Journal of Musculoskeletal Trauma

2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures: Sung Jin Kim, Chul Hyun Cho; J Korean Fract Soc 2011;24(2):151-155. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.151

PURPOSE
To evaluate outcomes 2.4 mm volar locking compression plate for treatment of unstable distal radius fractures.
MATERIALS AND METHODS
We retrospectively analyzed the results in 22 cases, which were treated by 2.4 mm volar locking compression plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results.
RESULTS
All cases had bony union. The mean Mayo wrist performance score was 85.23. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 6.04 mm to 9.68 mm, radial inclination from 15.61degrees to 19.61degrees, volar tilt from -13.73degrees to 7.66degrees and intraarticular step-off from 0.79 mm to 0.33 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured 0.86 mm, radial inclination 0.41degrees, volar tilt 0.54degrees and intraarticular step-off 0.02 mm (p>0.05). Postoperative complication included that flexor pollicis longus and 2nd flexor digitorum profundus were ruptured in 1 case.
CONCLUSION
Treatment of unstable distal radius fractures using a 2.4 mm volar locking compression plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.

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Treatment of the Communited Distal Radius Fracture Using Volar Locking Plate Fixation with Allogenic Cancellous Bone Graft in the Elderly
Je Kang Hong, Chang Hyun Shin
Journal of the Korean Fracture Society.2015; 28(1): 8. CrossRef

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Treatment for Unstable Distal Radius Fracture with Osteoporosis: Internal Fixation versus External Fixation: Jin Rok Oh, Tae Yean Cho, Sung Min Kwan; J Korean Fract Soc 2010;23(1):76-82. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.76

Abstract PDF

PURPOSE
To compare the functional and radiological outcomes of volar plating to that of external fixation for treating unstable osteoporotic distal radius fracture.
MATERIALS AND METHODS
From March 2006 to March 2008, 36 patients with osteoporosis over 60-year old were selected for this study. They were divided into two groups; group I (open reduction and internal fixation with volar fixed angle plate) and group II (closed reduction and external fixation). Clinical outcomes and radiologic outcomes were evaluated.
RESULTS
There was no statistical difference between group I and group II in range of motion and DASH score, BMD score. However, the grip strength and PRWE score were found to be higher in group II (p<0.05). In radiologic evaluation, group I showed higher radial inclination, volar tilting angle (p<0.05).
CONCLUSION
Internal fixation using Volar-fixed Angle Plate seems to give more stable fixation for distal articular fragments compared to external fixation. it could allow early postoperative exercise and could result in low incidence of postoperative complication such as pin track infections and joint stiffness. Therefore, the internal fixation could be more desirable treatment method to manage unstable distal radius fracture.

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Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis
Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin
Journal of the Korean Fracture Society.2013; 26(4): 248. CrossRef

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Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures: Chul Hyun Cho, Ki Choer Bae, Doo Hyun Kwon; J Korean Fract Soc 2008;21(3):220-224. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.220

Abstract PDF

PURPOSE
To evaluate outcomes volar T-locking compression plate for treatment of unstable distal radius fractures.
MATERIALS AND METHODS
We retrospectively analysed the results in 35 cases, which were treated by volar plating with T-LCP. We evaluated the clinical results according to the Mayo wrist scoring system and radiographic results.
RESULTS
The mean score was 83.86 respectively. Between preoperative and immediate postoperative radiographic measurements, averaged radial length was improved from 5.75 mm to 11.53 mm, radial inclination from 12.86 degrees to 22.56 degrees, volar tilt from -3.64 degrees to 9.90 degrees and intraarticular step-off from 1.48 mm to 0.42 mm. Between immediate postoperative and latest follow-up radiographic measurements, mean loss of radial length measured 0.43 mm, radial inclination 0.46 degrees, volar tilt 0.89 degrees.
CONCLUSION
Treatment of unstable distal radius fractures using a volar T-LCP showed satisfactory outcomes. We think that it is good surgical option to allow return to daily living, result in early postsurgical wrist motion.

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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
The Fate of Pronator Quadratus Muscle after Volar Locking Plating of Unstable Distal Radius Fractures
Chae-Hyun Lim, Heun-Guyn Jung, Ju-Yeong Heo, Young-Jae Jang, Yong-Soo Choi
Journal of the Korean Fracture Society.2014; 27(3): 191. CrossRef
2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
Sung-Jin Kim, Chul-Hyun Cho
Journal of the Korean Fracture Society.2011; 24(2): 151. CrossRef
Short Term Results of Operative Management with 2.4 mm Volar Locking Compression Plates in Distal Radius Fractures
Ki-Chul Park, Chang-Hun Lee
Journal of the Korean Fracture Society.2009; 22(4): 264. CrossRef
Plate Fixation of AO Type C3 Fractures of the Distal Radius
Eun-Sun Moon, Myung-Sun Kim, Hyeong-Won Park, Min-Sun Choi
Journal of the Korean Fracture Society.2009; 22(3): 172. CrossRef
Biosorption of Mercury (II) from Aqueous Solutions by Zygnema fanicum Algae
Gh. Shams Khoramabad, A. Jafari, J. Hasanvand Jamshidi
Journal of Applied Sciences.2008; 8(11): 2168. CrossRef
Volar Plating of Distal Radius Fractures
Kwang-Hyun Lee
Journal of the Korean Fracture Society.2008; 21(4): 325. CrossRef

