Journal of Musculoskeletal Trauma

Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus: Ji Kang Park, Yong Min Kim, Dong Soo Kim, Eui Sung Choi, Hyun Chul Shon, Kyoung Jin Park, Byung Ki Cho; J Korean Fract Soc 2012;25(2):129-135. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.129

Abstract PDF: PURPOSE
To evaluate the clinical outcomes of operative treatment using a transolecranon approach with a dual locking plate for unstable intercondylar fractures of the distal humerus.
MATERIALS AND METHODS
Eighteen patients were followed for more than 1 year after surgical treatment for unstable intercondylar fractures of the humerus. Anterior transpositioning of the ulnar nerve and an early rehabilitation program to allow range of motion (ROM) exercise from postoperative week 1 were used for all cases. The clinical and functional evaluation was performed according to the Mayo Elbow Performance Index and Cassebaum's classification of ROM.
RESULTS
The range of elbow joint motion was a flexion contracture mean of 12.8 degrees to a further flexion mean of 119.3 degrees at the final follow-up. The Mayo Elbow Performance Index was an average of 88.5 points. Among the results, 6 were excellent, 9 good, 2 fair, and 1 poor. Therefore, 15 cases (83.3%) achieved satisfactory results. Fourteen cases (77.7%) achieved a satisfactory ROM according to Cassebaum's classification. All cases achieved bone union, and the interval to union was an average of 14.2 weeks.
CONCLUSION
Dual locking plate fixation through the transolecranon approach seems to be one of the effective treatment methods for unstable intercondylar fractures of the humerus because it enables the anatomical reduction and rigid fixation of articulation, and early rehabilitation exercise.

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Nonunion of Humeral Intercondylar Comminuted Fracture Treated with Fibular Graft: A Case Report: Jin Rok Oh, Chang Ho Lee, Ki Yeon Kwon, Hoi Jeong Chung; J Korean Fract Soc 2010;23(1):118-121. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.118

Nonunion of comminuted distal humeral fracture is troublesome problem to orthopedic surgeon. We report a case of 59 years old woman, who suffered nonunion of comminuted distal humeral fracture previously treated by open reduction and internal fixation with plate and screws concomitantly autoiliac bone graft. We reconstructed humeral condyle with fibular inlay graft inside cortical shell of intercondylar bone fragment and obtained excellent result in radiological and functional outcome.

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Update 1 of: Destruction and Detection of Chemical Warfare Agents
Yoon Jeong Jang, Kibong Kim, Olga G. Tsay, David A. Atwood, David G. Churchill
Chemical Reviews.2015; 115(24): PR1. CrossRef

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Operative Treatment of Displaced Intercondylar Fracture of the Distal Humerus with Reconstruction Plate: Ryuh Sup Kim, Tong Joo Lee, Kyoung Ho Moon, Seung Rim Park, Moon Lee; J Korean Fract Soc 2007;20(2):172-177. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.172

Abstract PDF: PURPOSE
To evaluate the therapeutic effects of chevron olecranon osteotomy and bilateral reconstruction plate as operative treatment for distal humerus intercondylar fracture.
MATERIALS AND METHODS
Among patients operated for distal humerus intercondylar fracture in our hospital from June, 1997 to October, 2005, 26 patients were selected who could be followed-up for more than one year. The average follow-up period was 15 months. All olecranon osteotomies were chevron osteotomy and all fractures were treated with internal fixation using bilateral reconstruction plate. The ulnar nerve was checked in all cases. Three patients in which case the plate might irritate the ulnar nerve, received with ulnar nerve anterior transposition. Cassebaum's classification and Mayo elbow performance score were used to evaluate at three, six and twelve months.
RESULTS
Mean bone union period was 11.7 weeks. There were 9 excellent cases, 11 good cases, 4 fair cases and 2 poor cases. Mean flexion contracture was 11Â° and further flexion was 126Â° at last follow-up.
CONCLUSION
Bilateral reconstruction plate internal fixation using chevron olecranon osteotomy showed strong fixation and good clinical results and it is possible for early rehabilitation treatment.

