Journal of Musculoskeletal Trauma

Anatomically Percutaneous Wiring Reduction in Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures: Young Mo Kim, Chan Kang, Deuk Soo Hwang, Yong Bum Joo, Woo Yong Lee, Jung Mo Hwang; J Korean Fract Soc 2011;24(3):230-236. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.230

Abstract PDF: PURPOSE
To report the method of anatomical reduction and its maintenance by percutaneous wiring reduction in minimally invasive plate osteosynthesis for distal tibial fractures.
MATERIALS AND METHODS
17 cases that were diagnosed oblique, spiral or transverse fracture of distal tibia from August 2007 to February 2010 and were able to anatomically reduce by the method of percutanous wiring reduction in minimally invasive plate osteosynthesis were included in this study. Mean age was 50, and mean follow up period was 18 months. We investigated the period until bone union was achieved, degree of angulation angle, and complications. For postoperative evaluation, Olerud and Molander ankle score and VAS pain score in daily living were checked.
RESULTS
The mean varus/valgus angulation after bone union on AP radiograph was 0.9 degrees and the mean anterior/posterior angulation on lateral radiograph was 2.0 degrees The mean Olerud and Molander ankle score was 89.4, and mean pain score due to walk adjacent to metal plate was 0 points.
CONCLUSION
By the method of percutaneous wiring reduction in distal tibial fracture, anatomical reduction is easily acquired, and only by wire itself, reduction could be maintained, so that without additional manual reduction, plate could be easily fixed.

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Fixation Failure of Compression Hip Screw in Unstable Intertrochanteric Fracture of Femur: Deuk Soo Hwang, Sang Goo Kwak, Young Mo Kim, Dae Chul Nam, Ui Pyo Hong; J Korean Soc Fract 2003;16(4):600-604. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.600

PURPOSE
To evaluate the factor of fixation failure in association of the early controlled weight bearing exercise after using a compression hip screw (CHS) for unstable intertrochanteric fracture of femur in old ages.
MATERIALS AND METHODS
Between May 1998 and February 2002, 8 cases of fixation failure of CHS among the 80 patients were evaluated. We compared gender, age, fracture type with a matched group that fixation failure was not noted. During operation, we performed valgus nailing of compress lag screw and compressed fracture gap with a bolt as soon as possible. The patients were encouraged partial weight bearing 4~5 days after operation and compaired immediate postoperative and postoperative 2 weeks x-ray films about degree of slippage or varus angulation of femur.
RESULTS
In 5 cases, cut-out of the lag screw were found. In 3 cases, plate fracture and fixation failure were found. Relation between timing of partial weight bearing and fixation failure was not significant (p=0.146). But in 5 cases of failure, they continued weight bearing in spite of excessive slippage of the lag screw.
CONCLUSION
Early controlled partial weight bearing exercise after operation of intertrochanteric fracture of the femur were reported good for functional recovery in old ages. But, excessive slippage of the lag screw or varus angulation of proximal femur were found on follow up period, patient teaching and control of ambulation is strongly recommended.

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Treatment of Failed Intertrochanteric Fractures to Maintain the Reduction in Elderly Patients
Soon-Yong Kwon, Hyun-Woo Park, Sang-Uk Lee, Soo-Hwan Kang, Jae-Young Kwon, Jung-Hoon Do, Seung-Koo Rhee
Journal of the Korean Fracture Society.2008; 21(4): 267. CrossRef

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Minimally Invasive Percutaneous Plate Osteosynthesis for Distal Tibial Shaft Fracture: Jun Young Yang, Kwang Jin Rhee, June Kyue Lee, Deuk Soo Hwang, Hyun Dae Shin, Hyun Ho Lee; J Korean Soc Fract 2002;15(2):286-291. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.286

