Journal of Musculoskeletal Trauma

Treatment Strategy of Infected Nonunion: Hyoung Keun Oh; J Korean Fract Soc 2017;30(1):52-62. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.52

The management of infected nonunion is based on a detailed evaluation of patients, the involved bone and soft tissues, stability of fixation, and type of bacterial pathogens. Preoperative surgical planning and strategies for each step is mandatory for the successful treatment of infected nonunion. The radical debridement of infected tissues, including the unstable implant, is one of the most important procedures. Adequate soft tissue coverage should be considered for the appropriate management of infection; a reconstructive procedure and stable skeletal stabilization by internal or external fixation is also necessary later. A restoration of bone defects and bony union can be accomplished with bone grafting, distraction osteogenesis, vascularized fibular grafting, and induced membrane technique.

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Systematic Diagnosis and Treatment Principles for Acute Fracture-Related Infections
Jeong-Seok Choi, Jun-Hyeok Kwon, Seong-Hyun Kang, Yun-Ki Ryu, Won-Seok Choi, Jong-Keon Oh, Jae-Woo Cho
Journal of the Korean Fracture Society.2023; 36(4): 148. CrossRef
The Antibiotic Cement Coated Nail and Masquelet Technique for the Treatment of Infected Nonunion of Tibia with Bone Defect and Varus Deformity: A Case Report
Min Gu Jang, Jae Hwang Song, Dae Yeung Kim, Woo Jin Shin
Journal of the Korean Fracture Society.2022; 35(1): 26. CrossRef

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Scaphoid Fractures and Nonunion: Jin Rok Oh; J Korean Fract Soc 2016;29(1):79-92. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.79

Abstract PDF: Fracture of scaphoid is relatively common, and accurate and prompt diagnosis leads to bony union with good clinical outcome. However, it can be easily missed due to vague symptomatic complaints by patients, which in turn leads to negligence of a doctor in making the diagnosis or anatomical shape of scaphoid that causes minute fracture to be ignored while viewing simple radiography. When missed, nonunion of scaphoid gradually progresses to arthritic change in the wrist. Thus when fracture of the scaphoid is suspected, further evaluation should be initiated with care, and if the diagnosis is confirmed, a proper treatment plan must be set with assessment of stability of the fracture fragment. Internal fixation is usually proposed since solid fixation of the fracture provides early return to daily activity. When nonunion of the scaphoid is present, most patients can achieve bony union with avascular bone graft and internal fixation. However, if there is sclerotic change, large bone cyst or avascular necrosis of the fracture fragment, internal fixation with bone graft that includes vascular supply should be introduced in order to achieve bony union.

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Clinical Results of Various Surgical Techniques for Isolated Fracture of Greater Tuberosity of Humerus: Nam Su Cho, Seong Cheol Moon, Yong Girl Rhee; J Korean Fract Soc 2013;26(2):133-139. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.133

Abstract PDF

PURPOSE
To compare the clinical and radiologic outcomes of various surgical techniques for an isolated fracture of greater tuberosity of the humerus.
MATERIALS AND METHODS
From February 2001 to December 2008, 31 patients, who underwent an operation for isolated greater tuberosity fracture and were followed up for more than 1 year, were enrolled in this study. The mean age at the time of operation was 49.3 years (range, 23-73 years). The operation methods included in this study were as follows: a transosseous suture using nonabsorbable suture material (16 cases), a fixation by cannulated screws (10 cases), tension band wiring (2 cases), bony fragment excision with rotator cuff repair (2 cases), and percutaneous pinning (1 case).
RESULTS
At the last follow-up, the average Constant score was 79.4 and Korean Shoulder Score (KSS) was 81.2. Among the various operation methods used in this study, the transosseous suture had the highest scores with 82.5 in Constant score and 89.3 in KSS. Bone union was achieved at average 10.3 weeks (range, 7-15 weeks), and there were 2 cases in which the reoperation was required due to internal fixation failure. Postoperative shoulder stiffness occurred in 3 cases, and all the cases were done with the deltopectoral approach.
CONCLUSION
Clinically and radiologically satisfactory results were obtained using various operation techniques for an isolated greater tuberosity fracture of the humerus. The transosseous suture showed relatively better results than the other methods used in this study. To achieve favorable clinical and radiologic results, it is important to select an appropriate surgical approach and fixation method according to the fracture site, degree of displacement, and size of fragment.

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Biomechanical comparisons of hook plate and screw fixations in split-type greater tuberosity fractures of the humerus
Fa-Chuan Kuan, Kai-Lan Hsu, Chih-Kai Hong, Yueh Chen, Chen-Hao Chiang, Hao-Ming Chang, Wei-Ren Su
Journal of Shoulder and Elbow Surgery.2022; 31(6): 1308. CrossRef

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Treatment of Non-union Distal Humerus Fractures after Operation: Hyung Sik Kim, Ki Joon Jang, Yun Rak Choi, Il Hyun Koh, Ho Jung Kang; J Korean Fract Soc 2012;25(4):310-316. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.310

Abstract PDF

PURPOSE
This study is a retrospective analysis of patients who had undergone surgical treatment for non-union of distal humerus fracture. We evaluated them in terms of causes of injury, radiologic findings, and clinical outcomes such as prognosis.
MATERIALS AND METHODS
Seven consecutive radiologic patients who were confirmed to have nonunion of a distal humerus fracture underwent reoperations. These patients had already undergone operations for distal humerus fractures. This survey was held from 2005 to 2010. The average period up to diagnosis of non-union after the first operation was 7.4 months (4 to 16 months). The mean follow-up period was 24.6 months (12 to 65 months). Each patient was graded functionally according to the Mayo Elbow Performance Score and the Disabilities of the Arm, Shoulder and Hand Score.
RESULTS
Osteosynthesis was performed by internal fixation with plates and screws and then a bone graft for non-union of the distal humerus fracture. The average range of motion within the elbow joints was found to be a flexion contracture of 18.8 degrees (0~30 degrees) and further flexion of 120.2 degrees (102~140 degrees). Among postoperative complications, three cases of medium-degree stiffness, two cases of medial column nonunion, and one case of dissociation of the internal fixator were reported.
CONCLUSION
Stable internal fixation for maintenance reduction status is essential after accurate initial anatomical reduction. We concluded that nonunion could be prevented by additional surgical treatment such as autogenous bone graft, if it is necessary.

