Journal of Musculoskeletal Trauma

Avulsion Fractures around the Hip Joint and Pelvis: Ha-Yong Kim, Hajun Jang, Jung-Taek Kim, Jin-Woo Kim, Jun-Il Yoo, Won-Sik Choy, Yonghan Cha; J Korean Fract Soc 2024;37(3):150-157. Published online July 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.3.150

Abstract PDF: Avulsion fractures occur when tendons or ligaments are subjected to forces greater than they can withstand at the apophysis or enthesis, regardless of the fusion status. Given the diverse muscular structures around the pelvis and hip joint, which serve as origins for multiple muscles leading to the lower extremities, these areas are vulnerable to such injuries. Pelvic avulsion fractures commonly af-fect young athletes, but they can also occur in adults. Diagnosis typically involves assessing the trauma history, clinical examination, and radiographic imaging. In cases of unclear diagnosis, additional tests, such as computed tomography or magnetic resonance imaging, may assist in treatment decisions and diagnosis. Although most avulsion fractures respond well to conservative treatment, surgical interven-tion may be preferred in severe displacements, significant retraction in active athletes, or when a faster recovery is necessary. Chronic or neglected injuries may lead to excessive osseous formation around the pelvis, causing impingement syndromes. Recognizing the characteristic radiological findings based on the pelvic anatomy aids in accurate diagnosis because chronic injuries might mimic tumors or infectious conditions, necessitating a careful differential diagnosis.

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Fragility Fractures of the Pelvis and Sacrum: Se-Won Lee, Ju-Yeong Kim; J Korean Fract Soc 2023;36(1):29-38. Published online January 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.1.29

Abstract PDF: The incidence of fragility fractures of the pelvis (FFP) has increased significantly due to the aging popu-lation and improved diagnostic modalities. The evaluation and treatment of these patients differ from that of high-energy pelvic ring injuries typically seen in younger patients. Therefore, it is important to classify the FFP by patterns of the classification system to standardize optimal treatment criteria and appropriate treatment strategy. However, some cases are not classifiable according to the FFP classifi-cation. A newly proposed classification that can be verified by comparing existing FFP classifications is needed to overcome the weak points. Non-operative treatment is usually considered first and should focus on early mobilization. Operative fixation should focus on stabilizing the minimally invasive pelvic ring than the reduction of fractures to facilitate early mobilization and avoid complications that can arise from comorbidities associated with immobility.

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Ankle Fractures in Children: Classification and Treatment: Ha-Yong Kim, Yong-Han Cha, Woo-Suk Kim, Won-Sik Choy; J Korean Fract Soc 2021;34(2):87-95. Published online April 30, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.2.87

Abstract PDF: Pediatric ankle fractures are defined as damage to the metaphysis, epiphyseal plate, and epiphysis of the distal tibia and fibula. Although the injury mechanism could be similar, the fracture patterns and treatment of pediatric ankle fractures are different from those of adults. In children, growth plate injuries are more common with a force that would cause sprains in adults because the ligaments are stronger than the growth plate cartilage in children. In the adolescent period, unique fractures, called “transitional fractures”, occur while the physis is closed. For a diagnosis, plain images of the anteroposterior, lateral, and mortise views are essential. Stress radiographs, ultrasound, and magnetic resonance imaging can be used for suspected ligament injuries. The treatment goal is to restore the articular congruity, normal bony alignment, and preserve the epiphyseal plate to ensure normal growth. Pediatric ankle fractures frequently lead to premature physeal arrest, angular deformities, malunion, and posttraumatic arthritis even after anatomic reduction. Treating surgeons should follow-up children for a sufficient time and explain to the caregiver the possible complications before treatment.

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Risk Factors Affecting the Early Complications of Femoral Head Fractures: HoeJeong Chung, Jin-Woo Lee, Dong Woo Lee, Hoon-Sang Sohn; J Korean Fract Soc 2020;33(4):204-209. Published online October 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.4.204

Abstract PDF: Purpose
This study analyzed the prognostic factors in patients with femoral head fractures by comparing two groups with and without complications.
Materials and Methods
A retrospective study was performed on femoral head fracture patients who visited two different level-1 trauma centers from January 1, 2014 to June 30, 2018. Thirty-three patients with a follow-up period of more than one year were included. Early complications were defined as fair or poor in the Thompson–Epstein clinical evaluation criteria and grades 3 or 4 in the Kellgren– Lawrence classification within one year after the fracture. The patients were divided into two groups, with and without early complications. Statistical analysis was performed for the nominal variables with a Fisher’s exact test and continuous variables using a Mann–Whitney U test.
Results
Nine patients (27.3%) had early complications, and there were no significant differences according to age, sex, treatment method, combined fractures, Pipkin classification, and AO/OTA classification between the two groups.
Conclusion
The prognosis in femoral head fractures is difficult to predict. Therefore, the validation of existing classifications or a new classification is necessary.

