Journal of Musculoskeletal Trauma

Retrograde Intramedullary Nailing or the Treatment of Segmental Femoral Shaft Fracture Including Distal Part: Jong Ho Yoon, Byung Woo Ahn, Chong Kwan Kim, Jin Woo Jin, Ji Hoon Lee, Hyun Ku Cho, Joo Hyun Lee; J Korean Fract Soc 2009;22(3):145-151. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.145

PURPOSE
To evaluate the usefulness of the retrograde intramedullary nailing for the treatment of segmental femoral shaft fracture including distal part.
MATERIALS AND METHODS
We reviewed 15 patients of segmental femoral fracture, who had treated with retrograde intramedullary nailing and followed-up more than 1 year from January 2003 to October 2007. There were 10 men, 5 women, and the mean age was 45 years old. There were associated fracture in 10 cases. We evaluate the time for union, non-union and malunion by radiologic finding and functional assessment by Sanders' criteria.
RESULTS
The mean time of union was 21 weeks. There was one delayed union in proximal fracture site. There was no shortening more than 1.5 cm, no angular deformity more than 10 degrees, no postoperative infection or instability. According to Sanders' criteria, there were excellent clinical results in 9 cases, good results in 5 cases and fair result in 1 case.
CONCLUSION
The retrograde intramedullary nailing can be a useful method for treatment of segmental femoral shaft fracture including distal part.

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Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef

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Cerclage Wiring in Internal Fixation of Displaced Acetabular Fractures: Chong Kwan Kim, Jin Woo Jin, Jong Ho Yoon, Sung Won Jung, Jung Wook Peang; J Korean Fract Soc 2008;21(2):95-102. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.95

Abstract PDF

PURPOSE
To evaluate the usefulness of wire fixation in displaced acetabular fractures.
MATERIALS AND METHODS
From January 2000 to December 2005, 19 cases of displaced acetabular fracture were treated with wire fixation. According to Letournel's classification there were 9 both column fracture, 5 transverse fracture, 3 anterior column with posterior hemitransverse and 2 T-type fracture. Only wire fixation in 13 cases and wire with plate or wire with screw fixation in 6 cases.
RESULTS
We evaluate the accuracy of reduction by Matta' criteria, anatomical reduction in 12 cases, incomplete reduction in 4 cases, poor reduction in 2 cases and surgical secondary congruence in 1 case. The clinical results showed excellent in 12 cases, good in 4 cases, fair in 2 cases and poor in 1 case. The radiological results showed excellent in 10 cases, good in 4 cases, fair in 3 cases and poor in 2 cases. There were 4 cases of complication; wound infection in 1case, post-traumatic arthritis in 1 case and heterotopic ossification in 2 cases.
CONCLUSION
The cerclage wiring is a preferable method in internal fixation of displaced acetabular fractures that can facilitate reduction and achieve stable fixation.

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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
Comparative Results of Acetabular Both Column Fracture According to the Fixation Method
Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park
Hip & Pelvis.2011; 23(2): 131. CrossRef

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Treatment of Stable Intertrochanteric Fractures Using a Short Side Plate Dynamic Hip Screw: Chong Kwan Kim, Jin Woo Jin, Sung Won Jung, Wan Sub Kwak, Jae Il Jo, Woo Sik Kim; J Korean Fract Soc 2006;19(3):309-313. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.309

Abstract: PURPOSE
To evaluate the usefulness of a 2 holes side plate dynamic hip screw for the treatment of stable intertrochanteric fracture of the femur.
MATERIALS AND METHODS
Between January 2000 and September 2004, 46 patients with intertrochanteric fracture of the femur were treated with 2 hole side plate dynamic hip screw (Group 1, 25 cases) or 4 hole side plate dynamic hip screw (Group 2, 21 cases). The mean age of the patient was 70 years, with a mean follow-up duration of 13 months. The time for operation, surgical incision length, blood loss, time for union, the sliding distance, change in the femoral neck-shaft angle and patient's walking ability were evaluated.
RESULTS
The mean operation time and mean incision length were shortened, and mean blood loss was decreased in Group 1 (p<0.01). There was no statistical difference in the union time, the mean change in the femoral neck-shaft angle and the mean sliding distance of the lag screw at the last follow-up. The mean mobility score of the Parker and Palmer was 8.0 points before the fracture and 7.2 points at the last follow-up.
CONCLUSION
Two-hole side plate dynamic hip screw is a useful device, in terms of the operation time, morbidity of operation site, satisfactory union rate and functional recovery of the patient in treatment of elderly patients with stable intertrochanteric fractures of the femur.

