Journal of Musculoskeletal Trauma

Clinical Features and Outcomes of Pelvic Insufficiency Fractures: Yong Min Seo, Young Chang Kim, Ji Wan Kim; J Korean Fract Soc 2017;30(4):186-191. Published online October 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.4.186

Abstract PDF: PURPOSE
The purpose of this study was to investigate the radiological and epidemiological characteristics, as well as the clinical course of pelvic insufficiency fractures in the elderly population.
MATERIALS AND METHODS
At a Haeundae Paik Hospital, we retrospectively reviewed patients with pelvic insufficiency fractures between March 2010 and May 2017. The demographic data of patients were analyzed, and bone mineral density and bone turnover markers were evaluated to estimate the metabolic status of the bone. The radiological characteristics were evaluated by comparing the simple x-ray images with the computed tomography images, and the types of fractures were classified via computed tomography images. For clinical course evaluation, we investigated comorbid complications, and compared the walking ability scale before and 6 months after the fracture.
RESULTS
A total of 42 patients were included, with an average age of 76.5 years. All were female except one case. In 5 cases where the initial medical examination was from another institution, the fracture was not found in 3 cases. All cases received conservative treatment. After the diagnosis of pelvic bone fracture using a simple x-ray imaging, additional fractures were found in 81.0% of the study population using a computed tomography. Initiation of gait occurred at an average of 2.8 weeks, and every case except 1 (97.6%) fully recovered their gait ability.
CONCLUSION
We concluded that there was a limitation with diagnosing pelvic insufficiency fracture using only a simple x-ray imaging technique. In general, cases in this study showed conservative treatment yielded favorable clinical outcome with relatively less critical complications.

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Clinical Outcomes of Fasciotomy for Acute Compartment Syndrome: Ji Yong Park, Young Chang Kim, Ji Wan Kim; J Korean Fract Soc 2015;28(4):223-229. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.223

Abstract PDF: PURPOSE
The purpose of this study is to evaluate clinical outcomes and complications after fasciotomy in acute compartment syndrome.
MATERIALS AND METHODS
Seventeen cases diagnosed as compartment syndrome and underwent fasciotomy from January 2011 to February 2015 were evaluated retrospectively. We investigated the causes and regions of acute compartment syndrome, the methods of wound management, the necessity of skin graft, and the complications including amputation and infection.
RESULTS
According to the causes of acute compartment syndrome, there were 7 fractures, 1 traumatic hematoma, 6 reperfusion injury, and 3 rhabdomyolysis. The regions of acute compartment syndrome were 3 cases of thigh, 10 cases of leg, and 3 cases of foot. One case had acute compartment syndrome involving thigh, leg, and foot. Of 17 cases, 3 cases died due to reperfusion injury and one case with severe necrosis of soft tissues underwent amputation. Among the 13 cases excluding 4 cases with death or amputation, 3 cases underwent split thickness skin graft. Shoelace technique and/or vacuum-assisted closure (VAC) was used for 9 cases, and wound closure without skin graft was achieved in all except one case, while 2 cases required skin graft among 4 cases without shoelace technique or VAC. There were 2 cases of infection.
CONCLUSION
Acute compartment syndrome caused by reperfusion injury had poor outcomes. Shoelace technique and/or VAC were useful for management of wound after fasciotomy.

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Modified Stoppa Approach in Acetabular Fractures: Ji Wan Kim, Young Chang Kim; J Korean Fract Soc 2014;27(4):274-280. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.274

