Journal of Musculoskeletal Trauma

Tension Band Wiring Technique for Distal Radius Fracture with a Volar Articular Marginal Fragment: Technical Note: Neunghan Jeon, Jong Keon Oh, Jae Woo Cho, Youngwoo Kim; J Korean Fract Soc 2020;33(1):38-42. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.38

Most distal radius fractures are currently being treated with anterior plating using anatomical precontoured locking compression plates via the anterior approach. However, it is difficult to fix the volar articular marginal fragment because these anatomical plates should be placed proximally to the watershed line. There were just a few methods of fixation for this fragment on medical literature. Herein, we introduced a tension band wiring technique for fixation of a volar articular marginal fragment in the distal radius.

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Hook plate versus periarticular-type volar locking plate for distal radius fractures involving the volar lunate facet in Korea: a retrospective cohort study
Hyun-Jae Park, Joo-Hak Kim
Journal of Musculoskeletal Trauma.2025; 38(4): 221. CrossRef

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Clinical Outcomes of Minimally Invasive Surgery in Sanders Type IV Intra-Articular Calcaneal Fractures: Jun Young Lee, Hyunwoong Jang, Young Wook Kim; J Korean Fract Soc 2019;32(4):181-187. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.181

Abstract PDF: PURPOSE
This study evaluated the radiologic and clinical results in patients who underwent minimal invasive surgery using sinus tarsi approach in Sanders type IV calcaneal fracture.
MATERIALS AND METHODS
This retrospective study evaluated 13 cases of Sanders type IV calcaneus fractures that were treated by minimal invasive surgery using the sinus tarsi approach from July 2012 to April 2017. Further, these cases could be followed up for more than 12 months. Bone union, radiologic parameters such as BÃ¶hler's angle, Gissane's angle, calcaneal height, length, and width, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and the postoperative complications were evaluated.
RESULTS
Bony union was achieved in all the cases at the final follow up, and the mean union time was 5.5 months. One patient underwent reoperation for a surgical site infection, six patients had post traumatic arthritis, and two of them underwent subtalar joint fusion. The mean AOFAS ankle-hindfoot score was 81.2. At the final follow-up, the mean values of BÃ¶hler's angle and Gissane's angle were 20Â° and 119.8Â°, respectively, and the mean values of the calcaneus height, length, and width were 46.8 mm, 81.8 mm, and 45.6 mm, respectively.
CONCLUSION
Minimal invasive surgery using the sinus tarsi approach for Sanders type IV calcaneal fracture resulted in satisfactory anatomic reduction and stable fixation, and satisfactory clinical and radiologic results were obtained in most of the patients. Minimal invasive surgery is thought to reduce the soft tissue-related complications as compared to surgery using the extensile lateral approach.

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Anterior Approach for the Acetabular Fractures: Jae Youn Yoon, Jae Woo Cho, Ji Wan Kim; J Korean Fract Soc 2019;32(3):157-164. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.157

Abstract PDF

In the surgical treatment of acetabular fractures, the anterior approach is used widely for anterior column fractures with or without posterior column fractures. This paper reviews the anterior approach for the anatomical reduction and rigid fixation of acetabular fractures: traditional ilioinguinal approach, modified Stoppa approach, and new Pararectal approach.

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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

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Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures in Elderly Patients: Comparison of the Minimally Invasive Approach and Extensile Lateral Approach: Hong Ki Park, Jae Yoon Ko, Seung Kwan Lee, Jong Min Baik; J Korean Fract Soc 2019;32(3):135-142. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.135

Abstract PDF

PURPOSE
As the functional demands for activities in elderly patients are increasing according to their life extension, the need for surgical treatment is also increasing in elderly patients with displaced intra-articular calcaneal fractures. In addition to the extensile lateral approach (ELA), which is a surgical procedure that showed good results on intra-articular calcaneal fractures, the minimally invasive approach (MIA) also showed an outstanding result. This study compared the radiological and clinical results of intraarticular calcaneus fractures in elderly patients in two groups: ELA and MIA.
MATERIALS AND METHODS
Thirty patients aged over 65 years with intra-articular calcaneus fractures, who could be followed-up more than 14 months, were included in this study. Thirteen patients of the MIA group and 17 patients of the ELA group were analyzed retrospectively using radiological and clinical assessments.
RESULTS
No significant difference in union time, posterior facet reduction accuracy, subtalar osteoarthritis frequency, Bohler angle, calcaneal width, American Orthopaedic Foot and Ankle Society score, visual analogue scale score, 36-item short form survey, and foot function index was observed between the two groups. The p-value of the average height of the calcaneus correction, average length of calcaneal correction, and average loss of correction length were <0.001, 0.005, and 0.015, respectively. The incidence of complications, including soft tissue necrosis and bone infection, were 23.1% in the ELA group and none in the MIA group.
CONCLUSION
The clinical outcomes were similar in the two groups. The degree of reduction of fracture showed a better result in the MIA group than the ELA group. Furthermore, there were no complications in the MIA group, whereas the ELA group showed some complications.

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Clinical and Radiological Outcomes of ‘Blocking Kirschner Wire Technique’ in Displaced Intra-Articular Calcaneal Fractures via the Extended Sinus Tarsi Approach
Jeong-Kil Lee, Chan Kang, Sang-Bum Kim, Gi-Soo Lee, Jung-Mo Hwang, Byung-Kuk An
Journal of the Korean Orthopaedic Association.2021; 56(3): 224. CrossRef

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Paratricipital Approach for AO/OTA Type C2 Intra-Articular Fracture of Distal Humerus: Chul Hyung Lee, Doo Hun Sun, Deukhee Jung, Chung Han An; J Korean Fract Soc 2019;32(3):128-134. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.128

Abstract PDF

PURPOSE
The aim of this study was to determine the outcomes of fixation of AO/OTA type C2 fractures among intra-articular fractures of the distal humerus using the paratricipital approach (side to side retraction of the triceps).
MATERIALS AND METHODS
From June 2008 to January 2018, 12 patients underwent an open reduction and internal fixation with the paratricipital approach and were followed-up for more than 10 months after surgery. According to the AO/OTA classification, type C2 fractures were chosen among the intraarticular distal humerus fractures. An extended posterior incision was used over the olecranon in the prone position, preserving the insertion site of the triceps brachii muscle. The fracture site was exposed by retracting the muscle side-to side through a dissection of the medial and lateral intermuscular septum of the triceps brachii muscle. The therapeutic results were assessed by the anatomical reduction of the articular surface and integrity of the metaphyseal contour in postoperative simple radiographs, complications, such as neuropathy or non-union, and the Mayo elbow performance score (MEPS) were checked to estimate the functional outcome.
RESULTS
In the postoperative simple radiographs, no case showed more than 1 mm step-off and the disrupted contour of the distal humerus was recovered to normal alignment in most cases. The range of elbow joint motion in the last follow-up was 133.8Â° on average with a mean flexion contracture of 5.0Â°. The clinical results depending on the MEPS were excellent, except for two cases, which were good. Neuropathy of the ulnar nerve was observed in one patient, which was resolved after metal removal.
CONCLUSION
The paratricipital approach is useful technique in AO/OTA type C2 intra-articular distal humerus fractures that provides sufficient exposure of the surgical field, without injury to the triceps brachii muscle and postoperative complications associated with the trans-olecranon approach.

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Short-Term Results After Intra-Articular Fractures of the Distal Humerus Treated by a Paratriceps Approach
Petar Petkov
Scripta Scientifica Medica.2025; 57(1): 48. CrossRef

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Anatomical Reduction with Brick-Work Technique in Comminuted Intraarticular Distal Radius Fractures: Hyoung Min Kim, Hyung Lae Cho, Jong Woo Chae, Myung Ji Shin; J Korean Fract Soc 2018;31(1):1-8. Published online January 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.1.1

Abstract PDF: PURPOSE
This study examined the clinical outcomes of comminuted intraarticular distal radius fractures treated by an anatomical reduction using a brick-work technique.
MATERIALS AND METHODS
Seventeen patients with AO/OTA type 23-C3 distal radius fractures were enrolled in this study. An anatomical reduction of the articular surface was achieved using a brick-work technique through the dorsal approach and dorsal plates were used for fixation. The postoperative functional results were assessed with the range of motion of the wrist and the modified Mayo wrist score (MMWS). In addition, the radial length, radial inclination, volar tilt, and Lidstrom score were evaluated from the radiology results. The mean postoperative follow-up period was 13.6 months.
RESULTS
All patients showed bony union and the mean range of motion of the injured wrists was 94% (92% to 95%) of the uninjured side. The mean MMWS was 85.3, and the functional results were excellent in 12 patients, good in 4, and fair in one at the final follow-up. Based on the final radiographic measurements, the radial length, volar tilt, and radial inclination were 11.4 mm (10.0 to 13.5 mm), 6.6Â° (âˆ’1.8Â° to 9.2Â°), and 21.3Â° (20.1Â° to 25.7Â°), respectively. The radiologic results according to the Lidstrom score were excellent in 14 patients and good in three.
CONCLUSION
An anatomical reduction with the brick-work technique is relatively easy, results in a reproducible clinical outcome, and could be a safe and effective treatment option for severe comminuted intraarticular distal radius fractures that are not amenable to volar plate fixation.

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Reduction Technique of Dome Impaction Using the Modified Stoppa Approach: A Technical Note: Ji Wan Kim, Yong Min Seo, Hyo Seok Jang; J Korean Fract Soc 2017;30(3):131-136. Published online July 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.3.131

Abstract PDF

In elderly acetabular fractures, central dislocation of the femoral head and impacted superior dome of the acetabulum is common. Unreduced dome impaction can lead to degenerative arthritis and results in poor results. Herein, we present a case of operative reduction and fixation performed via the modified Stoppa approach in acetabular fracture with superior dome impaction.