Abstract PDF

INTRODUCTION: Minimally invasive percutaneous plate osteosynthesis(MIPPO) was performed to treat distal tibial shaft fracture, and the results were compared to those of open plate fixation to find appropriate treatments MATERIALS AND METHODS: Among the patients who visited the Orthopedics Department at our hospital and were diagnosed with distal tibial shaft fracture, 12 cases that received MIPPO and 14 cases receiving open plate fixation were chosen for the study. The average age of patients were 57.8 and 50.8 years, and the male:female ratio was 1:1 in both cases. The average post-operative follow up period was 18 months and 19.5 months, and simple X-ray was done to evaluate the fracture healing.
RESULTS
The cases that received MIPPO, the operation time was 46.5 minutes and the average period of hospitalization was 25.3 days. There were no Nonunion, one case of delayed union, and one case of superficial infection. In the open plate fixation group, was 115.6 minutes and 48.3 days. Nonunion was in two cases, delayed union in two cases, superficial infection in one case, and deep infection in two cases. The nonunion cases were later given autogenous bone graft and fracture healing was attained.
CONCLUSION
By performing MIPPO quicker recovery of the patient can be made. Infection and nonunion, the most important complications due to operation, can be reduced. MIPPO thus seems to be the method leading to more close physiologic bone fusion in the treatment of distal tibial shaft fracture.

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The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture
Seong-Jun Ahn, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Seong-Ho Yoo, Kwan-Taek Oh
Journal of the Korean Fracture Society.2013; 26(4): 314. CrossRef

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Effect of the Ultrasound and LASER in the fracture healing in rabbits: Jun Young Yang, Kwang Jin Rhee, June Kyu Lee, Deuk Soo Hwang, Hyun Dae Shin, Jun ho Lee; J Korean Soc Fract 2001;14(3):305-312. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.305

Abstract PDF: PURPOSE
To study the effectiveness of the ultrasound and LASER on the fracturehealing in rabbits.
MATERIALS AND METHODS
This study was performed on rabbits using the Hi-Tech 2000 (Ultrasound+LASER) which was made in our institute. After anesthesia of the rabbit, the shaft of tibia was fractured with Gigli saw under aseptic condition, and then intramedullary nailing using K-wire was performed. We evaluated left tibia as control and right tibia as experimental. we applicated ultrasound and LASER from 7 days after operation and sacrificed at 3 weeks and 5 weeks after operation. Gross findings, simple radiologic findings, and histologic findings were evaluated by modified Zorlu scoring system. With use of T-test of SAS system ( level of significance, P < 0.05 ), difference between left and right tibia were evaluated to be determined the effect of ultrasound and LASER on the fracture-healing.
RESULTS
At postoperative 3 weeks, differences were noted in 4 cases but we could detect no significant difference between left and right side. At postoperative 5 weeks, differences were noted 6 cases and significant difference was noted.
CONCLUSIONS
Seeing this results, ultrasound and LASER treatment was effective in fracture healing. However we think that additional studies for accurate quantitative and qualitative analysis, biomechanical test in callus, microangiographic study and clinical research to determine the effectiveness of ultrasound and LASER in clinical field are needed.

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Popliteal Artery Injury Associated with Fracture and/or Dislocation of the Knee: Jun Young Yang, Kwang Jin Rhee, June Kyu Lee, Deuk Soo Hwang, Ki Yong Byun, Taek Soo Jeon; J Korean Soc Fract 2000;13(3):494-500. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.494

Abstract PDF: PURPOSE
To compare the outcome in patients who have popliteal artery injury associated with fracture and/or dislocation around the knee according to treatment option.
MATERIALS AND METHODS
We have reviewed fourteen cases of popliteal artery injury patients associated with fracture and/or dislocation injury around the knee who had visited at Chungnam National University Hospital from April 1997 to July 1999.
RESULTS
Combined skeletal injuries included fracture of distal femur, fracture of proximal tibia, and dislocation of the knee. Internal or external fixation was applied for skeletal injuries. We repaired the injured popliteal artery using end-to-end anastomosis (3 cases), interposed saphenous vein graft (9 cases), prosthetic vein graft (1 case), or thrombectomy alone (1 case). The amputation rate was 21 % (3 out of 14 patients). In limb salvage cases, we evaluated the function of knee joint, and the results were as follows : good 5 cases, fair 3 cases, and poor 3 cases.
CONCLUSION
Early diagnosis and prompt management for injuries of the popliteal artery is the most important factor to save the limb. Also, complete resection of all injured portion of vessel and reconstruction of patency through interposed saphenous vein graft are most useful method.

