Journal of Musculoskeletal Trauma

The Results of Intramedullary Nailing with Sliding Restriction and Dynamization Method in Treating Intertrochanteric Fractures: Hyun Cheol Oh, Sang Hoon Park, Jae Seok Chae, Han Kook Yoon; J Korean Fract Soc 2024;37(1):8-14. Published online January 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.1.8

Abstract PDF: Purpose
To evaluate the results of intramedullary nailing with sliding restriction and dynamization methods in treating intertrochanteric fractures.
Materials and Methods
From August 2016 to March 2019, patients aged 65 years and older who underwent intramedullary nailing in treating intertrochanteric fractures were enrolled in this study. The radiological and clinical results were analyzed in 49 patients who had undergone lag screw sliding re-striction and dynamization of the distal interlocking screw method.
Results
Forty-seven patients achieved union without complications (95.9%). The mean union period was 6.5 weeks (range, 6-9 weeks). Complications occurred in two patients (4.1%), including the cut through of the lag screw in one patient and varus deformity of more than 10° in the other. The preinjury mean Koval grade was 2.8 (range, 1-7). The mean was 3.3 (range, 1-7) at the final follow-up, and the mean difference was 0.5 (range, 0-2).
Conclusion
Intramedullary nailing with a sliding restriction and dynamization method for treating in-tertrochanteric fractures achieved union. The reduction achieved during surgery was maintained with good clinical results. This method is a safe and effective treatment technique for femoral intertrochanteric fractures.

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The Surgical Outcomes for Isolated Greater Tuberosity Fracture of Proximal Humerus: Eun Sun Moon, Myung Sun Kim, Young Jin Kim; J Korean Fract Soc 2007;20(3):239-245. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.239

PURPOSE
To evaluate the adequate surgical methods and postoperative rehabilitation by analyzing the outcome of surgical treatment for isolated greater tuberosity fracture of proximal humerus.
MATERIALS AND METHODS
Ten patients who allowed at least 1 year follow up after the surgical treatment of isolated greater tuberosity fractures were evaluated. Their mean age was 52.3 years (range, 28~67) and mean follow up duration was 23.8 months (range, 12~36). We choosed the different approaches and fixation methods according to size, location and presence of comminution of the fragment, and combined injury. The rehabilitation programs were indivisualized and we evaluated the clinical outcomes using UCLA and Constant scoring system.
RESULTS
According to the UCLA scoring system, 5 cases were excellent, 3 cases were satisfactory, and 2 cases were unsatisfactory. By the Constant scoring system, 8 cases were excellent and 2 cases were good. The average bony union time was 7.6 weeks (range, 6~8) except the 2 cases of revision surgery. Two cases were operated using cannulated screws alone, 3 cases using only nonabsorbable sutures and 5 cases using cannulated screws and nonabsorbable sutures. One out of two revision cases was developed from the negligence of preoperative shoulder anterior dislocation with rupture of subscapularis, and the other was caused by improper immobilization of the fracture site postoperatively.
CONCLUSION
Not only the adequate surgical approaches and the fixation methods according to the size and comminution of fragment, but also the identification of combined injuries were very important in the surgical treatment for the isolated greater tuberosity fracture. And we considered that the adequate postoperative rehabilitation and proper protection based on the intraoperative fixation stability play an important role for the better clinical and radiological outcomes.

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Clinical Features and Characteristics of Greater Tuberosity Fractures with or without Shoulder Dislocation
Dong-Wan Kim, Young-Jae Lim, Ki-Cheor Bae, Beom-Soo Kim, Yong-Ho Lee, Chul-Hyun Cho
Journal of the Korean Fracture Society.2018; 31(4): 139. CrossRef
The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate
Dong-Ju Shin, Young-Soo Byun, Se-Ang Chang, Hee-Min Yun, Ho-Won Park, Jae-Young Park
Journal of the Korean Fracture Society.2009; 22(3): 159. CrossRef

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Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method: Gyu Min Kong, Byoung Ho Suh, Dong Joon Kim; J Korean Fract Soc 2007;20(2):178-183. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.178

Abstract PDF

PURPOSE
To evaluate the result of joint depression type of intraarticular calcaneal fractures treated with Essex-Lopresti method.
MATERIALS AND METHODS
From March 2001 to February 2005, Thirty two patients' joint depression type of intraarticular calcaneal fractures which treated with Essex-Lopresti method were clinically and radiographically evaluated retrospectively.
RESULTS
According to Creighton-Nebraska Health Foundation Assessment Score (C-N score), there were 5 excellent, 11 good, 6 fair and 10 poor results. BÃ¶hler angle was corrected from 10.3 degrees to 24.5 degrees. There was a positive correlation between size of depressed fragment and C-N score (p<0.01).
CONCLUSION
Essex-Lopresti method can substitute open reduction methods in joint depression type of intraarticular calcaneal fractures which have relatively large depressed joint fragments.

