Journal of Musculoskeletal Trauma

Original Articles

Posterior Anti-Glide Plating for Supination External Rotation Type Lateral Malleolar Fractures: Clinical Comparison of Locking versus Non-Locking One-Third Semi-Tubular Plate Fixation: Jun Young Lee, Yong Jin Cho, Dong Hyuk Cha, Hyun Bai Choi, Jung Ho Lee; J Korean Fract Soc 2022;35(2):57-62. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.57

Abstract PDF: Purpose
The purpose of this study was to evaluate and compare the clinical and radiological outcomes between locking plates and non-locking plates using posterior anti-glide plating for supination external rotation type lateral malleolar fractures.
Materials and Methods
A total of 50 patients who underwent internal fixation of posterior anti-glide plating due to lateral malleolar fractures, classified as supination-external rotation (SER) as per the Lauge-Hansen classification system, at our hospital from January 2017 to November 2018 were retro-spectively evaluated. Patients were divided into two groups: 1/3 semi-tubular locking plate (24 patients) and 1/3 semi-tubular non-locking plate (26 patients). A radiographic assessment was performed after surgery to evaluate the time of bone union. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional score was measured after the surgery to evaluate the clinical outcomes.
Results
The two groups showed similar distributions in sex, age, height, body mass index, fracture pattern, and mean follow-up period. Complete bone union was obtained in all cases and the mean bone union time was 13.00±3.38 weeks in Group 1 and 12.92±3.26 weeks in Group 2 (p=0.87). The mean AOFAS score at 24 weeks was 95.66±2.86 in Group 1 and 95.84±2.79 in Group 2 (p=0.82). The mean AOFAS score at 48 weeks was 97.25±3.54 in Group 1 and 96.57±3.07 in Group 2 (p=0.47). Two cases of complications were observed in the non-locking plate group.
Conclusion
For the treatment of Lauge-Hansen SER type lateral malleolar fracture, internal fixation us-ing locking 1/3 semi-tubular plate and non-locking 1/3 semi-tubular plate are both favorable fixation methods.

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Comparison of the Results between Plating and Intramedullary Nailing for Ipsilateral Fibular Fractures in Pilon Fractures: Yong Jin Cho, Jun Young Lee, Jae Hwan Lim, Je Hong Ryu, Jung Ho Lee; J Korean Fract Soc 2021;34(3):97-104. Published online July 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.3.97

Abstract PDF: Purpose
To compare the results between plating and intramedullary nailing for ipsilateral fibular fractures in pilon fractures.
Materials and Methods
Among 124 patients with pilon fractures from November 2008 to March 2019, 50 patients with a fibular fracture were studied retrospectively and divided into two groups: Group A using a plate and Group B using a Rush pin. The radiological tests confirmed the fracture pat-terns (Rüedi–Allgöwer classification, AO/OTA classification) and evaluated the degree of reduction of fibular and tibial fractures after surgery. The American Orthopaedic Foot & Ankle Society (AOFAS) was examined for a clinical evaluation, and the complications were checked.
Results
The two groups showed similar distributions in gender, age, injury mechanism, diabetes, smoking, mean follow-up period, Rüedi–Allgöwer classification, AO/OTA classification, and open fracture. The fibular fractures were classified as simple, wedge, multiple, and segmental, showing significant differences between the two groups (p=0.03). There was no difference in the Talocrural angle, Shenton line, and Dime sign. In the reduction of pilon fractures, the appropriate reduction was obtained in 22 cases (88.0%) for both groups. The AOFAS averaged 83.24 in Group A and 80.44 points in Group B, showing no significant difference in complications (nonunion, malunion, infection, and arthritis).
Conclusion
Regardless of how the fibular fracture was fixed, the reduction of pilon fractures in both groups showed good results. Both intramedullary nail and plate fixation could be a suitable fixation method for ipsilateral fibular fractures with a low risk of shortening in pilon fractures.

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Treatment of the Femoral Fracture Using Sirus(R) 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; J Korean Fract Soc 2015;28(2):103-109. Published online April 30, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.2.103

Abstract PDF: PURPOSE
The purpose of this study is to analyze the clinical results of fixation using Sirus(R) nail in patients with femoral subtrochanteric and shaft fracture and the difference in the frequency of complications according to the entry portal.
MATERIALS AND METHODS
From July 2006 to August 2013, at least 1-year clinical follow-up, we retrospectively analyzed 36 cases with femoral subtrochanteric (15 cases) and shaft fracture (21 cases) who underwent surgery using Sirus(R) nail. We reviewed the records of operation time, intra-operative amounts of bleeding and complications. At last follow-up, we reviewed clinical results by Ray-Sanders criteria and analyzed the periods of bone union on the radiograph. We also measured changing of the femoral neck-shaft angle in the subtrochanteric fractures and angulation in the shaft fractures, respectively. Considering anatomical variation of the trochanter and fracture position of subtrochanteric and femoral shaft, entry points were divided into subgroups, and the clinical results were compared.
RESULTS
The mean Ray-Sanders score was 27.4, 27 cases (75.0%) were good or excellent. The mean periods of bone union was 21.1 weeks in 31 cases. The mean neck-shaft angles were 135.7o preoperatively, 130.2o postoperatively. The mean angulation of the femur was 24.4o preoperatively, 2.4o postoperatively in patients of femoral shaft fractures. Despite no statistical significance, greater trochanter tip entry point and lateral entry point had a higher rate of frequency than medial entry point, with respect to the occurrence of iatrogenic fracture and malalignment.
CONCLUSION
Using Sirus(R) nail for femoral subtrochanteric and shaft fractures showed good clinical and radiographic results and a high rate of union. Medial entry point yielded slightly better results in the occurrence of iatrogenic fracture and malalignment, compared to greater trochanter tip entry point and lateral entry point.

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Impacted Cancellous Allograft and Valgus Fixation of Intertrochanteric Fracture Nonunion: Soon Yong Kwon, Young Kyun Woo, Jong Min Sohn, Jin Hwa Chung, Jung Ho Lee, Yong Sik Kim; J Korean Soc Fract 2002;15(1):65-71. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.65

Abstract PDF: PURPOSE
The aim of this study was attempted to evaluate the effects of impacted cancellous allograft and valgus fixation in the management of nonunion of intertrochanteric fracture of the femur.
MATERIALS AND METHODS
Between June 1995 and October 1999, 5 patients, ranging from 38 to 75 years of age, with nonunion of femoral intertrochanteric fracture, whose primary treatment had been done with compression hip screws, were treated with impacted cancellous allograft and valgus fixation RESULTS: After follow-up from 13 months to 24 months, among the 5 cases, 4 cases resulted in the union in a mean time of 16 weeks, improvement of LLD in a mean length of 0.8cm and good function of abduction, but 1 case resulted in nonunion, followed by total hip arthroplasty.
CONCLUSION
For patients with nonunion of femoral intertrochanteric fracture, impacted cancellous allograft and valgus fixation provide a good result of union.

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