Journal of Musculoskeletal Trauma

Peroneus Tendon Dislocation Associated with Fracture of Lateral Process of Talus: A Case Report: Youn Soo Hwang, Sung Jun Jo, Kwang Yeol Kim, Hyung Chun Kim, Dong Seon Kim; J Korean Fract Soc 2014;27(3):222-226. Published online July 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.3.222

Abstract PDF: Traumatic peroneal tendon dislocation in association with fracture of the lateral process of the talus is a rare injury, which is difficult to diagnose. As a result, early detection is often delayed, which in turn leads to ankle pain and dysfunction. We treated a patient by open reduction and screw fixation in fracture of the lateral process of talus and primary repair of the superior peroneal retinaculum. We report this case with a brief review of the literature.

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Arthroscopic Repair for Traumatic Peripheral Tear of Triangular Fibrocartilage Complex: Seung Ju Jeon, Chan Sam Moon, Ho Seung Jeon, Haeng Kee Noh, Sung Hwan Kim; J Korean Fract Soc 2007;20(4):330-334. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.330

Abstract PDF: PURPOSE
To assess the results of an arthroscopic repair for traumatic peripheral tears of triangular fibrocartilage complex (TFCC, Palmer type Ib).
MATERIALS AND METHODS
10 patients with traumatic peripheral TFCC tear were treated with outside-in technique with arthroscope and evaluated with an average follow-up of 19 months (range, 15 to 28 months). The clinical outcomes were assessed with investigation of pain, range of motion, grip strength, return to job and patient's satisfaction.
RESULTS
The arthroscopic repair of traumatic peripheral TFCC tear resulted in significant pain relief and increase in functional ability of wrist, that is, 8 excellent, 1 good and 1 fair results. At last follow-up, the average of flexion was 79Â° (range 76~86Â°), average of extension was 78Â° (range 70~84Â°), average pronation was 85Â° (range 75~91Â°) and average supination was 87Â° (range 79~92Â°). Nine patients except one were back to their original job.
CONCLUSION
Arthroscopic repair of traumatic peripheral TFCC tear could be used for pain relief and increase in functional ability of wrist.

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Result of Early Active Range of Motion Exercise after Bankart Repair of Traumatic Anterior Instability: Haeng Kee Noh, Jong Woong Park, Jung Il Lee, Jung Ho Park; J Korean Fract Soc 2007;20(1):53-57. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.53

Abstract PDF: PURPOSE
To evaluate prospectively the results of early active exercise after open Bankart repair of traumatic anterior shoulder instability.
MATERIALS AND METHODS
From January, 2001 to June, 2003, 26 patients who were followed up at least 1 year after open Bankart repair for traumatic anterior shoulder instability were evaluated. Average age was 23.9 years old (range, 19~43) with 24 males and 2 females. We evaluated them using the functional shoulder scores (modified Rowe score, ASES score), range of motion, VAS pain scale, patient's subjective satisfaction and return to unlimited daily living activity.
RESULTS
The shoulder functional scores increased significantly. At last follow up, the final range of motion were flexion in average 5Â° deficit in comparison to normal side, external rotation in average 10o deficit, and internal rotation in T9. The patient's subjective satisfaction was good in 2l patients (81%). Return to unlimited daily activity was possible in 23 patients (88.5%), and 19 patients (73%) rejoined to sports activity before injury. There were complications including anterior recurrent subluxation in 1 case, weakness of subscapularis muscle in 1 case.
CONCLUSION
In traumatic anterior shoulder instability, early active range of motion exercise after open Bankart repair does not decrease shoulder stability. Early exercise can be useful for returning to previous level of sports activity in young active patients.

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The Necessity of Deltoid Ligament Repair in Lateral Malleolar Fracture Combined with Medial Clear Space Widening: Bo Kyu Yang, Sung Ho Hahn, Seung Rim Yi, Young Joon Ahn, Jae Ho Yoo, Min Seok Kim, Byung June Chung; J Korean Fract Soc 2005;18(3):281-285. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.281