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Treatment of Calcaneus Fractures: Recent Trend for Acute Fractures and Complications
Woo-Chun Lee
Journal of the Korean Fracture Society.2007; 20(4): 361. CrossRef

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Treatment of Diaphyseal Fractures of Forearm Both Bones: Comparison between Plate Fixation and Rush Pin Intramedullary Nailing: Myung Ho Kim, Moon Jib Yoo, Hong Geun Jung, Hee Gon Park, Woo Sup Byun, Ji Yong Chun, Suk Ha Jeon; J Korean Fract Soc 2006;19(2):215-220. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.215

Abstract

PURPOSE
To compare the functional results between the plate fixation and Rush pin insertion for the treatment of diaphyseal fractures of the forearm both bones.
MATERIALS AND METHODS
We reviewed 51 patients who were treated for diaphyseal fractures of the both forearm bones from 1995 to 2003, and evaluated them with Anderson's method. Eighteen patients were treated with plate fixation of both bones (group I), 14 patients treated with of the Rush pin insertion of the radius and plate fixation of the ulna (group II), 11 patients treated with plate fixation of the radius and Rush pin insertion of the ulna (group III), and 8 patients treated with Rush pin insertion of forearm both bones (group IV).
RESULTS
Seventeen out of eighteen cases obtained favorable result (94.4%) in group I, 12 out of 14 cases (85.7%) in group II, 7 out of 11 cases (63.3%) in group III, and 4 out of 8 cases (50.0%) in group IV with statistically significant differences between the groups (p=0.04).
CONCLUSION
Plate fixation of forearm both bones yield the best result. Thus, plate fixation of both forearm bones is recommended in treating the diaphyseal fractures of both forearm bones. At least one bone is recommended to be fixed with a plate if it is not possible to fix both forearm bones with plates.

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Shaft Fractures of Both Forearm Bones: The Outcomes of Surgical Treatment with Plating Only and Combined Plating and Intramedullary Nailing
Sang Bum Kim, Youn Moo Heo, Jin Woong Yi, Jung Bum Lee, Byoung Gu Lim
Clinics in Orthopedic Surgery.2015; 7(3): 282. CrossRef
Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail
Kwang-Yul Kim, Moon-Sup Lim, Shin-Kwon Choi, Hyeong-Jo Yoon
Journal of the Korean Fracture Society.2008; 21(2): 157. CrossRef

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A Comparison according to Insertion Method for Intramedullary Nailing in Proximal Tibial Fractures: Sang Ho Moon, Byoung Ho Suh, Chung Soo Hwang, Tae Hyun Yoon; J Korean Fract Soc 2006;19(1):17-23. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.17

Abstract: PURPOSE
To compare clinical and radiological results between standard insertion method and semiextended method which was designed to improve proximal fixation and alignment in proximal tibia fracture.
MATERIALS AND METHODS
A retrospective review from May 2000 to February 2004, identified 24 extraarticular fractures in proximal tibia, initially treated with locked intramedullary nails at least 1 year follow up. There were 12 open injuries, 4 segmental, 3 butterfly fragments and 17 comminuted. Semiextended method was used in 10 fratures and standard insertion method which is cephalad to tibial tubercle in 14. Follow up clinical assessment consisted of review of associated injuries and complications and these two methods were compared by postoperative angulation and displacement in anteroposterior and lateral radiographs. Data were analysed by t-tests.
RESULTS
In semiextended group, average angulation was 2.3 degrees in coronal and 2.8 degrees in sagittal plane and average displacement was 4.5 mm in coronal and 5.3 mm in sagittal. In ordinary group, average angulation was 5.1 degrees in coronal and 7.4 degrees in sagittal plane and average displacement was 6.1 mm in coronal and 5.3 mm in sagittal. In semiextended group, there were significant reduction in coronal angulation (p=0.006) and sagittal angulation (p=0.001), but there was no significant difference in coronal (p=0.344) and sagittal (p=0.99) displacement. Both groups showed anterior, valgus angulation and posterolateral displacement in most cases. There were 14 associated injuries and one patient developed nonunion and was treated by nail exchange with autogenous bone graft.
CONCLUSION
Our retrospective analysis demonstrated that semiextended method is effective for reducing coronal and sagittal angulation, but is not helpful for reducing displacement in both planes.

