Journal of Musculoskeletal Trauma

Use of Composite Wiring on Surgical Treatments of Clavicle Shaft Fractures: Kyung Chul Kim, In Hyeok Rhyou, Ji Ho Lee, Kee Baek Ahn, Sung Chul Moon; J Korean Fract Soc 2016;29(3):185-191. Published online July 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.3.185

Abstract PDF: PURPOSE
To introduce the technique of reducing displaced or comminuted clavicle shaft fracture using composite wiring and report the clinical results.
MATERIALS AND METHODS
Between March 2006 and December 2013, 31 consecutive displaced clavicle fractures (Edinburgh classification 2B) treated by anatomic reduction and internal fixation using composite wiring and plates were retrospectively evaluated. The fracture fragments were anatomically reduced and fixed with composite-wiring. An additional plate was applied. Radiographic assessments for the numbers of fragments, size of each fragment and amount of shortening and displacement were performed. The duration for fracture union and complications were investigated retrospectively. The mean fallow-up duration was 15.9 months.
RESULTS
The mean number of fragments was 1.7 (1-3) and the mean width of fracture fragment was 7.1 mm (4.5-10.6 mm). The mean shortening of the clavicle was 20.5 mm (10.3-36.2 mm). The mean number of composite wires used in fixation was 1.9 (1-3). Radiographic union was achieved in all patients with a mean time to union of 11.6 weeks. There were no complications including metal failure, pin migration, nonunion, or infection.
CONCLUSION
The composite wiring was suitable for fixation of small fracture fragment and did not interfere with the union, indicating that it is useful for treatment of clavicle shaft fracture.

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Scapholunate Dissociation Associated with Intra-articular Fractures of Distal Radius: Bon Seop Koo, Kyung Chul Kim, Hun Kyu Shin, Jin Heon Kwak; J Korean Soc Fract 2001;14(4):733-738. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.733

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the risk factors in the occurrence of scapholunate dissociation in relation to the intra-articular fracture of distal radius.
MATERIALS AND METHODS
We performed a retrospective evaluation of 170 cases of the fractures. Average age was 52 years(range, 24-85 years). We reviewed both medical records and radiographic films and analyzed the data according to age, width of the medullary cavity of the third metacarpal bone and fracture morphology.
RESULTS
Nine cases(5.3%) of scapholunate dissociation, mean age of 56 years, all had widened medullary cavity, radial styloid process fracture with radial displacement, a vertical fracture line invading articular surface, depression of scaphoid facet(6 cases) and lunate facet(3 cases). Degree of fracture displacement was not significant.
CONCLUSION
In distal radius intra-articular fracture which occurred in old patient with widened metacarpal medulla and had a radially displaced radial styloid fracture, an articular surface involving vertical fracture line and a depression of scaphoid or lunate facet, we should be careful in the concurrence of scapholunate dissociation.

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The Angular Deformity of Interlocking Nailing in Tibial Fractures: Hwa Jae Jeong, Kyung Chul Kim, Jae Yeul Choi, Bon Seop Koo, Jung Hee Oh; J Korean Soc Fract 2000;13(4):905-911. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.905

Abstract PDF: PURPOSE
We studied the relationship between angular deformity and possibly contributing factors in the treatment of tibial fractures with interlocking nailing.
MATERIALS AND METHODS
Intramedullary nailing of the tibia was performed on 49 cases and were followed for the minimum of 12 months. We analyzed relationship between angular deformity and postoperative tibial alignment, operative technique and other factors.
RESULTS
Of the 49 cases, 19(38%) were angulated. Angular deformity was seen in 60%, 51.8% and 11.8% in the proximal, distal and middle third of tibial fractures respectively. With AO classification, Group A,B,C were angulated in 32.4%, 55.6%, 66.7%. In group A, 43.8% of spiral fractures, 28.6% of oblique fractures and 14.3% of transverse fractures were angulated. The cases combined with fibular fracture showed higher incidence of angular deformity than the cases with intact fibula. The opening of fracture and the nail insertion site were not significant to angular deformity.
CONCLUSION
Angular deformity of interlocking nailing in tibial fractures were more common in proximal, comminuted and spiral fractures. Precise attentions to operative technique i. e. accurate anatomical reduction and centromedullary nail orientation are recommended to prevent angular deformity. In proximal third tibial shaft fractures where muscles and patellar tendon has deforming force on fracture fragment, authors believe that use of interlocking nailing must be limited with fracture pattern.

