Journal of Musculoskeletal Trauma

Usefulness of Percutaneous Cannulated Screws with Tension Band Wiring for Minimally Displaced Fractures of the Patella: Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Eun Woo Bae; J Korean Fract Soc 2022;35(4):142-150. Published online October 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.4.142

Abstract PDF: Purpose
To evaluate the usefulness of percutaneous cannulated screws with tension band wiring (PC-STBW), a minimally invasive surgical technique, compared to conservative treatment for a minimally displaced patella transverse fracture.
Materials and Methods
The subjects included patients from 2010 to 2019 with transverse patella fractures, who were diagnosed as minimally displaced fractures, and were followed up for at least 1 year. Of these, 61 patients who were treated with cylinder casts were classified as Group A, and 53 patients who were treated with PCSTBW were classified as Group B. The clinical evaluation was carried out by evaluation of the radiographic bone union and calculation of the Bostman knee score. Any complications observed were investigated.
Results
All patients in both groups showed no further displacement of the fracture gap, and the bone union was achieved in all cases. The functional evaluation of the knee joint measured at the 8- and 12-week follow-up showed superior results in Group B wherein subjects were treated with surgery, and similar results were seen in both groups during the 6 months and 1-year follow-up. One case in Group A suffered the complication of knee stiffness.
Conclusion
For the treatment of minimally displaced transverse patellar fractures, both conservative treatment and PCSTBW showed similar good results at the 6-month and one-year follow-up. However, the PCSTBW technique showed superior clinical results in the early stage follow-up within 12 weeks.

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Results of Single Small Incision Minimally Invasive Plate Osteosynthesis in the Treatment of the Distal Radius Fractures: Young Sung Kim, Jong Pil Kim, Phil Hyun Chung, Ho Min Lee, Bo Sung Go; J Korean Fract Soc 2020;33(2):72-80. Published online April 30, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.2.72

Abstract PDF: Purpose
This study compared minimally invasive plate osteosynthesis (MIPO) using a single small skin incision and conventional open volar locking plate fixation (OP) for distal radius fracture to identify outcome difference.
Materials and Methods
Forty-three patients who underwent MIPO using a single small skin incision or OP for distal radius fractures were evaluated retrospectively. Of the patients, 21 were treated with MIPO using a single small skin incision and 22 with the OP method through the conventional volar approach. The postoperative radiographic results and clinical outcomes at the final follow-up in each group were compared.
Results
All patients achieved bone union in the MIPO and OP groups. No significant differences in the bone union time, alignment, range of motion, QuickDASH, or pain score were observed. On the other hand, the size of the incision was significant: 23 mm in the MIPO group and 55 mm in the OP group (p<0.001).
Conclusion
MIPO technique using a single small incision showed similar satisfactory radiographic and functional outcomes compared to conventional OP for distal radius fractures. The MIPO technique using a single small incision offered advantages, including cosmetic benefits and minimal soft tissue damage, is recommended, particularly in young women and high functional demand patients.

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Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures: Ho Min Lee, Young Sung Kim, Jong Pil Kim, Phil Hyun Chung, Suk Kang, Kaung Suk Jo; J Korean Fract Soc 2018;31(3):94-101. Published online July 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.3.94

PURPOSE
This study compared the radiological and clinical results of minimally invasive plate osteosynthesis (MIPO) and intramedullary nailing (IMN) of distal tibial fractures, which were classified as the simple intra-articular group and extra-articular group.
MATERIALS AND METHODS
Fifty patients with distal tibial fractures, who could be followed-up more than 12 months, were evaluated. Group A consisted of 19 patients treated with MIPO and group B consisted of 31 patients treated with IMN. The results of each group were analyzed by radiological and clinical assessments.
RESULTS
The mean operation times in groups A and B were 72.4 minutes and 65.7 minutes, respectively. The mean bone union times in groups A and B were 16.4 weeks and 15.7 weeks, respectively. The bone union rate in groups A and B were 100% and 93%, respectively. The ranges of ankle motion were similar in the two groups at the last follow-up. The mean American Orthopaedic Foot and Ankle Society score was similar: 90.1 in group A and 90.5 in group B. The radiological and clinical results were similar in the intra and extra-articular groups. In groups A and B, two cases of posterior angulation and five cases of valgus deformity of more than 5Â° were encountered.
CONCLUSION
Both MIPO and IMN achieved satisfactory results in extra-articular AO type A and simple articular extension type C1 and C2 distal tibia fractures.

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Intramedullary Nailing versus Minimally Invasive Plate Osteosynthesis for Distal Tibia Shaft Fractures: Retrospective Comparison of Functional and Cosmetic Outcomes
Kahyun Kim, In Hee Kim, Geon Jung Kim, SungJoon Lim, Ji Young Yoon, Jong Won Kim, Yong Min Kim
Journal of Korean Foot and Ankle Society.2023; 27(3): 93. CrossRef

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A Comparison between Compression Hip Screw and Intramedullary Nail for the Treatment of AO/OTA A2.2 Intertrochanteric Femoral Fracture: Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Jong Hyun Kim; J Korean Fract Soc 2013;26(1):44-49. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.44

Abstract PDF

PURPOSE
To compare the result between the compression hip screw (CHS) and intramedullary (IM) nail for the treatment of AO/OTA A2.2 intertrochanteric fracture.
MATERIALS AND METHODS
We retrospectively reviewed 95 cases of AO/OTA A2.2 intertrochanteric fracture, which were treated with CHS or IM nail by one surgeon from March 1994 to December 2009. One group was treated with CHS (Group I, 28 cases) and the other was treated with IM nail (Group II, 67 cases). We evaluated the mean operation time, the amount of bleeding and transfusion, hospital duration, radiological results and the clinical outcome with the mobility score of Parker and Palmer.
RESULTS
Radiologically, the tip-apex distance, change of neck-shaft angle, and union time were not significantly different between both groups (p>0.05). Clinically, the mean operation time, the amount of bleeding and transfusion, hospital duration and the mobility score were not significantly different (p>0.05). The post-operative complications were lag screw slippage over 25 mm (1 case) and loosening of device (1 case) in group I. In group II, there were perforation of the femoral head (1 case), nail breakage (1 case) and deep infection (1 case).
CONCLUSION
There was no significant differences that are clinical and radiological results in the treatment of AO/OTA A2.2 intertrochanteric fracture, using CHS and IM nail.

