Journal of Musculoskeletal Trauma

Clinical and Radiologic Outcome of Intertrochanteric Fracture Treatment Using TFNA (Trochanteric Fixation Nail-Advanced): Hyeon Joon Lee, Hyun Bai Choi, Ba Rom Kim, Seung Hwan Jo, Sang Hong Lee; J Korean Fract Soc 2021;34(3):105-111. Published online July 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.3.105

Purpose
This study evaluated the clinical and radiological outcomes of TFNA (Trochanteric Fixation NailAdvanced; Depuy Synthes) for the treatment of proximal femur fractures.
Materials and Methods
This was a retrospective study of 64 patients diagnosed with a proximal femur fracture from January 2019 to November 2019. The patient’s demographic data, preoperatively and postoperatively Koval grade, modified Harris hip score, EQ-5D (Euro-Qol-5 Dimension), sliding and advancement of the blade, radiologic outcome, and complications were investigated.
Results
Fifty patients were available for evaluation at one year postoperatively. The patients reported the following: the Koval grade decreased after surgery; the modified Harris hip score decreased from 78.56±8.88 to 72.74±6.59 (p=0.149); the mean EQ-5D decreased from 0.75±0.09 to 0.72±0.06 (p=0.000). Satisfactory reduction was achieved on a postoperative radiographic examination in 47 patients in six months. Complications occurred in seven cases.
Conclusion
TFNA is considered an appropriate implant for treating intertrochanteric fractures of the femur with a minimum follow-up of one year.

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GS Hip Nail versus Affixus Hip Fracture Nail for the Intramedullary Nailing of Intertrochanteric Fractures
Seungcheol Kwon, Minjae Lee, Heeyeon Lee, Jihyo Hwang
Journal of Clinical Medicine.2023; 12(21): 6720. CrossRef
Comparison of the Clinical and Radiological Outcomes of TFNA (Trochanteric Fixation Nail-Advanced) and PFNA-II (Proximal Femoral Nail Antirotation-II) Treatment in Elderly Patients with Intertrochanteric Fractures
Min Sung Kwon, Young Bok Kim, Gyu Min Kong
Journal of the Korean Fracture Society.2022; 35(4): 162. CrossRef

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Results of Exchange Nailing in Hypertrophic Nonunion of Femoral Shaft Fracture Treated with Nailing: Suenghwan Jo, Gwang Chul Lee, Sang Hong Lee, Jun Young Lee, Dong Hwi Kim, Sung Hae Park, Young Min Cho; J Korean Fract Soc 2019;32(2):83-88. Published online April 30, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.2.83

Abstract PDF: PURPOSE
This study examined the outcomes of exchange nailing for the hypertrophic nonunion of femoral shaft fractures treated with intramedullary nailing as well as the factors affecting the treatment outcomes.
MATERIALS AND METHODS
From January 1999 to March 2015, 35 patients, who had undergone intramedullary nailing with a femoral shaft fracture and underwent exchange nailing due to hypertrophic nonunion, were reviewed. This study investigated the time of union and complications, such as nonunion after exchange nailing, and analyzed the factors affecting the results.
RESULTS
Bone union was achieved in 31 cases (88.6%) after exchange nailing and the average bone union period was 22 weeks (14â€“44 weeks). Complications included persistent nonunion in four cases, delayed union in one case, and superficial wound infection in one case. All four cases with nonunion were related to smoking, three of them were distal shaft fractures, and one was a midshaft fracture with underlying disease.
CONCLUSION
Exchange nailing produced satisfactory results as the treatment of hypertrophic nonunion after intramedullary nailing. Smoking is considered a factor for continuing nonunion even after exchange nailing. In the case of a distal shaft, where the intramedullary fixation is relatively weak, additional efforts are needed for stability.

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Usefulness of Spring Plate for Acetabular Posterior Wall Fracture Including Small Fragment: Jeong Hoon Kang, Sang Hong Lee, Hyeon Jun Lee; J Korean Fract Soc 2016;29(1):19-25. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.19

Abstract PDF

PURPOSE
We applied internal fixation using a spring plate against an acetabular posterior wall fracture including small fragments and then evaluated the clinical and radiological results and want to understand the usefulness of the spring plate.
MATERIALS AND METHODS
Fifteen patients in whom fixation was difficult using leg screws or a metal plate because of a small bone fragment, in patients with posterior wall acetabular fractures who presented in our hospital since August of 2011 to March of 2014 were enrolled. The mean age was 42.6 years (range 24-54 years) with relatively young patients, and they were followed-up for at least one year. We analyzed the rate of reduction after surgery using the classification of Matta in radiographs, and the classification of Borrelli in 3-dimensional computed tomography (CT) and clinical results were evaluated using the clinical grading system.
RESULTS
There were five cases of anatomical reduction, 9 cases of imperfect reduction, and 1 case of unsatisfactory reduction according to the classification of Matta. Except for one case during the follow-up period, the union of bone was successful without failure of fixation and the clinical results were 6 cases of excellence, 8 cases of good, and 1 case of failure. Articular displacement was also evaluated in postoperative CT scan according to Borrelli's criteria. The mean of gap and step off was 2.04 mm, 1.3 mm.
CONCLUSION
Use of leg screw fixation and so on in posterior wall fractures including a small fragment of the acetabular rim is not easy. However the method using spring plate fixation enables relatively accurate reduction and fixation for a small fragment and the clinical outcome showed satisfactory results.