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The Treatment of Femur Fractures in Neonates with a Pavlik Harness: Two Cases Report: Bon Seop Koo, Kyung Chul Kim, Ji Hyo Hwang; J Korean Soc Fract 2000;13(4):1033-1037. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1033

Abstract PDF: Femur fractures during birth are very rare and the treatment of the fractures is variable. Pavlik harness is available in the treatment of the femur fractures in infants but any literature on the treatment of the birth fractures of femurs can not be found as far as we know. We experienced two cases of femur fractures in neonates treated with Pavlik harness and present them with a review of the literature.

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Analysis of result of operative treatment for distal radius fracture: Jae Yul Choi, Kyung Chul Kim, Kyung Ho Kim; J Korean Soc Fract 2000;13(2):338-342. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.338

Abstract PDF

PURPOSE
: This study was performed to compare and analyze the result of operative treatment of each type of distal radius fracture.
MATERIALS AND METHODS
: From June 1995 to December 1998, operative treatment for 78 cases of distal radius fracture were performed. According to Fernandez classification of distal radius fracture, there were 31 Type III fractures, 28 Type I fractures. Mean follow up period was 23months and result was assessed according to scoring system of Sarmiento et al.
RESULT
: Excellent to good result were obtained 71.4% in Type I, 100% in Type II, 77.4% in Type III, 100% in Type IV, 50% in Type V.
CONCLUSION
: We obtained good result for Type I, II, III, IV with several operative method but complex method for Type V was not satisfactory.

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Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate
Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef
Comparison of Operative Management in Distal Radius Fractures Using 3.5 mm Versus 2.4 mm Volar Locking Compression Plates
Sung-Sik Ha, Tae-Ho Kim, Ki-Do Hong, Jae-Chun Sim, Jong Hyun Kim
Journal of the Korean Fracture Society.2011; 24(2): 156. CrossRef

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Treatment of Comminuted Supracondylar and Intercondylar Femoral Fractures with AO Dynamic Condylar Screw: Kyung Chul Kim, Jae Yeul Choi, Hwa jae Jeong, Bon Seep Koo, Kyung Ho Kim; J Korean Soc Fract 1999;12(2):253-258. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.253

Abstract PDF: Between 1990 and 1995, 22 comminuted supracondylar and intercondylar femoral fractures in 22 patients were treated with the AO dynamic condylar screw(DCS). Minimum twelve months of clinical and radiographic follow-up evaluation were available on all patients. All cases achieved clinical and radiographic bony union. Functional results were graded using a Schatzker and Lambert's criteria. Results were seen to be excellent to good to fair in 100% of A2 cases, 86% of C2 cases, 75% of A3 cases and 67% of C3 cases. The more comminuted fractures were found to have worse clinical results and more radiographic malunion. The ability to obtain good fixation in osteoporotic bone is distinct advantage of the DCS. The results of DCS fixation compare favorably with previous studies using other fixation devices in comminuted supracondylar and intercondylar femoral fractures

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Bipolar Hemiarthroplasty for the Treatment of Displaced Femoral Neck Fracture in Elderly Patients: Uncemented versus Cemented femoral stems: Jae Yeul Choi, Kyung Chul Kim, Hwa Jae Jeong, Bon Seop Koo, Ho Joong Lee; J Korean Soc Fract 1999;12(2):195-202. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.195

