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Review Articles
Treatment of avulsion fractures around the knee
Jeong-Hyun Koh, Hyung Keun Song, Won-Tae Cho, Seungyeob Sakong, Sumin Lim
J Musculoskelet Trauma 2025;38(2):63-73.   Published online March 31, 2025
DOI: https://doi.org/10.12671/jmt.2025.00073
AbstractAbstract PDF
Avulsion fractures of the knee occur when tensile forces cause a bone fragment to separate at the site of soft tissue attachment. These injuries, which frequently affect adolescent athletes, can involve the cruciate and collateral ligaments, arcuate complex, iliotibial band, and patellar and quadriceps tendons. Radiographs aid in the initial diagnosis, while computed tomography and magnetic resonance imaging facilitate a comprehensive evaluation of injury severity and concomitant damage. Specific avulsion fracture types include: anterior cruciate ligament avulsions (tibial site, Meyers and McKeever classification), posterior cruciate ligament avulsions (tibial attachment, Griffith's classification), Segond fractures (anterolateral complex injury), iliotibial band avulsions, medial collateral ligament avulsions (reverse Segond, Stieda fractures), arcuate complex avulsions ("arcuate sign"), medial patellofemoral avulsions (patellar dislocations), and patellar/quadriceps tendon avulsions. The treatment depends on the fracture location, displacement, and associated injuries. Non-displaced fractures can be managed conservatively, while displaced fractures or those with instability require surgical reduction and fixation. Prompt recognition and appropriate intervention prevent complications such as deformity, nonunion, malunion, and residual instability. This review provides an overview of the pathogenesis, diagnosis, and management of knee avulsion fractures to guide clinical decision-making.

Citations

Citations to this article as recorded by  
  • Lateral marginal fractures of the patella and patellofemoral pain
    Jae-Ang Sim, Chul-Ho Kim, Ji Wan Kim
    Journal of Musculoskeletal Trauma.2025; 38(3): 152.     CrossRef
  • 19,182 View
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  • 1 Crossref
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Avulsion Fractures of around the Hand
Dong Whan Kim, Jung Il Lee
J Korean Fract Soc 2024;37(3):158-168.   Published online July 31, 2024
DOI: https://doi.org/10.12671/jkfs.2024.37.3.158
AbstractAbstract PDF
An avulsion fracture occurs when soft tissues, including the tendons and ligaments, are forcibly detached from the main bone by an external force. The hand contains numerous anatomical structures, such as ligaments, tendons, and volar plates, which are essential for maintaining multidirectional motion and joint stability. Excessive force applied in a specific direction can damage these structures, leading to avulsion fractures around the joint. These fractures can result in severe complications if left untreated or improperly managed, including joint deformity, contracture, nonunion or malunion of the fracture, secondary osteoarthritis, and limited range of motion. Therefore, an accurate examination, diagnosis, and appropriate treatment are crucial for preventing these adverse outcomes. An avulsion fracture can be managed conservatively when the avulsed fragment does not compromise joint stability or motion. Nevertheless, surgical intervention is required to stabilize the fragment if it affects joint stability or motion. The use of internal fixation has become more prevalent because of recent advances in small implants for fixation.
  • 1,088 View
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Crush Syndrome: Traumatic Rhabdomyolysis, Reperfusion Injury
Yong-Cheol Yoon
J Korean Fract Soc 2023;36(2):62-68.   Published online April 30, 2023
DOI: https://doi.org/10.12671/jkfs.2023.36.2.62
AbstractAbstract PDF
A crush injury causes damage to bones, muscles, blood vessels, nerves, and other tissues caused due to pressure. Crush syndrome is a reperfusion injury that occurs throughout the body after a crush injury and leads to traumatic rhabdomyolysis, in which muscle fibers are broken down. Owing to the decreased blood supply, inflammation, and changes in metabolic activity, fluids and electrolytes in the blood can move into tissues, causing hypovolemic shock. In addition, toxic substances resulting from cell destruction can circulate through the bloodstream, causing electrolyte imbalances, renal failure, arrhythmias, and cardiac arrest, with approximately 15% of patients with acute renal failure dying. The treatment for crush syndrome involves aggressive fluid therapy and correction of the electrolyte imbalances, while patients with acute renal failure may require dialysis. Surgical treatment may include debridement and irrigation of necrotic tissue, and fasciotomy is necessary to address compartment syndrome, a complication that may arise.
  • 1,298 View
  • 29 Download
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Original Article
Comparison of Surgical Outcomes for Lisfranc Joint Injuries: Dorsal Bridge Plating versus Transarticular Screw versus Combination
Ba Rom Kim, Jun Young Lee, Sung Hun Yang, Seung Hyun Lee
J Korean Fract Soc 2023;36(1):17-24.   Published online January 31, 2023
DOI: https://doi.org/10.12671/jkfs.2023.36.1.17
AbstractAbstract PDF
Purpose
In Lisfranc joint injury, the traditional treatment has been open reduction and internal fixation with a transarticular screw. Despite this, additional complications, such as damage to the articular surface and breakage of the screw, have been reported. Therefore, this study compared the clinical and radiological outcomes of dorsal bridge plating with those of transarticular screws and combination treatment in Lisfranc joint injury.
Materials and Methods
Among the 43 patients who underwent surgical treatment due to Lisfranc joint injury from June 2015 to March 2021, 40 cases followed for more than six months after surgery were analyzed, excluding three patients: one lost to follow-up, one had to amputate, and one expired. The radiological parameters were measured using the Wilppula classification in the last follow-up. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score.
Results
The AOFAS midfoot score, according to the surgical method, was significantly higher in the dorsal bridge plating (p=0.003). The radiological outcomes showed significantly better anatomical reduction when dorsal bridge plating was used (p=0.040). According to the Wilppula classification, the AOFAS midfoot score improved as the quality of anatomical reduction improved (p=0.018). Finally, the AOFAS midfoot score decreased as the number of column fixations increased (p=0.002). There were two complications: screw breakage in dorsal bridge plating and superficial skin necrosis in the combination treatment. Skin defects caused by necrosis improved after negative pressure wound therapy and split-thickness skin graft.
Conclusion
In treating Lisfranc joint injuries, open reduction and internal fixation by dorsal bridge plating can be an appropriate treatment option. Nevertheless, studies, such as long-term follow-up research, on complications, such as osteoarthritis, will be needed.
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Review Article
Lisfranc Joint Injury
Bi O Jeong, Jungtae Ahn
J Korean Fract Soc 2022;35(2):83-89.   Published online April 30, 2022
DOI: https://doi.org/10.12671/jkfs.2022.35.2.83
AbstractAbstract PDF
The Lisfranc joint complex is composed of complex bony structures, ligaments, and soft tissues and has a systematic interrelationship. Sufficient radiologic modalities should be considered for an accurate initial diagnosis. Based on an accurate understanding of normal anatomy and restoration of anatomical relationships, the diagnosis should be obtained, and more discussion is needed on detailed treatment strategies.
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Case Report
Injury of the Ascending Branch of the Lateral Femoral Circumflex Artery Caused by a Spike of the Displaced Lesser Trochanter in an Intertrochanteric Femoral Fracture - A Case Report -
Soon Ho Huh, Hong-Man Cho, Jiyeon Park
J Korean Fract Soc 2021;34(2):71-75.   Published online April 30, 2021
DOI: https://doi.org/10.12671/jkfs.2021.34.2.71
AbstractAbstract PDF
Although vascular injuries associated with femoral intertrochanteric fractures have been reported infrequently, bleeding due to vascular injury can lead to severe complications that can be potentially life and limb-threatening. The authors report a case of an injury of the ascending branch of the lateral femoral convolutional artery in a patient who underwent surgical treatment for a femoral intertrochanteric fracture. Vascular injury occurred due to the sharp margin of displaced lesser trochanter five weeks after surgery. Percutaneous transcatheter embolization was done and improved without additional complications. Therefore, the surgeons need to be aware of possible associated vascular injuries caused by displaced lesser trochanter fragments in femoral intertrochanteric fractures.

