Journal of Musculoskeletal Trauma

Factors Affecting Posterior Angulation in Retrograde Intramedullary Nailing for Distal Femoral Fractures: Hohyoung Lee, Ji Ho Jeong, Min Su Kim, Bum Soo Kim; J Korean Fract Soc 2018;31(2):50-56. Published online April 30, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.2.50

Abstract PDF: PURPOSE
To analyze the factors that cause a posterior angulatory deformity in the retrograde intramedullary nailing of distal femoral fractures.
MATERIALS AND METHODS
Fifty-five patients with distal femur fractures who were treated with retrograde intramedullary nailing were enrolled in this study. They were followed-up for at least one year postoperatively. The posterior angulatory deformity was evaluated according to the fracture location, pattern, and insertion point and the insertion point was compared with the ideal point derived from the radiographs of 100 normal adults. The correlation between the posterior angulation and the entry point of the nail was analyzed.
RESULTS
The posterior angulation was similar in terms of the fracture location; a meaningful difference was noted among the fracture patterns (p=0.047). The posterior angulation was significantly greater when the entry point was located more posteriorly, accepting a malreduced state (p=0.012).
CONCLUSION
Posterior angulation was smaller in the transverse fracture and the posterior location of the entry point from the apex of the Blumensaat's line increased the posterior angulation.

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Treatment of Femoral Intertrochanteric Fracture with Proximal Femoral Nail: Bum Soo Kim, Sogu Lew, Sang Hun Ko, Sung Do Cho, Jeung Hun Yang, Moon Su Park; J Korean Fract Soc 2004;17(1):1-6. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.1

PURPOSE
To evaluate the usefulness of proximal femoral nail in the treatment of intertrochanteric fracture.
MATERIALS AND METHODS
The authors investigated the classificaton of fracture, operation time, the amount of intraoperative and postoperative bleeding, the amount of transfusion, postoperative ambulation status, bone union time and the complication among 45 cases who were treated with proximal femoral nail from Jan. 2001 to June 2002.
RESULTS
The mean operation time was 116 minutes, and the amount of bleeding was 524 ml in average. The amount of intraoperative transfusion was 1.4 pints and that of postoperative transfusion was 1.1 pints. The complications were the intraoperative penetration of antirotational screw through the femoral neck in 2 cases, separation of the fracture fragment while inserting the nail in 4 cases, irritation of skin by retropulsion of antirotation screw in 2 cases, and penetration of antirotation screw through femoral head in 1 case.
CONCLUSION
Proximal femoral nail was effective for the treatment of intertrochanteric fracture, however the surgeon should be carful about collision of the insertion handle against pelvis when the fracture line coincides with the insertion point of nail, especially in obese patients.

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Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -
Chae-Hyun Lim, Young-Yool Chung, Jeong-Seok Kim, Chung-Young Kim
Hip & Pelvis.2013; 25(1): 44. CrossRef
Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails
Il Ho Park, Jong Kyoung Won, Kye Young Han
Hip & Pelvis.2012; 24(2): 117. CrossRef
Results of the Proximal Femoral Nail-Antirotation (PFNA) in Patients with an Unstable Pertrochanteric Fracture
Yerl-Bo Sung, Sung-Il Jo
The Journal of the Korean Hip Society.2011; 23(1): 39. CrossRef
Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture
Jong Min Lim, Jeung Il Kim, Jong Seok Oh, Kuen Tak Suh, Jae Min Ahn, Dong Joon Kang
Journal of the Korean Fracture Society.2010; 23(4): 360. CrossRef
Treatment of Intertrochanteric Fracture: Comparison of Proximal Femoral Nail and Proximal Femoral Nail A
Jung Ho Park, Jong Woong Park, Joon Ho Wang, Jae Wook Lee, Jung Il Lee, Jae Gyoon Kim
Journal of the Korean Fracture Society.2008; 21(2): 103. 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
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

