Journal of Musculoskeletal Trauma

Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture: Jong Min Lim, Jeung Il Kim, Jong Seok Oh, Kuen Tak Suh, Jae Min Ahn, Dong Joon Kang; J Korean Fract Soc 2010;23(4):360-366. Published online October 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.4.360

PURPOSE
To evaluate the radiologic, clinical results between who had intertrochanteric fracture, treated with Compression Hip Screw (CHS) and Proximal Femoral Nail Antirotation (PFNA).
MATERIALS AND METHODS
We retrospectively reviewed each 36 and 48 patients of intertrochanteric fracture which were treated with CHS or PFNA by one surgeon from January 2005 to June 2009. We evaluated mean operation time, amount of bleeding, radiologic results, and the clinical outcomes with the mobility score of Parker and Palmer, social function scoring system.
RESULTS
The mean operation time, amount of bleeding were less in the PFNA group, there were 116.7 min, 486.1 ml for the CHS group versus 87.7 min, 289.6 ml for the PFNA group. The radiologic results were not significantly different. Decrease of mobility score of Parker and Palmer, social function score were similar. Proximal migration of leg screw and perforation of femoral head was 2 case and deep infection was 1 cases in CHS group.
CONCLUSION
There were no significant differences that are clinical and radiological results in treatment of intertrochanteric fracture using the CHS and PFNA. But PFNA is less invasive device than CHS, therefore it may be useful device in elderly patients.

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Chronic kidney disease patients with intertrochanteric fracture have a high mortality rate
Tae Woo Kim, Sang-Min Lee, Nam Hoon Moon, Won Chul Shin
Injury.2021; 52(8): 2350. CrossRef
Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients
Sung-Hwan Kim, Soo-Won Lee, Gyu-Min Kong, Mid-Um JeaGal
Hip & Pelvis.2012; 24(1): 45. CrossRef
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
A Comparison of Intramedullary and Extramedullary Fixations for the Treatment of Reverse Oblique or Transverse Intertrochanteric Femoral Fractures
Yerl-Bo Sung, Jung-Yun Choi, Eui-Yub Jung
Hip & Pelvis.2012; 24(2): 109. CrossRef

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Alterations in Serum Levels of Receptor Activator of Nuclear Factor-kappa B Ligand and Osteoprotegerin in Patients with Head Injury and Fracture: Shin Young Park, Kuen Tak Suh, Chang Hoon Ryu, Seung Hun Woo, Jung Sub Lee, Seong Gang Kim; J Korean Fract Soc 2008;21(2):145-150. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.145

Abstract PDF

PURPOSE
Receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG) have been shown to be important regulators of osteoclastogenesis during bone remodeling, and their expressions were examined during fracture healing in a mouse model of tibial fracture. However, studies linking RANKL and OPG in patients with head injury and fracture are lacking. We evaluated the changes in serum levels of RANKL and OPG in patients with head injury and fracture (head injury group) and in patients with fracture (fracture group) and compared these with levels found in healthy control subjects.
MATERIALS AND METHODS
18 male patients of head injury and fracture and 20 male patients of fracture alone were enrolled. 20 healthy men were recruited to serve as controls. Within the first few hours of admission to hospital, at 4, 8 and 12 weeks after injury 20 ml of blood were obtained from 18 patients with head injury and fracture and 20 patients with fracture only.
RESULTS
RANKL levels were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury. OPG levels were significantly higher in the head injury group than in the fracture group at 4, 8 and 12 weeks after injury. RANKL/OPG ratios were significantly lower in the head injury group than in the controls immediately after and 4, 8 and 12 weeks after injury, and were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury.
CONCLUSION
We have shown changes in the profiles of RANKL, OPG and RANKL to OPG ratio. The altered RANKL, OPG and RANKL/OPG ratio in the head injury group lasted longer than in those of the fracture group.

