Journal of Musculoskeletal Trauma

The Significance of Calcaneal Posterior Tuberosity Fragment Reduction When Treated with Open Reduction in Displaced Intra-Articular Calcaneal Fractures: Hong Ki Park, Jong Ryoon Baek, Jang Seok Choi, Sang Jin Lee, Je Won Paik; J Korean Fract Soc 2016;29(4):233-241. Published online October 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.4.233

Abstract PDF: PURPOSE
We attempt to evaluate the significance of calcaneal posterior tuberosity fragment reduction when treated with surgical open reduction in displaced intra-articular calcaneal fractures.
MATERIALS AND METHODS
A total of 90 patients with displaced intra-articular calcaneal fracture, between January 2010 and December 2015, treated with open reduction and internal fixation were enrolled in this study. At postoperative 3 months, we evaluated the reduction state of calcaneal posterior tuberosity fragment by measuring the degree of lateral displacement of the posterior tuberosity fragment on the calcaneal axial view. Moreover, we also evaluated the difference in the calcaneal length and height with the uninjured side on the lateral view of both sides. In addition, we estimated the reduction state of the posterior facet by measuring the degree of gap and step-off on the semi-coronal view of postoperative computed tomography and estimated the restoration of calcaneal angle by measuring the difference in BÃ¶hler's and Gissane angle with the uninjured side on the lateral view of both sides.
RESULTS
The correlation coefficient with 3 components for evaluating the reduction state of posterior tuberosity fragment and gap and step-off of posterior facet was r=0.538, 0.467, r=0.505, 0.456, r=0.518, and 0.493, respectively, and restoration of BÃ¶hler's and Gissane angle was r=0.647, 0.579, r=0.684, 0.630, r=0.670, and 0.628, respectively. The relationship of each component shows a significant correlation as all p-values were <0.01.
CONCLUSION
The precise reduction of calcaneal posterior tuberosity fragment developed by the primary fracture line was considered as an important process of anatomical reduction of calcaneal body, including the posterior facet and calcaneal angle restoration.

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Vertebral Recompression after Vertebroplasty or Kyphoplasty: Deuk Soo Jun, Do Hyun Moon, Young Kyu Ko, Jang Seok Choi, Byoung Keun An, Je Won Paik, Min Ho Park; J Korean Fract Soc 2015;28(2):110-117. Published online April 30, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.2.110

PURPOSE
The purpose of this study was to examine incidence of recompression and risk factors in the patients with osteoporotic vertebral compression fracture (OVCF) after vertebroplasty or kyphoplasty.
MATERIALS AND METHODS
This study was conducted on 179 vertebral bodies of 126 patients who underwent vertebroplasty or kyphoplasty on OVCF from January 2004 to August 2013.
RESULTS
When anterior vertebral height of fractured vertebrae declined by more than 3 mm from the height immediately after vertebroplasty or kyphoplasty, it was judged that recompression had occurred. Recompression was observed in a total of 58 vertebrae (32.4%). Recompression occurrences were found to be decreasing significantly when fractured vertebrae were the thoracic spine. In addition, osteonecrosis occurred in the preoperative vertebrae and restoration degree of anterior vertebral height immediately after vertebroplasty or kyphoplasty affected recompression occurrences significantly. The other factors (age, sex, bone mineral density, steroid medication history, follow-up duration, cement volume, vertebroplasty or kyphoplasty, and approach method) were compared, but no statistical significance was found.
CONCLUSION
The risk of vertebral recompression is more common, especially when osteonecrosis occurred in preoperative vertebrae or when vertebroplasty or kyphoplasty achieved remarkable restoration of anterior vertebra height. When performing vertebroplasty or kyphoplasty, such conditions should be considered carefully.

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Effect of Weekly Teriparatide Administration Followed by Percutaneous Balloon Kyphoplasty on Post-Menopausal Osteoporotic Compression Fracture Treatment
Sung-Ha Hong, Seung-Pyo Suh, Woo Jin Shin, Seung Gi Lee, Byung Jun Kang
Journal of the Korean Orthopaedic Association.2022; 57(1): 35. CrossRef
Analysis of the Cement Distribution Pattern and Other Risk Factors that Affect the Incidence of Recompression Fractures of Vertebral Bodies after Vertebroplasty or Kyphoplasty
Deuk Soo Jun, Jong Min Baik, Young Hyun Yoon
Journal of the Korean Orthopaedic Association.2022; 57(3): 204. CrossRef
Clinical Characteristics of Elderly People with Osteoporotic Vertebral Compression Fracture Based on a 12-Year Single-Center Experience in Korea
Seung-Kwan Lee, Deuk-Soo Jun, Dong-Keun Lee, Jong-Min Baik
Geriatrics.2022; 7(6): 123. CrossRef
Risk Factors for Recollapse of the Augmented Vertebrae After Percutaneous Vertebral Augmentation: A Systematic Review and Meta-Analysis
Weibo Yu, Weixing Xu, Xiaobing Jiang, De Liang, Wang Jian
World Neurosurgery.2018; 111: 119. CrossRef