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Treatment of Intercondylar Fractures of Humerus with Y-plate: Jin Young Park, Joong Bae Seo, Ji Yong Chun, Myoung Ho Kim, Sang Hyuk Min, Joo Hong Lee; J Korean Fract Soc 2006;19(4):443-448. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.443

Abstract

PURPOSE
To evaluate the results of the treatment of intercondylar fractures of the humerus using Y-plate.
MATERIALS AND METHODS
The subjects were 17 patients with intercondylar fracture of humerus who were treated using the Y-plate. Nine cases were C1 type, 4 were C2 type, and the remaining 4 were C3 type. 11 subjects had accompanying fractures of another part of the body. The average age was 48.8. The average follow up period was 33 months. We used Mayo Elbow Performance Score and Risborough-Radin's rating score for each patient as the methods of rating.
RESULTS
The average range of motion of the elbow was 105 degrees (50~150 degrees). According to Cassebaum's classification for elbow range of motion, 7 cases were rated very good, 1 cases were good, 4 cases were fair, and 1 cases were poor. According to Mayo Elbow Performance Score, 7 were excellent, 7 were good, 2 fair, and 1 poor. Of the 3 patients who were fair or poor in Mayo Elbow Performance Score, 2 were type C3 fractures, and all 3 had major accompanying fractures. No significant postoperative complications developed in all cases.
CONCLUSION
The fixation with Y-plate can still be a relatively good modality of treatment for interconylar fractures of the humerus in selected cases, in spite of the known mechanical weakness of the Y-plate. The patients with severe intra-articular comminution showed relatively poor results. And we think that the age of the patient and the energy of the injury have more or less influence on the results of treatment.

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Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus
Ji-Kang Park, Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho
Journal of the Korean Fracture Society.2012; 25(2): 129. CrossRef
Operative Treatment of Distal Humeral Comminuted Fractures with Orthogonal Plating
Joong-Bae Seo, Jae-Sung Yoo
Journal of the Korean Fracture Society.2011; 24(3): 243. CrossRef
Operative Treatment of Displaced Intercondylar Fracture of the Distal Humerus with Reconstruction Plate
Ryuh Sup Kim, Tong Joo Lee, Kyoung Ho Moon, Seung Rim Park, Moon Lee
Journal of the Korean Fracture Society.2007; 20(2): 172. CrossRef

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Comminuted Intercondylar Fracture of the Distal Humerus in Adults: Jin Rok Oh, Yeo Seung Yoon, Dong Kyu Lee, Man Seung Her; J Korean Fract Soc 2006;19(2):208-214. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.208

Abstract

PURPOSE
To evaluate the therapeutic results of communited intercondylar fractures of the distal humerus that were treated by surgical treatment.
MATERIALS AND METHODS
From January, 1998 to December, 2004, we reviewed fifteen cases of intercondylar fracture of the distal humerus, which were treated by surgical treatment. The follow up period ranged from six month to 5 years. The functional results were evaluated using Broberg and Morrey's functional scale according to surgical approach, type of plate and location of plating.
RESULTS
The functional results were as follows; seven excellent, six good, one fair and one poor. The mean range of motion in elbow joint was 7~106 degrees. The mean functional score was 86.6 points through olecranon osteotomy, 90.5 points through Campbell's posterior approach. The mean functional score was 91.6 points in cases using 2 reconstruction plate, 78 points in cases using 1 reconstruction plate and 1/3 semitubular plate, and 86 points in case using 1 reconstruction plate and lag screws. The mean functional score was 88.9 points in cases by posterior and lateral fixation, 86 points in cases by both posterior fixation and 97 points in case by both lateral fixation.
CONCLUSION
There are no significant differences in treatment outcome according to surgical approach, different plate and location of plating.