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A Comparison of Clinical Results between Compression Hip Screw and Proximal Femoral Nail as the Treatment of AO/OTA 31-A2.2 Intertrochanteric Femoral Fractures
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, In Hwa Back, Kyeong Soo Eom
Journal of the Korean Orthopaedic Association.2016; 51(6): 493. CrossRef

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Missed Variation of the Essex-Lopresti Injury Associated with Type-I Monteggia Equivalent Lesion: A Case Report: Young Sung Kim, Phil Hyun Chung, Suk Kang, Ho Min Lee, Jong Pil Kim; J Korean Fract Soc 2012;25(3):219-222. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.219

Abstract PDF: The authors report the case of a patient with the combination of a Type I Monteggia equivalent lesion and Essex-Lopresti injury. This combination of injury is very rare, and an associated distal radioulnar injury is often missed. We hope our experience illustrates the need to examine the wrist joint carefully and to be aware of the potential for distal radioulnar joint instability in all patients with type I Monteggia equivalent lesions.

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Interposition of Periosteum in Distal Tibial Physeal Fractures of Children: Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Jae Woo Cho; J Korean Fract Soc 2011;24(1):73-78. Published online January 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.1.73

Abstract PDF: PURPOSE
To evaluate the factors influencing periosteal interposition in distal tibial physeal fractures of children.
MATERIALS AND METHODS
34 cases of distal tibial physeal fractures were analysed. We confirmed the presence of periosteal interposition with MRI in all cases and accessed the relationship between periosteal interposition and gender, age, cause of injury, type of fracture, degree of initial displacement and after closed reduction.
RESULTS
9 (26.5%) of 34 fractures had interposed periosteum. There was no statistically significant correlation between periosteal interposition and gender, age, cause of injury (p>0.05). 5 (83.3%) of 6 pronation-eversion-external rotation type of fractures according to Dias-Tachjian classification had interposed periosteum and that was a statistically significant correlation (p=0.006). As Salter-Harris type was toward to high degree, there were decreasing tendency of periosteal interposition (p=0.026). There was high rate of periosteal interposition in case of displacement more than 2 mm in each initial and after closed reduction (p<0.05).
CONCLUSION
There was high incidence of periosteal interposition in pronation-eversion-external rotation type with displacement more than 2 mm in distal tibial physeal fractures of children. But, periosteal interposition could occur in fractures with mild displacement less than 2 mm, if initial fracture displacement was more than 2 mm, the methods of treatment should be decided after confirm the presence of periosteal interposition with MRI after closed reduction.

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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

Abstract 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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Double Tension Band Wiring for Olecranon Fractures: Suk Kang, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Jin Wook Chung, Jong Pil Kim; J Korean Fract Soc 2008;21(2):130-134. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.130

Abstract PDF

PURPOSE
To evaluate the clinical results of double tension band wiring for communited olecranon fractures involving proximal 1/3.
MATERIALS AND METHODS
We reviewed 9 cases of communited olecranon fractures involving proximal 1/3 treated with double tension band wiring followed for minimum 10 months. There were 2 cases of olecranon fractures involving only proximal 1/3, 6 cases of olecranon fractures involving from proximal 1/3 to middle 1/3 and 1 case of olecranon fractures involving from proximal 1/3 to distal 1/3. We analyzed the bone union time, radiologic results for gap, reduction loss, pin migration, pain, range of motion, complications and functional outcomes at last follow up.
RESULTS
All patients had solid bone union without additional surgery and average union time was 10.3 weeks. Anatomical reduction could be obtained in 8 of 9 cases but there was 1 mm step off in one case. 36 pins were used to fix the fractures, 1 pin of 18 distal pins and 2 pins of 18 proximal pins were migrated to backward but there was no reduction loss. Only 1 distal pin needed early removal due to skin irritation. Average range of motion ranged from flexion contracture 3.3 degrees to further flexion 137.8 degrees. On functional analysis, we got 8 cases of good result, 1 case of fair result and there was no poor result.
CONCLUSION
Double tension band wiring for comminuted olecranon fracture involving proximal 1/3 was concluded to give a firm fixation of the fracture site as bone union could be acquired without serious pin problems.

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Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates
Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon
Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
Olecranon Nonunion after Operative Treatment of Fracture
Ho-Jung Kang, Ji-Sup Kim, Myung-Ho Shin, Il-Hyun Koh, Yun-Rak Choi
Journal of the Korean Fracture Society.2015; 28(1): 30. CrossRef

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Treatment of Subtrochanteric Femur Fractures Using Intramedullary Devices: Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Chong Suk Park, Sang Ho Lee; J Korean Fract Soc 2008;21(1):13-18. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.13

Abstract 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.