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Affirmative Effect of Hwaweo-jeon (Huayu-jian) in Osteoblast Cells and Tibia Fracture-induced Mice
Soo-Hwan Lee, Kira Parichuk, Yun-yeop Cha
Journal of Korean Medicine Rehabilitation.2020; 30(1): 13. CrossRef

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The Treatement of the Unstable Proximal Humerus Fracture Using Bifurcate Angled Blade Plate with Tension Band Wiring: Kuen Tak Suh, Hyoung Lok Roh, Myung Soo Youn, Jung Sub Lee; J Korean Fract Soc 2006;19(4):424-430. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.424

Abstract

PURPOSE
To evaluate the results of internal fixation with bifurcate angled blade plate and tension band wiring of greater tuberosity or rotator cuff for the unstable proximal humerus fracture.
MATERIALS AND METHODS
Nineteen cases of unstable proximal humerus fracture who were followed up for more than 1 year were treated using bifurcate angled blade plate and tension band wiring between March 2003 and March 2005. Average age of the patients was 46.5 years (range, 24 to 69), and there were 9 male and 10 female patients. The radiological results were evaluated by bony union and neck shaft angle. In addition, the clinical results were evaluated by Neer's evaluation criteria.
RESULTS
In 18 out of 19 cases, bony union was obtained in average 12.5 weeks after operation. The neck shaft angles of sixteen cases were between 120 and 140 degrees by Paavolainen method. According to Neer's evaluation criteria, 17 cases showed excellent or good results.
CONCLUSION
The patients treated using bifurcate angled blade plate and tension band wiring could exercise earlier because of good initial stability. Also, the radiological and clinical results were relatively good. The treatment of unstable proximal humerus fracture with bifurcate angled blade plate and tension band wiring was considered as a good method.

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Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures
Chung Hee Oh, Joo Han Oh, Sae Hoon Kim, Ki Hyun Jo, Sung Woo Bin, Hyun Sik Gong
Journal of the Korean Fracture Society.2008; 21(3): 213. CrossRef

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Malalignment of Tibial Fracture Following Interlocking Intramedullary Nailing: Seung Wook Yang, Hyung Taek Park, Kuen Tak Suh; J Korean Soc Fract 2000;13(2):236-243. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.236

Abstract PDF: PURPOSE
: The purpose of this study was to evaluate the incidence and the factors that influence on malalignment following interlocking nailing for tibial fracture.
MATERIALS AND METHODS
: The authors analysed 59 patients, 60 cases tibial fracture treated with interlocking intramedullary nailing from 1993 to 1997 about nail insertion site, nail entrance angle and fracture type with roentegenogram. Malalignment was defined as 5 degree or more angular deformity in varus-valgus, 10 degree or more angular deformity in anterior-posterior plane.
RESULTS
: Malalignment was found in 15 cases out of 60(25%). We found malalaignment in 7 cases out of 11(64%)in proximal fracture, 6 cases out of 29(21%) in middle fracture, 2 cases out of 20(10%) in distal fracture(p<0.001). Correlation between nail insertion site or medial entrance angle and angular deformity was higher in proximal fractures. In midshaft wedge fractures, direction of main fragment influenced on the axial alignment.
CONCLUSION
: Centromedullary nail orientation is required to prevent malalignment after interlocking intramedullary nailing. Precise selection of nail insertion site and nail entrance angle under the C-arm control in proximal tibial fracture is necessary. Fracture type and fragment direction must be considered during tibial nailing in comminuted tibial fracture.

