Journal of Musculoskeletal Trauma

Comparison of outcomes of reinforced tension band wiring and precontoured plate and screw fixation in the management of Mayo type IIIB olecranon fractures: Hyun Goo Kang, Tong Joo Lee, Samuel Jaeyoon Won; J Musculoskelet Trauma 2025;38(2):96-101. Published online February 28, 2025; DOI: https://doi.org/10.12671/jmt.2025.00059; Correction in: J Musculoskelet Trauma 2025;38(3):168

Background
Mayo type IIIB olecranon fractures are characterized by significant displacement and comminution, presenting a challenge in selecting the appropriate fixation technique. This study compared the clinical and radiographic outcomes, complications, and reoperation rates of reinforced tension band wiring (TBW) and precontoured plate and screw fixation (PF) in the surgical treatment of Mayo type IIIB olecranon fractures.
Methods
This retrospective review analyzed 24 patients diagnosed with Mayo type IIIB olecranon fractures, who were treated between 2005 and 2023. Of these, 11 patients underwent reinforced TBW, and 13 received precontoured PF. Clinical outcomes were assessed using Disabilities of the Arm, Shoulder, and Hand (DASH) scores and the Mayo Elbow Performance Score (MEPS). Radiographic outcomes focused on fracture union. Operative times, complication rates, and reoperation rates were compared between the groups.
Results
Both the reinforced TBW and PF groups achieved satisfactory clinical outcomes, with no significant between-group differences in DASH and MEPS scores (P>0.05). Radiographic union was achieved in all patients. The reinforced TBW group demonstrated a significantly shorter operative time than the PF group (93.6±7.4 min vs. 132.3±13.7 min; P<0.001). Complication rates were similar between the two groups (reinforced TBW, 38.4%; PF, 36.3%), but hardware-related irritation occurred more frequently in the reinforced TBW group. Reoperations were required in 15.8% of the reinforced TBW group due to hardware irritation, whereas no reoperations were necessary in the PF group.
Conclusions
Reinforced TBW and PF are both effective surgical options for managing Mayo type IIIB olecranon fractures, yielding comparable clinical and radiographic outcomes. While reinforced TBW offers shorter operative times and lower costs, PF is associated with fewer hardware-related complications. Further prospective studies are needed to optimize treatment strategies for these complex fractures. Level of Evidence: Level III.

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Are posterior olecranon locking plates a problem for patients after fracture healing because of prominence?
Reva Qiu, Mallika Makkar, Richard Buckley
Injury.2025; 56(11): 112769. CrossRef

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Avulsion Fractures around the Hip Joint and Pelvis: Ha-Yong Kim, Hajun Jang, Jung-Taek Kim, Jin-Woo Kim, Jun-Il Yoo, Won-Sik Choy, Yonghan Cha; J Korean Fract Soc 2024;37(3):150-157. Published online July 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.3.150

Abstract PDF: Avulsion fractures occur when tendons or ligaments are subjected to forces greater than they can withstand at the apophysis or enthesis, regardless of the fusion status. Given the diverse muscular structures around the pelvis and hip joint, which serve as origins for multiple muscles leading to the lower extremities, these areas are vulnerable to such injuries. Pelvic avulsion fractures commonly af-fect young athletes, but they can also occur in adults. Diagnosis typically involves assessing the trauma history, clinical examination, and radiographic imaging. In cases of unclear diagnosis, additional tests, such as computed tomography or magnetic resonance imaging, may assist in treatment decisions and diagnosis. Although most avulsion fractures respond well to conservative treatment, surgical interven-tion may be preferred in severe displacements, significant retraction in active athletes, or when a faster recovery is necessary. Chronic or neglected injuries may lead to excessive osseous formation around the pelvis, causing impingement syndromes. Recognizing the characteristic radiological findings based on the pelvic anatomy aids in accurate diagnosis because chronic injuries might mimic tumors or infectious conditions, necessitating a careful differential diagnosis.

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Demographic and Radiographic Parameters as Predictors of Reduction Loss after Conservative Treatment of Distal Radius Fractures in Adults: Kyu Jin Kim, Dae Won Shin, Seong Kee Shin; J Korean Fract Soc 2023;36(2):45-51. Published online April 30, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.2.45

Abstract PDF: Purpose
This study examined the demographic and radiological risk factors for later reduction loss of distal radius fractures treated conservatively. Materials and Methods This study enrolled patients treated for distal radius fractures between January 2017 and December 2019. Seventy-eight patients were included in the analysis and divided into two groups. The patients who showed minimal reduction loss within an acceptable radiologic angle after initial manual reduction were classified as Group A. The patients who showed reduction loss out of an acceptable radiologic angle and finally malunited or converted to surgical treatments were classified as Group B. The patient’s age and bone marrow density were used as demographic data. The initial X-ray images were evaluated to determine the fracture type. Various radiological parameters were measured. Results The 78-patient study cohort consisted of nine men and 69 women with a mean age of 67 years. Forty-eight cases were sorted into Group A, and 30 cases into Group B. On logistic regression analysis, the age of 80 or older was a risk factor for later fracture displacement among the demographic factors (p=0.037, odds ratio=4.937). Among the radiographic factors, the presence of distal ulnar fracture and dorsal cortical comminution were disclosed as risk factors of later displacement (p=0.049, 0.003, odds ratio=3.429, 7.196). Conclusion When conservative management for distal radius fracture is decided in patients more than 80 years of age or accompanied by a distal ulnar fracture or with dorsal cortical comminution, the possibility of later displacement of the distal radius should be considered.

