Journal of Musculoskeletal Trauma

Comparison of Bone Mineral Density in Elderly Patients according to Presence of Intertrochanteric Fracture: Sang Ho Moon, Byoung Ho Suh, Dong Joon Kim, Gyu Min Kong, Hyeon Guk Cho; J Korean Fract Soc 2007;20(3):222-226. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.222

PURPOSE
To analyze difference in bone mineral density (BMD) between intertrochanteric fracture and control group and to explore the predictive value of BMD for intertrochanteric fracture.
MATERIALS AND METHODS
57 patients who were over 60-year-old with intertrochanteric fracture were examined. For control group, 110 patients who did not have any fracture were selected. Dual energy X-ray absorptiometry was studied at 1, 2, 3, 4 lumbar vertebrae, femoral neck, trochanter and Ward's triangle. BMD was compared at each site between two groups statistically.
RESULTS
Fracture group consisted of 16 male, 41 female and was average 70.8 year old. Control group consisted of 21 male, 89 female and was average 68.1 year old. There was no differences in sex and age between two groups (p>0.05). BMD of L1, L2 and mean lumbar area were significantly less in fracture group than control group (p<0.05). There was no difference between two groups in BMD of another sites (p>0.05).
CONCLUSION
BMD of L1, L2 and mean lumbar area in fracture group had lower value significantly, but had no differences between two groups at another sites. BMD of L1, L2 and mean lumbar area might be used as the most sensitive predictive indicator for risk of osteoporotic fractures including intertrochanteric fracture in elderly patient.

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An Analysis of the Changes in Bone Mineral Density in Long-Stay Patients of a Geriatric Hospital in Relation to Physical Therapy
Sang-Min Lee, Soon-Hee Kim, Ji-Sung Kim, Joong-San Wang, Sung-Won Kim, Nyeon-Jun Kim, Sook-Hee Lee, Kyoung-Ok Min
Journal of International Academy of Physical Therapy Research.2011; 2(2): 267. CrossRef
Comparison of Bone Mineral Density in Elderly Patients over 65 Years according to Presence and Types of Hip Fracture
Myung-Ho Kim, Moon-Jib Yoo, Joong-Bae Seo, Hyun-Yul Yoo, Sang-Young Moon
Journal of the Korean Fracture Society.2010; 23(3): 263. CrossRef
The Relationship between Hip Fracture and Bone Mineral Density in Elderly Patients
Hwa Jae Jeong, Jae-Yeol Choi, Jinmyung Lee, Kyubo Choi, Byeongsam Jeon
Journal of the Korean Orthopaedic Association.2010; 45(3): 228. CrossRef
The Usefulness of Hip to Thigh Ratio as an Anthropometric Indicator for the Incidence of Hip Fracture
Jin Park, Kyu Hyun Yang, Seong Hwan Moon
Journal of the Korean Fracture Society.2009; 22(1): 1. CrossRef

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A Comparison according to Insertion Method for Intramedullary Nailing in Proximal Tibial Fractures: Sang Ho Moon, Byoung Ho Suh, Chung Soo Hwang, Tae Hyun Yoon; J Korean Fract Soc 2006;19(1):17-23. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.17

Abstract: PURPOSE
To compare clinical and radiological results between standard insertion method and semiextended method which was designed to improve proximal fixation and alignment in proximal tibia fracture.
MATERIALS AND METHODS
A retrospective review from May 2000 to February 2004, identified 24 extraarticular fractures in proximal tibia, initially treated with locked intramedullary nails at least 1 year follow up. There were 12 open injuries, 4 segmental, 3 butterfly fragments and 17 comminuted. Semiextended method was used in 10 fratures and standard insertion method which is cephalad to tibial tubercle in 14. Follow up clinical assessment consisted of review of associated injuries and complications and these two methods were compared by postoperative angulation and displacement in anteroposterior and lateral radiographs. Data were analysed by t-tests.
RESULTS
In semiextended group, average angulation was 2.3 degrees in coronal and 2.8 degrees in sagittal plane and average displacement was 4.5 mm in coronal and 5.3 mm in sagittal. In ordinary group, average angulation was 5.1 degrees in coronal and 7.4 degrees in sagittal plane and average displacement was 6.1 mm in coronal and 5.3 mm in sagittal. In semiextended group, there were significant reduction in coronal angulation (p=0.006) and sagittal angulation (p=0.001), but there was no significant difference in coronal (p=0.344) and sagittal (p=0.99) displacement. Both groups showed anterior, valgus angulation and posterolateral displacement in most cases. There were 14 associated injuries and one patient developed nonunion and was treated by nail exchange with autogenous bone graft.
CONCLUSION
Our retrospective analysis demonstrated that semiextended method is effective for reducing coronal and sagittal angulation, but is not helpful for reducing displacement in both planes.

