cortical fractures developed by closed nailing procedures and 3 deep infections, one after closed nailing and two after open nailing. There was no sequela related directly to the intramedullary nailing. Authors thought is that open intramedullary nailing is beneficial to the unstable comminuted fracture of femoral shaft in spite of increasing risk of infection, because that permits accurate reduction and secure fixation of the comminuted fragments and sometimes bone grafting with compatible clinical results.

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Interlocking Intramedullary Nailing of the Femoral Shaft Fracture: A Comparison between Gross-Kempf Nail and Interlocking Compression Nail: Ki Soo Kim, Yong Soo Choi, Chae In Lim, Yang Min Chung; J Korean Soc Fract 1995;8(4):767-776. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.767

Abstract PDF: Various designs of interlocking intramedullary nailing systems allowing closed nailing techniques have been used in the treatment of femoral shaft fractures, but there are little objective data available to compare their performance. The authors reviewed 58 patients of femoral shaft fractures which were treated at Kwang ju christian hospital from April 1992 to June 1994. The Gross-Kempf nail was used in 39 patients and the Interlocking compression nail was used in 19 patients. The purpose of this study is to determine if there are any significant difference in the application, ease of use or clinical outcome. The average follow up period up period was 21.5 months (range 12 to 31 months) and the results were as follows. 1. Two nails have similar indication for use, but G-K nail was more satisfactory for proximal fractures of the femur and I-C nail was used as a compression nail with application of one proximal interlocking screw in oval hole in simple stabilizable fractures(Winquist Hansen type I and / or type II). 2. In the G-K naiBing group, the partially threaded screw of distal locking gaining purchase in only one cortex comes loose more often and backs out more frequently. In the I-C nailing group, the fully threaded screw of distal locking is able to fail of screw because of smaller core diameter of the screw. Successful distal locking is not only dependent upon strength of transverse screw, but also upon achieving cortical fixations with threads. 3. Complications seemed to be failure of operative principle and postoperative care rather than any intrinsic problems with the nail themselves.

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Operative Treatment of the Supracondylar Fracture of the Fenlur: Sang Won Park, Jeong Dae Suh, Ja Sung Koo; J Korean Soc Fract 1995;8(4):777-783. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.777

Abstract PDF: The treatment of supracondylar fractures of the femur is still evolving and the results of different methods are still incomplete and controversial. Severe soft tissue damage, comminution and intraarticular extension of fracture lead to unsatisfactory results in many cases, regardless of the adequate treatment. We reviewed 26 cases of supracondylar fractures of the femur treated by internal fixation excluding isolated condylar fracture of the femur(type B by AO classification), according to the rating system of Neer et at. with average follow up period of 19 months(range 14 months to 34 months). According to AO classification, 11 cases(42.3%) were type A and 15 cases(57.7%) were type C. Of the twenty six cases, 8 cases were treated with anatomical plate fixation, 7 cases with dynamic condylar screw, 4 cases with AO-DCP, 3 cases with angle blade plate, 2 cases with Judet plate and 2 cases with IM nail. The results obtained were as follows; 1. The average time of clinical union was 21 weeks in type A and 23.1 weeks in type C. 2. According to Neers criteria, excellent were in 5 cases, satisfactory in 12 cases and unsatisfactory in 9 cases. 3. The complications were delayed union in 5 cases, deep infection in 2 cases in open fractures, angular deformity in 11 cases, and Bimited range of motion below 90 degrees in 11 cases.

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Posterior Hip Dislocation with Femoral Head and Neck Fracture: Yoo Sung Seo, Hyung Suk Choi, Soo Jae Yim, Soo Kyun Rah, Chang Uk Choi; J Korean Soc Fract 1995;8(4):784-791. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.784

Abstract PDF: Posterior hip dislocation with femoral head and neck fracture(Pipkin type III) was considered as a rare injury, However, the advance of high speed motor vehicle accidental injury has contributed to its increased incidence and the choice of treatment is still controversial. Mechanism of injury was considered as a kind of secondary trauma of inversion or internal rotation force with hip joint was flexed position state. Three cases of posterior hip dislocation with femoral head and neck fracture(Pipkin type III)have been experienced and follow up still now at Soon Chun Hyang University hospital. The results were evaluated by Thomson Epsteins clinicoradiologic criteria and Harris hip score and follow up radiologic findings. As a results of this study, we are more prefer primary open reduction and rigid internal fixation than primary joint replacement arthroplasty due to be occured in young age group. And futher evaluation should be needed.

