Journal of Musculoskeletal Trauma

Clinical Outcomes of Triple Tension Band Wirings in Comminuted Patellar Fracture: A Comparison with Conventional Tension Band Wiring: Hyun-Cheol Oh, Han-Kook Yoon, Joong-Won Ha, Sang Hoon Park, Sungwoo Lee; J Korean Fract Soc 2024;37(2):82-86. Published online April 30, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.2.82

Purpose
This study devised triple tension band wirings (TTBW) fixation in patients with comminuted patella fractures to compare the clinical result of TTBW with that of tension band wiring (TBW).
Materials and Methods
This study was conducted on 91 patients who had undergone surgery diagnosed with acute patella fracture from January 2011 to December 2016. The study included 51 double TBW patients (Group 1) and 40 patients with TTBW (Group 2).
Results
Five out of 51 cases had a loss of reduction and fixation failure in Group 1, and no failure of fracture formation healing occurred in Group 2. Nonunion was noted in one case in Group 1 and no case in Group 2. Eight K-wire migration cases were observed in Group 1, which was not observed in Group 2. Six patients in Group 1 underwent revisional surgery. No patients in Group 2 had a reoperation. As a result of a one-year follow-up after the operation, the mean range of motion of the knee joint in groups 1 and 2 was 128.3°±11.3° and 127.9°±10.8°, respectively. The Lysholm’s scores for groups 1 and 2 were 90.8±4.2 and 90.3±3.8 points, respectively, which was not statistically significant.
Conclusion
TTBW is a helpful technique for the surgical treatment of comminuted patella fractures. The TTBW method has less reoperation due to nonunion and fixation failure. After a one-year followup, the clinical results were similar to the conventional TBW method.

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Lateral marginal fractures of the patella and patellofemoral pain
Jae-Ang Sim, Chul-Ho Kim, Ji Wan Kim
Journal of Musculoskeletal Trauma.2025; 38(3): 152. CrossRef

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The Results of Intramedullary Nailing with Sliding Restriction and Dynamization Method in Treating Intertrochanteric Fractures: Hyun Cheol Oh, Sang Hoon Park, Jae Seok Chae, Han Kook Yoon; J Korean Fract Soc 2024;37(1):8-14. Published online January 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.1.8

Abstract PDF: Purpose
To evaluate the results of intramedullary nailing with sliding restriction and dynamization methods in treating intertrochanteric fractures.
Materials and Methods
From August 2016 to March 2019, patients aged 65 years and older who underwent intramedullary nailing in treating intertrochanteric fractures were enrolled in this study. The radiological and clinical results were analyzed in 49 patients who had undergone lag screw sliding re-striction and dynamization of the distal interlocking screw method.
Results
Forty-seven patients achieved union without complications (95.9%). The mean union period was 6.5 weeks (range, 6-9 weeks). Complications occurred in two patients (4.1%), including the cut through of the lag screw in one patient and varus deformity of more than 10° in the other. The preinjury mean Koval grade was 2.8 (range, 1-7). The mean was 3.3 (range, 1-7) at the final follow-up, and the mean difference was 0.5 (range, 0-2).
Conclusion
Intramedullary nailing with a sliding restriction and dynamization method for treating in-tertrochanteric fractures achieved union. The reduction achieved during surgery was maintained with good clinical results. This method is a safe and effective treatment technique for femoral intertrochanteric fractures.

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Comparison of Reductions of Left and Right Proximal Portions of Intertrochanteric Fractures Treated by Intramedullary Nailing: Hyun Cheol Oh, Joong Won Ha, Yung Park, Sang Hoon Park, Han Kook Yoon; J Korean Fract Soc 2021;34(2):64-70. Published online April 30, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.2.64

Abstract PDF

Purpose
This study examined the effect of lag screw insertion on proximal fragments by separating the right and left sides of intertrochanteric fractures in elderly patients that underwent intramedullary nailing.
Materials and Methods
Patients aged ≥65 years that underwent intramedullary nailing after a diag-nosis of intertrochanteric fractures during the period February 2012 to May 2016 were included in the study. The subjects were divided into right and left side groups. The effect of the clockwise rotational force generated when a lag screw was inserted on the proximal fragment was evaluated in both groups.
Results
In the right and left groups, most proximal fragments were located in the intramedullary canal after surgery (45 cases [75.0%] and 67 cases [73.6%], respectively). Clockwise rotation due to lag screw placement in the right group occurred in two cases (3.3%), which both showed internal rotation, and in four cases (4.4%) in the left group, all of which showed external rotation.
Conclusion
After intramedullary nailing of intertrochanteric fractures in elderly patients, proximal fragments were mostly located in the intramedullary cavity. The results obtained confirmed that the clockwise rotational force generated by lag screw insertion did not affect left or right sides.

