Journal of Musculoskeletal Trauma

Progression of Compression and Related Factors in Conservative Management of Osteoporotic Vertebral Compression Fractures: Young Do Koh, Jeong Soo Park; J Korean Fract Soc 2015;28(2):132-138. Published online April 30, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.2.132

PURPOSE
The purpose of this study is to determine the ideal period of brace application for thoracolumbar (T10-L2) osteoporotic vertebral compression fracture (OVCF) based on the progression of the vertebral compression with passage of time and to evaluate the factors associated with progression of thoracolumbar OVCF, when treated conservatively.
MATERIALS AND METHODS
This retrospective study included a total of 46 patients who were diagnosed with thoracolumbar OVCF and could be followed-up for at least 6 months. In this study, the increase of compression rate and the mean slope of compression rate per weeks were compared between two periods (from diagnosed date to 8 weeks and from 8 weeks to 6 months), as the standard point. Age, bone mineral density (BMD), osteoporosis treatment after injury, diabetes mellitus (DM) as underlying disease were also compared between two groups (setting up 15% as standard point of increase of compression rate, <15% and > or =15%). Statistical analyses were performed using the paired t-test to assess the increase of compression rate and using the linear mixed model to assess the mean slope change. The relationships between the factors and progression of compression were analyzed using t-test, chi-square test, and logistic regression analysis.
RESULTS
The increase of compression rate was 13.03% and 1.97% in each period and the difference between those two periods was 11.06% (p=0.00). At 8 weeks of follow-up, the mean slope was reduced by 1.12 (p=0.00). No statistically significant difference in related factors was observed between two groups.
CONCLUSION
Considering the increase of compression rate with passage of time, brace should be applied strictly for an initial 8 weeks. And age, BMD, osteoporosis treatment after injury, and DM as underlying disease are not predictors of progression of compression in vertebral fractures.

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The Factors between the Progression of the Compression Rate and Magnetic Resonance Imaging Findings in Osteoporotic Vertebral Fracture Patients Treated with Teriparatide
Taebyeong Kang, Seung-Pyo Suh, Jeongwoon Han, Byungjun Kang, Changhyun Park
Journal of the Korean Orthopaedic Association.2023; 58(5): 392. CrossRef
Effect of Weekly Teriparatide Administration Followed by Percutaneous Balloon Kyphoplasty on Post-Menopausal Osteoporotic Compression Fracture Treatment
Sung-Ha Hong, Seung-Pyo Suh, Woo Jin Shin, Seung Gi Lee, Byung Jun Kang
Journal of the Korean Orthopaedic Association.2022; 57(1): 35. CrossRef
Treatment Effect with Weekly Teriparatide in the Vertebral Compression Fractures in Patients with Severe Osteoporosis
Seok-Ha Hwang, Young-Kyun Woo, Ho-Seung Jeon, Seung-Pyo Suh, Joo-Young Kim, Jae-Nam Kim
Journal of the Korean Orthopaedic Association.2019; 54(6): 528. CrossRef
The Influence of Initial Magnetic Resonance Imaging Findings on the Compression Rate of Thoracolumbar Osteoporotic Vertebral Compression Fracture
Seok-Ha Hwang, Seung-Pyo Suh, Young-Kyun Woo, Ho-Seung Jeon, Ho-Won Jeong
Journal of the Korean Orthopaedic Association.2018; 53(4): 341. CrossRef
A Retrospective Clinical Survey of Vertebral Compression Fractures
Ji Hye Oh, Yun Kyu Lee, Jae Soo Kim, Hyun Jong Lee, Sung Chul Lim
Journal of Acupuncture Research.2018; 35(4): 219. CrossRef

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The Relationship between Progression of Body Collapse and MRI Findings in Osteoporotic Stable Thoracolumbar Fractures: Young Do Koh, Jong Seok Yoon, Ji Young Hwang, Hyun Sik Park; J Korean Fract Soc 2008;21(4):304-311. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.304

Abstract PDF

PURPOSE
To find out the relationship between the initial Magnetic Resonance Image (MRI) findings and the progression of vertebra collapse when treated with Jewett brace in osteoporotic stable thoracolumbar fractures.
MATERIALS AND METHODS
We divided 38 cases of 37 patients of thoracolumbar osteoporotic stable thoracolumbar fractures who were treated with Jewett brace into two groups. One group was composed of those body collapse progressed more than 10% compared with the initial state, and the other group less than 10%. We analyzed the relationships between the progression of collapse and the superior endplate fractures, the fracture line extending to posterior cortex, the size of bone marrow edema, the signal intensity on T1 and T2 weighted MR images, the presence of paravertebral hematoma, and the degree of posterior extensor muscle atrophy using MR images.
RESULTS
The body collapse was more likely to progress when there was superior endplate fracture, when it showed larger size of bone marrow edema on T1 weighted image, and transverse low signal on T2 weighted image. But extending of fracture line to posterior cortex, presence of paravertebral hematoma, and degree of posterior extensor muscle atrophy did not show any statistical correlations to progression of collapse.
CONCLUSION
The body collapse is more likely to progress when there was superior endplate fracture, larger low signal on T1 weighted image and low signal on T2 weighted image at initial MRI treated with Jewett brace.

