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Case Report
Irreducible Ankle Fracture Dislocation due to Dislocated Tibialis Posterior Tendon - A Case Report -
Seungyup Shin, Bum-Soo Kim, Ji-Won Lee, Euisun Yoon
J Korean Fract Soc 2023;36(2):52-56.   Published online April 30, 2023
DOI: https://doi.org/10.12671/jkfs.2023.36.2.52
AbstractAbstract PDF
An irreducible ankle dislocation is a rare injury. The cause is a dislocation of the distal fibula anteriorly or posteriorly or the insertion of soft tissue, such as the deltoid ligament or posteromedial tendon. The tibialis posterior tendon can be dislocated through distal tibiofibular diastasis and prevent reduction of the ankle joint. The authors experienced anterolateral ankle fracture dislocation with a diastasis of the distal tibiofibular joint, and reduction was impossible because of impingement of the tibialis posterior tendon dislocated anteriorly through the distal tibiofibular diastasis. This paper reports the treatment of this injury.
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Original Articles
Clinical Outcomes of Customized Staple Fixation Using K-wire in Metacarpal Base or Neck Fractures
Hong-ki Jin, Hyoung Min Kim, Yong Seung Oh, Jihoon Kim
J Korean Fract Soc 2021;34(1):23-29.   Published online January 31, 2021
DOI: https://doi.org/10.12671/jkfs.2021.34.1.23
AbstractAbstract PDF
Purpose
This study was designed to evaluate the radiological and clinical outcomes of a new surgical technique—customized staple fixation using K-wire—in displaced metacarpal neck or base fractures. Materials and Methods: From November 2016 to May 2017, 13 unstable metacarpal neck and base fractures (10 patients) were treated with II-shaped customized K-wire staples fixation, after performing open reductions through minimal dorsal incisions. The radiological and clinical outcomes were retrospectively evaluated. Results: A mean of 2.6 staples were used for each fracture fixation. Preoperative angulation of 36.3°was reduced to 3.1° postoperatively. A week after surgery, the volar short arm splint was replaced with a dorsal splint to initiate active range of motion exercise, and the splint was subsequently removed after 3 weeks. The radiologic union was achieved at a mean of 5.1 weeks, and total active motion was recovered at a mean of 7.4 weeks. On a mean, K-wire staples were removed at 16.5 weeks after the surgery, and the mean treatment took 18.6 weeks. At the final follow-up (at mean 27.3 weeks), no significant difference was observed for total active motion of the digits and grip strength, when compared to the contralateral hand. Complete union was achieved in all fractures without deformity, or complications such as infection or nerve injury. All patients were satisfied with the cosmetic and functional outcomes. Conclusion: K-wire stapling is an effective alternative modality in treating unstable displaced metacarpal neck or base fractures. It requires minimal incision to enable open reduction. In addition, early mobilization is ensured through the rigid fixations. Moreover, it prevents postoperative joint stiffness and reduces the time needed for treatment.

Citations

Citations to this article as recorded by  
  • Individualized herbal prescriptions for delayed union: A case series
    Jiyoon Won, Youngjin Choi, Lyang Sook Yoon, Jun-Hwan Lee, Keunsun Choi, Hyangsook Lee
    EXPLORE.2023; 19(2): 260.     CrossRef
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Primary Open Reduction and Plate Fixation in Open Comminuted Intra-Articular Distal Radius Fracture
Jun-Ku Lee, Soonchul Lee, Weon Min Cho, Minkyu Kil, Soo-Hong Han
J Korean Fract Soc 2021;34(1):16-22.   Published online January 31, 2021
DOI: https://doi.org/10.12671/jkfs.2021.34.1.16
AbstractAbstract PDF
Purpose
There are no standard surgical treatments for open distal radius fractures (DRFs), and the fracture fixator is chosen by the surgeon’s own experience. This study compared the outcomes of open reduction and volar locking plating (OR VLP) between closed and open AO-OTA type C3 DRFs. Materials and Methods: Patient data were retrospectively collected between January 2010 and December 2018. Only patients aged >18 years with AO-OTA C3 DRFs were included. After further exclusion, the patients with DRFs were divided into two groups: 13 patients with open DRFs in Group 1 and 203 patients with closed DRFs in Group 2. Data on the patient characteristics and treatment-related factors were further investigated. For the radiological evaluation, the radial height, volar height, and volar titling were measured based on the final plain radiography, and the union time was measured. The wrist range of motion (ROM), pain visual analogue scale score, and modified Mayo wrist score for function were measured at the final outpatient follow-up. Finally, the complications associated with OR VLP fixa-tion were investigated. Results: In the demographic comparison, the patients with open fractures were older (mean age, 62years) than those with closed fractures (mean age, 57 years), without a statistically significant differ-ence. The patients with open DRFs had longer antibiotic therapy and hospital stay durations. Although they presented a higher radial inclination, with statistical significance, the clinical implication was low with a mean difference of 3°. No significant differences were observed for the remaining radiological parameters, wrist ROM, and functional scores. An open DRF did not increase the complication rates,including deep infection. Conclusion: Depending on the expertise of the operating surgeon, the primary OR VLP fixation in open intra-articular comminuted DRF did not increase the incidence of deep infections and yielded similar outcomes to a closed intra-articular comminuted DRF.
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Results of Single Small Incision Minimally Invasive Plate Osteosynthesis in the Treatment of the Distal Radius Fractures
Young Sung Kim, Jong Pil Kim, Phil Hyun Chung, Ho Min Lee, Bo Sung Go
J Korean Fract Soc 2020;33(2):72-80.   Published online April 30, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.2.72
AbstractAbstract PDF
Purpose
This study compared minimally invasive plate osteosynthesis (MIPO) using a single small skin incision and conventional open volar locking plate fixation (OP) for distal radius fracture to identify outcome difference.
Materials and Methods
Forty-three patients who underwent MIPO using a single small skin incision or OP for distal radius fractures were evaluated retrospectively. Of the patients, 21 were treated with MIPO using a single small skin incision and 22 with the OP method through the conventional volar approach. The postoperative radiographic results and clinical outcomes at the final follow-up in each group were compared.
Results
All patients achieved bone union in the MIPO and OP groups. No significant differences in the bone union time, alignment, range of motion, QuickDASH, or pain score were observed. On the other hand, the size of the incision was significant: 23 mm in the MIPO group and 55 mm in the OP group (p<0.001).
Conclusion
MIPO technique using a single small incision showed similar satisfactory radiographic and functional outcomes compared to conventional OP for distal radius fractures. The MIPO technique using a single small incision offered advantages, including cosmetic benefits and minimal soft tissue damage, is recommended, particularly in young women and high functional demand patients.
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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
AbstractAbstract 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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Review Article
Reconstruction of a Traumatic Soft Tissue Defect
Jong Woong Park
J Korean Fract Soc 2015;28(4):256-265.   Published online October 31, 2015
DOI: https://doi.org/10.12671/jkfs.2015.28.4.256
AbstractAbstract PDF
Soft tissue defect combined with an open fracture is a very challenging problem to the orthopaedic surgeon. Many complicated open fractures remain with soft tissue defect, chronic osteomyelitis, and sometimes terminate with major limb amputation. Soft tissue defect should be reconstructed as soon as possible, particularly when the bone, tendon, or neurovascular structures are exposed. Exposure for longer than a week significantly increases the risk of secondary infection and tissue necrosis. For the simple soft tissue defect, negative pressure wound closure technology has been introduced and many superficial wounds have been treated successfully using this method. For the more complicated wounds, many kinds of local flaps, pedicled flaps, muscle and fascisocutaneous flaps can be indicated according to the characteristics of the wounds. The free flaps including free vascularized bone graft can be considered as a final choice for the most difficult wound problems. In this article, various reconstruction strategies for soft tissue defect after traumatic open fracture are reviewed.

Citations

Citations to this article as recorded by  
  • New proposal for skin grafts on tendon-exposed wounds
    Jung Hwan Um, Dong In Jo, Soon Heum Kim
    Archives of Plastic Surgery.2022; 49(01): 86.     CrossRef
  • Soft Tissue Reconstruction for Open Tibia Fractures
    Young-Woo Kim, Ho-Youn Park, Yoo-Joon Sur
    Archives of Hand and Microsurgery.2020; 25(3): 207.     CrossRef
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Original Articles
Treatment of Type IIIb Open Tibial Fractures
Seong Yeon Lim, Il Jae Lee, Jae Ho Joe, Hyung Keun Song
J Korean Fract Soc 2014;27(4):267-273.   Published online October 31, 2014
DOI: https://doi.org/10.12671/jkfs.2014.27.4.267
AbstractAbstract PDF
PURPOSE
The purpose of this study is to evaluate the outcome of treatment for patients with Type IIIb open tibial fractures.
MATERIALS AND METHODS
This study targeted 35 adult patients for whom follow-up was possible over one year after undergoing surgical treatment. There were 29 males and six females with an average age of 45 years.
RESULTS
Fracture location was proximal in 10 cases, midshaft in 13 cases, and the distal part of the tibia in 12 cases. An average of 10 days was observed for definitive fixation with soft tissue coverage of the injury. The mean time to radiographic union was 27 weeks. Sixteen cases (45.7%) of complications were observed. Three cases of superficial infection, two cases of deep infection, four cases of partial flap necrosis, three cases of mal-alignment, three cases of joint stiffness, and one case of hardware breakage were observed. The mean lower extremity functional scale score was 68.5 and the factors influencing the clinical results were severity of open wound (p=0.000) and occurrence of complications (p=0.000) according to results of multiple regression analysis.
CONCLUSION
In treatment of Type IIIb open tibial fractures, good clinical results can be expected provided that complications are prevented through proper reduction, firm fixation, early soft tissue reconstruction, and early rehabilitation.

