Journal of Musculoskeletal Trauma

Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture: Kwang Jun Oh, Sung Tae Lee, Suk Ha Lee, Jin Ho Hwang, Min Suk Kang; J Korean Fract Soc 2010;23(1):6-12. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.6

PURPOSE
To evaluate the radiographic and functional outcomes between who had unstable intertrochanteric fracture, treated with the ITST (lag screw design) and the PFNA (helical blade design).
MATERIALS AND METHODS
We selected each 17 and 13 patients of unstable intertrochanteric fracture which were treated with ITST or PFNA from April 2005 to December 2008. We evaluated the radiographic results by follow-up radiography and the clinical outcomes with the mobility score of Parker and Palmer, Social function scoring system.
RESULTS
The mean sliding distance of cervical screw with ITST nails was not shown significant differences than with using PFNA nails. The other factors were not statistically different. Decrease of mobility score of Parker and Palmer, Social function score were similar. 2 cases of cutting out was noted with ITST nails and 1 case of cutting out was noted with PFNA nails.
CONCLUSION
Unlike the existed biomechanical reposts, there are no differences that are clinical and radiological results in treatment of unstable intertrochanteric fracture using the ITST nails and PFNA nails.

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Does the Helical Blade Lead to Higher Rates of Fixation Failure as Compared to Lag Screw in the Cephalomedullary Nailing Treatment of Hip Fractures? A Systematic Review and Meta-Analysis
Chul-Ho Kim, Han Soul Kim, Yong-Chan Kim, Dou Hyun Moon
Journal of Orthopaedic Trauma.2021; 35(8): 401. CrossRef
Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail
Jae-Cheon Sim, Tae-Ho Kim, Ki-Do Hong, Sung-Sik Ha, Jong-Seong Lee
Journal of the Korean Fracture Society.2013; 26(1): 37. CrossRef
Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails
Il Ho Park, Jong Kyoung Won, Kye Young Han
Hip & Pelvis.2012; 24(2): 117. CrossRef

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Comminuted Pilon Fractures: Comparative Outcome Analysis according to Surgical Techniques: You Jin Kim, Hong Geun Jung, Joo Hong Lee, Woo Sup Byun, Sung Tae Lee; J Korean Fract Soc 2007;20(1):6-12. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.6

Abstract PDF

PURPOSE
To evaluate the overall surgical outcome of the tibial pilon comminuted fractures and perform the comparative analysis between the limited internal fixation-external fixation group and the delayed open reduction-internal fixation (ORIF) group.
MATERIALS AND METHODS
From June 1997 to June 2004, 17 tibial pilon comminuted fractures were treated with the limited internal fixation-external fixation (6 cases) or the delayed open reduction-internal fixation (11 cases). The average age of the patients was 47.7 years (range: 41~63 years), male was fourteen patients, female was three. Follow-up period was average 33.6 months (range: 12~84 months). The clinical outcomes were evaluated by using AOFAS ankle-hindfoot score and patient satisfaction was also evaluated.
RESULTS
AOFAS score at final follow-up was 80.4 points, and 88% of the patients were satisfied with the results. AOFAS scores of the external fixation group and the delayed ORIF group were average 77.0 points and 82.2 points respectively, which did not show the statistical difference (p>0.05). Bony union was achieved at average 16.0 weeks. There were 18 complications such as skin necrosis.
CONCLUSION
We have achieved relatively encouraging functional results and high patient satisfaction for pilon comminuted fractures, without significant result difference between the two surgical techniques.

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The Result of Using an Additional Mini-Locking Plate for Tibial Pilon Fractures
Suenghwan Jo, Jun Young Lee, Boseon Kim, Kang Hyeon Ryu
Journal of the Korean Fracture Society.2017; 30(2): 75. CrossRef

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Open Intramedullary Nail with Tension Band Sutures & Lock Sutures on Proximal Humeral Three-part Fracture: Jin Oh Park, Jin Young Park, Sung Tae Lee, Hong Keun Park; J Korean Fract Soc 2007;20(1):45-52. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.45

