Journal of Musculoskeletal Trauma

Comparison of the Surgical Treatment Results of Avulsion Fracture of the Anterior Cruciate Ligament between Children and Adults: Eun Kyoo Song, Sang Jin Park, Keun Bae Lee; J Korean Fract Soc 2007;20(2):196-201. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.196

Abstract PDF: PURPOSE
To compare the clinical and radiological results after surgical treatments of the avulsion fractures of ACL between children and adults.
MATERIALS AND METHODS
40 cases (18 cases of children, 22 cases of adults), who underwent surgical treatments after avulsion fractures of the ACL and followed up more than one year, were enrolled. Fractures were classified by modified Meyers & McKeever criteria. Range of motion, LK score, Lachman test, Pivot-Shift test, quadriceps muscle atropy and TelosÂ® stress arthrometer were compared.
RESULTS
The types of fracture in children were categorized into 8 cases of type II, 10 cases of type III, and 2, 15, 5 cases of type II, III, IV each in adult group. Mean LK score showed significant difference between 99.3 points in children and 89.5 points in adults (p<0.05). In addition, accompanied injuries and the high degree of fracture leaded low LK score. However, there was no significant difference in range of motion, Lachman test and Pivot-Shift test. Anterior laxity by TelosÂ® device showed an average of 2.0 mm in children, 2.5 mm in adults (p>0.05).
CONCLUSION
Children group showed better treatment results of avulsion fracture of ACL. Higher incidence of type II fractures and less combined injuries considered to be factors for better results.

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Radical Necrotic Bone Resection and Ilizarov Technique for Infected Nonunion of the Tibia: Keun Bae Lee, Byung Soo Kim, Sung Taek Jung, Eun Kyoo Song, Kyung Do Kang; J Korean Fract Soc 2005;18(4):405-409. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.405

Abstract PDF: PURPOSE
To evaluate the clinical results of radical necrotic bone resection and distraction osteogenesis for the treatment of infected nonunion of tibia using the Ilizarov technique.
MATERIALS AND METHODS
32 patients who were followed up at least 1 year after the treatment of infected nonunion of tibia from March 1995 to March 2001 were evaluated. Their mean age was 43 years and mean duration of follow-up was 37 months. The results were divided into bone results and functional results and analyzed by grading to excellent, good, fair, and poor.
RESULTS
The average amount of bone lengthening was 5.3 cm (range, 2~10 cm) and the average healing index was 61.5 days/cm (range, 52.7~70.4 days/cm). Bony union was obtained at average 10.3 months in all cases. The bone result was excellent in 9 cases, good 18, and fair 5. The functional result was excellent in 8 cases, good 16, fair 7, and poor 1 case.
CONCLUSION
Ilizarov technique is an effective method in the treatment of infected nonunion of tibia for early range of motion exercise, weight bearing and correction of limb shortening.

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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 the Nonunion of Femur Shaft Fractures after Interlocking Intramedullary Nailing: Keun Bae Lee, Eun Sun Moon, Eun Kyoo Song, Jin Choi, Sung Taek Jung; J Korean Soc Fract 2002;15(4):497-503. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.497

Abstract PDF

PURPOSE
We analyzed the results of treatment for the nonunion of femur shaft fractures after interlocking intramedullary(IM) nail fixation. MATERIALS & METHODS: Thirty-three patients who underwent interlocking IM nailing due to femur shaft fractures from May, 1990 to July, 2000 and followed up for more than one year were evaluated retrospectively. Mean age at the time of operation was 40 years(Range, 19-68). 27 cases were men and 6 cases were women. By Weber and Brunner classification of the nonunion, hypervascular type were 10 cases(30%), avascular type 21cases(64%), mixed type 2 cases(6%). Infected type among the avascular type of nonunion were 5 cases(23%). Results were evaluated with bone union by treatment methods and complications.
RESULTS
According to the causes and types of nonunion, we performed IM nail exchange in seven cases, IM nail exchange and bone grafting in eleven cases, external fixation in five cases, compression plating and bone grafting in three cases, and only cancellous bone grafting in seven cases. Radiographical union was achieved in 19 weeks, 17 weeks, 20 weeks, 16 weeks and 15 weeks respectively. There 's no statistically significant difference between treatment methods. There are no cases of nonunion, malunion and infection.
CONCLUSION
The selection of appropriate treatment method by the cause and type of each nonunion is very important to achieve the bony union in the treatment for the nonunion of femur shaft fractures after interlocking intramedullary nailing.