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Femoral Shaft Fracture Treated with Flexible Intramedullary Ender Nail: Beom Koo Lee, Young Ju Kim, Suk Woong Yoon, Jae Hee Cho, Byung Gug Lee; J Korean Soc Fract 1995;8(4):792-798. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.792

Abstract PDF: Various methods have been used in the treatment of femoral shaft fractures. Recently closed intramedullary interlocking nailing is recommended as one of the most successful methods, but its use is technically demanding and much exposure to radiation is needed. In comparison, flexible intramedullary nail such as Ender nail is easy to use and cause less damage to the patient. We used the Ender nail in the treatment of femoral shaft fracture from 1989 to 1993 and the result were as follows; 1. Average patient age is 38.2 years old and major cause of the fracture was traffic accident. 2. Bony union was obtained in 14 cases of 17 cases with primary operation. Average bony union time was 14.2 weeks. 3. Mean operative time was 40 minutes in Winquist-Hansen type I and II ,90 minutes in Winquist-Hanserl type III and IV. 4. Ender nail migration over 10mm was noted in 9 of 17 cases. Average migration was 10mm in knee and 24mn in trochanteric area. 5. Complication were as follows ; Nail migration causing pain in 9 cases, delayed union 4 cases, non-union 3 cases, varus deformity in 3 cases, shortening in 4 cases. In Winquist-Hansen type III and IV ,76.9% of cases suffered from some complication. 6. Flexible intramedullary nail was easy to apply but we thought that Ender nail is inadequate treatment method for Winquist-Hansen type III and IV because of high complication rate.

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Refracture of the Femur after Plate Removal: Sung Kwan Hwang, Jung Ho Rah, Hee Jeon Park, Yeo Seung Yoon, Jae Beom Han; J Korean Soc Fract 1995;8(4):799-806. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.799

Abstract PDF

Internal fixation with dynamic compression plate is an accepted method of treating diaphyseal fractures of the adult femur. Good results have been reported using the principles laid down by the AO group(Muller et al 1979). Refracture after secure union of a broken femur has been achieved is rare, but it is most devastating complication. There were 5 refractures out of 64 removals after fractures of the femur at the department of Orthopaedic Surgery, Yonsei University Wonju college of Medicine between January, 1988 and June, 1994. After clinical and roentgenographical analysis, following results were obtained. 1. The causes of the refracture were trivial injuries or slip down injury. 2. Among 5 cases, the average time from insertion to removal was 19.2 months, with a ranged from 16 to 28 months. 3. The internal from removal of implant to refracture was 5.6 wks, with a range from 3 to 9 weeks. 4. The incidence of refracture in out hospital(7.8%) was somewhat higher than reported incidence by others. 5. The femur plates should not be removed prior to 2 years postoperatively and its removal should be postponed, if possible. 6. It is reasonable to postpone its removal until bone strength is adequate for full activity.

Citations

Citations to this article as recorded by

Refractures of the Upper Extremity in Children
Hui Wan Park, Ick Hwan Yang, Sun Young Joo, Kun Bo Park, Hyun Woo Kim
Yonsei Medical Journal.2007; 48(2): 255. CrossRef

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The Comparision of Conservative Treatment with Operative Treatment in Bursting fracture: Chung Nam Kang, Jong Oh Kim, Oh Yong Kang, Seung Youn Ahn; J Korean Soc Fract 1995;8(4):807-814. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.807

Abstract PDF

Internal fixation with dynamic compression plate is an accepted method of treating diaphyseal The treatment of stable bursting fracture of thoracolumbar spine has long been controversal and middle column theory has been known important factor to determine fracture stability, following to "Three column theroy" by Denis & McAfee in 1983. We have analyBed kyphotic angle and compression degree, each 7 cases of thoracolumbar stable bursting fracture, treated consertive or operative, from Oct. 1993 to Dec. 1994. We obtained following results; 1. The correction of kyphotic angle was more increased in the average 12 in conservative treatment and decreased in the average 8.3 in operative treatment than admission date. 2. The correction of compression degree was more increased in the average 30% in conservative treatment and decreased in the average 18% in operative treatment. 3. More severe deformity was noted in the active young adult rather than old age. 4. MRI study and bending stress view are needed in the detect of the posterior column injury. In summary, more severe deformity was noted not only in the adult, but in the conservative treatment. Thus, we must consider the operative treatment in active young adult in cases of stable bursting fracture.

