Journal of Musculoskeletal Trauma

The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture: Seong Jun Ahn, Suk Woong Kang, Bu Hwan Kim, Moo Ho Song, Seong Ho Yoo, Kwan Taek Oh; J Korean Fract Soc 2013;26(4):314-320. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.314

PURPOSE
To evaluate the efficacy of surgical treatment through retrospective comparison of minimally invasive percutaneous plate osteosynthesis (MIPPO) vs open plate fixation in the treatment of the distal femur fractures.
MATERIALS AND METHODS
Thirty-one patients with distal femur fractures from January 2002 to December 2010 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 17 patients treated with MIPPO, and group B was comprised of 14 patients treated with open plate fixation. Clinical outcomes including operation time, transfusion rate, rehabilitation, range of motion, and interval change of postoperative C-reactive protein (CRP) were evaluated to assess postoperative inflammatory reaction, postoperative complications and clinical results with the use of Sanders criteria.
RESULTS
The operative time was 86/135 min and transfusion volume was 0.8/1.9 unit respectively. The postoperative 3-day and 7-day CRP were 7.4/1.5 mg% in group A and 10.3/2.4 mg% in group B, showing more minimal tissue injury and early recovery in group A. There were no significant differences in clinical results by Sanders criteria in both groups.
CONCLUSION
Both MIPPO and open plate fixation for the treatment of distal femur fractures showed comparably good results. However, the MIPPO technique is superior to group B in view of minimal tissue injury and operation time and was proven to lessen the transfusion rate.

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Usefulness of Reduction and Internal Fixation Using a 2.4 mm Hand Plating System in Type AO 33-A3 Distal Femur Fracture: Technical Note
Bong-Ju Lee, Ja-Yeong Yoon, Seungha Woo
Journal of the Korean Fracture Society.2023; 36(1): 25. CrossRef

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The Diagnosis of Osteoporotic Occult Vertebral Fracture and Vertebroplasty: Seong Jun Ahn, Bu Hwan Kim, Moo Ho Song, Seong Ho Yoo, Yeong Joon Kim; J Korean Fract Soc 2012;25(3):208-214. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.208

Abstract PDF: PURPOSE
To evaluate the effectiveness of magnetic resonance imaging (MRI) for the diagnosis and usefulness of vertebroplasty in osteoporotic occult vertebral fractures.
MATERIALS AND METHODS
Of 472 osteoporotic vertebral fractures treated from May 2003 to July 2009, 45 patients were diagnosed with occult osteoporotic vertebral fracture. Their medical charts and radiographs were reviewed. The degree of vertebral body collapse was graded by a semiquantitative method. In order to increase the reliability, interpretation was based on radiographic diagnoses from 3 orthopedic surgeons. Vertebroplasty was performed at 31 of the 45 patients, for whom conservative treatment failed. Pre-operatively and post-operatively, pain was evaluated using a visual analog scale (VAS).
RESULTS
We observed 55 occult fractures in 45 patients. Forty vertebrae (72.7%) among the 55 vertebrae were just adjacent to an old vertebral fracture with deformation of the vertebral body. The rediagnosis rate of occult fracture attempted without MRI was only 21.8%. The average pre-operative VAS score of 8.07 (6~9) was improved to 2.43 after surgery and showed no delayed vertebral body collapse.
CONCLUSION
Gadolinium enhancement of MRI is critical to the diagnosis of occult vertebral fractures, which are 9% of whole osteoporotic vertebral fractures. Seventy-two point seven percent of occult vertebral fractures were just adjacent to an old vertebral fracture with collapse of the vertebral body. This means that if vertebroplasty is performed without thorough MRI examination, it may fail.

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The Comparison of MIPPO vs Open Plate Fixation in the Treatment of the Distal Tibia Fracture: Seong Ho Yoo, Seong Jun Ahn, Moo Ho Song, Bu Hwan Kim, Min Soo Lee, Jong Ha Park; J Korean Fract Soc 2006;19(1):29-33. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.29