Abstract PDF

PURPOSE
To evaluate the results according to the difference of age and bone mineral density (BMD) of the surgical treatments using open intramedullary nail with tension sutures and lock suture on proximal humeral three part fracture.
MATERIALS AND METHODS
30 patients treated by open intramedullary nail with tension band and lock suture technique on proximal humeral fractures were reviewed. After treatment, average follow up periods was 50 months (range; 17~143 month). Postoperative clinical outcome was evaluated using ASES functional score, Neer score and constant score.
RESULTS
Bony union were obtained all except one case. Range of motion, mean forward elevation was 142Â°, mean external rotation was 56Â°, mean external rotation at 90Â° abduction was 68Â°. Average pain score of visual analog scale was 1.5. Average functional score of American Shoulder and Elbow Society was 86. Average Neer score was 89. Constant score was 85. Pain and functional score of group I were better than those of group, however, there was no statistically significant difference (p>0.05). In the comparison between group III and group IV, the results were same (p>0.05).
CONCLUSION
The patients treated using open intramedullary nailing, tension band and lock suture could enable early ROM exercise and show good clinical results. This treatment method will be useful in old age osteoprorotic patients.

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Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures
Chung Hee Oh, Joo Han Oh, Sae Hoon Kim, Ki Hyun Jo, Sung Woo Bin, Hyun Sik Gong
Journal of the Korean Fracture Society.2008; 21(3): 213. CrossRef

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Triceps-Sparing Posterior Approach for Intra-articular Fracture of Distal Humerus: Suk Ha Lee, Sung Tae Lee, Jin Young Park, Jung Sup Keum, Jong Ryun Baek, Kwang Jun Oh; J Korean Fract Soc 2006;19(1):51-55. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.51

Abstract: PURPOSE
To evaluate the therapeutic results of intra-articular fracture of distal humerus treated through triceps sparing posterior approach.
MATERIALS AND METHODS
From February 2001 to December 2003, we reviewed total 9 cases of intra-articular fracture of distal humerus, which were treated by surgical treatment and were followed more than for 12 months. According to the OTA classification, nine cases were classified as type A; two, as type C1; five, as type C2; two. Triceps sparing posterior approach was used in all nine patients. An extensile posterior incision was used over the olecranon without triceps muscle injury. Exposure of the fracture site was done by obtaining medial-lateral mobility through dissection of medial and lateral edge of triceps muscle. Therapeutic results were assessed by bone union, duration for fracture union, complication. and for functional estimation, Mayo elbow performance score was checked and analysed.
RESULTS
The range of the elbow joint motion was flexion contracture 5.2 degree to further flexion 135.5 degree on average. Clinical results using Mayo elbow performance score were as follows; six excellent, three good. Compressive neuropathy of ulnar nerve which has been done anterior transposition was observed in one patient.
CONCLUSION
Triceps sparing posterior approach is useful surgical technique that provides sufficient exposure of medial and lateral condyle without injury of triceps muscle in intra-articular fracture of distal humerus to the extent of OTA type C2.

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Elbow Dislocation Combined with Coronoid Process and Radial Head Fracture: Sung Tae Lee, Jin Hyung Choi, Joong Bae Seo, Jin Young Park; J Korean Fract Soc 2005;18(4):437-442. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.437

Abstract PDF: PURPOSE
To evaluate the clinical outcome for terrible triad injury of the elbow joint. MATERIAL AND METHODS: We reviewed consecutive 10 cases retrospectively among 12 terrible triad injuries, which had been followed up for a minimum 1 year. The average age at the time of injury was 45 years (range, 32~72). All cases were dislocated posteriorly. The 3 cases had fracture of olecranon. Combined medial and lateral approach was performed in 3 cases, medial and lateral approach after extensile posterior approach in 4 cases, transolecranon approach using existed olecranon fracture in 2 cases, and transolecranon approach in 1 case were done.
RESULTS
The average Mayo elbow performance score was 87, with 5 excellent, 4 good, and 1 poor results. Results by Riseborough and Radin's rating criteria include 9 good and 1 fair. The 8 cases were stable. But 2 cases were classified with moderate and severe instability; these cases had been performed by radial head allograft and excision respectively.
CONCLUSION
A stable, functional elbow can be restored in terrible triad injury by early active rehabilitation after anatomic reduction and firm internal fixation.

