Journal of Musculoskeletal Trauma

Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis: Ki Chan An, Gyu Min Kong, Jang Seok Choi, Hi Chul Gwak, Joo Yong Kim, Sung Yub Jin; J Korean Fract Soc 2013;26(4):248-253. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.248

Abstract PDF: PURPOSE
To determine the influence of osteoporosis on the results of percutaneous K-wire fixation for distal radius fractures.
MATERIALS AND METHODS
Between March 2007 and February 2011, Fifty seven patients who underwent fixative surgery with K-wires after closed reduction and those available for follow-up for at least 6 months were reviewed. They were divided into the two groups of T score -3 or more (group 1) and T score less than -3 (group 2). These groups were compared by the range of motion of the wrist and Disabilities of the Arm, Shoulder and Hand (DASH) score. Radiologic evaluations consisting of radial length, radial inclination and volar tilt were compared. In group 1 with 34 cases, the average age was 65.4 years (50 to 78 years) and T score was -1.97 (-0.1 to -2.93). In group 2 with 23 cases, the average age was 74 years (54 to 89 years) and T score was -4.11 (-3.1 to -6.97).
RESULTS
There was no statistical difference between group 1 and group 2 in terms of range of motion, DASH score and radiologic evaluations.
CONCLUSION
In the case of no volar side cortical comminution, percutaneous K-wire fixation can be applied for the treatment of distal radius fracture with osteoporosis.

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Comparison of Open Fixation and Closed Percutaneous Pinning in Jakob Stage II Lateral Condylar Fractures of Children: Eui Sung Choi, Dong Soo Kim, Hyun Chul Shon, Yong Min Kim, Kyoung Jin Park, Jun Mo Jeon, Gee Kang Park; J Korean Fract Soc 2006;19(2):277-282. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.277

Abstract: PURPOSE
To compare the results of open fixation and closed percutaneous pinning in managing Jakob stage II lateral condylar fractures of children's elbow.
MATERIALS AND METHODS
Since Febuary 2000, We operated 21 children with Jakob stage II lateral condylar fractures of elbow. Eleven of the 21 were treated with closed percutaneous pinning, open fixation was done to the other 10 children. Each patient was evaluated about range of motion, carrying angle, scar satisfaction and radiologic findings for comparison between closed pinning and open fixation groups.
RESULTS
Open fixation group showed 3.8 degrees decrease of elbow motion while closed pinning group showed no significant decrease. Carrying angle and radiologic findings were not different between the two groups. Open fixation group expressed dissatisfaction to their scars (average 5.2 cm) whereas all the patients of closed pinning group were satisfied with their functional and cosmetic outcomes.
CONCLUSION
In managing Jakob stage II lateral condyle fractures of children's elbow, closed percutaneous pinning was thought to be superior to open fixation because of the same functional outcome and much better cosmetic results.

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Clinical Results after Percutaneous Surgical Treatment of Intra-articular Fracture of the Distal Radius: Jae Ryong Cha, Jung Hoei Ku, Hyung Lae Cho, Jin Wan Kim, Yoo Dae Kim, Young Il Park, Seong Hwak Hong; J Korean Fract Soc 2005;18(3):304-310. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.304

Abstract PDF: PURPOSE
To evaluate the clinical and radiologic results of percutaneous surgical treatment of the intra-articular fractures of the distal radius, we have compared the results of percutaneous pinning and the combination of percutaneous pinning with external fixation after closed reduction.
MATERIALS AND METHODS
We analysed the results of 52 patients with intra-articular fracture who received the operative treatment with closed reduction in the period of June, 1995 to June, 2001 and also were in regular follow-up at least one year. We used the subjective analysis by Cole & Obletz and the objective analysis by Scheck.
RESULTS
We have found the outcome that 83.3% of percutaneous pinning were graded above "Good" in type B and C1 and 82.2% of the combination treatment of percutaneous pinning with external fixation were graded above "Good" in type C2 and C3.
CONCLUSION
The percutaneous pinning and external fixator after closed reduction in intra-articular fractures of the distal radius are considered useful to restore the articular congruity and make good clinical results.

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Displaced Supracondylar Fractures of the Humerus in Children Treated by Percutaneous Lateral K-wire Pinning: Soon Hyuck Lee, Sang Won Park, Kwang Suk Lee, Jong Ryoon Baek, Sang Won Lee; J Korean Soc Fract 2003;16(3):392-398. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.392