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Internal Fixation of Clavicle Lateral and Fracture with Mini T-plate: Byung Woo Ahn, Jong Ho Yoon, Chong Kwan Kim, Sung Won Chung, Young Il Kwan, Young Ho Lee, Chan Wan Park; J Korean Fract Soc 2005;18(4):410-414. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.410

Abstract PDF

PURPOSE
To evaluate the effectiveness of a mini T-plate fixation in clavicle lateral end fractures.
MATERIALS AND METHODS
We reviewed eleven cases of calvicle lateral end fracture which were treated with open reduction and internal fixion with mini T-plate from May 2000 to December 2004. The follow up period was 12 months minimum. The radiologic result, pain and shoulder function were evaluated by the ASES shoulder score.
RESULTS
All cases showed satisfactory results. Seven cases (63%) were excellent, and four (37%) cases were good. There were no fair or poor results. All cases showed radiologic union by the fifteenth week. No complications such as metal breakage, limited motion, infections were seen.
CONCLUSION
This study demonstrates that using a mini T-plate fixation which is easy and induces no injury of acromiocalvicular joint, contributes to provide stable fixation in clavicle lateral end fractures.

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Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome
Seong Cheol Moon, Chul Hee Lee, Jong Hoon Baek, Nam Su Cho, Yong Girl Rhee
Journal of the Korean Fracture Society.2014; 27(2): 127. CrossRef
The Surgical Outcomes of Clavicle Lateral End Fractures Fixed with the Oblique T Locking Compession Plate
Seung-Oh Nam, Young-Soo Byun, Dong-Ju Shin, Jung-Hoon Shin, Chung-Yeol Lee, Tae-Gyun Kim
Journal of the Korean Fracture Society.2011; 24(1): 41. CrossRef
Comparison of Results of Tension Band Wire and Hook Plate in the Treatment of Unstable Fractures of the Distal Clavicle
Chul-Hyun Park, Oog-Jin Shon, Jae-Sung Seo
Journal of the Korean Fracture Society.2011; 24(1): 55. CrossRef

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Effect of Alternative Splinting at Extension and 90degrees Flexion on Range of Motion after Open Reduction and Internal Fixation of Distal Femur Fracture: Chong Kwan Kim, Jong Ho Yoon, Byung Woo Ahn, Chin Woo Jin, Dong Wook Kim, Young Il Kwan, Young Ho Lee; J Korean Fract Soc 2005;18(2):144-148. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.144

Abstract PDF

PURPOSE
To evaluate the usefulness of early range of motion exercise by using 90degrees knee flexion splint after open reduction and internal fixation in fracture of distal femur.
MATERIALS AND METHODS
We reviewed twenty-six cases of distal femur fractures which were treated with open reduction and internal fixation from February 2002 to November 2003. One group (group A) were treated by using 30degrees knee flexion splint, the other group (group B) were treated by using 90degrees flexion and full extension splint alternativley by post-operative 1 week. The follow up period was minimally 12 months. The range of motion and Schatzker and Lambert criteria were evaluated.
RESULTS
The mean period to gain 90degrees knee flexion was 11.4 (7~14) weeks in group A, and 6.6 (3~8) weeks in group B. Mean range of motion was 94.7degrees (average flexion contracture 9.5degrees ) in A group and 108.7degrees (average flexion contracture 6.3degrees ) in B group at 12 weeks follow-up. According to Schatzker and Lambert criteria, excellent result was achieved in 10 cases (38%), good result in 13 cases (50%), fair result in 3 cases (12%).
CONCLUSION
This study demonstrates that alternative splinting at extension and 90degrees flexion contribute to early recovery of range of motion in distal femur fractures treated with internal fixation.