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Biomechanical Comparison of Fixation Methods for Posterior Wall Fractures of the Acetabulum: Conventional Reconstruction Plate vs. Spring Plate vs. Variable Angle Locking Compression Plate
HoeJeong Chung, Hoon-Sang Sohn, Jong-Keon Oh, Sangho Lee, DooSup Kim
Medicina.2024; 60(6): 882. CrossRef

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The Result of Open Reduction and Mini-Plate Fixation for Displaced Talar Neck Fracture: Woong Chae Na, Sang Hong Lee, Jun Young Lee, Sang Jun Lee, Boseon Kim; J Korean Fract Soc 2015;28(4):215-222. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.215

Abstract PDF

PURPOSE
We evaluated the complications, radiological and clinical results after operative treatment using a mini-plate for fixation of displaced talar neck fractures.
MATERIALS AND METHODS
There were 20 cases of displaced talar neck fractures from May 2006 to December 2011; we performed a retrospective chart review of 15 patients treated by open reduction and internal fixation using a mini-plate who had more than 2 years of follow-up. According to Hawkin's classification, there were 7 cases of type II fractures and 8 cases of type III fractures. During postoperative 12-16 weeks we checked magnetic resonance imaging. The assessment of clinical results was based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.
RESULTS
Mean union period was 11.6 weeks (10-15 weeks). Nonunion and malunion did not occur in all cases. The mean AOFAS score was 88.2 points (80-97 points). There were 5 cases of avascular necrosis. Of these, there were 3 cases of body collapse and 4 cases of post-traumatic arthritis. In the statistical analysis, there was no correlation between the elements including gender, Hawkin's classification and union rates and clinical results.
CONCLUSION
Mini-plate fixation of a displaced talar neck fracture is thought to be a good technique, with a low rate of malunion and also showed satisfactory results in radiological and clinical assessment.

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Outcome of Type 3 Talar Neck Fractures by Means of Medial Malleolar Osteotomy and Large Distractor
Sung Hae Park, Jun Young Lee, Jung Woo Lee
Journal of the Korean Orthopaedic Association.2019; 54(1): 45. CrossRef
The Measurement of Normal Talus in Korean Cadaver
Dong-Jun Ha, Heui-Chul Gwak, Jeon-Gyo Kim, Jung-Han Kim, Chang-Rak Lee, Young-Jun Kim, Jeong-Han Lee, Byung-Ho Ha, Ui-Cheol Kim
Journal of Korean Foot and Ankle Society.2016; 20(4): 163. CrossRef

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Treatment for Concurrent Ipsilateral Femoral Neck and Shaft Fractures Using Reconstruction Nail with Temporary K-Wires: Sang Joon Lee, Sang Hong Lee, Sang Ho Ha, Gwang Chul Lee; J Korean Fract Soc 2015;28(1):23-29. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.23

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the results of operative treatment using a reconstruction nail after temporary K-wire fixation of the femoral neck for ipsilateral femoral neck and shaft fractures.
MATERIALS AND METHODS
A total of 11 cases were treated, which were followed-up for more than two years, between August 2007 and July 2012. The average age was 51 years (29-69 years) and men were dominant counting eight cases. All cases were operated with a reconstruction nail after temporary K-wire fixation of the femoral neck. Bone union periods, alignment, etc. were evaluated by radiological methods and accompanying damage and complications were also investigated. Functional evaluation was performed in accordance with Friedman and Wyman criteria at the last follow-up.
RESULTS
The average time for union of the femoral shaft was 22.5 weeks (12-32 weeks), and femoral neck was 13.1 weeks (8-20 weeks). There was no nonunion, and four femoral shaft fractures resulted in delayed union. There was one case of leg length discrepancy more than 2 cm long, but malalignment of more than 10 degrees was not observed. Avascular necrosis of the femoral head did not occur. Functional results were good in eight cases, fair in two cases, and poor in one case.
CONCLUSION
Treatment with reconstruction nailing after temporary K-wire fixation of the femoral neck is thought to be a good method which prevents neck displacement and has low complication rates.

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The Treatment of Subtrochanteric Fractures with Proximal Femoral Nail Antirotation: Chi Hyoung Pak, Sang Hong Lee, Sang Ho Ha, Gwang Chul Lee, Kyoung Chul Song; J Korean Fract Soc 2013;26(4):284-291. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.284

Abstract PDF

PURPOSE
The purpose of this study was to analyze the results of treating subtrochanteric femoral fractures with proximal femoral nail antirotation (PFNA).
MATERIALS AND METHODS
Twenty five consecutive patients diagnosed with subtrochanteric femoral fractures underwent intramedullary fixation using PFNA and followed-up for over 12 months. According to the Seinsheimer's classification, there were 2 type IIA, 9 type IIB, 2 type IIIA, 3 type IV and 9 type V. According to the AO classification, there were 10 type A, 9 type B and 6 type C. There were 16 cases of closed reduction group and 9 cases of limited open reduction group. Retrospectively, radiological outcomes were assessed at the union period, change of neck shaft angle, tip-apex distance, Cleveland index, sliding of lag screw and complication.
RESULTS
Union was achieved in 23 of 25 cases, over an average of 17 weeks. Limb length shortening below 2 cm occurred in 7 patients. The Cleveland index was shown in 80% of 5, 6, 8 and 9 zone; the tip apex distance was 19.6 mm; the mean sliding distance was 4.4 mm; and the mean change of femur neck and shaft angle was varus 3 degree at the final follow-up. Complications included 3 cases of delayed union and 2 cases of nonunion.
CONCLUSION
With its early bony union, ambulation, rehabilitation and low complication, PFNA is a useful and reliable choice for the treatment of subtrochanteric fractures of the femur. Limited open reduction and additional fixation such as cable grip are recommended if it is difficult to obtain anatomical reduction by closed reduction.