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Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing
Suenghwan Jo, Gwang Chul Lee, Sang Hong Lee, Jun Young Lee, Dong Hwi Kim, Sung Hae Park, Young Min Cho
Journal of the Korean Fracture Society.2019; 32(2): 83. CrossRef

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Usefulness of Interlocking Compression Nail in Treatment of Femoral Shaft Stable Fracture: Keun Bae Lee, Sung Taek Jung, Eun Sun Moon, Eun Kyoo Song, Kwang Cheul Jeong; J Korean Soc Fract 2001;14(4):601-608. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.601

Abstract PDF: PURPOSE
The goal of our study was to evaluate the usefulness and results of the Interlocking Compression Nail in femoral shaft stable fractures.
MATERIALS AND METHODS
The 87 patients, 88 cases, who were underwent internal fixations with interlocking compression nail for the stable fracture of the femoral shaft were evaluated. The majority of the causes of injury was traffic accident and the majority of location of the fractures was middle one thirds. The classification of the fracture using Winquist-Hansen classification showed that grade 0 were 23 cases(26.1%), grade 1, 47 cases(53.4%) and grade 2, 18 cases(20.5%). We used ICnail(Osteo, Switzerland) that can actively compress the fracture gap, maximum 10mm.
RESULTS
We used active compression in 63 cases(71.6%) and the mean length of compression was 2.3mm(range 1-5mm). The bone union was seen in 63 cases(71.6%) at postoperative 4 months and in 87 cases(98.9%) at postoperative 6 months. There was one case of delayed union, but there were no nonunion, infection, leg length discrepancy, and angular or rotational deformity, disturbing the daily activity.
CONCLUSION
The interlocking compression nail can reduce the fracture gap easily and effectively using compression screw by active interfragmentary compression. Thereby promote fracture healing and postoperative stability at the fracture site can be obtained, so early weight bearing is possible. Especially, this is recommendable useful method for femoral shaft stable fracture.

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Treatment of subtrochanteric fracture - Comparison of treatment efficacy according to internal fixation device -: Taek Rim Yoon, Sung Man Rowe, Eun Kyoo Song, Jong Yoon Seol, Sang Gyoo Shin; J Korean Soc Fract 2001;14(2):189-199. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.189

Abstract PDF

PURPOSE
The purpose of this study was to compare the clinical results of subtrochanteric fractures which were treated with compression hip screw, intramedullary nailing and Rowe plate.
MATERIALS AND METHODS
From 1991 to 1999, 84 cases of subtrochanteric fractures were treated in Chonnam national university hospital. Among them, 25 cases were treated with compression hip screw, 18 cases with interlocking IM nailing and 32 cases with Rowe plate. Excluding pathologic fracture, there were 24 cases(group A), 16 cases(group B) and 30 cases(group C) of subtrochanteric fractures which were followed over 1 year. Mean follow up period was 18, 21, 24 months each. We compared the fracture pattern, operation time, operation method, additional fixation, bone union and complications among the groups.
RESULTS
We devided subtrochanteric fracture into below class II and above class III based on Seinsheimer classification. The overall clinical results were 1 case below class II, 22 above III in group A, 12 below II, 6 above II in group B, and 4 below II, 26 above III in group C. The average operation time was 153 minutes in group A, 166 in group B, and 150 in group C. Additional wiring was performed in 15 cases in group A, 1 in group B and 6 in group C. Interfragmentary screw fixation was performed only in group A(12 cases). Bone graft was performed in 6 cases in group A, 6 cases in group B and 11 cases in group C. The complications were as follows; delayed union 1 case in group A, 2 cases in group B and 6 cases in group C.; Nonunion only 1 case in group B; varus deformity 4 cases in group B and 2 cases in group C; metal failure 1 case in group B and 1 case in group C.
CONCLUSIONS
In treatment of subtrochanteric fractures, compression hip screw was applied to more communited fractures than intramedullary nail, but with additional fixation safe union and excellent clinical outcomes obtained. For intramedullary nailing, great care should be taken not to produce varus malalignment. In plate fixation, we should keep in mind the possibility of metal failure and varus malalignment. Weight bearing should be delayed.

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Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
Hip & Pelvis.2014; 26(2): 107. CrossRef
Efficacy of Percutaneous Cerclage Wiring in Intramedullary Nailing of Subtrochanteric Femur Fracture - Technical Note -
Ki-Chul Park, Hee-Soo Kim
Journal of the Korean Fracture Society.2013; 26(3): 212. CrossRef
The Treatment of Subtrochanteric Fracture with Cephallomedually Nail -Minimal Incision and Lowman Clamp Assisted Reduction-
Jang Seok Choi, Do Hyun Moon, Young Tae Noh
Journal of the Korean Fracture Society.2011; 24(4): 301. CrossRef

