Journal of Musculoskeletal Trauma

Use of Miniplate for Severe Comminuted Metadiaphyseal Fractures of the Distal Radius: Jong Ryoon Baek, Yong Cheol Yoon, Seung Hyun Baek; J Korean Fract Soc 2019;32(4):204-210. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.204

Abstract PDF: PURPOSE
This study investigated the clinical and radiological outcomes of patients undergoing provisional fixation in conjunction with locking plate fixation. Miniplates were used as the reduction plates for the surgical treatment of severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius.
MATERIALS AND METHODS
The radial length, radial inclination, volar tilt, and radial intra-articular step-off were measured preoperatively, postoperatively, and at one year after surgery in 12 patients (eight males, four females, mean age 55.4 years old). The patients underwent volar locking plate fixation with miniplate as a reduction plate for severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius. Clinical evaluations were conducted using the modified Mayo wrist score (MMWS).
RESULTS
Bone union was achieved in all cases. The mean MMWS was 81.8 points, including two excellent, three good, and seven fair cases. Radiological improvements were observed in the average radial length (preoperative, 6.4 mm; postoperative, 11.8 mm), average radial inclination (10.2Â° to 22.4Â°), average volar tilt (âˆ’4.5Â° to 10.6Â°), and average radial intra-articular step-off (4.8â€“0.8 mm) (all, p<0.05). Radiographic measurements obtained immediately after surgery and at the final follow-up revealed insignificant decreases in radial length (0.6 mm), radial inclination (0.4Â°), and volar tilt (0.9Â°) (all, p>0.05).
CONCLUSION
Miniplate fixation can be an effective treatment option as a reduction plate for the treatment of distal radial fractures, which is challenging to reduce and maintain due to severely comminuted metadiaphysis fractures with the intra-articular fracture.

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Comparison of the Treatment Results between Reduction with Percutaneous Wiring and Reduction without Percutaneous Wiring in Reverse Oblique Trochanteric Fractures (AO Classification 31-A3.3): Jae Woo Park, Oog Jin Shon, Seung Wan Lim; J Korean Fract Soc 2017;30(4):192-197. Published online October 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.4.192

Abstract PDF: PURPOSE
The aim of this study was to investigate the utility of percutaneous wiring in the reduction of reverse oblique trochanteric fractures (AO classification 31-A3.3) by analyzing the treatment results with or without the use of percutaneous wiring.
MATERIALS AND METHODS
Thirty-five cases from January 2008 to August 2014 that could be followed-up for at least one year were selected among patients with unstable trochanteric fractures who underwent either internal fixation or open reduction. Seventeen patients underwent surgery with percutaneous wire fixation but another 18 patients underwent surgery without it. All patients received a closed reduction and internal fixation with an intramedullary nail. The factors evaluated were as follows: the length of operation, loss of blood, length of in-hospital stay, lower limb function scale, return to preinjury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, time taken for bone attachment, quality of post-operative reduction, and complications.
RESULTS
No significant difference in the mean operative time, loss of blood, length of in hospital stay, lower limb function scale, return to pre-injury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, and quality of postoperative reduction was observed between the two groups. A significant difference was noted in the time taken for bone attachment (p=0.032). Bone attachment took 13.3 weeks (9â€“17 weeks) on average when fixed with percutaneous wiring and no patient was found to have any complications. When treated without percutaneous wiring, however, bone attachment took 17.8 weeks (12.5â€“28.0 weeks) on average and three cases resulted in delayed union.
CONCLUSION
Percutaneous wiring is a recommended treatment option for patients with an unstable trochanteric fracture.

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Use of Composite Wiring on Surgical Treatments of Clavicle Shaft Fractures: Kyung Chul Kim, In Hyeok Rhyou, Ji Ho Lee, Kee Baek Ahn, Sung Chul Moon; J Korean Fract Soc 2016;29(3):185-191. Published online July 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.3.185

Abstract PDF: PURPOSE
To introduce the technique of reducing displaced or comminuted clavicle shaft fracture using composite wiring and report the clinical results.
MATERIALS AND METHODS
Between March 2006 and December 2013, 31 consecutive displaced clavicle fractures (Edinburgh classification 2B) treated by anatomic reduction and internal fixation using composite wiring and plates were retrospectively evaluated. The fracture fragments were anatomically reduced and fixed with composite-wiring. An additional plate was applied. Radiographic assessments for the numbers of fragments, size of each fragment and amount of shortening and displacement were performed. The duration for fracture union and complications were investigated retrospectively. The mean fallow-up duration was 15.9 months.
RESULTS
The mean number of fragments was 1.7 (1-3) and the mean width of fracture fragment was 7.1 mm (4.5-10.6 mm). The mean shortening of the clavicle was 20.5 mm (10.3-36.2 mm). The mean number of composite wires used in fixation was 1.9 (1-3). Radiographic union was achieved in all patients with a mean time to union of 11.6 weeks. There were no complications including metal failure, pin migration, nonunion, or infection.
CONCLUSION
The composite wiring was suitable for fixation of small fracture fragment and did not interfere with the union, indicating that it is useful for treatment of clavicle shaft fracture.

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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; J Korean Fract Soc 2014;27(3):206-212. Published online July 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.3.206

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the results of tension band wiring and additional circumferential wiring in treatment of comminuted patella fractures.
MATERIALS AND METHODS
A retrospective study of 67 patients with follow-up period longer than six months who underwent tension band wiring and additional circumferential wiring for comminuted patellar fracture from January 2004 to December 2012 was conducted. Analysis was based on radiological evaluation of bony union and articular surface displacement, and clinically by evaluating the postoperative function of the knee joint using the Levack scoring system.
RESULTS
Only one case out of 67 (1.5%) showed nonunion without metal breakage while good bone union was achieved in all other cases. Excluding the nonunion case, range of motion was 90 degrees minimum, 135 maximum, 129 on average. Average displacement was less than 2 mm, and 64 out of 67 cases showed satisfactory outcome with excellent functional score according to the Levack scoring system.
CONCLUSION
Tension band wiring and additional circumferential wiring technique for treatment of comminuted patella fractures can be considered as an effective treatment for achievement of good bone union and restoration of normal knee function.