Citations

Citations to this article as recorded by  
  • Effect of Korean Medicine Treatments in Patients with Proximal Tibia Fracture: A Retrospective Observational Study
    Jung Min Lee, Eun-Jung Lee
    Journal of Korean Medicine Rehabilitation.2020; 30(3): 141.     CrossRef
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Result of Surgical Treatment for the Femoral Head Fracture
Joon Soon Kang, Kyoung Ho Moon, Tong Joo Lee, Jong Hyuck Yang
J Korean Fract Soc 2014;27(3):198-205.   Published online July 31, 2014
DOI: https://doi.org/10.12671/jkfs.2014.27.3.198
AbstractAbstract PDF
PURPOSE
This study analyzed the clinical and radiological long-term follow-up results of patients with femoral head fracture who received surgical treatments.
MATERIALS AND METHODS
Retrospective evaluation was performed for 20 patients with femoral head fracture who received surgical treatments between December 1997 and May 2010. According to Pipkin's classification, there were five type I, six type II, one type III, and eight type IV fractures.
RESULTS
The average Merle d'Aubigne'-Postel score was 12.8 (12.80+/-3.53). According to surgical method, the score for the bony fragment excision group was 9.8 (9.83+/-2.79), and that for the open reduction and internal fixation group was 13.9 (13.92+/-3.07). Depending on Thompson-Epstein criteria, two patients were good, two were fair, and two were poor in the bony fragment excision group. Four patients were excellent, six were good, and three were poor in the open reduction and internal fixation group.
CONCLUSION
Bony fragment excision should be performed with caution in patients with femoral head fracture. Considering fragment size, location, and presence of acetabular fracture, better outcome can be expected using the open reduction and internal fixation method in comparison with excision.
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The Clinical Results of Opening Wedge Osteotomy in the Volarly Malunited Distal Radius
Seoung Joon Lee, Jin Ho Choi
J Korean Fract Soc 2014;27(1):29-35.   Published online January 31, 2014
DOI: https://doi.org/10.12671/jkfs.2014.27.1.29
AbstractAbstract PDF
PURPOSE
To report the clinical results of opening wedge osteotomy graft in the volarly malunited distal radius.
MATERIALS AND METHODS
Ten patients with volarly malunited distal radius fractures treated by opening wedge osteotomy were included in this study. Grip power, range of motion of the wrist, radiographic parameter and Mayo wrist scores were retrospectively evaluated.
RESULTS
At the final follow-up, the rotation of the forearm, the range of motion of wrist, and the grip power were improved. The average radial inclination improved to 22.2degrees, the average volar tilting improved to 5.6degrees, and the average ulnar variance improved to 0.8 mm. The average Mayo wrist score was improved to 85.6.
CONCLUSION
Opening wedge osteotomy for volarly malunited distal radius was considered as one of the good treatments to restore anatomy of the distal radius and distal radioulnar joint and also to improve the function of the wrist joint.
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The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture
Seong Jun Ahn, Suk Woong Kang, Bu Hwan Kim, Moo Ho Song, Seong Ho Yoo, Kwan Taek Oh
J Korean Fract Soc 2013;26(4):314-320.   Published online October 31, 2013
DOI: https://doi.org/10.12671/jkfs.2013.26.4.314
AbstractAbstract PDF
PURPOSE
To evaluate the efficacy of surgical treatment through retrospective comparison of minimally invasive percutaneous plate osteosynthesis (MIPPO) vs open plate fixation in the treatment of the distal femur fractures.
MATERIALS AND METHODS
Thirty-one patients with distal femur fractures from January 2002 to December 2010 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 17 patients treated with MIPPO, and group B was comprised of 14 patients treated with open plate fixation. Clinical outcomes including operation time, transfusion rate, rehabilitation, range of motion, and interval change of postoperative C-reactive protein (CRP) were evaluated to assess postoperative inflammatory reaction, postoperative complications and clinical results with the use of Sanders criteria.
RESULTS
The operative time was 86/135 min and transfusion volume was 0.8/1.9 unit respectively. The postoperative 3-day and 7-day CRP were 7.4/1.5 mg% in group A and 10.3/2.4 mg% in group B, showing more minimal tissue injury and early recovery in group A. There were no significant differences in clinical results by Sanders criteria in both groups.
CONCLUSION
Both MIPPO and open plate fixation for the treatment of distal femur fractures showed comparably good results. However, the MIPPO technique is superior to group B in view of minimal tissue injury and operation time and was proven to lessen the transfusion rate.

Citations

Citations to this article as recorded by  
  • Usefulness of Reduction and Internal Fixation Using a 2.4 mm Hand Plating System in Type AO 33-A3 Distal Femur Fracture: Technical Note
    Bong-Ju Lee, Ja-Yeong Yoon, Seungha Woo
    Journal of the Korean Fracture Society.2023; 36(1): 25.     CrossRef
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Case Report
Interposition of Extensor Pollicis Longus Tendon in Smith's Fracture in a Child: A Case Report
Seung Ju Jeon, Haeng Kee Noh, Do Yeon Kim, Sung Hoon Jung, Jun Beum Shin, Ho Seung Jeon
J Korean Fract Soc 2013;26(1):65-68.   Published online January 31, 2013
DOI: https://doi.org/10.12671/jkfs.2013.26.1.65
AbstractAbstract PDF
Entrapment of the extensor pollicis longus tendon is reported rarely on Smith's fractures in children. In our case, a 15 year old boy with Smith's fracture received treatment of closed reduction at another hospital. When he visited our hospital, a wide gap at the fracture site was detected on radiograph and the thumb movement was limited. We have doubt the entrapment of the soft tissue, especially the tendon. We decided on open reduction. In the operation field, entrapment of the extensor pollicis longus tendon at the gap of the fracture site was found through dorsal approach. In addition, fracture treatment with K-wire fixation after reduction of extensonr pollicis longus tendon reduction was done. Therefore, we report this case with a review of the literatures.
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Original Articles
Surgical Treatment of the Perilunate Dislocation and the Lunate Dislocation with Dorsal Approach
Soo Hong Han, Jin Myoung Dan, Dong Hoon Lee, Young Woong Kim
J Korean Fract Soc 2011;24(4):347-353.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.347
AbstractAbstract PDF
PURPOSE
To evaluate the clinical and radiologic outcomes of the perilunate dislocation and the lunate dislocation which were managed surgically through a dorsal approach.
MATERIALS AND METHODS
Retrospective reviews of the 13 patients who had minimum 1-year follow-up after surgical treatment through isolated dorsal approach for their perilunate dislocations or the lunate dislocations were performed. The case that dislocated lunate migrated proximally through the wrist was excluded in this series. We evaluated the DASH score in questionnaire method and Mayo wrist score to analyze the clinical outcomes. Radiologic results were investigated by measurement of the scapho-lunate angle, and fracture union was also evaluated in the case of trans-scaphoid dislocation.
RESULTS
The mean DASH Score was 16.3 points (range, 10.8~26.7 points) and the mean Mayo wrist score was 79 points (range, 65~90 points) at the final follow-up. There were 2 cases of excellent, 7 cases of good and 4 cases of fair in the Mayo wrist score. On the radiologic analysis, the mean scapho-lunate angle was 49.0degrees (range, 35~55degrees) and all cases were within the normal range. All cases of the trans-scaphoid perilunate dislocation achieved bone union.
CONCLUSION
Author's cases showed satisfactory outcomes in clinically and radiologically. Isolated dorsal approach could give anatomical reduction and appropriate internal fixation in treatment of the perilunate dislocations and the lunate dislocations except the rare case of proximal migration of the lunate through the wrist.
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Operative Treatment in the Delayed Diagnosed Fracture and Dislocation of Hamatometacarpal Joint
Suk Ha Lee, Jong Wong Park, Jin Il Kim, Seoung Joon Lee
J Korean Fract Soc 2011;24(3):249-255.   Published online July 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.3.249
AbstractAbstract PDF
PURPOSE
The purpose is to evaluate and report the results that treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint.
MATERIALS AND METHODS
We evaluated 12 cases that had been treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint. The mean interval between injury and operation was 34 days (21~60 days), the mean age of 12 cases was 28.1 years old, and mean follow-up period was 18 months. The computer tomography was done in all cases and the fracture and dislocation types were classified by Cain's classification. For the evaluation of results, pain scale, grasping power, range of motion of wrist and metacarpophalangeal joint were analyzed preoperatively and at final follow up, and the arthritic change of the hamatometacarpal joint was also checked.
RESULTS
According to Cain's classification, type Ia was one case, type Ib was two, type II was six, and type III was three. The pain scale was improved from 7.75 preoperatively to 0.92 at last follow up. The mean grasping power was improved up to 97.5% of normal. The preoperative range of motion of the wrist joint measured to be 60 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 75 degrees in extension and 80 degrees in flexion. The preoperative range of motion of the metacarpophalangeal joint measured to be 0 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 0 degrees in extension and 85 degrees in flexion. Carpometacarpal arthritis was developed in two cases.
CONCLUSION
The open reduction and internal fixation is considered as one of good treatment option in the delayed diagnosed hamatometacarpal fracture and dislocation.

