Journal of Musculoskeletal Trauma

Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients: Han Jun Lee, Jong Won Kim, Jae Sung Lee, Jae June Yang, Woo Young Hwang; J Korean Fract Soc 2010;23(3):276-281. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.276

PURPOSE
To evaluate clinicoradiological outcomes after cementless bipoloar hemiarthroplasty in elderly patients with femoral intertrochanteric fractures.
MATERIALS AND METHODS
From March 2006 to February 2008, 28 patients-all in patients greater than 80 years of age, classified unstable intertrochanteric fractures in Evans classification-were followed for more than 1 year. 24 patients were women and 4 patients were men. The mean age of the patients was 84.6 years, the mean follow-up period was 16.3 months. Harris hip score, postoperative inguinal and thigh pain, Parker and Palmer mobility score were analyzed clinically. The radiological results were assessed using various radiological indicies including bone-union, fit and alignment change of femoral stem and vertical subsidence.
RESULTS
The average Harris hip score was 82.9, Parker and Palmer mobility score preoperative 8.0 changed to 5.2 postoperatively. More than moderate pain was presented in 1 case. There were no cases of varus deformity or osteolysis. All stems were stable without significant alignment change or subsidence except 1 case of periprosthetic fracture. There were no dislocation, thromboembolism, death during operation or hospital days.
CONCLUSION
In elderly patients, cementless bipolar hemiarthroplasty is good treatment method of unstable intertrochanteric fracture and short-term clinicoradiological outcomes proved to be satisfactory.

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The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures
Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim
Hip & Pelvis.2014; 26(2): 99. CrossRef

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Long Term Follow up Results of the Operative Treatment of the Acromioclavicular Joint Dislocation with a Wolter Plate: Ki Ser Kang, Han Jun Lee, Jae Sung Lee, Jae Yoon Kim, Yong Beom Park; J Korean Fract Soc 2009;22(4):259-263. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.259

Abstract PDF

PURPOSE
To evaluate the long-term clinical and radiological results of the operative treatment of the acromioclavicular dislocation with a Wolter plate. MATERIALS AND METHODS: We reviewed clinical and radiological data of twenty patients (mean age: 37 years) who underwent the operative treatment of acromioclavicular joint dislocation using a Wolter plate from September, 1999 to December, 2002 with minimum of five years follow-up (average 6 years 7 months). The clinical outcomes of twenty patients were evaluated by UCLA scoring and radiological results of fifteen patients with available radiograph were evaluated by Zanca view and stress view. RESULTS: The mean UCLA score was mean 33 points (range, 27~35) at final follow up. By clinical evaluation, twelve cases (60%) were excellent, six cases (30%) were good and two cases were poor (10%). By radiological evaluation, eight cases (54%) were excellent (without displacement), five cases (33%) were good (displacement <5 mm) and two cases (13%) were poor (displacement >5 mm). Erosive change in acromioclavicular joint was seen in poor case. CONCLUSION: Wolter plate fixation may be a useful modality for treating acromioclavicular joint dislocation. Great care should be taken to make the hook hole at the appropriate position during operation for long-term prognosis.

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Clinical outcomes of bending versus non-bending of the plate hook in acromioclavicular joint dislocation
Min Su Joo, Hoi Young Kwon, Jeong Woo Kim
Clinics in Shoulder and Elbow.2021; 24(4): 202. CrossRef
Clinical Comparison of Two Types of Hook Plate in Surgical Treatment of Acromioclavicular Dislocation - AO Hook Plate and Wolter Plate -
Jea-Yeol Choi, Eugene Kim, Haw-Jae Jeong, Jin Whan Ahn, Hun-Kyu Shin, Se-Jin Park, Seung-Hee Lee, Jae-Wook Lee, Kyu-Bo Choi
The Journal of the Korean Shoulder and Elbow Society.2012; 15(2): 123. CrossRef

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Radiologic Analysis and Treatment of Posterior Malleolar Fractures of the Ankle: Jae Sung Lee, Soo Yong Kang, Han Jun Lee, Young Bong Ko; J Korean Fract Soc 2009;22(2):98-103. Published online April 30, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.2.98