Abstract

PURPOSE
To evaluate the efficacy of the surgical treatment through the comparison of MIPPO vs open plate fixation in the treatment of the distal tibia fracture retrospectively.
MATERIALS AND METHODS
30 patients with distal tibia fracture from Jun. 2001 to Jun. 2004 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 15 patients treated with MIPPO, Group B was 15 patients treated with open plate fixation. The clinical outcomes were evaluated retrospectively from operation time, rehabilitation, ROM, interval change of postoperative CRP to assess postoperative inflammatory reaction, postoperative complications and clinical result with the use of McLennan and Ungersma criteria.
RESULTS
There were no significant differences in clinical result by McLennan and Ungersma criteria in both groups. The postoperative 3 days and 7 days CRP were 4.0mg% (0.9~7.2)/0.5 mg% (0.1~1.5) in group A and 7.97mg% (2.8~14.6)/1.0mg% (0.3~1.6) in group B, shows more minimal tissue injury and early recovery in group A. Operation time in group A was shorter than group B. Normal recovery of ROM was quicker in Group A. In complications, group A showed one superficial infection and one angular deformity and group B showed one superficial infection, one infected nonunion and two ankle stiffness.
CONCLUSION
There were no significant differences in clinical result and bony union. MIPPO technique is superior to group B in view of the minimal tissue injury, complications, operation time and postoperative rehabilitation.

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Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture
Oog Jin Shon, Dae Sung Kim
Journal of the Korean Fracture Society.2010; 23(1): 42. CrossRef

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Multiple Fractures of Forearm Both Bones: A Case Report of 5 Separate Sites: Bu Hwan Kim, Moo Ho Song, Seong Jun Ahn, Seong Ho Yoo, Min Soo Lee; J Korean Fract Soc 2005;18(4):466-469. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.466

Abstract PDF

We have experienced multiple fractures of forearm both bones, which revealed the following fractures: comminuted fracture of olecranon, short oblique fracture of proximal ulnar shaft, transverse fracture of ulna mid-shaft, comminuted fracture of radial head, comminuted fracture of distal radius.

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Treatment of a Segmental Ulnar Shaft Fracture and an Olecranon Fracture
Myoung Soo Kim, Kyu Pill Moon, Hyung Joon Cho, Jung Yun Bae, Kuen Tak Suh
Journal of the Korean Orthopaedic Association.2010; 45(6): 496. CrossRef

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Treatment of Completely Displaced Supracondylar Fracture of Humerus in Children: Bu Hwan Kim, Mu Jung Heo, Won Jun Hwang; J Korean Soc Fract 2003;16(4):585-591. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.585

Abstract PDF

PURPOSE
We performed a retrospective study of completely displaced supracondylar fracture of humerus in children to evaluate the result of primary open reduction and internal fixation for this injuries, and also to know whether it is recommendable or not for such injuries.
MATERIALS AND METHODS
For 5 years duration from March '96 to Feb. '01, we treated 58 cases of completely displaced supracondylar fractures of humerus in children. Among them we performed primary open reduction and internal fixation of this fracture in 14 cases. We followed up those cases more than 18 months and evaluated the results by Flynn et al. and Mark et al. criteria.
RESULTS
Eleven of them resulted in excellent grading by both Flynn and Mark criteria. Three cases not involved in excellent grading proved to be good result by Mark criteria. But by Flynn criteria, 2 cases showed good results and the other one proved to be fair. In all cases, the patient and parents were satisfied cosmetically and functionally. Only in one case, the recorded grading was different, fair by Flynn and good by Mark criteria.
CONCLUSION
Primary open reduction and internal fixation in the treatment of completely displaced and not easily reduced supracondylar fracture of humerus in children resulted excellent and good results with few complications, and patients were satisfied with the results functionally and cosmetically. So we recommend proceeding to primary open treatment and internal fixation for these difficult fractures with low threshold to open reduction.

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Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique
H.-Y. Lee, S.-J. Kim
The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef

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Prevention of Fracture During Removal of ILMN in Tibia Fracture: Bu Hwan Kim, Myoung Hee Choi, Sang Hun Yi, Mu Jung Heo; J Korean Soc Fract 2001;14(4):628-631. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.628

Abstract PDF: PURPOSE
Sometimes we experience refracture of tibia during removal of ILMN after complete union of fracture. We evaluated surgical technique in order to know how we can avoid the fracture of posterior cortex of tibia during removal of ILMN.
MATERIALS AND METHODS
From Jan. 1993 to Dec. 1999, we removed 86 cases of ILMN used for tibia fracture. Among them, 40 cases of Ace titanium ILMN were removed. We compared the fracture rate of tibia during removal of Ace titanium ILMN.
RESULTS
The refracture rate during removal of Ace titanium ILMN was 17.2% (5/29cases) previously, but after careful "slow and steady" removal of nail, the refracture rate was reduced to 0%(0/11 cases, P<0.05).
CONCLUSION
Take some cares during removal of ILMN is important to reduce the fracture rate of tibia during removal of Ace titanium ILMN.