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Treatment of Periprosthetic Femoral Fractures after Hip Arthroplasty: Jung Hoon Choi, Jong Hyuk Jeon, Kyung Jae Lee; J Korean Fract Soc 2020;33(1):43-51. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.43

Abstract PDF: Although the incidence of postoperative periprosthetic femoral fractures after hip arthroplasty is expected to increase, these complex fractures are still challenging complications. To obtain optimal results for these fractures, thorough clinical and radiographic evaluation, precise classification, and understanding of modern management principles are mandatory. The Vancouver classification system is a simple, effective, and reproducible method for planning proper treatments of these injuries. The fractures associated with a stable femoral stem can be effectively treated with osteosynthesis, though periprosthetic femoral fractures associated with a loose stem require revision arthroplasty. We describe here the principles of proper treatment for the patients with periprosthetic femoral fractures as well as how to avoid complications.

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Principles for Management of Periprosthetic Acetabular Fractures after Hip Arthroplasty: Chan Woo Park, Hyoung Keun Oh, Woo Suk Lee, Youn Soo Park, Seung Jae Lim; J Korean Fract Soc 2019;32(3):148-156. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.148

Abstract PDF

Periprosthetic acetabular fracture (PAF) is an uncommon complication following hip arthroplasty. However, as the number of people needing hip prostheses continues to rise, the absolute number of PAF is expected to increase as well. These fractures may occur either intraoperatively or postoperatively. Postoperative fractures can be caused by traumatic events or by pathologic conditions related to periacetabular osteolysis. The management of PAF usually depends on the degree of displacement and the stability of the acetabular component. While most of non-displaced fractures can be managed nonoperatively by protected weight bearing, displaced fractures with unstable implants require surgical intervention, which is often technically challenging. This review summarized the latest findings on the epidemiology, the diagnosis, the classification, and the treatment of PAF.

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Treatment of Periprosthetic Femoral Fractures after Hip Arthroplasty
Jung-Hoon Choi, Jong-Hyuk Jeon, Kyung-Jae Lee
Journal of the Korean Fracture Society.2020; 33(1): 43. CrossRef

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Prediction of Concomitant Lateral Meniscus Injury with a Tibia Plateau Fracture Based on Computed Tomography Assessment: Wonchul Choi, Yunseong Choi, Go Tak Kim; J Korean Fract Soc 2018;31(4):132-138. Published online October 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.4.132

Abstract PDF

PURPOSE
This study examined whether any fracture pattern shown in computed tomography (CT) scan is associated with the presence of lateral meniscus (LM) injury in a tibia plateau fracture.
MATERIALS AND METHODS
Fifty-three tibia plateau fractures with both preoperative CT and magnetic resonance imagings (MRI) available were reviewed. The patient demographics, including age, sex, body mass index, and energy level of injury were recorded. The fracture type according to the Schatzker classification, patterns including the lateral plateau depression (LPD), lateral plateau widening (LPW), fracture fragment location, and the number of columns involved were assessed from the CT scans. The presence of a LM injury was determined from the MRI. The differences in the factors between the patients with (Group 1) and without (Group 2) LM injuries were compared and the correlation between the factors and the presence of LM injury was analyzed.
RESULTS
The LM was injured in 23 cases (Group 1, 43.4%) and intact in 30 cases (Group 2, 56.6%). The LPD in Group 1 (average, 8.2 mm; range, 3.0â€“20.0 mm) and Group 2 (average, 3.8 mm; range, 1.4â€“12.1 mm) was significantly different (p < 0.001). The difference in LPW of Group 1 (average, 6.9 mm; range, 1.2â€“15.3 mm) and Group 2 (average, 4.8 mm; range, 1.4â€“9.4 mm) was not significant (p=0.097). The other fracture patterns or demographics were similar between in the two groups. Regression analysis revealed that an increased LPD (p=0.003, odds ratio [OR]=2.12) and LPW (p=0.048, OR=1.23) were significantly related to the presence of a LM tear.
CONCLUSION
LPD and LPW measured from the CT scans were associated with an increased risk of concomitant LM injury in tibia plateau fractures. If such fracture patterns exist, concomitant LM injury should be considered and an MRI may be beneficial for an accurate diagnosis and effective treatment.

