Journal of Musculoskeletal Trauma

Irreducible Ankle Fracture Dislocation due to Dislocated Tibialis Posterior Tendon - A Case Report -: Seungyup Shin, Bum-Soo Kim, Ji-Won Lee, Euisun Yoon; J Korean Fract Soc 2023;36(2):52-56. Published online April 30, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.2.52

Abstract PDF: An irreducible ankle dislocation is a rare injury. The cause is a dislocation of the distal fibula anteriorly or posteriorly or the insertion of soft tissue, such as the deltoid ligament or posteromedial tendon. The tibialis posterior tendon can be dislocated through distal tibiofibular diastasis and prevent reduction of the ankle joint. The authors experienced anterolateral ankle fracture dislocation with a diastasis of the distal tibiofibular joint, and reduction was impossible because of impingement of the tibialis posterior tendon dislocated anteriorly through the distal tibiofibular diastasis. This paper reports the treatment of this injury.

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Treatment of Neglected Proximal Interphalangeal Fracture Dislocation Using a Traction Device: A Case Report: Yongun Cho, Jai Hyung Park, Se Jin Park, Ingyu Lee, Eugene Kim; J Korean Fract Soc 2019;32(4):222-226. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.222

Abstract PDF: This paper reports the use of a traction device for the treatment of neglected proximal interphalangeal fracture dislocations. A 44-year-old man with a fracture dislocation of a right ring finger proximal interphalangeal joint was admitted 17 days after the injury. Closed reduction and external fixation were performed using a dynamic traction device and C-arm under a brachial plexus block. Passive range of motion exercise was started after two weeks postoperatively and active range of motion exercise was started after three weeks. The traction device was removed after five weeks. No infection occurred during the traction period. No subluxation or displacement was observed on the X-ray taken two months postoperatively. The active range of motion of the proximal interphalangeal joint was 90Â°. The patient was satisfied with the functional result of the treatment with the traction device. The dynamic traction device is an effective treatment for neglected fracture dislocations of the proximal interphalangeal joint of a finger.

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Surgical Outcomes of the Monteggia Type 2 Fracture Dislocation in Adults: Sung Choi, Daegeun Jeong, Youngsoo Byun, Taehoe Gu, Sungsoo Ha, Dongju Shin; J Korean Fract Soc 2019;32(1):6-13. Published online January 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.1.6

Abstract PDF: PURPOSE
This study examined clinical outcomes of Monteggia fracture type 2, which is the most common in adults with a high rate of accompanied injuries.
MATERIALS AND METHODS
From June 2004 to November 2015, a retrospective study was performed on 12 patients diagnosed with Monteggia fracture type 2 with a follow-up period of at least 6 months after surgery. The clinical outcomes were evaluated using the Mayo elbow performance score (MEPS), and the existence of accompanied injures, radiological result, and complications were analyzed.
RESULTS
Posterior instability was confirmed in all patients and accompanied fractures were detected in 9 patients (75.0%) on the radial head, whereas 10 patients (83.3%) were found on the coronoid process. The average arc of motion was 107Â° (70Â°â€“130Â°) and the mean MEPS was 89 (45â€“100). Additional re-operation due to re-dislocation, radioulnar synostosis, elbow instability, ulna nonunion, and radial head nonunion were performed in 4 cases (33.3%).
CONCLUSION
The Monteggia fracture type 2 is more commonly associated with radial head fractures and coronoid process fractures rather than other types, which causes elbow instability. Because the rate of additional surgery due to complications is high, the treatment of Monteggia fracture type 2 requires careful assessments.

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Nerve Injury in Posterior Hip Fracture-Dislocation: Hyung Ku Yoon, Byung Moon Park, Young Kwan Koh, Han Joon Cho; J Korean Soc Fract 2002;15(2):192-200. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.192

Abstract PDF

PURPOSE
To assess the relationship between the type of hip fracture-dislocation and nerve injury, the relationship between the treatment of hip fracture-dislocation and nerve recovery and the effectiveness of electromyography(EMG)-nerve conduction study(NCV) for the diagnosis of nerve injury and clinical result.
MATERIALS AND METHODS
We reviewed 8 cases associated with nerve injury of 52 cases which were diagnosed and treated for hip fracture-dislocation from March 1993 to December 1999 with an average follow up period 18.1 months. Mean age was 36.1 years. We assessed the diagnosis of nerve injury through physical exam at emergency room and follow up EMG-NCV. The clinical results of nerve recovery were evaluated according to the Clawson-Seddon classification.
RESULT
The cause of injury was motor vehicle accident in all cases. The outcome of the nerve injury was analyzed as 4 complete recovery, 3 partial recovery, 1 no recovery for 31 months follow up. The clinical result was analyzed as 7 satisfactory and 1 unsatisfactory. The latter was complete sciatic nerve injury, seemed to be recovered at follow up EMG-NCV but unsatisfactory for clinical result.
CONCLUSION
The nerve injury of the posterior hip fracture-dislocation was not rare and the rate of nerve injury was relatively good. The limitation as a clinical outcome was revealed in the EMG-NCV because one case which seemed to be recovered at follow up EMG-NCV was unsatisfactory for clinical result. In future, we think to require non-invasive, more reliable method for the diagnosis and follow up of the nerve injury and the study of the factor, can improve the nerve recovery.