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External Fixation with Five Pins for Unstable Fractures of the Distal Radius: Kyoung Duck Kwak, Cheol Eun Ko, Seung Il Baek, Sang Min Ahn, Chan Jong Jung, Ki Baek Ahn, Jae Su Roh; J Korean Fract Soc 2006;19(3):346-351. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.346

Abstract: PURPOSE
To evaluate the results of five-pin external fixation, with the fifth pin stabilizing the distal radius articular fragment, for unstable distal radial fractures.
MATERIALS AND METHODS
Twenty cases of unstable distal radial fractures were treated with five-pin external fixation (5-pin group). The fifth pin was inserted into the distal articular fragment and attached to the external fixation frame. Metacarpal pins were removed at sixth week in 12 cases and at third in 8 cases, and radial pins were removed at eighth or ninth week. The radiographic results of 5-pin group were compared with those of 20 cases of traditional four-pin external fixation (4-pin group).
RESULTS
The postoperative radial inclination was 23.1 degrees in 5-pin group and 22.2 degrees in 4-pin group; while at last follow-up 21.8o and 15.1 degrees respectively. Postoperative volar tilt was 8.5 degrees and 7.3o; while at last follow-up 6.3 degrees and 0.1 degrees respectively. Postoperative radial shortening was 0.3 mm, 0.4 mm; while at last follow-up 1.1 mm and 2.1 mm respectively. In 5-pin group, there were no significant differences in results whether the metacarpal pins were removed at sixth or third week.
CONCLUSION
Five-pin external fixation, with the fifth pin stabilizing the distal articular fragment, enhanced early motion of the wrist maintaining fracture stability in unstable fractures of the distal radius.

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T Plate Fixation for Unstable Fracture of Distal Clavicle: Ho Jung Kang, Kwan Kyu Park, Hong Kee Yoon, Hyung Keun Song, Soo Bong Hahn; J Korean Fract Soc 2006;19(3):329-334. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.329

Abstract

PURPOSE
To review clinical and radiological results after open reduction and internal fixation with T plate for unstable distal clavicle fractures.
MATERIALS AND METHODS
From July. 1999 to December 2002, nine patients with distal clavicle Neer type II fractures were treated by open reduction and internal fixation with T plate. The bony union was confirmed by plain radiography. The clinical results were analyzed according to the classification by Kona et al.
RESULTS
Average time to fracture union was 8 weeks in all cases. The functional results were as follows: excellent in 7 cases and good in 2 cases. Screw loosening occurred in one case, but bony union was achieved.
CONCLUSION
We recommend T plate fixation as another treatment method for unstable distal clavicle fractures.

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Usefulness of the Additional K-Wire Fixation and Suture for Reinforce the Treatment of Distal Clavicle Fracture Using Modified Tension Band Wiring
Seung-Bum Chae, Chang-Hyuk Choi, Dong-Young Kim
Journal of the Korean Fracture Society.2016; 29(2): 107. CrossRef
Treatment of Distal Clavicle Fracture Using Hook Plate
Su-Han Ahn, Hyeong-Jo Yoon, Kwang-Yeol Kim, Hyung-Chun Kim, In-Yeol Kim
Journal of the Korean Fracture Society.2011; 24(1): 48. CrossRef
The Surgical Outcomes of Clavicle Lateral End Fractures Fixed with the Oblique T Locking Compession Plate
Seung-Oh Nam, Young-Soo Byun, Dong-Ju Shin, Jung-Hoon Shin, Chung-Yeol Lee, Tae-Gyun Kim
Journal of the Korean Fracture Society.2011; 24(1): 41. CrossRef
Results of Hook Plate Fixation of Unstable Distal Clavicle Fractures
Hoon-Sang Sohn, Byung Chul Jo
Journal of the Korean Fracture Society.2011; 24(4): 335. CrossRef
Modified Spring Plate for Treatment of Unstable Distal Clavicle Fractures
Sang-Myung Lee, Il-Jung Park, Hyung-Min Kim, Jae-Chul Park, Sung-Gil Cho, Yoon-Chung Kim, Seung-Koo Rhee
Journal of the Korean Fracture Society.2010; 23(1): 64. CrossRef
Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle
Kyeong-Seop Song, Hyung-Gyu Kim, Byeong-Mun Park, Jong-Min Kim, Sung-Hoon Jung, Bong-Seok Yang
Journal of the Korean Fracture Society.2009; 22(1): 24. CrossRef

