Journal of Musculoskeletal Trauma

Open Reduction and Internal Fixation in Comminuted Radial Head Fracture: Jun Ku Lee, Tae Ho Kim, Choongki Kim, Soo Hong Han; J Korean Fract Soc 2019;32(4):173-180. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.173

PURPOSE
Radial head fractures, which account for 33% of all fractures, are treated depending on the Mason classification. In comminuted type 3 fractures, open reduction internal fixation (ORIF), and radial head arthroplasty are the treatment options. This study examined the clinical outcome of modified Mason type 3 radial head fractures using ORIF with a plate.
MATERIALS AND METHODS
The medical records and image of 33 patients, who underwent ORIF for modified Mason type 3 radial head fractures, were reviewed retrospectively. The preoperative plain radiographs and computed tomography images were used to examine the location of the fracture of the radial head, the number of fragments, union, joint alignment, and traumatic arthritis at the final follow-up. The range of motion (ROM) of the elbow at the last follow-up, pain score (visual analogue scale), modified Mayo elbow score (MMES), and complications were analyzed for the clinical outcome.
RESULTS
Of the 33 cases, 14 were men and 19 were women. The mean age was 41.8 years and the average follow-up period was 19 months. The functional ROM was divided into three groups according to the number of bone fragments: 141.2Â°Â±9.3Â° of 3 (n=20), 123.8Â°Â±18.5Â° of 4 (n=7), 100.7Â°Â±24.4Â° of more than 4 (n=6). Furthermore, the MMES were 88.2Â±2.9, 83.7Â±4.3, and 77.3Â±8.4, respectively (p=0.027). Depending on the radial head fracture location, the ROM and MMES were 130.7Â°Â±7.5Â° and 82.1Â±4.7, respectively, with poor outcomes on the ulnar aspect compared to 143.1Â°Â±3.8Â° and 89.9Â±3.2 on the radial aspect.
CONCLUSION
Various factors, such as the degree of crushing and location involved in the clinical outcome. In particular, the result was poor in the case of more than four comminuted fragments or chief position located in the ulnar aspect. In this case, radial head arthroplasty may be considered in the early stages.

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Does the coronoid fracture in terrible triad injury always need to be fixed?
Yeong-Seub Ahn, Seong-Hwan Woo, Sungmin Kim, Jun-Hyuk Lim, Tae-Hoon An, Myung-Sun Kim
BMC Surgery.2024;[Epub] CrossRef
Results of the Use of Bioabsorbable Magnesium Screws for Surgical Treatment of Mason Type II Radial Head Fractures
Chul-Hyung Lee, Seungha Woo, Hyun Duck Choi
Clinics in Orthopedic Surgery.2023; 15(6): 1013. CrossRef

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Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing: Suenghwan Jo, Gwang Chul Lee, Sang Hong Lee, Jun Young Lee, Dong Hwi Kim, Sung Hae Park, Young Min Cho; J Korean Fract Soc 2019;32(2):83-88. Published online April 30, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.2.83

Abstract PDF: PURPOSE
This study examined the outcomes of exchange nailing for the hypertrophic nonunion of femoral shaft fractures treated with intramedullary nailing as well as the factors affecting the treatment outcomes.
MATERIALS AND METHODS
From January 1999 to March 2015, 35 patients, who had undergone intramedullary nailing with a femoral shaft fracture and underwent exchange nailing due to hypertrophic nonunion, were reviewed. This study investigated the time of union and complications, such as nonunion after exchange nailing, and analyzed the factors affecting the results.
RESULTS
Bone union was achieved in 31 cases (88.6%) after exchange nailing and the average bone union period was 22 weeks (14â€“44 weeks). Complications included persistent nonunion in four cases, delayed union in one case, and superficial wound infection in one case. All four cases with nonunion were related to smoking, three of them were distal shaft fractures, and one was a midshaft fracture with underlying disease.
CONCLUSION
Exchange nailing produced satisfactory results as the treatment of hypertrophic nonunion after intramedullary nailing. Smoking is considered a factor for continuing nonunion even after exchange nailing. In the case of a distal shaft, where the intramedullary fixation is relatively weak, additional efforts are needed for stability.

