Journal of Musculoskeletal Trauma

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Original Articles

Prediction of Syndesmotic Instability according to the Lateral Malleolus Fracture Pattern in Supination-External Rotation Type Ankle Fractures: Short Oblique versus Long Oblique Fracture: Chan-Jin Park, Min-Su Lee, Keun-Bae Lee; J Korean Fract Soc 2024;37(1):39-45. Published online January 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.1.39

Abstract PDF

Purpose
This study examined whether preoperative radiological evaluations can predict syndesmotic instability according to the lateral malleolus fracture pattern in supination-external rotation-type ankle fractures.
Materials and Methods
This study enrolled 132 patients (132 ankles) with supination-external rotation stage 3 and 4 ankle fractures. Three-dimensional computed tomography was used for the morphological classification of the lateral malleolus fractures. A long oblique fracture was defined when the posterior cortical bone height of the fracture was 4.5 cm or more from the plafond of the distal tibial articular surface. A short oblique fracture was defined when the height was less than 4.5 cm. The demographic characteristics and syndesmotic instability of the two groups were evaluated.
Results
Short oblique fractures were confirmed in 102 cases, and long oblique fractures were confirmed in 30 cases. Long oblique fractures occurred at a statistically significantly higher incidence in younger ages and among males compared to short oblique fractures. Syndesmotic instability was more common in long oblique fractures.
Conclusion
In supination-external rotation-type ankle fractures, syndesmotic instability was observed in approximately 13%. Specifically, when the fracture pattern of the lateral malleolus is long oblique, the incidence of syndesmotic instability is approximately three times higher than in short oblique fractures. Therefore, meticulous evaluations of the lateral malleolus fracture pattern and establishing an appropriate treatment plan before surgery are crucial.

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Relationship of lateral malleolar fracture patterns to posterior malleolar fracture morphology in supination-external rotation ankle fractures in Korea: a retrospective cohort stduy
Jong-Eun Kim, Chan-Jin Park, Jun-Young Lee, Keun-Bae Lee, Gun-Woo Lee
Journal of Musculoskeletal Trauma.2025; 38(4): 212. CrossRef

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Comparison of a Novel Box-Frame External Fixator and Conventional Delta-Frame External Fixator in the Staged Treatment of Distal Tibia Fractures: Yong-Cheol Yoon, MinKyu Shin, Chang-Wug Oh, Jong-Keon Oh; J Korean Fract Soc 2020;33(3):125-133. Published online July 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.3.125

Abstract PDF

Purpose
Distal tibia fractures with severe soft-tissue edema or intra-articular fractures are treated by staged operations using external fixators. Definitive surgery that maintains ligamentotaxis has been difficult using existing fixators. This study introduced a novel ‘box-frame’ external fixator and evaluated its clinical usefulness.
Materials and Methods
This study included 45 patients (32 males, 13 females) diagnosed with distal tibia fractures who underwent staged operations between March 2012 and March 2016, with a follow-up of at least one year. The patients were divided into two groups. In one group, fixation was performed with a box-frame external fixator (Group A). In the other group, fixation was performed with a delta-frame external fixator (Group B). The following outcomes were evaluated: the time until definitive surgery, operative time of the definitive surgery, radiation exposure time, bone union, time to achieve bone union, postsurgical complications, American Orthopaedic Foot & Ankle Society anklehindfoot score, and ankle range of motion.
Results
Compared to the delta-frame, the box-frame showed a statistically significant reduction in the mean radiation-exposure time and operative time during the definitive surgery by 58 seconds and 25 minutes, respectively. The differences in the time until definitive surgery, bone union, time to achieve bone union, postsurgical complications, and functional scores were not significant.
Conclusion
The box-frame external fixator can be a useful treatment method in the staged surgery of distal tibia fractures.

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Temporary Circular External Fixation for Spanning the Traumatized Ankle Joint
Nando Ferreira, Niel Bruwer, Adriaan Jansen van Rensburg, Ernest Muserere, Shao-Ting Jerry Tsang
JBJS Essential Surgical Techniques.2024;[Epub] CrossRef
Temporary circular external fixation for spanning the traumatised ankle joint: A cohort comparison study
William D. Harrison, Franklin Fortuin, Matthieu Durand-Hill, Etienne Joubert, Nando Ferreira
Injury.2022; 53(10): 3525. CrossRef

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Case Report

Treatment of Neglected Proximal Interphalangeal Fracture Dislocation Using a Traction Device: A Case Report: Yongun Cho, Jai Hyung Park, Se Jin Park, Ingyu Lee, Eugene Kim; J Korean Fract Soc 2019;32(4):222-226. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.222

Abstract PDF: This paper reports the use of a traction device for the treatment of neglected proximal interphalangeal fracture dislocations. A 44-year-old man with a fracture dislocation of a right ring finger proximal interphalangeal joint was admitted 17 days after the injury. Closed reduction and external fixation were performed using a dynamic traction device and C-arm under a brachial plexus block. Passive range of motion exercise was started after two weeks postoperatively and active range of motion exercise was started after three weeks. The traction device was removed after five weeks. No infection occurred during the traction period. No subluxation or displacement was observed on the X-ray taken two months postoperatively. The active range of motion of the proximal interphalangeal joint was 90Â°. The patient was satisfied with the functional result of the treatment with the traction device. The dynamic traction device is an effective treatment for neglected fracture dislocations of the proximal interphalangeal joint of a finger.

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Original Articles

Use of a Distraction Dynamic External Fixator in the Treatment of Comminuted Middle Phalanx Base Fractures: Sang Woo Kim, Chae Chil Lee, Sang Hun Ko, Il Yeong Hwang, Min Seok Kim, Woo Young Jin; J Korean Fract Soc 2019;32(1):1-5. Published online January 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.1.1

Abstract PDF

PURPOSE
This paper suggests the use of distraction dynamic external fixators (DDEF) for the treatment of proximal middle phalanx fractures.
MATERIALS AND METHODS
Seven patients, who were diagnosed with comminuted intra-articular fractures at the base of the middle phalanx from February 2014 to November 2016, were enrolled in this study (volar aspect 6 cases, dorsal aspect 1 case). They underwent a closed reduction under a C-arm image intensifier, and DDEF was applied with general anesthesia. Range of motion (ROM) exercise was encouraged after 3 to 5 days postoperatively, and DDEF was removed after 5 weeks. Subluxation, angulation and displacement were evaluated 6 weeks postoperatively.
RESULTS
The patients who were treated with DDEF showed a normal proximal interphalangeal joint ROM (100Â°), and there was no subluxation or displacement on the X-ray film 6 weeks postoperatively. In addition, there were no signs of infection, such as local heat, redness, and pus-like discharge.
CONCLUSION
DDEF helps maintain the reduction and reducing forces through the ligamentotaxis. The joint stiffness is reduced, which it makes early return to daily life easier.

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Treatment of Neglected Proximal Interphalangeal Fracture Dislocation Using a Traction Device: A Case Report
Yongun Cho, Jai Hyung Park, Se-Jin Park, Ingyu Lee, Eugene Kim
Journal of the Korean Fracture Society.2019; 32(4): 222. CrossRef

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A Comparison of the Results between Internal Fixation and External Fixation in AO C Type Distal Radius Fractures: Yoon min Lee, Hwa Sung Lee, Seok Whan Song, Jae Hoon Choi, Jong Tae Park; J Korean Fract Soc 2018;31(3):87-93. Published online July 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.3.87

Abstract PDF

PURPOSE
The purpose of this study was to evaluate the radiological and clinical results of plate fixation and external fixation with additional devices for treating distal radius fracture in AO type C subtypes, and propose a treatment method according to the subtypes.
MATERIALS AND METHODS
Two hundred and one AO type C distal radius fracture patients were retrospectively reviewed. Eighty-five patients in group 1 were treated with volar or dorsal plate, and 116 patients in group 2, were treated with external fixation with additional fixation devices. Clinical (range of mtion, Green and O'Brien's score) and radiological outcomes were evaluated.
RESULTS
At the 12-month follow-up, group 1 showed flexion of 64.4Â°, extension of 68.3Â°, ulnar deviation of 30.6Â°, radial deviation of 20.8Â°, supination of 76.1Â°, and pronation of 79.4Â° in average; group 2 showed flexion of 60.5Â°, extension of 66.9Â°, ulnar deviation of 25.5Â°, radial deviation of 18.6Â°, supination of 73.5Â°, and pronation of 75.0Â° in average. The mean Green and O'Brien score was 92.2 in group 1 and 88.6 in group 2. The radial height of group 1 and group 2 was 11.6/11.4 mm; radial inclination was 23.2Â°/22.5Â°; volar tilt was 11.6Â°/8.7Â°; and the ulnar displacement was 1.27/0.93 mm.
CONCLUSION
Judicious surgical techniques during device application and tips for postoperative management during external fixation can produce similar clinical results compared with internal fixation patients.

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Intra-articular fracture distal end radius external fixation versus locking volar radius plate: A comparative study
S.P.S Gill, Manish Raj, Santosh Singh, Ajay Rajpoot, Ankit Mittal, Nitin Yadav
Journal of Orthopedics, Traumatology and Rehabilitation.2019; 11(1): 31. CrossRef

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Additional Hinged External Fixation in Complex Elbow Injury: Tong Joo Lee, Taek Ho Hong, Nak Chul Kim; J Korean Fract Soc 2015;28(3):169-177. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.169

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the use of hinged external fixation in management of complex elbow injury.
MATERIALS AND METHODS
We retrospectively reviewed clinical outcomes in 10 patients with elbow dislocation and associated fractures of both the radial head and the coronoid process from January 2007 to December 2013. All ten patients were treated by hinged external fixation after open reduction and internal fixation. The indication for use of a hinged external fixator was persistent instability after fixation of the fractures. Early mobilization was started at 1 week (6.5 days) after surgery. The external fixator was removed at 6 weeks after surgery. Cassebaum classification and Mayo elbow performance score were used for clinical and functional evaluation. The follow-up period was at least 1 year.
RESULTS
At the last follow-up, the average further flexion was 127degrees, and the average flexion contracture was 16degrees. The average pronation was 83degrees and the average supination was 78degrees. By the Cassebaum classification after 1 year follow-up, patients were classified as 4 excellent, 4 good, and 2 poor. According to the Mayo elbow performance score, the average score was 87 points (65-100 points) with 3 excellent, 6 good, and 1 fair. Stability was restored in all patients at the last follow-up. There was no case of nonunion and the average union period was 11.5 weeks.
CONCLUSION
This study advocated the additional use of a hinged external fixator in the treatment of complex elbow instability, especially when fixation of fractures and repair of soft tissues were not sufficient. Providing adequate stability and allowing early motion, additional external fixation could improve the functional outcome.

