Journal of Musculoskeletal Trauma

A Comparison of the Results between Internal Fixation and External Fixation in AO C Type Distal Radius Fractures: Yoon min Lee, Hwa Sung Lee, Seok Whan Song, Jae Hoon Choi, Jong Tae Park; J Korean Fract Soc 2018;31(3):87-93. Published online July 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.3.87

PURPOSE
The purpose of this study was to evaluate the radiological and clinical results of plate fixation and external fixation with additional devices for treating distal radius fracture in AO type C subtypes, and propose a treatment method according to the subtypes.
MATERIALS AND METHODS
Two hundred and one AO type C distal radius fracture patients were retrospectively reviewed. Eighty-five patients in group 1 were treated with volar or dorsal plate, and 116 patients in group 2, were treated with external fixation with additional fixation devices. Clinical (range of mtion, Green and O'Brien's score) and radiological outcomes were evaluated.
RESULTS
At the 12-month follow-up, group 1 showed flexion of 64.4Â°, extension of 68.3Â°, ulnar deviation of 30.6Â°, radial deviation of 20.8Â°, supination of 76.1Â°, and pronation of 79.4Â° in average; group 2 showed flexion of 60.5Â°, extension of 66.9Â°, ulnar deviation of 25.5Â°, radial deviation of 18.6Â°, supination of 73.5Â°, and pronation of 75.0Â° in average. The mean Green and O'Brien score was 92.2 in group 1 and 88.6 in group 2. The radial height of group 1 and group 2 was 11.6/11.4 mm; radial inclination was 23.2Â°/22.5Â°; volar tilt was 11.6Â°/8.7Â°; and the ulnar displacement was 1.27/0.93 mm.
CONCLUSION
Judicious surgical techniques during device application and tips for postoperative management during external fixation can produce similar clinical results compared with internal fixation patients.

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Intra-articular fracture distal end radius external fixation versus locking volar radius plate: A comparative study
S.P.S Gill, Manish Raj, Santosh Singh, Ajay Rajpoot, Ankit Mittal, Nitin Yadav
Journal of Orthopedics, Traumatology and Rehabilitation.2019; 11(1): 31. CrossRef

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Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures: Sung Ki Park, Chang Wug Oh, Jong Keon Oh, Kyung Hoon Kim, Woo Kie Min, Byung Chul Park, Won Ju Jeong, Joo Chul Ihn; J Korean Fract Soc 2010;23(3):289-295. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.289

Abstract PDF

PURPOSE
To assess the result of staged minimally invasive plate osteosynthesis (MIPO) for distal tibial fracture with an open wound or injured soft tissue.
MATERIALS AND METHODS
In 20 patients (mean age, 47.8 year-old) with distal tibial fractures, there were 4 type A fractures and 16 type C fractures based on the AO classification system. Eight of the 20 patients had open fractures. MIPO was performed on average 23.9 days after bridging external fixation. At the final follow-up, we assessed the radiological results of bone union and alignment. Functional results were also evaluated by measuring the degrees of ankle motion and the American Orthopedic Foot & Ankle Society (AOFAS) scores.
RESULTS
Seventeen of 20 cases (85%) achieved primary union at an average of 21.3 weeks. There were 3 cases of nonunion requiring a bone graft. The mean AOFAS score was 88.5 (range, 67~92) and the average range of ankle motion was 49.2degrees (plantarflexion: 37.4degrees, dorsiflexion: 11.8degrees). Complication included 2 cases of minor mal-alignment, 1 case of claw toe and 1 case of peroneal neuropathy. Patients over the age of 60 had lower functional results. Additional factors did not affect the final results.
CONCLUSION
Staged MIPO may achieve satisfactory results in distal tibial fractures with soft tissue compromise, decreasing deep infections and soft tissue complications.

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Anterolateral Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures Using an Anterolateral Locking Plate
Dongwhan Suh, Hwan Hee Lee, Young Hoon Han, Jae Jung Jeong
Journal of Korean Foot and Ankle Society.2020; 24(1): 19. CrossRef
Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures
Sung-Kyu Kim, Keun-Bae Lee, Keun-Young Lim, Eun-Sun Moon
Journal of the Korean Fracture Society.2011; 24(1): 33. CrossRef

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Treatment for Unstable Distal Radius Fracture with Osteoporosis: Internal Fixation versus External Fixation: Jin Rok Oh, Tae Yean Cho, Sung Min Kwan; J Korean Fract Soc 2010;23(1):76-82. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.76

Abstract PDF

PURPOSE
To compare the functional and radiological outcomes of volar plating to that of external fixation for treating unstable osteoporotic distal radius fracture.
MATERIALS AND METHODS
From March 2006 to March 2008, 36 patients with osteoporosis over 60-year old were selected for this study. They were divided into two groups; group I (open reduction and internal fixation with volar fixed angle plate) and group II (closed reduction and external fixation). Clinical outcomes and radiologic outcomes were evaluated.
RESULTS
There was no statistical difference between group I and group II in range of motion and DASH score, BMD score. However, the grip strength and PRWE score were found to be higher in group II (p<0.05). In radiologic evaluation, group I showed higher radial inclination, volar tilting angle (p<0.05).
CONCLUSION
Internal fixation using Volar-fixed Angle Plate seems to give more stable fixation for distal articular fragments compared to external fixation. it could allow early postoperative exercise and could result in low incidence of postoperative complication such as pin track infections and joint stiffness. Therefore, the internal fixation could be more desirable treatment method to manage unstable distal radius fracture.

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Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis
Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin
Journal of the Korean Fracture Society.2013; 26(4): 248. CrossRef

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Staged Minimally Invasive Plate Osteosynthesis of Proximal Tibial Fracture: Joon Woo Kim, Chang Wug Oh, Jong Keon Oh, Hee Soo Kyung, Woo Kie Min, Byung Chul Park, Kyung Hoon Kim, Hee Joon Kim; J Korean Fract Soc 2009;22(1):6-12. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.6

Abstract PDF

PURPOSE
To assess the results of staged MIPO (Minimally Invasive Plate Osteosynthesis) for proximal tibial fractures with compromised soft tissue.
MATERIALS AND METHODS
Eighteen proximal tibial fractures (AO 41:9 cases, AO 42:9 cases) included this study. Ten were open fractures. After temporary external fixation until soft tissue healed (mean 27.3 days), MIPO was performed secondarily without bone graft. We assessed the bony union and knee function, and affecting factors of the results were investigated.
RESULTS
All fractures united at 20 weeks (range, 11~32) except 1 case. Mean range of knee flexion was 134.4degrees and mean IOWA knee score was 89.1. There were 2 superficial and 2 delayed deep infections from open fractures (grade II:1 case, grade III:3 cases), although they healed after implant removal. Open fractures seem to influence the infection rate. Otherwise, there was no related factor affecting the results.
CONCLUSION
MIPO after temporary external fixation can provide favorable results in proximal tibial fractures with soft tissue injuries, but attention of delayed infection should be paid in open fractures.

