Journal of Musculoskeletal Trauma

The Antibiotic Cement Coated Nail and Masquelet Technique for the Treatment of Infected Nonunion of Tibia with Bone Defect and Varus Deformity: Min Gu Jang, Jae Hwang Song, Dae Yeung Kim, Woo Jin Shin; J Korean Fract Soc 2022;35(1):26-30. Published online January 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.1.26

Abstract PDF: Infective nonunion after fracture surgery can cause persistent pain and inflammatory exudate in patients, requiring long-term treatment. To treat infective nonunion, radical debridement of infective bone and soft tissue should be performed, followed by stable internal fixation and bone graft. Multiple treatment strategies need to be considered according to the classification of chronic osteomyelitis, size of the bone defect, degree of bone malalignment, and severity of the soft tissue injury. This paper reports a case of a patient treated with an antibiotic cement-coated nail and a Masquelet technique to treat the infected nonunion of the tibia with a bone defect and varus deformity.

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Rendezvous Surgery for Peri-Implant Fractures around Locking Compression Plate on Anterolateral Bowed Femur - A Case Report -: Hong Man Cho, Jiyeon Park; J Korean Fract Soc 2020;33(3):159-163. Published online July 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.3.159

Abstract PDF: An 84-year-old female visited with an intertrochanteric femoral fracture. The patient had undergone an open reduction and internal fixation with a compressive plate and elastic nail in an ipsilateral atypical diaphyseal femoral fracture in the past. Compressive plate and elastic nail remained, and anterolateral bowing was presented. To treat the periprosthetic trochanteric fracture, a proximal femoral nail was used without removing the previously inserted compressive plate. Under the “rendezvous” technique, using a combination of fixating intramedullary nail and compressive plate simultaneously, the distal screw was fixed, and a femoral head lag screw was inserted after reducing the fracture. Complete union of the fracture was achieved 16 months after the operation, and a decrease in mobility function was not found postoperatively. The authors report this case for the “rendezvous” technique as a treatment option for elderly patients with periprosthetic trochanteric fractures, who had previously undergone surgical treatment for ipsilateral atypical diaphyseal femoral fractures with anterolateral bowing.

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Outcomes following Treatment of Geriatric Distal Femur Fractures with Analyzing Risk Factors for the Nonunion: Soo young Jeong, Jae Ho Lee, Ki Chul Park; J Korean Fract Soc 2019;32(4):188-195. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.188; Correction in: J Musculoskelet Trauma 2020;33(1):62

PURPOSE
Many international journals have published studies on the results of distal femoral fractures in elderly people, but only a few studies have been conducted on the Korean population. The aim of this study was to determine the factors that are associated with the outcomes and prognosis of fixation of distal femur fractures using the minimally invasive plate osteosynthesis (MIPO) technique in elderly patients (ageâ‰¥60) and to determine the risk factors related witht he occurrence of nonunion.
MATERIALS AND METHODS
This study is a retrospective study. From January 2008 to June 2018, distal femur fracture (AO/OTA 33) patients who underwent surgical treatment (MIPO) were analyzed. A total of 52 patients were included in the study after removing 121 patients that met with the exclusion criteria. Medical records, including surgical records, were reviewed to evaluate the patients' underlying disease, bone mineral density, the number of days delayed from surgery, complications and mortality. In addition, follow-up radiographs were used to determine bone union, delayed union and nonunion.
RESULTS
The average time to achieve bone union was 19.95 weeks, the rate of nonunion was 20.0% (10/50) and the overall mortality was 3.8% (2/52). There were no significant differences in the clinical and radiological results of those patients with or without periprosthetic fracture. On the univariate analysis, which compared the union group vs. the nonunion group, no factors were identified as significant risk factors for nonunion. On the multiple logistic regression analysis, medical history of cancer was identified as a significant risk factor for nonunion (p=0.045).
CONCLUSION
The rate of nonunion is high in the Korean population of elderly people suffering from distal femur fracture, but the mortality rate appears to be low. A medical history of cancer is a significant risk factor for nonunion. Further prospective studies are required to determine other associated factors.

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Comparison of Clinical Outcomes for Femoral Neck System and Cannulated Compression Screws in the Treatment of Femoral Neck Fracture
Jae Kwang Hwang, KiWon Lee, Dong-Kyo Seo, Joo-Yul Bae, Myeong-Geun Song, Hansuk Choi
Journal of the Korean Fracture Society.2023; 36(3): 77. CrossRef

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Operative Treatment of Pediatric Distal Forearm Bothbone Fracture: Sang Uk Lee, Changhoon Jeong, Il Jung Park, Jaeyoung Lee, Seman Oh, Kyung Hoon Lee, Sanghyun Jeon; J Korean Fract Soc 2015;28(4):237-244. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.237

Abstract PDF: PURPOSE
Pediatric patients with distal forearm bothbone fractures of surgical indication were treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna at our institution. The purpose of this study is to evaluate clinical and radiological results.
MATERIALS AND METHODS
From February 2012 to June 2014, we retrospectively evaluated 16 out of 18 cases with distal forearm bothbone fractures treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna with at least 1-year follow-up. The average age at operation was 9.1 years (7-13 years).
RESULTS
Adequate reduction for both radius and ulna was achieved for all cases, and none of the cases showed re-displacement until the last follow-up. Mean 6.6 weeks lapsed until bony union was observed for the radius. For the ulna, the mean was 6.5 weeks. All patients gained full wrist range of motion at the last visit.
CONCLUSION
For pediatric distal forearm bothbone fractures, intrafocal Kapandji reduction and internal fixation with Kirschner wire for radius and reduction and internal fixation with a flexible intramedullary nail for ulna is the technique for handy reduction. Use of this technique can prevent re-displacement during the union process and achieve excellent clinical and radiologic results.