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Arthroscopic-Assisted Reduction and Internal Fixation of Patella Fractures: Sang Hun Ko, Sung Do Cho, Hwa Yeop Na, Woo Suk Kim, You Young Jeong, Chang Yeul Kwag, Bum Soo Kim; J Korean Soc Fract 2003;16(4):482-489. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.482

Abstract PDF

PURPOSE
The aim of this study is to report the clinical effectiveness of arthroscopic-assisted reduction and internal fixation of patella fractures.
MATERIALS AND METHODS
We analyzed fifteen patella fractures, which had been operated by using an arthroscopic-assisted technique from January, 2000 to April, 2003 at our hospital. After clinical follow-ups for at least 1 year, clinical analyses had been done by using the Cincinnati Knee Rating System Score, Lysholm Score Scale, and radiological findings.
RESULTS
In our study group, the Cincinnati Knee Rating System scores were from 80 to 100, with a mean of 89.9. The Lysholm Scoring Scale scores ranged from 81 to 100 with a mean of 90.8 for the same group. Radiologically, we obtained complete anatomical reduction of articular surfaces in 80 percent of cases. Arthroscopic-assisted reduction for patella fractures brought clinically satisfactory results that are accurate articular surface reduction, early recovery of motion range, knee joint stability and minimal soft tissue damage, etc.
CONCLUSION
The operative treatment for patella fractures using arthroscopic-assisted reduction is an effective alternative method to open reduction.

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Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases
Ji-Hye Geum, Hyeon-Jun Woo, Jong-gyu Kim, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2020; 30(4): 203. CrossRef
Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef

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The Treatment Of Humeral Shaft Fracture With Rertograde Ao Unreamed Humeral Nail: Tae Woo Park, Sung Do Cho, Young Sun Cho, Bum Soo Kim, Sogu Lew, Moon Chan Kim, Ki Young Kim; J Korean Soc Fract 2002;15(3):398-403. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.398

Abstract PDF: PURPOSE
To evaluate the results of the treatment of humeral shaft fractures using retrograde AO Unreamed Humeral Nail(UHN).
MATERIALS AND METHOD
From Apr. 1998 and Aug. 2001, 18 humeral shaft fractures were treated with retrograde AO UHN. All fractures were classified according to the AO classification. The results were analyzed by bony union time, range of motion and complication.
RESULTS
There were eleven cases of A3, two B2, one B3, four A2 humeral middle shaft fractures according to the AO classification. The mean bony union time was 12.2 weeks(range;9-16 weeks). All patients regained full range of motion of the shoulder joint and the elbow joint but 2 patients with intraopenatively ruptured capsule had transient elbow motion limitation. Complications were iatrogenic fractures at the entry portal in 2 patients(15%), transient shoulder pain in 4 patients(30.7%), nonunion in 1 patient(7.6%), required bone graft and internal fixation after removal of the nail at 13 months postoperatively.
CONCLUSION
The treatment of humeral shaft fracture with retrograde AO unreamed humeral nail is one of the good options to reduce the rate of non-union or delayed union by compression effect if the intraoperative errors is prevented.

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Comparison of Surgical Treatment for Acromioclavicular Joint Dislocation: Tae Woo Park, Sung Do Cho, Yong Sun Cho, Bum Soo Kim, Sogu Lew, Jong Ken Woo; J Korean Soc Fract 2002;15(1):59-64. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.59

Abstract PDF: PURPOSE
To evaluate the result of modified Bosworth method augmented with Mersilene tape(MBM) compared with modified Bosworth method(MB).
MATERIALS AND METHODS
Thirty two acromiclavicular dislocation wrer treated with MB(15cares) or MBM(17 cases) and the mean follow up period was 26 months(12-43 months). We assessed the radiological and clinical evaluation(X-Ray & Weitzman Criteria) and complications.
RESULTS
Twenty nine cases(91%)(MB 13, MBM 16) were "excellent" or "good" according to the Weitzman criteria. At last follow-up, mean difference of the coracocalvialar distance between the normal and the injured site were 1.9mm(MB) and 1.6mm(MBM) and two ceses were developed the arthritis, and then performed the distal clavicle resection.
CONCLUSION
Modified Bosworth method augmented with Mersilene tape is a good option for acromioclavicular dislocation in stabilizing the joint, even if the screw loosening occurs with early postoperative ROM.