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Internal fixation with pelvic plate for displaced Acetabular Fracture: Taek Rim Yoon, Sung Nam Jung, Sang Jin Park, Eun Kyoo Song; J Korean Soc Fract 2000;13(4):733-740. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.733

Abstract PDF

PURPOSE
The purpose of this study was to review the clinical and radiographic results after plate fixation for displaced acetabular fracture.
MATERIALS AND METHODS
A clinical analysis was performed on 47 cases of displaced unstable acetabular fracture which had been fixed with plates and screws. Clinical and radiographical results were analyzed according to Epstein criteria.
RESULTS
In 44 cases, internal fixation was performed using only plate and screws. In three cases, the fixation was augmented with cerclage wiring. The fracture type included posterior wall or posterior column fracture in 37 cases(78.7%). Satisfactory results were achieved in 39 cases(86.7%) on clinical grade and 40 cases(88.9%) on radiographic grade. The complications were deep wound infection in two cases, avascular necrosis of femoral head in one case, post traumatic arthritis in 2 cases, and malunion with partial ankylosis in one case. Total hip arthroplasty were needed in two cases with avascular necrosis and infection.
CONCLUSION
Early surgical treatment including accurate anatomical reduction and stable internal fixation is emphasized for better clinical and radiographic results. The plate and screw fixation is well indicated for posterior wall and/or posterior column fracture of acetabulum.

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Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture
Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong
Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef
Comparative Results of Acetabular Both Column Fracture According to the Fixation Method
Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park
Hip & Pelvis.2011; 23(2): 131. CrossRef
Treatment of Acetabular Column Fractures with Limited Open Reduction and Screw Fixation
Jung-Jae Kim, Hyoung Keun Oh, Sung-Yoon Kim
Journal of the Korean Fracture Society.2007; 20(1): 26. CrossRef

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Ilizarov Method for Treatment of Tibia Nonunion Associated with Bone Defects: Sung Taek Jung, Keun Bae Lee, Eun Kyoo Song, Sung Nam Jung; J Korean Soc Fract 1999;12(4):932-939. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.932

Abstract PDF: PURPOSE
: This study was to evaluate the results and complications in gap nonunions of the tibia treated by Ilizarov method MATERIALS and METHODS : We reviewed 30 patients of tibial nonunions(23 atrophic, 7 hypertrophic) with bone loss(1-l3cm, mean 4.6cm) who were treated by Ilizarov technique. The causes of bone defect were open fracture with bone loss(15 cases) and infected nonunions(15 cases). Bone defects were closed by Ilizarov bone transport technique.
RESULTS
All patients had satisfactory union. The mean distraction-consolidation index (distraction-consolidation time/ distraction gap) was 1.3 months/cm. The younger patients and metaphyseal lengthening healed faster than the older patients and diaphyseal lengthening. Even though, we met with the numerous complicationt such as pain around the pin site, pin site infection and delayed union, we could successfully treat most of them.
CONCLUSION
: The application of Ilizarov techniques to nonunions of the tibia with bone defect was very effective, but correct technique and careful follow-up examination was required to avoid complications.

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Use of the Ilizarov Technique for Treatment of Infected Non-Union: Sung Taek Jung, eun Kyoo song, Bong suk Bae; J Korean Soc Fract 1998;11(2):398-404. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.398

Abstract PDF: We reviewed infected non-union of tibia and femur which had been treated by radical resection of the necrotic bone and Ilizarov method in thirty-nine patients. All patients had either one-segment or two segment lengthening of bone with a technique of bone transport. The size of the bone defect that was bridged averaged 5.7cm (range, 2 to 16cm). All cases attained bone union and the infection was eradicated in all pattints before the fixator was removed. The mean duration of external fixator was 14 months(range, 4-28months). The mean external fixation index was 1.6 months/cm and the mean distraction index was 23.2 days/cm. The functional results were exellent in 3 patients, good in 19, fair in 9, poor in 8. The bone results were excellent in 5 patients, good in 20, fair in 10, poor in 4. Complication were pin tract infection in 15 patients, equinus contracture of ankle in 2, knee flexion contracture in 1, transient sensory change in 1, axial deviation in 2, premature consolidation in 2, delayed union in 2, and leg length discrepancy in 2, and refracture in 1. In conclusion, the Ilizarov method is very effective for treatment of infected non-union with bone loss, limb shortening and soft tissue defect.

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Anatomy and Classification: Eun Kyoo Song; J Korean Soc Fract 1996;9(4):841-845. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.841

Abstract PDF: No abstract available.