Citations

Citations to this article as recorded by  
  • Delayed Deep Femoral Artery Injury Secondary to Migrated Lesser Trochanter Fragment After Intertrochanteric Fracture Fixation: A Case Report and Updated Literature Review
    Slavko Čičak, Josip Kocur, Vedran Farkaš, Petra Čičak, Stjepan Ištvanić, Marko Lovrić, Marko Perić, Nenad Koruga, Tomislav Ištvanić
    Geriatric Orthopaedic Surgery & Rehabilitation.2025;[Epub]     CrossRef
  • Vascular Complications Following Trans-Trochanteric Fracture: Case Report and Literature Review
    Robert Bot, Adrian Tirla, Simona Daniela Cavalu
    Reports.2025; 8(4): 191.     CrossRef
  • 617 View
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  • 2 Crossref
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Original Article
Risk Factors for Subsequent Contralateral Hip Fracture following Osteoporotic Hip Fracture Surgery
Kyung-Jae Lee, Jung-Hoon Choi, Hee-Uk Ye, Young-Hun Kim, Kyung-Hwan Lim
J Korean Fract Soc 2021;34(2):51-56.   Published online April 30, 2021
DOI: https://doi.org/10.12671/jkfs.2021.34.2.51
AbstractAbstract PDF
Purpose
This study examined the risk factors contributing to subsequent hip fractures in patients with osteoporotic hip fractures.
Materials and Methods
Between March 2008 and February 2016, 68 patients sustained a subsequent contralateral hip fracture after surgery for a primary osteoporotic hip fracture (Study group). The patients were compared with 475 patients who had been followed up for a minimum of one year with a unilateral osteoporotic hip fracture (Control group). The demographic data, bone mineral density (BMD), osteoporosis medication, osteoporotic fracture history, comorbid disease, type of surgery, preoperative, postoperative ambulatory capacity, and postoperative delirium in the two groups were compared.
Results
The demographic data, BMD, osteoporosis medication history, comorbid disease, type of surgery, and postoperative delirium were similar in the two groups. At three months after the primary surgery, the poor ambulatory capacity was significantly higher in the study group than the control group (p<0.001).
Conclusion
The ambulatory capacity after primary surgery is an important risk factor in the occurrence of subsequent hip fractures after osteoporotic hip fracture. Cause analysis regarding the poor ambulatory capacity after surgery will be necessary, and the development of a functional recovery program and careful management of the walking ability recovery will be needed.

Citations

Citations to this article as recorded by  
  • Osteoporotic Hip Fracture: How We Make Better Results?
    Byung-Chan Choi, Kyung-Jae Lee
    Journal of the Korean Fracture Society.2024; 37(1): 52.     CrossRef
  • 834 View
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  • 1 Crossref
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Case Report
Latent Superior Gluteal Artery Injury by Entrapment between the Fragments in Transverse Acetabular Fracture - A Case Report -
Hyuk Jin Choi, Byung Chul Kim, Hoon Kwon, Jae Hoon Jang
J Korean Fract Soc 2021;34(1):30-33.   Published online January 31, 2021
DOI: https://doi.org/10.12671/jkfs.2021.34.1.30
AbstractAbstract PDF
The superior gluteal artery is branched from the internal iliac artery and is located outside the pelvis through a greater sciatic notch. This anatomical characteristic makes the artery vulnerable to injury when pelvic fracture involves the sciatic notch. In the case of a superior gluteal artery injury, hemodynamic instability can occur, and appropriate evaluation and management are mandatory in the acute phase. On the other hand, if the initial detection of the injury is neglected due to a masked pattern, it can cause massive bleeding during surgery, resulting in difficult hemostasis. This paper reports an experience of a latent superior gluteal artery injury by entrapment between the fragments of a transverse acetabular fracture.

Citations

Citations to this article as recorded by  
  • Superior gluteal artery injury in pelvic ring injury and acetabular fracture: Single center observational study
    Hoon Kwon, Jae Hoon Jang, Nam Hoon Moon, Seung Joon Rhee, Dong Yeon Ryu, Tae Young Ahn
    Journal of Orthopaedic Science.2024; 29(6): 1483.     CrossRef
  • 777 View
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  • 1 Crossref
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Review Articles
Tendon Healing: A Review of Basic Science and Current Progress
Young Woo Kwon, Pei Wei Wang, Jun-Ku Lee
J Korean Fract Soc 2020;33(4):227-237.   Published online October 31, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.4.227
AbstractAbstract PDF
The tendon connects the muscles to the bones and transmits the loads generated by the muscles to the bones to move the joints, support the joints, and provide stability to the joints. Approximately 30% of patients complaining of musculoskeletal pain are associated with tendon disease, and approximately 50% of musculoskeletal injuries are caused by a tendon injury. Despite this frequent treatment of tendon damage, studies on the basic biology that provide scientific evidence for treatment, such as development, tendon injury, and healing, are still very limited. This review first summarizes the classification and composition of the tendon identified so far, the surrounding tissue, and the blood supply to the tendon. The limitations of the tendon recovery process after a tendon injury are also discussed. Finally, this review examines ways to improve tendon recovery and the biological approaches and tissue engineering that have been currently studied. In conclusion, innovative progress in promoting tendon healing has not been achieved despite the many advances in the basic structure of the tendon, and the cell and regulatory molecular factors involved in tendon recovery. Biological approaches and tissue engineering, which have become a recent issue, have shown many possibilities for the recovery of damaged cases, but further research will be needed until clinical application.
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Fixation Options of Unstable Posterior Pelvic Ring Disruption: Ilio-Sacral Screw Fixation, S2AI Fixation, Posterior Tension Band Plate Fixation, and Spino-Pelvic Fixation
Dong Hee Kim, Jae Hoon Jang, Myungji Shin, Gu Hee Jung
J Korean Fract Soc 2019;32(4):240-247.   Published online October 31, 2019
DOI: https://doi.org/10.12671/jkfs.2019.32.4.240
AbstractAbstract PDF
The fixation methods that can be used for unstable posterior pelvic ring injuries have undergone many innovative changes due to the recent development of surgical and imaging techniques. After understanding the appropriate indications of first and second sacroiliac screw fixation and spinopelvic fixation, innovative methods, including the trans-sacral screw fixation, posterior tension-band plate fixation, and the S2AI screw, would be chosen and applied. Considering the anatomical complexity and proximity to the surrounding vessels and nerves in the posterior fixation, the safe zone according to the fixation options should be well understood in preoperative planning. Moreover, the functional reduction of the posterior pelvic ring through the reduction and fixation of the anterior lesion should be achieved before placing the implant to reduce the number of malposition-related complications.