Abstract PDF

PURPOSE
For the treatment of displaced children supracondylar fractures, closed reduction and lateral pinning were performed consecutively and their results were analyzed.
MATERIALS AND METHODS
During the period from January 1997 to May 2001, all children with displaced supracondylar fractures of the humerus were treated by closed reduction and lateral K-wire pinning. Among them, 44 fractures with more than 1 year follow up were selected. Carrying angle and range of motion were measured. Baumann angle and lateral humerocapital angles were measured from the anteroposterior and lateral radiograph 3 times (immediate post op, K-wire removal, last follow up).
RESULTS
Results were graded according to the criteria of Flynn et al. using both cosmetic and functional evaluation. According to the cosmetic factor, 36 cases (82%) were excellent and 8 cases (18%) were good. According to the functional factor, 39 cases (88%) were excellent and 5 cases (12%) were good. No statiscally significant differences, as seen on Baumann and humerocapital angle, between immediate post operative films and films taken at the time of K-wire removal (p=0.082, p=0.27). There was no significant differences in Baumann and humerocapital angle at the time of K-wire removal and last follow up (p=0.19, p=0.27).
CONCLUSION
Closed reduction and lateral K-wire pinning is considered as an acceptable modality of the treatment of displaced children supracondylar fractures.

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Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique
H.-Y. Lee, S.-J. Kim
The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef

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The Analysis of the Percutaneuos Pinning of Supracondylar Fractures in Children: SangMok Lee, SoHak Jung, JaeHo Jang, JungHwan Son, JaeDo Kim; J Korean Soc Fract 2003;16(2):284-291. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.284

Abstract PDF: PURPOSE
Supracondylar fracture was known as supracondylar dilema because of complication and difficulty in treatment. Many methods were devised to prevent and minimize the complications. Among the treatment methods, closed reduction and percutaneous pinning was widely used for most of supracondylar fractures. But arguments was existed for the the pinning methods such as pinning site and number of pins.
MATERIALS AND METHODS
We reviewed 44 cases of displaced supracondylar fractures treated by closed reduction and percutaneous pining. The pins were removed about 4~5 weeks after operation and range of motion was begun. All cases was reviewed restropectively and results was analysed by Flynn grading system. The pinning method was analysed.
RESULTS
There were no significant clinical results among the methods of percutaneous pinnings. Even though two crossed pins from the lateral and medial condyles were preferable for most fractures. The results are that 1)At least 2 K-wires were needed. 2)Prognosis was not influenced by the pinning site. 3)The complication was prevented by accurate reduction using image intensifier during operation.
CONCLUSION
Two lateral parallel pins were alternative method for marked swelling and severely displaced fractures.

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Complications and Affecting Factors for Intracapsular Femoral Neck Fractures Treated by Multiple Pinning: Sung Jung Kim, Shin Yoon Kim, Gi Bong Cha, Chang Wug Oh, Il Hyung Park, Joo Chul Ihn; J Korean Soc Fract 2002;15(2):201-208. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.201

Abstract PDF

PURPOSE
To investigate the relationship between the complications of intracapsular femoral neck fractures treated by multiple pinning and several affecting factors.
MATERIALS AND METHODS
Sixty-eight patients with intracapsular femoral neck fractures were treated by multiple pinning from March 1993 to January 2000 and followed at more than one year. Relationship between the complications such as failure of union, collapse of femoral head due to osteonecrosis of femoral head and several affecting factors including displacement of fracture according to Garden stage, state of reduction, position of screws, time interval from injury to operation, and fracture level were analyzed. The Fisher exact test, chi-square test, and multivariate logistic regression analysis were used to find the relevant factors influencing incidence of complications. Statistical significance was set at p < 0.05.
RESULTS
Position of screw was the most important single factor affecting the results of treatment of intracapsular femoral neck fracture (p=0.046). Moreover, the Garden stage and position of screw were revealed affecting the incidence of complications together with other factors (each p value was 0.028 and 0.027).
CONCLUSION
We considered that satisfactory position of screw was important to reduce complications after multiple pinning for intracapsular femoral neck fracture. And the results of operation also seemed to closely relate with multiple factors including Garden stage and status of reduction.

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Factors Predicting Complications after Internal Fixation of Femoral Neck Fractures
Tae-Ho Kim, Jong-Oh Kim, Sung-Sik Kang
Journal of the Korean Fracture Society.2009; 22(2): 79. CrossRef

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Closed Reduction and Percutaneous Pinning in Displaced Surgical Neck Fracture of the Proximal Humerus: Ju Hong Lee, Gyu Hyung Kim; J Korean Soc Fract 2000;13(2):406-413. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.406

Abstract PDF: PURPOSE
: to appreciate the effectiveness of th closed reduction and percutaneous pinning(CRPP) in reducible but unstable displaced surgical neck fracture of the humerus.
MATERIALS AND METHODS
: reviewed 30 patients(19 cases in CRPP and 11 cases in ORIF) with at least 1 year follow-up, comparing clinical union time, elapse time for surgery and clinical results using UCLA end-result scoring system in two froups and determining prognostic factors in CRPP.
RESULTS
: Clinical union was seen 8.4 weeks in CRPP and 11.2 weeks in ORIF. The difference between two groups in the clinical results was not significant. Lower UCLA score in CRPP correlated with the increment in age(p<0.05), but not with sex and metaphyseal comminution. Elapse time for surgery was taken average 38minutes in CRPP and average 95 minutes in ORIF. The postoperative complications in CRPP were 1 in nonunion, 4 in stiffness and 4 in pin loosening, most of them were occurred in female over sixty. SUMMARY : CRPP is a useful alternative and may be primarily applicable method in respect of comparable results to ORIF, minimal soft tissue damage and shorter surgical time. However, in cases of female with sixty or more, ORIF would be preferred because of poor bone quality, less compliant, and frequent joint stiffness.