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Unilateral Facet dislocation of Lumbosacral Junction: a case report: Bu Hwan Kim, Jong In Im, Yong Kyun Im, Chang Hoon Ryu; J Korean Soc Fract 1999;12(1):98-102. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.98

Abstract PDF: Unilateral lumbosacral facet dislocation is very rare. In a review of literatures, only 14 cases have been documented. We could not find any report about this unusual injury in Korea. The mechanism of injury is hyperflexion and rotation. In general, attention is drawn to the association of fractured transverse process as an important clue to diagnosis. Attempts at closed reduction are futile, and the treatment of choice is open reduction and internal fixation with lumbosacral fusion.

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Review of Guide to Medical Certificate issued by Korean Medical Association: Bu Hwan Kim, Jong In Im, Yong Kyun Im, Uk Nam; J Korean Soc Fract 1999;12(1):56-60. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.56

Abstract PDF

Doctors have some difficulties in deciding the duration of expected treatment for certain trauma patient in issuing medical certificate because of rarity of references about the medical certificate. In 1996, Korean Medical Association published Guide to Medical Certificate which helped many doctors in their practice of certificate issuing. But in reviewing the contents of the book, we would like to point out a few problems for amendment in next issue.

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PARK Formula Can Replace "Guide to Medical Certificate" Published by Korean Medical Association in Deciding the Treatment Duration
Chan Yong Park, Kwang Hee Yeo, Sora Ahn
Journal of Trauma and Injury.2018; 31(2): 58. CrossRef
Ethical aspects for the rules and procedures for issuing medical certificates
Byung-In Choe, Gwi-Hyang Lee
Journal of the Korean Medical Association.2014; 57(7): 594. CrossRef

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Treatment of Pilon Fracture, limited ORIF with External Fixation by Ilizarov Method: Bu Hwan Kim, Jong In Im, Yong Kyun Yim, Deog Jeong Kang, Uk Nam; J Korean Soc Fract 1998;11(4):798-805. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.798

Abstract PDF: The authors retrospectively reviewed 22 pilon fractures in 22 patients treated with limited ORIF with external fixation by Ilizarov method. Clinical follow up averaged 28 months (range, 16-45 months). Interfragmental screw fixation of key fragments were done in fifteen cases and bone-grafting was done in thirteen cases. The average duration of external fixation was fourteen weeks. All of the fractures healed (one after delayed bone-grafting). The subjective and objective results were classified according to Ovadia and Beals. Sixteen patients (72%) had good and excellent results at final follow up. On the basis of these early results, the prevalence of complications asociated with pilon fractures and their treatments can be decreased by external fixation of Ilizarov method and limited internal fixation. We conclude that this method is good treatment modality on tibial pilon frature.

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Operative Treatment of Clavicle Fracture: Bu Hwan Kim, Jong In Im, Uoung Kyun Yim, Jung Ju Kim; J Korean Soc Fract 1998;11(3):658-664. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.658

Abstract PDF

Clavicle fracture is one of the most common fractures and can be treated by conservative methods with a high rete of union and operative treatment itself was rearded as a cause of nonunion. But recently, we experienced some cases of delayed or nonunion following conservative treatment especially in high energy trauma patient. So we tried to treat 35 cases of clavicle fractures by open reduction and internal fixation with or without bone graft and analyzed the results. Results were as following. 1. The functional results were excellent in 16 cases(45.7%), good in 13 cases(37.1%), fair in 4 cases(11.4%) and poor in 1 case(0.28%), except 1 case of initial brachial plexus injury. 2. Of the 34 cases (except 1 case of nonunion), average time to union was 8.2 weeks in Knowles pin fixation and 8.4 weeks using plate with or without bone graft. Knowles pin fixation and 8.4 weeks using plate with or without bone graft. In the treatment of flesh clavicle fracture for early rehabilitation especially in young patients, open reduction and internal fixation is thought to be good method.