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Remodelling of Angular Deformity in Birth-Associated Femoral Shaft Fracture: Soon Hyuck Lee, Sung Tae Lee, In Rok Yoo, Seoung Joon Lee; J Korean Fract Soc 2005;18(3):330-334. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.330

Abstract PDF: PURPOSE
To find out the process of bone remodelling and risk factors in birth-associated femoral fracture.
MATERIALS AND METHOD
We evaluated the four femoral fractures in three neonates about the obstetric and family history, and measured the angulation at the fracture site and the angle between the proximal and distal epiphysis of the femur on the radiographies taken at regular intervals.
RESULTS
The incidence of birth-associated femoral fracture was 0.06%. In two cases, fracture angulation and interepiphyseal angle had been decreased. However the angular deformity was worsened in two cases, but the interepiphyseal angle had been decreased regardless to the change of fracture angulation. So the alignment of epiphyseal plate came to normal alignment of joint surface.
CONCLUSION
The underlying disorder should be searched, because of its rarity. The physeal reorientation that makes joint alignment near normal irrespective of amount of angular deformity is assumed as the predominant mechanism in remodelling process of the angular deformity.

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Radiologic Result of Treatment of Intertrochanteric Fracture Using Compression Hip Screw: Involvement of Lateral Cortex: Suk Ha Lee, Sung Tae Lee, Kwang Jun Oh, Yong Bae Kim, Woo Seung Lee, Ji Sung Jun, In Rok Yoo, Jung Sup Keum; J Korean Fract Soc 2005;18(2):115-119. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.115

Abstract PDF

PURPOSE
To assess the meaning of the unstable intertrochanteric fracture of femur with involvement of lateral cortex by analysing the radiologic result of the surgical treatment using a compression hip screw.
MATERIALS AND METHODS
Classifing patients (who has taken the surgical treatment for intertrochanteric fracture of femur using compression hip screw from January 1999 to June 2002) in our hospital with 24 patients who had not much difference statistically in the compression screw located within the femur, Tip-Apex distance (TAD) the Singh Numerical Value of osteoporosis. The results were divided into two groups, group A (without fracture extends through lateral cortex of femur: 16 cases) and B (fracture extends through lateral cortex of femur: 8 cases), when analyzing it. And then analyzed the final examination in the evaluation of electrical potential level by radiology, change of the inside and outside of neck-shaft angle, descent level of the screw and the change of the neck-shaft angle.
RESULTS
In the latest follow up, the sliding amount of the screw in group B, the average was 14.9+/-9.3 mm, and 6.7+/-3.6 mm in group A. There was no difference statistically (p value>0.05). In the varus change in group B, the average was 8.00+/-8.12degrees and in group A it ws 2.75+/-2.63degrees There was statistical difference(p value<0.05). In displacement after operation, it was 7.60+/-2.61 mm in group B and 0.5+/-1.80 mm in group A. There was statistical difference (p value<0.05).
CONCLUSION
The intertrochanteric fracture with involvement of lateral cortex of femur have to be considered as unstable fracture having tendency of displacement.

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Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation
Ui Seoung Yoon, Jin Soo Kim, Jae Sung Seo, Jong Pil Yoon, Seung Yub Baek
Journal of the Korean Fracture Society.2010; 23(3): 270. CrossRef

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Treatment of Fractures of Distal Radius using External Fixator: Sung Tae Lee, Seok Ha Lee, Kwang Jun Oh, Jong In Na, Ji Sung Jun, In Rok Yu; J Korean Soc Fract 2003;16(3):407-415. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.407