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Autogenous Inlay Bone Graft for Distal Humerus Nonunion with Metaphyseal Bone Defect: A Technical Note
Yong-Suk Lee, Dongmin Kim, Min-Sung Kang, Jong-Hwa Park, Sang-Uk Lee
Archives of Hand and Microsurgery.2020; 25(1): 39. CrossRef

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Clinical Outcome of Surgical Treatment for Intra-articular Distal Humerus Fracture: Myung Jin Lee, Hyeon Jun Kim, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Chul Hong Kim, Lib Wang, Hyun Woo Sung; J Korean Fract Soc 2010;23(2):201-205. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.201

Abstract PDF

PURPOSE
To evaluate functions of the elbow joint according to surgical approach, time to exercise, and type of fracture after surgical treatment for the intra-articular comminuted fracture of the distal humerus.
MATERIALS AND METHODS
27 patients with the intra-articular comminuted fractures of the distal humerus underwent surgery from March, 2000 to January, 2007. We investigated the surgical approach, time for union, time to exercise and age. We also evaluated postoperative functions of the elbow joint according to the flexion contracture, the range of motion and the Mayo elbow performance score.
RESULTS
The average follow-up period was 37 months and the average time for union was 14 weeks. The average range of flexion was 115 degrees, the average flexion contracture was 10 degrees, and the Mayo elbow performance score with average value of 85 point showed good clinical results. There were no statistically significant differences in functions of the elbow joint according to the operative method and age. However, patients with early postoperative exercise within 6 days showed statistically better outcomes than patients with postoperative exercise after 7 days. Type C1, 2 fractures showed statistically better results than the type C3 fracture.
CONCLUSION
Stable fixation and early exercise are required to prevent postoperative complications and restore functions of the elbow joint with an intra-articular comminuted fracture of the distal humerus.

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Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus
Ji-Kang Park, Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho
Journal of the Korean Fracture Society.2012; 25(2): 129. CrossRef

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Surgical Treatment of Pathologic Humeral Fracture: Ho Jung Kang, Byoung Yoon Hwang, Jae Jeong Lee, Kyu Ho Shin, Soo Bong Hahn, Sung Jae Kim; J Korean Fract Soc 2010;23(2):187-193. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.187

Abstract PDF

PURPOSE
To evaluate and analyze the radiographic and clinical outcomes after the surgical treatments of pathologic humeral fractures.
MATERIALS AND METHODS
From October 1993 to September 2007, a retrospective investigation was conducted with a total of 13 patients who underwent operations for pathologic humeral fractures. The methods of surgical treatment were as follows-four cases of open reduction and internal fixation; eight cases of closed reduction and internal fixation with intramedullary nailing; and one of radical excision and hemiarthroplasty.
RESULTS
Of nine patients with metastatic bone lesions, three were diagnosed with primary cancer after the incidence of pathologic humeral fracture. The mean period between the diagnosis of primary cancer and pathologic fracture in the latter six cases was 36.7 (2~144) months and the mean survival period after the surgical treatments was 22.8 (12~35) weeks in all patients with bone metastasis. Fracture unions were noted in all four cases of primary humeral bone lesion but none in metastatic cases. Pain relief and functional recovery were noted in eleven patients of this study.
CONCLUSION
Satisfactory clinical outcomes with sustained pain relief and functional recovery were observed after the surgical treatments of pathologic humeral fracture. Benign bone lesions require more active and early treatments in order to facilitate the functional recovery of upper extremities and fracture union. With pathologic humeral fractures originated from metastasis, palliative treatments were preferred to fracture union method for planning long-term pain relief and functional recovery.

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The application of a dual-lead locking screw could enhance the reduction and fixation stability of the proximal humerus fractures: a biomechanical evaluation
Eunju Lee, Hyeon Jang Jeong, Yeon Soo Lee, Joo Han Oh
Frontiers in Surgery.2024;[Epub] CrossRef
Therapeutic Approach to Humeral Pathologic Fracture Caused by Benign Bone Tumor
Jeung Il Kim, Um Ji Kim, Nam Hoon Moon, Hui Taek Kim, Tae Young Ahn, In Sook Lee, You Seon Song, Kyung Un Choi
Journal of the Korean Orthopaedic Association.2016; 51(6): 509. CrossRef

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The Results of Surgical Treatment for Nonunion of Phalanges in the Hand: Hee Dong Kim, Yoon Hong Kim, Yong Soo Choi, Heun Guyn Jung; J Korean Fract Soc 2008;21(2):140-144. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.140

Abstract PDF: PURPOSE
To evaluate the results of internal fixation and autogenous bone graft for the phalangeal nonunion in the hand.
MATERIALS AND METHODS
From Feb. 2000 until May 2006, thirteen cases that had been treated for non-union of phalanges in the hand were investigated retrospectively. Seven cases were treated with mini-plate fixation and autogenous cancellous graft and six cases with Kirschner wire fixation and autogenous cancellous graft. We analyzed bony union period radiographically and clinical results according to Belsky's score.
RESULTS
Thirteen cases obtained bony union. Seven cases of mini-plate fixation and bone graft, and six cases of K-wire fixation and bone graft achieved the bony union postoperatively on average 7.9 weeks and 6.3 weeks, respectively. Clinical results were "good" in four cases and "poor" in nine cases according to the Belsky's score. Only one of ten cases with associated injuries, such as tendon, nerve, arterial injuries and other finger fractures in the injured hand, had the good clinical result, but all three cases without associated injuries had the good one.
CONCLUSION
Internal fixation and autogenous bone graft can be a successful treatment of phalangeal nonunion. However, more careful choice of surgical treatment methods and preoperative explanation of poor post-operative results or complications should be made for phalangeal nonunion with associated injuries in the finger because of poor outcome in those cases.