Citations

Citations to this article as recorded by  
  • Reliability of classification of ring and little finger carpometacarpal joint fracture subluxations: a comparison between two-dimensional computed tomography and three-dimensional computed tomography classifications
    J. H. Kim, S.-S. Kwon, S. J. Moon, J. S. Choe, H. I. Kwak, S. Y. Lee, H. J. Le, J. Y. Kim
    Journal of Hand Surgery (European Volume).2016; 41(4): 448.     CrossRef
  • Fourth and Fifth Metacarpal Base Arthrodesis for Posttraumatic Arthritis of Fifth Carpometacarpal Joint
    Chul-Hyung Kang, Eun-Sok Son, Chul-Hyun Cho
    Journal of the Korean Society for Surgery of the Hand.2013; 18(4): 184.     CrossRef
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Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?
Jae Kwang Yum, Yong Woon Shin, Hee Sung Lee, Jae Gu Park
J Korean Fract Soc 2011;24(2):138-143.   Published online April 30, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.2.138
AbstractAbstract PDF
PURPOSE
A technique of cerclage wire fixation in comminuted fracture of the clavicle shaft is thought to interfere the fracture healing, so authors studied radiographically and clinically about the cases of cerclage wiring of the fracture fragments with the plate and screws fixation in the comminuted fracture of the shaft of the clavicle.
MATERIALS AND METHODS
According to following inclusion criteria, total 18 patients (male: 15, female: 3) were investigated; Patients who visited hospital due to clavicle shaft comminuted fracture from February 2005 to April 2009, who underwent surgery utilizing more than 2 cerclage wire fixation for the fragments when open reduction and plate fixation were operated and who could be follow-up over one year. The duration for fracture union, functional outcome and complications were investigated retrospectively.
RESULTS
Radiological bone union was accomplished in average 13.3 weeks (12~16 weeks) and there was no complication such as nonunion, delayed union or infection. Range of motion of ipsilateral shoulder joint was recovered in all patients except one at the final follow-up.
CONCLUSION
The clinical and radiographical results of the plate and screws fixation with cerclage wiring of the fragments in comminuted clavicle shaft fracture showed that the cerclage wiring does not interfere the fracture healing, so authors think that this method is a good alternative operation if it is performed carefully to minimize soft tissue dissection.

Citations

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  • Surgical Management of Comminuted Midshaft Clavicle Fractures Using Reconstruction Plate and Circumferential Wiring: Does the Circumferential Wiring Interfere with the Bone Union?
    Kyung-Tae Kim, Chung-Shik Shin, Young-Chul Park, Dong-hyun Kim, Min-Woo Kim
    Journal of the Korean Orthopaedic Association.2021; 56(3): 245.     CrossRef
  • Supplementary Technique for Unstable Clavicle Shaft Fractures: Interfragmentary Wiring and Temporary Axial K-Wire Pinning
    Jinmyoung Dan, Byung-Kook Kim, Ho-Jae Lee, Tae-Ho Kim, Young-Gun Kim
    Clinics in Orthopedic Surgery.2018; 10(2): 142.     CrossRef
  • 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
    Journal of the Korean Fracture Society.2016; 29(3): 185.     CrossRef
  • TO EVALUATE THE SURGICAL OUTCOME OF NON-UNION CLAVICLE USING PLATE AND SLIVERS OF AUTOLOGOUS ILIAC CREST CORTICOCANCELLOUS BONE GRAFT
    Mohammed Tauheed, Shashi Kumar Yalagach, Vivek Purushothaman, Anwar Shareef Kunnath K
    Journal of Evidence Based Medicine and Healthcare.2016; 3(25): 1121.     CrossRef
  • Anatomical Reduction of All Fracture Fragments and Fixation Using Inter-Fragmentary Screw and Plate in Comminuted and Displaced Clavicle Mid-Shaft Fracture
    Kyoung Hwan Koh, Min Soo Shon, Seung Won Lee, Jong Ho Kim, Jae Chul Yoo
    Journal of the Korean Fracture Society.2012; 25(4): 300.     CrossRef
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Intra-articular Calcaneal Fractures Treated with Open Reduction and Internal Fixation: A Comparative Study between Groups with and without Bone Graft
Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Sung Hwan Jo, Hoon Yang
J Korean Fract Soc 2010;23(2):180-186.   Published online April 30, 2010
DOI: https://doi.org/10.12671/jkfs.2010.23.2.180
AbstractAbstract PDF
PURPOSE
This study compares the clinical results of open reduction and internal fixation with and without bone graft for the treatment of intra-articular calcaneal fractures.
MATERIALS AND METHODS
Twenty-five patients who had open reduction and internal fixation for intra-articular calcaneal fractures and available for at least 1 year of follow-up were included in this study. Fifteen cases were operated with bone graft. Period to bone union and functional evaluation score were compared between both groups with analysis of complications.
RESULTS
Bone union was achieved in all cases with average bone union time of 11.6 weeks and 12.8 weeks in group with and without bone graft respectively. Creighton-Nebraska Health Foundation (CNHF) functional score was 86.5 points and 80.3 points respectively. The period to bone union and the CNHF score in the comparison of two groups were statistically insignificant. Complications were observed in four cases of group without bone graft and 5 cases of group with bone graft.
CONCLUSION
This study indicates that bone graft does not play a significant role in bone union and functional outcome when intra-articular calcaneal fractures are treated with open reduction and internal fixation.

Citations

Citations to this article as recorded by  
  • Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures
    Chul Hyun Park, Oog Jin Shon
    Journal of the Korean Fracture Society.2016; 29(3): 221.     CrossRef
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Operative Treatment of Trapezium Fractures
Ho Jung Kang, Nam Heon Seol, Man Seung Heo, Soo Bong Hahn
J Korean Fract Soc 2009;22(4):276-282.   Published online October 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.4.276
AbstractAbstract PDF
PURPOSE
Fractures of trapezium are uncommon carpal bone fractures and often unrecognized lesions. We investigated about operative treatment of trapezium fracture. MATERIALS AND METHODS: Seven patients with fractures of trapezium were evaluated after surgical treatment with a mean follow up time of 18 months (12 months~3 years). Functional assessment (pain, limitation in activities of daily living, satisfaction), physical examination (range of motion, grip strength), and radiographic evaluation were performed. Traumatic arthritis and carpometacarpal joint subluxation were confirmed by radiograph. RESULTS: During study period, 122 cases were carpal bone fractures, and seven of 122 cases were fractures of trapezium. All cases were intra-articular fractures of trapezium. 1st carpometacarpal joint dislocation at 4 patients, Bennett's fracture at 1 patient, hamate hook fracture at 1 patient, and base of 4th proximal phalanx fracture at 1 patient were associated with fracture of trapezium. Open reduction and internal fixation were performed at 6 cases and 1st carpometacarpal joint arthrodesis was performed at 1 case because of neglected fracture. One of 6 cases which were performed to open reduction and internal fixation was reoperated to external fixation due to reduction loss. Clinically 6 patients revealed good results. one of 7 patients experienced limitation of thumb opposition. CONCLUSION: Based on the good results obtained with surgical intervention, we advocated open reduction and internal fixation for fractures with intraarticular depressed more than 2 mm or combined with Bennett's fracture or carpometacarpal subluxation.
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Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture
Sang Ho Ha, Jun Young Lee, Sang Hong Lee, Sung Hwan Jo, Jae Cheul Yu
J Korean Fract Soc 2009;22(4):225-231.   Published online October 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.4.225
AbstractAbstract PDF
PURPOSE
To evaluate the result of treatment of proximal femoral shaft fracture with limited open reduction and intramedullary nailing. MATERIALS AND METHODS: Fifteen patients who had limited open reduction and intramedullary nailing due to proximal femoral shaft fracture for follow-up for more than 12 months were selected between March 2001 and December 2005. The clinical and radiologic results were analyzed. Winquist-Hansen classification and OTA/AO classification were used. RESULTS: Thirteen cases achieved bone union and 2 cases showed delayed union. The mean bone union period was 21.3 weeks (14~32). There was no postoperative infection. Nonunion was observed in 2 cases of which bone union was acquired with the exchange of intramedullary nail and bone graft in one case and with the additional plate fixation and bone graft in the other case. CONCLUSION: Treating proximal femoral shaft fracture with limited open reduction and intramedullary nailing seems to be a technique to manage proximal femoral shaft fracture that has combined fracture or ipsilateral femoral fracture or is unable to acquire acceptable reduction with closed reduction.
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Crescent Fracture-dislocation of Sacroiliac Joint: Affecting Factors of Operative Results
Hee Soo Kim, Chang Wug Oh, Poong Taek Kim, Young Soo Byun, Joo Woo Kim, Byung Chul Park, Woo Kie Min, Hyun Joo Lee
J Korean Fract Soc 2009;22(2):71-78.   Published online April 30, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.2.71
AbstractAbstract PDF
PURPOSE
To assess the affecting factors of results after the operation of Crescent fracture-dislocation in sacro-iliac joint.
MATERIALS AND METHODS
In 19 patients (mean age, 47.4 year-old) of open reduction and internal fixation for Crescent fracture-dislocation, there were seven type I, 9 type II, and 3 type III fractures according to Day's classification. We assessed affecting factors of radiological and functional results, such as patients' ages, surgical approaches, the fixation extent of pelvic ring, and fracture patterns.
RESULTS
Seventeen of 19 cases united at 14.5 weeks in average, and 2 non-unions occurred with the fixation failure of posterior ring. Satisfactory results were 14 and 15 in radiological and functional evaluation, respectively. In complications, three cases of leg length discrepancy were from an imperfect reduction and two fixation failures. Surgical approach did not show any difference of results, but all cases of unsatisfactory reduction occurred from posterior ring fixation through the anterior approach. Fixation of both rings seemed to have satisfactory results, comparing to posterior ring only. Older patients over 60 year-old had more complications and a tendency to show an unsatisfactory result.
CONCLUSION
In operative treatment of Crescent fracture-dislocation of sacro-iliac joint, it is better to fix both anterior and posterior rings. But, caution is needed to prevent complications in old-aged patients.