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Double Parallel Plates Fixation for Distal Humerus Fractures
Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk-Jin Lee, Joon Oh Lee, Kyu-Won Oh, Hyun Sik Gong
Journal of the Korean Fracture Society.2010; 23(2): 194. CrossRef

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Treatment of Intercondylar Fracture of Distal Humerus in Adult: Kyung Won Song, Seung Yong Lee, Sung Il Shin, Jin Young Lee, Kab Rae Kim, Hyung Seok Oh, Jin Duck Kim, Dae Eun Choi; J Korean Fract Soc 2006;19(1):62-66. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.62

Abstract

PURPOSE
To evaluate and report the clinical results of the treatment of distal humerus intercondylar fractures treated with internal fixation through the modified posterior approach.
MATERIALS AND METHODS
From January 1999 to October 2003, 20 patient who had intercondyle fracture of the distal humerus treated with internal fixation through the modified posterior approach. We evaluated bone union, complication, postoperative elbow function.
RESULTS
The average follow up period was 12.8 months. Nearly all most cases united at 14 weeks in an average. There were two neuropraxia and two hardware failure. The range of the elbow joint motion was flexion contracture 8 degree (5~15 degree) to further flextion 120 degree (75~140 degree) in average. The functional result with Riseborough and Radin's functional scale were as follows; 13 good, 4 fair, 3 poor.
CONCLUSION
Not with severe comminuted like type C3 fracture, but in cases with intercondylar distal humerus fracture the modified posterior approach provided satisfactory exposure for open reduction and rigid internal fixation with satisfactory bone union. There was satisfactory bone union and good clinical result in postoperative elbow function.

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Double Parallel Plates Fixation for Distal Humerus Fractures
Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk-Jin Lee, Joon Oh Lee, Kyu-Won Oh, Hyun Sik Gong
Journal of the Korean Fracture Society.2010; 23(2): 194. CrossRef

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Intercondylar Fracture of Distal Humerus in Children: Woo Suk Lee, Whan Yong Chung, Woo Sik Kim, Yong Chan Kim, Taek Soo Jeon, Nam Hyun Kim, Kyoo Tae Kim; J Korean Fract Soc 2004;17(4):380-383. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.380

Abstract PDF

Intercondylar fractures of the distal humerus are very rare in children. The pattern of the fracture would suggest that the mechanism of injury involves a fall directly on the flexed elbow. Most agree that the undisplaced fracture can be managed conservatively. With increasing displacement and comminution, the opinions tend to differ. We suggest that closed reduction with percutaneous K wire pinning and open reduction with percutaneous K wire pinning offer a satisfactory methods by which to treat displaced intercondylar fracture in children.

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Adolescent Distal Humerus Fractures: ORIF Versus CRPP
Phillip Bell, Brian P. Scannell, Bryan J. Loeffler, Brian K. Brighton, R. Glenn Gaston, Virginia Casey, Melissa E. Peters, Steven Frick, Lisa Cannada, Kelly L. Vanderhave
Journal of Pediatric Orthopaedics.2017; 37(8): 511. CrossRef

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Clinical Outcome of Surgical Treatment of Distal Humerus Intercondylar Fractures Through the Transolecranon Approach Combined with Anterior Transposition of the Ulnar Nerve: Kwang Hyun Lee, Seong Pil Lee, Kyu Tae Hwang, Joo Hak Kim; J Korean Fract Soc 2004;17(2):70-75. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.70

Abstract PDF: PURPOSE
To analyze the clinical outcomes of surgical treatment of distal humerus intercondylar fractures through the transolecranon approach combined with anterior transposition of the ulnar nerve.
MATERIALS AND METHODS
Eight patients who had distal humerus intercondylar fractures were included in this study and underwent operative treatment through the transolecranon approach for sufficient operative field with anterior transposition of the ulnar nerve and fixed with reconstruction plate.
RESULTS
The results were evaluated using Riseborough and Radin rating criteria. Seven cases of eight cases were achieved good results with flexion contracture less than 30 degrees and forward flexion more than 115 degrees. However, one case was acheived poor result with 40 degrees of flexion contractue and 70 degrees of forward flexion. There were no the compressive ulnar neuropathy.
CONCLUSION
We found the transolecranon approach and anterior transposition of the ulnar nerve a viable option for surgical treatment of the distal humerus intercondylar fractures

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Treatment of Supracondylar-Intercondylar Femoral Fractures with a Retrograde Intramedullary Nailing: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Yong Jin Jeon; J Korean Fract Soc 2004;17(2):110-116. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.110

