Journal of Musculoskeletal Trauma

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

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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Treatment of Proximal Shaft Fracture of Tibia with Intramedullary Nail: Analysis According to AO Classification and the Poller Screw: Chang Wug Oh, Sung Jung Kim, In Ho Jeon, Hee Soo Kyung, Byung Chul Park, Joo Chul Ihn, Kyung Hoon Kim, Yun Kee Woo; J Korean Fract Soc 2004;17(2):133-137. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.133

Abstract PDF

PURPOSE
This was a retrospective study to evaluate the results of intramedullary nailing in proximal shaft fracture of tibia. We analyzed those results according to AO classification and Poller screw.
MATERIALS AND METHODS
Thirty-three proximal tibial shaft fractures (32 patients) were followed for more than one year. In AO classification, there were 6 cases of type A, 14 cases of type B, and 13 cases of type C. We used Poller screws in 14 operations. We evaluated translation, angulation and nonunion after surgeries.
RESULTS
Twenty-eight cases (85%) were united primarily, but nonunions occurred in 5 cases. Malalignment (angulation>5degree or translation>5 mm) was found in 14 cases (42%). In Poller screw used and non-used groups, the malalignment was respectively showed in 2 cases (14%) and 12 cases (63%). According to AO classification, nonunion was found in only type B with 5 cases (36%).
CONCLUSION
Intramedullary nailing of proximal shaft fracture of tibia showed relatively lower rate of primary union. Especially, when initial fractures have a butterfly fragment, it showed the higher rate of nonunion. Moreover, the malalignment rate was relatively higher, yet it is possible to reduce the rate of malalignment by using Poller screw.

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Open Source-Based Surgical Navigation for Fracture Reduction of Lower Limb
Sanghyun Joung, Jaeyeong Park, Chul-Woo Park, Chang-Wug Oh, Il Hyung Park
Transactions of the Korean Society of Mechanical Engineers A.2014; 38(5): 497. CrossRef

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Minimally Invasive Plate Osteosynthesis for Distal Femoral Fractures: Sung Jung Kim, Chang Wug Oh, In Ho Jeon, Hee Soo Kim, Byung Chul Park, Hee Soo Kyung, Joo Chul Ihn, Ho Sung Jung; J Korean Soc Fract 2003;16(4):474-481. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.474

Abstract PDF

PURPOSE
We retrospectively reviewed the outcomes and advantages of minimal invasive plating osteosynthesis (MIPO) technique as a new treatment of distal femoral fractures.
MATERIALS AND METHODS
Sixteen supracondylar femoral fractures (15 patients) were treated by MIPO technique and evaluated radiologically and functionally after minimal 1 year follow-up (average; 22 months, range; 13~42 months). There were 9 women and 6 men with a mean age of 46 years old (range 35 to 64 years). Seven fractures were extended into knee joints (AO/OTA type C), and 9 were extraarticular (AO/OTA type A). Five cases were open fractures (type I; 2, type II; 3) according to the Gustilo-Anderson classification. After minimal lateral parapatellar incision and accurate reduction of intra-articular fractures, the supracondylar fractures were fixed by percuatneous plating method without exposure of fracture area. Neer scoring was used for functional evaluation of knee.
RESULT
At a mean of 17 weeks (range 14 to 22), most fractures united without secondary procedures. One case of nonunion had the procedure of bone graft, but there were no other complications including shortening over 1 cm, mal-alignment over 10 degrees, or deep infections. All the cases had good or excellent knee function, and the average range of knee motion was 120.6 degrees.
CONCLUSION
MIPO technique is a worthwhile method of managing distal femoral fractures with good unions and functional recovery.

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The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture
Seong-Jun Ahn, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Seong-Ho Yoo, Kwan-Taek Oh
Journal of the Korean Fracture Society.2013; 26(4): 314. CrossRef
Treatment of Distal Femur Fracture with Minimally Invasive Locking Compression Plate Osteosynthesis
Ki-Chul Park, Kyu-Sung Chung, Joon-Ki Moon
Journal of the Korean Fracture Society.2012; 25(1): 13. 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
Surgical Treatment of AO Type C Distal Femoral Fractures Using Locking Compression Plate (LCP-DF, Synthes®)
Kap-Jung Kim, Sang Ki Lee, Won-Sik Choy, Won-Cho Kwon, Do Hyun Lee
Journal of the Korean Fracture Society.2010; 23(1): 20. CrossRef
What is an Ideal Treatment?
Chang-Wug Oh
Journal of the Korean Fracture Society.2008; 21(4): 347. CrossRef

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Treatment of Nonunion in the Long Bone with Low Intensity Pulsed Ultrasound (LIPUS) and LASER: In Ho Jeon, Chang Wug Oh, Sung Jung Kim, Hee Soo Kyung, Il Hyung Park, Byung Chul Park, Joo Chul Ihn, Jun Young Yeo; J Korean Soc Fract 2003;16(2):177-185. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.177

Abstract PDF: PURPOSE
Low-intensity, pulsed ultrasound (LIPUS) has demonstrated a stimulation and acceleration of the normal fracture-repair process in cellular bases as well in animal and human models. In this study, the adjunctive effect of LIPUS and LASER was investigated in established nonunion of the long bones.
MATERIALS AND METHODS
Study group consisted of eight patients to whom conventional bone graft and adjunctive LIPUS and LASER was applied. On the other hand, eight patients in the control group underwent bone graft only. Eleven men and five women were included in this study and the average age of the patients was 41.7 years (range, 19~62 years). Six of the tibias and ten of the femurs met the criteria for established nonunion. The average fracture age, the post-fracture period before the start of LIPUS/LASER treatment, was 502 days.
RESULTS
Seven of the ten nonunions who were treated by LIPUS and LASER healed completely in an average treatment time of 141 days (range, 101~202 days) and otherwise, in control group, five of the eight nonunions healed completely, in 240 days (range, 183~283 days).
CONCLUSION
This clinical study showed a positive effect of LIPUS and LASER on the rate of osseous repair, especially accelerated time to initial callus cortical bridging compared to that of conventional treatment.