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Comparison of Surgical Treatment for Acromioclavicular Joint Dislocation: Tae Woo Park, Sung Do Cho, Yong Sun Cho, Bum Soo Kim, Sogu Lew, Jong Ken Woo; J Korean Soc Fract 2002;15(1):59-64. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.59

Abstract PDF: PURPOSE
To evaluate the result of modified Bosworth method augmented with Mersilene tape(MBM) compared with modified Bosworth method(MB).
MATERIALS AND METHODS
Thirty two acromiclavicular dislocation wrer treated with MB(15cares) or MBM(17 cases) and the mean follow up period was 26 months(12-43 months). We assessed the radiological and clinical evaluation(X-Ray & Weitzman Criteria) and complications.
RESULTS
Twenty nine cases(91%)(MB 13, MBM 16) were "excellent" or "good" according to the Weitzman criteria. At last follow-up, mean difference of the coracocalvialar distance between the normal and the injured site were 1.9mm(MB) and 1.6mm(MBM) and two ceses were developed the arthritis, and then performed the distal clavicle resection.
CONCLUSION
Modified Bosworth method augmented with Mersilene tape is a good option for acromioclavicular dislocation in stabilizing the joint, even if the screw loosening occurs with early postoperative ROM.

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Ilizarov Treatment of Nonunions with Bone Defect in the Tibia: Soo Bong Hahn, Hong Jun Park, Kee Hong Song; J Korean Soc Fract 2000;13(1):13-19. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.13

Abstract PDF: PURPOSE
To analyze the clinical results and complications of internal transport by Ilizarov for defect nonunion of tibia MATERIALS AND METHODS: We performed a retrospective review of 24 patients undertaken internal transport by Ilizarov for defect nonunion of tibia from January 1991 to December 1997. There were 21 males and 3 females with a mean age of 33.4 years(range, 17-64 years). On average, the size of bone defect measured 7.9 cm(range, 2-17 cm). Bone defects were gradually closed by progressive internal transport. After internal transport, bone grafts on 14 docking sites were performed because of delayed union. Soft tissue defects were treated with secondary closures(6 cases), skin grafts(4 cases), and flaps(4 cases).
RESULTS
According to Paley and Catagni's classification, bone results were excellent in 19 cases, good in 4 cases, and poor in 1 case. Functional results were excellent in 2 cases, good in 21 cases, and poor in 1 case. According to Paley's classification, the complications were developed as follows; Problems were pin site infections(12 cases), joint contractures(9 cases), and distraction gap delayed consolidations(3 cases). Obstacle was absent. Complication was refracture(1 case). The average distraction consolidation index was 39.4 days/cm. The average percentage transport was 139.7 %.
CONCLUSION
The application of Ilizarov to defect nonunion of the tibia is effective, but correct technique and careful follow-up is required.

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Treatment of comminuted supracondylar fractures of the femur using Ilizarov method: Myung Chul Yoo, Yoon Je Cho, Ki Tack Kim, Young Soo Chun, Na Sil Pyo, Sung Gun Kim; J Korean Soc Fract 1999;12(3):529-537. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.529

Abstract PDF: PURPOSE
To evaluate the effectiveness of the Ilizarov method as a treatment of open or comminuted supracondylar fractures which are uncommon, and difficult to manage because of the wide range of potential complications.
MATERIALS and METHODS
Between 1992 and 1999, we treated open or comminuted supracondylar fractures of the femur by Ilizarov method in whole period or conversion to OR/IF with or without bone graft after transient Ilizarov fixation. There were 13 cases in 11 patients. Open comminuted fractures were seven cases and closed comminuted fracutres were six cases. We compared Ilizarov method in all procedures and temporary mode followed by internal fixation for definite care.
RESULTS
According to Schatzker and Lamberts assessment the results were good or excellent in ten cases(77%). And the results were rated as good or excellent in 67% of case of Ilizarov method in all procedures, and 86% of cases changed to OR/IF.
CONCLUSION
Ilizarov technique is an useful method in cases of open and/or comminuted supracondylar fractures of the femur. And after initial stabilization of fracture, conversion to OR/IF is advisable to prevent pin site infection and allow ROM excercise of the knee joint.