Abstract PDF

PURPOSE
We analyzed the cases of supracondylar-intercondylar femoral fracture treated with retrograde intramedullary nail and report the clinical results and its usefulness.
MATERIALS AND METHODS
We reviewed 17 cases of supracondylar-intercondylar femoral fracture that had been treated with retrograde intramedullary nail and each of patients had been followed up for a minimum one year. Post-operative functional assessment was performed using a scale developed by Sanders et al. The evaluation scale assesses range of motion, pain, walking ability, return to work, and alignment and shortening as measured on radiograph.
RESULTS
According to functional assessment of Sanders et al, there were 6 excellent, 9 good, 1 fair, and 1 poor results, that is, 94% showed above excellent results. Bony union was obtained in average 5 months after operation. The post-operative complications were varus deformity in 1 case, wound infection in 1 case, stiffness of knee joint in 1 case, and metal failure in 1 case.
CONCLUSION
The treatment of supracondylar-intercondylar femoral fracture with retrograde intramedullary nail is one of the good surgical options for clinically preferable results with the advantages in early joint motion and early ambulation.

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Retrograde Intramedullary Nailing or the Treatment of Segmental Femoral Shaft Fracture Including Distal Part
Jong-Ho Yoon, Byung-Woo Ahn, Chong-Kwan Kim, Jin-Woo Jin, Ji-Hoon Lee, Hyun-Ku Cho, Joo-Hyun Lee
Journal of the Korean Fracture Society.2009; 22(3): 145. CrossRef

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Muller Type C Intercondylar Fractures of Femur : Comparative Analysis by Surgical Approach: Hong Geun Jung, Myung Ho Kim, Moon Jib Yoo, Suk Joo Yoo, Sung Churl Lee, Jin Young Park, Sang Hyuk Min; J Korean Soc Fract 2000;13(1):64-73. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.64

Abstract PDF: PURPOSE
The purpose of this study is to compare the functional results of Muller type C intercondylar fractures treated by 2 different surgical approaches : lateral and extensile approach.
MATERIALS AND METHODS
The study is based on 20 patients 21 knees of Muller type C intercondylar fractures. Two surgical approaches, i.e. 13 cases with lateral and 8 cases with extensile approach were used. The functional evaluation of results was done with criteria by Schatzker and Lambert. Excellent and good was grouped superior while fair and failure was grouped inferior.
RESULTS
Comparative analysis by surgical approach showed that among total 10 cases of C2 fractures, 6 cases(85.7%) of lateral approach and 2 cases(66.7%) of extensile approach were categorized in inferior group. Among the 8 cases in type C3 fractures, 3 cases treated surgically using the lateral approach showed fair and failure results and 3 cases(60%) of the remaining 5 cases using the extensile approach showed good results.
CONCLUSION
There was no significant result difference between lateral and extensile approach in type C2 fractures, but in C3 fracture, cases with extensile approach showed better results. Therefore the extensile approach should be recommended in C3 intercondylar fractures with intra-articular comminution.

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Refracture of Forearm Bone after Plate Removal: Sung Keun Sohn, Byeong Hwan Kim, Sang Ki Lee; J Korean Soc Fract 2000;13(1):132-138. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.132

Abstract PDF

PURPOSE
: To evaluate the results of operative treatment for intercondylar fracture of the distal humerus in adults.
MATERIALS AND METHODS
: From February 1994 to June 1998, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 12 of them were treated by open reduction and internal fixation(dual plate for 8, screw & K-wire for 4) and 3 of them by open reduction & Ilizarov fixation. Open or closed fracture and AO classification of fracture were considerd as a prognostic factor. The functional results were analyzed by Jupiter's critera.
RESULTS
: There were 2 excellent, 2 good in C1 type, one excellent, 2 good, one fair and 2 poor in C2 type, and one excellent, 2 good, 2 poor in C3 type. And there were one good and one poor in 2 open fractures and 4 excellent, 5 good, one fair and 3 poor in closed fractures. The average range of motion of the elbow joint was 85 degrees(30 degrees-115 degrees). Overall results show excellent and good in 67%(10 of 15) and poor in 27%(4 of 15).
CONCLUSION
: It's not easy to get satisfactory results in treatment for intercondylar fracture of the distal humerus We suggest that more efforts are needed to get anatomical reduction, rigid internal fixation and early joint motion in interconylar fracture of the distal humerus.