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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

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Intramedullary K-wire Fixation for Displaced Fracture of Distal Radius: Byung Woo Ahn, Chong Kwan Kim, Jong Youl Lee, Chae Ik Chung, Jong Ho Yoon, Young Min Kim, Jin Woo Jin, Kang Hoon Kim, Guk Sang Chung, Dong Wook Kim; J Korean Fract Soc 2005;18(1):54-59. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.54

Abstract PDF: PURPOSE
To evaluate indications and effectiveness of intramedullary K-wire fixation for distal radial fractures.
MATERIALS AND METHODS
Twenty one fractures of distal radius treated with intramedullary K-wire fixation from April 2001 to September 2002 were evaluated. The mean age was 67.8(range 46~82). Severely comminuted intra-articular fractures and Barton's fractures were excluded. One or two K-wires were added percutaneously. To assess the functional result, we used Green and O'Brien score system. The radiographic assessment included a scoring system based on measurements of radial length, radial inclination, volar tilt and step-off of the radial articular surface.
RESULTS
Average follow up period was 13.5 months. In functional result, excellent and good result were obtained in 18 cases (86%). In radiologic result, mean loss of radial length, radial inclination and volar tilt were 0.9 mm, 1.4degrees, 0.9degrees, respectively.
CONCLUSION
The advantages of intramedullary K-wire fixation were relatively simple procedure, low occurrence of soft tissue complications and early wrist motion. Intramedullary K-wire fixation was good to maintaining reduction in osteoporotic bone.

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Surgical and Conservative Treatment of Acetabular Fractures: Chong Kwan Kim, Byung Woo Ahn, Saeng Guk Lee, Jae Ik Chung, Jin Woo Jin, Kwon Ho Kim, Kang Hoon Kim; J Korean Soc Fract 2003;16(3):309-318. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.309

Abstract PDF

PURPOSE
Fractures of the acetabulum remain a major challenge to the orthopedic surgeons. Although the operative treatment for the complex fractures is preferred, inaccurate reduction and then incongruity of the hip joint lead to serious complication such as premature osteoarthritis. We evaluated the results of surgical and conservative treatment for acetabular fractures.
MATERIALS AND METHODS
From January 1996 to March 2001, we reviewed 55 cases retrospectively. Posterior wall fracture (13 cases) was the most common by Letournel's classification and followed by both column fracture (10 cases). Causes of injuries included 41 cases of traffic accident and 8 cases of falling down. We divided the cases into an operation group (28 cases) and conservative group (27 cases) and evaluated the results as excellent, good, fair or poor according to Matta's clinical and radiological grade criteria.
RESULTS
Anatomical or satisfactory reduction was obtained in 22 cases of operative group and clinical results were excellent in 7 cases, good in 13 cases. Conservative group revealed excellent and good clinical results in 15 of 27 cases.
CONCLUSION
In cases of the displaced complex fractures, posterior wall fracture with instability and displaced fractures involving the weight bearing dome of the acetabulum, open reduction and internal fixation after accurate evaluation of the fracture pattern could allow earlier ROM exercise and have the result in better prognosis.

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Clinical Results of Surgical Treatment of Acetabular Fractures according to Quality of Reduction
Sang-Hong Lee, Min-Kyu Shin, Sueng-Hwan Jo
The Journal of the Korean Orthopaedic Association.2007; 42(2): 153. CrossRef

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Treatment of Supracondylar Fracture of the Humerus in Children: by Immediate Closed Reduction & Lateral Percutaneous K-Wire Fixation: Byung Woo Ahn, Chong Kwan Kim, Jeong Hwan Kim, Chae Ik Chung, Jae Kyu Park, Young O Kim, Jong Ho Yoon; J Korean Soc Fract 2001;14(4):753-761. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.753

Abstract PDF: PURPOSE
To analyze children with displaced supracondylar fractures of the humerus that were treated by immediate closed reduction and then maintained by lateral percutaneous K-wire fixation.
MATERIALS AND METHODS
70 cases of supracondylar fractures of the humerus(5 type I, 19 type II, 46 type III) were treated, 14 fractures(5 type I, 7 type II, 2 type III) with cast, 49 fractures(12 type II, 37 type III) with lateral percutaneous pinning, 7 fractures(7 type III) with open reduction and internal fixation. The K-wire were removed after averaging 6.2 weeks of operation in out patient clinic. The follow-up period ranged from 6 months to 28 months, averaging 13 months.
RESULT
By Flynn's functional and cosmetic criteria, 47 fractures(95.9%) among 49 fractures, treated with immediate closed reduction and lateral percutaneous pinning, resulted in satisfactory criteria. Only one fracture was reoperated due to reduction loss.
CONCLUSION
Immediate closed reduction and lateral percutaneous K-wire fixation appears to be safe and reliable option for the treatment of supracondylar fractures of the humerus in children.