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Surgical outcomes of acetabular fracture of elderly patients with superomedial dome impaction
Eic Ju Lim, Hyun-Chul Shon, Jae-Young Yang, Joosuk Ahn, Jung Jae Kim, Ji Wan Kim
Scientific Reports.2023;[Epub] 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

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Posterior Dual Plating for Distal Shaft Fractures of the Humerus: Chul Hyun Cho, Kwang Yeung Jeong, Beom Soo Kim; J Korean Fract Soc 2017;30(3):117-123. Published online July 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.3.117

Abstract PDF

PURPOSE
To evaluate the results and efficacy of posterior dual plating for distal shaft fractures of the humerus.
MATERIALS AND METHODS
We retrospectively analyzed 12 patients, who underwent open reduction and internal fixation using posterior dual plating for distal shaft fractures of the humerus, between July 2007 and July 2015, with at least 6 months of follow-up. After locating the radial nerve without dissection via posterior triceps splitting, the fracture was stabilized using a short 3.5 mm locking compression plate. Then additional fixation, using a long 3.5 mm locking compression plate, was performed. The clinical outcomes were assessed in accordance with the Mayo Elbow Performance Index (MEPI) scoring system, and the radiological outcomes were assessed using serial plain radiographs.
RESULTS
Eleven patients (91.7%) had bony union, and the mean union period was 13.9 weeks. In one patient, delayed union was treated by autogenous iliac bone graft at 8 months after surgery, which resulted in bony union. The mean MEPI score was 95.8, and the clinical outcomes were excellent in 9 patients and good in 3 patients. Postoperative complications included 1 elbow stiffness by heterotopic ossification and 1 temporary radial nerve palsy. One patient with temporary radial nerve palsy was completely recovered within the first 4 days after surgery.
CONCLUSION
Posterior dual plating for distal shaft fractures of the humerus revealed satisfactory clinical and radiological outcomes. It can be a useful alternative to provide stable fixation without the need for a dissection of the radial nerve.

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Quantitative Analysis of the Radial Nerve Pathway Relative to the Humerus Shaft Length: A Cadaveric Study Aimed at Minimizing Nerve Injury in Fracture Treatment
Chang-Jin Yon, Beom-Soo Kim, Eun-Seok Son, Chul-Hyun Cho
Clinics in Orthopedic Surgery.2026; 18(3): 405. CrossRef

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Outcomes of Severe Comminuted Distal Radius Fractures with Pronator Preserving Approach: Seung Hyun Cho, Hong Gi Park, Deuk Soo Jun, Jae Ang Sim, Young Hak Roh, Yong Cheol Yoon, Jong Ryoon Baek; J Korean Fract Soc 2015;28(3):178-185. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.178

Abstract PDF

PURPOSE
We investigate the outcomes of treatment of patients with severe comminuted distal radius fractures with volar plate fixation using a pronator-preserving approach.
MATERIALS AND METHODS
Fourteen patients with severe comminution of the distal radius fractures for whom anatomical reduction of the fractures was deemed difficult to achieve with traditional approaches were enrolled. The gender ratio was 8 males to 6 females, and the average age of the patients was 64.9 years. According to the AO/OTA classification of fractures, 2 patients had 23-A3 fractures, 7 patients had 23-C2, and 5 patients had 23-C3. Radial length, radial inclination, and volar tilt were measured for radiologic evaluation. Modified Mayo wrist score (MMWS) was used for clinical outcome.
RESULTS
Bony union was achieved in all 14 patients without signs of complications. The average time-to-union was 4.3 months (3-6 months). The radiological findings at the final follow-up were as follows: the average radial inclination was 20.5degrees; the average volar tilt, 7.57degrees; and the average radial length, 11.8 mm. At the final follow-up, the results of the MMWS were 'Fair' in 1 patient, 'Good' in 4, and 'Excellent' in 9.
CONCLUSION
We propose that a pronator-preserving approach is an effective treatment for severe comminuted distal radius fracture.

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Use of Miniplate for Severe Comminuted Metadiaphyseal Fractures of the Distal Radius
Jong-Ryoon Baek, Yong-Cheol Yoon, Seung Hyun Baek
Journal of the Korean Fracture Society.2019; 32(4): 204. CrossRef

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Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate: Jae Cheon Sim, Sung Sik Ha, Ki Do Hong, Tae Ho Kim, Min Chul Sung; J Korean Fract Soc 2015;28(1):46-52. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.46

Abstract PDF: PURPOSE
The purpose of this study is to evaluate outcome of variable-angle volar locking plate for treatment of distal radius fractures.
MATERIALS AND METHODS
We retrospectively analyzed the results in 45 cases treated by variable-angle volar locking plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results.
RESULTS
All cases had bony union. The mean Mayo wrist performance scoring system was 84.8. Between preoperative and immediate postoperative radiographic measurement, the mean radial length improved from 8.4 to 11.8 mm, radial inclination from 14.2degrees to 22.4degrees, volar tilt from -4.5degrees to 9.6degrees, and intraarticular step-off from 1.8 to 0.3 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured 0.8 mm, radial inclination 0.4degrees, and volar tilt 0.9degrees (p>0.05). All cases showed bone union with no evidence of malunion, nonunion, or metal failure.
CONCLUSION
Treatment of distal radius fractures using variable angle volar locking plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.

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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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A Case of Surgically Treated by Transperitoneal Approach in Delayed Neurological Deficit after Sacral Fracture: A Case Report: Young Soo Jang, Jong Seok Lee, Jae Hyuk Choi, Sung Ju Bae, Chan Il Bae; J Korean Fract Soc 2013;26(1):69-72. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.69

Abstract PDF: This study reviews a case of sacral fracture with delayed onset neurological deficit that showed good results after decompressive surgery. The delayed neurological deficit appeared at 4 weeks after injury and it was treated with anterior decompression through transperitoneal approach. A 23-year-old woman was injured in a car accident and had bilateral pubic rami fractures and fractures of the sacral ala on the right side. She was treated with external fixation devices for approximately four weeks, but complained of pain and numbness. The dorsiflexion and plantalflexion of the right ankle was weakened and graded as grade 2. Preoperative pelvic and sacral radiographs, computed tomography, magnetic resonance imaging and electromyelography, and nerve conduction study were performed to identify the region of neurological deficit, and we decided to implement neurological decompression. By transperitoneal approach, we performed bone curratage and decompression around the region of sacral alar slope and S1 foramen. The pain and numbness of the right foot cleared up. Dorsiflexion and plantalflexion of the right ankle improved to grade 5. Anterior decompression by transperitoneal approach proved to bring satisfactory results in a patient, who presented delayed neurological deficit after sacral fracture.

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Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus: Ji Kang Park, Yong Min Kim, Dong Soo Kim, Eui Sung Choi, Hyun Chul Shon, Kyoung Jin Park, Byung Ki Cho; J Korean Fract Soc 2012;25(2):129-135. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.129

Abstract PDF: PURPOSE
To evaluate the clinical outcomes of operative treatment using a transolecranon approach with a dual locking plate for unstable intercondylar fractures of the distal humerus.
MATERIALS AND METHODS
Eighteen patients were followed for more than 1 year after surgical treatment for unstable intercondylar fractures of the humerus. Anterior transpositioning of the ulnar nerve and an early rehabilitation program to allow range of motion (ROM) exercise from postoperative week 1 were used for all cases. The clinical and functional evaluation was performed according to the Mayo Elbow Performance Index and Cassebaum's classification of ROM.
RESULTS
The range of elbow joint motion was a flexion contracture mean of 12.8 degrees to a further flexion mean of 119.3 degrees at the final follow-up. The Mayo Elbow Performance Index was an average of 88.5 points. Among the results, 6 were excellent, 9 good, 2 fair, and 1 poor. Therefore, 15 cases (83.3%) achieved satisfactory results. Fourteen cases (77.7%) achieved a satisfactory ROM according to Cassebaum's classification. All cases achieved bone union, and the interval to union was an average of 14.2 weeks.
CONCLUSION
Dual locking plate fixation through the transolecranon approach seems to be one of the effective treatment methods for unstable intercondylar fractures of the humerus because it enables the anatomical reduction and rigid fixation of articulation, and early rehabilitation exercise.

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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; J Korean Fract Soc 2011;24(4):347-353. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.347

Abstract PDF: PURPOSE
To evaluate the clinical and radiologic outcomes of the perilunate dislocation and the lunate dislocation which were managed surgically through a dorsal approach.
MATERIALS AND METHODS
Retrospective reviews of the 13 patients who had minimum 1-year follow-up after surgical treatment through isolated dorsal approach for their perilunate dislocations or the lunate dislocations were performed. The case that dislocated lunate migrated proximally through the wrist was excluded in this series. We evaluated the DASH score in questionnaire method and Mayo wrist score to analyze the clinical outcomes. Radiologic results were investigated by measurement of the scapho-lunate angle, and fracture union was also evaluated in the case of trans-scaphoid dislocation.
RESULTS
The mean DASH Score was 16.3 points (range, 10.8~26.7 points) and the mean Mayo wrist score was 79 points (range, 65~90 points) at the final follow-up. There were 2 cases of excellent, 7 cases of good and 4 cases of fair in the Mayo wrist score. On the radiologic analysis, the mean scapho-lunate angle was 49.0degrees (range, 35~55degrees) and all cases were within the normal range. All cases of the trans-scaphoid perilunate dislocation achieved bone union.
CONCLUSION
Author's cases showed satisfactory outcomes in clinically and radiologically. Isolated dorsal approach could give anatomical reduction and appropriate internal fixation in treatment of the perilunate dislocations and the lunate dislocations except the rare case of proximal migration of the lunate through the wrist.