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The Factors between the Progression of the Compression Rate and Magnetic Resonance Imaging Findings in Osteoporotic Vertebral Fracture Patients Treated with Teriparatide
Taebyeong Kang, Seung-Pyo Suh, Jeongwoon Han, Byungjun Kang, Changhyun Park
Journal of the Korean Orthopaedic Association.2023; 58(5): 392. CrossRef
Statistical Analysis on Hospitalized Patients with Thoracolumbar Compression Fracture at Single Korean Medicine Hospital: Retrospective Review
Hyun jin Jang, So jeong Kim, Min Ju Kim, Hyeon Kyu Choi, Pil Je Park, Kang Yeon soo, Jeong Kyo Jeong, Ju Hyun Jeon, Young Il Kim
Journal of Korean Medicine.2023; 44(2): 149. CrossRef
The Influence of Initial Magnetic Resonance Imaging Findings on the Compression Rate of Thoracolumbar Osteoporotic Vertebral Compression Fracture
Seok-Ha Hwang, Seung-Pyo Suh, Young-Kyun Woo, Ho-Seung Jeon, Ho-Won Jeong
Journal of the Korean Orthopaedic Association.2018; 53(4): 341. CrossRef
The Relationship between the Progression of Kyphosis in Stable Thoracolumbar Fractures and Magnetic Resonance Imaging Findings
Deuk Soo Jun, Won Ju Shin, Byoung Keun An, Je Won Paik, Min Ho Park
Asian Spine Journal.2015; 9(2): 170. CrossRef

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The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture: Young Do Koh, Jong Seok Yoon, Sung Il Kim; J Korean Fract Soc 2008;21(1):57-61. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.57

Abstract PDF: PURPOSE
To study which factors affect the deformity correction of vertebral body during kyphoplasty procedure.
MATERIALS AND METHODS
25 osteoporotic vertebral compression fractures were treated with balloon kyphoplasty from October 2006 to May 2007. Lateral radiographs were taken at 5 different stages with preoperative lateral decubitus position, after placing the patient in prone position on an operation table, after inflating balloon, after deflation and removal of the balloon, after inserting the cement. Then we analyzed the compression ratios and kyphotic angles of the vertebral bodies in each stage.
RESULTS
Placing the patient in prone position showed significant postural reduction in kyphotic angle and restorement of the anterior and middle body height. The inflation of the balloon demonstrated significant reduction of kyphotic angle and restorement of the anterior and middle body height. After the deflation, anterior and middle body height has decreased significantly. After the deflation, the kyphotic angle and the anterior and middle body heights were not restored signigicantly compared with those of initial prone position.
CONCLUSION
Vertebral height and kyphotic angle were partially recovered by inflating the balloon, but the correction was lost after deflating the balloon. Statistically, the body deformity was not restored significantly after deflating the balloon compared with that of intraoperative prone position. Therefore, we concluded that, in kyphoplasty of osteoporotic compression fractures, the postural reduction is the most important factor in deformity correction of fractured vertebral bodies.

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Comparative Study of Intramedullary Nailing and Plate for Metaphyseal Fractures of the Distal Tibia: Hoon Jeong, Jae Doo Yoo, Young Do Koh, Hoon Sang Sohn; J Korean Fract Soc 2007;20(2):154-160. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.154

Abstract PDF

PURPOSE
To compare the radiological and clinical results between intramedullary nailing and plate fixation in the treatment of distal tibial fractures.
MATERIALS AND METHODS
19 cases of distal tibial metaphyseal fractures within 4 cm of the ankle joint line were enrolled. Ten patients were treated with interlocking intramedullary nail and the others with plate and screws.
RESULTS
The mean union time was 14 weeks in nailing group and 16 weeks in plate group. The average angulation in AP view was 4.1 degrees in nailing group and 3.1 degrees in plate group. The average angulation in lateral view was 1.7 degrees in nailing group and 2.7 degrees in plate group. The rotational deformity was 2.8 degrees in nailing group and 1.7 degrees in plate group in average. There was no implant failure and soft tissue problem.
CONCLUSION
There was no difference in clinical and radiological results between intramedullary nailing and plate in the treatment of the distal tibial fractures and, considering the preservation of the soft tissue, the intramedullary nails are a reliable method for managing distal metaphyseal fractures of the tibia.

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Does a Customized 3D Printing Plate Based on Virtual Reduction Facilitate the Restoration of Original Anatomy in Fractures?
Seung-Han Shin, Moo-Sub Kim, Do-Kun Yoon, Jae-Jin Lee, Yang-Guk Chung
Journal of Personalized Medicine.2022; 12(6): 927. CrossRef
A Comparison of the Results between Intramedullary Nailing and Minimally Invasive Plate Osteosynthesis in Distal Tibia Fractures
Chul-Hyun Park, Chi-Bum Choi, Bum-Jin Shim, Dong-Chul Lee, Oog-Jin Shon
Journal of the Korean Orthopaedic Association.2014; 49(4): 285. CrossRef

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Thoracolumbar Fracture with Posterior Ligament Complex Injury: Won Ju Shin, Deuk Soo Jun, Young Do Koh, Jea Yoon Cho; J Korean Fract Soc 2006;19(2):265-270. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.265

Abstract: PURPOSE
To evaluate the clinical features and radiographical landmarks of patients who has a thoracolumbar fracture combined with posterior ligament complex injury retrospectively.
MATERIALS AND METHODS
The preoperative plain radiographys, axial CT, MRI and medical records of 27 patients were reviewed who were confirmed the posterior ligament complex injury in operation from January, 2002. to December, 2004.
RESULTS
The patients were from 15 years to 75 years of age (mean 39.1 years), 20 males and 7 females. The mechanisms of injury were 17 falls from a height, 7 traffic accidents and 3 direct blow injuries. There were 17 cases (63%) in thoracolumbar transitional zone, such as 11 cases in T11-T12, 6 cases T12-L1. There were 9 cases of compression fracture and 18 cases of burst fracture according to the shape of fractured vertebra. In the plain radiograph, the degree of kyphotic angle was between 6~49 degrees (mean 22 degrees), anterior vertebral height loss was 7~70% (mean 39%), and posterior vertebral height loss was 0~8% (mean 3%). 21 cases (78%) were the anterior vertebral height loss below 50%, 23 cases (85%) were the degree of kyphotic angle below 30 degrees. Neurological deficits were not registered. 23 cases (85%) were positive in MRI and 24 cases (89%) were positive in direct focal tenderness in the view of posterior ligament complex injury. Conclusions: The posterior ligament complex injury is common finding of the thoracolumbar fracture. The high resolution MRI findings and direct focal tenderness are very importance in identifying the posterior ligament complex injury that is important prognostic factor particularly in mild anterior vertebral height loss and mild kyphotic angle in the plain radiograph.