Citations

Citations to this article as recorded by  
  • Clinical Research through Computational Anatomy and Virtual Fixation
    Ju Yeong Kim, Dong-Geun Kang, Gu-Hee Jung
    Journal of the Korean Orthopaedic Association.2023; 58(4): 299.     CrossRef
  • 1,087 View
  • 17 Download
  • 1 Crossref
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Case Reports
Bilateral Gluteal Necrosis and Deep Infection after Transarterial Embolization for Pelvic Ring Injury in Patient with Hemodynamic Instability: A Case Report
Sung Jin Park, Chang Ho Jeon, Nam Hoon Moon, Yong Geon Park, Jae Hoon Jang
J Korean Fract Soc 2019;32(1):56-60.   Published online January 31, 2019
DOI: https://doi.org/10.12671/jkfs.2019.32.1.56
AbstractAbstract PDF
Transarterial embolization is accepted as effective and safe for the acute management in hemodynamically unstable patients with pelvic ring injury. However, transarterial embolization has potential complications, such as gluteal muscle/skin necrosis, deep infection, surgical wound breakdown, and internal organ infarction, which are caused by blocked blood flow to surrounding tissues and organs, and many studies on the complications have been reported. Here, we report an experience of the management of gluteal necrosis and infection that occurred after transarterial embolization, with a review of the relevant literature.
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Capitellar Osteochondral Impacted Fracture of the Humerus in an Adult Female: A Case Report
Jaekwang Yum, Minkyu Seong, Kyungil Kim
J Korean Fract Soc 2018;31(4):154-158.   Published online October 31, 2018
DOI: https://doi.org/10.12671/jkfs.2018.31.4.154
AbstractAbstract PDF
Capitellar osteochondral impaction fractures of the humerus are an uncommon injury and not encompassed by commonly used classification systems, such as that of Bryan and Morrey. Only a few cases of capitellar osteochondral impaction fractures have been reported. We report a case of a 53-year-old female with a capitellar osteochondral impaction fracture. The osteochondral fracture fragment of the capitellum was impacted and there was a step-off on the articular surface. Recovery of congruence in the capitellar articular surface was necessary. Satisfactory clinical and radiological results were obtained through the ‘lever arm’ reduction of the fracture fragment with a small osteotome and fixation with ‘raft’ K-wire.
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Original Article
Surgical Outcome of Posterior Pelvic Fixation Using S1, S2 Screws in Vertically Unstable Pelvic Ring Injury
Kwang Hee Yeo, Nam Hoon Moon, Jae Min Ahn, Jae Yoon Jeong, Jae Hoon Jang
J Korean Fract Soc 2018;31(1):9-17.   Published online January 31, 2018
DOI: https://doi.org/10.12671/jkfs.2018.31.1.9
AbstractAbstract PDF
PURPOSE
Iliosacral screw fixation is an effective and less invasive method that is used widely for the definitive treatment of unstable pelvic ring injuries. On the other hand, fixation failures after iliosacral screw fixation have been reported in vertically unstable pelvic ring injuries. This study examined the surgical outcomes of posterior pelvic fixation using S1 and S2 screws in vertically unstable pelvic ring injuries.
MATERIALS AND METHODS
Between January 2011 and April 2016, 17 patients with vertically unstable pelvic ring injuries who met the minimum 1 year follow-up criteria were treated with internal fixation using posterior pelvic S1 and S2 screws. Their mean age was 43.9 years. According to the AO/OTA classification, 10 patients had C1, 6 had C2, and 1 had C3 injuries. Surgical treatments of single or multiple steps, where necessary, were performed by two surgeons. The clinical and radiologic outcomes were assessed retrospectively using radiographs and medical records.
RESULTS
Overall, 16 patients had bone healing without screw loosening; however, one patient could not maintain anterior pelvic fixation because of an open fracture and deep infection in the anterior pelvic ring. Of five patients who complained of neurological symptoms after injury, three had partially recovered from their neurological deficit. At the last follow-up, the clinical outcomes according to the Majeed score were excellent in 5, good in 6, fair in 4, and poor in 2 patients. The postoperative radiologic outcomes by Matta and Tornetta's method were excellent in 5, good in 8, and fair in 4 patients. Malposition of the S2 screw was identified in one case. The mean time to union was 14.6 weeks after surgery.
CONCLUSION
S1 and S2 screw fixation can be an effective treatment option for posterior pelvic stabilization in vertically unstable pelvic ring injuries when considering the surgical outcomes, such as screw loosening and loss of reduction.

Citations

Citations to this article as recorded by  
  • Fixation Options of Unstable Posterior Pelvic Ring Disruption: Ilio-Sacral Screw Fixation, S2AI Fixation, Posterior Tension Band Plate Fixation, and Spino-Pelvic Fixation
    Dong-Hee Kim, Jae Hoon Jang, Myungji Shin, Gu-Hee Jung
    Journal of the Korean Fracture Society.2019; 32(4): 240.     CrossRef
  • 566 View
  • 3 Download
  • 1 Crossref
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Review Articles
Lisfranc Joint Injuries: Diagnosis and Treatment
Hyun Seok Yim, Sung Ha Hong, Ki Sun Sung
J Korean Fract Soc 2016;29(4):283-293.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.283
AbstractAbstract PDF
Injuries to the Lisfranc joint are relatively rare, but they are often misdiagnosed or inadequately treated, resulting in poor long-term outcomes. Understanding of anatomical structure and injury mechanism, careful clinical and radiographic evaluations are needed to recognize and treat Lisfranc joint injuries. In this article, we review the anatomy, biomechanics, injury mechanisms, injury classification, clinical presentation, radiographic evaluation, treatment, outcome, and complications of Lisfranc joint injuries.

Citations

Citations to this article as recorded by  
  • Lisfranc Sports Injuries: What Do We Know So Far?
    Godsfavour C Maduka, Divinegrace C Maduka, Naeem Yusuf
    Cureus.2023;[Epub]     CrossRef
  • Effects of Acupuncture Treatment and Taping Therapy After Lisfranc Joint Injuries: A Case Report
    Shin-Ae Kim, Su-Woo Kang, Eun-Ji Lee, Min-Kyung Kwak, Hui-Gyeong Jeong, Jae-Uk Sul
    Journal of Acupuncture Research.2017; 34(4): 197.     CrossRef
  • 1,756 View
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Current Concepts of Fractures and Dislocation of the Hand
Yong Cheol Yoon, Jong Ryoon Baek
J Korean Fract Soc 2016;29(2):143-159.   Published online April 30, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.2.143
AbstractAbstract PDF
Fractures and dislocation of the hand is a body injury involving complex structures and multiple functions, which frequently occur as they represent 10%-30% of all fractures. Such fractures and dislocation of the hand should be treated in the context of stability and flexibility; and tailored treatment is required in order to achieve the most optimal functional performance in each patient since deformation may occur if not treated, stiffness may occur with unnecessarily excessive treatment, and both deformation and stiffness may occur coincidently with inappropriate treatment. Stable injuries can be fixed with splintage whereas surgery is actively considered for unstable injuries. In addition, surgeons should keep in mind that as the surgical intervention is done aggressively, aggressive rehabilitation must be followed in correspondence with the surgical intervention. Successful outcome requires effort to prevent any potential complication including nerve hypersensitivity and infection. Finally, it is also important that the patient to know that swelling, stiffness, and pain may last for a long period of time until the recovery of fractures and dislocation of the hand.