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A Novel Technique in Comminuted Patella Fractures: Minimally Invasive Pericerclage Osteosynthesis Using Drainage Trocar
Fırat Fidan, Abdülkadir Polat, Cengiz Kazdal, Emre Bal
Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy.2022; 18(4): 427. CrossRef
Current Treatment Strategies for Patella Fractures
David J. Hak, Philip F. Stahel, Dustin J. Schuett, Mark E. Hake, Cyril Mauffrey, E. Mark Hammerberg, Philip F. Stahel, David J. Hak
Orthopedics.2015; 38(6): 377. CrossRef

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Modified Tension Band Wiring Combined with Anti-Gliding Loop Augmentation Technique for the Treatment of Comminuted Patellar Fracture: Technical Note and Report of Early Results: Technical Note: Han Jun Lee, Jae Jun Yang, Ho Joong Jung, Hyoung Seok Jung; J Korean Fract Soc 2013;26(4):321-326. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.321

Abstract PDF: In order to investigate the feasibility of a modified tension band combined with anti-gliding loop augmentation technique for the treatment of comminuted patellar fracture, 21 patients with comminuted patellar fracture were enrolled in this study. After the modified tension band wiring of patellar fracture, a cerclage wire was passed around the patella. Anti-gliding loops were made on the bending sites of Kirshner-wires. A knot was tied using both ends of the anti-gliding loops, and the cerclage wire was tightened using proximal knots. Bone union was achieved at 4.5+/-1.5 months postoperatively without nonunion. The Lysholm score was 87.1+/-2.8, and the range of motion of the knee was 2.1degrees+/-3.4degrees to 132.2degrees+/-6.5degrees at the last follow-up. The modified tension band combined with anti-gliding loop augmentation technique might be considered an alternative modification of modified tension band wiring for the treatment of comminuted patellar fracture.

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Anatomical Reduction of All Fracture Fragments and Fixation Using Inter-Fragmentary Screw and Plate in Comminuted and Displaced Clavicle Mid-Shaft Fracture: Kyoung Hwan Koh, Min Soo Shon, Seung Won Lee, Jong Ho Kim, Jae Chul Yoo; J Korean Fract Soc 2012;25(4):300-304. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.300

Abstract PDF

PURPOSE
To report the treatment results of anatomical reduction of all fracture fragments and internal fixation using an inter-fragmentary screw and plate in displaced mid-shaft clavicle fracture with comminution.
MATERIALS AND METHODS
Between June 2005 and August 2011, 13 consecutive displaced clavicle fractures with comminution (Edinburgh classification IIB2) treated by anatomic reduction and internal fixation using inter-fragmentary screw and plate were retrospectively evaluated. There were 11 male and 2 female patients with a mean age of 37.4 years (15~55 years). The right clavicle was injured in 4 patients and the dominant arm was involved in 46%. The mean duration from trauma to surgery was 7.0 days. The cause of injury was a traffic accident in three, a fall in two, and sports activity or direct injury in eight patients. All of the fracture pieces were anatomically reduced and fixed with inter-fragmentary screws. An additional plate was applied to maintain and reinforce the reduction of the fracture. Radiographic assessments for the numbers of fragments and the amount of shortening and displacement were performed. To verify the fracture healing and determine the time from fracture surgery to union and complications, all of the radiographs taken after surgery were evaluated.
RESULTS
The number of fragments was 2 in 7 cases, 3 in 5 cases, and 6 in one case. The mean shortening of the clavicle was 1.1 cm (0.3~2.1 cm) and mean displacement between the main fragments was 2.6 cm (1.3~4.5 cm). The mean duration of follow-up was 16.5 months (8~26 months). Radiographic union was achieved in all patients with a mean time to union of 10.8 weeks (8~14 weeks). There were no complications including metal failure, nonunion, or infection.
CONCLUSION
Anatomical reduction of all the fracture fragments and fixation using inter-fragmentary screws in addition to the usual plate fixation showed good fracture healing in displaced clavicle fracture with comminution.

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Additional fixation using a metal plate with bioresorbable screws and wires for robinson type 2B clavicle fracture
Woo Jin shin, Young Woo Chung, Seon Do Kim, Ki-Yong An
Clinics in Shoulder and Elbow.2020; 23(4): 205. CrossRef
Use of Composite Wiring on Surgical Treatments of Clavicle Shaft Fractures
Kyung Chul Kim, In Hyeok Rhyou, Ji Ho Lee, Kee Baek Ahn, Sung Chul Moon
Journal of the Korean Fracture Society.2016; 29(3): 185. CrossRef

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Operative Treatment of Distal Humeral Comminuted Fractures with Orthogonal Plating: Joong Bae Seo, Jae Sung Yoo; J Korean Fract Soc 2011;24(3):243-248. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.243

Abstract PDF: PURPOSE
To analyze the results of operative treatment for Comminuted Fracture of Distal Humerus with Transolecranon approach and Orthogonal plating.
MATERIALS AND METHODS
The subjects were 22 patients with Comminuted fracture of humerus who were treated with Orthogonal plating. Patient's age, sex, type of fracture, surgical approach, method of fixation, time of operation, time of bony union, complication, range of motion were investigated, and Function of elbow was evaluated by functional evaluation of Riseborough and Radin, Mayo Elbow Performance Score (MEPS).
RESULTS
Age, sex, injuried arm, operation time were not related to postoperative result. Type C2 fractures showed better results in function and range of motion (ROM) than type C3 fractures. Also early rehabilitation was important to functional recovery and ROM. The postoperative ROM was average 110. Good were 16 cases, fair were 6 cases in functional evaluation of Riseborough and Radin. Excellent were 13 cases, good were 8 cases, fair was 1 case in MEPS.
CONCLUSION
Operative treatment with Transolecranon approach and Orthogonal plating showed favorable result on its function. Intraarticular comminution and early rehabilitation were closely related to postoperative function of elbow.