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Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
Hip & Pelvis.2014; 26(2): 107. CrossRef
Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques
Chul-Hyun Park, Chul-Wung Ha, Sang-Jin Park, Min-Su Ko, Oog-Jin Shon
Journal of the Korean Fracture Society.2013; 26(2): 112. CrossRef
Treatment of Subtrochanteric Nonunion with a Blade Plate
Youn-Soo Park, Jin-Hong Kim, Kyung-Jea Woo, Seung-Jae Lim
Journal of the Korean Orthopaedic Association.2011; 46(1): 42. CrossRef

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Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture: Suk Kang, Jong Pil Kim, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Sang Ho Lee, Jin Wook Chung; J Korean Fract Soc 2007;20(4):339-344. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.339

Abstract PDF: The complications following paediatric femur fracture are leg length discrepancy, angulation deformity, rotational deformity, ischemic limb. But, stiff knee is rarely expressed after trauma like paediatric femur fracture. We report a case of stiff knee due to entrapment of quadriceps femoris tendon at displaced fracture site after conservative treatment by Russel traction and hip spica cast in paediatric femur fracture. We treated successfully by resection of distal end of proximal segment of femur and release of quadriceps femoris tendon for flexion contracture of the knee.

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Treatment of Humeral Shaft Fracture with Retrograde Flexible Nail: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Young Sung Kim, Sung Pock Park, Kwang Uk An; J Korean Fract Soc 2006;19(3):340-345. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.340

Abstract: PURPOSE
To evaluate and report the clinical and radiological results of the intramedullary fixation by retrograde flexible nail in the humeral shaft fracture.
MATERIALS AND METHODS
From July 2002 to May 2005, seventeen cases who had the humeral shaft fracture were treated with the intramedullary fixation by retrograde flexible nail. Fifteen cases were followed up and the clinical and radiological results were analyzed.
RESULTS
All of the cases had satisfactory fracture union, and none of the patient had limitation in shoulder or elbow joint movement, and shoulder or elbow joint pain, and average ASES was 42.86 point. There was 1 case of delayed union, and 3 cases of distal nail displacement. Another severe complications were not occurred.
CONCLUSION
Intramedullary fixation by retrograde flexible nail is one of the effective method in the humeral shaft fracture without nerve or vessel injuries, and also can avoid the complication of wide soft tissue incision or rotator cuff injury.

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Operative Treatment in Midshaft Fractures of Clavicle using Reconstruction Plate and Interfragmentary PDS Suture: Phil Hyun Chung, Suk Kang, Chung Soo Hwang, Jong Pil Kim, Young Sung Kim, Sung Pock Park, Jin Wook Chung; J Korean Fract Soc 2006;19(3):335-339. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.335

Abstract

PURPOSE
We are reporting the result of comminuted midshaft fractures of clavicle treated by reconstruction plate fixation and PDS augmentation easily fixing butterfly fragments with minimal soft tissue dissection.
MATERIALS AND METHODS
We reviewed 42 cases of operatively treated displaced comminuted midshaft fractures of clavicle at our hospital from March, 2001 to May 2004 whom were followed up for more than one year after the operation. According to Robinson classification, we grouped simple fractures as group A, and comminuted fractures as group B. Internal fixation using reconstruction plate has been chosen for type A fracture. Type B has been treated by reconstruction plate fixation with PDS augmentations. Shoulder function, union time and complications has been studied according to the fracture type retrospectively.
RESULTS
All cases had complete bone union with average union time of 8.6 weeks for type A and 8.9 weeks for type B. Weitzman functional evaluation did not show significant differences.
CONCLUSION
PDS augmentation in comminuted midshaft fracture of clavicle easily fix the butterfly fragments with least soft tissue damage and lessen the bone graft. Therefore it considered to be one of the available treatment methods for comminuted midshaft fracture of clavicle.

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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
Journal of the Korean Fracture Society.2011; 24(2): 138. CrossRef

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Transverse Fracture through Screw Site after Cannulated Screw Fixation in Vertical Patella Fracture: A Case Report: Suk Kang, Phil Hyun Chung, Chung Soo Hwang, Jong Pil Kim, Young Sung Kim, Chong Suck Parke; J Korean Fract Soc 2006;19(1):96-99. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.96

Abstract

Many complications after operative treatment of patella including redisplacement of fracture, refracture, weakness of extensor muscles, patellofemoral joint arthritis, metal failure, malunion, infection, avascular necrosis were reported. We report a case of transverse fracture of patella through the cannulated screw fixation site used to fix previous vertical patella fracture with a review of the literatures.

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Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef

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Interlocking Intramedullary Nailing in Distal Tibial Metaphyseal Fractures: Young Sung Kim, Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Ho Min Lee; J Korean Fract Soc 2005;18(3):269-274. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.269

Abstract PDF

PURPOSE
To evaluate and compare the outcome in fracture of distal tibial metaphyseal fractures involving ankle joint and not involving the ankle joint treated by interlocking imtramedullary nailing.
MATERIALS AND METHODS
Twenty six cases of distal tibial metaphyseal fractures treated by interlocking intramedullary nailing whom were able to follow up for more one year were selected and 10 cases involved ankle joint and the rest 16 cases did not. In all cases, more than 2 distal locking screws were inserted after reaming for the nailing, and cannulated screws or K-wires fixation were inserted for 8 cases of fractures involving ankle joint out of 10. We analyzed preoperative fracture type, union time, function of joint, and complications at final follow up.
RESULTS
According to Robinson's classification for distal tibial metaphyseal fractures, there were 9 cases of type I, 7 of 2A, 4 of 2B, 6 of 2C. Union time taken for distal tibial fractures involving ankle were average of 17 weeks (12~20 weeks) and for the fractures not involving ankle joint were average of 19 weeks (12~28 weeks). Klemm and Borner's functional evaluation showed above good in 8 cases (80%) of fracture involving ankle joint and 13 cases (81%) of fracture not involving the ankle joint, and functional evaluation did not show significant differences as well as the complication rate in both group.
CONCLUSION
Interlocking intramedullary nailing is one of the effective methods for treatment of distal tibial metaphyseal fracture involving articular surface of the ankle.