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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; J Korean Fract Soc 2013;26(4):248-253. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.248

Abstract PDF: PURPOSE
To determine the influence of osteoporosis on the results of percutaneous K-wire fixation for distal radius fractures.
MATERIALS AND METHODS
Between March 2007 and February 2011, Fifty seven patients who underwent fixative surgery with K-wires after closed reduction and those available for follow-up for at least 6 months were reviewed. They were divided into the two groups of T score -3 or more (group 1) and T score less than -3 (group 2). These groups were compared by the range of motion of the wrist and Disabilities of the Arm, Shoulder and Hand (DASH) score. Radiologic evaluations consisting of radial length, radial inclination and volar tilt were compared. In group 1 with 34 cases, the average age was 65.4 years (50 to 78 years) and T score was -1.97 (-0.1 to -2.93). In group 2 with 23 cases, the average age was 74 years (54 to 89 years) and T score was -4.11 (-3.1 to -6.97).
RESULTS
There was no statistical difference between group 1 and group 2 in terms of range of motion, DASH score and radiologic evaluations.
CONCLUSION
In the case of no volar side cortical comminution, percutaneous K-wire fixation can be applied for the treatment of distal radius fracture with osteoporosis.

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The Treatment of Subtrochanteric Fracture with Cephallomedually Nail: Minimal Incision and Lowman Clamp Assisted Reduction: Jang Seok Choi, Do Hyun Moon, Young Tae Noh; J Korean Fract Soc 2011;24(4):301-306. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.301

Abstract PDF

PURPOSE
To evaluate the radiographic results of patients with subtrochanteric femoral fracture using minimal incision and cephalomedullary nail technique.
MATERIALS AND METHODS
This study was performed on 54 patients, 54 cases of hip, recruited among patients who underwent minimal incision and Cephalomedullary nail from September 2005 to August 2008 and were available for 1-year or longer follow up. The gender ratio was 37 males and 17 females, and the mean age at the time of surgery was 57.4 years (range; 16~81 years). According to injury mechanism, traffic accident was 29 cases, fall down form high height was 18 cases, slip down was 7 cases. In classification by Seinsheimer, type II was 23 cases (m/c), type III was 18 cases, type IV was 13 cases. Average follow up period was 14 months (12~18). Radiographic evaluation was performed for time taking union, mal-union and complication.
RESULTS
53 of the 54 cases united. 39 of 54 reductions were anatomic. 19 fractures had a monir varus deformity of proximal fragment (between 2degrees and 5degrees). There was no varus deformity of more than 5degrees. 1 case that had been treated with PFN had nail breakage without trauma. There were no other complications.
CONCLUSION
Surgical treatment of subtrochanteric fractures with minimal incision and Cephalomedullary nail technique can reslut in excellent reduction without complications including inflammation & malunion. Careful attention to detail for using Lowman clamp is demanding to decrease soft tissue injury.

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The Treatment of Subtrochanteric Fractures with Proximal Femoral Nail Antirotation
Chi Hyoung Pak, Sang Hong Lee, Sang Ho Ha, Gwang Chul Lee, Kyoung Chul Song
Journal of the Korean Fracture Society.2013; 26(4): 284. CrossRef
Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques
Chul-Hyun Park, Chul-Wung Ha, Sang-Jin Park, Min-Su Ko, Oog-Jin Shon
Journal of the Korean Fracture Society.2013; 26(2): 112. CrossRef

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Treatment using Reduction of Lateral and Posterior Displacement in Unstable Intertrochanteric Fractures of the Elderly: Jae Ang Sim, Jang Seok Choi, Do Hyun Moon, Seung Jun Ahn; J Korean Fract Soc 2005;18(4):390-393. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.390