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The value of magnetic resonance imaging in the preoperative diagnosis of tibial plateau fractures: a systematic literature review
Gregoire Thürig, Alexander Korthaus, Karl-Heinz Frosch, Matthias Krause
European Journal of Trauma and Emergency Surgery.2023; 49(2): 661. CrossRef

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Fixation of the Greater Trochanter in Arthroplasty for Unstable Intertrochnateric Fracture: Dong Hyeok Choi, Ju Yeong Heo, Young Jae Jang, Young Yool Chung; J Korean Fract Soc 2014;27(1):58-64. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.58

Abstract PDF

PURPOSE
We classified fractures of the greater trochanter (GT) and evaluated fracture fragment stability according to GT type.
MATERIALS AND METHODS
A total of 43 patients with an unstable intertrochanteric fracture treated between January 2007 and July 2009 with bipolar hemiarthroplasty were included in this study. GT fractures were classified as type A, B, C, or D and fixed using either cerclage wiring alone, cerclage wiring and non-absorbable suture or a greater trochanteric reattachment (GTR) plate.
RESULTS
Type A fractures were fixed using cerclage wiring with non-absorbable suture in two cases, cerclage wiring in six cases and GTR plate in seven cases. Failure occurred in three cases of type A fractures treated with cerclage wiring alone. A total of 11 type B fractures were fixed with cerclage wiring (7), cerclage wiring and non-absorbable suture (3) and GTR plate (1). There was no failure of type B fractures. Type C fractures were fixed using cerclage wiring with non-absorbable suture in one case and GTR plate in three. There was no fixation in three cases. Of 10 type D fractures, six were treated with cerclage wiring and one with GTR plate. Fixation was not performed in three patients. There was no failure in type C and D type fractures.
CONCLUSION
Fracture fragment stability differed according to fracture types. Cerclage wiring alone was insufficient to fix type A fractures, so type A fracture required a stronger fixation method.

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Primary Arthroplasty for Unstable and Failed Intertrochanteric Fractures: Role of Multi-Planar Trochanteric Wiring Technique
Javahir A. Pachore, Vikram Indrajit Shah, Sachin Upadhyay, Shrikunj Babulal Patel
Hip & Pelvis.2023; 35(2): 108. CrossRef
The Efficacy of Suture Fixation of the Greater Trochanter in Unstable Intertrochanteric Fractures
Ki-Choul Kim, Hee-Gon Park, Jae-Wook Park
Clinics in Orthopedic Surgery.2021; 13(4): 468. CrossRef
Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?
Kee Haeng Lee, Dong Hun Lee, Jong Ho Noh, Yoon Vin Kim
Orthopaedics & Traumatology: Surgery & Research.2019; 105(1): 41. CrossRef
Selecting Arthroplasty Fixation Approach Based on Greater Trochanter Fracture Type in Unstable Intertrochanteric Fractures
Min-Wook Kim, Young-Yool Chung, Sung-an Lim, Seung-Woo Shim
Hip & Pelvis.2019; 31(3): 144. CrossRef

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Analysis of Risk Factors for the Posterolateral Articular Depression and Status of Posterolateral Fragment in Lateral Condylar and Bicondylar Tibial Plateau Fractures with Joint Depression: Jung Yun Choi, Yong Woon Shin, Beom Jung Lee; J Korean Fract Soc 2013;26(4):241-247. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.241