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The Surgical Outcomes for Isolated Greater Tuberosity Fracture of Proximal Humerus: Eun Sun Moon, Myung Sun Kim, Young Jin Kim; J Korean Fract Soc 2007;20(3):239-245. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.239

Abstract PDF

PURPOSE
To evaluate the adequate surgical methods and postoperative rehabilitation by analyzing the outcome of surgical treatment for isolated greater tuberosity fracture of proximal humerus.
MATERIALS AND METHODS
Ten patients who allowed at least 1 year follow up after the surgical treatment of isolated greater tuberosity fractures were evaluated. Their mean age was 52.3 years (range, 28~67) and mean follow up duration was 23.8 months (range, 12~36). We choosed the different approaches and fixation methods according to size, location and presence of comminution of the fragment, and combined injury. The rehabilitation programs were indivisualized and we evaluated the clinical outcomes using UCLA and Constant scoring system.
RESULTS
According to the UCLA scoring system, 5 cases were excellent, 3 cases were satisfactory, and 2 cases were unsatisfactory. By the Constant scoring system, 8 cases were excellent and 2 cases were good. The average bony union time was 7.6 weeks (range, 6~8) except the 2 cases of revision surgery. Two cases were operated using cannulated screws alone, 3 cases using only nonabsorbable sutures and 5 cases using cannulated screws and nonabsorbable sutures. One out of two revision cases was developed from the negligence of preoperative shoulder anterior dislocation with rupture of subscapularis, and the other was caused by improper immobilization of the fracture site postoperatively.
CONCLUSION
Not only the adequate surgical approaches and the fixation methods according to the size and comminution of fragment, but also the identification of combined injuries were very important in the surgical treatment for the isolated greater tuberosity fracture. And we considered that the adequate postoperative rehabilitation and proper protection based on the intraoperative fixation stability play an important role for the better clinical and radiological outcomes.

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Clinical Features and Characteristics of Greater Tuberosity Fractures with or without Shoulder Dislocation
Dong-Wan Kim, Young-Jae Lim, Ki-Cheor Bae, Beom-Soo Kim, Yong-Ho Lee, Chul-Hyun Cho
Journal of the Korean Fracture Society.2018; 31(4): 139. CrossRef
The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate
Dong-Ju Shin, Young-Soo Byun, Se-Ang Chang, Hee-Min Yun, Ho-Won Park, Jae-Young Park
Journal of the Korean Fracture Society.2009; 22(3): 159. CrossRef

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Surgical Treatment of Posterior Wall Fractures of the Acetabulum: Young Soo Byun, Se Ang Chang, Young Ho Cho, Dae Hee Hwang, Sung Rak Lee, Sang Hee Kim; J Korean Fract Soc 2007;20(2):123-128. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.123

Abstract PDF: PURPOSE
To evaluate the results of surgical treatment of posterior wall fractures of the acetabulum and to determine the factors affecting the results.
MATERIALS AND METHODS
Thirty-one posterior wall fractures were reviewed; 7 type A1-1, 19 type A1-2 and 5 type A1-3 by AO classification. Postoperatively, the accuracy of the reduction was evaluated. At the final follow-up, clinical and radiographic results were evaluated with medical records and radiographs. The factors affecting the results were determined.
RESULTS
The reduction was graded as anatomical in 22 patients, imperfect in seven and poor in two. The clinical result was excellent in 21 hips, good in six, fair in three and poor in one. The quality of the reduction was strongly associated with the clinical result. The radiographic result was excellent in 22 hips, good in five, fair in two and poor in two. The clinical result was related closely to the radiographic result. Complications were osteoarthritis in three patients, osteonecrosis of the femoral head in one, heterotopic ossification in one, penetration of a screw into the joint in one and iatrogenic sciatic nerve injury in one. The factors affecting the clinical results were fracture patterns, the surgeon's experience, the accuracy of the reduction and late complications.
CONCLUSION
In this present series of posterior wall fractures, as their prognosis depends on the severity of the injury and the accuracy of the reduction, satisfactory result can be obtained by anatomical reduction with thorough preoperative planning and the surgeon's experience.

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Surgical Treatment of the Myositis Ossificans in Supracondylar Fracture of the Humerus in Children: A Case Report: Tai Seung Kim, Kee Cheol Park, Seung Pyo Seo; J Korean Fract Soc 2006;19(4):482-485. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.482

Abstract

Supracondylar fracture of the humerus is a common injury in the pediatric patient. A less common complication is the development of myositis ossificans. Although frequently cited as a possible complication, there are few reported cases of this occurring in the pediatric patient. We present a case report of a 8 year old boy who developed myositis ossificans after a supracondylar fracture of the humerus. After one year of the injury, we could ascertained radiologically complete maturation of the mass which developed in front of the distal humerus and markedly made motion of the elbow joint limited. We could obtain further motion through the surgical resection and then physical therapy. Now, eleven months have lapsed since the mass was removed, the range of motion is almost normal, and the recurrence of myositis ossificans is not existed.

