Journal of Musculoskeletal Trauma

Total Hip Arthroplasty Following Acetabular Fracture: Myung Chul Yoo, Yoon Je Cho, Kang Il Kim, Young Soo Chun, Dong Oh Ko, Jin Woong Yi; J Korean Soc Fract 2003;16(2):121-127. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.121

Abstract PDF: PURPOSE
We evaluated the results of secondary total hip arthroplasty (THA) after acetabular fracture. MATERIAL & METHODS: Twenty cases of THA were performed to treat acetabular fracture as a secondary treatment after conservative management (6 cases) or internal fixation (14 cases). The mean follow up period was 5 years 2 months. The cause of secondary THA was post traumatic arthritis in 15 hips and osteonecrosis of the femoral head in 5. Cementless acetabular cup was used in 18 cases and cemented in 2 cases. Cementless femoral component was used in 18 cases and cemented in 2 cases. Serial Harris hip score (HHS), pain, limb length discrepancy and radiographs were evaluated.
RESULTS
HHS improved from 57 points to 91 points. Osteolysis in the acetabular component occurred in 2 cases and 5 cases in the femoral component. Loosening occurred in 2 cases of cemented acetabular components and 1 case in the femoral component. In this study, 3 cases (15%) required revision of the acetabular component and 2 cases (10%) of the femoral component.
CONCLUSION
The clinical results of THA after acetabular fracture was inferior to that of conventional arthroplasty. The secure cementless acetabular fixation with proper bone grafting is mandatory to improve the survival of acetabular component.

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Treatment of Peritrochanteric Fracture of Femur with Angulated Blade Plate: Myung Chul Yoo, Yoon Je Cho, Kang Il Kim, Young Soo Chun, Chang Hyeok Kwon, Dong Jin Shin; J Korean Soc Fract 2001;14(3):351-357. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.351

Abstract PDF: PURPOSE
To clarify the efficacy of angulated blade plate fixation in the treatment of complex peritrochanteric fracture of femur.
MATERIALS AND METHODS
Thirty peritrochanteric fractures treated with angulated blade plate, with a follow-up period of more than twelve months, were included. There were twenty subtrochanteric fractures and ten intertrochanteric fractures in which compression hip screw could not be applied due to comminution of trochanteric area. Average age was fifty six years(range, 17 to 76). Average follow-up period was 22.4 months(range, 12 to 31).
RESULTS
Average time to bony union for those fractures that healed primarily was 5 months. Solid union occurred in all cases with two malunion. Infection, implant failure, femoral head protrusion was not occurred.
CONCLUSION
Angulated blade plate can be a useful alternative for the fixation of comminuted peritrochanteric fracture if appropriate fixatives are not available.

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Treatment of Periprosthetic Fracture Following Total Elbow arthroplasty: Myung Chul Yoo, Yong Girl Rhee, Yoon Je Cho, Kang Il Kim, Young Lin Cho; J Korean Soc Fract 2000;13(1):193-199. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.193

PURPOSE
: To classify the pattern of periprosthetic fracture after total elbow replacement(TER) and introduce the principles of treatment in various fracture patterns.
MATERIALS AND METHODS
: Four patients(1 man and 3 women) were evaluated, who had periprosthetic fractures following total elbow arthroplasty, form July 1997 to October 1998. The incidence of fracture among TERs was 6%(4/62) and the average follow-up period was 1 year 6 months. The locations of periprosthetic fractures were classified according to Hanyu et al. The result were analyzed about the treatment modalities, the period to bony union, elbow motion and complication.
RESULTS
: Type2 and type 3 fractures were treated with closed reduction and hanging splint, whereas type 1 fracture showing loosening of humeral component was treated with revision arthroplasty. Type 4 fracture was treated with open reduction and internal fixation. The period to bone union was 5 months in average. The elbow motion ranged between 7.5degrees to 106.2degrees at the last follow-up. Type 3 showed anterior angulation deformity of 20degrees.
CONCLUSION
: Fracture pattern, stability, and loosing of component should be considered to select treatment modality. In transverse fracture proximal to the humeral stem tip(type 3), open reduction and internal fixation is recommended because of difficulties in maintaining alignment of fracture fragment. Postoperative rehabilitation program is very important to prevent limitation of elbow motion

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Treatment of Periprosthetic Fracture after Total Elbow Replacement Arthroplasty
Hyunseok Seo, Jin-Hyung Im, Joo-Yup Lee
Journal of the Korean Fracture Society.2020; 33(2): 110. CrossRef

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Treatment of comminuted supracondylar fractures of the femur using Ilizarov method: Myung Chul Yoo, Yoon Je Cho, Ki Tack Kim, Young Soo Chun, Na Sil Pyo, Sung Gun Kim; J Korean Soc Fract 1999;12(3):529-537. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.529