Abstract PDF

PURPOSE
To evaluate risk factors of posterolateral articular depression and characteristics of the posterolateral fragment in lateral condylar and bicondylar tibial plateau fractures with joint depression.
MATERIALS AND METHODS
We reviewed 48 patients of Schatzker type II and type V (type II 34, type V 14) and evaluated risk factors of posterolateral articular depression according to the posterolateral fragment, fibular fracture, and Schatzker classification. We evaluated the position of articular depression and anterolateral fracture line of the posterolateral fragment and measured anterior to posterior lengths of the posterolateral fragment.
RESULTS
Posterolateral articular depression was found in 20 of 34 cases (59%) with coexisting posterolateral fragment and in 16 of 21 cases (76%) with coexisting fibular fracture. There was a significant difference in the occurrence of posterolateral articular depression with the existence of the posterolateral fragment and fibular fracture (p<0.001). Multivariate regression analysis revealed that fibular fracture increased the occurrence of posterolateral articular depression (odds ratio 24.5, 95% confidence interval 2.2-267.2). Fifty-seven percentage of the anterolateral fracture line of the posterolateral fragment existed posterior to the anterior margin of the fibular head.
CONCLUSION
This study showed that fibular fracture affects posterolateral articular depression in Schatzker type II and V tibial plateau fractures. Selecting a fixation device and performing fracture reduction requires a careful consideration since the anterolateral fracture line of the posterolateral fragment exists posterior to the anterior margin of the fibular head.

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

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Evaluation of the Patterns of Fractures and the Soft Tissue Injury Using MRI in Tibial Plateau Fractures: Ji Yong Chun, Hee Gon Park, Sung Su Hwang; J Korean Fract Soc 2007;20(4):302-308. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.302

Abstract PDF

PURPOSE
To compare information about fracture type in MRI with simple radiograph in tibial plateau fractures and evaluate tibial plateau fractures type and accompanying soft tissue injury, and evaluate usefulness of MRI in tibial plateau fractures.
MATERIALS AND METHODS
Compared MRI with simple radiograph about Schatzker classification, depression of articular surface and displacement of bone fragment from the 68 examples who checked MRI and we evaluated soft tissue injury around knee joint.
RESULTS
There were 7 examples of Schatzker type change after MRI check. Average depression of articular surface in simple radiograph was 2.93 mm and 4.28 mm in MRI. It increased by 1.35 mm and it was meaningful statistically (p<0.05). There was no significant difference between MRI and simple radiograph of displaced bone fragment (p=0.168). There were 58 (85.3%) cases of soft tissue injury in MRI.
CONCLUSION
MRI can find additional fracture line or articular depression that can't be found in simple radiograph and gives more information about articular depression and soft tissue that is useful in surgical plans. I think preoperative MRI is necessary to better treatment of fracture & treatment of periarticular soft tissue injury in tibial plateau fracture.

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The Use of Fresh Frozen Allogenic Bone Graft in the Impacted Tibial Plateau Fractures
Yeung Jin Kim, Soo Uk Chae, Jung Hwan Yang, Ji Wan Lee, Dae Han Wi, Duk Hwa Choi
Journal of the Korean Fracture Society.2010; 23(1): 26. CrossRef

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The Efficacy of the Treatment of Thoracolumbar Spine Fractures with Short-segment Posterior Instrumentation and Fusion: Hwa Yeop Na, Joon Cheol Choi, Jun Won Choi, Sang Ho Lee, Young Sang Lee, Woo Sung Kim, Sang Yoon Lee, Jong Won Won, Sang Ho Han; J Korean Fract Soc 2006;19(2):241-246. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.241

Abstract

PURPOSE
To evaluate the safety and usefulness of the short-segment posterior instrumentation and fusion in the treatment of thoracolumbar spine fractures.
MATERIALS AND METHODS
Forty-two patients were treated by short-segment pedicle screw instrumentation and fusion between Oct. 1998. and Jan. 2004 by single surgeon. All patients were treated posteriorly and all the pedicle screws are monoaxial. Intraoperative rod bending and fixation technique was used to reduce the collapsed vertebral body and correct the kyphotic angle. The follow up duration is mean 2.1 year (1~6 year). The mean age is 40.2 year (18~60 year) old. The fractures were classified by Denis' classification and Load-Sharing Classification. Preoperative and postoperative changes of kyphotic angle and vertebral body height were measured. Denis' Pain Score and Work scales, Frankel neurologic grade were obtained during follow-up evaluation for patients.
RESULTS
All the cases got solid bony union. Mean Load-Sharing Score was 7.3. Clinical results were good. The mean kyphotic angle was preoperatively 14.5 degree, immediate postoperatively 7.5 degree, and last follow up 9.2 degree. The mean anterior vertebral heights s were 60.8% preoperatively, 83.4% immediate postoperatively, and 79.5% last follow up. There was only one case of screw breakage but no revision operation due to loss of reduction. All the cases showed satisfactory clinical results.
CONCLUSION
This study suggest that short-segment instrumentation and fusion using pedicle screw system for thoracolumbar spine fractures could lead to good results, if comminution of vertebral body is considered in the selection of approach.