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Which side should be taken care of when positioning a lag screw in intertrochanteric femoral fracture: right or left?
Min Uk Do, Kyeong Baek Kim, Sang-Min Lee, Hyun Tae Koo, Won Chul Shin
European Journal of Trauma and Emergency Surgery.2025;[Epub] CrossRef
Midterm Outcomes of Intramedullary Fixation of Intertrochanteric Femoral Fractures Using Compression Hip Nails: Radiologic and Clinical Results
You-Sung Suh, Jae-Hwi Nho, Min Gon Song, Dong Woo Lee, Byung-Woong Jang
Clinics in Orthopedic Surgery.2023; 15(3): 373. CrossRef

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Pediatric Femoral Neck Fracture: Joo Hyung Han, Hoon Park; J Korean Fract Soc 2021;34(1):34-43. Published online January 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.1.34

Abstract PDF: Pediatric femoral neck fracture is an uncommon injury with a high complication rate, regardless of the appropriate diagnosis and management. The bony anatomy and blood supply of the proximal femur in a skeletally immature patient differ from those in adult patients. Generally, these fractures result from high-energy trauma, but pathologic hip fractures also occur, usually from low-energy trauma. Pediatric femoral neck fractures are categorized using the Delbet classification system. This classification guides management and aids clinicians in determining the risk of avascular osteonecrosis. The ideal surgical treatment is determined by the fracture type and the age of the patient. Reduction, which is achieved using a closed or open procedure, combined with stable fixation and/or cast immobilization, is recommended for most of these fractures. Anatomical reduction within 24 hours from the injury may result in a good surgical outcome. Although the effects of capsular decompression after reduction and fixation have not been established, decompression is easy to perform and may reduce the risk of avascular necrosis. Despite appropriate management, osteonecrosis can occur after all types of pediatric femur neck fractures. Other complications include coxa vara, nonunion, and premature physeal arrest.

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Atypical Fracture-Like Insufficiency Fracture of the Tibia with Prolonged Bisphosphonate Drug: A Case Report: Min Jung Park, Su Jin Lee, Jin Hwa Kam, Yun Tae Lee, Ju Hyung Yoo, Hyun Cheol Oh, Joong Won Ha, Yung Park, Sang Hoon Park, Seong Hoon Kim, Han Kook Yoon; J Korean Fract Soc 2017;30(3):137-141. Published online July 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.3.137

Abstract PDF

Atypical femoral fracture related to a long-term bisphosphonate therapy has commonly been reported; however, a fracture at the site other than the femur has rarely been reported to date. Herein, we report a case of a patient on long-term bisphosphonate therapy who presented atypical tibial insufficiency fracture at the anterolateral aspect of diaphysis, without trauma. We, for the first time in Korea, present this case with a literature review.

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Atypical Femoral Fracture Occurring at a Proximal Screw Insertion Site after Plate Removal in a Distal Femoral Fracture
Jin Woo Jin, Sung Jin Shin, Jong Min Jeon
Journal of the Korean Orthopaedic Association.2024; 59(4): 314. CrossRef

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Comparison of Greater Trochanter Versus Piriformis Entry Nail for Treatment of Femur Shaft Fracture: Jong Hee Lee, Jong Hoon Park, Si Yeong Park, Seong Cheol Park, Seung Beom Han; J Korean Fract Soc 2014;27(4):287-293. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.287

