Journal of Musculoskeletal Trauma

Crescent Fracture-dislocation of Sacroiliac Joint: Affecting Factors of Operative Results: Hee Soo Kim, Chang Wug Oh, Poong Taek Kim, Young Soo Byun, Joo Woo Kim, Byung Chul Park, Woo Kie Min, Hyun Joo Lee; J Korean Fract Soc 2009;22(2):71-78. Published online April 30, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.2.71

PURPOSE
To assess the affecting factors of results after the operation of Crescent fracture-dislocation in sacro-iliac joint.
MATERIALS AND METHODS
In 19 patients (mean age, 47.4 year-old) of open reduction and internal fixation for Crescent fracture-dislocation, there were seven type I, 9 type II, and 3 type III fractures according to Day's classification. We assessed affecting factors of radiological and functional results, such as patients' ages, surgical approaches, the fixation extent of pelvic ring, and fracture patterns.
RESULTS
Seventeen of 19 cases united at 14.5 weeks in average, and 2 non-unions occurred with the fixation failure of posterior ring. Satisfactory results were 14 and 15 in radiological and functional evaluation, respectively. In complications, three cases of leg length discrepancy were from an imperfect reduction and two fixation failures. Surgical approach did not show any difference of results, but all cases of unsatisfactory reduction occurred from posterior ring fixation through the anterior approach. Fixation of both rings seemed to have satisfactory results, comparing to posterior ring only. Older patients over 60 year-old had more complications and a tendency to show an unsatisfactory result.
CONCLUSION
In operative treatment of Crescent fracture-dislocation of sacro-iliac joint, it is better to fix both anterior and posterior rings. But, caution is needed to prevent complications in old-aged patients.

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General Assessment and Initial Management of Polytrauma Patients
Hyoung Keun Oh
Journal of the Korean Fracture Society.2013; 26(3): 230. CrossRef
Damage Control and Provisional Fixation
Hyoung Keun Oh
Journal of the Korean Fracture Society.2010; 23(3): 346. CrossRef

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Minimally Invasive Plate Osteosynthesis for Comminuted Subtrochanteric Fracture of the Femur: Chang Wug Oh, Jong Keon Oh, Sung Jung Kim, Shin Yoon Kim, Seung Hoon Baek, In Ho Jeon, Poong Taek Kim, Sang Won Lee; J Korean Fract Soc 2006;19(4):407-411. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.407

Abstract

PURPOSE
To evaluate the outcomes of patients with comminuted subtrochanteric femoral fractures using minimally invasive plate osteosynthesis (MIPO) technique.
MATERIALS AND METHODS
Twelve patients with a mean age of 38.2 years, who sustained comminuted subtrochanteric femoral fractures, were treated using MIPO technique. All patients suffered these fractures either from traffic accidents (6) or falls from height (6). Average follow-up was 4.3 years (range, 29~78 months). Patients were assessed radiographically and clinically with regards to time to union, malunion, and complications. According to the Seinsheimer's classification, there were 1 type III, 7 type IV, and 4 type V. Type C fractures were ten according to AO-OTA classification.
RESULTS
Union was achieved in 7 of 12 cases, in an average of 23.4 weeks (range, 12~42 weeks). Three definite non-unions with implant failures, needed the procedure of implant change and bone graft. In other two patients, early bone graft was performed for anticipated nonunion of comminuted area. The most common complication was metal failures (2 plate failures and 3 screw breakages). Limb length shortening of 1.5 cm occurred in one patient, and external rotation malunion of 15 degrees was noted in one patient. No patients developed infection.
CONCLUSION
Preserving biology of the fracture fragments, the use of MIPO technique using DCS has proven to be less successful in comminuted subtrochanteric fractures, comparing to fractures in other areas. To avoid mechanical failure, the careful and protective weight bearing is needed until the callus-bridging is seen in the commniuted area.