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Recent Trends in Treatment of Supracondylar Fracture of Distal Humerus in Children
Soon Chul Lee, Jong Sup Shim
Journal of the Korean Fracture Society.2012; 25(1): 82. CrossRef

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Surgical Treatment of Displaced Intra-articular Calcaneal Fractures: Minimum of 2-year Follow-up: Myung Ho Kim, Hong Geun Jung, Joong Bae Seo, You Jin Kim, Je Wook Yu; J Korean Fract Soc 2006;19(2):201-207. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.201

Abstract: PURPOSE
To evaluate the overall clinical features and postoperative functional results of the intra-articular calcaneal fractures at more than 2 years follow-up, and also to compare the results at postoperative 1 year with the results at more than 2-year follow-up.
MATERIALS AND METHODS
The study is based on 39 intra-articular calcaneal fractures (34 patients) that underwent surgical treatment from March 1997 to May 2002 with at least 2 years follow-up. The overall postoperative results were evaluated with Creighton-Nebraska functional scale. The comparison of results at postoperative 1 year was also performed with results at more than 2-year follow-up.
RESULTS
By Sanders classifications, there were 13 type II fractures (33.3%), 20 type III (51.3%), and 6 type IV fractures (15.4%). Average follow-up period was 35 months (range: 24~87 months) and at final follow-up of more than 2 years, Creighton-Nebraska score was average 76.0 (range: 30~100) which significantly improved from postoperative 1-year results of 67.1 (range: 22~95) (p<0.05).
CONCLUSION
The clinical outcome at more than 2 years after surgical treatment of intra-articular calcaneal fractures was quite promising, which significantly improved compared to 1-year results. Therefore, we concluded that functional results of calcaneal fractures should be evaluated at least 2 years after the treatment.

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Treatment of Bony Mallet Finger: Closed Reduction Using Extension Block K-wire: Jae Yeol Choi, Hwa Jae Jung, Ho Jin Lee, Kyung Mo Son, Young Hun Kim; J Korean Fract Soc 2004;17(4):362-367. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.362

Abstract PDF

PURPOSE
To review the result of bony mallet finger treated with a closed reduction using extension block K-wire MATERIALS AND METHODS: Between January 2001 and November 2002, among the patients with bony mallet finger underwent closed reduction using extension block K-wire, we retrospectively reviewed 14 patients with 14 fractures who had a minimum follow-up of 12 months.
RESULTS
There were 10 men and 4 women, with an average follow-up for all cases 15.7 months (range, 12 months~18 months). According to Crawford's evaluation criteria, we obtained 7 excellent, 5 good, 2 fair. We obtained bony union in all patients, with no remained pain. The average ROM was 67 degrees at postoperative 12 months. Postoperative complications occurred in two cases, which were nail deformity and mild osteoarthritis at the distal interphalangeal joint. There was no pin site infection.
CONCLUSION
This technique is not only easier but also less invasive than other techniques for reduction of mallet finger. Also, it shows excellent result with lower complication rate. So, it seems a reliable treatment for bony mallet finger.

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Osteoarthritis after Extension Block Technique for the Bony Mallet Finger
Sung Hoon Koh, Jung Hyun Park, Jin Soo Kim, Si Young Roh, Kyung Jin Lee, Dong Chul Lee
Archives of Hand and Microsurgery.2021; 26(4): 238. CrossRef
Comparison of Surgical Outcomes of Percutaneous K-Wire Fixation in Bony Mallet Fingers with Use of Towel Clip versus 18-Gauge Needle
Ho-Seung Jeon, Chan-Sam Moon, Seo-Goo Kang, Kyeong-Seop Song, Uk-Hyun Choi
Journal of the Korean Society for Surgery of the Hand.2013; 18(1): 1. CrossRef
Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip
Chung Soo Han, Duke Whan Chung, Bi O Jeong, Hyun Chul Park, Jin Young Kim, Cheol Hee Park, Jin Sung Park
Journal of the Korean Fracture Society.2009; 22(4): 283. CrossRef

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Results of Surgical Treatment in Schatzker Type VI Tibial Plateau Fracture: Kyung Jin Song, Kwang Bok Lee, Seung Jin Moon, Joo Hong Lee; J Korean Fract Soc 2004;17(1):32-37. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.32

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the factors influencing the results for the treatment of the Schatzker type VI tibial plateau fractures.
MATERIALS AND METHODS
Twenty-two cases of the 21 patients in Schatzker type VI tibial plateau fractures were analyzed. Treatment results were analyzed according to the type of fracture (open vs closed), method of operative treatment, angulation more than 5 degree and status of infection. The functional results was evaluated by Hohl's functional criteria. Student t-test was used for the statistical analysis.
RESULTS
Functional outcome demonstrated 5 excellent, 8 good, 6 fair and 3 poor results. There was no significant difference in the treatment results between type of fracture, method of operative treatment and status of infection. Among 9 cases with angular deformity of more than 5 degree, 2 showed excellent or good result and 7 showed fair or poor result (p<0.05). There was no significant difference between rate of postoperative infection and the mean period of the clinical bone union (p=0.66).
CONCLUSION
Accurate anatomical reduction and rigid fixation is essential for the treatment of Schatzker type VI tibial plateau fractures for the prevention of the angular deformity. And early weight bearing exercise should be controlled for the prevention of loss of reduction and loss of alignment leading to angular deformity.