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Refractures of the Upper Extremity in Children
Hui Wan Park, Ick Hwan Yang, Sun Young Joo, Kun Bo Park, Hyun Woo Kim
Yonsei Medical Journal.2007; 48(2): 255. CrossRef

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Treatment of comminuted distal humeral intercondylar fracture using transolecranon approach: Kwang Hyun Lee, Myung Ryul Park, Jae Min Lee, Tae Hyoung Kweon; J Korean Soc Fract 1999;12(4):981-987. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.981

Abstract PDF: Fracture of the distal humerus is rare, so the surgeons experience is limited. This injuries represent a constellation of complex articular fractures and anatomic complexity of distal humerus makes surgical treatment, open reduction and internal fixation is difficult. We analyze the clinical result of immediate open reduction, rigid internal fixation, and early postoperative motion. From Nov. 1990 to Sep. 1997, the authors analyzed the clinical results of 5 cases those who underwent operative treatment using transolecranon approach, internal fixation with Y plate and early motion for comminuted distal humeral intercondylar fracture. ROM exercise was started at average 2.2 weeks postoperatively. 4 of 5 patients obtained satisfactory results by Riseborough and Radin rating criteria. One patient obtained poor result of 40 degree flexion contracture and 90 degree further flexion of elbow. Transolecranon approach makes the complete anatomic reduction of articular surface possible and the satisfactory results is associated with immediate, complete anatomic reduction and rigid fixation in conjuction with early postoperative motion.

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Treatment of Nonunion in Femoral Supracondylar and Intercondylar Fracture: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yu, Eun No Lee, Yoon Yeup Kim; J Korean Soc Fract 1999;12(4):844-850. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.844

Abstract PDF: The femoral supracondylar and intercondylar fractures are difficult to be treated due to severe soft tissue damage, comminution, intraarticular extension of fracture and injury to the quadriceps mechanism frequently. The causes of nonunion are inadequate anatomical reduction, fixation failure, bone defect and infection occasionally, which is difficult to be treated. The authors analyzed 16 cases with nonunion of femoral supracondylar and intercondylar fracture who had been treated surgicdlly from January 1990 to December 1991 According to AO/ASIF classification in the initial fracture patterns, type A were 8 cases, type B was 1 case and type C were 7 cases. The duration between initial treatment and surgical treatment of nonunion was 6 months in average. The causes of nonunion were fixation failure due to inadequate device selection in 9 cases, inadequate anatomical reduction or surgical technique in 4 cases and infection in 3 cases. The treatmentt were internal fixation with Dynamic condylar screw(DCS) in 9 cases, internal fixation with condylar blade plate in 4 cases, monofocal lenghtening with Ilizarov in 1 case and bifocal lenghtening with Ilizarov in 2 cases. According to Schatzker classification, the good result was obtained in 11 cases(68.8%). The complications were 3 knee joint ankyloses, 2 superficial wound infections, 1 delayed union and 1 deep vein thrombosis. In conclusion, the requirement for the good result in treatment of nonunion are exact anatomical reduction, rigid fixation and autogenous bone graft.

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Treatment of Comminuted Supracondylar and Intercondylar Femoral Fractures with AO Dynamic Condylar Screw: Kyung Chul Kim, Jae Yeul Choi, Hwa jae Jeong, Bon Seep Koo, Kyung Ho Kim; J Korean Soc Fract 1999;12(2):253-258. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.253

Abstract PDF: Between 1990 and 1995, 22 comminuted supracondylar and intercondylar femoral fractures in 22 patients were treated with the AO dynamic condylar screw(DCS). Minimum twelve months of clinical and radiographic follow-up evaluation were available on all patients. All cases achieved clinical and radiographic bony union. Functional results were graded using a Schatzker and Lambert's criteria. Results were seen to be excellent to good to fair in 100% of A2 cases, 86% of C2 cases, 75% of A3 cases and 67% of C3 cases. The more comminuted fractures were found to have worse clinical results and more radiographic malunion. The ability to obtain good fixation in osteoporotic bone is distinct advantage of the DCS. The results of DCS fixation compare favorably with previous studies using other fixation devices in comminuted supracondylar and intercondylar femoral fractures