Abstract PDF

PURPOSE
To evaluate the advantages of reduction of lateral and posterior displacement in unstable intertrochanteric fractures of the elderly.
MATERIALS AND METHODS
From January, 1997 to December, 2001, we reviewed 23 cases of unstable intertrochanteric fractures in the elderly, which underwent by reduction of lateral and posterior displacement. Using the device of internal fixation is dynamic compression hip screw (DHS), the follow up period was minimally 12 months (mean 16 months). We estimated the clinical results, the radiologic results and complications.
RESULTS
The satisfactory results was regarded as walking with walking frame and 21 cases (91.3%) showed satisfactory results. The average period of radiologic union was 18 weeks. The average sliding of lag screw was 5.3 mm and the average changes of femoral neck-shaft angle was 2.6 degree. As for the complications, 2 cases showed superficial infection and 2 cases showed pain over trochanteric area.
CONCLUSION
In the unstable intertrochanteric fractures of the elderly, treatment with reduction of lateral and posterior displacement can be considered one of reduction technique.

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Unstable Intertrochanteric Femoral Fracture Treated with Mini-incision Reduction Technique and Intramedullary Nail
Oog Jin Shon, Dae Sung Kim
Journal of the Korean Fracture Society.2010; 23(1): 13. CrossRef

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Modified Ender Nailing For Intertrochanteric Fracture of the Femur: Jin Wan Kim, Jeong Hoi Goo, Hyung Lae Cho, Young Chul Ko, Young Il Park, Seong Hwak Hong, Man Jun Park, Jang Seok Choi; J Korean Fract Soc 2005;18(4):379-384. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.379

Abstract PDF: PURPOSE
To evaluate the modified Ender nailing technique for the treatment of femoral intertrochanteric fractures in elderly patients.
MATERIALS AND METHODS
31 cases of femoral intertrochanteric fractures treated by modified Ender nailing from May 1997 to December 2004 were included in this study. We analyzed the method of the anesthesia, amount of intraoperative blood loss, operation time, number of used nail, postoperative ability of ambulation, postoperative complication, and the time for radiological union.
RESULTS
22 cases were operated under epidural anesthesia and 9 cases under general anesthesia. The average amount of intraoperative blood loss was 55 ml and average time for operation was 37 minutes. The average number of used nails were 3.1. The postoperative ambulatory ability was clinically recovered to the preoperative ambulatory ability in 23 cases, and decreased than before in 8 cases. Postoperative complications included knee joint pain or limitation of motion of the knee joint and distal migration of the nails. The average time for radiological bone union was 17.1 weeks postoperatively.
CONCLUSION
The modified Ender nailing technique is the one of the proper method in elderly femoral intertrochanteric fractures with associated medical problems. This method reduce the operation time and the amount of intraoperative blood loss.

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Treatment of Fractures of the Hip in Children: Do Hyun Moon, Jang Seok Choi, Jong Hun Lee; J Korean Fract Soc 2004;17(3):283-286. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.283

Abstract PDF: PURPOSE
To evaluate the result of early anatomical reduction and internal fixation of hip fracture in children.
MATERIALS AND METHODS
From January 1996 to July 2002, 21 cases (mean, 9 years) of hip fracture were available for follow-up more than 1 year. We performed early anatomical reduction and internal fixation within 24 hours as possible. Fractures were classified according to the 4 types described by Delbet. The results were analyzed according to the functional results by Ratliff and the incidence of complication.
RESULTS
There were no type I, 7 type II, 10 type III and 4 type IV fractures. Avascular necrosis of femoral head in 2 cases (type II, III). Functional result was 18 Good, 1 Fair and 2 Poor.
CONCLUSION
Fractures of the hip in children have been associated with a very high rate of serious complications, but our treatment by early anatomical reduction and interal fixation reduced rates of complication and had good functional result.

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Treatment of Unstable Intertrochanteric Femoral Fracture with the AO/ASIF Proximal Femoral Nail (PFN): Do Hyun Moon, Jang Seok Choi, Geon Beom Kim, Jin Won Kim, Ki Tae Kim; J Korean Soc Fract 2003;16(2):136-142. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.136

Abstract PDF

PURPOSE
To review the clinical and radiographic results of the treatment of unstable intertrochanteric femoral fractures with a proximal femoral nail (PFN).
MATERIALS AND METHODS
We reviewed 47 unstable intertrochanteric femoral fracture cases that had been treated with a PFN operatively. The clinical and radiographic results and complications were analyzed. The mean age was 76.8 years old (62~96 years old) and the mean duration of follow-up was 15 months (12~24 months).
RESULTS
The postoperative walking ability was regarded as satisfactory when the patient could walk alone using an walking frame without others aids and satisfactory results was achieved in 43 cases (91.5%). In all cases the radiologic bone union was obtained. The average sliding of femoral neck screw was 3.0 mm and the average change of neck-shaft angle was 2.6 degree. There were three cases of postoperative complication which were including 1 case of cut-out of femoral neck screw, local superficial infection in 1 case and pain complaints over trochanteric area in 1 case.
CONCLUSION
The PFN is an useful implant for the treatment of unstable intertrochanteric femoral fracture because of the simplicity of the surgical technique and the low level of the complications encountered.