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Treatment of Tibial Fractures In Children With Pin and Plaster Technique: Byoung Ho Suh, Gyu Min Kong, Sang Ho Moon, Dong Joon Kim, Jin Woo Kwon, Se Won Park; J Korean Fract Soc 2005;18(3):325-329. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.325

Abstract PDF: PURPOSE
To evaluate the result of tibial shaft fractures in children treated with pin and plaster method.
MATERIALS AND METHODS
From March 1998 to February 2003, Tibial shaft fractures in thirty six pediatric patients which were treated with pin and plaster method were clinically and radiologicaly evaluated retrospectively.
RESULTS
Mean bony union duration was 9.8 weeks. All fractures healed within acceptable angulations. There was neither delayed union nor nonunion. There were complications related to the pins, including superficial and deep infection, skin sloughing. There were 7 cases of tibial overgrowth but they had no functional disability.
CONCLUSION
Pin and plaster method can substitute other operative methods in tibial fractures in children which is difficult to reduce or maintain reduction by conservative treatment.

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Treatment of Lateral Malleolar Fractures using Minimally Invasive Plate Osteosynthesis Technique: Dong Joon Kim, Byoung Ho Suh, Jin Woo Kwon, Gyu Min Kong, Sang Ho Moon, Jong Moon Bae; J Korean Fract Soc 2005;18(3):286-290. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.286

Abstract PDF

PURPOSE
To evaluate the efficacy and complication of minimally invasive plate osteosynthesis (MIPO) technique for lateral malleolar fracture.
MATERIALS AND METHODS
From January 2001 to December 2003, we had treated 13 cases of lateral malleolar fracture (AO-OTA classification, type A: 4, type B: 9) by MIPO technique and followed them up more than 1 year. Operation time, union time, radiologic alignment, range of motion of the ankle joint, functional results according to criteria of Meyer and complication were evaluated.
RESULTS
After the final follow-up, all the fractures were healed without any second procedure, full-weight bearing ambulation was started in average 10 weeks. Any malunion was not observed by the inadequate bending of plate. Two patients felt a discomfort of ankle because the location of plate was lower than the tip of the lateral malleolus, but all the patients had excellent or satisfactory ankle functions. No deep infection or soft tissue compromise were observed at the last follow up.
CONCLUSION
Minimally invasive plate osteosynthesis technique is safe and worthwhile method in management of lateral malleous fractures while avoiding the complications associated with conventional open plating methods.

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Percutaneous Plating of Weber B Fibular Fractures
Amol Saxena, Andrew Yun
The Journal of Foot and Ankle Surgery.2017; 56(2): 366. CrossRef
Minimally invasive percutaneous plate osteosynthesis for ankle fractures: a prospective observational cohort study
Robinson Esteves Santos Pires, Cyril Mauffrey, Marco Antônio Percope de Andrade, Leonardo Brandão Figueiredo, Vincenzo Giordano, João Carlos Belloti, Fernando Baldy dos Reis
European Journal of Orthopaedic Surgery & Traumatology.2014; 24(7): 1297. CrossRef

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A Comparison of Vertebroplasty Versus Conservative Treatment in Osteoporotic Compression Fractures: Sang Ho Moon, Dong Joon Kim, Chung Soo Hwang, Sang Eon Lee, Se Won Park; J Korean Fract Soc 2004;17(4):374-379. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.374