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Severe Comminuted and Displaced Patellar Fracture Treated by Partial or Total Patellectomy: Kuen Tak Suh, Taek Geon Lee, Weon Wook Park, Chong Il Yoo, Kyu Yeol Lee, Bu Hwan Kim; J Korean Soc Fract 1997;10(4):851-859. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.851

Abstract PDF: The results of partial and total patellectomy as a treatment for severe comminuted and displaced patellar fracture were assessed retrospectively with the use of clinical criteria and radiologic findings. Sixteen patients treated with patellectomy(four total and twelve partial patellectomies) were followed up for an average of 3 years 4 months and valuated. According to the Bostmans fracture classification, there were type I In 5 cases(31%), type II in 7 cases(44%), and type III in 4 cases(25%). The results of the patellectomy were relatively good since excellent result was shown in 11(69%) among 16 cases. The comparison between partial and total patellectomy was difficult because the fracture patterns treated by these techniques were different. In this study, the result of the partial patellectomy was better than that of the total patellectomy, but their difference was not statisticaliy significant(P>0.05). The results of the study indicated that partial or total patellectomy could be one of the effective treatment methods for severe comminuted and displaced patellar fracture. However total patellectomy should be recommended only when the entire patella was too severely comminuted to function as a part of the extensor mechanism of the knee.

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Multiple Pinning in Femoral Neck Fractures: Kuen Tak Suh, Taek Geon Lee, Chang Il Yoo; J Korean Soc Fract 1997;10(4):727-737. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.727

Abstract PDF: The incidence of femoral neck fracture has steadily increased with lengthening of the average life span. The end results of treatement have been improving with the development of internal fixation devices. However, the anatomic characteristics of femoral neck has made the complications of nonunion and avascular necrosis as a common result. Authors analysed 47 patients, with over 2 years follow-up on an average, who were more than twenty years old and treated with multiple Knowles pins or cannulated screws during the period from February 1988 to February 1994. Following results were obtained. 1. Among 47 patients, 23 cases(49%) were male and 24 cases(51%) were female. The highest incidence was found in the sixth decade. 2. The most common cause of femoral neck rracture was slip down(55%). 3. According to the Gardens classification, the displaced fracture(Garden stage III and IV) was more common (68%), and according to the anatomic classification, transcervical type was the most common (40%). 4. Among 47 patients, there were 1 case of nonunion(7%) and 2 cases of avascular necrosis of femoral head(13%) in the nondisplaced fractures(15 cases), compared to 6 cases of nonunion(19%) and 8 cases of avascular necrosis of femoral head(25%) in the displaced fractures(32 cases). There were 4 cases of nonunion(15%) and 5 cases of avascular necrosis of femoral head(19%) among the 26 patients treated with multiple Knowles pins, compared to 3 cases of nonunion(14%) and 5 cases of avascular necrosis of femoral head(28%) among the 21 patients treated with cannulated screws. 3 cases of nonunion(10%) and 4 cases of avascular necrosis of femoral head(13%) were developed among 30 cases in which acceptable reduction was achieved after closed reduction. 4 cases of nonunion(24%) and 6 cases of avascular necrosis of femoral head(35%) were developed among 17 cases in which poor reduction was achieved. 11 cases(42%) were complicated among 26 cases below Singh index grade 3 and 6 cases(29%) were complicat among 21 cases above Singh index grade 4. 5. Factors that may affect the success of treatment in femoral neck fracture are not the type of internal fixation device used, but rather anatomic site of fracture, the degree of displacement, degree of osteoporsis and accuracy of reduction.

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Patellectomy and Rehabilitation: Kuen Tak Suh, Seung Wook Kim; J Korean Soc Fract 1996;9(4):850-858. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.850

Abstract PDF: No abstract available.