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Short Segment Fixation of Flexion-Distraction Injuries in Thoracolumbar Spines: Young Do Koh, Jeong Joon Lee, Jong Kyong Ha; J Korean Fract Soc 2005;18(4):452-458. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.452

Abstract PDF: PURPOSE
To evaluate the efficacy of short segment fixation in flexion-distraction injuries of thoracolumbar junction.
MATERIALS AND METHODS
Twenty-five patients with a flexion-distraction injury in thoracolumbar junction confirmed by radiogram or MRI and stabilized with a short construct spanning short segment were included in this study. We investigated the location of fractures, type of fractures, anterior or posterior vertebral body height, and preoperative and postoperative kyphotic angle of injuried motion-segments on radiologic examinations and clinical outcome on the Oswestry score.
RESULTS
A significant correction of deformity was achieved, from a mean preoperative kyphosis of 17.3 degrees to a mean postoperative kyphosis of 8.4 degrees. The loss of correction were minimal. The mean Oswestry score was 6.9, with 84% of patients having minimal disability (<20%) and no correlation with age, sex, the location of fractures, type of fractures, change of kyphotic angle.
CONCLUSION
This study demonstrates the efficacy of posterior open reduction and short segment fixation of flexion-distraction injuries.

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Treatment of Vertebral Pseudarthrosis after Compression Fracture: Young Do Koh, Hoon Jeong; J Korean Fract Soc 2004;17(2):191-196. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.191

Abstract PDF: PURPOSE
To clarity the features of vertebral pseudarthrosis and to evaluate the efficacy of posterior instrumentation and fusion in treatment of it.
MATERIALS AND METHODS
Twelve patients with severe back pain and intravertebral pseudarthrosis showing vacuum phenomenon were treated by in situ posterior instrumentation and fusion. The kyphotic angle of pre- and post-treatment was measured on a lateral radiograph. MRI was performed in all patients. The intravertebral instability was confirmed from the dynamic lateral view. The pain level was assessed both before and after the treatment using a visual analog scale. The kyphotic angle at last follow up was also checked.
RESULTS
In eight cases, intravertebral instability was shown at the clefts in flexion-extension radiographs. MRI showed that the cleft was low intensity on the T1- weighted image and high intensity on the T2-weighted image. The pre-and postoperative mean kyphotic angles were -18.3degrees and -8.5degrees respectively. The preoperative average pain score was nine and postoperative four. At last follow up the mean kyphotic angle was -16.6degrees CONCLUSION: The cleft with intravertebral vacuum phenomenon and magnetic resonance findings of low intensity on the T1-weighted scans and high intensity on the T2-weighted scans suggests that the cleft is a pseudarthrosis associated with avascular necrosis of the vertebral body. The posterior instrumentation and fusion provides satisfactory pain relief in patient with vertebral pseudarthsosis.

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MRI Findings of Posterior Ligament Complex Injury in Thorcolumbar Bursting Fractures: Young Do Koh, Yeo Heon Yun, Hoon Jeong; J Korean Soc Fract 2003;16(4):541-547. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.541

Abstract PDF: PURPOSE
To investigate the MR findings of structures injured in the burst fractures of thoracolumbar spine.
MATERIALS AND METHODS
Twenty-one patients who had thoracolumbar burst fractures with posterior ligament complex injury on MRI were studied. For the evaluation of stability of fractures, we used the scheme described by Oner et al. We identified the state of posterior ligament complex on surgery.
RESULTS
The MRI findings of ALL were state 1 in four, state 2 in fourteen, and state 3 in three. Those of PLL were state 1 in twelve, state 2 in six, and state 3 in three. The findings of posterior ligament complex were state 2 in one, state 3 in three, and state 4 in seventeen. The endplate state 1 was in four, state 2 in six, state 3 in seven, and state 4 in four. The disc state 1 was in twelve, state 2 in six, state 3 in two, state 4 in one. The vertebral body involvement state was 1 in four, state 2 in nine, and state 3 in eight. The injuries of posterior ligament complex were confirmed intraoperatively in all twenty-one patients.
CONCLUSION
We recommend the use of MRI to evaluate stability of fractures and state of posterior ligament complex in thoracolumbar burst fractures.

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Fracture of Vertebral Body in Flexion-Distraction Injury of Thoracolumbar Spine: Young Do Koh, Jong Oh Kim, Yeo Hon Yun, Jae Doo Yoo, Jun Mo Jung; J Korean Soc Fract 2003;16(2):262-269. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.262

Abstract PDF

PURPOSE
To evaluate the configuration of vertebral body fractures in flexion-distraction injuries of thoracolumbar spine.
MATERIALS AND METHODS
We investigated the location of fractures, anterior or posterior vertebral body height, kyphotic angle of injured segments, canal encroachment and severity of comminution on radiologic examinations of 21 cases.
RESULTS
There were 11 compression fractures and 9 burst fractures. 85% of fractures were located in the inferior vertebrae of injured segments. Anterior vertebral height decreased by 27% on average with decrease of 18% in compression fractures and 40% in burst fractures. Posterior height decreased by 1% on average with increase of 1% in compression fractures and decrease of 4% in burst fractures. The average kyphotic angle of injured segments was 19.5 degrees with 15.4degrees in compression fractures and 26.8 degrees in burst fractures. The canal encroachment in 9 burst fractures was 27% on average, and the comminution of vertebral body was mild in 74%.
CONCLUSION
The fracture of vertebral body in flexion-distraction injuries of thoracolumbar spine was very common, and located on the inferior vertebrae of injured segment. The decrease of vertebral height, canal encroachment and severity of comminution was relatively less than the estimated from mechanism of injury, with offset effect of distraction force.

