Journal of Musculoskeletal Trauma

Restoration of Lateral Tibial Plateau Widening and Articular Depression Is Necessary to Prevent Valgus Deformities after Arthroscopic Reduction and Internal Fixation in AO/OTA 41.B2 or B3 Fractures: Jun-Ho Kim, Kang-Il Kim, Sang-Hak Lee, Gwankyu Son, Myung-Seo Kim; J Korean Fract Soc 2024;37(3):125-136. Published online July 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.3.125

Abstract PDF: Purpose
This study examined the factors affecting valgus deformities after arthroscopic reduction and internal fixation (ARIF) in lateral joint-depression tibial plateau fractures.
Materials and Methods
Patients with lateral joint-depression tibial plateau fractures treated with ARIF were assessed retrospectively. The radiological evaluations included the articular depression distance (ADD) and the lateral plateau widening distance (LPWD) on preoperative and postoperative computed tomography. A postoperative valgus deformity was defined as valgus malalignment (mechanical axis ≥3°) and valgus deviation (Δmechanical axis of the operated knee from the healthy knee of ≥5°). Subgroup analyses based on a postoperative valgus deformity were performed to compare the clinical outcomes, including the range of motion, patient-reported outcomes measures, and failure and osteoarthritis progression. Furthermore, factors affecting the postoperative mechanical and Δmechanical axes were assessed.
Results
Thirty-nine patients were included with a mean follow-up of 44.6 months (range, 24-106 months). Valgus malalignment and valgus deviation were observed after ARIF in 10 patients (25.6%) and five patients (12.8%), respectively. The clinical outcomes were similar in patients with and without a postoperative valgus deformity. On the other hand, lateral compartment osteoarthritis progression was significantly higher in the valgus deformity group than in the non-valgus deformity group (valgus malalignment group: 50.0% vs 6.9%, p=0.007; valgus deviation group: 60.0% vs 11.8%, p=0.032). One patient with valgus deformity underwent realignment surgery at postoperative five years. The preoperative ADD and postoperative LPWD were significantly associated with the postoperative mechanical (both, p<0.001) and Δmechanical (ADD, p=0.001; LPWD, p=0.025) axes. Moreover, the lateral meniscectomized status during ARIF was significantly associated with the Δmechanical axis (p=0.019).
Conclusion
Osteoarthritis progression was highly prevalent in patients with postoperative valgus deformity. Thus, the restoration of lateral plateau widening and articular depression and preservation of the meniscus are necessary to prevent a valgus deformity after ARIF in lateral joint-depression tibial plateau fractures.

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Primary Open Reduction and Plate Fixation in Open Comminuted Intra-Articular Distal Radius Fracture: Jun-Ku Lee, Soonchul Lee, Weon Min Cho, Minkyu Kil, Soo-Hong Han; J Korean Fract Soc 2021;34(1):16-22. Published online January 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.1.16

Abstract PDF: Purpose
There are no standard surgical treatments for open distal radius fractures (DRFs), and the fracture fixator is chosen by the surgeon’s own experience. This study compared the outcomes of open reduction and volar locking plating (OR VLP) between closed and open AO-OTA type C3 DRFs. Materials and Methods: Patient data were retrospectively collected between January 2010 and December 2018. Only patients aged >18 years with AO-OTA C3 DRFs were included. After further exclusion, the patients with DRFs were divided into two groups: 13 patients with open DRFs in Group 1 and 203 patients with closed DRFs in Group 2. Data on the patient characteristics and treatment-related factors were further investigated. For the radiological evaluation, the radial height, volar height, and volar titling were measured based on the final plain radiography, and the union time was measured. The wrist range of motion (ROM), pain visual analogue scale score, and modified Mayo wrist score for function were measured at the final outpatient follow-up. Finally, the complications associated with OR VLP fixa-tion were investigated. Results: In the demographic comparison, the patients with open fractures were older (mean age, 62years) than those with closed fractures (mean age, 57 years), without a statistically significant differ-ence. The patients with open DRFs had longer antibiotic therapy and hospital stay durations. Although they presented a higher radial inclination, with statistical significance, the clinical implication was low with a mean difference of 3°. No significant differences were observed for the remaining radiological parameters, wrist ROM, and functional scores. An open DRF did not increase the complication rates,including deep infection. Conclusion: Depending on the expertise of the operating surgeon, the primary OR VLP fixation in open intra-articular comminuted DRF did not increase the incidence of deep infections and yielded similar outcomes to a closed intra-articular comminuted DRF.

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Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates: Ki Do Hong, Tae Ho Kim, Jae Cheon Sim, Sung Sik Ha, Min Chul Sung, Jong Hyun Jeon; J Korean Fract Soc 2015;28(1):59-64. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.59

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the clinical results of locking compression plate (LCP) fixation for olecranon fractures with proximal ulna comminution.
MATERIALS AND METHODS
We review 10 cases of olecranon fractures with proximal ulna comminution treated with LCPs from August 2011 to August 2013. Follow-up period was from 12 months to 18 months. Mean age was 63.1 years (35-84 years). According to the Mayo classification, there were eight type IIB, and two type IIIB fractures. We used Mayo classification. Clinical evaluation was performed based on radiographic union of olecranon and measurements of range of motion at last follow-up. Disability of the arm, shoulder and hand (DASH) score and Mayo elbow performance score (MEPS) were used for evaluation of functional recovery.
RESULTS
All patients had bone union. According to the MEPS, nine of ten patients had a good or excellent outcome. The mean DASH score was 18.6. All cases started postoperative range of motion (ROM) within 14 days. Elbow ROM was more than 110degrees in all cases except one. Mean radiological bony union time was 4.2 months (2.5-6.0 months) postoperatively. Complication was hardware irritation in three patients.
CONCLUSION
Internal fixation using LCP for olecranon fractures with proximal ulna comminution can be a good treatment option which obtains good clinical results and enables early ROM.

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Result of Surgical Treatment for the Femoral Head Fracture: Joon Soon Kang, Kyoung Ho Moon, Tong Joo Lee, Jong Hyuck Yang; J Korean Fract Soc 2014;27(3):198-205. Published online July 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.3.198

Abstract PDF: PURPOSE
This study analyzed the clinical and radiological long-term follow-up results of patients with femoral head fracture who received surgical treatments.
MATERIALS AND METHODS
Retrospective evaluation was performed for 20 patients with femoral head fracture who received surgical treatments between December 1997 and May 2010. According to Pipkin's classification, there were five type I, six type II, one type III, and eight type IV fractures.
RESULTS
The average Merle d'Aubigne'-Postel score was 12.8 (12.80+/-3.53). According to surgical method, the score for the bony fragment excision group was 9.8 (9.83+/-2.79), and that for the open reduction and internal fixation group was 13.9 (13.92+/-3.07). Depending on Thompson-Epstein criteria, two patients were good, two were fair, and two were poor in the bony fragment excision group. Four patients were excellent, six were good, and three were poor in the open reduction and internal fixation group.
CONCLUSION
Bony fragment excision should be performed with caution in patients with femoral head fracture. Considering fragment size, location, and presence of acetabular fracture, better outcome can be expected using the open reduction and internal fixation method in comparison with excision.

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Results of Intramedullary Nailing of Femoral Shaft Fracture: Trochanteric Entry Portal (Sirus Nail) versus Piriformis Entry Portal (M/DN Nail): Sang Ho Ha, Woong Hee Kim, Gwang Chul Lee; J Korean Fract Soc 2014;27(1):50-57. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.50

Abstract PDF

PURPOSE
To compare treatment results obtained using the trochanteric (Sirus nail) entry portal with those obtained using the Piriformis fossa (M/DN) entry portal during intramedullary (IM) nailing of femur shaft fractures.
MATERIALS AND METHODS
Four hundreds and thirty-two patients treated for femur shaft fracture using IM nails from February, 2001 to May, 2010 were divided into two groups. group 1 was composed of 180 patients treated through the trochanteric (Sirus nail; n=180) entry portal, while group 2 contained 170 patients treated through the piriformis fossa (M/DN nail; n=170) entry portal. We compared the clinical and radiographic findings of both groups to evaluate the treatment results.
RESULTS
Functional result, range of motion and union time (18, 20 weeks) were similar in both groups. The operation time of patients in the over-weighted group was 90 minutes in group 1 and 120 minutes in group 2 (p<0.05). Additionally, the blood loss was 280 ml in group 1 and 335 ml in group 2, and in case of over-weight patients, group 2 showed more blood loss (p<0.05). The duration of exposure to fluoroscopy differed slightly, with group 1 being less exposed than group 2; however, this difference was not significant (p>0.05). There were 18 iatrogenic fractures in group 1 and 4 in group 2 (p<0.05).
CONCLUSION
There was not much difference in complications based on clinical and radiographic findings of both groups. For groups using the trochanteric entry portal, the operation time was shorter and blood loss was lower than in groups using the piriformis entry portal. Iatrogenic fracture occurred more often in the group using the trochanteric entry portal than in the group using the piriformis entry portal.