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Measurement of Angulation after Treatment of Fractures of the Tibia: Comparison of Conventional Methods and New Method Using Mechanical Axis: Chul Yong Chung, Chan Young Son, Sun Bon Koo, Sang Eun Kim; J Korean Soc Fract 1998;11(4):912-917. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.912

Abstract PDF: The importance of residual angular deformity after tibial fracture is still uncertain. but it is generally assumed that osteoarthritis of the ankle and the knee will result when the deformity is severe. Therefore accurate measurement of the alignment of the tibia is important clinically and in research. We compared the results of conventional methods (method 1,2) of measuring the angulation deformity after a fracture of the shaft of the tibia, with a new method using mechanical axis reported by Milner11) (method 3). Sixty-seven patients of tibial fractures with angulation deformity treated at sei Gang General Hospital from January 1995 to December 1996 were evaluated. Samples of 20 sets of standard AP and lateral radiographs of both tibia were measured. The results obtained were as follows. 1. The difference between the angles obtained by Milner's new method (method 3) and conventional methods (method 1,2) was significant in all planes. 2. Both the mean intra-& interobserver difference were minimal in new method, compared with conventional methods, t all planes. 3. There is no statistically significant difference using by paired T-test between angles obtained by new method and conventional methods (p>0.05). From these results, an angulation of measuring the new method was accurate and has good inter- and intraoesrver reliability.

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Treatment of Pilon Fracture, limited ORIF with External Fixation by Ilizarov Method: Bu Hwan Kim, Jong In Im, Yong Kyun Yim, Deog Jeong Kang, Uk Nam; J Korean Soc Fract 1998;11(4):798-805. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.798

Abstract PDF: The authors retrospectively reviewed 22 pilon fractures in 22 patients treated with limited ORIF with external fixation by Ilizarov method. Clinical follow up averaged 28 months (range, 16-45 months). Interfragmental screw fixation of key fragments were done in fifteen cases and bone-grafting was done in thirteen cases. The average duration of external fixation was fourteen weeks. All of the fractures healed (one after delayed bone-grafting). The subjective and objective results were classified according to Ovadia and Beals. Sixteen patients (72%) had good and excellent results at final follow up. On the basis of these early results, the prevalence of complications asociated with pilon fractures and their treatments can be decreased by external fixation of Ilizarov method and limited internal fixation. We conclude that this method is good treatment modality on tibial pilon frature.

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Treatment of Unstable Open Tibial Fractures with Ilizarov System: Won Sik Choy, Kwang Won Lee, Ha Yong Kim, In Sung Hwang; J Korean Soc Fract 1998;11(3):567-575. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.567

Abstract PDF: The treatment of open comminuted tibial shaft fractures have a high incidence of complications and often result in poor outcomes. General principles of treatment are accepted throughout most surgeons, which include aggressive debricdement, antibiotics, early stabilization, early soft tissue coverage, and prophylactic bone graft. But, recently there is a controversy on the bony stabilization methods; one group of authors favors external fixator, and the other group favors unreamed interlocking intramedullary nail. In this paper, we carried out retrospective study of the 42 cases of open comminuted tibial shaft fractrues managed with Ilizarov external fixator (minimum follow up of one year(average: 2.8 years)). The purpose of this study is to evaluate the results of treatment with an Ilizarov method for the patients with open comminuted tibia fractures (open type III-A and more by Gustilo and Anderson classification and, type B and more by AO classification). The results were as follows; 1. It has taken 7.4 months to achieve bony union with relatively delayed healing time for the diaphyseal fractures and fractures with higher energy injury on AO classification). The results were as follows; 1. It has taken 7.4 months to achieve bony union with relatively delayed healing time for the diaphyseal fractures and fractures with higher energy injury on AO classification. 2. Forty eight additional operations were needed for 27 patients; 24 bone grafts for 19 atients, 1 case of bone marrow injection, 4 cases of corticotomy and bone transport, 4 cases of sequestrectomy, 3 cases of internal fixation with plate, 2 cases of IM nailings, and 2 cases of Ilizarov correction in operating room. 3. Following complications were resulted in; delayed union 14 cases, nonunion 1 case, superficial infection 2 cases, deep infection 8 cases, chronic osteomyelitis 3 cases, refracture 2 cases, knee stiffness 6 cases, ankle stiffness 5 cases, subtalar stiffness 8 cases, lateral angulation 4 cases, anteroposterior angulation 4 cases, and leg length discrepancy 5 cases. 4. Twenty patients, at the final follow-up, could walk without limping and live their life with no activity limitation. 5. At the final follow-up, 19 patients complained intermittent pain on fracture sites, knees or feet and ankles. We could conclude that the Ilizarov external fixator can be a stabilizer of choice for the open comminuted (Gustilo type III and more than AO type B) tibial shaft fractures of which fracture line extended over the proximal or distal metaphysis.