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Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures
Chung-Shik Shin, Eea-Sub Chung, Chang-Eon Yu, Byeong-Yeol Choi
Journal of Korean Society of Spine Surgery.2012; 19(2): 47. CrossRef

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Stability and Usefulness of Compression Hip Screw in the Treatment of Femur Intertrochanter Fracture in the Elderly: Jong Oh Kim, Kwon Jae Roh, Yeo Heon Yun, Young Do Koh, Jae Doo Yoo, Jun Mo Jung, Han Cheon Bang, Jae Hak Jung; J Korean Soc Fract 2003;16(2):128-135. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.128

Abstract PDF: PURPOSE
To evaluate the relationship between fracture stability and functional results, and analyze the correlation between stability factors and the outcome in intertrochanteric fractures of the elderly.
MATERIALS AND METHODS
Of the 231 patients, 84 patients with age above 60 were able to follow up for minimum 6 months. We measured the sliding length of the lag screw, varus degree, position of lag screw, reduction status and medialization of distal fragment radiologically. The functional outcome of the treatment was evaluated with the Clawson's result classification and we evaluated the correlation between the radiological results of measurement and the functional recovery depending on the Evans fracture classification.
RESULTS
There were good results in 40 cases out of 51 stable fractures, and in 10 cases out of 33 unstable fractures (p<0.001). In case of sliding of lag screw more than 10 mm, good results were obtained in 4 cases, and poor in 21. And in case of sliding less than 10 mm, good results were obtained in 46, and poor in 13 (p<0.001). But there was no relationship between other radiologic factors and clinical results. In unstable type, there were 12 cases with lag screw sliding more than 10 mm and 10 cases with less than 10 mm. In comminuted type, there were 11 cases with lag screw sliding more than 10 mm and 2 cases with less than 10 mm (p<0.001).
CONCLUSION
The sliding of lag screw more than 10 mm may result in poor outcome. As in comminuted unstable pattern, sliding of lag screw might be excessive, the use of compression hip screw alone is not a good treatment option.

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Ideal Placement of the Herbert/Whipple Screw in Scaphoid Fracture: A Model Study: Jae Doo Yoo, Jong Oh Kim, Yeo Hon Yun, Young Do Koh, Su Young Bae, Jeong Joon Lee; J Korean Soc Fract 2002;15(4):581-586. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.581

Abstract PDF: PURPOSE
To evaluate optimal placement of the Herbert/Whipple screw in scaphoid fracture.
MATERIALS AND METHODS
Forty eight models molded from four cadaver scaphoids were used for this study. Using the Herbert/Whipple jig, the guide wire was placed distal to proximal into each scaphoid with twelve method which were four entry points and three target points. Guide wire placement was then evaluated with three planes in the proximal, middle, distal planes and distance from the nearest cortex.
RESULTS
The most concentric position in the proximal plane was D5, in the middle plane C10. As distal entry point, the most concentric position in proximal plane was C. There were no statistical concentric, as middle, distal plane, and proximal entry point, CONCLUSION: The most ideal placement were D5 in proximal fractures of the scaphoid, C5 in distal fractures. In waist fractures of the scaphoid, there were relatively safe, except A0 and D0. The position of entry points was more important than that of target points for ideal screw placement.

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Operative Treatment of Acetabular Fractures: Jong Oh Kim, Yo Hun Yun, Dong Wook Kim, Young Do Koh, Jae Doo Yoo, Hyoung Jin Jeong, Yi Kyoung Shin; J Korean Soc Fract 2000;13(4):761-770. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.761

Abstract PDF: PURPOSE
We reviewed 47 cases of acetabular fractures which was treated operatively, to review the clinical results of operative treatment of acetabular fractures considering the experience of a surgeon, to assess the relationship between the quality of the operative reduction and the clinical results.
MATERIALS AND METHODS
We reviewed 47 cases of acetabular fractures which was treated operatively from September 1993 to December 1999 and follow up more than 1 year. And we analyzed retrospectively the data in the aspect of the relationships between the radiologic evaluation of the reduction and the clinical results, and we reviewed the initial 20 cases as a group I and the later 27 cases as a group II to compare the differences of clinical results of the two groups.
RESULTS
In the accuracy of reduction, anatomical reductions were 4 hips in the group I and 13 in the group II, satisfactory 7 hips in the group I and 9 hips in the group II, unsatisfactory 9 hips in the group I and 5 hips in the group II. We assess the over-all clinical result with the criteria of Merle d'Aubigne and Postel. In the group I, 20 hips, the clinical result was excellent for 3 hips(15%), good for 6 hips(30%), fair for 5 hips(25%), and poor for 6(30%) hips. In the group II, 27 hips, the clinical result was excellent for 11 hips(41%), good for 8 hips(30%), fair for 5 hips(18%), and poor for 3(11%).
CONCLUSION
The accuracy of reduction was closely related to the clinical results. And the more a surgeon getting experienced, the better accurate reduction and clinical results were possible.