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Clinical Study of Pin Fixation of Suprecondylar Fracture of the Humerus in Children: Jun Kwang Park, Tae Hyun Yoon, Young Lae Moon, Kwang Kim; J Korean Soc Fract 2000;13(2):208-215. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.208

Abstract PDF: PURPOSE
: The supracondylar fracture of the humerus is the most common elbow injury in children. They are commonly treated with closed reduction and percutaneous pin fixation. We measured the stability of supracondylar fractures, fixed with different configuration of pins, according to the each type of supracondylar fractures. MATERIAL AND METHOD : We reviewed 42 supracondylar fractures of the humerus in children that were treated with percutaneous pon fixtion from 1988 to 1997. The follow up period ranged from 1.5 to 41 months. The patient's average age was 9.2 years. The most common cause of injury was fall down injury in thirty three. The extension type is the most common, accounting for 95% of cases. We compared the initial post-op films with the follow up films which was checked at 2-3weeks later to establilish the stability by assessing the anterior beak prominence of the proximal fragment on lateral radiograph.
RESULT
: There were 8 cases of Type II-A (hyperextension post cortext intact AP, lateral appearance), 10 cases of Typer II-B (displaced/ angulated with osseous contact AP, lateral appearance) and 24cases of Type III(completely displaced AP, lateral appearance). The greatest stability was achieved with two crossed pons placed from the medial and lateral condyles. Final failure of the fixation occurred in two cases of the group II-B, fixed with only two lateral pins.
CONCLUSION
: The two crossed pins which were placed from the medial and lateral condyles provided the greatest stability of the fracture fragment. When we treat the type II-B pattern fracture (displaced/ angulated with osseous contact AP, lateral appearance), we must check the rotational stability after lateral pin fixation. If the fracture is unstable, we must fix the fracture with additional medial crossed pin fixation.

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Ulnar nerve palsy After Percutaneous Pinning in Childrens Supracondylar fracture: Tai Seung Kim, Jay Rim Choi, Kuhn Sung Whang; J Korean Soc Fract 1999;12(3):674-678. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.674

Abstract PDF: Many authors have described percutaneous pinning techniques as the treatment of choice for most supracondylar fractures. But little information is available concerning ulnar nerve injury resulting from pinning techniques. When the surgeon is faced with a postoperative ulnar nerve palsy, it can be the result of unrecognized preoperative palsy, manipulation during surgery, or damage to the nerve by one of the medial pin placements. The options for management include exploration, medial pin removal, or observation. We reviewed our hospital records on the 132 supracondylar elbow fractures that we treated in children from 1991 to 1998 There were 16 palsies found with normal preoperative and abnormal postoperative ulnar nerve function. Normal nerve function returned without exploration and early medial pin removal in all cases. We recommand that observation is the appropriate way to manage these postoperative ulnar nerve palsies in most cases.

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External fixation versus percutaneous pinning for unstable Colles'fracture: Suk Woong Yoon, Tae Sung Hwang, Jong Haeng Lee; J Korean Soc Fract 1999;12(2):461-470. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.461

Abstract PDF: The twenty-three cases of unstable Colles fracture were treated from Jan. 1994 to May 1998 at the department of orthopaedic surgery of Seoul Red Cross Hospital. Among them, the sixteen cases were treated with closed reduction with percutaneous pinning, others were treated with external fixator(Ace colles quadrilateral devices, USA). A retrospective study was made and evaluated using the Modification of Gartland and Werley's scoring system. The result of this study were as follow: 1. The ratio of male to female was 9 cases(39%) to 14 cases(61%). 2. The causes were falling down from a height 12 cases(50%), slip down 8 cases(35%) and traffic accident 3 cases(13%). 3. The reduction loss did not occur with the patients treated external fixation using Ace colles qredrilateral device, however three cases of the reduction loss have occurred with the patients using percuteneous pinning. 4. According to the Modification of Gartland and Werley's scoring system, the results of exteral fixation were excellent 4 cases(58%), good 1 case(14%), fair 1 case(14%) and poor 1 case(14%). and for percutoneous pinning, excellent 6 cases(38%), good 4 cases(25%), fair 2 cases(12%) and poor 4 cases(25%). 5. The complications of cases using external fixation were pin site infection 1 case and wrist stiffness 1 case, but for percutaneous pinning, reduction loss 3 cases. pin site infection 2 cases, wrist stiffness 2 cases, and decreased external rotation of forearm 3 cases.