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Clinical Study on Operative Technique and Management of Tibial condylar Fractures: Su Chan Lee, Beom Koo Lee, Do Hyun Moon, Jin Hong Ko, Young Kyu Kim, Hong Ki Park, Jun MO Jung, Hyun Park; J Korean Soc Fract 1998;11(3):533-539. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.533

Abstract PDF: We reviewed fifteen cases of tibial condylar fractures, especially, Schatzker type VI treated with hybrid method from January 1995 to May 1997. We attained satisfactory bony union in all cases. There were not serious complications such as deep wound infection and severe angular deformity, but partial ankylosis. After operation, the patients could do knee motion exercise immediately and had no difficulty in getting maintenance of reduction and fracture healing. In conclusions, the hybrid method is an excellent treatment in soft tissue care, maintenance of reduction, and early ambulation and fracture healing in the cases of tibial condylar fractures.

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Use of the Ilizarov Technique for Treatment of Infected Non-Union: Sung Taek Jung, eun Kyoo song, Bong suk Bae; J Korean Soc Fract 1998;11(2):398-404. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.398

Abstract PDF: We reviewed infected non-union of tibia and femur which had been treated by radical resection of the necrotic bone and Ilizarov method in thirty-nine patients. All patients had either one-segment or two segment lengthening of bone with a technique of bone transport. The size of the bone defect that was bridged averaged 5.7cm (range, 2 to 16cm). All cases attained bone union and the infection was eradicated in all pattints before the fixator was removed. The mean duration of external fixator was 14 months(range, 4-28months). The mean external fixation index was 1.6 months/cm and the mean distraction index was 23.2 days/cm. The functional results were exellent in 3 patients, good in 19, fair in 9, poor in 8. The bone results were excellent in 5 patients, good in 20, fair in 10, poor in 4. Complication were pin tract infection in 15 patients, equinus contracture of ankle in 2, knee flexion contracture in 1, transient sensory change in 1, axial deviation in 2, premature consolidation in 2, delayed union in 2, and leg length discrepancy in 2, and refracture in 1. In conclusion, the Ilizarov method is very effective for treatment of infected non-union with bone loss, limb shortening and soft tissue defect.

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Treatment of the Supracondylar and Intercondylar Fracture of the Humerus in Adults: Sang Won Park, Young Soo Byun, Ki Hoon Kang, Sang Won Han; J Korean Soc Fract 1998;11(2):378-383. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.378

Abstract PDF: Supracondylar and intercondylar fracture of the adult humerus is uncommon and present a difficult management problem. The purpose of this study is to analyse the clinical results according to types of the fracture and methods of the treatment. The authors reviewed twenty-eight patients treated for supracondylar and intercondlar fracture of the adult humerus at the Department of Orthopaedic Surgery, Korea University Hospital from January 1990 to August 1996. The mean follow up period was 41 months (12months to 79months). The results were as follows: 1. According to AO classification, there were 9 cases(32%) of Type A, and 19 cases(68%) of Type C. 2. The Methods of treatment were closed reduction and cast immobilization in 4 cases, closed reduction and fixation with K-wire or screw in 11 cases, open reduction and fixation with K-wire or screw in 7 cases and open reduction and plate fixation in 6 cases. 3. Poor results can be expected after closed reduction and cast immobilization, open fracture, above 60 years old, and Type C according to AO classification.