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Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures
Jin Young Han, Ki Youn Kwon
Journal of the Korean Fracture Society.2020; 33(1): 1. CrossRef

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The Reliability of Proximal Femoral Shaft Fracture Classification: Sang Wook Lee, Sang Bong Ko, Myung Rae Cho, Ho Hyoung Lee; J Korean Fract Soc 2006;19(1):6-10. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.6

Abstract: PURPOSE
The Garden classification by which femur neck fracture is classified and the Boyd-Griffin classification by which trochanteric fracture is classified are studied on the reproducibility, repeatability, interobserver's and intraobserver's reliability and then reliability.
MATERIALS AND METHODS
56 cases in femoral neck fracture and 60 cases in trochanteric fracture who were operated from May 1999 to December 2003 were classified by three observers who are hip surgeon, orthopaedic surgeon and senior residentship doctors three times. Femur neck fracture was classified by Garden's method which used commonly and trochanteric fracture was classified by Boyd-Griffin method which is classified by the pattern of fracture and degree of comminution. We got the interobserver's and intraobserver's Kappa score using the Stata 7.0 statistically. The statistical analysis was made by Stata 7.0.
RESULTS
Garden classification in femur neck fracture showed moderate agreement in intraobserver reliability and fair agreement in interobserver reliability. Boyd-Griffin classification in trochanteric fracture showed substantial agreement in intraobserver reliability and moderate agreement in interobserver reliability.
CONCLUSION
Boyd-Griffin classification showed over moderate agreement but Garden classification showed fair agreement, so using Garden classification in femur neck fracture has some problem in reliability and application.

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Evaluation of Rotational Displacement of the Posterior Facet on the Sagittal Plane in Computed Tomographic Images of Calcaneal Fractures: Su Young Bae, Yi Kyoung Shin, Jong Oh Kim, Jung Hee Lee, Churl Woo Lee, Jae Hung Shin; J Korean Fract Soc 2005;18(2):165-169. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.165

Abstract PDF

PURPOSE
To find out whether or not the computed tomographic (CT) classification systems of the calcaneal fracture are efficient in illuminating displaced posterior facet fragment and the degree of displacement can be evaluated by analyzing serial CT images.
MATERIALS AND METHODS
Seventy-seven hundred calcaneal fractures were classified by CT classification systems including Sanders classification, and the sagittal rotation angle of the posteior facet fragment was measured on the plain lateral radiograph. Among the serial axial CT images, a number of images with the cortical bone embedded in the cancellous portion were recorded and any significant relationship between each data were evaluated.
RESULTS
The conventional CT classification systems are rather insufficient in illuminating the extent of sagittal rotatory displacement. However, the number of CT images in which the cortical radiodensity was observed showed a significantly related with the degree of displacement.
CONCLUSION
The conventional CT classification of the calcaneal fractures is unsatisfactory in expressing the degree of sagittal rotatory displacement of the posterior facet fragment; this problem may be alleviated by observing the number of axial CT images in which cortical radiodensity was revealed within the calcaneal body.

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Tricortical-allobone Grafting in Screw Fixation for Intra-articular Calcaneal Fracture via Ollier Approach
Taejung Bang, Su-Young Bae, Seung Hun Woo, Hyung-Jin Chung
Journal of Korean Foot and Ankle Society.2017; 21(1): 27. CrossRef
The Effect of Temporary K-wire Fixation in the Plate Fixation for Displaced Intra-articular Calcaneal Fracture
Kiwon Young, Jin Su Kim, Jinseon Moon
Journal of Korean Foot and Ankle Society.2014; 18(3): 119. CrossRef

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Treatment of Peterson classification Type VI of Physeal Injury in Ankle Joint: 2 cases report: Byung Il Lim, Tai Seung Kim, Kuhn sung Whang, Il Hoon Sung; J Korean Soc Fract 2000;13(4):1061-1066. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1061

Abstract PDF

Peterson classification type VI, which has been reported newly on physeal injury classification, is defined as partial missing of the metaphysis and epiphysis with a portion of the physis. It has not been reported in the Republic of Korea to our knowledge. Because this is an open fracture, immediate surgery is needed in all cases. Angular deformity and leg length discrepancy occurs as a result of the formation of the physeal bar. Additional reconstuctive operation, therefore, should be necessary. We report two cases of Peterson classification type VI, both cases were open fracture at the level of ankle joint owing to pedestrian traffic accident. In our experience, Peterson classification type VI required multiple operations because progression of angular deformity with growth, and must be followed up until maturity.

