Journal of Musculoskeletal Trauma

Minimal Invasive Fixation Methods for the Metacarpal Fracture: Ki Youn Kwon, Jin Rok Oh, Ji Woong Kwak; J Korean Fract Soc 2022;35(1):9-15. Published online January 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.1.9

Abstract PDF: Purpose
This study compared the radiologic and clinical outcomes of metacarpal fractures treated with two minimally invasive surgical techniques: Kirschner wire (K-wire) fixation and headless screw fixation.
Materials and Methods
This study included 52 patients (46 males and 6 females; age 18-55 years) with distal metacarpal fractures (middle and distal shaft, including the neck) who had undergone K-wire fixation or headless screw fixation. All subjects were followed up for at least six months. The radiologic assessments were performed to evaluate the angular deformity and shortenings. The total active motion (TAM), grip strength, and patients’ subjective functional assessment were measured to evaluate the hand function. The time taken to return to work (RTW) and adverse events were analyzed.
Results
Of the 52 cases, metacarpal fractures treated with headless screw fixation and K-wire fixation showed a significant difference associated with early RTW (p<0.05). There were no significant differences between the subjects treated with K-wire fixation and those with headless screw fixation in terms of the radiologic measurement, hand function examinations, complications, and adverse events (p>0.05).
Conclusion
After a six-month follow-up, minimally invasive K-wire fixation and headless screw fixation produced similar clinical and radiologic outcomes in subjects with metacarpal fractures. Compared to K-wire fixation, however, headless screw fixation led to earlier functional recovery and might be a better option for treating metacarpal fractures in this regard.

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Scaphoid Fractures and Nonunion: Jin Rok Oh; J Korean Fract Soc 2016;29(1):79-92. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.79

Abstract PDF: Fracture of scaphoid is relatively common, and accurate and prompt diagnosis leads to bony union with good clinical outcome. However, it can be easily missed due to vague symptomatic complaints by patients, which in turn leads to negligence of a doctor in making the diagnosis or anatomical shape of scaphoid that causes minute fracture to be ignored while viewing simple radiography. When missed, nonunion of scaphoid gradually progresses to arthritic change in the wrist. Thus when fracture of the scaphoid is suspected, further evaluation should be initiated with care, and if the diagnosis is confirmed, a proper treatment plan must be set with assessment of stability of the fracture fragment. Internal fixation is usually proposed since solid fixation of the fracture provides early return to daily activity. When nonunion of the scaphoid is present, most patients can achieve bony union with avascular bone graft and internal fixation. However, if there is sclerotic change, large bone cyst or avascular necrosis of the fracture fragment, internal fixation with bone graft that includes vascular supply should be introduced in order to achieve bony union.

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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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Comparison of Early Fixation and Late Fusion of 4, 5th Carpometacarpal Joint in the Intra-Articular Fractures of 4th and 5th Metacarpal Base: Chang Ho Yi, Jin Rok Oh; J Korean Fract Soc 2011;24(1):60-66. Published online January 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.1.60

Abstract PDF

PURPOSE
To evaluate clinical results between early fixation group and delayed fusion group in treatment of intraarticular fracture of 4th, 5th metacarpal base.
MATERIALS AND METHODS
From March 2002 to December 2006, 21 cases of early fusion and 11 cases of delayed fusion of 4, 5th carpometacarpal joint were reviewed retrospectively or were included in this study. Average follow up period is 39.9 months. Bony union was checked by plain films at follow up. DASH-questionnaire, VAS pain scale, grip power and range of motion of 4th, 5th metacarpophalangeal joint were also checked at last follow up.
RESULTS
In radiologic study, bony union was confirmed in all cases of two groups. Early fixation group showed better outcomes than delayed fusion group in range of motion, DASH-questionnaire and VAS pain scale with statistical significant (p<0.004).
CONCLUSION
Because early fixation group showed better clinical outcomes than delayed fusion group, early diagnosis and proper surgical treatment are important for better outcomes in treatment of intraarticular fracture of 4th, 5th metacarpal base.