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Comparison of Treatment Methods in Gartland Type III Pediatric Supracondylar Humeral Fracture: Lateral Entry Pin versus Crossed-Pin Technique: Young Hoon Jo, Tai Seung Kim, Dong Yun Kim; J Korean Fract Soc 2015;28(3):186-193. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.186

Abstract PDF: PURPOSE
The aim of this study was to compare the results of the lateral entry pin technique and the crossed pin technique in treatment of Gartland type III humerus supracondylar fracture.
MATERIALS AND METHODS
Seventeen patients (group I) underwent surgery using the lateral entry pin technique, and 33 patients (group II) underwent surgery using the crossed pin technique for Gartland type III humerus supracondylar fracture in Hanyang University Seoul Hospital between January 2011 and January 2014. Maintenance of reduction was compared between the 2 surgical techniques by measuring changes in Baumann angle and lateral humerocapitellar angle after surgery and after pin removal in groups I and II. In addition, the final carrying angle and level of loss of functional movement were measured for comparison of clinical results between the 2 groups. Occurrence of ulnar nerve palsy in the 2 groups was also examined.
RESULTS
The mean Baumann angle and lateral humerocapitellar angle changes were 3.3degrees and 3.7 in group I and 3.1degrees and 3.4degrees in group II, respectively. No statistically significant differences were found between the 2 groups. Clinical results showed that the changes in the final carrying angle and range of motion were 2.9degrees and 2.6degrees in group I and 2.6degrees and 3.0degrees in group II, respectively, indicating no significant differences between the 2 groups. In terms of nerve damage, 1 patient in group II had temporary iatrogenic ulnar nerve palsy.
CONCLUSION
The lateral entry pin technique may be regarded as an appropriate treatment that reduces the risk of iatrogenic ulnar nerve palsy and provides satisfactory results in Gartland type III humerus supracondylar fracture patients.

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Steinmann Pin Assisted Reduction of Subtrochanteric Femoral Fracture: Seung Wan Lim, Oog Jin Shon; J Korean Fract Soc 2015;28(1):17-22. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.17

Abstract PDF

PURPOSE
Nail insertion is the treatment of choice for subtrochanteric femoral fracture, but displacement of proximal bone fragment makes it difficult to find an ideal entry point. Therefore, in this study we aimed to determine the usefulness of treatment of subtrochanteric femoral fracture using Steinmann pin assisted reduction, internal fixation, and insertion of intramedullary nails.
MATERIALS AND METHODS
We evaluated 33 patients who were followed-up more than a year with a displaced subtrochanteric femoral fracture treated with closed reduction and intramedullary nail fixation between January 2008 and March 2013. In addition, we studied postoperative bone union time, postoperative reduction status, change of the femur neck shaft angle, evaluation of hip joint function, return to daily life, and complications.
RESULTS
All fractures with Steinmann pin assisted reduction were united but they included three cases of delayed union. In Fogagnolo classification, all cases were up to acceptable states and the varus change of femur neck shaft angle was 0.94degrees+/-3.1degrees; no significant difference in Harris hip score was observed between preoperative and last follow-up (p>0.05).
CONCLUSION
There were satisfactory results in bone union and reduction state with Steinmann pin assisted reduction. Therefore, Steinmann pin assisted reduction is a useful surgical technique for subtrochanteric femoral fracture.

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Percutaneous acetabular anchoring pin-assisted cephalomedullary nailing for subtrochanteric and unstable intertrochanteric fractures
Keong-Hwan Kim, Youngsik Yoon, Eic Ju Lim
Injury.2020; 51(3): 769. CrossRef

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The Result Treated by Open Reduction and Internal Fixation with Minimally Invasive Technique in Joint Depressive Calcaneal Fracture: Sueng Hwan Jo, Jun Young Lee, Sang Ho Ha, Sung Won Cho, Sang Ha Park; J Korean Fract Soc 2013;26(2):126-132. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.126

Abstract PDF

PURPOSE
To evaluate the short term follow-up results of minimally invasive technique in the management of Sanders type II, III, and IV joint depressive calcaneal fracture.
MATERIALS AND METHODS
Between May 2008 and May 2011, we studied 17 cases undergoing treatment with minimally invasive technique with modified sinus tarsi approach for Sanders II, III, and IV joint depressive intra-articular calcaneal fracture and were followed up for more than 1 year. We evaluated the treatment result by assessing the radiologic parameters (Bohler angle, Gissane angle, and calcaneal height/width/length) and clinical outcomes (American Orthopaedic Foot and Ankle Society [AOFAS] score and visual analog scale [VAS]) and investigating the complication.
RESULTS
Radiological results improved from 7.9degrees to 19.8degrees in the Bohler angle after the operation. Satisfactory results were obtained in clinical assessment with average AOFAS score of 82.45 and the average VAS score of 3.94. We experienced 3 cases of complications, 1 case of superficial wound infection and radiologic findings of subtalar arthritis in 2 cases.
CONCLUSION
Minimally invasive technique may be a useful alternative surgical method in the management of Sanders type II, III, and IV joint depressive calcaneal fracture that cannot adopt extensile approach, which enable to obtain good radiological and clinical results.

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Outcomes of Minimally Invasive Surgery in Intra-Articular Calcaneal Fractures: Sanders Type III, Joint Depressive Type Calcaneal Fracture
Je Hong Ryu, Jun Young Lee, Kang Yeol Ko, Sung Min Jo, Hyoung Tae Kim
Journal of the Korean Fracture Society.2023; 36(3): 85. CrossRef
Towards uniformity in communication and a tailor-made treatment for displaced intra-articular calcaneal fractures
Tim Schepers
International Orthopaedics.2014; 38(3): 663. CrossRef

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Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques: Oog Jin Shon, Ji Hoon Shin, Chul Wung Ha; J Korean Fract Soc 2013;26(1):50-55. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.50

Abstract PDF: PURPOSE
We evaluated the clinical outcomes of tibia segmental fractures treated by intramedullary nailing using various reduction techniques.
MATERIALS AND METHODS
From January 2003 to June 2009, 18 segmental tibial fracture patients treated by intramedullary nail were enrolled with a minimum 12-month follow-up. The mean follow-up was 38 months (range 15-72). According to the AO classification, the fractures were types 42C2.1, 42C2.2, and 42C2.3 in four, ten, and four patients, respectively. Ten fractures were closed and eight were open. We used various techniques for reduction during operation and investigated bone union time and complication (non-union, malunion etc.).
RESULTS
Bone grafting was performed in three patients. Complete union was achieved in all patients. The mean time for union was 16.3 weeks (range 12-21), except in three delayed union patients. All radiological evaluations showed good alignment (less than 5 degree) except in two patients; and the mean deformity angle was 2.2 degree. Knee range of motion (ROM) was 129 degree, and ankle ROM was 68 degree. Local wound infection occurred in two patients.
CONCLUSION
Intramedullary nailing is a successful method in the acute management of segmental tibial fractures, if accompanied by appropriate reduction technique.