Abstract PDF

PURPOSE
The purpose of this study was to classify posterior malleolar fractures according to the position of fragments and to analyze radiologic features of each type.
MATERIALS AND METHODS
We analyzed forty-six patients of ankle fractures involving a posterior malleolus who were treated between January 2004 and December 2007. The posterior malleolar fractures were categorized into three types (posterolateral, posteromedial, shell) based on the major fracture line. In each type, we analyzed amount of displacement, involvement of articular surface, existence of subluxation and osteochondral impacted fragments.
RESULTS
The forty-six patients were categorized into three types: Posterolateral (PL) type (33 cases, 72%), Posteromedial (PM) type (8 cases, 17%), shell type (5 cases, 11%). Of the 8 cases with PM type, 7 cases showed displacement more than Grade II, 4 cases showed subluxation of ankle joint, and 3 cases showed osteochondral impacted fragment. Average involvement of articular surface of PM type is 35% (15~65%).
CONCLUSION
Posterior malleolar fractures with medial extension tended to have adverse effect on ankle stability and Preoperative CT scan is essential for evaluation of fracture type and determination of appropriate surgical approach.

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Treatment of Isolated Posterior Malleolus Fracture in the Ankle
Ji Hoon Kim, Seong Mu Cha, Dae Yeon Jo, Jin Soo Suh
Journal of the Korean Orthopaedic Association.2014; 49(1): 29. CrossRef

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The Effect of COX-2 Inhibitor on the Expression of MMP-13 during Early Fracture Healing Phase in Rats: Ki Ser Kang, Han Jun Lee, Jae Sung Lee, Ho Sung Ryu; J Korean Fract Soc 2009;22(1):45-50. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.45

Abstract PDF: PURPOSE
This study investigated the effect of COX-2 inhibitor on the expression of MMP-13 in the healing process of fracture. MATERIAL AND METHODS: Adult Sprague-Dawley rats were divided into two groups of twenty five rats each. Unilateral femoral shaft fractures were created artificially under displacement in all two groups. COX-2 inhibitor was only given to the experimental group from the postoperative day 1. At 2 weeks after fracture the rats were sacrificed and the callus from each group was used for histologic examination and real time RT-PCR for MMP-13 expression.
RESULTS
Histologically, proliferation of osteoblasts and formation of osteoid was less abundant in the experimental group. In real time RT-PCR, the mean expression of MMP-13 is 2.84+/-2.50 in the control group compared with 1.16+/-1.05 in the experimental group.
CONCLUSION
In the early stage of fracture healing, COX-2 inhibitor suppress the expression of MMP-13.

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The Treatment of Posterolateral Malleolar Fractures using Percutaneous Reduction Technique: Jae Sung Lee, Han Jun Lee, Jae Hyun Yoo, Hee Chun Kim; J Korean Fract Soc 2009;22(1):19-23. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.19

Abstract PDF: PURPOSE
To evaluate the usefullness of the percutaneous reduction technique with K-wire that could reduce the displaced posterolateral fracture fragment which persisted even after an anatomical reduction of the lateral malleolar fracture.
MATERIALS AND METHODS
From January 2004 to December 2006, we reviewed 72 patients who underwent surgical treatment for their trimalleolar fractures. We estimated the clinical and radiological results of 5 cases treated by percutaneous reduction technique with K-wire when more than the distal tibial articular step-off was left after reduction of the lateral malleolar fracture. The method of reduction starts with temporary fixation of lateral malleolar fracture followed by checking ankle radiographic image to confirm the accuracy of reduction. In case of incomplete reduction of the posterior fragment, a K-wire is inserted into the posterior fragment and pushed downward to the ankle joint level, and then lag screws were inserted.
RESULTS
The average articular involvement by the posterolateral fracture fragment was 30.2%. The average step-off after reduction of the lateral malleolar fracture was 3.7 mm. At the final follow up, step-off was less than 2 mm in all cases. In clinical results by Baird and Jackson score, 3 out of 5 cases were excellent, other 2 were good.
CONCLUSION
Percutaneous reduction technique for posterolateral fragment using the K-wire is relatively easy. This technique may be useful when the posterolateral fragment is large (more the 25% of articular surface) and not severely comminuted.