PURPOSE
The purpose of this study is to evaluate the clinical results of modified Stoppa approach in acetabular fractures.
MATERIALS AND METHODS
Twelve patients who underwent surgery using the modified Stoppa approach for acetabular fractures were enrolled. There were 10 cases of isolated acetabular fracture, two cases of acetabular fracture combined with pelvic ring injury. There were two cases of anterior column fracture, nine cases of both column fracture, and one case of T-type fracture according to Letournel classification. The clinical outcomes were evaluated from Harris hip score (HHS) at postoperative one year and complications. The radiologic result was evaluated according to Matta criteria; anatomical, imperfect, and poor.
RESULTS
According to the radiological results, there were eight cases of anatomical, three cases of imperfect, and one case of poor reduction. The average HHS was 82.5 and 10 patients had excellent or good results. The other two patients had poor results due to lumbosacral plexopathy and poor reduction, respectively. The complication included one case of incomplete sciatic nerve palsy, which was recovered at postoperative three months.
CONCLUSION
Internal fixation of acetabular fractures using the modified Stoppa approach had satisfactory clinical and radiological outcomes. The modified Stoppa approach can be a useful option for acetabular fractures with appropriate indication and anatomical information.

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Adhesion of External Iliac Vessels Found in a Modified Stoppa Approach to Acetabular Fracture in a Patient with a History of Previous Abdominal Surgery
Seong-Tae Kim, Seungyup Shin, Hohyoung Lee, Seong Man Jeon
Journal of the Korean Orthopaedic Association.2022; 57(1): 68. CrossRef
Anterior Approach for the Acetabular Fractures
Jae Youn Yoon, Jae-Woo Cho, Ji Wan Kim
Journal of the Korean Fracture Society.2019; 32(3): 157. CrossRef
Reduction Technique of Dome Impaction Using the Modified Stoppa Approach: A Technical Note
Ji Wan Kim, Yong Min Seo, Hyo-Seok Jang
Journal of the Korean Fracture Society.2017; 30(3): 131. CrossRef
Biological fixation of pelvic ring and acetabular fractures: a pilot study with anatomical validation
Abdelfattah Mohamed Fathy Saoud, Ahmed Mohamed Sallam, Ahmed Mohamed Morsey
Current Orthopaedic Practice.2017; 28(3): 303. CrossRef
Cerclage Clamping Using Cerclage Passer for Reduction of Anterior and Posterior Column Fracture
Ki Chul Park, Hyun Joong Cho, Hun Chul Kim, Kyung-Sik Min, Hae Won Jeong
Journal of the Korean Orthopaedic Association.2016; 51(6): 486. CrossRef

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Ankle Fracture Associated with Tibia Shaft Fractures: Ji Wan Kim, Hong Joon Choi, Dong Hyun Lee, Young Chang Kim; J Korean Fract Soc 2014;27(2):136-143. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.136

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the incidence of ankle injury in ipsilateral tibial shaft fractures and to assess the risk factors for ankle injury associated with tibial shaft fractures.
MATERIALS AND METHODS
Sixty patients with tibial shaft fractures were enrolled in this retrospective study. The incidence and characteristics of ankle injury were evaluated, and fracture classification, fracture site, and fracture pattern of the tibial shaft fractures were analyzed for assessment of the risk factors for ankle injury combined with tibial shaft fractures.
RESULTS
Ankle injury occurred in 20 cases (33%). There were four cases of lateral malleolar fracture, four cases of posterior malleolar fracture, two cases of distal tibiofibular ligament avulsion fracture, and 10 cases of complex injury. Fourteen cases (70%) of 20 cases of ankle injury were diagnosed from x-ray films, and the other six cases were recognized in ankle computed tomography (CT). Ankle injury occurred in 45.1% of distal tibial shaft fractures and found in 41.4% of A type, but there was no statistical significance. Ankle injury was observed in 54% of cases of spiral pattern of tibial shaft fracture and the incidence was statistically higher than 19% of cases of non-spiral pattern tibial shaft fracture.
CONCLUSION
Ankle injury was observed in 33% of tibial shaft fractures; however, only 70% could be diagnosed by x-ray. Ankle injury occurred frequently in cases of spiral pattern of tibial shaft fracture, and evaluation of ankle injury with CT is recommended in these cases.