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A STUDY OF ANATOMICAL CONFIGURATION OF LATERAL TIBIAL CONDYLE USING MR AXIAL IMAGE: Sung Do Cho, Yong Sun Cho, Bum Soo Kim, Tae Woo Park, So Gu Lew, Su Young Jung; J Korean Soc Fract 2001;14(3):398-403. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.398

Abstract PDF: PURPOSE
To evaluate the anatomical configuration of the lateral tibial condyle using the MR axial images and to present the proper configuration of the head of the buttress plate that fit the lateral tibial condyle of Korean MATERIALS AND METHODS: With 110 MR axial images of the knee joint of male and female, we calculate the ratio of the maximal height of the arc of the l ateral tibial condyle to the length of the line between the end point of the arc of the lateral tibial condyle(the ratio of convexity) and the angle of the peak point of arc of the lateral tibial condyle(the angle of convexity), the absolute value of the difference of the angle of the end point of the arc(the value of symmetry) of that. then we evaluate the head of 3 the buttress plates with same methods and then compare with the result of the lateral tibial condyle.
RESULTS
The ratio and angle of convexity of Korean were average 0.216/49.04(total), 0.203/49.35(male), 0.235/50.36(female), and the value of symmetry were average 5.68(total), 5.76(male), 5.56(female). the ratio and angle of convexity of the head of buttress plate were average 0.177/43.21(EGIRE), 0.114/25(AO), 0.101/23.83(Solco) and the value of the symmetry were 1.643(EGIRE), 0.75(AO), 1.5(Solco). the ratio of convexity was correlated with age, height, and weight but angle of convexity was not correlated with weight.
CONCLUSION
The anatomical configuration of the lateral tibial condyle of Korean did not fit that of the head of the buttress plates and it would be necessary to make a new plate that fit the lateral tibial condyle for Korean.

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TREATMENT OF PROXIMAL TIBIA FRACTURE WITH HYBRID EXTERNAL FIXATOR: Tae Woo Park, Sung Do Cho, Youg Sun Cho, Bum Soo Kim, Sogu Lew, Su Yeon Hwang; J Korean Soc Fract 2001;14(2):285-290. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.285

Abstract PDF

PURPOSE
To evaluate the results and usefulness of hybrid external fixator in the treatment of proximal tibia fracture. MATERIAL AND METHOD: From Jan. 1997 to Jan. 2000, 19 proximal tibia fracture were treated with hybrid external fixator with or without limited internal fixation to stabilize the articular surface. All fractures were classified according to the AO classification. The results were analyzed by ROM(range of motion), bony union time, fracture reduction with MPTA(medial proximal tibial angle) and joint congruency.
RESULT
There were 1 A2, 7 A3, 1 C1, 8 C2, 2 C3 proximal tibial fractures according to the AO classification. Open fractures were 10 patients. The mean bony union time was 13 wks(range 8-36wks) and the mean length of time in the external fixator was 14wks(range 8-36wks). At last follow up, the MPTA of the proximal tibia was 87.9 degree. 2 patients developed varus(82 degree) and valgus(92 degree) deformity respectively. Complications were intermittent pin drainage in 6 patients(31.6%), deep infection in 1 patient(5.3%) and nonunion in 4 patients(21%) required bone graft and internal fixation with plate at 6 months postoperatively. Four nonunions were 3 C2 and 1 C3 according to the AO classification and three were open fracture(1 type I, 1 type IIIb, 1 type IIIc : Gustilo type) CONCLUSION: Hybrid external fixation is a good treatment option for proximal tibial fractures. However, nonunion and angular deformity would occur in severe metaphyseal comminution and soft tissue injury. Accurate fracture reduction and careful soft tissue management is prerequisite and if necessory early bone graft should be considered in such cases.