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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; J Korean Fract Soc 2011;24(2):138-143. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.138

Abstract PDF

PURPOSE
A technique of cerclage wire fixation in comminuted fracture of the clavicle shaft is thought to interfere the fracture healing, so authors studied radiographically and clinically about the cases of cerclage wiring of the fracture fragments with the plate and screws fixation in the comminuted fracture of the shaft of the clavicle.
MATERIALS AND METHODS
According to following inclusion criteria, total 18 patients (male: 15, female: 3) were investigated; Patients who visited hospital due to clavicle shaft comminuted fracture from February 2005 to April 2009, who underwent surgery utilizing more than 2 cerclage wire fixation for the fragments when open reduction and plate fixation were operated and who could be follow-up over one year. The duration for fracture union, functional outcome and complications were investigated retrospectively.
RESULTS
Radiological bone union was accomplished in average 13.3 weeks (12~16 weeks) and there was no complication such as nonunion, delayed union or infection. Range of motion of ipsilateral shoulder joint was recovered in all patients except one at the final follow-up.
CONCLUSION
The clinical and radiographical results of the plate and screws fixation with cerclage wiring of the fragments in comminuted clavicle shaft fracture showed that the cerclage wiring does not interfere the fracture healing, so authors think that this method is a good alternative operation if it is performed carefully to minimize soft tissue dissection.

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Surgical Management of Comminuted Midshaft Clavicle Fractures Using Reconstruction Plate and Circumferential Wiring: Does the Circumferential Wiring Interfere with the Bone Union?
Kyung-Tae Kim, Chung-Shik Shin, Young-Chul Park, Dong-hyun Kim, Min-Woo Kim
Journal of the Korean Orthopaedic Association.2021; 56(3): 245. CrossRef
Supplementary Technique for Unstable Clavicle Shaft Fractures: Interfragmentary Wiring and Temporary Axial K-Wire Pinning
Jinmyoung Dan, Byung-Kook Kim, Ho-Jae Lee, Tae-Ho Kim, Young-Gun Kim
Clinics in Orthopedic Surgery.2018; 10(2): 142. CrossRef
Use of Composite Wiring on Surgical Treatments of Clavicle Shaft Fractures
Kyung Chul Kim, In Hyeok Rhyou, Ji Ho Lee, Kee Baek Ahn, Sung Chul Moon
Journal of the Korean Fracture Society.2016; 29(3): 185. CrossRef
TO EVALUATE THE SURGICAL OUTCOME OF NON-UNION CLAVICLE USING PLATE AND SLIVERS OF AUTOLOGOUS ILIAC CREST CORTICOCANCELLOUS BONE GRAFT
Mohammed Tauheed, Shashi Kumar Yalagach, Vivek Purushothaman, Anwar Shareef Kunnath K
Journal of Evidence Based Medicine and Healthcare.2016; 3(25): 1121. CrossRef
Anatomical Reduction of All Fracture Fragments and Fixation Using Inter-Fragmentary Screw and Plate in Comminuted and Displaced Clavicle Mid-Shaft Fracture
Kyoung Hwan Koh, Min Soo Shon, Seung Won Lee, Jong Ho Kim, Jae Chul Yoo
Journal of the Korean Fracture Society.2012; 25(4): 300. CrossRef

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Internal Fixation Using Double Plates for Comminuted Olecranon Fractures in Adults: Hyun Dae Shin, Jae Hoon Yang, Pil Sung Kim; J Korean Fract Soc 2009;22(3):166-171. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.166

Abstract PDF

PURPOSE
To evaluate the clinical usefulness of internal fixation with double plates for comminuted olecranon fractures.
MATERIALS AND METHODS
Nine patients with olecranon fractures which are classified into Mayo type IIB (7 cases) and type IIIB (2 cases) underwent internal fixation using double plates from June 2002 to September 2005. They were followed-up for more than 12 months and average period of follow-up was 14 (12~18) months. Six cases were males and three were females. Mean age was 40.7 (21~63) years. We used open reduction and internal fixation using double plates. Clinical assessment index was pain, range of motion (ROM), stability and function of joint at last follow-up. The sum of four indices were compared. Also, we evaluated starting time of full ROM exercise, bony union time and complications.
RESULTS
All cases started postoperative ROM within 7 days and clinical results were evaluated using Mayo elbow performance index. 'Excellent', 'good' were 2, 6 cases, respectively and 1 case was 'fair'. Elbow ROM was more than 110o in all cases except one. Mean radiological bony union time was 3.9 (2.5~5) months postoperatively. There were heterotrophic ossifications in 3 cases as complication.
CONCLUSION
Internal fixation using double plates for comminuted olecranon fractures in adults can be good treatment option which obtains good clinical results and enables early ROM.