Abstract PDF: PURPOSE
To evaluate the necessity of deltoid ligament repair in lateral malleolar fracture associated with medial clear space widening.
MATERIALS AND METHODS
The 82 cases of 82 patients received surgical treatment for lateral malleolar fracture with medial clear space widening in our hospital from Jan. 1996 to Feb. 2002. 73 male and 9 female patients were included respectively. Average follow-up period was 13.2 month (12~50). The methods of internal fixation of lateral malleolar fracture were 66 cases by cortical screw, 16 by plate and screws, and 9 by transfixing screw.
RESULTS
Satisfactory reduction was obtained in 65 of 73 cases by only internal fixation of lateral malleolar fracture. Transfixing screw was needed in 8 cases. There was no need for repair of deltoid ligament. In clinical evaluation, no cases of limitation of movement in ankle was seen at final follow-up time. In radiologic evaluation, average medial clear space widening before operation was 5.89 mm (4.5~13 mm) and that of last follow-up time was 2.54 mm (1.5~3.5 mm). 95.2% was above good result.
CONCLUSION
In treatment of unstable lateral malleolar fracture associated with medial clear space widening due to rupture of deltoid ligament, we obtained satisfactory result by accurate anatomical reduction or internal fixation. In these cases, there were no need for repair of deltoid ligament.

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Meniscal Injuries with Tibial Plateau Fractures: Yong In, Won Jong Bahk, Oh Soo Kwon, Chae Gwan Kong, Ju Young Kim; J Korean Soc Fract 2003;16(4):490-495. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.490

Abstract PDF: PURPOSE
The purpose of this study is to evaluate by arthroscopy the incidence of meniscal injury and the result of its treatment in fractures of the tibial plateau.
MATERIALS AND METHODS
From March 2000 to July 2002, twenty-three patients with tibial plateau fractures were examined and treated by arthroscopy before reduction of the fractures. Following the classification by Schatzker, there were 3 pure cleavage fractures (type I), 7 with cleavage and depression (type II), 4 with pure central depression (type III), one medial condyle fracture (type IV) and 8 with meta-diaphyseal fractures (type VI). Meniscal injuries were treated by meniscectomy or meniscal repair. Second look arthroscopy for patients treated with meniscal repair were performed at 6 months after operation or at time of the fixative removal.
RESULTS
Thirteen knees (56%) were found to have meniscal injuries. There were 11 lateral meniscal tears, eight of which were periphral and repaired. There were 3 complex lateral meniscal tears which required partial meniscectomy. The five medial meniscal tears were required all partial meniscectomy. Six of the eight patients who were repaired the meniscal tears evaluated by second look arthroscopy. Five patient showed complete healing and one showed incomplete healing.
CONCLUSION
Every effort should be made to repair the meniscal tears in tibial plateau fractures.

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Treatment of Distal Clavicle Fractures with Coracoclavicular ligament Injury: Nam Yong Choi, Suk Ku Han, Seong Jin Park, Ki Ho Na, Young Hun Kim, Hyun Seok Somg, Yong Jin Kwon; J Korean Soc Fract 2002;15(1):21-27. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.21

Abstract PDF: PURPOSE
To evaluate the radiological and clinical results of the treatment of distal clavicular fractures with coracoclavicular ligament injury by coracoclavicular fixation with plating or repair of coracoclavicular ligament.
MATERIALS AND METHODS
Sixteen cases with minimum six months of follow-up were included in our study. Male was twelve and average age was 43(28-80). Ten cases of Craig type 2 were treated with coracoclavicular screw fixation with plating. Six cases of Craig type 5 were treated with coracoclavicular screw fixation with repair of coracoclavicular ligament. The radiologic assessment including coracoclavicular distance and union time and the clinical assessment including range of motion and degree of pain were evaluated.
RESULTS
Fifteen cases were united, but one case developed osteomyelitis and nonunion. Full range of motion was achieved in fifteen cases at last follow-up. Average coraco- clavicular distance compared to contralateral site in AP view was 2.1 mm increase in patients with plate fixation and 1.3 mm increase in patients with ligament repair. Average union time was 14.3 weeks and little differenece was noted between two groups(P>0.05).
CONCLUSION
Coracoclavicular screw fixation with plating or repair of coracoclavicular ligament were a useful method to treat distal clavicular fractures combined with coracoclavicular ligament injury.