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Ankle Fracture with Syndesmosis Separation : Radiographic Landmark and Results of Trans-Syndesmotic Screw Fixation: Chong Kwan Kim, Byung Woo Ahn, Sang Guk Lee, Young Hwan Kim, Chae Ik Chung, Sik Hwang; J Korean Soc Fract 1999;12(4):948-955. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.948

Abstract PDF: In the treatment of ankle f1racture, anatomical reduction and restoration of ankle mortise is very important. But tranf-syndesmotic screw fixation for syndesmosis seperation is dependent on the condition in operation field. The purpose of this study is to analyse the radiographic and clinical relults. to evaluate the need for trans-syndesmotic screw fixaition, and to know the effectiveness of radiogrphic landmarks for diagnofis of the syndesmosis separation, retrospectively. The patients were divided into two groups. The Croup I(25cases) were treated with trant-syndetmotic screw and group II(42 cases) were treated without trans-syndesmotic screw fixation . The clinical results were excellent in 13, good 9 in group I and excellent in 19, good in 17 in group II. The radiographic results were excellent in 6, good in 8 in group I and excellent in 23, good 14 in group II. In the radiographic findings, the false negative result of tibiofibular overlap was 15.6%(M: 20.8%, F: 10.4%), tibiofibular clear space was 16.8%(M: 21.6%, F: 11.9%) and ratio of tibiofibular overlap to fibular width was 14.2%(M: 14.9%, F: 13.6%). There was no siginificant statsitical difference in the ratio of tibiofibular overlap to fibular width between male and female. We consider that the ratio of tibiofibular overlap to tibiofibular width are more reliable diagnostic criteria for syndemosis separation than the tibiofibular overlap and tibiofibular clear space. Trans-syndesmotic tcrew fixation is not alswaya required to maintain the integrity of the tibiofibular syndesmosis if the diastasis was satisfactorily reduced with rigid fixation.

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Ipsilateral Fracture of the Femoral Neck and Shaft: Chong Kwan Kim, Jeong Hwan Kim, Dae Young Kim; J Korean Soc Fract 1998;11(4):738-744. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.738

Abstract PDF: Ipsilateral femoral neck and shaft fractures are uncommon and have difficulty in diagnosis. The injury results from high energy trauma. From January, 1990 to March, 1995, 10 cases of ipsilateral femur neck and shaft fractures had been treated. Follow up period varied from 10 months to 3 years (average 1 year 10 month). The purpose of this study is to evaluate the fracture pattern of neck, complications due to delayed operation, and efficient methods of fixation. The neck fractures were minimally displaced or not displaced in 8 cases. The femur shaft fractures were usually comminuted and located at midshaft. The timing of operation was often determined by the patient's status as a multiple trauma victim, but a delay of days to cases, diagnosis was delayed, but there was no complication, like as avascular necrosis and nonunion. There was one case of nonunion of femur shaft, and which was treated with bone graft. We could not find the difference in complication rate among the fixation methods. Anatomic reduction and stable fixation seem to be more important than the method of fixation and timing of operation.

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Intertrochanteric Fractures of the Femur Treated with 95degree Angled Blade Plate in over 60 years Old patients: Chong Kwan Kim, Dae Young Kim; J Korean Soc Fract 1998;11(4):1001-1010. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.1001

Abstract PDF: Surgical stabilization is the treatment of choice for both stable and unstable intertrochanteric fractures. Unfortunately, the elderly patient has poor quality of bone. Because of osteoporotic bone, management of unstable comminuted fracture is very difficult in reduction and fixation of fracture. Now the sliding compression hip screw is the device used for hip screws have been used widely. these device have most commonly, and also intramedullary hip screws have been used widely. These device have many advantages in the treatment of interrochanteric fracture. But fixation failure occur not uncommonly in osteoporotic comminuted unstable fracture. For the pupose of stable fixation in osteoporotic femur neck and head, we used the 95degree angled blade plate(=condylar plate). We experienced that the blade portion of condylar plate offer a good fixation stability. clinical results were good in 31 cases of intertrochanteric fracture treated with condylar plate. There was no cutting out of head, excessive shortening and excessive varus deformity. Most of all cases, except one, were united within average 4months. We consider that using the condylar plate for osteoporotic unstable intertrochanteric fracture would be another good modality if surgeons have a surgical skill.

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

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

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