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Results of the Kapandji Procedure in the AO Type C Distal Radius Fracture in Patients over Age 60: Chul Hong Kim, Sung Soo Kim, Myung Jin Lee, Hyeon Jun Kim, Bo Kun Kim, Young Hoon Lim; J Korean Fract Soc 2012;25(3):191-196. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.191

Abstract PDF: PURPOSE
To evaluate the clinical and radiologic results of the Kapandji procedure in AO classification type C distal radius fracture patients over 60 years old.
MATERIALS AND METHODS
Twenty-one type C distal radius fracture patients over the age of 60 years who were treated with the Kapandji procedure from June 2004 to June 2009 in our hospital and had a post-operative follow-up period of more than 1 year were enrolled. The volar tilt, radial inclination, and radial length were measured for the radiographic analysis using the modified Lidstrom scoring system about post-operative reduction loss in every follow-up radiogram. The clinical result was assessed with a visual analogue scale (VAS) and Korean Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) score at the last follow-up.
RESULTS
The mean radiologic loss of volar tilt was 1.1degrees and the mean loss of radial length was 2.6 mm and the mean radial inclination loss was 2.7degrees compared with the immediate post-operative period and last follow-up period. The average VAS and DASH scores were 1.4 and 15.9.
CONCLUSION
The radiologic results of closed reduction and percutaneous pinning using the Kapandji technique for distal radius AO type C fracture patients over 60 years of age was not satisfactory. Nevertheless, the clinical results were satisfactory.

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Treatment of Tibial Plateau Fractures Using a Locking Plate and Minimally Invasive Percutaneous Osteosynthesis Technique: Hee Gon Park, Dae Hee Lee, Kyung Joon Lee; J Korean Fract Soc 2012;25(2):110-116. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.110

Abstract PDF: PURPOSE
To acknowledge the importance of precise reduction of articular surface of tibial plateau fractures and to make a guideline of treatment by evaluating outcomes and effectiveness of using locking plate and minimally invasive percutaneous osteosynthesis technique.
MATERIALS AND METHODS
Twenty-nine patients who underwent surgery for tibial plateau fracture from November 2005 to March 2010 were enrolled with 12 months follow-up in a retrograde manner. The Shatzker classification was used to classify fractures, and we used lateral submeniscal approach to make a precise reduction of articular surface. Radiologic evaluation was determined by presence of bone union, malalignment, and reduction loss or joint depression of articular surface. Post-operative infection, time of active movement of the knee joint, time of partial weight loading, and range of motion (ROM) of knee joint were evaluated. Lysholm Knee Score was used for functional evaluation.
RESULTS
Bone union took place in all but one case that developed osteomyelitis. Angulation deformity of more than 10degrees and reduction loss or joint depression of more than 5 mm were not observed. There was one case of osteomyelitis and one case of superficial surgical site infection. There were satisfactory clinical results, with an average time of active knee joint movement and weight loading of 6 weeks. The average ROM of knee joint was 125degrees in the last follow up. As for functional evaluation using Lysholm Knee Score, cases showed an average Lysholm Knee Score of 94 which was a satisfactory result.
CONCLUSION
In cases of tibial plateau fractures, if a surgeon accurately reduces the articular surface of joint and use minimally invasive locking plate it will help in bone union biologically, reducing the incidence of soft tissue injuries, and biomechanically maintaining the articular surface of the joint, proving itself to be a useful method of treatment.

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Minimally Invasive Plate Osteosynthesis for the Upper Extremity Fracture Using a Lumbar Spreader: Surgical Technique: Gu Hee Jung, Chyul Hyun Cho, Jae Do Kim; J Korean Fract Soc 2011;24(1):83-86. Published online January 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.1.83

Abstract PDF: The minimally invasive plate osteosynthesis (MIPO) which is extensively performed, is very dependent on the indirect reduction technique to prevent the exposure of fracture sites. Indirect reduction with the use of the femoral distractor is a much more efficient technique to restore the length in the fracture of lower limbs. However, the femoral distractor cannot be used for fracture of upper limbs, and other instruments for indirect reduction have not yet been reported. Therefore, we introduce the novel indirect reduction technique with the use of the lumbar spreader for the MIPO of upper limbs.

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The 'beta-wire Technique' for the Fixation of Ulnar Styloid Process Fracture: Surgical Technique: Jee Hyoung Kim, Jin Hak Kim, Song Lee, Seung Jin Yang, Chang Wook Yoo, Tae Hwan Chun; J Korean Fract Soc 2010;23(1):104-108. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.104

Abstract PDF

For the fixation of ulnar styloid process fracture, we want to introduce the 'beta-wire technique', which is easy to learn and practice and thought to give a compressive force to the fracture site.

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Korean Medicine Treatments for the Angular Deformity of Wrist Fracture with Disuse Osteopenia: A Case Report
Myung Jin Oh
Korean Journal of Acupuncture.2018; 35(4): 234. CrossRef

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The Amount and Related Factors of Reduction Loss in Distal Radius Fracture after Treatment by Kapandji Technique: Eun Sun Moon, Myung Sun Kim, Il Kyu Kong; J Korean Fract Soc 2007;20(3):252-259. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.252

Abstract PDF

PURPOSE
To evaluate the amount and related factors of reduction loss in distal radius fracture after treatment by Kapandji technique.
MATERIALS AND METHODS
From September 2004 to May 2006, 44 cases (43 patients) of distal radius fractures were treated by Kapandji technique. Fracture were classified with AO classification and volar tilt, radial inclination, and radial length were measured in preoperative, immediate, postoperative radiographs. Also the amount and related risk factors of reduction loss were analyzed. In addition, the radiological results at last follow up were evaluated using modified Lidstrom scoring system.
RESULTS
There was significantly more reduction loss of volar tilt in the patients with AO type C comparing with other fracture types, but the patients who were treated using three k-wire fixations including intrafocal K-wires showed significantly more reduction loss of volar tilt also. Overall radiological results at last follow up showed that excellent was 50% in cases with dorsal comminution, but, the other cases 90%. In addition, excellent was 70% in type A cases, but, in type C 44%.
CONCLUSION
Kapandji technique percutaneous pinning is the one of effective treatment options for distal radius fracture. But, type of fracture, total number of K-wires, and presence of dorsal cortical comminution showed the significant relation with postoperative reduction loss of volar tilt and overall radiological results at last follow up.