Abstract PDF

PURPOSE
To compare clinical and radiological results between vertebroplasty and conservative treatment in osteoporotic compression fractures of thoracolumbar spine.
MATERIALS AND METHODS
34 patients were reviewed with at least 1 year follow up. Vertebroplasty was used in 14 and conservative treatment was done in 20 fractures. These groups were compared by clinical results which were evaluated by the scoring system according to pain, mobility and analgesic usage at preoperative, postoperative 1 month and postoperative 1 year. And also compared by the increment of kyphosis and loss of vertebral body height in lateral films at the same time. We compared duration of hospitalization between two groups.
RESULTS
Vertebroplasty group showed statistically significant less pain and mobility than conservative treatment (p<0.05), but there was no differences in analgesic usage at postoperative 1 year while significant difference at 1 month. In radiological comparison, vertebroplasty showed less increment of kyphosis and loss of body height significantly (p<0.05). Also vertebroplasty group had shorter hospitalization stay significantly (p<0.05).
CONCLUSION
Our retrospective analysis demonstrated that vertebroplasty provided significant pain relief, improvement of motion and reduction of analgesic usage and also provided considerable spinal stabilization that prevented further kyphosis and collapse.

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Outcome Comparison between Percutaneous Vertebroplasty and Conservative Treatment in Acute Painful Osteoporotic Vertebral Compression Fracture
Hwa-Yeop Na, Young-Sang Lee, Tae-Hoon Park, Tae-Hwan Kim, Kang-Won Seo
Journal of Korean Society of Spine Surgery.2014; 21(2): 70. CrossRef
Large Pulmonary Embolus after Percutaneous Vertebroplasty - A Case Report -
Sang Ho Moon, Soo Won Lee, Byoung Ho Suh, Sung Hwan Kim
Journal of Korean Society of Spine Surgery.2009; 16(1): 46. CrossRef

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Treatment of Ipsilateral Femur Neck & Shaft Fracture: Jin Woo Kwon, Ki Hwon Kim, Sang Ho Moon, Kyu Min Kong, Kyong Tae Sohn, Sang Hoon Lee, Tae Woo Kwon; J Korean Soc Fract 2003;16(3):319-326. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.319

Abstract PDF: PURPOSE
The purpose of this study was to analyse the result of operative treatment in ipsilateral femur neck and shaft fracture.
MATERIALS AND METHODS
Eleven cases of ipsilateral femur neck and shaft fractures were operated and followed more than 1 year. There were 11 men and the mean age at index operation was 38 years (range 22~54). In neck fracture there were 3 of type I, 6 of type II, and 1 of type III according to Garden classification, shaft fractures were located at middle 1/3(7 cases), at distal 1/3(4 cases). We evaluate the operation time, union time, nonunion, malunion, and clinical evaluation with pain and joint stiffness.
RESULTS
In neck fractures treatment methods were 8 of multiple pinning, 2 of reconstruction nail and 1 of CHS, in shaft fractures 2 of DCP, 7 of retrograde nailing (3 Ender nail, 4 interlocking nail). The mean operation time was 180 minutes in reconstruction nail, 220 minutes in multiple pinning and DCP and 200 minutes in multiple pinning and retrograde nailing. The mean time for shaft union was 5 months. The complications were 1 case of neck reduction loss during operation in reconstruction nailing group, 2 of aseptic necrosis of femur head, 2 of shaft nonunion in retrograde nailing group, 1 of persistant pain around knee in Ender nailing group.
CONCLUSION
The author think that reconstruction nail fixation is technically difficult, thus neck and shaft fracture be fixed individually. Neck fracture can be fixed first without difficulty and shaft fracture should be fixed rigidly due to comminution.