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Surgical Treament for Unstable Intra-articular Fracture of the Distal Radius with Rayhack's Transulnar Percutaneous Pinning Technique: Eui Chan Jang, Ho Sung Ryu, Jae Sung Lee, Jung Nam Han; J Korean Soc Fract 1999;12(2):422-428. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.422

Abstract PDF: There has been many treatment modalities in the distal radius fracture. Although there is no doubt that external fixators have a role in the treatment of some highly displaced distal radius fractures, many unstable distal radius fractures may be treated adequately with far less complicated and intrusive percutaneous pinning technique. The purpose of this study was to evaluate indication and effectiveness of Rayhack's transulnar percutaneous pinning technique. Authors reviewed the unstable intra-articular fracture of the distal radius of 15 cases treated with Rayhack's transulnar percutaneous pinning technique between March 1994 and February 1997. At the final follow-up examination, the mean loss of radial length, radial inclination and volar tilt was respectively 0.4mm (3.9%), 2.0 (10.6%), 2.1 (14.7%). Posttraumatic arthritis was occurred in 1 case (11.1%) of less than 1mm residual articular step-off, 2 cases (40%) of more than 1mm and less than 3mm residual articular step-off, 1 case (100%) of more than 3mm residual articular step-off. Distal radioulnar joint synostosis by percutaneous pinning was not found. According to Demerit point rating system, excellent to good results were obtained in 73.3%. Authors suggest that Rayhack's pinning technique can be applied in terms of simple procedure, cost-effectiveness and functional outcome.

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Essex-Loprestis Axial Pinning in the Treatment of Intraarticular Calcaneal Fracture: Hyung Koo Yoon, Kwang Pyo Jeon, Kyung Hoon Kang, Jin Il Kim, Dong Soo Kim, Kyung Soub Song; J Korean Soc Fract 1999;12(2):344-350. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.344

Abstract PDF

Fracture of the calcaneus is the most commonly encountered among fracture of tarsal bone and it is difficult to obtain accurate reduction because the calcaneus has cancellous trabecular enclosed with thin cortical bone. In the past, the result of treatment was poor. Recently, closed reduction and axial pin fixation for tongue type fracture and open reduction and internal fixation for joint depression type fractures are considered as generally accepted treatment methods. The purpose of this study is to evaluate the efficacy of axial pin fixation in joint depression(group A) and tongue type(group B). Retrospective study was performed in 20 patient(23 feet) with intraarticular calcaneal fractures which were treated with axial pin fixation from July 1993 to June 1996. Minimum follow up period was 1 year(average 20 months). The obtaining results were as follows : 1. Cause of injury was fall down in the 18 cases(90%). 2. We obtained excellent or good results from the performance of operation within 2 weeks on trauma patient, in the 16 cases(69%). And we obtained excellent or good results in the 14 cases, showing above 20degreesof postoperative B.. ohler angle. 3. In fracture of joint depression type, there is no relationship between clinical result and degree of joint depression in follow up CT. 4. The complications were subtalar arthritis and two neuroma in sural nerve. We propose our experience obtained in 23 cases that axial pin fixation was a good method for treatment of intraarticular fracture, joint depression type as well as tongue type.

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Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method
Gyu Min Kong, Byoung Ho Suh, Dong Joon Kim
Journal of the Korean Fracture Society.2007; 20(2): 178. CrossRef

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Treatment of Femoral Neck Fracture with Multiple Pinning: Sang Won Park, Jong Ryoon Baek, Sang Seok Han; J Korean Soc Fract 1999;12(2):220-230. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.220

Abstract PDF

The incidence of femoral neck fracture is increasing because of the lengthening of human life span and a rising incidence of industrial trauma. Despite of the advance in treatment, femoral neck fracture presents poor prognosis and high rate of complications such as avascular necrosis or non- union due to anatomical consideration. It still remains one of the unsolved fracture as far as treatments and results are concerned. The purpose of this paper is to study the clinical results and factors predisposing to complication after multiple pin pixation of femoral neck fracture. The authors reviewed 50 cases of femoral neck fracture treated by multiple pin fixation at the Department of Orthopedic Surgery, Korea University Hospital from January 1989 to December 1996 with followed up period of more than 1 year and analyzed the relationship between the clinical results and age, degree of displacement, degree of osteoporosis, interval between onset of injury and operation, reducibility and complications. The results obtained were as follows: 1. The functional results by Lunceford criteria were excellent in 15 cases (30%), good in 13 cases(26%), fair in 9 cases(18%), and poor in 13 cases(26%) 2. Union occurred in 36 cases (72%) and the mean duration of union was 6.1 months. 3. There were 12 cases (24%) of avascular necrosis, 2 cases(4%) of non- union, 2 cases (4%) of malunion and 1 case of traumatic osteoarthritis. 4. Poor results were noted in cases of displaced fracture, osteoporotic bone under the Singh index 3, reduced in varus or valgus. Above results suggest that there was a relationship between the prognosis and bone density, degree of displacement and type of reduction, but the interval between the onset and operation within one month, and age distribution did not influence the end result.