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Treatment Options of Osteoporotic Vertebral Compression Fractures: Yu Mi Kim, Tae Kyun Kim, Dae Moo Shim, Kyeong Hoon Lim; J Korean Fract Soc 2018;31(3):114-121. Published online July 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.3.114

Abstract PDF

This paper reviews previous studies on the treatment of osteoporotic vertebral compression fractures in elderly patients to determine what factors should be considered for successful treatment. In osteoporotic vertebral compression fractures, the primary treatment is conservative treatments. Other treatments include osteoporosis treatment, pain control, orthosis, and physical therapy. Recently, percutaneous catheterization or balloon plasty is performed for rapid pain recovery and early ambulation. Percutaneous catheterization or balloon posterior plasty is effective in reducing pain and improving the activity ability. Surgical treatment should be considered in cases of nonunion or osteonecrosis, dent, deformation, and spinal cord compression after conservative treatment has failed. In surgical treatment, posterior spinal fixation and vertebroplasty are more advantageous in terms of the amount of bleeding, operation time compared to the anterior approach, but the most appropriate method should be selected through the patient's condition and understanding of each surgical method.

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Effects of Herbal Medicines on Bone Mineral Density Score in Osteoporosis or Osteopenia: Study Protocol for a Systematic Review and Meta-Analysis
Su Min Hong, Eun Jung Lee
Journal of Korean Medicine Rehabilitation.2021; 31(2): 49. CrossRef
Spinal Stability Evaluation According to the Change in the Spinal Fixation Segment Based on Finite Element Analysis
Cheol-Jeong Kim, Seung Min Son, Jin-Young Heo, Chi-Seung Lee
Journal of the Computational Structural Engineering Institute of Korea.2020; 33(3): 145. CrossRef

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A Comparative Study of TRIGENâ„¢ INTERTAN Nail (InterTAN) and Proximal Femoral Nail Antirotation 2 (PFNA2) in the Patients with Intertrochanteric Fractures: Jae Hoon Jang, Jeung Il Kim, Um Ji Kim, Nam Hoon Moon; J Korean Fract Soc 2016;29(2):128-136. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.128

Abstract PDF

PURPOSE
The primary purpose of this study was to demonstrate that the TRIGENâ„¢ INTERTAN nail (InterTAN) could show better clinical outcome compared to the proximal femoral nail antirotation 2 (PFNA2) for treatment of intertrochanteric fracture in the elderly.
MATERIALS AND METHODS
Between March 2009 and December 2013, 164 patients with intertrochanteric fractures who met our inclusion and exclusion criteria were enrolled in this study. Evaluation variables, including operation time, blood loss during the operation, incidence of perioperative complications, clinical results at the last follow-up, and radiographic findings were assessed for comparison of the 2 implants.
RESULTS
Intraoperative lateral wall fracture was significantly higher in the PFNA2 group (p<0.05) and tip apex distance was significantly higher in the InterTAN group (p<0.05). Sliding of the proximal fragment at the last follow-up was significantly higher in the PFNA2 group. However, there was no significant difference in union rate, time to union, postoperative complications, and clinical outcomes at the last follow-up between the 2 groups.
CONCLUSION
Based on these data, clinical outcomes at the last follow-up were equivalent between InterTAN and PFNA2.

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Unstable Intertrochanteric Fracture: Do We Know Everything? A Review
Balaji Zacharia, Harshitha Hayavadana Udupa
SN Comprehensive Clinical Medicine.2022;[Epub] CrossRef

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Minimally Invasive Percutaneous Plate Stabilization Using a Medial Locking Plate for Proximal Tibial Fractures: Technical Note: Jae Ang Sim, Beom Koo Lee, Kwang Hui Kim, Yong Seuk Lee; J Korean Fract Soc 2013;26(4):327-332. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.327

Abstract PDF

Minimally invasive plate osteosynthesis (MIPO) is beneficial for proximal tibial fractures since these injuries are mostly caused by high energy traumas. The advantages of MIPO are minimization of soft tissue dissection and preservation of periosteal vascularization. Lateral plating has mostly developed as MIPO for proximal tibial fractures. We introduce minimal invasive percutaneous plate stabilization using a medial locking plate as alternative treatment for proximal tibial fractures.

