Journal of Musculoskeletal Trauma

Comparison of a Novel Box-Frame External Fixator and Conventional Delta-Frame External Fixator in the Staged Treatment of Distal Tibia Fractures: Yong-Cheol Yoon, MinKyu Shin, Chang-Wug Oh, Jong-Keon Oh; J Korean Fract Soc 2020;33(3):125-133. Published online July 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.3.125

Purpose
Distal tibia fractures with severe soft-tissue edema or intra-articular fractures are treated by staged operations using external fixators. Definitive surgery that maintains ligamentotaxis has been difficult using existing fixators. This study introduced a novel ‘box-frame’ external fixator and evaluated its clinical usefulness.
Materials and Methods
This study included 45 patients (32 males, 13 females) diagnosed with distal tibia fractures who underwent staged operations between March 2012 and March 2016, with a follow-up of at least one year. The patients were divided into two groups. In one group, fixation was performed with a box-frame external fixator (Group A). In the other group, fixation was performed with a delta-frame external fixator (Group B). The following outcomes were evaluated: the time until definitive surgery, operative time of the definitive surgery, radiation exposure time, bone union, time to achieve bone union, postsurgical complications, American Orthopaedic Foot & Ankle Society anklehindfoot score, and ankle range of motion.
Results
Compared to the delta-frame, the box-frame showed a statistically significant reduction in the mean radiation-exposure time and operative time during the definitive surgery by 58 seconds and 25 minutes, respectively. The differences in the time until definitive surgery, bone union, time to achieve bone union, postsurgical complications, and functional scores were not significant.
Conclusion
The box-frame external fixator can be a useful treatment method in the staged surgery of distal tibia fractures.

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Temporary Circular External Fixation for Spanning the Traumatized Ankle Joint
Nando Ferreira, Niel Bruwer, Adriaan Jansen van Rensburg, Ernest Muserere, Shao-Ting Jerry Tsang
JBJS Essential Surgical Techniques.2024;[Epub] CrossRef
Temporary circular external fixation for spanning the traumatised ankle joint: A cohort comparison study
William D. Harrison, Franklin Fortuin, Matthieu Durand-Hill, Etienne Joubert, Nando Ferreira
Injury.2022; 53(10): 3525. CrossRef

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Morbidity and Mortality of the Elderly after Early Operation for Trochanteric Fractures: Se Ang Jang, Young Ho Cho, Young Soo Byun, Ki Hong Park, Hyun Seong Yoo, Chul Jung; J Korean Fract Soc 2013;26(3):199-204. Published online July 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.3.199

Abstract PDF

PURPOSE
To find out the effect of early closed reduction and internal fixation (within 24 hours after admission to hospital) on the morbidity and mortality in the elderly with intertrochanteric fractures of the femur.
MATERIALS AND METHODS
Retrospectively, we analyzed 99 patients with intertrochanteric fracture of the femur who underwent surgery from January, 2009 to December, 2010. We reviewed 89 of the 99 patients and checked for early complications and reviewed the mortality rates 3 months, 6 months and 1 year after surgery. There were 24 males and 65 females. The average age was 79.8 years (61-99 years). According to the American Society of Anesthesiologists classification, 25 patients were class 1, 37 patients were class 2, 26 patients were class 3, and 1 patient was class 4. All patients were operated on by one surgeon, who was skilled in inserting intramedullary nail.
RESULTS
The average surgical time was 43 minutes and the average intraoperative blood loss was 165 ml. Sixteen patients experienced delirium but all of them recovered. One patient had pneumonia at one month after surgery. Pressure sores developed in one patient but improved with conservative treatment. Pulmonary thromboembolism developed in some patients one month after surgery. Three patients (3.4%) died within three months and one patient (1.1%) died between three and six months after surgery, but no patient died between six months and one year after surgery.
CONCLUSION
If patients are optimized for the operation, early internal fixation of trochanteric fracture in elderly patients after arrival at the hospital should be considered to reduce early complications and mortality.

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PREOPERATIVE NUTRITIONAL STATUS OF HIP FRACTURE PATIENTS: A PILOT STUDY IN 116 PATIENTS
Myung-Sang Moon, Min-Suk Park, Bong-Keun Park, Dong-Hyeon Kim, Min-Geun Yoon
Journal of Musculoskeletal Research.2017; 20(01): 1750002. CrossRef

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A Comparative Study of Reamed and Unreamed Nail for Femoral Shaft Fracture's Treatment: Hee gon Park, Myoung ho Kim, Mun jib Yoo, Woo sup Byun; J Korean Soc Fract 2003;16(2):169-176. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.169