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Comparison of Clinical Outcomes for Femoral Neck System and Cannulated Compression Screws in the Treatment of Femoral Neck Fracture
Jae Kwang Hwang, KiWon Lee, Dong-Kyo Seo, Joo-Yul Bae, Myeong-Geun Song, Hansuk Choi
Journal of the Korean Fracture Society.2023; 36(3): 77. CrossRef
Internal Fixation for Femoral Neck Fracture in Patients between the Ages of Twenty and Forty Years
Ui-Seoung Yoon, Jin-Soo Kim, Hak-Jin Min, Jae-Seong Seo, Jong-Pil Yoon, Joo-Young Chung
Journal of the Korean Fracture Society.2010; 23(1): 1. CrossRef

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The Comparative Sturdy of Treatment between the Skeletal Traction and the Operation of the Supracondylar Fracture in Children: Eu Sub Chung, Young Kee Lee, Byoung Ho Lee; J Korean Soc Fract 1998;11(4):970-976. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.970

Abstract PDF: The most common fracture about the elbow joint in children is supracondylar fracture. That treatment has many fitsfalls and had writtened about its method and the prevention of serious complication such as Volkmann ischemic contractre and cubitus varus deformity. the authors analyzed the follow-up results of 58 cases of supracondylar fractures treated by skeletal traction, percutaneous pinning and open reductionin Persbyterian Medical Center from March 1992 to November 1996. The average follow-up was 20 months(12-54 months). The results were as follows. 1. The mean age was 7.8 years, ranged from 1 year to 15 years, and the male and the female ratio was 1.9:1. 2. Seventeen cases were treated with skeletal traction group, thirty cases with closed reduction and percutaneous pinning group, eleven cases with open reduction and internal fixation group. 3. The average duration of admission in skeletal traction group was 23.5 days, 5.2 days in percutaneous pinning group and 14.7 days in open reduction and internal fixation group. 4. The ration of hospital cost to that in the skeletal group were 0.85+/-0.18 in the percutneous pinning group, and 1.43+/-0.21 in the open reduction and internal fixation group. 5. According to the Mitchell and Adams' criteria, the results of skeletal tracion group were excellent in 58.8%, good in 35.3% and poor in 5.9%; the results of percutaneous pinning group were excellent in 60%, good in 36.7% and poor in 3.3% ; and those of open reduction group were excellent in 54.5%, good in 27.3% and poor in 18.2%, respectively, on mean follow-up of 1 year and 8 month. So, our result indicated that the closed reducion and percutaneous pinning is a simple and cost-effective method for treatment of supracondylar fractures of the humerus in children, but some instances, the skeletal traction might be another treatment method in supracondylar fractures.

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Comparison of Results According to the Type and Procedure in Unstable Fracture of the Distal Radius: Jin Young Park, Hong Geun Jung, Moon Jib Yoo, Jeong Wan Kim; J Korean Soc Fract 1998;11(2):435-441. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.435

Abstract PDF

In the treatment of an unstable fracture of the distal radius, the anatomical reduction of articular surface and the maintenance of radial length are essential. Recently, more extensive therapeutic method was introdced for reduction and maintenance of distal radius fracture. To compare the results between type C2 and C3 that were treated with pinning and the results between pinning and pinning with external fixation in type C3 according to AO classification, we analysed anatomical and functional results of unstable fracture of the distal radius from June, 1994 to september, 1996 at DanKook University Hospital. There were 12 cases of C2 type with pinning, 17 cases of C3 type with pinning and 14 cases C3 type with external fixation and pinning. Among the 43 cases, the most commom type was C3 (31cases), and open fractures were 6 (14%)cases. The following results were obtained; 1. For comparison of C2 type with C3 type that were treated with pinning, the results of C2 type were better anatomically and functionally. 2. For comparison of percutaneous pinning with percutaneous pinning and external fixation in C3 type, the results of C3 type that were treated by pinning and external fixation were better anatomically and functionally.