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Treatment of the Trimalleolar Fracture Using Posterolateral Approach: Minimum 2-year Follow Up Results: Gwang Chul Lee, Jun Young Lee, Sang Ho Ha, Jae Won You, Sang Hong Lee, Hong Moon Sohn, Ki Young Nam, Kwang Hyo Seo; J Korean Fract Soc 2011;24(4):328-334. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.328

Abstract PDF

PURPOSE
To analyze the long term follow up results of treatment with posterolateral approach and to investigate its usefulness in the patients of trimalleolar fracture with posterior fragment which is above 25% of articular involvement.
MATERIALS AND METHODS
There were 34 cases of trimalleolar fracture in our hospital from May 2004 to April 2008. We investigated 20 patients who underwent operation with the posterolateral approach and over-2 years follow up cases. The mean follow up period was 34 (24~58) months. Preoperative posterior malleolar fragment involved above 25% of articular surface in all cases and displaced more than 2 mm in 11 cases. We analyzed the radiologic type of posterior malleolar fragments and evaluated the function and pain through AOFAS score and complications.
RESULTS
All cases showed primary union at mean 13.1 weeks. The complications are that partial ankylosis result of soft tissue contracture is seen in 2 cases (10%) and post-traumatic arthritis is seen in 1 cases (5%) and 17 cases (85%) of all patients are showed excellent AOFAS score.
CONCLUSION
The posterolateral approach is a valuable method because that it enables us to easily reduction and internal fixation of the posterior malleolus and lateral malleolus at one time and the results are satisfied for a long time follow up.

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Outcomes of Immediate Operative Treatment of Ankle Trimalleolar Open Fractures
Jun-Young Lee, Yong-Jin Cho, Sin-Wook Kang, Yung-Min Cho, Hyun-Bai Choi
Journal of Korean Foot and Ankle Society.2020; 24(1): 25. CrossRef

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Operative Treatment of Distal Humeral Comminuted Fractures with Orthogonal Plating: Joong Bae Seo, Jae Sung Yoo; J Korean Fract Soc 2011;24(3):243-248. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.243

Abstract PDF: PURPOSE
To analyze the results of operative treatment for Comminuted Fracture of Distal Humerus with Transolecranon approach and Orthogonal plating.
MATERIALS AND METHODS
The subjects were 22 patients with Comminuted fracture of humerus who were treated with Orthogonal plating. Patient's age, sex, type of fracture, surgical approach, method of fixation, time of operation, time of bony union, complication, range of motion were investigated, and Function of elbow was evaluated by functional evaluation of Riseborough and Radin, Mayo Elbow Performance Score (MEPS).
RESULTS
Age, sex, injuried arm, operation time were not related to postoperative result. Type C2 fractures showed better results in function and range of motion (ROM) than type C3 fractures. Also early rehabilitation was important to functional recovery and ROM. The postoperative ROM was average 110. Good were 16 cases, fair were 6 cases in functional evaluation of Riseborough and Radin. Excellent were 13 cases, good were 8 cases, fair was 1 case in MEPS.
CONCLUSION
Operative treatment with Transolecranon approach and Orthogonal plating showed favorable result on its function. Intraarticular comminution and early rehabilitation were closely related to postoperative function of elbow.

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2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures: Sung Jin Kim, Chul Hyun Cho; J Korean Fract Soc 2011;24(2):151-155. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.151

Abstract PDF

PURPOSE
To evaluate outcomes 2.4 mm volar locking compression plate for treatment of unstable distal radius fractures.
MATERIALS AND METHODS
We retrospectively analyzed the results in 22 cases, which were treated by 2.4 mm volar locking compression plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results.
RESULTS
All cases had bony union. The mean Mayo wrist performance score was 85.23. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 6.04 mm to 9.68 mm, radial inclination from 15.61degrees to 19.61degrees, volar tilt from -13.73degrees to 7.66degrees and intraarticular step-off from 0.79 mm to 0.33 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured 0.86 mm, radial inclination 0.41degrees, volar tilt 0.54degrees and intraarticular step-off 0.02 mm (p>0.05). Postoperative complication included that flexor pollicis longus and 2nd flexor digitorum profundus were ruptured in 1 case.
CONCLUSION
Treatment of unstable distal radius fractures using a 2.4 mm volar locking compression plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.

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Is dorsal cortex drilling necessary for distal radius fractures treated with a volar locking plate? A comparative study of near-cortex-only and far-cortex drilling
Chul Hong Kim, Sung Yoon Jung, Hyeon Jun Kim, Si-Hyun Park
Journal of Trauma and Injury.2025; 38(3): 248. CrossRef
Treatment of the Communited Distal Radius Fracture Using Volar Locking Plate Fixation with Allogenic Cancellous Bone Graft in the Elderly
Je Kang Hong, Chang Hyun Shin
Journal of the Korean Fracture Society.2015; 28(1): 8. CrossRef

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Treatment of the Posterior Malleolar Fracture Using Posterior Approach: Hyun Wook Chung, Dong Hwan Kim, Si Hoon Yoo, Jin Soo Suh; J Korean Fract Soc 2010;23(1):50-56. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.50

Abstract PDF

PURPOSE
For fixation of the large posterior malleolar fracture fragment, indirect anterior fixation with cannulated screw has been widely used, but the anatomical reduction is not always obtained. The purpose of this article is to evaluate the clinical result of posterior malleolar fractures treated with anatomical reduction and internal fixation using posterior approach.
MATERIALS AND METHODS
We have analyzed the 15 patients with posterior malleolar fractures, treated with posterior approach from August 2005 to August 2008. The mean follow up period was 17.6 months, We have reviewed the perioperative joint integrity, method of operation, postoperative care, bony union and complication. A clinical outcome was evaluated by AOFAS (American orthopedic foot and ankle society) scaling system and Olerud & Molander scoring system.
RESULTS
Among 15 cases, posterolateral approach and posteromedial approach were chosen in 9 cases and 6 cases respectively. The radiologic unions were achieved at 12.4 (12~18) weeks. Mean AOFAS score was 90.3 (72~98), and Olerud & Molander score was "excellent" in 5 cases, "good" in 7 cases, "fair" in 1 case and "poor" in 2 cases. Postoperative complications in 2 cases revealed a posttraumatic arthritis and a scar band contracture respectively.
CONCLUSION
In posterior malleolar fracture of ankle joint, the integrity of joint has closely affected clinical outcomes. We suggest that a posterior approach for posterior malleolar fracture with especially incarcerated fragments and comminuted fractures, can be a useful method for anatomical reduction and stable fixation, and satisfactory clinical results.

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Single lateral approach for open reduction and internal fixation of posterior malleolar fragment in Weber B rotational ankle fracture
Jaehyung Lee, Hwan Ryu, Jae Yong Park
Medicine.2023; 102(3): e32725. CrossRef
Posterior Malleolus Fractures in Trimalleolar Ankle Fractures: Malleolus versus Transyndesmal Fixation
Bilgehan Tosun, Ozgur Selek, Umit Gok, Halil Ceylan
Indian Journal of Orthopaedics.2018; 52(3): 309. CrossRef
Single Oblique Posterolateral Approach for Open Reduction and Internal Fixation of Posterior Malleolar Fractures With an Associated Lateral Malleolar Fracture
Jun Young Choi, Ji Hoon Kim, Hyeong Tak Ko, Jin Soo Suh
The Journal of Foot and Ankle Surgery.2015; 54(4): 559. CrossRef

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Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating: In Jung Chae, Sang Won Park, Soon Hyuck Lee, Won Noh, Ho Joong Kim, Seung Beom Hahn; J Korean Fract Soc 2009;22(4):252-258. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.252

Abstract PDF

PURPOSE
To evaluate the radiologic and clinical results of treatment of the Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual incision approach and dual plating. MATERIALS AND METHODS: Twelve cases in eleven patients of Shatzker type 6 tibia plateau fracture which has been treated using the lateral and posteromedial dual incision approach and dual plating were analyzed with an average follow-up of 16 months. Times to union, alignment and reduction loss on radiograph and postoperative clinical outcome with checking the range of motion of the knee joint, Knee Society Score and UCLA activity scale were analyzed and evaluated. RESULTS: In all cases, bony union was obtained in an average fifteen weeks after the operation, and there was no reduction loss. The arc of motion of the knee joint at the latest follow-up was 132 degrees on average. Average of Knee Society Score was 85 and UCLA activity scale was decreased from 9.6 points preoperatively to 5.7 points postoperatively. CONCLUSION: The treatment of Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual approach and dual plating have shown clinically preferable results of excellent recovery of joint motion and good knee society score by early range of motion exercise after firm fixation. However, it was high energy injury, so the sports activity of patients was significantly decreased.

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Staged Treatment of Bicondylar Tibial Plateau Fracture (Schatzker Type V or VI) Using Temporary External Fixator: Correlation between Clinical and Radiological Outcomes
Seung Min Ryu, Han Seok Yang, Oog Jin Shon
Knee Surgery and Related Research.2018; 30(3): 261. CrossRef
Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures
Jae-Ang Sim, Kwang-Hui Kim, Yong-Seuk Lee, Sang-Jin Lee, Beom-Koo Lee
Journal of the Korean Orthopaedic Association.2014; 49(4): 278. CrossRef
Current Concepts in Management of Tibia Plateau Fracture
Sang Hak Lee, Kang-Il Kim
Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef

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The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach: Sung Sik Ha, Jae Chun Sim, Ki Do Hong, Jae Young Kim, Kwang Hee Park, Yoon Ho Choi; J Korean Fract Soc 2009;22(4):246-251. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.246

Abstract PDF

PURPOSE
To evaluate clinical and radiological results of surgical treatment of distal femur medial condyle fracture using lateral anatomical plate of opposite side through medial approach. MATERIALS AND METHODS: This study reviewed the results of 9 cases of distal femur medial condyle fracture treated with lateral anatomical plate of opposite side through medial approach from December 2005 to June 2007, after a follow up of more than 12 months. There were 2 males and 7 females with a mean age of 63.1 (57~72) years. The clinical results were evaluated using the Schatzker's criteria, and the radiographic results were evaluated using the bone union time. RESULTS: Using the Schatzker's criteria, 7 cases of the 9 patients (78%) showed exellent results. The mean time for bone union was 13.4 (11~15) weeks. There were 3 cases of pain on full weight bearing same as previous operative state by degenerative osteoarthritis. There weren't complications as joint stiffness, infection, varus & rotational deformity, malunion, nonunion, and metal failure. CONCLUSION: Plate fixation using medial approach provides the proper anatomical reduction and stronger fixation, and outcome good results.