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Biomechanical Comparison of Dual and Posterior Locking Plates in an Ex Vivo Comminuted Olecranon Fracture Model
Andrew D. Sobel, Jacob M. Babu, Travis D. Blood, E. Scott Paxton
The Journal of Hand Surgery.2022; 47(8): 796.e1. CrossRef
Surgical Treatment of Comminuted Olecranon Fracture Using Locking Compression Plate Fixation
Eunchang Lee, Seong-Hee Cho, Jun-Il Yoo, Jin-Hyung Im, Dong-Geun Kang, Jin Sung Park
Archives of Hand and Microsurgery.2021; 26(1): 18. CrossRef
The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture
In-Tae Hong, Kyunghun Jung, Yoon Seok Kim, Soo-Hong Han
Archives of Hand and Microsurgery.2019; 24(2): 133. CrossRef
Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates
Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon
Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures
Bo-Kun Kim, Hyun-Dae Shin, Kyung-Cheon Kim, Yoo-Sun Jeon
Journal of the Korean Orthopaedic Association.2011; 46(2): 146. CrossRef

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Primary Subtalar Arthrodesis for the Treatment of Intra-articular Calcaneal Comminuted Fractures: Hong Geun Jung, Yu Jin Kim, Suk Ha Jeon; J Korean Fract Soc 2006;19(4):418-423. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.418

Abstract

PURPOSE
To evaluate the functional outcomes of the severely comminuted intra-articular calcaneal fractures that were selectively treated with primary subtalar arthrodesis.
MATERIALS AND METHODS
This study is based on the 9 patients, 10 feet of intra-articular severely comminuted calcaneal fractures that were treated with open reduction and internal fixation with primary subtalar arthrodesis due to inability to reconstruct the subtalar articular surface with follow-up of more than 1 year. Postoperative clinical evaluation was performed with AOFAS Hindfoot functional scores. The patient satisfaction, returning to previous occupation and complications were also investigated.
RESULTS
Follow-up period was average 20.3 months. Overall AOFAS functional score at final follow-up was average 71.8 points and VAS pain score was 3.9. Fifty percent of the patients were satisfied with the surgery and 80% of the patients were able to return to their previous occupations at average 8.4 months after trauma. Post-operative complications were 2 cases of sural nerve injuries and 1 hindfoot valgus malunion.
CONCLUSION
We concluded that the primary subtalar arthrodesis is a viable surgical option for severely comminuted calcaneal fractures with favorable functional result and early returning of most patients to their previous occupations.

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Joint-Sparing Surgical Management of Sanders IV Displaced Intra-Articular Calcaneal Fractures
Thomas S. Roukis
Clinics in Podiatric Medicine and Surgery.2019; 36(2): 251. CrossRef
Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures
Seung Hun Woo, Hyung-Jin Chung, Su-Young Bae, Sun-Kyu Kim
Journal of the Korean Orthopaedic Association.2017; 52(1): 49. CrossRef
Bilateral Open Transcalcaneal Fracture with Talonavicular Dislocation - A Case Report -
Hun Park, Sung Jin Shin, Sang Rim Kim, Kwang Woo Nam, Sung Wook Choi, Kyu Bum Seo, Jun Young Seo
Journal of the Korean Fracture Society.2011; 24(1): 87. CrossRef
Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef

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Treatment of Fractures of Distal Radius using External Fixator: Sung Tae Lee, Seok Ha Lee, Kwang Jun Oh, Jong In Na, Ji Sung Jun, In Rok Yu; J Korean Soc Fract 2003;16(3):407-415. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.407

Abstract PDF: PURPOSE
To assess the clinical and radiological results from the treatment of the intraarticular distal radius fracture by using the external fixator and confirm the usefulness of the external fixator from this study. MATERIALS & METHODS: We selected 20 cases of the distal radius fracture patients, who were treated with external fixator, among the patients from March, 1998 to March, 2001 and they could be followed for 1 year. There were 12 males and 8 females with a mean age of 53.4. According to AO classification, there were 2 cases for type A (10%), 2 cases for type B (10%), 5 cases for type C1 (25%), 9 cases for type C2 (45%), and 2 cases for type C3 (10%). In the 16 cases, the external fixator was used alone and in the other 2 cases, the external fixator was used with K-wires fixation. In the last 2 cases, K-wires fixation and autogenous iliac bone graft were combined.
RESULTS
In more severe form of distal radius fracture such as complete intraarticular fracture (type C2, C3 of AO classification), the better outcome in clinical and radiologic results was showed when additional K-wires fixation and/or autogenous iliac bone graft were combined rather than using the external fixator only. Particularly, in the cases of type C2, the poorest outcomes of radial length loss 2.7 mm (4.0%), radial inclination loss 1.4 (4.9%), volar tilting loss 2.4 (6.9%) were showed when the external fixator was used alone. The three worst results were from the cases of using external fixator alone in type C2. In the two cases of combination with K-wire fixation, the result of type C2 was excellent and that of type C3 was good. The results of the last two cases (type C2, C3) of combination with K-wire fixation and autogenous iliac bone graft were all excellent.
CONCLUSION
In this study, we confirmed that the better result could be achieved when the treatment were performed with combination with K-wire and/or autogenous iliac bone graft rather than using the external fixator alone.

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The Fate of Large Butterfly Fragments in Femoral Shaft Comminuted Fractures Treated withClosed Interlocking Intramedullary Nailing: Keun Bae Lee, Jae Yoon Chung, Eun Sun Moon, Eun Kyoo Song, Kwang Cheul Jeong; J Korean Soc Fract 2002;15(4):504-510. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.504

Abstract PDF: PURPOSE
To evaluate the radiographic changes and union of large butterfly fragments after closed interlocking IM nailing for femoral shaft comminuted fractures.
MATERIALS AND METHODS
The objects of this study were 23 cases(15 males, 8 females) of femoral shaft comminuted fractures with butterfly fragments larger than 5cm and with the follow up period of 12 months or more from June 1995 to June 2000. We assessed the size, the degrees of displacement and angulation of the large butterfly fragments at preoperatively, one day, one month and three month postoperatively and evaluated the union at four month and six month postoperatively.
RESULTS
The size of the fragments was 8.4cm (5.0-13.0) in average. The distance between the fragment and shaft was 15.9cm preoperatively and 10.1, 7.7, 6.8cm at one day, one month and three month postoperatively. In 13 cases of angulation over 5 degrees, it changed from 19.6 degrees preoperatively to 13.9 degrees , 8.4 degrees , 5 . 9 degrees at one day, one month and three month postoperatively. There is no increase in angulation.The union was completed at 4 months in 13 cases (56.5%) and at 6 months in all except one case of delayed union, in which we did not do any further procedure until the union was achieved.
CONCLUSION
In femoral shaft comminuted fractures with displaced large butterfly fragments treated with closed interlocking IM nailing, the distance and angulation of fragments decreased gradually and even the fragments were inverted or largely displaced and angulated the fragments were united. So the caution must be given not to displace the fragments intraoperatively and to keep anatomical position of the fragments by active exercise and hydrostatic pressure of the muscles of thigh postoperatively. Then the open reduction and internal fixations of the fragments will not be necessary.