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Changes in Oxygen Saturation and Walk in Relation to Smoking and Types of Shoes
Jea-Cheol Park, Jong-Man Han, Woon-Soo Cho, Yong-Nam Kim
The Journal of Korean Physical Therapy.2015; 27(1): 55. CrossRef

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The Treatment of Danis-Weber Type B Fractures of the Distal Fibula by Multiple Kirschner Wires Fixation: Ho Yoon Kwak, Baik Young Song, Sang Wook Bae, Nam Hong Choi, Jin Young Kim; J Korean Soc Fract 2000;13(3):529-536. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.529

Abstract PDF

PURPOSE
To evaluate the accuracy of reduction and stability of fixation according to different methods of internal fixation for the Danis-Weber classification type B fractures of the distal fibula. MATERIAL AND METHODS: Seventy-three cases with follow up of average 13 months were divided into three groups: plate fixation(Group I, 36), more than two lag screws fixation (Group II, 13) and multiple K wires fixation with less than one lag screw(Group III, 24). We measured the bimalleolar angle and axial displacement of the fracture ends for radiographic evaluation, and used the Meyer's classification for clinical evaluation.
RESULTS
There was significant difference of postoperative fibular shortening between group I(0.44mm) and III(0.17mm) on the anteroposterior view(p=0.003), but no difference of it on the lateral view. The changes of bimalleolar angle and the increment of fibular shortening showed no significant difference among three groups.
CONCLUSION
Multiple K wires fixation combined with less than one lag screw for Danis-Weber type B fractures of distal fibula demonstrated that it provides accurate reduction and stable internal fixation.

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Posterior Plating in Distal Fibular Fracture
Choong-Hyeok Choi, Young-A Cho, Jae-Hoon Kim, Il-Hoon Sung
Journal of the Korean Fracture Society.2007; 20(2): 161. CrossRef

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Non-operative Treatment of Fracture of Distal Radius in Adults: Sang Won Park, Ki Hoon Kang, Ki Hong Lee; J Korean Soc Fract 1999;12(1):153-161. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.153

Abstract PDF: The authors analysed ninety-five cases of fracture of distal radius in adults with non-operative treatment followed for more than one year at Korea University Hospital from January 1991 to December 1996 to evaluate the clinical results according to the types of fracture by Fernandez classification and the methods of non-operative treatment. The results obtained were as follows ; 1. Methods of treatment were closed reduction and cast immobilization in 51 cases(53.7%) and closed reduction and percutaneous pinning in 44 cases(46.3%). 2. In a group treated with closed reduction and cast immobilization, the results of subjective evaluation were excellent in 3.9%, good in 47.1%, fair in 45.1% and poor in 3.9%, and the results of objective evaluation were good in 42.8%, fair in 36.5%, and poor in 20.7%. 3. In a group treated with closed reduction and percutaneous pinning, the results of subjective evaluation were excellent in 6.8%, good in 54.5%, fair in 29.5% and poor in 9.2%, and the results of objective evaluation were excellent in 15%, good in 46.6%, fair in 35%, and poor in 3.4%. 4. The results of subjective evaluation according to fracture type were excellent and good in 91.3% of type I, 42.1% of type II, and 10% of type III, and the results of objective evaluation were excellent and good in 78.3% of type I, 52.6% of type II, and 3.5% of type III. 5. The results of subjective and objective evaluation were not satisfactory in patients older than seventy years old. Above results suggest that the clinical results of non-operative treatment were not satisfactory in type III, therefore external fixation or operative treatment is recommended.

