Journal of Musculoskeletal Trauma

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

Abstract 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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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

Abstract 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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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

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.

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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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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

Abstract 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.

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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

Abstract 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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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

Abstract 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.

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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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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

Abstract 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.

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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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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

Abstract 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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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

Abstract 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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Operative Treatment of Radial Head Fracture of Mason type III: Ho Jung Kang, Moon Soo Park, Sang Jin Shin, Eung Shick Kang, Byeong Mun Park; J Korean Soc Fract 1999;12(3):732-740. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.732

Abstract PDF: The treatment of choice for Mason type III radial head fracture was total excision. But, open reduction and internal fixation of fractures of the radial head has become a commonplace as the result of both improvements in the techniques and implants for the fixation of small articular fragments as well as increasing recognition of the important role that the radial head plays in the stability of the forearm and elbow, particularly in the face of acute combined osseous and ligamentous injury. To date, reports of radial head fixation have made little mention on Mason type III fracture. From January 1993 to September 1997, 10 patients with fracture of radial head(Mason type III) were treated at Yong-dong Severance Hospital, Yonsei University College of Medicine. There were 6 males and 4 females with average age of 30 years(range 16 to 47). All of the fractures were comminuted and Mason type III. Seven fractures were the results of falling down and two slipping down and one pedestrian injury. Six fractures(60%) were evaluated as good or excellent by Bruces criteria. The heterotopic ossification was complicated in two cases. The nonunion of radial head fracture occured in two cases. The radial nerve palsy occured in one case. The partial ankylosis of elbow developed in three cases. Kirschners wires migrated in four cases. Open reduction and internal fixation increased the range of motion and decreased the subjective pain and did not cause any proximal migration of radius, impingement of ulnar carpal and radiocapitellar joint and could be a good treatment modality. The further evaluation should be directed to camparison between the open reduction and internal fixation and prosthetic replacement after total excision of radial head.

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Open Reduction & Internal Fixation for The Nonunion of Scaphoid Fracture: Eung Shick Kang, Ho Jeong Kang, Keun Soo Lee; J Korean Soc Fract 1996;9(1):8-14. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.8

Abstract PDF

Scaphoid fracture is the most common carpal bone fracture and at least 5% of acute fractures of the scaphoid fail to unite after conservative treatment. The failures have been attributed to delay in beginning treatment, inadequate immobilization, displacement of fragments, instability due to ligamentous injury, and inadequate blood supply of the proximal fragment. Previously, some authors reported several kinds of treatment mordality for nonunion of scaphoid. Of all the techniques that have been introduced, we have used open reduction and internal fixation (O/R & I/F) with autogenous iliac bone graft(AIBG). We reviewed the 10 cases of patients who underwent O/R & IT with K-wire or Herbert screw and A1BG from Jan 1985 to Aug 1994. The results were as follow 1.Among 10 cases, 9 cases were male and 1 case was female, and all cases were right hand, and most common age group was twenties (70%). 2.The most common cause of injury was falling with outstretched hand in 8 cases. 3.In the previous treatment, 8 cases had non-specific treatment and 2 cases had cast immobilization. 4.In the operation method, open reduction and internal fixation (O/R & IT) with K-wire combined with autogenous iliac bone graft (AIBG) for 8 cases, and O/R & I/F with Herbert screw combined with AIBG for I case and O/R & I/F with Herbert screw without bone graft for 1 case. 5-After operation, average duration of cast immobilization was 2.8 months (2.5months-3months). 6.All patients had a bony union with average duration 6.2 months (3months- 10months).

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Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture
Jae Kwang Kim, Jong Oh Kim, Seung Yup Lee, Nam Hoon Do
Journal of the Korean Fracture Society.2009; 22(2): 104. CrossRef

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A Clinical Analysis of Open Reduction of the Ankle Fracture: Eun Kyoo Song, Go Hun Chung, Dae Yeon Hong; J Korean Soc Fract 1996;9(1):212-219. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.212

Abstract PDF: The ankle is a modified hinge joint consisting of tibial plafond, medial and lateral malleolus, talus and many soft tissue structures, which play important role in weight bearing and walking. Ankle joint injury is determined by patients age, quality of bone, the position of a ankle at trauma, direction and degree, velocity of force. Hence, it is very important to understand the mechanism of trauma in order to make definite diagnosis and proper treatment. The authors analysed 71 cases(66 patients) of the ankle fracture which were admitted and treated in Orthopaedic Department, Chonnam University Hospital from Aug. 1985 to June 1994. The most common type of the ankle fracture was supination external rotation type(17 cases, 23.9%), by the classification of Lauge-Hansen, and type C(30 cases, 42.3%) by the AO classification. According to the criteria of Meyer using the clinical and radiological result, pronation-external rotation type gave the best result and the worst results obtained from pronation-dorsiflexion type. We concluded that classification of Lauge-Hansen & AO were useful in the diagnosis and treatment of ankle fracture and accurate reduction and rigid internal fixation of the lateral malleolus, distal fibula and distal tibiofbular diastasis was important in treatment of the ankle fracture.

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Open Reduction & Internal Fixation of Long Bone Fracture in Osteopetrosis Patient: Bu Hwan Kim, Jong In In, Woo Seong Choi; J Korean Soc Fract 1995;8(2):407-412. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.407

Abstract PDF

Bone quality in osteopetrosis patient is very hard but brittle and easily fractured by triviat trauma. In case of pathological fractures in osteopetrosis patient, most of the fractures are treated by conservative treatments. But some long bone fractures are difficult to treat conservatively. A few surgeons treated the fracture by open reduction and internal fixation(ORIF) and they came to agree that ORIF of fractures were very difficult technically. We tried plate and screw fixation for a subtrochanteric fracture of femur in a 20-year-old osteopetrosis patient who have already had 4 previous long bone fractures. 1. We changed drill bit everytime for every screw hole penetration and it took about 2 minutes for a hole. 2. ORIF is adventageous in fracture of suitable location in osteopetrosis patient.

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Triple Osteotomy for Hallux Valgus in Patient with Osteopetrosis - A Case Report -
Seung Do Cha, Hyung Soo Kim, Jeong Hyun Yoo, Jai Hyung Park, Joo Hak Kim, Joo Won Joh
The Journal of the Korean Orthopaedic Association.2008; 43(6): 808. CrossRef

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Fracture of Distal Radius Treated with Open Reduction and Internal Fixation: Bak Yeong Jeong, Seung Wook Yang, Young Cheol Shin, Young Ho Kim; J Korean Soc Fract 1994;7(2):501-511. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.501

Abstract PDF: Seventeen cases of unstable comminuted fractures of distal radius were treated with open reduction and internal fixation from Jul. 1988 to Apr. 1992 at the department of orthopaedic surgery at Maryknoll Hospital. Most of the fractures were the resutts of high-energy impact and the results of this study were as follows: 1. According to Fernandez classification, the type A 3.2 fracture was most common, and nine of 17 patients were classifled as C2 and C3 (intra-articular comminuted fracture) and eight as A3(extra-articular comminuted fracture). 2. The final result of wrist motion showed dorsiflexion/palmar flexion to be 77.6% of the opposite site and of the grip strength was 80.6% of the opposite site. 3. In the cases of extra-articular comminuted fracture, attention was focused on restoration of radial length, and in the cases of intra-articular fracture, better results were obtained with achieving congruent articular reduction. 4. The funtional end results were superior especially in young patients.

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