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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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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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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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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

Citations to this article as recorded by  
  • 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

Citations to this article as recorded by  
  • 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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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
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

Citations to this article as recorded by  
  • 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

Citations to this article as recorded by  
  • 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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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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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 Article
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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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

Citations to this article as recorded by  
  • 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

Citations to this article as recorded by  
  • 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

Citations to this article as recorded by  
  • 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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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

Citations to this article as recorded by  
  • 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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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

Citations to this article as recorded by  
  • 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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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.

Citations

Citations to this article as recorded by  
  • 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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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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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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