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Radiologic Follow-up Results of Distraction After Treatment of Distal Radius Fractures using External Fixator: Jong Oh Kim, Dong Wook Kim, Young Do Koh, Jae Doo Yoo, Kyoung Soo Kim; J Korean Soc Fract 1999;12(4):988-994. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.988

Abstract PDF: External fixation for severe fractures of the distal radius is accepted treatment offering the potential advantages of controlled distraction, accurate positioning of fracture fragments, and avoidance of extensive open procedures. One of the limitation of external fixation for distal radius fractures is excessive distraction, which affect the outcome. This study was conducted to evaluate the changes of the distraction of the intercarpal and radiocarpal joint, developed after treatment of distal radius fractures with external fixator. Restrospective study was done for 28 paitents, who were evaluated by chart review, questionnaire, radiograph, and physical examination. The carpal height ratio, radial inclination, velar tilt, radial length were measured in the postoperative and follow-up radiographs. The carpal height ratio was used to quantify the distraction. Functional evaluation was performed with Demerit-Point system described by Garthland and Werley. Five fractures had an excellent results, 16 had a good results, 4 had a fair results, and 3 had poor results. After union, average radial inclination was 21.3 degree, average dorsal angulation was -0.5 degree, and radial shortening was 1mm. Increased carpal height ratio of the 9 cases did not decrease to less than 0.56 at one year after operation. The over-distraction of intercarpal and radiocarpal joint developed after external fixation of the distal radius fracture, did not have decreased in the one year follow-up radiographs after operation. The over- distraction should be avoided intraoperativly.

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Brooker Intramedually Nailing for the Treatment of Distal 1/3 Tibial Fractures with Compromised Soft Tissue: Chung Nam Kang, Jong Oh Kim, Yeo Hon Yun, Dong Wook Kim, Young Do Koh, Jae Doo Yoo, Jong Keon Oh, Ki Woong Lee; J Korean Soc Fract 1999;12(4):924-931. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.924

Abstract PDF: The treatment of distal tibial fractures with compromised soft tissue poses many problems that usually occurs from the high-energy trauma, and the results are often unsatisfactory following lots of complications like loss of reduction, malunion, and inlection. We studied to evaluate the treatment results of Brooker intramedually nailing for the distal 1/3 tibial fractures with compromised soft tissue. Twenty-three cases of distal tibial fractures with comprolnised soft tissue were reviewed and we analyzed the results of surgical treatment in the viewpoint of union time, loss of reduction, malunion, complication and its final outcome. The range of follow-up was 24 months to 38 months with mean 29 months follow-up. Most of patients were between twenty and sixty years, and average age was 43.2 years. Acording to Gustilo and Andersons classification, 3 were Type I, 2 were Type II of 5 open fractures. According to Tschernes classification, 13 were Grade I, 5 were Grade II of 18 closed fractures. The average to union was 15 weeks with range 11 to 20 weeks. The healing was slowest in Tschernes Type II and fastest in Tschernes Type I fracture. There were 3 cases of malunion, more than 5 degrees. All of the 3 cases were posterior angulation. Only 1 case was the loss of reduction. This case was 3 to 10 degrees of varus angulation. There were 3 cases of superficial infection. The infection was controlled with antibiotic therapy. Only 1 case was acceptable of the final outcome. This case waf limping gait because of pain and loss of ankle dorsiflexion to 15 degrees. But, the limitation of ordinary work was not seen. And 18 cases were excellent and 4 cases were good. We recommand that wherever possible, Brooker intramedually nailing can be used for distal tibial fractures with compromised soft tissue. And a high rate of union and a low rate of complication can be expected with thit treatment modality.

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Relationship between Simple X-ray and CT Findings on the Degree of Canal Encroachment in Burst Fracture of Thoracolumbar Junction: Young Do Koh, Jong Oh Kim; J Korean Soc Fract 1999;12(2):388-394. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.388

Abstract PDF: In burst fracture of thoracolumbar junction, compressive injury of middle column is characteristic and neurologic symptom develops by retropulsion of bony fragment into spinal canal. Authors had treated 44 cases with burst fracture of thoracolumbar junction at Ewha Woman' University Mokdong Hospital from September, 1993 to December, 1997 and analyzed the relationships between simple radiologic findings and canal encroachment and between neurology and canal encroachment. The results were as follows; Canal encroachment by bony fragment was larger in lower vertebra than in upper one. Canal encroachment was larger in Denis type A than in type B. Both anterior vertebral height(AVH) and presence of neurology were not related with the amount of canal encroachment. The lesser loss of posterior vertebral height(PVH) and kyphotic angle were, the more canal encroachment was. In summary, factors that influenced the amount of canal encroachment were fracture level and type. There was no significant relationship between neurology and the amount of canal encroachment. AVH, PVH and kyphotic angle were not related with the amount of canal encroachment.

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Risk Factors in Progression of Deformity in Compression Fracture of Thoracolumbar Junction: Young Do Koh, Jong Oh Kim; J Korean Soc Fract 1999;12(2):372-378. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.372

Abstract PDF

Compression fracture of thoracolumbar junction is considered to be stable, and usually treated by conservative methods, such as bed rest followed by bracing. However, we can often see the progression of deformity during follow-up. Authors had treated 62 cases with compression fractures of thoracolumbar junction conservatively at Ewha Woman' University Mokdong Hospital from September, 1993 to December, 1997, and analyzed risk factors of progression in anterior vertebral height (AVH) collapse and kyphotic angle after the minimum 1 year follow-up. The results were as follows; The anterior vertebral height significantly more decreased in the group with age over 60, but increase of kyphotic angle was not related with age factor. In female, decrease of AVH and increase of kyphotic angle were more than in male. AVH significantly more decreased in L1 than in T12 or L2, but increase of kyphotic angle was not related with fracture level. Decrease of AVH and increase of kyphotic angle were not related with fracture type. Osteoporosis seems to be the most important single risk factor in progression of compression and more strict wearing of well-fitting brace is necessary to protect the progression in case of severe osteoporosis.