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Does cerclage wiring interfere with fracture healing of osteosynthesis in comminuted midshaft clavicle fractures? A multicenter study
Hyo Jin Lee, Yong Bok Park, Chang Heon Shim, Young Min Noh
Orthopaedics & Traumatology: Surgery & Research.2021; 107(8): 103091. CrossRef
Comparison of Plate Versus Threaded K-wire for Fixation of Midshaft Clavicular Fractures
Young-Jin Ko, Chul-Hyun Park, Oog-Jin Shon, Jae-Sung Seo
Journal of the Korean Fracture Society.2012; 25(2): 123. CrossRef
Surgical Techniques for Percutaneous Reduction by Towel Clips and Percutaneous Intramedullary Fixation with Steinmann Pins for Clavicle Shaft Fractures
Ki-Do Hong, Jae-Chun Sim, Sung-Sik Ha, Tae-Ho Kim, Jong-Hyun Kim, Jong-Seong Lee
Journal of the Korean Fracture Society.2012; 25(1): 31. CrossRef
Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?
Jae-Kwang Yum, Yong-Woon Shin, Hee-Sung Lee, Jae-Gu Park
Journal of the Korean Fracture Society.2011; 24(2): 138. CrossRef
Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Jung-Ho Kang, Kwang-Hee Park
Journal of the Korean Fracture Society.2007; 20(3): 233. CrossRef

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Severe Comminuted and Displaced Patellar Fracture Treated by Partial or Total Patellectomy: Kuen Tak Suh, Taek Geon Lee, Weon Wook Park, Chong Il Yoo, Kyu Yeol Lee, Bu Hwan Kim; J Korean Soc Fract 1997;10(4):851-859. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.851

Abstract PDF: The results of partial and total patellectomy as a treatment for severe comminuted and displaced patellar fracture were assessed retrospectively with the use of clinical criteria and radiologic findings. Sixteen patients treated with patellectomy(four total and twelve partial patellectomies) were followed up for an average of 3 years 4 months and valuated. According to the Bostmans fracture classification, there were type I In 5 cases(31%), type II in 7 cases(44%), and type III in 4 cases(25%). The results of the patellectomy were relatively good since excellent result was shown in 11(69%) among 16 cases. The comparison between partial and total patellectomy was difficult because the fracture patterns treated by these techniques were different. In this study, the result of the partial patellectomy was better than that of the total patellectomy, but their difference was not statisticaliy significant(P>0.05). The results of the study indicated that partial or total patellectomy could be one of the effective treatment methods for severe comminuted and displaced patellar fracture. However total patellectomy should be recommended only when the entire patella was too severely comminuted to function as a part of the extensor mechanism of the knee.

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Treatment of Distal Tibial Fractures by Interlocking Intramedullary Nailing: Bu Hwan Kim, Joung In Yim, Hee Yeong Chung, Jung Ju Kim; J Korean Soc Fract 1997;10(2):316-323. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.316

Abstract PDF: Intramedullary rigid nailing has been used to treat diaphyseal fracture of tibia, but with improvement of practical technical ideas, especially development of interlocking transverse screw, the indication of intramedullary nailing for tibial fracture became expanded to the fractures occurred 3cm proximal to the ankle joint. We treated 34 distal tibial fractures from Mar. 1992 to Feb. 1995 and followed up at least more than one year. The results of treatment were as follows ; 1. Time for union was 11.3 weeks in closed fracture group and 19 weeks in open group. 2. According to the functional classification of Klemm and Borner, excellent and good results were obtained in 30 cases(94.1%). 3. Complications developed in 7 cases which include ankle motion limitation, angular deformity, delayed union.

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Miniplate and Miniscrew Fixation for the Metacarpal and Phalangeal Fractures: Bu Hwan Kim, Jong In Yim, Deog Jeong Kang; J Korean Soc Fract 1997;10(1):150-155. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.150