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Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures: Sung Ki Park, Chang Wug Oh, Jong Keon Oh, Kyung Hoon Kim, Woo Kie Min, Byung Chul Park, Won Ju Jeong, Joo Chul Ihn; J Korean Fract Soc 2010;23(3):289-295. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.289

Abstract PDF

PURPOSE
To assess the result of staged minimally invasive plate osteosynthesis (MIPO) for distal tibial fracture with an open wound or injured soft tissue.
MATERIALS AND METHODS
In 20 patients (mean age, 47.8 year-old) with distal tibial fractures, there were 4 type A fractures and 16 type C fractures based on the AO classification system. Eight of the 20 patients had open fractures. MIPO was performed on average 23.9 days after bridging external fixation. At the final follow-up, we assessed the radiological results of bone union and alignment. Functional results were also evaluated by measuring the degrees of ankle motion and the American Orthopedic Foot & Ankle Society (AOFAS) scores.
RESULTS
Seventeen of 20 cases (85%) achieved primary union at an average of 21.3 weeks. There were 3 cases of nonunion requiring a bone graft. The mean AOFAS score was 88.5 (range, 67~92) and the average range of ankle motion was 49.2degrees (plantarflexion: 37.4degrees, dorsiflexion: 11.8degrees). Complication included 2 cases of minor mal-alignment, 1 case of claw toe and 1 case of peroneal neuropathy. Patients over the age of 60 had lower functional results. Additional factors did not affect the final results.
CONCLUSION
Staged MIPO may achieve satisfactory results in distal tibial fractures with soft tissue compromise, decreasing deep infections and soft tissue complications.

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Anterolateral Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures Using an Anterolateral Locking Plate
Dongwhan Suh, Hwan Hee Lee, Young Hoon Han, Jae Jung Jeong
Journal of Korean Foot and Ankle Society.2020; 24(1): 19. CrossRef
Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures
Sung-Kyu Kim, Keun-Bae Lee, Keun-Young Lim, Eun-Sun Moon
Journal of the Korean Fracture Society.2011; 24(1): 33. CrossRef

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Treatment for Unstable Distal Radius Fracture with Osteoporosis: Internal Fixation versus External Fixation: Jin Rok Oh, Tae Yean Cho, Sung Min Kwan; J Korean Fract Soc 2010;23(1):76-82. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.76

Abstract PDF

PURPOSE
To compare the functional and radiological outcomes of volar plating to that of external fixation for treating unstable osteoporotic distal radius fracture.
MATERIALS AND METHODS
From March 2006 to March 2008, 36 patients with osteoporosis over 60-year old were selected for this study. They were divided into two groups; group I (open reduction and internal fixation with volar fixed angle plate) and group II (closed reduction and external fixation). Clinical outcomes and radiologic outcomes were evaluated.
RESULTS
There was no statistical difference between group I and group II in range of motion and DASH score, BMD score. However, the grip strength and PRWE score were found to be higher in group II (p<0.05). In radiologic evaluation, group I showed higher radial inclination, volar tilting angle (p<0.05).
CONCLUSION
Internal fixation using Volar-fixed Angle Plate seems to give more stable fixation for distal articular fragments compared to external fixation. it could allow early postoperative exercise and could result in low incidence of postoperative complication such as pin track infections and joint stiffness. Therefore, the internal fixation could be more desirable treatment method to manage unstable distal radius fracture.

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Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis
Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin
Journal of the Korean Fracture Society.2013; 26(4): 248. CrossRef

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Comparison of Treatment Outcomes of Infected Nonunion of the Tibia by Ilizarov Fixator according to Location of Nonunion and Reconstruction of Soft Tissue Defect: Soo Kyung Lee, Jung Ryul Kim, Jong Han Lim, Jun Mo Lee; J Korean Fract Soc 2010;23(1):57-63. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.57

Abstract PDF: PURPOSE
To study clinical results and complications in the treatment of infected nonunion of the tibia according to location of nonunion and reconstruction for soft tissue defect.
MATERIALS AND METHODS
36 cases of tibia infected nonunion which were treated with the llizarov included in this study. There were proximal 1/3 in 14, middle 1/3 in 10, and distal 1/3 in 11 cases. Coverage of the soft tissue were treated with the free flap in 8 cases as classified group A and non-free flap in 17 cases classified group B. We evaluated the healing index, complications and comparing the results of each treatment by the Paley method.
RESULTS
Bone union was achieved in all cases. The proximal nonunion showed better results than those in the middle and distal area; average healing index: 35.6 days/cm (p=0.038), bone results: 92.9% (p=0.025), functional result: 90.5% (p=0.03). Group B showed significantly better results as it showed average healing index: 30.3 days/cm (p=0.015), bone results: 85.7% (p=0.025), functional results: 90.5% (p=0.015).
CONCLUSION
The nonunion of proximal 1/3 showed better results than other sites. Soft tissue reconstruction with free flap that control infection more effectively, could be improved the treatment outcomes.

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Staged Management of High Energy Proximal Tibia Fractures with Severe Soft Tissue Damage: Seung Ryul Lee, Jae Hoon Yang, June Kyu Lee, Hyun Dae Shin, Kyung Cheon Kim, Kyu Woong Yeon, Young Mo Kim; J Korean Fract Soc 2009;22(3):152-158. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.152

Abstract PDF: PURPOSE
To find out the efficiency of two staged operation of patients with high energy proximal tibia fracture with severe soft tissue damage, the first step being external fixation, and the second, internal fixation with plates.
MATERIALS AND METHODS
The study group was the 42 patients who had followed for one year out of a group of 56, performed the first step external fixation and the second step internal fixation with plates retrospectively, from March 2003 to March 2007. The average age of the study group was 51.4, 26 men, and 16 women participating in this study. The average time of follow up was 32 months. In the final follow up, investigations of the radiological assessments and functional abilities of the bony fusion were carried out along with the complications of the soft tissue.
RESULTS
The duration after the first step external fixation until second step internal fixation to be performed was 14.9 (6~40) days in average. The final bone fusion took about 15 weeks, and according to the final follow up, the range of motion of the knee was around 110.8 degrees (6.2~117 degrees). In 31 cases, only the internal fixation was performed, while in 11 cases, soft tissue reconstruction was carried out with the internal fixations. As for the complications there were 2 cases of deep soft tissue infection, 2 cases of nonunion, 1 case of malunion and 1 case of knee joint stiffness.
CONCLUSION
In cases of proximal tibia fracture with severe soft tissue damage, external fixation was important to secure the safety of the fracture, carry forward the anatomical alignment, plan the soft tissue safety and manage the wound to decrease the number of microbial in the next operation, which is the internal fixation with plates.

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Staged Minimally Invasive Plate Osteosynthesis of Proximal Tibial Fracture: Joon Woo Kim, Chang Wug Oh, Jong Keon Oh, Hee Soo Kyung, Woo Kie Min, Byung Chul Park, Kyung Hoon Kim, Hee Joon Kim; J Korean Fract Soc 2009;22(1):6-12. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.6

Abstract PDF

PURPOSE
To assess the results of staged MIPO (Minimally Invasive Plate Osteosynthesis) for proximal tibial fractures with compromised soft tissue.
MATERIALS AND METHODS
Eighteen proximal tibial fractures (AO 41:9 cases, AO 42:9 cases) included this study. Ten were open fractures. After temporary external fixation until soft tissue healed (mean 27.3 days), MIPO was performed secondarily without bone graft. We assessed the bony union and knee function, and affecting factors of the results were investigated.
RESULTS
All fractures united at 20 weeks (range, 11~32) except 1 case. Mean range of knee flexion was 134.4degrees and mean IOWA knee score was 89.1. There were 2 superficial and 2 delayed deep infections from open fractures (grade II:1 case, grade III:3 cases), although they healed after implant removal. Open fractures seem to influence the infection rate. Otherwise, there was no related factor affecting the results.
CONCLUSION
MIPO after temporary external fixation can provide favorable results in proximal tibial fractures with soft tissue injuries, but attention of delayed infection should be paid in open fractures.

Citations

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MINIMALLY INVASIVE OSTEOSYNTHESIS WITH PLATE OR NAIL FOR META-DIAPHYSEAL TIBIAL FRACTURES - WHAT IS BETTER?
B. Makelov
Trakia Journal of Sciences.2023; 21(4): 357. CrossRef
Effect of Korean Medicine Treatments in Patients with Proximal Tibia Fracture: A Retrospective Observational Study
Jung Min Lee, Eun-Jung Lee
Journal of Korean Medicine Rehabilitation.2020; 30(3): 141. CrossRef
Comparison of Time to Operation and Efficacies of Ultrasound-Guided Nerve Block and General Anesthesia in Emergency External Fixation of Lower Leg Fractures (AO 42, 43, 44)
Chan Kang, Sang-Bum Kim, Youn-Moo Heo, You-Gun Won, Byung-Hak Oh, June-Bum Jun, Gi-Soo Lee
The Journal of Foot and Ankle Surgery.2017; 56(5): 1019. CrossRef
Minimally Invasive Plate Osteosynthesis for Proximal Tibial Shaft Fracture
Young-Soo Byun, Ki-Chul Park, Hyun-Jong Bong, Chang-Hoon Lee
Journal of the Korean Fracture Society.2011; 24(1): 23. CrossRef
The Use of Fresh Frozen Allogenic Bone Graft in the Impacted Tibial Plateau Fractures
Yeung Jin Kim, Soo Uk Chae, Jung Hwan Yang, Ji Wan Lee, Dae Han Wi, Duk Hwa Choi
Journal of the Korean Fracture Society.2010; 23(1): 26. CrossRef
Management of Open Fracture
Gu-Hee Jung
Journal of the Korean Fracture Society.2010; 23(2): 236. CrossRef
Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures
Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn
Journal of the Korean Fracture Society.2010; 23(3): 289. CrossRef
Intramedullary Nailing of Proximal Tibial Fractures
Young-Soo Byun, Dong-Ju Shin
Journal of the Korean Fracture Society.2009; 22(3): 197. CrossRef
Proximal Tibia Fracture: Plating
Ki-Chul Park
Journal of the Korean Fracture Society.2009; 22(3): 206. CrossRef

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Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures: Jae Sung Lee, Yong Beom Park, Han Jun Lee; J Korean Fract Soc 2008;21(2):124-129. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.124

Abstract PDF: PURPOSE
To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation.
MATERIALS AND METHODS
We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test.
RESULTS
There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score.
CONCLUSION
The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.