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The Influence of Initial Magnetic Resonance Imaging Findings on the Compression Rate of Thoracolumbar Osteoporotic Vertebral Compression Fracture
Seok-Ha Hwang, Seung-Pyo Suh, Young-Kyun Woo, Ho-Seung Jeon, Ho-Won Jeong
Journal of the Korean Orthopaedic Association.2018; 53(4): 341. CrossRef
Nonfusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Jae-Jung Jeong, Young-Chan Cha, Ji-Kang Park
Spine.2011; 36(2): 170. CrossRef
The Efficacy of Kyphoplasty on Osteoporotic Vertebral Compression Fracture - A 1-Year Follow-up Study -
Dong-Ki Ahn, Song Lee, Dea-Jung Choi, Hoon-Seok Park, Kwan-Soo Kim, Tae-Woo Kim
Journal of Korean Society of Spine Surgery.2009; 16(2): 79. CrossRef
Clinical Outcome of Conservative Treatment for Osteoporotic Compression Fractures in Thoracolumbar Junction
Whoan Jeang Kim, Jong Won Kang, Kun Young Park, Jae Guk Park, Se Hyun Jung, Won Sik Choy
Journal of Korean Society of Spine Surgery.2006; 13(4): 240. CrossRef
Results of Non-fusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Seong Choi, Hyun-Chul Shon, Kyoung-Jin Park, Kyeong-Il Jeong, Young-Chan Cha, Hu-Shan Cui
Journal of Korean Society of Spine Surgery.2005; 12(2): 132. CrossRef

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The prognostic factors in Tongue shaped calcaneal fractures treated by Essex-Lopresti method: Jong Oh Kim, Dong Wook Kim, Young Do Koh, Jae Doo Yoo, Dong Wook Lee; J Korean Soc Fract 1999;12(2):328-334. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.328

Abstract PDF: There is a great difference in opinion regarding the treatment of intraarticular fractures of the calcaneus. In Essex-Lopresti method, a heavy Steinmann pin is introduced into the cancellous part of tongue fragment and the fracture is reduced by lifting the fragment by the level effect of the Steinmann pin. The authors had treated 38 cases in 36 patients with displaced intraarticular tongue shaped fractures using Essex-Lopresti axial fixation at our hospital from 1993 to 1997. We obtained the following results. 1. Of 36 patients, 31 patients were male and 5 female 2. The main cause of fractures were fall from height in 86 percent of cases and spine injury was associated in 8 cases(22%). 3. The favorable result was obtained in 29 cases(76%). 4. The poor prognostic factors in functional outcome were old age, comminution of fracture, osteoporosis and the loss of correction in B.. ohler angle at postoperative and follow up Xrays.

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Results and Problems of open Intramedullary Nailing of Femoral Shaft Fracture: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Jae Doo You, Kyoung Soo Kim; J Korean Soc Fract 1999;12(1):28-34. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.28

Abstract PDF: The intramedullary nailing is one of the most available methods in treatment of femoral shaft fracture. The closed intramedullary nailing is known to be the best method of treatment of femur shaft fracture, but it is not always available in cases of deficit of equipment, severe associated injury, and some fracture pattern. The open intramedullary nailing has advantage of easily obtaining anatomical reduction but it increases the risk of infection, the incidence of delayed union and additional operations inevitably. We reviewed 33 cases of open intramedullary nailing in femur shaft fracture from September 1994 to September 1997. The results were as follows : 1. The average union time was 27.3 weeks. 2. Location of fractures was middle one-thirds in most cases, and Winquist-Hansen classification type II was the most common. 3. The complication included 8 delayed unions, 3 nonunions, 2 infections, shortening of more than two centimeters in 3 patients. 4. In 4 cases, we did open intramedullary nailing with bone graft initially, but all of them has complication as delayed union and nonunion. We can use open intramedullary nailing method in some femur shaft fractures, but there are many problems and complications. So we must consider it carefully before using this method.

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Essex-Lopresti Axial Fixation for Intra-articular Calcaneal Fractures: Young Do Koh, Jong Oh Kim; J Korean Soc Fract 1998;11(2):371-377. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.371

Abstract PDF: Fracture of the calcaneus is quite common, and displace intraarticular fractures can be associated with serious and prolonged disability. However, there still a great deal of controversy regarding the treatment of intraarticular fractures of calcaneus. Authors had treated 41 cases of 32 patients with displaced intraarticular calcaneal fractures using Essex-Lopresti axial fixation at Ewha Woman's University Mokdong Hospital from September, 1993 to February, 1996, and analyzed the functional results after the minimum 2 year follow-up. The results as follows; 1. Of 41 intraarticular calcaneal fractures, 27 fractures were tongue type and 14 fractures were joint depression type according to Essex-Lopresti classification. 2. Postoperatively Bohler angle was restored to mean 24.5degree intongue type, and to mean 13.8degree in joint depression type. 3. The reduction loss of Bohler angle was 7% in tongue type and 18.8% in joint depression type at the final follow-up. 4. The satisfactory results were obtained in 77.7% of tongue type and in 49.9% of joint depression type.