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MINIMALLY INVASIVE OSTEOSYNTHESIS WITH PLATE OR NAIL FOR META-DIAPHYSEAL TIBIAL FRACTURES - WHAT IS BETTER?
B. Makelov
Trakia Journal of Sciences.2023; 21(4): 357. CrossRef
Effect of Korean Medicine Treatments in Patients with Proximal Tibia Fracture: A Retrospective Observational Study
Jung Min Lee, Eun-Jung Lee
Journal of Korean Medicine Rehabilitation.2020; 30(3): 141. CrossRef
Comparison of Time to Operation and Efficacies of Ultrasound-Guided Nerve Block and General Anesthesia in Emergency External Fixation of Lower Leg Fractures (AO 42, 43, 44)
Chan Kang, Sang-Bum Kim, Youn-Moo Heo, You-Gun Won, Byung-Hak Oh, June-Bum Jun, Gi-Soo Lee
The Journal of Foot and Ankle Surgery.2017; 56(5): 1019. CrossRef
Minimally Invasive Plate Osteosynthesis for Proximal Tibial Shaft Fracture
Young-Soo Byun, Ki-Chul Park, Hyun-Jong Bong, Chang-Hoon Lee
Journal of the Korean Fracture Society.2011; 24(1): 23. CrossRef
The Use of Fresh Frozen Allogenic Bone Graft in the Impacted Tibial Plateau Fractures
Yeung Jin Kim, Soo Uk Chae, Jung Hwan Yang, Ji Wan Lee, Dae Han Wi, Duk Hwa Choi
Journal of the Korean Fracture Society.2010; 23(1): 26. CrossRef
Management of Open Fracture
Gu-Hee Jung
Journal of the Korean Fracture Society.2010; 23(2): 236. CrossRef
Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures
Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn
Journal of the Korean Fracture Society.2010; 23(3): 289. CrossRef
Intramedullary Nailing of Proximal Tibial Fractures
Young-Soo Byun, Dong-Ju Shin
Journal of the Korean Fracture Society.2009; 22(3): 197. CrossRef
Proximal Tibia Fracture: Plating
Ki-Chul Park
Journal of the Korean Fracture Society.2009; 22(3): 206. CrossRef

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Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures: Jae Sung Lee, Yong Beom Park, Han Jun Lee; J Korean Fract Soc 2008;21(2):124-129. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.124

Abstract PDF: PURPOSE
To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation.
MATERIALS AND METHODS
We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test.
RESULTS
There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score.
CONCLUSION
The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.

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Comminuted Pilon Fractures: Comparative Outcome Analysis according to Surgical Techniques: You Jin Kim, Hong Geun Jung, Joo Hong Lee, Woo Sup Byun, Sung Tae Lee; J Korean Fract Soc 2007;20(1):6-12. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.6

Abstract PDF

PURPOSE
To evaluate the overall surgical outcome of the tibial pilon comminuted fractures and perform the comparative analysis between the limited internal fixation-external fixation group and the delayed open reduction-internal fixation (ORIF) group.
MATERIALS AND METHODS
From June 1997 to June 2004, 17 tibial pilon comminuted fractures were treated with the limited internal fixation-external fixation (6 cases) or the delayed open reduction-internal fixation (11 cases). The average age of the patients was 47.7 years (range: 41~63 years), male was fourteen patients, female was three. Follow-up period was average 33.6 months (range: 12~84 months). The clinical outcomes were evaluated by using AOFAS ankle-hindfoot score and patient satisfaction was also evaluated.
RESULTS
AOFAS score at final follow-up was 80.4 points, and 88% of the patients were satisfied with the results. AOFAS scores of the external fixation group and the delayed ORIF group were average 77.0 points and 82.2 points respectively, which did not show the statistical difference (p>0.05). Bony union was achieved at average 16.0 weeks. There were 18 complications such as skin necrosis.
CONCLUSION
We have achieved relatively encouraging functional results and high patient satisfaction for pilon comminuted fractures, without significant result difference between the two surgical techniques.

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The Result of Using an Additional Mini-Locking Plate for Tibial Pilon Fractures
Suenghwan Jo, Jun Young Lee, Boseon Kim, Kang Hyeon Ryu
Journal of the Korean Fracture Society.2017; 30(2): 75. CrossRef

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External Fixation of Pediatric Femur Fractures: Yeung Jin Kim, Tae Kyun Kim, Hwan Deok Yang, Hyung Joon Kim, Jin Young Park, Sang Jin Eun; J Korean Fract Soc 2006;19(3):369-373. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.369

Abstract: PURPOSE
To evaluate unilateral external fixation when applied as the standard treatment of displaced femoral shaft fractures in children.
MATERIALS AND METHODS
From 2000 through 2004, we used a unilateral external fixator (Any-fix(R)) to treat 24 femoral shaft fractures. The average age of the patients was 8.3 years (range, 5.6 to 14.8). 16 fractures were isolated, and 8 were associated with polytrauma. There were 4 open fractures. Patients were followed clinically and radiologically until healing and at 1 year.
RESULTS
Average time of external fixation was 97 days (range, 57 to 130 days). All patients regained the normal range of motion of knee joint without significant residual leg length discrepancy or growth disturbance. There were no nonunion, or rotationary deformities. There were 26 pin tract infection (total pin number: 108) (24%), all of which were resolved with antibiotics. No patient developed osteomyelitis. There were two refractures after fixator removal. There was one case of reduction loss and one of valgus deformity.
CONCLUSION
The external fixation is a useful alternative for operative management of femoral shaft fractures because of minimal invasive operation, and early mobilization in prepuberty.

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Treatment of the Unstable Distal Radius Fracture with External Fixation and Bone Cement in Elderly Patients: Dong Chul Kim, Suc Hyun Kweon, Dae Moo Shim, Churl Hong Chun, Ha Heon Song, Jeung Woo Kim; J Korean Fract Soc 2006;19(3):352-356. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.352

Abstract: PURPOSE
To evaluate the functional and radiologic results in the using of external fixation with bone cement (polymethylmethacrylate, PMMA) for unstable, osteoporotic distal radius fractures in elderly patients that have high morbidity and chronic medical problems.
MATERIALS AND METHODS
We retrospectively analyzed 12 cases of 12 patients who were treated by external fixation and bone cement for unstable distal radius fractures in the aged persons with poor general condition from January 2003 to July 2004 and followed over one year. We analyzed the radiologic results, and measured the ranges of motion and grip strengths. Functional results were evaluated using the Modified Mayo Wrist Scoring System.
RESULTS
Radiographically, mean volar tilt, mean radial inclination and mean radial length were 8.33o, 24.66 mm and 11.31o respectively on the last follow-up. The mean arc of range of motion was 74.4% of that the uninjured side, and the mean grip strength was 78.0% of that the contralateral side. The average Modified Mayo Wrist Score was 78.3. There were reflex sympathetic dystrophy in a case and pin tract infection in 3 cases as complications associated with external fixator.
CONCLUSION
External fixation and bone cement is useful method for radial length maintenance, preventing reduction loss, restoring the articular surface, early exercise of the wrist joint without morbidity of donor site for unstable distal radius fractures requiring autogenous bone graft in the elderly patients.

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External Fixation with Five Pins for Unstable Fractures of the Distal Radius: Kyoung Duck Kwak, Cheol Eun Ko, Seung Il Baek, Sang Min Ahn, Chan Jong Jung, Ki Baek Ahn, Jae Su Roh; J Korean Fract Soc 2006;19(3):346-351. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.346

Abstract: PURPOSE
To evaluate the results of five-pin external fixation, with the fifth pin stabilizing the distal radius articular fragment, for unstable distal radial fractures.
MATERIALS AND METHODS
Twenty cases of unstable distal radial fractures were treated with five-pin external fixation (5-pin group). The fifth pin was inserted into the distal articular fragment and attached to the external fixation frame. Metacarpal pins were removed at sixth week in 12 cases and at third in 8 cases, and radial pins were removed at eighth or ninth week. The radiographic results of 5-pin group were compared with those of 20 cases of traditional four-pin external fixation (4-pin group).
RESULTS
The postoperative radial inclination was 23.1 degrees in 5-pin group and 22.2 degrees in 4-pin group; while at last follow-up 21.8o and 15.1 degrees respectively. Postoperative volar tilt was 8.5 degrees and 7.3o; while at last follow-up 6.3 degrees and 0.1 degrees respectively. Postoperative radial shortening was 0.3 mm, 0.4 mm; while at last follow-up 1.1 mm and 2.1 mm respectively. In 5-pin group, there were no significant differences in results whether the metacarpal pins were removed at sixth or third week.
CONCLUSION
Five-pin external fixation, with the fifth pin stabilizing the distal articular fragment, enhanced early motion of the wrist maintaining fracture stability in unstable fractures of the distal radius.