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Medial Plating of Distal Femoral Fracture with Locking Compression Plate-Proximal Lateral Tibia: Cases' Report
Se-Ang Jang, Young-Soo Byun, In-Ho Han, Dongju Shin
Journal of the Korean Fracture Society.2016; 29(3): 206. CrossRef

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A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture: Jeong Seok Moon, Woo Chun Lee; J Korean Fract Soc 2009;22(1):13-18. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.13

Abstract PDF

PURPOSE
To compare the clinical results between the extensile lateral approach and sinus tarsi approach in the open reduction of the Sanders type II calcaneal fracture.
MATERIALS AND METHODS
From July 2002 to Februry 2007, thirty two patients having thirty three calcaneal fractures of Sanders type II were managed with open reduction and internal fixation using the extensile lateral approach or sinus tarsi approach. The mean age of 19 patients using extensile lateral approach was 43.3 years. The mean age of 13 patients using sinus tarsi approach was 46.3 years. Clinical outcome, radiographic parameters, and postoperative complications were compared between both groups.
RESULTS
There was no difference between two groups associated with patients demographs. The mean AOFAS score and VAS between both groups were not different (p=0.716, p=0.774). The mean Bohler's angle and Gissane's angle between both groups were not different (p=0.343, p=0.357). Two cases of sural nerve injury, one malunion, and one deep infection were occurred in the group of extensile lateral approach. However, patients using sinus tarsi approach had no postoperative complications.
CONCLUSION
The clinical results of sinus tarsi approach may be comparable with those of extensile lateral approach, with the advantages of reduced risk of postoperative complications.

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The Extensile Lateral Approach to the Calcaneus
Rohan Bhimani, Kush C. Shah, Rishin J. Kadakia
Techniques in Foot & Ankle Surgery.2025;[Epub] CrossRef
Extensile lateral versus sinus tarsi approach for calcaneal fractures
Chuangang Peng, Baoming Yuan, Wenlai Guo, Na Li, Heng Tian
Medicine.2021; 100(31): e26717. CrossRef
Lateral Extensile Approach Versus Minimal Incision Approach for Open Reduction and Internal Fixation of Displaced Intra-articular Calcaneal Fractures: A Meta-analysis
Andrea Seat, Christopher Seat
The Journal of Foot and Ankle Surgery.2020; 59(2): 356. CrossRef
Surgical Treatment of Calcaneal Fractures of Sanders Type II and III by A Minimally Invasive Technique with 6.5 mm Cancellous Screw
Yong Seung Oh, Kyung Ho Lee, Jung Ho Kim, Myoung Jin Lee
Journal of Korean Foot and Ankle Society.2019; 23(3): 116. CrossRef
A systematic review and meta-analysis of the sinus tarsi and extended lateral approach in the operative treatment of displaced intra-articular calcaneal fractures
Tomasz L. Nosewicz, Siem A. Dingemans, Manouk Backes, Jan S.K. Luitse, J. Carel Goslings, Tim Schepers
Foot and Ankle Surgery.2019; 25(5): 580. CrossRef
Meta‐analysis of two surgical approaches for calcaneal fractures: sinus tarsi versus extensile lateral approach
Fei Zhang, Hongtao Tian, Shilun Li, Bo Liu, Tianhua Dong, Yanbin Zhu, Yingze Zhang
ANZ Journal of Surgery.2017; 87(3): 126. CrossRef
Usefulness of Treatment with 6.5 mm Cancellous Screw and Steinmann Pin Fixation for Calcaneal Joint Depression Fracture
Gi-Soo Lee, Chan Kang, Deuk-Soo Hwang, Chang-Kyun Noh, Gi-Young Lee
Journal of Korean Foot and Ankle Society.2015; 19(1): 11. CrossRef
Open reduction and internal fixation with conventional plate via L-shaped lateral approach versus internal fixation with percutaneous plate via a sinus tarsi approach for calcaneal fractures – A randomized controlled trial
Shengli Xia, Yaogang Lu, Huizhong Wang, Zuming Wu, Ziping Wang
International Journal of Surgery.2014; 12(5): 475. CrossRef
Intra-articular Calcaneal Fractures Treated with Open Reduction and Internal Fixation -A Comparative Study between Groups with and without Bone Graft-
Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Sung Hwan Jo, Hoon Yang
Journal of the Korean Fracture Society.2010; 23(2): 180. CrossRef

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Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures: Chul Hyun Cho, Ki Choer Bae, Doo Hyun Kwon; J Korean Fract Soc 2008;21(3):220-224. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.220

Abstract PDF

PURPOSE
To evaluate outcomes volar T-locking compression plate for treatment of unstable distal radius fractures.
MATERIALS AND METHODS
We retrospectively analysed the results in 35 cases, which were treated by volar plating with T-LCP. We evaluated the clinical results according to the Mayo wrist scoring system and radiographic results.
RESULTS
The mean score was 83.86 respectively. Between preoperative and immediate postoperative radiographic measurements, averaged radial length was improved from 5.75 mm to 11.53 mm, radial inclination from 12.86 degrees to 22.56 degrees, volar tilt from -3.64 degrees to 9.90 degrees and intraarticular step-off from 1.48 mm to 0.42 mm. Between immediate postoperative and latest follow-up radiographic measurements, mean loss of radial length measured 0.43 mm, radial inclination 0.46 degrees, volar tilt 0.89 degrees.
CONCLUSION
Treatment of unstable distal radius fractures using a volar T-LCP showed satisfactory outcomes. We think that it is good surgical option to allow return to daily living, result in early postsurgical wrist motion.

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Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate
Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef
The Fate of Pronator Quadratus Muscle after Volar Locking Plating of Unstable Distal Radius Fractures
Chae-Hyun Lim, Heun-Guyn Jung, Ju-Yeong Heo, Young-Jae Jang, Yong-Soo Choi
Journal of the Korean Fracture Society.2014; 27(3): 191. CrossRef
2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
Sung-Jin Kim, Chul-Hyun Cho
Journal of the Korean Fracture Society.2011; 24(2): 151. CrossRef
Short Term Results of Operative Management with 2.4 mm Volar Locking Compression Plates in Distal Radius Fractures
Ki-Chul Park, Chang-Hun Lee
Journal of the Korean Fracture Society.2009; 22(4): 264. CrossRef
Plate Fixation of AO Type C3 Fractures of the Distal Radius
Eun-Sun Moon, Myung-Sun Kim, Hyeong-Won Park, Min-Sun Choi
Journal of the Korean Fracture Society.2009; 22(3): 172. CrossRef
Biosorption of Mercury (II) from Aqueous Solutions by Zygnema fanicum Algae
Gh. Shams Khoramabad, A. Jafari, J. Hasanvand Jamshidi
Journal of Applied Sciences.2008; 8(11): 2168. CrossRef
Volar Plating of Distal Radius Fractures
Kwang-Hyun Lee
Journal of the Korean Fracture Society.2008; 21(4): 325. CrossRef

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Treatment of Intra-articular Calcaneal Fractures Using Minimally Invasive Sinus Tarsi Approach in Diabetic Patients: Hong Moon Sohn, Sang Ho Ha, Sang Hong Lee, Jun Young Lee, Jeong Ho Kim, Sang Jun Lee; J Korean Fract Soc 2008;21(3):195-199. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.195

Abstract PDF

PURPOSE
Wound problems occur in 5~30% of intra-articular calcaneal fractures following operation. Diabetes mellitus, large incisions and abundant dissection can increase the risk of wound problems that may require skin graft or other additional care. The authors used minimally invasive technique to treat intra-articular calcaneal fractures in diabetic patients and evaluated the results and complications of this method. MATERIALS AND METHODS: Between January 2002 and July 2005, 12 patients with intra-articular calcaneal fractures who had underlying diabetes mellitus were treated using minimally invasive technique with a modified sinus tarsi approach. The patients had an average age of 47 years (39~67) and were followed an average of 19 months (13~32). The mean period between injury and operation was 8 days (5~14). Crutch assisted partial weight bearing was advised for an average of 7.3 weeks (6~9) and full weight bearing was allowed after average of 9.3 weeks (7~11).
RESULTS
According to AOFAS scale for ankle and hindfoot, patients had the following results: excellent - 1 patient (8%), good - 9 patients (75%), fair - 1 patient (8%), unsatisfied - 1 patient (8%). Bone union was achieved in all cases and there were no events of deep infection or skin necrosis.
CONCLUSION
Treating intra-articular calcaneal fractures by minimally invasive technique is an excellent operative method for patients with diabetes mellitus, as this method can minimize soft tissue incision and resulting deep infection and skin necrosis.

Citations

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Ankle and foot fracture management in patients with diabetes: an evidence-based review
Caroline E Plant, Arham Farukh Qureshi, Anna Chapman
Orthopaedics and Trauma.2026; 40(2): 105. CrossRef

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Testicular Necrosis after Ilioinguinal Approach for Pelvic Nonunion: A Case Report: Sang Eun Park, Young Yul Kim, Jong Hun Ji, Chang Whan Han, Weon Yoo Kim; J Korean Fract Soc 2006;19(4):490-493. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.490

Abstract

Pelvic nonunion is very difficult to treat. According to the nonunion site, anterior or posterior surgical approach should be used selectively. And if the nonunion site is located in both anterior and posterior, both anterior and posterior surgical approach should be used. We report a case of testicular necrosis after ilioinguinal approach used as a anterior approach to pelvis to treat pelvic nonunion developed as a result of unstable pelvic ring injury.

