Journal of Musculoskeletal Trauma

Intramedullary Plate Fixation for the Comminuted Fracture of the Femoral Shaft: A Case Report: Ju O Kim, Mun Su Jeong, Bong Ju Park; J Korean Fract Soc 2007;20(4):345-348. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.345

Abstract PDF: A case of the comminuted fracture of the femoral shaft with osteoporosis is presented. The patient lacked sufficient bony stability and cortical bone-contact which allows union by conventional reconstruction method. Therefore, the authors performed a technique utilizing an intramedullary plate in combination with the standard lateral plate in order to obtain bony stabilization, early range of motion of the knee, and partial weight bearing ambulation and the technique is introduced.

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Comparison of the Unloading Effect of the Lower Limb Casts: Ju O Kim, Sang Moon Yoo, Han Ki Lim, Seung Jun Choi; J Korean Soc Fract 2001;14(4):623-627. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.623

Abstract PDF: PURPOSE
We compared and evaluated the unloading effect and the availability of four different types of lower limb casts.
MATERIALS AND METHODS
The subjects were ten healthy men who had no gait disturbances, neuromuscular disorder, and deformities of lower extremities. The mean age was 25.2years(22-29) and the mean weight was 62.6kg(53.9-69.1). The trials consisted of patellar tendon bearing(PTB) casts, short leg casts, long leg extension casts, and long leg 30Â° flexion casts. In each experiment, ten sets of measurements were taken with all subjects wearing four different types of lower limb casts and walking on a flat surface indoors. The load cell was placed on the sole of the foot and wrapped with casts so that we could measure the pressure of the sole during gait. The percentage of load reduction was calculated by comparing pressure of the soles and the bottom of the casts.
RESULTS
The unloading effects of the PTB, the short leg, the long leg extension, and the long leg 30Â° flexion casts were 23.8%, 19.5%, 25.5%, 27.9% of the loading. No significant difference of unloading effect was demonstrated between each four different types of lower limb casts(P>0.05).
CONCLUSION
Notwithstanding the clinical success of the lower limb casts in below knee fractures, the unloading effect of the casts was limited and any type of the casts did not show better unloading effects.

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Operative Treatment of the Femur Intertrochanteric Fracture Using the Gamma nail and the Compression Hip Screw: Ju O Kim, Jae Il Oh, Sang Moon Yoo, Han Ki Lim; J Korean Soc Fract 2001;14(2):166-173. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.166

PURPOSE
To compare and analyze the operative results of compression hip screw with those of gamma nail in the treatment of intertrochanteric fracture of femur.
MATERIALS AND METHODS
We performed retrospective analysis of intertrochanteric fracture of femur using the compression hip screws on 16 cases(stable 8 cases, unstable 8 cases) and compared the results with those of 21 cases(stable 5 cases, unstable 16 cases) of Gamma nail fixation. All the 37 cases were operated between April 1992 and May 1997 and followed for minimal 12 months. We permitted earlier weight bearing for the Gamma nail inserted group(1 week vs 3 weeks). We evaluated the operation time, bleeding amount, intraoperative and postoperative complications, bone union time, neck-shaft angle, and functional assessment by follow up radiographs and clinical results.
RESULTS
The average operation time was shorter in the Gamma nail group than in the compression hip screw group (97+/-23.3 compared with 117+/-35.9 minutes; p<0.05). The average amount of bleeding was lesser in the Gamma nail group than in the compression hip screw group (592 compared with 712 ml: p<0.05). The fracture union time and clinical function of two groups showed no statistically significant difference(p>0.05). During Gamma nail insertion, crack was developed in one femoral shaft which was united after bed rest and delayed weight bearing. Postoperative complications were coxa vara in 3 cases(1 case on Gamma nail, 2 cases on CHS) and cutting out of lag screw in 3 cases(1 case on Gamma nail, 2 cases on CHS), but showed no statistically significant difference between two groups(p=0.781).
CONCLUSION
Early weight bearing can be encouraged for the Gamma nail group and this seemed to be beneficial for the old patients. The Gamma nail fixation is considered as a useful method for the patients with intertrochanteric fracture if it is managed with proper technique.