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Usefulness of Computed Tomography on Distal Tibia Intra-Articular Fracture Associated with Spiral Tibia Shaft Fracture
Seong-Eun Byun, Sang-June Lee, Uk Kim, Young Rak Choi, Soo-Hong Han, Byong-Guk Kim
Journal of the Korean Fracture Society.2016; 29(2): 114. CrossRef

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Neurologic Injury within Pelvic Ring Injuries: Ji Wan Kim, Dong Hoon Baek, Jae Hyun Kim, Young Chang Kim; J Korean Fract Soc 2014;27(1):17-22. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.17

Abstract PDF

PURPOSE
To evaluate the incidence of neurologic injury in pelvic ring injuries and to assess the risk factors for neurologic injury related to pelvic fractures.
MATERIALS AND METHODS
Sixty-two patients with the pelvic ring injury were enrolled in the study from March 2010 to May 2013. When the neurologic injury was suspected clinically, the electro-diagnostic tests were performed. Combined injuries, fracture types, and longitudinal displacements were examined for correlations with the neurologic injury.
RESULTS
There were 7 cases of AO/OTA type A, 37 cases of type B, and 18 cases of type C. Among them, 25 patients (40%) had combined spine fractures, and the average of longitudinal displacement was 7 mm (1-50 mm). Of the 62 patients, 13 (21%) had neurologic injury related with pelvic fractures; 5 with lumbosacral plexus injury, 5 with L5 or S1 nerve injury, 2 with obturator nerve injury, and 1 case of lateral femoral cutaneous nerve injury. There were no relationships between the neurologic injuries and fracture types (p=0.192), but the longitudinal displacements of posterior ring and combined spine fractures were related to the neurologic injury within pelvic ring injury (p=0.006, p=0.048).
CONCLUSION
The incidence of neurologic injury in pelvis fracture was 21%. In this study, the longitudinal displacements of posterior ring and combined spine fractures were risk factors for neurological injury in pelvic ring injury.

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Surgical Outcome of Posterior Pelvic Fixation Using S1, S2 Screws in Vertically Unstable Pelvic Ring Injury
Kwang Hee Yeo, Nam Hoon Moon, Jae Min Ahn, Jae Yoon Jeong, Jae Hoon Jang
Journal of the Korean Fracture Society.2018; 31(1): 9. CrossRef

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Hip Arthroplasty in Intertrochanteric Fractures: Is It Acceptable Treatment?: Young Chang Kim, Ji Wan Kim, Jae Young Lim; J Korean Fract Soc 2014;27(1):105-112. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.105

Abstract PDF

No abstract available.

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Primary Cementless Hip Arthroplasty in Unstable Intertrochanteric Femur Fracture in Elderlys: Short-term Results
Su-Hyun Cho, Hyung Lae Cho, Hong Cho
Hip & Pelvis.2014; 26(3): 157. CrossRef

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The Incidence of Venous Thromboembolism in Trauma Patients with Pelvic or Acetabular Fracture: Ji Wan Kim, Hyun Wook Chung, Young Chang Kim; J Korean Fract Soc 2012;25(4):250-256. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.250

Abstract PDF

PURPOSE
To evaluate the incidence of venous thromboembolism (VTE) in trauma patients with pelvic or acetabular fracture and determine high risk factors.
MATERIALS AND METHODS
Twenty-three patients who had a pelvic or acetabular fracture were enrolled between March 2011 and February 2012. All patients had mechanical and chemical prophylaxis and underwent deep vein thrombosis (DVT) computed tomography around 2 weeks after injury for evaluation of VTE. The relationships between VTE and each of sex, age, body mass index, injury severity score, intensive care unit stay, transfusion, operation time, coagulopathy, and associated injury were analyzed.
RESULTS
A total of 8 patients developed VTE (34.8%), of which 5 had DVT, 2 had pulmonary embolism (PE), and one had both DVT and PE. The group with a VTE risk score of 14 or more had a significantly higher incidence of VTE.
CONCLUSION
Careful attention is needed in management of patients with pelvic or acetabular fracture.