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Analysis of different entry portals for femoral nail with two different nail designs-straight nail versus lateral angulated nail - Does it make a difference?
Sanjay Yadav, Saurabh Singh, Anil Kumar Rai
Journal of Clinical Orthopaedics and Trauma.2019; 10(5): 912. CrossRef
Comparing Entry Points for Antegrade Nailing of Femoral Shaft Fractures
Ujash Sheth, Chetan Gohal, Jaskarndip Chahal, Aaron Nauth, Tim Dwyer
Orthopedics.2016;[Epub] CrossRef
The Curative Effect Comparison Between Prolonged Third Generation of Gamma Nail and Prolonged Dynamic Hip Screw Internal Fixation in Treating Femoral Intertrochanteric Fracture and the Effect on Infection
Wenye He, Wei Zhang
Cell Biochemistry and Biophysics.2015; 71(2): 695. CrossRef
Treatment of Femur Subtrochanteric Fracture Using the Intramedullary Long Nail; Comparison of Closed Reduction and Minimal Open Reduction
Sang Joon Lee, Sang Hong Lee, Sang Soo Park, Hyung Seok Park
Journal of the Korean Orthopaedic Association.2015; 50(1): 18. CrossRef
Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report
Ji-Hwan Kim, Seung-Oh Nam, Young-Soo Byun, Han-Sang Kim
Journal of the Korean Fracture Society.2015; 28(1): 71. CrossRef
Treatment of the Femoral Fracture Using Sirus® Nail: A Comparison of Complication according to the Entry Potal
Young-Yool Chung, Dong-Hyuk Choi, Dae-Hyun Yoon, Jung-Ho Lee, Ji-Hun Park
Journal of the Korean Fracture Society.2015; 28(2): 103. CrossRef
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
Journal of the Korean Fracture Society.2014; 27(4): 287. CrossRef

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Treatment of Distal Femoral Fractures Using Polyaxial Locking Plate: Sang Eun Park, Hyun Taek Kang, Young Yul Kim, Jae Jung Jeong, Jung U Lee, Weon Yoo Kim; J Korean Fract Soc 2011;24(4):321-327. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.321

Abstract PDF

PURPOSE
To report the clinical outcome of polyaxial locking plate (Noncontact bridging (NCB) plate (Zimmer, Warsaw, Indiana)) for the treatment of distal femur fracture with minimal invasive percutaneous periosteal osteosynthsis (MIPPO) technique.
MATERIALS AND METHODS
Between February 2008 to April 2010, twenty six patients (11 men, 15 women), twenty eight cases diagnosed as distal femoral fractures are enrolled in this retrospective study. The mean age of the patients was 63 years (34 to 85) and the mean follow-up was 20.3 months (12 to 32). According to the AO/ASIF classification, 15 fractures were type A, 1 type B and 9 type C. And there were 3 periprsthetic fractures around knee. The analysis of the clinical and radiologic outcome were performed by Sanders functional evaluation scale and radiologic follow up after operation, respectively.
RESULTS
Among 28 cases, 25 cases united without additional operation. According to Sanders functional evaluation scale, there were 11 excellent, 9 good, 4 fair, 2 poor. As complications, there were 1 knee stiffness, 1 delayed union, 1 implant failure with refracture, 1 implant loosening. Three patients except one knee stiffness, underwent a second LISS plating using NCB plate and and bone grafting, resulting in a satisfactory final outcome.
CONCLUSION
Internal fixation using polyaxial locking plate with MIPO technique may be one of the most effective methods for the treatment of distal femoral fractures.

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Usefulness of Reduction and Internal Fixation Using a 2.4 mm Hand Plating System in Type AO 33-A3 Distal Femur Fracture: Technical Note
Bong-Ju Lee, Ja-Yeong Yoon, Seungha Woo
Journal of the Korean Fracture Society.2023; 36(1): 25. CrossRef
Incidence of nonunion after surgery of distal femoral fractures using contemporary fixation device: a meta‐analysis
Byung-Ho Yoon, In Keun Park, Youngwoo Kim, Hyoung-Keun Oh, Suk Kyu Choo, Yerl-Bo Sung
Archives of Orthopaedic and Trauma Surgery.2021; 141(2): 225. CrossRef

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Avulsion Fracture of Calcaneal Tubercle Treated with Cannulated Cancellous Screws and Wire: Surgical Technique: Chang Ho Yi, Jin Rok Oh; J Korean Fract Soc 2011;24(3):262-266. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.262

Abstract PDF: The incidence rate of calcaneal fracture consists about 2% of all fractures, and, of the fracture, calcaneal tubercle avulsion fracture is known to be rare. To treat non-displaced calcaneal tubercle avulsion fracture, conservative treatment such as cast fixation is applied. However, most cases accompany displacement of the avulsion fragment, and, usually, surgery is necessary to treat the displaced fracture. Although surgical fixation simply by cancellous screw or tension wire is widely used, fixation failure is potential complication in this method. Thus, this study wants to introduce a prospective and useful method that further strengthens the calcaneal fixation by using both cannulated screw and tension band wiring.

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Operative Treatment in the Delayed Diagnosed Fracture and Dislocation of Hamatometacarpal Joint: Suk Ha Lee, Jong Wong Park, Jin Il Kim, Seoung Joon Lee; J Korean Fract Soc 2011;24(3):249-255. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.249

Abstract PDF

PURPOSE
The purpose is to evaluate and report the results that treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint.
MATERIALS AND METHODS
We evaluated 12 cases that had been treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint. The mean interval between injury and operation was 34 days (21~60 days), the mean age of 12 cases was 28.1 years old, and mean follow-up period was 18 months. The computer tomography was done in all cases and the fracture and dislocation types were classified by Cain's classification. For the evaluation of results, pain scale, grasping power, range of motion of wrist and metacarpophalangeal joint were analyzed preoperatively and at final follow up, and the arthritic change of the hamatometacarpal joint was also checked.
RESULTS
According to Cain's classification, type Ia was one case, type Ib was two, type II was six, and type III was three. The pain scale was improved from 7.75 preoperatively to 0.92 at last follow up. The mean grasping power was improved up to 97.5% of normal. The preoperative range of motion of the wrist joint measured to be 60 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 75 degrees in extension and 80 degrees in flexion. The preoperative range of motion of the metacarpophalangeal joint measured to be 0 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 0 degrees in extension and 85 degrees in flexion. Carpometacarpal arthritis was developed in two cases.
CONCLUSION
The open reduction and internal fixation is considered as one of good treatment option in the delayed diagnosed hamatometacarpal fracture and dislocation.

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Reliability of classification of ring and little finger carpometacarpal joint fracture subluxations: a comparison between two-dimensional computed tomography and three-dimensional computed tomography classifications
J. H. Kim, S.-S. Kwon, S. J. Moon, J. S. Choe, H. I. Kwak, S. Y. Lee, H. J. Le, J. Y. Kim
Journal of Hand Surgery (European Volume).2016; 41(4): 448. CrossRef
Fourth and Fifth Metacarpal Base Arthrodesis for Posttraumatic Arthritis of Fifth Carpometacarpal Joint
Chul-Hyung Kang, Eun-Sok Son, Chul-Hyun Cho
Journal of the Korean Society for Surgery of the Hand.2013; 18(4): 184. CrossRef

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Comparison of Results between Internal Plate Fixation and Hemiarthroplasty in Comminuted Proximal Humerus Fracture: Doo Sup Kim, Dong Kyu Lee, Chang Ho Yi, Jang Hee Park, Jung Ho Rah; J Korean Fract Soc 2011;24(2):144-150. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.144

Abstract PDF

PURPOSE
Authors compare clinical and radiological results of internal fixation group and hemiarthroplasty group for comminuted proximal humerus fracture to find out which the treatment method have to be chose for comminuted proximal humerus fractures.
MATERIALS AND METHODS
Patients who were treated from March 2005 to March 2007 and available for 2 years follow-up were targets of this study. The internal fixation group had 38 cases, and hemiarthroplasty group included 26 cases. The results were analyzed both clinically and radiologically.
RESULTS
On average, Bone union took 15.6 weeks in the internal fixation group. Constant score between the internal fixation and hemiarthroplasty groups were on average 75+/-6.5 points and 70+/-7.4 points (p=0.034). In 3-part fracture, Constant score between both groups were 78+/-5.4 points from the former and 71+/-2 points, respectively (p=0.028). In 4-part fracture group, Constant score were 72+/-8 points for the internal fixation group and 69+/-9.2 points for the hemiarthroplasty group (p=0.041).
CONCLUSION
Internal plate fixation can gain better outcome than hemiarthroplasty in 4-part fracture as well as 3-part fracture of proximal humerus by careful dissection for preservation of blood supply for humeral head and optimal reduction.

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Surgical treatment of proximal humerus fractures: a systematic review and meta-analysis
Erik Hohmann, Natalie Keough, Vaida Glatt, Kevin Tetsworth
European Journal of Orthopaedic Surgery & Traumatology.2022; 33(6): 2215. CrossRef
Effectiveness and Safety of Interventions for Treating Adults with Displaced Proximal Humeral Fracture: A Network Meta-Analysis and Systematic Review
Long Chen, Fei Xing, Zhou Xiang, Ara Nazarian
PLOS ONE.2016; 11(11): e0166801. CrossRef
Meta-analysis comparing locking plate fixation with hemiarthroplasty for complex proximal humeral fractures
Jiezhi Dai, Yimin Chai, Chunyang Wang, Gen Wen
European Journal of Orthopaedic Surgery & Traumatology.2014; 24(3): 305. CrossRef

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Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture: Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun; J Korean Fract Soc 2010;23(3):303-309. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.303

Abstract PDF

PURPOSE
To evaluate the surgical outcomes of open reduction and internal fixation of AO calcaneal plate in displaced intra-articular fractures of the calcaneus.
MATERIALS AND METHODS
From January 2004 to July 2007, 25 patients with 27 displaced intra-articular calcaneal fractures were treated by open reduction and internal fixation using the AO calcaneal plate. Preoperative, postoperative evaluations and a follow-up after 1 year were done radiologically by the Bohler angle, Gissane angle, heel height and width among all patients. Their functional status was assessed by means of the Maryland foot score.
RESULTS
The mean Bohler angle, Gissane angle, heel height and width were restored comparing with preoperative data. However, in Sanders type IV, some losses of reduction occurred at 1 year follow-up (p<0.05). The mean Maryland foot scores were 85 points in type II, 82 points in type III and 63 points in type IV. Sanders types significantly affected the clinical results (p<0.05).
CONCLUSION
The AO calcaneal plate fixation using extensile L-shpaed lateral approach shows satisfactory radiologic and clinical results in the treatment of displaced intra-articular calcaneal fractures.

