Journal of Musculoskeletal Trauma

Treatment of Trochanteric Fractures of the Femur with Compression Hip Screw-Analysis of Factors associated with Failure of Fixation-: Chan Hoon Yoo, Hong Tae Kim, Young Soo Byun, Jun Mo Nam, Young Ho Cho, Seong Gun Moon; J Korean Soc Fract 2002;15(3):312-319. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.312

Abstract PDF: PURPOSE
This study was performed to analyze the significant factors that may affect failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.
MATERIALS AND METHODS
From May 1995 to July 2000, the authors analyzed 97 cases of trochanteric fracture of the femur treated with the compression hip screw and followed more than one year. We classified the fracture type by Jensen 's method. We used Singh index for the degree of osteoporosis. In the post-operative radiograph, we checked neck-shaft angle, state of reduction, position of the lag screw within the femoral head, tip-apex distance, and sliding distance of the lag screw. The relationship between these factors and failure of fixation was statistically analyzed.
RESULTS
There were 17 cases (17.5%) of failure of fixation ; 15 cases (15.4%) of excessive sliding of the lag screw, 1 case (1%) of cutting out of the lag screw, and 1 case (1%) of valgus malunion. There were significant relationships between failure of fixation and old age over 80, unstable fracture, telescoping reduction, anterior or medial displacement of the distal fragment, and anterior placement of the lag screw within the femoral head.
CONCLUSION
Accurate reduction and avoidance of the placement of the lag screw in the anterior part of the femoral head were important factors to prevent failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.

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Salter-Harris Type IV Physeal Fracture of the Distal Radius: A Case Report: Young Soo Byun, Hong Tae Kim, Kyoung Hoon Hyun, Jun Mo Nam, Young Ho Cho; J Korean Soc Fract 2001;14(4):739-744. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.739

Abstract PDF: Physeal fractures in children are the most common in the distal radius. In the distal radius Salter-Harris type II physeal fractures occur predominantly, while type IV physeal fractures are quite rare. For type IV physeal fractures, open reduction and internal fixation are usually indicated to align both the physis and the articular surface. Growth arrest can be developed by premature physeal closure depending on multiple factors, particularly the severity of trauma. We treated a type IV physeal fracture of the distal radius with open reduction and internal fixation in an 11-year-old boy, but growth arrest with gross deformity and painful motion limitation of the wrist occurred. The deformity in external appearance was nearly corrected and symptoms were improved by surgical shortening of the ulna 3 years after injury, and the final result was satisfactory.

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Blade Plate Fixation of Proximal Tibial Fractures: Young Soo Byun, Hong Tae Kim, Soon Man Hong, Sang Chul Shin, Soo Yeol Jeon, Byung Doo Jang; J Korean Soc Fract 2000;13(3):507-514. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.507

Abstract PDF: PURPOSE
This study demonstrates the effectiveness of the blade plate as an implant for the operative management of proximal tibial fractures.
MATERIALS AND METHODS
Twelve proximal tibial fractures (AO classification, 10 type A and 2 type C) were treated by direct or indirect reduction and condylar blade plate fixation. The condylar blade plate was fixed on the anteromedial surface of the proximal tibia and cancellous bone graft was performed in 4 fractures with severe cortical comminution or bone defect in early cases. At the final follow-up assessment, the patients were evaluated as to subjective symptoms, objective findings, and radiographic findings.
RESULTS
All fractures were healed in an average of 13.2 weeks (range, 9.0 to 25.0 weeks). There were 3 major complications of a delayed union, a 6-degree varus malunion, and a reduced range of motion of the knee related with associated multiple fractures of the ipsilateral lower limb, but there were no soft tissue problems, loss of fixation, infection, nonunion, and traumatic arthritis. A few patients complained a prominence of the plate on the anteromedial side of the proximal tibia.
CONCLUSION
Blade plate fixation is a reliable method of stable fixation to obtain good results for proximal tibial fractures by early rehabilitation and good fracture healing, particularly in patients with osteoporosis and cortical comminution.

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Treatment of Femoral Neck Fractures with Cannulated Screws: Chan Hoon Yoo, Hong Tae Kim, Young Soo Byun, Sang Chul Shin, Byung Doo Jang, Kyoung Hoon Hyun; J Korean Soc Fract 2000;13(3):445-453. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.445

Abstract PDF: PURPOSE
This study was performed to evaluate the results of femoral neck fractures in adult treated with cannulated screws and the factors that may affect results.
MATERIALS AND METHODS
From April 1992 to December 1998, the authors analysed 53 cases of femoral neck fracture treated with cannulated screws and followed more than one year. According to Garden's classification and anatomic location, we classified the fracture type. We used Garden alignment index for the accuracy of reduction and Singh index for the degree of osteoporosis. The clinical results were analysed by Lunceford's assessment.
RESULTS
According to Lunceford's assessment, the results were good or excellent in 40 cases(75%). Mean bony union time was 16.3 weeks. There were 10 cases(19%) of avascular necrosis of the femoral head, 6 cases(11%) of nonunion and 2 cases(4%) of malunion. There were significant relationship between complication rate and accuracy of reduction(P<0.01), operative delay more than 7 days(P<0.05).
CONCLUSION
The important factors that may affect the results are accuracy of reduction and interval between injury and time of operation, the others were degree of displacement, anatomic site, degree of osteoporosis. The results of this study indicate that cannulated screw fixation is an effective method for femoral neck fractures in adult.