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Treatment of Comminuted Fractures of Proximal Tibia using MIPO technique: Beom Koo Lee, Hyunchul Jo, Gi Serk Eom, Jin Won Kim; J Korean Soc Fract 2002;15(2):243-250. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.243

Abstract PDF

PURPOSE
To evaluate the advantages of fixation of metaphysis by minimally invasive plate osteosynthesis(MIPO) technique for comminuted fractures of the proximal tibia. MATERIALS & METHODS: from January 1997 to February 2000, 18 cases of comminuted fracture of the proximal tibia were treated using MIPO technique. Operation time, union time, radiologic alignment, range of motion of the knee joint, functional and anatomical results according to Rassmusen's grading criteria, complications were evaluated. Minimal follow-up time was 12 months.
RESULTS
Operation time was average 51 minutes (30-80 minutes). Time to bone healing was average 10.6 weeks (9-14 weeks) There was 1 case of valgus angular deformity greater than 5 degrees. 6 cases in acceptable bony alignment less than valgus 5 degrees and 11 cases were classified into normal bony alignment. Range of motion of the knee joint was 0-140 degrees in 13 cases, 0-120 degrees in 3 cases, 0-90 degrees in 1 case, 10-90 degrees in 1 case. Rasmussen's grading criteria for functional outcome revealed there were 14 cases(77.8%) excellent results, 4 cases(22.2%) good result. and grading criteria for anatomical outcome revealed there were 7 cases(38.9%) excellent results, 11 cases(61.1%) good result.
CONCLUSION
MIPO technique for comminuted fracture of the proximal tibia seems to be a good techinque to obtain more rapid bony union with less complication.

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Treatment of Proximal Tibia Fractures Using LCP by MIPO Technique
Sang-Ho Ha, Dong-Hui Kim, Jun-Young Lee
Journal of the Korean Fracture Society.2010; 23(1): 34. CrossRef

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Comparison of radial head excision and open reduction & internal fixation for comminuted radial head & neck fracture: Jae Gune Jun, Chul Hyung Lee, Sung Jun Han, Sang Seon Lee, Won Tae Choi, Ho Rim Choi, Jeong Woung Lee; J Korean Soc Fract 2001;14(1):106-112. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.106

Abstract PDF: PURPOSE
The goals of the present study were to compare of radial head excision and open reduction k internal fixation for comminuted radial head & neck fracture.
MATERIALS AND METHODS
From march 1993 to February 1999, Patients with fracture of radial head (Mason type III) who were treated at Dae-Jeon Sun General hospital were enrolled in the study. The average duration of follow up was 3 years and 3 months. Six patients(Group A) were treated with radial head excision and fourteen patients(Group B) were treated with open reduction and internal fixation.
RESULTS
By functional rating index(modified After B.F. Morrey et al), in Group A, the results were classified as excellent(1 patient), good(No patient), fair(2 patients), and poor(3 patients), and in Group B, excellent(4 patients), good(5 patients), fair(3 patients), and poor(2 patients).
CONCLUSION
We concluded clinically to obtain better outcome in group which were treated with open reduction and internal fixation than radial head excision. Therefore, though the treatment of choice for Mason type III radial head fracture was total excision, in consideration of complication, procedure to preserve radial head was desirable. We must give careful consideration to possibility of open reduction and decision of radial head excision.

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Treatment of Comminuted Fractures of Femur & Tibia with Ilizarov Apparatus: Soo Bong Hahn, Hong Jun Park, Hui Wan Park, Sung Hun Kim; J Korean Soc Fract 2000;13(1):20-29. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.20

Abstract PDF: PURPOSE
To evaluate the effectiveness of Ilizarov external fixator for the treatment of unstable closed or open comminuted femoral and tibial fractures, especially those with severe soft tissue injury by clinical and radiological analysis.
MATERIALS AND METHODS
Fifty six consecutive femoral or tibial fractures were treated using Ilizarov external fixator between May 1991 and August 1998 and followed up for minimum 12 months upto 36 months with the average of 16 months. All of them consisted of comminuted or segmental fractures. And thirty five cases of them were open fractures. There were nine Type I, seventeen Type II, five Type IIIA, and four Type IIIB fractures. Primary closure was performed for Type I and II fractures. Split-thickness skin graft (5 cases) and free vascularized flap (3 cases) were used for severe soft tissue defects.
RESULTS
All fractures healed within the average of 7.7 months (from minimum 3 months to maximum 24 months). Bone grafts were performed in 39 cases. Bony union was obtained in all the cases with Ilizarov method. The most common complication, the adjacent joint contracture was developed in 21 cases (37.5%). Pin site infection in 12 cases (21.4%), delayed union in 3 cases (5.4%), angulation deformity in 2 cases (3.6%) were developed.
CONCLUSION
The Ilizarov external fixation technique is one of the effective methods in the management of unstable closed or open comminuted femoral or tibial fractures.