Citations

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  • General Assessment and Initial Management of Polytrauma Patients
    Hyoung Keun Oh
    Journal of the Korean Fracture Society.2013; 26(3): 230.     CrossRef
  • Damage Control and Provisional Fixation
    Hyoung Keun Oh
    Journal of the Korean Fracture Society.2010; 23(3): 346.     CrossRef
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  • 28 Download
  • 2 Crossref
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Case Report
Irreducible Dislocation of the Interphalangeal Joint of the Thumb: A Case Report
Phil Hyun Chung, Suk Kang, Chung Soo Hwang, Jong Pil Kim, Young Sung Kim, Kwang Uk An
J Korean Fract Soc 2008;21(2):165-168.   Published online April 30, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.2.165
AbstractAbstract PDF
Dislocations of the interphalangeal joint of the thumb are rather uncommon as a result of the inherent stability of the interphalangeal joint. Irreducible dislocations of these joint are rare. The authors report a case of irreducible dislocation of the interphalangeal joint of the thumb with interposed palmar plate, and reduced by open reduction.
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Original Articles
Two-staged Delayed Minimally Invasive Percutaneous Plate Osteosynthesis for Distal Tibial Open Fractures
Jung Hwan Yang, Seok Hyun Kweon, Jeung Woo Kim, Jin Young Park, Hyun Jun Kim, Chul Min Lim
J Korean Fract Soc 2008;21(1):24-30.   Published online January 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.1.24
AbstractAbstract PDF
PURPOSE
To evaluate the outcomes of distal tibial open fractures treated by two-staged delayed minimally invasive percutaneous plate osteosynthesis (MIPPO) technique.
MATERIALS AND METHODS
25 cases of distal tibial open fractures were treated with temporary ring fixation and two-staged delayed MIPPO. A mean age was 46 years old, follow-up was 23 months. The type of fracture was evaluated using the AO/OTA classification. The type of open fracture was evaluated using the Gustilo-Anderson classification that revealed 6 cases of type I, 9 cases of type II, 8 cases of type IIIA and 2 cases of type IIIB. We analyzed the radiologic results and postoperative complications. The clinical and functional result were evaluated by using Teeny and Wiss scores.
RESULTS
The average time of bone union was 18 weeks in 24 cases. There were three delayed union that achieved union twenty weeks after second operation, and 1 case underwent bone graft with additional plate fixation. 6 cases of skin necrosis were treated with skin graft, 2 cases were treated with flap. The clinical and functional assessment showed that 6 cases were excellent, 16 cases were good, 2 cases were fair, and 1 case were poor results.
CONCLUSION
Two-staged MIPPO technique for distal tibia open fractures seems to be a good procedure to obtain bone union.

Citations

Citations to this article as recorded by  
  • Combined minimally invasive external and internal fixation in the treatment of pilon fractures
    AhmedSh Rizk, MohamadS Singer, MohamadE Al-Ashhab
    The Egyptian Orthopaedic Journal.2014; 49(3): 259.     CrossRef
  • Staged Protocol in Treatment of Open Distal Tibia Fracture: Using Lateral MIPO
    Oog Jin Sohn, Dong Hwa Kang
    Clinics in Orthopedic Surgery.2011; 3(1): 69.     CrossRef
  • Management of Open Fracture
    Gu-Hee Jung
    Journal of the Korean Fracture Society.2010; 23(2): 236.     CrossRef
  • Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures
    Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn
    Journal of the Korean Fracture Society.2010; 23(3): 289.     CrossRef
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Treatment of Subtrochanteric Femur Fractures Using Intramedullary Devices
Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Chong Suk Park, Sang Ho Lee
J Korean Fract Soc 2008;21(1):13-18.   Published online January 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.1.13
AbstractAbstract PDF
PURPOSE
The purpose of this study is to compare the result between closed reduction and minimal open reduction in case of difficult reduction for subtrochanteric fractures fixed with intramedullary nail.
MATERIALS AND METHODS
From Jan. 2001 to May 2005, 35 cases of subtrochanteric femur fracture treated by intramedullary nail and followed up for more than a year were selected out of 42 subtrochanteric femur fractures. Fielding classification and Russel-Taylor classification were used, and according to the fracture classification and method of reduction, the patients were grouped into closed or open reduction group. Fracture with minimal displacement or anatomical reduction was fixed by closed reduction, but in case of failed closed reduction or loss of reduction, minimal incision was made for open reduction and internal fixation, and the result between two groups were compared.
RESULTS
In total of 35 cases, 15 cases were fixed by closed reduction and the rest 20 cases required open reduction. Operation time, amount of transfusion, total hospital days, partial weight bearing ambulation, and union time did not show significant differences between two groups. Ambulation and range of motion after the operation were satisfying in both groups.
CONCLUSION
In treatment of subtrochanteric femur fracture with intramedullary nail, both closed and open reduction shows satisfying result, therefore when anatomical reduction is difficult to achiev by closed reduction, minimal incision open reduction and additional fixation is strongly recommended to obtain anatomical reduction and firm fixation.

Citations

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  • Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
    Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
    Hip & Pelvis.2014; 26(2): 107.     CrossRef
  • Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques
    Chul-Hyun Park, Chul-Wung Ha, Sang-Jin Park, Min-Su Ko, Oog-Jin Shon
    Journal of the Korean Fracture Society.2013; 26(2): 112.     CrossRef
  • Treatment of Subtrochanteric Nonunion with a Blade Plate
    Youn-Soo Park, Jin-Hong Kim, Kyung-Jea Woo, Seung-Jae Lim
    Journal of the Korean Orthopaedic Association.2011; 46(1): 42.     CrossRef
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Comminuted Pilon Fractures: Comparative Outcome Analysis according to Surgical Techniques
You Jin Kim, Hong Geun Jung, Joo Hong Lee, Woo Sup Byun, Sung Tae Lee
J Korean Fract Soc 2007;20(1):6-12.   Published online January 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.1.6
AbstractAbstract PDF
PURPOSE
To evaluate the overall surgical outcome of the tibial pilon comminuted fractures and perform the comparative analysis between the limited internal fixation-external fixation group and the delayed open reduction-internal fixation (ORIF) group.
MATERIALS AND METHODS
From June 1997 to June 2004, 17 tibial pilon comminuted fractures were treated with the limited internal fixation-external fixation (6 cases) or the delayed open reduction-internal fixation (11 cases). The average age of the patients was 47.7 years (range: 41~63 years), male was fourteen patients, female was three. Follow-up period was average 33.6 months (range: 12~84 months). The clinical outcomes were evaluated by using AOFAS ankle-hindfoot score and patient satisfaction was also evaluated.
RESULTS
AOFAS score at final follow-up was 80.4 points, and 88% of the patients were satisfied with the results. AOFAS scores of the external fixation group and the delayed ORIF group were average 77.0 points and 82.2 points respectively, which did not show the statistical difference (p>0.05). Bony union was achieved at average 16.0 weeks. There were 18 complications such as skin necrosis.
CONCLUSION
We have achieved relatively encouraging functional results and high patient satisfaction for pilon comminuted fractures, without significant result difference between the two surgical techniques.

Citations

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  • The Result of Using an Additional Mini-Locking Plate for Tibial Pilon Fractures
    Suenghwan Jo, Jun Young Lee, Boseon Kim, Kang Hyeon Ryu
    Journal of the Korean Fracture Society.2017; 30(2): 75.     CrossRef
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Result of Early Active Range of Motion Exercise after Bankart Repair of Traumatic Anterior Instability
Haeng Kee Noh, Jong Woong Park, Jung Il Lee, Jung Ho Park
J Korean Fract Soc 2007;20(1):53-57.   Published online January 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.1.53
AbstractAbstract PDF
PURPOSE
To evaluate prospectively the results of early active exercise after open Bankart repair of traumatic anterior shoulder instability.
MATERIALS AND METHODS
From January, 2001 to June, 2003, 26 patients who were followed up at least 1 year after open Bankart repair for traumatic anterior shoulder instability were evaluated. Average age was 23.9 years old (range, 19~43) with 24 males and 2 females. We evaluated them using the functional shoulder scores (modified Rowe score, ASES score), range of motion, VAS pain scale, patient's subjective satisfaction and return to unlimited daily living activity.
RESULTS
The shoulder functional scores increased significantly. At last follow up, the final range of motion were flexion in average 5° deficit in comparison to normal side, external rotation in average 10o deficit, and internal rotation in T9. The patient's subjective satisfaction was good in 2l patients (81%). Return to unlimited daily activity was possible in 23 patients (88.5%), and 19 patients (73%) rejoined to sports activity before injury. There were complications including anterior recurrent subluxation in 1 case, weakness of subscapularis muscle in 1 case.
CONCLUSION
In traumatic anterior shoulder instability, early active range of motion exercise after open Bankart repair does not decrease shoulder stability. Early exercise can be useful for returning to previous level of sports activity in young active patients.
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Treatment of Acetabular Column Fractures with Limited Open Reduction and Screw Fixation
Jung Jae Kim, Hyoung Keun Oh, Sung Yoon Kim
J Korean Fract Soc 2007;20(1):26-32.   Published online January 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.1.26
AbstractAbstract PDF
PURPOSE
To evaluate the results of limited open reduction and screw fixation of acetabular fractures.
MATERIALS AND METHODS
Six acetabular fractures were treated with fluoroscopic guided screw fixation. The mean age was 46 years old and mean follow-up period was 18 months. There were 3 anterior column fractures, 2 transverse fractures and 1 both column fracture. Anterior column screw fixation was used in 5 cases and posterior column fixation in 1 case. Limited ilioinguinal approach was used in 4 cases and percutaneous screw fixation in 2 cases.
RESULTS
The mean union time was 16.6 weeks. The postoperative radiographic results revealed 2 cases with an anatomic reduction and 4 cases with an imperfect reduction. The clinical results showed 1 case with excellent, 4 cases with good and 1 case with fair. Regarding complication, there was 1 case of SI joint penestration without clinical symptoms.
CONCLUSION
Limited open reduction and screw fixation can be a useful alternative treatment for acetabular fractures in patients with minimally displaced fracture, severe multisystem trauma and soft tissue injury not suitable to traditional treatment.
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Interlocking Intramedullary Nail in Distal Tibia Fracture
Oog Jin Shon, Sung Min Chung
J Korean Fract Soc 2007;20(1):13-18.   Published online January 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.1.13
AbstractAbstract PDF
PURPOSE
To evaluate the effectivity of interlocking intramedullary nailing for distal tibia fracture and prognostic factor to bone healing.
MATERIALS AND METHODS
From April 2000 to June 2005, 21 cases who had distal tibia fracture were treated by interlocking intramedullary nail were analyzed. The duration of follow-up was more than 1 year. We evaluated clinical results by IOWA ANKLE rating system and union time by simple X-ray. Furthermore, we estimated prognostic factor to union time.
RESULTS
The bone union was achieved at average 18.5 weeks. At the last follow-up, there was no non-union and infection. Average IOWA ANKLE rating score was 91.3 point. The union time was delayed in open and segmental fracture at initial fracture. And severe soft tissue injury in open fracture revealed bad result.
CONCLUSION
We concluded that interlocking intramedullary nail is effective method for treatment of the distal tibial fractures. And, adequate soft tissue management is important to bone healing and clinical outcome.