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Subtrochanteric Fracture Reduction during Intramedullary Nailing: Technical Note
Gyu Min Kong
Journal of the Korean Fracture Society.2019; 32(2): 107. CrossRef

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Operative Treatment of Unstable Pelvic Ring Injury: Sang Hong Lee, Sang Ho Ha, Young Kwan Lee, Sung Won Cho, Sang Soo Park; J Korean Fract Soc 2012;25(4):243-249. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.243

Abstract PDF

PURPOSE
To analyze the clinical and radiological results of the different fixation methods according to the type and displacement of unstable pelvic ring injuries.
MATERIALS AND METHODS
Twenty-three patients with unstable pelvic ring injuries from January 2005 to December 2009 were classified according to the AO/OTA classification system. When patients had been diagnosed with unstable pelvic ring injuries with partial instability, they were treated by anterior fixation with a plate and posterior percutaneous iliosacral screw fixation. When patients had been diagnosed with unstable pelvic ring injuries with complete instability, they were treated by open reduction and anterior to posterior fixation with a plate through the ilioinguinal approach. The radiological results were evaluated using Matta and Saucedo's method, and the clinical results were evaluated using Rommens and Hessmann's method.
RESULTS
The outcomes from the radiological evaluation were that the displacement of the posterior pelvic ring were improved by about 6.65 mm in unstable pelvic ring injuries with partial instability. The displacement of the posterior pelvic ring were improved by about 7.8 mm in unstable pelvic ring injuries with complete instability. The clinical results were excellent in 13 cases and good in 6 cases on latest follow-up.
CONCLUSION
Good results can be achieved by selecting the treatment method according to the type of unstable pelvic ring injurie and displacement.

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Functional outcomes in pelvic fractures and the factors affecting them– A short term, prospective observational study at a tertiary care hospital
Subhajit Ghosh, Sameer Aggarwal, Prasoon Kumar, Vishal Kumar
Journal of Clinical Orthopaedics and Trauma.2019; 10(5): 896. CrossRef
Outcome of Surgical Treatment of AO Type C Pelvic Ring Injury
Do Hyeon Moon, Nam Ki Kim, Jun Sung Won, Jang Seok Choi, Dong Hyun Kim
Hip & Pelvis.2014; 26(4): 269. CrossRef
Minimally Invasive Plate Osteosynthesis for Humeral Proximal or Distal Shaft Fractures Using a 3.5/5.0 Metaphyseal Locking Plate
Hyoung Keun Oh, Suk Kyu Choo, Jung Il Lee, Dong Hyun Seo
Journal of the Korean Fracture Society.2012; 25(4): 305. CrossRef

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The Results of Two Stage Surgical Treatment of Pilon Fractures: Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Sang Hong Lee, Gwang Chul Lee, Kwang Hyo Seo; J Korean Fract Soc 2012;25(3):177-184. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.177

Abstract PDF

PURPOSE
To report the good results of two-stage treatment in pilon fractures.
MATERIALS AND METHODS
A retrospective study of 23 patients among 30 patients with pilon fractures from March 2006 to November 2008, who underwent two-stage treatment of pilon fractures with a minimum of 24 months follow-up. The mean follow-up period was 28 months (24~41 months). In the first stage of the operation, open reduction of the articular surface and external fixation were performed after minimal incision. As the soft tissue healed, locking compression plate fixation was performed with the Minimally invasive plate osteosynthesis. Radiographic evaluation was graded by the criteria of Burwell and Charnley, and functional assessment of the ankle was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.
RESULTS
The fractures were united within 16 weeks (12~30 weeks). The radiologic results showed anatomical reduction in 18 cases and a mean AOFAS score of 81. The mean range of ankle motion was 44 degrees. There were four complications: 1 case of wound infection and 3 cases of ankle osteoarthritis.
CONCLUSION
Two-stage treatment of pilon fractures is a good treatment method because it is designed to obtain early anatomical reduction, definitive stable fixation, low rates of soft tissue complication, and good range of ankle motion.

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Current Concepts in Management of Pilon Fracture
Jun-Young Lee, Sang-Joon Lee
Journal of the Korean Fracture Society.2014; 27(2): 173. CrossRef

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Treatment of the Trimalleolar Fracture Using Posterolateral Approach: Minimum 2-year Follow Up Results: Gwang Chul Lee, Jun Young Lee, Sang Ho Ha, Jae Won You, Sang Hong Lee, Hong Moon Sohn, Ki Young Nam, Kwang Hyo Seo; J Korean Fract Soc 2011;24(4):328-334. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.328

Abstract PDF

PURPOSE
To analyze the long term follow up results of treatment with posterolateral approach and to investigate its usefulness in the patients of trimalleolar fracture with posterior fragment which is above 25% of articular involvement.
MATERIALS AND METHODS
There were 34 cases of trimalleolar fracture in our hospital from May 2004 to April 2008. We investigated 20 patients who underwent operation with the posterolateral approach and over-2 years follow up cases. The mean follow up period was 34 (24~58) months. Preoperative posterior malleolar fragment involved above 25% of articular surface in all cases and displaced more than 2 mm in 11 cases. We analyzed the radiologic type of posterior malleolar fragments and evaluated the function and pain through AOFAS score and complications.
RESULTS
All cases showed primary union at mean 13.1 weeks. The complications are that partial ankylosis result of soft tissue contracture is seen in 2 cases (10%) and post-traumatic arthritis is seen in 1 cases (5%) and 17 cases (85%) of all patients are showed excellent AOFAS score.
CONCLUSION
The posterolateral approach is a valuable method because that it enables us to easily reduction and internal fixation of the posterior malleolus and lateral malleolus at one time and the results are satisfied for a long time follow up.