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Retrograde Intramedullary Nail for Femoral Shaft Fracture with Limited Indications: Sung Jung Kim, Chang Wug Oh, Joo Chul Ihn, Hee Soo Kim, In Ho Jeon, Hee Soo Kyung, Il Hyung Park, Kyung Hoon Kim; J Korean Soc Fract 2003;16(1):45-51. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.45

Abstract PDF

PURPOSE
This is a retrospective study to analyze the results after retrograde intramedullary(IM) nailing in femoral shaft fractures with limited indications.
MATERIALS AND METHODS
Twenty-four femoral shaft fractures(21 patients) were operated with unreamed IM nail(Unreamed femoral nail, SynthesR) in a retrograde method and were followed for more than 1 years. There were 16 men and 5 women, and the mean age at index operation was 41 years (range 18-76 years). In Winquist-Hansen classifications, there were 10 of type I, five of type II, three of type III, and six of type IV. All the patients had associated fractures or injuries, and there were eight ipsilateral tibia fractures, five ipsilateral proximal femoral fractures(including neck and trochanter), four ipsilateral pelvic or acetabular fracture, three bilateral femoral fractures, and one ipsilateral knee injury according to the used indications. In radiological study, we evaluated the time for union, non-unions and malunion, and clinical evaluation with Neer 's criteria was done.
RESULTS
Most fractures(87.5%) were primarily united cases, and the mean time for union was 15.8 weeks(range 12-20 weeks). Three cases of delayed union or nonunion were developed, but a shortening over 1cm or malunion over 10 degrees angular deformity were not found. Evaluating the knee functions, the Neer score was 86.9 in average and all the cases were above satisfactory grade. The average range of knee motion was 120.2 degrees, and the mild knee pain was developed in three cases.
CONCLUSION
The retrograde IM nailing can be a useful option for femoral shaft fractures with limited indications, including ipsilateral fractures of other areas or multiple fractures.

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Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture
Chang-Wug Oh, Jong-Keon Oh, Woo-Kie Min, Shin-Yoon Kim, Seung-Hoon Baek, Byung-Chul Park, Hyung-Soo Ahn, Tae-Gong Kim
Journal of the Korean Fracture Society.2007; 20(2): 135. CrossRef
Retrograde Intramedullary Nailing for the Treatment of Ipsilateral Femoral Shaft and Neck Fracture
Chang-Wug Oh, Jong-Keon Oh, Shin-Yoon Kim, Ki-Bong Cha, In-Ho Jeon, Byung-Chul Park, Woo-Kie Min, Tae-Gong Kim
The Journal of the Korean Orthopaedic Association.2007; 42(3): 380. CrossRef

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

Abstract PDF

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

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

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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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Ilizarov/Hybrid-Ring External Fixation in the Management of Tibial Plafond Fractures: Chang Wug Oh, Byung Chul Park, Joo Chul Ihn, Sung Jung Kim, Hee Soo Kim, Saeng Guk Lee; J Korean Soc Fract 2000;13(2):244-251. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.244

Abstract PDF

PURPOSE
: To evaluate the results of the treatment of distal tibial fracture using ring or hybrid ring external fixator and to compare the results according to the influencing factors.
MATERIALS AND METHODS
: The authors analized 30 patients, 31 cases of distal tibial fracture who were treated by Ilizarov ring external fixator or hybrid ring external fixator at our hospital from May 1996 to August 1998 and were followed up over 1 year. The type of distal tibial fractrue were classified according to AO group, type A was 7 cases, and type C was 24(C1:5, C2:4, C3:15)cases. Restoration of articular surface of the distal tibia was performed through closed method or minimal invasive technique by minimal internal fixation with K-wire or screw. Then fixation of th distal tibia was done by ring external with multiple transfixing wire. Connection to the tibial shaft was done by Ilizarov ring external fixator(15 cases), or mono-external fixator(Dyna-Extor, 16 cases).
RESULTS
: By Tornetta's assessment of functional results, excellent was 5, good 19, fair 4 and poor 3cases. According to AO classification, the functional results of type A, 7cases were all above good results, among 24 cases of type C, 4cases of C1, 2 cases of C2, and 11 cases of C3 were above good results and there was no statistical difference between the results and the fracture type(P=0.024). One of 3 cases of poor functional results was open type C3 fracture and was complicated with osteomyelitis and refracture, and others two cases type C2 fracture which were complicated with malunion.
CONCLUSION
: The authors had a good results without soft tissue complication after the treatment of distal tibial fracture patients by Ilizarov ring external fixator or hybrid ring external fixator.

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Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator
Suk Kyu Choo, Kyung Wook Nha, Hyoung Keun Oh, Dong Bong Lee
Journal of the Korean Fracture Society.2007; 20(4): 323. 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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