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The Effect of External Distractor on Recovery of B hler angle in Displaced Intraarticular Calcaneal Fractures: Deuk Soo Hwang, Kwang Jin Rhee, June Kyu Lee, Jung Hee Choi; J Korean Soc Fract 2000;13(2):375-381. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.375

Abstract PDF: PURPOSE
: We had studied the results retrospectively in displaced intraarticular calcaneal fractures treated with internal fixation by screw for thalamic portion and percutaneous pinning by K-wire using minimal Ollier's lateral approach, so we had reported good results, but recovery of B hler angle loss was difficult technically. So, we used intraoperative external distractor combined with previous our method.
MATERIALS AND METHODS
: We analysed retrospectively B hler angle and clinical results on 12 cases with clcaneal fracture, who underwent an operation for displaced intraarticular calcaneal fracture by using external distractor from January 1997 to August 1998. B hler angle were measured at preoperative, postoperative and last follow-up X-ray. Surgical technique is through minimal Ollier's lateral approach, reduced and fixed with screw of displaced posterior facet and used intraoperative external distractor for restoring of deperssed calcaneal tuberosity and then did percutaneous pinning with K-wire. RESULTS : In the previous our reports, the mean preoperative and postoperative B hler angle were -0.9degrees, 19.1degreeseach other and the mean recovery of B hler angle was 20.1degrees. After we use the intraoperative external distractor, the mean preoperative and postoperative B hler angle were 0.92degrees, 26.0degreeseach other and the mean recovery of B hler angle is 26.9degrees. It is nearly normal range of korean's B hler angle (31.1degrees+/-0.4 degrees). Also there is no complication such as intraoperative calcaneal tuberosity fracture and soft tissue injury(skin necrosis, neurovascular injury).
CONCLUSION
: We obtained enough restoration of B hler angle to normal range by using our previous method combined with intraoperative external distractor.

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The Treatment of the displaced Distal Radius fractures-Prospective study-: Jun Young Yang, Hyun Dae Shin, Kwang Jin Rhee, Jun Kyu Lee, Deuk Soo Hwang, Jang Ik Lee, Jung Hee Choi; J Korean Soc Fract 1999;12(2):411-421. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.411

Abstract PDF: Fractures of the distal end of the radius, including Colles'fractures, represent the most common fractures of the upper extremity. Over the past years, many clinicians had thought of fractures of the distal radius as being a group of injuries with a relatively good prognosis. Today, fractures of the distal radius are recognized as very complex injuries with variable prognosis that depend upon the fracture type and the treatment given. We performed a prospective study in 51 patients(52 cases), by using treatment protocol of Palmer, we treated each fracture according to physiological age, activity, X-ray findings and stability after closed reduction. Final outcomes were evaluated by modified clinical scoring system, criteria for anatomical results and combined functional and anatomical results. Results by using modified clinical scoring system were excellent; 8 cases, good; 16 cases, fair; 22 cases, and poor; 6 cases. Results by using criteria for anatomical results were excellent; 8 cases, good; 26 cases, fair; 10 cases; and poor; 8 cases. In wrist rating scales of New York Orthopaedic Hospital, excellent; 7 cases, good; 32 cases, fair; 6cases, and poor; 7 cases. In our study, fractures of the distal radius were occurred frequently in active young male with high energy injuries. Criteria about acceptable range of reduction in treatment protocol of Palmer were too wide to obtain satisfactory results. Results from many assessment systems did not matched with each other because of differences of point of views. The results of this study proposed that even acceptable reduction is obtained, better outcomes will be brought by operative modality due to decreased frequency of reduction loss and radial shortening. And also, physical therapy after fracture treatment is considered as one of the important factors influencing functional results and the satisfaction of patients themselves.