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Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures
Young Sung Kim, Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Soon Young Park
Journal of the Korean Orthopaedic Association.2021; 56(4): 317. CrossRef
Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures
Ho-Min Lee, Young-Sung Kim, Jong-Pil Kim, Phil-Hyun Chung, Suk Kang, Kaung Suk Jo
Journal of the Korean Fracture Society.2018; 31(3): 94. CrossRef
Intramedullary Nailing of Distal Tibial Fractures with Percutaneous Reduction by Pointed Reduction Forceps
Jae-Kwang Hwang, Chung-Hwan Kim, Young-Joon Choi, Gi-Won Lee, Hyun-Il Lee, Tae-Kyung Kim
Journal of the Korean Fracture Society.2014; 27(2): 144. CrossRef
Comparative Study of Intramedullary Nailing and Plate for Metaphyseal Fractures of the Distal Tibia
Hoon Jeong, Jae-Doo Yoo, Young-Do Koh, Hoon-Sang Sohn
Journal of the Korean Fracture Society.2007; 20(2): 154. CrossRef

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Treatment of Tibial Shaft Fractures in Children Using K-wires Fixation: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Ho Jun Cheon; J Korean Fract Soc 2004;17(4):384-388. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.384

Abstract PDF: PURPOSE
To report the effectiveness of Kirschner wire fixation for the treatment of unstable tibial shaft fractures in children.
MATERIALS AND METHODS
We analyzed 15 cases of pediatric tibial shaft fractures treated at our hospital with fixation using K-wire and followed up for more than 1 year from July 1998 to January 2002. The subjects included 11 boys and 4 girls. The ages ranged from 3 to 10 years at the time of injury, with the average age being 7.9 years. We examined the presence of angulation, leg length discrepancy, joint motion limitation, and complications.
RESULTS
Bony fusion was obtained in all patients by an average of postoperative 9.5 weeks. At the time of last follow-up (by an average of postoperative 1 year and 4 months), anterior and posterior radiographs showed an average of 4.2degree angulation, and lateral radiographs showed an average of 4.4degree angulation. The affected leg was extended by an average of 3.7 mm compared to the opposite leg according to Bell-Thompson's radiographs. As for complications, infection was developed around the pin in 3 cases but treated with the administration of oral antibiotics and sterilization around the site without progressing to deep infection. We could not observe joint motion limitation, pain and difficulties related with discrepancy in leg length.
CONCLUSION
We concluded that fixation using K-wire for children with tibial shaft fractures was a safe and effective method of surgery that could be performed easily, did not require secondary surgery to remove the wire, and showed sufficient stability after fixation.

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Treatments of the Nonunion of Femoral Shaft Fractures after Interlocking Intramedullary Nailing: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Jae Sang Park; J Korean Fract Soc 2004;17(2):95-102. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.95

Abstract PDF: PURPOSE
To investigate and analyze the clinical result in the treatment of aseptic nonunion of femoral shaft fracture after interlocking intramedullary nailing MATERIALS AND METHODS: We reviewed 23 cases of aspetic nonunion of femoral shaft fracture after interlocking intramedullary nail from March 1995 to February 2003 and follow up more than one year. 8 cases were treated by metal exchange, 3 cases by autogenous bone graft and the rest 12 cases by metal exchange and bone graft on the basis of fracture gap and type of nonunion. We evaulated nonunion type, union time and clinical result. Those patients were treated by interlocking intramedullary nail with or without bone graft. Union were accepted when the radiographic evidences showed bridging callus on both end of femoral shaft fracture with clinical evidences showing abscence of pseudomotion or pain.
RESULTS
All patients were united by one operation. Average union time were 4.8 months in metal exchange group, 3.9 months in metal exchange with autograft bone graft group, and 4.3 months in bone graft group. 15 patients (65.2%) showed hypervascular nonunion including 7 Elephant foot types (46.7%) and 8 oligotrophic types (53.5%), and 8 patients (34.8%) showed avascular nonunion according to Weber-Brunner classification CONCLUSION: Based on our analysis on clinical outcome and stability of nonunion occuring after initial interlocking intramedullary nailing in femoral shaft fracture, interlocking intramedullary nailing with bone graft made early ambulation possible and promoting returning to normal daily life much earlier, thus based on this data, we recommend interlocking intramedullary nailing for treating femoral shaft fracture along with bone graft.

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Treatment of Supracondylar-Intercondylar Femoral Fractures with a Retrograde Intramedullary Nailing: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Yong Jin Jeon; J Korean Fract Soc 2004;17(2):110-116. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.110

Abstract PDF

PURPOSE
We analyzed the cases of supracondylar-intercondylar femoral fracture treated with retrograde intramedullary nail and report the clinical results and its usefulness.
MATERIALS AND METHODS
We reviewed 17 cases of supracondylar-intercondylar femoral fracture that had been treated with retrograde intramedullary nail and each of patients had been followed up for a minimum one year. Post-operative functional assessment was performed using a scale developed by Sanders et al. The evaluation scale assesses range of motion, pain, walking ability, return to work, and alignment and shortening as measured on radiograph.
RESULTS
According to functional assessment of Sanders et al, there were 6 excellent, 9 good, 1 fair, and 1 poor results, that is, 94% showed above excellent results. Bony union was obtained in average 5 months after operation. The post-operative complications were varus deformity in 1 case, wound infection in 1 case, stiffness of knee joint in 1 case, and metal failure in 1 case.
CONCLUSION
The treatment of supracondylar-intercondylar femoral fracture with retrograde intramedullary nail is one of the good surgical options for clinically preferable results with the advantages in early joint motion and early ambulation.

