Journal of Musculoskeletal Trauma

Risk Factors of Fixation Failure in Femoral Neck Fractures: Sung Hyun Yoon, Kyu Beom Kim, Hyung Jun Lee, Kyung Wook Kim; J Korean Fract Soc 2023;36(4):118-124. Published online October 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.4.118

Abstract PDF: Purpose
Internal fixation after a femoral neck fracture (FNF) is one of the conventional treatment options for the young and active elderly patients. However, fixation failure of internal fixation is a probable complication. The treatment of fixation failure after a primary internal fixation of the FNF remains a challenge.
Materials and Methods
Between July 2002 and March 2017, 83 patients who underwent internal fixation after FNF were retrospectively analyzed. Radiological assessments, including Pauwels’ angle, fracture level, reduction quality, and bone union, were measured, preoperatively and postoperatively. Moreover, intraoperative variables such as time to surgery, surgical time, and estimated blood loss were also evaluated.
Results
The patients were divided into the fixation failure and the non-failure groups. Among the 83 patients, 17 cases (20.5%) of fixation failure after the primary internal fixation of the FNF were identi-fied. When comparing the two groups according to the radiographic data, Pauwels’ angle and the reduction quality based on Garden’s angle showed significant differences (p<0.001). Moreover, when comparing the intraoperative variables, unlike the surgical time and estimated blood loss, significant differences were noted in the time interval from injury to surgery and specifically in whether the surgery was performed within 12 hours after injury (p<0.001).
Conclusion
Pauwels’ angle, reduction quality, and time to surgery are the major factors that can predict the possibility of internal fixation failure of the FNF. Early and accurate anatomical reduction is needed to decrease complications after the internal fixation of the FNF.

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Pulmonary Embolism Complication after Surgical Treatment of Patella Fracture: A Case Report: Yong Beom Kim, Hyung Suk Choi, Dong Ill Chun, Jung Moo Seo, Byung Ill Lee; J Korean Fract Soc 2014;27(2):162-166. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.162

Abstract PDF: Deep vein thrombosis and pulmonary embolism are serious and fatal complications in orthopedic surgery. Most cases of symptomatic pulmonary embolism in knee surgery have been reported after total knee arthroplasty, but rarely after patella fracture. We report on a case of symptomatic pulmonary embolism after surgical treatment of a patella fracture in a 42-year-old female patient.

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Acute Compartment Syndrome of the Thigh Caused by Contusion: 4 Cases Report: Oog Jin Shon, Gi Beom Kim, Chul Hyun Park; J Korean Fract Soc 2012;25(3):215-218. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.215

Acute compartment syndrome of the thigh, which usually occurs in the anterior compartment, is a rare condition. It can have various causes including femur fractures, vessel injury, pseudoaneurysm of the femoral or popliteal artery, and use of anticoagulant. However, there have been few reports of acute compartment syndrome of the thigh without fracture caused by blunt trauma. We report 4 cases of acute compartment syndrome of the thigh without fracture caused by blunt trauma, in which three patients were treated with fasciotomy and a Vacuum-Assisted wound Closure system and the other one had a delayed diagnosis, and eventually underwent above-knee amputation.

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A Clinical Case Study of Residual Symptoms after Decompression of Traumatic Compartment Syndrome
Min Jung Ji, Seong Chul Lim, Jae Soo Kim, Hyun Jong Lee, Yun Kyu Lee
The Acupuncture.2015; 32(3): 197. CrossRef
Clinical Outcomes of Fasciotomy for Acute Compartment Syndrome
Ji Yong Park, Young Chang Kim, Ji Wan Kim
Journal of the Korean Fracture Society.2015; 28(4): 223. CrossRef

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Treatment of Unstable Intertrochanteric Femoral Fracture with the AO/ASIF Proximal Femoral Nail (PFN): Do Hyun Moon, Jang Seok Choi, Geon Beom Kim, Jin Won Kim, Ki Tae Kim; J Korean Soc Fract 2003;16(2):136-142. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.136