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Anatomical Study of Symphysis Pubis Using 3 Dimensional Computed Tomography in Koreans
Ji Wan Kim, Jung Min Park, Jae Suk Chang
Journal of the Korean Fracture Society.2013; 26(1): 32. CrossRef

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Comparison of Uniportal and Biportal Vertebroplasty in Bone Cement Distribution and Leakage: Jae Hyup Lee, Kang Sup Yoon, Seung Baik Kang, Hyunchul Jo, Sang Ki Lee, Bong Soon Chang, Choon Ki Lee, Ji Ho Lee; J Korean Fract Soc 2006;19(4):471-476. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.471

Abstract: PURPOSE
To evaluate the differences of radiological outcomes of uniportal and biportal vertebroplasty in the point of bone cement distribution and leakage.
MATERIALS AND METHODS
A retrospective study reviewing the period between May 2002 and January 2006 investigated 100 vertebrae which underwent vertebroplasty and followed for more than three months by uniportal approach (55 vertebrae, group 1) and biportal approach (45 vertebrae, group 2). The operative time, the amount of bone cement injected, anterior vertebral height restoration, kyphotic angle, bone cement distribution, and bone cement leakage were evaluated.
RESULTS
The amount of injected bone cement of group 1 (3.9 cc) was statistically smaller than that of group 2 (5.1 cc) (p=0.016). There were no significant differences in the operative time, anterior vertebral height restoration, kyphotic angle in both groups. The rate of bone cement distribution over 8 zones was significantly higher in group 2 than in group 1 (p=0.014). However, the rate of bone cement distribution over 7 zones and the rate of bone cement distributed on whole anterior vertebral body were not significantly different in both groups. The cement leakage was not also significantly different in both groups.
CONCLUSION
Although the amount of injected bone cement was smaller in uniportal vertebroplasty, the radiological results and cement leakage were similar to biportal vertebroplasty. These findings suggest that uniportal vertebroplasty can be the operative options in osteoporotic vertebral fracture.

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Treatment of Complex Tibial Plateau Fractures: A Modified Patient Positioning for the Combined Anterior and Posterior Approaches: Jong Keon Oh, Chang Wug Oh, Seung Beom Hahn, Kwon Jae Roh, Kwan Hee Lee; J Korean Fract Soc 2006;19(3):396-400. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.396

Abstract

We have treated thirteen complex plateau fractures involving both condyles with one of the following conditions with the use of the combined anterior and posterior approaches in a modified supine position. Associated PCL avulsion fracture, displacement of major fracture plane dominantly at the back, large coronal fracture fragment involving medial or lateral condyles. A patient is placed on an operation table in supine position with a bump under the contralateral buttock. The well leg is placed in a lithotomy position and the injured leg is placed over a sterilized Mayo stand separately. For the posterior approach the table was tilt toward the injured side with the hip abducted and rotated externally. With a modified patient's positioning we were able to use combined anterior and posterior approaches simultaneously for the management of certain complex plateau fractures without changing the draping.

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Current Concepts in Management of Tibia Plateau Fracture
Sang Hak Lee, Kang-Il Kim
Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef

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Treatment of Intercondylar Fracture of Distal Humerus in Adult: Kyung Won Song, Seung Yong Lee, Sung Il Shin, Jin Young Lee, Kab Rae Kim, Hyung Seok Oh, Jin Duck Kim, Dae Eun Choi; J Korean Fract Soc 2006;19(1):62-66. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.62

Abstract

PURPOSE
To evaluate and report the clinical results of the treatment of distal humerus intercondylar fractures treated with internal fixation through the modified posterior approach.
MATERIALS AND METHODS
From January 1999 to October 2003, 20 patient who had intercondyle fracture of the distal humerus treated with internal fixation through the modified posterior approach. We evaluated bone union, complication, postoperative elbow function.
RESULTS
The average follow up period was 12.8 months. Nearly all most cases united at 14 weeks in an average. There were two neuropraxia and two hardware failure. The range of the elbow joint motion was flexion contracture 8 degree (5~15 degree) to further flextion 120 degree (75~140 degree) in average. The functional result with Riseborough and Radin's functional scale were as follows; 13 good, 4 fair, 3 poor.
CONCLUSION
Not with severe comminuted like type C3 fracture, but in cases with intercondylar distal humerus fracture the modified posterior approach provided satisfactory exposure for open reduction and rigid internal fixation with satisfactory bone union. There was satisfactory bone union and good clinical result in postoperative elbow function.

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Double Parallel Plates Fixation for Distal Humerus Fractures
Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk-Jin Lee, Joon Oh Lee, Kyu-Won Oh, Hyun Sik Gong
Journal of the Korean Fracture Society.2010; 23(2): 194. CrossRef

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Triceps-Sparing Posterior Approach for Intra-articular Fracture of Distal Humerus: Suk Ha Lee, Sung Tae Lee, Jin Young Park, Jung Sup Keum, Jong Ryun Baek, Kwang Jun Oh; J Korean Fract Soc 2006;19(1):51-55. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.51

Abstract: PURPOSE
To evaluate the therapeutic results of intra-articular fracture of distal humerus treated through triceps sparing posterior approach.
MATERIALS AND METHODS
From February 2001 to December 2003, we reviewed total 9 cases of intra-articular fracture of distal humerus, which were treated by surgical treatment and were followed more than for 12 months. According to the OTA classification, nine cases were classified as type A; two, as type C1; five, as type C2; two. Triceps sparing posterior approach was used in all nine patients. An extensile posterior incision was used over the olecranon without triceps muscle injury. Exposure of the fracture site was done by obtaining medial-lateral mobility through dissection of medial and lateral edge of triceps muscle. Therapeutic results were assessed by bone union, duration for fracture union, complication. and for functional estimation, Mayo elbow performance score was checked and analysed.
RESULTS
The range of the elbow joint motion was flexion contracture 5.2 degree to further flexion 135.5 degree on average. Clinical results using Mayo elbow performance score were as follows; six excellent, three good. Compressive neuropathy of ulnar nerve which has been done anterior transposition was observed in one patient.
CONCLUSION
Triceps sparing posterior approach is useful surgical technique that provides sufficient exposure of medial and lateral condyle without injury of triceps muscle in intra-articular fracture of distal humerus to the extent of OTA type C2.

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Operative Treatment of Traumatic Humeral Shaft Fracture: Comparision of Interlocking IM Nailing and Plate Fixation by Posterior Approach: Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Ho Sup Song; J Korean Fract Soc 2005;18(2):93-99. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.93

Abstract PDF

PURPOSE
To compare the results and complications of interlocking IM nailing and plate fixation by posterior approach in the treatment of traumatic humeral shaft fracture MATERIALS AND METHODS: From March 1997 to March 2003, 49 patients undergone operation due to traumatic humeral shaft fracture. Follow-up was over one year. 28 patients operated with interlocking IM nailing initially and 21 operated with plate fixation by posterior approach prospectively. Statistics were compared using clinical and radiological outcomes and complications.
RESULTS
Radiologically, bone union was observed after an average of 14.3 weeks in IM nailing, and 11.7 weeks in plate fixation. So plate fixation showed earlier bone union (p=0.012). Nonunion occurred in 4 cases (14.3%) operated with IM nailing, and 1 case (4.8%), that was open shaft fracture, with plate fixation. Nonunion occurred more frequently when operated by IM nailing. 6 cases showed limitation of shoulder movement due to damage of the rotator cuff by IM nail entry site. 1 case showed radial nerve palsy, and 1 case showed axillary nerve palsy in the case of IM nailing. Also, secondary surgery due to complications was operated in 9 cases (32.1%) in IM nailing and 1 case (4.8%) in plate fixation (p=0.03).
CONCLUSION
In the case of traumatic humeral shaft fracture plate fixation by posterior approach was more useful than IM nailing in the decrease of complications and bone union. Such approach is thought to be an excellent method for anatomic reduction and nerve exploration in the case of open and comminuted fracture which accompany nerve injuries

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Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn
The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef
Minimally Invasive Anterior Plating of Humeral Shaft Fractures
Hyun-Joo Lee, Chang-Wug Oh, Do-Hyung Kim, Kyung-Hyun Park
Journal of the Korean Fracture Society.2011; 24(4): 341. CrossRef
Result of Interlocking Intramedullary Nailing for Humeral Shaft Fracture Evaluation of Post-operative Shoulder Function
Seung Rim Park, Tong Joo Lee, Ryuh Sub Kim, Kyoung Ho Moon, Dong Seok You
Journal of the Korean Fracture Society.2007; 20(2): 166. CrossRef

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Treatment of Fractures of the Distal Radius using Locking Compression Plate: Jae Cheon Sim, Nam Sik Chung, Ki Do Hong, Sung Sik Ha, Ji Hoon Kang; J Korean Fract Soc 2005;18(2):100-104. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.100

Abstract PDF

PURPOSE
To evaluate the usefulness of locking compression plate (LCP) and volar plating through anterior approach for distal radius fracture.
MATERIALS AND METHODS
We retrospectively analysed that 15 distal radius fracture, which would not be reduced by closed reduction or too comminuated to maintain reduction or articular surface inconguency, were treated by open reduction through anterior approach and volar plating using LCP. The results were evaluated by preoperative and postoperative radiographs. Functional results were analysed using the Modified Mayo Wrist Scoring System.
RESULTS
All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (9.0 mm vs. 11.8 mm), radial inclination (14.7degrees vs. 20.9degrees ), volar tilt (-6.3degrees vs. 8.3degrees ) and articular step-off (1.4 mm vs. 0.3 mm) were improved. The average Modified Wrist Score was 89. Nonunion or malunion was not occurred.
CONCLUSION
Open reduction through anterior approach and volar plating using LCP is a useful method that provides excellent results with few complications in the treatment of fracture of the distal radius.