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Non-operative Treatment of Fracture of Distal Radius in Adults: Sang Won Park, Ki Hoon Kang, Ki Hong Lee; J Korean Soc Fract 1999;12(1):145-152. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.145

Abstract PDF: The authors analysed ninety-five cases of fracture of distal radius in adults with non-operative treatment followed for more than one year at Korea University Hospital from January 1991 to December 1996 to evaluate the clinical results according to the types of fracture by Fernandez classification and the methods of non-operative treatment. The results obtained were as follows ; 1. Methods of treatment were closed reduction and cast immobilization in 51 cases(53.7%) and closed reduction and percutaneous pinning in 44 cases(46.3%). 2. In a group treated with closed reduction and cast immobilization, the results of subjective evaluation were excellent in 3.9%, good in 47.1%, fair in 45.1% and poor in 3.9%, and the results of objective evaluation were good in 42.8%, fair in 36.5%, and poor in 20.7%. 3. In a group treated with closed reduction and percutaneous pinning, the results of subjective evaluation were excellent in 6.8%, good in 54.5%, fair in 29.5% and poor in 9.2%, and the results of objective evaluation were excellent in 15%, good in 46.6%, fair in 35%, and poor in 3.4%. 4. The results of subjective evaluation according to fracture type were excellent and good in 91.3% of type I, 42.1% of type II, and 10% of type III, and the results of objective evaluation were excellent and good in 78.3% of type I, 52.6% of type II, and 3.5% of type III. 5. The results of subjective and objective evaluation were not satisfactory in patients older than seventy years old. Above results suggest that the clinical results of non-operative treatment were not satisfactory in type III, therefore external fixation or operative treatment is recommended.

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Radiological Findings and Classification of the Acetabular Fractures: Woo Shin Cho; J Korean Soc Fract 1997;10(3):458-464. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.458

Abstract PDF: Correct classification based on the accurate radiological evaluation is the keypoint in proper management of the acetabular fracture. Interpretation of the radiologic features of the acetabular fracture requires understanding of the relationship between radiologic landmarks and anatomic structures composing acetabulum. The standard radiographic views include acetabular A-P, iliac oblique and obturator oblique views. CT is mandatory for evaluation and provides more accurate informations, such as size and location of the fragment, joint impaction, intraarticular fragment, comminution, dislocation of the femoral head and sacroiliac joint involvement. Combined interpretation of the standard radiographic views and CT is essential. Tomography and 3-D CT provide additional information. Two representative classification systems of the acetabular fracture are Judet and Leteurnal classification and comprehensive classification of AO. Judet and Letpurnal focused on anatomic two columns and two walls, and devided the acetabular fracture into five elementary and five associated fracture types. The elementary fracture types are basically two part and the associated fractures are combination of at least two elementary types and so, they are three or four part fractures. Comprehensive classification system is based on Judet and Letournal classification and follows skeletal AO classification system. It is apprehensive, logic, universal and easy to computerize. Besides, it shows fracture personality which is important prognostic factors. Type A represnets single wall or column fractures, type B tran,iverse oriented fractures, and type C complete articular fracture, namely floating acetaoulum. The sequence in groups under the type is correlated with the prognosis but not always in types.

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The Classiflcation and Management of Intraarticular Calcaneal Fracture Based on Computed Tomography: Jae lk Shim, Taik Seon Kim, Sung Jong Lee, Suck Ha Lee, Chang Moo You, Young Bae Kim; J Korean Soc Fract 1996;9(3):742-749. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.742

Abstract PDF

Displaced intraarticular fractures of the calaneus require operative intervention to restore the anatomy of the bone, which in turn is the requirement for recovery of subtalar joint mobility. To evaluate the complex contour of calcaneal anatomy, a classification for intraarticular calcaneal fractures was used, based on standardized coronal and transverse computed tomography scans of os calsis. From January 1993 to December 1994, intraarticular calcaneal fractures of 47 cases treated in Korea Veterans Hospital were analysed preoperatively with C.T. scan and classified by Sandersclassification system. And clinical evaluation of the patients was done by Maryland Foot Score postoperatively. The result were as follows:Type I fractures were found in 10 cases. 25 cases of 47 cases were classified as type II and subdivided as II A in 13 cases, II B in 6 cases, II C in 6 cases. Type III fractures were found in 8 cases and subdivied as III AB in 4 cases, III BC in 3 cases, III AC in 1 case. Type IV fractures were found in 4 cases. This classification aids a surgeon to make perioperative decision, because it has prognostic significance.