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Surgical Treatment of Calcaneal Fractures of Sanders Type II and III by A Minimally Invasive Technique with 6.5 mm Cancellous Screw
Yong Seung Oh, Kyung Ho Lee, Jung Ho Kim, Myoung Jin Lee
Journal of Korean Foot and Ankle Society.2019; 23(3): 116. CrossRef
Usefulness of Treatment with 6.5 mm Cancellous Screw and Steinmann Pin Fixation for Calcaneal Joint Depression Fracture
Gi-Soo Lee, Chan Kang, Deuk-Soo Hwang, Chang-Kyun Noh, Gi-Young Lee
Journal of Korean Foot and Ankle Society.2015; 19(1): 11. CrossRef

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Intra-articular Calcaneal Fractures Treated with Open Reduction and Internal Fixation: A Comparative Study between Groups with and without Bone Graft: Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Sung Hwan Jo, Hoon Yang; J Korean Fract Soc 2010;23(2):180-186. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.180

Abstract PDF

PURPOSE
This study compares the clinical results of open reduction and internal fixation with and without bone graft for the treatment of intra-articular calcaneal fractures.
MATERIALS AND METHODS
Twenty-five patients who had open reduction and internal fixation for intra-articular calcaneal fractures and available for at least 1 year of follow-up were included in this study. Fifteen cases were operated with bone graft. Period to bone union and functional evaluation score were compared between both groups with analysis of complications.
RESULTS
Bone union was achieved in all cases with average bone union time of 11.6 weeks and 12.8 weeks in group with and without bone graft respectively. Creighton-Nebraska Health Foundation (CNHF) functional score was 86.5 points and 80.3 points respectively. The period to bone union and the CNHF score in the comparison of two groups were statistically insignificant. Complications were observed in four cases of group without bone graft and 5 cases of group with bone graft.
CONCLUSION
This study indicates that bone graft does not play a significant role in bone union and functional outcome when intra-articular calcaneal fractures are treated with open reduction and internal fixation.

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Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures
Chul Hyun Park, Oog Jin Shon
Journal of the Korean Fracture Society.2016; 29(3): 221. CrossRef

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Treatment for Unstable Distal Radius Fracture with Osteoporosis: Internal Fixation versus External Fixation: Jin Rok Oh, Tae Yean Cho, Sung Min Kwan; J Korean Fract Soc 2010;23(1):76-82. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.76

Abstract PDF

PURPOSE
To compare the functional and radiological outcomes of volar plating to that of external fixation for treating unstable osteoporotic distal radius fracture.
MATERIALS AND METHODS
From March 2006 to March 2008, 36 patients with osteoporosis over 60-year old were selected for this study. They were divided into two groups; group I (open reduction and internal fixation with volar fixed angle plate) and group II (closed reduction and external fixation). Clinical outcomes and radiologic outcomes were evaluated.
RESULTS
There was no statistical difference between group I and group II in range of motion and DASH score, BMD score. However, the grip strength and PRWE score were found to be higher in group II (p<0.05). In radiologic evaluation, group I showed higher radial inclination, volar tilting angle (p<0.05).
CONCLUSION
Internal fixation using Volar-fixed Angle Plate seems to give more stable fixation for distal articular fragments compared to external fixation. it could allow early postoperative exercise and could result in low incidence of postoperative complication such as pin track infections and joint stiffness. Therefore, the internal fixation could be more desirable treatment method to manage unstable distal radius fracture.

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Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis
Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin
Journal of the Korean Fracture Society.2013; 26(4): 248. CrossRef

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Surgical Outcome of Stable Scaphoid Nonunion without Bone Graft: Eun Sun Moon, Myung Sun Kim, Il Kyu Kong, Min Sun Choi; J Korean Fract Soc 2010;23(1):69-75. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.69

Abstract PDF: PURPOSE
To evaluate the results of Acutrak-screw fixation without bone-graft for the treatment of stable scaphoid nonunion and to assess its prognostic factors.
MATERIALS AND METHODS
Fifteen patients who underwent internal fixation using Acutrak-screw without bone graft for stable scaphoid nonunion were studied. Standard radiographs and CT were analyzed for degenerative changes (presence of cystic change and periscaphoid osteoarthritis), the nonunion site using fragment ratio and union. Clinically, patients age and the interval to surgery were evaluated.
RESULTS
Mean follow-up duration was 31 months and 11 of 15 (73.3 percentages) cases healed at mean time of 12.8 weeks. Fragment ratio of nonunion site was 37.2 percentages in nonunion group and 54.2 percentages in union group (p=0.016). Presence of cystic change and periscaphoid osteoarthritis showed no singnificant statistical difference in both groups. Younger age lower than 20 years was closely related with bone union (p=0.001). But there were little correlation between bone union and interval to surgery.
CONCLUSION
Internal fixation without bone graft showed 73.3 percentages of overall union rate in the treatment of stable scaphoid nonunion. And young patients who have distally located stable scaphoid nonunion can be successfully treated with internal fixation without bone graft.

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Internal Fixation for Femoral Neck Fracture in Patients between the Ages of Twenty and Forty Years: Ui Seoung Yoon, Jin Soo Kim, Hak Jin Min, Jae Seong Seo, Jong Pil Yoon, Joo Young Chung; J Korean Fract Soc 2010;23(1):1-5. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.1

Abstract PDF

PURPOSE
To retrospectively analysis of results of operatively treatment for femoral neck fracture occurred in twenties to thirties.
MATERIALS AND METHODS
20 patients were selected whom we were able to follow up at least 2 years after internal fixation for femoral neck fracture in twenties to thirties from 1998 to 2005. Mean age was 32.2 (21~39) and average follow up period was 26.3 (24~45) months. According to preoperative X-ray, there were 6 cases for Garden classification stage I, 10 for stage II and 4 for stage III, and 7 cases for subcapital fracture, 9 for transcervical fracture, 4 for basicervical fracture. In all cases, operations were performed within 12 hours after the injury. The operations were done after satisfying reduction with the Garden alignment index, with three cannulated screws for internal fixation. Postoperative results were analyzed by clinical symptoms and radiological examinations during follow up periods.
RESULTS
In immediately postoperative radiological examination, satisfying anatomical reduction with Garden alignment index was obtained in all cases, and unions were obtained within 4.5 months after the operation (3~6 month). Avascular necrosis of femoral head occurred in 7 cases of all patients (35.0%). The average time of occurrence of avascular necrosis of femoral head after operation was 10.7 months (9~15 months). Avascular necrosis was occutted 5 (31.3%) in fracture without displacement (Garden stage I, II), 2 (50.0%) in fracture with displacement (Garden stage III) and 4 in subcapital fracture, 3 in transcervical fracture.
CONCLUSION
The incidence of avascular necrosis of femoral head after the operation for displaced and nondisplaced femoral neck fracture between twenties and forty years was no significant difference.

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Comparison of Clinical Outcomes for Femoral Neck System and Cannulated Compression Screws in the Treatment of Femoral Neck Fracture
Jae Kwang Hwang, KiWon Lee, Dong-Kyo Seo, Joo-Yul Bae, Myeong-Geun Song, Hansuk Choi
Journal of the Korean Fracture Society.2023; 36(3): 77. CrossRef

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Operative Treatment of Trapezium Fractures: Ho Jung Kang, Nam Heon Seol, Man Seung Heo, Soo Bong Hahn; J Korean Fract Soc 2009;22(4):276-282. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.276

Abstract PDF: PURPOSE
Fractures of trapezium are uncommon carpal bone fractures and often unrecognized lesions. We investigated about operative treatment of trapezium fracture. MATERIALS AND METHODS: Seven patients with fractures of trapezium were evaluated after surgical treatment with a mean follow up time of 18 months (12 months~3 years). Functional assessment (pain, limitation in activities of daily living, satisfaction), physical examination (range of motion, grip strength), and radiographic evaluation were performed. Traumatic arthritis and carpometacarpal joint subluxation were confirmed by radiograph. RESULTS: During study period, 122 cases were carpal bone fractures, and seven of 122 cases were fractures of trapezium. All cases were intra-articular fractures of trapezium. 1st carpometacarpal joint dislocation at 4 patients, Bennett's fracture at 1 patient, hamate hook fracture at 1 patient, and base of 4th proximal phalanx fracture at 1 patient were associated with fracture of trapezium. Open reduction and internal fixation were performed at 6 cases and 1st carpometacarpal joint arthrodesis was performed at 1 case because of neglected fracture. One of 6 cases which were performed to open reduction and internal fixation was reoperated to external fixation due to reduction loss. Clinically 6 patients revealed good results. one of 7 patients experienced limitation of thumb opposition. CONCLUSION: Based on the good results obtained with surgical intervention, we advocated open reduction and internal fixation for fractures with intraarticular depressed more than 2 mm or combined with Bennett's fracture or carpometacarpal subluxation.

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Internal Fixation Using Double Plates for Comminuted Olecranon Fractures in Adults: Hyun Dae Shin, Jae Hoon Yang, Pil Sung Kim; J Korean Fract Soc 2009;22(3):166-171. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.166

Abstract PDF

PURPOSE
To evaluate the clinical usefulness of internal fixation with double plates for comminuted olecranon fractures.
MATERIALS AND METHODS
Nine patients with olecranon fractures which are classified into Mayo type IIB (7 cases) and type IIIB (2 cases) underwent internal fixation using double plates from June 2002 to September 2005. They were followed-up for more than 12 months and average period of follow-up was 14 (12~18) months. Six cases were males and three were females. Mean age was 40.7 (21~63) years. We used open reduction and internal fixation using double plates. Clinical assessment index was pain, range of motion (ROM), stability and function of joint at last follow-up. The sum of four indices were compared. Also, we evaluated starting time of full ROM exercise, bony union time and complications.
RESULTS
All cases started postoperative ROM within 7 days and clinical results were evaluated using Mayo elbow performance index. 'Excellent', 'good' were 2, 6 cases, respectively and 1 case was 'fair'. Elbow ROM was more than 110o in all cases except one. Mean radiological bony union time was 3.9 (2.5~5) months postoperatively. There were heterotrophic ossifications in 3 cases as complication.
CONCLUSION
Internal fixation using double plates for comminuted olecranon fractures in adults can be good treatment option which obtains good clinical results and enables early ROM.