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Traumatic Bilateral Anterior Hip Dislocation: A Case Report
Sung-Taek Jung, Hyun-Jong Kim, Myung-Sun Kim, Young-Jin Kim, Sang-Kwan Cho
Journal of the Korean Fracture Society.2008; 21(1): 62. CrossRef

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Results of Treatment of Fracture-Dislocations of Elbow: Dong Soo Kim, Soon Ho Hwang, Chil Soo Kwon, Jong Kuk Ahn, Byung Hyun Jung, Yerl Bo Sung, Jae Kwang Yum, Hyung Jin Chung; J Korean Soc Fract 2000;13(1):178-185. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.178

Abstract PDF: PURPOSE
: This study analyzed clinical and biomechanical data from patients with elbow fracture dislocation to correlate long-term objective result with the specific injury type and treatment rendered. This can provide a basis for the management of this difficult injuries.
MATERIALS AND METHODS
: Fifteen patients with elbow dislocation were studied from October, 1992 to October, 1997 in Sang-Gye Paik Hospital. The average duration of follow up was 4.2 years.
RESULTS
: On the basis of an objective functional grading score that included elements of pain, motion, strength, and stability, the results were excellent in five(33%), good in five(33%), fair in one(7%), poor in four(27%). Prolonged immobilization greater than four weeks was associated with poor results. The results were closely related to the combined injuries and duration of immobilization. In case of radial head fractures, the best result was obtained in patients with Mason type II fractures treated by open reduction and internal fixation using Herbert screw and early complete radial head excision. SUMMARY AND CONCLUSION : The most common combined injury is radial head fracture. Early complete radial head excision and encouraging early ROM had more satisfactory result than delayed radial head excision or internal Fixation for Mason type III fracture.

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Isolated Fracture Dislocation of the Tarsal Navicular: Case report: Bum Soo Kim, Sung Do Cho, Yong Sun Cho, Tae Woo Park, Chang Sung So; J Korean Soc Fract 1997;10(4):925-928. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.925

Abstract PDF

Isolated fracture dislocation of the tarsal navicular bone is a very rare injury. The mechanism of injury of this fracture dislocation is known as a horiBontal or axial load in plantar flexed foot. Anatomical reduction using closed or open methods is recommended for displaced navicular fractures to achieve a satisfactory result and early mobilization of the foot is required to get a good range of motion at the tarsal joint. Authors report one case of isolated fracture dislocation of the tarsal navicular which was treated with closed reduction and percutaneous K-wire fixation.

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Fractures of the Tarsal Bone
Young Hwan Park, Hak Jun Kim, Soo Hyun Kim
Journal of the Korean Fracture Society.2016; 29(4): 276. CrossRef

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A Clinical Study of Traumatic Posterior Fracture-Dislocation of the Hip: 13 cases with operative treatment: Won Yoo Kim, Jin Young Kim, Kun Young Park, Chang Boon Jeong; J Korean Soc Fract 1994;7(2):457-464. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.457

Abstract PDF: Traumatic Posterior hip fracture-dislocation is uncommon injury, which induces the traumatic arthritis, joint contracture and avascular necrosis of the femoral head as a late complication. Among 23 patients with traumatic fracture-dislocation of the hips, 13 patients who underwent operative intervention were reviewed retrospectively: all patients were men ranging from 24 to 59 years old. A dash-board injury of car accident was leading cause of the traumatic dislocation in this series(9 cases, 64%). Associated injuries were found in 11 cases(84%). In follow-up ranging from 12 months to 36 months(averge, 18 months). Ten were treated by closed reduction; 6, by closed reduction followed by subsequent open reduction and internal fixation for unstable fracture of the acetabulum; 3, by primary open reduction; and 4, delayed open reduction. The results according to the Epstein and Thompson clinical criteria for evaluating results were good at 5 of 6 patients treated by closed reduction followed by open reduction for acetabular fracture. It was concluded that early closed reduction followed by open anatomic reduction with removal of all loose fragments of bone and cartilage and restoration of stability by internal fixation of the fracture of the acetaulum offers the best prognosis.

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Posterior Fracture Dislocation of the Hip with Fracture of the Femoral Head: Choong Gil Lee, Jin Woo Kwon, Jun Wan Park, Young Dae Park, Sung Ho Shin; J Korean Soc Fract 1994;7(2):302-307. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.302

Abstract PDF: The femoral head rarely is fractured in fracture-dislocation of the hip and probably result from forces transmitted axially along the femoral shaft with the hip flexed 60 degrees or less in neutral abduction and adduction. Pipkin subclassified Epstein-Thompson type 5 fracture-dislocations into four additional subtypes according to head fragment location and presence of neck, acetabulum fracture. Hougaard and Thomsen reviewed 203 posterior hip dislocations and found that 13 patients with a fracture of the femoral head(Pipkin type 1,2). 1 with fractures of femoral head and neck(Pipkin type 3), 2 with fractures of femoral had and acetabulum(Pipkin type 4). Epstein, Wiss, and Cozen reported that 11 cases of Pipkin type 1,26 of type 2,8 of type 3, and 10 of type 4. We experienced 2 cases of Pipkin type 3 and 3 of type 4 from January, 1990 and the results obtained were as follows. 1. By Pipkin classification, type 3 was 2 cases and type 4 was 3 cases. 2. In 2 cases of type 3, was treated by primary bipolar endoprosthesis due to comminution of head, neck and the other was by emergency open reduction of dislocation, multiple Knowles pinning of neck fracture, screw fixation of large head fragmnt, multiple knowles pinning of neck fracture, screw fixation of large head fragment, and quardratus femoris pedicled bone graft. 3. In 3 cases of type 4, one was reduced successfully by manipulation and treated conservatively. Two cases were initially treated by closed reduction and delayed open screws fixation of large acetabular rim fragments, during which head fragments were not removed. 4. There had been no clinical or radiological evidence of avascular necrosis of femoral head at 17 months follow up, but increased isotope uptake on bone scanning in type 3 patient. 5. All type 4 patients had not complained of hip pain and no evidence of radiological avascular necrosis of femoral heads at average 29 months follow up.

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