Journal of Musculoskeletal Trauma

Usefulness of CT Scan in Treatment of Calcaneal Fracture: Hak Jun Kim, Kwon Ick Ha, Jeong Ro Yoon, Jae Ik Shim, Taik Seon Kim, Young Bae Kim, Woo Seung Lee, Jae Hyuck Choi; J Korean Soc Fract 2003;16(4):526-533. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.526

PURPOSE
Accurate fracture classification is difficult because of its complex bony architecture and there is no definitive treatment modality according to fracture pattern or classification. We evaluated the fracture pattern using simple radiography and CT scan simultaneously and then the result according to treatment modalities and fracture classification.
MATERIALS AND METHODS
We evaluated 24 patients (26 cases) who suffered intraarticular calcaneal fracture were treated with closed reduction and axial pinning or open reduction and plate fixation. There were had taken CT scan. Fractures were classified with two different manner using both plain radiography and CT scan. Essex-Lopresti classification was made with plain radiography and Sanders classification was made with CT scan. Radiographic results were measured of preoperative and postoperative Bohler angle on plain x-ray. 16 patients (17 cases) were analyzed for clinical outcomes by Salama's criteria focused on pain, patients' satisfaction, walking abilities and usage of orthosis.
RESULTS
Mean followed-up period was 6 years (range 1~8.8 years). 8 cases were classified into tongue type intraarticular calcaneal fractures by plain radiography and 9 cases into joint depression type. According to Sanders classification by CT scan, 5 cases were classified into type IIA, 1 case IIC, 4 cases type IIIA, 4 cases IIIB and 3 case type IV. 12 fractures were reduced by closed reduction and axial fixation and 5 cases by open reduction and internal fixation. There was no correlation between clinical outcomes and treatment modality but there was linear correlation between clinical outcomes and postoperative Bohler angle (correlation coefficient = 0.04). In 8 cases of tongue type by plain radiography, sanders type IIC was only 1 case which calcaneal tuberosity connected to articular facet but articular involvements were observed in remaining cases.
CONCLUSION
Accurate eavaluation of articular facet in calcaneal fracture by CT scan is necessary to determining to select the treatment option.

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Physiological Characteristics and Anti-Obesity Effect of Lactobacillus plantarum K6 isolated from Kimchi
Seulki Kim, Sang-Dong Lim
Journal of Milk Science and Biotechnology.2017; 35(4): 221. CrossRef

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Surgical Treatment of Internal Malleolar Fracture of the Ankle: Rush Rod Versus Plate Osteosynthesis: Hak Jun Kim, Kwon Ick Ha, Jae Ik Shim, Taik Seon Kim, Jeong Ro Yoon, Young Bae Kim, Woo Seung Lee, Jae Young Chang; J Korean Soc Fract 2003;16(4):519-525. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.519

Abstract PDF: PURPOSE
We evaluated the results between the methods of open reduction and internal fixation using plate and screws and the methods of closed reduction and fixation with rush pin in lateral malleolar fractures.
MATERIALS AND METHODS
We analysed the 33 fractures of lateral malleolus which had been treated by open reduction and internal fixation using plate and screws or closed reduction and fixation with rush pin from January 1995 to January 2002 and had been observed over 1 year. The 33 patients were observed for the comparison of radiologic and clinical results in according to the measure of McLennan and Ungersma.
RESULTS
Among the 33 cases, 15 cases were treated by open reduction and internal fixation with plate, and 18 cases were treated by closed reduction and Rush rods fixation. In according to the measure of McLennan and Ungersma, good radiologic result was 60% (9 cases) and excellent clinical result was 27% (4 cases) in plate fixation, and good radiologic result was 61% (11 in 18 cases) and excellent clinical result was 39% (7 in 18 cases) in Rush rods fixation.
CONCLUSION
In ankle fractures of elderly patients who have soft tissue problems and osteoporotic bony quality, radiologic and clinical results of internal fixation of distal fibula were relatively same between fixation with plate and screws and Rush rods. Therefore, closed reduction and internal fixation with Rush rods is one of the good treatment modalities of distal fibular fracture.