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Comparison of Outcomes for Unstable Distal Radius Intraarticular Fractures: T-locking Compression Plate versus External Fixator: Chul Hyun Cho, Su Won Jung, Sung Won Sohn, Chul Hyung Kang, Ki Cheor Bae, Kyung Jae Lee; J Korean Fract Soc 2008;21(1):51-56. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.51

Abstract PDF

PURPOSE
To compare the outcomes between T-locking compression plate (T-LCP) and external fixator (EF) for unstable distal radius intraarticular fractures.
MATERIALS AND METHODS
We retrospectively analysed the results in 22 cases with T-LCP, 20 cases with EF. We evaluated the clinical results according to the Mayo Wrist Scoring System, radiographic results.
RESULTS
The mean score was 84.6 in the T-LCP group and 80.5 in the EF group respectively. Final radiographic measurements for the T-LCP group averaged 10.5 mm radial length, 21.7degrees radial inclination, 9.8degrees volar tilt and 0.25 mm intraarticular step-off. The EF group averaged 10.1 mm radial length, 20.3 degrees radial inclination, 6.3 degrees volar tilt and 0.73 mm intraarticular step-off.
CONCLUSION
Both groups showed satisfactory final clinical outcomes. But T-LCP group allowed return to daily living, resulting in early postsurgical wrist motion. By the anatomical reduction, final volar tilt, intraarticular step-off were statistically better in the T-LCP group.

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Comparative Analysis of the Results of Fixed-angle versus Variable-angle Volar Locking Plate for Distal Radius Fracture Fixation
Seung-Do Cha, Jai-Hyung Park, Hyung-Soo Kim, Soo-Tae Chung, Jeong-Hyun Yoo, Joo-Hak Kim, Jung-Hwan Park
Journal of the Korean Fracture Society.2012; 25(3): 197. CrossRef
Treatment for Unstable Distal Radius Fracture with Osteoporosis -Internal Fixation versus External Fixation-
Jin Rok Oh, Tae Yean Cho, Sung Min Kwan
Journal of the Korean Fracture Society.2010; 23(1): 76. CrossRef

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Bone Transport Over the Intramedullary Nail for Defects of Long Bone: Jae Young Roh, Chang Wug Oh, Jong Keon Oh, Hee Soo Kyung, Byung Chul Park, Woo Kie Min, Joon Woo Kim, Chang Hyun Cho; J Korean Fract Soc 2008;21(1):37-44. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.37

Abstract PDF

PURPOSE
To evaluate the results of bone transport using external fixator over an intramedullary nail for defects of long bone.
MATERIALS AND METHODS
We treated 14 cases of bone defect after chronic osteomyelitis or trauma of tibia (12 cases) and femur (2 cases) using this method. The mean age of index procedure was 46.9 years, and all of them had follow-up study for a mean of 3 years. After the corticotomy and insertion of intramedullary nail, bone transport was done by external fixators. Then, the segment was moved and bone graft was done at docking site.
RESULTS
The mean transported amount was 5.8 cm, and the external fixator was removed after 141 days. The mean external fixation index was 25.6 days/cm. Primary union of distraction and docking site was achieved in all, but one had failure in union of docking site. According to the Mekhail's functional criteria, there were 5 excellent, 6 good, and 3 fair results. Among 15 complications, there were 2 major complications with residual sequelae, and they were 1 recurred osteomyelitis and 1 flexion contracture of knee.
CONCLUSION
Bone transport using external fixator over an intramedullary nail, can successfully solve defects of long bone. Since this method can remove external fixators earlier than the conventional method, it has fewer complications and makes patients to return to daily life earlier.

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Treatment for Bone Defect of Open Tibial Fractures by Using Intramedullary Nail Fixation with Autogenous Iliac Bone Graft
Hyub Sakong, Ki Cheor Bae, Chul Hyun Cho, Kyung Jae Lee, Eun Seok Son, Du Han Kim
Journal of the Korean Fracture Society.2012; 25(4): 288. CrossRef

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Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator: Suk Kyu Choo, Kyung Wook Nha, Hyoung Keun Oh, Dong Bong Lee; J Korean Fract Soc 2007;20(4):323-329. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.323

Abstract PDF: PURPOSE
We analyed the mid-term results of distal tibial fractures treated with ilizarov external fixator and functional results according to delayed metaphyseal healing and fracture pattern.
MATERIALS AND METHODS
We reviewed 23 distal tibial fractures treated with ilizarov external fixator followed for minimum two year (mean 53 months). There were 10 A fractures, 2 B fractures, and 11 C fractures according to the AO classification. Radiographically, we analyzed bony union time according to translation of diaphyseal-metaphyseal fracture line and assessed arthritic score. Functional results was assessed with AOFAS score and analyzed according to delayed healing and fracture pattern.
RESULTS
Average union time was 21 weeks. Delayed healing of metaphyseal fracture line was associated translational displacement >3 mm (p=0.01). AOFAS scrore was averaged to 68 and there was no stastical significance between delayed metaphyseal healing and functional results (p=0.31). But, low AOFAS score and arthritis score was related to fracture type (p=0.02). In 11 C fractures, radiographic arthritic change were developed in 6 cases (55%).
CONCLUSION
The main prognosis of distal tibial fractures depends on articular involvement and to shorten the external fixation time, metaphyseal fracture should be reduced within 3mm.

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Comminuted Pilon Fractures: Comparative Outcome Analysis according to Surgical Techniques: You Jin Kim, Hong Geun Jung, Joo Hong Lee, Woo Sup Byun, Sung Tae Lee; J Korean Fract Soc 2007;20(1):6-12. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.6

Abstract PDF

PURPOSE
To evaluate the overall surgical outcome of the tibial pilon comminuted fractures and perform the comparative analysis between the limited internal fixation-external fixation group and the delayed open reduction-internal fixation (ORIF) group.
MATERIALS AND METHODS
From June 1997 to June 2004, 17 tibial pilon comminuted fractures were treated with the limited internal fixation-external fixation (6 cases) or the delayed open reduction-internal fixation (11 cases). The average age of the patients was 47.7 years (range: 41~63 years), male was fourteen patients, female was three. Follow-up period was average 33.6 months (range: 12~84 months). The clinical outcomes were evaluated by using AOFAS ankle-hindfoot score and patient satisfaction was also evaluated.
RESULTS
AOFAS score at final follow-up was 80.4 points, and 88% of the patients were satisfied with the results. AOFAS scores of the external fixation group and the delayed ORIF group were average 77.0 points and 82.2 points respectively, which did not show the statistical difference (p>0.05). Bony union was achieved at average 16.0 weeks. There were 18 complications such as skin necrosis.
CONCLUSION
We have achieved relatively encouraging functional results and high patient satisfaction for pilon comminuted fractures, without significant result difference between the two surgical techniques.

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The Result of Using an Additional Mini-Locking Plate for Tibial Pilon Fractures
Suenghwan Jo, Jun Young Lee, Boseon Kim, Kang Hyeon Ryu
Journal of the Korean Fracture Society.2017; 30(2): 75. CrossRef

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Radiologic Reduction Loss after Surgical Treatment of Distal Radius Fracture: Heun Guyn Jung, Jin Bae Choi, Seung Yong Seo, Yong Soo Choi; J Korean Fract Soc 2006;19(4):454-459. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.454

Abstract: PURPOSE
To compare and analyse radiologic reduction loss between fixation with K-wire only group and fixation with K-wire and external fixator group for surgical treatment of distal radial fracture.
MATERIALS AND METHOD
We analysed 60 patients who received the operative treatment with K-wire fixation only or K-wire and external fixator and also were in regular follow up at least one year. We compared radiologic reduction loss of radial length, radial inclination and volar tilt between immediate post-operative radiograph and latest follow up radiograph according to operative methods, fracture patterns and age groups.
RESULTS
Reduction loss of volar tilt was greater in fixation with K-wire only group than fixation with K-wire and external fixator group (p<0.05). Reduction losses of radial length and radial inclination were more in intra-articular subgroup than extra-articular subgroup in fixation with K-wire only group (p<0.05). No significant difference of reduction loss was noted between intra-articular and extra-articular subgroups in fixation with K-wire and external fixator group.
CONCLUSION
More radiologic reduction loss can be expected in fixation with K-wire only group for intra-articular distal radius fracture compared with extra-articular distal radius fracture. Additional external fixation should be added in intra-articular distal radius fracture to reduce radiologic reduction loss.

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External Fixation of Pediatric Femur Fractures: Yeung Jin Kim, Tae Kyun Kim, Hwan Deok Yang, Hyung Joon Kim, Jin Young Park, Sang Jin Eun; J Korean Fract Soc 2006;19(3):369-373. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.369

Abstract: PURPOSE
To evaluate unilateral external fixation when applied as the standard treatment of displaced femoral shaft fractures in children.
MATERIALS AND METHODS
From 2000 through 2004, we used a unilateral external fixator (Any-fix(R)) to treat 24 femoral shaft fractures. The average age of the patients was 8.3 years (range, 5.6 to 14.8). 16 fractures were isolated, and 8 were associated with polytrauma. There were 4 open fractures. Patients were followed clinically and radiologically until healing and at 1 year.
RESULTS
Average time of external fixation was 97 days (range, 57 to 130 days). All patients regained the normal range of motion of knee joint without significant residual leg length discrepancy or growth disturbance. There were no nonunion, or rotationary deformities. There were 26 pin tract infection (total pin number: 108) (24%), all of which were resolved with antibiotics. No patient developed osteomyelitis. There were two refractures after fixator removal. There was one case of reduction loss and one of valgus deformity.
CONCLUSION
The external fixation is a useful alternative for operative management of femoral shaft fractures because of minimal invasive operation, and early mobilization in prepuberty.