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Treatment of Acromioclayicular Dislocation-Comparative Study between Operative and Conservative Method: Young Su Lee, Min Ki Kim; J Korean Soc Fract 1997;10(4):918-924. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.918

Abstract PDF: There has been considerable controversy as to the method of treatment of acromioclavicular joint especially in grade III injury. We treated 27 cases of the complete dislocation of acromioclavicular dislocation with operative method(15 cases) and conservative method(12 cases) from October 1989 to November 1995. The purpose of this study is to compare the clinical and radiological result of two treatment method. The average follow up period was thirty nine months and the result as follows. 1. Of the 27 cases, there was 18 male and 9 female patients, and peak incidence was in 3rd and 4th decades(51%). 2. The most common causes of the injury was traffic atcident(49%). 3. The functional results were similiar to all treatment modalities, and coracoclavicular interval ratio was well manintained regardless of treatment. 4. Complication rate was more lower in the group of conservative treatment. 5. The conservative treatment was proven to be a valuable method for acromioclavicular dis- location except in a few situations.

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Treatment of Chronic Uncontrolled Infected Nonunion of Femur and Knee with the Ilizarov Instrument: 3 cases reports: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suck Ha Lee, Hyung Gon Jee; J Korean Soc Fract 1997;10(4):801-811. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.801

Abstract PDF: We analysed three cases, repectively. The first case was chronic uncontrolled infected nonunion of femur due to open type III fracture which had been operated unsuccessfully at least 5 times. The second case was a infected nonunion and shortening of leg due to infecton of soft tissue surgery and then after knee arthrodesis. The third case was result from the total knee arthroplasty failure and then after knee arthrodesis. Ilizarov instrument was applied to this case for the knee joint arthrodesis. All cases showed bony union after average 14.6 months. The exact bony lengthening in the two cases after treatment was 11cm and 13cm and the healing index was 49.Odays/cm and 50.8days/cm The complications included the pin tract infection in all three cases and pin breakage in 2 of the cases. We achieved bony lengthening and bony union with relief of infection in 3 cases of chronic uncontrolled infected nonunion of femur treated with extensive saucerizaton and fixation using the Ilizarov instrument. These are the results of our treatment of chroic uncontrolled infected nonunion of femur using the Ilizarov instrument.

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Treatment of Acromioclavieular Dislocation: Comparative Study between Conservative Treatment and Two Operative Method: Chang Hyuk Choi, Chang Jin Kang; J Korean Soc Fract 1996;9(4):1039-1046. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1039

Abstract PDF: We treated 43 cases of the complete dislocation of the acromioclavicular dislocation with the modified Weaber and Dvnn method(22 cases), Phemister method(12 cases) and conservative method(9 cases) from April 1987 to February 1995. The purpose of this study is to compare the clinical and radiological results of two operative method and conservative treatment. The average follow up period was fifty sit months and the results were as follows: 1. Of the 43 patients, there was 34 male and 9 femaie patients, and peak incidence was in 3rd and 4th decades(4775). 2. Cause of injury was fall down (20 cases), traffic accident(12 cases), and slip down(11 cases) and left side was predominent with 26 cases(60%). 3. The functional result by the Weitzmann criteria was Excellent in 15 cases(68%), Good in 5 cases(23%), and Fair in 2 cases(9%) with Modified Weaber and Dunn method, and 8 cases(66%), 2cases(17%),and 2cases(17%) with Phemister method, and 5 cases(55%), 2 cases(23%), and 2cases(23%) with conservative treatment. 4. There were no maior complications that could affect the end results. 5. The functional results were similiar to all treatment modalities, and coracoclavicular interval ratio was well maintained regardless of two operative method, but less complication and more patient satisfaction were after Modifid Weaber and Dunn method.