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Outcomes of Immediate Operative Treatment of Ankle Trimalleolar Open Fractures
Jun-Young Lee, Yong-Jin Cho, Sin-Wook Kang, Yung-Min Cho, Hyun-Bai Choi
Journal of Korean Foot and Ankle Society.2020; 24(1): 25. CrossRef

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The PFNA Nail for Pertrochanteric Fracture of the Femur without Fracture Table: Jeoung Ho Kim, Sang Hong Lee, Kwang Chul Lee, Sung Won Cho; J Korean Fract Soc 2011;24(3):217-222. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.217

Abstract PDF

PURPOSE
The purpose of this study is to analyze the results of intertrochanteric fractures treatment with proximal femoral nail antirotation (PFNA) without using fracture tables and thereby prevent complications.
MATERIALS AND METHODS
Forty cases of intertrochanteric fracture of 39 patients that were treated with PFNA without using fracture tables between January 2008 to December 2009 were analyzed. There were 13 males and 27 females. The mean age was 76 years old. Using AO classification, 6 cases were A1, 25 cases were A2 and 9 cases were A3. The operation was done without using fracture tables at supine position. Operation time, intraoperative bleeding were checked. For the result, Cleveland index, tip apex distance, fracture site sliding rate, change of femur neck and shaft angle were evaluated. Bone union time and complications were also estimated from the follow up radiograph. Statistics were analyzed using Independent T-test.
RESULTS
The mean operation time was 40 minutes (25 to 70 minutes) and mean intraoperative bleeding was 113 cc (40 to 250 cc). The Cleveland index was shown 94% of 5, 6, 8 and 9 zone, the tip apex distance was 12.96 mm (6 to 22 mm), the fracture sliding distance was 1.9 mm (0 to 6 mm), the change of femur neck and shaft angle was 2.5 degree (0~10 degree) and the average bone union time was 15 weeks (8 to 24 weeks). The complication include 2 cases of delayed union and 2 cases of varus deformities.
CONCLUSION
We have shortened the operation time by closed reduction methods without using the fracture tables, and the complication were minimized with using simple tools like a reduction forcep or bone hook at PFNA blade insertion.

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Clinical and Radiologic Outcome of Intertrochanteric Fracture Treatment Using TFNA (Trochanteric Fixation Nail-Advanced)
Hyeon Joon Lee, Hyun Bai Choi, Ba Rom Kim, Seung Hwan Jo, Sang Hong Lee
Journal of the Korean Fracture Society.2021; 34(3): 105. CrossRef
The Treatment of Subtrochanteric Fractures with Proximal Femoral Nail Antirotation
Chi Hyoung Pak, Sang Hong Lee, Sang Ho Ha, Gwang Chul Lee, Kyoung Chul Song
Journal of the Korean Fracture Society.2013; 26(4): 284. CrossRef

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Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture: Sang Ho Ha, Jun Young Lee, Sang Hong Lee, Sung Hwan Jo, Jae Cheul Yu; J Korean Fract Soc 2009;22(4):225-231. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.225

Abstract PDF: PURPOSE
To evaluate the result of treatment of proximal femoral shaft fracture with limited open reduction and intramedullary nailing. MATERIALS AND METHODS: Fifteen patients who had limited open reduction and intramedullary nailing due to proximal femoral shaft fracture for follow-up for more than 12 months were selected between March 2001 and December 2005. The clinical and radiologic results were analyzed. Winquist-Hansen classification and OTA/AO classification were used. RESULTS: Thirteen cases achieved bone union and 2 cases showed delayed union. The mean bone union period was 21.3 weeks (14~32). There was no postoperative infection. Nonunion was observed in 2 cases of which bone union was acquired with the exchange of intramedullary nail and bone graft in one case and with the additional plate fixation and bone graft in the other case. CONCLUSION: Treating proximal femoral shaft fracture with limited open reduction and intramedullary nailing seems to be a technique to manage proximal femoral shaft fracture that has combined fracture or ipsilateral femoral fracture or is unable to acquire acceptable reduction with closed reduction.

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Treatment of Intra-articular Calcaneal Fractures Using Minimally Invasive Sinus Tarsi Approach in Diabetic Patients: Hong Moon Sohn, Sang Ho Ha, Sang Hong Lee, Jun Young Lee, Jeong Ho Kim, Sang Jun Lee; J Korean Fract Soc 2008;21(3):195-199. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.195

Abstract PDF: PURPOSE
Wound problems occur in 5~30% of intra-articular calcaneal fractures following operation. Diabetes mellitus, large incisions and abundant dissection can increase the risk of wound problems that may require skin graft or other additional care. The authors used minimally invasive technique to treat intra-articular calcaneal fractures in diabetic patients and evaluated the results and complications of this method. MATERIALS AND METHODS: Between January 2002 and July 2005, 12 patients with intra-articular calcaneal fractures who had underlying diabetes mellitus were treated using minimally invasive technique with a modified sinus tarsi approach. The patients had an average age of 47 years (39~67) and were followed an average of 19 months (13~32). The mean period between injury and operation was 8 days (5~14). Crutch assisted partial weight bearing was advised for an average of 7.3 weeks (6~9) and full weight bearing was allowed after average of 9.3 weeks (7~11).
RESULTS
According to AOFAS scale for ankle and hindfoot, patients had the following results: excellent - 1 patient (8%), good - 9 patients (75%), fair - 1 patient (8%), unsatisfied - 1 patient (8%). Bone union was achieved in all cases and there were no events of deep infection or skin necrosis.
CONCLUSION
Treating intra-articular calcaneal fractures by minimally invasive technique is an excellent operative method for patients with diabetes mellitus, as this method can minimize soft tissue incision and resulting deep infection and skin necrosis.