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Bipolar Clavicular Dislocation: A Case Report: Han Jun Lee, Jae Sung Lee, Young Bong Ko; J Korean Fract Soc 2008;21(4):316-319. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.316

Abstract PDF

Bipolar clavicular dislocation is simultaneous dislocation of both poles of the clavicle (mainly an anterior dislocation of the sternoclavicular joint and a posterior dislocation of acromioclavicular joint) and rarely reported. We report a case of bipolar claviclular dislocation after a seat belt injury and describe its presumed mechanism and treatment with a review of literature.

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Case of the Month #177: Bipolar Clavicular Dislocation: Radiologic Evaluation of a Rare Traumatic Injury
Michael P. Loreto, Dawn Pearce
Canadian Association of Radiologists Journal.2012; 63(2): 156. CrossRef
Clavicle Midshaft Fracture with Acromioclavicular Joint Dislocation: A Case Report
Chul-Hyun Cho, Chul-Hyung Kang, Soo-Won Jung, Hyuk-Jun Seo
Journal of the Korean Fracture Society.2009; 22(4): 297. CrossRef

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Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures: Jae Sung Lee, Yong Beom Park, Han Jun Lee; J Korean Fract Soc 2008;21(2):124-129. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.124

Abstract PDF: PURPOSE
To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation.
MATERIALS AND METHODS
We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test.
RESULTS
There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score.
CONCLUSION
The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.

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Nonunion with a Bony Defect of the Humerus: Treatment by Shortening: Jae Sung Lee, Soo Yong Kang, Jae Hyun Yoo; J Korean Fract Soc 2008;21(1):45-50. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.45

Abstract PDF: PURPOSE
To evaluate clinical results and advantage of interposition and shortening technique for the treatment of the humeral nonunion with bone defect.
MATERIALS AND METHODS
Eight patients with the humeral nonunion with bone defect underwent interposition of fragments and shortening had been followed-up for more than one year (mean 70 months, 16~156). There were 4 men and 4 women with a mean age of 60.5 years (range, 48 to 75 years). There included 3 proximal, 3 diaphysis and 2 distal metaphysis according to the site, mean size of the bone defect was 3.3 cm (2~5). The time to union, discrepancy of upper extremity, functional results, cosmetic satisfaction and postoperative complications were assessed.
RESULTS
All patients achieved to bone union, average union time was 10.2 weeks (range 8~14). Average limb discrepancy was 2.3 cm. All had improvement in shoulder and elbow motion after operation. Seven patients were satisfied with the cosmetic result and none had functional deficit due to limb discrepancy.
CONCLUSION
Treatment by Interposition of fragments and shortening in the intractable nonunion of humerus with a bony defect can achieve not only good functional result, shortened bone union time and improved in shoulder and elbow motion.

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Injury of Lateral Meniscus Associated with Tibia Plateau Fracture: Young Bok Jung, Suk Kee Tae, Dong Lyul Yang, Jae Sung Lee, Jung Il Lim; J Korean Soc Fract 2001;14(1):60-65. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.60

Abstract PDF: PURPOSE
To analyse the frequency of soft tissue injuries associated with tibial plateau fracture through arthoscopy and demonstrate the pattern and treatment of lateral meniscal tear which is the most frequently concomitant injury. MATERIAL AND METHOD: We evaluated the charts, X-rays and arthoscopic records of the 27 patients who had been diagnosed as tibial plateau fracture and received the arthoscopic examination or arthoscopic assisted operative management and analysed the injury pattern, association of schatzker classification and treatment of the 9 patients who had been concomitant with lateral meniscal tear.
RESULT
In our cases, lateral meniscus tear was the most common among the soft tissue injury it was revealed that a longitudinal tear at the peripheral area was shown in 8 cases, which were treated with meniscal repair and a radial tear of the central area in l cases, treated with partial menisectomy.
CONCLUSION
Lateral meniscus injury is one of the most frequently concomitant with tibial plateau fracture, In those cases, arthroscopic meniscal repair would be helpful for better prognosis.