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Staged Management of High Energy Proximal Tibia Fractures with Severe Soft Tissue Damage
Seung-Ryul Lee, Jae-Hoon Yang, June-Kyu Lee, Hyun-Dae Shin, Kyung-Cheon Kim, Kyu-Woong Yeon, Young-Mo Kim
Journal of the Korean Fracture Society.2009; 22(3): 152. CrossRef

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Comparison of the results between reamed and unreamed femoral nailing: Bum Soo Kim, Sung Do Cho, Yong Sun Cho, Tae Woo Park, Sogu Lew, Hyung Jin Cho, Soo Hyun Cho; J Korean Soc Fract 2001;14(2):208-213. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.208

Abstract PDF: PURPOSE
To evaluate the effectiveness between reamed and unreamed nailing in the treatment of femoral shaft fracture.
MATERIALS AND METHODS
Among the patients of femoral shaft fracture who were treated with reamed and unreamed nail, we reviewed 49 patients whose follow-up was possible for more than 1 year. The patients were divided into two groups: the reamed and the unreamed group. We reviewed union time, nonunion rate, complication and operation time and compared the effectiveness.
RESULTS
The average union time was 30.6 weeks in unreamed group and 27.8 weeks in reamed group, which was not different statistically. There were 5 cases of nonunion in 22 unreamed cases and 3 cases in 27 reamed cases, which meant no statistical difference. There was no significant difference of complications between the two groups. The mean operation time was 141 minutes in reamed group and 110 minutes in unreamed group, which meant statistical difference.
CONCLUSION
There was no significant difference in union time, nonunion rate and comlication between reamed and unremed group. The operation time was shorter in unreamed group, so unreamed nailing can be preferred in the treatment of multiply injured patient.

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Treatment of the Open Tibial Fractures with Unreamed AO Intramedullary Nail: Bum Soo Kim, Sung Do Cho, Yong Sun Cho, Soon Woo Hong, Hyung Jin Cho, Ki Yong Kim; J Korean Soc Fract 2000;13(1):81-86. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.81

Abstract PDF: PURPOSE
To evaluate the results of open tibial fractures treated with unreamed AO intramedullary nail MATERIALS AND METHODS: Among the patiens of open tibial fractures who were treated with unreamed AO intramedullary nail from January 1993 to August 1998, the authors reviewed 34 patients whose follow-up was possible for more than one year. Fourteen patients were treated with AO external fixator after meticulous debridement, followed by unreamed AO intramedullary nailing, and the other 20 patients were treated with primary unreamed AO intramedullary nailing after debridement. The authors evaluated the results by the union time and the presence of complication.
RESULTS
The average union time was 26.3 weeks. There was no significant difference of union time and complications between the patients who were treated with AO exteranl fixator followed by unreamed AO intramedullary nailing and the patients who were treated primarily with debridement and unreamed AO intramedullary nailing. However there was high incidence(21%) of interlocking screw breakage.
CONCLUSION
With meticulous debridement and close observation of the wound, the open tibial fractures can be effectively treated with unreamed AO intramedullay nailing. Unreamed intramedullary nailing of open tibial fractures immediately after trauma can be recommended in selected cases.

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Operative Treatment of Metacarpal Shaft Fracture: Bum Soo Kim, Sung Do Cho, Yong Sun Cho, Tae Woo Park, Hwa Chel Cheong, Soon Woo Hong, Soo Hyun Cho; J Korean Soc Fract 1999;12(3):720-726. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.720