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Ilizarov Method for Treatment of Large Bone Defect: Hae Ryong Song, Young June Park, Ji Yeon Kim; J Korean Soc Fract 1996;9(3):794-800. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.794

Abstract PDF: Twenty eight long bone defects were treated with internal bone transport using Ilizarov method. The causes of defect were open fracture (ten cases), infected non-union(nine cases), and osteomyelitis(nine cases). The mean bone defect was 8.5cm ranging from 2.5cm to 22cm in open fracture and 5.8cm ranging from 1.8cm to 17cm in an infected nonunion, and 7.2cm ranging from 3.4cm to 12cm in osteomyelitis. Internal bone transport was performed with transverse ring system. Free latissimus dorsi muscle flap was done in three cases and rotational muscle flap in seven cases. Single level lengthening was done in 26 cases and double level lengthening in two cases. Fibular transport was done in five cases. All cases obtained bone union. The radiologic consolidation index was 89 day/cm in tibia, 71d ay/cm in femer, and 42.5 day/cm in humerus. External fixation index was 96 day/cm in tibia, 86 day/cm in femur, and 48.5 day/cm in humerus. Complications were pin tract infection(25 cases), equinus contracture of ankle(7 cases), knee flexion contracture(4 cases), delayed union(11 cases), premature consolidation(2 cases) and refracture(1 case). Ilizarov method is a useful treatment for large bone defect inopen fracture and infected nonunion. To obtain better result, careful postoperative management and intensive physiotherapy are recommended.

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Treatment of acromioclavicular dislocation by a Phemister method: Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Sung Soo Kim, Hyung Hwan Lee; J Korean Soc Fract 1996;9(1):154-160. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.154

Abstract PDF: Acromio-clavicular joint dislocation occurs when both acromioclavicular and coracoclavicular ligaments are ruptured and brings to deformity, arthralgia and limitation of motion of the shoulder joint. The treatment of complete acromioclavicular dislocation is controversial, and both of the conservative and surgical treatment are reported to be relatively successful. But, conservative treatment have many disadvantages and now rarely advocated. Recently, there are increasing tendencies to treat the acromioclavicular dislocatioll with anatomical reduction of acromioclavicular joint and rigid internal fixation for early movement of shoulder Joint. We report the results of 16 cases of acute acromioclavicular dislocation treated with Phemister or modified Phemister method. The results are as follows. 1. Among 16 cases,14 cases were males and 9 cases were belong to 3rd decade and 4th decade. 2. The most common cause of injuries was slip down. 3. Postoperative difference in coracoclavicular distance on radiogram was 0.1 mm on average. 4. Clinical results were excellent in 14 cases, good in 1 case and acceptable in 1 case. 5. Complications were redislocation in 1 case and K-wire migration in 1 case, but there was no arhritic changes on the affected A-C joint.

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Treatment with bone block transfer of coracoacromial ligment in acromioclayicular injury: Byung Chang Lee, Sang Soo Kim, Dae Moo Shim, Sang Do Cha; J Korean Soc Fract 1996;9(1):146-153. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.146

Abstract PDF: Several studies have shown the effectiveness of reconstruction of acromioclavicular ligament with coracoacromial ligament in treating the Grade III acromioclavicular joint injury. One of these is a bone block transfer of coracoacromial ligament into the medullary canal of the clavicle to prevent occasional pullout of the transfered ligament. Eleven cases with complete acromioclavicular dislocation(acute 3, chronic 8) were treated by this method. We modified slightly the original method described by Shoji et at. to increase the success rate. Failure of coracoclavicular reconstruction occurred in two cases. All except one patient regained nearly painlefs range of shoulder motion. One patient showed severe restriction of shoulder abduction and definite deformity. In functional evaluation by the Weitzman criteria, five were excellent, four good, one fair, and one poor. Radiologic results for restoration of coracoclavicular interval showed marked improvement but were not consistent with clinical results. Main technical problems were harvesting bone block and fixation of ligament. To obtain good osseus healing without pull out of transferred ligament, we found that preservation of bone ligament junction and careful harvest of full thickness acromiai bone block was important.

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The Ilizarov Method for the Treatment of Open Intraarticular Fractures around the Knee Joint: Clinical Analysis of 6 Cases: Chang Hyouk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Yong Joo Kim; J Korean Soc Fract 1996;9(1):119-128. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.119