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Effects of Yuhan Bone Connecting Powder on the Repair of Fractures in Rats: Il Yong Choi, Tai Seung Kim, Il Hoon Sung, Won Kyu Kim, Yun Young Choi, Kwan Hyoung Lee, Kyu Sung Hwang; J Korean Soc Fract 2000;13(4):1067-1079. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1067

Abstract PDF: OBJECTIVES
We have studied the effects of Yuhan bone connecting powder on the healing process of the frauture at the osteotomized bones in rat, using bone densitometer, X-ray and morphological studies after administration of Yuhan bone connecting powder which has been reported in China as enhancing the processes of the fracture healing.
MATERIALS AND METHODS
90 Sprague-Dawley male rats were divided into the rib and tibia osteotomy groups. Each group was subdivided into the control, low dosage and high dosage groups. Rib and tibia were osteotomized under the general anesthesia with ketamin. From the next day after operation, Yuhan bone connecting powder diluted with distilled water was administrated to low(0.68g/kg) and high(1.36g/kg) dosage groups per se. Same amount of the distilled water was used to the control group. 1.5cm long rib including the osteotomy site and whole tibia were excised. Bone densitometer using dual energy X-ray absorptiometry, radiological and morphological studies with HE stain and alcian blue(pH 2.5)-PAS stain were performed.
RESULTS
BMD showed statistically significant difference between control group, low dose group and high dose group at 2weeks after treatment(p=0.035), but did not show such a good result at 1week(p=ns) and 4weeks(p=0.091) after treatment. Radiologically, after treatment for 2 weeks, the low and high dose groups showed more active callus formation than control group. Morphologically, dilated numerous blood vessels adjacent the bony trabeculae and well developed cartilagenous callus were observed in the experimental group at the 1st week. At the 2nd week, many newly formed bony trabeculae were formed from the cartilagenous callus, and at the 4th week relatively thick compact bone and bony trabeculae were connecting the both osteotomy ends.
CONCLUSION
BMD at the osteotomy site seemed to be increased after administration with Yuhan bone connecting powder to rats, and this finding was supported radiologically at 2weeks after treatment. Morphologically, at the early stage of the fracture healing, numerous dilated blood vessels were distributed and many bony trabeculae were formed from the cartilagenous callus. At the remodelling stage relatively thick compact bone was connecting the both ends of the osteotomy site. So it is suggested that Yuhan bone connecting powder would induce enhancing the healing process of the osteotomized bone in rat through active vascularization, mineralization of the cartilage matrix, endochondral ossification and remodelling.

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The Acute surgical Treatment in Superior Peroneal Retinacular Injury in Ankle: Suk Goo Han, Nam Yong Choi, In Tak Choo, Sung Jin Park, Young Mok Kang, In Ju Lee; J Korean Soc Fract 1998;11(3):605-610. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.605

Abstract PDF: The superior peroneal retinacular injury in ankle is often diagnosed as an ankle sprain and treated conservatively because of normal bony contour in type 1,2 injury according to Eckery's classification and small bony fragment with early union, evenly displaced in type 3. But its complications such as peroneal tendinitis and recurrent subluxation or dislocation of peroneal tendons sometimes develop late. Compared to peroneal tendinitis, the surgical treatment method for recurrent subluxation or dislocation of peroneal tendons is known superor to conservative method in results. And many reconstructive methods have been reported. In spite of their good results, harmfulness to normal structures, recurrences and technical difficulties may be a problem. So we perfomed 10 cases of acute surgical repair in superior peroneal retinacular injuries in ankle from March 1993 to February 1997 and prospectively analysed their clinical and radiological results with complications. Preoperative radiological diagnosis was done by plain films, peroneal tenography with computed tomography and also postperatively evaluated with plain films and peroneal tenography. 1. The most common cause of injury was sports(6 cases) including ski injury(4 cases) and average age of the patient was 29(17-56) years. 2. 4 cases of bony avulsion(type 3) were fixed with mini-screws and mean duration of bony union was 3.6 months. 3. The incidental subluxation or dislocation of peroneal tendons was not found intraoperatively and postoperatively. 4. All patients are able to participate in active exercise postoperatively except one patient who complains of lateral ankle discomfort due to peroneal tendinitis. In conclusion, acute surgical repair of superior peroneal retinacular injury in ankle is a recommended method to prevent it's complications such as peroneal retinacular injury in ankle is a recommended method to prevent it's complications such as peroneal tendinitis and subluxation or dislocation of peroneal tendons especially, in young and active patients.

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