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Minimally Invasive Plate Osteosynthesis for Femoral Mid-Diaphyseal Fractures
Hyoung-Keun Oh, Suk-Kyoo Choo, Jong-In Kim, Sung-Jong Woo
Journal of the Korean Fracture Society.2013; 26(2): 140. 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
Minimally Invasive Plate Osteosynthesis of Subtrochanteric Femoral Fractures
Chang-Wug Oh
Journal of the Korean Fracture Society.2009; 22(2): 123. CrossRef
What is an Ideal Treatment?
Chang-Wug Oh
Journal of the Korean Fracture Society.2008; 21(4): 347. CrossRef

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Fixation Failure of LCP during the Treatment of Proximal Humerus Fractures: Woo Kie Min, Sang Jin Sin, In Ho Jeon, Ki Bong Cha, Chang Wuk Oh, Poong Taek Kim, Sang Ho Cheon; J Korean Fract Soc 2006;19(2):188-192. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.188

Abstract

PURPOSE
To evaluate the causative factors in the catastrophic failure of LCP in the proximal humerus fracture.
MATERIALS AND METHODS
Six patients (6 cases) were collected between October 2003 and July 2005. The mean age was 55.6 years (range: 38~70). The cause of injury was road traffic accident in four, fall down in one and slip down in one. According to the Neer classification, four were 2 part fractures, each one in 3 part fracture and 4 part fracture.
RESULTS
Fixation failure occurred due to back-out of the plate and screw in five and plate breakage in one. Analysis of the preoperative radiographs revealed medial cortical defect in all and no bone graft and tension band wiring in the greater tuberosity fragment were carried out. Postoperative radiographs showed the anatomical reduction in three and non-anatomical in three.
CONCLUSION
Non-anatomical reduction, insufficient medial bony buttress, inadequate screw length to the head and the neglect for the greater tuberosity fragment were the contributing factors to the failure of LCP. Knowledge of these factors will enable the surgeon to avoid failure of the LCP. Augmentation fixation and bone graft procedures with careful preoperative planning are necessary for successful fixation of LCP.

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The Result of Conservative Treatment of Proximal Humerus Fracture in Elderly Patients
Seung-Gil Baek, Chang-Wug Oh, Young-Soo Byun, Jong-Keon Oh, Joon-Woo Kim, Jong-Pil Yoon, Hyun-Joo Lee, Hyung-Sub Kim
Journal of the Korean Fracture Society.2013; 26(4): 292. CrossRef
A Separate Approach and Cephalo-Diaphyseal Plate Fixation for the Comminuted Metadiaphyseal Fractures of the Proximal Humerus
Sung-Weon Jung
Journal of the Korean Fracture Society.2013; 26(1): 8. CrossRef
Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years
Ki Won Lee, Young Joon Choi, Hyung Sun Ahn, Chung Hwan Kim, Jae Kwang Hwang, Jeong Ho Kang, Han Ho Choo, Jun Seok Park, Tae Kyung Kim
Clinics in Shoulder and Elbow.2012; 15(1): 25. CrossRef
Open Intramedullary Nail with Tension Band Sutures & Lock Sutures on Proximal Humeral Three-part Fracture
Jin-Oh Park, Jin-Young Park, Sung-Tae Lee, Hong-Keun Park
Journal of the Korean Fracture Society.2007; 20(1): 45. CrossRef

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A Biomechanical Advantage of the Lengthening with an External Fixator Over an Intramedullary Nail: An Experimental Study in Saw Bones and Cadeveric Bones: Chang Wug Oh, Poong Taek Kim, Hae Ryong Song, Jong Keon Oh, Hyung Soo Ahn, Byung Chul Park, Byung Guk Min, Sung Ki Park, Young Heon Sohn; J Korean Fract Soc 2005;18(3):335-340. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.335

Abstract PDF: PURPOSE
To know biomechanical differences in methods of limb lengthening between using monolateral external fixator and using external fixator over an intramedullary nail.
MATERIALS AND METHODS
In acryl rods, saw-bone, and cadeveric bone, we created two lengthening models of using monolateral external fixator and using external fixator over an intramedullary nail. The axial compression test was done on the site of osteotomy for lengthening. To fix the models, half pins of 5 mm in diameter and nails of 9 mm in diameter were used. Using MTS (Material Test System) machine, we evaluated the differences of axial stiffness according to the presence of an intramedullary nail or the numbers of half-pins which were fixed at each side of osteotomy.
RESULTS
Lengthening over an intramedullary nail, comparing to monolateral external fixator only, increased the axial stiffness by 1.1~1.2 times in acryl rods, 1.2~1.6 times in saw bones, and 15.6~15.9 times in cadeveric bones when the same numbers of half-pins were used. In saw bone and cadaveric bone, the group of two half pins in lengthening over an intramedullary nail was stiffer than the group of three pins in lengthening with monolateral external fixator.
CONCLUSION
In the distraction of the limb, the addition of an intramedullary nail may increase the axial stiffness of the frame of monolateral external fixator. In lengthening over an intramedullary nail, it is enough to distract the bone with fixing two half pins at each sides of osteotomy.