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Knowledge, Health Belief, and Preventive Behavioral Intention related to Venous Thromboembolism (VTE) of the Patients with Lower Limb Musculoskeletal System Disorders
Hye Jin Yang, Hee-Young Kang
The Journal of Korean Academic Society of Nursing Education.2013; 19(4): 531. CrossRef

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Functional Evaluation of Wrist According to Changes of Length after Operation in Fracture of Both Bones of Forearm: Seung Suk Seo, Ki Yong Kim, Jang Seok Choi, Young Chang Kim, Jae Keun Park; J Korean Soc Fract 2003;16(1):74-82. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.74

Abstract PDF: PURPOSE
To evaluate the relationship between the length changes of both forearm bones and function of wrist. To know permitted length discrepancy for good wrist function after operation in fracture of both bones of forearm MATERIALS AND METHODS: From Jan. 1995 to Dec. 2000, 21 cases were followed over 1 year, were treated with compression plate and screws due to fracture of both bones of forearm in our hospital. Mean duration of follow-up was 3 years 6 months. The postoperative length difference was compared to preoperative or unaffected side in roentgenography. Four groups were defined to A, B, C and D by postoperative length difference ; < or =1mm, 1 2mm, 2 3mm, and >3mm for comparison. The function of wrist joint was evaluated with the Anderson 's classification and Mayo modified wrist score.
RESULT
Group A were 11 cases(52.3%), B 5 cases(23.8%), C 4 cases(19.0%) and D 1 case(4.8%). By the Anderson 's classification, the number of Excellent were 11 cases(52.3%), Good 7(33.3%), Fair 3(14.3%). In the group of the length difference lesser than 2mm, the number of Excellent were 11, and Good 5. The Mayo modified wrist score was 75.15 in the group of the length difference lesser than 2mm, that was higher than 61.15 in the group of more than 2mm.
CONCLUSION
To obtain a good wrist function after operative treatment of fracture of both bones of forearm the length discrepancy of both bones should be lesser than 2mm.

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AMRI Study of Associated Soft Tissue Injury in Tibial Plateau Fractures: Jang Suk Choi, Young Chang Kim, Sung Suk Seo, Ki Chan Ahn, Chang Sub Lee, Jae Sang Choi; J Korean Soc Fract 2000;13(3):501-506. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.501

Abstract PDF: Tibial plateau fractures can occur concomitent with injuries to the collateral, cruciate ligament and mensci. The purpose of this article is to demonstrate the frequency of soft tissue injuries associated with tibial plateau fractures and analyze the pattern of fracture more accurately by magnetic resonance imaging(MRI). Thirty one plateau fractures were evaluated in this study. MRI was more accurate in determining the classification of the fracture and measuring the displacement and depression of fragment. There was a 71%(22 of 31) frequency of associated soft tissue injuries in this series of tibial plateau fractures. The medial collateral ligaments were injured in 32.3%(10 of 31), the anterior cruciate ligaments in 29%(9 of 31), the posterior cruciated ligament in 22.5%(7 of 31), the lateral collateral ligament in 19.4%(6 of 31), and the menisci in 39%(12of 31). Schatzker type II and IV fracture patterns were associated with the highest frequency of soft tissure injuries. Medial collateral ligament injuries were most commonly associated with Schatzker type II fracture patterns. Menisci were most commonly injured with Schazker type IV fracture patterns. Most of the patients with acute tibial plateau fracture were commonly associated with ligamentous and meniscal injuries. MRI can aid in accurate evaluation of tibial plateau fracture patterns and decision of treatement plan.