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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
Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures
Jae-Ang Sim, Kwang-Hui Kim, Yong-Seuk Lee, Sang-Jin Lee, Beom-Koo Lee
Journal of the Korean Orthopaedic Association.2014; 49(4): 278. CrossRef

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Arthroscopic Assisted Intra-Articular Reduction and Internal Fixation of Tibia Plateau Fracture: Dong Hwi Kim, Gwang Chul Lee, Kwi Youn Choi, Sung Won Cho, Sang Ho Ha; J Korean Fract Soc 2013;26(3):191-198. Published online July 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.3.191

Abstract PDF

PURPOSE
We evaluated the results of arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window along with any additional bone grafts.
MATERIALS AND METHODS
From March 2006 to March 2009, twelve patients with arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures over 5 mm in depression and displacement on the articular surface in computed tomography (CT) were enrolled in this study. We reduced or removed the depressed fracture fragment using freer without making a cortical window. Then, we accomplished internal fixation by a cannulated screw. All cases have not received bone graft. Both the postoperative clinical and radiological results were evaluated by the Rasmussen system.
RESULTS
The fractures were healed completely in an average of 9 (range from 7 to 12) weeks. According to Rasmussen classification, we obtained satisfactory clinical results as excellent in 8 cases, good in 3 cases, and fair in 1 case; and radiological results were excellent in 7 cases and good in 5 cases.
CONCLUSION
We consider that arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window and any additional bone grafts is are a useful methods for attaining satisfactory results.

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Current Concepts in Management of Tibia Plateau Fracture
Sang Hak Lee, Kang-Il Kim
Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef

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Treatment of Proximal Tibia Fractures Using LCP by MIPO Technique: Sang Ho Ha, Dong Hui Kim, Jun Young Lee; J Korean Fract Soc 2010;23(1):34-41. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.34

Abstract PDF

PURPOSE
We wanted to evaluate the efficacy of MIPO (minimal invasive plate osteosynthesis) technique by LCP (locking compression plate) for treating proximal tibia fractures.
MATERIALS AND METHODS
Twenty-three patients, who had operation due to proximal tibia fracture and available for follow up for more than 1 year were included in this study. Cause of injury and accompanied injuries were checked. Operation time, period to bone union, range of joint motion and alignment were evaluated with complications.
RESULTS
Mean bone union time was 13.7 weeks (10~20). Twenty-one cases of the patients showed angulation of less than 5 degrees and 17 cases had normal range of motion. Five cases showed skin irritation by the plate and 2 cases had superficial infection.
CONCLUSION
LCP by MIPO technique for treating proximal tibia fracture showed excellent results. Delicate technique is required for the proper adjustment of LCP and the alignment of the lower leg.

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EVALUATION OF FUNCTIONAL OUTCOME OF SURGICAL TREATMENT FOR FRACTURE AROUND KNEE WITH LOCKING PLATE
VIKAS KUNTWAD, AMOL WAGH, SATYAJEET A HORE
Asian Journal of Pharmaceutical and Clinical Research.2023; : 213. CrossRef
Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures
Jae-Ang Sim, Kwang-Hui Kim, Yong-Seuk Lee, Sang-Jin Lee, Beom-Koo Lee
Journal of the Korean Orthopaedic Association.2014; 49(4): 278. CrossRef
Minimally Invasive Percutaneous Plate Stabilization Using a Medial Locking Plate for Proximal Tibial Fractures - Technical Note -
Jae Ang Sim, Beom Koo Lee, Kwang Hui Kim, Yong Seuk Lee
Journal of the Korean Fracture Society.2013; 26(4): 327. CrossRef

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Treatment of Senile Osteoporotic Intertrochanteric Fracture using Proximal Femoral Nail: Dong Hui Kim, Sang Hong Lee, Young Lae Moon, Jun Young Lee, Kun Sang Song; J Korean Fract Soc 2007;20(3):215-221. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.215

Abstract PDF

PURPOSE
Clinical and radiologic results of femur intertrochanteric fractures treated with ITST nail in elderly patients with osteoporosis were analysized to evaluate the efficacy and complication of ITST nailing.
MATERIALS AND METHODS
32 patients who were treated with ITST nail due to femur intertrochanteric fracture and were followed up for more than 1 year were analysed. According to Evans classification, 11 cases were stable fractures and 21 cases were unstable fractures. Clinically, ambulatory function was compared and radiologically, BMD of healthy leg was checked with analysis of postoperative bone union and complication.
RESULTS
In ambulatory function comparison before and after the operation, there were 9 cases of good, 17 cases of moderate and 6 cases of poor. Considering social activity after the operation, 7 cases showed normal ambulation, 9 cases showed ambulatory with one cane, 5 cases showed two cane ambulation and 11 cases showed dependent ambulation. In radiologic evaluation, T-score of ward triangle in healthy femoral neck showed BMD of -3.12. In 20 cases, bone union was observed within 3 months. The patients with low BMD result had poor outcome. There were 2 cases of intraoperative proximal femur fracture, 3 cases of nonunion and 4 cases of death within 1 year.
CONCLUSION
In elderly patients with intertrochanteric fracture, ITST nailing is relatively efficient treatment. However, in pateint with severe osteoporosis (T-score<-3.0) and unstable fracture pattern, arthroplasty should be considered due to relatively high complicaton rate.