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Treatment of the Unstable Distal Radius Fracture with External Fixation and Bone Cement in Elderly Patients: Dong Chul Kim, Suc Hyun Kweon, Dae Moo Shim, Churl Hong Chun, Ha Heon Song, Jeung Woo Kim; J Korean Fract Soc 2006;19(3):352-356. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.352

Abstract: PURPOSE
To evaluate the functional and radiologic results in the using of external fixation with bone cement (polymethylmethacrylate, PMMA) for unstable, osteoporotic distal radius fractures in elderly patients that have high morbidity and chronic medical problems.
MATERIALS AND METHODS
We retrospectively analyzed 12 cases of 12 patients who were treated by external fixation and bone cement for unstable distal radius fractures in the aged persons with poor general condition from January 2003 to July 2004 and followed over one year. We analyzed the radiologic results, and measured the ranges of motion and grip strengths. Functional results were evaluated using the Modified Mayo Wrist Scoring System.
RESULTS
Radiographically, mean volar tilt, mean radial inclination and mean radial length were 8.33o, 24.66 mm and 11.31o respectively on the last follow-up. The mean arc of range of motion was 74.4% of that the uninjured side, and the mean grip strength was 78.0% of that the contralateral side. The average Modified Mayo Wrist Score was 78.3. There were reflex sympathetic dystrophy in a case and pin tract infection in 3 cases as complications associated with external fixator.
CONCLUSION
External fixation and bone cement is useful method for radial length maintenance, preventing reduction loss, restoring the articular surface, early exercise of the wrist joint without morbidity of donor site for unstable distal radius fractures requiring autogenous bone graft in the elderly patients.

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External Fixation with Five Pins for Unstable Fractures of the Distal Radius: Kyoung Duck Kwak, Cheol Eun Ko, Seung Il Baek, Sang Min Ahn, Chan Jong Jung, Ki Baek Ahn, Jae Su Roh; J Korean Fract Soc 2006;19(3):346-351. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.346

Abstract: PURPOSE
To evaluate the results of five-pin external fixation, with the fifth pin stabilizing the distal radius articular fragment, for unstable distal radial fractures.
MATERIALS AND METHODS
Twenty cases of unstable distal radial fractures were treated with five-pin external fixation (5-pin group). The fifth pin was inserted into the distal articular fragment and attached to the external fixation frame. Metacarpal pins were removed at sixth week in 12 cases and at third in 8 cases, and radial pins were removed at eighth or ninth week. The radiographic results of 5-pin group were compared with those of 20 cases of traditional four-pin external fixation (4-pin group).
RESULTS
The postoperative radial inclination was 23.1 degrees in 5-pin group and 22.2 degrees in 4-pin group; while at last follow-up 21.8o and 15.1 degrees respectively. Postoperative volar tilt was 8.5 degrees and 7.3o; while at last follow-up 6.3 degrees and 0.1 degrees respectively. Postoperative radial shortening was 0.3 mm, 0.4 mm; while at last follow-up 1.1 mm and 2.1 mm respectively. In 5-pin group, there were no significant differences in results whether the metacarpal pins were removed at sixth or third week.
CONCLUSION
Five-pin external fixation, with the fifth pin stabilizing the distal articular fragment, enhanced early motion of the wrist maintaining fracture stability in unstable fractures of the distal radius.

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Treatment of Distal Radius Fractures Using the Percutaneous K-wire Reduction-Fixation and External Fixator: Sang Jin Cheon, Ja Gyung Ku, Dong Ho Lee, Hui Taek Kim, Jeung Tak Suh; J Korean Fract Soc 2006;19(2):228-235. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.228

PURPOSE
To analyse the results of treatment of unstable intra-articular distal radius fractures using the percutaneous K-wire reduction-fixation and external fixator.
MATERIALS AND METHODS
A retrospective follow-up study of 22 cases was carried out. With use of the system of AO classification 9 cases were in C1 and 7 in C2, and 6 in C3. The average duration of follow-up for all fractures was 35 months. We evaluated the radiologic results, the functional results according to clinical evaluation scoring system by Green and O'Brien and osteoarthritis grade according to arthritic grading system by Knirk and Jupiter.
RESULTS
Excellent and good results were rated in 17 cases (77%) of all cases. At last follow-up the mean loss of radial length, radial inclination and volar tilt were 1.4 mm, 1.0o, and 1.4o respectively. Also 7 patients had grade I, 1 patient grade II, and 1 patient grade III arthritis.
CONCLUSION
We think that percutaneous K-wire reduction-fixation and external fixation is useful treatment method for the unstable intra-articular distal radius fracture. But severely comminuted AO type C3 fractures would need additional treatments such as open reduction and bone graft to acquire and maintain the articular reduction for better results.

Citations

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Management of Comminuted Intra-articular Fractures of the Distal Radius: Arthroscopically Assisted Reduction and Pin Fixation Supplemented with External Fixation
Jong-Pil Kim, Hyun-Jin Yu
The Journal of the Korean Orthopaedic Association.2009; 44(2): 233. CrossRef
Comparison of Outcomes for Unstable Distal Radius Intraarticular Fractures - T-locking Compression Plate versus External Fixator -
Chul-Hyun Cho, Su-Won Jung, Sung-Won Sohn, Chul Hyung Kang, Ki-Cheor Bae, Kyung-Jae Lee
Journal of the Korean Fracture Society.2008; 21(1): 51. CrossRef
Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures
Chul Hyun Cho, Ki Choer Bae, Doo Hyun Kwon
Journal of the Korean Fracture Society.2008; 21(3): 220. CrossRef

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Arthroscopically Assisted Limited Open Reduction and Ilizarov External Fixation of Tibial Pilon Fractures: Jin Young Lee, Gab Lae Kim, Hyung Seok Oh, Kun Ho Shin, Deok Yong Park; J Korean Fract Soc 2006;19(2):176-181. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.176

Abstract: PURPOSE
To evaluate the clinical results of the pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation.
MATERIALS AND METHODS
This is a retrospective study of the clinical result, bone union, complication and postoperative ankle function of 22 pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation between January 1999 to March 2004.
RESULTS
Clinical follow up averaged 16 months, with an average age of 39.2. All patients with type 1 and 2 fracture had excellent or good score by Ovadia and Beals criteria. Closed fractures healed within 13 weeks and open fractures within 16 weeks after surgery in average. Average range of motion of the ankle was 12o dorsiflexion (0~20 degree) and 25o plantar flexion (15~35 degree).
CONCLUSION
Minimal soft tissue dissection and anatomical reduction are very important factor for minimizing complication and satisfactory ankle function. So, arthroscopically assisted limited open reduction and Ilizarov external fixation is an effective treatment option for tibial pilon fractures.

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Problems of Anterior External Fixation in Unstable Pelvic Ring Injury: Jun Dong Chang, Young Jin Seo, Yong Hyuck Choi; J Korean Fract Soc 2005;18(4):394-398. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.394

Abstract PDF

PURPOSE
To determine the problems of anterior external fixators in unstable pelvic ring injuries.
MATERIALS AND METHODS
We reviewed 25 patients with an unstable pelvic ring injuries who had been treated with only anterior external fixator over one year follow-up. By Tile's classification, type B 14, type C 11 and the radiological results were evaluated preoperation, postoperation and bone union state. The clinical evaluation was done in termas of the residual pain, discrepency in limb length, rotational deformities, gait disturbance, neurologic deficiency.
RESULTS
In 25 patients with an unstable pelvic ring injuries, 18 (72%) patients were reducted and 3 (17%) patients of 25 were reduction failure at last follow up, they were all Tile type C. The residual pain was graded normal 3, mild 11, moderate 10, severe 1 respectively. The cases with discrepency in limb length and gait disturbance were 6 (all type C), 10 (type B 3, type C 7) respectively. The complication were 4 pin site infection, 3 pressure sore and 1 pyogenic hip arthritis.
CONCLUSION
Our results indicate that anterior external fixator should be limited to vitally unstable patients in acute resuscitative phase and cases without vertical displacement.

Citations

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Outcome of Surgical Treatment of AO Type C Pelvic Ring Injury
Do Hyeon Moon, Nam Ki Kim, Jun Sung Won, Jang Seok Choi, Dong Hyun Kim
Hip & Pelvis.2014; 26(4): 269. CrossRef
General Assessment and Initial Management of Polytrauma Patients
Hyoung Keun Oh
Journal of the Korean Fracture Society.2013; 26(3): 230. CrossRef
Damage Control and Provisional Fixation
Hyoung Keun Oh
Journal of the Korean Fracture Society.2010; 23(3): 346. CrossRef

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Case Report

Avulsion Facture of Short External Rotators in the Proximal Femur: A Case Report: Myung Rae Cho, Sang Bong Ko, Dae Ui Jeung; J Korean Fract Soc 2005;18(3):345-348. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.345

Abstract PDF: Although avulsion fractures of greater and lesser trochanters rarely develop in hip fractures, avulsion fracture of short external rotators has not reported still online literature. Moreover, avulsion fracture of short external rotators can simulate the intertrochanteric fracture, and is difficult to differentiate from it on plain radiograph. This study is on the case 74-year old male patient who had avulsion fracture of short external rotators, and had the internal fixation with wire by open reduction under the diagnosis of the intertrochanteric fracture.

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Original Articles

A Biomechanical Advantage of the Lengthening with an External Fixator Over an Intramedullary Nail: An Experimental Study in Saw Bones and Cadeveric Bones: Chang Wug Oh, Poong Taek Kim, Hae Ryong Song, Jong Keon Oh, Hyung Soo Ahn, Byung Chul Park, Byung Guk Min, Sung Ki Park, Young Heon Sohn; J Korean Fract Soc 2005;18(3):335-340. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.335

Abstract PDF: PURPOSE
To know biomechanical differences in methods of limb lengthening between using monolateral external fixator and using external fixator over an intramedullary nail.
MATERIALS AND METHODS
In acryl rods, saw-bone, and cadeveric bone, we created two lengthening models of using monolateral external fixator and using external fixator over an intramedullary nail. The axial compression test was done on the site of osteotomy for lengthening. To fix the models, half pins of 5 mm in diameter and nails of 9 mm in diameter were used. Using MTS (Material Test System) machine, we evaluated the differences of axial stiffness according to the presence of an intramedullary nail or the numbers of half-pins which were fixed at each side of osteotomy.
RESULTS
Lengthening over an intramedullary nail, comparing to monolateral external fixator only, increased the axial stiffness by 1.1~1.2 times in acryl rods, 1.2~1.6 times in saw bones, and 15.6~15.9 times in cadeveric bones when the same numbers of half-pins were used. In saw bone and cadaveric bone, the group of two half pins in lengthening over an intramedullary nail was stiffer than the group of three pins in lengthening with monolateral external fixator.
CONCLUSION
In the distraction of the limb, the addition of an intramedullary nail may increase the axial stiffness of the frame of monolateral external fixator. In lengthening over an intramedullary nail, it is enough to distract the bone with fixing two half pins at each sides of osteotomy.

