Journal of Musculoskeletal Trauma

Tension Band Plating for a Stress Fracture of the Anterior Tibial Cortex in a Basketball Player: A Case Report: Chul Hyun Park, Woo Chun Lee; J Korean Fract Soc 2012;25(4):323-326. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.323

Stress fractures of the anterior tibial cortex are prone to complete fracture because these stress fractures occur on the tension side of the bone. Recently, surgical treatments are preferred in high-performance athletes requiring rapid return to sports. We report our experience of a case in which stress fracture of the anterior tibial cortex was treated using anterior tension band plating in a male athlete and successful bony union and rapid return to sports were achieved.

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Stress fractures of the tibia
Jung Min Park, Ki Sun Sung
Arthroscopy and Orthopedic Sports Medicine.2015; 2(2): 95. CrossRef

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Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level: Jeong Gook Seo, Jong Ho Park, Jeong Seok Moon, Woo Chun Lee; J Korean Fract Soc 2009;22(1):39-44. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.39

Abstract PDF: PURPOSE
To evaluate the relationship between the level of screw fixation and the stability of the segment of endplate fracture after posterior pedicle screw instrumentation for thoracic and lumbar burst fractures.
MATERIALS AND METHODS
The 41 patients of burst fractures who had been operated with pedicle screw instrumentation were retrospectively evaluated. The patients were divided into two groups by the levels of screw fixation. One group was treated with screws fixed by one-level to the direction of fractured endplate (One-level group, 16 cases). The other group was treated with screws fixed by two-level to the direction of endplate fracture (Two-level group, 25 cases). The two groups were compared by the radiographic changes of kyphotic angle between the day of surgery and 6 months after surgery.
RESULTS
At the 6 months, one-level group showed the change of kyphotic angle of 17.5+/-2.4 degrees, which was different from two-level group of 5.2+/-0.8 degrees (p=0.000).
CONCLUSION
In posterior pedicle screws fixation for thoracic and lumbar burst fractures, 2 vertebrae to the direction of the endplate fracture should be included to prevent the postoperative kyphotic change.

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A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture: Jeong Seok Moon, Woo Chun Lee; J Korean Fract Soc 2009;22(1):13-18. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.13

Abstract PDF

PURPOSE
To compare the clinical results between the extensile lateral approach and sinus tarsi approach in the open reduction of the Sanders type II calcaneal fracture.
MATERIALS AND METHODS
From July 2002 to Februry 2007, thirty two patients having thirty three calcaneal fractures of Sanders type II were managed with open reduction and internal fixation using the extensile lateral approach or sinus tarsi approach. The mean age of 19 patients using extensile lateral approach was 43.3 years. The mean age of 13 patients using sinus tarsi approach was 46.3 years. Clinical outcome, radiographic parameters, and postoperative complications were compared between both groups.
RESULTS
There was no difference between two groups associated with patients demographs. The mean AOFAS score and VAS between both groups were not different (p=0.716, p=0.774). The mean Bohler's angle and Gissane's angle between both groups were not different (p=0.343, p=0.357). Two cases of sural nerve injury, one malunion, and one deep infection were occurred in the group of extensile lateral approach. However, patients using sinus tarsi approach had no postoperative complications.
CONCLUSION
The clinical results of sinus tarsi approach may be comparable with those of extensile lateral approach, with the advantages of reduced risk of postoperative complications.

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Citations to this article as recorded by