Citations

Citations to this article as recorded by  
  • Current concepts in the management of phalangeal fractures in the hand
    Hyun Tak Kang, Jun-Ku Lee
    Journal of Musculoskeletal Trauma.2025; 38(3): 109.     CrossRef
  • Current Concepts in Management of Phalangeal Fractures
    Yohan Lee, Sunghun Park, Jun-Ku Lee
    Journal of the Korean Fracture Society.2022; 35(4): 169.     CrossRef
  • 1,198 View
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Original Articles
Concomitant Carpal Injuries in Distal Radius Fractures: Retrospective Analysis by Plain Radiographs and Computed Tomography
Chul Hyun Cho, Eun Seok Son
J Korean Fract Soc 2015;28(1):1-7.   Published online January 31, 2015
DOI: https://doi.org/10.12671/jkfs.2015.28.1.1
AbstractAbstract PDF
PURPOSE
The purpose of this study is to evaluate the incidence and characteristics of concomitant carpal bone fractures and ligament injuries and to analyze risk factors for carpal injuries in patients with distal radius fractures.
MATERIALS AND METHODS
A total of 362 patients with 379 distal radius fractures were reviewed retrospectively. Associated carpal bone fractures and ligament injuries were evaluated by plain radiographs and computed tomography at the time of initial trauma. Correlation between associated carpal injuries and various parameters was also analyzed.
RESULTS
Of 379 distal radius fractures, 39 cases (10.3%) had one or more carpal bone fracture and 40 cases (10.6%) had carpal ligament injuries. Overall, carpal injuries occurred in 59 cases (15.6%) distal radius fractures. Associated carpal ligament injuries showed correlation with young age and associated carpal bone fractures showed correlation with AO type B distal radius fractures. Carpal injuries including fracture and ligament injury showed correlation with male, high energy trauma, or associated injuries beyond wrist.
CONCLUSION
The incidence of concomitant carpal injuries in patients with distal radius fractures is relatively high. Concomitant carpal injuries were more common in young age, male, high energy trauma, AO type B distal radius fractures, or associated injuries beyond wrist.

Citations

Citations to this article as recorded by  
  • Korean Medicine Treatments for the Angular Deformity of Wrist Fracture with Disuse Osteopenia: A Case Report
    Myung Jin Oh
    Korean Journal of Acupuncture.2018; 35(4): 234.     CrossRef
  • Comparison of Distal Radius Fractures with or without Scaphoid Fractures
    Jin Rok Oh, Dong Woo Lee, Jun Pyo Lee
    Journal of the Korean Society for Surgery of the Hand.2016; 21(1): 23.     CrossRef
  • 971 View
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Neurologic Injury within Pelvic Ring Injuries
Ji Wan Kim, Dong Hoon Baek, Jae Hyun Kim, Young Chang Kim
J Korean Fract Soc 2014;27(1):17-22.   Published online January 31, 2014
DOI: https://doi.org/10.12671/jkfs.2014.27.1.17
AbstractAbstract PDF
PURPOSE
To evaluate the incidence of neurologic injury in pelvic ring injuries and to assess the risk factors for neurologic injury related to pelvic fractures.
MATERIALS AND METHODS
Sixty-two patients with the pelvic ring injury were enrolled in the study from March 2010 to May 2013. When the neurologic injury was suspected clinically, the electro-diagnostic tests were performed. Combined injuries, fracture types, and longitudinal displacements were examined for correlations with the neurologic injury.
RESULTS
There were 7 cases of AO/OTA type A, 37 cases of type B, and 18 cases of type C. Among them, 25 patients (40%) had combined spine fractures, and the average of longitudinal displacement was 7 mm (1-50 mm). Of the 62 patients, 13 (21%) had neurologic injury related with pelvic fractures; 5 with lumbosacral plexus injury, 5 with L5 or S1 nerve injury, 2 with obturator nerve injury, and 1 case of lateral femoral cutaneous nerve injury. There were no relationships between the neurologic injuries and fracture types (p=0.192), but the longitudinal displacements of posterior ring and combined spine fractures were related to the neurologic injury within pelvic ring injury (p=0.006, p=0.048).
CONCLUSION
The incidence of neurologic injury in pelvis fracture was 21%. In this study, the longitudinal displacements of posterior ring and combined spine fractures were risk factors for neurological injury in pelvic ring injury.

Citations

Citations to this article as recorded by  
  • Surgical Outcome of Posterior Pelvic Fixation Using S1, S2 Screws in Vertically Unstable Pelvic Ring Injury
    Kwang Hee Yeo, Nam Hoon Moon, Jae Min Ahn, Jae Yoon Jeong, Jae Hoon Jang
    Journal of the Korean Fracture Society.2018; 31(1): 9.     CrossRef
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Case Report
Surgical Management of Comminuted Avulsion Fracture of the Proximal Fibula with Lateral Collateral Ligament Injury: Technical Note
Jong Min Kim, Byeong Mun Park, Sang Hoo Lee, Seung Ju Jeon, Jun Beum Shin, Kyeong Seop Song
J Korean Fract Soc 2013;26(1):77-80.   Published online January 31, 2013
DOI: https://doi.org/10.12671/jkfs.2013.26.1.77
AbstractAbstract PDF
Anteromedial force to the knee in an extended position can cause an avulsion fracture of the proximal fibula with combined injuries to the posterolateral ligaments. Avulsion fractures of the proximal fibula are rare and current management of these fractures is based on few descriptions in literature. Various surgical methods of fixation for these fractures have been reported, but there is still no standard treatment modality. Anatomic reduction of these fractures is technically difficult, and failure of reduction may cause posterolateral instability, secondary arthritis and other complications. We present our experience with two such cases of comminuted avulsion fractures of the proximal fibular with posterolateral ligament ruptures surgically fixated with a locking compression hook plate and non absorbable sutures.