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Treatment of Supracondylar or Intercondylar Fracture of Humerus in Adult: Byung Ho Lee, Sang Ho Ha, Sun Jin Choi; J Korean Soc Fract 1998;11(3):665-671. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.665

Abstract PDF: Distal humerus fracture, particularty those that involve the articular surface, in adult has remained one of the most difficult of all fractures to manage. The goal of this study is to analyze clinical result according to fracture pattern and method of treatments and to recognize complicating factor affecting prognosis. Nonoperatively managed intraarticular fractures are likely to have compromised functional outcome. Open anatomic reduction and stable fixation secure enough to permit early functional, pain-free motion of the elbow showed best result. Stable fixation of fracutre is achieved with use of single or dual plates with additional lag screws depending on the fracture pattern. When there is segmental articular fragments, interfragmentary bipolar threaded screw(Herbert screw) may be useful. autogenous cancellous bone grafting is sometimes advisable when the diaphyseal portion of the fracture is comminuted. Transolecranon approach affords excellent surgical exposure of the joint surface for fracture with comminuted intra-articular component and there was no postoperative complication.

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Treatment of the Supracondylar and Intercondylar Fracture of the Humerus in Adults: Sang Won Park, Young Soo Byun, Ki Hoon Kang, Sang Won Han; J Korean Soc Fract 1998;11(2):378-383. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.378

Abstract PDF: Supracondylar and intercondylar fracture of the adult humerus is uncommon and present a difficult management problem. The purpose of this study is to analyse the clinical results according to types of the fracture and methods of the treatment. The authors reviewed twenty-eight patients treated for supracondylar and intercondlar fracture of the adult humerus at the Department of Orthopaedic Surgery, Korea University Hospital from January 1990 to August 1996. The mean follow up period was 41 months (12months to 79months). The results were as follows: 1. According to AO classification, there were 9 cases(32%) of Type A, and 19 cases(68%) of Type C. 2. The Methods of treatment were closed reduction and cast immobilization in 4 cases, closed reduction and fixation with K-wire or screw in 11 cases, open reduction and fixation with K-wire or screw in 7 cases and open reduction and plate fixation in 6 cases. 3. Poor results can be expected after closed reduction and cast immobilization, open fracture, above 60 years old, and Type C according to AO classification.

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Delayed Management of Supracondylar and Intercondylar Fracture of the Femur Using the Composite Graft(Autograft+Processing Allograft): Young Kyun Woo, Seung Koo Rhee, Soen Yong Kwon, Hwa Sung Lee, Joo Yup Lee; J Korean Soc Fract 1996;9(4):951-957. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.951

Abstract PDF: There are many difficuties and problems to get anatomical reduction and rigid internal fixation in treatment of supracondylar and intercondylar fracture of the fumur. Authors reviewed and clinically analysed 7 patients w.ith svpracondylar and intercondylar fracture of the femur treated by delayed reconstruction from August 1993 to Decfmber 1995. Of 1 cases, there were 5 cases of open and 2 cases of closed fracture. According to AO classification, 7 cases were classified as followed; A3 type-l case, C2 type-4 cases, and C3 type-2 cases. They underwent surgical treatment at average 35 days after injury(range from 25 days to 58 days). Main causes of delay in surgical treatment were poor preoperative condition associated with mulliple injuries in 3 cases, wound problems at the site of open fracture in 3 cases and the combined state in 1 case. For internal fixation of fractures, a supracondylar nail in 4 cases and a dynamic condylar screw in 3 cases were used, and the bony defective area of fracture site in all 1 cases was replaced by the composite graft made of the autogenous cancellous bone and the processing allograft(Tutoplast). The period of follow up was from 8 months to 30 months(average time 14.8 months). There were no infection or allograft-rejection postoperatively. Clinical union was achieved from 6 months to 10 months in 6 cases, and nonunion associated with incomplete incorporation of graft bone was developed in 1 case. In 6 cases of clinical union, clinical assessment estimated by Schatzker and Lamberts criteria was fair in 1 case and failure in 5 cases, and change of tibiofemoral alignment occurred in 2 cases. The above poor clinical results could be considered to be derived from the delayed operative intervention resulting in joint stiffness due to soft tissue contracture, arthritis and large bony defect. In conclusion, even if it showed poor clinical results, the composite graft made of the autogenous cancellous bone and the pmcessing allograft could serve as a possible alternative for restoration of large bony defect in delayed management of supracondylar and intercondylar fracture of the fumur.