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Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteic Fractures in the Elderly
Byung-Hak Kim, Young-Yool Chung, Sung-Chang Ki, Dae-Hyun Yoon, Ji-Hoon Ryu
Journal of the Korean Orthopaedic Association.2011; 46(5): 399. CrossRef
Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision
Se Dong Kim, Oog Jin Sohn, Jae Ho Cho
Journal of the Korean Fracture Society.2008; 21(1): 1. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)
Kee-Byoung Lee, Byung-Taek Lee
Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef
Treatment of Intertrochanteric Fracture with Proximal Femoral Nail
Dae Joong Kim, Sung Chan Ki, Young Yool Chung
Journal of the Korean Fracture Society.2007; 20(1): 40. CrossRef

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Functional Evaluation of Wrist According to Changes of Length after Operation in Fracture of Both Bones of Forearm: Seung Suk Seo, Ki Yong Kim, Jang Seok Choi, Young Chang Kim, Jae Keun Park; J Korean Soc Fract 2003;16(1):74-82. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.74

Abstract PDF: PURPOSE
To evaluate the relationship between the length changes of both forearm bones and function of wrist. To know permitted length discrepancy for good wrist function after operation in fracture of both bones of forearm MATERIALS AND METHODS: From Jan. 1995 to Dec. 2000, 21 cases were followed over 1 year, were treated with compression plate and screws due to fracture of both bones of forearm in our hospital. Mean duration of follow-up was 3 years 6 months. The postoperative length difference was compared to preoperative or unaffected side in roentgenography. Four groups were defined to A, B, C and D by postoperative length difference ; < or =1mm, 1 2mm, 2 3mm, and >3mm for comparison. The function of wrist joint was evaluated with the Anderson 's classification and Mayo modified wrist score.
RESULT
Group A were 11 cases(52.3%), B 5 cases(23.8%), C 4 cases(19.0%) and D 1 case(4.8%). By the Anderson 's classification, the number of Excellent were 11 cases(52.3%), Good 7(33.3%), Fair 3(14.3%). In the group of the length difference lesser than 2mm, the number of Excellent were 11, and Good 5. The Mayo modified wrist score was 75.15 in the group of the length difference lesser than 2mm, that was higher than 61.15 in the group of more than 2mm.
CONCLUSION
To obtain a good wrist function after operative treatment of fracture of both bones of forearm the length discrepancy of both bones should be lesser than 2mm.

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Assessment of Surgical Treatment of Acetabular Fracture after Minimum Five-year Follow-up: Do Hyun Moon, Jang Seok Choi, Ki Ju Park, Jong Min Yun; J Korean Soc Fract 2002;15(3):342-348. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.342

Abstract PDF: PURPOSE
To review the clinical and radiographic results of operative treatment of acetabular fractures for which there were minimum five-year follow-up.
MATERIALS AND METHODS
We reviewed 22 acetabular fracture cases that had been treated operatively from March 1993 to July 1996. Each of the patients had been followed for a minimum five-year. The radiographic results were classified by Matta 's criteria and the clinical results were analyzed according to d 'Aubigne and Postel 's criteria.
RESULTS
Satisfactory reduction were obtained in 18 hips (81.8%), 14 and 13 hips of which were included in good or excellent categories of roentgenographic and clinical results respectively. Overall radiographic results for 17 hips (77.3%) at the one-year follow-up and 14 hips (63.6%) at the minimum five-year follow-up were excellent or good. According to clinical criteria, 16 hips (72.7%) at the one-year follow-up and 13 hips (59.1%) at the minimum five-year follow-up were classified as excellent or good.
CONCLUSION
Folow-up roentgenographic and clinical results were good or excellent in satisfactory reduction group. Threrefore the accuracy of reduction is an important prognostic factor in acetabular fracture. The results were worse at the minimum five-year follow-up than at the one-year follow-up. Late-postoperative complication is expected to increase as time passes.