Citations

Citations to this article as recorded by  
  • Fixation of fibular head avulsion fractures with the proximal tibiofibular screw: Technique guide and clinical experience
    Ryan A. Paul, Shu Yang Hu, Ananya Pathak, Ryan Khan, Daniel B. Whelan
    Trauma Case Reports.2025; 57: 101175.     CrossRef
  • Treatment of avulsion fractures around the knee
    Jeong-Hyun Koh, Hyung Keun Song, Won-Tae Cho, Seungyeob Sakong, Sumin Lim
    Journal of Musculoskeletal Trauma.2025; 38(2): 63.     CrossRef
  • Treatment of Avulsion Fractures around the Knee
    Sumin Lim
    Journal of the Korean Fracture Society.2024; 37(2): 117.     CrossRef
  • 1,285 View
  • 27 Download
  • 3 Crossref
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Original Articles
Anatomical Study of Symphysis Pubis Using 3 Dimensional Computed Tomography in Koreans
Ji Wan Kim, Jung Min Park, Jae Suk Chang
J Korean Fract Soc 2013;26(1):32-36.   Published online January 31, 2013
DOI: https://doi.org/10.12671/jkfs.2013.26.1.32
AbstractAbstract PDF
PURPOSE
To acquire anatomical data for the normal pelvic bone structure using three-dimensional computed tomography (3D CT) and to propose the most appropriate angle and screw length for safe screw insertion during symphysis pubis plating.
MATERIALS AND METHODS
We performed 3D CT analysis in 52 patients who required plating and selected a medial and lateral insertion point between the symphysis pubis and the pubic tubercle. Using a three-dimensional medical image analysis program, we evaluated the appropriate screw length, sagittal angle, and oblique angle at each point in this cohort.
RESULTS
At the medial point, the sagittal angle was determined to be 49.1degrees with an average screw length of 49.4 mm. At the lateral point, we calculated an average screw length of 49.1 mm, oblique angle of 23.2degrees, and sagittal angle of 45.7degrees. The screw length was longer in men than in women (4.6 mm and 7.3 mm, respectively) at the medial and lateral point.
CONCLUSION
At the symphysis pubis diastasis, we can insert the screw caudally at 49degrees with a minimal length of 37 mm at the medial point. We can insert the screw caudally at 46degrees, medially at 23degrees, with a minimal 34 mm length at the lateral point.
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Operative Treatment of Unstable Pelvic Ring Injury
Sang Hong Lee, Sang Ho Ha, Young Kwan Lee, Sung Won Cho, Sang Soo Park
J Korean Fract Soc 2012;25(4):243-249.   Published online October 31, 2012
DOI: https://doi.org/10.12671/jkfs.2012.25.4.243
AbstractAbstract PDF
PURPOSE
To analyze the clinical and radiological results of the different fixation methods according to the type and displacement of unstable pelvic ring injuries.
MATERIALS AND METHODS
Twenty-three patients with unstable pelvic ring injuries from January 2005 to December 2009 were classified according to the AO/OTA classification system. When patients had been diagnosed with unstable pelvic ring injuries with partial instability, they were treated by anterior fixation with a plate and posterior percutaneous iliosacral screw fixation. When patients had been diagnosed with unstable pelvic ring injuries with complete instability, they were treated by open reduction and anterior to posterior fixation with a plate through the ilioinguinal approach. The radiological results were evaluated using Matta and Saucedo's method, and the clinical results were evaluated using Rommens and Hessmann's method.
RESULTS
The outcomes from the radiological evaluation were that the displacement of the posterior pelvic ring were improved by about 6.65 mm in unstable pelvic ring injuries with partial instability. The displacement of the posterior pelvic ring were improved by about 7.8 mm in unstable pelvic ring injuries with complete instability. The clinical results were excellent in 13 cases and good in 6 cases on latest follow-up.
CONCLUSION
Good results can be achieved by selecting the treatment method according to the type of unstable pelvic ring injurie and displacement.

Citations

Citations to this article as recorded by  
  • Displacement of an anterior pelvic ring fracture after L5, S1, and iliac screw fixation: a case report
    Euijin Cho, Joonghyuk Kim, Hyeongyu Lim, Kyeol Han, Yonghun Pee, Junhong Min, Il-Tae Jang, Jeesoo Jang
    Journal of Korean Society of Geriatric Neurosurgery.2025; 21(1): 24.     CrossRef
  • Functional outcomes in pelvic fractures and the factors affecting them– A short term, prospective observational study at a tertiary care hospital
    Subhajit Ghosh, Sameer Aggarwal, Prasoon Kumar, Vishal Kumar
    Journal of Clinical Orthopaedics and Trauma.2019; 10(5): 896.     CrossRef
  • 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
  • Minimally Invasive Plate Osteosynthesis for Humeral Proximal or Distal Shaft Fractures Using a 3.5/5.0 Metaphyseal Locking Plate
    Hyoung Keun Oh, Suk Kyu Choo, Jung Il Lee, Dong Hyun Seo
    Journal of the Korean Fracture Society.2012; 25(4): 305.     CrossRef
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Case Report
Missed Variation of the Essex-Lopresti Injury Associated with Type-I Monteggia Equivalent Lesion: A Case Report
Young Sung Kim, Phil Hyun Chung, Suk Kang, Ho Min Lee, Jong Pil Kim
J Korean Fract Soc 2012;25(3):219-222.   Published online July 31, 2012
DOI: https://doi.org/10.12671/jkfs.2012.25.3.219
AbstractAbstract PDF
The authors report the case of a patient with the combination of a Type I Monteggia equivalent lesion and Essex-Lopresti injury. This combination of injury is very rare, and an associated distal radioulnar injury is often missed. We hope our experience illustrates the need to examine the wrist joint carefully and to be aware of the potential for distal radioulnar joint instability in all patients with type I Monteggia equivalent lesions.
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Original Article
Injury Severity and Patterns of Accompanying Injury in Spinal Fracture
Hun Park, Kyung Jin Song, Kwang Bok Lee, Joo Hyun Sim
J Korean Fract Soc 2012;25(3):203-207.   Published online July 31, 2012
DOI: https://doi.org/10.12671/jkfs.2012.25.3.203
AbstractAbstract PDF
PURPOSE
To examine the relationship between injury severity and patterns of associated injury in spinal fracture.
MATERIALS AND METHODS
From March 2004 to March 2010, a retrospective study was conducted on 291 patients who had undergone surgeries due to spinal fractures. Spinal fractures were categorized as upper cervical, lower cervical, thoracic, thoracolumbar, and lumbar region, and the severity of fracture was measured using the Abbreviated Injury Scale and Injury Severity Score (ISS). We evaluated the correlation between the fracture site and the incidence and injury severity of the associated injury, and compared the neurologic damage according to the presence/absence of the associated injury.
RESULTS
Spinal fracture occurred in the thoracic (43.5%) and lower cervical (30.0%) levels, and associated injury developed in 134 patients (47%). The area of associated injury was in the extremity (41.2%), thorax (25.5%), head, neck, and face (21.9%). Lower cervical fracture (34.5%) had a lower prevalence than thoracic (81%) and lumbar fracture (61%). The average ISS of the associated injury was 17.14 for the thoracic fracture, 12.30 for the lower cervical fracture, 8.7 for the thoracolumbar fracture and 5.69 for the lumbar fracture. Neurologic damage was highly frequent in the lower cervical fracture and included 54 patients (62.1%) and was less frequent in the upper cervical fracture, which included 7 patients (17.9%) (p=0.032).
CONCLUSION
Although the associated injury was less frequent in the lower cervical spine among the spinal fractures that underwent surgical treatment, there was a high risk of neurologic damage in the case of associated injury; therefore, there is a need to pay special attention to patients that suffer damage in this area. In addition, since the degree of the associated injury in the thoracic and lower cervical fracture is significant, an appropriate management strategy for the associated injury must be considered.