Abstract PDF

The goal of treatment of fractures of the metacarpals includes the restoration or preservation of hand function. To accomplish this goal, the physician must select a method that will offer the least soft tissue damage and accelerate the mobilization of the injured part as soon as the fracture stability permits. The majority of fractures of metacarpals can be effectively treated by nonoperative approach, but when several metacarpals are fractured, when there is open soft tissue trauma, and when there are displaced fractures that cannot be reduced or cannot maintain the reduction, internal fixation is indicated. The authors reviewed 117 cases of metacarpal shaft fractures on which the operative treatment was performed. Closed reduction and percutaneous Kirschner wire fixation were performed on the 62 cases, open reduction and Kirschner wire fixation were performed on the 12 cases, closed reduction and percutaneous screw fixation were performed on the 16 cases, and open reduction and plate and screw fixation were performed on the 27 cases. The patient was followed up for 36 months in average. The results were evaluated on the basis of total active motion of the fingers. The results were satisfactory in 92 percent of the cases in closed reduction and percutaneous Kirschner wire fixation cases, 75 percent in open reduction and Kirschner wire fixation cases, 85 percents in open reduction and plate and screw fixation cases, and all the cases of the patients in the closed reduction and percutaneous screw fixation cases. The closed reduction and percutaneous screw fixation provided relatively stable fixation and minimal soft tissue injury, so the injured hand could be mobilized soon after the operation, and consequentely the excellent outcome was accomplished. So the authors suggest that in selected cases, the closed reduction and percutaneous screw fixation can be used as one of the good treatment methods in the treatment of metacarpal fractures.

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A Comparative Study of Tensile Strength of Three Operative Fixation Techniques for Metacarpal Shaft Fractures in Adults: A Cadaver Study
Jin Rok Oh, Doo Sup Kim, Jun Seop Yeom, Sang Kyu Kang, Yun Tae Kim
Clinics in Orthopedic Surgery.2019; 11(1): 120. CrossRef
Modified Bouquet Technique for Treatment of Metacarpal Neck Fractures
Yong-Gyu Sung, Seok-Whan Song, Yoon-Min Lee
Journal of the Korean Society for Surgery of the Hand.2016; 21(3): 137. CrossRef
Antegrade Intramedullary Prebent K-wire Fixation for the 5th Metacarpal Neck Fracture
Tae-Hyung Kim, Bo Hyeon Kim, In-Ho Jung, Dong-Hyun Kim
Journal of the Korean Fracture Society.2011; 24(1): 67. CrossRef
Bouquet Pin Intramedullary Nail Technique of the 5th Metacarpal Neck Fractures
Myung-Ho Kim, Moon-Jib Yoo, Jong-Pil Kim, Ju-Hong Lee, Jin-Won Lee
Journal of the Korean Fracture Society.2007; 20(1): 64. CrossRef

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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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Operative Treatment for Acromiclavicular Joint Dislocation: Bum Soo Kim, Sung Do Cho, Ki Bong Kim; J Korean Soc Fract 1998;11(1):1-7. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.1

Abstract PDF: Acoromioclavicular dislocation occurs frequently in young athletes and recently in automobile accident victims and laborers, and there are various kinds of operative methods for this injury. Authors performed operative treatment for 45 cases of acromioclavicular dislocation: 30 cases of modified Phemister operation and 15 cases of modified Bosworth operation from March 1992 to June 1996. Authors analysed the result of the treatment and the results obtained were as follows. 1. The clinical results evaluated by Weitzman criteria were all satisfactory in both modified Phemister method and modified Bosworth method. 2. The radiologic results were evaluated by the difference of the distance from the coracoid process to the clavicle between the normal and the injured site. And the result was more satisfactory in modified Bosworth method. 3. There were less complications in modified Bosworth method.

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Isolated Fracture Dislocation of the Tarsal Navicular: Case report: Bum Soo Kim, Sung Do Cho, Yong Sun Cho, Tae Woo Park, Chang Sung So; J Korean Soc Fract 1997;10(4):925-928. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.925

Abstract PDF

Isolated fracture dislocation of the tarsal navicular bone is a very rare injury. The mechanism of injury of this fracture dislocation is known as a horiBontal or axial load in plantar flexed foot. Anatomical reduction using closed or open methods is recommended for displaced navicular fractures to achieve a satisfactory result and early mobilization of the foot is required to get a good range of motion at the tarsal joint. Authors report one case of isolated fracture dislocation of the tarsal navicular which was treated with closed reduction and percutaneous K-wire fixation.

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Fractures of the Tarsal Bone
Young Hwan Park, Hak Jun Kim, Soo Hyun Kim
Journal of the Korean Fracture Society.2016; 29(4): 276. CrossRef

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