Abstract PDF: PURPOSE
The comparative analysis of clinical difference between the use of reamed nail and unreamed nail in treatment of femoral shaft fracture.
MATERIALS AND METHODS
In 105 patients with femoral shaft fracture who were treated with reamed nail or unreamed nail between June of 1997 and April of 2000, 95 patients who underwent more than a year of follow-up were selected. Winquist-Hansen criteria was applied for the classification of fracture. Based on the medical records and radiological examinations, conducted a retrospective, statistical analysis of the duration of operation, the amount of bleeding during operation, the first time of callus formation, union time, and complications.
RESULTS
The average duration of operation was 107 minutes for reamed nail group, and 94 minutes for unreamed nail group, and the difference was statistically significant (p<0.005). The amount of bleeding during the operation was 400 mL for reamed nail group and 250 mL for unreamed nail group, and the difference was statistically significant (p<0.001). There was no statistical difference in the first time of callus formation and union time between the two groups but, in general union time tend to be long in unreamed nail group.
CONCLUSION
In the treatment of femoral shaft fracture, the use of unreamed nail was shown to have an advantage over the use of reamed nail in terms of the duration of operation and the amount of bleeding. We recommend restrictive cases.

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The Evaluation of Clinical and Radiographic Prognostic Factors for the Surgically Treated Unstable Ankle Fractures: Hong Geun Jung, Hee Kon Park, Moon Jib Yoo, Tai Won Kim; J Korean Soc Fract 2002;15(2):216-225. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.216

Abstract PDF

PURPOSE
The purpose of this study is to analyze the clinical and radiographic prognostic factors which may affect the postoperative clinical results of the unstable ankle fractures.
MATERIALS AND METHODS
This study is based on 75 unstable ankle fractures treated by open reduction and internal fixation from May 1994 to August 2000, with a minimum follow-up period of 12 months(range : 13 months-7 years 3 months). The 75 patients were average 40.5 years old with male: female ratio of 52:23. Based on Lauge-Hansen classification, the supination-external rotation type was the most common with 42 (56.0%) cases. The clinical results was assessed by American Orthopaedic Foot and Ankle Society(AOFAS) functional scale. The sex, age, side of injury, body weight, trauma-operation interval, operation time, cause of injury as the possible postoperative clinical prognostic factors and fracture type, anatomical reduction of fracture, preoperative medial clear space, postoperative medial clear space, talo-crural angle, talar tilt, tibio-fibular clear space, tibio-fibular overlap space as the possible radiographic prognostic factor were statistically analyzed RESULT: Postoperative AOFAS functional scale was average 81.0 points with 23(30.7%) cases excellent, 17(22.7%) good, 18(24.0%) fair and 17(22.7%) cases poor results. The age, the operation time(p<0.001) and the anatomical reduction of fracture(p<0.005) were found to be statistically significant factors affecting the prognosis. The other clinical and radiographic factors did not significantly affect the clinical results.
CONCLUSION
The surgically treated unstable ankle fractures in patients whose age was above 41 years old or operation time exceeding 90 minutes or unsatisfied anatomical reduction of fractures showed significantly poor clinical results.

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Analysis of Bone Mineral Density of Ankle Fracture Patients
Tae Hyung Kim, Jae Hyung Lee, Seung-Hwan Park
Journal of the Korean Orthopaedic Association.2021; 56(4): 334. CrossRef

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The Result of Modified Bankart Operation with Suture Anchor in Traumatic Recurrent Anterior Dislocation of Shoulder Joint: Kwang Suk Lee, Jung Dae Seo, Kwang Jun Oh, Seung Joon Lee, Seung Yong Wang; J Korean Soc Fract 2001;14(3):484-490. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.484

Abstract PDF

PURPOSE
The purpose of this study was to evaluate the clinical result of modified Bankart operation repairing the Bankart lesion with capsular shifting using suture anchor in traumatic recurrent anterior dislocation of shoulder joint MATERIALS AND METHODS: All of the cases were treated with modified Bankart operation. The inferior and superior capsular flaps were advanced to the anterior aspect of glenoid neck and fixed with three suture anchors in 30 degrees abduction and external rotation of shoulder joint. Especially the inferior 1/3 capsular flap was sutured over the superior 2/3 capsular flap. We used the grading system of Rowe and Zarins as measuring function, pain, stability, range of motion of shoulder joint.
RESULT
The clinical results were excellent in 80%, good in 20%. The mean loss of motion at follow up study was 2% of flexion and 7% of external rotation.
CONCLUSION
This operative technique is useful in repairing the Bankart lesion and gaining adequate capsular tension. And the using of suture anchor could save the operation time.