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Arthroscopically Assisted Limited Open Reduction and Ilizarov External Fixation of Tibial Pilon Fractures: Jin Young Lee, Gab Lae Kim, Hyung Seok Oh, Kun Ho Shin, Deok Yong Park; J Korean Fract Soc 2006;19(2):176-181. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.176

Abstract: PURPOSE
To evaluate the clinical results of the pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation.
MATERIALS AND METHODS
This is a retrospective study of the clinical result, bone union, complication and postoperative ankle function of 22 pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation between January 1999 to March 2004.
RESULTS
Clinical follow up averaged 16 months, with an average age of 39.2. All patients with type 1 and 2 fracture had excellent or good score by Ovadia and Beals criteria. Closed fractures healed within 13 weeks and open fractures within 16 weeks after surgery in average. Average range of motion of the ankle was 12o dorsiflexion (0~20 degree) and 25o plantar flexion (15~35 degree).
CONCLUSION
Minimal soft tissue dissection and anatomical reduction are very important factor for minimizing complication and satisfactory ankle function. So, arthroscopically assisted limited open reduction and Ilizarov external fixation is an effective treatment option for tibial pilon fractures.

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External Fixator and External Fixator Supplemented with K-wire in the Treatment of Distal Radius Fractures: Sang Wook Bae, Ho Yoon Kwak, Baik Yong Song, Young Joo Ahn; J Korean Fract Soc 2005;18(3):311-316. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.311

Abstract PDF: PURPOSE
To evaluate the differences of the outcome between external fixator and external fixator supplemented with K-wire in the treatment of distal radius fractures.
MATERIALS AND METHODS
Twenty-one cases which underwent external fixation (external fixation group) and 28 cases, external fixation supplemented with K-wire (external fixation with K-wire group), were analyzed. Radial length, radial inclination and volar tilt were compared in preoperative, immediate postoperative radiographs, and radiographs after removal of external fixator between two groups. And functional outcome including flexion, extension, pronation and supination of wrist were compared between two groups and wrist pain, as well.
RESULT
Radial length and radial inclination in the postoperative radiographs and radiographs after removal of external fixator showed no difference between two groups, but volar tilt of external fixation group measured 2.1+/-4.2 degrees, 1.3+/-3.8 degrees and external fixation with K-wire group, 8.8+/-2.3 degrees, 8.5+/-2.4 degrees respectively, so that external fixation with K-wire group showed better reduction and maintenance. Wrist flexion and extension about postoperative 6 months measured 25.6+/-8.2 degrees, 25.1+/-10.2 degrees, respectively, in external fixation group and 42.5+/-15.2 degrees, 33.6+/-9.5 degrees in external fixation with K-wire group, so that external fixation with K-wire group showed better functional results.
CONCLUSION
In the treatment of distal radius fractures, to obtain better reduction and function result, external fixations supplemented with K-wire need to be taken into consideration.

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Clinical Results after Percutaneous Surgical Treatment of Intra-articular Fracture of the Distal Radius: Jae Ryong Cha, Jung Hoei Ku, Hyung Lae Cho, Jin Wan Kim, Yoo Dae Kim, Young Il Park, Seong Hwak Hong; J Korean Fract Soc 2005;18(3):304-310. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.304

Abstract PDF: PURPOSE
To evaluate the clinical and radiologic results of percutaneous surgical treatment of the intra-articular fractures of the distal radius, we have compared the results of percutaneous pinning and the combination of percutaneous pinning with external fixation after closed reduction.
MATERIALS AND METHODS
We analysed the results of 52 patients with intra-articular fracture who received the operative treatment with closed reduction in the period of June, 1995 to June, 2001 and also were in regular follow-up at least one year. We used the subjective analysis by Cole & Obletz and the objective analysis by Scheck.
RESULTS
We have found the outcome that 83.3% of percutaneous pinning were graded above "Good" in type B and C1 and 82.2% of the combination treatment of percutaneous pinning with external fixation were graded above "Good" in type C2 and C3.
CONCLUSION
The percutaneous pinning and external fixator after closed reduction in intra-articular fractures of the distal radius are considered useful to restore the articular congruity and make good clinical results.

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Two-Stage Reconstruction of Infected Nonunion of Long Bones using Antibiotics-Impregnated Cement Beads: Se Hyun Cho, Soon Taek Jeong, Hyung Bin Park, Sun Chul Hwang, Yong Chan Ha, In Hwan Hwang; J Korean Fract Soc 2004;17(4):395-400. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.395

Abstract PDF

PURPOSE
To evaluate treatment results between internal and external fixation groups in two-stage reconstruction of infected nonunion of long bones using antibiotics-impregnated cement beads.
MATERIALS AND METHODS
In the first stage, preexisting hardwares were removed and radical debridement was done. The dead space was filled with antibiotics -impregnated cement beads and the nonunion site was immobilized by external fixation, cast or skeletal traction. In the second stage, all cases were divided into two groups; the nonunion was fixed by internal fixation in group I versus external fixation in group II. The intervening period between the first and second stage was average 8.7 weeks (range, 3~23 weeks).
RESULTS
The follow-up period was average 45 months (range, 16~71 months). Infection control and bone union were achieved in all 13 cases of group I. Infection recurred in two of 28 cases in group II, one underwent above-knee amputation and the other case was lost in follow-up. The mean number of supportive operations including repeated curettage, augmentation and change of infected pins, angular correction, and soft tissue flap was average 2 and 6.2 times respectively in group I and group II. Bony union period was average 19.3 and 23.1 weeks in each group. According to Paley's classification, group I was similar to group II in bony and functional result (p>0.05).
CONCLUSION
Antibiotics-impregnated cement beads provided positive effect on infection control. Internal fixation group showed less number of additional operations and earlier bony union than external fixation group.

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Treatment of Infected Nonunion
Sang-Ho Ha
Journal of the Korean Fracture Society.2007; 20(2): 206. CrossRef

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Closed Reduction and External Fixation of Displaced Fractures of the Proximal Humerus: Seung Ju Jeon, Ho Seung Jeon, Kye Nam Cho, Jae Ho Choi, Joon Yong Lee; J Korean Fract Soc 2004;17(1):43-48. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.43

Abstract PDF: PURPOSE
This is a retrospective study to analyze the functional results of closed reduction and external fixation of unstable fractures of the proximal humerus.
MATERIALS AND METHODS
Ten unstable proximal humerus fractures were managed with closed reduction and external fixation in which other operative methods are not proper due to comminution, osteoporosis or poor general condition of patients. 4 cases of 2-part and 6 cases of 3-part fracture were included. Radiologically union of fracture, malunion and the evdence of avascular necrosis of humeral head were assessed and the functional results were analyzed with Neer scoring system.
RESULTS
Radiologically all fractures were healed but in 2 cases malunion was resulted because of reduction loss in proximal fragment. Pin site infection was developed in 7 cases and oral antibiotics were needed. The functional results were excellent in 4, satisfactory in 3 and unsatisfactory in 3 cases. 2 cases with malunion and one case with lack of postoperative cooperation resulted in functionally unsatisfactory.
CONCLUSION
External fixation is an alternative method in the treatment of unstable proximal humerus fractures in which open reduction or percutaneous pinning are not proper due to comminution, osteoporosis or poor general condition of patient.

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Surgical Treatment of Fractures of the Distal Radius in Patients Older Than 65 Years: Jeung Tak Suh, Dae Woong Kim, Chong Il Yoo; J Korean Soc Fract 2003;16(4):563-569. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.563

Abstract PDF

PURPOSE
To analyze the results of surgical treatment of the displaced distal radius fractures in elderly patients over 65 years old who were treated with percutaneous K-wire fixation only and percutaneous K-wire fixation with external fixation. MATERIAL AND METHOD: We evaluated 24 cases of the distal radius fracture in patients older than 65 years from January 1998 to December 2001. The patients were followed up at least 12 months postoperatively. We compared the surgical results of 14 cases, treated with percutaneous K-wire fixation only with the surgical results of 10 cases, treated with percutaneous K-wire fixation with external fixation. We evaluated the functional results according to demerit point system and the radiographic results (radial length, radial inclination, volar tilt).
RESULTS
According to demerit point system, the mean score of demerit point was 9.9 in the group of percutaneous K-wire fixation and 5.3 in the group of percutaneous K-wire with external fixation respectively (p<0.05). In radiographic results, the percent of the mean loss of radial length, radial inclination and volar tilt were 23.2%, 12% and 41.7% in the group of percutaneous K-wire fixation and 11%, 5.9% and 27.4% in the group of percutaneous K-wire with external fixation respectively (p<0.05).
CONCLUSION
Percutaneous K-wire with external fixation showed better functional and radiographic results than percutaneous K-wire fixation only for the treatment of the displaced distal radius fractures in elderly patients older than 65 years and percutaneous K-wire with external fixation is thought to be a one of the most effective treatment of the displaced distal radius fractures in elderly patients.