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The Correlation between Surgical Timing and Perioperative Complications in the Treatment of Displaced Supracondylar Humeral Fractures of Children: Soo Hong Han, Duck Yun Cho, Hyung Ku Yoon, Byung Soon Kim, Jae Hwa Kim, Hyung Kun Park, Se Hyen Kim; J Korean Soc Fract 2003;16(2):278-283. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.278

Abstract PDF: PURPOSE
Even though emergent percutaneous pinning after closed reduction is the popularized treatment of the displaced type II and type III pediatric supracondylar fractures of the humerus, the timing of pinning still presents controversy. The purpose of this study is to suggest an appropriate surgical time without significant perioperative complications.
MATERIALS AND METHODS
From April 1995 to January 2002, 179 consecutive patients who had undergone surgical treatment were selected. They were divided to 5 groups [A group: 8 hours or less following injury (24 cases), B group: from 9 to 16 hours (63 cases), C group: from17 hours to 24 hours (63 cases), D group: from 25 hours to 48 hours (18 cases), and E group: from 49 hours to 72 hours (11 cases)] and reviewed retrospectively to analyze perioperative complications and operation time.
RESULTS
There was no significant difference between each group with respect to surgical wound infection, iatrogenic ulnar nerve injury, VIC, operation time and the necessity of reoperation (p>0.05).
CONCLUSION
Within the parameters outlined in our study, we could not find the any meaningful correlation between surgical timing and occurrence of perioperative complications and also, we think that the timing of percutaneous pinning can be delayed to the time when a surgeon considers it appropriate.

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Surgical Treatment for Fractures of the Talus: Ho Rim Choi, Jang Geun Lee, Hun Hwi Choi, Sung Woo Choi; J Korean Soc Fract 2003;16(1):67-73. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.67

Abstract PDF: PURPOSE
To evaluate the clinical results and develope guidelines for surgical treatment of talus fracture.
MATERIALS AND METHODS
Among the 60 cases that were treated during March 1990 to November 2000, 34 cases were treated operatively and followed up for more than one year( range: 1 4.4 years ). They were analyzed retrospectively with questionnaire directly or by telephone interview, radiograms and medical records. Clinical results were evaluated by Hawkins 'scoring system.
RESULTS
25 out of 34 cases showed satisfactory results. Unisatisfactory results were seen in cases that we couldn 't achieve anatomical reduction due to severe communition, and also in case of delayed treatment due to associated trauma and soft tissue injury. Six out of 8 cases that showed no Hawkins 'sign developed avascular necrosis. However, satisfactory results were achieved through conservative treatment.
CONCLUSION
Satisfactory results could be achieved through early anatomical reduction and rigid internal fixation followed by aggressive rehabilitation. There was no differences in clinical results either by the surgical approach or method of internal fixation. Avascular necrosis was not essentially related to the clinical results.

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Assessment of Surgical Treatment of Acetabular Fracture after Minimum Five-year Follow-up: Do Hyun Moon, Jang Seok Choi, Ki Ju Park, Jong Min Yun; J Korean Soc Fract 2002;15(3):342-348. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.342

Abstract PDF: PURPOSE
To review the clinical and radiographic results of operative treatment of acetabular fractures for which there were minimum five-year follow-up.
MATERIALS AND METHODS
We reviewed 22 acetabular fracture cases that had been treated operatively from March 1993 to July 1996. Each of the patients had been followed for a minimum five-year. The radiographic results were classified by Matta 's criteria and the clinical results were analyzed according to d 'Aubigne and Postel 's criteria.
RESULTS
Satisfactory reduction were obtained in 18 hips (81.8%), 14 and 13 hips of which were included in good or excellent categories of roentgenographic and clinical results respectively. Overall radiographic results for 17 hips (77.3%) at the one-year follow-up and 14 hips (63.6%) at the minimum five-year follow-up were excellent or good. According to clinical criteria, 16 hips (72.7%) at the one-year follow-up and 13 hips (59.1%) at the minimum five-year follow-up were classified as excellent or good.
CONCLUSION
Folow-up roentgenographic and clinical results were good or excellent in satisfactory reduction group. Threrefore the accuracy of reduction is an important prognostic factor in acetabular fracture. The results were worse at the minimum five-year follow-up than at the one-year follow-up. Late-postoperative complication is expected to increase as time passes.

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The Surgical Treatment of Distal Clavicle Fractures: Eun Sun Moon, Jong Wook Jung, Gwang Cheul Jeong; J Korean Soc Fract 2001;14(4):706-713. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.706

Abstract PDF: PURPOSE
To evaluate and analyze the clinical and radiological result of surgical treatment for distal clavicular fractures.
MATERIALS AND METHODS
From Jan. 1995 to May. 2000, eighteen cases of distal clavicle fractures were treated operatively. Among them, fifteen cases with more than 12 months follow-up were analyzed retrospectively. In Neer classification, type I was 1 case and 14 cases were type II. We performed closed reduction in 4 cases and open reduction in 11 cases. We treated with Steinman pin in I case, K-wires in 6 cases and coracoclavicular screw(Bosworth technique) in 6 cases. One case was treated with coracoclavicular screw due to screw loosening which was used in primary operation. Another case was treated by internal fixation with plate and K-wire due to delayed union after conservative treatment of segmental fracture. Mean follow up period was 18 months(12~62 months). Clinical results was evaluated by Kona s criteria.
RESULTS
Radiological evidence of solid union was detected within 10 weeks in 13 cases. Clinical results were satisfactory in 13 cases (excellent in 10 cases and good in 3 cases). In K-wire fixation, all six cases were demonstrated excellent result. In coracoclavicular screw fixation, four of six cases were excellent, one was good and one was fair. Poor result was noted in one case of Steinmann pin fixation due to nonunion and limitation of range of motion. SUMMARY: Surgical treatment of distal claviclular fracture would obtain satisfactory clinical result with early range of motion exercise and reduce the complications such as nonunion and sustained pain.