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The Compression Hip Screw with Trochanter Stabilizing Plate for Internal Fixation of Unstable Intertrochanteric Fractures: Jin Ho Cho; J Korean Fract Soc 2005;18(3):221-226. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.221

Abstract PDF: PURPOSE
To evaluate trochanter stabilizing plate and compression hip screw can prevent excessive impaction and cutting-out in unstable intertrochanteric fractures.
MATERIALS AND METHODS
One hundred twenty-one patients with intertrochanteric fractures were treated between December 1999 and March 2002. Of the patients, twenty-four patients were treated with an additional TSP on the CHS. Nineteen patients were followed for more than six months. The fractures were classified according to the AO classification. Impactions of compression lag screw were measured immediate postoperatively and postoperatively three months later on simple radiographs. Functional results were followed Salvati-Wilson assessment score at postoperative six months later.
RESULTS
The group consisted of seven men and twelve women, and the mean age was 73 years. Two were classified as A2.2, six A2.3, one A3.2, and ten A3.3 fractures. Mean impaction was 5.4 mm (range 1.8 to 11.4 mm). Functional results were excellent in 32% and good in 53%. Eighteen patients had healed after operation. One complication required a bipolar hemiarthroplasty due to cutting-out of lag screw.
CONCLUSION
In three-part and four-part intertrochanteric fractures with lateral cortex breakage or vertical fracture in greater trochanter, the addition of TSP to CHS can prevent abductor muscle weakness due to fracture impaction, limb shortening and additional lateral cortical fracture. It also helps early weight bearing and bone healing.

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Minimally Invasive Plate Osteosynthesis in Unstable Fractures of the Distal Tibia: Se Ang Chang, Hyug Soo Ahn, Young Soo Byun, Ji Hwan Kim, Hoon Ho Bang, Do Yop Kwon; J Korean Fract Soc 2005;18(2):155-159. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.155

Abstract PDF

PURPOSE
evaluate the effectiveness of minimally invasive plate osteosynthesis (MIPO) in unstable fractures of the distal tibia.
MATERIALS AND METHODS
From March 2001 to December 2003, 21 cases with unstable fractures of the distal tibia were treated with MIPO technique and followed for at least one year. Eighteen cases were extra-articular and three cases were intra-articular fractures. According to AO classification, six cases were 42-A, four 42-B, one 42-C, seven 43-A, and three 43-C. There was only one case of Gustilo-Anderson type II open fracture. We reviewed the results of fracture healing, axial and rotational deformity, ankle motion, and complications RESULTS: All fractures were healed in an average of 16.1 weeks (range, 11 to 24 weeks). There was only one case of 7-degree posterior angular deformity, but no cases of rotational malalignment. Recovery of ankle motion was satisfactory in all patients within 5-degree loss of motion. Subcutaneous abscess was developed in one case after fracture healing and cured by a drainage with implant removal.
CONCLUSION
Although MIPO technique is technically more demanding than the traditional open technique, MIPO technique is an effective method for unstable fractures of the distal tibia because it minimizes incidence of soft-tissue compromise and infection and provides good fracture healing.

Citations

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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
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
Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures
Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn
Journal of the Korean Fracture Society.2010; 23(3): 289. 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
Basic Principle of the Locking Compression Plate
Keun Bae Lee
Journal of the Korean Fracture Society.2008; 21(3): 261. 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
Minimally Invasive Plate Osteosynthesis, MIPO
Young-Soo Byun
Journal of the Korean Fracture Society.2007; 20(1): 99. 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

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Closed Reduction and Percutaneous Fixation in the Treatment of Proximal Humerus Fractures: Seung Ju Jeon, Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Hyung Sam Kim; J Korean Soc Fract 2002;15(2):173-180. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.173

Abstract PDF: PURPOSE
This is a retrospective study to analyze the functional results of closed reduction and percutaneous fixation of displaced unstable proximal humerus fractures.
MATERIALS AND METHODS
We report 23 patients, 20 with 2-part and 3 with 3-part proximal humerus fractures that can be reduced closed but remain unstable in which percutaneous fixation was performed. The fixation methods were multiple pinning in 10, multiple cannulated screw fixation in 8, Rush pin fixation in 3 and Rush pin combined with other methods in 2. The functional rusults were analyzed with Neer,scriteria.
RESULTS
The functional rusults were excellent in 14, satisfactory in 4 and unsatisfactory in 5. No significant difference was not noted in the long term follow-up results according to the fixation methods but Rush pin resulted in impingement and displacement of greater tuberosity.
CONCLUSION
Closed reduction and percutaneous fixation is a useful alternative to open reduction and internal fixation for the displaced 2-part or 3-part proximal humerus fractures that can be reduced closed but remain unstable.