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The Change of Kyphotic Angle and Anterior Vertebral Height after Posterior or Posterolateral Fusion with Transpedicular Screws for Thoracolumbar Bursting Fractures: Jae Sung Ahn, June Kyu Lee, Deuk Soo Hwang, Young Mo Kim, Won Jung Kim, Kyu Hwan Byun; J Korean Soc Fract 1999;12(2):379-387. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.379

Abstract PDF

The purposes of this study are to make an operative treatment option of thoracolumbar burst fractures by the degree of initial kyphotic deformity or by the degree of initial loss of anterior vertebral height. We analyzed sixty-three cases of one segmental thoracolumbar bursting fractures treated surgically by posterior or posterolateral fusion with short segmental transpedicular screws fixation method using Diapason or CD from January, 1992 to October, 1996. Indications of operative treatment were that the degree of initial kyphotic deformity was above 15degreesor initial loss of anterior vertebral height was above 30%. Minimum follow-up period was 12 months and the results were as follows : 1. Entirely, mean kyphotic angle was 21.6degreesinitially, 11.3degreespostoperatively and 14.2degrees at the end of follow-up. Mean anterior vertebral height was 59.6% initially, 83.8% postoperatively and 80.8% at the end of follow-up. So 10.3degrees , 24.2% was corrected postoperatively and loss of correction was 2.9degrees , 3% at the end of follow-up. 2. In the respect of the degree of initial kyphotic deformity, when compared above 30degrees with below 30degrees , loss of correction was 7.3degrees , 1.4degrees at the end of follow-up respectively and this result had significant difference between these two groups statistically. 3. In the respect of initial loss of anterior vertebral height, when compared above 55% with below 55%, loss of correction was 7.7%, 2.2% at the end of follow-up respectively and this result had significant difference between these two groups statistically. 4. In the respect of time interval from injury to operation, when compared within 2 weeks with after 2 weeks, respectively loss of correction was 1.7-2.2degrees , 3-3.9% and 4.1degrees , 6.7% at the end of follow-up and this results had significant difference between these two groups statistically. These data suggested if initial kyphotic angle is below 30degrees or initial loss of anterior vertebral height less than 55%, short segmental transpedicular screw fixation provide sufficient stability but if initial kyphotic angle is above 30degrees or initial loss of anterior vertebral height is above 55%,additional anterior interbody fusion may be considered.

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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
Nonfusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Jae-Jung Jeong, Young-Chan Cha, Ji-Kang Park
Spine.2011; 36(2): 170. CrossRef
Efficiency of Implant Removal for Treatment of the Thoraco-lumbar Unstable Fractures - Multi Segments Fixation · Single Segment Fusion -
Heui-Jeon Park, Young-Jun Shim, Wan-Ki Kim, Tae-Yeon Cho, Sung-Min Kwon
Journal of Korean Society of Spine Surgery.2011; 18(3): 103. CrossRef
Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level
Jeong-Gook Seo, Jong-Ho Park, Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 39. CrossRef
Clinical Efficacy of Implant Removal after Posterior Spinal Arthrodesis with Pedicle Screw Fixation for the Thoracolumbar Burst Fractures
Kyung-Jin Song, Kyu-Hyung Kim, Su-Kyung Lee, Jung-Ryul Kim
The Journal of the Korean Orthopaedic Association.2007; 42(6): 808. CrossRef
Results of Non-fusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Seong Choi, Hyun-Chul Shon, Kyoung-Jin Park, Kyeong-Il Jeong, Young-Chan Cha, Hu-Shan Cui
Journal of Korean Society of Spine Surgery.2005; 12(2): 132. CrossRef
Relationships between Posterior Ligament Complex Injury and Plain Radiograph in Thoracolumbar Spinal Fracture
Heui-Jeon Park, Phil-Eun Lee, Byung-Ho Lee, Myung-Soon Kim
Journal of Korean Society of Spine Surgery.2005; 12(2): 140. CrossRef