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Concomitant Ipsilateral Femoral Neck and Shaft Fractures: Kuen Tak Suh, Sang Jin Cheon, Chong Il Yoo; J Korean Soc Fract 1996;9(2):458-465. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.458

Abstract PDF: Concomitant ipsilateral fractures of the femoral neck and shaft are rare, and present diagnostic difficulties and complex choices as to treatment. At the Department of Orthopedic surgery, Pusan National University Hospital, from April 1987 to June 1998, 18 cases of the concomitant ipsilateral fractures of the femoral neck and shaft had been treeated and followed up for 48.7 months in average (ranging from 12 months to 89 months). Initially one case of the femoral neck fracture was missed, which was a non-displaced fracture. Femoral reck fractures were treated with multiple screws or pins in all cases except two cases treated with recon struction nail. For the femoral shaft fractures, plate and screws were applied in 12 cases, Ender nails in three cases, reconstruction nail in two cases and skeletal traction in one case. Nonunion of femoral shaft fracture was developed in one case treated with skeletal fraction, metal loosening in one case treated with Ender nails, and limited motion of the knee in three cases which had knee injuries. But in our cases, avascular necrosis of femoral head and nonunion of the femoral neck and metal failure were not developed. The key factors of successful treatment for concomitant ipsilateral fractures of the femoral neck and shaft seemed to be careful evaluation of the associated hip injures in felnoral shaft fracture and early anatomical reduction and rigid fixation of fractures with early motion of joints.

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Injuries of the Tarsometatarsal Joint: Chong Il Yoo, Jeung Tak Suh, Kuen Tak Suh, Yong Jin Kim, Hui Taeg Kim, Kie Bong Wang; J Korean Soc Fract 1992;5(2):219-226. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.219

Abstract PDF: Because of the anatomical configuration of the tarsornetatarsal joints with their strong ligmanet connections, the injries in this regicon are rare. But the injury is associated with a high potential for chronic disability.Authors reviewed and clinically analysed 18 cases of tarsometatarsal joint injuries which were followed more than one year at the orthopedic department of Pusan National University durging the period from January 1986 to December 1990. The results were as follows ; 1. The incidence was higher in male and young active age group. 2. The most common cause of the injury was traffic accident (50.0%). 3. Tarsal and metatarsal fractures were commonly combined (61.1%) 4. The most frequent injury type by Hardcastles classification was total inconjgrulty type (55.5%). 5. Overall result estimated by Hardcastles criteria was good in 5 cases (27.8%), fair in 8 cases (44.4%), and poor in 5 cases (27.8%). 6. The causes of poor resulted cases were severe crushing injury, inadequate anatomical reduction, delayed treatment due to combind injury and loss of medial longitudinal arch. 7. Late complications such as traumatir arthrltis, paln and foot deformity were seen more than half of the cases.

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A Clinical Study of Proximal Humeral Fractures and Fracture-Dislocations: Chong Il Yoo, Jeung Tak Suh, Kuen Tak Suh, Wan Joo Hong; J Korean Soc Fract 1989;2(1):18-28. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.18

Abstract PDF: A study was made of 39 cases of proximal humeral fractures and fracuture dislocations in adults who had been hospitalized and treated at the Department of Orthopedic Surgery, Pusan National University Hospital, from March 1983 to August 1988. Analysis was based on the age, sex distribution, causes, classification of fracture, associated injuries, treatments, results of treatment and complications. The results obtained were as follows; 1. the age of the patients ranged from 15 to 82 years with a mean of 46.8 years the highest incidence was in the fifth decades and male were affected more frequently than female. 2. The main cause of the fractures was traffic accident 20(51.3%) and the others were slip-down 10(25.6%), fall from a height 8(20.5%) and direct blow 1(2.6%) 3. According to Neers classification, 2-part fracture 28(71.8%) was the most common type and followed by 1-part fracture, head-splitting or head-fragmented fracture, 3-part fracture and 4-part fracture in the order of frequency. 4. Among the 39 cases, 25 cases(64.1%) were treated conservatively an 14 cases(35.9%) operatively. 5. The most common complication was joint stiffness. 6. The results of the cases were rated by the Neers numerical system. Of 39, 14 cases (35.9%) were excellent, 21 cases(53.8%) satisfactory, and 4 cases(10.3%) poor. Most of the poor results were the cases that were immobilized for a long time because of severe comminution, associated injury or poor general condition. It was thought important to allow early motion of joint to obtain a good functional result.

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