Abstract PDF: Forty five patients above the age of 60 with displaced femoral neck fractures were treated by bipolar hemiarthroplasty in Kangbuk Samsung hospital from January 1990 to January 1995. We evaluated these patients for comparison of the results between the cemented and uncemented femoral fixation, especially in elderly patients with medical illness or osteoporosis. During a follow up period of more than two years, the authors found less thigh pain(5.2% versus 38%) and slightly higher Harris hip scores(84.5 versus 80.0 points) in the cemented group in comparison with the uncemented group. Radiographic examination showed less radiolucent zones in the cemented group. Comparing the operative time(86.2 versus 83.8 minutes), hospital stay(4.7 weeks versus 5.3 weeks), blood loss(385 versus 381 ml) during the operation. The postoperative mortality rate was 2%, and the follow-up mortality rate was 11% in the first year. There was no significant difference between two groups in mortality rate. Thus in bipolar hemiarthroplasty in elderly patients with displaced femoral neck fracture, we have obtained satisfactory results despite of poor bone condition and osteoporosis except thigh pain. But the follow up period was too short to assess the late complications of the hemiarthroplasty such as acetabular erosion, implant loosening, so long-term follow up will be necessary

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AClinical Resutlt of Modified Phemister Method for Acute Acromioclavicular Dislocation: Duk Yun Cho, Jae Hwa Kim, Kyung Chul Kim; J Korean Soc Fract 1998;11(4):947-952. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.947

Abstract PDF: There are many procedures for the treatment of acute A-C injury which have many complic ation such as limitation of shoulder motion, post traumatic arthritis and recurrence of dislocation etc. From July 1992 to June 1996 at National Medical Center, 21 patients with A-C injury had been treated by modified Phemister operation. The mean follow up time was 14.6 months. The following results are obtained. 1. There was no limitation of shoulder motion in 20 cases. 2. The comparison of coraco-clavicular distance after surgery ( 2.24 mm ) with that of fallow up ( 3.95 mm ) showed no significant difference. 3. Clinical resuls showed that good in 18 cases, fair in 2 cases, poor in 1 case. From the above result, we suggest that Modified Phemister method is simple and good procedure in the treatment of acute A-C dislocation.

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Treatment of the Posterior Malleolar Fracture: Hwa Jae Jeong, Kyung Chul Kim, Seoung Woo Chung; J Korean Soc Fract 1998;11(4):924-931. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.924

Abstract PDF

Posterior malleolar fractures are usually caused by an abduction or external rotation injury. indications for open reduction of the posterior malleolar fracture depend on its size and the amount of displacement. If the fragment of the posterior malleolus involves more than 25% to 30% of the articular surface, it should be treated by anatomical reduction and internal fixation. Authors analysed twenty-three patients of ankle fractures with the posterior malleolar fractures who were treated in Kangbuk Samsung Hospital between March 1993 and March 1997. Thirteen patients whose posterior malleolar fracture involved less than 30% of articular surface were treated conservatively (Group 1), while ten patients with involvement of more than 30% of articular surface were treated by open reduction and internal fixation. Among the ten patients treateed by open reduction, the five patients were indirectly fixed through anterior approach (Group 2), another five patients were directly fixed through posterior approach (Group 3). In group 1, the patients whose opsterior malleolus involved more than 25% of articular surface have unsatisfactory results compared to patients whose posterior malleolus involved less than 25% of articular surface(P<0.04). The results of the treatment were better in those directly fixed through posterior appproach than in those indirectly fixed through anterior approach regardless of size of the fragment(P<0.05).

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Treatment of the Trimalleolar Fracture Using Posterolateral Approach: Minimum 2-year Follow Up Results
Gwang Chul Lee, Jun-Young Lee, Sang-Ho Ha, Jae-Won You, Sang-Hong Lee, Hong-Moon Sohn, Ki-Young Nam, Kwang-Hyo Seo
Journal of the Korean Fracture Society.2011; 24(4): 328. CrossRef
The Treatment of Posterolateral Malleolar Fractures using Percutaneous Reduction Technique
Jae-Sung Lee, Han-Jun Lee, Jae-Hyun Yoo, Hee-Chun Kim
Journal of the Korean Fracture Society.2009; 22(1): 19. CrossRef
Treatment of the Posterior Malleolar Fragment of Trimalleolar Fracture Using Posterolateral Approach - Preliminary Report -
Jun-Young Lee, Sang-Ho Ha, Kyung-Hwan Noh, Sang-Jun Lee
The Journal of the Korean Orthopaedic Association.2009; 44(4): 422. CrossRef
Radiologic Analysis and Treatment of Posterior Malleolar Fractures of the Ankle
Jae Sung Lee, Soo Yong Kang, Han Jun Lee, Young Bong Ko
Journal of the Korean Fracture Society.2009; 22(2): 98. CrossRef