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Biomechanical Comparison of Dual and Posterior Locking Plates in an Ex Vivo Comminuted Olecranon Fracture Model
Andrew D. Sobel, Jacob M. Babu, Travis D. Blood, E. Scott Paxton
The Journal of Hand Surgery.2022; 47(8): 796.e1. CrossRef
Surgical Treatment of Comminuted Olecranon Fracture Using Locking Compression Plate Fixation
Eunchang Lee, Seong-Hee Cho, Jun-Il Yoo, Jin-Hyung Im, Dong-Geun Kang, Jin Sung Park
Archives of Hand and Microsurgery.2021; 26(1): 18. CrossRef
The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture
In-Tae Hong, Kyunghun Jung, Yoon Seok Kim, Soo-Hong Han
Archives of Hand and Microsurgery.2019; 24(2): 133. CrossRef
Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates
Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon
Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures
Bo-Kun Kim, Hyun-Dae Shin, Kyung-Cheon Kim, Yoo-Sun Jeon
Journal of the Korean Orthopaedic Association.2011; 46(2): 146. CrossRef

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Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone: Haw Jae Jung, Jae Yeol Choi, Hun Kyu Shin, Eugene Kim, Se Jin Park, Yong Taek Lee, Gwang Sin Kim, Jong Min Kim; J Korean Fract Soc 2007;20(4):291-296. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.291

Abstract PDF

PURPOSE
To perform comparative analysis between the results of internal fixation and hemiarthroplasty in unstable intertrochanteric fracture of osteoporotic bone.
MATERIALS AND METHODS
From February 2003 to February 2006, 36 patients treated surgically for unstable intertrochanteric fractures were evaluated. The patient's age was older than 70 year old; the T-score of preoperative bone mineral density (BMD) was lower than -3.0; they were followed up for more than 1 year. The patient were divided into two groups. One group was treated with dynamic hip screw or proximal femoral nail (Group A, 23 cases), and the other group was treated with bipolar hemiarthroplasty (Group B, 13 cases). The two groups were compared in terms of hip joint function using Clawson classification and radiologically.
RESULTS
Nonunion and fixation failure happened in 6 cases (26%) of gruop A. However, all patients in group B showed stable maintenance of implant. Recovery of hip joint function was found in 13 cases (43%) of group A, whereas 12 cases (93%) of group B recovered.
CONCLUSION
Nonunion and failure of fixation happened more frequently in internal fixation than bipolar hemiarthroplasty, and the postoperative hip joint function was better in bipolar hemiarthroplasty than internal fixation. Therefore, bipolar hemiarthroplasty might be better operative treatment for unstable intertrochanteric fracture of osteoporotic bone.

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The Stability Score of the Intramedullary Nailed Intertrochanteric Fractures: Stability of Nailed Fracture and Postoperative Patient Mobilization
Sung-Rak Lee, Seong-Tae Kim, Min Geun Yoon, Myung-Sang Moon, Jee-Hyun Heo
Clinics in Orthopedic Surgery.2013; 5(1): 10. CrossRef
Analysis of the Factors Involved in Failed Fixation in Elderly Intertrochanteric Femoral Fracture
Joon Soon Kang, Ryuh Sup Kim, Bom Soo Kim, Young Tae Kim, Seung Hyun Hong
Journal of the Korean Fracture Society.2012; 25(4): 263. 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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Surgical Treatment of Scapular Fracture using by Plate Fixation: 4 Cases Report: Dae Moo Shim, Jeong Woo Kim, Seok Hyun Kweon, Ul Oh Jeung, Jong Myung Lee; J Korean Fract Soc 2006;19(3):381-387. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.381

Abstract

Fractures of the scapula are relatively uncommon injuries and most can be treated satisfactorily with non-operative methods. But scapular fractures are being seen with increasing frequency in our mechanized society, specially in patients who have multiple injuries. So most injuries were related high energy, that residual deformities were high and related to the residual symptoms. Authors had done open reduction and internal fixation with plate in the four cases of the scapular fracture and analyzed that results.

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Clinical Results of Lateral-Posterior Internal Fixation for the Treatment of Scapular Body Fractures
Yoon-Min Lee, Joo-Dong Yeo, Seok-Whan Song
Journal of the Korean Orthopaedic Association.2020; 55(1): 46. CrossRef

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Analysis of Affecting Factors of Fixation Failure of Femoral Neck Fractures Using Internal Fixation: Soo Jae Yim, Seung Han Woo, Min Young Kim, Jong Seok Park, Eung Ha Kim, Yoo Sung Seo, Byung Il Lee; J Korean Fract Soc 2006;19(3):297-302. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.297

Abstract

PURPOSE
To evaluate the factors which influence on the fixation failure after internal fixation using multiple cannulated screws in the patients with femoral neck fracture.
MATERIALS AND METHODS
Ninty-six patients (male: 63, female: 33) who underwent closed reduction and internal fixation of femoral neck fracture between Feb. 1994 and Jun. 2002 with use of multiple cannulated screws. The mean age was 68 years (17~90) and mean follow-up period was average 50 months (36 months~6 years). The fixation failure was defined by change in fracture position above 10 mm, change in each screws position above 5%, backing above 20 mm, or perforation of the head, respectively. They were evaluated with the age, gender, fracture type, accuracy of reduction, placement of screws, posterior comminution and also studied the risk factors which influenced nonunion and the development of avascular necrosis.
RESULTS
Twenty-four patients out of 96 patients had radiographic signs of fixation failure. The incidence of nonunion in the fixation failure group was 41% (10/24) and AVN was 33% (8/24). There were statistically significant correlations between fixation failure and nonunion and that posterior comminution, poor reduction and improper placement of the screws were the major factors contributing to nonunion.
CONCLUSION
In case of femoral neck fracture of internal fixation using multiple cannulated screws, posterior comminution, poor reduction and improper placement of the screws were the major factors contributing to nonunion and fixation failure.

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Clinical Results of Internal Fixation of Subcapital Femoral Neck Fractures
Joon Soon Kang, Kyoung Ho Moon, Joong Sup Shin, Eun Ho Shin, Chi Hoon Ahn, Geon Hong Choi
Clinics in Orthopedic Surgery.2016; 8(2): 146. CrossRef
Internal Fixation for Femoral Neck Fracture in Patients between the Ages of Twenty and Forty Years
Ui-Seoung Yoon, Jin-Soo Kim, Hak-Jin Min, Jae-Seong Seo, Jong-Pil Yoon, Joo-Young Chung
Journal of the Korean Fracture Society.2010; 23(1): 1. CrossRef
Factors Predicting Complications after Internal Fixation of Femoral Neck Fractures
Tae-Ho Kim, Jong-Oh Kim, Sung-Sik Kang
Journal of the Korean Fracture Society.2009; 22(2): 79. 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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Internal Fixation with Two Lowprofile Plates in Fractures of the Distal Tibia: Dong Eun Shin, Duck Yun Cho, Hyung Ku Yoon, Tae Hyung Kim; J Korean Fract Soc 2006;19(2):170-175. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.170

Abstract: PURPOSE
To evaluate the functional results after internal fixation with two low profile plates in fractures of the distal tibia.
MATERIALS AND METHODS
From March 1998 to October 2002, twelve patients with fractures of the distal tibia were treated with internal fixation using two low profile plates and followed for at least one year. Fractures according to AO/OTA classification were one Type A1, four Type A2, two Type C1, two Type C2 and three Type C3. We analyzed the functional results by the Olerud and Molander ankle scoring system and the postoperative complications.
RESULTS
The average functional score was 81.2 points and the results were three excellent, six good, one fair and two poor. Bony union was achieved in all cases. There was 1 case of superficial wound infection as a complication.
CONCLUSION
Internal fixation with two low profile plates in fractures of the distal tibia may minimize the incidence of soft tissue complications and provide good bony union and functional results. Therefore, we consider internal fixation with two low profile plates as a good alternative treatment of the distal tibial fracture.

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Treatment of Comminuted Subtrochanteric Fractures of the Femur by High-Energy Trauma: Taek Soo Jeon, Woo Sik Kim, Sang Bume Kim, Cheol Mog Hwang, Kyu Tae Kim, Sun Hong Kim; J Korean Fract Soc 2006;19(2):135-140. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.135

Abstract

PURPOSE
The purpose is to evaluate the effectiveness of open reduction and internal fixation in comminuted subtrochanteric fractures caused by high energy trauma at a non-osteoporotic young age.
MATERIALS AND METHODS
Of all cases of subtrochanteric fractures caused by high energy trauma under 60 years old from February 2000 to February 2004, we analyzed 16 patients who had severe comminuted fractures (Seinsheimer classification type IV, V). The mean age is 43.5 (31~54) years old. Mean follow-up period was 22 (14~38) months. We tried to reduce anatomically as much as possible and fixed firmly using a compression hip screw in all cases. Additional procedures such as interfragmentary screw fixation, cerclage wiring or lateral stabilization plating were performed in 13 cases. Bone grafting was performed in 8 cases. We evaluated bony union rate, time to union, status of reduction, varus deformity and rate of implant failure using a simple X-ray. We also analyzed the clinical result using the Harris hip score including range of motion, pain and limping gait, so on.
RESULTS
In all 16 cases, bony union was achieved and the mean time to union was 24 (20~32) weeks. There was no intra-operative complication. Postoperative complications such as loss of reduction, varus deformity, implant failure or infection did not occur. Clinically, the Harris hip score was 98.9 (97~100) points.
CONCLUSION
Optimal open reduction and firm internal fixation with or without additional fixation was thought to be a recommendable method of treatment for comminuted subtrochanteric fractures of the femur caused by high energy trauma at a young age.

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Treatment of Subtrochanteric Femur Fractures Using Intramedullary Devices
Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Chong Suk Park, Sang Ho Lee
Journal of the Korean Fracture Society.2008; 21(1): 13. CrossRef

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Elbow Function and Complications after Internal Fixation for Fractures of the Distal Humerus: Hyug Soo Ahn, Young Ho Cho, Young Soo Byun, Do Yop Kwon, Seung Oh Nam, Dong Young Kim; J Korean Fract Soc 2006;19(1):56-61. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.56

Abstract

PURPOSE
To evaluate the functional results of the elbow and the complications after internal fixation for distal humeral fractures.
MATERIALS AND METHODS
We reviewed 38 distal humeral fractures; 12 type A, 7 type B and 19 type C by AO classification. There were six low columnar fractures in type A and nine in type C. Six type C fractures were open. The fracture healing and complications were assessed and the functional result was evaluated by rating system of Jupiter et al.
RESULTS
Type A fractures were healed in an average of 10.6 weeks, type B 7.7 weeks and type C 11.5 weeks. Ulnar neuropathy occurred in six cases, loss of fixation in two cases, nonunion in one case, heterotopic ossification in one case and traumatic arthritis in one case. The functional result showed excellent or good in 34 cases (89%) and fair or poor in 4 cases (11%). Open fractures showed significantly worse result than closed fractures.
CONCLUSION
To obtain the satisfactory results, stable fixation followed by early motion is required in most distal humeral fractures. Ulnar neuropathy occurs postoperatively in high incidence and the result of open fractures is worse than that of closed fractures.