Abstract PDF: PURPOSE
To evaluate the effectiveness of the Ilizarov method as a treatment of open or comminuted supracondylar fractures which are uncommon, and difficult to manage because of the wide range of potential complications.
MATERIALS and METHODS
Between 1992 and 1999, we treated open or comminuted supracondylar fractures of the femur by Ilizarov method in whole period or conversion to OR/IF with or without bone graft after transient Ilizarov fixation. There were 13 cases in 11 patients. Open comminuted fractures were seven cases and closed comminuted fracutres were six cases. We compared Ilizarov method in all procedures and temporary mode followed by internal fixation for definite care.
RESULTS
According to Schatzker and Lamberts assessment the results were good or excellent in ten cases(77%). And the results were rated as good or excellent in 67% of case of Ilizarov method in all procedures, and 86% of cases changed to OR/IF.
CONCLUSION
Ilizarov technique is an useful method in cases of open and/or comminuted supracondylar fractures of the femur. And after initial stabilization of fracture, conversion to OR/IF is advisable to prevent pin site infection and allow ROM excercise of the knee joint.

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Sbuchondral Curettage & Bone Peg Fixation in Osteochondral Fracture of The Talus: Myung Chul Yoo, Yoon Je Cho, Hyun Sub Kwon, Jae Young Park; J Korean Soc Fract 1998;11(4):932-940. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.932

Abstract PDF: Osteochondral fracture is an attached fragment of subchondral bone become partially or completely separated from the underlying bone. Accurate diagnosis of osteochondral fracture of the talus,mainly caused by trauma, is difficult because osteochondral lesion is not detected easily on the roentgenographic examination. Osteochondal fracture is intraarticular fracture, thus operative approach and fixation is technically difficult and requires talus, with subchondral bone curettage through percutaneous extraarticular transtalar approact under the C-arm guide without arthrotomy in three cases of minimally detached or elevated osteochondral fragment. And two cases of partially detached osteochondral fragment treated by bone peg fixation with arthrotomy. We obtained good functional results at the follow-up of a mean of 1 year and 5 months. We believe that the subchondral curettage and bone peg fixation are excellent treatment methods for osteochondral fracture of the talus.

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Treatment of Femur Neck and Intertrochanteric Fractures in the Elderly with primary Hemiarthroplasty: Myung Chul Yoo, Ki Tack Kim, Yoon Je Cho, Seung Duk Sun, Gyoung Chean Park; J Korean Soc Fract 1994;7(2):412-421. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.412

Abstract PDF

From January 1982 through December 1992, 102 hips in 100 patients had a primary hemiarthroplasty for the treatment of femur neck and intertrochanteric fractures in the elderly who had severe comminuted fractures or poor bone quality and poor genenral condition. Of these, we reviewed 62 hips in 62 patients with a minimum follow-up over one year. 1. The average age at operation was 71.7 years(50-96 years). 2. The most common cause of injury was slip down in 56 cases(90.4%). 3. Bone quality was evaluated with Singh index radiologically and 42 cases(67.8%) were classified to below grade III. 4. Most patients were possible to sit and start wheel chair ambulation within a week and the average period of time from operation to partial weight bearing was 12.9 days. 5. In clinical evaluation, the average Harris hip score was 75.9 in the femoral neck fractures and 71.9 in intertrochanteric fractures and 73.2 in the unipolar endoprosthesis group and 69.5 in the bipolar endoprosthesis at the final follow up. 6. Postoperatively, 13 hips(21%) had only mild discomfort, 6 hips(10%) had moderate pain, one hip(1.6%) had severe pain on the ipsilateral hip or thigh, or knee. 7. The most common early postoperative complications were superficial wound infection(3 cases, 6.4%). 8. In the radiological evaluation, the most common late postoperative complications were leg length discrepancy(L.L.D) in 6 cases(9.7%) and acetabular erosion in 5 cases(8.1%). 9. In the analysis of the relationship between prosthetic head size compared to acetabular size and acetabular erosion, more proper size of prosthetic head raised less acetabular erosion, 1 case(2.5%), and large size of prosthetic head raised more acetabular erosion, 2 cases(28%). There was no significant difference in the incidence of the acetabular erosion between the unipolar and bipolar endoprosthesis group. In this study, most of the patients had relatively good results and lower incidence of local or general complictions. Therefore, hemiarthroplasty can be suggested for one of primary treatment method of intertrochanteric fractures and femur neck fractures in elderly patients who had fevere comminuted fractures or poor bone quality and poor general condition.

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The Efficacy of Suture Fixation of the Greater Trochanter in Unstable Intertrochanteric Fractures
Ki-Choul Kim, Hee-Gon Park, Jae-Wook Park
Clinics in Orthopedic Surgery.2021; 13(4): 468. CrossRef
Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients
Han-Jun Lee, Jong Won Kim, Jae-Sung Lee, Jae June Yang, Woo-Young Hwang
Journal of the Korean Fracture Society.2010; 23(3): 276. CrossRef

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