Abstract PDF: PURPOSE
To assess the clinical and radiological results from the treatment of the intraarticular distal radius fracture by using the external fixator and confirm the usefulness of the external fixator from this study. MATERIALS & METHODS: We selected 20 cases of the distal radius fracture patients, who were treated with external fixator, among the patients from March, 1998 to March, 2001 and they could be followed for 1 year. There were 12 males and 8 females with a mean age of 53.4. According to AO classification, there were 2 cases for type A (10%), 2 cases for type B (10%), 5 cases for type C1 (25%), 9 cases for type C2 (45%), and 2 cases for type C3 (10%). In the 16 cases, the external fixator was used alone and in the other 2 cases, the external fixator was used with K-wires fixation. In the last 2 cases, K-wires fixation and autogenous iliac bone graft were combined.
RESULTS
In more severe form of distal radius fracture such as complete intraarticular fracture (type C2, C3 of AO classification), the better outcome in clinical and radiologic results was showed when additional K-wires fixation and/or autogenous iliac bone graft were combined rather than using the external fixator only. Particularly, in the cases of type C2, the poorest outcomes of radial length loss 2.7 mm (4.0%), radial inclination loss 1.4 (4.9%), volar tilting loss 2.4 (6.9%) were showed when the external fixator was used alone. The three worst results were from the cases of using external fixator alone in type C2. In the two cases of combination with K-wire fixation, the result of type C2 was excellent and that of type C3 was good. The results of the last two cases (type C2, C3) of combination with K-wire fixation and autogenous iliac bone graft were all excellent.
CONCLUSION
In this study, we confirmed that the better result could be achieved when the treatment were performed with combination with K-wire and/or autogenous iliac bone graft rather than using the external fixator alone.

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Operative treatment of diaphyseal fractures of both forearm bones in adults: Eui Hwan Ahn, Sung Tae Lee, Ja Heon Koo; J Korean Soc Fract 2001;14(2):245-252. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.245

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the effectiveness of operative methods for diaphyseal fractures of both forearm bones in adults.
MATERIALS AND METHODS
Forty five cases with diaphyseal fractures of both forearm bones over 18 year old that are treated by operative methods from January 1994 to December 1998 were followed and analyzed. The most common age group was 3rd and 4th decade(each, 24.4%). Traffic accident was the most common cause of injuries(31.2%). Among both the radius and ulna, middle 1/3 was the most common level of fractures(60%, 57.8%). In operative methods, open redeuction and internal fixation with dynamic compression plate(D.C.P.) and screws were performed in 39 cases, closed reduction and internal fixation with Rush pin were performed in 5 cases, And another 1 case was performed with D.C.P. and Rush pin simultaneously.
RESULTS
According to simple X-ray and physical examinations, The average of bone union periods was 12.7 weeks in radius, 13.5 weeks in ulna. The range of bone union periods according to the level of fractures was from 12.4 weeks to 14.1 weeks. For the functional results assessed by Grace and Eversmann method, excellent was 48.9%, good was 35.6%, acceptable was 11.1% and unacceptable was 4.4%.
CONCLUSION
The functional result was satisfactory in 84.5%. So the operative method of diaphyseal fractures of both forearm bones, if proper operative method had been selected and meticulous surgical technique had been performed, was considered as recommendable method.

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Treatment of a Segmental Ulnar Shaft Fracture and an Olecranon Fracture
Myoung Soo Kim, Kyu Pill Moon, Hyung Joon Cho, Jung Yun Bae, Kuen Tak Suh
Journal of the Korean Orthopaedic Association.2010; 45(6): 496. CrossRef

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Posterior Dislocation of Elbow Joint with Fracture of Radial Head and Coronoid Process (Terrible triad of Elbow Fracture and Dislocation): case report: Eui Hwan Ahn, Sung Tae Lee, Hyun Sik Ahn; J Korean Soc Fract 2000;13(4):1011-1015. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1011

Abstract PDF: Dislocation of the elbow with fracture of the radial head and the coronoid process is a complex injury that includes severe damage to both soft tissue and bone. The above injury is named as 'terrible triad of elbow fracture and dislocation'. This injury is very rare and difficult to treat and this combined lesion has been reported to have a worse prognosis than either of the single injury. The complications of ectopic ossification, recurrent dislocation, and loss of motion are recognized as a source of considerable concern to the treating orthopaedic surgeon. Many authors emphasized the importance of fixation of coronoid process. The proper management of radial head fracture is controversial. Whatever method used, the elbow must be stable enough to permit early motion. We treated 2 patients who sustained posterior dislocation of elbow with fracture of radial head and coronoid process. First case was treated by closed reduction for dislocation of elbow immediately. After 2 days, radial head was excised and coronoid process was fixed with pulled-out technique. Second case was treated by closed reduction for dislocation of elbow immediately. After 3 days, radial head was treated with open reduction and internal fixation with K-wire and teared anular ligament was repaired. Clinical result of both cases was good