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Treatment of Infected Nonunion in Supracondylar and Intercondylar Fractures of the Femur after Open Reduction and Internal Fixations: Ho Geun Chang, Eung Joo Lee, Sang Chun Ahn; J Korean Soc Fract 1996;9(4):921-929. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.921

Abstract PDF: The postoperative complications in open reduction and internal fination of supracondylar and intercondylar fractures of the femur include leg length discrepanfy, infection, skin necrosis, irritation by implants, valgus or varus deformity, bony destruction associated with vascular disturbance, instability of thr knee joint and translation of the frartured surface. The most vulnerable complication among them may be infection. Then infected nonunion is dangerous to the patients and its treatment is very difficult. Authors evaluated 25 cases of 25 patients who were treated and followed up evaluation over one year in the department of Orthopaedic Surgery, College of Medicine, Hallym University from January, 1988 to June, 1995. All cases were treated by open reduction & internal fixations. Four cases of them had developed infected nonunion. After we treated these cases wr could reach following results: 1. The cause of infection was primarily staphylococcus aureus in all cases. 2. Among 4 cases of infected nonunion, external fixator was preformed in 3 patients and interlocking IM nailing in remainder. 3. The infection was managed with intravenous antibiotics, frequent irrigation. insertion of antibiotic impregnated beads and daily dressing. 4. Erythrocyte sedimentation rate was normalized at average 8.5 months(range, from 1.5 to 26 months). 5. The union was accomplished at mean 5.4 months in 21 cases without infection and at mean 17.7 months(range, from 10 to 35 months) in 4 cases with infued nonuion after infection developed. 6. The main complications were limitated range of motion of the knee(30 to 100 degree flexion) and shortening of affected extremity. 7. In conclusion, we suggest that early removal of implant in situ, external fination and bone graft after infection controlled is an adequate plan for the treatment of infected nonunion in supracondylar and intracondylar fractures of the femur.

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Treatment of Intercondrlar Fracture of Elbow using Y-Plate through Extraartieular Olecranon Osteotomy in the Posterior Approach: Ho Guen Chang, Sang Su Lee, Eung Ju Lee, Jun Dong Chang, Won Ho Cho, Chang Ju Lee; J Korean Soc Fract 1996;9(4):1118-1124. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1118

Abstract PDF: Iniercondylar fractures of the distal humerus in adults are rare and notoriously difficult to treat. We treated 8 patients by open reduction and internal fixation using Y-plate with extraarticular olecranon osteotomy in posterior approach. L-shaped osteotomy was performed at the extraarticular portion of olecranon with triceps tendon insertian remained to proximal portion of it, using air-saw. The follow-up period ranged from 12 to 30 months with average of 19.7 months. The fractures were dassified according to AO classification. The results were evaluated using Jupiter et al grading system. 1) There was no loosening of fixation Cevice of humeral condyle and olecranon. 2) Niether delayed union nor nonunion of olecranon and humeral condyle were found. 3) Exellent grade was achieved in 4 patients(50%), three(38%) had good, and one(12%) poor. Flexion-extension arc ranged from 60 degree to 120 degree with mean of 98.8 degree. 4) Complications included postoperatile neuritis in one, myositis ossificance in one, and heterotopic bone in one patient. Authors would introduce the method and result of extraarticular olecranon osteotomy in posterior approach for the intercondylar fracture of distal humerus, as a new technique.

