Journal of Musculoskeletal Trauma

The Clinical and Radiological Results of Vancouver Type B1 and C Periprosthetic Fractures: Bo Ram Na, Taek Rim Yoon, Kyung Soon Park; J Korean Fract Soc 2016;29(1):26-33. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.26

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the clinical and radiologic results of plate fixation in the Vancouver B1 and C periprosthetic femoral fracture (PFF).
MATERIALS AND METHODS
Twenty patients who had sustained a Vancouver type B1 and C periprosthetic fracture after hip arthroplasty (years 2002-2012) were identified. The mean age was 66.0 years (range, 43-85 years) and the mean follow-up duration of the group was 38 months (range, 12-102 months). The dynamic compression plate (DCP) group included 12 patients and the locking compression plate (LCP) group included eight patients. Harris hip score (HHS) and walking ability, knee joint range of motion (ROM) were compared before injury and last follow-up. Fracture union rate and period were compared.
RESULTS
The mean HHS score was 90.7 (64-96). There was no statistical difference between the two groups. At the last follow-up, knee joint ROM was 103.3degrees (105degrees-140degrees) in the DCP group and 118.4degrees (110degrees-140degrees) in the LCP group, showing good results in the LCP group (p=0.043). No significant difference in the fracture union rate and union periods was observed between the two groups.
CONCLUSION
A better result for the postoperative knee flexion exercise capacity was observed in the LCP group. Use of LCP plate fixation is a good option in management of Vancouver classification B1 and C PFF.

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Negative Pressure Wound Therapy for Traumatic Soft Tissue Defects: Keun Bae Lee, Jin Choi, Eun Sun Moon, Taek Rim Yoon, Keun Young Lim; J Korean Fract Soc 2006;19(1):67-71. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.67

PURPOSE
To evaluate the negative pressure wound therapy for traumatic soft tissue defects by vacuum-assised closure (V.A.C.(R)).
MATERIALS AND METHODS
33 patients with traumatic soft tissue defects were treated by using V.A.C.(R) which removes edema fluid, eliminates an extrinsic cause of microcirculatory embarrassment and may directly stimulate cellular proliferation of reparative granulation tissue. We removed all necrotic tissue prior to application of the V.A.C.(R). The foam dressing was placed into direct contact with wound and was changed every 48~72 hours. The setting for vacuum pump was continuous pressure of 100 to 125 mm Hg. C-reactive protein was checked to evaluate wound infection. We measured wound size and total duration of treatment.
RESULTS
Mean duration of treatment was 25.2 days and mean decrease of wound size was 31.9%. The concentration of CRP after V.A.C.(R) therapy reduced by day 8 below 1.0 mg/dl and gradually decreased to normal level by day 10. All patients showed hastened wound healing by rapid formation of granulation tissue.
CONCLUSION
Negative pressure wound therapy is useful in patients with traumatic soft tissue defects, which reduces treatment duration and cost by rapid wound healing and effective infection control.

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Negative-Pressure Wound Therapy Using Modified Vacuum-Assisted Closure in Patients with Diabetic Foot Ulcers
Bong Jae Kim, Ji Hye Suk, A Ra Jo, Jong Kun Ha, Chan Woo Jung, Seong Oh Park, Hyung Taek Park, Mi Kyung Kim
Journal of Korean Diabetes.2011; 12(2): 122. CrossRef
Acute Management of Soft Tissue Defect in Open Fracture
Ki-Chul Park
Journal of the Korean Fracture Society.2010; 23(1): 155. CrossRef

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Use of Cancellous Bone Allograft in the Treatment of Long bone Fractures: Keun Bae Lee, Taek Rim Yoon, Jae Yoon Chung, Sung Taek Jung, Jae Joon Lee; J Korean Soc Fract 2001;14(4):776-782. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.776

Abstract PDF

PURPOSE
The goal of our study was to evaluate the usefulness of frozen cancellous bone allograft in the treatment of long bone fractures that had bone defect and nonunion.
MATERIALS AND METHODS
22 cases of long bone fractures(femur and tibia) with severe comminution or bone defect and nonunion were treated by operation using frozen cancellous bone allograft from March 1998 through May 2000. Thirteen were male and nine were female. The average age was 55 years old (range, 17-76 years) and the mean duration of follow-up was 20.1 months(range, 10-37 months). Eleven cases were femoral fractures, 7 cases of tibial fractures, and 4 cases of nonunion. Allografts were achieved from the patients of femoral neck fracture or osteoarthritis of the hip, and cadaveric donors. The specimens were carefully evaluated based on medical history and laboratory examination about the acute or chronic infection, and bloodtransmitted diseases. The results were evaluated by clinically, such as infection, pain at fracture site, immunological rejection and by radiologically union or resorption of allografts.
RESULTS
Radiologically, bone union was obtained in 14 cases(63.6%) at 6 months after operation, in all except two cases(90.9%) at 9 months after operation. Clinically, pain at fracture site, infection, and immunologic rejection were not observed.
CONCLUSION
In the treatment of severe comminuted fracture or nonunion of long bones, cancellous allograft transplantation after strict donor selection and appropriate screening was a good substitution for autograft avoiding of donor site morbidity or limitation in quantity.