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Treatment of Senile Osteoporotic Intertrochanteric Fracture using Proximal Femoral Nail: Dong Hui Kim, Sang Hong Lee, Young Lae Moon, Jun Young Lee, Kun Sang Song; J Korean Fract Soc 2007;20(3):215-221. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.215

Abstract PDF

PURPOSE
Clinical and radiologic results of femur intertrochanteric fractures treated with ITST nail in elderly patients with osteoporosis were analysized to evaluate the efficacy and complication of ITST nailing.
MATERIALS AND METHODS
32 patients who were treated with ITST nail due to femur intertrochanteric fracture and were followed up for more than 1 year were analysed. According to Evans classification, 11 cases were stable fractures and 21 cases were unstable fractures. Clinically, ambulatory function was compared and radiologically, BMD of healthy leg was checked with analysis of postoperative bone union and complication.
RESULTS
In ambulatory function comparison before and after the operation, there were 9 cases of good, 17 cases of moderate and 6 cases of poor. Considering social activity after the operation, 7 cases showed normal ambulation, 9 cases showed ambulatory with one cane, 5 cases showed two cane ambulation and 11 cases showed dependent ambulation. In radiologic evaluation, T-score of ward triangle in healthy femoral neck showed BMD of -3.12. In 20 cases, bone union was observed within 3 months. The patients with low BMD result had poor outcome. There were 2 cases of intraoperative proximal femur fracture, 3 cases of nonunion and 4 cases of death within 1 year.
CONCLUSION
In elderly patients with intertrochanteric fracture, ITST nailing is relatively efficient treatment. However, in pateint with severe osteoporosis (T-score<-3.0) and unstable fracture pattern, arthroplasty should be considered due to relatively high complicaton rate.

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The PFNA Nail for Pertrochanteric Fracture of the Femur without Fracture Table
Jeoung Ho Kim, Sang Hong Lee, Kwang Chul Lee, Sung Won Cho
Journal of the Korean Fracture Society.2011; 24(3): 217. CrossRef
Results of Osteoporotic Treatment Drug after Periarticular Fracture of Hip
Soo Jae Yim, Young Koo Lee, Cheong Kwan Kim, Hyun Seok Song, Hee Kyung Kang
Journal of the Korean Fracture Society.2010; 23(2): 167. CrossRef

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Treatment of High-energy Distal Tibia Intraarticular Fractures with Two-staged Delayed Minimal Invasive Plate Osteosynthesis: Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Jae Won You, Sang Hong Lee, Kwang Chul Lee; J Korean Fract Soc 2007;20(1):19-25. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.19

Abstract PDF

PURPOSE
To evaluate the short-term results of two-staged delayed minimal invasive plate osteosynthesis in high-energy intraarticular fractures of the distal tibia.
MATERIALS AND METHODS
Thirteen patients, who underwent two-staged delayed minimal invasive plate osteosynthesis for intraarticular fractures of the distal tibia between January 2002 and July 2004, were followed for more than one year. The mean interval time between first stage and second stage of the procedures was 28.6 days (range, 14~34 days). By Ruedi-Allgower classification, there were two cases in type I, three cases in type II, and eight cases in type III. There were six cases in type B and seven cases in type C patients according to AO/OTA classification. Radiographs were graded by the criteria of Burwell and Charnley and ankle functions were graded by the criteria of Mast and Teipner. Union time and postoperative complications were also analysed.
RESULTS
Average union time was 16.9 weeks (range, 14~20 weeks) in twelve of the thirteen fractures, but there was one fracture resulting in soft tissue complication and infected nonunion. At the latest follow-up, review of the radiographic results showed that ten cases of fractures (77%) achieved an anatomic reduction, two cases (15%) achieved fair reduction and one case (8%) achieved a poor reduction. And clinical functional assessment showed that nine cases (69%) were good results, three cases were (23%) fair results and one case (8%) was poor result.
CONCLUSION
Two-staged delayed minimal invasive plate osteosynthesis is an excellent option for the treatment of high-energy intraarticular fractures of the distal tibia.