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Complications after Surgical Treatment in Fracture of The Neck of Humerus: Ho Jung Kang, Sang Jin Shin, Dae Eui Lim, Eung Shick Kang; J Korean Soc Fract 2001;14(1):91-98. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.91

Abstract PDF: PURPOSE
The causes and risk factors of complications following operative treatment of fracuture of neck of humerus were analysis. MATERIALS & METHODS: From 1995 to 1998, 32 cases of fracture of neck of humerus on which operative treatment have been taken were reviewed. The average age was 48.3 years. There were 13 cases of two part fracture, 11 cases of three part fracture and 8 cases of four part fracture, with 4 cases associated with comminution. Closed reduction and pinning was performed in 11 cases. An external fixator was applied in 1 case. Other 18 cases underwent open reduction using various fixation method including 4 K-wires, 2 cannulated screws, 5 plates, 1 Ender nail and 6 tension band wirings combined with screws each. 2 cases were underwent hemiarthroplasty.
RESULTS
Thirteen patients (41%) had postoperative complications. There were 3 nonunion, 2 pin site infection, 2 inferior subluxation of humeral head, 3 impingement syndrome, 1 hardware failure, 1 avascular necrosis of humeral head and 1 glenoid rim erosion. The incidence of postoperative complication was high in ages older than 40 years and the four part and comminuted fractures. The insufficient fixation due to osteoporosis, incomplete reduction, surgical technique and use of inappropriate implant were considered as related causative factures.
CONCLUSION
The patient's age, the quality of bone, severity of fracture and methods of fixation are all important contributing factors for postoperative complications.

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The Surgical Reconstruction of Osteoporotic Vertebral Fractures: Suck Woo Kim, Yung Khee Chung; J Korean Soc Fract 2001;14(1):30-36. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.30

Abstract PDF

PURPOSE
The purpose of this study is to analyze the surgical results of 11 patients who underwent posterior instrumentation and anterior interbody fusion using titanium mesh vertebral ring(MOSS) in osteoporotic vertebral fracture. MATERIAL AND METHODS: From May 1997 to July 1999, we checked plain radiographs every 3 months and evaluated the change of kyphotic angle, fusion rate, change of clinical, neurologic symptoms and complications of these patients.
RESULTS
There were only average 0.2 degree correction of preoperative kyphotic angle at last follow-up X-ray. However, we confirmed successful bony fusion at nine of eleven patients(82%) and ten of eleven patients(90.9%) got satisfactory clinical results. Four patients with neurologic symptoms have recovered from their original neurologic status. Only one patient reoperated her back because of displacement of surgical device used in previous operation.
CONCLUSION
Among the surgical treatment methods in osteoporotic vertebral fractures, posterior instrumentation and anterior interbody fusion using titanium mesh vertebral ring(MOSS) is recommended as one of the effective surgical methods in severe osteoporotic patients.

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Kümmell's Disease Treated with Percutaneous Vertebroplasty: Minimum 1 Year Follow-Up
Jae Won Park, Jong-Hwa Park, Hong Jun Jeon, Jong Young Lee, Byung Moon Cho, Se-Hyuck Park
Korean Journal of Neurotrauma.2017; 13(2): 119. CrossRef
Peculiarities of Treatment of Patients with Complicated Compression Fractures of Thoracic and Lumbar Spine Vertebral Bodies on the Background of Osteoporosis
S T Vetrile, Aleksandr Alekseevich Kuleshov, L Yu Darchiya, S T Vetrile, A A Kuleshov, L Yu Darchiya
N.N. Priorov Journal of Traumatology and Orthopedics.2009; 16(2): 34. CrossRef
Delayed vertebral collapse with neurological deficits secondary to osteoporosis
K-T Kim, K-S Suk, J-M Kim, S-H Lee
International Orthopaedics.2003; 27(2): 65. CrossRef
Surgical Treatment of Kümmell Disease with Neurologic Deficits - Posterolateral Decompression and Posterior Reconstruction -
Ki-Tack Kim, Kyung-Soo Suk, Jin-Moon Kim
Journal of Korean Society of Spine Surgery.2001; 8(2): 136. CrossRef

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Osteopetrosis combined with Subtrochanteric Fracture of Femur: A Case Report: Ok Gyun An, Jong Ho Jang, Young Kyu Lim; J Korean Soc Fract 2000;13(4):804-808. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.804

Abstract PDF: Osteopetrosis (Albers-Schonberg's disease, Marble bones, and chalk bones) is a rare genetic disorder in which the bony structure throughout the body becomes dense and brittle. Because of the fragility of the pathologic bone, fractures are common and insufficient development of the bone marrow, optic atrophy, deafness, and facial paralysis can be developed to complications. We report a case of 35-year-old female with the autosomal dominant form of osteopetrosis combined with subtrochanteric fracture of femur that underwent surgical treatment.

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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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A Comparision of conservative and Operative Treatmene in the Bony Mallet Finger: Ik Su Choi, Su In Roh, Hong Ju Ha, Jin Goo Kang, Dae Yeon Kim; J Korean Soc Fract 1999;12(4):1021-1026. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.1021

Abstract PDF

Mallet finger is a commom deformity caused by disruption of the extensor mechnism at the dorsal base of the distal phalanx. Patients can by managed by either conservative or operative treatment depending on some factors, such as the fracture type and interval from injury to medical treatment. However, whether to perform conservative or operative treatment is in debate. We conducted this study to compare the results of conservative and operative treatment of mallet finger caused by intra-articular fracture of the distal phalanx, with not mere than one third of the articular surface of the distal phalanx involved. From March 1994 to April 1999, we experienced 26 cases of bony mallet fingers. Following are the results. 1. The result by Kanies scale was satisfactory in 9 cases of 12 in conservative treatment(75%), and 10 cases of 14 in operative treatment(71%)(P>0.05). 2. The result was satisfactory in 8 cases of 10 in patients who were treated within 2 weeks(80%), and 4 cases of 7 in those treated after 4 weeks(57%)(P<0.05). 3. Conservative treatment was more cost effective, easier to perform compared to operative treatment. Thus, we suggest conservative treatment as the better treatment method for bony mallet finger with ont more than one third of the articular surface of the distal phalanx involved.