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

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

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

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

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

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

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

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

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Treatment of Ipsilateral Femur and Tibia Fractures: Yong Bum Park, sang Ho Moon, Chung Su Hwang, Soon Hyun; J Korean Soc Fract 1998;11(4):754-760. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.754

Abstract PDF

Ipsilateral femur and tibia fractures - so called "floating knee" are caused by high energy trauma and frequently associated with many problems such as hemorrhagic shock, higher morbidity, delayed union, knee stiffness, etc. To get a satisfactory functional result, rigid internal fixation and early mobilization are regarded as treatment priciples at present. Authors analyzed the functional outcomes of floatinhg knee injuries according to the fracture type and methods of surgical treatments. Twenty-eight patients were diagnosed as ipsilateral femur and tibia shaft fractures and treated surgically at the Dongguk University Hospital between June 1990 and May 1996. Average age was 34.5 years, and males were predominant. Majority of cases (27 out of 28) were caused by traffic accident. According to the classification of Blake and McBryde, type I injuries were observed in 17 cases and type II in 11 cases. Average follow up period was 1.3 years. All patients were treated by surgical methods which were selected appropriately with concideration of fracture types. 14 of 17 type I injuries were treated with intramedullary nailing for both femur and tibia fractures. Among these cases, 9 were excellent and 4 were good results. But in type II injuries, only 3 of 4 cases which were fixed with intramedullary nailing for femur and plate for tibia fractures were good results. Conclusively, Intramedullar nailing is an excellent method for ipsilateral femur and tibia fracture and type II injuries which have intra-articular fracture lines meet with worse results than type I.

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Efficacy of Integrated Korean Medicine Treatment Including Motion-Style Acupuncture Treatment for L1 Burst Fracture and Bilateral Femoral Condyle, Proximal Tibial, and Proximal Fibular Comminuted Fractures: A Case Report
Da Dam Kim, Seong Hyeon Jeon, Woo Young Kim
Journal of Acupuncture Research.2024;[Epub] CrossRef
Comparison of Floating Knee according to Presence of Knee Joint Injury
Eau-Sup Chung, Jong Hyuk Park, Hee Rack Choi, Joo Hong Lee, Kwang-Bok Lee
Journal of the Korean Fracture Society.2012; 25(4): 277. CrossRef

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Treatments of the delayed Union or Nonunion of Tibial Shaft Fracture Fixed with Interlocking IM nail: Yong Bum Park, chung Soo Hwang, Phil Hyun Chung, Suk Kang, Dong Joo Chae, Han Chul Kim, Sang Ho Moon, Jong Phil Kim, Dae Jin Kim; J Korean Soc Fract 1998;11(3):552-559. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.552

Abstract PDF: Interlocking intramedullary nailing has been the first choice treatment of most tibial shaft fractures because its rigidity of fixation allows early ROM and weight bearing. Although most interlocking nailing procedures are performed with closed reduction that preserve periosteal blood supply, delayed union or nonunion is often occurs. so secondary procedures, such as bone graft, dynamization, nail exchange, are necessary to achieve fracture healing. We analyzed 25 cases of delayed union or nonunion from 432 tibial shaft fractures fixed initially with static interlocking intramedullary nailing since January 1990 till January 1996. Overall incidence of delayed union or nonunion is 5.8%(25/432). Secondary procedures included mainly iliac bone graft or dynamization. Average time to achieve bone union after secondary procedure is 6.1 months. The more distracted or displaced fracture ends after interlocking nailing or the more comminuted fracture fragments led to the more delayed bone union. Careful attention to minimize distraction or displacement during interlocking nailing is necesary to decrease the incidence of delayed union or nonunion. And appropriate procedures should be performed when delayed union or nonunion is predicted, which result in success in most cases.

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Infected non-union of the Tibia: Kwon Ik Ha, Seung Ho Kim, Kyoung Ho Yoon, Sang Ho Moon; J Korean Soc Fract 1997;10(4):812-815. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.812

Abstract PDF: There are two major problems in the management of infected non-union of the tibia: how to treat the infection; and how to obtain bony union. The previous treatment as debridement and antibiotic therapy often failed. Multiple hospitalization, many operative procedures, and prolonged treatments with parenteral antibiotics cause not only functional disability but also economic hardship and loss of self-esteem. The authors reviewed a case of infected non-union of the tibia who has received 12 operations and prolonged intravenous antibiotic therapy. It is suggested that if appropriate drainage, complete excision of necrotic tissues and rigid fixation is provided, prolonged intravenous antibiotic therapy seems to be unnecessary.

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