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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
Journal of the Korean Fracture Society.2007; 20(1): 53. CrossRef

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Modified Phemister Operation for Acromioclavicular Dislocation: Jin Yung Park, Gun Nam Kim, Byung Sam Min, Moon Jib Yoo; J Korean Soc Fract 2001;14(3):456-462. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.456

Abstract PDF: PURPOSE
To evaluate the clinical results after modified Phemister operation for complete dislocation of acromioclavicular joint.
MATERIALS AND METHODS
Thirty-seven cases of Fifty-three cases complete dislocation of acromioclavicular joint which were treated modified Phemister operation, follow up for at least one year, were evaluated. After operation, applied Kenny-Howard brace for six weeks and removed the inserted pins at ten to twelve weeks postoperatively. The ROM exercise was started at postoperative six weeks and meticulous ROM exercise was begun at pin removal. The clinical results were evaluated with range of movement, comparision of the coracoclavicular distance after surgery with that of follow up, and complications.
RESULTS
The range of motion were forward elevation 150 degree, external rotation 71 degree, external rotation at 90 degree abduction 77 degree, and internal rotation T8. The comparision of coracoclavicular distance after surgery(0,6mm) with that of follow up(1.0mm) showed no significant ligament laxity. The complication were subluxation in 2 cases, heterotrophic calcification in 3cases, broken K-wire in 2cases, pin site infection in 7cases and distal clavicle osteolysis in 3cases, which were healed at follow up radiographically.
CONCLUSION
To prevent of redislocation of acromioclavicular joint, we tried to insert the pin during relatively long period for sufficient healing of ruptured coracoclavicular ligament. Although immobilization period was relatively long period, clinical results were good.

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Operative Treatment of the Capitellar Fracture of the Humerus: Ho Jung Kang, Sang Jin Shin, Hyoung Sik Kim, Eung Shick Kang; J Korean Soc Fract 2000;13(3):584-590. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.584

Abstract PDF: PURPOSE
The capitellar fractures of the humerus are rare. Furthermore, the treatment of the fracture has been controversial. This study presents the experience in the operative treatment of capitellar fractures of the humerus.
MATERIALS AND METHODS
Eleven patients with an average age of 41.0 years (range, 15-76 years) were included in this study. The average length of follow-up was 13.6 months (range, 12-17 months). Type I fracture was noticed in ten patients and type III in one patient. Herbert screws, Kirschner wires, cancellous screw and miniscrew were used for internal fixation. The postoperative immobilization period averaged 6.7 days (range, 3-10 days).
RESULTS
Flexion of the elbow averaged 135 degrees (range, 100-150 degrees), with an average flexion contracture of 17 degrees (range, 5-45 degrees). Supination averaged 83 degrees (range, 20-90 degrees) and pronation averaged 87 degrees (range, 80-90 degrees). Seven patients had an excellent functional results, two good and two fair according to Broberg and Morrey elbow-rating scale. The complications included loosening of Kirschner's wires in two patients, osteochondral loose body in one, nonunion and heterotopic ossification in one and severe limitation of motion in one.
CONCLUSION
The early motion of the elbow joint after anatomical reduction and internal fixation for the displaced capitellar fracture is an effective treatment in restoring normal elbow function.

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Two stage Operative Treatment of Supracondylar Open Comminuted Fracture of Femur: Temporary fixation with Transarticular Ender nails: Song Lee, Dong Ki Ahn, Seung Hwan Kim, Sung Wook Chun; J Korean Soc Fract 2000;13(3):470-478. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.470

Abstract PDF: PURPOSE
In many cases of open comminuted supracondylar fracture, it is very hard to apply traditional methods. So we have used Ender nails for temporary transarticular fixation. We thought that it could provide enough stability to control the wound and didn't promote further soft tissue damage or infection. We performed 2nd stage rigid fixation and bone graft after soft tissue healing. We have studied to prove this staged operation valuable to treat the very severe open comminuted supracondylar fracture of femur.
MATERIALS AND METHODS
We analysed 16 cases which have been treated with such staged operation method from April 1992 to April 1996 about complication, union time and functional result in retrospective method.
RESULTS
We could prevent severe wound infection in all cases. We performed 2nd stage rigid fixation and bone graft average 6 weeks after first stage temporary fixation. The average union time was 8 months and average range of motion was 10degrees flexion contracture and 100degrees further flexion.
CONCLUSION
In patients with very severe open comminuted supracondylar fracture of femur, the temporary fixation with transarticular Ender nails allowed the successful initial management for the secondary rigid fixation and bone graft and time could be saved for management of concomitant injuries. So this new staged operation is considered as a good method for safety, union time and functional result.