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Osteoporotic Distal Radius Fracture-conservative Treatment
Seok-Whan Song
Journal of the Korean Fracture Society.2008; 21(1): 81. CrossRef

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Treatment of the Distal Metaphyseal Fractures of Tibia - Comparison between Internal Fixation with a Plate and screws and External Fixation with Ilizarov Device: Sung Churl Lee, Moon Jib Yoo, Hyun Seok Seo; J Korean Soc Fract 2002;15(3):371-378. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.371

Abstract PDF

PURPOSE
The purpose of this study was to compare the results between open reduction and internal fixation with plate and screws and closed reduction and external fixation with Ilizarov device for the fracture of disatal metaphyseal fracture of tibia.
MATERIALS AND METHODS
In this study, the results in treatment of the 19 distal metaphyseal fractures of tibia with closed reduction and external fixation with Ilizarov device were compared with those in treatment of the 23 fractures with open reduction and internal fixation with a plate and screws. The cases were the patients who had been treated for the fractures at the Department of Orthopaedic Surgery, Dankook University Hospital from May 1997 to December 2000. The results of treatment were analysed using functional evaluation by Mast and Teipner and radiological evaluation by Ovadia and Beals.
RESULTS
The results were as follows: 1. The major causes of injury were motor vehecle accidents, fall-downs, and falls from a height in order. 2. Treatment of the fractures with closed reduction and external fixation with Ilizarov device showed comparable results to that with open reduction and internal fixation with a plate and screws. 3. Complications in treatment were a little more frequent in open reduction and internal fixation with a plate and screws than in closed reduction and external fixation with Ilizarov device.
CONCLUSION
Considering the results, closed reduction and external fixation with Ilizarov device is thought to be one of recommendable options in treatment of the distal metaphyseal fractures of tibia with the advantages in wound management, prevention of stiffness of ankle joint, and convenience in removal of the device.

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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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External fixation of distal radius fracture: Deok Weon Kim, Moon Ki Kim; J Korean Soc Fract 2002;15(2):258-263. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.258

Abstract PDF: PURPOSE
In the treatment of an unstable intraarticular distal radius fracture, we report the result of a retrospective study of reduction maintaining effect of external fixation.
MATERIALS AND METHODS
During the period from May 1996 to May 1999, 19 patients 20 cases with AO type C2, C3 distal radius fracture were treated by external fixation and followed-up for 2 years or longer. Six had AO type C2 fracture, and fourteen type C3. We evaluated immediate postoperative & follow-up radiological evaluation by volar tilt, radial inclination, radial length difference. As combined treatment, additional reduction maintaining effect of bone graft or internal fixation was evaluated also.
RESULT
Mean reduction loss of 2 years or longer follow-up after external fixation was volar tilt 7.2 degrees, radial inclination 4.3 degrees, radial length 3.1 mm. As additional reduction maintaining effect, internal fixation had statistically significant effect(p <0.05)-especially radial length maintenance, but bone graft not significant.
CONCLUSIONS
In unstable intraarticular distal radius fracture, after open reduction or bone graft etc. for intraarticular anatomic reduction, we consider external fixation or combined internal fixation for reduction maintenance.

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Treatment of Femoral Shaft Fractures with External Fixators in Children: Ha Yong Kim, Jong Hyun Park, Seung Hun Lee, Kap Jung Kim, Kwang Won Lee, Byung Sung Kim, Won Sik Choy; J Korean Soc Fract 2002;15(1):36-44. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.36

Abstract PDF

PURPOSE
This study was to assess the amount of overgrowth and convenience after external fixation of pediatric femoral fracture.
MATERIALS AND METHODS
Followed-up more than 18 months were 20 childrens treated with external fixator for femoral fracture(mean follow-up periods: 25.5 months). Mean age was 7.15 years(range: 4-11 years). End to end apposition was done on the closed reduction. Evaluation of the result was done with five parameters; clinical results, radiological results, parents`satisfaction with questionnaire, hospital fee and complications.
RESULTS
Clincal results were not any disability in all cases. No angulation deformity was estimated in all cases, and overgrowth was estimated average 4.8mm (range: -1 ~ 13mm). Answer for questionnaire was revealed satisfactory result. Total hospital fee was average 831 thousand won in external fixator group, and average 289 thousand won in treated group with cast.
CONCLUSION
We propose that external fixation in closed femoral shaft fractures of children could be a rational alternative mode of therapy, because it has excellent clinical & radiological results and parents were satisfied with its convenience & final results. Total hospital fee was statistically higher in external fixator group.

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Comparison of Flexible Intramedullary Nailing with External Fixation in Pediatric Femoral Shaft Fractures
Do-Young Kim, Sung-Ryong Shin, Un-Seob Jeong, Yong-Wook Park, Sang-Soo Lee, Keun-Min Park
The Journal of the Korean Orthopaedic Association.2008; 43(1): 30. CrossRef
WDM-PON upstream transmission using Fabry–Perot laser diodes externally injected by polarization-insensitive spectrum-sliced supercontinuum pulses
Yang Jing Wen, Chang-Joon Chae
Optics Communications.2006; 260(2): 691. CrossRef

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Comparison of External Fixation and Interlocking IM Nail in Open Tibial Fractures: Hyung Jin Chung, Duck Kyu Kim, Yerl Bo Sung, Jong Guk Ahn; J Korean Soc Fract 2001;14(4):632-642. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.632

Abstract PDF: PURPOSE
To compare and analyze the results of the treatment based on the method of treatment between interlocking IM nail and external fixation of type II, III A, and III B open fractures of the tibia] shaft.
MATERIALS AND METHODS
A clinical analysis was performed on 57 cases of type II, III A, and III B open fractures of tibial shaft from January 1994 to October 1999 those studies are followed at least 1 year or more. The results was analyzed according to complications and functional results based on operative methods of types of open fractures.
RESULTS
In aspect of delayed union and nonunion, interlocking IM nail indicate a great results(p = 0.036) in type II. In angulation, interlocking IM nail marks an outstanding results in case of type II. There is no difference between interlocking IM nail and external fixation in infection. But, the delay of operation after injury increase the possibilities of infection.
CONCLUSION
At present, especially in type m, external fixation was preferred. But, interlocking IM nail has a good results in aspect of complications. Therefore unreamed intramedullary nailing for open tibia shaft fractures is a good treatment method to be recommended.

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Surgical Treatment for Tibial Condyle Fracture of the Proximal Tibia: Won Tae Choi, Bo Yel Choi, Chul Hyung Lee, Eui Soon Kim, Jeong Woung Lee, Doo Hoon Sun, Myung Sang Moon; J Korean Soc Fract 2001;14(2):291-297. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.291

Abstract PDF: PURPOSE
To evaluate the results of operative treatment for tibial condyle fracture of the proximal tibia. MATERIAL AND METHODS: From March 1995 to June 1999, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 10 of them were treated by open reduction and internal fixation(plate & screw for 8, screw & K-wire for 2) and 5 of them by closed reduction and Ilizarov fixation. Preoperative prognostic factors were considered as the fracture type of Schatzker classification, associated injury, and closed or open fracture. Functional outcome was evaluated results by Blokker`s criteria.
RESULTS
According to Schatzker classification, type III were 4 cases, type IV were 6 cases, and type V were 5 cases. At last follow up, average range of motion was 115degrees (Internal fixation was 110degrees, External fixation was 130degrees) The results was according to Blokker`s criteria, 11 cases(73%) had satisfactory acceptable results, among 4 cases(27%) of non-acceptable criteria.
CONCLUSION
For treatment of tibia condyle complicated communited fracture, we are able to consider that rigid internal fixation with anatomical reduction and external fixation for early range of motion.