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Surgical Outcome of Stable Scaphoid Nonunion without Bone Graft
Eun Sun Moon, Myung Sun Kim, Il Kyu Kong, Min Sun Choi
Journal of the Korean Fracture Society.2010; 23(1): 69. CrossRef
The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures
Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Sueng Hwan Jo
Journal of the Korean Fracture Society.2007; 20(3): 227. CrossRef

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Classification of Femoral Neck Fractures: Soo Ho Lee, Ewy Ryong Chung, Hyung Sun Ahn, Jae Suk Chang, Key Yong Kim; J Korean Soc Fract 1996;9(1):88-96. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.88

Abstract PDF: The authors have reviewed 45 cases of femoral neck fractures from January 1991 to September 1994 with special reference to fracture classification. Follow-up periods for these cases were more than 1 year for all of these cases. The results were as follows: 1. AO classification of femoral neck fractures is better than Garden's classification in its simplicity and less inter-observer variations. 2. AO classification of femoral neck fractures is better than Garden's classification in predicting healing complications of internal fixation of femoral neck fractures. 3. Another factors predicting healing complications are the accuracy of reduction and the postoperative bone scintigraphy. With the above results, we concluded that AO classification of femoral neck fractures seems to be useful in clinical application to femoral neck fractures together with Garden's classification.

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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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A Clinical Experience of Surgical Treatment for Type C of AO Classification of Supracondylar Fractures of the Femur: Yung Khee Chung, Jung Han Yoo, Myung Ryool Park, Baek Yong Song, Yong Wook Park, Jun Tae Kim; J Korean Soc Fract 1995;8(1):22-30. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.22

Abstract PDF: The treatment of supracondylar fractures of the femur remains many problem because of its complications. Particularly, the type C fracture of AO classification causes the traumatic arthritis, limitation of motion, shortening, as well as angular deformity, especially varus. In the past, there has been a reluctance toward treatment of supracondylar fractures of the frmur with internal fixation. But, recently, a trend toward internal fixation has become evident and good results has been reported by several authors. We studied 9 cases of type C of AO classification of supracondylar fracture of the femur at our hospital from January,1989 to February, 1993. The longest follow up was 49 months and the shortest was 12 months, the average being 22.2 months And the results were as follows 1. Age distribution was between 29 and 60 years old, and the ratio between male and females was 5:4. The most common cause of injury was traffic accident. 2. Seven patients were associated with injuries of other parts and the most frequent associated fracture was patellar fracture and the most common associated injury was cerebral contusion. 3. The average time of clincal union was 22 weeks in operative treatment and 13 weeks in conserv alive treatment. 4. In type C AO classification, 6 out of 9 cases treated by anatomical reduction and early motion achieved good to excellent results(50%), but all type C3 fractures is healed in slightly varus position. 5. In conclusion, type C3 of the supracondylar fracture of femur should be reduced to the neutral or slightly valgus position, or the ends of distal cancellous screws should be penetrated the medial femoral cortex because of progressing varus deformity after operation.

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A clinical study of ankle fractures: In Hwan Jeong, Jeong Hwan Oh, Eui Hwan Ahn, Kyung Jong Ham; J Korean Soc Fract 1991;4(2):347-355. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.347

Abstract PDF: No abstract available.

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A clinical study of ankle fracture: Kwang Jin Rhee, Deuk Soo Hwang, Young Ahn Jin; J Korean Soc Fract 1991;4(1):63-74. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.63

Abstract PDF: No abstract available.

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Treatment of the Proximal Humeral Fractures: Se Il Suk, Sang Hoon Lee, In Joon Kim, Min Jong Park; J Korean Soc Fract 1989;2(1):1-8. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.1

Abstract PDF: Thirty-four patients with proximal humeral fratures were treated at department of orthopedic surgery, college of medicine, Seoul National University between 1978 and March, 19 99. They were followed up between six months and three and half years with average of 1.2 years. Mean age was 52.9 years and traffic accidents was the most common cause of injury. According to the Neers classification, there were seven one-part(20%), sixteen two-part(48%), seven three-part(20%) and four four-part(12%) fractures or fracture-dislocations. The methods of treatment and its results were analyzed according to the Neers classificatioin and they were summarized as follows; 1. Seven one-part fractures were treated conservatively and showed satisfactory results in all. 2. Sixteen two-part fractures were treated conservatively except tow old cases and showed satisfactory results except one. 3. Seven three-part fractures were tried to be reduced by closed means but unacceptable five cases were treated by open reduction. They showed satisfactory results except one. 4. Four four-part fractures were treated by open reduction in two, by prosthesis in headsplitting and severely comminuted cases. They showed satisfactory results except one.

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