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Treatment of Femoral Shaft Fracture by Interlocking Intramedullary Nailing - Relative Analysis Between Closed Nailing and Open Nailing -: Jong Oh kim, Young Do Koh; J Korean Soc Fract 1998;11(2):328-336. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.328

Abstract PDF: The closed intramedullary nailing is the best method of treatment in femur shaft fracture, but it is not available in some fracture patten or fracture level, and also need specific technique under specific equipment. conventional closed intramedullary nailing dose not provide adequate fixation if cortical contact of the major fragments is lost due to severe comminution. Open intramedullary nailing with aditional wire fixation or bone graft do not always produce good result and involved and increased risk of infection, delayed union, and also need additional operation. We analysed 80 cases of interlocking intramedullary nailing from September 1994 to September 1997. closed intramedullary nailing was used in 47 cases and open intramedullary nailing in 33 cases. The results were as follows; 1. The average union time was 17.58 weeks in closed Im nailing group, and 27.32weeks in open IM nailing group. 2. In open IM nailing group, complications incluled 10 delayed union, 3 nonunion, two infections, shortening of more than two centimeters, which occurred in 3patients. In closed IM nailing group only one complication is transient peroneal nerve palsy.

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Correction Angular Deformity & Evaluation of Overgrowth for Femoral Shaft Fractures in Children: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Jae Doo You, Seong Man Kim; J Korean Soc Fract 1998;11(1):123-128. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.123

Abstract PDF: We reviewed 40 cases of femoral shaft fractures in children treated with Russel traction. The treatment of femoral shaft fractures in children is various according to age. Satisfactory result have been reported with russel traction. At an average follow-up of 30 months, We obtained following results. 1. The average time of traction was 18 days, and hip spica cast was applied for 28 days. 2. Malunion exceeding 25degree in flexion & valgus & varus was not developed. 3. Remodeling of angulation deformities occurred slowly over the duration of the follow-up period in our patients. At the last evaluation no patient was aware that he had any residual angulation but many did have X-ray evidence of an abnormal contour of the femur, that is average rate of spontaneous correction is 83% in anterior angulation, 87% in varus deformities, 88% in valgus deformities. 4. Fracture occurred most commonly in the middle third of the femoral shaft, but overgrowth was the greatest in proximal one third fracture. The average overgrowth was 1.2 cm in length and, growth acceleration was the greatest in oblique fracture and, among the children 4 to 9 years of age, significant overgrth(average 1.2 cm) was seen. 5. Skeletal Russel traction is easy, safe and convenient to treat all femoral shaft fractures of the children between four and ten years old.

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Traumatic Fracture - Dislocation of the Hip: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Sang Hoon Ko, Jae Doo Yoo, Joo Seok Eom, Dong Wook Lee; J Korean Soc Fract 1997;10(4):772-777. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.772

Abstract PDF: Traumatic dislocation or fracture-dislocation of the hip is relatively uncommon, but high velocity accidents have increased its incidence in recent years. The purpose of this study was to review the result of the treatment and to evaluate the prognostic factor. We retroprospectively reviewed 28 patients with traumatic fracture-dislocation of the hip between October, 1993 and March, 1996. 21 were males and 7 females. The mean age was 33.5 years(range, 11 to 67 years). Average follow-up was 18 months(range, 13 to 28 months). Exellent or good results were obtained in 19 patients(68%) by the criteria of Epstein. The complications were followings 2 cases of avascular necrosis and 1 case of osteoarthritis. Factors associated with a good prognosis included an early reduction, low level of initial trauma, abscence of associated injury.

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Comparison of Hemiarthroplasty and Compression Hip Screw on Elderly Unstable Intertrochanteric Fractures: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Sang Hoon Ko, Ki Woong Lee; J Korean Soc Fract 1997;10(4):738-745. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.738

Abstract PDF

Intertrochanteric fractures of the femur usually occur in the elderly and osteoporotic patients. These appear to be increasing in frefuence and are usually unstable. Sixthy two cases were treated ai our hospital from September 1993 through October 1995. 29 elderly patients underwent bipolar hemiarthroplasty and 33 patients underwent internal fixation with compression hip screw(C.H.S). The results were as follows ; 1. Functional results according to hip rating scale of Merle D,Aubiigne was superior in bipolar group. 2. The incidence of postoperative complications was much fewer in bipolar group than in compression hip screw group. 3. In casees of definite osteoporosis with Singhs index below 3 and Evans unstable type frartures, the incidence of mechanical complications was increased, especially in compression hip screw group. 4. There was no siginificant difference between 2 groups in operative time and blood loss.

Citations

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Fixation of Greater Trochanter Using an AO Trochanteric Reattachment Device (AO TRD) in Arthroplasty for Intertrochanteric Femur Fracture of Elderly Patients
Weon-Yoo Kim, Young-Yul Kim, Jae-Jung Jeong, Do-Joon Kang
Hip & Pelvis.2013; 25(4): 274. CrossRef
Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -
Chae-Hyun Lim, Young-Yool Chung, Jeong-Seok Kim, Chung-Young Kim
Hip & Pelvis.2013; 25(1): 44. CrossRef
Hip Arthroplasty Using Collarless Polished Tapered Stem -Minimum 2 Years Follow-up Results-
Yerl-Bo Sung, Jung-Yun Choi, Su-Chan Oh
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Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients
Sung-Hwan Kim, Soo-Won Lee, Gyu-Min Kong, Mid-Um JeaGal
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Cemented Bipolar Hemiarthroplasty for Intertrochanter Fracture in Elderly Patients - Minimum 2-Years Follow-up Results -
Sung Kwan Hwang, Dong Hyun Kang, Tae Yeon Cho, Chang Ho Yi
Hip & Pelvis.2010; 22(3): 209. CrossRef

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Hemiarthroplasty for Treatment of Proximal Humerus Fracture: Chung Nam Kang, Jong Oh Kim, Sang Hun Ko, Young Do Koh; J Korean Soc Fract 1997;10(3):685-693. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.685