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Management of Ipsilateral Femur and Tibia Fractures, with Retrograde and Antegrade Nailings from the Knee: Chang Wug Oh, Jong Keon Oh, Woo Kie Min, In Ho Jeon, Hyung Soo Ahn, Hee Soo Kyung, Poong Taek Kim, Jung Ho Noh; J Korean Fract Soc 2005;18(2):131-135. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.131

Abstract PDF

PURPOSE
To review the results in the management of ipsilateral femur and tibia fractures, using femoral and tibial intramedullary nailings with single incision on the knee.
MATERIALS AND METHODS
We treated 19 cases of ipsilateral femur and tibia fractures (floating knee), and the retrograde femoral nailing and antegrade tibial nailing were done with single incision on the knee. Except one patient of early death, 18 patients were included in this study. The mean age of index procedure was 34.1 years, and all of them had follow-up study for a mean of 2.4 years. The mean injury severity score was 18.8, and 12 patients had other fractures in the lower extremity.
RESULTS
Primary union was achieved in all, but one patient of femur and two of tibia. The average period for union was 27.6 weeks for femur and 24.5 weeks for tibia. One femoral nonunion occurred due to the metal failure after using short nail, and two tibial nonunion were caused by the bone loss with open tibial fractures. Most patients showed no limitation in knee motion. According to Karlstrom-Olerud criteria, functional results showed 14 excellent, 3 good and 1 acceptable. The protrusion of nail tip into the knee joint made the acceptable result with moderate limitation of knee motion, but it improved after the removal of nail.
CONCLUSION
CONCLUSION: Simultaneous retrograde femoral and antegrade tibial nailing with single incision on the knee, with an appropriate technique, can achieve the satisfactory result in the management of the ipsilateral femur and tibia fractures.

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Ipsilateral Femoral Segmental and Tibial Fractures: A Case Report
Oog Jin Sohn, Chul Hyun Park, Sang Keun Bae
Journal of the Korean Fracture Society.2009; 22(3): 193. CrossRef

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Internal Bone Transport in the Management of Tibial Bone Defects: Chang Wug Oh, Woo Kie Min, Hee Soo Kyung, Il Hyung Park, In Ho Jeon, Byung Chul Park, Poong Taek Kim, Young Heon Sohn; J Korean Fract Soc 2005;18(1):36-42. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.36

Abstract PDF

PURPOSE
To retrospectively review the results of internal bone transport in the management of tibial bone defect using ilizarov fixator.
MATERIALS AND METHODS
We treated 39 cases of tibial bone defect (16 of traumatic bone loss, 23 after treatment of osteomyelitis). The mean age of index procedure was 33.8 years (range, 13~66 years), and all of them had follow-up study for a mean of 3.5 years (range, 1.6~8 years). The mean transported amount was 6.3 cm (range, 2.7~20 cm), and the external fixator was removed after 345 days (range, 120~700 days). The mean external fixation index was 60.3 days/cm (range, 13.1~121.3 days/cm).
RESULTS
Primary union of distraction and docking site was achieved in all, but two patients had failure in union of docking site. Functional results showed 6 excellent, 19 good, 10 fair, and 4 fair. The patients under age 20 showed better functional outcomes than the others. Among 73 complications (incidence, 1.87 cases/ patient), 27 of major complications with residual sequelae occurred in 20 patients. The residual sequelae were more common in the patients who had the concomitant injuries in the same leg.
CONCLUSION
Internal bone transport can solve the large amount of tibial bone defect. However, the complications are not uncommon, which might be related to the concomitant injures in the same leg.