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Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate
Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef
Comparative Analysis of the Results of Fixed-angle versus Variable-angle Volar Locking Plate for Distal Radius Fracture Fixation
Seung-Do Cha, Jai-Hyung Park, Hyung-Soo Kim, Soo-Tae Chung, Jeong-Hyun Yoo, Joo-Hak Kim, Jung-Hwan Park
Journal of the Korean Fracture Society.2012; 25(3): 197. CrossRef
Results of the Kapandji Procedure in the AO Type C Distal Radius Fracture in Patients over Age 60
Chul Hong Kim, Sung Soo Kim, Myung Jin Lee, Hyeon Jun Kim, Bo Kun Kim, Young Hoon Lim
Journal of the Korean Fracture Society.2012; 25(3): 191. CrossRef

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Modified Phemister Technique with Tension Band Wiring in Acromioclaviculr Joint Dislocation: Yu Jin Kim, Hun Kyu Shin, Ji Won Lee; J Korean Fract Soc 2006;19(4):431-436. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.431

Abstract: PURPOSE
To evaluate the clinical and radiological result of surgical treatment of acromioclavicular joint dislocation, using modified Phemister technique with tension band wiring.
MATERIALS AND METHODS
We chose 17 patients who were able to follow up 1 year or more among the patients who were diagnosed as acromioclavicular joint dislocation in our hospital through January 2000 to Feburary 2005 and took modified Phemister technique with tension band wiring. Evaluation of the surgical results was done with the condition of pain, activity of daily living, range of motion, muscle tone by constant score system, and with preoperative, postoperative and last follow up radiographs.
RESULTS
Clinical evaluation was average 92 point by Constant score system from 84 point to 100 point. Subjective evaluation was 11 excellent (65%), 6 good (35%). Radiological evaluation was 9 excellent (54%), 6 good (38%), 2 fair (12%), and no poor group. On the final follow up, two cases showed inflammatory reaction at where pins were inserted, but after the removal of the pins, the inflammation was subsided.
CONCLUSION
The modified Phemister surgery for acromioclavicular dislocation is one of effective techniques, we can obtain firm fixation, exercise full range of motion early and there is no complication of re-dislocation.

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The Result of the Modified Extension Block Technique in Bony Mallet Finger: Seung Rim Yi, Sung Ho Hahn, Bo Kyu Yang, Yang Joon Ahn, Jae Hoo Yoo, Yong Beom Yeo, Sung Woo Bin; J Korean Fract Soc 2006;19(2):236-240. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.236

Abstract

PURPOSE
To evaluate the treatment outcomes of the modified extension block technique for bony mallet finger.
MATERIALS AND METHODS
This study included 16 patients who had been treated with the modified extension block technique for bony mallet finger from December 2002 to January 2004. The average duration of follow up was 13 (12~17) months. The indication of operation was the presence of a large bony fragment invading more than 1/3 of the articular surface or the palmar subluxation in the distal interphalangeal joint.
RESULTS
The average extension lag was 2.3 degrees, and the range of motion of the distal interphalangeal joint was 68.8 degrees. Radiograph showed bony union state in all cases. By the Crawford's evaluation criteria, 12 cases (75%) was excellent or good. Postoperative complications occurred in 3 cases, which were reduction loss within postoperative 2 weeks in 2 cases and mild pain with motion in 1 case.
CONCLUSION
The modified extension block technique is a easy and simple method. It shows a good result without complications from skin incision. So, it seems a useful method for bony mallet finger.

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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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Treatment of Pediatric Displaced Supracondylar Fractures of the Humerus by Pin Leverage Technique: Han Yong Lee, Joo Hyoun Song; J Korean Fract Soc 2006;19(1):83-88. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.83

Abstract

PURPOSE
To evaluate a new treatment method by pin leverage technique in Gartland type III fractures to avoid forceful manipulation or open reduction.
MATERIALS AND METHODS
99 cases were included in this study and divided into 3 groups (I;open reduction, II; closed reduction and percutaneous pin fixation, III; pin leverage technique), and we analyzed timing to operation, length of operation, associated neurovascular injuries, complications, and clinical and radiological outcomes at final follow-up.
RESULTS
The average length of operation 119, 57, and 68 minutes respectively. The associated nerve injuries were 8, 2, and 2 cases respectively. There were a case of superficial pin tract infection in group I, three cases of superficial pin tract infection and a case of iatrogenic ulnar nerve injury in group II. At final follow-up, clinical results were excellent or good in all cases and there were 5 cases (8.3%) of fair results in group II radiologically. Closed reduction with pin leverage technique were failed in 5 cases.
CONCLUSION
In treatment of Gartland type III fractures, pin leverage reduction technique is considered to be a good alternative prior to open reduction, because it provides shortened length of operation, avoidance of forceful manipulation and open reduction.

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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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Lateral Plate Fixation of Distal Tibial Metaphyseal Fracture Using Minimally Invasive Plate Osteosynthesis Technique: Ki Do Hong, Sung Sik Ha, Nam Sik Chung, Jae Cheon Sim, Sang Cheon Ahn; J Korean Fract Soc 2006;19(1):24-28. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.24

Abstract

PURPOSE
To evaluate the efficiency of lateral plate fixation using minimally invasive plate osteosynthesis (MIPO) technique as a treatment of distal tibial metaphyseal fracture.
MATERIALS AND METHODS
Among the patient who were treated from March, 2002 to September, 2004, the cases of twenty patients with distal tibial metaphyseal fracture treated by lateral plate fixation using MIPO technique who were able to be followed up for at least one-year period were reviewed in this study. According to AO/OTA classification, five were type A1, twelve cases were type A2 and other three cases were type A3, and among them two cases were open fracture type I according to the Gustillo-Anderson classification. Radiologic studies and clinical assessment described by Daniel et al and complication following the treatment were evaluated.
RESULTS
At a mean of 16.4 weeks (range 11 to 23), all fractures united without secondary procedures. According to clinical assessment, all cases had good and excellent result, and there were no complications.
CONCLUSION
The lateral plate fixation using MIPO technique of distal tibial metaphyseal fracture is an efficient method of treatment with high functional recovery rate which minimize soft tissue damage, decreases the risk of infection and incidence of nonunion at the same time as the classic MIPO technique does, and it is a useful alternative method when there is a anteromedial soft tissue damage.