Abstract PDF: The functional end result is more important than fracture healing in the hand fracture treatment. Accurate open reduction and internal fixation with miniplate and miniscrew for metacarpal and phalangeal fractures of hand provides firm fixation and allows early postoperative mobilization which reduce the incidence of joint stiffness and tendon adhesion. The authors have reviewed 17 cases of metacarpal and phalangeal fractures of the hand in 13 patients which were treated with miniplate and miniscrew fixations in the department of orthopaedic surgery, Dae Dong General Hospital from Mar. 1994 to Feb. 1996. The following results were obtained. 1.The firm fixation allowed range-of-motion exercises in most patients between 3-14 days. 2.The roentgenographic union was obtained within 14.8 weeks in average. 3.The mean TAM(total active motion) range at last follow up was 247 in the metacarpal fracture and 226 in the phalangeal fracture. 4. The complications(tendon adhesion & loss of reduction) occurred in 2 cases(11.8%). In conclusion, fixation with miniplate and miniscrew for metacarpal and phalangeal fractures of the hand is considered to be an effective method in the treatment of metacarpal & phalangeal fractures.

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Problems of Interlocking Intramedullary Nailing for Fracture Treatment: Bu Hwan Kim, Jong In In, Yi Chul Kim; J Korean Soc Fract 1997;10(1):142-149. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.142

Abstract PDF: With the introduction of image intensifier in orthopaedic surgery, interlocked intramedullary nailing is one of the most prevailing method in the treatment of long bone fracture especially in femur and tibia. Advantages of this method are rigid fixation of fracture fragment resistant to rotational force, low infection rate, possible early post-operative motion and weight bearing and bone graft effect by medullar reaming procedure. But we had encountered variable complications during and after operation of 63 cases in 59 patients who had undergone interlocking nailing for femur or tibia fractures from Mar 1990 to Feb 1992 at Dae Dong General Hospital. The results were as follows : 1. Delayed union and nonunion developed in nine cases and infection was noted in nine cases, seven of them were superficial infections. 2. Operative complication were encountered with four cases of new fracture, three cases of angolation deformity, four cases of shortening. 3. Four cases of nail profusion was developed because of inadequate implant length. Postoperative metallic failure was found in three cases. 4. Sufficient preoperative planning and skillful technique can decrease the complications.

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Operative Treatment of Unstable Fracture of Distal Radius: Bu Hwan Kim, Jong In In, Hee Yeong Chung, Yong Kyun In; J Korean Soc Fract 1996;9(3):774-780. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.774

Abstract PDF: Fracture of distal radius represent the most common fractures of upper extremity. Recently, distal radius fractures are recognized as very complex injuries with a variable prognosis according to the fracture type and the treatment. Because unstable distal radius fractures have a high incidence of secondary displacement and shortening, they are not amenable to the traditional methods of closed manipulation. We classified distal radius fractures by Fernandez classification and analysed thirty-six cases of fractures followed up more than one year at Dae-Dong Hospital from March 1993 to September 1994 after ORIF with T-plate. The result were as follows: 1. ORIF of unstable fracture of distal radius with small T-plate, selective bone graft using volar approach, 81% of the patients had a rating of good or excellent by the modified scoring system of Green and OBrien. 2. Severely comminuted fractures as Fernandez type V necessitated additional fixation such as external fixator. 3. Femandez classification based on the mechanism of injury was helpful in planning the treatment of unstable distal radius fractures.

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Treatment of A-C joint dislocation with cannulated screw fixation under local anesthesia: Bu Hwan Kim, Jong In Yim, Deog Jeong Kang; J Korean Soc Fract 1996;9(1):185-192. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.185

Abstract PDF: In 1941, Bosworth used noncannulated coracoclavicular lag screw to Oeat acute A-C joint dislocation. In 1989, Tsou fixed coracoclavicular joint with percutaneous cannulated screw under general anesthesia in the treatment of acute A-C joint complete dislocations. We tried to treat 10 cases of acute A-C joint dislocations with cannulated screw fixation of C-C joint under local anesthesia, so we report the results with review of literatures. The results were as follows 1. Results of treatment were good in 7 cases, fair in 2 cases, and poor in 1 case by Weaver and Dunn evaluation criteria. 2. The operations were done under local anesthesia, but in two cases operation ended under general anesthesia due to discomfort of the patients. 3. In skeletally thin patient, it was very difficult to make accurate hole and we experienced an iatrogenic fracture of clavicle and coracoid process. This technique is not recommendable in skeletally thin patient. 4. Operation took 42 minutes on average(from 30 minutes to 105 minutes) though it took more time in the early cases. 5. We had several complications in 3 patients. Misdirection of screw(1 case), screw loosening and pull out(1 case), subluxation of A-C joint after removal of screw(2 cases), and iatrogenic fracture of clavicle and coracoid process(1 case) but no case of metal breakage or infection.