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The PFNA Nail for Pertrochanteric Fracture of the Femur without Fracture Table
Jeoung Ho Kim, Sang Hong Lee, Kwang Chul Lee, Sung Won Cho
Journal of the Korean Fracture Society.2011; 24(3): 217. CrossRef
Results of Osteoporotic Treatment Drug after Periarticular Fracture of Hip
Soo Jae Yim, Young Koo Lee, Cheong Kwan Kim, Hyun Seok Song, Hee Kyung Kang
Journal of the Korean Fracture Society.2010; 23(2): 167. CrossRef

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Operative Treatment of Patellar Fractures: Dong Hui Kim, Jung Man Kim, In Jun Koh; J Korean Fract Soc 2004;17(4):314-318. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.314

Abstract PDF

PURPOSE
To establish a general guide line in the treatment of the patellar fracture MATERIALS AND METHODS: Twenty three patellar fractures followed for 2.2 years in average, treated with internal fixation were evaluated retrospectively. The primary fixations were the metal screw fixation in 7, the Dall-Miles' cable circumferential fixation in 14 and combination of both methods in 2 cases. The additional fixations were the tension band wiring in 9, the load sharing cable fixation in 3 and combination of both methods in 5 cases. The initial postoperative immobilazation of the knee joint in flexion, preferably 90degrees, for 7 days was effective to gain full range of motion RESULTS: Complete union without displacement was achieved in all cases. Full ROM was achieved in all cases except one.
CONCLUSION
The choice of internal fixation need to be individualized according to the level of comminution, bone strength, fracture site and soft tissue damage. A strong internal fixation, initial immobilization in flexion followed by early ROM exercise were important factors to gain good result.

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Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases
Ji-Hye Geum, Hyeon-Jun Woo, Jong-gyu Kim, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2020; 30(4): 203. CrossRef
Treatment of Transverse Patellar Fracture with Cannulated Screws
Jung-Man Kim, Ju-Seok Yoo, Yong-Jin Kwon, Jang-Ok Cheon
Journal of the Korean Fracture Society.2007; 20(2): 149. CrossRef

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Effect of Growth Hormone on Osteoblast and New Bone Formation: Hae Ryong Song, Young Jin Kang, Ki Churl Chang, Seong Chang Yeon, Ja Min Koo, Hyeon Hui Kim; J Korean Soc Fract 2003;16(3):423-431. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.423

Abstract PDF: PURPOSE
To evaluate effect of growth hormone on osteoblast and new bone formation.
MATERIALS AND METHODS
Bone defect of the tibia with preserved periosteum was made and fixed with external fixator. Intramuscular injection of growth hormone for 8 weeks in experimental group and saline in control group was performed. New bone formation at the bone defect in radiograph and bone mineral density (BMD) by quantitative computed tomography were evaluated at 8 weeks after surgery. Rat osteosarcom cells were cultured in both group to evaluate cell viability of osteoblast, alkaline phosphatase activity, and mRNA expression of osteocalcin by RT-PCR.
RESULTS
Experimental group showed more callus formation and higher BMD at the bone defect site and the distal tibia compared to control group and there was significant difference. Proliferation of osteoblast, alkaline phosphatase activity, mRNA of osteocalcin at 5 days after culture were significantly higher in experimental group than those in control group.
CONCLUSIONS
Growth hormone has positive effect on osteoblast and callus formation in vivo and vitro studies.