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Intertrochanteric fracture associated with posterior hip dislocation: Do Hyun Moon, Jang Seok Choi, Ki Tae Kim; J Korean Soc Fract 2002;15(1):72-76. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.72

Abstract PDF: Femoral head fracture associated with posterior dislocation of the hip had been considered a rare industrial injury. However, with advances in high-speed travel its incidence increased. Previously, intertrochanteric fractures associated with posterior dislocation of hip had not been reported. Here, we report on cases of intertrochanteric fracture associated with posterior dislocation of the hip.

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A Comparison of Using Closed Interlocking Nailing versus Plate Fixation in Humeral Shaft Comminuted Fractures: Dong Gyu Lee, Woo Dong Nam, Jang Seok Choi; J Korean Soc Fract 1999;12(1):126-134. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.126

Abstract PDF: The purpose of this paper is to compare the results, complication, advantages and disadvantages of treatment with closed interlocking intramedullary nail with those with plate in humeral shaft comminuted fractures. The authors have reviwed 25 cases of humeral shaft comminuted fractures, which were treated with closed interlocking intramedullary nail in 14 cases and plate in 11 cases, from November 1992 to May 1996. The results were as follows: 1. The average time of operation in closed interlocking nailing was 72 minutes and that of plate fixation was 104 minutes. 2. The average time for bone union was 14.7 weeks in closed interlocking nailing and 14.9 weeks in plate fixation. 3. The complications of closed interlocking nailing were 2 cases of delayed union, 1 case of nonunion, 1 case of postoperative radial nerve palsy and 3 cases of pain and stiffness of shoulder. 4. The complications of plate fixation were 1 case of delayed union, 2 cases of nonunion, 1 case of postoperative radial nerve palsy, 1 case of stiffness of shoulder. 5. Excellent and good functional results rated by Stewart and Hundley were 12(85%) cases in closed interlocking nailing and 8(73%) cases in plate fixation. We concluded that closed interlocking nailing is one of the better useful method of treatment in humeral shaft comminuted fractures but, the procedures should be performed exactly.

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Treatment of Open Type-III Tibial Shaft Fractures -Comparison Between Ilizarov External Fixation and Secondary Intramedullary Nailing-: Hoon Kim, Woo Dong Nam, Ki Chan Ahn, Seung Seok Seo, Young Chang Kim, Jang Seok Choi, Young Goo Lee; J Korean Soc Fract 1998;11(1):191-197. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.191

Abstract PDF: Open type III tibial shaft fractures have a high incidence of complication and a poor outcome. The most usual method of stabilization is by external fixation, but there are several complications as infection, delayed union and nonunion. We tried to compare the results of Ilizarov external fixation cases with the case of secondary intramedullary nailing after temporary Ilizarov fixation. There was no significant difference in the union time of Ilizarov external fixation and secondary intramedullary nailing after temporary Ilizarov fixation. But the patients were more comfortable in the secondary intramedullary nailing. In conclusions, secondary intramedullary nailing after temporary Ilizarov fixation is the useful method in the treatment of open type III tibial shaft fractures.

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The Treatment and Complications of Ipsilateral Fracture of the Femur and tibia: Kyu Min Kong, Ki Chan Ahn, Sung Seok Seo, Young Chang Kim, Jang Seok Choi, Young Goo Lee; J Korean Soc Fract 1997;10(3):556-561. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.556

Abstract PDF: Ipsilateral fracture of the femur and tibia is difficult to treat because it is often comminuted and combined with severe soft tissue injury. And The result of treatment is poor in most cases. The thirty-four cases were treated at Pusan Paik Hospital from March, 1992 to February, 1995. The result were as follows; 1. The bony union time was shorter in the intramedullary nailing than other methods. 2. There were less complications in the group of used intramedullary nailing than other methods. 3. The intramedullary nailing was relatively good treatment method for ipsilateral fracture of the femur and tibia.