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Minimally Invasive Plate Osteosynthesis for Fractures of Distal Tibia
Tae Hun Kim, So Hak Chung
Kosin Medical Journal.2014; 29(1): 23. CrossRef
Staged Protocol in Treatment of Open Distal Tibia Fracture: Using Lateral MIPO
Oog Jin Sohn, Dong Hwa Kang
Clinics in Orthopedic Surgery.2011; 3(1): 69. CrossRef
Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture
Oog Jin Shon, Dae Sung Kim
Journal of the Korean Fracture Society.2010; 23(1): 42. CrossRef

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Minimally Invasive Plate Osteosynthesis for Distal Tibial Metaphyseal Fracture: Ki Chul Park, Ye Soo Park; J Korean Fract Soc 2005;18(3):264-268. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.264

Abstract PDF

PURPOSE
To retrospectively reviewed the outcomes and advantages of minimally invasive plate osteosynthesis (MIPO) technique as a new treatment of distal tibial metaphyseal fracture.
MATERIALS AND METHODS
Nineteen distal tibial metaphyseal fractures were treated by MIPO technique and evaluated radiologically and functionally. A mean age was 46 years old (range 20~69 years) and a mean follow-up was 15 months (range 6~37 months). Sixteen fractures were not extended into ankle joint (AO/OTA type A1;4, A2;8, A3;4) and three fractures were extended into ankle joint (AO/OTA type C1;2, C2;1). Two cases were open fractures (type I;1, type III-A;1) according to the Gustilo-Anderson classification.
RESULT
At a mean of 18 weeks (range 12 to 24), all fractures united without secondary procedures. A mean score was 94.2 point by Baird ankle scoring system. There were no complications including shortening over 1 cm, mal-alignment over 5 degrees, deep infection, or implant failure.
CONCLUSION
MIPO technique of distal tibial metaphyseal fracture is a worthwhile method with good unions and functional recovery.

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Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures
Ho-Min Lee, Young-Sung Kim, Jong-Pil Kim, Phil-Hyun Chung, Suk Kang, Kaung Suk Jo
Journal of the Korean Fracture Society.2018; 31(3): 94. CrossRef
A Comparison of the Results between Intramedullary Nailing and Minimally Invasive Plate Osteosynthesis in Distal Tibia Fractures
Chul-Hyun Park, Chi-Bum Choi, Bum-Jin Shim, Dong-Chul Lee, Oog-Jin Shon
Journal of the Korean Orthopaedic Association.2014; 49(4): 285. CrossRef
Analysis of the Result Treated with Locking Compression Plate-Distal Tibia and Zimmer Periarticular Locking Plate in Distal Tibia Fracture
Jun-Young Lee, Sang-Ho Ha, Sung-Won Cho, Sung-Hae Park
Journal of the Korean Fracture Society.2013; 26(2): 118. CrossRef
Comparative Analysis of Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Intramedullary Nailing in Distal Tibial Metaphyseal Fractures
Gwang Chul Lee, Jun Young Lee, Sang Ho Ha, Hong Moon Sohn, Yi Kyu Park
Journal of the Korean Fracture Society.2012; 25(1): 20. CrossRef
Clinical Outcomes of Locking Compression Plate Fixation through Minimally Invasive Percutaneous Plate Osteosynthesis in the Treatment of Distal Tibia Fracture
Jae-Sung Yoo, Hyun-Woo Park
Journal of the Korean Fracture Society.2012; 25(2): 117. CrossRef
Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures
Sung-Kyu Kim, Keun-Bae Lee, Keun-Young Lim, Eun-Sun Moon
Journal of the Korean Fracture Society.2011; 24(1): 33. CrossRef
Management of Fractures of Distal Tibia by Minimally Invasive Plate Osteosynthesis through an Anterior Approach
Gu-Hee Jung, Jae-Do Kim, Jae-Ho Jang, Sung-Keun Heo, Dong-won Lee
Journal of the Korean Orthopaedic Association.2010; 45(6): 473. CrossRef
Comparative Study Using of Treatment with Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Interlocking Intramedullary Nailing in Distal Tibia Fractures
Chang Hwa Hong, Jong Seok Park, Sang Seon Lee, Soo Ik Awe, Woo Jong Kim, Ki Jin Jung
Journal of the Korean Fracture Society.2010; 23(3): 296. CrossRef
A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures
Kee-Byung Lee, Si-Young Song, Duek-Joo Kwon, Yong-Beom Lee, Nam-Kyou Rhee, Jun-Ha Choi
Journal of the Korean Fracture Society.2008; 21(4): 286. CrossRef
Minimally Invasive Percutaneous Plate Osteosynthesis Using Periarticular Plate for Distal Tibial Fractures
Young Mo Kim, Jae Hoon Yang, Dong Kyu Kim
Journal of the Korean Fracture Society.2007; 20(4): 315. CrossRef
Treatment of High-energy Distal Tibia Intraarticular Fractures with Two-staged Delayed Minimal Invasive Plate Osteosynthesis
Hong-Moon Sohn, Jun-Young Lee, Sang-Ho Ha, Jae-Won You, Sang-Hong Lee, Kwang-Chul Lee
Journal of the Korean Fracture Society.2007; 20(1): 19. CrossRef

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Double Plating of Proximal Tibial Fractures Using Minimally Invasive Percutaneous Osteosynthesis Technique: Chang Wug Oh, Jong Keon Oh, In Ho Jeon, Hee Soo Kyung, Il Hyung Park, Byung Chul Park, Woo Kie Min, Ji Ho Lee; J Korean Fract Soc 2005;18(3):250-255. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.250

Abstract PDF

OBJECTIVES
To evaluate the results and its efficacy of double plating for proximal tibial fractures using minimally invasive percutaneous osteosynthesis (MIPO) technique. MATERIAL & METHODS: Twenty-three fractures, followed-up more than 1 year, were included in this retrospective study. There were 18 men and 5 women, and the mean age was 53.5 years-old. According to the AO-OTA classification, five were 41A, 13 were 41C, and 5 were 42. There were four open fractures (grade I- three, grade III A-one case). The plates were fixed on the medial and lateral sides of tibia with MIPO technique. Functional and radiographic results were evaluated by the modified Rasmussen system.
RESULTS
All fractures healed without bone graft, and the mean period for fracture healing was 19.3 weeks (range, 10~32 weeks). All other patients had excellent or good clinical or radiological results, except for two patients of a fair clinical result after a combined injury. Complications included one case of shortening (1 cm) and two cases of mal-alignments (varus less than 10 degrees). There was one case of superficial infection, but no patient showed deep infection.
CONCLUSION
Double plating using MIPO technique can provide favorable results in the treatment of proximal tibial fractures.