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Treatment for Unstable Distal Radius Fracture with Osteoporosis -Internal Fixation versus External Fixation-
Jin Rok Oh, Tae Yean Cho, Sung Min Kwan
Journal of the Korean Fracture Society.2010; 23(1): 76. CrossRef

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A Clinical Comparision of Multiple Pinning With Bipolar Endoprosthesis of the Femoral Neck Fractures in the Elderly Patients: Jae Ik Lee, Myung Hwan Son, Jae Hong Park, Kang Hoon Kim; J Korean Soc Fract 1998;11(2):321-327. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.321

Abstract PDF: The goal of the treatment of femoral neck fractures is early ambulation to prevent the complications such as pneumoniae or atelectasis, deep vein thrombosis, pulmonary embolism, bed sore, general weakness. The authors have tried to asess the outcome and complication of multiple pinning (28 cases) and biploar endoprosthesis (35 cases) for femoral neck fractures in average 18 momths with the range of 12 months to 5 years from May 1990 to May 1996. The results were asessed by interval from injury to operation, post operative complication and mortality rate, weight bearing time, Lunceford hip grading method. The results were as folllows: 1. Post operative complications rate were 43% in multiple pinning, and 26% in bipolar group. 2. The mortality rate was 14.2% in multiple pinning group and 11.4% in bipolar endoprosthesis group. 3. The functional results evaluated by Lunceford's methods were satisfactory in 64% of multiple pinning group and 71% in bipolar endoprosthesis group. We concluded that displaced fractures, subcapital fracture, severe osteoporosis, old fracture over 3 weeks in elderly patients, bipolar endoprosthesis gave a more reliable results.

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Multiple Pinning in Femoral Neck Fractures: Kuen Tak Suh, Taek Geon Lee, Chang Il Yoo; J Korean Soc Fract 1997;10(4):727-737. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.727

Abstract PDF: The incidence of femoral neck fracture has steadily increased with lengthening of the average life span. The end results of treatement have been improving with the development of internal fixation devices. However, the anatomic characteristics of femoral neck has made the complications of nonunion and avascular necrosis as a common result. Authors analysed 47 patients, with over 2 years follow-up on an average, who were more than twenty years old and treated with multiple Knowles pins or cannulated screws during the period from February 1988 to February 1994. Following results were obtained. 1. Among 47 patients, 23 cases(49%) were male and 24 cases(51%) were female. The highest incidence was found in the sixth decade. 2. The most common cause of femoral neck rracture was slip down(55%). 3. According to the Gardens classification, the displaced fracture(Garden stage III and IV) was more common (68%), and according to the anatomic classification, transcervical type was the most common (40%). 4. Among 47 patients, there were 1 case of nonunion(7%) and 2 cases of avascular necrosis of femoral head(13%) in the nondisplaced fractures(15 cases), compared to 6 cases of nonunion(19%) and 8 cases of avascular necrosis of femoral head(25%) in the displaced fractures(32 cases). There were 4 cases of nonunion(15%) and 5 cases of avascular necrosis of femoral head(19%) among the 26 patients treated with multiple Knowles pins, compared to 3 cases of nonunion(14%) and 5 cases of avascular necrosis of femoral head(28%) among the 21 patients treated with cannulated screws. 3 cases of nonunion(10%) and 4 cases of avascular necrosis of femoral head(13%) were developed among 30 cases in which acceptable reduction was achieved after closed reduction. 4 cases of nonunion(24%) and 6 cases of avascular necrosis of femoral head(35%) were developed among 17 cases in which poor reduction was achieved. 11 cases(42%) were complicated among 26 cases below Singh index grade 3 and 6 cases(29%) were complicat among 21 cases above Singh index grade 4. 5. Factors that may affect the success of treatment in femoral neck fracture are not the type of internal fixation device used, but rather anatomic site of fracture, the degree of displacement, degree of osteoporsis and accuracy of reduction.

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The Treatment of Supracondylar Fracture of The Humerus in Children: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Cheol Min Kim, Sang Hoon Ko, Seung Wook Jeong; J Korean Soc Fract 1997;10(2):393-400. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.393

Abstract PDF: Supracondylar fracture of distal humerus is up to 60% of all fractures around the elbow in children. Complications of this fracture include nerve injury, arterial injury, skin slough, Volkmanns ischemic contracuture, and changes in carrying angle. Many different treatment methods to minimize these complications have been devised. Recently, closed reduction and percutaneous pinning with K-wire is most widely used in treating supracondylar fractures in children exept in some rare cases such as unreducible fracture by closed reduction. However, troublesome changes in the carrying angle which do not interfere with function but the appearance of the arm is unsatisfactory, continue in approximately 30% of most series. We reviewed 59 cases which were treated by closed reduction and percutaneous pinning in supracondylar fracuture of the humerus. The purpose of our study is to evaluate the cosmetic and functional results and complications and to analysis the relationship between the stability of reduction and method of pinning. The results are as follows; 1) There were many cosmetic problems, actually. Change over 10 degrees in carrying angle compared to the normal site was as high as 10 cases(17%) of 59 cases. 2) There was no functional problem such as limitatioin of motion. 3) There was no significant complication. 4) The cross pinning fixation was more stable than lateral pinning fixation only. 5) Accurate anatomical reduction is required to prevent unsatisfactory result regardless the treatment method.