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The Operative Treatment of Acetabular Fracture: Deuk Soo Hwang, Kwang Jin Rhee, Jun Young Yang, Jang Ik Lee; J Korean Soc Fract 1999;12(2):212-219. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.212

Abstract PDF: PURPOSE
To analysis clinical and radiological result of surgically treated acetabular fractures and to present appropriate surgical approach for fracture type. MATERIAL AND METHODS: A review of 51 surgically treated acetabular fractures, treated between April 1988 and October 1996, using single surgical exposures and combined surgical exposures was conducted. The classification was used Judet & Letournel,s classification and the surgical approach was applied Kocher-Langenbeck, Ilioinguinal, and Combined approach according to fracture aspect. The result was rated on a radiographic as well as a clinical result scale based on Matta,s.
RESULTS
The most common fracture was 14 posterior wall fracture and 7 transverse fracture. the surgical approach was applied Kocher-Langenbeck 29 cases, ilioinguinal 10 cases, and combined approach 8 cases, triradiate approach 2 cases and Extended iliofemoral approach 1 case. A satisfactory reduction was obtained in 87% of the cases (concentric, gap < 3mm). Clinical results were excellent in 28%, good in 54%, fair in 12%, and poor in 6%. Radiologic results at followup indicated 40% excellent results, 35% good results, 16% fair results, and 9% poor results. Postoperative complications appeared in 7 cases including posttraumatic arthritis 2 cases. Two patients later required total hip arthroplasty for avascular necrosis of femoral head and posttraumatic arthritis.
CONCLUSION
Ilioinguinal approach was good method for access to the anterior wall and column fracture, but in case of severe comminuted medial wall fracture company with anterior column, internal fixation is impossible. So, accurate assesment of the fracture pattern by careful radiologic analysis is essential. The posterosuperior dome fracture is important to anatomical reduction because of high risk of posttraumatic arthritis. In case of Transverse fracture, T-shape fracture, and both column, the more displaced column was reduced first, followed by opposite column after reduction identify by intraoperative radiography. We can be attained satisfactory reduction. Therefore, combined approach was good surgical method for this complex fracture.

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Radiologic Evaluation of the Ankle Joint: Comparison of Different criteria & its A vailability of Clinical Practice: Deuk Soo Hwang, Seung Ho Yune, Kwang Jin Rhee, June Kyu Lee, Je Taek Jeong; J Korean Soc Fract 1998;11(4):880-885. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.880

Abstract PDF: Generally it is Known that the best clinical results in treatment of injuries of the ankle are obtained by anatomical restoration of the joint. For objective measurements of tibiotalar joint, some investigators ued different criteria and defined the specific reference points under variable angle of internally rotated anteroposterior projection. But, occasionally we didn't acquire the accurate roentgenographic finding that was suggested by investigators. So, we check the variable angle of internal rotation film in addition to angle suggested by investigators and compare the criteria between them. The purpose of this study is to evaluate availability of internally rotated mortise view and its criteria in clinical practice. Following results was acquired. First, there was no significant difference in measuring the medical clear space on depand on variability of rotation angle. Second, the overlapping distance of tibiofibular syndesmosis decreased by increasing internal rotation angle, but was not under 1mm (ie, index of injury). A third, to measure the Weber's 3 criteria, we need to check the variable internal rotation angle, if necessary. Finally, we acquired the normal range of measurement about Tile's 2 criteria by variable internal rotation angle.

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Recovery of Walking Ability After Operation for Unstable Intertrochanteric fractures of the Femur in Elderly. -Timing on weight Bearing-: Deuk Soo Hwang, Hyun Tae Jung, Sang Beom Kim, Jin soo Kim; J Korean Soc Fract 1998;11(2):296-303. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.296