Citations

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  • Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures
    Jung-Han Kim, Heui-Chul Gwak, Chang-Rack Lee, Yang-Hwan Jung
    Journal of Korean Foot and Ankle Society.2015; 19(3): 86.     CrossRef
  • 854 View
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  • 1 Crossref
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Case Report
Medial Plantar Nerve Injury after Screw Fixation of the Calcaneus Fracture
Bong Cheol Kwon, Yong Woon Shin, Duck Joo Kwon, Nam Kyou Rhee
J Korean Fract Soc 2006;19(2):288-290.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.288
AbstractAbstract
We present a case of medial plantar nerve injury by screw tip after open reduction and internal fixation of intraarticular calcaneus fracture. We reviewed the risk and prevention technique of medial plantar nerve injury in fixing the calcaneus fracture.
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Original Articles
Comparison of Open Fixation and Closed Percutaneous Pinning in Jakob Stage II Lateral Condylar Fractures of Children
Eui Sung Choi, Dong Soo Kim, Hyun Chul Shon, Yong Min Kim, Kyoung Jin Park, Jun Mo Jeon, Gee Kang Park
J Korean Fract Soc 2006;19(2):277-282.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.277
AbstractAbstract
PURPOSE
To compare the results of open fixation and closed percutaneous pinning in managing Jakob stage II lateral condylar fractures of children's elbow.
MATERIALS AND METHODS
Since Febuary 2000, We operated 21 children with Jakob stage II lateral condylar fractures of elbow. Eleven of the 21 were treated with closed percutaneous pinning, open fixation was done to the other 10 children. Each patient was evaluated about range of motion, carrying angle, scar satisfaction and radiologic findings for comparison between closed pinning and open fixation groups.
RESULTS
Open fixation group showed 3.8 degrees decrease of elbow motion while closed pinning group showed no significant decrease. Carrying angle and radiologic findings were not different between the two groups. Open fixation group expressed dissatisfaction to their scars (average 5.2 cm) whereas all the patients of closed pinning group were satisfied with their functional and cosmetic outcomes.
CONCLUSION
In managing Jakob stage II lateral condyle fractures of children's elbow, closed percutaneous pinning was thought to be superior to open fixation because of the same functional outcome and much better cosmetic results.
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Arthroscopically Assisted Limited Open Reduction and Ilizarov External Fixation of Tibial Pilon Fractures
Jin Young Lee, Gab Lae Kim, Hyung Seok Oh, Kun Ho Shin, Deok Yong Park
J Korean Fract Soc 2006;19(2):176-181.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.176
AbstractAbstract
PURPOSE
To evaluate the clinical results of the pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation.
MATERIALS AND METHODS
This is a retrospective study of the clinical result, bone union, complication and postoperative ankle function of 22 pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation between January 1999 to March 2004.
RESULTS
Clinical follow up averaged 16 months, with an average age of 39.2. All patients with type 1 and 2 fracture had excellent or good score by Ovadia and Beals criteria. Closed fractures healed within 13 weeks and open fractures within 16 weeks after surgery in average. Average range of motion of the ankle was 12o dorsiflexion (0~20 degree) and 25o plantar flexion (15~35 degree).
CONCLUSION
Minimal soft tissue dissection and anatomical reduction are very important factor for minimizing complication and satisfactory ankle function. So, arthroscopically assisted limited open reduction and Ilizarov external fixation is an effective treatment option for tibial pilon fractures.
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The Comparison of MIPPO vs Open Plate Fixation in the Treatment of the Distal Tibia Fracture
Seong Ho Yoo, Seong Jun Ahn, Moo Ho Song, Bu Hwan Kim, Min Soo Lee, Jong Ha Park
J Korean Fract Soc 2006;19(1):29-33.   Published online January 31, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.1.29
AbstractAbstract
PURPOSE
To evaluate the efficacy of the surgical treatment through the comparison of MIPPO vs open plate fixation in the treatment of the distal tibia fracture retrospectively.
MATERIALS AND METHODS
30 patients with distal tibia fracture from Jun. 2001 to Jun. 2004 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 15 patients treated with MIPPO, Group B was 15 patients treated with open plate fixation. The clinical outcomes were evaluated retrospectively from operation time, rehabilitation, ROM, interval change of postoperative CRP to assess postoperative inflammatory reaction, postoperative complications and clinical result with the use of McLennan and Ungersma criteria.
RESULTS
There were no significant differences in clinical result by McLennan and Ungersma criteria in both groups. The postoperative 3 days and 7 days CRP were 4.0mg% (0.9~7.2)/0.5 mg% (0.1~1.5) in group A and 7.97mg% (2.8~14.6)/1.0mg% (0.3~1.6) in group B, shows more minimal tissue injury and early recovery in group A. Operation time in group A was shorter than group B. Normal recovery of ROM was quicker in Group A. In complications, group A showed one superficial infection and one angular deformity and group B showed one superficial infection, one infected nonunion and two ankle stiffness.
CONCLUSION
There were no significant differences in clinical result and bony union. MIPPO technique is superior to group B in view of the minimal tissue injury, complications, operation time and postoperative rehabilitation.

Citations

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  • Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture
    Oog Jin Shon, Dae Sung Kim
    Journal of the Korean Fracture Society.2010; 23(1): 42.     CrossRef
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Case Report
Neglected Traumatic Posterior Hip Dislocation in a Crutch-walking Patient: A Case Report
Yong Min Kim, Hyun Chul Shon, Dong Soo Kim, Eui Sung Choi, Kyung Jin Park, Se Hyuk Im
J Korean Fract Soc 2005;18(4):474-477.   Published online October 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.4.474
AbstractAbstract PDF
Traumatic posterior hip dislocation should be reduced emergently, but diagnosis could be delayed in a patient with head trauma or in developing countries. We have experienced neglected posterior hip dislocation for three months in a crutch-walking patient who had ipsilateral tibia fracture and alert mentality. Open reduction followed by six-weeks skeletal traction was performed. At one year follow-up, the reduced hip showed good range of motion with no evidence of avascular necrosis.
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Original Articles
Internal Fixation of Clavicle Lateral and Fracture with Mini T-plate
Byung Woo Ahn, Jong Ho Yoon, Chong Kwan Kim, Sung Won Chung, Young Il Kwan, Young Ho Lee, Chan Wan Park
J Korean Fract Soc 2005;18(4):410-414.   Published online October 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.4.410
AbstractAbstract PDF
PURPOSE
To evaluate the effectiveness of a mini T-plate fixation in clavicle lateral end fractures.
MATERIALS AND METHODS
We reviewed eleven cases of calvicle lateral end fracture which were treated with open reduction and internal fixion with mini T-plate from May 2000 to December 2004. The follow up period was 12 months minimum. The radiologic result, pain and shoulder function were evaluated by the ASES shoulder score.
RESULTS
All cases showed satisfactory results. Seven cases (63%) were excellent, and four (37%) cases were good. There were no fair or poor results. All cases showed radiologic union by the fifteenth week. No complications such as metal breakage, limited motion, infections were seen.
CONCLUSION
This study demonstrates that using a mini T-plate fixation which is easy and induces no injury of acromiocalvicular joint, contributes to provide stable fixation in clavicle lateral end fractures.

Citations

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  • Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome
    Seong Cheol Moon, Chul Hee Lee, Jong Hoon Baek, Nam Su Cho, Yong Girl Rhee
    Journal of the Korean Fracture Society.2014; 27(2): 127.     CrossRef
  • The Surgical Outcomes of Clavicle Lateral End Fractures Fixed with the Oblique T Locking Compession Plate
    Seung-Oh Nam, Young-Soo Byun, Dong-Ju Shin, Jung-Hoon Shin, Chung-Yeol Lee, Tae-Gyun Kim
    Journal of the Korean Fracture Society.2011; 24(1): 41.     CrossRef
  • Comparison of Results of Tension Band Wire and Hook Plate in the Treatment of Unstable Fractures of the Distal Clavicle
    Chul-Hyun Park, Oog-Jin Shon, Jae-Sung Seo
    Journal of the Korean Fracture Society.2011; 24(1): 55.     CrossRef
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Operative Treatment of Intraarticular Calcaneal Fracture: Comparison of Outcomes between Open Reduction and Closed Reduction
Chang Hun Sung, Byeong Mun Park, Kyeong Seop Song, Hyung Gyu Kim, Jong Min Kim, Tae Eun Kim
J Korean Fract Soc 2005;18(2):170-175.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.170
AbstractAbstract PDF
PURPOSE
To evaluate the clinical outcomes and radiographic results of operative treatment for intraarticular calcaneal fracture.
MATERIALS AND METHODS
We reviewed 57 cases of intraarticular calcaneal fracture managed with operative treatment, from January, 2000 to June, 2003. The type of intraarticular calcaneal fracture is classified by the Essex-Lopresti classification and Sanders by computed tomography. The 20 cases were managed by open reduction, 37 cases by closed reduction.
RESULTS
On clinical outcomes in the case of open reduction and internal fixation, above good in 13 cases, poor in 2 cases; closed reduction, above good in 16 cases, poor in 10 cases. Averages of Bohler angle were increased from 11degrees (preoperative state) to 21degrees (last follow up) in open reduction, and from 14degrees to 20.9degrees in closed reduction.
CONCLUSION
Open reduction was considered to be one of good treatment option if the anatomical reduction and stable fixation can be obtained.