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Immediate hip spica cast application for femoral shaft fractures in children: Han Yong Lee, Kee Won Rhyu, Jin Young Chung, Mun Ik Sohn, Chang Ki Kim, Yong Koo Kang; J Korean Soc Fract 2003;16(1):91-97. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.91

Abstract PDF

PURPOSE
To evaluate an efficacy of immediate closed reduction and hip spica casting in pediatric patients with femoral shaft fractures.
MATERIALS AND METHODS
27 cases of 27 pediatric patients who had been treated conservatively for the femoral shaft fractures under 10 years of age were retrospectively reviewed. The cases with serious associated injuries were excluded. The hospital stay, duration of traction and hip spica cast, frequencies of plain radiographs, clinical and radiological outcomes at the final follow-up, and financial aspects were evaluated comparatively between the groups of immediate hip spica casting(12 cases) and traction-casting(15 cases).
RESULTS
The patients treated with immediate hip spica casting had a mean hospital stay of 7.8 days, compared with a mean of 25.8 days for those treated with traction and casting. The mean duration of immobilization were 44.2 days in the group of immediate hip spica casting, and 65.1 days in the group of traction and casting. The radiologic examinations were performed 2 times and 6.9 times respectively. The clinical and radiological outcomes at the final follow-up were good in both groups. Insignificant leg length discrepancies were seen in 3 cases each group. The total charges of traction and casting was 2.4 times higher than that of immediate hip spica casting.
CONCLUSION
The immediate hip spica casting seems to be an effective method of treatment in femoral shaft fractures without serious associated injuries under 10 years of age because there are several advantages such as satisfactory result, shortened hospitalization and immobilization, reduction of total charges, and lowered the risk of radiologic exposures.

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Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture
Suk Kang, Jong Pil Kim, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Sang Ho Lee, Jin Wook Chung
Journal of the Korean Fracture Society.2007; 20(4): 339. 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 Acromioclayicular Dislocation-Comparative Study between Operative and Conservative Method: Young Su Lee, Min Ki Kim; J Korean Soc Fract 1997;10(4):918-924. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.918

Abstract PDF: There has been considerable controversy as to the method of treatment of acromioclavicular joint especially in grade III injury. We treated 27 cases of the complete dislocation of acromioclavicular dislocation with operative method(15 cases) and conservative method(12 cases) from October 1989 to November 1995. The purpose of this study is to compare the clinical and radiological result of two treatment method. The average follow up period was thirty nine months and the result as follows. 1. Of the 27 cases, there was 18 male and 9 female patients, and peak incidence was in 3rd and 4th decades(51%). 2. The most common causes of the injury was traffic atcident(49%). 3. The functional results were similiar to all treatment modalities, and coracoclavicular interval ratio was well manintained regardless of treatment. 4. Complication rate was more lower in the group of conservative treatment. 5. The conservative treatment was proven to be a valuable method for acromioclavicular dis- location except in a few situations.

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Operative Treatment of Forearm Fractures in Children: Nam Gee Lee, Seung Ki Kim, Won Jong Bahk, Hyun Joon Song, Ban Chang; J Korean Soc Fract 1997;10(1):195-202. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.195

Abstract PDF: Management of severe diaphyseal fracture of radius and ulna in children can be a challenging problem. Reduction and maintenance of the position of two mobile parallel bones is difficult because pronating and supinating muscles produce angulatory as well as rotational forces. Open reduction and internal fixation are generally accepted for adult forearm fractures, but controversy surrounds open reduction for children. What should be done for the irreducible fracture that will result in a malunion? Several authors advocate open reduction in children over 10 years of age rather than accept poor position. And others advocate open reduction regardless of age if closed reduction is unsatisfactory. We reviewed thirteen children between 6-14 years of age, who had irreducible fractures of diaphysis of forearm both bone, and who were treated with open reduction and internal fixation with plate for mid 1/3 fractures(4 cases) and open reduction and internal fixation with K-wires for distal 1/3 fractures(9 cases). The results were as follows; 1. 2 cases(15%) had limitation of pronation within 10 comparing with uninjured side. But 11 cases(85%) had equal movements on both sides. And the range of motions of the elbow and wrist are within normal limit. 2. More than 20 angulation for mid 1/3 fracture over 10 years of age, and more than 20 angulation or 20% displacement for distal 1/3 fracture over 6 years of age, it would be better to perform a surgical treatment if nonsurgical treatment was failed. 3. Immobilization periods were 5 weeks for plate fixation group and 6.9 weeks for K-wire fixatioin group. Bone union was occurred in all cases, at 9 weeks in plate fixation group and 8 weeks in K-wire fixation group. 4. Its better to fix with plate ofr promimal 2/3 fracture and K-wire for distal 1/3 fracture in case of operation. In conclusion, our results of open reduction and internal fixation were satisfactory if adequate alignment of fractures had not been achieved or maintained.

