Journal of Musculoskeletal Trauma

Combined Anterolateral and Lateral Approaches in Treatment of Extra-articular Fracture of the Distal Humerus: Dae Gyu Kwon, Kyoung Ho Moon, Suk In Na, Byung Ki Shin, Tong Joo Lee; J Korean Fract Soc 2012;25(3):185-190. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.185

PURPOSE
The purpose of this study was to analyze the clinical effectiveness of open reduction in the treatment of distal humeral fracture using a newly designed combined approach of anterolateral and lateral approaches to protect the radial nerve.
MATERIALS AND METHODS
We investigated 24 consecutive cases of distal humeral fracture who received open reduction and internal fixation with a plate and screws with a minimum follow-up period of 1 year. We analyzed the patients' age, sex, fracture pattern, timing of the union, range of motion of the elbow joint, and complications. The Mayo elbow performance index (MEPI) was employed for the assessment of elbow joint function.
RESULTS
Clinical union was observed at 10.8 weeks (6~20 weeks) on average. Pre-operatively, there were 3 cases of incomplete radial nerve palsy. All of the cases recovered, and there was no additional radial nerve palsy due to surgery. According to the MEPI, 13 cases were "excellent" and 10 cases were "good" or better, comprising 95.83% of the cases. The range of motion at the elbow was 5.5 degrees (0~15 degrees) of extension, and 131.5 degrees (120~145 degrees) of flexion, suggesting no functional disability. The duration of return to work was 11.2 weeks (5~32 weeks) on average. There were no nonunion, malunion, or infection complications.
CONCLUSION
The combined anterolateral and lateral approach we designed is a clinically effective approach due to facilitation of protection of the radial nerve and attainment of adequate fixation space.

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Posterior Dual Plating for Distal Shaft Fractures of the Humerus
Chul-Hyun Cho, Kwang-Yeung Jeong, Beom-Soo Kim
Journal of the Korean Fracture Society.2017; 30(3): 117. CrossRef
Modified Combined Approach for Distal Humerus Shaft Fracture: Anterolateral and Lateral Bimodal Approach
Tong Joo Lee, Dae Gyu Kwon, Suk In Na, Seung Do Cha
Clinics in Orthopedic Surgery.2013; 5(3): 209. CrossRef

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Interlocking Intramedullary Nailing for Treating Most Distal Tibial Fracture: In Heon Park, Kyung Won Song, Sung Il Shin, Jin Young Lee, Seung Yong Lee, Tae Hyoung Kim, Jeong Hun Cha; J Korean Soc Fract 2003;16(3):356-362. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.356

Abstract PDF

PURPOSE
We analyzed the result of treatment for most distal extraarticular tibial fracture using interlocking intramedullary nail.
MATERIALS AND METHODS
From January 1999 to April 2002, 8 patients who had most distal tibial fracture were treated by interlocking intramedullary nailing. The duration of follow-up was more than 12 months. The mean age was 41.5 years old. There were 5 males and 3 females. During follow-up period, we evaluated the bone union, range of motion of knee and ankle joint and gait pattern.
RESULTS
The average distance from fracture line to ankle joint line was 1.1 cm. The bone union was achieved at average 18.6 weeks. At the last follow-up, there was no limited motion on knee. But at one case, ankle range of motion was limited from 5 degree extension to 35 degree flexion. There was no gait disturbance.
CONCLUSION
Interlocking intramedullary nailing can be recommendable and useful in the most distal tibial fractures.

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Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures
Jung-Han Kim, Heui-Chul Gwak, Chang-Rack Lee, Yang-Hwan Jung
Journal of Korean Foot and Ankle Society.2015; 19(3): 86. CrossRef
Interlocking Intramedullary Nail in Distal Tibia Fracture
Oog Jin Shon, Sung Min Chung
Journal of the Korean Fracture Society.2007; 20(1): 13. CrossRef

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Treatment of Distal Tibial Fractures by Interlocking Intramedullary Nailing: Jung Ryul Kim, Hyung Suk Lee, Moon Ki Choi, Kwang Bok Lee, Jong Hyuk Park, Jun Mo Lee; J Korean Soc Fract 2003;16(3):348-355. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.348

Abstract PDF

PURPOSE
To analyze the result of treatment for distal tibial fractures by interlocking intramedullary nailing.
MATERIALS AND METHODS
Eighteen patients who underwent interlocking intramedullary nailing for distal tibial fracture were followed up for more than one year. We analyzed the fracture configuration, presence of fibular fracture, angular deformity and bone union by follow-up radiograph, and complications. The functional results were assessed by Baird's ankle scoring system.
RESULTS
According to Robinson classification, there were 4 type I fractures, 12 type IIA fractures, and 2 type IIB fractures. All cases were combined with fibular fracture. The mean union period of 18 cases were 21.9 weeks. There were three complications with 3 cases of valgus deformity. In functional outcome according to Baird's ankle scoring system, 15 patients (83%) showed satisfactory results.
CONCLUSION
We concluded that interlocking intramedullary nailing is effective method for the treatment of the distal tibial fractures. However, to avoid valgus deformity of the distal tibia when combined distal fibular fracture, fibular reduction and rigid fixation should be needed.