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Percutaneous K-wire fixation for Unstable Fracture of distal radius: Chol Yong Jung, Young Chan Son, Jun Bum Bae, Moon Do Choi; J Korean Soc Fract 2000;13(4):996-1002. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.996

Abstract PDF: PURPOSE
To evaluate the clinical validity of the percutaneous K-wire fixation in applying to unstable extraarticular fracture of distal radius of patients who are older than 50 years. MATERIAL AND METHODS: The validity of K-wire fixation was examined, using subjective study of Cole and Oblelz and objective study of Scheck, on the 20 cases of unstable extraarticular fracture of distal radius of patients older than 50 years, who were treated with percutaneous K-wire fixation and followed up more than 1 year, out of 160 patients with distal radius fracture, treated in the department of orthopedic surgery of our hospital from January 1994 to August 1998.
RESULTS
The result was examined with subjective study of Cole and Oblelz and objective study of Scheck. Combined judgement was made by adding up the scores of both objective and subjective study. 5 excellent cases and 12 good cases were brought forth by subjective study. Objective study achieved the result of average 18 degree of radial angle, 9.8mm of radial length and 3.6 degree of volar angle. Combined judgement achieved a good result of 3 excellent cases, 14 good cases and 3 fair cases.
CONCLUSION
Percutaneous K-wire fixation is expected to be a simple, less invasive, more effective and valuable operation method in the treatment of extraarticular fracture of distal radius with severe comminution

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The Result Of Surgical Treatment Of The Femur Unstable Intertrochanteric Fracture Using Compression Hip Screw: Analysis Of Effect Of Degree Of Force On Trauma And Degree Of Osteoporosis: Ki Do Hong, Sung Sik Ha, Sang Weon Park; J Korean Soc Fract 2000;13(4):795-803. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.795

Abstract PDF: PURPOSE
To analyise the effect of degree of force on trauma and degree of osteoporosis in femoral unstable intertrochanteric fracture's result of treatment using compression hip screw.
MATERIALS AND METHODS
From January 1993 to December 1997, 55 patients who were operated with compression hip screw and followed up for more than 1 year were devided into high and low energy injured group by the mechanism of the trauma and also devided low(gradeIV,V,VI) and high grade osteoporosis group(gradeI,II,III) by Singh's index. We analize and compare the result of treatment in each groups.
RESULTS
The averrage rate of mechanincal complication was 24%. The mechanical complication rate of the high grade osteoporosis group(34%) was higher than low grade osteoporosis group(9%)(p<0.05). The average subsidence of compression screw was 9.9mm and it shows significant difference between low(7.8mm ) and high grade osteoporosis group(11.5mm )(p<0.05). The average increased varus deformity of neckshaft angel during follow up was 3.8degrees and it shows singnificant defference between high energy injuried group(4.6degrees ) and low energy injuried group(2.7degrees)(p<0.05). No difference was seen in each groups for time of bone union(p>0.05). In view of functional recovery by Clawson's method, no difference between pre-injury and postoperative state was seen in 7 cases(22%) in high grade osteoporosis group and 13 cases(57%) in low grade osteoporosis group, thus worse functional recovery was seen in high grade osteoporosis group.
CONCLUSIONS
We observed higher mechanical complication rate, more compression screw subsidence and worse functional recovery in high grade osteoporosis group and more varus deformity in high energy injured group. Thus we need more attension to treatment and follow up in high energy injured, severe osteoporotic unstable intertrochanteric fracture.

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Prognosis of early internal fixation in unstable pelvic fractures: Jang Yeol Lee, Do Hun Moon, Gun Beom Kim; J Korean Soc Fract 2000;13(4):741-748. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.741

Abstract PDF

PURPOSE
This study was conducted to analyze the clinical prognosis of early internal fixation in unstable pelvic fracture. MATERIAL AND METHOD: We analyzed the sixteen patients. The average age of the patients was 34 years(range, 21-64 years). They were followed up for average 21 months. The sixteen pelves were classified by Tile ; Type B 3 cases, Type C 13 cases. Nine patients(56%) had the associated injuries. In 13 patients(81%), internal fixation were performed within 3 weeks after the injury. Fixation was accomplished by the plates and screws. We assessed the functional, radiological results and postoperative complications.
RESULTS
Fourteen(88%) patients were fully ambulatory, had no limp, did not need assistive devices. Fifty percents of the patients had returned to the previous jobs and 31% had to change the jobs. On radiolograph, there were 14 excellent and 2 good reduction. Three postoperative complications happened ; two superficial infections and one lumbar neuropathy, which resolved spontaneously. Three patients with associated injuries, who had delayed fixation, appealed gait disturbance and chronic pain.
CONCLUSION
early internal fixation of unstable pelvic ring fractures may be expected to yield satisfactory functional success and radiologic results in the majority of patients