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Interlocking Medullary Nailing in Severe Comminuted Fracture of the Femoral Shaft: Young Goo Lee, Jang Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seong Seok Seo, Young Jae Kim; J Korean Soc Fract 1996;9(1):105-111. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.105

Abstract PDF: The interlocking medullary nail widens the range of the indication for medullary osteosynthesis of the femoral shaft fractures. Twenty one cases with the comminuted fracture of the femoral shaft were reviewed, which had been treated by closed or or semi-open IM nailing at the Department of Orthopedic Surgery, Pusan Paik Hospital from March 1991 to December 1993. The results were as follows 1. The period of fracture union was 22.1 weeks in Winquist-Hansen Grade III,27.4 weeks in Grade IV , 19.6 weeks in segmental. And its period was 22.6 weeks in closed and 26.2 weeks in semi-open IM nailing. 2. The result of closed interlocking medullary nailing was better and complications were less than semi-open interlocking medullary nailing. 3. The severely comminuted femoral shaft fractures were unstable and there were the risk of shortening, rotation and inadequate reduction. Therefore, when the closed interlocking medullary nailing did not gain the anatomical reduction, it was altemative method to perform semi-open interlocking medullary nailing. From above result, we conclude that closed interlocking medullary nailing or semi-open interlocking medullary nailing seems to be a favorabel method for treatment of severe comminuted femoral shaft fracture.

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Scapulothoracic Dissociation: Two cases report: Man Ho Byun, Sung Seok Seo, Hyun Duk Yu, Young Chang Kim, Jang Seok Choi, Young Ku Lee; J Korean Soc Fract 1995;8(3):467-470. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.467

Abstract PDF: Scapulothoracic dissociation is rare injury and as a result of severe shoulder girdle trauma. muptiple fractures of the upper extremity and closed disruption of scapula from the thorax are combined with damage to the local neurovascular structures, brachial plexus and subclavian artery. Tracitionally, above-the-elbow amputation and shoulder arthrodesis have been used to treat the flail upper extremity. Now we experienced two cases of scapulothoracic dissociation managed by forequarter amputation, shoulder and above-the elbow amputation and then present two cases of scapulothoracic dissociation through case and textbook review.

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Treatment of the Tibia Shaft Fractures with Unreamed Intramedullary Interlocking Nail: Ki Chan Ahh, Seung Seok Seo, Hyun Duek Yoo, Jang Seok Choi; J Korean Soc Fract 1994;7(1):95-104. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.95

Abstract PDF: In general, blood supply of the long bones contributes three ways-nutrient, metaphyseal and periosteal vessels. Its vascular damage is caused by major trauma or extensive soft tissue det-achment. When the diaphysis of long bone is reamed, endosteal blood supply is eliminated. In our hospital, 23 selected cases of the diaphyseal fracture of tibla have been treated by manipulative reduction, unlearning of the medullary canal and fixation of fracture fragments with an Interlocking intramedullary nail for preserration its vascularity as possible. We analized the patients from Jan. 1992 to May 1993, who were followed up for a mean 12 months. Most of cases were acute, 18 of these cases were open fracture and main cause of the injury was traffic accidents. Overall, 90% of the patients were judged to have good or excellent result based on both clinical and radiological parameters, and the average bony union time was 17 weeks. The complications were mainly infection(3 cases), loosening or breakage of the locking screws(3 cases) and delayed union(1 case). The merits of unlearned interlocking nailing were relatively easy procedure, short operation time, decreased complcations, rigid fixation and early rehabilitation. We concluded that unlearned intramedullary interlocking nailing is a useful method to treat the tibia shaft fractures, especially open type.

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A Clinieal Study of the Tibial Pilon Fractures: Cheol Kwak, Sung Seok Soe, Hyun Duk Yoo, Young Chang Kim, Jang Seok Choi, Young Ku Lee; J Korean Soc Fract 1992;5(2):260-267. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.260

Abstract PDF: Intraarticular fractures of the distal tibia, the so-called pilon tibial fracture, usually resultfrom a torsional injury, a motor vehicle accident, or a fall from a height. The management of these fractures has been notoriously difficult due to the comminution of the distal tibia, articular incongruity, and asscociat ed soft-tissue trauma. The best results of treatment reported for this fracture, have followed early open reduction and rigid internal fixation to restore length, recon struction of the plafond, primary cancellous bone-grafting, butress plate on tibia, early motion and prolonged non weight-bearing. The purpose of this study was to examine the experience of the Pusan Paik Hospital between 1986 and 1991 as it relates to the treatment of 20 pilon fractures and to correlates the Clinical fesults with fracture type. They were followed post-operatively for an average of 22.3 months. The results were as follows 1. The most frequent type of the fraEture was type III according to Ruedl and Allgowe Classification. 2. Open reduction and internal fixation in cases type II & III has showed better resulis than those treated conservatively. 3. The fibula fracture fixed internally with a plate first often makes re construction of the distal tlbia easier. 4. The most often complication was the ankle joint pain.

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