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Influence of Process Conditions on the Quality Characteristics of Beef-Bone Broth
Byung-Su Kim, Gye-Won Kim, Jae-Yong Shim
Food Engineering Progress.2014; 18(1): 15. CrossRef

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Treatment of subtrochanteric fracture - Comparison of treatment efficacy according to internal fixation device -: Taek Rim Yoon, Sung Man Rowe, Eun Kyoo Song, Jong Yoon Seol, Sang Gyoo Shin; J Korean Soc Fract 2001;14(2):189-199. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.189

Abstract PDF

PURPOSE
The purpose of this study was to compare the clinical results of subtrochanteric fractures which were treated with compression hip screw, intramedullary nailing and Rowe plate.
MATERIALS AND METHODS
From 1991 to 1999, 84 cases of subtrochanteric fractures were treated in Chonnam national university hospital. Among them, 25 cases were treated with compression hip screw, 18 cases with interlocking IM nailing and 32 cases with Rowe plate. Excluding pathologic fracture, there were 24 cases(group A), 16 cases(group B) and 30 cases(group C) of subtrochanteric fractures which were followed over 1 year. Mean follow up period was 18, 21, 24 months each. We compared the fracture pattern, operation time, operation method, additional fixation, bone union and complications among the groups.
RESULTS
We devided subtrochanteric fracture into below class II and above class III based on Seinsheimer classification. The overall clinical results were 1 case below class II, 22 above III in group A, 12 below II, 6 above II in group B, and 4 below II, 26 above III in group C. The average operation time was 153 minutes in group A, 166 in group B, and 150 in group C. Additional wiring was performed in 15 cases in group A, 1 in group B and 6 in group C. Interfragmentary screw fixation was performed only in group A(12 cases). Bone graft was performed in 6 cases in group A, 6 cases in group B and 11 cases in group C. The complications were as follows; delayed union 1 case in group A, 2 cases in group B and 6 cases in group C.; Nonunion only 1 case in group B; varus deformity 4 cases in group B and 2 cases in group C; metal failure 1 case in group B and 1 case in group C.
CONCLUSIONS
In treatment of subtrochanteric fractures, compression hip screw was applied to more communited fractures than intramedullary nail, but with additional fixation safe union and excellent clinical outcomes obtained. For intramedullary nailing, great care should be taken not to produce varus malalignment. In plate fixation, we should keep in mind the possibility of metal failure and varus malalignment. Weight bearing should be delayed.

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Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
Hip & Pelvis.2014; 26(2): 107. CrossRef
Efficacy of Percutaneous Cerclage Wiring in Intramedullary Nailing of Subtrochanteric Femur Fracture - Technical Note -
Ki-Chul Park, Hee-Soo Kim
Journal of the Korean Fracture Society.2013; 26(3): 212. CrossRef
The Treatment of Subtrochanteric Fracture with Cephallomedually Nail -Minimal Incision and Lowman Clamp Assisted Reduction-
Jang Seok Choi, Do Hyun Moon, Young Tae Noh
Journal of the Korean Fracture Society.2011; 24(4): 301. CrossRef

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Surgical Treatment of Subtrochanteric Fracture with Compression Hip Screw: Taek Rim Yoon, Sung Man Rowe, Keun Bae Lee, Jae Il Oh; J Korean Soc Fract 2001;14(1):1-7. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.1

Abstract PDF: PURPOSE
The purpose of this study was to review the clinical results of 23 cases of subtrochanteric fractures which were treated with compression hip screw fixation and evaluation of the advantage of lateral position.
MATERIALS AND METHODS
From December 1993 to October 1999, 23 cases(l4 male, 9 female) of subtrochanteric fractures were treated with open reduction and internal fixation using compression hip screw. The mean age was 51.3 years(range, 18-89 years). All operations were done on the standard surgical table in lateral position, and additional fixation was done by supplementary screw fixation or cerclage wiring in 19 cases.
RESULTS
All patients (100%) went on to union on the average of 15 weeks (range l2-28 weeks). There were no complications, such as nonunion, malunion, or fixation loss. There was one delayed union which revealed radiographical bony union at postoperative 7 months.
CONCLUSION
Fixation with compression hip screw with or without additional fixation was thought to be a recommendable method of treatment for subtrochanteric fracture. The surgical procedure with the patient on lateral position enabled the surgeon to do interfragmentory fixation more safely and effectively with less disturbance of soft tissues attached to the fractured fragment.