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Two-Stage Treatment of Infected Nonunion of the Tibia using Antibiotics Impregnated Cement Beads and External Fixator: Yeon Cheon Jeong; J Korean Soc Fract 2000;13(4):884-890. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.884

Abstract PDF: PURPOSE
To evaluate the results of two-stage treatment for infected nonunion of the tibia using antibiotics impregnated cement beads(AICB) and external skeletal fixation.
MATERIALS AND METHODS
We analyzed 25 infected tibial nonuinon that were treated with AICB and external skeletal fixation from July 1995 to April 1998. The average follow-up was 25 months. In the first stage, sequestrectomy and radical debridement was performed. and then the soft tissue and bony defects were filled with AICB and was stabilized with external skeletal fixation. In the second stage, after removal of AICB and the nonunion site was either grafted with autogenous cancellous bone graft(17 patients) or internal bone transport(8 patients) was performed according to the bone defect size.
RESULTS
The average bony union time was 36.8 weeks. The intervening time between the first and second stages of treatment was 4 to 6 weeks (average 5.4 weeks). There were 8 pin tract infections, 1 Postoperative infection after the second-stage bone grafting. According to Paley's functional assessment system, excellent or good results were obtained in 20 cases. There was no poor result.
CONCLUSION
In our opinion, the above advocated two-stage treatment is an acceptable treatment modality for the management of infected tibial nonunion.

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Bicondylar Tibial Plateau Fractures Treated with Hybrid-Ring External Fixator: Chang Wug Oh, Hee Soo Kyung, Joo Chul Ihn, Byung Chul Park, Young Chul Choi; J Korean Soc Fract 2000;13(4):877-883. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.877

Abstract PDF

PURPOSE
This study was designed to evaluate the indirect reduction or limited internal fixation with hybrid external fixation for bicondylar fractures of proximal tibia. MATERIALS & METHODS: Twenty-two cases (mean age; 49) proximal tibial fractures have been treated, including 7, type V and 15, type VI. After reconstruction of articular surface, the hybrid fixation was applied at the condyle and shaft with or without limited internal fixation by cannulated screw or one-third plate. We permitted early ROM exercise of knee and partial weight-bearing about 4 weeks after operation.
RESULTS
Time to union averaged 15.6 weeeks(range ; 11-20 weeks). There were 4 cases of nonunion including three cases of early bone graft for severe comminution and one infection. Functional scoring revealed 5 excellent, 12 good, 3 fair and 2 poor results. 18 out of 22 cases had good or excellent result in anatomical grading. The mean range of knee motion was 116 degrees(from 4.1 to 120 degrees). In complications, there were two cases of malunion, one deep infection, and one pin-site infection, but soft tissue compromise such as skin necrosis was not happened.
CONCLUSION
The indirect reduction or limited internal fixation with hybrid external fixation for bicondylar fractures of proximal tibia have advantages of anatomic, stable fixation, early mobilization and less soft tissue dissection, so good results of knee function can be accomplished.

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Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures
Jae-Sung Lee, Yong-Beom Park, Han-Jun Lee
Journal of the Korean Fracture Society.2008; 21(2): 124. CrossRef

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Two Stage Treatment of Infected Nonunion of Femur with Antibiotics Impregnated Cement Beads and External Fixator: Hyung Bin Park, Yeon Chen Jung, Hae Ryong Song; J Korean Soc Fract 2000;13(4):817-824. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.817

Abstract PDF: PURPOSE
The purpose of this study was to find out the treatment efficiency of two stage osteosynthesis with antibiotic cement beads and external skeletal fixation for infected nonunion of femur.
MATERIALS AND METHODS
In the first stage, radical debridement was performed. The soft tissue and bony defects were filled with antibiotics impregnated cement beads and the nonunion site was stabilized with external skeletal fixation. In the second stage, the debrided nonunion site was repaired with bone grafting. The intervening time between the first and second stages of treatment was 4 to 6 weeks (average 5.4 weeks). The bone defects ranged from 0.5 to 14cm, Autogeneous iliac cancellous bone grafting was performed in 17 patients and microvascularized fibular graft was performed in 5 patients.
RESULTS
The follow-up period was average 45 months (range, 27-62 months). Infection control and bone union were achieved in all 22 cases. Postoperative infection after the second-staged bone grafting occurred in one patient. This recurred case was treated with repeated two staged operation. Even though aggressive physical theraphy was done, all patients had relevant knee flexion deficits. 14 patients were achieved more than 100 degrees of knee flexion, but 8 patients had less than 80 degrees of range of motion.
CONCLUSION
We have found that two-stage treatment with antibiotic beads local therapy, external skeletal fixation, and staged bone grafting is an acceptable treatment modality for the management of infected femoral nonunion. It results in rapid recovery from osteomyelitis and a predictable recovery from nonunion.

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Radiologic Follow-up Results of Distraction After Treatment of Distal Radius Fractures using External Fixator: Jong Oh Kim, Dong Wook Kim, Young Do Koh, Jae Doo Yoo, Kyoung Soo Kim; J Korean Soc Fract 1999;12(4):988-994. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.988

Abstract PDF: External fixation for severe fractures of the distal radius is accepted treatment offering the potential advantages of controlled distraction, accurate positioning of fracture fragments, and avoidance of extensive open procedures. One of the limitation of external fixation for distal radius fractures is excessive distraction, which affect the outcome. This study was conducted to evaluate the changes of the distraction of the intercarpal and radiocarpal joint, developed after treatment of distal radius fractures with external fixator. Restrospective study was done for 28 paitents, who were evaluated by chart review, questionnaire, radiograph, and physical examination. The carpal height ratio, radial inclination, velar tilt, radial length were measured in the postoperative and follow-up radiographs. The carpal height ratio was used to quantify the distraction. Functional evaluation was performed with Demerit-Point system described by Garthland and Werley. Five fractures had an excellent results, 16 had a good results, 4 had a fair results, and 3 had poor results. After union, average radial inclination was 21.3 degree, average dorsal angulation was -0.5 degree, and radial shortening was 1mm. Increased carpal height ratio of the 9 cases did not decrease to less than 0.56 at one year after operation. The over-distraction of intercarpal and radiocarpal joint developed after external fixation of the distal radius fracture, did not have decreased in the one year follow-up radiographs after operation. The over- distraction should be avoided intraoperativly.

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Treatment of comminuted Tibial Fractures using Ilizarov Method: Eui Hwan Ahn, Sung Tae Lee, Hyeon Seok Kang; J Korean Soc Fract 1999;12(4):916-923. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.916

Abstract PDF: From March 1996 to March 1999, thirty two cases of comminuted tibial fractures were treated with Ilizarov external fixator. 13 cases were closed fractures and 19 cases open fractures. Among 19 open fractures, there were 3 cases of Gustilo type I, 10 cases of type II and 6 cases of type III fractures. All the cases could not be initially treated by open reduction and internal fixation because of open wound or severe comminution. Among 32 cases, 4 were tibial condyles, 22 were tibial shafts, 6 were tibial plafonds. All the cases were followed up from a minimum 12 months up to 35 months with an dverage of 22 months. We obtained satisfactory bony union in ail cases with the average duration of 18.1 weeks. Bone graft was done initially in two cases. Numerous complications were encountered, most commonly, joint stiffness and pin tract infection were developed but they were treated well. To avoid such complications, careful management was needed. According to Tuckers clafsification, the result was graded as excellent in 8, good in 18, fair in 4 and poor in 2 cases. We conclude that Ilizarov external fixatior is a very useful method for initial treatment in getting reduction, maintenance of reduction, early ambulation and fracture healing in cases of communited tibial fractures whether open or closed.