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Treatment of comminuted Tibial Fractures using Ilizarov Method: Eui Hwan Ahn, Sung Tae Lee, Hyeon Seok Kang; J Korean Soc Fract 1999;12(4):916-923. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.916

Abstract PDF: From March 1996 to March 1999, thirty two cases of comminuted tibial fractures were treated with Ilizarov external fixator. 13 cases were closed fractures and 19 cases open fractures. Among 19 open fractures, there were 3 cases of Gustilo type I, 10 cases of type II and 6 cases of type III fractures. All the cases could not be initially treated by open reduction and internal fixation because of open wound or severe comminution. Among 32 cases, 4 were tibial condyles, 22 were tibial shafts, 6 were tibial plafonds. All the cases were followed up from a minimum 12 months up to 35 months with an dverage of 22 months. We obtained satisfactory bony union in ail cases with the average duration of 18.1 weeks. Bone graft was done initially in two cases. Numerous complications were encountered, most commonly, joint stiffness and pin tract infection were developed but they were treated well. To avoid such complications, careful management was needed. According to Tuckers clafsification, the result was graded as excellent in 8, good in 18, fair in 4 and poor in 2 cases. We conclude that Ilizarov external fixatior is a very useful method for initial treatment in getting reduction, maintenance of reduction, early ambulation and fracture healing in cases of communited tibial fractures whether open or closed.

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Remodelling and Reangulation following the Fracture of Both Bones of the Forearm in Children: Sung Tae Lee, Jeong Hwan Oh, Eui Hwan Ahn, Hyuck Jun Lee; J Korean Soc Fract 1997;10(4):972-978. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.972

Abstract PDF: One-hundred fifty children underwent closed reduction for the fracture of both bones of the forearm were retrospectively reexamed with an average follow-up time of 28.7 months(range, 13-60 months). Patients were divided into three groups of 50-complete fractures, 50-green-stick fractures broken intact cortex and 50-green-stick fractures preserved intact cortex. The rate of the reangulation after closed reduction was lowest on the green-stick fractures preserved intact cortex. Forty-seven patients with residual angulation after healing were divided into two age groups of 4-10 years and 10- 15 years at the time of fracture. In children younger than 10 years of age with residual angulation after distal fractures of both bones of the forearm, the change of orientation of the epiphyseal plate toward the normal seemed to account for nearly all the actual correction at the site of fracture. The hinge should be used to aid in an accurate and stable reduction. The importance of the orientation of the epiphyseal plate is related to the distance between the fracture site and the epiphyseal plate according to the age of the patient.

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Treatment of Femoral Shaft Fracture with Intramedullary Nailing: A Comparison of Ender Nailing with Interlocking Intramedullary Nailing: Sung Tae Lee, In whan Jeong, Dong Heon Kim, Kyu Cheol Shin, Moon Koo Lee; J Korean Soc Fract 1996;9(2):409-415. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.409

Abstract PDF: The rigid internal fixation of the femoral shaft fracture with intramedullary nailing enables early joint motion and reduces morbidity. The authors reviewed the results of 38 patients treated with Ender nailing(22 casses) and interlocking intramedullary nailing(16 cases) between March 1989 and March 1994. The resuls were as follows. 1. The average bony union time in Ender nailing(18.9 weeks) was similar to interlocking intramedullary nailing(18.7 weeks). 2. The average time to acHieve full range of motion of the knee was shorter in intramedullary nailing (10.2 weeks) than in Ender nailing(13.5 weeks). 3. Interlocking intramedullary nailing required shorter time to achieve full weight Ender nailing. 4. The average operation time was shorter in Ender nailing(55 mins.) than in interlocking intramedullary nailing(100 mins). Interlocking intramedullary nailing is thought to be a better option than Ender nailing in fixa lion of femur shaft fracture by our study. However, in elderly patients or multiple injured patieilts, Ender nailing can be used advantageously for shorter operation time and technical sim plicity.

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