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A Operative treatment of the three-part, four-part Fracture and Fracture dislocation in proximal humerus: Young Su Lee, Min Ki Kim; J Korean Soc Fract 1997;10(1):112-118. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.112

Abstract PDF: The three part, four part fracture and fracture-dislocation of proximal humerus generally need operative treatment but treatment of these fractures has remained controversal. The purpose of this study is to analyze the result of operative treatment of three-part, four-part fracture and fracture dislocation in proximal humerus. From Jan 1990 to July 1995, Eleven patiens were reviewed and the result were summerized as follows. 1. There were 4 three-part fracture, 1 four-part fracture, 4 three-part fracture-dislocation, 1 head-spliting fracture, 1 impression fracture. 2. Open reduction and internal fixation was done in 7 cases, prothetic replacement was done in 4 cases. 3. The result were analyzed accroding to scoring system of Neer. 1) The excellent or satisfactory result were seen in 5 cases of three part fracture and fracture-dislocation, but in none case of four-part fracture. 2) The excellent or satisfactory result were seen in 3 cases with open reduction and internal fixation, and in 3 cases with prothetic replacement. 4. Among the cases with joint disability(5), there are 1 three-part fracture-dislocation, 1 head-spliting, 2 three-part fracture, 1 four-part fracture. 5. The rigid fixation and early mobilization is considered to be a good modality.

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Comparison of Compression Hip Screw, Captured Hip Screw and Gamma-Locking Nail in Intertrochanteric Fracture of Femur: Eu Seup Chung, Kyung Seo Choi, Min Ki Kim, Jong Bong Lee; J Korean Soc Fract 1996;9(4):876-883. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.876

Abstract PDF: It is well known that most of the intertrochanteric fractures of femur occur in elderly patients with osteoporosis and poor general conditions. So, there are many problems in the treatment of intertrochanteric fractures of femur due to osteoporosis and unstable patterns of fracture and poor general conditions in clderly patients. Various devices have been developed and the results of treatment have been improved, but the morbidity and the mortality still remain high. The authors analysed 33 cases of compression hip screw(group 1), 19 cases of captured hip screw(group 2), and 13 cases of Camma-locking nail(group 3) amomg 65 cases of intectrochanteric fracture of femul operated at Presbyterian Medical Center from Jan.1990 to Aug.1994. We compared the intraoperative and postoperative complications amomg the three devices, and obtained the following results; 1. The incidences of fixation failure were not sigmificant among the three groups. 2. The lag screw penetration of femoral head and angulation were higher in Gamma-locking nail group(23%) among the three groups. 3. Most of anterior displacement of distal fragment and severe impaction of fracture site were occured in unstable fracture and higher in captured hip screw group(16%), and none in Camma locking nail group. 4. In Gamma-locking nail group, severe impaction at fractuie site was not found but the lag screw penetration of femoral head and angulation were higher. In the other two groups, the results were reverse.

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Comparison between Transolecranon Approach and Posterior Approach in Comminuted Intercondylar Fracture of the Distal Humerus: Soo Kyoon Rah, Sang Ki Kim, Joong Geun Choi, Yon Il Kim, Chang Uk Choi; J Korean Soc Fract 1996;9(4):1069-1075. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1069

Abstract PDF

The comminuted iniercondyiar fractvre of the distal humeruf is rather uncommon injury. Because of anatomic complexity of the distal humerus, any incongrousness makes loss of function of the elbow joint. Hence, for the complete restoration of the articular surface and joint nlotion, wide exposure is necessary, while stable internal fixation and early post operative exercise should be conducted. With the frefuency of comminution and displacement, this intraarticular fracture is difficult to treat. But the fabrication of new implants and development of surgical approach method has increased the reliability of operative stabilization. The authors compared 36 patients of distal humeral fracture treated with transolecranon approach and Campbells posterior approach at the Department of Orthopaedic Surgery. College of Medicine, Soonchunhyang University from Dec. 1991 to Oct. 1994 and following results were obtained. In transolecranon approach, the operation time was slightly longer with technical difficulties. However, we had excellent exposure of posterior aspect of lower end of the humerus and had a good range of motion, especially in flexion contracture compared with posterior approach. Also, we hardly observed complications of fracture of the olecranon in transolecranon approach.