Abstract PDF: PURPOSE
The purpose of this study was to compare the clinical outcome of femoral shaft fracture treatment with intramedullary nailing performed using a greater trochanter and a piriformis entry nail.
MATERIALS AND METHODS
A total of 57 patients treated by antegrade nailing for a femoral shaft fracture between January 2008 and April 2013 were included in this study. We evaluated postoperative radiographs of 57 femoral shaft fractures stabilized with femoral intramedullary nailing at a single institutional center. The cases included 25 piriformis fossa entry nails and 32 greater trochanter entry nails. Outcome measures included the alignment, union rate and duration of union, complications, operation time, intra-operative bleeding, and a pain rating scale.
RESULTS
The alignment, union rate, and duration of union did not differ significantly between the groups with piriformis fossa and trochanteric nailing. In addition, no significant differences regarding complications and operation time were observed between the two groups. Less intra-operative bleeding was observed in the trochanteric nailing group. This difference was statistically significant (p=0.044).
CONCLUSION
Use of a femoral nail specially designed for the trochanteric insertion resulted in equally high union rates, duration of union, and low complication rates. Thus, greater trochanter entry nails were similar to conventional antegrade femoral nailing through the piriformis fossa.

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Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent: Kun Bo Park, Hoon Park, Hyun Woo Kim, Hui Wan Park, Jae Young Roh; J Korean Fract Soc 2010;23(2):206-212. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.206

Abstract PDF: PURPOSE
To evaluate the results of interlocking humeral nail for femur shaft fractures through the greater trochanter in older children and adolescent.
MATERIALS AND METHODS
Eleven femoral shaft fractures in ten patients were selected. They were consisted of 9 boys and 1 girl. Two patients had osteogenesis imperfecta and one patient had a simple bone cyst as an underlying disease. 7 cases were right side and 4 cases were left side. The mean age at the time of operation was 12 years and 7 months (8 years 11 months~15 years 7 months). The mean follow-up period was 21 months and interlocking humeral nail was inserted at the greater trochanter in all patients.
RESULTS
All patients had a complete bony union without any complication such as infection, nonunion, leg length discrepancy and metal failure. Avascular necrosis of femoral head and coxa valga were not developed in all patients.
CONCLUSION
Intramedullary nailing through the greater trochanter using interlocking humeral nail is effective and safe treatment for the femoral shaft fracture in older children and adolescents.

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Bipolar Hemiarthroplasty for the Femoral Neck Fractures in Elderly Patients: Woong Kyo Jeong, Sang Won Park, Soon Hyuck Lee, Jong Hoon Park, Suk Ha Lee, Ji Hoon Kang, Gi Won Choi, Won Noh; J Korean Fract Soc 2008;21(1):8-12. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.8

Abstract PDF: PURPOSE
To evaluate the clinical results of bipolar hemiarthroplasty in elderly patients more than 65 years of age with a femoral neck fracture.
MATERIALS AND METHODS
Forty-six bipolar hemiarthroplasties in 43 patients more than 65 years of age which could be followed more than 3 years were included in this study. The clinical outcomes were evaluated using Harris hip score, pain score and support score. The radiological results were analyzed by femoral stem loosening and bipolar cup migration.
RESULTS
The average Harris hip score was 88.7 (62~96) points. An excellent score was recorded in 34 cases, good in 7 cases, fair in 3 cases and poor in 2 cases. The average pain score was 39.3 points and there were no pain in 20 cases, slight pain in 17 cases, mild pain in 6 cases and moderate pain in 2 cases. The average support score was 9.6 points and 32 patients could walk without the use of any assistive devices. Two cases were converted to total hip arthroplasty due to femoral stem loosening with or without bipolar cup migration.
CONCLUSION
For the early ambulation and functional recovery of elderly patients with femoral neck fracture, bipolar hemiarthroplasty was considered as one of recommendable methods.

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Proximal Femoral Nail (PFN) for the Treatment of the Femoral Trochanteric Fracture: Seong Jun Ahn, Jong Hoon Park; J Korean Fract Soc 2004;17(1):7-12. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.7

Abstract PDF

PURPOSE
We report our experience of treatment of peritrochanteric fractures with newly designed proximal femoral nail.
MATERIALS AND METHODS
We have studied 24 cases of the peritrochanteric fractures using PFN between Jun. 2001 and Aug. 2002 excluding 3 cases (1 case expired due to ARF and pulmonary complication, 2 cases were loss of follow-up). The mean age was 69.6 years and the mean duration of follow-up was 12 months.
RESULTS
The mean medial cortical displacement of postoperative roentgenogram was 4.6mm, the mean anterior cortical displacement of postoperative roentgenogram was 4.1 mm, the mean degree of sliding of lag screw between postoperative and last follow-up roentgenogram was 1.2 mm. Neck-shaft angle was average 3.3degrees varus angulation (from postoperative average 131.1degrees to last follow-up average 127.8degrees). Allowed to begin weight-bearing at 1 week postoperatively, the mean union time was 10 weeks and all cases showed bony union and there were no evidence of delayed union or nonunion. Perioperatve complications were pulmonary embolism, DVT, varus deformity, 2 thigh pains, and so on.
CONCLUSION
We obtained satisfactory results in treatment of the femoral trochanteric fractures using PFN in point of early ambulation, excellent union rate and minimal complication.