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Ilizarov External Fixation for Severe Open Tibial Shaft fractures in Adults: Jeung Tak Suh, Tae Wook Nam, Chong Il Yoo; J Korean Soc Fract 1999;12(3):549-556. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.549

Abstract PDF: PURPOSE
It is to evaluate and discuss the result of severe open tibial shaft fractures treated by Ilizarov external fixation.
MATERIALS and METHODS
From the January 1992 to July 1997, 34 cases of severe open tibial shaft fracture in adults were treated with Ilizarov external fixator. 20 males and 14 females were followed for at least 1 year.
RESULTS
Fractures were evenly distributed through proximal 1/3 to distal 1/3 and its pattern was mostly comminuted one. According to Gustilo-Anderson classification, it mainly consisted of type IIIa &IIIb(28 cases: 82%). Mean bony union time was 40.2 months. There were 5 cases(15%) of delayed union, 2 cases(6%) of nonunion, 5 cases(15%) of deep infection including 3 cases(9%) of osteomyelitis, 10 cases(29%) of pin tract infection, 4 cases(12%) of malunion and 11 cases(32%) of ankle stiffness.
CONCLUSION
Conclusively, in the first place, for the successful treatment with Ilizarov external fixator, determining appropriate indications is the most important. Secondly, active reconstruction of soft tissue environment and early prophylactic bone graft, if necessary, are also essential to shorten union time. Thirdly, meticulous care of pin site and ankle motion is needed for the prevention of the two most common complications even though they are considered to be minor.

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External fixation versus percutaneous pinning for unstable Colles'fracture: Suk Woong Yoon, Tae Sung Hwang, Jong Haeng Lee; J Korean Soc Fract 1999;12(2):461-470. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.461

Abstract PDF: The twenty-three cases of unstable Colles fracture were treated from Jan. 1994 to May 1998 at the department of orthopaedic surgery of Seoul Red Cross Hospital. Among them, the sixteen cases were treated with closed reduction with percutaneous pinning, others were treated with external fixator(Ace colles quadrilateral devices, USA). A retrospective study was made and evaluated using the Modification of Gartland and Werley's scoring system. The result of this study were as follow: 1. The ratio of male to female was 9 cases(39%) to 14 cases(61%). 2. The causes were falling down from a height 12 cases(50%), slip down 8 cases(35%) and traffic accident 3 cases(13%). 3. The reduction loss did not occur with the patients treated external fixation using Ace colles qredrilateral device, however three cases of the reduction loss have occurred with the patients using percuteneous pinning. 4. According to the Modification of Gartland and Werley's scoring system, the results of exteral fixation were excellent 4 cases(58%), good 1 case(14%), fair 1 case(14%) and poor 1 case(14%). and for percutoneous pinning, excellent 6 cases(38%), good 4 cases(25%), fair 2 cases(12%) and poor 4 cases(25%). 5. The complications of cases using external fixation were pin site infection 1 case and wrist stiffness 1 case, but for percutaneous pinning, reduction loss 3 cases. pin site infection 2 cases, wrist stiffness 2 cases, and decreased external rotation of forearm 3 cases.

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Reamed versus Unreamed Intramedullary Nailing after External Fixator Application in the Treatment of Open Tibial-Shaft Fracture: Dong Bae Shin, Joon Cheol Choi, Young Soo Lee, Yong Jeng Kim, Soo Hong Han, Dong Eun Shin, Yeun Ho Lee; J Korean Soc Fract 1999;12(2):272-276. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.272

Abstract PDF: The authers reviewed 15 patients of open fracture of the tibial shaft who were treated by external fixation followed by intramedullary nailing. These fractures comprised two Type-I, two Type-II, four Type-IIIa, and seven Type-IIIb injuries. Ten patients were treated with unreamed intramedullary nailing and 5 patients were treated with reamed intramedullary nailing. The results were analyzed as followings: 1. All fractures had union at 5.2 months after intramedullary nailing and 4 true osteomyelitis were developed. 2. All osteomyelitis were developed for the patients who were treated with reamed intramedullary nailing. 3. There was no osteomyelitis who were treated with unreamed intramedullary nailing. 4. Delayed conversion to intramedullary nailing after control of pin tract infection had no effect for prevention of osteomyelitis.

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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 High-Energy Tibial Plateau Fracture: A comparison of External Fixation with Limited Internal Fixation to Plate and Screw Fixation: Suk Woong Yoon, Tae Sung Hwang, Byoung Gue Park; J Korean Soc Fract 1998;11(4):769-777. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.769

Abstract PDF: High energy tibial plateau fractures are associated with wevere articular depression, separation of both condyles, diaphyseal comminution and dissociation & loss of integrity of the soft tissue envelop. Thus it is very difficult to treat these fractures satisfactorily and severe complications may be developed. Authors carried out plate and screw fixation in 11 patients and external fixation(Ilizarov external fixator) with limited internal fixation in 8 patientsl who sustained high-energy tibial plateau fracture between Jan. 1992 and Feb. 1996. We compared the operative results of plate and screw fixation and external fixation with limited internal fixation in high-energy tibial plateau fractures which was follow up from 12months to 28months. The results were as follows; 1. The complications such as limitation of knee motion(3 cases), traumatic arthritis(1 case), angular deformity(2 cases), superficial infection(2 cases), deep infection(1 case), instability(1 case) were observed in plate fixation group. Limitation of knee motion(1 case), traumatic arthritis(1 case), delayed union(1 case) were developed in external fixation group. 2. According to Blokker's criteria, 6 cases(55%) among 11cases of plate and screw fixation group and 5 cases(63%) among 8 cases of Ilizarov external fixator group had satisfactory results. Ilizarov external fixation with limited internal fixation is useful method of treatment for high-energy tibial plateau fractures when extensive dissection and internal fixation are contraindicated due to comminution at the fracture site and compromise of the soft tissue.

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Treatment of Intraarticular Calcaneal Fractures using Ilizarov Exteranl Fixation: Byeong Yeon Seong, Dong Seong Park, Seung Jun Park, Sang Wook Kim; J Korean Soc Fract 1998;11(3):591-596. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.591

Abstract PDF

Open reduction and internal fixation (ORIF) is gaining in popularity as method of choice for the treatment of displaced intraarticular calcaneal fracture since diagnosis and classification of computed tomography have become routine. But early weight-bearing cannot be allowed by convertional ORIF, and delayed weight-bearing may contributed to heel had pain and dystrophy. We performed combined technique of limited internal fixation and Ilizrov external fixation to ten-cases of displaced intraarticular calcaneal fractures, between February 1994 and February 1996. The follow-up period in this study was at least two years. This method can provide not only anatomical reduction, but also stable fixation. None of patients complained of heel pad pain, which was attributed to the desensitization of the heel by early weight-bearing. None of patients went on to late collapse of the posterior facet. clinical results were rated as excellent in six, good in three, and fair in one case. Pin-track infection, complicated operative technique, cumbersomeness and expensiveness of the external fixator itself were shortcomings of this method. We consider this method as one of options for the treatment of displaced intraarticular calcaneal fracture.

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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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Operative Results in AO Type C3 of Tibial Pilon Fracture: Limited Internal Fixation and Hybrid External Fixation: Byeong Yeon Seong, dong Seong Park, seung Jun Park, Sang Wook Kim, Taek Geon Lee; J Korean Soc Fract 1998;11(3):576-584. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.576

Abstract PDF: The intraarticular fractures of the distal tibia has been the most difficult problem due to severe comminution of itself, little bone mass and poor circulation of soft tissue. Recently limited internal fixation with hybrid external fixation has been reported to provide a good clinical results for the severely commnuted or open pilon fractures as a AO type C3. From February 1994 to February 1996, the authors analyzed the clincal and radiological results of 2 year follow-up in 7 cases of the AO type C3 pilon fractures who were treated with combination of limited internal fixation and hybrid externalfixation. 6 cases had good or excellent clinical and radiological results without any serious complications such as skin sloughs, skin infection, malunion and nonunion, but one case had a nonunion who were treated with internal fixation and autogenous iliac bone graft. We believe that the combination of limited internal fixation and hybrid external fixation that does not cross the ankle joint, provides the good clinical results in AO type C3 pilon fractures by early ankle joint motion.