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Medical Certiflcate in Orthopedic Trauma Patient: reasonable duration of expected treatment: Bu Hwan Kim, Yong Kyun In; J Korean Soc Fract 1995;8(3):675-677. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.675

Abstract PDF

Medical certificates in orthopedic trauma patients should be issued cautiously because of the important roles of the documents to the offenders and victims of accidents. But in real practice, we can find only a few references which can help doctors to decide the "duration of expected treatment" in trauma patients. A pamphlet issued by Korean Orthopedic Association "Guide to the medical certification in trauma patient" helped us a lot but it was published too long ago and had a few problems, so we suggests some ideas for revising the pamphlet.

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PARK Formula Can Replace "Guide to Medical Certificate" Published by Korean Medical Association in Deciding the Treatment Duration
Chan Yong Park, Kwang Hee Yeo, Sora Ahn
Journal of Trauma and Injury.2018; 31(2): 58. CrossRef

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Operative Treatment of Intra-articular Fractures of the Calcaneus by Sanders Classification: Jong In Yim, Bu Hwan Kim, Hee Yeong Chung, Woo Sung Choi; J Korean Soc Fract 1995;8(3):628-637. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.628

Abstract PDF: The os calcis is the most frequently fractured than any other tarsal bone and the displaced intraarticular fracture account for 60-75% of them. Because of complex contour of calcaneus, it is difficult to evaluate the pattern of fracture exactuly by conventional roentgenograms. But recently, computed tomography clearly defines fracture patterns of subtalar joint and calcaneocuboid joint. From Feb. 1992 to Jan. 1994. we analyzed 18 feet in 16 patients of intraarticular calcaneal fractures after routine preoperative CT scan and Sandersclassification. All cases were operated through extensile lateral approach and internally fixed with plate and screws. The clinical and radiographic analysis were as follows: 1. Sanders classification of 18 cases were type I in 3, type I in 8, type III in 4 and type IV in 3. 2. As the fracture line moves medially, intraoperative visualization of joint, reduction becomes more difficult and the prognosis worsens in type II and IIIBC. 3. By SandersCT classification of calcaneal fracture, it help us in understanding fracture pattern more detail and in deciding of the method of treatment and in the predicting of the prognosis.

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Locked Intramedullary Nailing of Tibial Segmental Fractures: Bu Hwan Kim, Jong In Yim, Hee Yeong Chung, Joon Young Park; J Korean Soc Fract 1995;8(3):557-565. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.557

Abstract PDF: Recently closed interlocting intramedullary nailing under image intensifier has been widely used in the treatment of segmental fracture of long bone and good results have been reported. Twenty-six segmental fractures of tibia were treated with interlocking intramedullary nailing from Mar. 1989 to Feb. 1993 at Dae-Dong General Hospital and all cases were followed up more than 18 months. In this paper we are reporting the results of twenty-six segmental tibial fracture treatment. 1. Seventeen patients were male and 7 patients were female. 2. Eighteen cases(69.2%) were caused by traffic accident and ipsilateral fibular fractures were the most common associated injury. 3. Most common type of fractures were Melis type II(10 cases 38.4fo), proximal fracture lies in the middle third of the shaft and the distal fracture lies in the lower third. 4. Average union time in closed fractures was 23.0 weeks and 29.5 weeks in open fracture with average 28.5 weeks.

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Open Reduction & Internal Fixation of Long Bone Fracture in Osteopetrosis Patient: Bu Hwan Kim, Jong In In, Woo Seong Choi; J Korean Soc Fract 1995;8(2):407-412. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.407

Abstract PDF

Bone quality in osteopetrosis patient is very hard but brittle and easily fractured by triviat trauma. In case of pathological fractures in osteopetrosis patient, most of the fractures are treated by conservative treatments. But some long bone fractures are difficult to treat conservatively. A few surgeons treated the fracture by open reduction and internal fixation(ORIF) and they came to agree that ORIF of fractures were very difficult technically. We tried plate and screw fixation for a subtrochanteric fracture of femur in a 20-year-old osteopetrosis patient who have already had 4 previous long bone fractures. 1. We changed drill bit everytime for every screw hole penetration and it took about 2 minutes for a hole. 2. ORIF is adventageous in fracture of suitable location in osteopetrosis patient.