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A Comparison of Using Closed Interlocking Nailing versus Plate Fixation in Humeral Shaft Comminuted Fractures: Dong Gyu Lee, Woo Dong Nam, Jang Seok Choi; J Korean Soc Fract 1999;12(1):126-134. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.126

Abstract PDF: The purpose of this paper is to compare the results, complication, advantages and disadvantages of treatment with closed interlocking intramedullary nail with those with plate in humeral shaft comminuted fractures. The authors have reviwed 25 cases of humeral shaft comminuted fractures, which were treated with closed interlocking intramedullary nail in 14 cases and plate in 11 cases, from November 1992 to May 1996. The results were as follows: 1. The average time of operation in closed interlocking nailing was 72 minutes and that of plate fixation was 104 minutes. 2. The average time for bone union was 14.7 weeks in closed interlocking nailing and 14.9 weeks in plate fixation. 3. The complications of closed interlocking nailing were 2 cases of delayed union, 1 case of nonunion, 1 case of postoperative radial nerve palsy and 3 cases of pain and stiffness of shoulder. 4. The complications of plate fixation were 1 case of delayed union, 2 cases of nonunion, 1 case of postoperative radial nerve palsy, 1 case of stiffness of shoulder. 5. Excellent and good functional results rated by Stewart and Hundley were 12(85%) cases in closed interlocking nailing and 8(73%) cases in plate fixation. We concluded that closed interlocking nailing is one of the better useful method of treatment in humeral shaft comminuted fractures but, the procedures should be performed exactly.

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Treatment of Long Spiral Comminuted Fracture of the Shaft of Humerus Using Multifilament Cerclage Cables and External Fixator: Ho Yoon Kwak; J Korean Soc Fract 1998;11(4):958-963. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.958

Abstract PDF: Long spiral comminuted fracture of the shaft of humerus, which is more common today than in the past, is one of the most difficult fractures to treat and remains challenge to orthopaedic surgeons. From Feb. 1995 to Nov. 1996, We have treated 6 cases of long spiral comminuted fracture of the shaft of humerus by internal fixation with multifilament cerclage cables combined with external fixation, and achieved bony union in all cases at average 4 months and good clinical results. The advantages of this operation method are minimal damage to the adjacent soft tissues by relatively small exposure, minimal internal instrumentation, early mobilization and the need of secondary operation for implants removal is eliminated. Also, It may be suggested that the author's operative method is one of the solutions for treatment of long spiral comminuted shaft fracture of humerus involving metadiaphyseal area.

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Treatment of Unstable Open Tibial Fractures with Ilizarov System: Won Sik Choy, Kwang Won Lee, Ha Yong Kim, In Sung Hwang; J Korean Soc Fract 1998;11(3):567-575. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.567

Abstract PDF: The treatment of open comminuted tibial shaft fractures have a high incidence of complications and often result in poor outcomes. General principles of treatment are accepted throughout most surgeons, which include aggressive debricdement, antibiotics, early stabilization, early soft tissue coverage, and prophylactic bone graft. But, recently there is a controversy on the bony stabilization methods; one group of authors favors external fixator, and the other group favors unreamed interlocking intramedullary nail. In this paper, we carried out retrospective study of the 42 cases of open comminuted tibial shaft fractrues managed with Ilizarov external fixator (minimum follow up of one year(average: 2.8 years)). The purpose of this study is to evaluate the results of treatment with an Ilizarov method for the patients with open comminuted tibia fractures (open type III-A and more by Gustilo and Anderson classification and, type B and more by AO classification). The results were as follows; 1. It has taken 7.4 months to achieve bony union with relatively delayed healing time for the diaphyseal fractures and fractures with higher energy injury on AO classification). The results were as follows; 1. It has taken 7.4 months to achieve bony union with relatively delayed healing time for the diaphyseal fractures and fractures with higher energy injury on AO classification. 2. Forty eight additional operations were needed for 27 patients; 24 bone grafts for 19 atients, 1 case of bone marrow injection, 4 cases of corticotomy and bone transport, 4 cases of sequestrectomy, 3 cases of internal fixation with plate, 2 cases of IM nailings, and 2 cases of Ilizarov correction in operating room. 3. Following complications were resulted in; delayed union 14 cases, nonunion 1 case, superficial infection 2 cases, deep infection 8 cases, chronic osteomyelitis 3 cases, refracture 2 cases, knee stiffness 6 cases, ankle stiffness 5 cases, subtalar stiffness 8 cases, lateral angulation 4 cases, anteroposterior angulation 4 cases, and leg length discrepancy 5 cases. 4. Twenty patients, at the final follow-up, could walk without limping and live their life with no activity limitation. 5. At the final follow-up, 19 patients complained intermittent pain on fracture sites, knees or feet and ankles. We could conclude that the Ilizarov external fixator can be a stabilizer of choice for the open comminuted (Gustilo type III and more than AO type B) tibial shaft fractures of which fracture line extended over the proximal or distal metaphysis.

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Swanson Prosthesis Replacement of the Comminuted Radial Head Fracture Associated with Posterior Dislocation of the Elbow: 3 Cases Experienced: Soo Kyoon Rah, Jin Il Kim, Chi Soo Sohn, Yon Il KIm, Chang Uk Choi; J Korean Soc Fract 1998;11(1):47-55. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.47

Abstract PDF: Radial head resection is the accepted treatment of comminuted radial head fractures in adults, but the results are not always satisfactory. a number of well-known problems can ensue. These include chronic elbow and wrist pain, limited of motion, cubitus valgus, proximal radial migration, and new bone formation at the site of excision. Prosthetic replacement of radial head after excision offers theoretical advantages in the prevention of these problems. We are reporting three cases of patients, who had treated Swanson silastic prosthesis after comminuted radial head fracture associated posterior dislocation of the elbow.

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The Treatment of Comminuted Fractures of Distal Humerus with Rigid Internal Fixation and Early Motion: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Joo Hyung Lee, Seung Jun Park; J Korean Soc Fract 1998;11(1):28-33. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.28

Abstract PDF

Comminuted fractures of distal humerus are difficult fracures to treat because of their rarity and associated significant comminution. The results of managing theses fractures non-operatively are limited by failure to get anantomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudoarthrosis. The goals of open reduction are to preserve articular surface and restore elbow function. Hence an operative management with anatomical reduction of fragments becomes the treatment of choice for these fractures. Authors analyzed 17 patients, with 30 months follow-up on an average, who were treated with open reduction and rigid internal fixation followed early mobilization during the period from jan. 1991 to Dec. 1996. Following results were obtained. 1. According to the Muller's classification, type A was 4 cases(23.5%), type B was 4 (23.5%), and type C was 9(53%) 2. Excellent or good results were obtained in 12 cases(71%) by the criteria of Aitken and Rorabeck. 3. There were limitation of full extension over 5degreein all cases and no other severe complications causing disability of elbow.