Citations

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  • The Clinical Effects of Complex Korean Medicine Treatment in Patients with Cervical Spine Fracture Caused by Traffic Accident: A Report of 2 Cases
    Si-Hoon Han, Gi-Eon Lee, Kyeong-Sang Jo, Da-Young Byun, Min-Seok Oh
    Journal of Korean Medicine Rehabilitation.2018; 28(2): 113.     CrossRef
  • Clinical results of early stabilization of spine fractures in polytrauma patients
    Ki-Chul Park, Ye-Soo Park, Wan-Sik Seo, Jun-Ki Moon, Bo-Hyun Kim
    Journal of Critical Care.2014; 29(4): 694.e7.     CrossRef
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Case Report
Treatment of a 3rd Lumbar Vertebra Translational Injury Combined with Incomplete Cauda Equina Syndrome in Ankylosing Spondylitis: A Case Report
Jin Wan Kim, Young Chul Ko, Chul Young Jung, Il Soo Eun, Young June Kim, Chang Kyu Kim
J Korean Fract Soc 2012;25(1):77-81.   Published online January 31, 2012
DOI: https://doi.org/10.12671/jkfs.2012.25.1.77
AbstractAbstract PDF
Ankylosing spondylitis is a rheumatic disease in which mainly the spinal and sacroiliac joints are affected. Patients with ankylosing spondylitis are at significant risk for spinal fracture when exposed to even minor trauma. Most spinal fractures with ankylosing spondylitis occur in the cervical spine, whereas spinal fractures in thoracic or lumbar spine are rare, especially in the lower lumbar spine. Furthermore, neurologic symptoms in cases of lower lumbar spine fracture are rarer than in cases of cervical and thoracic spinal fracture. We have experienced a case of translation injury of the 3rd lumbar vertebra accompanied by incomplete cauda equine syndrome in ankylosing spondylitis and the authors gained good clinical results with surgical treatment. We have reported here on this case and have included a review of the relevant literature.
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Original Article
Is CT Angiography a Reliable Tool for Diagnosis of Traumatic Vessel Injury in the Lower Extremities?
Jong Hyuk Park, Kwang Bok Lee, Hyuk Park, Jun Mo Lee
J Korean Fract Soc 2012;25(1):26-30.   Published online January 31, 2012
DOI: https://doi.org/10.12671/jkfs.2012.25.1.26
AbstractAbstract PDF
PURPOSE
Computed tomographic (CT) angiography is the first choice of diagnosis in traumatic vessel injury in the lower extremities, replacing angiography. The purpose of this study was to investigate the clinical reliability of CT angiography through a retrospective study.
MATERIALS AND METHODS
Seventeen patients underwent CT angiography before surgery for traumatic vessel injury in the lower extremities from 2009 to 2010, and a comparative analysis of operative findings in all patients with a positive predictive value and sensitivity were measured.
RESULTS
In all patients, 16 artery ruptures and 1 compartment syndrome occurred. In 15 artery ruptures, preoperative findings of CT angiography and surgical findings were consistent, and the positive predictive value was 93.8%. One patient with posterior tibial artery rupture was revealed as normal in CT angiography; thus, sensitivity was 93.8% (15/16 patients), and the accuracy rate was 88.2% (15/17 patients).
CONCLUSION
Though CT angiography is a reliable tool for diagnosis in traumatic vessel injury in the lower extremities, a more invasive test will be needed, especially peripheral angiography or diagnostic exploration, in cases of relatively small vessel injuries around the ankle or compartment syndrome because of low accuracy.
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Case Report
Multiple Non-contiguous Spine Fractures with Concomitant Injuries: A Case Report
Soo Uk Chae, Yeung Jin Kim, Jung Hwan Yang, Ji Wan Lee, Jae In Park
J Korean Fract Soc 2011;24(3):267-270.   Published online July 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.3.267
AbstractAbstract PDF
Multiple non-contiguous spinal fracture is a special type of multi-level spinal injury, which is rare but most frequently occur in motor vehicle accident or a falling from a height. We report five patients of multiple non-contiguous spinal fractures. All patients underwent segmental pedicle screws fixation without fusion for preserving facet joints and minimizing blood loss and operation time. We performed necessary operation for any concomitant injuries at the same day.
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Original Articles
TFCC Injury Associated with the Triquetral Dorsal Chip Fracture
Seoung Joon Lee, Jin Ho Hwang, Min Seok Kang, Jong Woong Park
J Korean Fract Soc 2009;22(3):179-184.   Published online July 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.3.179
AbstractAbstract PDF
PURPOSE
To evaluate the usefulness of wrist arthroscopic examination in patient with persistent pain after the triquetral dorsal chip fracture and also to determine its relationship with TFCC injury in the triquetral dorsal chip fracture patient manifesting persistent pain.
MATERIALS AND METHODS
This study is based on six cases presenting persistent pain in the ulnar aspect after the triqeutral posterior cord fracture that were treated conservatively. Wrist arthroscopy was carried out for all six cases. All were preoperatively and postoperatively evaluated using VAS pain scale, grip power, ulnar grind test, Kleinman shearing test and lunotriquetral ballottment test.
RESULTS
Preoperatively, ulnar grind test yielded positive results in all six cases, Kleiman shearing test proved positive in three cases and lunotriquetral ballottment test yielded positive result in one case. In the arthroscopic findings, synovitis and TFCC injury were detected in all cases, and based on Palmer classification of TFCC injury, type IA was determined in five cases and type ID in one case. Arthroscopic TFCC partial resection and synovectomy were carried out. VAS pain scale improved from an average 8 points preoperatively to 3 points postoperatively. The difference of grip power between the normal and the other side improved from average of 15 lb preoperatively to 5 lb postoperatively. Based on postoperatively physical examination at 6 weeks, all cases yielded negative results in the ulnar grind test and Kleiman shearing test.
CONCLUSION
We think that TFCC injury is one of the causes of persistent pain after triquetral dorsal chip fracture. We recommend an arthroscopic TFCC partial resection as a valuable treatment option.
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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
AbstractAbstract 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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Case Reports
Bipolar Clavicular Dislocation: A Case Report
Han Jun Lee, Jae Sung Lee, Young Bong Ko
J Korean Fract Soc 2008;21(4):316-319.   Published online October 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.4.316
AbstractAbstract PDF
Bipolar clavicular dislocation is simultaneous dislocation of both poles of the clavicle (mainly an anterior dislocation of the sternoclavicular joint and a posterior dislocation of acromioclavicular joint) and rarely reported. We report a case of bipolar claviclular dislocation after a seat belt injury and describe its presumed mechanism and treatment with a review of literature.

Citations

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  • Case of the Month #177: Bipolar Clavicular Dislocation: Radiologic Evaluation of a Rare Traumatic Injury
    Michael P. Loreto, Dawn Pearce
    Canadian Association of Radiologists Journal.2012; 63(2): 156.     CrossRef
  • Clavicle Midshaft Fracture with Acromioclavicular Joint Dislocation: A Case Report
    Chul-Hyun Cho, Chul-Hyung Kang, Soo-Won Jung, Hyuk-Jun Seo
    Journal of the Korean Fracture Society.2009; 22(4): 297.     CrossRef
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Medial Transposition of Radial Nerve in Distal Humerus Shaft Fracture: A Report of Six Cases
Sang Uk Lee, Weon Yoo Kim, Soo Hwan Kang, Yong Soo Park, Seung Koo Rhee
J Korean Fract Soc 2008;21(3):240-243.   Published online July 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.3.240
AbstractAbstract PDF
Sometimes serious tension occurs in the radial nerve when doing internal fixation for distal humerus shaft fracture or neurorrhaphy for radial nerve injury. Medial transposition of radial nerve on fracture site can avoid direct radial nerve injury by fracture fragment, radial nerve tension by plating for distal humerus shaft fracture, and also safe from neural tension during neurorrhaphy of damaged radial nerve. We reported here total 6 cases of backward transposition of radial nerve including 2 cases of radial nerve injury associated with humerus fracture and 4 cases of comminuted fracture of humerus shaft.