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Periprosthetic Fracture after Locked Plating in the Osteoporotic Long Bone Fracture
Ki-Chul Park, Hong-Sik Kim, Jeong-Han Oh
Journal of the Korean Orthopaedic Association.2012; 47(3): 222. CrossRef
2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
Sung-Jin Kim, Chul-Hyun Cho
Journal of the Korean Fracture Society.2011; 24(2): 151. CrossRef
Treatment of Femur Supracondylar Fracture with Locking Compression Plate
Seong Ho Bae, Seung Han Cha, Jeung Tak Suh
Journal of the Korean Fracture Society.2010; 23(3): 282. CrossRef
Comparison of Outcomes for Unstable Distal Radius Intraarticular Fractures - T-locking Compression Plate versus External Fixator -
Chul-Hyun Cho, Su-Won Jung, Sung-Won Sohn, Chul Hyung Kang, Ki-Cheor Bae, Kyung-Jae Lee
Journal of the Korean Fracture Society.2008; 21(1): 51. CrossRef
Basic Principle of the Locking Compression Plate
Keun Bae Lee
Journal of the Korean Fracture Society.2008; 21(3): 261. CrossRef
Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
Chul Hyun Cho, Ki Choer Bae, Doo Hyun Kwon
Journal of the Korean Fracture Society.2008; 21(3): 220. CrossRef

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Early Postoperative Complications of Calcaneal Fractures Following Operative Treatment by a Lateral Extensile Approach: Young Soo Byun, Young Ho Cho, Jun Woo Park, Jin Seok Lee, Ji Hwan Kim; J Korean Fract Soc 2004;17(4):323-327. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.323

Abstract PDF

PURPOSE
To analyze early postoperative complications of calcaneal fractures operated by a lateral extensile approach and to identify risk factors for wound complications.
MATERIALS AND METHODS
From July 1990 to February 2003, 116 calcaneal fractures in 104 patients were treated by open reduction and internal fixation through a lateral extensile approach. The patient's records were reviewed for early postoperative complications. Statistical analysis was performed to determine significant relationships between predicted variables and the development of wound complications.
RESULTS
Fourteen fractures (12.0%) developed infection. Ten of them were superficial infection and four were deep infection that required surgical treatment. Eight fractures (6.9%) developed skin necrosis. Six of them were marginal skin necrosis and two were flap necrosis that required surgical treatment. Seven fractures (6.0%) developed sural nerve injury, but their symptoms were improved without additional treatment. Open fracture (p=0.003) and prolonged operating time (p=0.049) increased significantly the rate of wound complications.
CONCLUSION
The rate of early postoperative complications of calcaneal fractures operated by a lateral extensile approach is high. These complications can be reduced by meticulous treatment of an open wound, reduced operating time within 90 minutes through preoperative planning and skillful technique, and correct incision to avoid damage of the sural nerve.

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Results in Operative Treatment of Open Calcaneal Fracture
Ba Rom Kim, Jun Young Lee, Donghyuk Cha
Journal of Korean Foot and Ankle Society.2021; 25(3): 133. CrossRef
Bilateral Open Transcalcaneal Fracture with Talonavicular Dislocation - A Case Report -
Hun Park, Sung Jin Shin, Sang Rim Kim, Kwang Woo Nam, Sung Wook Choi, Kyu Bum Seo, Jun Young Seo
Journal of the Korean Fracture Society.2011; 24(1): 87. CrossRef
Treatment of Intra-articular Calcaneal Fractures Using Minimally Invasive Sinus Tarsi Approach in Diabetic Patients
Hong-Moon Sohn, Sang-Ho Ha, Sang-Hong Lee, Jun-Young Lee, Jeong-Ho Kim, Sang-Jun Lee
Journal of the Korean Fracture Society.2008; 21(3): 195. CrossRef

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Penetration of Joints by Screws on Anterior Process of Calcaenus: Choong Hyeok Choi, Il Hoon Sung, Bong Geun Lee, Doo Jin Paik, Dong Won Kim; J Korean Fract Soc 2004;17(3):257-260. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.257

Abstract PDF: PURPOSE
This study was performed to determine the involvement of joints by screws, inserted on the anterior process of the calcaneus, using cadaveric specimens.
MATERIALS AND METHODS
An L-shaped lateral incision was performed on 32 embalmed feet (16 cadavers). An H-plate was applied on lateral wall of the calcaneus and it's anterior margin was located at 4 mm posterior to the lateral margin of the calcaneocuboidal joint. 3.5 mm cortical screws were inserted perpendicularly to the lateral calcaneal wall through the plate. Each calcaneus was dissected and taken out from the foot, and whether the tips of screws penetrated joints on the anterior process was evaluated.
RESULTS
11 (17.2%) of 64 screws, inserted on the anterior process, penetrated joints. Among them, seven screws involved the calcaneocuboidal joint and four screws penetrated the anterior facet of the subtalar joint. In two cases, both joints were penetrated by screws.
CONCLUSION
This study shows that joint surfaces could be penetrated by screws inserted from the lateral surface on the anterior process of the calcaneus. Care should be given to selecting the length and insertional angle of screws. Intraoperative radiography would be needed to observe the articular surface on the anterior process, when screws were inserted to the anterior process close to the calcaneocuboidal joint.

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Anterolateral Approach for the Distal Metaphyseal Fracture of the Tibia: Taek Soo Jeon, Jae Woo Lim, Whan Yong Chung, Woo Suk Lee, Woo Sik Kim, Cheol Mog Hwang, Yong Chan Kim, Nam Hyun Kim, Yong Sang Kim, Sung Kwan Jo; J Korean Fract Soc 2004;17(3):243-248. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.243

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the effectiveness of anterolateral approach of the ankle for the distal tibial fracture in aspect of preventing complication and acquiring union.
MATERIALS AND METHODS
Authors reviewed 21 patients of distal metaphyseal fracture of the tibia treated by anterolateral approach and lateral plating method from February, 2000 to May, 2002. Mean follow-up period was 17 months (12~29 months). There were twelve type A, two type B, and four type C patients according to AO/OTA classification. We have analyzed the bone union rate and Ovadia`s functional scale. We also reviewed the complication rate, such as soft tissue problem and postoperative infection.
RESULTS
In all cases union was achieved and mean time to union were 16 weeks. The functional result by Ovadia's scale were 17 excellent cases and 4 good cases in objective evaluation, and 19 excellent cases and 2 good cases in subjective evaluation. Wound infection occurred in one case, but the infection was controlled after plate removal and the union was acquired through cast immobilization. There was no other complication, such as soft tissue necrosis.
CONCLUSION
The anterolateral approach is a safe and worthwhile method for distal tibia fracture while avoiding some of the complication associated with standard anteromedial approach and plating method.

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Operative Treatment of Proximal Tibial Plateau Fractures through Lateral Submeniscal Approach: Hyug Su An, Se Ang Chang, Jun Woo Park, Jin Seok Lee, Hun Ho Bang; J Korean Fract Soc 2004;17(3):237-242. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.237

Abstract PDF: PURPOSE
The purpose of this study was conducted to evaluate the clinical results of proximal tibial plateau fractures treated with open reduction and internal fixation through the lateral submeniscal approach and allowed early motion of the knee and to evaluate the effectiveness of the approach.
MATERIALS AND METHODS
From January 1998 to December 2002, fifty four patients who underwent open reduction through the lateral submeniscal approach for proximal tibia plateau fracture and had a follow-up more than one year were included in this study. Clinical results were evaluated by postoperative radiographs taken at the last follow-up and Porter's assessment method.
RESULTS
Anatomical reduction was achieved under direct vision through the submeniscal approach in most of the cases in this study. The postoperative radiographs showed anatomical reduction in 32 cases (59%) and adequate reduction with displacement within 2 mm in 20 cases (37%). The clinical evaluation by Porter's assessment method revealed that 49 cases (91%) were acceptable results of excellent or good at the final follow-up CONCLUSION: This study indicates that open reduction and internal fixation through the lateral submeniscal approach can be a good option for proximal tibia plateau fractures because it allows accurate reduction of the articular fractures, which is confirmed directly during operation, identification and repair of associated soft tissue injuries are facilitated, sufficient bone graft and stable fixation of the articular fragments under direct vision allow early motion of the knee.

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Lateral Approach for Internal Fixation of the Distal Humeral Shaft Fractures: Seung Koo Rhee, Joo Yup Lee, Yoo Joon Suh, Joon Ho Lee, Nong Kyoum Ahn; J Korean Fract Soc 2004;17(2):83-89. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.83

Abstract PDF

PURPOSE
To investigate the efficacy and advantages of the lateral approach for internal fixation of the distal humeral shaft fractures.
MATERIALS AND METHODS
Twelve patients with distal humeral shaft fractures who underwent open reduction and internal fixation using plate and screws by lateral approach from January, 1997 to May, 2002 were investigated. Postoperative results after a minimum 1 year follow-up were assessed using union rate, elapsed time to union, postoperative complications such as iatrogenic radial nerve palsy, range of motion of the elbow joint. Clinical outcomes were evaluated with Mayo elbow performance scoring system.
RESULTS
Union was achieved in all cases. The average time to union was 9 weeks (range, 7~12 weeks). Four cases of preoperative radial nerve palsy were revealed as contusion of the intact nerve and resolved completely by three months. The mean elbow range of motion was from 5 to 138 degrees. The average Mayo elbow performance score was 91 points; 9 cases ranked as excellent and 3 as good.
CONCLUSION
Distal humeral shaft fractures can be treated successfully through open reduction and internal fixation using plate and screws. Lateral approach is recommended to stabilize distal humeral shaft fractures without compromising the range of motion of the elbow, and to protect or explore the injured radial nerves easily

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Modified anterolateral approach for internal fixation of Holstein–Lewis humeral shaft fractures
Ho Min Lee, Young Sung Kim, Suk Kang, Min Young Lee, Jong Pil Kim
Journal of Orthopaedic Science.2018; 23(1): 137. CrossRef
Posterior Dual Plating for Distal Shaft Fractures of the Humerus
Chul-Hyun Cho, Kwang-Yeung Jeong, Beom-Soo Kim
Journal of the Korean Fracture Society.2017; 30(3): 117. CrossRef

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Clinical Outcome of Surgical Treatment of Distal Humerus Intercondylar Fractures Through the Transolecranon Approach Combined with Anterior Transposition of the Ulnar Nerve: Kwang Hyun Lee, Seong Pil Lee, Kyu Tae Hwang, Joo Hak Kim; J Korean Fract Soc 2004;17(2):70-75. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.70