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Internal fixation with pelvic plate for displaced Acetabular Fracture: Taek Rim Yoon, Sung Nam Jung, Sang Jin Park, Eun Kyoo Song; J Korean Soc Fract 2000;13(4):733-740. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.733

Abstract PDF

PURPOSE
The purpose of this study was to review the clinical and radiographic results after plate fixation for displaced acetabular fracture.
MATERIALS AND METHODS
A clinical analysis was performed on 47 cases of displaced unstable acetabular fracture which had been fixed with plates and screws. Clinical and radiographical results were analyzed according to Epstein criteria.
RESULTS
In 44 cases, internal fixation was performed using only plate and screws. In three cases, the fixation was augmented with cerclage wiring. The fracture type included posterior wall or posterior column fracture in 37 cases(78.7%). Satisfactory results were achieved in 39 cases(86.7%) on clinical grade and 40 cases(88.9%) on radiographic grade. The complications were deep wound infection in two cases, avascular necrosis of femoral head in one case, post traumatic arthritis in 2 cases, and malunion with partial ankylosis in one case. Total hip arthroplasty were needed in two cases with avascular necrosis and infection.
CONCLUSION
Early surgical treatment including accurate anatomical reduction and stable internal fixation is emphasized for better clinical and radiographic results. The plate and screw fixation is well indicated for posterior wall and/or posterior column fracture of acetabulum.

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Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture
Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong
Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef
Comparative Results of Acetabular Both Column Fracture According to the Fixation Method
Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park
Hip & Pelvis.2011; 23(2): 131. CrossRef
Treatment of Acetabular Column Fractures with Limited Open Reduction and Screw Fixation
Jung-Jae Kim, Hyoung Keun Oh, Sung-Yoon Kim
Journal of the Korean Fracture Society.2007; 20(1): 26. CrossRef

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Treatment of the Femoral Shaft Fractures with Interlocking Compression Nail: Sung Taek Jung, Taek Rim Yoon, Jong Keun Seon; J Korean Soc Fract 1998;11(2):281-287. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.281

Abstract PDF

The results of treatment of femoral shaft fractures with interlocking compression nail, the third generation nail, were evaluated to determine the incidence of union of the fracture & clinical usefulness. Fifty-three femoral fractures that had been treated by interlocking compression nailing between February 1994 and March 1996 and had been followed for more than twelve months were included in this study. forty-eight cases were fresh closed fracture and five, fresh open fracture. The results were as follows 1. According to Winquist-Hansen classification, 25 cases were type I, 13 type II, 7 type III, 5 type IV, 3 type V. 2. Union occurred in 52(97%) of 53 femoral shaft fractures. The mean fracture union period was 18.1 weeks with a range of 10 to 32 weeks. 3. Postoperative complication were delayed union(5 cases), leg length discrepancy(2 cases) and nonunion(1 case). We concluded that interlocking compression nailing for femoral shaft fracture seems to promote the fracture healing process without conversion to dynamic intramedullary fixation.

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Additive Manufacturing of Patient-specific Femur Via 3D Printer Using Computed Tomography Images
Wang Kyun Oh, Ki Seon Lim, Tea Soo Lee
Journal of the Korean Society of Radiology.2013; 7(5): 359. CrossRef

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Double-Plating in the Comminuted Supracondylar Fracture of the Distal Femur: Taek Rim Yoon, Sung Taek Jung, Hyoung Yeon Seo; J Korean Soc Fract 1997;10(4):778-784. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.778

Abstract PDF: Supracondylar fracture of femur is not well suited to internal fixation. A wide canal, a thin cortex, comminution and compound wound make open reduction more difficult. Especially, type C2 and C3 on AO classification is problematic. The cases of nine patients who had type C2 or C3 fracture including three open fractures and deficient medial-cortical buttress were reviewed. Stable fixation was achieved with the lateral condylar buttress plate. Additional stabilization with a medial plate and bone graft from the iliac crest was applied in all nine patients. At an average duration of follow-up nineteen months(range from twelve to forty-eight months), all of the fracture had healed. Evaluation of the functional outcome revealed two excellent, three good and four fair results. In three patient, less than 90 degree of flexion of the knee was present and in six, the arc of flexion was limited to between 90 and 110 degrees. One patient had two centimeter shortening, one had medial screw loosening which need not additional fixation. The results of our study suggest that, for the treatment of patients who have a difficult fracture in whom stable fixation of the distal part of the femur cannot be achieved with a condylar buttress plate because of medial cortical communition, a short distal condylar fragment, or loss of metaphyseal bone, double-plating is indicated.

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