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Clinical Results of Locked Unreamed Nailing in Tibial Shaft Fractures: Duck Yun Cho, Hee Chun Kim, Kyung Chul Kim; J Korean Soc Fract 1997;10(3):575-582. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.575

Abstract PDF: We reviewed the results of the treatment of 23 tibial shaft fractures in 22 patients by primary unlearned locked intramedullary nailing. The duration of follow-up was average 10.1 months (range, from 6 to 27 months). The results were as follows : 1. There were 11 open and 12 closed fractures. 2. All fractures united clinically in an average time of 17.9 weeks(range 10 to 26 weeks), and radiologically in an average time of 19.4 weeks (range, 10 to 31 weeks). 3. Complications included 1(4.3%) case with delayed union and 3(13.0%) cases with malunion. 4. No patient had deep infection and there were no broken nails or screws in this series. 5. No fracture refuired an additional procedure before union, such as dynamization or bone graft.

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Neural Injuries in Elbow Fracture in Children: Kyung Chul Kim, Bon Sub Koo, Hae Du Sung; J Korean Soc Fract 1997;10(2):388-392. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.388

Abstract PDF: Due to the unique anatomical characteristics of elbow, it is well known that fracture involving elbow joint, relatively common in children, frequently accompanies nerve injuries. In recent studies, most of these injury are reported to be resolved within average 2~3months spontaneously. The authors reviewed 91 elbow fractures revealing 9 neural injuries in children at Kangbuk Samsung Hospital from January 1990 to December 1995 retrospectively. These injuries occurred in 9 patient whose age ranged from 5~8 years. The overall incidence of neural injuries appeared to be around 9.8%. There were three radial, three ulnar, two interosseous, one median neuropathies detected. Two of the ulnar nerve injuries were iatrogenic, resulting from closed reduction and percutaneous pinning. All of the deficit, resolved spontaneously within a range 1~7 months(average 2.6months).

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Operative Treatment of the Tibial Condylar Fracture: Kyung Chul Kim, Jae Yeul Choi, Joon Sik Kim, Young Soo Jhe, Sang Yuon Woo; J Korean Soc Fract 1996;9(2):431-438. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.431

Abstract PDF: The tibial condylar fractures often produce disabilities of the knee joint because it is frequently accompanied by injuries of the ligaments and the menisci. Schatzker had reported that the most common type of the tibial condylar fracture was pure central depression, but we have obtained the result that the most common one of these fractures is cleavage combined with depression and satisfactory outcome. We have analyzed 28 cases of the tibial condylar fractures treated by operative method at the department of the orthopaedic surgery, Kangbuk Samsung hospital from Jan. 1990 to May 1994. We obtained the results as follows; 1. Males were predominant and the patients mean age was 42 years. 2. The most common cause of injuries was pedestrian traffic accident. 3. The most common fracture type according to Schatzkers classification was type II, which was different from the result of Schatzker. 4. We have obtained 68% of acceptable results bu Porters criteria.