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Treatment of Open Type-III Tibial Shaft Fractures -Comparison Between Ilizarov External Fixation and Secondary Intramedullary Nailing-: Hoon Kim, Woo Dong Nam, Ki Chan Ahn, Seung Seok Seo, Young Chang Kim, Jang Seok Choi, Young Goo Lee; J Korean Soc Fract 1998;11(1):191-197. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.191

Abstract PDF: Open type III tibial shaft fractures have a high incidence of complication and a poor outcome. The most usual method of stabilization is by external fixation, but there are several complications as infection, delayed union and nonunion. We tried to compare the results of Ilizarov external fixation cases with the case of secondary intramedullary nailing after temporary Ilizarov fixation. There was no significant difference in the union time of Ilizarov external fixation and secondary intramedullary nailing after temporary Ilizarov fixation. But the patients were more comfortable in the secondary intramedullary nailing. In conclusions, secondary intramedullary nailing after temporary Ilizarov fixation is the useful method in the treatment of open type III tibial shaft fractures.

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The Treatment and Complications of Ipsilateral Fracture of the Femur and tibia: Kyu Min Kong, Ki Chan Ahn, Sung Seok Seo, Young Chang Kim, Jang Seok Choi, Young Goo Lee; J Korean Soc Fract 1997;10(3):556-561. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.556

Abstract PDF: Ipsilateral fracture of the femur and tibia is difficult to treat because it is often comminuted and combined with severe soft tissue injury. And The result of treatment is poor in most cases. The thirty-four cases were treated at Pusan Paik Hospital from March, 1992 to February, 1995. The result were as follows; 1. The bony union time was shorter in the intramedullary nailing than other methods. 2. There were less complications in the group of used intramedullary nailing than other methods. 3. The intramedullary nailing was relatively good treatment method for ipsilateral fracture of the femur and tibia.

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Fracture of Femur Neck Associated with Technical Errors in Closed Intramedullary Nailing of the Femur: Yong Hoon Kim, Ki Chan Ahn, Sung Suk Seo, Young Chang Kim, Jang Suk Choi, Young Gu Lee; J Korean Soc Fract 1997;10(1):73-78. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.73

Abstract PDF: Closed intramedullary nailing has become increasingly popular in the management of fracture of the femur because of a high rate of union and a low rate of complications. Since the development, it has been widely used in more applicable level of femoral shaft fracture. Therefore, complications of intramedullary nailing was rarely seen, especially rare in case of fractures of the femoral neck associated with technical errors. The three cases of femoral neck fracture with technical errors during intramedullary nailing for treatment of femoral shaft fracture in Paik Hospital, Pusan from April 1994 to July 1995 are reported herein to document that this complication can occur. Three cases of the femoral neck fracture were treated by closed reduction and internal fixation with Knowles pin.

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Treatment using Intramedullary Fixation for Open Tibial Diaphyseal Fractures: Young Goo Lee, Jnng Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seung Seok Seo, Sang Hun Ha; J Korean Soc Fract 1996;9(3):583-592. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.583

Abstract PDF: This fractures of tibial shaft are common and open injuries are frequently accompanied due to its anatomical characteristics. External fixation was widely used for treatment of open fractures of tibia, but recently internal fixation combined with appropriate debridement and antibiotics has been reported, with more comfortness and less secondary operations. We analysed 33 cases of open tibial diaphyseal fractures treated using intramedullary fixation devices. The results were as follows. 1. The methods of fixation were Ender nail, 15 cases, and interlocking nail, 18 cases. And 17 cases out of 18 interlocking nail were unlearned one. 2. The Ender nail was used in 5 cases for open type I fracture, 7 type II, 2 type III-a and 1 type III-b, And the interlocking nail was used in 9 cases for type 1, 7 type II, 1 type IIIa and 1 type III-b. The average operation time was 55 minutes for Ender nail, while 14 minutes for interlocking nail. 3. The Ender nailing group has 6 complications;one case superficial infection, one deep infection, one delayed union, one nonunion and two angulation deformities. The interlocking nailing group has also 6 complications;one case superficial infection, two deep infections, one delayed union, one nonunion and one peroneal nerve palsy. 4. The average union period was 18.4 weeks in Ender nail and 19.1 weeks in interlocking nail.