Citations

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  • Transhumeral Anterior Radial Nerve Transposition to Simplify Anticipated Future Humeral Reconstruction
    David A. Muzykewicz, Reid A. Abrams
    The Journal of Hand Surgery.2017; 42(7): 578.e1.     CrossRef
  • Transfracture medial transposition of the radial nerve associated with plate fixation of the humerus
    Ali Hassan Chamseddine, Amer Abdallah, Hadi Zein, Assad Taha
    International Orthopaedics.2017; 41(7): 1463.     CrossRef
  • Trans-fracture transposition of the radial nerve during the open approach of humeral shaft fractures
    Ali H. Chamseddine, Hadi K. Zein, Abdullah A. Alasiry, Nader A. Mansour, Ali M. Bazzal
    European Journal of Orthopaedic Surgery & Traumatology.2013; 23(6): 725.     CrossRef
  • Humerus Shaft Fractures in Leisure Sport 'Flyfish Riding' - 4 Cases Report -
    Bong Gun Lee, Ki Chul Park, Youn Ho Choi, Woo Sung Jung, Kyu Tae Hwang
    Journal of the Korean Fracture Society.2012; 25(4): 327.     CrossRef
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Original Article
Alterations in Serum Levels of Receptor Activator of Nuclear Factor-kappa B Ligand and Osteoprotegerin in Patients with Head Injury and Fracture
Shin Young Park, Kuen Tak Suh, Chang Hoon Ryu, Seung Hun Woo, Jung Sub Lee, Seong Gang Kim
J Korean Fract Soc 2008;21(2):145-150.   Published online April 30, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.2.145
AbstractAbstract PDF
PURPOSE
Receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG) have been shown to be important regulators of osteoclastogenesis during bone remodeling, and their expressions were examined during fracture healing in a mouse model of tibial fracture. However, studies linking RANKL and OPG in patients with head injury and fracture are lacking. We evaluated the changes in serum levels of RANKL and OPG in patients with head injury and fracture (head injury group) and in patients with fracture (fracture group) and compared these with levels found in healthy control subjects.
MATERIALS AND METHODS
18 male patients of head injury and fracture and 20 male patients of fracture alone were enrolled. 20 healthy men were recruited to serve as controls. Within the first few hours of admission to hospital, at 4, 8 and 12 weeks after injury 20 ml of blood were obtained from 18 patients with head injury and fracture and 20 patients with fracture only.
RESULTS
RANKL levels were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury. OPG levels were significantly higher in the head injury group than in the fracture group at 4, 8 and 12 weeks after injury. RANKL/OPG ratios were significantly lower in the head injury group than in the controls immediately after and 4, 8 and 12 weeks after injury, and were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury.
CONCLUSION
We have shown changes in the profiles of RANKL, OPG and RANKL to OPG ratio. The altered RANKL, OPG and RANKL/OPG ratio in the head injury group lasted longer than in those of the fracture group.

Citations

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  • Affirmative Effect of Hwaweo-jeon (Huayu-jian) in Osteoblast Cells and Tibia Fracture-induced Mice
    Soo-Hwan Lee, Kira Parichuk, Yun-yeop Cha
    Journal of Korean Medicine Rehabilitation.2020; 30(1): 13.     CrossRef
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Case Report
Medial Plantar Nerve Injury after Screw Fixation of the Calcaneus Fracture
Bong Cheol Kwon, Yong Woon Shin, Duck Joo Kwon, Nam Kyou Rhee
J Korean Fract Soc 2006;19(2):288-290.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.288
AbstractAbstract
We present a case of medial plantar nerve injury by screw tip after open reduction and internal fixation of intraarticular calcaneus fracture. We reviewed the risk and prevention technique of medial plantar nerve injury in fixing the calcaneus fracture.
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Original Articles
Delayed Operative Treatment of Long Bone Fractures in Patients with Brain Injury
Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Young Kwan Lee
J Korean Fract Soc 2006;19(2):157-162.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.157
AbstractAbstract
PURPOSE
To evaluate the postoperative progress and outcomes of bone injured patients with long bone fracture showing callus formation and deformity due to delayed surgical treatment.
MATERIALS AND METHODS
10 cases with more than 1 year follow up were chosen from 12 patients with long bone fracture whose surgical treatment was delayed due to brain injury. Exuberant callus formation and deformations were observed. Average delayed period was 6.7 weeks (4~10 weeks). Preoperative callus formation, shortening and angulation were evaluated using plain radiographs. Total operation time and transfusion amount were compared with that from operations done within 2 weeks following accident. Postoperative bone union was checked.
RESULTS
In all cases, preformed angulation and hypertrophic ossification made reduction difficult and this increased total operation time and transfusion amount but had no statistical importance. In patients with humerus and femur fractures accompanying brain injury, massive hypertrophic ossification was observed both in preoperative period and in postoperative period. Average bone union period was 13.5 weeks in humerus fractures, 17.9 weeks in femur fractures. The bone union period was shorter in subject group but had no statistical importance.
CONCLUSION
Early surgical treatment is essential to patients with long bone fracture accompanying brain injury but if early surgical treatment can not be done, proper immobilization to fracture site should be done.

Citations

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  • Alterations in Serum Levels of Receptor Activator of Nuclear Factor-κB Ligand and Osteoprotegerin in Patients with Head Injury and Fracture
    Shin Young Park, Kuen Tak Suh, Chang Hoon Ryu, Seung Hun Woo, Jung Sub Lee, Seong-Gang Kim
    Journal of the Korean Fracture Society.2008; 21(2): 145.     CrossRef
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Short Segment Fixation of Flexion-Distraction Injuries in Thoracolumbar Spines
Young Do Koh, Jeong Joon Lee, Jong Kyong Ha
J Korean Fract Soc 2005;18(4):452-458.   Published online October 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.4.452
AbstractAbstract PDF
PURPOSE
To evaluate the efficacy of short segment fixation in flexion-distraction injuries of thoracolumbar junction.
MATERIALS AND METHODS
Twenty-five patients with a flexion-distraction injury in thoracolumbar junction confirmed by radiogram or MRI and stabilized with a short construct spanning short segment were included in this study. We investigated the location of fractures, type of fractures, anterior or posterior vertebral body height, and preoperative and postoperative kyphotic angle of injuried motion-segments on radiologic examinations and clinical outcome on the Oswestry score.
RESULTS
A significant correction of deformity was achieved, from a mean preoperative kyphosis of 17.3 degrees to a mean postoperative kyphosis of 8.4 degrees. The loss of correction were minimal. The mean Oswestry score was 6.9, with 84% of patients having minimal disability (<20%) and no correlation with age, sex, the location of fractures, type of fractures, change of kyphotic angle.
CONCLUSION
This study demonstrates the efficacy of posterior open reduction and short segment fixation of flexion-distraction injuries.
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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
AbstractAbstract 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