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Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures
Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn
Journal of the Korean Fracture Society.2010; 23(3): 289. CrossRef
The Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Proximal and Distal Tibia Fracture
Joon Soon Kang, Seung Rim Park, Sang Rim Kim, Yong Geun Park, Jae Ho Jung, Sung Wook Choi
Journal of the Korean Fracture Society.2010; 23(2): 172. CrossRef
Two-staged Delayed Minimally Invasive Percutaneous Plate Osteosynthesis for Distal Tibial Open Fractures
Jung Hwan Yang, Seok Hyun Kweon, Jeung Woo Kim, Jin Young Park, Hyun Jun Kim, Chul Min Lim
Journal of the Korean Fracture Society.2008; 21(1): 24. CrossRef

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Treatment of Distal Femoral Shaft and Supracondylar Fracture with aRetrograde Intramedullary Nailing: Sang Hong Lee, Jun Young Lee, Sang Ho Ha, Hong Moon Sohn, Kwang Chul Lee; J Korean Fract Soc 2004;17(2):103-109. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.103

Abstract PDF

PURPOSE
Retrograde intramedullary nailing has been recommended as one of the treatment options for the distal femoral fracture, particularly in patients who are obese, are pregnant, has sustained ipsilateral femoral neck fracture, have multiple injuries. However there are some disadvantage such as post-arthrotomy infection, knee joint stiffness. This paper is to evaluate the result and complication of treatment of distal femoral fracture with a retrograde intramedullary nailing.
MATERIALS AND METHODS
We reviewed 13 cases (distal femoral shaft fracture: 6 cases, supracondylar fracture: 7 cases) of the distal femoral fracture who had been treated with retrograde intramedullary nailing and follow up for more than 12 months from January 1999 to December 2001. The rate of bony union, range of motion of the knee, complications were evaluated.
RESULTS
The mean duration of bony union was 20 weeks (range, 16~25 weeks). A case of delayed union was developed. In 4 cases of 13 cases showed posterior angulation below 6 degree, which did not need further treatment. According to Saunder's criteria, excellent result was achieved in 8 patients, good result in 5 patients, respectively.
CONCLUSION
This study showed good clinical and radiological results of union with retrograde intramedullary nailing at the distal femoral fracture and ipsilateral multiple fracture

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Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef
Axial Malalignment after Minimally Invasive Plate Osteosynthesis in Distal Femur Fractures with Metaphyseal Comminution
Jae-Ho Jang, Gu-Hee Jung, Jae-Do Kim, Cheung-Kue Kim
Journal of the Korean Orthopaedic Association.2011; 46(4): 326. CrossRef

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The Surgical Treatment of displaced Acetabular Fracture: Sang Hong Lee, Kyung Ho Kim, Pyong Ju; J Korean Soc Fract 2000;13(3):454-462. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.454

Abstract PDF: PURPOSE
To analysis clinical and radiological results of operative treatment of displaced acetabular fractures and establish the guideline for the operative treatment of displaced acetabular fracture with the analysis of the clinical and radiological results.
MATERIALS AND METHODS
A clinical analysis was performed on 36 patients with displaced acetabular fractures who had been operated on and followed for minimum 1 year period from January 1993 to December 1998. Clinical outcome was analyzed clinically by Harris hip scoring system and radiologically by Matta's roentgenographic grading system.
RESULTS
According to Letournel's classification, we had 25 elementary fractures(69%) and 12 associated fracture(31%). Among the elementary fractures, the posterior wall fracture was the most common type(17 cases, 47%) and both column fracture was the most common type among associated fractures(5 cases, 11%). Surgical approaches were 22 Kocher-Langenbeck, 8 extended iliofemoral, 3 triradiate transtrochanteric, 3 ilioinguinal. The mean duration of follow up after the operation was 2.2 years (range, 1 to 7 years). Among thirty six patients who had followed up more than one year, the satisfactory results were achieved in 27 cases (75%) on clinical grade and 26 cases (72%) on radiographic grade. The complications were developed in 20 cases out of 36 cases including posttraumatic arthritis 7 cases, heterotopic ossification 4 cases.
CONCLUSION
In the majority of the displaced acetabular fractures, accurate open reduction and internal fixation was recommended. It seems that the satisfactory operative reduction of the fracture is the factor that correlates with a satisfactory clinical result according to our study. Therefore in the surgical treatment of the acetabuluar fractures, it is essential to achieve an anatomical reduction and firm fixation by fully understanding the pathologic anatomy and by choosing an appropriate approach and fixation device.

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Operative treatment of humeral shaft fracture: Comparision of plate fuation and intramedullary nailing: Sang Ho Ha, Jae Won You, Sang Hong Lee, Dong Min Shin, Young Bae Pyo, Byoung Ho Lee, Min Hyok Choi; J Korean Soc Fract 1999;12(3):712-719. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.712

Abstract PDF

PURPOSE
Examine a humeral shaft fracture which had been treated with a plate and screw fixation or intramedullary nailing and compare these two methods with each other according to clinical and radiologic results and access the clinical avaliablity.
MATERIALS AND METHODS
Take 116 cases of humeral shaft fracture which had been treated with plate and screw fixation(73 cases) or intramedullary nailing(43 cases) and compare these two methods with each other according to bone union time, average operation time and nonunion rate.
RESULTS
Bony union in plate fixation was achieved 1.2 weeks earlier than intramedullary nailing(P>0.05). The average time of operation in intramedullary nailing was 58 minutes, which was shorter than that in plate fixation(P<0.05). The prevalence of nonunion was higher in intramedullary nailing than that in plate fixation, which was thought due to the fanning relaxation, fracture site distraction and/or inappropriate operative technique. Limitation of shoulder motion occasionally occurred in intramedullary nailing, so approriate device selection and surgical technique should be considered.
CONCLUSIONS
We concluded that the results of interlocking IM nailing were not superior to the results of plate fixation. But it is an attractive technique for the rapid closed stabilization of polytrauma patients and segmental and communited fractures.