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Retrograde Intramedullary Nailing or the Treatment of Segmental Femoral Shaft Fracture Including Distal Part
Jong-Ho Yoon, Byung-Woo Ahn, Chong-Kwan Kim, Jin-Woo Jin, Ji-Hoon Lee, Hyun-Ku Cho, Joo-Hyun Lee
Journal of the Korean Fracture Society.2009; 22(3): 145. CrossRef

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Treatment of Femoral Shaft Fracture with External Fixator in Children: Phil Hyun Chung, Suk Gang, Dong Ju Chae, Jong Pil Kim, Sung Pock Park; J Korean Soc Fract 2002;15(3):421-426. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.421

Abstract PDF: PURPOSE
Children with femoral shaft fractures in association with other injuries such as head injuries, abdominal injuries, open fractures, multiple fractures, or unstable displaced fractures require operative treatment rather than being treated in conservative methods. In this study, we compare the surgical result of femoral shaft fracture using external fixator in children, and evaluate the complications and the related factors as well as the advantage over the other management described in the literature.
MATERIALS AND METHODS
We reviewed 15 cases of femoral shaft fractures in children admitted between May, 1995 and May, 2000. The mean age was 8 years and 2months old (range: 6-12 year-old, 9 boys, 6 girls). All the evaluations were based on the postoperative radiologic studying and clinical findings. In the radiologic evaluations, bony union time, angular deformity, and leg length discrepancy in both sagittal and coronal plane were evaluated, and in the clinical evaluations, we analyzed the duration of external fixation, hospital day, range of motion in both hip and knee joint, and post-operative complications.
RESULTS
The average bony union time based on the radiologic studying was 10.9 weeks (ranging from 7 to 24 weeks). Angular deformity at the fracture site was less than 5 degrees and no rotational deformity was found in all 15 cases. The average length of overriding fracture fragment was 11.7 mm (ranging from 10 to 15 mm) and average leg length discrepancy was 2.1 mm (ranging from -3 to +10mm). Duration of external fixation averaged 12.1 weeks (ranging from 9 to 24 weeks) and average hospital day was 29.4 day (ranging from 21 to 48 day). None of the patient had limitation in hip or knee joint movement. There were 1 case of refracture (case of pathologic fracture) and 4 cases of pin tract infection(superficial infection).
CONCLUSION
At our institution, we observed average overgrowth of 2.1 mm and no severe complications excepts in 1 case of refracture due to pathologic fracture. Thus we concluded that closed reduction and external fixation is effective in treating open, or unstable displaced fracture of femoral shaft with other associated injuries in pediatric population, and it is also believed to be effective means in treating closed femoral fractures.

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Nail Breakage after Femoral Interlocking Intramedullary Nailing: Suk Kang, Phil Hyun Chung, Dong Ju Chae, Jong Pil Kim, Joon Han Kim, Sung Pock Park, Jae Sang Park; J Korean Soc Fract 2002;15(3):363-370. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.363

Abstract PDF

PURPOSE
We analyze the clinical causes and precautions of nail breakage followed by femoral intramedullary nailing MATERIALS AND METHODS: We reviewed 12 cases of nail breakage followed by the femoral intramedullary nailing from Jan. 1993 to Feb. 2001 and for each cases, we analyzed used nail diameter, patient weight and used nail, time to nail breakage and configuration of non-union. We classified fracture site at the time of trauma as proximal 1/3, middle 1/3, distal 1/3, and evaluated gap of fracture site, displacement of fragment after surgery, location and treatment of broken nail on each part, and analyzed the causes of nail breakage RESULTS: The average time of nail breakage was 8.1 months and distal 1/3 fracture were major as 6 cases. Those were mainly comminuted fracture of Winquist-Hansen type II. After surgery, gap of fracture site and displacement of fragment were mostly observed in middle 1/3 fracture and, in the part of middle 1/3, the site of nail breakage took place in fracture site. Especially in the distal 1/3 fracture, nail breakage happened usually in distal first locking screw hole. The causes of nail breakage were inadequately small diameter of nail inserted into the isthmic portion of medullary canal in proximal fracture, inaccurate reduction of fracture site in middle fracture, and the use of short length of nail and its mechanical damage caused by inaccurate insertion of distal locking screw in distal fracture.
CONCLUSION
To prevent nail breakage while femoral intramedullary nailing, in proximal fracture, adequate diameter of nail has to be inserted into the isthmic portion of medullary canal. In middle fracture, the accurate reduction of fracture site will be necessary, and the case of distal fracture, enough length of nail has to be used and especially it is important not to cause mechanical injury with the accurate insertion of distal locking screw in nail

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Comparison of our self-designed rotary self-locking intramedullary nail and interlocking intramedullary nail in the treatment of long bone fractures
Bailian Liu, Ying Xiong, Hong Deng, Shao Gu, Fu Jia, Qunhui Li, Daxing Wang, Xuewen Gan, Wei Liu
Journal of Orthopaedic Surgery and Research.2014;[Epub] CrossRef
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
Journal of the Korean Fracture Society.2009; 22(4): 225. CrossRef