The Extensile Lateral Approach to the Calcaneus
Rohan Bhimani, Kush C. Shah, Rishin J. Kadakia
Techniques in Foot & Ankle Surgery.2025;[Epub] CrossRef
Extensile lateral versus sinus tarsi approach for calcaneal fractures
Chuangang Peng, Baoming Yuan, Wenlai Guo, Na Li, Heng Tian
Medicine.2021; 100(31): e26717. CrossRef
Lateral Extensile Approach Versus Minimal Incision Approach for Open Reduction and Internal Fixation of Displaced Intra-articular Calcaneal Fractures: A Meta-analysis
Andrea Seat, Christopher Seat
The Journal of Foot and Ankle Surgery.2020; 59(2): 356. CrossRef
Surgical Treatment of Calcaneal Fractures of Sanders Type II and III by A Minimally Invasive Technique with 6.5 mm Cancellous Screw
Yong Seung Oh, Kyung Ho Lee, Jung Ho Kim, Myoung Jin Lee
Journal of Korean Foot and Ankle Society.2019; 23(3): 116. CrossRef
A systematic review and meta-analysis of the sinus tarsi and extended lateral approach in the operative treatment of displaced intra-articular calcaneal fractures
Tomasz L. Nosewicz, Siem A. Dingemans, Manouk Backes, Jan S.K. Luitse, J. Carel Goslings, Tim Schepers
Foot and Ankle Surgery.2019; 25(5): 580. CrossRef
Meta‐analysis of two surgical approaches for calcaneal fractures: sinus tarsi versus extensile lateral approach
Fei Zhang, Hongtao Tian, Shilun Li, Bo Liu, Tianhua Dong, Yanbin Zhu, Yingze Zhang
ANZ Journal of Surgery.2017; 87(3): 126. CrossRef
Usefulness of Treatment with 6.5 mm Cancellous Screw and Steinmann Pin Fixation for Calcaneal Joint Depression Fracture
Gi-Soo Lee, Chan Kang, Deuk-Soo Hwang, Chang-Kyun Noh, Gi-Young Lee
Journal of Korean Foot and Ankle Society.2015; 19(1): 11. CrossRef
Open reduction and internal fixation with conventional plate via L-shaped lateral approach versus internal fixation with percutaneous plate via a sinus tarsi approach for calcaneal fractures – A randomized controlled trial
Shengli Xia, Yaogang Lu, Huizhong Wang, Zuming Wu, Ziping Wang
International Journal of Surgery.2014; 12(5): 475. CrossRef
Intra-articular Calcaneal Fractures Treated with Open Reduction and Internal Fixation -A Comparative Study between Groups with and without Bone Graft-
Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Sung Hwan Jo, Hoon Yang
Journal of the Korean Fracture Society.2010; 23(2): 180. CrossRef

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Treatment of Calcaneus Fractures: Recent Trend for Acute Fractures and Complications: Woo Chun Lee; J Korean Fract Soc 2007;20(4):361-367. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.361

Abstract PDF: No abstract available.

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Nonoperative Treatment of Isolated Lateral Malleolar Fracture: Woo Chun Lee, Jong Ho Ahn; J Korean Fract Soc 2005;18(3):291-293. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.291

Abstract PDF

PURPOSE
To evaluate the results of conservative treatment for isolated lateral malleolus fracture without medial ankle injury.
MATERIALS AND METHODS
From March 1999 to February 2003, 25 ankles in 25 patients were treated for isolated lateral malleolus fracture and followed for more than one year. Mean age was 46.9 years (range, 20~71 years). Cases without any swelling or tenderness on the deltoid area, or cases with minimal pain, swelling or tenderness on the deltoid area and medial clear space 1 mm or less on stress radiograph were included for the study. Immediate weight bearing was allowed with below-knee cast immobilization in all cases.
RESULTS
All were supinatin-external rotation stage II injury and mean duration of cast immobilization was 6.3+/-1.6 weeks after injury. There was no case which showed widening of medial clear space during routine radiographic follow-up. There was no change in the degree of displacement in spite of immediate weight bearing with short leg cast on.
CONCLUSION
Because the lateral malleolus fracture without medial injury can be managed nonoperatively, we need to differentiate this type of fracture to avoid unnecessary surgery, and for early return to normal daily activity.

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Posterior Plating in Distal Fibular Fracture
Choong-Hyeok Choi, Young-A Cho, Jae-Hoon Kim, Il-Hoon Sung
Journal of the Korean Fracture Society.2007; 20(2): 161. CrossRef

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Treatement of Diastasis of the Distal Tibiofibular Syndesmosis: Woo Chun Lee, Han Suk Ko, Cheol Lee, Ki Heon Nam, Kang Hoon Ko, Jong Deuk Rha; J Korean Soc Fract 2001;14(4):677-684. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.677

Abstract PDF: PURPOSE
To investigate the indication of transfixation of distal tibiofibular syndesmosis.
MATERIALS AND METHODS
Twenty-two patients were surgically treated for diastasis of the distal tibiofibular syndesmosis and followed for more than one year. The decision to transfix the syndesmosis was made according to the result of intraoperative stress test.
RESULTS
In patients with bimalleolar fracture, good or excellent clinical results were obtained in all patients, and no widening of the medial clear space and I mm or no widening of the tibiofibular clear space was observed. In patients with deltoid ligament tear, good or excellent results were obtained in five patients, and the medial clear space was widened more than 1mm in three patients and tibiofibular clear space was widened 2mm or more in four patients.
CONCLUSION
We believe that transyndesmotic fixation is not required if anatomical bimalleolar fracture fixation is achieved, and in patients who have deltoid ligament rupture, it may be better to transfix the syndesmosis regardless of the level of fibular fracture.