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Citations to this article as recorded by

The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures
Seung-Wook Baek, Kyu-Dong Shim, Ye-Soo Park
Journal of the Korean Fracture Society.2011; 24(4): 354. CrossRef
Biomechanical Efficacy of Various Anterior Spinal Fixation in Treatment of Thoraco-lumbar Spine Fracture
Ye-Soo Park, Hyoung-Jin Kim, Choong-Hyeok Choi, Won-Man Park, Yoon-Hyuk Kim
Journal of the Korean Fracture Society.2007; 20(1): 70. CrossRef

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Clinical Evaluation of Antibiotics Prophylaxis Against Infection in Clean Orthopaedic Surgery: Nam Hyun Kim, Soo Bong Hahn, Hong Jun Park; J Korean Soc Fract 1995;8(4):815-822. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.815

Abstract PDF: Prophylactic antibiotic treatment to prevent postoperative wound infection is an appealing routine to the orthopaedic surgeon. But, there has been no adequate guideline of prophylactic antibiotics in the field of ctean orthopaedic surgery. The purpose of this study was to investigate the method of effective administration of antibiotics and the factors affecting the postoperative infection in clean orthopaedic surgery. Two hundred and forty one patients were included in a prospective randomized double-blind trial comparing the efficacy of three days(group 1,42 patients) versus that of five days cefotiam(group II, 199 patients) injection for prophylaxis against wound infection in patients who had an operation using bone plate, Ender of Kiintscher nails, or other internal fixation devides. The two groups were similar in terms of mean age, sex ratio, duration of preoperative hospital stay, underlying risk factors and type of surgical procedure. A wound infection developed in one of the forty-two patients in group I(2.3%) and in nine of 199 patients in group II(4.5%). This difference of infection rate is not stati stically significant(p>O.05). Staphylococcus aureus, Staphylococcus epidermidis , Klebsiella pneumoniae and Enterobacter aerogenes were the common infecting organisms. And the infection rate in lower extremity operations was higher than that of other regions in the group II (p In conclusion. the recommended method of administration of prophylactic antibiotics in clean orthopaedic surgery to prevent postoperative wound infection is a high dosage injection of antibiotics one hour before surgery, intraoperative infusion of one dosage when the operation lasts more than one hour and then postoperatively within 72 hours. This will reduce the adverse effects of medication and will also reduce the costs.

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Complication Related to Interlocking Nailing of the Tibia Fracture: Sung Kwan Hwang, Ji Man Yoo; J Korean Soc Fract 1995;8(4):823-829. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.823

Abstract PDF

PURPOSE
The study of complications after tibia fracture treated with interlocking nails of various kinds. MATERIAL & METHOD: A retrospective review of 60 cases of tibial fractures treated with interlocking nailing was under- taken to document the spectrum of complication associated with this procedure. The 60 cases of tibia fracture were followed up at least 1 year, related to clinical and radiographic union. Complications were categorized into intraoperative, early postoperative and late postoperative group.
RESULTS
1. Intraoperative complication developed in 11 cases(16.6%) : propagation of proximal tibia fracture in 5 cases(8.3%) and malalignment in 6 cases(10%), among them 3 cases(50%) occurred at proximal 1/3 facture site, 2 cases(33%) occurred at distal 1/3 site and 1 case(16%) occurred at mid 1/3 site. 2. Early post operative complication occurred in 4 cases(6.7%), lesional entry point infection in 3 cases, hematoma in 1 cases without nerve injury or compartment syndrome. 3. In late complication groups were as follows(28 cases, 47%) deep infection in 4 cases(6.6%), hard ware failure in 3 cases(5%) limb shortening more than ten in 3 cases(5%), 6 cases(10%) were angular deformity more than 5 degree and delayed union occurred in 5 cases(8.3%) which need secondary operation. 7 cases(11%) had knee pain, were rated as patellar tendinitis or implant protrusion.