Abstract PDF

PURPOSE
To review the clinical and radiographic results of the treatment of unstable intertrochanteric femoral fractures with a proximal femoral nail (PFN).
MATERIALS AND METHODS
We reviewed 47 unstable intertrochanteric femoral fracture cases that had been treated with a PFN operatively. The clinical and radiographic results and complications were analyzed. The mean age was 76.8 years old (62~96 years old) and the mean duration of follow-up was 15 months (12~24 months).
RESULTS
The postoperative walking ability was regarded as satisfactory when the patient could walk alone using an walking frame without others aids and satisfactory results was achieved in 43 cases (91.5%). In all cases the radiologic bone union was obtained. The average sliding of femoral neck screw was 3.0 mm and the average change of neck-shaft angle was 2.6 degree. There were three cases of postoperative complication which were including 1 case of cut-out of femoral neck screw, local superficial infection in 1 case and pain complaints over trochanteric area in 1 case.
CONCLUSION
The PFN is an useful implant for the treatment of unstable intertrochanteric femoral fracture because of the simplicity of the surgical technique and the low level of the complications encountered.

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Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteic Fractures in the Elderly
Byung-Hak Kim, Young-Yool Chung, Sung-Chang Ki, Dae-Hyun Yoon, Ji-Hoon Ryu
Journal of the Korean Orthopaedic Association.2011; 46(5): 399. CrossRef
Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision
Se Dong Kim, Oog Jin Sohn, Jae Ho Cho
Journal of the Korean Fracture Society.2008; 21(1): 1. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)
Kee-Byoung Lee, Byung-Taek Lee
Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef
Treatment of Intertrochanteric Fracture with Proximal Femoral Nail
Dae Joong Kim, Sung Chan Ki, Young Yool Chung
Journal of the Korean Fracture Society.2007; 20(1): 40. CrossRef

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Prognosis of early internal fixation in unstable pelvic fractures: Jang Yeol Lee, Do Hun Moon, Gun Beom Kim; J Korean Soc Fract 2000;13(4):741-748. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.741

Abstract PDF

PURPOSE
This study was conducted to analyze the clinical prognosis of early internal fixation in unstable pelvic fracture. MATERIAL AND METHOD: We analyzed the sixteen patients. The average age of the patients was 34 years(range, 21-64 years). They were followed up for average 21 months. The sixteen pelves were classified by Tile ; Type B 3 cases, Type C 13 cases. Nine patients(56%) had the associated injuries. In 13 patients(81%), internal fixation were performed within 3 weeks after the injury. Fixation was accomplished by the plates and screws. We assessed the functional, radiological results and postoperative complications.
RESULTS
Fourteen(88%) patients were fully ambulatory, had no limp, did not need assistive devices. Fifty percents of the patients had returned to the previous jobs and 31% had to change the jobs. On radiolograph, there were 14 excellent and 2 good reduction. Three postoperative complications happened ; two superficial infections and one lumbar neuropathy, which resolved spontaneously. Three patients with associated injuries, who had delayed fixation, appealed gait disturbance and chronic pain.
CONCLUSION
early internal fixation of unstable pelvic ring fractures may be expected to yield satisfactory functional success and radiologic results in the majority of patients

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Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint
Kwang-Jun Oh, Jin-Ho Choi
Journal of the Korean Fracture Society.2013; 26(3): 184. CrossRef
Surgical Fixation of Sacroiliac Joint Complex in Unstable Pelvic Ring Injuries
Kwang-Jun Oh, Seok-Min Hwang
Hip & Pelvis.2012; 24(2): 139. CrossRef
Operative Treatment of Unstable Pelvic Ring Injury
Sang Hong Lee, Sang Ho Ha, Young Kwan Lee, Sung Won Cho, Sang Soo Park
Journal of the Korean Fracture Society.2012; 25(4): 243. CrossRef
Crescent Fracture-dislocation of Sacroiliac Joint: Affecting Factors of Operative Results
Hee-Soo Kim, Chang-Wug Oh, Poong-Taek Kim, Young-Soo Byun, Joo-Woo Kim, Byung-Chul Park, Woo-Kie Min, Hyun-Joo Lee
Journal of the Korean Fracture Society.2009; 22(2): 71. CrossRef