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Treatment for the Supracondylar Fractures of the Distal Humerus with Cannulated Screw
Jin Soo Park, Young Khee Chung, Jung Han Yoo, Kyu Cheol Noh, Kook Jin Chung, Dong Nyoung Lee
Journal of the Korean Fracture Society.2007; 20(1): 58. CrossRef

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Treatment of Commiuted Fractures of the Proximal Tibia Using Ilizarov External Fixator: Jae Ik Lee, Myung Hwan Son, Jae Hong Park, Kang Hoon Kim; J Korean Soc Fract 1998;11(1):198-204. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.198

Abstract PDF: Twenty one comminuted fractures of the proximal tibia in 21 patients were treated with Ilizarov external fixator from May 1990 to May 1996 in Pusan City Medical Center. The average duration of external fixation was 17weeks, and all of the fractures healed without bone graft. The mean time to union was 18weeks in closed comminuted fractures, and 21 weeks in Gustilo type I, II open fractures. The complications with this technique were pin tract infection 3 cases, pin loosening 6 cases, septic arthritis 1 case, post-traumatic osteoathritis 1 case, and joint ankylosis 1 case. The average duration of follow up was 18 months. The range of knee motion of 19 cases of the the 21 patients was at least 115-degrees arc. Post-operative immediate exercise was possible, and partial weight bearing with crutch was also possible after post-operative 4 weeks. We concluded that Ilizarov external fixation is a satisfactory technique for the treatment of selected comminuted fractures of the proximal tibia.

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Operative Treatment of Comminuted Fraeture of the Patella: Yung Khee Chung, Jung Han Yoo, Yong Wook Park, Gyu Cheol Roh; J Korean Soc Fract 1996;9(4):970-976. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.970

Abstract PDF

The patella, lying within the quadriceps tendon mechanism and subcutaneous in position, is susceptible to the effects of both direct and indirect trauma. Patella fractures are intra-articular injuries and have a significant effect on knee function. The tension band wiring technique is widely used for treating fractures of the patella and is often the treatment of choice. We reviewed tweenty nine cases of cemminuted fracture of the patella treated with surgical methods from Jan. 1989 to Mar. 1995 and fellowed up more than one year, from the department of of hopedic surgiry, Kangnam Sacred Heart Hospital, Hallym University. The results were as follows: 1. According to the classincation of Bostman, there were 6 cases(20.7%) of type 1.16(55.2%) of II A, 5(17.2%) of II B and 2(6.9%) of III. 2. Of tweenty nine cases, tweenty six(89.7%) were treated by modified tension band wiring with cerclage wiring (MTBW with CW) and three(10.3%) by partial patellectomy with cerclage wiring(PP with CW). 3. Among tweenty six cases treated with MTBW with CW. tweenty one cases(76.9%) revealed a good or exellent result according to the Cincinnati rating system. 4. Especially, among 5 cases of type II B & 2 cases of type III comminuted fracture treated with MTBW with CW, 5 cases(73.4%) revealed good result. We concluded that the use of modified tension band wiring with cerclage wiring for the comminuted fracture of patella has been shown to be a satisfactory method.

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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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Treatment of Comminuted Fracture of the Distal Humerus by New Y-Anatomical Plate: Churl Hong Chun, Sang Soe Kim, Sung Man Rowe, Eun Sun Moon, Myoung Churl Ko; J Korean Soc Fract 1996;9(4):1076-1084. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1076

Abstract PDF: OBJECTIVES
The characteristics of comminuted fractures of the distal end of the humerus in adult are severe comminution of bony fragments, loss of bony continuity and displaced fragments by muscle action. The ideal treatment is to reestabilish a normal elbow-that is to reestablish the articular congruity. the alignment and early motion as soon as pessible. But no matter what treatment is used perfect results are seldom obtained. The purpose of this study is to analyze the clinical results of the new Y-Anatomical plate, which has well adaptable and more malleable characteristics for the fracture of the distal humerus. MATERIALS AND NLETHEDS: The fracture types of the distal humerus were 5 supracondylar and 12 intercondylar, which were classified according to the Riseborugh & Radin classification 4 type II, 2 type III and 6 type IV. The patients who have been treated by new Y-Anatomical plate from September 3992 to January 1995.
RESULTS
Fourteen of the 17 cases(81.2%) were considered acceptable results for a mean follow-up 26 months study according to the functional motion of the elbow by Cassebaum and criteriae by Jupiter J.B.etc. The patient who did exercise the elbow joint within two weeks from post-operation, gathered better results than other patients who did it after four weeks from post-operation. Complications are nonunion, ankylosing elbow and metal failure.
CONCLUSION
In the study reported here, new Y-Anatomical plate was sufficiently obtained the anatomical reduction with stable fixation, so it would allow early motion of the elbow joint to be possible and decrease the complication compared to Tri-radiate plates. Also the most important indicator of end result was the starting time of physiothmpy.