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Bone Transport Over the Intramedullary Nail for Defects of Long Bone
Jae-Young Roh, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Byung-Chul Park, Woo-Kie Min, Joon-Woo Kim, Chang-Hyun Cho
Journal of the Korean Fracture Society.2008; 21(1): 37. CrossRef
Minimally Invasive Plate Osteosynthesis to Prevent or Treat the Deformity after Distraction Osteogenesis
Chang-Wug Oh, Byung-Chul Park, Il-Hyung Park, Hee-Soo Kyung, Woo-Kie Min, Seung-Hoon Baek, Seung-Kil Baek
The Journal of the Korean Orthopaedic Association.2007; 42(6): 764. CrossRef

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Operative Treatment of Type III Coronoid Process Fractures: In Ho Jeon, Woo Kie Min, Chang Wug Oh, Hee Soo Kyung, Byung Chul Park, Poong Taek Kim, Joo Chul Ihn, Jung Yup Lee; J Korean Fract Soc 2004;17(4):338-344. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.338

Abstract PDF: PURPOSE
To review the clinical results of eight cases of typeIII coronoid process fractures which were treated operatively.
MATERIALS AND METHODS
Eight patients with coronoid type III fracture were reviewed retrospectively. All were men with an average age of 33. There were three isolated fractures, two elbow dislocations, two radial head and neck fractures, and one medial collateral ligament rupture. Open reduction and internal fixation through anterior approach with canulated screws was used. The patients were followed up for a mean of 31 months (24 to 60).
RESULTS
Average active elbow joint motion at the most recent follow up was 105degrees. The average Mayo Elbow Performance Score was 76.9 (50 to 95). There was one excellent result, four good, two fair, and one poor.
CONCLUSION
Early open reduction and stable internal fixation provided a reliable method for the treatment of type III coronoid process fractures. Any associated ligament injuries to the elbow and fracture comminution were considered as important prognostic factors.

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Grade III Tibia Open Fractures Treated with Unreamed Tibial Nailing: Chang Wug Oh, Hee Soo Kyung, Do Heon Kim, Il Hyung Park, Poong Taek Kim, Joo Chul Ihn, Yeon Ki Woo, Jung Yup Lee; J Korean Fract Soc 2004;17(2):148-152. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.148

Abstract PDF

PURPOSE
This is a retrospective study to analyze the results of unreamed intramedullary nailing in grade III tibial open fracture.
MATERIALS AND METHODS
Twenty-nine Gustilo-Anderson grade III tibial open fractures fixed with unreamed tibial nail were followed more than one year. Primary union rate, union time, infection, conversion to external fixation, ankle and knee function according to different grade of open, fracture level, AO classification, and muscle flap were evaluated.
RESULTS
Primary union was achieved at sixteen fractures. There were three delayed union that achieved union twenty week after primary operation. And eight undergone secondary bone grafts which were done after inflammation sign subcided. Complications about infection were in five cases. Two cases were unable to maintain internal fixation due to deep infection, and three of superficial infection were treated with repeated debridement and antibiotics use.
CONCLUSION
In grade III tibial open fracture, unreamed nailing with early soft tissue reconstruction and early prophylactic bone graft can be a good treatment.

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Management of Open Fracture
Gu-Hee Jung
Journal of the Korean Fracture Society.2010; 23(2): 236. CrossRef
Management of Open Tibial Fractures: Role of Internal Fixation
Yerl-Bo Sung
Journal of the Korean Fracture Society.2007; 20(4): 349. CrossRef

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Effect of injected calcium-sulfate on the consolidation of distraction osteogenesis in rabbit model: Chang Wug Oh, Poong Taek Kim, Byung Chul Park, Il Hyung Park, Hee Soo Kyung, Seung Hoon Baek; J Korean Soc Fract 2002;15(2):271-277. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.271

Abstract PDF: PURPOSE
To investigate whether injection of calcium sulfate salt powder could be used to facilitate consolidation of early & fast distraction osteogenesis.
MATERIALS AND METHODS
Group I was experimental group and Groups II and III were controls. After 3 days of latency period, a small distractor was distracted for a total of 8 mm for 4 days. Calcium sulfate salt powder suspended in carboxymethylcellulose(CMC) solution was injected, whereas CMC media alone was injected in one control group and without intervention in the other control group. Plain radiographs were taken on every weeks. We assesed the bone mineral density(BMD) at 3 and 6 weeks and %BMD was calculated. The rabbits were sacrificed at 6 weeks for histologic examination.
RESULTS
In radiography, the distracted area was consolidated in the experimental group but not in control groups. The % BMD of the experimental group was significantly greater than that of control groups at 6 weeks(p<0.01). In histologic examination, greater amount of newly formed bone was noted in the distraction zone of the experimental group, compared to two control groups.
CONCLUSION
Implantation of calcium sulfate powder can accelerate consolidation in distraction osteogenesis in rabbits.