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Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures
Jae-Ang Sim, Kwang-Hui Kim, Yong-Seuk Lee, Sang-Jin Lee, Beom-Koo Lee
Journal of the Korean Orthopaedic Association.2014; 49(4): 278. CrossRef
Minimally Invasive Plate Osteosynthesis for Proximal Tibial Shaft Fracture
Young-Soo Byun, Ki-Chul Park, Hyun-Jong Bong, Chang-Hoon Lee
Journal of the Korean Fracture Society.2011; 24(1): 23. CrossRef
Treatment of Proximal Tibia Fractures Using LCP by MIPO Technique
Sang-Ho Ha, Dong-Hui Kim, Jun-Young Lee
Journal of the Korean Fracture Society.2010; 23(1): 34. CrossRef
Staged Minimally Invasive Plate Osteosynthesis of Proximal Tibial Fracture
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Woo-Kie Min, Byung-Chul Park, Kyung-Hoon Kim, Hee-Joon Kim
Journal of the Korean Fracture Society.2009; 22(1): 6. CrossRef

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Modified Tension Band Technique With Looped Pin: Eun Woo Lee, Han Jun Lee, Tae Ho Kim; J Korean Fract Soc 2005;18(1):48-53. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.48

Abstract PDF

PURPOSE
Fixation of fracture using modified tension band is a very useful treatment method, but loss of fixation caused by loosening of K-wires still remain problem. So we have studied the usefulness of modified tension band with looped pin in order to prevent loss of internal fixation.
MATERIALS AND METHODS
From September 1999 to June 2002, we had treated 40 patients with this technique, including 16 patella, 8 olecranon, 8 distal clavicle fractures in which three were nonunion fractures, 5 ankle fractures and 3 acromioclavicular joint separations. We looped the pin which has been used for ring external fixator, in line with its long axis.
RESULTS
After mean postoperative follow-up of 20 months, there were no loosening of looped pin in all cases and we obtained satisfactory results of functional evaluation. There were no complications of nonunion or metallic irritation.
CONCLUSION
We concluded that modified tension band with looped pin could prevent displacement of internal fixation, and reduce the subsequent complications. Especially in elbow and shoulder joint that the displacement of fixation pin occured frequently, It was considered as very useful operative technique.

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Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins
Kyung-Hag Lee, Yohan Lee, Young Ho Lee, Bong Wan Cho, Min Bom Kim, Goo Hyun Baek
Journal of Orthopaedic Surgery.2019;[Epub] CrossRef
Nanostructured ATO Anodes Produced by RF Magnetron Sputtering for Li-Ion Batteries
O. Cevher, U. Tocoglu, H. Akbulut
Acta Physica Polonica A.2015; 127(4): 1065. CrossRef

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Operative Treatment of Patellar Fractures: Dong Hui Kim, Jung Man Kim, In Jun Koh; J Korean Fract Soc 2004;17(4):314-318. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.314

Abstract PDF

PURPOSE
To establish a general guide line in the treatment of the patellar fracture MATERIALS AND METHODS: Twenty three patellar fractures followed for 2.2 years in average, treated with internal fixation were evaluated retrospectively. The primary fixations were the metal screw fixation in 7, the Dall-Miles' cable circumferential fixation in 14 and combination of both methods in 2 cases. The additional fixations were the tension band wiring in 9, the load sharing cable fixation in 3 and combination of both methods in 5 cases. The initial postoperative immobilazation of the knee joint in flexion, preferably 90degrees, for 7 days was effective to gain full range of motion RESULTS: Complete union without displacement was achieved in all cases. Full ROM was achieved in all cases except one.
CONCLUSION
The choice of internal fixation need to be individualized according to the level of comminution, bone strength, fracture site and soft tissue damage. A strong internal fixation, initial immobilization in flexion followed by early ROM exercise were important factors to gain good result.

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Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases
Ji-Hye Geum, Hyeon-Jun Woo, Jong-gyu Kim, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2020; 30(4): 203. CrossRef
Treatment of Transverse Patellar Fracture with Cannulated Screws
Jung-Man Kim, Ju-Seok Yoo, Yong-Jin Kwon, Jang-Ok Cheon
Journal of the Korean Fracture Society.2007; 20(2): 149. CrossRef

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Reduction of Pediatric Forearm Diaphyseal Fractures by Pin Leverage Technique: Soo Hong Han, Duck Yun Cho, Hyung Ku Yoon, Byung Soon Kim, Sung Hoon Kang, Tae Hyung Kim; J Korean Fract Soc 2004;17(1):59-63. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.59

Abstract PDF

PURPOSE
Although the majority of children's forearm diaphyseal fractures may be treated conservatively with closed reduction and cast immobilization, unstable or irreducible fractures are usually treated by surgical management. Authors performed percutaneous pin leverage reduction technique for irreducible displaced diaphyseal fractures. The aim of this study is to determine the efficacy of pin leverage technique in pediatric forearm diaphyseal fractures MATERIALS AND METHODS: In this retrospective study, we reviewed 22 cases of forearm diaphyseal fractures reduced by percutaneous pin leverage technique between 1997 and 2002. We analyzed radiographs, operation time, hospital stay and immobilization period, range of motion, postoperative complications and functional results by Thomas.
RESULTS
Average length of follow up was 28 months with mean age of 10.5 years. All fractures in this series healed less than 2 degrees of diaphyseal angulation. Average operation time including anesthesia was 42 minutes and hospital stay was 4.6 days. Time to union was 49.6 days in average and range of motion and functional results were satisfactory in all cases except one case of congenital radioulnar synostosis. There was one case of superficial pin track infection as complication.
CONCLUSION
In operative treatment of children's diaphyseal fractures of forearm bones, percutaneous pin leverage reduction technique is a good alternative method prior to open reduction in case of difficult closed reduction.