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Breakage of Reamer during Tibia Intramedullary Nailing - A Case Report -
Ho Yoon Kwak, Jin Su Kim, Ki Won Young, Joo Won Joh, Sae Min Hwang
Journal of the Korean Fracture Society.2013; 26(4): 333. CrossRef

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Comparison between Interlocking IM Nail and Ender Nail in the Treatment of Shaft Fracture of the Tibia: Dong Chul Lee, Sang Ho Lee, Se Dong Kim; J Korean Soc Fract 1995;8(4):830-840. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.830

Abstract PDF: The shaft of tibia is prone to the open wounds owing to the subcutaneous location and poor muscular envelope. The open wounds frequently result in the severe complications and major disabilities, such as infection, delayed union and nonunion. The choice of treatment should be considered cautiously. The intramedullary fixation of the shaft has the advantage of early weight bearing as well as relative firm fixation. Sixty four cases of fracture of the tibia shaft were treated with interlocking IM nail(38 cases) or Ender nail(26 cases) from December 1985 to January 1993. 1. The most common causes of the tibia fracture were the pedestrian injury and motorcycle accident. 2. There was no difference in operation time between interlocking IM nail group and 5 weeks in Ender nail group. the average time of operation was about 70 minutes. 3. The mean time of cast support was 2.5 weeks in interlocking IM nail group and 5 weeks in Ender nail group. The mean duration of nonweight bearing was 7.6 weeks in interlocking IM nail group,9.2 weeks in Ender nail group. 4. The mean duration of bone union was 18.7 weeks in interlocking IM nail group,21.4 weeks in Ender nail group. The interlocking IM nail group seemed to obtain earlier bone union(2.5 weeks) than Ender nail group, but there was no significance in statistical analysis in the bone union time between two groups. 5. Angular deformities were found in 3 cases in interlocking IM nail group and 4 cases in Ender nail group, which occured in the communited fracture and both ends fracture of the tibia shaft, segmental fractures. Delayed union was also occured in 5 cases in Ender nail group and 3 cases in interlocking IM nail group.

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Treatment of Open Fracture of Tibial Shaft with Non-reamed Interlocking Nailing: Byung Woo Min, Kwang Soon Song, Chearl Hyung Kang, Ki Weon Park; J Korean Soc Fract 1995;8(4):841-847. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.841

Abstract PDF: Intramedullary nailing for the treatment of a fractured tibia has proven its value not only through rigid fixation but also early joint motion and weight bearing which promote more rapid bony union and functional recovery. Recently reaming intramedullary nailing technique leaves the problems of destroying the endosteal blood supply, which associated with delayed union and postoperative infection. The purpose of this study is to evaluate the results and the complications of nonreamed interlocking intramedullary nailing in the treatment of open tibial fractures. The authors reviewed 20 cases of open fractures of tibial shaft that were treated with nonreamed interlocking intramedullary nailing from May 1993 to July 1994 The follow up period ranged from 12 to 26 months. The results were summariBed as follows. 1. The average period of radiologic union was obtatined in 21.2 weeks. 2. Complications include 1 case of delayed union and 1 case of postoperative infection in Type III open tibial fracture. Locking screw broke in 1 case of Type I open tibial fracture. 3. According to the criteria of functional results by Klemm and Borner, 18 cases(90%) showed excellent results.

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Treatment of Tibial Fractures by Brooker-Tibial Nail in Adulthood: Chong Kwan Kim, Byong Woo Ahn, Hyeng Ho Jo; J Korean Soc Fract 1995;8(4):848-854. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.848

Abstract PDF: Fracture of the tibial shaft is seen frequently due to increased traffic accident and industrial injury. In treatment of tibial fracture, intramedullary nailing has become preferred method. But distal interlocking procedure has been limited in cases of poor skin condition and bony crack near the distal locking site. Also require more radiation and operation time. Blocker-tibial nails are available for that cases, reduced the radiation and operation time. We treated 71 fractures of the tibia by Blocker-tibial nail from Jan. 1990 to Dec. 1994 and we analysed as follow. 1. 69 cases were treated by closed method and 2 cases were treated by open method. 2. Blocker-tibial nail provided rigid fixation of fracture and it made early exercise of joint motion and ambulation. 3. There were 6 cases of complication with a little impairment of function finally; non-union(1). deep infection(1), irritation by nail protrusion(2), rotation deformity(1) and nail bending(1). 4. The advantages of Broocker-tibial nail are as follows; (1) Reduction of operation time and irradiation. (2) Relative firm fixation in spite of distal skin problem and bony problem.