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External Fixator and External Fixator Supplemented with K-wire in the Treatment of Distal Radius Fractures: Sang Wook Bae, Ho Yoon Kwak, Baik Yong Song, Young Joo Ahn; J Korean Fract Soc 2005;18(3):311-316. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.311

Abstract PDF: PURPOSE
To evaluate the differences of the outcome between external fixator and external fixator supplemented with K-wire in the treatment of distal radius fractures.
MATERIALS AND METHODS
Twenty-one cases which underwent external fixation (external fixation group) and 28 cases, external fixation supplemented with K-wire (external fixation with K-wire group), were analyzed. Radial length, radial inclination and volar tilt were compared in preoperative, immediate postoperative radiographs, and radiographs after removal of external fixator between two groups. And functional outcome including flexion, extension, pronation and supination of wrist were compared between two groups and wrist pain, as well.
RESULT
Radial length and radial inclination in the postoperative radiographs and radiographs after removal of external fixator showed no difference between two groups, but volar tilt of external fixation group measured 2.1+/-4.2 degrees, 1.3+/-3.8 degrees and external fixation with K-wire group, 8.8+/-2.3 degrees, 8.5+/-2.4 degrees respectively, so that external fixation with K-wire group showed better reduction and maintenance. Wrist flexion and extension about postoperative 6 months measured 25.6+/-8.2 degrees, 25.1+/-10.2 degrees, respectively, in external fixation group and 42.5+/-15.2 degrees, 33.6+/-9.5 degrees in external fixation with K-wire group, so that external fixation with K-wire group showed better functional results.
CONCLUSION
In the treatment of distal radius fractures, to obtain better reduction and function result, external fixations supplemented with K-wire need to be taken into consideration.

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Clinical Results after Percutaneous Surgical Treatment of Intra-articular Fracture of the Distal Radius: Jae Ryong Cha, Jung Hoei Ku, Hyung Lae Cho, Jin Wan Kim, Yoo Dae Kim, Young Il Park, Seong Hwak Hong; J Korean Fract Soc 2005;18(3):304-310. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.304

Abstract PDF: PURPOSE
To evaluate the clinical and radiologic results of percutaneous surgical treatment of the intra-articular fractures of the distal radius, we have compared the results of percutaneous pinning and the combination of percutaneous pinning with external fixation after closed reduction.
MATERIALS AND METHODS
We analysed the results of 52 patients with intra-articular fracture who received the operative treatment with closed reduction in the period of June, 1995 to June, 2001 and also were in regular follow-up at least one year. We used the subjective analysis by Cole & Obletz and the objective analysis by Scheck.
RESULTS
We have found the outcome that 83.3% of percutaneous pinning were graded above "Good" in type B and C1 and 82.2% of the combination treatment of percutaneous pinning with external fixation were graded above "Good" in type C2 and C3.
CONCLUSION
The percutaneous pinning and external fixator after closed reduction in intra-articular fractures of the distal radius are considered useful to restore the articular congruity and make good clinical results.

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Treatment of Periarticular Fracture of Elbow with Hinged External Fixator: Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Chang Hwa Hong, Yong Bum Joo; J Korean Fract Soc 2005;18(3):299-303. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.299

Abstract PDF: PURPOSE
To evaluate the result of the treatment with external fixator and early ROM exercise to prevent the stiffness and contracture of the elbow in unstable elbow injury.
MATERIALS AND METHODS
From Jan. 1997 to Dec. 2001, ten patients of unstable elbow injury treated with hinged external fixator and early ROM exercise were evaluated. The age was average 37 years. The patients were followed at least 1 years and motorcycle injury (4 cases) was most common. Nine cases were comminuted fractures and one case was fractures with dislocation. We estimated the result of the treatment with Mayo elbow performance index.
RESULTS
ROM exercise started in average 2 days after operation. Two cases were treated by ilizarov and eight cases treated by elbow distracter modified by the author. The result of the treatment was estimated as following: excellent in two, good in three cases, fair in eight cases, and poor in two case.
CONCLUSION
There were satisfactory results in patients treated with external fixation with early ROM exercise, whose injuries had difficulty in being fixed internally. The authors recommend hinged external fixation and early ROM exercise to prevent postoperative stiffness & contracture of elbow joint in this circumference.

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Two-Stage Reconstruction of Infected Nonunion of Long Bones using Antibiotics-Impregnated Cement Beads: Se Hyun Cho, Soon Taek Jeong, Hyung Bin Park, Sun Chul Hwang, Yong Chan Ha, In Hwan Hwang; J Korean Fract Soc 2004;17(4):395-400. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.395

Abstract PDF

PURPOSE
To evaluate treatment results between internal and external fixation groups in two-stage reconstruction of infected nonunion of long bones using antibiotics-impregnated cement beads.
MATERIALS AND METHODS
In the first stage, preexisting hardwares were removed and radical debridement was done. The dead space was filled with antibiotics -impregnated cement beads and the nonunion site was immobilized by external fixation, cast or skeletal traction. In the second stage, all cases were divided into two groups; the nonunion was fixed by internal fixation in group I versus external fixation in group II. The intervening period between the first and second stage was average 8.7 weeks (range, 3~23 weeks).
RESULTS
The follow-up period was average 45 months (range, 16~71 months). Infection control and bone union were achieved in all 13 cases of group I. Infection recurred in two of 28 cases in group II, one underwent above-knee amputation and the other case was lost in follow-up. The mean number of supportive operations including repeated curettage, augmentation and change of infected pins, angular correction, and soft tissue flap was average 2 and 6.2 times respectively in group I and group II. Bony union period was average 19.3 and 23.1 weeks in each group. According to Paley's classification, group I was similar to group II in bony and functional result (p>0.05).
CONCLUSION
Antibiotics-impregnated cement beads provided positive effect on infection control. Internal fixation group showed less number of additional operations and earlier bony union than external fixation group.

Citations

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Treatment of Infected Nonunion
Sang-Ho Ha
Journal of the Korean Fracture Society.2007; 20(2): 206. CrossRef

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Treatment for Intractable Infected Nonunion of Lower Extremity in Elderly People using External Fixator: Seung Jun Park, Jong Sup Shim, Sung Kee Shin; J Korean Fract Soc 2004;17(2):177-183. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.177

Abstract PDF

PURPOSE
To introduce and report the results of treatment of old patients' infected nonunion using external fixator.
MATERIALS AND METHODS
Nine patients more than 60 years old were included in the study. Four cases had combined medical problems of diabetes, hypertension, and vascular disorder. We used Ilizarov fixator in eight cases and uni-lateral external fixator in one. All patients were treated with debridement, broad sequestrectomy, segmental resection, bone graft and compression of fracture site about 1~1.5 cm. We evaluated the final results by functional result and complication according to the criteria of Paley.
RESULTS
Average length discrepancy was 1.7 cm before operation by initial bone loss and final follow-up shortening was average 2.6 cm. Mean duration of fixtor removal was 5.2 months. We acquired bony union lastly in 8 cases. Final functional result was 3 excellent, 2 good, 2 fair and 2 poor. Among them, 2 good, 1 fair and 1 poor cases had medical problem.
CONCLUSION
In old patients, compression of nonunion site and early joint motion using external fixator seemed to be very useful in the treatment of intractable infected nonunion of lower extremity and in minimizing duration of treatment.

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Manufacturing Techniques of Ancient Forged High-tin Bronze Wares from Archaeological Sites in Bagan, Myanmar
Jae Sung Lee, Yee Yee Win, Bonnie Lee, Jae Eun Yu
Journal of Conservation Science.2023; 39(5): 673. CrossRef
Treatment of Infected Nonunion
Sang-Ho Ha
Journal of the Korean Fracture Society.2007; 20(2): 206. CrossRef

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Biomechanical Analysis of Hybrid External Fixation for the Distal Tibial Fractures: A FEM Study: Duk Young Jung, Boug Ju Kim, Seok Bae Ryu, Jong Keon Oh; J Korean Fract Soc 2004;17(2):160-166. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.160

Abstract PDF: PURPOSE
To analyze the biomechanical effects of different frame configurations of the hybrid external fixators for distal tibial fractures on the frame stiffness and stress distribution with a finite element method (FEM).
MATERIALS AND METHODS
Five configurations were simulated: Group I: two wires with convergence angle of 60degrees, Group II: 3rd wire on a bisector axis of the group I. Group III: two wires with 30degrees. Group IV: 3rd wire on a bisector axis. Group V: two wires with 30degree and a half pin on the distal articular fragment. Each group was simulated under compression, torsion, anterior-posterior and lateral-medial bending load. Stiffness, stress and deformation values were calculated.
RESULTS
The overall stiffness was increased by 15~30% with the addition of a third wire, and by 150~400% with a anteromedial half pin on the articular fragment. The half pin decreased the stress level of the frame by about 43% and the deformation of the 5/8 ring by about 30%.
CONCLUSION
The addition of a half pin on the articular fragment is not only a method of increasing the stiffness but also a way of decreasing the stress concentration and the deformation of the frame.

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Closed Reduction and External Fixation of Displaced Fractures of the Proximal Humerus: Seung Ju Jeon, Ho Seung Jeon, Kye Nam Cho, Jae Ho Choi, Joon Yong Lee; J Korean Fract Soc 2004;17(1):43-48. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.43

Abstract PDF: PURPOSE
This is a retrospective study to analyze the functional results of closed reduction and external fixation of unstable fractures of the proximal humerus.
MATERIALS AND METHODS
Ten unstable proximal humerus fractures were managed with closed reduction and external fixation in which other operative methods are not proper due to comminution, osteoporosis or poor general condition of patients. 4 cases of 2-part and 6 cases of 3-part fracture were included. Radiologically union of fracture, malunion and the evdence of avascular necrosis of humeral head were assessed and the functional results were analyzed with Neer scoring system.
RESULTS
Radiologically all fractures were healed but in 2 cases malunion was resulted because of reduction loss in proximal fragment. Pin site infection was developed in 7 cases and oral antibiotics were needed. The functional results were excellent in 4, satisfactory in 3 and unsatisfactory in 3 cases. 2 cases with malunion and one case with lack of postoperative cooperation resulted in functionally unsatisfactory.
CONCLUSION
External fixation is an alternative method in the treatment of unstable proximal humerus fractures in which open reduction or percutaneous pinning are not proper due to comminution, osteoporosis or poor general condition of patient.