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Stress fractures in calcaneus and juxtatectal region of the acetabulum : case report: Soon Man Hong, Hong Tae Kim, Young Soo Byun, Sang Chul Shin, Kyoung Hoon Hyun, Soo Yeol Jeon; J Korean Soc Fract 1999;12(4):749-753. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.749

Abstract PDF: We have experienced a fatigue fracture occurred in the calcaneus of 49-year-old man and an insufficiency fracture occurred in the juxtatectal region of acetabulum in 70 -year-old woman. Both cases healed successively after rest. We suggest these fractures must be considered in differential diagnosis.

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Surgical Treatment of Comminuted Interior Patellar Pole Fractures by Separate Vertical Wirings: A New Method of Internal Fixation: Young Soo Byun, Hong Tae Kim, Chan Hoon Yoo, Hyun MiH Kim, Yeon Min Park, Sang Chul Shin; J Korean Soc Fract 1999;12(3):584-592. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.584

Abstract PDF: The inferior pole fragments of patellar fractures should be reduced anatomically whenever possible because any resection of the inferior pole fragments results in patella baja and abnormal patellofemoral biomechanics. However, there are still no effective methods of stable fixation for comminuted inferior patellar pole fractures. The purpose of this study is to introduce a new method of internal fixation of separate vertical wirings for comminuted inferior patellar pole fractures and to present the results of the wirings. Thirteen patients with comminuted inferior patellar pole fracture were treated with 2 to 4 separate vertical wirings, which provided the sufficient strength to allow early motion without loss of reduction during fracture healing. All the fractures were healed in anatomical position and all the patients regained full range of motion of the knee. Loss of fixation occurred in a patient by foiling on the ground, but the fracture was healed by the wirings again. There were no patients with radiographic evidence of posttraumatic osteoarthritis at the final follow-up. Overall result was rated as excellent in all the patients. The results of this study indicate that separate vertical wirings are an effective method of stable fixation enough to allow early motion without loss of reduction during fracture healing for comminuted inferior patellar pole fractures.

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Intraoperative Fracture of the Tibia Associated with Removal of the Interlocking Intramedullary Nail: Report of 5 cases: Chan Hoon Yoo, Young Soo Byun, Hong Tae Kim, Hyun Min Kim, Yeon Min Park, Soo Yeol Jeon; J Korean Soc Fract 1999;12(3):538-542. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.538

Abstract PDF

We have experienced five cases of intraoperative fracture of the tibia assoicated with removal of ACE interlocking tibial nail. All fractures occured in young patients whose ages ranged from eighteen to twenty-nine years(mean, 24 years). We think the main reason of the fracture was characteristic design of ACE nail such as prominent distal angulation and posterior longitudinal slot. The other factors were age of the patient, material of the nail and timing of removal of the nail. In conclusion, we advise caution in the removal of the ACE reamed interlocking intramedullary tibial nail in young patient.

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Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report
Ji-Hwan Kim, Seung-Oh Nam, Young-Soo Byun, Han-Sang Kim
Journal of the Korean Fracture Society.2015; 28(1): 71. CrossRef

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Treatment of Tibial Shaft Fractures with Ender Nailing and Postoperative Functional Bracing: Young Soo Byun, Hong Tae Kim, Won Ho Cho, Se Ang Chang, In Hak Choi, Jin Wook Jung; J Korean Soc Fract 1997;10(3):541-547. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.541

Abstract PDF: Ender nailing is an alternative method of treatment of selected unstable tibial shaft fractures. The purpose of this study is to evaluate the result of functional treatment with Ender nailing and postoperative functional bracing. We treated 31 tibial shaft fractures(16 closed, 15 open) with closed Ender nailing and postoperative functional bracing between August 1990 and September 1994 and followed up the patients from minimum 10 months to 74 months. Clinical analyses were as follows; 1. According to AO classification, 10 cases were Type A simple fractures(32%), 14 Type B wedge fractures(45%), and 7 Type C complex fractures(23%). 2. Ninety four percent of the fractures united in an average time of 17.3 weeks. The average time to union of complex fractures was longer than that of simple and wedge fractures(P<0.05). 3. There were two nonunions(6.5%), two delayed unions(6.5%), and three angulatory malunions(9.7%) between 6 and 10 , but there was no putient of significant shortening, joint stiffness, or infection. The Ender nails provide sufficient stability at the fracture site of the tibial shaft to permit carly weight-bearing in a functional brace, and this treatment provides early fracture union with less complicatioins and facilitates functional recovery.

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