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Results of the Proximal Femoral Nail-Antirotation (PFNA) in Patients with an Unstable Pertrochanteric Fracture
Yerl-Bo Sung, Sung-Il Jo
The Journal of the Korean Hip Society.2011; 23(1): 39. CrossRef
Proximal Femoral Nail Antirotation and Proximal Femoral Nail in Intertrochanteric Fractures
Sung Soo Kim, Chul Hong Kim, Jin Hun Kang, Dong Hoon Han, Yong Seung O
Journal of the Korean Orthopaedic Association.2011; 46(5): 392. CrossRef
The Comparison between ITST™ (Intertrochanteric/Subtrochanteric) & DHS (Dynamic Hip Screw) in Unstable Femur Intertrochanteric Fracture
Ho-Seung Jeon, Byung-Mun Park, Kyung-Sub Song, Hyung-Gyu Kim, Jong-Ju Yun
Journal of the Korean Fracture Society.2009; 22(3): 131. CrossRef
Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA)
Myung-Sik Park, Young-Jin Lim, Young-Sin Kim, Kyu-Hyung Kim, Hong-Man Cho
Journal of the Korean Fracture Society.2009; 22(2): 91. CrossRef
Operative Treatment with ITST in Femur Trochanteric Fracture
Ki-Do Hong, Jae-Chun Sim, Sung-Sik Ha, Jae-Young Kim, Jung-Ho Kang, Kwang-Hee Park
Journal of the Korean Fracture Society.2008; 21(4): 274. CrossRef
Treatment of Intertrochanteric Fracture: Comparison of Proximal Femoral Nail and Proximal Femoral Nail A
Jung Ho Park, Jong Woong Park, Joon Ho Wang, Jae Wook Lee, Jung Il Lee, Jae Gyoon Kim
Journal of the Korean Fracture Society.2008; 21(2): 103. CrossRef
Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision
Se Dong Kim, Oog Jin Sohn, Jae Ho Cho
Journal of the Korean Fracture Society.2008; 21(1): 1. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)
Kee-Byoung Lee, Byung-Taek Lee
Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef

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Result of 29 consecutive patients with the distal femiral fracture: Analysis of the result treated with AO DCS(dynamic condylar Screw) Supracondylar nail, May anatomical plate: Weon Yoo Kim, Jin Hyung Sung, Chong Hoon Park, Jeong Soo Park, Jin Yong Kim; J Korean Soc Fract 1996;9(1):68-75. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.68

Abstract PDF: Twenty-nine cases of the surgically treated distal femoral fracture were analyzed to compare internal fixatorw (AO DCS,Supracondylar nail, May anatomical plate),who were treated at Department of orthopaedic surgery, Taejon Saint Marys hospital from Jan. 1992 to Jun. 1994. The cases were classified according to AO classification and minmum 12 months(average:22.4 monthw) follow up. Following results were obtained: 1.Male was more common than female, age distrbution was between 16 and 77 years old(average 40.4), abd the most common cause of the fracture was traffic accident. 2.The most comon type C by AO classification(type A 11 cases, type B 1 case, type C 17 cases). 3.According to Schatzkers criteria in the clincal result, type A,B were better resykt than type C, and severe soft tissue damage, comminution and joint involvement lead to unsatisfactory results. 4.Supracondylar nail was inadequate implant due to inferior clinical result(1 excellent, 2 good and 3 poor). 5.DCS had more sateafactory result than other internal fixators(supracondylar nail, May anatomical plate). Based on the observations, the better results depend on the amount of initial trauma, early anatomical reduction, rigid internal fixation and exercise of the knee joint.