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Treatment of the Femoral Shaft FracturesUsing Unreamed Interlocking Intramedullary Nail: Chang Wook Oh, Joo Chul Ihn, Poong Taek Kim, Shin Yoon Kim, Hee Soo Kyung, Chung Hyun Lee; J Korean Soc Fract 2000;13(4):832-836. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.832

Abstract PDF: PURPOSE
To evaluate the usefulness of unreamed nailing inthe treatment of femoral shaft fractures.
MATERIALS AND METHODS
Between March 1996 and June 1998, unreamed nailing with closed method was done for 74 patients with 82 femoral shaft fractures. The main indications for this treatment were multiple injury or isolated femoral fracture above Winquist type II. The influence of Winquist- Hansen classification, anatomical location, and open injury over bone union and the influence of injury severity score over general complication including fat embolism were investigated.
RESULTS
Primary union occurred in 76 cases(93%) with 6 cases of nonunion and 10(12%) of delayed union, and mean time to union was 27 weeks. In open fractures, the union time was delayed(32 weeks) rather than closed fracture. In Winquist classification, there was no stastical importance on time to union, but nonunion was most common in Winquist type IV. Anatomical location has no influence on time to union. In the view point of multiple injury, the group above 18 points(31 patients) in injury severity score had none of fat embolism, but the group below 18 points(43 patients) had 2 patients.
CONCLUSION
The treatment of femoral shaft fractures by unreamed nailing had longer time to union with higher rate of delayed union, and we think that the theoretical advantage of decreasing pulmonary complications is controversial.

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The biomechanical Study on the Extraction Strengths of Iliosacral Lag Screws: Poong Taek Kim, Chang Wug Oh, Joo Chul Ihn, Jun Dae Kwun; J Korean Soc Fract 2000;13(4):696-701. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.696

Abstract PDF

PURPOSE
The purpose of this study is for the rigid fixation of the pelvic ring by quantifying and comparing the extraction strength of cancellous screws in the sacral ala and body.
MATERIALS AND METHODS
Six cadaveric human pelvis were obtained for test of the extraction strengths of three groups of 7.0mm cannulated cancellous screws: shortthreaded in the sacral ala, short-threaded in the sacral body, long-threaded in the sacral body. The extraction strengths of these groups were compared with each other.
RESULTS
The mean extraction strengths of short-threaded screws in the sacral ala, short-threaded screws in the sacral body and long-threaded screws in the sacral body were 10.26N, 25.85N and 48.37N respectively. The mean extraction strength of the long-threaded screws in the body was significantly greater than that of the shortthreaded screws in the ala and body. The mean extraction strength of the short-threaded screws in the body was greater than that of the short-threaded screws in the ala, but insignificant statistically.
CONCLUSION
In choosing iliosacral lag screws to stabilize the posterior pelvic ring disruption, superior fixation is achieved by inserting the long-threaded screw in the sacral body.

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Crescent Fracture-dislocation of Sacroiliac Joint: Affecting Factors of Operative Results
Hee-Soo Kim, Chang-Wug Oh, Poong-Taek Kim, Young-Soo Byun, Joo-Woo Kim, Byung-Chul Park, Woo-Kie Min, Hyun-Joo Lee
Journal of the Korean Fracture Society.2009; 22(2): 71. CrossRef

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Effect of Insertion of Bone Graft Substitutes on Consolidation of Distracted Callus: Changes of Radiography & Bone Mineral Density in the Tibia of Rabbits: Chang Wug Oh, Poong Taek Kim, Byung Chul Park, Hae Ryong Song, Il Hyung Park, Jun Ho Baek, Hyung Jin Park; J Korean Soc Fract 2000;13(4):687-695. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.687