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Interlocking Medullary Nailing in Severe Comminuted Fracture of the Femoral Shaft: Young Goo Lee, Jang Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seong Seok Seo, Young Jae Kim; J Korean Soc Fract 1996;9(1):105-111. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.105

Abstract PDF: The interlocking medullary nail widens the range of the indication for medullary osteosynthesis of the femoral shaft fractures. Twenty one cases with the comminuted fracture of the femoral shaft were reviewed, which had been treated by closed or or semi-open IM nailing at the Department of Orthopedic Surgery, Pusan Paik Hospital from March 1991 to December 1993. The results were as follows 1. The period of fracture union was 22.1 weeks in Winquist-Hansen Grade III,27.4 weeks in Grade IV , 19.6 weeks in segmental. And its period was 22.6 weeks in closed and 26.2 weeks in semi-open IM nailing. 2. The result of closed interlocking medullary nailing was better and complications were less than semi-open interlocking medullary nailing. 3. The severely comminuted femoral shaft fractures were unstable and there were the risk of shortening, rotation and inadequate reduction. Therefore, when the closed interlocking medullary nailing did not gain the anatomical reduction, it was altemative method to perform semi-open interlocking medullary nailing. From above result, we conclude that closed interlocking medullary nailing or semi-open interlocking medullary nailing seems to be a favorabel method for treatment of severe comminuted femoral shaft fracture.

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Scapulothoracic Dissociation: Two cases report: Man Ho Byun, Sung Seok Seo, Hyun Duk Yu, Young Chang Kim, Jang Seok Choi, Young Ku Lee; J Korean Soc Fract 1995;8(3):467-470. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.467

Abstract PDF: Scapulothoracic dissociation is rare injury and as a result of severe shoulder girdle trauma. muptiple fractures of the upper extremity and closed disruption of scapula from the thorax are combined with damage to the local neurovascular structures, brachial plexus and subclavian artery. Tracitionally, above-the-elbow amputation and shoulder arthrodesis have been used to treat the flail upper extremity. Now we experienced two cases of scapulothoracic dissociation managed by forequarter amputation, shoulder and above-the elbow amputation and then present two cases of scapulothoracic dissociation through case and textbook review.

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A Clinieal Study of the Tibial Pilon Fractures: Cheol Kwak, Sung Seok Soe, Hyun Duk Yoo, Young Chang Kim, Jang Seok Choi, Young Ku Lee; J Korean Soc Fract 1992;5(2):260-267. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.260

Abstract PDF: Intraarticular fractures of the distal tibia, the so-called pilon tibial fracture, usually resultfrom a torsional injury, a motor vehicle accident, or a fall from a height. The management of these fractures has been notoriously difficult due to the comminution of the distal tibia, articular incongruity, and asscociat ed soft-tissue trauma. The best results of treatment reported for this fracture, have followed early open reduction and rigid internal fixation to restore length, recon struction of the plafond, primary cancellous bone-grafting, butress plate on tibia, early motion and prolonged non weight-bearing. The purpose of this study was to examine the experience of the Pusan Paik Hospital between 1986 and 1991 as it relates to the treatment of 20 pilon fractures and to correlates the Clinical fesults with fracture type. They were followed post-operatively for an average of 22.3 months. The results were as follows 1. The most frequent type of the fraEture was type III according to Ruedl and Allgowe Classification. 2. Open reduction and internal fixation in cases type II & III has showed better resulis than those treated conservatively. 3. The fibula fracture fixed internally with a plate first often makes re construction of the distal tlbia easier. 4. The most often complication was the ankle joint pain.

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Intramedullary nailing of humeral shaft fractures in patients with multiple trauma: Sang Ho Park, Young Chang Kim; J Korean Soc Fract 1992;5(1):82-89. Published online May 31, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.1.82

Abstract PDF: No abstract available.

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Medullary fixation with rush pin of fracture of the forearm bone in adults: Young Chang Kim, Hae Ill Jung; J Korean Soc Fract 1991;4(2):340-346. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.340

Abstract PDF: No abstract available.

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