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A Clinical Study of Fracture of Distal Radius: Pitfall of Treatment of Intraarticularly comminuted fracture: Chong Hoon Park, Won Yoo Kim, Jin Hyung Sung, Kyong Ho Yoo, Jin Yiung Kim; J Korean Soc Fract 1996;9(1):33-41. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.33

Abstract PDF: The fracture of the distal radius was first described as the fracture of the radius with dorsally eisplaced fragment within distal 1.5 inch at 1814 by Abraham Calles.since that, according to feature of fractures, many classifications have been introduced. Although there are many kinds of msthod in treatment of fracture of the distal radius, we find difficulty in selecting adequate method of treatment of intraarticularly comminuted fracture of the distal radius.And recently the intraarticularly comminuted fracture is occasionally recognized as nit a simple fracture but a complicated fracture because of postraumtic arthritrs, malunion, nonunion,and stiff hand after treatment.So,we retrospectively reviewed thirty-eight cases which were treated by several methods for 5 year from Jan.1990 to Dec. 1994 at the our hospital. The results were as follows. 1.In general, the incidence was mare higher in male, but the older in age, the more incidence in female. 2.The most common catse as a single cause of injury was a traffic accident. 3.By the point system for subjective evaluation and objective evaouation of Gartland and Werley, the excellent or good result were represented at the extraarticular fractures or undisplaced inraarticaular fracture among Collesfracture, Bartons Chauffeurs, Smiths, and lunste load fracture, which had been treated by sugar-tongs splint or percutaneous pinnongs after the closed reduction. And the excellent result was especially showed at the volar Bartons jractures which had been managed by the plate fixation after the open reduction. But the poor result was represented at the intraarticularly comminuted fractures of the distal radius, which had been treated by percutaneoys pinning(2 cases)or only external fixation without an additional fixation(4 cases) after the closed reduction. In conclusiln, the investigatir thought that the anatomical reduction, more secure fixation, and sometimes bone grafting in treating the intraarticylarlycomminuted fracture of the distal radiuw were essential fir having satisfactory clinical result.

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Comparative Study between Compression Plate with Screw Fixation and Interlocking Intramedullary Nailing of Tibial Shaft Fractures in Adult: Sang Won Park, Jong Hoon Park; J Korean Soc Fract 1995;8(1):278-283. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.278

Abstract PDF: Various methods have been used in the treatment of tibial shaft fractures in adults. In recent years, generally accepted two surgical methods are compression plate with screw fixation and intramedullary nailing. The authors reviewed 73 cases of tibial shaft fractures, treated by operation in Department of Orthopedic Surgery, Korea University Hospital from June 1986 to April 1993 and minimum follow up period was one year. All cases were devided into 2 Groups, open reduction with compression plate fixation(35 cases) and closed reduction with interlocking intramedullary nailing(38 cases), and the two-groups were compared with each other. The results were as follows: 1. The average time of clinical and radiological union were 17.5 weeks & 26.3 weeks in the compression plate group and 12.3 weeks & 18.5 weeks in the interlocking intramedullary nailing group respectively. 2. Bony union rate was not influenced by the level of the tibial fracture. It was delayed especially in the comminuted fracture. 3. Two cases of delayed union, one case of superficial infection and two cases of limited range of motion occured in the compression plate group. Two cases of delayed union and one case of infection combined limited hee motion occured in the interlocking intramedullary nailing group. 4. According to our clinical study, interlocking intramedullary nailling is regarded as a better method for the management of comminuted tibial shaft fracture than compression plaate and screw fixation.

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Reduction and Percutaneous Pinning of Displaced Supracondylar Fracture of the Humerus in Children: Won Yoo Kim, Jin Young Kim, Kun Young Park, Chong Hoon Park, Hwa Sung Lee; J Korean Soc Fract 1994;7(2):471-479. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.471

Abstract PDF: Closed reduction and percutaneous pinning of displaced supracondylar fractures of the humerus in children yielded simple fracture management, less neurological and vascular complications, reduced hospitalization day and increased satisfactory out-comes. We treated twenty-seven cases of these fractures(extension type : twenty-five cases) by such a method. The accurate closed reduction of a supracondylar fracture could be obtained and confirmed by image intensifier. The maintanence of a reduction was stabilized by application of K-wires. Our study showed that the limitation of range of motion of the elbow joint was not signifiint(three cases, below ten degrees extension block and changes of carrying angle was also minimal three cases, below ten degrees). In twenty-seven cases, excellent results were recorded in 93% on at least on year follow-up.

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