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Comparison of Shoulder Range of Motion, Pain, Function, Scapular Position Between Breast Cancer Surgery and Shoulder Surgery Female Patients
Min-ji Lee, Suhn-yeop Kim, Jae-kwang Shim
Physical Therapy Korea.2015; 22(1): 9. CrossRef
Minimally Invasive Plate Osteosynthesis for Humeral Proximal or Distal Shaft Fractures Using a 3.5/5.0 Metaphyseal Locking Plate
Hyoung Keun Oh, Suk Kyu Choo, Jung Il Lee, Dong Hyun Seo
Journal of the Korean Fracture Society.2012; 25(4): 305. CrossRef
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
Journal of the Korean Fracture Society.2010; 23(1): 118. CrossRef
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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Clinical and Functional Result after Internal Fixation of Severely Displaced Floating Shoulder: Sang Hun Ko, Chang Hyuk Choe, Sung Do Cho, Jae Sung Seo, Jong Oh Kim, Jaedu Yu, Sang Jin Shin, In Ho Jeon, Kwang Hwan Jung, Jong Keun Woo, Ji Young Jeong, Gwon Jae No; J Korean Fract Soc 2006;19(1):46-50. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.46

Abstract: PURPOSE
To evaluate the follow-up result of 11 cases that were operated with internal fixation of scapular neck and internal fixation of clavicle or acromioclavicular dislocation for severely displaced floating shoulder which was high energy injury and unstable.
MATERIALS AND METHODS
We examined the scapular neck fracture with clavicle fracture or acromioclavicular joint dislocation by multidisciplinary research from August 1997 to July 2004. The scapular neck fractures were operated in the case of translational displacement of more than 25 mm and angular displacement of more than 45 degrees with 3.5 mm reconstruction plate fixation and internal fixation for clavicle fracture or acromioclavicular joint perpormed simultaneously. And we evaluated 11 cases that can be followed up for more than 9 months.
RESULTS
We achieved bony union in all cases. In ASES functional score, we got average 89.2 (75~95) points. In Rowe functional score, we got average 89.1 (75~100) points. In complication, there was external rotation weakness in 1 case.
CONCLUSION
In severely displaced floating shoulder due to high energy injury, we got good clinical and functional result after internal fixation for scapular neck and clavicle or acromioclavicular joint.

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Internal Fixation of Clavicle Lateral and Fracture with Mini T-plate: Byung Woo Ahn, Jong Ho Yoon, Chong Kwan Kim, Sung Won Chung, Young Il Kwan, Young Ho Lee, Chan Wan Park; J Korean Fract Soc 2005;18(4):410-414. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.410

Abstract PDF

PURPOSE
To evaluate the effectiveness of a mini T-plate fixation in clavicle lateral end fractures.
MATERIALS AND METHODS
We reviewed eleven cases of calvicle lateral end fracture which were treated with open reduction and internal fixion with mini T-plate from May 2000 to December 2004. The follow up period was 12 months minimum. The radiologic result, pain and shoulder function were evaluated by the ASES shoulder score.
RESULTS
All cases showed satisfactory results. Seven cases (63%) were excellent, and four (37%) cases were good. There were no fair or poor results. All cases showed radiologic union by the fifteenth week. No complications such as metal breakage, limited motion, infections were seen.
CONCLUSION
This study demonstrates that using a mini T-plate fixation which is easy and induces no injury of acromiocalvicular joint, contributes to provide stable fixation in clavicle lateral end fractures.

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Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome
Seong Cheol Moon, Chul Hee Lee, Jong Hoon Baek, Nam Su Cho, Yong Girl Rhee
Journal of the Korean Fracture Society.2014; 27(2): 127. CrossRef
The Surgical Outcomes of Clavicle Lateral End Fractures Fixed with the Oblique T Locking Compession Plate
Seung-Oh Nam, Young-Soo Byun, Dong-Ju Shin, Jung-Hoon Shin, Chung-Yeol Lee, Tae-Gyun Kim
Journal of the Korean Fracture Society.2011; 24(1): 41. CrossRef
Comparison of Results of Tension Band Wire and Hook Plate in the Treatment of Unstable Fractures of the Distal Clavicle
Chul-Hyun Park, Oog-Jin Shon, Jae-Sung Seo
Journal of the Korean Fracture Society.2011; 24(1): 55. CrossRef

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Effect of Alternative Splinting at Extension and 90degrees Flexion on Range of Motion after Open Reduction and Internal Fixation of Distal Femur Fracture: Chong Kwan Kim, Jong Ho Yoon, Byung Woo Ahn, Chin Woo Jin, Dong Wook Kim, Young Il Kwan, Young Ho Lee; J Korean Fract Soc 2005;18(2):144-148. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.144

Abstract PDF

PURPOSE
To evaluate the usefulness of early range of motion exercise by using 90degrees knee flexion splint after open reduction and internal fixation in fracture of distal femur.
MATERIALS AND METHODS
We reviewed twenty-six cases of distal femur fractures which were treated with open reduction and internal fixation from February 2002 to November 2003. One group (group A) were treated by using 30degrees knee flexion splint, the other group (group B) were treated by using 90degrees flexion and full extension splint alternativley by post-operative 1 week. The follow up period was minimally 12 months. The range of motion and Schatzker and Lambert criteria were evaluated.
RESULTS
The mean period to gain 90degrees knee flexion was 11.4 (7~14) weeks in group A, and 6.6 (3~8) weeks in group B. Mean range of motion was 94.7degrees (average flexion contracture 9.5degrees ) in A group and 108.7degrees (average flexion contracture 6.3degrees ) in B group at 12 weeks follow-up. According to Schatzker and Lambert criteria, excellent result was achieved in 10 cases (38%), good result in 13 cases (50%), fair result in 3 cases (12%).
CONCLUSION
This study demonstrates that alternative splinting at extension and 90degrees flexion contribute to early recovery of range of motion in distal femur fractures treated with internal fixation.

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Treatment of Femur Supracondylar Fracture with Locking Compression Plate
Seong Ho Bae, Seung Han Cha, Jeung Tak Suh
Journal of the Korean Fracture Society.2010; 23(3): 282. CrossRef

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Two-Stage Reconstruction of Infected Nonunion of Long Bones using Antibiotics-Impregnated Cement Beads: Se Hyun Cho, Soon Taek Jeong, Hyung Bin Park, Sun Chul Hwang, Yong Chan Ha, In Hwan Hwang; J Korean Fract Soc 2004;17(4):395-400. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.395

Abstract PDF

PURPOSE
To evaluate treatment results between internal and external fixation groups in two-stage reconstruction of infected nonunion of long bones using antibiotics-impregnated cement beads.
MATERIALS AND METHODS
In the first stage, preexisting hardwares were removed and radical debridement was done. The dead space was filled with antibiotics -impregnated cement beads and the nonunion site was immobilized by external fixation, cast or skeletal traction. In the second stage, all cases were divided into two groups; the nonunion was fixed by internal fixation in group I versus external fixation in group II. The intervening period between the first and second stage was average 8.7 weeks (range, 3~23 weeks).
RESULTS
The follow-up period was average 45 months (range, 16~71 months). Infection control and bone union were achieved in all 13 cases of group I. Infection recurred in two of 28 cases in group II, one underwent above-knee amputation and the other case was lost in follow-up. The mean number of supportive operations including repeated curettage, augmentation and change of infected pins, angular correction, and soft tissue flap was average 2 and 6.2 times respectively in group I and group II. Bony union period was average 19.3 and 23.1 weeks in each group. According to Paley's classification, group I was similar to group II in bony and functional result (p>0.05).
CONCLUSION
Antibiotics-impregnated cement beads provided positive effect on infection control. Internal fixation group showed less number of additional operations and earlier bony union than external fixation group.

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Treatment of Infected Nonunion
Sang-Ho Ha
Journal of the Korean Fracture Society.2007; 20(2): 206. 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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The Treatment of Mason Type II Radial Head Fractures using Closed Reduction and K-wire Fixation: Byung Ki Kwon, Song Lee, Dong Ki Ahn, Joon Seong Park, Sang Kyu Cha; J Korean Fract Soc 2004;17(3):277-282. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.277

Abstract PDF: PURPOSE
To analyze the clinical results of the treatment of Mason type II radial head fractures using closed reduction and K-wire internal fixation under C-arm guide by radiologically and functionally.
MATERIALS AND METHODS
Between March 2001 and October 2003, 7 patients with Mason type II radial head fracture were treated by closed reduction and internal fixation using K-wires under C-arm guide. The average age of the patients was 38 (5 to 57) years old, and average duration of follow up was 20 (5 to 36) months. At last follow up, we evaluated the radiological results and functional results by classifying excellent, good, fair and poor according to functional rating system of Broberg and Morrey.
RESULTS
The range of motion of the elbow at last follow up, average flexion contracture was 1.4 (0 to 10) degrees, further average flexion was 146.4 (140 to 150) degrees, average supination was 74.2 (70 to 80) degrees and average pronation was 75 (70 to 80) degrees. In the functional results, 6 cases were excellent and 1 case was good. In the radiological evaluations, the average time of union was 5 (4 to 6) weeks after the operation and no serious complication was occurred in any cases.
CONCLUSION
In the treatment of Mason type II radial head fracures, closed reduction and K-wire internal fixation under C-arm guide was an effective method of treatment with satisfactory results and no complications.

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Factors Predisposing to Complications After Internal Fixation of Femoral Neck Fracture: Sang Won Park, Chang Yong Hur, Jong Ryoon Baek, Seong Jun Park; J Korean Soc Fract 2003;16(4):441-446. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.441

Abstract PDF

PURPOSE
To analyze the factors predisposing to complications after internal fixation of femoral neck fracture.
MATERIALS AND METHODS
We reviewed retrospectively the results of percutaneous internal fixation of femoral neck fracture using multiple pinning, in 52 cases who were treated from Jan. 1996 to Dec. 2001. Relationship between the complications and several factors such as the age, sex, time interval from injury to operation, Garden stage, Singh index, internal fixation device and state of redction were analyzed.
RESULTS
The functional results by Lunceford criteria were excellent in 23 cases (44%), good in 15 cases (29%), fair in 2 cases (3.8%) and poor in 12 cases (23.1%). The avascular necrosis of the femoral head were occured in 14 cases (26.9%). Among these, 1 case of non-union, 2 cases of mal-union were accompanied. No stastically significant relationship between the age, sex, time interval from injury to operation, Garden stage, Singh index, internal fixation device, state of redction and complication. However, there was 4 times higher complication rate in Garden stage 3 or 4 group than its rate in Garden stage 1 (odds ratio 3.889), and 3 times higher complication rate in non-anatomical reduction group (odds ratio 3.22).
CONCLUSION
Factors predisposing to complications after internal fixation of femoral neck fracture seemed to closely relate with Garden stage and state of reduction.