Abstract PDF

Intertrochanteric fracture of the femur frequently occurs in elderly patients with osteoporosis, represent as unstable and comminuted fracture, is the major cause of the morbidity and mortality in old ages. In the past, the goal of treatment of a fracture was to obtain union with little regard early ambulation is thought to be the best treatment modality. Fifty-three patients with unstable intertrochanteric fracture of the femur treated by possible anatomic reduction and internal fixation with compression hip screw were divided two groups and reviewed. In group A, 25 patients were began to bearing partial weight during six to eight weeks after operation. In group B, 28 patients were began to bearing partial weight as soon as possible(during first to third week after operation). The results were as follows; 1. According to Koval's classification, 6 cases(24.0%) in group A and 12 cases(42.9%) in group B maintained their prefracture ambulatory ability at more than 1 year postoperatively. 12 cases(48.0%) in group A, 8 cases(28.6%) in group B lost more than two grade of ambulatory ability. 2. Average loss of neck-shaft angle was 5.87degree in group A and 9.41degree in group B. Also average shortening was 5.2mm in group A and 12.7mm in group B at more than 1 year postoperatively. 3. The complications were two cases of nonunion in group A, two cases of femur fracture around compression hip screw in group B. There was no evidence of nail penetration or metal failure in both group. We concluded that better results are obtained in the respect of recovery of walking ability when partial weight bearing was started in early, even if more malunion was occurred, which is not seemed to be a severe problem for ordinary daily living in elderly.

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A Comparative Study of Bipolar Hemiarthroplasty for Intertrochanteric Fracture: Direct Anterior Approach versus Conventional Posterolateral Approach
Young Yool Chung, Seung-Woo Shim, Min Young Kim, Young-Jae Kim
Hip & Pelvis.2023; 35(4): 246. CrossRef
Hemiarthroplasty through Direct Anterior Approach for Unstable Femoral Intertrochanteric Fractures in the Elderly: Analysis of Early Cases
Ji-Hun Park, Young-Yool Chung, Sung-Nyun Baek, Tae-Gue Park
Hip & Pelvis.2022; 34(2): 79. CrossRef
The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures
Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim
Hip & Pelvis.2014; 26(2): 99. CrossRef
Changes in Patient Pattern and Operation Methods for Intertrochanteric Fractures
Dong-Hui Kim, Sang-Hong Lee, Sang-Ho Ha, Jae-Won You
Journal of the Korean Orthopaedic Association.2011; 46(1): 49. CrossRef
Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients
Han-Jun Lee, Jong Won Kim, Jae-Sung Lee, Jae June Yang, Woo-Young Hwang
Journal of the Korean Fracture Society.2010; 23(3): 276. CrossRef
Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone
Haw Jae Jung, Jae Yeol Choi, Hun Kyu Shin, Eugene Kim, Se-Jin Park, Yong Taek Lee, Gwang-Sin Kim, Jong-Min Kim
Journal of the Korean Fracture Society.2007; 20(4): 291. CrossRef

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Percutaneous & Minimal Internal Fixation of Displaced Intraarticular Calcaneal Fractures: Deuk Soo Hwang, June Kyu Lee, Hong Rok Oh, Seung Jin Lee; J Korean Soc Fract 1997;10(1):233-241. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.233

Abstract PDF

A displaced intraarticular fracture of the calcaneus is difficult to reduction and to restore its function, and its management still remains controversies. Treatment recomendation ranges from conservative to operative method using percutaneous pins, bone grafting and open reduction with internal or external flxators. We analysed retrospectively 24 displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation of intraarticular fracture of posterior facet in whole 48 cases(36 person) calcaneal fractures between January 1990 to April 1996 at the Department of Orthopaedic Surgery, Chungnam National University Hospital. A single Ollier approach was used in all cases. And we did not add any bone graft on the defected portion of calcaneal fractures. The technique and the result were as follows ; 1. An approach to the sinus tarsi with only Oiliers small lateral incision made an offer a good field for open reduction to the displaced posterior facet of calcaneus and diminishes the risk of lateral soft tissue problems. 2. Even only minimal internal fixation of thalamic joint fragment and percutaneous axial pin fixation of the body is enough to prevent the calcaneal redisplacement and provides enough stability to permit functional aftercare(early exercise and weight bearing) with a good result. 3. The Bohler angle is technically difficult to restoration to normal range of angle in our minimal operative method. 4. A bone graft is an alternative and is not necessary. We proposed our experience obtained in 24 cases as a good method ofr treatment of displaced intraarticular calcaneal fracture, especially in joint depressioin type and tongue type without severe comminution.