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Arthroscopic Treatment of The Tibial Intercondylar Eminence Fractures: Han Chul Kim, Beom Kim; J Korean Soc Fract 2000;13(3):488-493. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.488

Abstract PDF: PURPOSE
To compare operative results between pull-out wiring and retrograde screw fixation for displaced tibial intercondylar eminence fracture.
MATERIALS AND METHODS
From March 1997 to February 1999, authors carried out pull-out wiring in 3 patients and retrograde screw fixation in 5 patients who sustained typeII and typeIII displaced tibial intercondylar eminence fractures follow up for 16 months(mean).
RESULTS
The Union time was mean 7 wk in pull-out wiring and 6.5 wk in retrograde screw fixation. Limitation of knee motion(1 case) developed in retrograde screw fixation group and reoperated for adhesiolysis. Pull-out wiring group were all full motion recovered. Anterior instability(1 case) developed in retrograde screw fixation group and pull-out wiring group had no instability. Operation time for retrograde screw fixation group was mean 98min and pull-out wiring group was 105 min.
CONCLUSION
The outcome of pull-out wiring group were superior to retrograde screw fixation group. It can be stably fixed and allow early motion exercise. Besides, in case of small bony fragment, it is difficult for fixation with screw. And even impossible. In child cases, the multiple percutaneous pinning can lead to good result. So authors believe that pull-out wiring is worthy for tibial intercondylar eminence fracture.

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Effects of Fibular Fixation for Interlocking Nailing of Distal Tibiofibular Fractures: Sang Ho Moon, Phil Hyun Chung, Chung Soo Hwang, Dong Ju Chae, Beom Kim; J Korean Soc Fract 2000;13(2):296-302. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.296

Abstract PDF: PURPOSE
: To compare redioiogic results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures.
MATERIALS AND METHODS
: From April 1993 to February 1999, 26 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 61 fractures fixed with nails only. Average age of patients was 41.8 years. These two groups were compared by frequency of malalignment, degree of postoperative angulation, angulation according to comminution, angulation according to fracture configuration. The statistical analysis was evaluated by t-test.
RESULTS
: Fibular fixation group had no malalignment while non-fixations had angulation of 1.2+/-1.1 degree and non-fixation had 3.0+/-2.1. So fixation had lessor angulation than non-fixation significantly(p=0.004). In lateral rediographs, each had 1.3+/- 1.1, 2.8+/-2.3 degree and showed significant difference(p=0.027). In type I and II fractures of Winquist-Hansen classification, fixation group showed lesser degree of angulation in A-P plane significantly(p=0.008) but no significant difference in lateral plane. In type III and IV, no significant difference in both planes. According to configuration of fractures, transverse and spiral fractures showed no significant differences but oblique configurations had significant differences in A-P plane(p=0.002) CONCLUSION : Interlocking intramedullary nail with fibular fixation has the advantage in maintenance of alignment during insertion of nail in distal tibiofibular fractures, especially in Winquist-Hansen classification type I and II and oblique fractures in anteroposterior plane, so it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

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Recovery of Walking Ability After Operation for Unstable Intertrochanteric fractures of the Femur in Elderly. -Timing on weight Bearing-: Deuk Soo Hwang, Hyun Tae Jung, Sang Beom Kim, Jin soo Kim; J Korean Soc Fract 1998;11(2):296-303. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.296