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Surgical Treatment of Type II distal clavicle end Fracture: Phil Hyun Chung, Suk Kang, Dong Joo Chae, Jong Pil Kim, Sang Ho Lee; J Korean Soc Fract 2002;15(2):106-113. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.106

Abstract PDF: PURPOSE
Many authors have supported open reduction and internal fixation of type II distal clavicle fractures because of high rates of nonunion and delayed union after conservative treatment. Authors analyzed thirty-nine cases of type II distal clavicle fractures which had been treated operatively and reviewed the result of operative treatment retrospectively.
MATERIALS AND METHODS
We evaluated 39 unstable distal 1/3 clavicular fractures with operative treatment from May 1992 to December 1999 and followed up for at least 1 year. According to the classification of Rockwood, type IIa was 28cases and IIb was 11 cases. We treated all the cases by open reduction, such as transacromial pin fixation in 27 cases, and plate and screws with or without bone graft in 12 cases. The operative method was chosen in operative field.
RESULT
We analyzed the results in term of the time to radiologic union, functional evaluation, and complications. Average time to union was 8.5 weeks in the cases of transacromial pin fixation and 12.7 weeks in the cases using plate and screws with or without bone graft. Functional results was evaluated by classification of functional results by Kona et al. In cases of transacromial pin fixation, excellent result was 13 cases and good was 14 cases. In cases of plate and screws, excellent result was 4 cases, good 6 cases, fair 1 case, and poor was 1 case. The complications of transacromial pin fixation were 4 cases of pin site infection and 1 case of pin migration. But, neither nonunion nor deep infection was appeared. The complication of plate and screws was 2 cases of metal failure in which were fixated by only two cortical screws on distal fragment.
CONCLUSION
We concluded that minimal open reduction and transacromial pin fixation is thought to be good method in treatment of distal 1/3 clavicular fracture in regard to the time to union, functional results, and complications.

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Treatment of Intertrochanteric Fractures of Femur Using Intramedullary Hip-Screw: Phil Hyun Chung, Chung Soo Hwang, Suk Gang, Dong Ju Chae, Jong Pil Kim, Joon Han Kim; J Korean Soc Fract 2001;14(4):575-583. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.575

Abstract PDF: PURPOSE
We analyze the results of the treatment of intertrochanteric fractures by using intramedullary hip screw.
MATERIALS AND METHODS
We reviewed 34 patients of intertrochanteric fracture who were treated by using of intramedullary hip screw from March 1998 to February 2000, and we classified the fractures by Evans system. 26 cases were treated by closed reduction and internal fixation; 8 cases were by open reduction and internal fixation. We analyzed fracture figure and stability, amount of sliding of lag screw, the change of femur neck-shaft angle, postoperative activity and postoperative complication RESULTS: Bony union was obtained in average 14.3 weeks. Gap of fracture site was formed in 2 cases and crack on entry area of nail was formed in 1 case. Postoperative wound infection occurred in laces and delayed union occurred in 1 case. The change of femur neck-shaft angle showed an average decrease 1.7 degree in stable fractures, 3.5 degree in unstable fractures. Lag screw was sided an average 1.0 mm in stable fractures, 2.6 mm in unstable fractures. Postoperative mobility were analyzed by score of Parker and Palmer, and showing from 7.6 score pretrauma to 3.37 score postoperation in 1 month, 5.0 score postoperation in 3 months, 7.48 score postoperation in 6 months and 7.5 score postoperation in one year.
CONCLUSION
Intramedullary hip screw in intertrochanteric fractures reduced the collapse by processing union of fracture site due to the less decreases of femur neck shaft angle and the shortening by sliding of lag screw

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A Comparison of Interlocking Nail with Wiring versus Plate Fixation in Long Oblique or Spiral Fractures of Humeral Shaft: Phil Hyun Chung, Sang Ho Moon; J Korean Soc Fract 2000;13(3):555-561. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.555

Abstract PDF: PURPOSE
To compare functional results between interlocking intramedullary nail with wiring and plate for treating long oblique or spiral diaphyseal fractures of humerus.
MATERIALS AND METHODS
From April 1996 to February 1999, 9 long oblique or spiral fractures were treated with antegrade humeral locked nails and wiring after minimal open reduction, and another 9 fractures were fixed with plate and screws. Average age of patients was 45.8 years and average follow-up was 13.5 months.
RESULTS
Nail group showed earlier clinical and radiologic union than plate and screw group. All patients with plate and screw group(plate fixation) had clinical union within 5.8+/-2.5 weeks and radiologic union within 8.5+/-2.1 weeks. But, all patients with wiring had clinical union within 2.8+/-0.6 weeks and radiologic union within 5.5 +/-1.6 weeks. At last follow-up, average range of shoulder motion in plate group was larger than nailing group, but that was stastically insignificant. Plate fixations had more complications than nailing, for example, deep infection, non-union, implant failure and radial nerve injury.
CONCLUSION
Interlocking intramedullary nail with wiring has the advantages of minimal tissue trauma and scar formation, sufficient reduction and fixation, early union and fewer complication. So it can be a worthy alternative for the treatment of long oblique or spiral fractures of humerus.