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Pediatric Forearm Bone Fractures Treated with Flexible Intramedullary Nail
Suk Kyu Choo, Jin Hwan Kim, Hyung Keun Oh, Dong Hyun Kim
Journal of the Korean Fracture Society.2007; 20(2): 190. CrossRef

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

Abstract PDF

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

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The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture
Seong-Jun Ahn, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Seong-Ho Yoo, Kwan-Taek Oh
Journal of the Korean Fracture Society.2013; 26(4): 314. CrossRef
Treatment of Distal Femur Fracture with Minimally Invasive Locking Compression Plate Osteosynthesis
Ki-Chul Park, Kyu-Sung Chung, Joon-Ki Moon
Journal of the Korean Fracture Society.2012; 25(1): 13. CrossRef
Axial Malalignment after Minimally Invasive Plate Osteosynthesis in Distal Femur Fractures with Metaphyseal Comminution
Jae-Ho Jang, Gu-Hee Jung, Jae-Do Kim, Cheung-Kue Kim
Journal of the Korean Orthopaedic Association.2011; 46(4): 326. CrossRef
Surgical Treatment of AO Type C Distal Femoral Fractures Using Locking Compression Plate (LCP-DF, Synthes®)
Kap-Jung Kim, Sang Ki Lee, Won-Sik Choy, Won-Cho Kwon, Do Hyun Lee
Journal of the Korean Fracture Society.2010; 23(1): 20. CrossRef
What is an Ideal Treatment?
Chang-Wug Oh
Journal of the Korean Fracture Society.2008; 21(4): 347. CrossRef

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The Results of Surgical Treatment of Acute Acromio-clavicular Separation, Type III: Sung Ho Hahn, Bo Kyu Yang, Seung Rim Yi, Shun Wook Chung, Dong Ho Lee, Min Seok Kim; J Korean Soc Fract 2003;16(2):235-243. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.235

Abstract PDF: PURPOSE
The purpose of this study is to compare the Phemister technique with the modified Phemister technique for the patients with Rockwood type 3, acromio-clavicular separation.
MATERIALS AND METHODS
The 45 cases of 45 patients received surgical treatment for Rockwood type 3, acute acromio-clavicular separation in our hospital from Feb. 1992 to Aug. 2001 later with the follow-up study were selected as subjects. The average ages were 28.1 years old, male and female were 42, 3 persons, respectively. Physical examination and plain radiography were used for their diagnosis and the intervals between injury and surgical treatment were 7.8 days. In intraoperative finding, we performed Phemister technique in 15 cases according not to be able to repair coraco-clavicular ligament (group I), modified Phemister technique in 30 cases according to be able to repair that (group II). The average follow up period was 16.2 months, and the UCLA shoulder scoring system and the acromio-clavicular separation scoring system were used to obtain clinical results.
RESULTS
Only in Group II, the complication after surgery were associated with superficial infection in two cases and K-wire migration in one case. At last follow up, there were no pain and limitation of range of motion in all cases, and two cases in Group II were found to be subluxation in radiography. Clinical results revealed excellent was 93.3%, good was 6.7% in UCLA shoulder scoring system in both groups, and excellent was 90%, good was 10% for group II in acromio-clavicular separation scoring system.
CONCLUSION
The results are considered to be good with only Phemister technique in type 3, acute injury occurred in working ages.

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Treatment of Acute Acromioclavicular Dislocation with Modified Phemister Technique: Myung Hwan Son, Byung Chul Kim, Nam Wook Kang, Tae Young Choi; J Korean Soc Fract 1999;12(3):686-692. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.686

Abstract PDF: There are various kinds of operative methods for the treatment of acute acromioclavicular dislocation but many complications such as posttraumatic arthritis, limitation of shoulder motion, and recurrence of dislocation would be developed. We have experienced 23 cases of acute acromioclavicular dislocation treated by modified Phemister technique from January 1992 to January 1997 and followed-up at least 1 year at Department of Orthopaedic Surgery, Pusan City Medical Center. The results were as follows: 1. The clinical results were evaluated by Weaver and Dunn were good in 19 cases, fair in 3 cases, poor in 1 case. 2. The radiological results were evaluated by the difference of the distance from the coracoid process to the clavicle between normal and injured site. The comparison of coraco-clavicular distance after surgery(1.76 mm) with that of follow up(2.41 mm) showed no significant difference(P>0.05, by Student t-test). 3. There was no posttraumatic arthritis and limitation of shoulder motion in all cases. So we suggest that modified Phemister technique is a good method for aute acromioclavicular dislocation.

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Treatment of communited & Segmental Femoral shaft Fracture by using Interlocking nailing: Comparison between Closed and Open techniques: Chang Hyuk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Ho Sun Chang; J Korean Soc Fract 1999;12(3):516-522. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.516

Abstract PDF: When femoral shaft fracture with severe communition and segmentation result from violent force, they are frequently associated with severe soft tissue damage. Treatment of this unstable fracture need the rigid fixation in order to prevent shorting and rotational loading. In terms of this advantages, interlocking nailing technique was widely used with open and closed methods. In the cases of fractures that having large fragments and wide displacement, closed technique has disadvantage of difficulties in anatomic reduction and its maintenance. Nineteen femoral shaft fractures had been treated by these techniques alternatively at our hospital between Feburary 1994 and Feburary 1997 and had been followed for more than 12 months. Among the 19 cases, closed techniques were 11 cases and open 8 cases. We evaluated the results of two treatment methods in terms of the bone union time, complications and functional results. Mean duration of the bone union time was 24.2 weeks in closed interlocking nailing, 24.5 weeks in open. There was no difference between the bone union time and the operation techniques(p-value>0.05). And complications were delayed union in two cases. In conclusion, in the cases of severe comminuted and segmental femoral shaft fractures especially with posteromedial fragment, open technique was more useful than closed technique, in terms of anatomic restoration and getting functional recovery afford to preinjury level of work.