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Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint
Kwang-Jun Oh, Jin-Ho Choi
Journal of the Korean Fracture Society.2013; 26(3): 184. CrossRef
Surgical Fixation of Sacroiliac Joint Complex in Unstable Pelvic Ring Injuries
Kwang-Jun Oh, Seok-Min Hwang
Hip & Pelvis.2012; 24(2): 139. CrossRef
Operative Treatment of Unstable Pelvic Ring Injury
Sang Hong Lee, Sang Ho Ha, Young Kwan Lee, Sung Won Cho, Sang Soo Park
Journal of the Korean Fracture Society.2012; 25(4): 243. CrossRef
Crescent Fracture-dislocation of Sacroiliac Joint: Affecting Factors of Operative Results
Hee-Soo Kim, Chang-Wug Oh, Poong-Taek Kim, Young-Soo Byun, Joo-Woo Kim, Byung-Chul Park, Woo-Kie Min, Hyun-Joo Lee
Journal of the Korean Fracture Society.2009; 22(2): 71. CrossRef

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Posterior Short Segment Instreumntation and Fusion for the Unstable Thoracolumbar Spine Fracture: A Comparative Study: Ki Tack Kim, Gyu Pyo Hong, Dae Woo Hwang, Sang Un Lee, Sang Wook Bae; J Korean Soc Fract 2000;13(2):352-360. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.352

Abstract PDF: INTRODUCTION : In treating of acute unstable thoracolumbar spine fractures, current trend is a toward short segment instrumentation to spare the motion segments. Many authors reported the result of short instrumentation and fusion, but there have been few reports about the effect of additional screw fixation at fractured vertebra in posterior short segment instrumentation and fusion. Therefore, the objective of this study is to compare the results of treatment between with/without screw fixation at the fractured vertebra in posterior short segment pedicle screw fixation. MATERIAL AND METHODS : Twenty-three patients with unstable thoracolumbar spine fractures were treated with posterior short segment instrumentation and fusion. Eleven cases classified into group A were not fixed at the fractured vertebre. They were followed up to average 45 months(24-79). Twelve cases classified into group B were treated with screw fixation at the injured vertebra and followed up to average 38 months(14-78). Authors evaluated the radiologic assessment, such as wedge angle of fractured body, local kyphotic angle and wedge index(the ratio of anterior body height to posterior body height), the neurologic assessment by Frankel grade system and functional assessment by Denis system.
RESULTS
: There was no complication resulted from additional pedicle screw fixation at fractured level. In rediologic assessment, wedge angle were measured at preoperative, postoperative and last follow-up time as follows; in group A, 22.2degrees -11.3degrees -14.1degrees and in group B, 19.5degrees -8.8degrees -9.8degrees . The local kyphotic angle measured were 17.9degrees -7.0degrees -14degrees in group A and 17.1degrees -6.3degrees -7.9degrees in group B. The wedge index were 42.9%-22.6%-28.5% in group A and 40%-19.5%-22.4% in group B. At last follow-up time, eight eases showed Frankel grade E and three cases showed grade D in group A, and all cases of group B were Frankel E. Denis pain score were satisfctory in all of both group and Denis work score were also satisfactory in two group except one case of group A.
CONCLUSIONS
: Additional screw fixation at fractured verteba did not cause any complication. There was no significant difference in reduction rate between two groups(P>0.05), but group B showed better maintenance of correction of kyphotic deformity than that of group A(P<0.05). In conclusion, it seems that additional screw fixation at fractured level may be better method in maintaining asgittal alignment and decreasing the risk collapsing of body.

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Treatment of fractures of the Distal Radius with External Fixator: C Y Huh, J R Yoon, H S Ha; J Korean Soc Fract 1999;12(4):995-1002. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.995

Abstract PDF

PURPOSE
: Recently, intraarticular fractures or unstable fractures with severe comminution of the distal radius are increasing in younger ages, which are known to be difficult to treat. We designed this study to evaluate the clinical results and the prognosis of the external fixators for the treatment of the fractures of the distal radius. Material and Method : We reviewed 16 cases of the distal radius fractures, which were treated surgically with the external fixdtors since January 1995 to December 1997. We applied the external fixator with closed reduction and Kirschner-wire fixation in 8 cases, and in the rest of the cases we did minimal open reduction before the application of the exteranl fixator, because it was not enough to reduce the articular fragments in those cases with closed reduction For the analysis of the clinincal results, we used the Demerit point rating system, and for the analysis of the radiologic parameter, we measured radial height, radial inclination, and volar tilting in comparison with the uninjured side from the anteroposterior and the lateral X-ray films which were taken at preoperative, postoperative, and last follow-up period.
RESULTS
In clinical results by Demerit rating point system, 2 cases were excellent, 10 cases were good, 4 cases were fair, and none of the cases was poor. In radiologic results, the average of the radial height was 8.43mm, the average of the radial inclination was 17.68o, and the average of the volar tilting was 3.870.
CONCLUSION
: It is suggested that external fixator is one of the useful modalities in the treatment of the unstable fractures of the distal radius, and we can also improve the results of the intraarticular fractures by using the minimal open reduction technique.