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Surgical Treatment of Fractures of the Distal Radius in Patients Older Than 65 Years: Jeung Tak Suh, Dae Woong Kim, Chong Il Yoo; J Korean Soc Fract 2003;16(4):563-569. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.563

Abstract PDF

PURPOSE
To analyze the results of surgical treatment of the displaced distal radius fractures in elderly patients over 65 years old who were treated with percutaneous K-wire fixation only and percutaneous K-wire fixation with external fixation. MATERIAL AND METHOD: We evaluated 24 cases of the distal radius fracture in patients older than 65 years from January 1998 to December 2001. The patients were followed up at least 12 months postoperatively. We compared the surgical results of 14 cases, treated with percutaneous K-wire fixation only with the surgical results of 10 cases, treated with percutaneous K-wire fixation with external fixation. We evaluated the functional results according to demerit point system and the radiographic results (radial length, radial inclination, volar tilt).
RESULTS
According to demerit point system, the mean score of demerit point was 9.9 in the group of percutaneous K-wire fixation and 5.3 in the group of percutaneous K-wire with external fixation respectively (p<0.05). In radiographic results, the percent of the mean loss of radial length, radial inclination and volar tilt were 23.2%, 12% and 41.7% in the group of percutaneous K-wire fixation and 11%, 5.9% and 27.4% in the group of percutaneous K-wire with external fixation respectively (p<0.05).
CONCLUSION
Percutaneous K-wire with external fixation showed better functional and radiographic results than percutaneous K-wire fixation only for the treatment of the displaced distal radius fractures in elderly patients older than 65 years and percutaneous K-wire with external fixation is thought to be a one of the most effective treatment of the displaced distal radius fractures in elderly patients.

Citations

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Osteoporotic Distal Radius Fracture-conservative Treatment
Seok-Whan Song
Journal of the Korean Fracture Society.2008; 21(1): 81. CrossRef

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Treatment of Infected Nonunion of Long Bone Shaft: Comparison between Fixation by Antibiotic-cement Loaded Intramedullary Nailing and Fixation by Antibiotic-cement Loaded External Monofixator: Ki Ho Nah, Seong Jin Park, Suk Ku Han, Hyun Suk Song, Nam Yong Choi; J Korean Soc Fract 2003;16(4):511-518. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.511

Abstract PDF: PURPOSE
To evaluate the surgical results between fixations by antibiotic-cement loaded intramedullary nailing and antibiotic-cement loaded external monofixator in the treatment of infected nonunion of long bone shaft with mild bone loss and shortening of less than 1 cm.
MATERIALS AND METHODS
Among the 15 cases of infected nonunion of long bone shaft, 6 cases treated with fixation by antibiotic-cement coated intramedullary nailing and 3 cases treated with fixation by intramedullary nailing along with antibiotic-cement beads insertion were divided as group I (n=9), and other 6 cases treated with fixation by external monofixator along with antibiotic-cement beads insertion were divided as group II (n=6). There was no difference between the two groups in the degree of infection in the laboratory data and clinical feature and degree of bone loss and shortening. Male was in 7 and 5 patients, average age of the patients was 34.8 (26~53) and 37.2 (20~63) years old and average follow-up period was 15.9 (12~35) and 19.3 (15~41) months in group I and II respectively.
RESULTS
Among the nine cases of group I, 3 cases were newly convereted into fixation by antibiotic-cement coated intramedullary nailing at average 9.5 weeks. Radiologic union was gained at the average of 26 weeks from the time of initial nail fixation. Infection was responsive at 6.1 weeks by laboratoey data. Knee ROM of more than 100 degrees was gained in all case and average shortening was 9.2 mm in the last follow-up. And external rotation deformity of more than 5 degrees was noted in 1 case. Among the six cases of group II, radiologic union was gained at 14 weeks in 1 case without converting to internal fixation, and the other 5 cases were converted to antibiotic cement loaded intramedullary nailing at average 12.5 weeks because of delayed uinon or angulation deformity, and radiologic union was gained at average 44 weeks from the time of fixation by external fixator. Infection was responsive at 10.2 weeks by laboratoey data. Knee ROM of more than 100degrees was gained in 5 cases, and average shortening was 11.8 mm in the last follow-up.
CONCLUSION
In the treatment of infected nonunion of long bone shaft with mild bone loss and shortening of less than 1 cm, the fixation by intramedullary nailing with the use of antibiotic-cement prefers to the fixation by external monofixator with the use of antibiotic-cement in the velocity of union, control of infection, and in the clinical aspects such as alignment, early ambulation and joint stiffness.

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Treatment of Fractures of Distal Radius using External Fixator: Sung Tae Lee, Seok Ha Lee, Kwang Jun Oh, Jong In Na, Ji Sung Jun, In Rok Yu; J Korean Soc Fract 2003;16(3):407-415. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.407

Abstract PDF: PURPOSE
To assess the clinical and radiological results from the treatment of the intraarticular distal radius fracture by using the external fixator and confirm the usefulness of the external fixator from this study. MATERIALS & METHODS: We selected 20 cases of the distal radius fracture patients, who were treated with external fixator, among the patients from March, 1998 to March, 2001 and they could be followed for 1 year. There were 12 males and 8 females with a mean age of 53.4. According to AO classification, there were 2 cases for type A (10%), 2 cases for type B (10%), 5 cases for type C1 (25%), 9 cases for type C2 (45%), and 2 cases for type C3 (10%). In the 16 cases, the external fixator was used alone and in the other 2 cases, the external fixator was used with K-wires fixation. In the last 2 cases, K-wires fixation and autogenous iliac bone graft were combined.
RESULTS
In more severe form of distal radius fracture such as complete intraarticular fracture (type C2, C3 of AO classification), the better outcome in clinical and radiologic results was showed when additional K-wires fixation and/or autogenous iliac bone graft were combined rather than using the external fixator only. Particularly, in the cases of type C2, the poorest outcomes of radial length loss 2.7 mm (4.0%), radial inclination loss 1.4 (4.9%), volar tilting loss 2.4 (6.9%) were showed when the external fixator was used alone. The three worst results were from the cases of using external fixator alone in type C2. In the two cases of combination with K-wire fixation, the result of type C2 was excellent and that of type C3 was good. The results of the last two cases (type C2, C3) of combination with K-wire fixation and autogenous iliac bone graft were all excellent.
CONCLUSION
In this study, we confirmed that the better result could be achieved when the treatment were performed with combination with K-wire and/or autogenous iliac bone graft rather than using the external fixator alone.

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Anterior Approach and Volar T-plate fixation of Distal Radius Fracture: Woo Sung Choi, Weon Yoo Kim, Dong Won Choi, Yun Hack Shin, Jin Young Kim; J Korean Soc Fract 2003;16(2):244-252. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.244

Abstract PDF

PURPOSE
To analyze the radiologic and clinical results of open reduction and volar plating through anterior approach for distal radius fracture.
MATERIALS AND METHODS
We retrospectively analysed that 19 distal radius fracture, which would not be reduced by closed reduction or too comminuted to maintain reduction or articular surface incongruency, were treated by open reduction and volar plating through anterior approach. The results were evaluated by preoperative and immediate postoperative radiographics and clinical results were analysed using Green and O'Brien scoring system at final follow up.
RESULTS
All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (8.8 mm +/-4.8 mm vs. 11 mm +/-3 mm), radial inclination (15 degrees+/-5.7 degreesvs. 20degrees+/-5degrees), volar tilt (-11 degrees+/-13 degrees vs. 7 degrees+/-4 degrees) and ulnar plus variant (4 mm+/-3 mm vs. 0 mm+/-1 mm) were improved. The clinical evaluation revealed 9 excellent cases, 7 good cases, 2 fair cases and 1 poor case. The reduction loss and flexor pollicis longus rupture was occurred in one patient, who had severely displaced comminute fracture in initial injury.
CONCLUSION
Using volar plating, authors gain good radiologic and clinical results. But, additional external fixation is recommended to prevent further collapse in severly comminuted fractures.

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Is dorsal cortex drilling necessary for distal radius fractures treated with a volar locking plate? A comparative study of near-cortex-only and far-cortex drilling
Chul Hong Kim, Sung Yoon Jung, Hyeon Jun Kim, Si-Hyun Park
Journal of Trauma and Injury.2025; 38(3): 248. CrossRef
Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate
Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef

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Surgical treatment using external fixator for unstable intra-articular fracture of distal radius: Chul Hong Kim, Byeong Hwan Kim, Sung Won Lee, Wook Kim; J Korean Soc Fract 2003;16(1):83-90. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.83

Abstract PDF: PURPOSE
To analyze the results of surgical treatment using external fixator for unstable intra-articular fracture of distal radius. MATERIAL AND METHODS: We investigated 38 cases of distal radius fracture from Mar. 1990 to Dec. 2000. The patients were followed up for average 18 months postoperatively. We compared the results of 22 cases, treated with open reduction and internal fixation(ORIF) to the results of 16 cases, treated with ORIF and external fixation. We evaluated the results of the mean loss of radial length, radial inclination, volar tilt and traumatic arthritis according to demerit point rating system above the Fernandez classification IV.
RESULTS
According to demerit point rating system, excellent to good results were obtained in 72.7% at ORIF and external fixator, compared to 43.8% at case of ORIF only. In the last follow up, the mean loss of radial length was 0.6mm in case of ORIF, but 0.4 mm in case of ORIF and external fixator, the mean loss of radial inclination was 2.3 and 1.5 degrees, the mean loss of volar tilt was 2.5 and 2.2 degrees, respectively (p < 0.05). Postoperative complications were developed in 9 cases. Malunion was in 4 cases of ORIF and external fixator, in 2 cases of ORIF. Metacarpal bone fracture was in 1 case of ORIF and external fixation. Traumatic arthritis was in 2 cases of ORIF.
CONCLUSION
Open reduction and internal fixation combined with external fixation was thought to be a better method than open reduction and internal fixation for the treatment of unstable intra-articular fractures of the distal radius of the Fernandez classification IV and IV, because that was more comfortable and convenient to patients and was useful to prevent late displacement.