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Treatment of Scaphoid Fractures and Nonunions: Wan-Sun Choi; J Korean Fract Soc 2022;35(4):182-189. Published online October 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.4.182

Abstract PDF: A scaphoid fracture is one of the most common types of wrist fractures, and if treatment is delayed, there is a high possibility of nonunion due to anatomical factors such as limited blood supply to the injured bone. Therefore, it is important to suspect a scaphoid fracture based on the mechanism of wrist injury and physical examination of the patient. A computed tomography scan or magnetic resonance imaging can also aid early diagnosis of the fracture. Stable acute fractures can be treated conservatively, but unstable fractures require surgical treatment, and percutaneous screw fixation is usually performed. Nonunions require bone grafts and are treated with non-vascularized bone grafts and screw fixation. However, if the nonunion is located at the proximal pole, a vascularized bone graft may be considered because there is a possibility of avascular necrosis. Pedicled vascularized and free vascularized medial femoral condyle bone grafts are mainly used in such cases. The treatment of a proximal pole nonunion with impaired blood flow remains controversial. There are conflicting opinions on whether a nonvascularized bone graft is sufficient or whether a vascularized bone graft is necessary.

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Current Treatment of Calcaneal Fractures and Dislocation: Dae Jin Nam, Sung Hyun Lee; J Korean Fract Soc 2022;35(2):74-82. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.74

Abstract PDF: Calcaneal fractures are the most common fractures occurring in the tarsal bone. In the past, surgical treatments were not preferred because they were accompanied by severe comminution and soft tissue complications. In recent years, there have been great advancements in the treatment of calcaneal fractures owing to the development of new surgical techniques and instruments. However, a standard treatment method has not yet been established. In this review article, we summarize the latest information on the indications and treatment methods of calcaneal fractures.

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Current Management of Talar Fractures: Gun-Woo Lee, Keun-Bae Lee; J Korean Fract Soc 2022;35(1):31-37. Published online January 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.1.31

Abstract PDF: Talar fracture management is one of the most challenging tasks for orthopedic surgeons. High complication rates and functional impairments after talar fractures have been well documented, and thus, surgical strategies capable of perfect anatomic reduction and stable fixation are important. The current review was undertaken to provide recommendations regarding updated surgical strategies that include surgical timing, approach, fixation methods, and the prevention and treatment of possible complications.

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Recurrent Treatment Failure in Vancouver Classification Type C Periprosthetic Fractures around a Well Fixed Short Femoral Stem: Byeong Yeol Choi, Hong-Man Cho, Jiyeon Park; J Korean Fract Soc 2022;35(1):16-20. Published online January 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.1.16

Abstract PDF: A short femoral stem (type 1 cementless stem) is being increasingly used to perform total hip arthroplasty; however, various types of intra- or postoperative periprosthetic fractures have been reported in recent times. A 66-year-old woman with a history of bilateral total hip arthroplasties using a type 1B femoral stem was admitted 2 months post-operation for a Vancouver type C periprosthetic fracture. She underwent open reduction and internal fixation; however, we observed recurrent non-union and plate breakage at the same site. In this case report, we discuss the factors associated with treatment failure in patients with a Vancouver type C periprosthetic fracture following type 1 femoral stem im-plantation.

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Ankle Fractures in Children: Classification and Treatment: Ha-Yong Kim, Yong-Han Cha, Woo-Suk Kim, Won-Sik Choy; J Korean Fract Soc 2021;34(2):87-95. Published online April 30, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.2.87

Abstract PDF: Pediatric ankle fractures are defined as damage to the metaphysis, epiphyseal plate, and epiphysis of the distal tibia and fibula. Although the injury mechanism could be similar, the fracture patterns and treatment of pediatric ankle fractures are different from those of adults. In children, growth plate injuries are more common with a force that would cause sprains in adults because the ligaments are stronger than the growth plate cartilage in children. In the adolescent period, unique fractures, called “transitional fractures”, occur while the physis is closed. For a diagnosis, plain images of the anteroposterior, lateral, and mortise views are essential. Stress radiographs, ultrasound, and magnetic resonance imaging can be used for suspected ligament injuries. The treatment goal is to restore the articular congruity, normal bony alignment, and preserve the epiphyseal plate to ensure normal growth. Pediatric ankle fractures frequently lead to premature physeal arrest, angular deformities, malunion, and posttraumatic arthritis even after anatomic reduction. Treating surgeons should follow-up children for a sufficient time and explain to the caregiver the possible complications before treatment.

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Treatment of Proximal Femur Fracture with a Newly Designed Nail: Trochanteric Fixation Nail-Advanced (TFNA): Jae Youn Yoon, Ji Wan Kim; J Korean Fract Soc 2020;33(4):189-195. Published online October 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.4.189

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