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The Cause of the Nonunion of the Mid-clavicle Fractures: Jung Ro Yoon, Jae Ik Shim, Taek Seon Kim, Sung Jong Lee, Young Bae Kim, Hack Jun Kim, Kuk Whan Ahn, Jae Young Chang, Myung Pyo Hong; J Korean Soc Fract 2002;15(4):538-544. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.538

Abstract PDF: PURPOSE
Because the prognosis of the mid 1/3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare.However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion.
MATERIALS AND METHODS
We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients 'chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury.
RESULTS
15 of the 63cases had developed nonunion.. The average 8.6mm(2mm-17mm) shortening and average 9.7mm(2-22mm) in the union patients. The average 14.5mm(3mm-37mm) shortening and average 17.3mm(4-25mm) in the nonunion patients. We found that initial shortening > or =1 8 m m ( Fisher's exact test, p <0.01) and initial displacement > or =16mm(Chi-square test, p <0.01) at the fracture site were siinificantly associated with the development of nonunion.
CONCLUSION
The conservative treatment with figure-8-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several weeks, osteosynthesis should be considered.

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Surgical Treatment for Nonunion of Femoral Shaft Fractures: Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Young Bae Kim, Jong Ro Yoon, Eui Sang Seol, Kwang Yeol Park, Dae Woong Kang; J Korean Soc Fract 2001;14(3):364-370. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.364

Abstract PDF: PURPOSE
The purpose of this study is to analyze the clinical and radiological result of surgical treatment for femoral shaft nonunion.
MATERIALS AND METHODS
From January 1993 to December 1999, 21 cases of femoral shaft nonunion were treated surgically and followed for an average of 15 months. We analyzed initial cause of injuries, classification of fractures, and cause of nonunion in clinically and radiologically. The authors analyzed the average time to union and results after surgical treatment by rigid internal fixation with interlocking intramedullary nail and autogenous bone graft.
RESULTS
The mean duration of bony union was 22 weeks and bony union achieved in 18 cases(85.7%) of 21 cases. The complications were shortening of leg length and limping gait in 2 cases, partial limitation of knee joint in 2 cases, superficial infection in 2 cases.
CONCLUSION
Rigid internal fixation with interlocking intrameduallary nail and bone graft is useful method of treatment for femoral shaft nonunion according to cause and type of nonunion.

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Treatments of the Malunited Tibial Shaft Fracture: Taik Seon Kim, Jae Ik Shim, Sung Jong Lee, Suk Ha Lee, Yeon Sik Yu, Young Bae Kim, Kwang Yeol Park; J Korean Soc Fract 2000;13(4):897-904. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.897

Abstract PDF: PURPOSE
The malunited diaphyseal tibia fractures result in tibial shortening, angular deformities, gait disturbance, development of joint pain, etc. The authors analyzed the results of treatment consist of corrective osteotomy for diaphyseal malunion with internal or external fixation.
MATERIALS AND METHODS
The authors reviewed 18 cases of tibial diaphyseal malunion treated in Korea Veterans Hospital between January 1992 and December 1998. Mean follow-up period was 4.2 years. The preoperative deformities were varus, anterior or posterior bowing and shortening. The preoperative symptoms were knee joint pain, ankle joint pain, and gait disturbance. Corrective osteotomy was done on the site of malunion in all cases. Fixation were done with IM nailings(13 cases), plates(3 cases) and Ilizarov external fixator. We analyzed the unions radiologically and the knee pains with HSS score.
RESULTS
All malunions were successfully corrected. Mean duration of union was 4.5 month. In the coronal plane, preoperative varus deformity(mean 16.5degrees varus) was corrected to 3degrees of valgus. In the saggital plane, anterior and posterior bowing was corrected to neutral. In 15 cases of the patient with knee joint pain, the mean HSS score was improved from 69 preopertively to 82 postoperatively.
CONCLUSION
The correction of tibia diaphyseal malunion had good results by osteotomy at the malunited site and firm internal or external fixation. And it also improved knee joint pain significantly.