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Clinical Outcome of Surgical Treatment for Intra-articular Distal Humerus Fracture
Myung Jin Lee, Hyeon Jun Kim, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Chul Hong Kim, Lib Wang, Hyun Woo Sung
Journal of the Korean Fracture Society.2010; 23(2): 201. CrossRef

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Treatment of Radial Head and Neck Fracture in Children: Hyung Ku Yoon, Kuk Hwan Oh, Kyung Hoon Kang, J I Kim, Jong Hwa Yi; J Korean Soc Fract 1996;9(3):688-694. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.688

Abstract PDF: Fracture of radial head and neck in children is a relatively rare injury and comprises 5 to 10 percent of fractures of the elbow in children. Its prognosis has been considered relatively good, but prognosis is poor in severely displaced fractures of the radial head and neck, especially types II and III by OBriens classification and have a high risk of complication. We retrospectively reviewed 8 cases of radial head and neck fractures in 1 patients, who were treated from Jan.1992 to June 1994 at Kwang Myung Sung Ae Hospital. They were followed up for more than 1 year. The results were as follows; 1. There were 4 male and 3 female patients. One patient had bilateral involvement 2. The most common cause was fall down injury (6 cases). 3. According to O'Briens classification, 3 cases were type I and 5 cases were type II Treatments included simple immobilization(3 cases), closed reduction and plaster cast (4 cases), percutaneous K-wire leverage method(1 case). 4. According to the criteria of Tibone, the clinical result was excellent in 7 cases and good in 1 case. Primary angulation was the most important factor affecting the result and early closed reduction was important to obtain the satisfactory clinical result.

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Unusual Isolated lateroplantar Dislocation of the First Tarsometatarsal Joint: A case Report: Joo Hong Lee, Jae Hoon Lee, Hak Ji Kim, Kyung Jin Song, Byung Yun Hwang; J Korean Soc Fract 1996;9(2):349-353. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.349

Abstract PDF: Dislocation and fracture-dislocation fo the Tarsometatarsal joint were rare injuries, but an increase of motor vehicle accidents, industrial and athletic injuries seems to be responsible for an incresing incidence of these injuries. Because of the basic inherent stabilith of the bony architecture and the structures on the sole of the foot including the plantar fascia, the intrinsic foot muscles, peroneus, tibialis posterior tendon and the stronger plantar pligaments most dislocations occur in dorsal and lateral direction. We report a case of 32 year-old male patient who had an isolated fracture and disloction of the first Tarsometatarsal joint with laterai and plantarward displacement. This developed by in-car accident and which did not fit to any proposed classification systems. The diagnosis was delayed because of the combined injuries, but with open reduction and internal fixation with 2 smooth K-wires, satisfactory results could at 12 moonths follow-up study.

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Complications and Its Treatment of Ankle Fractures: In Kim, Seung Ko Rhee, Soon Yong Kwon, Ki Won Kim, Yong Keun Cho, Han Chang, Won Jong Bahk, Nam Kee Lee, Seung Ki Kim; J Korean Soc Fract 1995;8(4):736-746. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.736

Abstract PDF: We have investigated total 294 cases of ankle fractures, which were treated and followed for average 17 months after treatment at St. Marys hospital since 1980, to detect the complications and to define their provoking factors. The results were as follows; 1. Twenty-six cases out of total 294 cases of ankle fracture(8.8%) were complicated clinically and radiologically. 2. Their complications are osteoarthritis(8/26, 31%), diastasis of distal tibio-fibular syndesmosis(9/26, 34.6%), varus ankle deformity(5/26, 19.2%), malunion(6/26, 23%), non-union and ankle instability(each 2/26, 7.7%) in its order, but 14 cases of the 26 cases complained painful limited ankle motion and limp. So, clinical symptoms are not closely related with radiologic changes in complications of ankle fracture. 3. The complications are common in elderly patients over 50 of their ages(12.26, 46%) and in younger patients under 16 of their ages(5/26, 20%). 4. The complications are frequently found in pronation-external rotation injuries(6/61, 1O%), pronation-dorsiflexion(9/14, 64%) and supination-external rotation injuries(8/165, 4.8%) in orders. 5. Malpractice with misuse of instrument(12/26, 46%), mistakes in preoperative evaluation and neglect any ankle fracture or diastasis of syndesmosis(8/26, 30.7%) and severity of injuries(6.26, 23%) are common causes of complications of ankle fractures. 6. Varus ankle deformity due to early epiphyseal closure are shown in 5 cases(5/28, 20%) and three of them are treated with supramalleolar corrective osteotomies and Langenskiolds physolysis In conclusion, the complications of ankle fracture could be reduced by accurate pre-operative evaluation to detect the hidden soft tissue injuries or fracture mechanism and by also anatomic reduction, rigid internal fixation and early ankle motions. childrens ankle fracture will induce angular deformity and limb length discrepancy due to frequent epjphyseal damage, so long-term follow up should be kept in mind until their skeletal growth are ceased.