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Triple Osteotomy for Hallux Valgus in Patient with Osteopetrosis - A Case Report -
Seung Do Cha, Hyung Soo Kim, Jeong Hyun Yoo, Jai Hyung Park, Joo Hak Kim, Joo Won Joh
The Journal of the Korean Orthopaedic Association.2008; 43(6): 808. CrossRef

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A Comparison study of the Gamma Nail the Dynamic Hip Screw for Peritrochanteric Fractures: Jong In Im, Bu Hwan Kim, Gi Deug Lee; J Korean Soc Fract 1994;7(2):322-330. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.322

Abstract PDF: Early operative treatment of peritrochanteric fracture in geriatric patients is now accepted practice and numerous versions of a sliding nail-plate system are the most widely used implants. The Gamma nail was introduced for the treatment of peritrochanteric component and minimizing the surgical trauma. We have operated 46 cases and studied 30 cases were followed up over 1 year. At follow-up, all patients continued to ambulate and all fractures healed. and clinical results was satisfactory. But we experienced some technical problems and complications. Intraoperative complications included difficulty in securely placing the distal screws(1 patient) and small fracture of the base of the greater trochanter(2 patients). Postoperative complications included gluteal bursitis(3 patients), progressive varus deformity(3 patients), progressive varus deformity(3 patients), thigh & knee pain(2 patients), cutting out of the femoral head (1 patient), and a femoral shaft fracture through the distal locking screws following a fall. We had no cases of infection or nonunion. To minimize technical problems and complications, the following considerations are important. 1. Accurate preoperative templating is necessary. 2. Exact placement of the guide wire. It must enter the greater trochanter at the junction of its anterior third and posterior two-thirds, just lateral to its tip. 3. Selection of a nail 2mm narrower than the reamer was recommended. 4. Nail must be inserted by hand, not by hammering, along the medulla canal. 5. Lag screw must be inserted into femoral head deeply and avokd into superior part of head especially in severe porotic bone. 6. Subtrochanteric fractures extending to distal locking site are inapproprocate indication for standard Gamma-nailing. a spiral subtrochanteric fracture which cannot be reduced by a closed technique is managed with circumferential wiring with nimimal incision before nail is inserted. 7. Repeated check of device loosening is important, especially before distal locking screw insertion. Initial insertion of proximal part of distal screw is preferred and routine use of distal locking screws is prohibited. 8. Weighted bearing must be delayed when abnormal sliding of lag screw is noted before weight bearing and in severe osteoporosis with comminution.

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Clinical Analysis of Supracondylar Fracture of the Humerus in Children: Bu Hwan Kim, Kyo Seog Shin, Jae Hyek Kim, Doo Jeong Kim; J Korean Soc Fract 1992;5(2):325-333. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.325

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Supracondylar fracture of the humerus is the most common fracture of the elbow in children. There are many controversies about the methods of treatent. We analysed 41 cases of supracondylar fractures of the children from Jan. 1988 to Dec. 1990 according to the types of the fracture and methods of the treatment. The results were as follows . 1. Boys were more vulnerable to injury than girls by the ratio of 2.4 : 1, and all fractures were extension type. 2. The most common associated injuries were nerve injuries and all of them recovered spontaneously There were 2 cases of radial nerve palsies in patient with posteromedial displacements of distal fragments. 2 cases of median nerve palsies and 2 cases of ulnar nerve palsied with posterolateral displacements. 3. There were 30 cases of Excellent, 9 cases of Good and 2 cases of Fair results by the Flynn criteria. Only 7 cases showed limitation of elbow joint motion over 5 degrees after treatment. 4. We believe that percutaneous pinning was the choice procedure for treatment of displaced supracondylar fractures. The higher the severity, the poorer the result in Holmberg classification. 5. We used posterior approaches of 12 cases among 14 cases of open rdductions for anatomi. cal reduction of the fractures. We havent found and problem concerning the posterior approaches except some degrees of elbow joint motion limitations.

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Triple plate fixation for subtrochanteric, shaft and congylarfracture of femur: 1 case report: Bu Hwan Kim, Kyoo Seag Shin, Jae Jyek Kim, Jong In Im; J Korean Soc Fract 1991;4(1):123-127. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.123

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