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

Abstract PDF

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

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

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

Abstract

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

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

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Treatment of 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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Proximal Humeral Fracture with Epiphyseal Plate Injury: Sung Kwan Hwang, Jin Rok Oh, Jung Ho Rah, Ki Ho Kim; J Korean Soc Fract 1997;10(4):793-800. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.793

Abstract PDF: Proximal humerus fracture with epiphyseal plate injury does not cause the growth disturbances and deformity of humerus in comparison with other fracture of epjphyseal plate. The explanation about this phenomenon is that the fracture occurs microscopically in maturing Bone near provisional calcifying zone, another explanation is that the epiphyseal plate in proximal humerus greatly contribute the longitudinal growth of humerus and has trimendous remodelling potential. In this study, we experienced the 25 cases of proximal humeral epiphyseal injury from January, 1991 to June, 1997 We analyzed the growth disturbance and deformity of the proximal humeral epiphyseal plate in regard to age, fracture type, treatment method of the 15 cases with 3 years follow-up among the 25 cases. This fracture is most common in the age of 13 to 16, 11 cases among total 15 cases(75 percent). Most common fracture type is type II by Salter-Harris classification, 14 cases among total 15 cases, 3 cases is type IV by Neer-Horowitz classification, where, manual reduction was impossible because of interposition with biceps tendon between fracture fragments. There was no impairment of motion, growth distrubance and deformity in all cases. We concluded there is no direct correlation with patient age, the degree of fracture, displacement, treatment method in view of gorwth disurbance and deformity.

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Fracture around Hip Joint Combined with Ipsilateral Femoral Shaft Fracture: Sung Kwan Whang, Jung Ho Rha, Jin Rok Oh, Young Hyun Park; J Korean Soc Fract 1997;10(4):746-754. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.746

Abstract PDF: Fracture around hip joint combined with ipsilateral femoral shaft fracture is relatively uncommon injury and usually result from high-energy trauma. In many of cases, this fracture accompanies with multiple fractures and may be unrecognized the fracture around hip joint. The mechanism of this fracture is that the force on knee joint breaks femoral shaft, and then, when adductive position of femoral shaft, the remained force dislocates hip joint or breaks acetabulum, when abductive position of the shaft, the force breaks femoral neck or intertrochanter. The treatment methods of this fracture are many, but there is no choice of treatment. So, when we select method of treatment, we must consider patients all situations(patients age, pattern of fracture, qulality of bone, ability of surgeon, etc.). The purpose of this study is to make the algorithim of the selection of treatment method for rracture around hip joint combined with ipsilateral femoral shaft fracture. We reviewed 37 cases of fracture around hip joint combined with iplilateral femoral shaft fracture from Febrary 1978 to June 1996. The minimal follow-up period was 1 year. From the review, we made the algorithm of the selection of treatment method for fracture around hip joint combined with ipsilaterl femoral shaft fracture.

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Acceptable Angulation in Reduction of Humeral Supracondylar Fracture in Children: Seung Kwan Hwang, Jin Rok Oh; J Korean Soc Fract 1997;10(1):211-217. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.211

Abstract PDF: The purpose of this study is extraction of acceptable angulation range of humeral supracondylar fracture in children. Forty five cases of humeral supracondylar fracture were examined for 5 years and 5 months from February, 1990 to June, 1995. For analysis of the result according to angulation of distal fracture fragment of the reduction of fracture site, we measured the valgus-varus angle and rotatory angle of distal fracture fragment. Forty five cases were classified into three groups for the evaluation of result. If the distal fragment has valgus angulation below 5 degrees or rotaion angulation below 5 degrees, classified as group I. valgus angulation above 5 degrees and below 10 degrees or varus angulation below 5 degrees or rotation angulation above 5 degrees below 10 degrees, classified as group II, varus angulation above 5 degees or rotation angulation above 10 degrees, classified as group III. For evaluation of result, we standardized the range of motion, the change of carrying angle, the deformity of elbow. We gave point to these items, thus, total point above 10 points was evaluated as excellent, 8~9 points as good, below 7 points as unsatisfactory, Group I showed good result in 21 cases among 22 cases, in Group II, good result to in 16 cases among 18 cases. In Group I and II, the good result is 95%, 38 cases among 40 cases. Thus, we concluded that the acceptable range in reduction of humeral supracondylar fracture in children is valgus angle below 10 degrees, varus angle below 5 degrees, rotation angle below 10 degrees.

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Comparative analysis of the surgical treatment in the fracture offemoral neck: Ki Hong Choi, Chung Nam Kang, Jin Man Wang, Kwon Jae Roh, Jin Rok Oh; J Korean Soc Fract 1991;4(2):215-226. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.215

Abstract PDF: No abstract available.

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