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Effects of Fibular Fixation for Interlocking Nailing of Distal Tibiofibular Fractures: Sang Ho Moon, Phil Hyun Chung, Chung Soo Hwang, Dong Ju Chae, Beom Kim; J Korean Soc Fract 2000;13(2):296-302. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.296

Abstract PDF: PURPOSE
: To compare redioiogic results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures.
MATERIALS AND METHODS
: From April 1993 to February 1999, 26 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 61 fractures fixed with nails only. Average age of patients was 41.8 years. These two groups were compared by frequency of malalignment, degree of postoperative angulation, angulation according to comminution, angulation according to fracture configuration. The statistical analysis was evaluated by t-test.
RESULTS
: Fibular fixation group had no malalignment while non-fixations had angulation of 1.2+/-1.1 degree and non-fixation had 3.0+/-2.1. So fixation had lessor angulation than non-fixation significantly(p=0.004). In lateral rediographs, each had 1.3+/- 1.1, 2.8+/-2.3 degree and showed significant difference(p=0.027). In type I and II fractures of Winquist-Hansen classification, fixation group showed lesser degree of angulation in A-P plane significantly(p=0.008) but no significant difference in lateral plane. In type III and IV, no significant difference in both planes. According to configuration of fractures, transverse and spiral fractures showed no significant differences but oblique configurations had significant differences in A-P plane(p=0.002) CONCLUSION : Interlocking intramedullary nail with fibular fixation has the advantage in maintenance of alignment during insertion of nail in distal tibiofibular fractures, especially in Winquist-Hansen classification type I and II and oblique fractures in anteroposterior plane, so it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

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Comparison between results of treatment of the Femoral Neck and Intertrochanteric Fractures : Focused on Mortality rate and Complications: Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Tae Hoon Kim, Han Chul Kim, Yong Soon Kim; J Korean Soc Fract 1999;12(4):792-802. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.792

Abstract PDF

The incidence of femoral neck and intertrochanteric fractures has steadily increased with lengthening of the life span. It is well known that anatomical characteristics of femoral neck may evoke complications such as nonunion and avascular necrosis. And there are many problems in the treatment of femoral intertrochanteric fractures due to osteoporosis, unstable pattern of fracture and poor general condition in elderly patients. The author analyzed 56 cases(56 patients) of femoral neck fractures and 63 cases(61 patients) of femoral intertrochanteric fractures which we have been able to follow up more than 1 year from March 1991 to March 1997. The purpose of this study is 1) to analyze results of treatment, predisposing factors, complications and mortality rates, and so 2) to reduce the mortality rate and complication in these fractures. The results were as follows , 1. The difference in union time between both type of fractures was not significant. 2. The mortality rate during admission was 1.8% in femoral neck fractures and 6.3% in intertrochanteric fractures. 3. The mortality rate during 1 years was 3.6% in femoral neck fractures and 9.5% in femoral intertrochanteric fractures. 4. The predisposing factors associated with postoperative mortality rate were malnutrition. chronic obstructive pulmonary disease, previous contralateral hip fracture, and operation within 3 days.

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Anesthetic considerations for surgical treatment of geriatric hip fracture
Dong Kyu Lee, Seunguk Bang, Sangseok Lee
Anesthesia and Pain Medicine.2019; 14(1): 8. CrossRef
A Comparison of Clinical Results between Compression Hip Screw and Proximal Femoral Nail as the Treatment of AO/OTA 31-A2.2 Intertrochanteric Femoral Fractures
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, In Hwa Back, Kyeong Soo Eom
Journal of the Korean Orthopaedic Association.2016; 51(6): 493. CrossRef
Postoperative Mortality and the Associated Factors in Elderly Patients with Hip Fracture
You-Sung Suh, Yong-Beom Kim, Hyung-Suk Choi, Hong-Kee Yoon, Gi-Won Seo, Byung-Ill Lee
Journal of the Korean Orthopaedic Association.2012; 47(6): 445. CrossRef
One-Year Mortality Rate of Patients over 65 Years Old with a Hip Fracture
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Young Hwa Choi
Hip & Pelvis.2011; 23(2): 137. CrossRef

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Periosteal Impingement in Salter-Harris Type II Injury of proximal Tibial Epiphysis: Sang ho Mmn, Phil Hyun Chung; J Korean Soc Fract 1999;12(4):1046-1050. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.1046

Abstract PDF: Despite the frequent exposure of the knee in children to violent trauma, the incidence of fracture of the proximal tibial epiphysis is extremely low, accounting for about 0.5 per cent of all epiphyseal injuries. This is due to its freedom from collateral ligament attachments and therefore the frequent varus and valgus stresses to the knee are transmitted not to the epiphysis but rather to the metaphysis distal to it. Closed reduction and external immobilization is adequate treatment for most type - I or 3 fractures. Patients with displaced type - III or IV fractures undergo open reduction and internal fixation when there was significant displacement of the fragments or incongruity of the joint. The authors reviewed a case of Salter-Harris type II injury of proximal tibial epiphysis which required open reduction and internal fixation because it had the insertion spread of the periosteum into the separation site.

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Percutaneous Fixation in Medial Malleolar Fracture: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Ki Se Nam, Ho Kyun Bae; J Korean Soc Fract 1999;12(2):314-320. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.314

Abstract PDF: Fracture of the ankle is one of the most common fractures. Usually medial malleolar fractures, when non-displaced or minimally displaced, have been treated by closed reduction and cast immobilization for long period, so stiffness and osteoporosis of ankle were frequently inevitable. We investigated the result of percutaneous pinning or screw fixation and early mobilization in the treatment of medial malleolar fracture of the ankle. With clinical and radiological data, authors analysed 17 patients(17 ankles) who were treated with closed reduction and percutaneous pinning or screw fixation between August 1991 and May 1997. and following results were obtained. One case of pin site infection was noted and no nonunion or loss of fixation was identified and average duration of bone union was 12 weeks. According to Burwell's protocol, the good result are 16 cases, the fair is 1 case and the poor result is not observed. From the viewpoint of rehabilitation, authors consider percutaneuos pinning is an excellent plan of treatment of medial malleolar fractures, when non-displaced or minimally displaced.