Abstract PDF

Intertrochanteric fracture of the femur frequently occurs in elderly patients with osteoporosis, represent as unstable and comminuted fracture, is the major cause of the morbidity and mortality in old ages. In the past, the goal of treatment of a fracture was to obtain union with little regard early ambulation is thought to be the best treatment modality. Fifty-three patients with unstable intertrochanteric fracture of the femur treated by possible anatomic reduction and internal fixation with compression hip screw were divided two groups and reviewed. In group A, 25 patients were began to bearing partial weight during six to eight weeks after operation. In group B, 28 patients were began to bearing partial weight as soon as possible(during first to third week after operation). The results were as follows; 1. According to Koval's classification, 6 cases(24.0%) in group A and 12 cases(42.9%) in group B maintained their prefracture ambulatory ability at more than 1 year postoperatively. 12 cases(48.0%) in group A, 8 cases(28.6%) in group B lost more than two grade of ambulatory ability. 2. Average loss of neck-shaft angle was 5.87degree in group A and 9.41degree in group B. Also average shortening was 5.2mm in group A and 12.7mm in group B at more than 1 year postoperatively. 3. The complications were two cases of nonunion in group A, two cases of femur fracture around compression hip screw in group B. There was no evidence of nail penetration or metal failure in both group. We concluded that better results are obtained in the respect of recovery of walking ability when partial weight bearing was started in early, even if more malunion was occurred, which is not seemed to be a severe problem for ordinary daily living in elderly.

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A Comparative Study of Bipolar Hemiarthroplasty for Intertrochanteric Fracture: Direct Anterior Approach versus Conventional Posterolateral Approach
Young Yool Chung, Seung-Woo Shim, Min Young Kim, Young-Jae Kim
Hip & Pelvis.2023; 35(4): 246. CrossRef
Hemiarthroplasty through Direct Anterior Approach for Unstable Femoral Intertrochanteric Fractures in the Elderly: Analysis of Early Cases
Ji-Hun Park, Young-Yool Chung, Sung-Nyun Baek, Tae-Gue Park
Hip & Pelvis.2022; 34(2): 79. CrossRef
The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures
Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim
Hip & Pelvis.2014; 26(2): 99. CrossRef
Changes in Patient Pattern and Operation Methods for Intertrochanteric Fractures
Dong-Hui Kim, Sang-Hong Lee, Sang-Ho Ha, Jae-Won You
Journal of the Korean Orthopaedic Association.2011; 46(1): 49. CrossRef
Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients
Han-Jun Lee, Jong Won Kim, Jae-Sung Lee, Jae June Yang, Woo-Young Hwang
Journal of the Korean Fracture Society.2010; 23(3): 276. CrossRef
Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone
Haw Jae Jung, Jae Yeol Choi, Hun Kyu Shin, Eugene Kim, Se-Jin Park, Yong Taek Lee, Gwang-Sin Kim, Jong-Min Kim
Journal of the Korean Fracture Society.2007; 20(4): 291. CrossRef

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Treatment of the humeral shaft fracture with interlocking intramedullary nail: Seok Beom Kim, Jeong Woung Lee, Won Tai Choi; J Korean Soc Fract 1996;9(1):170-176. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.170

Abstract PDF: In general, fracture of the shaft of the humerus is treated non-operative or by operative methods. The accepted treatment of the Isolated low-energy humeral shaft fracture is non-operative method. However, the fracture of the humerus that are associated with high energy, significant communition, unstable fracture patterns, or fractures that have been difficult to reduce or maintain reduction have been difficult to treat or maintain reduction have been difficult to treat by non-operative method. This has led to the use of operative intervention for the treatment of the humeral shaft fracture. The use of open technique with plate and screw is difficult due to potential injury of the neurovascular structure, increased risk of the infection and extensile exposure of the fracture site. Intramedullary nailing has advantages over other techniques of internal fixation and has been used to maintain the alignment and length of humerus. Especially, hiornechanically locked intramedullary nailing has the theoretical advantage of providing a weight shearing device and a ability to decrease the effect of rotational shear at the fracture site. This would increase the inherent stability at the fracture site and thus promote union. Authors performed interlocking intramedullary nailing for 35 cases of humeral shaft fracture from July-1993 until May-1995.

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