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Treatment of Type IIIB Open Tibial Shaft Fractures: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Doo Koh, Jae Doo You, Jong Keon Oh, Young Seuk Kim; J Korean Soc Fract 1998;11(3):560-566. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.560

Abstract PDF

In general, severe open fractures of the tibial shaft have been treated initially with external fixation. However, despite many refinements in this technique, it has been associated with numerous complications, including problems at the sites of pins, non-union, delayed union, malunion, and infection. The purpose of this retrospective study is to analyze the results in a consecutive series of patients. There were 8 males and 2 females with an average age of the 44.9 years(range, 26-64 years). The mean follow up period was 23.2 nibtgs(range, 34-120 days). Free flap procedures were performed on all patients. The average time between removal of the fixator and intramedullary nailing was 16.5 days(range, 11-26 days). Indication of conversion to nailing was abscence of any serous discharge, reddness or local heating around pin-sites and normal renge of laboratory data. All 10 fractures had united with additional bone graft in 7 cases. The most frequent complications were delayed union in 7 cases and infection(superficial infection: 6 cases, osteomyelitis: 1 case) after IM nailing. We concluded that pin-tract infection is the major cause of infection after IM nail, but duration of external fixation and time interval(between removal of external fixator and nailing) are not isolated factors.

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Study on Instant Fish Cake Noodle Manufacturing Techniques Using Ultra-fine Powdered Kelp
Yoo-Jin Park, Se-Jong Kim, Myung-Ryun Han, Moon-Jeong Chang, Myung-Hwan Kim
Food Engineering Progress.2019; 23(3): 217. CrossRef
Treatment of Type IIIb Open Tibial Fractures
Seong Yeon Lim, Il Jae Lee, Jae Ho Joe, Hyung Keun Song
Journal of the Korean Fracture Society.2014; 27(4): 267. CrossRef

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The Treatment of Infected Nonunion of Femur after Open Reduction and Internal Fixation: Hee Soo kyung, Joo Chul Ihn, Byung Chul Park, Yong Goo Kim; J Korean Soc Fract 1998;11(3):540-545. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.540

Abstract PDF: Infected nonunion developed after open reduction and internal fixation is one of the serious complications among the treatments of fracture of long bone. It is very difficult to eliminate the infection, to correct the deformity and defect at the same time obtaining union. All six cases were male, the average of age was 34 years old from 21 to 49. Five cases were closed fracture and one was open fracture. For the primary internal implant, five cases were plate and one was intramedullary nail. About the 6 cases of infected nonunion of femur from June, 1994 to October, 1996, we performed the following procedure : after removal of internal fixation, extensive debridememt, complete sequestrectomy, firm fixation with Ilizarov external fixator, compression at fracture site and early autogenous cancellous bone graft. We obtained following results : 1. The average duration of infection was 7.8 months, average duration of bone union was 5.8 months. Average duration of follow-up was 17.5 months. 2. The average shortening of leg was 1.4cm. 3. According to classification of Paley and Catagni, the bone results were excellent in all cases, functional results were excellent in 4 cases and fair in 2 cases. 4. In conclusion, firm fixation with Ilizarov fixator, sequestrectomy, early autogenous cancellous bone graft and compression is one of the good treatment modalities of infected nonunion of the femur.

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Comparison of Results According to the Type and Procedure in Unstable Fracture of the Distal Radius: Jin Young Park, Hong Geun Jung, Moon Jib Yoo, Jeong Wan Kim; J Korean Soc Fract 1998;11(2):435-441. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.435

Abstract PDF

In the treatment of an unstable fracture of the distal radius, the anatomical reduction of articular surface and the maintenance of radial length are essential. Recently, more extensive therapeutic method was introdced for reduction and maintenance of distal radius fracture. To compare the results between type C2 and C3 that were treated with pinning and the results between pinning and pinning with external fixation in type C3 according to AO classification, we analysed anatomical and functional results of unstable fracture of the distal radius from June, 1994 to september, 1996 at DanKook University Hospital. There were 12 cases of C2 type with pinning, 17 cases of C3 type with pinning and 14 cases C3 type with external fixation and pinning. Among the 43 cases, the most commom type was C3 (31cases), and open fractures were 6 (14%)cases. The following results were obtained; 1. For comparison of C2 type with C3 type that were treated with pinning, the results of C2 type were better anatomically and functionally. 2. For comparison of percutaneous pinning with percutaneous pinning and external fixation in C3 type, the results of C3 type that were treated by pinning and external fixation were better anatomically and functionally.

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Treatment for Unstable Distal Radius Fracture with Osteoporosis -Internal Fixation versus External Fixation-
Jin Rok Oh, Tae Yean Cho, Sung Min Kwan
Journal of the Korean Fracture Society.2010; 23(1): 76. CrossRef

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Application & Use of an Ilizarov Technique for the Pilon Fracture: Jin Hong Ko, Beom Koo Lee, Do Hyun Moon, Sung We; J Korean Soc Fract 1997;10(4):879-885. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.879

Abstract PDF: A pilon fracture, which is defined as a comminuted intraarticular fracture of distal tibia, violates the articular region and the metaphysis with occasional extension into the diaphysis, and renders the bone difficult to restore to its anatomic shape. The best known treatment of the pilon fracture is, as recommended by A-O group. In the treatments of the fractures with severe comminution or with significant open soft tissue injury aggressive tries for internal fixation with plate and screws in the distal tibia will result in inevitable stripping of the soft tissue and the periosteum. Therefore, dangers of the delayed union, nonunion, soft tissue necrosis and infection will be increased. The authors treated 14 cases by the Ilizarov external fixation technique for treatment of pilon fracture of the tibia. The average duration of external fixation was thirteen weeks. The results were as follows. v1. Such techniques are especially useful in those injuries with extensive aricular communition and in the open pilon fracture with significant soft tissue compromise. 2. The average duration of external fixation was 13 weeks and the time to clinical union averaged 16.4 weeks. 3. In case of accurate reduction, the better clinical result was obtained.

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Treatment of Open Tibial Fracture with Enternal Fixator: Byung Chang Lee, Sang Soo Kim, Sang Do Cha; J Korean Soc Fract 1996;9(3):605-613. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.605

Abstract PDF: In a retrospective study from 1987 to 1993, we reviewed 191 patients with 203 open tibial fractures which were treated with external fixator and had adequate clinical and radiological follow up evaluation over 1 year. The configuration of fractures was classified using AO classification, and to extent of soft tissue damage was graded using to Gustilo classification of open fracture. There were 108 Grade I ;36 Grade II and 59 were Grade III. We used mainly unilateral two plane type(simple conventional type) and unilateral one plane type. To stabilize supplementarily large bony fragment, screw, K-wire or wire were used in 11, 41 and 6 cases respectively. 117(51.6%) open fracture wounds healed by delayed primary or secondary intentien, whereas 40(19.1%) patients received a split thickness skin graft, 31(15.3%) patients had a rotation of a myncutaneous flap, and 15(7.4%) patients received a free flap surgery for soft tissue coverage. The average time to union was 25.1 weeks. To obtain bone healing, we performed additionally bone graft in 89 cases(43.8%), fixator change only in 8 cases(3.9%), and fixator change with bone graft in 20 cases(9.9%). All cases except 28 open tibial fractures, which was performed fixator change, were treated by primary external fixation without a change of fixator. Major complications were delayed union, nonunion and pin tract infection, and superficial infection, chronic osteomyelitis, pin loosening and partial ankylosis of joint were developed. In conclusion, we think the external fixator is a routine device for open tibial fractures. The configuration of fracture and degree of soft tissue damage had influence on healing of open tibial fracrures. Supplementary fixation in combination with external fixation does not offer important advantages. We should pay attention to bone healing more than soft tissue healing in Crade I & II injury and to soft tissue healing more than bone healing in Grade III injury.