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Extension pin block technique versus extension orthosis for acute bony mallet finger; a retrospective comparison
Gurkan Gumussuyu, Mehmet Melih Asoglu, Olcay Guler, Hasan May, Adil Turan, Ozkan Kose
Orthopaedics & Traumatology: Surgery & Research.2021; 107(5): 102764. CrossRef

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Arthroscopically-Assisted Reduction and Fixation in Fractures of the Tibial Condyle: Jung Su Hwang, Han Chul Kim, Yong Soon Kim; J Korean Soc Fract 1999;12(1):90-97. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.90

Abstract PDF: Fractures of the tibial condyle are characterized that often involve the articular surfaces and frequently associated with soft tissue injuries such as collateral ligament, cruciate ligament and menisci of the knee. The author analyzed 12 cases of tibial condyle fractures, which were surgically treated by reduction of depressed articular surface under assist of arthroscopy and then fixed with cannulated cancellous screws and accompanied by bone graft under the control of image intensifier in 9 cases of the 12 cases. The purpose of this study are (1) obtaining accurate reduction of the depressed articular surface, (2) preventing knee joint from the surgical wide dissection, (3) not only bony problems but also combined menisci and ligament injuries were diagnosis and management. We can obtain more anatomical reduction and excellent or good functional knee score since extensive exposure is avoided. There is no complication with regard to arthroscopic surgery and rapid recovery with reduced pain and early full ROM are obtained after follow-up study of a mean of 1 year.

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Minimal Surgical Treatment of the Tibial Pilon Fracture: Min Young Chung, Chang Woo Kim, Joon Kwon Jung, Eun Hwan Bae, Ho Keun Park, Seong Ho Park, Jang Won Hur; J Korean Soc Fract 1999;12(1):113-118. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.113

Abstract PDF: The goals of the treatment of pilon fracture include to restore a normal anatomy and functional level of uninjured state. We analysed the clinical outcomes of the treatment of pilon fractures with calcaneal traction and percutaneous intramedullary nailing in the fibula (group A, 12 cases), or open reduction and internal fixation (group B, 11 cases) in 23 cases between April 1994 and March 1997. All of the patients were followed for at least one year (average, 18 months; range, 12 to 24 months). Fifteen patients were male (group A, 8; group B, 7), and eight were female (group A, 4; group B, 4). Falling-down injury is the most common cause and automobile accident is the second. According to the R.. uedi and Allg.. ower classification, type II fractures were most common. In the group A, two of the 12 fractures were type I, six were type II, and four were type III, and in the group B, two of the 11 fractures were type I, six were type II, and four were type III. According to the criteria of Mast and Teipner, in the group A, six were good result and six were fair, and in the group B, four were good, five were fair, and two were poor. A nonunion with wound infection and a malunion developed in the group B. The results in the group A were better than those in the group B in clinically, we propose the minimal surgical treatment is useful treatment option of pilon fracture.

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Surgical Treatment of Femoral Nonunion: Hyun Sik Gong, Hee Joong Kim, Han Soo Kim, Goo Hyun Baek, Sang Hoon Lee, Sang Rim Kim, Moon Sang Chung, Young Min Kim; J Korean Soc Fract 1999;12(1):1-5. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.1

Abstract PDF

Femur is one of the most frequent sites of nonunion and femoral nonunion imposes many complications secondary to repeated surgical procedures and immobilizations. Many kinds of treatment options have been used and studied for comparison, but still the classical principle is rigid fixation, bone grafting, and adequate postoperative immobilization. In this study, the results of surgical treatment for femoral nonunion were analyzed. From July 1995 to August 1997, a total of 14 cases of femoral nonunion were treated surgically at the department of Orthopedic Surgery of the Seoul National University Hospital. All cases were treated by autogenous bone graft and internal fixation. For internal fixation, plate and screws were used in 10 cases and intramedullary nail in 3 cases and compression hip screw in 1 case. Postoperatively, hip spica cast was applied in 8 cases, cast brace in 2 cases and long leg splint in 1 case. In the other 3 cases, no additional support was adopted. In all cases, clinical union was achieved at postoperative 5 months in average. There was no significant complication except one case of marked limited motion in knee followed by hip spica cast.

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Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing
Sung-Soo Kim, Sung-Keun Sohn, Chul-Hong Kim, Myung-Jin Lee, Lih Wang
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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Surgical Treatment for Displaced Talus Fracture-Dislocation: Kwang Soon Song, Chul Hyung Kang, Seong Ryeol Kim; J Korean Soc Fract 1998;11(4):906-911. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.906

Abstract PDF: Talus fracture is an uncommon fracture and frequently accompanied with serious complications such as avascular necrosis, nonunion and osteoarthritis. The purpose of this paper is to assess the effectiveness of open reduction and internal fixation in treatment of displaced talus fracture. Fourteen patients with severely displaced talus fracture-dislocation, classified as more severe than Hawkins type III and comminuted body fracture were evaluated. They were treated at Keimyung University Dongsan Medical Center during the period of July 1989 to August 1996. The average period for follow up was 53 months, ranging from 18 months to 8 years. All patients were treated by open reduction and internal fixation using screws except 2 cases of severe talar body fractures, which were treated by Blair fusion. according to Hawkins scoring system. the end results were excellent only in 4 cases, good in 2, fair in 5, poor in 3. Avascular necrosis developed in 3 cases and traumatic arthritis in 5 cases. In conclusion, displaced talus fracture-dislocation had a high incidence of postoperative complications(57%) in spite of early sugical treatment. It is essential to consider about possible complications and sequelae before operation is performed.