Abstract PDF: PURPOSE
This study was designed to know the effect of calcium-sulfate and xenograft on the distracted callus after lengthening.
MATERIALS AND METHODS
We had operation of subperiosteal osteotomy and external fixation on the tibial diaphysis of young New Zealand White rabbits(2.0-2.5kg); after 5 days of latency period, 7 mm(1mm/day, 2 times/day) of tibial lengthening was reached in a week. At 1 week after lengthening, the 1st experimental group of 7 rabbits received a pellet of calcium sulfate(Osteoset , Wright medical, USA) in the distraction gap, and the 2nd experimental group of 7 rabbits received 5mm2 of xenogrfat(Lubboc ) in the distraction gap. But, the control group of 7 rabbits did not receive any of above materials. We compared three groups with the changes of radiographic findings at every week and bone mineral ratio(DEXA) at every two weeks.
RESULTS
The time to complete consolidation of distraction callus of both experimental group(calcium sulfate;14 weeks, xenograft; 15.4 weeks) was shorter than that of control group(16.9 weeks) in radiographic findings. Maximum value of bone mineral ratio of distraction callus was higher and the time to reach the highest value was also shortened in the both experimental group compared to control group.
CONCLUSION
By use of bone substitutes as like calcium sulfate or xenograft in the distraction callus with external fixator, it may be possible to shorten the consolidation period and the fixator-wearing period.

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Intramedullary pressure changes in reamed and unreamed nailing systems: an experimental study in cadaveric femoral bones: Chang Wug Oh, Joo Chul Ihn, Poong Taek Kim, Il Hyung Park, Sung Jung Kim, Chung Hyun Lee; J Korean Soc Fract 2000;13(3):631-637. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.631

Abstract PDF: PURPOSE
This study was designed to investigate whether intramedullary pressure is different in reamed compared with unreamed femoral nailing in cadeveric femoral bones. MATERIALS & METHODS: Eight pairs of fresh-frozen cadaveric femoral bones were studied. The diameter of isthmus was checked from 10mm to 14mm and the length of femur was checked from 35cm to 44cm. Intramedullary pressure was measured in the distal femoral shaft at the supracondylar region. Data were monitored in femoral nailing procedures. We utilized the AO universal nail(reamed) and AO unreamed femoral nail.
RESULTS
Intramedullary pressure increased in the reamed group to 423.8 mmHg(mean pressure) during reaming by starting reamer(9 mm) and in the unreamed group to 290 mmHg(mean pressure) during insertion of nails(p=0.001). In the unreamed groups, the next high intramedullary pressure is 136.6 mmHg during proximal reaming. A statistiscally significant difference in intramedullary pressure was found during the first reaming process in the reamed group compared with the proximal reaming process in the unreamed group(p=0.005).
CONCLUSION
The data indicate that the intramedullary pressure during unreamed nailing process is lower than reamed nailing process. So we can consider that the unreamed nailing in multiple fracture or pulmonary injured patients is a good modalities.

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Three-Dimensional Computed Tomography of Acetabular Fractures: Poong Taek Kim, Joo Chul Ihn, Chang Wug Oh, Seung Hoon Oh; J Korean Soc Fract 2000;13(1):46-51. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.46

Abstract PDF: PURPOSE
In the evaluation of acetebular fractures, conventional radiography is limited by distortion, magnification, and overlap of fracture fragments. Computed tomography(CT) has already been shown to be superior in this field. The purpose of this paper was to use 3D reformations for classification of acetabular fractures and planning of operation.
MATERIALS AND METHODS
From July 1994 to December 1998, we reviewed 40 acetabular fractures. We evaluated fractures as plain X-ray(inlet & outlet view, AP view, obturator foramen & illiac wing view), axial CT with 3 mm slices, and 3D reformations. We classified fractures by classification of Letournel.
RESULTS
32 cases of 40 cases were displaced fractures, We recognized fracture easily in 3D reformations. 12 cases were posteior wall fracture. 9 cases were both column frctures. We interpretated both column fractures difficultly in plain X-ray, but we had many informations about rotation & displacement of fracture fragment by 3D reformations. Undisplaced fracture was 8 cases. We interpretated undisplaced fracture difficultly in 3D reformations and distinguished difficultly from normall 3D reformations.
CONCLUSION
3D reformations were useful for analysis of complex displaced fracture but not useful for analysis of undisplaced fracture. Acetabular internal oblique view was useful for analysis of quadrilateral space & posterior wall fractures. Acetabular external view was useful for decision of surgical approach.