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Treatment of Unstable Intraarticular Fracture of Distal Radius with External Fixator and Minimal open Reduction: Jae Sung Seo, Jin Myeung Dan, Dong Chul Lee, Se Dong Kim; J Korean Soc Fract 1996;9(2):283-289. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.283

Abstract PDF: The distal radius fracture is one of the most common fracture in orthopedics, but their optimal treatment has not been delineated, especially in unstable intraarticular fracture. The unstable intraarticular fracture is increasig due to high energy injury following industrialization and increasing traffic accidents. The unstable intraarticular facture of the distal radius comprises distince subgroups that are difficult to manage and are associated with a high frequency of posttraumatic arthritis. Authors treated 6 cases of unstable intraarticular fracture of distal radius using external fixator and minimal open reduction to improve anatomical and functional results. Six patient were followed up more than one year (mean 19.3 month) and the patients were assessed functional results by Green and 0Briens score and anatomical results by Stewarts scale. Using the external firator and minimal open reduction, is thought to be a useful method for treatment of unstable intraarticular fracture of the distal radius.

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Treatment of Neglected Fracture-Dislocation of the Ankle Using llizarov Device: A case report: Hong Jun Han, Dong Churl Kim, Seong Ho Lee; J Korean Soc Fract 1995;8(3):615-619. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.615

Abstract PDF: There was a close correlation between the final clinical result and the quality of reduction of the fracture fragments. Fracture-dislocations of the ankle are relatively rare and unstable injuries in which anatomical reduction and difficult by closed method. More recently, anatomical reduction, secure internal fixation and early motion have been advocated as principle of treatment for a success ful clinical outcome in fracture-dislocation of the ankle. We reviewed the result of a case of the neglected ankle fracture-dislocation that have been reduced anatomically by closed method using a Ilizarov device. Clinical and radiographic results of the technique were satisfactory after length of follow-up thirty-eight months.

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Surgical Treatment of Open Tibia Fractures: Intramedullary nailing versus external fixation: Hag Ji Kim, Kyung Jin Song, Byung Yun Hwang; J Korean Soc Fract 1995;8(3):544-550. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.544

Abstract PDF: There is still controversies in the method of surgical treatment for open tibia shaft fractures according to there degree of comminution and extent of soft tissue injury. It is generally accepted as open fracture type I, II can be treated with intramedullary nailing but there are so many suggestions for the type III fractures until now. We tried to evaluate the treatment result for the open tibia shaft fracture treated with intramedullary nailing or external fixatives with respect to seven parameters. time to union, tibial alignment, total number of operations, range of motion of the knee and ankle, pain, presence of infection, and complications. We retrospectively analyzed surgically treated sixty-sever tibia(sixty-six patients), forty-one tibia with extrernal fixatives and twenty-six tibia with intramedullaty nailing, at the Chonbuk University Hospital from January 1988 to December 1993 with mean follow up 32 months. Traffic accident was the most common cause of fracture. In Gustilos classification, 21 were in type I, 18 were in type II and 28 were in type III. Intramedullary nailing should be a safe alternative to extemal fixation for type I, II and III-A open fractures. External fixatives could be used temporarily or permanently for the type III-B and III-C fractures.

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External Fixation and Limited Internal Fixation in AO Type C Pilon Fracture: Report of Five Cases: Eun Woo Lee, Soo Yong Kang, Il Seok Kim; J Korean Soc Fract 1995;8(1):243-247. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.243

Abstract PDF: Techniaue of biologic fixation and external fifation are playing an crucial role in the management of the severe comminuted fracture with soft tissue injuries. To evaluate the treatment of severe pilon fracture by a conbination internal and external fixation, five high Pilon fractures with open or severs soft tissue injries were treated by a medial external fixator with an articulated ankle hinge(EBI) and limited internal flxation. Two AO C2 fractures and three AO C3 fractures were followed for a minimum of 1 year. All fractures united and had good functional results without any serious complication. We believe that external fixation and limited internal fixation using biologic principle is an excellent alternative method in high energy, complex fracture with diaphyseal comminution.

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Percutaneous Pinning & External Fixation In the Treatment of Proximal Humerus Fracture: Jeong Ho Park, Sung Woon Choi, Young Chan Son, Young Gi Hong, Jeong Hwan Son, Jae Do Kim; J Korean Soc Fract 1995;8(1):152-158. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.152

Abstract PDF: The management of displaced fractures of the proximal humerus is still under debate and the need to evaluate alternative methods has been emphasised. We treated the displaced, unstable 2-part or 3-part fractures by percutaneous pinning or external fixation after closed reduction to reduce the complications of open reduction such as soft tissue contracture, articular stiffness, neurovascular injury and potential non-union. In this paper, we analysed 8 cases of proximal humeral fractures treated by percutaneous pinning and external fixation from Sep. 1992 to Mar. 1994. The results were excellent ; 3 cases, satisfactory; 3 cases, and unstisfactory; 2 cases but no ftilures by the criteria for evaluation of Neer. We concluded that percutaneous pinning or external fixation of displaced, unstable 2-part or 3-part fractures is one of the good methods of treatment.

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Treatment of Wrist Frarture-Disluation using the Mini-External Fixator and Internal Fixation: Chil Soo Kwon, Young Uek Kim, Jin Hyok Kim, Won Ho Choi; J Korean Soc Fract 1992;5(2):417-425. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.417

Abstract PDF: Authors reviewed 8 cases of wrist fracture-dislocation treated with mini-external fixator and internal fixation form Septmeber 1989 to May 1992 with average 6 months follow up. The results were as follows ; 1. Mean ages were 47 years, most patients were young age. 2. We could achieve good results in intra-articular, communited, displaced fracture and open fracture of the wrist by using the mini-externall fixator and internal fixation. 3. Radial length and inclination was maintained mainly by the external fixator. Articular surface restoration and reconstruction was performed by bone graft and the limited internal fixation. We would like to recommend to use the mini-external fixator and limited internal fixation instead of plate and screws for the intraarticular fractue, displaced, communited farcture and open fracture of the wrist.

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Clinical study for use of monofixateur of open tibia fracutres: Seung Gyun Cha, Dong Chul Oh, Won Suk Lee, Ouc Jung Kim, Jin Yong Jung; J Korean Soc Fract 1990;3(2):262-267. Published online November 30, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.2.262

Abstract PDF: Open fracture is common in the tibia than any other long bones. Because of its precarious blood supply, delayed union, nonunion and infection are frequent complications. Many external fixation device has been useful for the management of unstable, comminuted open tibia fracture for its several advantages. Among the 20 cases of open tibia fracture treated with monofixateur device from May 1987 to April 1989, the following results were obtained. 1. By Gustilo et al. Type I, II and III fractures were seen in 2 patients (10%), 16 pateints (80%) and 2 patients (10%) respectively. 2. The average fixation time was 18 weeks and full weight bearing was performed at 31 weeks.

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Analysis of Results of External Fixation in the Tibial Shaft Fracture: Sang Soo Kim, Dae Moo Shim, Min Jong Lee, Yong Suk Shim; J Korean Soc Fract 1989;2(1):60-70. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.60

Abstract PDF: The fracture of the tibia shaft is difficult to treat because of high tendency of open fracture and complications such as osteomyelitis, soft tissue defect, delayed union and non-union. To evaluate that external fixation alone can be a final solution on treatment of the tibial fractures of the change of treament mode after external fixation, We studied 50 cases of fractures of the tibia shaft which were treated with external fixation between January 198 4 and June 1988. The results were as follows. 1. Among causes of injury, the traffic accidents were the most common. 2. Among the type of fractures, comminuted fractures were 26 cases(41%) and open fractures 47 cases(92%). By classification of Gustilo and Anderson most cases were open type III(60%). 3. The 4 cases(8%) were treated with external fixation alone and the time to union ave-raged 5.2 months. 4. For the 15 cases(30%), external fixators were removed, then applied cast and the time to union averaged 5.3 months. The 12 cases(24%) were treated with bone grafting and cast after removal of external fixator and the time to union averaged 6.8 months. 5. Among the secondary additional operatioin required after external fixation, bone operations were 34 cases, soft tissue operations 13 cases and comosite operations 3 cases. The bone 5 cases(39%) out of 13 cases of soft tissue operation. 6. The duration of external fixation was 22 days to 248 days, mean 101.6 days. 7. A retrospective evaluation of 50 cases treated external fixation revealed that external fixation was simple, safe and dffective method in the initial stage of fracture treatment but could not be a final Solution.

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