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Treatment of Two-part, Displaced Surgical Neck Fracture of the Proximal Humerus with Modified Ender Nail and Tension Band Technique: Kwang Won Lee, In Sung Hwang, Seung Hun Lee, Tae Gyoo Ahn, Ha Yong Kim, Whoan Jeang Kim, Won Sik Choy; J Korean Soc Fract 1999;12(2):395-401. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.395

Abstract PDF

Operative treatment of two-part, displaced surgical neck fractures of the proximal humerus is used when satisfactory closed reduction cannot be achieved or maintained. Recently, we modified the Ender nails by making an additional hole above the slot for wire incorporation. The purpose of this study was to assess the effects of stabilization of displaced and unstable surgical neck fractures of the humerus by Ender nailing and tension band technique. We reviewed the data of fourteen consecutive patients (10 women and 4 men) who had been treated with Ender nailing and tension band wiring between from Aug 1996 and Oct 1997 at Eulji Medical College Hospital. The average age of patients was 54 years (range, 38 to 79 years), and the average follow-up period was 18 months (range, 12 to 24 months). Bone union was observed at 6.3 weeks (range, 5.5 to 10 weeks), except one case of delayed union. There were no infections and nonunions. The average ranges of shoulder elevation and abduction were 140 degrees(100 degrees to 170 degrees) and 126 degrees(100 degrees to 160 degrees), respectively. The median value of the thumb to vertebral distance was L1, with a range of T6 to L5 for internal rotation, external rotation was 48 degrees (30 degrees to 70 degrees) . Radiography revealed one case of medial shift greater than 5mm, and 4 cases of lateral shift greater than 5mm of the humeral shaft. The average varus angulation of the humeral neck was 8.5o(0 degree to 34 degrees). Four patients (28.6%) were excellent (34 to 35), six patients (42.8%) were good (28 to 33), four patients (28.6%) were fair (21 to 27) in UCLA shoulder rating scale. In conclusion, Ender nailing and incorporation of the tension band wire loops provided additionally rotational and longitudinal stability in two-part displaced surgical neck fracture of the proximal humerus associated with osteoporosis.

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Treatment with Modified Steinmann Pins and Tension Band Wiring Technique in Proximal Humeral Comminuted Fractures with Osteoporosis
Soo-Tai Chung, Joo-Hak Kim, Hyung-Soo Kim, Sang-Joon Park
Journal of the Korean Fracture Society.2007; 20(2): 184. CrossRef

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Treatment of Open Fractures of the Tibial Shaft by Sequential Compression technique in Ilizarov device: Suk Ku Han, In Ju Lee, Nam Yong Choi, Sung Jin Park, Gyeol Yoo, Hyo Seng Ahn; J Korean Soc Fract 1998;11(4):817-824. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.817

Abstract PDF: External skeletal fixation is used widely in the management of open or closed tibial fractures, but delayed healing is common. There is concern that this might be due not only due to the severity of injury but also to the mechanical conditions imposed at the fracture site by the fixator. Since fractures treated by external skeletal fixation can rarely be reduced to perception nor held with absolute stability, union occurs by indirect healing, which is acutely sensitive to both the charactericstics and timing of mechanical stimulation. So, the achivevment of the optimum mechanical environment is particularly important where delay in bone healing is likely. Ilizarov external fixator is useful in treating open fractures of the tibial shaft because it permits axial micromotion which enhances bridging callus formation with stable fixation as well as its complications such as infected nonunion or limb length discrepancy. The impared healing with external fixation is often caused by wrong surgical technique, such as distraction of fracture fragments by fixation device. Sequential compression at fracture site may overcome any fracture gap in external skeletal fixation and also enhance endosteal bone formation. We applied sequential compression forces at the fracture site in 18 open fractures of the tibial shaft, trated by Ilizarov external fixator with or without autogenous bone grafting. Sequential compression technique is composed of initial compression with 1 mm/wk for 4 weeks and then compression 1 mm/10 days until adequate apposition of cortex and callus formation in radiograph. We acquired successful bony union in all cases except one which had additional bone grafting in open fractures of the tibial shaft by sequential compression technique using Ilizarov device.

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Metacarpal Shaft Fracture Treated by Closed Reduction and Percutaneous Intramedullary K-wire Fixationv: Soo Joong Choi, Chang Kyun Lim, Ho Guen Chang, Jun Dong Chang, Chang Ju Lee; J Korean Soc Fract 1998;11(1):100-106. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.100

Abstract PDF: The metacarpal shaft fracture has been reported as a stable fracture relatively, but operative treatment is indicated when there happens reduction loss, or is in need of early exercise. Intramedullary K-wire fixation has been used for unstable transverse or long oblique diaphyseal fracture of the metacarpal bone. The fracture site is not opened and the K-wires are introduced under X-ray control. The techniques can stablize the fracture site and allow immediate exercise postoperatively. We experienced 9 cases of 4th metacarpal shaft fracture treated by percutaneous intramedullary K-wire frxation with modified technique. The K-wire was used one or two ezch metacarpal fracture. The types of fracture were 4cases of transverse, 3 of oblique, 2 of comminuted. The average clinical union period were 5 weeks. There were not severe complications in all cases.

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Application & Use of an Ilizarov Technique for the Pilon Fracture: Jin Hong Ko, Beom Koo Lee, Do Hyun Moon, Sung We; J Korean Soc Fract 1997;10(4):879-885. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.879

Abstract PDF: A pilon fracture, which is defined as a comminuted intraarticular fracture of distal tibia, violates the articular region and the metaphysis with occasional extension into the diaphysis, and renders the bone difficult to restore to its anatomic shape. The best known treatment of the pilon fracture is, as recommended by A-O group. In the treatments of the fractures with severe comminution or with significant open soft tissue injury aggressive tries for internal fixation with plate and screws in the distal tibia will result in inevitable stripping of the soft tissue and the periosteum. Therefore, dangers of the delayed union, nonunion, soft tissue necrosis and infection will be increased. The authors treated 14 cases by the Ilizarov external fixation technique for treatment of pilon fracture of the tibia. The average duration of external fixation was thirteen weeks. The results were as follows. v1. Such techniques are especially useful in those injuries with extensive aricular communition and in the open pilon fracture with significant soft tissue compromise. 2. The average duration of external fixation was 13 weeks and the time to clinical union averaged 16.4 weeks. 3. In case of accurate reduction, the better clinical result was obtained.

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