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Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn
The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef

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Operative Treatment of Elbow Fractures and Dislocations in Adults: Sang Ho HA, Sang Hong Lee, Dong Min Shin, Young Bae Pyo, Pan Ok Kim; J Korean Soc Fract 1997;10(1):119-126. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.119

Abstract PDF: The elbow is highly constrained and stable joints in the body, but dislocation is not uncommon due to trauma such as traffic accident and sports injury. The relative incidence of associated fractures in previously reported series of elbow dislocations has ranged from 12% to 62%. Post-traumatic sequelae of the elbow fractures and dislocations are joint stiffness, nerve injury, non-union and heteroDopic ossification. Operative procedures for repair and reconstruction of the injured elbow are technically demanding and require careful planning. Because of the proximity of crucial neurovascular structures, a thorough knowledge of the anatomy and extensile exposure is essential. Thirteen adult patients with elbow dislocation associated with fractures about the elbow from June 1990 to June 1995 who had taken operative treatment were studied. The results were as follows ; 1. Most common direction of dislocation is posterior(8 cases) and most common associated fracture is radial head & neck fracture(7 cases). 2. Most common and disabling complication is limitation of motion(7 cases). 3. By the Mehlhoffs criteria, with regard to limitation of motion, pain, instability and neurovascular deficit, relatively good results are obtained at 9 cases(69%). 4. For better functional results, early reduction of dislocation, stable fixation of fracture and early motion is essential option in the management of elbow fractures and dislocations.

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Conservative Treatment for Distal Radius Fractures: Sang Ho Ha, Sang Hong Lee, Dong Min Shin, Young Bae Pyo, Hyun Sik Mun; J Korean Soc Fract 1996;9(2):319-325. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.319

Abstract PDF: Fracture of the distal radius is one of the most common injuries Met in the orthopaedic field. Once it was thought that good function comes despite poor anatomic restoration in distal radius fractures. But now maximum recovery of wrist function is dependent on accurate and stable reduction of the radial articular surface. We reviewed thirty-nine cases of distal radius fracture that were treated with closed reduction under C-arm field and then the wrist was immobilized by a sugar tong cast splint and then a long arm cast, from Aug. 1992 to Aug. 1995 at the Department of Orthopaedic Surgery of Chosun University Hospital. The results of this study were as follows; 1. The main causes of these injuries were from slipping(51.3%) and falling down(28.2%). 2. Among the 39 cases of distal radius fracture, 12 cases(30.8% ) had unstable fractures. 3. In the 39 case, satisfactory results were shown in 25 cases but, in the unstable fracture group, 10 cases out of 12 cases showed unsatisfactory results. 4. When the articular surface of the radius was severely comminuted and the fracture site was severely displaced, the result of this study was poor. 5. Accurate and stable reduction of the radial articular surface & radial length was significantly correlated with the clinical results.

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Operative Treatment of Subtrochonteric Fractures of the Femur: Sang Ho Ha, Sang Hong Lee, Young Bae Pyo, Yong Hyun Jeon; J Korean Soc Fract 1995;8(3):513-520. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.513

Abstract PDF

The reduction and maintenance of subtrochanteric fractures are difficult because most of these fractures are comminuted due to high velocity trauma. Although various devices of internal fixation have been developed to solve these problems, selecting the appropriate fixation device for different fracture types is difficult. Subtrochanteric fractures were treated operatively and analysed at Chosun University hospital from Jan.1985 to Dec.1991 and the following results were obtained. The most common type of fracture was type II a by Seinsheimer classification(11 cases,28.9%) The bone union rate was 81.8% in plate fixation group and 87.5% in intramedullary group. Of the 38 cases, 9 complications occured. From this study, it was concluded that intramedullary nailing is beneficial in subtrochanteric fractures associated with medial cortical comminution. Also, when plating was performed massive bone grafting & external support were required.

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On the role of the pre-ionization mechanism in the optical breakdown of molecular oxygen induced by CO2 laser: Numerical investigation
Yosr E. E.-D. Gamal, O. Aied Nassef, A. S. Salama
Physics of Plasmas.2019;[Epub] CrossRef

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Problems and Complications after Interlocking Intramedullary Nailing for Femoral Fracture: Young Bae Pyo, Sang Hong Lee, Young Hyun Jeon; J Korean Soc Fract 1995;8(3):505-512. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.505

Abstract PDF: Interlocking nailing is the best method available in treatment of femoral shaft fracture dui to its many advantages compared with other method. However, we have encountered many problems during the operative procedure and postoperative periods due to technical complexities. After we have evaluated problems during and after the procedure of interlocking nailing for the femoral fractures in 56 cases, we suggest the means to avoid these errors and complications. 1. Among the 54 patients,39 complications and technical errors have been reported in 19 patients. 2. Intraoperative complications and technical errors were encountered in ; 9 cases of improper portal of entry, 3 cases of new fragmentation,3 cases of angulation,2 cases of new fracture line,2 cases of failure of distal locking screw insertion,2 cases of distraction of fracture site, 1 case of proximal protrusion of nail and 1 case of rotation of nail. 3. Postoperative complications were encountered ,6 cases of delayed union,2 cases of nonunion,2 cases of limb shortening,2 cases of deep infection,2 cases of loosening of distal locking screw, 1 case of breakage of distal locking screw and 1 case of failure of nail.

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Treatment for the unicondylar fractures of the distal femur: Dong Min Shin, Sang Ho Ha, Jae Won You, Sang Hong Lee, Young bae Pyo, Min Heo Heo; J Korean Soc Fract 1993;6(2):271-278. Published online November 30, 1993; DOI: https://doi.org/10.12671/jksf.1993.6.2.271

Abstract PDF: No abstract available.