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The Combined Operative Treatment for Neglected Monteggia Fracture-Dislocation in Adolescent Period: Report of 2 cases: Churl Hong Chun, Sang Soo Kim, Jeong Min Yoo; J Korean Soc Fract 1998;11(4):964-969. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.964

Abstract PDF: There are various perative methods for the treatment of neglected Monteggia fracture-dislocation. ut, it is difficult to obtain good results by the onlyone operative method in the adolescent period. We reported two patients for the neglected Monteggia fracture-dislocation in adolescent period who were treated by the combined operative treatment. The combined operative method was, in regular sequence, the ulnar osteotomy, the fibrous tissus removed in the humeroradial joint, radial head reduction, Bell-Tawse annular-ligament reconstruction and fixating the radial head to the capitellum with the K-wire with neutral position. Finally, plate fixation in ulnar osteotomy site was done. After 3 weeks, we removed the K-wire and performed active ROM exercise. The clinical results were evaluated by Bruce scale at the follow-up 15 months and 53 months. The results were satisfactory without complications. So we canvass for this combined method about neglected Monteggia fracture-dislocation in adolescent period.

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

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

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Results Following The Surgical Treatment of Acromioclavicular Joint dislocations; A Comparison of Phemister With Bosworth Operation: Jin young Park, Suk Joo Lyu, Ki Hyuk Moon, Myung Ho Kim; J Korean Soc Fract 1998;11(1):8-15. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.8

Abstract PDF: To compare the results the Bosworth with Phemister operation, we performed the Bosworth operation in 7 case and then Phemister operation in 9 case serially from 1994 to 1997 and followed them up postoperatively. The average follow-up was 19.2 months, with the longest being 32 months, and the shortest being 12 months. The extraarticular coracoclavicular fixation was done with a cancellous screw in Bosworth operation, the transarticular fixation with two or three Kirschner wires in Phemister operation and the coracoclavicular ligaments were sutured to all patient in phemister operation group. The average immobilization period 6.8 weeks(S.D.:1.0 weeks) in Bosworth operation, 6.5 weeks(S.D.:1.4 weeks) in Phemister operation. The cancellous screw or the Kirschner wires were removed in 12.6 weeks(S.D.:1.6 weeks) postoperatively in Bosworth operation, 11.8 weeks(S.D.:1.7 weeks) in Phemister operation and physiotheraphy was progressed to obtain the full range of motion. All of the patients were evaluated on a subjective(pain, night pain, medication. instability, activities of daily living), objective(range of motion) and roentgenographic(degree of displacement) basis at last follow-up. Shoulder function was assessed according to the shoulder score devised by the American Shoulder and Elbow Surgeons. The pain of Shoulder persisted remained in 1 case of Bosworth operation and in 3 cases of Phemister operation. The night pain around acromioclavicular joint was remained in 2 cases of Phemister operation. Average shoulder function index in Bosworth operation was 95 points and in Phemister operation 87 points. Average range of motion of Bosworth operation was 176degree (S.D.:9degree in forward elevation, 68degree(S.D.:11degree in external rotation, 88.6degree(S.D.:12degree in cross-rotation at 90degreeabduction, 22cm (S.D.:11cm) in cross-body adduction and T9 in internal rotation and Phemister operation 147degree(S.D. 18degree in forward elevation, 72degree S.D.:12degree in external body adduction and T8 in internal ratation. All of the patients were satisfied for results of operation. After surgery, loss of reduction was found in 3 of 7 in Bosworth operation and all of the patients were over 40 years and then conversions to Phemister operation was needed. According to short-term follow-up we prefer the transarticular Phemister method and Bosworth operation may be avoided in patients over 40 yeras old.

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Operative Treatment for Acromiclavicular Joint Dislocation: Bum Soo Kim, Sung Do Cho, Ki Bong Kim; J Korean Soc Fract 1998;11(1):1-7. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.1

Abstract PDF: Acoromioclavicular dislocation occurs frequently in young athletes and recently in automobile accident victims and laborers, and there are various kinds of operative methods for this injury. Authors performed operative treatment for 45 cases of acromioclavicular dislocation: 30 cases of modified Phemister operation and 15 cases of modified Bosworth operation from March 1992 to June 1996. Authors analysed the result of the treatment and the results obtained were as follows. 1. The clinical results evaluated by Weitzman criteria were all satisfactory in both modified Phemister method and modified Bosworth method. 2. The radiologic results were evaluated by the difference of the distance from the coracoid process to the clavicle between the normal and the injured site. And the result was more satisfactory in modified Bosworth method. 3. There were less complications in modified Bosworth method.

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Acromioclavicular dislocation treated by weaver and drum operation: Dae Yong Han, Yeo Hon Yun, Jin Soo Park; J Korean Soc Fract 1992;5(1):14-21. Published online May 31, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.1.14

Abstract PDF: No abstract available.

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The role of lateral malleolus in normal growth and biomechanics of ankle clinical long term study in growing children: In Rhee Kim, Yong Sik Kim, Soon Yong Kwon, Kee Won Ryu, Seong Jin Park, Ko Seung; J Korean Soc Fract 1992;5(1):138-149. Published online May 31, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.1.138

Abstract PDF: No abstract available.

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