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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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Importance of maintenance medial buttress in treatment of supra-condylar and inter-condylar(T-condylar) fracture of the femur: Seung Ho Yune, Kwang Jin Rhee, Chan Hee Park, Ki Yong Byun, Sang Yong Lee, Seung Kwon Rho; J Korean Soc Fract 1996;9(1):50-58. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.50

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Recently, treatment of supracondylar and intercondylar(T-condylar) fracture of the femur has been changed from conservative treatment to do open reduction and internal fixation. Principles of anatomical reduction, rigid internal fixation and early knee joint exercise are recommended, but there are many difficulties and problems to get anatomial reduction and rigid internal fixation. we observed 3 cases of malunion & nonunion that were treated by ORIF. In these cases, there is a failure in restoring medial buttress of distal femur due to inadequate reduction and internal fixation. Dynamic condylar screw(DCS) or blade plate were usually used through lateral approach and laterally applying method can not always restore the medial buttress of the fracture site. In these cases, early exercise and early weight bearing have to be postponed,and the results were poor. So we want to emphasize the principles in open reduction and internal fixation of the supra-and inter-condylar fracture fo the femur. To get anatomecal reduction is very important, but if is not possible in severely comminuted fractures, we have to try to maintain medial buttress by another methods such as double plating(to add a medial auxiliary buttress plate to lateral internal fixation) or auxiliary external fixations instead of medial anatomical contact.

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Medial Plating of Distal Femoral Fracture with Locking Compression Plate-Proximal Lateral Tibia: Cases' Report
Se-Ang Jang, Young-Soo Byun, In-Ho Han, Dongju Shin
Journal of the Korean Fracture Society.2016; 29(3): 206. CrossRef
The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Kwang-Hee Park, Yoon-Ho Choi
Journal of the Korean Fracture Society.2009; 22(4): 246. CrossRef

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Clinical Study for Humerus Intercondylar Fracture in Adult: Hyung Ku Yoon, Kuk Rwan Oh, Kyung Hoon Kang, Jin Il Kim, Kye Sung Lee; J Korean Soc Fract 1995;8(1):93-100. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.93

Abstract PDF: The intercondylar fracture of distal humerus in adult is difficult to treat. Because it is difficult to obtain accurate anatomical reduction atd rigid internal fixation due to comminution and intraarticular components. The authors review the 13 cases of intercondylar fracture of the distal humerus in adult that were treated at the orthopaedic department of Sung Ae Hospital, from JAN 1988 to JUN 1992, and the result are as follows: 1. It was frequently occured in 3rd and 4th decades active male and old female over 60 years old. 2. We think that cast hinge elbow brace is recommendable method for improvement of elbow ROM through early active motion. 3. For accurate anatomical reduction and rigid internal fixation, transolecranon approach is recommended for the suffcient exposure of the articular surface.

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The Treatment of the Supracondylar-Intercondylar Fracture of the Femur: Joo Tae Park, Gil Yeong Ahn, Il Hyun Nam, Jung Kyu Ji; J Korean Soc Fract 1995;8(1):31-38. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.31

Abstract PDF: Although not as common as femoral shaft fracture, supracondylar-intercondylar fracture of the femur present considerable challanges in management. Because supracondylar-intercondylar fracture is frequently accompanied by severe soft tissue damage, comminution and intraarticular extension of fracture, it can produce some disability of the knee joint, So recently, early anatomical reduction, rigid internal fixation and early rehabilitation was recommended. The authors analyzed twenty cases of supracondylar-intercondylar fracture that treated at the Department of Orthopaedic Surgery of Pohang Saint Marys hospital from March, 1990 to December, 1993. The object of this study is to evaluate the corelation between the rigid internal fixation and early rehabilitation, The average follow up period was 18.3 months(form 14 to 27 months,) The results were as follows; 1, Among the twenty cases, male was more common than female and the prevalent age was 4th decade(50%). 2. The most common cause of injury was trafnc accident in 15 cases(75%). 3. During 1st 3weeks after operation, we started active R.0.M. exercise by using Thomas splint with Pearson attatchment and long leg brace with ischial weight bearing was applied from 3months to 6months (averge 4.2 months). We permit partial bearing Sweets after operation, 4. According to Schatzker and Lambert criteria, excellent were 16 cases, good 3 cases, feir 1 case. 5. We obtained satisfactory by rigid internal fixation and early rehabilitation.

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Surgical treatment of intercondylar fracture of distal humerus in adult: Chang Ju Lee, Won Ho Cho, Ho Geun Chang, Ju Sung Kim; J Korean Soc Fract 1991;4(1):15-21. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.15

Abstract PDF: No abstract available.

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