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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
Journal of the Korean Fracture Society.2008; 21(1): 8. CrossRef

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Surgical Treatment of Unstable Pelvic Bone Fracture Involving Sacroiliac Joint: Myung Ho Kim, Hee Gon Park, Moon jib Yoo, Jin Woo An; J Korean Soc Fract 2003;16(4):433-440. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.433

Abstract PDF: PURPOSE
To evaluate the results of surgical method using plate and screws in the treatment of unstable pelvic bone fracture involving Sacroiliac Joint.
MATERIALS AND METHOD
Authors reviewed 21 patients treated by surgical method from 1998 to 2002. Mean follow-up period was 15 months (12~24 month). Male were 16 and female were 5. We used plate and screws in 18 cases, just screws in 3 cases. We classified the type of fracture by Tile's classification and evaluated the results with Moon's criteria that based on reduction state in simple x-ray and patient's subjective satisfaction.
RESULTS
We got the bony union in all cases. By Moon's criteria, 10 cases were good, 7 cases were fair and 4 cases were poor. In 17 cases (80.9%), we got the results over fair. Mean weight bearing exercise periods were 6.4 weeks. There were 2 infection and 2 sacroiliac arthritis after operation.
CONCLUSION
As a method of surgical treatment on unstable pelvic bone fracture involving sacroiliac joint, we recommend open reduction and internal fixation with plate and screws and it may has particular advantages in early ambulation and satisfactory functional outcome.

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Hybrid External Fixation and Limited Internal Fixation for Severe Open Tibial Shaft Fractures: Hong Jun Han, Soo Uk Chae, Ul Oh Jeung; J Korean Soc Fract 2003;16(1):52-58. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.52

Abstract PDF: PURPOSE
To evaluate the radiographic and clinical results of severe open tibial shaft fracture treated by hybrid external fixation and limited internal fixation.
MATERIALS AND METHODS
We reviewed 25 patients open tibial shaft fracture(> or =Gustillo classification type II) which were treated with hybrid external fixation(AnyFixR) that was invented by authors and limited internal fixation between June 1998 to June 2001. 20 males and 5 females were minimum follow up period of 12 months(12-27 months). The mean age was 45 old years(11-72 old years). The results were based on the assessment radiographical analysis with duration of bony union, delayed union including of states of nonunion and malunion, clinical analysis with pain, joint range of motion, wound infection and skin & soft tissue coverage. All fractures were classified according to the Gustilo classification, there were 6 cases of type II, 9 cases of type IIIa and 10 cases of type IIIb. The cause of injury, there were 18 cases of motor vehicle accident, 5 cases of direct trauma and 2 cases of fall from height.
RESULTS
In twenty-five cases, fifteen had union, the average time of bone union was 6.8 months and additional bone graft without change of external fixator performed in ten cases, but one case have failed and then change of intramedullary nail with bone graft. In the group of bone graft, bone union was completed at mean 8.7 months. According to the clinical analysis, no pain in the fracture site, in complications, there were 2 cases of mild joint range of motion that has acceptable result and 2 cases of wound infection were treated with effective antibiotics theraphy and wound dressing. Five cases need to coverage of the open wound, 3 cases were flap operation and each case were muscle transfer, skin graft without change of external fixator.
CONCLUSION
The use of hybrid external fixation and limited internal fixation in severe open tibial shaft fracture to be successful for the stabilization of fracture and subsequent plastic and/or orthopaedic procedure for muscle and skin coverage, bone grafting are more easily accomplished without change of external fixator.

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Minimal Open Reduction and Interlocking IM Nailing of Comminuted Humeral Shaft Fracture: Comparison between Plate Internal Fixation: Kyeong Jin Han, Soo Ik Awe, Tae Young Kim, Shin Young Khang; J Korean Soc Fract 2002;15(4):573-580. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.573

Abstract PDF: PURPOSE
We compared the functional and radiological results after the minimal open reduction and interlocking IM nailing and LC-DCP plate internal fixation for the comminuted humeral shaft fractures.
MATERIALS AND METHODS
Fourteen plates(LC-DCP) and eighteen interlocking IM nail(AO unreamed IM nail) were applied after open reduction for 32 comminuted fractures of the humeral shaft between March 1997 and December 2001. They were followed up for a minimum 9 months after surgery and the radiological and functional results were evaluated.
RESULTS
The average fracture healing time was 13.2 weeks and union rate was 85.7% for plate internal fixation. The average fracture healing time was 12.4 weeks and union rate was 94,4% for interlocking IM nail. The average functional scores according to American Shoulder and Elbow Surgeon 's (ASES) shoulder score(Total 52 points) was 44 points for plate internal fixation and 47 points for interlocking IM nailing respectively.
CONCLUSION
Minimal open reduction and interlocking IM nailing is better method with good functional and radiological results than plate internal fixation for the comminuted humeral shaft fractures.

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Treatment of the Distal Metaphyseal Fractures of Tibia - Comparison between Internal Fixation with a Plate and screws and External Fixation with Ilizarov Device: Sung Churl Lee, Moon Jib Yoo, Hyun Seok Seo; J Korean Soc Fract 2002;15(3):371-378. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.371

Abstract PDF

PURPOSE
The purpose of this study was to compare the results between open reduction and internal fixation with plate and screws and closed reduction and external fixation with Ilizarov device for the fracture of disatal metaphyseal fracture of tibia.
MATERIALS AND METHODS
In this study, the results in treatment of the 19 distal metaphyseal fractures of tibia with closed reduction and external fixation with Ilizarov device were compared with those in treatment of the 23 fractures with open reduction and internal fixation with a plate and screws. The cases were the patients who had been treated for the fractures at the Department of Orthopaedic Surgery, Dankook University Hospital from May 1997 to December 2000. The results of treatment were analysed using functional evaluation by Mast and Teipner and radiological evaluation by Ovadia and Beals.
RESULTS
The results were as follows: 1. The major causes of injury were motor vehecle accidents, fall-downs, and falls from a height in order. 2. Treatment of the fractures with closed reduction and external fixation with Ilizarov device showed comparable results to that with open reduction and internal fixation with a plate and screws. 3. Complications in treatment were a little more frequent in open reduction and internal fixation with a plate and screws than in closed reduction and external fixation with Ilizarov device.
CONCLUSION
Considering the results, closed reduction and external fixation with Ilizarov device is thought to be one of recommendable options in treatment of the distal metaphyseal fractures of tibia with the advantages in wound management, prevention of stiffness of ankle joint, and convenience in removal of the device.

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Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator
Suk Kyu Choo, Kyung Wook Nha, Hyoung Keun Oh, Dong Bong Lee
Journal of the Korean Fracture Society.2007; 20(4): 323. CrossRef

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Metal Failure after Internal Fixation in the Treatment of Femur Mid-shaft Fractures: Kyung Jin Song, Jang Yeub Jeon, Jin Ho Yoon, Myung Sik Park, Byung Yeon Hwang; J Korean Soc Fract 2002;15(3):349-355. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.349

Abstract PDF: PURPOSE
To evaluate the causative factors of metal failure after internal fixation, and to suggest more rational treatment guideline that can prevent metal failure in the mid-shaft femur fractures.
MATERIALS AND METHODS
A retrospective review of 17 cases, who were treated with internal fixation for the femur mid-shaft fracture was analyzed. We evaluated the cause of injury, fracture type and site, associated injury, used instruments, duration to metal failure, and complications.
RESULTS
The metal failure occurred on average 14.8 months after internal fixation. As extrinsic factors, early exercise and weight-bearing in 7 cases, slip down during ambulation in 4 cases, improper physical therapy in 3 cases and unknown cause in 3 cases were related to metal failure. Most metal failure were occurred at the initial fracture site in 12 cases. Other metal failure site were empty holes in 1 case and proximal area of fracture site in 1 case, and screw breakage in 3 cases.
CONCLUSION
Accurate preoperative evaluation of fracture site, fracture type and proper selection of instrument, and precise surgical technique will be essential for the prevention of metal failure.

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Nonunion after open reduction and internal fixation of clavicle fractures: Jeung Tak Suh, Jung Sub Lee, Sung Jong Choi; J Korean Soc Fract 2001;14(4):714-719. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.714

Abstract PDF: PURPOSE
To report our experiences of treatment with reviewing literatures and articles about the fractures of plate and nonunion after open reduction and internal fixation of clavicle fracture.
MATERIALS AND METHODS
9 cases among 104 cases of clavicle fractures of reoperation due to the fractures of plate or nonunion after open reduction and internal fixation were included. Treatment results were analyzed after 5 months in regard to fracture site pain, gross deformities, limitation of movement of shoulder, discomfortness of casual activity, and patients' personal satisfaction.
RESULTS
According to the criteria of Kang et al 9 cases were classified into excellent 2 cases, good 4 cases, fair 2 cases, poor 1 case. All cases showed bone union average 14.4(12-26) weeks after reoperation. 3 cases of complications were 3 limitation of movement of shoulder, I superficial wound infection.
CONCLUSION
In operative treatment of clavicle fracture more than three screws in both side of fracture line shoulder be fixated and early exercise of shoulder motion seemed to be needed. In cases of less than three screws fixated, additional external protection is thought be necessary.