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Surgical Treatment of Acute acromioclavicular Dislocation: Hyoun Oh Cho, Kyoung Duck Kwak, Byeung Yong Kim, su Min Sohn, Jin Kyoung Moon; J Korean Soc Fract 1998;11(2):413-419. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.413

Abstract PDF: We have reviewed 40 patients of acute acromioclavicular dislocation all treated by several operative procedure from January 1990 to July 1996. After about 12 months follow up period, we analyzed the relationship between the type of operation and the clinical results. Several operative mothods were demonstrated till now, but 4 techniques or their combinations are commonly used. Those are fixation of acromioclavicular joint, fixation of coracoclavicular ligament, resection of distal end of clavicle and dynamic muscle transfer. Modified Phemister technique, modified phemister technique with coracoclavicular fixation and modified Bosworth technique were used with or without repairment of coracoclavicular ligament at our hospital. Modified Phemister technique showed less good results than those of other techniques especially when repair of the coracoclavicular ligamentwas not made, and the repair of the coracoclavicular ligaments or fixation of the coracoclavicular joint is an important factor affecting the final results.

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Treatment of Acetabular Fractures -Comparison of Conservative Treatment and Surgical Treatment According to AO Comprehensive Classification-: Chang Hyuk choi, Koing Woo Kwun, shin Kun Kim, Sang Wook Lee, seung Hee Kim; J Korean Soc Fract 1998;11(2):288-295. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.288

Abstract PDF: Acetabular fracture is a severe injury associated with other body injuries. they result in permanent disability due to management difficulty and its complications such as traumatic arthritis, avascular necrosis of femoral head, etc.. In order to restore excellent function of hip joint, anatomic reduction and secure internal fixation followed by early mobilization are neccessary. We analysed 21 patients who were diagnosed as type A1 acetabular fracture from Jan. of 1991 to Dec. of 1996, and compared the functional results of conservative treatment method with that of surgical treatment method. The results were as follows. 1. Conservative management was done at 8 cases, and surgical management was done at 13 cases with open reduction and internal fixation. 2. The functional result by Goodwin criteria was all satisfactory in conservative reatment method and 12 cases(92%) in surgical treatment method. 3. Associated injuries were found in 18 cases, among them pelvic bone fracture was the most common fractured site and knee ligament injury was the most common soft tissue injury. 4. In the cases of larger acetabular fragment or in the presence of associated injury and instability after closed reduction, faster rehabilitation was achieved by starting early range of motion exercise and weight-bearing after surgical treatment than classical conservative treatment.

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Operative Treatment of Intraarticular Fractures of the Distal Radius: Chung Nam Kang, Jin Man Wang, Kwon Jae Roh, Jong Oh Kim, Dong Jun Kim, Jong Keon Oh, Han Cheon Bang; J Korean Soc Fract 1998;11(1):56-62. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.56

Abstract PDF: Intraarticular fractures of the distal part of the radius comprise a distinct subgroup of fractures that are difficult to manage and are associated with a high frequency of complication and represent one of the greatest challenges to the orthopaedic surgeon. We reviewed 30 cases(28 patients) of intraarticular fractures of the distal radius treated surgically in orthopaedic department of Ewha medical center between January 1993 to May 1996 and analyzed the correlation between the clinical end results and radiographic parameters. The clinical end results were significantly worse when radia inclination didn't exceed 15, or radial length was less than 10mm or dorsal tilt exceeded 0. Ulna styloid fractre did adversely affect the clinical results. In our study 2mm articular step off did not show any difference in clinical results. But this is thought to be the result of relatively short period of follow up. Therefore we need to analyse this factor with long term follow up data.

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Surgical Treatment of Tibial Plateau Fracture: Validity of Arthroscopy: Shin Kang Cho, Jung Dae Oh, Young Sik Lee, Jin Tae Choi, Gyeong Hin Lim; J Korean Soc Fract 1997;10(4):832-842. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.832

Abstract PDF

Twenty tibial plateau fractures were surgically treated by means of the double images of the arthroscopy and the image intensifier. The purpose of this attempt was (1) obtaining more anatomical reduction of articular margin, (2) preventing knee joint from the surgical dissection and (3) simultaneous diagnosis & management of the combined meniscus and ligament injuries. Three aims of this study are searching for (1) the indications of the arthroscopic surgery for the libial plateau fractures, (2) the techniques of the arthroscopic surgery for reduction and fixation and (3) the techniques for reducing the risk of the arthroscopic surgery. As a result, we can obtain more anatomical reduction and excellent or good functional knee score after follow-up study of a mean of 1 year and 9 months. There is no complication with regard to arthroscopic surgery. But anatomical reduction of the bicondyle fractures with severe articular and metaphyseal comminution was technically difficult. So, the other technique as if open reduction will be needed.

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Arthroscopically-Assisted Reduction and Internal Fixation of Intra-Articular Fractures of the Lateral Tibial Plateau
Juhan Kim, Dong Hwi Kim, Jae-Hwan Lim, Hyunwoong Jang, Young Wook Kim
Journal of the Korean Orthopaedic Association.2019; 54(3): 227. CrossRef
Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating
In-Jung Chae, Sang-Won Park, Soon-Hyuck Lee, Won Noh, Ho-Joong Kim, Seung-Beom Hahn
Journal of the Korean Fracture Society.2009; 22(4): 252. CrossRef

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