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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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Treatment of Intertrochanteric Fractures of Femur in Elderly Patients over 65 Years Old: Yoo Seong Seo, Hyung Suk Choi, Sang Gi Kim, Byung Joon Shin, Soo Kyun Rah, Chang Uk Choi; J Korean Soc Fract 1995;8(1):54-60. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.54

Abstract PDF: The ipsilateral femur fracture after hip arthroplasty is rare, but serious complication. And its treatment is difficult and controversial. We experienced 6 patients who had the hip arthroplasty complicated by an ipsilateral femur fracture in postoperative period at the Department of Orthopaedic Surgery, Soonchunhyang Univesity from February 1990 to December 1993. The Type 1 fracture was 1 case, and 2 Type IV-A, and 1 Type IV-3, and 2 Type V according to AAOS classification. Bony union and satisfactory clinical results were achieved in all 6 cases.

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Surgical treatment of Unstable Acetabular Fracture Clinical analysis of 28 cases with consideration of surgical problems and complications: I Kim, Y K Woo, Y S Kim, S W Song, S Y Kwon, S A Park; J Korean Soc Fract 1994;7(2):444-456. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.444

Abstract PDF: Authors reviewed total 28 cases of acetabular fracture with operative management followed up over 1 year. The clinical results were retrospectively analyzed with consideration of surgical problems and complications. The overall results were as follows: 1. According to the classification by Judet and Letoumel(1974), 20 cases were elementary fractures and 8 cases were associated fractures. The posterior wall fractures were most common in 9 case. 2. Kocher-Langenbeck approach in 18 cases, ilioinguinal in 4 cases, iliofemoral in 4 cases and triradiate transtrochanteric approach in 2 cases were used. 3. The devices for internal fixation were as follows screw only in 8 cases. plate and screw in 14 cases, plate and screw with circumferential wiring In 4 cases, wire and staple only in 1 each case. 4. The early and late complications occurred postoperatively as follows : incomplete sciatic nerve palsy 2 cases, wound infection 2 cases as early complications and posttraumatic arthritis 6 cases. avascular necrofis of femoral head 2 cases, heterotropic ossification 1 case as late complications. Two cases of sciatic nerve palsy were spontaneously recovered and 2 cases of wound infection were controlled by adequate drainage and antibiotic therapy. And then, the total hip arthroflasty were carried out for 2 cases of avascular necrosis of femoral head, and 6 cases of posttaumatic arthritis and 1 case of heterotopic ossification were under observation. 5. Postoperatively, the causes of inadequate reduction and insufficient fixation were radiographically analyzed with immediate]y and lastly checked plain films, of which causes in 9 cases were as follows : inappropriate approach for exposure in 4 cases, delayed operation due to major associated injury over 3 weeks in 3 cases and severe comminution in 2 cases. As a result, we reached to put an emphasis on an importatnce of preoperative planning, including the evaluation of individual fracture personality, the choice of surgical approach and the method of internal fixation.

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Management of Acetabular Fracture: Kwang Jin Rhee, Jyun Kyu Lee, Chan Hee Park, Ho Suk Lee, Kyoung Tai Kim; J Korean Soc Fract 1994;7(1):137-143. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.137

Abstract PDF: Acetabulum consisting of the hip joint is the most important weight bearing portion in the lower extremity But if fractures of acetabulum are not accurately evaluated, classified, and reduced anatomically, major sequalae and complication are frequently developed. Because of complicated anatomy, difficulty with surgical exposure, frequent associated injury, the treat ment of acetabular fractures between conservative and surgical methods is still controversal. We studied roentgenographic finding, associated inlury, method of treatment and result of treatment. We reviewed forty cases of acetabular fracture from May 1985 to July 1993. The results was as follows; 1. The pervalent age was from second decade to forth decade. 2. We classified 40 cases by Letournel classification. The most common type was posterior wall fracture, the second was anterior column fracture. 3. Most common associated injury was pelvic bone fractures. 4. Surgical approaches were decided by the fracture type and duration from injury to operation. 5. In nonoperative treatment group, 73.3% of cases were excellent and good result, and in operative treatment group 88.0% of cases were excellent and good result. 6. The complications were occured in 12 cases(48.0%) of 25 cases of operative reatment group.

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