Abstract PDF: There are many difficulties in treating open intraarticular fracture around the knee joint because of its combined neurovascular injury and comminution of fracture site. The difficulties lie in choosing a fixation method, postoperative care, and analyzing the results of the treatment. Recently there is growing preference in using Ilizarov apparatus. The merits of Ilizarov in fracture treatment are early weight bearing and easy compression and distraction. In cases of this study, difficulties were subclassified into problems, obstacles. and complications. Six cases of open intraarticular fracture around the knee joint were treated from Mar., 1993 to Aug.,1994 and the average follow up period was twenty months and the results were as follows: 1. Of the six patients, there were five males and one female patients. 2. The cause of the fractures was traffic accident in five and crushing injury in one. 3. Of the six cases, five cases were combined femoral and tibial fractures and one case was only femoral condylar fracture. 4. In follow up study, there was thirty cases of difficulties such as pin site problem, pain, limitation femotion, and nonunion etc. 5. Of the seventy-four wires, pin site problem occurred at twenty pins but open wounds were cured without infection evidence. 6. The results were poor in all cases. 7. The Ilizarov technique requires adequate implantation and management to reduce an overall complication rate and improve functional results.

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The Treatment of Infected Nonunions of the Tibia by the Methods of Ilizarov: Chil Soo Kwon, Yong Uck Kim, Byung Hyun Jung, Kyung Seog Shin; J Korean Soc Fract 1995;8(2):347-353. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.347

Abstract PDF

Chronic infection of the shaft of tibia is one of the most perplexing dilemmas in orthopedic surgery. Difficult or resistant infection usually require more radical debridement of the septic bone and soft tissue in addition to application of stable fixation to enhance soft-tissue healing and bony union. The application of Ilizarov is possible to correct deformities, regenerate new bone tissue without the use of bone grafts, progressirely lengthen the extremity and allow weight bearing during the treatment period. Application of Ilizarov were preformed on eigtheen patients with infected nonunion of tibia between November 1989 February 1993. The result were as follows; 1. There were 16 males and 2 females with an average age of 39 years. 2. Fifteen of 18 patients had infected tibial nonunion associated with bone loss. 3. Two of 15 patients had infected nonunions associated with hemicircumferential bone loss. These tibiae were treated by hemicircumferential corticotomy and partial bone transport. 4. Twelve of 15 patients had an average 6.6cm of segmental bone loss. These were treated by coitictomy and internal bone transport. 5. The mean duration of treatment was 10.3 months. 6. The application of Ilizarov technique to diaphyseal infected nonunion and segmental defect is very encouraging. It may prove to be an excellent technique for further management of resisitant diaphyseal infection of bone.

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Bone Transport Over the Intramedullary Nail for Defects of Long Bone
Jae-Young Roh, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Byung-Chul Park, Woo-Kie Min, Joon-Woo Kim, Chang-Hyun Cho
Journal of the Korean Fracture Society.2008; 21(1): 37. CrossRef

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Department of Orthopedic Surgery, Kwang Ju Christian Hospital: Ki Soo Kim, Seung Hee Ko, Chang Moon Suh, Yong Soo Choi, Kyung Ho Kim, Dong Myung Lee, Yang Min Jung; J Korean Soc Fract 1994;7(2):553-561. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.553

Abstract PDF: The tibia, which is covered by subcutaneous tissue anteromdially, frequently sustain open comminuted fracture by trauma. The open fractures have higher risks of infection, nonunion, delayed union and joint stiffness. The authors reviewed 54 cases of open tibial fracture, treated at Kwang Ju Christian Hospital from January 1989 to December 1992. The results were as follows : 1. The most common cause of injury was traffic accident(41 case) and the average age of the patients was 32 years. 2. The radiographic union was obtained at 16.1 weeks in type I open fracture, 18.3 weeks in type III, 20.1 weeks in type IIIa,28.0 weeks in type IIIb, and 34.7 weeks in type IIIc open fracture. 3. The secondary operation was required frequently to obtain bone union in open type II, III fracture.

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Treatment of Distal Clavicular Fracture with Ruptured Coracoclavicular Ligament by Weaver and Dunn Method: In Heon Park, Kee Byoung Lee, Myung Ryool Park, Jin Young Lee, Kyun Ho Chang; J Korean Soc Fract 1989;2(2):288-291. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.288

Abstract PDF: We reported two patients with fracture of distal clavicle combined with rupture of the coracoclavicular ligament which was treated by Weaver and Dunn method recently. The following results were obtained: 1. The over all recovery were graded good. 2. The Weaver and Dunn nethod is recommendabel for several reasons such as relatively easy surgical procedure, elimination of secondary procedure and degenerative change of the acromioclavicular joint, cosmetic acceptability and early functional recovery.

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