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Fixation of Complex Acetabular Fractures Using Cerclage Cable Grip System(DALL-MILES): Poong Taek Kim, Joo Chul Ihn, Gun Wook Park, Yung Ook Choi, Chan Sig Park; J Korean Soc Fract 1999;12(4):761-766. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.761

Abstract PDF: From 1996, in the 13 fractures of the acetabulum surgically treated in Kyung Pook National Hospital and Sae-Myung Orthopedics, cerclage grip system(DALL-MILES) have been used as reduction and fixation tool. Cerclage cable inferted through the greater sciatic notch to a point just cephalad to the anterior inferior spine was greatly helpful for both reduction and internal fixation of thirteen complex acetabular fractures. This technique is especially useful when the fracture line extend into the greater sciatic notch. This is true of high posterior column fractures that extend up into the upper part of the notch, transverse fractures that have an anterior or posterior limb that is high, and both column fractures through ilioinguinal approach with T- extension. Reduction was achieved to within 3mm in 11 cases and 6mm in 2 cases. This reduction was maintained until nuion. The technique may contribute to fracture stabilization, but supplementary fixation was added in 12 patients with curved reconstruction plate over pelvic brim and posterior column in 1 patient.

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Hooked Spring Plate : Its uses in paterior wall acetabular fracture fixation: Joo Chul Ihn, Poong Taek Kim, Dong Kyu Shin; J Korean Soc Fract 1994;7(2):606-615. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.606

Abstract PDF

For fixation of small osteochondral fracture fragment which was difficult to fix with ordinary fixation device in comminuted acetabular posterior wall fracture, we employed a modified 3.5mm one thired tubular plate that was shaped into so-called hooked spring plate. During operation, one end of a plate with two to five hole is flattened for a lenght of 1cm. The flattened end is fashioned into two spikes by trimming the end to the adjacent screw holes with a wire cutter. The resultant spikes are bent to 90 with respect to the plate. The residual proteion of the plates is contoured with convex bow with respect to the surface of the bone. The hooks are placed either through the capsule and around the edge of the fragment or they are embedded into the fragment itself. Six consecutive patients undergoing Kocher-Langenbeck approach for open reduction with internal fixation of posterior wall acetabular fracture(7/91-1.93) were reviewed. There were five simple type and one associated type, as transverse and posterior wall. In two cases application of spring plate in isolation was done. In four cases application of spring plate as part of a reconstruction plate assembly was done All six fractures progressed to union without any loss of the reduction of fixation. In conclusion, the application of spring plate is mechanically sound, valuable for fixation of difficult small osteochondral fractures with avoidance of intaarticular penetration of metal. This method eliminates the need to employ screws in the immediate juxta-articular portion of the plate and promotes early rehabilitation.

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The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate
Dong-Ju Shin, Young-Soo Byun, Se-Ang Chang, Hee-Min Yun, Ho-Won Park, Jae-Young Park
Journal of the Korean Fracture Society.2009; 22(3): 159. CrossRef

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Intra-Articular Fractures of the Calcaneus: ORIF via Lateral Approac: Ik Dong Kim, Jo Chul Ihn, Poong Taek Kim, Byung Chul Park, Young Goo Lyu, Il Hyung Park, Sung Jung Kim; J Korean Soc Fract 1992;5(2):199-204. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.199

Abstract PDF: The os calcis is one of the most commonly injured tarsal bone and fractures involving the subtalar joint may cause serious and persistent disabilities. We treated 12 intra-artlcular calcaneal fractures in 11 patients from June, 1998 to April, 1992 by plate fixation after lateral approach. The Sanders fracture classification system was applied to out study which classify the fractures according to the number of the fractured segments and direction of the fracture lines after computerized axial tomography of the posterior facetal joint. The follow-up evaluation included questioning the patient about pain during activity and rest, the ability to walk and stand, range of subtalar motion and ability to return to work according to the assessment sheet for calcaneal fractures of Creighton Nebraska Health Foundationl We experienced 8 excellent and 2 good results among 12 cases and there was little complication.

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Herbert screw fixation of fracture of the radial head and capitellum: Ik Dong Kim, Joo Chul Ihn, Poong Taek Kim, Byung Chul Park, Young Goo Lyu, Il Hyung Park, Koo Hee Lee; J Korean Soc Fract 1991;4(2):356-361. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.356

Abstract PDF: No abstract available.

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Supracondylar osteotomy for cubitus varus deformity in adult: Ik Dong Kim, Poong Taek Kim, Byung Chul Park, Young Goo Lyu, Il Hyung Park, Byung Guk Min; J Korean Soc Fract 1991;4(1):22-29. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.22

Abstract PDF: No abstract available.