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Hybrid External Fixation and Limited Internal Fixation for Severe Open Tibial Shaft Fractures: Hong Jun Han, Soo Uk Chae, Ul Oh Jeung; J Korean Soc Fract 2003;16(1):52-58. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.52

Abstract PDF: PURPOSE
To evaluate the radiographic and clinical results of severe open tibial shaft fracture treated by hybrid external fixation and limited internal fixation.
MATERIALS AND METHODS
We reviewed 25 patients open tibial shaft fracture(> or =Gustillo classification type II) which were treated with hybrid external fixation(AnyFixR) that was invented by authors and limited internal fixation between June 1998 to June 2001. 20 males and 5 females were minimum follow up period of 12 months(12-27 months). The mean age was 45 old years(11-72 old years). The results were based on the assessment radiographical analysis with duration of bony union, delayed union including of states of nonunion and malunion, clinical analysis with pain, joint range of motion, wound infection and skin & soft tissue coverage. All fractures were classified according to the Gustilo classification, there were 6 cases of type II, 9 cases of type IIIa and 10 cases of type IIIb. The cause of injury, there were 18 cases of motor vehicle accident, 5 cases of direct trauma and 2 cases of fall from height.
RESULTS
In twenty-five cases, fifteen had union, the average time of bone union was 6.8 months and additional bone graft without change of external fixator performed in ten cases, but one case have failed and then change of intramedullary nail with bone graft. In the group of bone graft, bone union was completed at mean 8.7 months. According to the clinical analysis, no pain in the fracture site, in complications, there were 2 cases of mild joint range of motion that has acceptable result and 2 cases of wound infection were treated with effective antibiotics theraphy and wound dressing. Five cases need to coverage of the open wound, 3 cases were flap operation and each case were muscle transfer, skin graft without change of external fixator.
CONCLUSION
The use of hybrid external fixation and limited internal fixation in severe open tibial shaft fracture to be successful for the stabilization of fracture and subsequent plastic and/or orthopaedic procedure for muscle and skin coverage, bone grafting are more easily accomplished without change of external fixator.

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Treatment of Femoral Shaft Fracture with External Fixator in Children: Phil Hyun Chung, Suk Gang, Dong Ju Chae, Jong Pil Kim, Sung Pock Park; J Korean Soc Fract 2002;15(3):421-426. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.421

Abstract PDF: PURPOSE
Children with femoral shaft fractures in association with other injuries such as head injuries, abdominal injuries, open fractures, multiple fractures, or unstable displaced fractures require operative treatment rather than being treated in conservative methods. In this study, we compare the surgical result of femoral shaft fracture using external fixator in children, and evaluate the complications and the related factors as well as the advantage over the other management described in the literature.
MATERIALS AND METHODS
We reviewed 15 cases of femoral shaft fractures in children admitted between May, 1995 and May, 2000. The mean age was 8 years and 2months old (range: 6-12 year-old, 9 boys, 6 girls). All the evaluations were based on the postoperative radiologic studying and clinical findings. In the radiologic evaluations, bony union time, angular deformity, and leg length discrepancy in both sagittal and coronal plane were evaluated, and in the clinical evaluations, we analyzed the duration of external fixation, hospital day, range of motion in both hip and knee joint, and post-operative complications.
RESULTS
The average bony union time based on the radiologic studying was 10.9 weeks (ranging from 7 to 24 weeks). Angular deformity at the fracture site was less than 5 degrees and no rotational deformity was found in all 15 cases. The average length of overriding fracture fragment was 11.7 mm (ranging from 10 to 15 mm) and average leg length discrepancy was 2.1 mm (ranging from -3 to +10mm). Duration of external fixation averaged 12.1 weeks (ranging from 9 to 24 weeks) and average hospital day was 29.4 day (ranging from 21 to 48 day). None of the patient had limitation in hip or knee joint movement. There were 1 case of refracture (case of pathologic fracture) and 4 cases of pin tract infection(superficial infection).
CONCLUSION
At our institution, we observed average overgrowth of 2.1 mm and no severe complications excepts in 1 case of refracture due to pathologic fracture. Thus we concluded that closed reduction and external fixation is effective in treating open, or unstable displaced fracture of femoral shaft with other associated injuries in pediatric population, and it is also believed to be effective means in treating closed femoral fractures.

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External Fixation of Displaced Proximal Humeral Fracture: Suk Kyu Choo, Byung Jik Kim, Jin Hwan Kim, Seung Yeub Suk, In Hwan Hwang; J Korean Soc Fract 2002;15(3):379-384. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.379

Abstract PDF: PURPOSE
Proximal humerus fractures are relatively frequent and have variable treatment mothods. It is important to resolve union of the fracture site, good range of motion and function through the early ambulation in treatment results. We will know whether it is recommendable treatment or not and analyze the results of treatment on the effectiveness of the external fixator in two or three part fractures of the proximal humerus fractures.
MATERIALS AND METHODS
From May, 1999 to April, 2001, 8 cases in 8 patients were treated by external fixator on the proximal humerus fractures. Mean age was 44.7yrs(11 to 68 yrs), two part fracture 6 cases, three part fracture 2 cases in fracture classification by Neer. We treated 3 cases with ring external fixator, 4 cases with monoplane external fixator. We referred chart and radiographics to patients and assessed the results by Neer 's shoulder function table through final follow-up or phone call.
RESULTS
In all cases, we obtained bone union without neuroparalysis, neurovascular injury, avascular necrosis and other complications. Mean bone-union time was 7 weeks(5 to 12 weeks). Final functional assessments are excellent or good in 7 cases, poor in 1 case.
CONCLUSION
We obtained comfortable results after we performed external fixation on proximal humerus fracture and bone union was acquired and removed external fixator at 7 weeks through early ambulation. We think procedure has brief, low soft tissue damage, high stability and motily. Thus we think it is recommendable treatment on the displaced proximal humerus fractures.

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Treatment of the Distal Metaphyseal Fractures of Tibia - Comparison between Internal Fixation with a Plate and screws and External Fixation with Ilizarov Device: Sung Churl Lee, Moon Jib Yoo, Hyun Seok Seo; J Korean Soc Fract 2002;15(3):371-378. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.371

Abstract PDF

PURPOSE
The purpose of this study was to compare the results between open reduction and internal fixation with plate and screws and closed reduction and external fixation with Ilizarov device for the fracture of disatal metaphyseal fracture of tibia.
MATERIALS AND METHODS
In this study, the results in treatment of the 19 distal metaphyseal fractures of tibia with closed reduction and external fixation with Ilizarov device were compared with those in treatment of the 23 fractures with open reduction and internal fixation with a plate and screws. The cases were the patients who had been treated for the fractures at the Department of Orthopaedic Surgery, Dankook University Hospital from May 1997 to December 2000. The results of treatment were analysed using functional evaluation by Mast and Teipner and radiological evaluation by Ovadia and Beals.
RESULTS
The results were as follows: 1. The major causes of injury were motor vehecle accidents, fall-downs, and falls from a height in order. 2. Treatment of the fractures with closed reduction and external fixation with Ilizarov device showed comparable results to that with open reduction and internal fixation with a plate and screws. 3. Complications in treatment were a little more frequent in open reduction and internal fixation with a plate and screws than in closed reduction and external fixation with Ilizarov device.
CONCLUSION
Considering the results, closed reduction and external fixation with Ilizarov device is thought to be one of recommendable options in treatment of the distal metaphyseal fractures of tibia with the advantages in wound management, prevention of stiffness of ankle joint, and convenience in removal of the device.

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Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator
Suk Kyu Choo, Kyung Wook Nha, Hyoung Keun Oh, Dong Bong Lee
Journal of the Korean Fracture Society.2007; 20(4): 323. CrossRef

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External fixation of distal radius fracture: Deok Weon Kim, Moon Ki Kim; J Korean Soc Fract 2002;15(2):258-263. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.258

Abstract PDF: PURPOSE
In the treatment of an unstable intraarticular distal radius fracture, we report the result of a retrospective study of reduction maintaining effect of external fixation.
MATERIALS AND METHODS
During the period from May 1996 to May 1999, 19 patients 20 cases with AO type C2, C3 distal radius fracture were treated by external fixation and followed-up for 2 years or longer. Six had AO type C2 fracture, and fourteen type C3. We evaluated immediate postoperative & follow-up radiological evaluation by volar tilt, radial inclination, radial length difference. As combined treatment, additional reduction maintaining effect of bone graft or internal fixation was evaluated also.
RESULT
Mean reduction loss of 2 years or longer follow-up after external fixation was volar tilt 7.2 degrees, radial inclination 4.3 degrees, radial length 3.1 mm. As additional reduction maintaining effect, internal fixation had statistically significant effect(p <0.05)-especially radial length maintenance, but bone graft not significant.
CONCLUSIONS
In unstable intraarticular distal radius fracture, after open reduction or bone graft etc. for intraarticular anatomic reduction, we consider external fixation or combined internal fixation for reduction maintenance.