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Operative Treatment of Patellar Fracutres: Eun Kyoo Song, Dae Ik Kim, Hyung Seog Kim; J Korean Soc Fract 1996;9(3):640-646. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.640

Abstract PDF: Patella has important roles to enhance extensor mechanism of knee, therefore patellar fractures should be treated correctly according to the type and displacement of fractures for the preservation of patellar function. The purpose of study is to analyse the clinical results of operative treatment for patellar fractures. 77 cases of patellar fracture which were treated at Chonnam University Hospital between June 1985 and March 1995 were reveiwed. Among them, 32 cases with open reduction and internal fixation were included in this study. The mean follow-up period was 21.5 months(range twelve to eighty two months). Oircurnferential wiring, modified tension band wiring, malleolar screws and combination of circlage and tension band wiring were used as a fixatives. The clinical results were compared according to Reileys clinical evaluation criteria mainly by range of motions, mid-thigh circumferential difference. The most favorable results could be obtained with the combination of circlage and tension band wiring.

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A Clinical Analysis of Open Reduction of the Ankle Fracture: Eun Kyoo Song, Go Hun Chung, Dae Yeon Hong; J Korean Soc Fract 1996;9(1):212-219. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.212

Abstract PDF: The ankle is a modified hinge joint consisting of tibial plafond, medial and lateral malleolus, talus and many soft tissue structures, which play important role in weight bearing and walking. Ankle joint injury is determined by patients age, quality of bone, the position of a ankle at trauma, direction and degree, velocity of force. Hence, it is very important to understand the mechanism of trauma in order to make definite diagnosis and proper treatment. The authors analysed 71 cases(66 patients) of the ankle fracture which were admitted and treated in Orthopaedic Department, Chonnam University Hospital from Aug. 1985 to June 1994. The most common type of the ankle fracture was supination external rotation type(17 cases, 23.9%), by the classification of Lauge-Hansen, and type C(30 cases, 42.3%) by the AO classification. According to the criteria of Meyer using the clinical and radiological result, pronation-external rotation type gave the best result and the worst results obtained from pronation-dorsiflexion type. We concluded that classification of Lauge-Hansen & AO were useful in the diagnosis and treatment of ankle fracture and accurate reduction and rigid internal fixation of the lateral malleolus, distal fibula and distal tibiofbular diastasis was important in treatment of the ankle fracture.

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Open Reduction and Interrial Fixation of Displaeed Intraartieular Fractures of Calcaneus: Eun Kyoo Song, Dong Hyun Ryang; J Korean Soc Fract 1992;5(2):205-211. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.205

Abstract PDF: Nine displaced intraarticular fractures of the calcaneus involving subtalar joint in six patien ts were treated by open reduction and internal fixation with plate at department of orthopedic surgery, chonnam university hospital from April 1990 to October 1991. The clinical and radiographic results were analysed after follow-up from five to twenty three months. 1. Of 9 fractures, 7 fractures were joint depression type and 2 fractures were tongue type by Essex-Lopresti classification.2. The operations were performed though lateral approach in 8 cases and medial approach in 1 case. 3. At final follow-up 12 months in average the assessments of results by Salama and Rowe unit system showed satisfactory results in 89% and 67%, respectively. 4. The averge Bohler angle was -6.1 before operation and increased to 16.4 at final follow up. 5. The common complication were pain around ankle and heel, subtalar arthritis and cal-caneal deformlty etc.

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Application of the Ilizarow technique to the complications of tibial open fracture report of two cases: Eun Kyoo Song, Ju Chull Jeung, Sung Man Rowe, Hyung Soon Kim; J Korean Soc Fract 1991;4(2):332-339. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.332

Abstract PDF: No abstract available.

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Delayed Femoral Neck Fracture in Interlocking Intramedullary Nailed Femur: A case report: Sung Man Rowe, Eun Sun Moon, Eun Kyoo Song, Sung Taek Jung; J Korean Soc Fract 1989;2(2):269-273. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.269

Abstract PDF: We report an uncommon complication following interlocking intramedullary nailing of the femur: delayed femoral neck fracture after 5 months of unevenful postoperative course. He was a 47-year-old laborer with good quality of bone, nevertheless he sustained femoral neck fracture after minor fall on the ground. We thought that loss of bone elasticity caused by interlocked nail in the whole femoral shaft including intertrochanteric portion made stress concentration on the femoral neck to develop a fracture with minor magnitude of traumatic force.

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Compression Arthrodesis of Ankle Joint using Autocompression Angle Plate: Eun Sun Moon, Eun Kyoo Song, Yong Gi Choi; J Korean Soc Fract 1989;2(2):174-178. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.174

Abstract PDF: We performed the compression arthrodesis in ankle joint of 4 cases, using autocompression angle plate. In all cases, we made successful union within 3 months, without any specific complications. This method gives several advantages, such as short period of external support, good cosmetic effect, early union and early rehabilitation.

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