Citations

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Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
Chul Hyun Cho, Ki Choer Bae, Doo Hyun Kwon
Journal of the Korean Fracture Society.2008; 21(3): 220. CrossRef
Comparison of Outcomes for Unstable Distal Radius Intraarticular Fractures - T-locking Compression Plate versus External Fixator -
Chul-Hyun Cho, Su-Won Jung, Sung-Won Sohn, Chul Hyung Kang, Ki-Cheor Bae, Kyung-Jae Lee
Journal of the Korean Fracture Society.2008; 21(1): 51. CrossRef

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Comparison of Results According to the Type and Procedure in Unstable Fracture of the Distal Radius: Jin Young Park, Hong Geun Jung, Moon Jib Yoo, Jeong Wan Kim; J Korean Soc Fract 1998;11(2):435-441. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.435

Abstract PDF

In the treatment of an unstable fracture of the distal radius, the anatomical reduction of articular surface and the maintenance of radial length are essential. Recently, more extensive therapeutic method was introdced for reduction and maintenance of distal radius fracture. To compare the results between type C2 and C3 that were treated with pinning and the results between pinning and pinning with external fixation in type C3 according to AO classification, we analysed anatomical and functional results of unstable fracture of the distal radius from June, 1994 to september, 1996 at DanKook University Hospital. There were 12 cases of C2 type with pinning, 17 cases of C3 type with pinning and 14 cases C3 type with external fixation and pinning. Among the 43 cases, the most commom type was C3 (31cases), and open fractures were 6 (14%)cases. The following results were obtained; 1. For comparison of C2 type with C3 type that were treated with pinning, the results of C2 type were better anatomically and functionally. 2. For comparison of percutaneous pinning with percutaneous pinning and external fixation in C3 type, the results of C3 type that were treated by pinning and external fixation were better anatomically and functionally.

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Treatment for Unstable Distal Radius Fracture with Osteoporosis -Internal Fixation versus External Fixation-
Jin Rok Oh, Tae Yean Cho, Sung Min Kwan
Journal of the Korean Fracture Society.2010; 23(1): 76. CrossRef

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Management of Unstable Proximal Tibial Fractures Using the Ilizarov: Hong Gee Park, Beom Goo Lee, Soo Chan Lee, Do Hyun Moon, Jin Hong Ko, Ki Dong Kang, Hyun Park; J Korean Soc Fract 1997;10(2):332-337. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.332

Abstract PDF: We reviewed fifteen cases of unstable tibial fractures treated with Ilizarov method from May 1995 to May 1996. We attained satisfactory bony union in all cases without bone graft(Average time 19 weeks). There were numbers of complications, such as pin tract infection, angular deformity and joint ankylosis but its were soluble and careful management & numbers of minor surgery were needed to prevent & solve such complications. Post-op immediate weight bearing and ROM exercise were possible and showed no difficulty in getting mainteance of reduction & fracture healing, and serious joint ankylosis waa not developed. In conclusions, Ilizarov method is an excellent treatment in getting reduction, maintenance of reduction, early ambulation and fracture healing in the cases of unstable tibia fractures.

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Operative Treatment of Unstable Fracture of Distal Radius: Bu Hwan Kim, Jong In In, Hee Yeong Chung, Yong Kyun In; J Korean Soc Fract 1996;9(3):774-780. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.774

Abstract PDF: Fracture of distal radius represent the most common fractures of upper extremity. Recently, distal radius fractures are recognized as very complex injuries with a variable prognosis according to the fracture type and the treatment. Because unstable distal radius fractures have a high incidence of secondary displacement and shortening, they are not amenable to the traditional methods of closed manipulation. We classified distal radius fractures by Fernandez classification and analysed thirty-six cases of fractures followed up more than one year at Dae-Dong Hospital from March 1993 to September 1994 after ORIF with T-plate. The result were as follows: 1. ORIF of unstable fracture of distal radius with small T-plate, selective bone graft using volar approach, 81% of the patients had a rating of good or excellent by the modified scoring system of Green and OBrien. 2. Severely comminuted fractures as Fernandez type V necessitated additional fixation such as external fixator. 3. Femandez classification based on the mechanism of injury was helpful in planning the treatment of unstable distal radius fractures.