Citations

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  • Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures
    Seung Hun Woo, Hyung-Jin Chung, Su-Young Bae, Sun-Kyu Kim
    Journal of the Korean Orthopaedic Association.2017; 52(1): 49.     CrossRef
  • Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method
    Gyu Min Kong, Byoung Ho Suh, Dong Joon Kim
    Journal of the Korean Fracture Society.2007; 20(2): 178.     CrossRef
  • 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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Effect of Alternative Splinting at Extension and 90degrees Flexion on Range of Motion after Open Reduction and Internal Fixation of Distal Femur Fracture
Chong Kwan Kim, Jong Ho Yoon, Byung Woo Ahn, Chin Woo Jin, Dong Wook Kim, Young Il Kwan, Young Ho Lee
J Korean Fract Soc 2005;18(2):144-148.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.144
AbstractAbstract PDF
PURPOSE
To evaluate the usefulness of early range of motion exercise by using 90degrees knee flexion splint after open reduction and internal fixation in fracture of distal femur.
MATERIALS AND METHODS
We reviewed twenty-six cases of distal femur fractures which were treated with open reduction and internal fixation from February 2002 to November 2003. One group (group A) were treated by using 30degrees knee flexion splint, the other group (group B) were treated by using 90degrees flexion and full extension splint alternativley by post-operative 1 week. The follow up period was minimally 12 months. The range of motion and Schatzker and Lambert criteria were evaluated.
RESULTS
The mean period to gain 90degrees knee flexion was 11.4 (7~14) weeks in group A, and 6.6 (3~8) weeks in group B. Mean range of motion was 94.7degrees (average flexion contracture 9.5degrees ) in A group and 108.7degrees (average flexion contracture 6.3degrees ) in B group at 12 weeks follow-up. According to Schatzker and Lambert criteria, excellent result was achieved in 10 cases (38%), good result in 13 cases (50%), fair result in 3 cases (12%).
CONCLUSION
This study demonstrates that alternative splinting at extension and 90degrees flexion contribute to early recovery of range of motion in distal femur fractures treated with internal fixation.

Citations

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  • Treatment of Femur Supracondylar Fracture with Locking Compression Plate
    Seong Ho Bae, Seung Han Cha, Jeung Tak Suh
    Journal of the Korean Fracture Society.2010; 23(3): 282.     CrossRef
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Treatment of Open Tibial Shaft Fractures using Unreamed Nailing
Jong Keon Oh, Chang Wug Oh, Kwon Jae Roh, Duk Moon Chung
J Korean Fract Soc 2005;18(1):22-28.   Published online January 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.1.22
AbstractAbstract PDF
PURPOSE
To report the results of unreamed nailing using a nail with the largest possible diameter for the management of the open tibial shaft fractures.
MATERIALS AND METHODS
Nineteen patients with open tibial shaft fractures underwent unreamed nailing with the largest possible diameter according to the isthmic diameter measured on preoperative radiography. There were 1 Grade I, 6 Grade II, 9 Grade IIIa, 3 Grade IIIb open fractures. There were 4 type A, 12 type B, 3 type C fractures according to the OTA classification. Fractures were classified as The nail was introduced after gentle passage of a 7 to 8 millimeter-hand reamer.
RESULTS
Union was obtained in all cases. However 9 (47%) fractures required an additional procedures before union. In 6 cases, dynamization was done. Two of them were required exchange nailing for nonunion, 1 of two gained bony union through additional bone graft. Three of the others had gained union through exchange nailing, bone graft, bone transport respectively. There were one rotational malunion, one superfical and one deep infection. Interlocking screw breakage developed only in one patient.
CONCLUSION
Our data indicate that unreamed nailing in the management of open tibial fractures is safe and reliable method. Using a tight fitting nail with the largest possible diameter is a safe and effective way to avoid the problems of screw breakage.

Citations

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  • Treatment of Type IIIb Open Tibial Fractures
    Seong Yeon Lim, Il Jae Lee, Jae Ho Joe, Hyung Keun Song
    Journal of the Korean Fracture Society.2014; 27(4): 267.     CrossRef
  • Management of Open Tibial Fractures: Role of Internal Fixation
    Yerl-Bo Sung
    Journal of the Korean Fracture Society.2007; 20(4): 349.     CrossRef
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T-Plate Fixation for Fractures of Distal Radius
Jae Yeol Choi, Hwa Jae Jung, Hong Kyun Kim, Jong Keun Lee, Il Sung Chang
J Korean Fract Soc 2004;17(4):350-358.   Published online October 31, 2004
DOI: https://doi.org/10.12671/jkfs.2004.17.4.350
AbstractAbstract PDF
PURPOSE
To review the result of fractures of distal radius treated with the T-plate fixation and to recommend guideline for treatment of fracture of distal radius.
MATERIALS AND METHODS
Between January 1999 and December 2002, among the patients with fractures of distal radius underwent T-plate fixation, we retrospectively reviewed 52 cases that had a minimum follow-up of 12 months. According to the Fernandez classification of distal radius fractures, 18 cases were type I, 4 cases were type II, 22 cases were type III, 2 cases were type IV and 6 cases were type V. To assess the clinical result, we used the Demerit Point System and for the radiologic result, we used the Point system by Scheck. We Compare the result of treatment in fractures of distal radius by T-plate fixation and K-wire fixation in Type I and III.
RESULTS
Excellent to good results were obtained in 38 cases (73%) in clinical result and 39 cases (75%) in radiological results. Radiologic evidence of arthritis was presented 6 cases at follow-up examination. There was no evidence of statistical difference between Type I using T-plate and K-wire fixation (p>0.05). However in type III, result in the group of T-plate fixation were better than in pinning group (p<0.05).
CONCLUSION
We obtained good result for type III with T-plate but only T-plate fiaxtion for type V was not satisfactory

Citations

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  • Flexor Pollicis Longus Tendon Rupture as a Complication of a Closed Distal Radius Fracture - A Case Report -
    Do-Young Kim, Eun-Min Seo, Woo-Dong Nam, Seung-Jae Park, Sang-Soo Lee
    Journal of the Korean Fracture Society.2011; 24(2): 191.     CrossRef
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Grade III Tibia Open Fractures Treated with Unreamed Tibial Nailing
Chang Wug Oh, Hee Soo Kyung, Do Heon Kim, Il Hyung Park, Poong Taek Kim, Joo Chul Ihn, Yeon Ki Woo, Jung Yup Lee
J Korean Fract Soc 2004;17(2):148-152.   Published online April 30, 2004
DOI: https://doi.org/10.12671/jkfs.2004.17.2.148
AbstractAbstract PDF
PURPOSE
This is a retrospective study to analyze the results of unreamed intramedullary nailing in grade III tibial open fracture.
MATERIALS AND METHODS
Twenty-nine Gustilo-Anderson grade III tibial open fractures fixed with unreamed tibial nail were followed more than one year. Primary union rate, union time, infection, conversion to external fixation, ankle and knee function according to different grade of open, fracture level, AO classification, and muscle flap were evaluated.
RESULTS
Primary union was achieved at sixteen fractures. There were three delayed union that achieved union twenty week after primary operation. And eight undergone secondary bone grafts which were done after inflammation sign subcided. Complications about infection were in five cases. Two cases were unable to maintain internal fixation due to deep infection, and three of superficial infection were treated with repeated debridement and antibiotics use.
CONCLUSION
In grade III tibial open fracture, unreamed nailing with early soft tissue reconstruction and early prophylactic bone graft can be a good treatment.

Citations

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  • Management of Open Fracture
    Gu-Hee Jung
    Journal of the Korean Fracture Society.2010; 23(2): 236.     CrossRef
  • Management of Open Tibial Fractures: Role of Internal Fixation
    Yerl-Bo Sung
    Journal of the Korean Fracture Society.2007; 20(4): 349.     CrossRef
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Treatment of Completely Displaced Supracondylar Fracture of Humerus in Children
Bu Hwan Kim, Mu Jung Heo, Won Jun Hwang
J Korean Soc Fract 2003;16(4):585-591.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.585
AbstractAbstract PDF
PURPOSE
We performed a retrospective study of completely displaced supracondylar fracture of humerus in children to evaluate the result of primary open reduction and internal fixation for this injuries, and also to know whether it is recommendable or not for such injuries.
MATERIALS AND METHODS
For 5 years duration from March '96 to Feb. '01, we treated 58 cases of completely displaced supracondylar fractures of humerus in children. Among them we performed primary open reduction and internal fixation of this fracture in 14 cases. We followed up those cases more than 18 months and evaluated the results by Flynn et al. and Mark et al. criteria.
RESULTS
Eleven of them resulted in excellent grading by both Flynn and Mark criteria. Three cases not involved in excellent grading proved to be good result by Mark criteria. But by Flynn criteria, 2 cases showed good results and the other one proved to be fair. In all cases, the patient and parents were satisfied cosmetically and functionally. Only in one case, the recorded grading was different, fair by Flynn and good by Mark criteria.
CONCLUSION
Primary open reduction and internal fixation in the treatment of completely displaced and not easily reduced supracondylar fracture of humerus in children resulted excellent and good results with few complications, and patients were satisfied with the results functionally and cosmetically. So we recommend proceeding to primary open treatment and internal fixation for these difficult fractures with low threshold to open reduction.