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Bilateral Floating Knees Treated by 4 Intramedullary Nails: A Case Report: Phil Hyun Chung, Dong Ju Chae, Sang ho Moon, Ho Gyoon Bae; J Korean Soc Fract 1999;12(2):267-271. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.267

Abstract PDF: The treatment of simultaneous ipsilateral femoral and tibial fractures is a challenging therapeutic problem. Unfortunately, despites a number of reports on these fractures, guidelines for treatment have not been well established. Because the knee joint is isolated partially or completely, the term "floating knee"is used. But most of these injuries are ipsilateral and few bilateral cases were reported in the literatures. The authors reviewed a case of bilateral floating knee treated by 4 intramedullary nails without having any prolonged healing time or limited range of motion in both knee joint postoperatively.

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Malailgnment Following Intramedullary Nailing of Tibial Shaft Fracture - s comparison between medial parapatellar approachand patellar tendon spltting approach -: Dong Ju Chae, Phil Hyun Chung, Tae Young Kim; J Korean Soc Fract 1998;11(4):849-857. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.849

Abstract PDF: Intramedullary nailing is often the treatment of choice in the management of fractures in the tibial diaphysis. One of the most frequent complications of tibial nailing is fracture malalignment leading to angulatory or rotational deformities. Access to the proximal tibia for intramedullary nailing of the tibial shaft fractures may be via a patallar tendon splitting or paratendinous exposure. Although the tendon splitting approach is more direct, the incidence of knee pain is significantly higher when this technique is used. In addition, several cases of heterotopic ossification have been reported following tendon splitting approaches. For these reasons an incision medial to the tendon is generally chosen. We reviewed 140 cases(131 patients) of tibial shaft fractures who were treated by use of the intramedullary nailing from 1994 to 1997 and made a comparison between the medial parapatellar approach and the patellar tendon splitting approach about degree of malalignment. We have noticed that there was significant difference in the number of tibias that were malaligned after tibial nailing with the medial parapatellar access and the tendon splitting approach. With the medial parapatellar approach, malalignment was seen in 13/42 tibiae(31.0%) of the fractures of tibial shaft, 11/12 tibiae of the proximal third fractures and 2/10 tibiae of the distal third fractures respectively. With the patellar tendon splitting approach, malalignment was seen in 8/98 tibiae(8.2%) of the fractures of the tibial shaft, 4/15 tibiae of the proximal third fractures, 1/45 of the middle third fractures and 3/38 tibiae of the distal third fractures respectively. We conclude that the tendon splitting approach may be better for intramedullary nailing of the proximal fractures of the tibia and the medial parapatellar approach may be chosen for the treatment of the middle and distal shaft fractures of the tibia.

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Limited Internal Fixation for the Treatment of the Pilon Fracture: Phil Hyun Chung, Suk Kang, Sang Ho Mun, Won Suk Chae; J Korean Soc Fract 1998;11(4):841-848. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.841

Abstract PDF: The intraarticular fractures of the distal tibia-so called pilon fracture or plafond fracture- were caused by high energy and axial compression forces arising from motor vehicle accidents or falls from a height, and it is frequently associated with severe vomminution and soft tissue injury. Expecially soft tissue injury has been considered as a difficult problems to treat these fractures and there has been many controversies in the methods of treatment. We analized 30 cases of pilon fracture who were treated by limited internal fixation from March 1992 to March 1997. the average follow up period was 26 months(from 15 to 50 months). The results as follow: 1. According to Ruedi and Allgower classification, Type I were 4(13%), Type II were 14(46%) and Type III were 12(40%) cases. 2. By using Ovadia and Beals' radiologic assessment, limited internal fixation showed good and fair results in about 80% of cases. 3. By using Mast and Teipner's clinical functional assessment, limited internal fixation showed good and fair reults in about 80% of cases. 4. Complications after operation were traumatic arthritis(17%) and nonunion(3.3%). But there were no complications such as wound infection and skin necrosis. Limited internal fixation with casting provides good result to treat pilon fractures and it reduces the complications of soft tissues problem.

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Treatments of Tibial Condylar Fractures: Yong Bum Park, Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Dong Ju Chae, Han Chul Kim, Sang ho Moon, Seung Hun Lee, Tae Young Kim, Sun Hyun Yun; J Korean Soc Fract 1998;11(4):790-797. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.790

Abstract PDF: The tibial condylar fractures are characterized by intra-articular extension of fracture line and associated soft tissue injuries, and could affect knee alignment, stability, adn range of motion after treatments. Therefore, anatomical reduction and rigid internal fixation is mandatory to get satisfactory results. But this method of treatment can not be always possible due to technical dimend of surgical sklls and high risk of postoperative infection. The authors analyzed 43 cases of tibial condylar fractures, which were treated at the orthopaedic department of the Dongguk University Hospital from March 1990 to May 1996. Males were 34, and females were 9. Average age of patients was 41.4 years, and average follow up period was 18 months. The most common causes of injuries were traffic accidents (36 cases), and most common type of fracture was Schatzker type I. associated soft tissue injuries were observed in 21 cases. Treatment methods were chosen by degree of displacement of fracture fragment and associated soft tissue injuries. Conservative treatments were done in 23 cases and operative treatments in 20 cases. Satisfactory results were obtained in overall 32 cases(74%) regardless of the methods of treatment. Unsatisfactory results were observed in patients who had associated soft injuries and significant displacement of fracture. Conclusively, satisfactory results could be obtained in patients with tibial condylar fractures by appropriate selection of treatments according to displacement of fracture and associated soft tissue injuries.

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