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The Treatment of Pathologic Troehanterie Fracture of the Femur by Solitary Bone Cyst in Children: Sang Ho Ha, Sang Hong Lee, Byoung Ho Lee; J Korean Soc Fract 1992;5(2):394-399. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.394

Abstract PDF: Generally, pathologic fracture with solitary bone cyst was treated by plaster immobilization to stabilize the fracture site and there-after local steroid injection and curettage and bone graft in the remaining cyst. However, pathologic fracture involving weight bearing bone such as trochanter of the femur showed many complications : coxa, vara, avascular necrosis of femoral head, osteochondritis dissecans if they are treated by conservative method. We treated operatively for two unstable pathologic fractures of the trochanteric region of femur with large solitary bone cyst by primary curettage and autogenous bone graft with internal fixation and obtained satisfactory results.

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Treatment of the fractures of clavicle with butterfly fragment: Sang Hong Lee, Dong Min Shin, Geun Sig Rim; J Korean Soc Fract 1992;5(1):43-49. Published online May 31, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.1.43

Abstract PDF

No abstract available.

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Surgical Techniques for Percutaneous Reduction by Towel Clips and Percutaneous Intramedullary Fixation with Steinmann Pins for Clavicle Shaft Fractures
Ki-Do Hong, Jae-Chun Sim, Sung-Sik Ha, Tae-Ho Kim, Jong-Hyun Kim, Jong-Seong Lee
Journal of the Korean Fracture Society.2012; 25(1): 31. CrossRef
Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Jung-Ho Kang, Kwang-Hee Park
Journal of the Korean Fracture Society.2007; 20(3): 233. CrossRef

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Treatment of intertrochanteric fracture with ender nails over theage of 60 years old: Sang Ho Ha, Jae Won You, Sang Hong Lee, Young Bae Pyo, Yeon Seob Rowe; J Korean Soc Fract 1991;4(2):281-288. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.281

Abstract PDF: No abstract available.

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Tension band wiring and Modified tension band wiring in the Operative Treatment of Patella Fracture: Sang Ho Ha, Sang Hong Lee, Dong Min Shin, Young Bae Pyo; J Korean Soc Fract 1990;3(1):46-52. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.46

Abstract PDF: The authors report a clinical experience of 25 patients having patellar fracture who were treated with tension band wiring or modified tension band wiring from January 1984 to December 1988, at the Department of Orthopedic Surgery, Cho-Sun University Hospital. The results were as follows. 1. Out of 25 cases were treated by modified tension band wiring and remaining 5 cases were treated by tension band wiring. 2. The mean fracture healing period was 5.8 weeks in cases of modified tension band wiring and 6.8 weeks in tension band wiring. 3. Fixation by tesion band priciple has given acceptable results in comminuted fractures and transverse fractures both.

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Operative Treatment of Ankle Fractures: Sang Ho Ha, Sang Hong Lee, Dong Min Shin, Young Ju Chung, Keun Ho Park; J Korean Soc Fract 1990;3(1):34-39. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.34

Abstract PDF: The ankle is the most congrous joint in the lower extremity, bearing up to five times the body weight. Many clinical studies of ankle fractures have proven that good results depend upon an antomic reduction of the fracture. There remains, however, controversy as to the best method of obtaining this goal. More recently there has been interest in anatomic reduction & authors analysed 58 cases of ankle fractures treated operatively at Chosun University Hospital from january 1981 to December 1988. 1. The result of treatment was good or exellent in 49 cases(84.5%) of clinical results in 51 cases(87.9%) of radiological result, according to the criteria of Meyer. 2. Operative treatment affords the most predictable way to carry out an absolutely anatomic reduction of fractures & a low complication rate. 3. Most of the unsatisfactory group were severe displacement, commivuted fracture due to high violence.

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The Treatment of Type III Open Tibia Fractures with Ender Nails: Preliminary Report: Sang Ho Ha, Sang Hong Lee, Dong Min Shin, Jin Seok Park; J Korean Soc Fract 1989;2(2):219-228. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.219

Abstract PDF: Type III open tibial fracture is difficult to treat beacause of frequent complications, and recently external fixation have been used successfully. Intramedullary nailing with flexible nails is now routinely performed in Type I and II open tibial fractures. Thirteen cases of Type III open tibial fractures teated with Ender nails from January 1 983 to December 1988 were identified and retrospectively reviewed. The results were as follows; 1. The patients were predominantly more common in male and the average age was 41 years, and most common cause was traffic accident. 2. According to the Gustilo and Andersons classification, Type III-A was 7 cases, TypeIII-B was 5 cases, and Type III-C was 1 case. All 13 cases were combined fibular fracture. 3. All 13 cases were used two Ender nails, nailing methods were two antegrade insertioni (7 cases), two retrograde insertion (3 cases), and one antegrade & retrograde insertion (3 cases). 8 cases were operated within one day of accident, 7 cases were used other combined metals, and 5 cases were treated with Rush pinning of fibular fracture. 4. Among the secondary additional operation required after Ender nailing, bone operation were 7 cases, soft tissue operation were 5 cases, and delayed amputation were 2 cases. 5. Among II cases except amputation, controversial complications were nonunion (6 cases), chronic osteomyelitis (1 case), delayed union (1 case). 6. A retrospective evaluation of 13 cases treated Ender nailing revealed that Ender nailing was simple, effective method in some selected cases of Type III open tibia fractures.

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