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Treatment of Femoral Neck Fracture (Comparison of Knowles Pin and Cannulated Screw Fixation): Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Young Bae Kim, Shin Pyo Kang; J Korean Soc Fract 2000;13(4):809-816. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.809

Abstract PDF: PURPOSE
The authors have analyzed clinical and radiological results of the femoral neck fractures to evaluate the difference Knowles pin and cannulated screw fixation group.
MATERIALS AND METHODS
The patients were devided into two group retrospectively, Group I included 35 cases that were treated with Knowles pin fixation for femoral neck fracture and Group II included 30 cases that were treated with cannuled screw fixation for femoral neck fracture. Clinical information included operation time, total blood loss and functional outcome. Postoperative X-ray information included Garden alignment index, duration of union and complication(P>0.05).
RESULTS
There was no difference between the two fixation group regarding duration of union, functional outcome by Lanceford's method and complication(P>0.05).
CONCLUSION
Knowles pin fixation and cannulated screw fixation were considered to be proper as a fixaton method in a fracture of the femur neck.

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Treatment of Diaphyseal Fractures of the Forearm Both Bones: Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Young Bae Kim, Jeong Ro Yoon, Jeong Su Yoo; J Korean Soc Fract 2000;13(4):1016-1023. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1016

Abstract PDF

PURPOSE
To analyze the clinical and radiological result of diaphyseal fractures of the forearm both bones treated by plate fixation and plate fixation with intramedullary nailing.
MATERIALS AND METHODS
We reviewed 52 cases of diaphyseal fractures of the forearm both bones in adults that were treated and the follow-up period was 1 year above. The first group(I), 25 cases(48.1%) were treated with plate fixation in radius and ulna, the second group(II), 27 cases(51.9%) were treated with plate fixation in radius and threaded Steinman pin fixation in ulna. we analyzed the results by average union time and functional result according to Anderson's criteria.
RESULTS
The mean duration of union was in the first group, 12.3 weeks in the second group, 13.2 weeks. By Anderson's criteria, in the first group, 21 cases(84%) and in the second group, 22 cases(81.5%) had a good result. As complications in the first group, non-union 2 case, angulation deformity 1 case, rotational deformity 1 case and in the second group, non-union 4 cases, angulation deformity 2 cases.
CONCLUSION
We considered that satisfactory results can be obtained by rigid internal fixation with plates in radius & ulna and early mobilization in fractures of forearm both bones in adults and according to the type of fracture, Fixation with plate in radius and threaded Steinman pin in ulna was one of the proper methods.

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Treatment of a Segmental Ulnar Shaft Fracture and an Olecranon Fracture
Myoung Soo Kim, Kyu Pill Moon, Hyung Joon Cho, Jung Yun Bae, Kuen Tak Suh
Journal of the Korean Orthopaedic Association.2010; 45(6): 496. CrossRef
Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail
Kwang-Yul Kim, Moon-Sup Lim, Shin-Kwon Choi, Hyeong-Jo Yoon
Journal of the Korean Fracture Society.2008; 21(2): 157. CrossRef

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The Classiflcation and Management of Intraarticular Calcaneal Fracture Based on Computed Tomography: Jae lk Shim, Taik Seon Kim, Sung Jong Lee, Suck Ha Lee, Chang Moo You, Young Bae Kim; J Korean Soc Fract 1996;9(3):742-749. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.742

Abstract PDF

Displaced intraarticular fractures of the calaneus require operative intervention to restore the anatomy of the bone, which in turn is the requirement for recovery of subtalar joint mobility. To evaluate the complex contour of calcaneal anatomy, a classification for intraarticular calcaneal fractures was used, based on standardized coronal and transverse computed tomography scans of os calsis. From January 1993 to December 1994, intraarticular calcaneal fractures of 47 cases treated in Korea Veterans Hospital were analysed preoperatively with C.T. scan and classified by Sandersclassification system. And clinical evaluation of the patients was done by Maryland Foot Score postoperatively. The result were as follows:Type I fractures were found in 10 cases. 25 cases of 47 cases were classified as type II and subdivided as II A in 13 cases, II B in 6 cases, II C in 6 cases. Type III fractures were found in 8 cases and subdivied as III AB in 4 cases, III BC in 3 cases, III AC in 1 case. Type IV fractures were found in 4 cases. This classification aids a surgeon to make perioperative decision, because it has prognostic significance.

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Surgical Outcome of Stable Scaphoid Nonunion without Bone Graft
Eun Sun Moon, Myung Sun Kim, Il Kyu Kong, Min Sun Choi
Journal of the Korean Fracture Society.2010; 23(1): 69. CrossRef
The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures
Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Sueng Hwan Jo
Journal of the Korean Fracture Society.2007; 20(3): 227. CrossRef

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