Abstract PDF: PURPOSE
To analyze the clinical outcomes of surgical treatment of distal humerus intercondylar fractures through the transolecranon approach combined with anterior transposition of the ulnar nerve.
MATERIALS AND METHODS
Eight patients who had distal humerus intercondylar fractures were included in this study and underwent operative treatment through the transolecranon approach for sufficient operative field with anterior transposition of the ulnar nerve and fixed with reconstruction plate.
RESULTS
The results were evaluated using Riseborough and Radin rating criteria. Seven cases of eight cases were achieved good results with flexion contracture less than 30 degrees and forward flexion more than 115 degrees. However, one case was acheived poor result with 40 degrees of flexion contractue and 70 degrees of forward flexion. There were no the compressive ulnar neuropathy.
CONCLUSION
We found the transolecranon approach and anterior transposition of the ulnar nerve a viable option for surgical treatment of the distal humerus intercondylar 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

Abstract 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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Anterior Approach and Volar T-plate fixation of Distal Radius Fracture: Woo Sung Choi, Weon Yoo Kim, Dong Won Choi, Yun Hack Shin, Jin Young Kim; J Korean Soc Fract 2003;16(2):244-252. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.244

Abstract PDF

PURPOSE
To analyze the radiologic and clinical results of open reduction and volar plating through anterior approach for distal radius fracture.
MATERIALS AND METHODS
We retrospectively analysed that 19 distal radius fracture, which would not be reduced by closed reduction or too comminuted to maintain reduction or articular surface incongruency, were treated by open reduction and volar plating through anterior approach. The results were evaluated by preoperative and immediate postoperative radiographics and clinical results were analysed using Green and O'Brien scoring system at final follow up.
RESULTS
All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (8.8 mm +/-4.8 mm vs. 11 mm +/-3 mm), radial inclination (15 degrees+/-5.7 degreesvs. 20degrees+/-5degrees), volar tilt (-11 degrees+/-13 degrees vs. 7 degrees+/-4 degrees) and ulnar plus variant (4 mm+/-3 mm vs. 0 mm+/-1 mm) were improved. The clinical evaluation revealed 9 excellent cases, 7 good cases, 2 fair cases and 1 poor case. The reduction loss and flexor pollicis longus rupture was occurred in one patient, who had severely displaced comminute fracture in initial injury.
CONCLUSION
Using volar plating, authors gain good radiologic and clinical results. But, additional external fixation is recommended to prevent further collapse in severly comminuted fractures.

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Is dorsal cortex drilling necessary for distal radius fractures treated with a volar locking plate? A comparative study of near-cortex-only and far-cortex drilling
Chul Hong Kim, Sung Yoon Jung, Hyeon Jun Kim, Si-Hyun Park
Journal of Trauma and Injury.2025; 38(3): 248. CrossRef
Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate
Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef

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

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

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Triradiate Approach in Surgical Treatment of Complex Fracture of Acetabulum: Kang Il Kim, Kyung Hoi Koo, Bun Joong Kang, Hyung Bin Park, Sun Chul Hwang, Soon Taek Jeong, Hae Ryong Song, Se Hyun Cho; J Korean Soc Fract 2001;14(4):616-622. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.616

Abstract PDF: PURPOSE
To determine the advantages of triradiate approach in complex acetabular fractures, the results were reviewed for 24 patients who had open reduction and internal fixation of complex acetabular fractures with a triradiate approach.
MATERIALS AND METHODS
Twenty four patients were followed for a mean of 3 years after the operation. All patients with complex fractures of the acetabulum were treated with open reduction and internal fixation using Y-shaped triradiate incision, osteotomy of the greater trochanter, and arthrotomy of the hip joint. In 13 patients the fracture was fixed with reconstruction plates and in I 1 patients the fracture was fixed with the plates and wires.
RESULTS
All fractures united and no patient required subsequent total hip replacement arthroplasty. Four patients had heterotopic ossification without serious limitation of motion of the hip and one patient had grade IV lesion as defined by Brooker et al, which limited motion of the hip enough to impair function. Six patients showed posttraumatic arthritis at the latest radiograph. The overall clinical result was excellent for 7 hips, good for 13, and fair for 4 as defined by d' Aubigne and Postel. The radiological result was excellent for 13 hips, and good for 6 as defined by Matta. One femoral head necrosis was observed at the latest follow-up.
CONCLUSION
A triradiate approach provides a good extra and intraarticular access to complex fracture of the acetabulum, which facilitates an accurate reduction, rigid fixation, removal of loose osteochondral fragments and management of labial injury, without increased morbidity of the hip joint.

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Operative Treatment of Intraarticular Calcaneus Fractures with extensile lateral approach: Dong Kyu Shin, Yong Woon Kim; J Korean Soc Fract 2001;14(3):440-449. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.440

Abstract PDF: PURPOSE
Through the analysing intraarticular calcaneal fractures operated with extensile lateal approach and lateral plate fixation we tried to find the factors related to the result and to prove the usefulness of this treatment method. MATERIAL AND METHOD: We reviewed 50 intraarticular calcaneal fractures which were treated with this method between July 1995 and December 1998. We analysed the relationship between the fracture type and the accuracy of posterior facet reduction and between the accuracy of reduction and the clinical result. We also analysed the complication rate.
RESULT
We gained anatomical reduction in 64% among all cases. There was significant relationship statistically between the Sanders fracture type and accuracy of reduction(p=0.001). There were also significant relationship statistically between the Sanders fractrure type and the clinical result(p=0.045) and between the accuracy of reduction and clinical result(p=0.001). It was also possible to regain the calcaneal height, width and Bohler angle through this treatment method. There was only one wound complication which was skin necrosis and was treated with dressing and finally skin graft.
CONCLUSION
Sanders classification was very useful and reasonable for this kind of fracture. The accuracy of reduction of posterior facet was very important to clinical result. This treatment method for the calcaneal fracture was useful in the term of regain of anatomical components of calcaneus such as posterior facet congruency, calcaenal height, width and Bohler angle with acceptable rate of serious complication.

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Treatment of Coronal Split Fracture of the Femoral Condyle: Yong In, Seung Key Kim, Won Jong Bark, Jong Beom Park, Gun Chang, Han Chang; J Korean Soc Fract 2000;13(4):855-860. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.855

Abstract PDF: PURPOSE
To evaluate the results of treatment in 6 cases of coronal split fractures of the femoral condyle MATERIALS AND METHODS: Six cases of coronal split fractures of the femoral condyle were treated and followed up 16 to 36 months. Five cases were treated operatively. We used anteromedial approach for 3 cases, posteromedial approach for 1 case and posterolateral approach for other 1 case. Non-displaced case was treated conservatively with cast. We compared the results of each case using Letenneur assessment system.
RESULTS
All 3 cases approached anteromedially and the case approached posterolaterally showed good results. But the case approached posteromedially showed fair result with mild limitation of motion and pain. Non-displaced case treated with cast resulted in poor result with nonunion.
CONCLUSION
We propose operative treatment for coronal split fracture of the femoral condyle even though there is no displacement. Anteromedial approach and headless screw fixation could be the best method for reduction and fixation of fracture.

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Muller Type C Intercondylar Fractures of Femur : Comparative Analysis by Surgical Approach: Hong Geun Jung, Myung Ho Kim, Moon Jib Yoo, Suk Joo Yoo, Sung Churl Lee, Jin Young Park, Sang Hyuk Min; J Korean Soc Fract 2000;13(1):64-73. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.64

Abstract PDF: PURPOSE
The purpose of this study is to compare the functional results of Muller type C intercondylar fractures treated by 2 different surgical approaches : lateral and extensile approach.
MATERIALS AND METHODS
The study is based on 20 patients 21 knees of Muller type C intercondylar fractures. Two surgical approaches, i.e. 13 cases with lateral and 8 cases with extensile approach were used. The functional evaluation of results was done with criteria by Schatzker and Lambert. Excellent and good was grouped superior while fair and failure was grouped inferior.
RESULTS
Comparative analysis by surgical approach showed that among total 10 cases of C2 fractures, 6 cases(85.7%) of lateral approach and 2 cases(66.7%) of extensile approach were categorized in inferior group. Among the 8 cases in type C3 fractures, 3 cases treated surgically using the lateral approach showed fair and failure results and 3 cases(60%) of the remaining 5 cases using the extensile approach showed good results.
CONCLUSION
There was no significant result difference between lateral and extensile approach in type C2 fractures, but in C3 fracture, cases with extensile approach showed better results. Therefore the extensile approach should be recommended in C3 intercondylar fractures with intra-articular comminution.

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Treatment of comminuted distal humeral intercondylar fracture using transolecranon approach: Kwang Hyun Lee, Myung Ryul Park, Jae Min Lee, Tae Hyoung Kweon; J Korean Soc Fract 1999;12(4):981-987. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.981

Abstract PDF: Fracture of the distal humerus is rare, so the surgeons experience is limited. This injuries represent a constellation of complex articular fractures and anatomic complexity of distal humerus makes surgical treatment, open reduction and internal fixation is difficult. We analyze the clinical result of immediate open reduction, rigid internal fixation, and early postoperative motion. From Nov. 1990 to Sep. 1997, the authors analyzed the clinical results of 5 cases those who underwent operative treatment using transolecranon approach, internal fixation with Y plate and early motion for comminuted distal humeral intercondylar fracture. ROM exercise was started at average 2.2 weeks postoperatively. 4 of 5 patients obtained satisfactory results by Riseborough and Radin rating criteria. One patient obtained poor result of 40 degree flexion contracture and 90 degree further flexion of elbow. Transolecranon approach makes the complete anatomic reduction of articular surface possible and the satisfactory results is associated with immediate, complete anatomic reduction and rigid fixation in conjuction with early postoperative motion.