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Surgical Treament for Unstable Intra-articular Fracture of the Distal Radius with Rayhack's Transulnar Percutaneous Pinning Technique: Eui Chan Jang, Ho Sung Ryu, Jae Sung Lee, Jung Nam Han; J Korean Soc Fract 1999;12(2):422-428. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.422

Abstract PDF: There has been many treatment modalities in the distal radius fracture. Although there is no doubt that external fixators have a role in the treatment of some highly displaced distal radius fractures, many unstable distal radius fractures may be treated adequately with far less complicated and intrusive percutaneous pinning technique. The purpose of this study was to evaluate indication and effectiveness of Rayhack's transulnar percutaneous pinning technique. Authors reviewed the unstable intra-articular fracture of the distal radius of 15 cases treated with Rayhack's transulnar percutaneous pinning technique between March 1994 and February 1997. At the final follow-up examination, the mean loss of radial length, radial inclination and volar tilt was respectively 0.4mm (3.9%), 2.0 (10.6%), 2.1 (14.7%). Posttraumatic arthritis was occurred in 1 case (11.1%) of less than 1mm residual articular step-off, 2 cases (40%) of more than 1mm and less than 3mm residual articular step-off, 1 case (100%) of more than 3mm residual articular step-off. Distal radioulnar joint synostosis by percutaneous pinning was not found. According to Demerit point rating system, excellent to good results were obtained in 73.3%. Authors suggest that Rayhack's pinning technique can be applied in terms of simple procedure, cost-effectiveness and functional outcome.

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A Clinical Study of the Tibial Plafond Fractures: Seung Gyun Cha, Won Suek Lee, Kyoung Hoon Kim, Jin Hak Kim, Jin Yong Jung, Jae Sung Lee; J Korean Soc Fract 1992;5(2):268-274. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.268

Abstract PDF: The tibial plafond fractures result from an axial compression and rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displacement, it is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws, basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The author analysed the 22 cases of the tibial plafond fractures in 22 patients, which were treated at the department of orthopedic surgery in Dai Han hospital. From january 1989 to january 1991. The longest duration of follow up was 2 years and 6 months and shortest one was 7 months, and the average was 14 months The results were as follows ; 1. Among the 22 patients, male were 17 and female was five. 2. The major causes of injury were a fall from a height. 3. Regardless of the method of treatment the type I and II were In good and fair result, but the type III were fair in 4 cases and poor in 2 cases, other 5 cases were in good result. 4. It is important to remind the basic steps in reconstruction appllied in an indivisual case especially in type III. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, early motion of the ankle joint is possible. The early motion reduces stiffness of the ankle and will yeild the most satisfying rusult. But the anatomic reduction of ankle joint is difficult to be obtained in each case especlally in type III and may consider an ankle fusion.

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A Clinical Study of the Childrens Anltle Fracture: Seung Gyun Cha, Won Suck Lee, Kyoung Hoon Kim, Woo Tae Lee, Jin Hak Kim, Jae Sung Lee; J Korean Soc Fract 1992;5(2):236-243. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.236

Abstract PDF: The injuries of ankle in children occur mostly at the bony structure rather than ligamentous one, and some injuries of the growth plate may result in the arrest of entire growth an these may result to leg length discrepancy or deformity. Accurate treatment under the knowledge of injury mechanism is very important. We have reviewed 30 cases of childrens ankle fracture treated our clinics from Jan. 1987 to Dec. 1990. The results are as follows; 1. Traffic accident was most common cause of injury (50.0%). 2. According to Dias & Tachdjian classification, Supination-Invertion type was most common (11 cases). 3. The treatments performed were closed reduction & cast immobilization for 11 cases (36.7%), closed reduction & percutaneous pinning for 3 cases (10.0%), and open reduction & internal fixation for 16 cases(53.3%). 4. Among open reduction & internal fixation group, only 1 case(pronation-eversion-external rotation type) show angular deformaity. 5. For the prevention of complications, accurate reduction and adequate fixation was desired.

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