Abstract PDF: From 1993 to 1996, we have used hemiarthroplasty on shoulder for comminuted fracture and fracture-dislocation of proximal humerus. The study reviewed 8 patients with on average age 62.1 years. The hemiarthroplasty was performed at average 5 days following injury. The purpose of this study was to evaluate pain, function, range of motion, strength, patients satisfaction. All cases was performed using cement and surgical approach was deltopectoral. Average follow up was 33 months after operation(range, 24 to 45 months). According to UCLA shoulder rating scale, 5 patients(63%) were satisfactory and 3 patients(37%) were unsatisfactory. Average active flexion was 110, and average abduction was 97 and average external rotation was 39, average internal rotation to the first lumbar vertabrae. Average humeral offset on fractured shoulder was 20.5 and average humeral offset on normal uninjured shoulder was 30.8. For functional improvement of shoulder hemiarthroplasty, We concluded humeral length restoration and humeral offset preservation is very crucial factors.

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Complications of Interlocking Intramedullary Nailing for the Humeral Shaft Fracture: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Jong Keon Oh, Sang Hun Ko, Seung Wook Jeong; J Korean Soc Fract 1997;10(3):669-677. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.669

Abstract PDF: Several advantages of intramedullary nails over plates and external fixators have led to an anpansion of the surgical indications for humeral shaft tractures. But, various morbidities due to proximity of several important structures, such as rotator cuff and radial nerve, follwed the operation. We reviewed our experience with 23 cases of humeral shaft fractures that were treated by interlocking intramedullary nailing to evaluate the pitfalls and the complications of this technique. Fifteen men and 8 women were followed for average 19.5 months. Twenty one (91.3%) of them had midshaft fractures. According to AO/ASIF classification, type A was most common(60.9%), and followed by type B(26.1%) and type C(13.O%). Eighteen of them had associated injuries - 5 radial nerve palsies, 1 Volkmans ischemic contracture, and 14 had fracture of other sites. Indications for interlocking intramedullary nailing were unsatisfactory reduction after closed reduction, fracture of the ipsilateral upper extremity, segmental fractures, and multiple injuries. The operation was performed average 6.7 days after injury. The final results were evaluated with radiographs for quality of union and with physical examination for functional status of the shoulder. There were four cases of complication associated with increase morbidity. A post operative radial verve palsy, associated with the distal interlocking screw fixation was developed due to inappropriately short nail insertion. And in one case, fracture healing was delayed due to distraction of the fracture gap after nailing. In another case subacromial impingement was developed secondary to protruded nail tip because the length was thought be the common underlying causative factor. Finally there was a case of iatrogenic fracture at the site of distal interlocking screw fixation and it was thought to be a technical problem. The results gave us the conclusion that inappropriate nail length was the common underlying causative factor of the complications. Therefore in the interlocking IM nailing for the humeral shaft fractures, accurate measurment of nail length is one of the most cirtical factor for the good final result.

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The Treatment of Supracondylar Fracture of The Humerus in Children: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Cheol Min Kim, Sang Hoon Ko, Seung Wook Jeong; J Korean Soc Fract 1997;10(2):393-400. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.393

Abstract PDF: Supracondylar fracture of distal humerus is up to 60% of all fractures around the elbow in children. Complications of this fracture include nerve injury, arterial injury, skin slough, Volkmanns ischemic contracuture, and changes in carrying angle. Many different treatment methods to minimize these complications have been devised. Recently, closed reduction and percutaneous pinning with K-wire is most widely used in treating supracondylar fractures in children exept in some rare cases such as unreducible fracture by closed reduction. However, troublesome changes in the carrying angle which do not interfere with function but the appearance of the arm is unsatisfactory, continue in approximately 30% of most series. We reviewed 59 cases which were treated by closed reduction and percutaneous pinning in supracondylar fracuture of the humerus. The purpose of our study is to evaluate the cosmetic and functional results and complications and to analysis the relationship between the stability of reduction and method of pinning. The results are as follows; 1) There were many cosmetic problems, actually. Change over 10 degrees in carrying angle compared to the normal site was as high as 10 cases(17%) of 59 cases. 2) There was no functional problem such as limitatioin of motion. 3) There was no significant complication. 4) The cross pinning fixation was more stable than lateral pinning fixation only. 5) Accurate anatomical reduction is required to prevent unsatisfactory result regardless the treatment method.

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Treatment of Lateral Humeral Condyle Fractures in Children Using Closed Reduction and Percutaneous Pinning: Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Sang Hoon Ko, Seung Hyun Hwang; J Korean Soc Fract 1997;10(1):218-225. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.218

Abstract PDF: Treatment of lateral condyle fracture has been traditionally divided to closed and open treatment. Minimal displaced fracture of lateral humeral condyle can be appropriately treated with closed reduction and percutaneous K-wire fixation. Adherence to these guidelines is likely to prevent malunion, nonunion, premature epiphyseal closure, ulnar neue palsy, and cubitus valgus deformity, all possible complications of this fracture. Since September 1993, we managed 20 children with lateral condyle fracture of elbow using closed reduction and percutaneous pinning. And intraoperative arthrogram was done to confirm the reduction status. Pins were removed 6 weeks postoperatively. The average period of follow-up was 24 months. There was no significant difference in carrying angle, range of motion and physical activity compared to contralateral elbow. Valgus - varus stress view is a useful method in evaluating fracture stability and rupture of cartilage hinges and valgus - supination stress view is very useful for confirming the reduction. Arthrogram was considered to be useful in evaluating the reduction state and deciding the treatment plan.

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