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Result of Surgical Treatment of Calcaneal Fractures Using Extensile Lateral Approach: Sung Do Cho, Yong Sun Cho, Bum Soo Kim, Tae Woo Park, Gi Bong Kim, Key Yong Kim; J Korean Soc Fract 1999;12(2):320-327. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.320

Abstract PDF

Thirty-eight calcaneal fractures were treated with open reduction and internal fixation using extensile lateral approach from Jun. 1993 to Dec. 1996 and were followed more than a year. According to the Essex-Lopresti classification, there were 28 cases of joint depression type and 10 cases of tongue type. According to the Sanders classification, there were 20 cases of type II, 13 cases of type III and 5 cases of type IV. The purpose of this study is to analyze the results of surgical treatment of calcaneal fractures using extensile lateral approach and its complications. The results were as follows; 1. B.. ohler angle was improved from -2.4degrees to 20.5degrees and Gissane angle was improved from 114.5degrees to 120.4degreesafter the operation. The height of the calcaneus was improved from 75% to 95% and the width of the calcaneus was reduced from 119% to 106% of contralateral side. 2. yThe postoperative reduction status of the articular surface was analyzed by computed tomography(CT) in 18 patients and was found to be less than 2 mm of step-off in 10 cases, between 2 and 5 mm in 7 cases and more than 5 mm in 1 case. 3. Based on the assessment criteria of Salama et al., the functional results were excellent in 10 cases, good in 14 cases, fair in 10 cases, and poor in 4 cases. Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. 4. Fourteen cases (36.8%), developed postoperative complications such as heel pain, causalgia and numbness, subtalar arthritis, marginal necrosis of wound, lateral subfibular impingement and heel bulging. In conclusion, Because of high incidence of postoperative complications, careful and meticulous exposure technique in doing extensile lateral approach are necessary for a satisfactory outcomes.

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Treatment of Intra-articular Calcaneal Fractures Using Minimally Invasive Sinus Tarsi Approach in Diabetic Patients
Hong-Moon Sohn, Sang-Ho Ha, Sang-Hong Lee, Jun-Young Lee, Jeong-Ho Kim, Sang-Jun Lee
Journal of the Korean Fracture Society.2008; 21(3): 195. CrossRef

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The Operative Treatment of Acetabular Fracture: Deuk Soo Hwang, Kwang Jin Rhee, Jun Young Yang, Jang Ik Lee; J Korean Soc Fract 1999;12(2):212-219. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.212

Abstract PDF: PURPOSE
To analysis clinical and radiological result of surgically treated acetabular fractures and to present appropriate surgical approach for fracture type. MATERIAL AND METHODS: A review of 51 surgically treated acetabular fractures, treated between April 1988 and October 1996, using single surgical exposures and combined surgical exposures was conducted. The classification was used Judet & Letournel,s classification and the surgical approach was applied Kocher-Langenbeck, Ilioinguinal, and Combined approach according to fracture aspect. The result was rated on a radiographic as well as a clinical result scale based on Matta,s.
RESULTS
The most common fracture was 14 posterior wall fracture and 7 transverse fracture. the surgical approach was applied Kocher-Langenbeck 29 cases, ilioinguinal 10 cases, and combined approach 8 cases, triradiate approach 2 cases and Extended iliofemoral approach 1 case. A satisfactory reduction was obtained in 87% of the cases (concentric, gap < 3mm). Clinical results were excellent in 28%, good in 54%, fair in 12%, and poor in 6%. Radiologic results at followup indicated 40% excellent results, 35% good results, 16% fair results, and 9% poor results. Postoperative complications appeared in 7 cases including posttraumatic arthritis 2 cases. Two patients later required total hip arthroplasty for avascular necrosis of femoral head and posttraumatic arthritis.
CONCLUSION
Ilioinguinal approach was good method for access to the anterior wall and column fracture, but in case of severe comminuted medial wall fracture company with anterior column, internal fixation is impossible. So, accurate assesment of the fracture pattern by careful radiologic analysis is essential. The posterosuperior dome fracture is important to anatomical reduction because of high risk of posttraumatic arthritis. In case of Transverse fracture, T-shape fracture, and both column, the more displaced column was reduced first, followed by opposite column after reduction identify by intraoperative radiography. We can be attained satisfactory reduction. Therefore, combined approach was good surgical method for this complex fracture.

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Malailgnment Following Intramedullary Nailing of Tibial Shaft Fracture - s comparison between medial parapatellar approachand patellar tendon spltting approach -: Dong Ju Chae, Phil Hyun Chung, Tae Young Kim; J Korean Soc Fract 1998;11(4):849-857. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.849

Abstract PDF: Intramedullary nailing is often the treatment of choice in the management of fractures in the tibial diaphysis. One of the most frequent complications of tibial nailing is fracture malalignment leading to angulatory or rotational deformities. Access to the proximal tibia for intramedullary nailing of the tibial shaft fractures may be via a patallar tendon splitting or paratendinous exposure. Although the tendon splitting approach is more direct, the incidence of knee pain is significantly higher when this technique is used. In addition, several cases of heterotopic ossification have been reported following tendon splitting approaches. For these reasons an incision medial to the tendon is generally chosen. We reviewed 140 cases(131 patients) of tibial shaft fractures who were treated by use of the intramedullary nailing from 1994 to 1997 and made a comparison between the medial parapatellar approach and the patellar tendon splitting approach about degree of malalignment. We have noticed that there was significant difference in the number of tibias that were malaligned after tibial nailing with the medial parapatellar access and the tendon splitting approach. With the medial parapatellar approach, malalignment was seen in 13/42 tibiae(31.0%) of the fractures of tibial shaft, 11/12 tibiae of the proximal third fractures and 2/10 tibiae of the distal third fractures respectively. With the patellar tendon splitting approach, malalignment was seen in 8/98 tibiae(8.2%) of the fractures of the tibial shaft, 4/15 tibiae of the proximal third fractures, 1/45 of the middle third fractures and 3/38 tibiae of the distal third fractures respectively. We conclude that the tendon splitting approach may be better for intramedullary nailing of the proximal fractures of the tibia and the medial parapatellar approach may be chosen for the treatment of the middle and distal shaft fractures of the tibia.

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Operative Treatment of the Intercondyle of the Humerus in adults: Hyun Dae Shin, Kwang Jin Rhee, June Kyu Lee, Won Sok Lee, Seung Jin Lee; J Korean Soc Fract 1998;11(2):345-353. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.345

Abstract PDF: We had studied the results of operative treatments in twenty-seven interconylar fractures of the distal end of the humerus over a ten-year period retrospectively. From march 1989 to February 1996, 27 patients were included in this study. The fracture patterns were classified according to the system of Muller et al. and evaluated the results of the involved elbow by Jupiter's scale. The mean follow-up was 47.8 months. The operation method was open reduction by wide exposure and transolecranon approach and internal fixation between two condyles by cancellous screw or Hebert screw and two reconstruction plate rectangularly each other. Among 27, 17 were men and left elbow were 15. The mean average age was 50.2 (23- 72)years old. The most common injury mechanism was direct trauma in 18 cases(62.9%). By Muller classification C3 type were 12 cases(44.4%), while C1 were 5 cases and C2 were 5 cases and C2 were 10 cases. At last follow-up the elow ROM was average flexion angle 107 degrees(18 to 125 degrees). Except intolerable pain and partial stiffness of elbow, the postoperative complications were 4 cases ; dsyesthia of ulnar nerve were 2, infection were 1, and heterotopic ossification was 1 case. The results of excellent and good were 20 cases(74.1%). In 7 cases of fair and poor results, C3 were 4 cases and C2 were 2 cases. It was concluded that the transolecranon approach and dual-plate fixation on humerus for fractures of the intercondyle of the humerus was satisfactory and necessary to effort of rigid fixation and a early rehabilitation after operation as possible.

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Treatment of Supra-intercondylar Fractures of the Distal Femur Using the ModiHed Extensile Approach: Hee Soo Kyung, Joo Chul Ihn, Chan Sig Park; J Korean Soc Fract 1997;10(1):133-141. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.133

Abstract PDF: The management of supracondylar and interconylar fractures of the femur is fraught with a wide range of potential complications. Particularly, the type C3 fracture of AO classincation easily result in catastrophe in the form of traumatic arthritis, angular deformity, shortening, infection, post- operative joint stiffness and nonunion. During recent years. new concept and techniques of surgical treatment has been developed which permit more accurate anatomical reduction and stable internal fixation. We reports five cases of type C3 supra-interconylar fractures of the femur managed by modiHed extensile approach technique of Schatzker.

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Comparison between Transolecranon Approach and Posterior Approach in Comminuted Intercondylar Fracture of the Distal Humerus: Soo Kyoon Rah, Sang Ki Kim, Joong Geun Choi, Yon Il Kim, Chang Uk Choi; J Korean Soc Fract 1996;9(4):1069-1075. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1069

Abstract PDF

The comminuted iniercondyiar fractvre of the distal humeruf is rather uncommon injury. Because of anatomic complexity of the distal humerus, any incongrousness makes loss of function of the elbow joint. Hence, for the complete restoration of the articular surface and joint nlotion, wide exposure is necessary, while stable internal fixation and early post operative exercise should be conducted. With the frefuency of comminution and displacement, this intraarticular fracture is difficult to treat. But the fabrication of new implants and development of surgical approach method has increased the reliability of operative stabilization. The authors compared 36 patients of distal humeral fracture treated with transolecranon approach and Campbells posterior approach at the Department of Orthopaedic Surgery. College of Medicine, Soonchunhyang University from Dec. 1991 to Oct. 1994 and following results were obtained. In transolecranon approach, the operation time was slightly longer with technical difficulties. However, we had excellent exposure of posterior aspect of lower end of the humerus and had a good range of motion, especially in flexion contracture compared with posterior approach. Also, we hardly observed complications of fracture of the olecranon in transolecranon approach.

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Clinical Outcome of Surgical Treatment for Intra-articular Distal Humerus Fracture
Myung Jin Lee, Hyeon Jun Kim, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Chul Hong Kim, Lib Wang, Hyun Woo Sung
Journal of the Korean Fracture Society.2010; 23(2): 201. CrossRef

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