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Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques
Oog-Jin Shon, Ji-Hoon Shin, Chul-Wung Ha
Journal of the Korean Fracture Society.2013; 26(1): 50. CrossRef
Interlocking Intramedullary Nail in Distal Tibia Fracture
Oog Jin Shon, Sung Min Chung
Journal of the Korean Fracture Society.2007; 20(1): 13. CrossRef

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Treatment of the Distal Femoral Fracture with Anatomical Bone Plate: Sung Ho Hahn, Bo Kyu Yang, Seung Rim Yi, Shun Wook Chung, Je Oh Lee; J Korean Soc Fract 2000;13(2):258-266. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.258

Abstract PDF

PURPOSE
: In this paper, we have intended to evaluate the types of fracture of the distal femur treated with anatomical bone plate, simple and user's friendly apparatus and to assess their clinical results.
MATERIALS AND METHODS
: We retrospectively reviewed 21 cases in 20 patients who were followed up over 1 year among the patients that had distal femoral fractures treated with anantomical bone plate. We analysed their fracture types in AO classification and assessed clinical results according to Neer system. The average duration of follow-up was 30 months(range, 14months to 49 months).
RESULTS
: Ont of twenty-one cases, twelve were A type(A1, 3 cases;A2, 4cases;A3, 5 cases)and nine were C type(C1, cases;C2, 4cases; C3, 3 cases). But B type was none.
CONCLUSIONS
: This study demonstrate that the operation with anatomical bone plate is not only simple and user's friendly technique but also widely appleicable method to treat A and C types of the distal femoral fractures.

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The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Kwang-Hee Park, Yoon-Ho Choi
Journal of the Korean Fracture Society.2009; 22(4): 246. CrossRef

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Ilizarov/Hybrid-Ring External Fixation in the Management of Tibial Plafond Fractures: Chang Wug Oh, Byung Chul Park, Joo Chul Ihn, Sung Jung Kim, Hee Soo Kim, Saeng Guk Lee; J Korean Soc Fract 2000;13(2):244-251. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.244

Abstract PDF

PURPOSE
: To evaluate the results of the treatment of distal tibial fracture using ring or hybrid ring external fixator and to compare the results according to the influencing factors.
MATERIALS AND METHODS
: The authors analized 30 patients, 31 cases of distal tibial fracture who were treated by Ilizarov ring external fixator or hybrid ring external fixator at our hospital from May 1996 to August 1998 and were followed up over 1 year. The type of distal tibial fractrue were classified according to AO group, type A was 7 cases, and type C was 24(C1:5, C2:4, C3:15)cases. Restoration of articular surface of the distal tibia was performed through closed method or minimal invasive technique by minimal internal fixation with K-wire or screw. Then fixation of th distal tibia was done by ring external with multiple transfixing wire. Connection to the tibial shaft was done by Ilizarov ring external fixator(15 cases), or mono-external fixator(Dyna-Extor, 16 cases).
RESULTS
: By Tornetta's assessment of functional results, excellent was 5, good 19, fair 4 and poor 3cases. According to AO classification, the functional results of type A, 7cases were all above good results, among 24 cases of type C, 4cases of C1, 2 cases of C2, and 11 cases of C3 were above good results and there was no statistical difference between the results and the fracture type(P=0.024). One of 3 cases of poor functional results was open type C3 fracture and was complicated with osteomyelitis and refracture, and others two cases type C2 fracture which were complicated with malunion.
CONCLUSION
: The authors had a good results without soft tissue complication after the treatment of distal tibial fracture patients by Ilizarov ring external fixator or hybrid ring external fixator.

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Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator
Suk Kyu Choo, Kyung Wook Nha, Hyoung Keun Oh, Dong Bong Lee
Journal of the Korean Fracture Society.2007; 20(4): 323. CrossRef

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Surgical Treatment of the Fracture of the Distal Humerus: Chang Hyuk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Soo Il Han, Chang Jin Kang; J Korean Soc Fract 1997;10(1):104-111. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.104

Abstract PDF: The treatment of the fracture of the distal humerus has remained one of the most difficult of all fractures to manage. The goal of treatment, which is the same for other intraarticular fractures, is to reestablish articular congruity, rigid fixation and early active motion as soon as possible. It appears that the use of plates is currently the most acceptable method of fixation. The aim of this study is to clarify the correlation between various fixation methods and functional end results, in order to help in choosing treatment modalities. We reviewed 11 cases of the fractures of the distal humerus treated surgically in Orthopaedic Department of Taegu Hyosung University Hospital between 1992 and 1995. Clinical end results were as follows: 1. Of the 11 cases, there was 6 males and 5 females. Age was from 13 years old to 83 years old and mean age was 46 years old. 2. Muller classification consisted of 4 cases of A2, 1 case of B2, 3 cases of Cl and 3 cases of C2. The mean length of follow up was 15 months. Except for 2 cases of open wound and nonunion, time from injury to surgery was 8 days. Mean period of initial exercise was 4 weeks. 3. All surgical incisions were done with posterior approach; they consisted of 5 cases of dual-contoured plates, 4 cases of plate with screw and 2 cases of K-wires with screw. 4. Mean range of elbow motion was flexion 123 and extension defect 14. There was no limition of pronation and supination compared with the normal side. 5. The functional result by Jupiter criteria was excellent in 5 cases, good in 4 cases, fair in 1 case and poor in 1 case. 6. There were complications in 1 case of plate broken and 1 case of nonunion. 7. In the distal fracture of the humerus, There were 82% of excellent of good result by over-all functional result of Jupiter.

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