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Treatment of nonunion of proximal tibia: Treatment using external fixator: Kuhn Sung Whang, Il Hoon Sung, Jun Sic Park; J Korean Soc Fract 2002;15(2):129-137. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.129

Abstract PDF: PURPOSE
To evaluate causes, treatment methods, outcomes and usefulness of external fixator after we have treated patients with proximal tibial nonunion successfully using external fixator.
MATERIALS AND METHODS
We treated the 10 patients with proximal tibial nonunion between December, 1991 and December, 2000. Mean follow-up period was 18.5 months. We analyzed numbers of operations, operative methods and causes of nonunion, and rated bony and functional results according to Paley's classification.
RESULTS
The causes of nonunion were infection in 6 cases, insecure fixation in 4 cases. Bony union was achieved in all 10 cases. The mean time of union was 12.9 months. Complications were developed in 8 cases. Pin site infection occurred in 7 cases, pain in 8 cases, joint stiffness in 2 cases, angular deformity in 2 cases. Functional results were excellent in one, good in four, fair in three, poor in two.
CONCLUSIONS
We concluded that external fixation method using external fixator such as Ilizarov in treating nonunion of proximal tibia was very useful because of offering advantages of bony shortening and compression, bony lengthening, bone grafting and early weight bearing in patient with infected nonunion and bone defect with many complications

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The Biomechanics of Hybrid External Fixator: The Effect of Periarticular Half Pin on Frame Stiffness: Jong Keon Oh, Duk Young Jung, In Su Kim; J Korean Soc Fract 2002;15(2):114-122. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.114

Abstract PDF: OBJECTIVES
The purpose of this study was to identify the biomechanical effect of periarticular half pin in the hybrid external fixator.
METHODS
Simulated tibial plateau fractures were created using a polyvinylchloride pipe. Seven frame configurations were tested : a four-ring Ilizarov frame, a hybrid frame with three wires on peri-articular fragment, hybrid frames with wires and half pins on peri-articular fragment by four different configurations, a hybrid frame constructed with multiple levels of fixation in the periarticular fragment. A materials testing machine was used to apply pure compression, anterior and posterior bending, medial and lateral bending, and torsion. Stiffness values were calculated from the load deformation and torque angle curves RESULTS: The overall stiffness of the hybrid frame was increased up to 30% by replacing a coronal tension wire with a half pin placed on the sagittal plane. The hybrid frame constructed with two wires and a half pin on the sagittal plane of the periarticular fragment showed overall stiffness compatible with that of multi-level peri-articular fixation frame.
CONCLUSION
Our results show that the half pin placed on the periarticular fragment can be a effective tool to increase the stiffness of hybrid external fixators in this periarticular tibia fracture model.

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Treatment of Femoral Shaft Fractures with External Fixators in Children: Ha Yong Kim, Jong Hyun Park, Seung Hun Lee, Kap Jung Kim, Kwang Won Lee, Byung Sung Kim, Won Sik Choy; J Korean Soc Fract 2002;15(1):36-44. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.36

Abstract PDF

PURPOSE
This study was to assess the amount of overgrowth and convenience after external fixation of pediatric femoral fracture.
MATERIALS AND METHODS
Followed-up more than 18 months were 20 childrens treated with external fixator for femoral fracture(mean follow-up periods: 25.5 months). Mean age was 7.15 years(range: 4-11 years). End to end apposition was done on the closed reduction. Evaluation of the result was done with five parameters; clinical results, radiological results, parents`satisfaction with questionnaire, hospital fee and complications.
RESULTS
Clincal results were not any disability in all cases. No angulation deformity was estimated in all cases, and overgrowth was estimated average 4.8mm (range: -1 ~ 13mm). Answer for questionnaire was revealed satisfactory result. Total hospital fee was average 831 thousand won in external fixator group, and average 289 thousand won in treated group with cast.
CONCLUSION
We propose that external fixation in closed femoral shaft fractures of children could be a rational alternative mode of therapy, because it has excellent clinical & radiological results and parents were satisfied with its convenience & final results. Total hospital fee was statistically higher in external fixator group.

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Comparison of Flexible Intramedullary Nailing with External Fixation in Pediatric Femoral Shaft Fractures
Do-Young Kim, Sung-Ryong Shin, Un-Seob Jeong, Yong-Wook Park, Sang-Soo Lee, Keun-Min Park
The Journal of the Korean Orthopaedic Association.2008; 43(1): 30. CrossRef
WDM-PON upstream transmission using Fabry–Perot laser diodes externally injected by polarization-insensitive spectrum-sliced supercontinuum pulses
Yang Jing Wen, Chang-Joon Chae
Optics Communications.2006; 260(2): 691. CrossRef

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The Biomechanics of Hybrid External Fixator: Effectiveness of Bar to Ring Connection: Jong Keon Oh, Duk Young Jung, Seong Yong Yoon; J Korean Soc Fract 2001;14(4):783-791. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.783

Abstract PDF: OBJECTIVES
The biomechanical effects of bar to ring connection in a hybrid external fixator have not yet been clearly identified. The purpose of this study was to identify the biomechanical effects of bar to ring augmentation in the hybrid external fixator.
METHODS
Simulated tibial plateau fractures were created using a polyvinylchloride pipe. Groups of simulated periarticular tibia fractures were stabilized with one of six different external fixation constructs with components from one manufacturer. Six frame configurations were tested: a four-ring Ilizarov frame, a hybrid frame without bar to ring augmentation, hybrid frames with three different bar to ring augmentations, a hybrid frame constructed with multiple levels of fixation in the periarticular fragment. A material testing machine was used to apply pure compression, anterior and posterior bending, medial and lateral bending, and torsion. Stiffness values were calculated from the load deformation and torque angle curves RESULTS: The four-ring Ilizarov fixator was the stiffest in all modes of testing. Frame augmentation with three different types of bar-to-ring connection did increase stiffness in all modes of testing. No statistical difference was found between the stiffness of the frames with three different types of bar to ring augmentations. The stiffness of a hybrid frame constructed with multiple levels of fixation in the periarticular fragment was comparable to that of the fixators with bar to ring augmentation.
CONCLUSION
Our results show that the bar to ring augmentation increases the overall stiffness of hybrid external fixators in this periarticular tibia fracture model by 27-76%.

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Comparison of External Fixation and Interlocking IM Nail in Open Tibial Fractures: Hyung Jin Chung, Duck Kyu Kim, Yerl Bo Sung, Jong Guk Ahn; J Korean Soc Fract 2001;14(4):632-642. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.632

Abstract PDF: PURPOSE
To compare and analyze the results of the treatment based on the method of treatment between interlocking IM nail and external fixation of type II, III A, and III B open fractures of the tibia] shaft.
MATERIALS AND METHODS
A clinical analysis was performed on 57 cases of type II, III A, and III B open fractures of tibial shaft from January 1994 to October 1999 those studies are followed at least 1 year or more. The results was analyzed according to complications and functional results based on operative methods of types of open fractures.
RESULTS
In aspect of delayed union and nonunion, interlocking IM nail indicate a great results(p = 0.036) in type II. In angulation, interlocking IM nail marks an outstanding results in case of type II. There is no difference between interlocking IM nail and external fixation in infection. But, the delay of operation after injury increase the possibilities of infection.
CONCLUSION
At present, especially in type m, external fixation was preferred. But, interlocking IM nail has a good results in aspect of complications. Therefore unreamed intramedullary nailing for open tibia shaft fractures is a good treatment method to be recommended.

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Treatment of Open Tibial Fracture with Repofix External Fixator: Ho Choi, Hoon Kim, Neung cheol Shin, Sang Ho Shin, Dong Soo Han; J Korean Soc Fract 2001;14(3):412-418. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.412

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the results of treatment of open tibial fracture with Repofix external fixator by clinical and radiological assessement. MATERIAL AND METHODS: 24 cases of open tibial fracture, who had been treated with Repofix external fixator from Oct. 1995 to June 1999, were evaluated about distribution of gender, age, cause of injury, fracture site and pattern, and assessed bony union time and complication.
RESULTS
The mean period of application of external fixator was 12.3 weeks and we kept PTB cast until bony union for average 11.5 weeks. According to Gustilo-Anderson's classification, the mean bony union time was 21.7 w e e k s ( type I ), 36 weeks(type II) and 39 weeks(type III), simple fracture was 22 weeks, comminuted fracture was 32 weeks(p<0.05). Complications were pin site infection(9 cases), delayed union(3 cases), nonunion(1 cases) and focal skin necrosis(1 case). There was no loss of motion about joint.
CONCLUSION
Repofix external fixator, which has the advantages of accurate reduction without extension of wound and decreases motion limitation of neighboring joint, is alternative useful appratus for open tibial fracture.

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Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases
Ji-Hye Geum, Hyeon-Jun Woo, Jong-gyu Kim, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2020; 30(4): 203. CrossRef

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Treatment of Tibial Condylar Fractures Using the Ilizarov External Fixator: Dong Wha Lee, Kyoo Seog Shin, Jong Soon Kim, Yong Whee Kim, Jin Ho Seok; J Korean Soc Fract 2001;14(3):404-411. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.404

Abstract PDF: PURPOSE
The aim of this study is to report results of treatment of tibial condylar fracture using the Ilizarov external fixator. MATERIALS & METHOD: 21 Cases of tibial condylar fracture, which were operatively treated with Ilizarov external fixator were evaluated clinically & radiographically. All patients were followed for at least 1 years.
RESULTS
Primary bony union was achieved in 15 cases(71.4%) and bony union after secondary operative procedure was obtained in 6 cases(28.6%). The fracture was united within 6 months except 2 cases. As complications, pin irritation was observed in 6 cases and Joint stiffness in 1 case, delayed union in 1 cases, nonunion in 1case CONCLUSION: We could obtain satisfactory clinical results with using of Ilizarov external fixator in treating of tibial condylar fractures. The good indications for the use of Ilizarov external fixator seems to be high energy tibial condylar fracture difficult to fixation with other method. In cases of bony defect or severe comminuted fractures, we shall obtain better outcome when bone graft is performed.

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Surgical Treatment for Tibial Condyle Fracture of the Proximal Tibia: Won Tae Choi, Bo Yel Choi, Chul Hyung Lee, Eui Soon Kim, Jeong Woung Lee, Doo Hoon Sun, Myung Sang Moon; J Korean Soc Fract 2001;14(2):291-297. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.291

Abstract PDF: PURPOSE
To evaluate the results of operative treatment for tibial condyle fracture of the proximal tibia. MATERIAL AND METHODS: From March 1995 to June 1999, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 10 of them were treated by open reduction and internal fixation(plate & screw for 8, screw & K-wire for 2) and 5 of them by closed reduction and Ilizarov fixation. Preoperative prognostic factors were considered as the fracture type of Schatzker classification, associated injury, and closed or open fracture. Functional outcome was evaluated results by Blokker`s criteria.
RESULTS
According to Schatzker classification, type III were 4 cases, type IV were 6 cases, and type V were 5 cases. At last follow up, average range of motion was 115degrees (Internal fixation was 110degrees, External fixation was 130degrees) The results was according to Blokker`s criteria, 11 cases(73%) had satisfactory acceptable results, among 4 cases(27%) of non-acceptable criteria.
CONCLUSION
For treatment of tibia condyle complicated communited fracture, we are able to consider that rigid internal fixation with anatomical reduction and external fixation for early range of motion.

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