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Operative Treatment of the Type I and II Tibial Plateau Fracture: Jong Woong Park, Sung Kon Kim, Jung Ho Park, Joon Seok Hong, Jae Hun Kim; J Korean Soc Fract 2001;14(2):298-304. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.298

Abstract PDF: PURPOSE
To know the functional and radiologic results of the operative treatment for the type I and II tibial plateau fractures according to the methods of internal fixations.
MATERIALS AND METHODS
Twenty-six patients, who had been treated with open reduction and internal fixation for the type 1 or 2 tibial plateau fractures were evaluated. Twelve cases of type 1 fractures were fixated with 1 lag screw in 5, 2 lag screws in 4 and buttress plate in 3. Fourteen cases of type 2 fractures were fixated with 1 lag screw in 4, 2 lag screws in 6 and buttress plate in 4. The criteria of Hohl and Porter was used for the evaluation of the clinical and radiological results.
RESULTS
There was no significant difference in the clinical result in type 1 and 2 tibial plateau fractures according to the methods of fixations. And the radiological results were not significantly different in both of type 1 and 2 fractures.
CONCLUSION
If the anatomical reduction of the articular surface can be achieved, the methods of fixation for the type 1 and 2 tibial plateau fractures do not affect the final clinical and radiological results.

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Surgical Treatment for Tibial Condyle Fracture of the Proximal Tibia: Won Tae Choi, Bo Yel Choi, Chul Hyung Lee, Eui Soon Kim, Jeong Woung Lee, Doo Hoon Sun, Myung Sang Moon; J Korean Soc Fract 2001;14(2):291-297. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.291

Abstract PDF: PURPOSE
To evaluate the results of operative treatment for tibial condyle fracture of the proximal tibia. MATERIAL AND METHODS: From March 1995 to June 1999, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 10 of them were treated by open reduction and internal fixation(plate & screw for 8, screw & K-wire for 2) and 5 of them by closed reduction and Ilizarov fixation. Preoperative prognostic factors were considered as the fracture type of Schatzker classification, associated injury, and closed or open fracture. Functional outcome was evaluated results by Blokker`s criteria.
RESULTS
According to Schatzker classification, type III were 4 cases, type IV were 6 cases, and type V were 5 cases. At last follow up, average range of motion was 115degrees (Internal fixation was 110degrees, External fixation was 130degrees) The results was according to Blokker`s criteria, 11 cases(73%) had satisfactory acceptable results, among 4 cases(27%) of non-acceptable criteria.
CONCLUSION
For treatment of tibia condyle complicated communited fracture, we are able to consider that rigid internal fixation with anatomical reduction and external fixation for early range of motion.

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Treatment of Humeral Shaft Nonunion after Primary Internal Fixation: Jong Oh Kim, Yeo Hon Yun, Dong Wook Kim, Young Do Ko, Jae Doo Yoo, Jin Won Jung; J Korean Soc Fract 2001;14(2):236-244. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.236

Abstract PDF: PURPOSE
To evaluate the methods of treatment to obtain rigid fixation for nonunion of humerus shaft fractures developed after operative treatment.
MATERIALS AND METHODS
From January 1993 to January 2000, twenty-one patients of nonunion of humerus shaft after primary internal fixation were reviewed and the results were analyzed. Three cases who have loss of follow-up were excluded.
RESULTS
In twenty-one cases, nineteen had union but, two cases have failed. In the group of compression plate fixation and bone graft, bone union was completed at mean 4.4 months, in the group of IM nailing and bone graft at 4.9 months, in case of bone graft only with state of IM nailing at 5.5 months. Mean time until bone union was 4.6 months.
CONCLUSION
Distraction should be avoided during IM nailing at primary internal fixation. Secondly, To obtain rigid fixation in nonunion of humerus shaft after primary internal fixation, use larger and more broad plate, dual plate or IM nail.

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Treatment of the Two part or Three part Fracture of Proximal Humerus: Jin Rok Oh, Doo Hee Lee, In Gu Kim; J Korean Soc Fract 2000;13(4):960-969. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.960

Abstract PDF: PURPOSE
The current study is performed to evaluate the clinical outcomes of treatment for two part or three part fractures of proximal humerus. MATERIAL AND METHODS: Forty-five cases that followed up over 6 months were divided into three groups : conservative treatment(Group I, 16 cases), closed reduction with internal fixation(Group II, K-wire 10, schanz pin 4, cancellous screw 3, 17 cases) and plate and screw fixation(Group III, 12 cases). The range of motion, pain index with self assessed functional score, anatomical reduction and bone union period and complications were examined.
RESULTS
The range of motion was worst in group I, and anatomical reduction was best in group III. The functional score of group II(average 80), group III(average 73) were higher than group I, but there were no significant differences between group II and group III. Complications were noted in 17 cases, which occured mostly in group I and III. Avascular necrosis of humerus head was noted in one case of group II. Bone union period was average 10.4 weeks.
CONCLUSION
If anatomical reduction could be obtained by closed reduction and internal fixation with K-wire, schanz pin and cancellous screw in 2 part or 3 part proximal humerus fracture, it would provide a sufficient fixation for early rehabilitation and bone union, while minimizing complications.

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Prognosis of early internal fixation in unstable pelvic fractures: Jang Yeol Lee, Do Hun Moon, Gun Beom Kim; J Korean Soc Fract 2000;13(4):741-748. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.741

Abstract PDF

PURPOSE
This study was conducted to analyze the clinical prognosis of early internal fixation in unstable pelvic fracture. MATERIAL AND METHOD: We analyzed the sixteen patients. The average age of the patients was 34 years(range, 21-64 years). They were followed up for average 21 months. The sixteen pelves were classified by Tile ; Type B 3 cases, Type C 13 cases. Nine patients(56%) had the associated injuries. In 13 patients(81%), internal fixation were performed within 3 weeks after the injury. Fixation was accomplished by the plates and screws. We assessed the functional, radiological results and postoperative complications.
RESULTS
Fourteen(88%) patients were fully ambulatory, had no limp, did not need assistive devices. Fifty percents of the patients had returned to the previous jobs and 31% had to change the jobs. On radiolograph, there were 14 excellent and 2 good reduction. Three postoperative complications happened ; two superficial infections and one lumbar neuropathy, which resolved spontaneously. Three patients with associated injuries, who had delayed fixation, appealed gait disturbance and chronic pain.
CONCLUSION
early internal fixation of unstable pelvic ring fractures may be expected to yield satisfactory functional success and radiologic results in the majority of patients

Citations

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Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint
Kwang-Jun Oh, Jin-Ho Choi
Journal of the Korean Fracture Society.2013; 26(3): 184. CrossRef
Surgical Fixation of Sacroiliac Joint Complex in Unstable Pelvic Ring Injuries
Kwang-Jun Oh, Seok-Min Hwang
Hip & Pelvis.2012; 24(2): 139. CrossRef
Operative Treatment of Unstable Pelvic Ring Injury
Sang Hong Lee, Sang Ho Ha, Young Kwan Lee, Sung Won Cho, Sang Soo Park
Journal of the Korean Fracture Society.2012; 25(4): 243. CrossRef
Crescent Fracture-dislocation of Sacroiliac Joint: Affecting Factors of Operative Results
Hee-Soo Kim, Chang-Wug Oh, Poong-Taek Kim, Young-Soo Byun, Joo-Woo Kim, Byung-Chul Park, Woo-Kie Min, Hyun-Joo Lee
Journal of the Korean Fracture Society.2009; 22(2): 71. CrossRef

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Internal fixation with pelvic plate for displaced Acetabular Fracture: Taek Rim Yoon, Sung Nam Jung, Sang Jin Park, Eun Kyoo Song; J Korean Soc Fract 2000;13(4):733-740. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.733

Abstract PDF

PURPOSE
The purpose of this study was to review the clinical and radiographic results after plate fixation for displaced acetabular fracture.
MATERIALS AND METHODS
A clinical analysis was performed on 47 cases of displaced unstable acetabular fracture which had been fixed with plates and screws. Clinical and radiographical results were analyzed according to Epstein criteria.
RESULTS
In 44 cases, internal fixation was performed using only plate and screws. In three cases, the fixation was augmented with cerclage wiring. The fracture type included posterior wall or posterior column fracture in 37 cases(78.7%). Satisfactory results were achieved in 39 cases(86.7%) on clinical grade and 40 cases(88.9%) on radiographic grade. The complications were deep wound infection in two cases, avascular necrosis of femoral head in one case, post traumatic arthritis in 2 cases, and malunion with partial ankylosis in one case. Total hip arthroplasty were needed in two cases with avascular necrosis and infection.
CONCLUSION
Early surgical treatment including accurate anatomical reduction and stable internal fixation is emphasized for better clinical and radiographic results. The plate and screw fixation is well indicated for posterior wall and/or posterior column fracture of acetabulum.

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Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture
Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong
Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef
Comparative Results of Acetabular Both Column Fracture According to the Fixation Method
Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park
Hip & Pelvis.2011; 23(2): 131. CrossRef
Treatment of Acetabular Column Fractures with Limited Open Reduction and Screw Fixation
Jung-Jae Kim, Hyoung Keun Oh, Sung-Yoon Kim
Journal of the Korean Fracture Society.2007; 20(1): 26. CrossRef

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Significance of Anatomic Reduction in Acetabular Fracture: Sung Kon Kim, Jung Ho Park, Jong Wung Park, Joon Seok Hong, Jae Hun Kim; J Korean Soc Fract 2000;13(4):724-732. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.724

Abstract PDF

PURPOSE
The purpose of operative treatment in acetabular fracture is to restore anatomically the disrupted joint surface and prevent post-traumatic arthritis. We analysed the relationship between the types of the fracture, its location, reduction state with the development of post-traumatic arthritis and hip joint function in postoperative period.
METHOD
& MATERIAL: A clinical analysis was performed on 14 patients, excluding patients with anterior & posterior wall fracture, with displaced acetabular fracture who had been treated by open reduction and internal fixation. All patients had been followed for minimum 1 year in our department from May 1989, to February 1999.
RESULTS
The type of acetabular fracture was not correlated statistically with posttraumatic arthritis and Harris hip score. The reduction state of acetabular fracture was significantly correlated with post-traumatic arthritis and Harris hip score. The antomic location of acetabular fracture was not correlated statistically with post-traumatic arthritis but correlated with Harris hip score.
CONCLUSION
Anatomic reduction is more significant factor in postoperative outcome of acetabular fracture than the type of fracture and the anatomic location of fracture.