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Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails
Il Ho Park, Jong Kyoung Won, Kye Young Han
Hip & Pelvis.2012; 24(2): 117. CrossRef

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Torsional Deformity Following Intramedullary Nailing for Treatment of the Tibia Fractures: Ju O Kim, Sung Jun Lee, Yeub Kim, Hae Ryong Huh; J Korean Soc Fract 2000;13(4):928-934. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.928

Abstract PDF: PURPOSE
To determine the incidence and extent of torsional mal-alignment in patients with tibial shaft fractures treated with closed antegrade intramedullary(IM) nailing.
MATERIALS AND METHODS
We measured torsion using CT scanning in 35 patients. Affected tibiae were compared with the normal tibiae.
RESULTS
A torsional difference of 8degrees or more found in 22 cases(63%) as compared with the uninjured side. Only 7 of these cases could be clinically detected and only two patients noted the problem.
CONCLUSION
Torsional mal-alignment occurs in a significant number of tibial fractures treated by closed IM nailing in spited of careful attention to detail. We recommend that torsional mal-alignment be considered as a likely cause for less than optimal result after treatment of the tibial fractures by closed IM nailing and to investigate this further by performing CT scans.

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Plate augmentation for the nonunion of femur shaft fractures after interlocking intramedullary nail fixation: Ki Soo Kim, Ju O Kim, Hyun Guyn Jung, Byoung Oh Jung; J Korean Soc Fract 1999;12(1):21-27. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.21

Abstract PDF

Ten patients with nonunions of femoral shaft fractures were treated with plate augmentations and bone grafts. The patients sustained comminuted femoral shaft fractures and were fixed with interlocking intramedullary nails. Eight of the ten patients were inserted by closed technique and two were open. We followed the patients and waited for average 11.6 months, and during that periods, six of the ten patients received several procedures to facilitate union. But nails alone could not provide enough stability for the fracture unions. We exposed the nonunion sites, left the nails in situ, and applied additional plates with bone grafts. All nonunions were vascular and hypermobile, which could be corrected after plate applications. The patients were followed for at least 1 year(average 2.7 years), and all achieved radiologic solid unions after 7.7 months(average). No complications were noted. We believe that we can apply additional plates without removing previously inserted intramedullary nails for the hypermobile femoral shaft nonunions.

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The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation
Se Dong Kim, Oog Jin Sohn, Byung Hoon Kwack
Journal of the Korean Fracture Society.2008; 21(2): 117. CrossRef
Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing
Sung-Soo Kim, Sung-Keun Sohn, Chul-Hong Kim, Myung-Jin Lee, Lih Wang
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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The Calcaneal Trabecular Pattern as an Index of Osteoporosis and the Role of Osteoporosis in Ankle Joint Fractures: Ju O Kim, Hong Jun Han, Young Suk Kim, Sang Soo Kim; J Korean Soc Fract 1989;2(1):101-106. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.101

Abstract PDF: To provide another effective method of surveying osteoporosis, authors introduced the calcaneal trabecular pattern as an index of osteoporosis. We reviewed the roentgenograms of 144 patients with ankle or hip joint fracture. The trabecular pattern in the cacaneum(expressed as the calcaneal index) and that in the upper end of the femur(Singhs index) were well correlated, and both indices have a inverse correlation with age. The calcaneal index did not reveal any correlation with the type of ankle joint fractures, but it was estimated to provide useful information for ankle joint fractures in selection of treatment mode including fixation method and prediction of the prognosis.

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Treatment of difficult Nonunion by Modified Dual Onlay graft: Sang Soo Kim, Ju O Kim, Dae Moo Shim, Bong Joo Park, Young Jin Choe; J Korean Soc Fract 1988;1(1):86-90. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.86

Abstract PDF: For the difficult nonunion, such as large bone defect, severe osteoporosis, nonunion with repeated operations, or nonunion at the metaphyses, authors performed modified dual onlay bone graft. One side was appied wiht plate for the stabilization of the nonunion site and the other side with cortical bone from tibia for the osteogenecity. We performed this operation in five cases and all of them had good results. This method is believed to be superior in its stronger stabilization and less donor site problem, however, with sufficient osteogenecity, to the original dual onlay graft. Moreover, even to the metaphyseal area, plate can be contoured to the bone shape, which makes this operation applicable to all areas of bone.

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