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A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture
Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 13. CrossRef

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The Problem of Screw Failure at the Interlocking Nailing using AO Unlearned Tibial Nail(UTN) in the Treatment of the Tibial Shaft Fractures: Ki Young Byun, Kwang Jin Rhee, Jun Kye Lee, Deuk Soo Hwang, Chan Hee Park, Hyeong Seong Kim; J Korean Soc Fract 1996;9(2):480-488. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.480

Abstract PDF: Recently, the interlocking intramedullary nailing is being regarded as one of the best method using static or dynamic UTN(Unlearned Tibial Nail) in the treatment of the tibial shaft fractures. However it has made the locking screw break because the early weight bearing and exercise for the early bony union and the delayed removal of the static locked screw. Failure of the locking screw has not resulted in loss of reduction, but broken screw can make nail removal difficult. The authors have clinically analysed 17 patients of open tibial shaft fractures treated with static or dynamic interlocking intramedullary nailing using UTN followed by more than 6 months at Chung Nam National University Hospital from January 1993. to February 1995. 1. In all 17 cases, nails were inserted via closed method and early weight bearing was encouraged. 2. Among 17 cases, 4 cases of proximal static screw were broken, and all screw failures were occurred in static hole of proximal portion of AO UTN. 3. Among 17 cases, secondary dynamization was tried at POD 4 wks for early bony union in only one case and that revealed good result. So, We recommand that the locking screw of the proximal lowest hole should be removed before weight bearing because of its mechanical weakness, and that the start of weight bearing should be considered according to AO Groups principles including the character of the patient and fractures.

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Treatment of Unstable Intertrochanteric fracture of the femur in Elderly Patients: Deuk Soo Hwang, Cheol Se Ahn, Sang Yong Lee; J Korean Soc Fract 1996;9(2):376-383. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.376

Abstract PDF: Intertrochanteric fractrures in elderly are a frequent problem and are becoming more common as the population of elderly people in the population increase. The treatment of unstable intertrochanteric fracture present a challenging problem. Severe comminution in elderly osteoporotic patients renders internal fixation difficult and precipitate varus malpositioning after internal fixation. We analysed 48 unstable intertrochanteric fractures in 48 elderly patient (58 to 91 yeared, mean age : 78 years) with advanced osteoporosis (grade III or more by Singh et al., and by BMD) between May, 1990 to March, 1995 ; Nineteen had been treated with an anatomical reduction with dynamic hip screw(DHS). In addition to DHS fixation, additional circumferential wiring was done in 1 cases, adjunctive methylmethacrylate bone cement fixation in head and neck was done 2 cases. We classified lag screw fixation alone group as DHS , lag screw fixation and additional oircurnferential wire reinforcement group as DHS II. Twenty had been treated with an anatomical reduction with gamma nail. Another nine that had severe comminuted fracture had been treated with bipolar hemiarthroplasty. In DHS II and gamma nailing group, operation time was longer and amount of transfusion after postoperative period was much than DHS I group. In DHS fixation group, lag screw fixation and additional tircurnferential wire reinforcement of posteromedial fracture fragment group was more favor result than lag screw fixation alone. Nonunion developed in two cases of adjunctive methylmethacrylate fixation with DHS, and malunion(external rotation) developed in two cases of DHS fixation group. We concluded that better result are obtained when posteromedial fracture fragment reduced with circumferential wiring with DHS. In addition to anatomical reduction of fragment, encouraging early postoperative ambulation also contribute to good prognosis. A number of the patients who had fear for weight bearing after 3 month postoperatively compromise ambulation on further follow up. In severely commented fracture that was not able to get stable reduction or in patient necessary for early weight bearing, hemiarthroplasty permit to early ambulation, but it also have many disadvantage.

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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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