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Operative treatment of the Unstable Pelvic Bone Fracture: Byung Woo Min, Kwang Soon Song, Chul Hyung Kang, Young Soo Kim; J Korean Soc Fract 1996;9(3):518-524. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.518

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Unstable pelvic bone fracture caused by high-energy trauma that can result in life-threatening situations in which intrapelvic hemorrhage and neurovascular injury. Long-term complications are frequently present, such as leg length discrepancy, gait disturbance and chronic low-back pain. Recently it is principle that it is mandatory to restore the anatomy of pelvic ring structure and to fixistably by means of internal fixation or extemal fixation for successful outcome after unstable pelvicring injury. 26 cases of unstable pelvic bone fracture were treated operatively at the authors hospital between 1992 and 1994. We analyse the clinical and the radiological result. The following results were obtained. 1. The incidence of the unstable pelvic bone fracture was 26 cases(18.4%) of all pelvic bone fractures(141 cases). 2. By the classification of modified Tile, type B1 were 8 cases, type B2(3 cases). type C1(7 cases) and type C3(8 cases). 3. Associated organ injury were found most commonly in the acetabular fracture(8 cases), and other extremity fracture(8 cases), genitourinary system(6 cases) and hemopenitoneum(4 cases). 4. The specific fracture pattern was classified according to various anatomical locations such as transsymphysis(7 cases), transpubic(7 cases), combination of the trassymphysis and traspubic(1 cases), trassacroiliac(7 cases), transiliac(9 cases), transsacral(1 case) and sacroiliac fracture dis location(1 case). 5. According to the fracture location, following methods of stabilization were applied. For the ante rior portion of pelvic ring, plates(13 cases), external fixators(3 cases) and wirings(3 cases) were used. For the posterior portion of pelvic ring, plates(9 cases), percutaneous iliosacral screws(3 cases) and lag screw(1 case) were used. 6. The results revealed as excellent in 20 cases, good in 5 case and fair in 1 case. 7. Postoperative complications were fixation failure(2 cases), metal failure(1 case) and nerve injury(1 case).

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Surgical Treatment of Malunion and Nonunion after Pelvic Bone Fracture
Byung-Woo Min, Kyung-Jae Lee
Journal of the Korean Fracture Society.2015; 28(4): 266. CrossRef
Clinical Results of Surgical Treatment of Acetabular Fractures according to Quality of Reduction
Sang-Hong Lee, Min-Kyu Shin, Sueng-Hwan Jo
The Journal of the Korean Orthopaedic Association.2007; 42(2): 153. CrossRef

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Treatment of Unstable Tibial Fracture Using Interlocking Intramedullary Nailing: In Suk Oh, Do Hyun Moon, Jin Hong Ko, Su Chan Lee, Yeoung Hun Jang; J Korean Soc Fract 1995;8(1):269-277. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.269

Abstract PDF: With increasing industrial and traffic accident, tibia fractures by high energy has been increased and their treatment is difficult. There are many controversy concerning the method of treatment, because of many complications, such as malunion, delayed union, nonunion, infection and joint contracture. The use of an intramedullary nail with interlocking bolts, either closed or open thchnique has became an attractive alternative method of treatment for unstable fracture of tibia. From Januaiy, 1987 to December,1992 we treated 63 fractures of the tibia by minipulative reduction and fixation of the fracture fragments with rigid intramedullary nail at Department of Ouhopaedic Surgery Choong-ang Gil Hospital. The following result was obtained. 1) The average time from injury to operation is in closed and open fracture, 6 and 21 days respectively. 2) Of 63 fractures, 60 fractures united and the union rate was 95.2% 3) The average time of bone union was the 19.3 wks : the 17.8 wks in closed fracture ; the 21.6 wks in open fracture ; the 22.3 wks in Non-union. 4) Regardless of amount of comminution, we treated tibial fractures extending from 3 CM distal to the tibial tuberosity to 5 CM above the ankle joint. 5) Static and dynamic interlocking nailing were done 44 and 19 cases respectively. 6) We permitted weight bearing within 2 weeks in butterfly or oblique fracture within 6 weeks in communited or segmental fracture. 7) According to the functional classification of Klemm and 3,orner, among 63 cases, 35 were excellent,20 good,5 fEir and 3 poor.

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Surgical Treatment of the Unstable Fractures of the Proximal Humerus: Consideration of Surgery-related Problems and Complications: In Kim, Young Kyun Woo, Ju Hae Chang, Hyung Min Kim, Yong Sik Kim, Soon Yong Kwon, Yang Su Kim; J Korean Soc Fract 1995;8(1):126-139. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.126