Citations

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Comparative Results of Acetabular Both Column Fracture According to the Fixation Method
Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park
Hip & Pelvis.2011; 23(2): 131. CrossRef
Cerclage Wiring in Internal Fixation of Displaced Acetabular Fractures
Chong-Kwan Kim, Jin-Woo Jin, Jong-Ho Yoon, Sung-Won Jung, Jung-Wook Peang
Journal of the Korean Fracture Society.2008; 21(2): 95. CrossRef
Treatment of Acetabular Column Fractures with Limited Open Reduction and Screw Fixation
Jung-Jae Kim, Hyoung Keun Oh, Sung-Yoon Kim
Journal of the Korean Fracture Society.2007; 20(1): 26. CrossRef

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Treatment of Acetabular Fracture with Wire: Chang Soo Kang, Dong Hwa Woo, Doo Hwan Oh; J Korean Soc Fract 2000;13(3):432-439. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.432

Abstract PDF: PURPOSE
To evaluate the clinical and radiological results of wire fixation for acetabular fracture and its merits.
MATERIALS AND METHODS
From 1996 Jan. to 1998 Dec., 18 cases of being fixed by wire among 42 cases who being treated by surgical method were analyzed. We evaluated these cases after a mean follow up of 2.1 years. The fixation was done by wires in 11 cases, wires with plate in 3 cases and wires with screw in 4 cases.
RESULTS
According to Epstein's criteria, favorable results were achieved in 15 cases(83.3%) on clinical grade and 14 cases(77.7%) on radiographic grade.
CONCLUSION
The results of this study suggest that open reduction and internal fixation with wire is preferable method that can permit early ambulation, decrease postoperative complication and achieve firm fixation, comparing with open reduction and internal fixation with plate and screws, in treatment of displaced acetabular fractures.

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Functional Results of Olecranon Fracture-Dislocation According to the Methods of Internal Fixation: Won Sik Choy, Yong Bum Park, Kwang Won Lee, Whoan Jeang Kim, Ha Yong Kim, Jae Hun An, Chang Soo Ryu; J Korean Soc Fract 2000;13(2):414-420. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.414

Abstract PDF: PURPOSE
: This study was performed to compare the functional results according to the methods of internal fixation in olecranon fracture-dislocation.
MATERIALS AND METHODS
: Authors retrospectively analyzed in 13 adult patients with olecranon fracture-dislocation (Colton II D) who were treated by internal fixation from January 1991 to June 1998. Functional results were assessed by Broberg and Morrey system and radiographic results were analyzed in terms of articular step-off, articular gap and reduction loss.
RESULTS
: In regard to functional assessment, all oblique fractures treated with plate and screw showed 100% of satisfactory result whereas those treated with tension bands showed 33.4% of satisfactory result. Comminuted fractures treated with plate and screw showed 40% of satisfactory result whereas all two treated with tesion bands resulted in unsatisfactory result. In regard to radiologic assessment, three oblique fractures treated with plate and screw result whereas those treated with tension bands resulted in fair result. Comminuted fractures treated with plate and screw resulted in three fair, two poor radiologic results whereas those treated with tension bands resulted in one fair, one poor result.
CONCLUSION
: Plate and screw fixation can obtain more satisfactory functional and radiologic results than tension bands in oblique and comminuted olecranon fracture-dislocation

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Fixation of Complex Acetabular Fractures Using Cerclage Cable Grip System(DALL-MILES): Poong Taek Kim, Joo Chul Ihn, Gun Wook Park, Yung Ook Choi, Chan Sig Park; J Korean Soc Fract 1999;12(4):761-766. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.761

Abstract PDF: From 1996, in the 13 fractures of the acetabulum surgically treated in Kyung Pook National Hospital and Sae-Myung Orthopedics, cerclage grip system(DALL-MILES) have been used as reduction and fixation tool. Cerclage cable inferted through the greater sciatic notch to a point just cephalad to the anterior inferior spine was greatly helpful for both reduction and internal fixation of thirteen complex acetabular fractures. This technique is especially useful when the fracture line extend into the greater sciatic notch. This is true of high posterior column fractures that extend up into the upper part of the notch, transverse fractures that have an anterior or posterior limb that is high, and both column fractures through ilioinguinal approach with T- extension. Reduction was achieved to within 3mm in 11 cases and 6mm in 2 cases. This reduction was maintained until nuion. The technique may contribute to fracture stabilization, but supplementary fixation was added in 12 patients with curved reconstruction plate over pelvic brim and posterior column in 1 patient.

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Nonunion of the Clavicular Fracture: Sang Eun Lee, Il Hyun Nam, Sang Soo Lee, Dong Hee Lee, Keum Joo Lee; J Korean Soc Fract 1999;12(3):741-748. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.741

Abstract PDF

We analysed 20 cases of clavicular nonunions, treated by internal fixation with plate and bone graft at the Pohang St. Marrys Hospital between 1993 and 1997. Among them, sixteen patients had been treated with conservative method and four with surgery initially. Radiologically, seventeen nonunions were atrophic and three hypertrophic. Interposition of the injured soft tissue, inadequate reduction and insecure fixation were etiologic factors of nonunion in this study. The complete unionswere achieved in eighteen by plating with iliac bone graft and in two by intramedullary fixation with S-pin or Rush-pin each The average time for union was 14.2 weeks. The average length of follow-up was 16.5 months. The complications were limitation of motion in three patients and brachial plexus injury in one. Associated symptoms of the nonunion including pain disappeared in all patients. In this study, we discuss the cause and treatment of clavicular nonunion with specific attention to the rigid internal fixation and the outcome of treatment. We concluded that symptomatic nonunion of the clavicle could be treated by operation, and rigid internal fixation with plate and bone grafts are thought to be a reliable treatment for the nonunion of the clavicle.

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Costoclavicular Syndrome: A Case Report
Sung Keun Sohn, Sung Soo Kim, Chang Geun Song, Jong Ill Kwak
Journal of the Korean Fracture Society.2007; 20(1): 86. CrossRef

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Operative Treatment of Radial Head Fracture of Mason type III: Ho Jung Kang, Moon Soo Park, Sang Jin Shin, Eung Shick Kang, Byeong Mun Park; J Korean Soc Fract 1999;12(3):732-740. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.732

Abstract PDF: The treatment of choice for Mason type III radial head fracture was total excision. But, open reduction and internal fixation of fractures of the radial head has become a commonplace as the result of both improvements in the techniques and implants for the fixation of small articular fragments as well as increasing recognition of the important role that the radial head plays in the stability of the forearm and elbow, particularly in the face of acute combined osseous and ligamentous injury. To date, reports of radial head fixation have made little mention on Mason type III fracture. From January 1993 to September 1997, 10 patients with fracture of radial head(Mason type III) were treated at Yong-dong Severance Hospital, Yonsei University College of Medicine. There were 6 males and 4 females with average age of 30 years(range 16 to 47). All of the fractures were comminuted and Mason type III. Seven fractures were the results of falling down and two slipping down and one pedestrian injury. Six fractures(60%) were evaluated as good or excellent by Bruces criteria. The heterotopic ossification was complicated in two cases. The nonunion of radial head fracture occured in two cases. The radial nerve palsy occured in one case. The partial ankylosis of elbow developed in three cases. Kirschners wires migrated in four cases. Open reduction and internal fixation increased the range of motion and decreased the subjective pain and did not cause any proximal migration of radius, impingement of ulnar carpal and radiocapitellar joint and could be a good treatment modality. The further evaluation should be directed to camparison between the open reduction and internal fixation and prosthetic replacement after total excision of radial head.

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Problems of compression Hip Screw for the Treatment of Intertrochanteric Fracture in Elderly Patients: Kwon Jae Roh, Jong Oh Kim, Hyung Ho Kim; J Korean Soc Fract 1999;12(3):502-508. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.502

Abstract PDF

The principle in the treatment of an elderly patient with an intertrochanteric fracture has swung from traction to internal fixation due to complication such as pneumonia, skin ulcer, and thromboernbolic disease, etc. Many surgeons have used sliding compression screw for trochanteric fracture fixation which was regarded as a most effective device to manage the fracture. but, they have reported several risk factors to cause fixation failure such as screw impaction or loosening, because of osteoporosis, large defect on posteromedial aspect of neck, eccentric fixation of lag screw. The aim of the present investigation was to study the relationships between the type of fracture, the trabecular bone grading of proximal femur, reduction status, the implant position and the extent of impaction or loosening of the comression screw. We studied 47 elderly patients(age>60) who were managed using of compression hip screw as operative management and followed more than 6 months after operative treatment at Department of orthopaedic surgery, Ewha womens university Mokdong hospital from 1994 to 1998. The results were as follows 1. Screw impaction or loosening was developed in 7 cases of 47 cases after internal fixation. 2. Of 7 cases, 2 cases were stable fracture(modified Evans type I, II) and 5 cases unstable (modified Evans type III, IV, V). 3. Of 7 cases, 3 cases were high trabecula grade(grade VI, V, IV), 4 cases were low trabecula grade(grade I, II, III). 4. No siginificant diffierence of impaction or loosening development was in screw position. 5. Of 7 cases, 2 cases were anatomical reduction and 5 cases medial reduction.

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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
Journal of the Korean Fracture Society.2007; 20(3): 215. CrossRef

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Limited Internal Fixation for the Treatment of the Pilon Fracture: Phil Hyun Chung, Suk Kang, Sang Ho Mun, Won Suk Chae; J Korean Soc Fract 1998;11(4):841-848. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.841

Abstract PDF: The intraarticular fractures of the distal tibia-so called pilon fracture or plafond fracture- were caused by high energy and axial compression forces arising from motor vehicle accidents or falls from a height, and it is frequently associated with severe vomminution and soft tissue injury. Expecially soft tissue injury has been considered as a difficult problems to treat these fractures and there has been many controversies in the methods of treatment. We analized 30 cases of pilon fracture who were treated by limited internal fixation from March 1992 to March 1997. the average follow up period was 26 months(from 15 to 50 months). The results as follow: 1. According to Ruedi and Allgower classification, Type I were 4(13%), Type II were 14(46%) and Type III were 12(40%) cases. 2. By using Ovadia and Beals' radiologic assessment, limited internal fixation showed good and fair results in about 80% of cases. 3. By using Mast and Teipner's clinical functional assessment, limited internal fixation showed good and fair reults in about 80% of cases. 4. Complications after operation were traumatic arthritis(17%) and nonunion(3.3%). But there were no complications such as wound infection and skin necrosis. Limited internal fixation with casting provides good result to treat pilon fractures and it reduces the complications of soft tissues problem.

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