Citations

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  • Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique
    H.-Y. Lee, S.-J. Kim
    The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646.     CrossRef
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Surgical Treatment of Unstable Pelvic Bone Fracture Involving Sacroiliac Joint
Myung Ho Kim, Hee Gon Park, Moon jib Yoo, Jin Woo An
J Korean Soc Fract 2003;16(4):433-440.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.433
AbstractAbstract PDF
PURPOSE
To evaluate the results of surgical method using plate and screws in the treatment of unstable pelvic bone fracture involving Sacroiliac Joint.
MATERIALS AND METHOD
Authors reviewed 21 patients treated by surgical method from 1998 to 2002. Mean follow-up period was 15 months (12~24 month). Male were 16 and female were 5. We used plate and screws in 18 cases, just screws in 3 cases. We classified the type of fracture by Tile's classification and evaluated the results with Moon's criteria that based on reduction state in simple x-ray and patient's subjective satisfaction.
RESULTS
We got the bony union in all cases. By Moon's criteria, 10 cases were good, 7 cases were fair and 4 cases were poor. In 17 cases (80.9%), we got the results over fair. Mean weight bearing exercise periods were 6.4 weeks. There were 2 infection and 2 sacroiliac arthritis after operation.
CONCLUSION
As a method of surgical treatment on unstable pelvic bone fracture involving sacroiliac joint, we recommend open reduction and internal fixation with plate and screws and it may has particular advantages in early ambulation and satisfactory functional outcome.
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The Results of Operative Treatment in Open Type III Tibia Fracture
Kyung Jin Song, Sung Jin Shin, Byung Yun Hwang, Myung Sik Park
J Korean Soc Fract 2003;16(2):194-200.   Published online April 30, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.2.194
AbstractAbstract PDF
PURPOSE
The purpose of this study was to analyze the functional outcome and propose the guidelines in the surgical treatment of open type III tibial fracture.
MATERIALS AND METHODS
We have analyzed the treatment results of 44cases; age was ranged from 15 to 76 years, and there were 35 males and 7 females. The type of fracture according to the classification by Gustilo revealed type IIIa 14 cases, type IIIb 20 cases and type IIIc in 8 cases. We analyzed functional outcome according to the classification of functional result by Tucker.
RESULTS
The average union time of type IIIa was 9.2 months, IIIb 11.0 months, and IIIc was 13.8 months. The rotational flap and free flap were done during treatment and bone lengthening especially in type IIIc. Functional results were poor especially in type IIIc.
CONCLUSION
Debridement of devitalized tissue, early soft tissue coverage and sufficient stability using intramedullary nails will be necessary in type IIIa fracture. Rigid external fixation, early soft tissue coverage by rotational muscle flap and free flap reduced infection rate with satisfactory functional outcome especially in type IIIb and IIIc fractures.
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Hybrid External Fixation and Limited Internal Fixation for Severe Open Tibial Shaft Fractures
Hong Jun Han, Soo Uk Chae, Ul Oh Jeung
J Korean Soc Fract 2003;16(1):52-58.   Published online January 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.1.52
AbstractAbstract PDF
PURPOSE
To evaluate the radiographic and clinical results of severe open tibial shaft fracture treated by hybrid external fixation and limited internal fixation.
MATERIALS AND METHODS
We reviewed 25 patients open tibial shaft fracture(> or =Gustillo classification type II) which were treated with hybrid external fixation(AnyFixR) that was invented by authors and limited internal fixation between June 1998 to June 2001. 20 males and 5 females were minimum follow up period of 12 months(12-27 months). The mean age was 45 old years(11-72 old years). The results were based on the assessment radiographical analysis with duration of bony union, delayed union including of states of nonunion and malunion, clinical analysis with pain, joint range of motion, wound infection and skin & soft tissue coverage. All fractures were classified according to the Gustilo classification, there were 6 cases of type II, 9 cases of type IIIa and 10 cases of type IIIb. The cause of injury, there were 18 cases of motor vehicle accident, 5 cases of direct trauma and 2 cases of fall from height.
RESULTS
In twenty-five cases, fifteen had union, the average time of bone union was 6.8 months and additional bone graft without change of external fixator performed in ten cases, but one case have failed and then change of intramedullary nail with bone graft. In the group of bone graft, bone union was completed at mean 8.7 months. According to the clinical analysis, no pain in the fracture site, in complications, there were 2 cases of mild joint range of motion that has acceptable result and 2 cases of wound infection were treated with effective antibiotics theraphy and wound dressing. Five cases need to coverage of the open wound, 3 cases were flap operation and each case were muscle transfer, skin graft without change of external fixator.
CONCLUSION
The use of hybrid external fixation and limited internal fixation in severe open tibial shaft fracture to be successful for the stabilization of fracture and subsequent plastic and/or orthopaedic procedure for muscle and skin coverage, bone grafting are more easily accomplished without change of external fixator.
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Minimal Open Reduction and Interlocking IM Nailing of Comminuted Humeral Shaft Fracture: Comparison between Plate Internal Fixation
Kyeong Jin Han, Soo Ik Awe, Tae Young Kim, Shin Young Khang
J Korean Soc Fract 2002;15(4):573-580.   Published online October 31, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.4.573
AbstractAbstract PDF
PURPOSE
We compared the functional and radiological results after the minimal open reduction and interlocking IM nailing and LC-DCP plate internal fixation for the comminuted humeral shaft fractures.
MATERIALS AND METHODS
Fourteen plates(LC-DCP) and eighteen interlocking IM nail(AO unreamed IM nail) were applied after open reduction for 32 comminuted fractures of the humeral shaft between March 1997 and December 2001. They were followed up for a minimum 9 months after surgery and the radiological and functional results were evaluated.
RESULTS
The average fracture healing time was 13.2 weeks and union rate was 85.7% for plate internal fixation. The average fracture healing time was 12.4 weeks and union rate was 94,4% for interlocking IM nail. The average functional scores according to American Shoulder and Elbow Surgeon 's (ASES) shoulder score(Total 52 points) was 44 points for plate internal fixation and 47 points for interlocking IM nailing respectively.
CONCLUSION
Minimal open reduction and interlocking IM nailing is better method with good functional and radiological results than plate internal fixation for the comminuted humeral shaft fractures.
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Treatment of the Distal Metaphyseal Fractures of Tibia - Comparison between Internal Fixation with a Plate and screws and External Fixation with Ilizarov Device
Sung Churl Lee, Moon Jib Yoo, Hyun Seok Seo
J Korean Soc Fract 2002;15(3):371-378.   Published online July 31, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.3.371
AbstractAbstract PDF
PURPOSE
The purpose of this study was to compare the results between open reduction and internal fixation with plate and screws and closed reduction and external fixation with Ilizarov device for the fracture of disatal metaphyseal fracture of tibia.
MATERIALS AND METHODS
In this study, the results in treatment of the 19 distal metaphyseal fractures of tibia with closed reduction and external fixation with Ilizarov device were compared with those in treatment of the 23 fractures with open reduction and internal fixation with a plate and screws. The cases were the patients who had been treated for the fractures at the Department of Orthopaedic Surgery, Dankook University Hospital from May 1997 to December 2000. The results of treatment were analysed using functional evaluation by Mast and Teipner and radiological evaluation by Ovadia and Beals.
RESULTS
The results were as follows: 1. The major causes of injury were motor vehecle accidents, fall-downs, and falls from a height in order. 2. Treatment of the fractures with closed reduction and external fixation with Ilizarov device showed comparable results to that with open reduction and internal fixation with a plate and screws. 3. Complications in treatment were a little more frequent in open reduction and internal fixation with a plate and screws than in closed reduction and external fixation with Ilizarov device.
CONCLUSION
Considering the results, closed reduction and external fixation with Ilizarov device is thought to be one of recommendable options in treatment of the distal metaphyseal fractures of tibia with the advantages in wound management, prevention of stiffness of ankle joint, and convenience in removal of the device.