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A Clinical Study of Fracture of Distal Radius: Pitfall of Treatment of Intraarticularly comminuted fracture: Chong Hoon Park, Won Yoo Kim, Jin Hyung Sung, Kyong Ho Yoo, Jin Yiung Kim; J Korean Soc Fract 1996;9(1):33-41. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.33

Abstract PDF: The fracture of the distal radius was first described as the fracture of the radius with dorsally eisplaced fragment within distal 1.5 inch at 1814 by Abraham Calles.since that, according to feature of fractures, many classifications have been introduced. Although there are many kinds of msthod in treatment of fracture of the distal radius, we find difficulty in selecting adequate method of treatment of intraarticularly comminuted fracture of the distal radius.And recently the intraarticularly comminuted fracture is occasionally recognized as nit a simple fracture but a complicated fracture because of postraumtic arthritrs, malunion, nonunion,and stiff hand after treatment.So,we retrospectively reviewed thirty-eight cases which were treated by several methods for 5 year from Jan.1990 to Dec. 1994 at the our hospital. The results were as follows. 1.In general, the incidence was mare higher in male, but the older in age, the more incidence in female. 2.The most common catse as a single cause of injury was a traffic accident. 3.By the point system for subjective evaluation and objective evaouation of Gartland and Werley, the excellent or good result were represented at the extraarticular fractures or undisplaced inraarticaular fracture among Collesfracture, Bartons Chauffeurs, Smiths, and lunste load fracture, which had been treated by sugar-tongs splint or percutaneous pinnongs after the closed reduction. And the excellent result was especially showed at the volar Bartons jractures which had been managed by the plate fixation after the open reduction. But the poor result was represented at the intraarticularly comminuted fractures of the distal radius, which had been treated by percutaneoys pinning(2 cases)or only external fixation without an additional fixation(4 cases) after the closed reduction. In conclusiln, the investigatir thought that the anatomical reduction, more secure fixation, and sometimes bone grafting in treating the intraarticylarlycomminuted fracture of the distal radiuw were essential fir having satisfactory clinical result.

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Interlocking Medullary Nailing in Severe Comminuted Fracture of the Femoral Shaft: Young Goo Lee, Jang Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seong Seok Seo, Young Jae Kim; J Korean Soc Fract 1996;9(1):105-111. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.105

Abstract PDF: The interlocking medullary nail widens the range of the indication for medullary osteosynthesis of the femoral shaft fractures. Twenty one cases with the comminuted fracture of the femoral shaft were reviewed, which had been treated by closed or or semi-open IM nailing at the Department of Orthopedic Surgery, Pusan Paik Hospital from March 1991 to December 1993. The results were as follows 1. The period of fracture union was 22.1 weeks in Winquist-Hansen Grade III,27.4 weeks in Grade IV , 19.6 weeks in segmental. And its period was 22.6 weeks in closed and 26.2 weeks in semi-open IM nailing. 2. The result of closed interlocking medullary nailing was better and complications were less than semi-open interlocking medullary nailing. 3. The severely comminuted femoral shaft fractures were unstable and there were the risk of shortening, rotation and inadequate reduction. Therefore, when the closed interlocking medullary nailing did not gain the anatomical reduction, it was altemative method to perform semi-open interlocking medullary nailing. From above result, we conclude that closed interlocking medullary nailing or semi-open interlocking medullary nailing seems to be a favorabel method for treatment of severe comminuted femoral shaft fracture.

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Operative Treatment for Comminuted Fractures of the Proximal Humerus Using T-plate: Young Sik Pyun, Chang Soo Kang, Kwang Soon Song, Chul Hyung Kang, Byung Woo Min, Jin Soo Hwang; J Korean Soc Fract 1995;8(4):878-884. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.878

Abstract PDF: The shoulder is especially susceptible to stiffness following injury because of the formation of adhesions. Early mobilization prior to maturation of adhesions around the joint gliding surface is, therefore, an essential step in the management of the proximal humerus comminuted fractures. Our aims were accurate reduction and stable fixation to allow early mobilization and to achieve full functional recovery. During the eight-year period from January 1986 to June 1994,51 cases patients were treated surgically for comminuted fractures of the proximal part of the humerus by T-plate at our hospital. The results were summarized as follows; 1. There were 17 cases of the two-part fractures, 31 cases of the three-part fractures and 3 cases of the four-part fractures following to Neers classification. 2. The most common cause of injury was road traffic accident(34 cases). 3. The excellent or satisfactory results were seen 82% of the two-part fractures and 81% of the three-part fractures, whereas 67% of the four-part fractures. 4. The most frequent complication of comminuted fractures were motion limitation and pain(5 cases), delayed union(2 cases), plate bending(1 case) and infection(1 case) but avascular necrosis of the humeral head, non-union, myositis ossificans and plate breakage had not been developed in these cases. 5. T-plate was one of the good internal fixation devices for surgical treatment of the comminuted fractures of the proximal humerus.

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Silicone Rubber Replacement of the Severely Fractured Radial Head: Byung Woo Min, Chang Soo Kang, Young Sik Pyun, Kwang Soon Song, Young Wook Ha; J Korean Soc Fract 1994;7(1):43-48. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.43

Abstract PDF: The best method of treatment for displaced comminuted fractures of the radial head is still controversial. Early excision of the fractured radial head has been favored by a number of authors. but problems such as chronic pain in the elbow, forearm or wrist, restricted movement of the elbow, late subluxation of the distal radio-ulnar joint can ensue. So prosthetic replacement of the radial head had been advocated either for acute treatment of a fracture or for delayed treatment, when conservative treatment has failed. We analyzed 10 patients with comminuted radial head fracture treated by silastic prosthesls replacement shortly after injury from Jan. 1988 to Dec. 1992. The results were as follows. 1. Age distribution at operation was varied from 19 to 57 year with the average at 40.9 year. 2. The average time interval between initial radial head fracture and silastic prosthetic replacement was about 10 days(range 4 days to 18 days). 3. 6 patients(60%) were free of elbow, pain 2 patients(20%) had intermittent mild pain especially at night and 2 patients(20%) had mild pain only after heavy work. 4. All patients were free of wrist pain 5. There was no patient of breaking or tilting of prosthesis radiologically. 6. Overall assessment showed excellent in 4 patients(40%), good in 4 patients(40%) and poor in 2 patients(20%).

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