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Atraumatic Avulsion Fracture of Calcaneal Tuberosity in a Patient with Peripheral Neuropathy: A Case Report: Woo Chun Lee, Ki Heon Nam; J Korean Soc Fract 2001;14(1):85-90. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.85

Abstract PDF: Atraumatic calcaneal fractures associated with neurological abnormalities have been reported by several authors, and most of them are associated with diabetes. Chronic alcoholism is also a cause of neurological abnormality and neuropathic arthropathies associated with chronic alcoholism were reported. However we could not find any report of atraumatic calcaneal avulsion fracture associated with chronic alcoholism. We have treated a calcaneal avulsion fracture in a chronic alcoholic patient with open reduction and internal fixation, and the result was not satisfactory. We suggest that conservative treatment is better for the atraumatic calcaneal avulsion fracture in a chronic alcoholic patient with severe osteoporosis and neurological abnormalities.

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Assessment of the Stability of the Isolated Lateral Malleolar Fracture: Woo Chun Lee, Hyun Soo Park, Young Kil Han, Jang Woon Rim, Jong Deuk Rha; J Korean Soc Fract 1998;11(4):873-879. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.873

Abstract PDF: Recent advances in the understnading of the biomechanics of the ankle have given rise to the clinical uncertainty about the indications for the operative treament of isolated fractures of the lateral malleolus. If deltoid ligament injury is associated, it may be unstable and operation may be indicated. This study was done to determine if we are able to assess the stability of the isolated lateral malleolus fracture based on the fracture patterns seen on radiographs and clinical findings. 37 patients with malleolar fracture of the ankle were treated at Hanil General Hospital by open reduction and internal fixation from Dec. 1996 to Jan. 1998. Lauge-Hansen classification was tried in all cases to determine if it could be applied. Stress test under anesthesia on 10 isolated lateral malleolar fracture patients with clinical findings of injury on the deltoid ligament area, whose medial clear space were normal or widened less than 2 mm on initial film. Exploration of the deltoid ligament was performed in 6 of above 10 patients There were 21 supination-external rotation type injuries, 2 supination-adduction injuries, 1 pronation-abduction injury and 13 fractures could not be clearly categorized into specific group. In 6 among 13 unclear cases, there were short oblique fracture lime indicating pronation injury, but direction of the fracture line could not be clearly determined. In 4 cases, direction of the fracture lime indicated pronation injury, but the length of the fracture line was too long. In 3 cases, both the direction and length of the fracture line was indeterminate. The stress test on 10 isolated lateral malleolar fraactures with clinical findings of deltoid injury revealed less than 2 mm widening in 7 cases, more than 2 mm widening in 3 cases. In 3 cases with less than 2 mm widening, tearing of anterior third of superficial deltoid was confirmed by exploration. In 3 cases with more than 3 mm widening, partial rupture of the deep deltoid was observed in 2 cases and anterior third of superficial deltoid was torn in 1 case. We suggest that we cannot clearly assess the stability of isolated lateral malleolar fracture either by fracture patterns or clinical findings, so stress test can be considered in determining the stability.

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Interlocking Intramedullary Nailing of Femoral Shaft Fractures in Adolescents: Chil Soo Kwon, Jong Kuk Ahn, Jin Hyok Kim, Byung Hyun Jung, Yerl Bo Sung, Hyung Jin Jung, Jong Deuk Rha, Woo Chun Lee, Hyun Soo Park, Myung Ho Lee, Bu Maan Kim; J Korean Soc Fract 1996;9(4):914-920. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.914

Abstract PDF: Although treatment of femoral shaft fractures by traction and casting satisfactory in young children, it is less useful in obtaining and maintaining satisfactory alignment in adolescent patients. Residual angulation, malrotation. and leg length inequality is well documented. The options for surgical treatment of femoral shaft fractures in adolescents include extemal fixation, plate fixation, and intramedullary nailing. Surgical treatments carry the-risks of growth plate damage and infection, but these risks are very low. Recently, it is generally anepted that adolescent femoral shaft fractures are preferably treated by intramedullary nailing with care taken to avoid damaging the distal femoral physis. The authors experienced 9 femoral shaft fractures in 8 patients treated with interlocking intramedullary nails from August 1989 to May 1994, and followed up for more than 18 months(range from 18 to 45 months). The results were as follows: 1. There were 6 cases in male, 2 cases in female. Average age at the time of injury was 13 years(range, 11-14). 2. All fractures were united, and the nails were removed at an average 13.3 months after operation: no refracture or femoral neck fracture has since occured. 3. None had angular or rotational malunions, infection and avascular necrosis of femoral head. The average leg-length discrepancy at the last follow-up was 0.5cm(range, 0-1.0cm) and all were clinically acceptable. Coxa valga due to premature closure of trochanteric apophysis was not found. The average femoral neck-shaft angle was 133(130~138) at the last follow-up. So, interlocking intramedullary nailing is a reasonable alternative for the treatment of femoral shaft fracture in adolescents.

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