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  • Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator
    Suk Kyu Choo, Kyung Wook Nha, Hyoung Keun Oh, Dong Bong Lee
    Journal of the Korean Fracture Society.2007; 20(4): 323.     CrossRef
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Treatment of Severe Open Fractures of Tibial Shaft: Comparison Between Ilizarov External Fixation and Secondary Intramedullary Nailing
Hyoun Oh Cho, Kyoung Duck Kwak, Hong Joo Lee, Dae Hwan Lim, Sang Min Ahn, Jae Ho Chang, Kyung Ku Kang
J Korean Soc Fract 2002;15(2):234-242.   Published online April 30, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.2.234
AbstractAbstract PDF
PURPOSE
We tried to compare the results of Ilizarov external fixation cases with the cases of secondary intramedullary nailing after tempory Ilizarov fixation.
MATERIALS AND METHODS
From the January 1996 to February 2001 , 34 cases of severe open tibial shaft fracture in adults were treated with Ilizarov external fixation and secondary intramedullary nailing after temporary Ilizarov fixation. According to Gustilo- Anderson classification, it consisted of type II 2 ,IIIA 7 ,IIIB 9 ,IIIC 2cases in Ilizarov group ,and type II 2, IIIA 7, IIIB 5cases in secondary intramedullary nailing group.
RESULT
There was no significant difference in the union time of Ilizarov external fixation and secondary intramedullary nailing after temporary Ilizarov fixation. But the secondary nailed group had slightly better motion , less final angulation and felt more comfortable . It is the treatment preferred by patients and does not require the same high level of patient compliance as external fixation.
CONCLUSION
Secondary intramedullary nailing after temporary Ilizarov fixation is the useful method in the treatment of open fractures of tibia.
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Operative Treatment of Open Tibial Fracture
Kyung Jin Song, Sun Woong Jang
J Korean Soc Fract 2002;15(1):45-51.   Published online January 31, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.1.45
AbstractAbstract PDF
PURPOSE
The purpose of the present study was to clarify the contributing factors, such as the method of fracture stabilization, type of internal fixation and the deep infection rate(DIR) in the treatment of open tibial fractures. MATERIAL AND METHODS: We made a retrospective study of these 87 open tibial fractures treated with various fixation method. Patients were divided into immediate internal fixation(IIF) group, delayed internal fixation(DIF) group and external fixation(EF) groups. Fixation methods, deep infection rate related with fixation devices and time to bone union were compared and anaylzed according to the Gustilo`s classification.
RESULTS
The mean time to union in open type I, II, IIIa, IIIb, and IIIc was 5.7 months, 8.6 months, 7.1 months, 9.7 months, and 18.0 month respectively. The mean time to union in group IIF, DIF1, DIF2 and EF was 7.2 months, 8.1 months 5.5 months, and 10.7 months and 13.1 months. The mean time to union of group using a interlocking IM nailing, plate and screws, and external fixator was 6.3 month, 6.9 months, and 10.6 months. SUMMARY: We concluded that there is an advantage of immediate internal fixation over external fixation in the prevention of infection and promotion of fracture healing in the treatment of open tibia fractures. Immediate internal fixation could be recommended for type I, II, IIIa and some cases of IIIb open tibia fracture.
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Limb Salvage versus Early Amputation according to Mangled Extremity Severity Score in Treatment of the Lower Extremity Open Fractures associated with Severe Soft Tissue Injury
Kyung Jin Song, Yong Min Kim, Kyung Rae Lee
J Korean Soc Fract 2002;15(1):28-35.   Published online January 31, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.1.28
AbstractAbstract PDF
PURPOSE
To evaluate the availability of the mangled extremity severity score(MESS) in deciding the early treatment modality for the patients with open lower extremity fractures and severe soft tissue injury.
MATERIALS AND METHODS
Analyzed 27 patients for the lower extremity open fractures with extensive soft tissue injury. A comparative study using a MESS, a cause of injury, vascular injury and a fracture pattern, average hospital stay and average hospital charges were analyzed, and daily living ability and subjective self-evaluation were assessed.
RESULTS
There was statistically significant correlation applying MESS to patient group that had been operated by early amputation because of severe soft tissue and vascular injury. But there was no significant difference in the subjective self-assessment score, admission period and total cost during admission between each treatment method.
CONCLUSION
MESS can be used as an objective assessment criteria in deciding the proper treatment modality for the cases of lower limbs fracture with extensive soft tissues and vascular injury.
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Nonunion after open reduction and internal fixation of clavicle fractures
Jeung Tak Suh, Jung Sub Lee, Sung Jong Choi
J Korean Soc Fract 2001;14(4):714-719.   Published online October 31, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.4.714
AbstractAbstract PDF
PURPOSE
To report our experiences of treatment with reviewing literatures and articles about the fractures of plate and nonunion after open reduction and internal fixation of clavicle fracture.
MATERIALS AND METHODS
9 cases among 104 cases of clavicle fractures of reoperation due to the fractures of plate or nonunion after open reduction and internal fixation were included. Treatment results were analyzed after 5 months in regard to fracture site pain, gross deformities, limitation of movement of shoulder, discomfortness of casual activity, and patients' personal satisfaction.
RESULTS
According to the criteria of Kang et al 9 cases were classified into excellent 2 cases, good 4 cases, fair 2 cases, poor 1 case. All cases showed bone union average 14.4(12-26) weeks after reoperation. 3 cases of complications were 3 limitation of movement of shoulder, I superficial wound infection.
CONCLUSION
In operative treatment of clavicle fracture more than three screws in both side of fracture line shoulder be fixated and early exercise of shoulder motion seemed to be needed. In cases of less than three screws fixated, additional external protection is thought be necessary.
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Comparison of External Fixation and Interlocking IM Nail in Open Tibial Fractures
Hyung Jin Chung, Duck Kyu Kim, Yerl Bo Sung, Jong Guk Ahn
J Korean Soc Fract 2001;14(4):632-642.   Published online October 31, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.4.632
AbstractAbstract PDF
PURPOSE
To compare and analyze the results of the treatment based on the method of treatment between interlocking IM nail and external fixation of type II, III A, and III B open fractures of the tibia] shaft.
MATERIALS AND METHODS
A clinical analysis was performed on 57 cases of type II, III A, and III B open fractures of tibial shaft from January 1994 to October 1999 those studies are followed at least 1 year or more. The results was analyzed according to complications and functional results based on operative methods of types of open fractures.
RESULTS
In aspect of delayed union and nonunion, interlocking IM nail indicate a great results(p = 0.036) in type II. In angulation, interlocking IM nail marks an outstanding results in case of type II. There is no difference between interlocking IM nail and external fixation in infection. But, the delay of operation after injury increase the possibilities of infection.
CONCLUSION
At present, especially in type m, external fixation was preferred. But, interlocking IM nail has a good results in aspect of complications. Therefore unreamed intramedullary nailing for open tibia shaft fractures is a good treatment method to be recommended.
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Triradiate Approach in Surgical Treatment of Complex Fracture of Acetabulum
Kang Il Kim, Kyung Hoi Koo, Bun Joong Kang, Hyung Bin Park, Sun Chul Hwang, Soon Taek Jeong, Hae Ryong Song, Se Hyun Cho
J Korean Soc Fract 2001;14(4):616-622.   Published online October 31, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.4.616
AbstractAbstract PDF
PURPOSE
To determine the advantages of triradiate approach in complex acetabular fractures, the results were reviewed for 24 patients who had open reduction and internal fixation of complex acetabular fractures with a triradiate approach.
MATERIALS AND METHODS
Twenty four patients were followed for a mean of 3 years after the operation. All patients with complex fractures of the acetabulum were treated with open reduction and internal fixation using Y-shaped triradiate incision, osteotomy of the greater trochanter, and arthrotomy of the hip joint. In 13 patients the fracture was fixed with reconstruction plates and in I 1 patients the fracture was fixed with the plates and wires.
RESULTS
All fractures united and no patient required subsequent total hip replacement arthroplasty. Four patients had heterotopic ossification without serious limitation of motion of the hip and one patient had grade IV lesion as defined by Brooker et al, which limited motion of the hip enough to impair function. Six patients showed posttraumatic arthritis at the latest radiograph. The overall clinical result was excellent for 7 hips, good for 13, and fair for 4 as defined by d' Aubigne and Postel. The radiological result was excellent for 13 hips, and good for 6 as defined by Matta. One femoral head necrosis was observed at the latest follow-up.
CONCLUSION
A triradiate approach provides a good extra and intraarticular access to complex fracture of the acetabulum, which facilitates an accurate reduction, rigid fixation, removal of loose osteochondral fragments and management of labial injury, without increased morbidity of the hip joint.
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Selective treatment for completely displaced supracondylar fractures of the humerus in children
Chang Wug Oh, Byung Chul Park, Young Woo Kim
J Korean Soc Fract 2001;14(3):534-540.   Published online July 31, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.3.534
AbstractAbstract PDF
PURPOSE
This retrospective study was performed to know the clinical results after closed reduction and open reduction for completely displaced supracondylar fractures of distal humerus in children.
MATERIALS AND METHODS
Twenty-eight cases of this injury at the mean age of 6.4 (range 21- 138 months), have been followed up over the minimum of one year. The types according to the position of displacement were 15 in posteromedial, and 13 in posterolateral displacement. There were 4 cases of associated nerve palsies (3;median, 1; radial). We tried the closed reduction (17 cases), but open reduction (11 cases) was indicated in irreducible cases with or without severe swelling. Then, the fractures were stabilized by percutaneous K-wires with lateral (23 cases) or cross pinning (5 cases). The differences of Baumann's angle, humero-ulnar angle, and elbow motion to uninjured side were calculated, and Flynn's criteria was used for evaluation.
RESULTS
All fractures were united without any infection or soft tissue compromise. The symptoms of injured nerve recovered within 8 weeks. According to Flynn's cirteria, results were excellent in eleven, good in 12, fair in 2, and poor in 3. The rates of satisfactory results over good were similiar between closed and open reduction, and the other factors including age and type of displacement were not meaningful. The mean Baumann's angle was 8.7 in closed and 6.6 in open reduction group. None of the patients showed restricted elbow motion above 10 degrees, even in 3 cases of hypertrophic scars in the group of open reduction.
CONCLUSION
The selective use of open reduction in completely displced supracondylar fractures of distal humerus in children, would show results as good as closed reduction.
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Treatment of Open Tibial Fracture with Repofix External Fixator
Ho Choi, Hoon Kim, Neung cheol Shin, Sang Ho Shin, Dong Soo Han
J Korean Soc Fract 2001;14(3):412-418.   Published online July 31, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.3.412
AbstractAbstract PDF
PURPOSE
The purpose of this study is to evaluate the results of treatment of open tibial fracture with Repofix external fixator by clinical and radiological assessement. MATERIAL AND METHODS: 24 cases of open tibial fracture, who had been treated with Repofix external fixator from Oct. 1995 to June 1999, were evaluated about distribution of gender, age, cause of injury, fracture site and pattern, and assessed bony union time and complication.
RESULTS
The mean period of application of external fixator was 12.3 weeks and we kept PTB cast until bony union for average 11.5 weeks. According to Gustilo-Anderson's classification, the mean bony union time was 21.7 w e e k s ( type I ), 36 weeks(type II) and 39 weeks(type III), simple fracture was 22 weeks, comminuted fracture was 32 weeks(p<0.05). Complications were pin site infection(9 cases), delayed union(3 cases), nonunion(1 cases) and focal skin necrosis(1 case). There was no loss of motion about joint.
CONCLUSION
Repofix external fixator, which has the advantages of accurate reduction without extension of wound and decreases motion limitation of neighboring joint, is alternative useful appratus for open tibial fracture.

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  • Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases
    Ji-Hye Geum, Hyeon-Jun Woo, Jong-gyu Kim, Jung-Han Lee
    Journal of Korean Medicine Rehabilitation.2020; 30(4): 203.     CrossRef
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