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Treatment of Lateral Humeral Condyle Fractures in Children Using Closed Reduction and Percutaneous Pinning: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Sang Hoon Ko, Seung Hyun Hwang; J Korean Soc Fract 1997;10(1):218-225. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.218

Abstract PDF: Treatment of lateral condyle fracture has been traditionally divided to closed and open treatment. Minimal displaced fracture of lateral humeral condyle can be appropriately treated with closed reduction and percutaneous K-wire fixation. Adherence to these guidelines is likely to prevent malunion, nonunion, premature epiphyseal closure, ulnar neue palsy, and cubitus valgus deformity, all possible complications of this fracture. Since September 1993, we managed 20 children with lateral condyle fracture of elbow using closed reduction and percutaneous pinning. And intraoperative arthrogram was done to confirm the reduction status. Pins were removed 6 weeks postoperatively. The average period of follow-up was 24 months. There was no significant difference in carrying angle, range of motion and physical activity compared to contralateral elbow. Valgus - varus stress view is a useful method in evaluating fracture stability and rupture of cartilage hinges and valgus - supination stress view is very useful for confirming the reduction. Arthrogram was considered to be useful in evaluating the reduction state and deciding the treatment plan.

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Clinical Analysis of the Lateral Humeral Condyle Fracture in Children: Jong Oh Kim; J Korean Soc Fract 1996;9(3):678-687. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.678

Abstract PDF: The author have analyzed clinical and radiological materials of foully-five patients of lateral condylar fracture of the humerus who have been treated with close reduction and percutaneous pinning after arthrogram, open reduction and internal fixation and followed up for more than 6 month since September, 1993. If the fracture is incomplete will not be displaced after varus and valgus stress. Also We have checking arthrogram of reduction state. we have treated with close reduction and percutaneous pinning. If the fracture is complete the fragment may be displaced and open reduction with internal fixation is mandatory, the following results were obtained: 1. Age at diagnosis was 5.7 years in average ranging from two years to twelves years. thirty-three out of fourty-five children(73.3%) were male to reveal definite male prepoderance. 2. As for Milch type classification, three cases(5%) were of type I and foully two cases(95%) were of type II. According to Jakobs staging of displacement, 7 cases were of stage I, 25 cases were of stage II , and 13 cases were of stage III. 3. The open reduction were indicated as follows: Jak obs stage II unreduced, postinjury 48 hours relapsed, Jakob stage III. The closed reduction were indicated as follows: Jakobs stage I, II Badelon type I, II and undisplaced and reduceable with supination-valgus stress view, arthrogram. 4. The average period of postoperative cast immobilization was 4 weeks, active and gentle passive motion exercises were instituted thereafter. 5. The range of change in carrying angle was not influenced by degree of fragment displacement and method of treatment. 6. The complications were lateral condylar overgrowth(6 cases) and avascular necrosis(1 case). 7. The result of the treatment classified according to Hardacre assessement, were excellent in thirty one cases(69%), good in thirteen cases(29%), poor in one case(2%). In conclusion, the closed reduction and internal fixation with arthrogram, is considered as the treatment of choice for the minimally displaced lateral condylar fractures of the humerus in children.

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Fracture-SeFaration Involving the Entire Distal Humeral Epiphysis in a Young Child(Salter-Harris type I injury): A Case Report: Jong Ho Jang, Seung Gyun Cha, Kyoung Hoon Kim, Jeon Oh Kang; J Korean Soc Fract 1996;9(3):674-677. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.674

Abstract PDF: Fracture-separation of the distal humeral epiphysis is a rare injury, frequently misdiagnosed as a fracture of the lateral humeral condyle, a supracondylar fracture of the humerus or a dislocation of the elbow. Roentgenographic evaluation reveals posteromedial displacement of the distal epiphysis. Single contrast arthrography is performed in order to confirm diagnosis. Treatment is first directed toward prompt recognition of the injury. A manipulative closed reduction is usually recommended. We experienced a case of fracture-separation involving the entire distal humeral physis treated by closed reduction and percutaneous pinning. The result was excellent.

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Displaced Supracondylar Fractures of the Humerus in Children: Comparative Analysis between Percutaneous Pinning & Open Reduction: Won Sik Choy, Hyun Dae Shin, Hwan Jeung Kim, Kwang Won Lee, Hyung Sun Baik, Nam Hun Kim; J Korean Soc Fract 1996;9(2):330-340. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.330

Abstract PDF: Supracondylar fracture of the humerus is the Inost common fracture of the elbow in children and it can aiso be one of the most difficult fractures to be treated. The authors periormed retrospective study of 85 patients who were treated by percutaneous pinning, and by open reduction from 1989 to 1993. 1. The mean age 7.4 years, ranging from 2 years to 13 years and the male and female ralio was 2.1:1 2. The left side was more frequently involved(66%). 3. Treatment methods were PP 52% & OR 48% 4. According to tile Flynns criteria, the results of the treatment by PP wear excellent 80%, Good 4%. Fair 9%, Poor 7% and OR were 54%, 12%, 15%, 19%, respectively. 5. No stastisfically significant differences regarding maintenance of reduction were found when comparing crossd-pin and lateral-pin fixation.