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Treatment of Type III Open Tibial Fractures with Repofix External Fixator: Chang Hoon Jeon, Ye Yeon Won; J Korean Soc Fract 1995;8(4):855-863. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.855

Abstract PDF: We reviewed 18 patients with type III open tibial fracture from February 1992 to June 1995 (mean follow-up period 56.7 weeks) treated with Repofix external fixator. There were 16 men and 2 women. According to the Gustilos classification, there were type IIIa in 11 cases and type IIIb in 7 cases. Mean period of removal of external fixator was 19.3 weeks and after removal of external fixator, cast immobillization was performed in 4 cases. Among them, bony unions were noted in 15 cases and there were nonunion in 2 cases and malunion in 1 case. The causes of nonunion were failure of accurate reduction in 1 cases and severe initial comminuted fracture in 1 case. Complications were nerve injury, pin site infection and ring-type osteomyelitis. After removal of external fixator, nerve injuries were recovered and pin site infections except 1 case were healed. Ring-type osteomylitis was occurred in 1 case after removal of external fixator and osteomyelitis was dured after curettage. When type III open tibial fractures were treated with Repofix external fixator, there were advantages of 1) early weight bearing, 2) sagittal and coronal reduction of fracture and 3) correction of rotation. With advantages, this external fixator was appropriate for the treatment of type III open tibial fractures.

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The Surgical Treatment and Prognosis of the Talar Body Fracture: Hyung Yeoun Choi, Jae Hyung Lee, Il Ho Kim; J Korean Soc Fract 1995;8(4):864-869. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.864

Abstract PDF: Fracture of the talus is infrequent injury when they occur, gut, the complications of the displaced fractures are frequent and resulting disabilities are severe that the importance of proper management is emphasized. Authors reviewed 18 cases of talus fracture (Hawkins classification type III and IV) treated at Department of orthopaedic surgery, Capital Armed force Gerneral Hospital from 1991 to 1994 to evaluate the result. The results were as follows; 1. Most common cause was fall down. 2. Associated injuries were fracture of the medial malleolus, calcaneus and Bursting fracture of spine. 3. The methods of treatment were open reduction and screw fixation in all cases. 4. Classification by Hawkins were Type III in 12 cases and Type IV in 6 cases. 5. Final clinical result by Hawkins criteria were good in 6 cases, fair in 7 cases and poor in 5 cases. 6. Complications were avascular necrosis in 7 cases, degenerative arthritis in 5 and nonunion in 3.

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Triplane Fracture of the Distal Tibial Epiphysis: Jin Hwan An, Jae Keun So, Jae Chul Ok; J Korean Soc Fract 1995;8(4):870-877. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.870

Abstract PDF: The triplane fracture of the distal end of the tibia in adolescents is considered uncommon injuries, but recently it has received considerable attention in the orthopaedic literature. We reviewed five patients who had been treated at Kyung Hee University Hsopital for triplane fractures and followed up at least one year. The purposes of this paper were to determine the configuration of the fracture and the results of treatment. The cause of injury was slip down in three patients, fall down in one patients and sports injury in one patient. The mechanism of injury was supination-external rotation in four patients and unknown in one patient. The plain x-ray and CT were evaluated in all patients. On radiological evaluation, the initial displacement more than 2mm observed in four patients, but displaced fractures were reduced less than 2mm after treatment. The two fragment fractures were seen in two patients, three fragments in three patients. At last follow-up, complete union with anatomical position occurred without degenerative change of ankle joint and any deformity. We treated operatively in two patients, one with arthroscopic reduction and percutaneous pinning, the other with open reduction and internal fixation. Also we treated conservatively in one minimal displaced fracture and two displaced fractures. The results were graded using a modification of the Weber protocol. Points were assigned for pain, walking, activity, radiographic findings, function of the ankle joint, and deformity. The results was classified as excellent in 5 patients and good, fair and poor results was none. The complications was not developed in atl patients. The initial displacement, No. of fragments and treatment method were not significantly affect the results of treatment. Finally, we had excellent results in triplane fracture if the reduction less than 2mm regardless initial displacement can obtained.