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Treatment of the Pediatric Ankle Fracture: Kyung Chul Kim, Jae Yeul Choi, Joon Sik Kim, Young Soo Jhe, Beoung Chul Yun; J Korean Soc Fract 1996;9(2):341-348. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.341

Abstract PDF

The objectives of this study is to evaluate the incidence and the complicated results of pediatric ankle fracture. The injuries of the ankle in children occur mostly at physis rather than ligamentous structure, and the injuries of the physis may result in arrest of the growth of physis and these may lead to angular deformity, joint incongruity, and growth disturbance, which are frequently reported in the literatures. Accurate treatment under the clear understanding of mechanism of injury in very important for preventing this complications. We reviewed 17 cases of pediatric ankle fracture, from June 1990 to June 1994 and followed up for more than 1 year at department of orthopaedic surgery Kangbuk Samsung Hospital. We could obtain results as follows; 1. The mean age was 1 1 years old, and predominant in male. 2. Sports injury was the most common cause. 3. According to modified Dias and Tachdjan classification, supination inversion type was the most common and according to Salter Harris classification, type II was. 4. Eight cases were treated by closed reduction and immobilizatior in a plaster cast, and other nine by open reduction and internal fixation, among them, three cases had complications, such as angular deformity, Joint incongruity, and premature closure of physis.

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Interposition of Periosteum in Distal Tibial Physeal Fractures of Children
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Jae Woo Cho
Journal of the Korean Fracture Society.2011; 24(1): 73. CrossRef

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Treatment of Lateral Humeral Condylar Fractures in Children using Closed K-wire Fixation and Intraoperative Arthrogram: Chung Soo Hwang, Kyung Chul Kim, Phil Hyun Chung, Suk Kang, Eung Nam Cha, Yong Min Kim, Young Un An, Min Hyo Park; J Korean Soc Fract 1995;8(1):116-125. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.116

Abstract PDF: Lateral condylar fracture of humerus is the secondly most common elbow injury in childhood. Compared to the most common supracondylar fracture which is fracture of metaphysis around olecranon fossa, lateral condylar fracture is intraarticular, epiphyseal injury and easily displaced by extensor muscle pull. Therefore, lateral condylar fractures are reduced and fixed more frequently by open method than supracondylar fractures are. In spite of affording more accurate reduction, however, open treatment of fracture can be complicated by infection, avasular necrosis, disfiguring scars, etc. So, it is more desirable that accurate reduction and rigid fixation can be achieved by closed method. Sine July 1992, We manged 10 children with lateral condylar fractures of elbow using closed reduction, percutaneous K-wire fixation and intraoperative arthrogram for confirming the reduction status of articular margin. The fractures united and K-wires were removed within postop. 7 weeks(mean) in all cases. The patients were followed up for from 9 months to 2 years and 2 months postoperatively, revealed no great differences in carrying angle, range of motion and physical activity compared with contralateral elbow. Radiologic evaluation showed no definite complications except mild spur formation. Closed reduction and fixation followed by intraoperative arthrogram seemed tobe one of the useful method in the management of lateral humeral condylar fractures in children, especially in mildly displaced cases.

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The Type and Treatment of Elbow Fractrue in Children: Kyung Chul Kim, Jae Yeul Choi, Joon Sik Kim, Ahn Seok Choi; J Korean Soc Fract 1994;7(1):37-42. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.37

Abstract PDF

The elbow fractures in children are extremely common and sometimes its are quite difficult to determine the diagnosis. Failure to diagnose adequately and treat fractures of the elbow In children may result in severe complications, such as Volkmanns ischemec contracture, nerve injuries and angular deformity Therefore, accurate reduction without additional trauma and good maintenance are essential by closed or open method. A cllnical analysis was performed on 162 patients with elbow fractures and dislocations in Koryo General Hospital from Jan. 1985 to Jan. 1992. 1. The average age of children was 6 years 9 months, and sex ratio was predominently male(3:1) 2. The most common mechanism was fall from height in 142 cases(88%). 3. Fractures of supracondyle in children was common injuries of the elbow ; 89 cases(55%). 4. Although minimally dlsplaced lateral condyle fracture, the accepted method of treatment was open reduction.

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The Amount of Stemflow and Throughfall by the Rainfall in Pinus densiflora Forests
Kyoung-Jin Kim, Kun-Woo Chun, Tsugio Ezaki, Shoji Inoue
Journal of Rainwater Catchment Systems.2000; 5(2): 13. CrossRef

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