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Closed Reduction and Percutaneous K-wire Fixation in Supracondylar Fractures of the Humerus in Children: Soon Hyuck Lee, Jung Ho Park, Young Soo Byun; J Korean Soc Fract 1995;8(2):423-429. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.423

Abstract PDF: We evaluated the clinical results of the closed reduction and percutaneous K-wire fixation for supracondylar fracture of the humerus in thirty patients who were treated from Jan 1990 to Nov 1993. We analyzed the relationships between non-anatomical reduction and occurrence of varus deformity in displaced supracondylar fractures of the humerus in children. The following results were obtained: 1. There were twenty-two males and eight females, twelve cases of type IIB and eighteen cases of type IIIfractures by Gartland classification. Posteromedial displacement and fractures through the olecranon fossa were most common pattern. 2. After closed reduction, eleven rotations and three medial displacements of distal fragment, and three angular deformities of medial cortex were observed in eleven cases. 3. Radiologically, the differences of carrying angle compared with normal side were decreased in twenty-one cases, no changes in three cases, and increased in six cases. 4. Two cubitus varus deformities were developed in decreased cases more than six degrees of carrying angle with residual rotation and medial displacement. 5. We obtained relatively good results in supracondylar fracture of the humerus in children treated by closed reduction and percutaneous K-wire fixation with grossly normal carrying angle.

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Percutaneous Pinning & External Fixation In the Treatment of Proximal Humerus Fracture: Jeong Ho Park, Sung Woon Choi, Young Chan Son, Young Gi Hong, Jeong Hwan Son, Jae Do Kim; J Korean Soc Fract 1995;8(1):152-158. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.152

Abstract PDF: The management of displaced fractures of the proximal humerus is still under debate and the need to evaluate alternative methods has been emphasised. We treated the displaced, unstable 2-part or 3-part fractures by percutaneous pinning or external fixation after closed reduction to reduce the complications of open reduction such as soft tissue contracture, articular stiffness, neurovascular injury and potential non-union. In this paper, we analysed 8 cases of proximal humeral fractures treated by percutaneous pinning and external fixation from Sep. 1992 to Mar. 1994. The results were excellent ; 3 cases, satisfactory; 3 cases, and unstisfactory; 2 cases but no ftilures by the criteria for evaluation of Neer. We concluded that percutaneous pinning or external fixation of displaced, unstable 2-part or 3-part fractures is one of the good methods of treatment.

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Reduction and Percutaneous Pinning of Displaced Supracondylar Fracture of the Humerus in Children: Won Yoo Kim, Jin Young Kim, Kun Young Park, Chong Hoon Park, Hwa Sung Lee; J Korean Soc Fract 1994;7(2):471-479. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.471

Abstract PDF: Closed reduction and percutaneous pinning of displaced supracondylar fractures of the humerus in children yielded simple fracture management, less neurological and vascular complications, reduced hospitalization day and increased satisfactory out-comes. We treated twenty-seven cases of these fractures(extension type : twenty-five cases) by such a method. The accurate closed reduction of a supracondylar fracture could be obtained and confirmed by image intensifier. The maintanence of a reduction was stabilized by application of K-wires. Our study showed that the limitation of range of motion of the elbow joint was not signifiint(three cases, below ten degrees extension block and changes of carrying angle was also minimal three cases, below ten degrees). In twenty-seven cases, excellent results were recorded in 93% on at least on year follow-up.

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Displaced surgical neck fractures of humerus treated with pinning: Ju Hai Chang, Jong Min Sohn, Won Jong Bahk, Joon Taek Kong; J Korean Soc Fract 1992;5(1):65-71. Published online May 31, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.1.65

Abstract PDF: No abstract available.

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Treatment of acute acromioclavicular dislocation with percutaneous pinning: Hyoung Min Kim, Choong Seo Park, Youn Soo Kim, Jae Duk Ryu; J Korean Soc Fract 1992;5(1):28-36. Published online May 31, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.1.28

Abstract PDF: No abstract available.

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Treatment of supracondylar fractures of the humerus by percutaneouspinning in children: Sung Joon Kim, Jae Lim Cho, Euhn Sung Whang, Soo Tai Chung; J Korean Soc Fract 1991;4(1):30-36. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.30

Abstract PDF: No abstract available.

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