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Operative Treatment for Comminuted Fractures of the Proximal Humerus Using T-plate: Young Sik Pyun, Chang Soo Kang, Kwang Soon Song, Chul Hyung Kang, Byung Woo Min, Jin Soo Hwang; J Korean Soc Fract 1995;8(4):878-884. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.878

Abstract PDF: The shoulder is especially susceptible to stiffness following injury because of the formation of adhesions. Early mobilization prior to maturation of adhesions around the joint gliding surface is, therefore, an essential step in the management of the proximal humerus comminuted fractures. Our aims were accurate reduction and stable fixation to allow early mobilization and to achieve full functional recovery. During the eight-year period from January 1986 to June 1994,51 cases patients were treated surgically for comminuted fractures of the proximal part of the humerus by T-plate at our hospital. The results were summarized as follows; 1. There were 17 cases of the two-part fractures, 31 cases of the three-part fractures and 3 cases of the four-part fractures following to Neers classification. 2. The most common cause of injury was road traffic accident(34 cases). 3. The excellent or satisfactory results were seen 82% of the two-part fractures and 81% of the three-part fractures, whereas 67% of the four-part fractures. 4. The most frequent complication of comminuted fractures were motion limitation and pain(5 cases), delayed union(2 cases), plate bending(1 case) and infection(1 case) but avascular necrosis of the humeral head, non-union, myositis ossificans and plate breakage had not been developed in these cases. 5. T-plate was one of the good internal fixation devices for surgical treatment of the comminuted fractures of the proximal humerus.

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Fracture of Clavicle Accompanied by Injury of Subclavian Artery, Hemothorax and Arterial Occlusion by fhrornboembolism: Treated by Intraarterial Thrombolytic Procedure: Sung Churl Lee, Moon Jib Yoo, Suk Joo Lyu, Jin Young Park, Myung Ho Kim; J Korean Soc Fract 1995;8(4):885-888. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.885

Abstract PDF: Although most fractures of the clavicle are usually treated by closed means and heal uneventfully, serious injuries may occur and a delay in treateng these injuries may be life-threatening. One of such serious associated injuries is vascular injury. In this report, we present an unusual case in which a fracture of the clavicle was accompanied by an injury of the subclavian artery, hemothorax and concommitant arterial occlusion of upper extremity by throboernbolism. Treatment included resection of the injured part of the artery with bypass graft, thromboembolectomy and fixation of the clavicle with a plate and screws. Thereafter, the patient had suffered from repeated episodes of thrornboembolism of the upper extremity, a compartment syrdrome and a metal failure. It is critical in a patient with a clavicular fracture that a careful examination of the entire upper extremity be performed, with particular emphasis on the neurovascualr status.

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Negleeted Displaced Radial Neck Fracture Developed After the Reduction of Posterior Elbow Dislocation: A case report: Eun Sun Moon, Sung Taek Jung, Seong Tae Cho; J Korean Soc Fract 1995;8(4):889-892. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.889

Abstract PDF: The complete fracture-separation of proximal radial epiphysis is a comparatively rare injury In the original discription about this injury by Jeffery, the complete displacement of fracture was produced by a result of spontaneous reduction of dislocated elbow after initial nondisplaced fracture of radial neck with dislocation of elbow, We have experienced of development of complete posterior displaced radial neck fracture after reduction of the posterior elbow dislocation.