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Clinical Analsis of the Salter-Harris Type II Epiphyseal Injury of the Distal Femur: Ik Dong Kim, Poong Taek Kim, Byung Chul Park, Young Goo Lyu, Soo Ill Han; J Korean Soc Fract 1990;3(2):189-196. Published online November 30, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.2.189

Abstract PDF: Although most of distal femoral epiphyseal fracture is Salter-Harris type II, its prognosis is not uniformly good and poses several problems such as limb length discrepancy, varus or valgus angulation and limitation of knee motion. Authors experienced 9 cases of Salter-Harris type II distal femoral epiphyseal injuries who were treated at Kyoungpook National University Hospital from January, 1982 to June, 1987, All were foloowed for an average of two years and ten months (range, one to seven years) and analysed clinically. The results abtained were as follows. 1. 5 out of 9 cases between 16 and 18 years of age. 2. Significant limb length discrepancy beyond 2cm occurred in only 1 case, lengthening of 0.6cm in 2 cases and less than 1.0cm shortening in 6 cases. 3. Valgus angulation of 10 degress or less occurred in 5 cases and 20 degrees of valgus defromity in 1 case. Varus angulation of 5 degrees or less occurred in 2 cases and of 6 degrees in 1 case. 4. Limitation of knee motion was not observed in all cases. 5. Salter-Harris type II epiphyseal plate injuries does not always carry a good prognosis especially when involving the distal femoral epiphsis. It can bring about growth acceleration or deceleration and angular deformity. Early and anual follow-up until cessation of growth is mandatory.

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Compression Fixation Using a Condyla Plate for Subtrochanteric Fractures: Ik Dong Kim, Poong Taek Kim, Byung Chul Park, Young Wook Choi, Young Gu Lyu, Young Duk Jo; J Korean Soc Fract 1990;3(1):79-87. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.79

Abstract PDF: No abstract available.

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Fracture of the Neck of the Talus: Ik Dong Kim, Poong Taek Kim, Byung Chul Park, Young Wook Choi, Young Gu Lyu, Sung Ho Kim; J Korean Soc Fract 1989;2(2):179-188. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.179

Abstract PDF: We Clinically analysed 10 cases of fractures of the neck of the talus which had been treated at the Department of Orthopedic Surgery, Kyungbook Nantional University Hospital from 1984 to 1988 and the following results were obtained. 1. Of the 10 cases, Hawkiins type I was 2 cases, type II, 4 cases and type III, 4 cases. 2. Avascular necrosis was developed in 7 cases. 1 of type I, 3 of type II and 3 of type III. 3. In all 6 cases with comminution at subtalar and medial aspect of talus, avascular necrosis was developed. 4. Hawkins sign was evident in the plane roentgenogram from 5th weeks to 12th weeks(mean at 8th weeks) and we could diagnose the avascular necrosis of talar body at 9.3th weeks. 5. Bone scan was not a helpful diagnostic tool for the confirmation of the avascular necrosis of the talar body. 6. Absolute non-weight bearing is mandatory until solid union is obtained and partial weight bearing with PTB brace is advisable after emergence of the sign of revasculariztion on the plane roetgenogram. 7. Of the 10 cases of the fracture of the neck of the talus, satisfactory results were obtained in 7 cases and of the 7 cases with avascular necrosis, relatively good results were in 5 cases.

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Clinical Study on treatment of Mid-clavicular Non-union with Semitubular Plating and Bone Graft: Ik Dong Kim, Poong Taek Kim, Byung Chul Park, Young Wook Choi, Sang Bock Lee; J Korean Soc Fract 1989;2(1):29-33. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.29

Abstract PDF: We reviesed 4 patients with clavicular non-union who were treated by internal fixation with semitubular plate and iliac bone graft from Jan. 1984. to Oct. 1988. All 4 Patients had fractures at middle 1/3 of the clavicle. We have defined a non-united clavicular fracture as one that has not demonstrated healing at post-trauma 4 months. All 4 patients had symptoms due to non-union. All 4 patients were treated with semitubular plating and bone graft and achieved good union by average 9.8 weeks post-operatively and symptoms were disappeared. We might conclude that symptomataic non-union of the mid-clavicle could be treated with operative method and rigid internal fixation with semitubular plating and bone graft will be excellent method.

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