Abstract PDF: Authors reviewed and analyzed the 96 cases of the unstable proximal humerus fracture surgically managed in the department of orthopaedic surgery of Catholic University Medical College from 1981 to 1993. Analysis dealt with the fracture classification, the clinical assessment, surgical method and related complication, operative result. The overall results were as follows 1. According to the classification by Neer (1970),46 cases were 2 part fracture, 16 cases 3 part fracture,24 cases 4 part fracture,8 cases fracture -dislocation and 2 cases head splitting fracture; of 8 cases of fracture-dislocation,2 cases(3part-1/4part-1) were the iatrogenic displaced cases during manual reduction of 2 part fracture-dislocation. 2. The surgical methods were as follows; for fracture fixation of 80 cases, buttress T-plate in 48 cases, Rush pin and wire in 9 cases, cancellous screw and wire in 8 cases, Steinmann pin and wire 8 cases, Seidle nail in 3 cases, Herbert screw and wire in 1 case and Steinmann pin in 1 case were used respectively. Herbert screw was used in 6 cases for major or supplementary fixation. And joint replacement in 16 cases(14 hemiarthroplasty/2 total arthroplasty ) were performed. 3. The Operative results were analyzed with postoperative radiograph 1) Of 80 cases of open reduction; adequate reduction in 51 cases, inadequate reduction in 21 cases(varus-9, valgus-4, malreduction of greater tuberosity-4, highly located implant-3, excessive shortening-1), insufacient fixation in 5 cases, joint penetration of screw in 2 cases, iatrogenic shaft fracture in 1 case. 2) Of 16 cases joint replacement; adequate replacement in 12 cases, improper fixation or management of greater tuberosity in 3 cases, inappropriate retrotorsion of humeral component in 1 case. 4. Functional assessment by Neers method was done as follows: Of 80 cases open reduction group, excellent and satisfactory results in 59 cases, unsatisfactory and failure results in 21 cases. of 16 cases joint replacement group, satisfactory results in 10 cases and unsatisfactory results in 6 cases. 5. Complications occurred as follows: 1) Of 80 cases of open reduction; malunion with joint stiffness 26 cases, impingement in 4 cases, fixation loss in 3 cases, axillary nerve palsy, distant pin migration and avascular necrosis of humeral head in each 1 case. 2) Of 16 cases of joint replacement; joint stiffness in 7 cases, loosening of humeral component in 4 cases, nonunion of greater tuberosity and axillary nerve in each 1 case.

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Fracture of Distal Radius Treated with Open Reduction and Internal Fixation: Bak Yeong Jeong, Seung Wook Yang, Young Cheol Shin, Young Ho Kim; J Korean Soc Fract 1994;7(2):501-511. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.501

Abstract PDF: Seventeen cases of unstable comminuted fractures of distal radius were treated with open reduction and internal fixation from Jul. 1988 to Apr. 1992 at the department of orthopaedic surgery at Maryknoll Hospital. Most of the fractures were the resutts of high-energy impact and the results of this study were as follows: 1. According to Fernandez classification, the type A 3.2 fracture was most common, and nine of 17 patients were classifled as C2 and C3 (intra-articular comminuted fracture) and eight as A3(extra-articular comminuted fracture). 2. The final result of wrist motion showed dorsiflexion/palmar flexion to be 77.6% of the opposite site and of the grip strength was 80.6% of the opposite site. 3. In the cases of extra-articular comminuted fracture, attention was focused on restoration of radial length, and in the cases of intra-articular fracture, better results were obtained with achieving congruent articular reduction. 4. The funtional end results were superior especially in young patients.

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Surgical treatment of Unstable Acetabular Fracture Clinical analysis of 28 cases with consideration of surgical problems and complications: I Kim, Y K Woo, Y S Kim, S W Song, S Y Kwon, S A Park; J Korean Soc Fract 1994;7(2):444-456. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.444

Abstract PDF: Authors reviewed total 28 cases of acetabular fracture with operative management followed up over 1 year. The clinical results were retrospectively analyzed with consideration of surgical problems and complications. The overall results were as follows: 1. According to the classification by Judet and Letoumel(1974), 20 cases were elementary fractures and 8 cases were associated fractures. The posterior wall fractures were most common in 9 case. 2. Kocher-Langenbeck approach in 18 cases, ilioinguinal in 4 cases, iliofemoral in 4 cases and triradiate transtrochanteric approach in 2 cases were used. 3. The devices for internal fixation were as follows screw only in 8 cases. plate and screw in 14 cases, plate and screw with circumferential wiring In 4 cases, wire and staple only in 1 each case. 4. The early and late complications occurred postoperatively as follows : incomplete sciatic nerve palsy 2 cases, wound infection 2 cases as early complications and posttraumatic arthritis 6 cases. avascular necrofis of femoral head 2 cases, heterotropic ossification 1 case as late complications. Two cases of sciatic nerve palsy were spontaneously recovered and 2 cases of wound infection were controlled by adequate drainage and antibiotic therapy. And then, the total hip arthroflasty were carried out for 2 cases of avascular necrosis of femoral head, and 6 cases of posttaumatic arthritis and 1 case of heterotopic ossification were under observation. 5. Postoperatively, the causes of inadequate reduction and insufficient fixation were radiographically analyzed with immediate]y and lastly checked plain films, of which causes in 9 cases were as follows : inappropriate approach for exposure in 4 cases, delayed operation due to major associated injury over 3 weeks in 3 cases and severe comminution in 2 cases. As a result, we reached to put an emphasis on an importatnce of preoperative planning, including the evaluation of individual fracture personality, the choice of surgical approach and the method of internal fixation.

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