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Clinical Comparison in Intramedullary Fixation to Plate Fixation on Treatment of the Both Forearm Bone Fractures: Seog Yeong Jeong, Ung Moon, Soo Jae Yim, Seung Ryeol Yoon, Soo Kyun Rah, Chang Uk Choi; J Korean Soc Fract 1995;8(4):893-901. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.893

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The diaphyseal fractures of radius and ulnar have many problems like nonunion, malunion and functional disturbance with conservative treatment. Therefore, open anatomical reduction and rigid internal fixation have been widely used. The plate fixation has been employed in most both forearm bone fractures and the intramedullary pinning usually used in cases of the open fractures, comminuted types, multiple fractures or poor general conditions. Seventeen patients were treated with semitubular plate and eighteen cases by the closed or open reduction and intramedullary fixation with Rush pin(the operation methods were decised alternatively) were followed up more than one year at Soonchunhyang Gumi Hospital from June 1988 to Nov. 1992 and the results were compared and analyzed clinically. 1. Those two groups were demographically similar. 2. The operation time was 65 minites in Rush pin group, 85.6 minutes in plate group and the blood loss was 37.1cc in Rush pin group,85.3cc in plate group. 3. The immobilization period and the radiologic bone union time did not differentiate two groups significantly. 4. In plated group, one nonunion and one radius refracture after union(plate removed state) were occurred. 5. Between the two operatio methods selected alternatively, immobilization period, radiologic bone union and functional results were not different significantly, but the Rush pinning method was preferred due to simple operation technique, small operation scars, short operation time, a little blood ioss, a few complications.

Citations

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Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture
Yong Chan Lee, Hong Je Kang
Journal of the Korean Society for Surgery of the Hand.2015; 20(4): 168. CrossRef
Pediatric Forearm Bone Fractures Treated with Flexible Intramedullary Nail
Suk Kyu Choo, Jin Hwan Kim, Hyung Keun Oh, Dong Hyun Kim
Journal of the Korean Fracture Society.2007; 20(2): 190. CrossRef

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The Treatment of Volar Iunate Dislocation and Perilunar Dislocation: Kyu Cheol Shin, Dong Heon Kim, Ju Yong Shin; J Korean Soc Fract 1995;8(4):902-913. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.902

Abstract PDF

The treatment methods of volar lunate dislocation and dorsal perilunar dislocation were introduced variably. We treated 7 cases of volar lunate and dorsal perilunar dislocation by closed reduction and K-wire fixation, open reduction and isolated lunate excision. The 1 case of trans-scaphoid dorsal perilunar dislocation was treated by closed reduction and Herbert screw fixation. The result were as followed: 1. The early diagnosis and early treatment is the most improtant. 2. The closed reduction and percutaneous pinning has advatage of maintenance of reduction and stability of wrist joint. 3. The advantage of Herbert screw fixation is anatomical reduction of the scaphoid fracture but disadvantage is technical difficulty. 4. In open reduction, we must choose the approach that minimiBe the vascular damage to the lunate from the volar side. 5. The isolated lunate excision is not advised.

Citations

Citations to this article as recorded by

Carpal Tunnel Syndrome and Rupture of Flexor Tendon Associated from Neglected Anterior Lunate Dislocation
Young Yool Chung, Young Jae Jang
Journal of the Korean Society for Surgery of the Hand.2015; 20(1): 33. CrossRef
Surgical Treatment of the Perilunate Dislocation and the Lunate Dislocation with Dorsal Approach
Soo-Hong Han, Jin-Myoung Dan, Dong-Hoon Lee, Young-Woong Kim
Journal of the Korean Fracture Society.2011; 24(4): 347. CrossRef
Combined Lunate and Triquetrum Fracture: A Case Report
Joo-Hak Kim, Hyung-Soo Kim, Soo-Tae Chung, Jeong-Hyun Yoo, Seung-Do Cha, Joong-Hyo Lee, Jai-Hyung Park
Journal of the Korean Fracture Society.2008; 21(4): 320. CrossRef

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Fracture of the Capitate with Velar Perilunate Dislocation: One case report: Kwang Hyun Lee; J Korean Soc Fract 1995;8(4):908-913. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.908

Abstract PDF: Fracture of the capitate is a rare form of carpal injuries. It can occur with perilunate dislocation. In that case, capitate fracture associated with scaphoid fracture is common enough that it has been called the scaphocapitate fracture(or syndrome). A rare case of a displaced fracture of the capitate and unusual locked volar perilunate dislocation without scaphoid fracture is described. This carpal injury was treated by closed reduction and percutaneous pinning with one K-wire and the result is now excellent. A possible explantation of the mechanism underlying this conditian is offered and the literature is reviewed.

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