Citations to this article as recorded by  
  • 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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Differences of Fracture Types and Associated Injuries in Thoracolumbar Fractures Caused by Fall from Height and by In-Car Accident
Eui Sung Choi, Yong Min Kim, Dong Soo Kim, Kyung Jin Park, Kyeong Il Jeong, Yoon Moo Hur, Young Chan Cha, Jun Mo Jeon, Jong Won VKang
J Korean Fract Soc 2005;18(2):176-180.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.176
AbstractAbstract PDF
PURPOSE
To evaluate the differences of associated factors in thoracolumbar fractures according to the mechanism of injury, level and type of the fracture, associated injuries were investigated for comparison between injuries by fall from height and by in-car accident injury.
MATERIALS AND METHODS
Medical records and X-ray findings of 249 patients with fractures of thoracolumbar spine were reviewed retrospectively. Among them, 169 patients were injured by the two main causes. McAfee classification was adopted to determine the type of fracture. Associated injuries were classified as head and neck, chest and abdomen, pelvis, proximal and distal extremity, and neurologic deficit. Statistical analysis using Chi-square method was used for comparison between the two groups.
RESULTS
In overall patients, the most common cause of thoracolumbar fracture was fall from height (44.6%) followed by in-car accident (23.3%) and fall down (16.9%). In fall-from height gruoup, burst fracture was the most common (44.1%) while flexion-distraction injury was the most popular (39.7%) in in-car accident group (p=0.05). Comparison according to height of fall showed significant increase of multiple fractures (p=0.0326). Associated injuries of distal lower and upper extremities and pelvis were common in fall-from-height group, while injuries of head and neck, proximal part of upper extremity, chest and abdomen were common in in-car accident patients.
CONCLUSION
Type of fracture and distribution of associated injuries were significantly different between the two main causes of thoracolumbar injury, which seemed to be useful for understanding the mechanical events of injury and detecting associated injuries in each victim.

Citations

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  • Injury Severity and Patterns of Accompanying Injury in Spinal Fracture
    Hun Park, Kyung-Jin Song, Kwang-Bok Lee, Joo-Hyun Sim
    Journal of the Korean Fracture Society.2012; 25(3): 203.     CrossRef
  • Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures
    Chung-Shik Shin, Eea-Sub Chung, Chang-Eon Yu, Byeong-Yeol Choi
    Journal of Korean Society of Spine Surgery.2012; 19(2): 47.     CrossRef
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Conservative Treatment of the Displaced Clavicular Shaft Fracture in Multiple Injury
Hyun Dae Shin, Kwang Jin Rhee, Young Mo Kim, Se Min Woo, Ho Sup Song
J Korean Fract Soc 2004;17(4):333-337.   Published online October 31, 2004
DOI: https://doi.org/10.12671/jkfs.2004.17.4.333
AbstractAbstract PDF
PURPOSE
To analyse the comparative clinical results between adults with multiple injury including the clavicular shaft fracture and only clavicular shaft fracture who had supportive care through retrospective aspect.
MATERIALS AND METHODS
We had 48 adult patients in this hospital with simple fracture and multiple injury including the clavicular shaft whom we were able to evaluate at least more than a year. 12 of 48 patients were with only clavicular shaft fracture and the rest of them were with multiple injury. We classified patients into two groups those who had fracture with displacement for group A (A1 for the cases with over 50% of fracture surface contact rate and A2 for less than 50% from the images of simple X-ray) and those who had comminuted fracture for B. We compared the time of bone union, nonunion rate of only clavicular fractures and multiple injury, clinical results for patients who had supportive care with retrospective aspect.
RESULTS
A1 (7 cases), A2 (4 cases), B (1 case) were prevalent in the group of only clavicular shaft fracture and A1 (8 cases) and A2 (16 cases) and B (12 cases) were prevalent in the group of multiple injury. For the cases with supportive care, we could find 1 nonunion case (8%) and 11 union cases on average 2.91 months in the group of only clavicular shaft fracture and 7 nonunion cases (19%) and 29 union cases on average 3.58 months in the group of multiple injury. The best clinical results had occurred in 8 cases (67%) of only clavicular shaft fracture group and 19 cases (53%) of multiple injury group. We could find out the union from all 8 nonunion cases that took operation afterward.
CONCLUSION
Although the choice of treatment of clavicular fracture is supportive care, but multiple injury including the clavicular fracture is a high-energy injury, so the possibility of comminuted and displacement is high, so that nonunion rate is high. The possibility of early surgery must be considered seriously.
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Bone & Soft Tissue Injuries Diagnosed by Magnetic Resonance Imaging in Thoracolumbar Fractures
Yong Min Kim, Dong Soo Kim, Eui Seong Choi, Hyun Chul Shon, Kyoung Jin Park, Gi Seok Han, Jae Jung Jeong, Kyoung Il Jeong, Yung Sung Kim
J Korean Fract Soc 2004;17(2):184-190.   Published online April 30, 2004
DOI: https://doi.org/10.12671/jkfs.2004.17.2.184
AbstractAbstract PDF
PURPOSE
To assess diagnostic efficacy of the MRI in thoracolumbar fractures, especially in changes of bone and soft tissue which cannot be documented by other diagnostic tools.
MATERIALS AND METHODS
Among 85 patients managed for thoracolumbar fractures between January 1997 and June 2003, MRI was performed in 30 patients to get more informations. Plain X-ray, CT and MRI of these cases were reviewed retrospectively by two orthopaedic spine surgeons and one radiologist to investigate the informations which only MRI could afford.
RESULTS
14 (46.7%) among 30 patients had occult fractures of vertebrae other than main fracture which had not been diagnosed as fractured. Besides 6 patients who showed distraction of posterior structure on plain X-ray, injury of posterior ligament complex was confirmed by MRI in 12(40%) patients. Additionally, MRI visualized other soft tissue injuries such as intramuscular and subcutaneous hematoma, changes of the spinal cord and intervertebral disc. In 16 among 30 patients, informations achieved from MRI were the most important factors in deciding treatment modality.
CONCLUSION
MRI seems to be efficient in visualizing not only soft tissue injury such as ligament but also occult fractures of additional vertebra in thoracolumbar fractures, therefore MRI seems to be an important diagnostic tool in decision of treatment modalities, especially in cases of uncertain stability.

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  • Measurement Discrepancy of Sagittal Parameters between Plain Radiography and 3D Computed Tomography in Thoracolumbar and Lumbar Fractures
    Dong-Soo Kim, Yong-Min Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Ji-Kang Park, Hyun-Cheol Lee
    Journal of the Korean Orthopaedic Association.2012; 47(3): 198.     CrossRef
  • Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures
    Ki-Chan An, Dae Hyun Park, Yong-Wook Kwon
    Journal of the Korean Fracture Society.2011; 24(3): 256.     CrossRef
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Meniscal Injuries with Tibial Plateau Fractures
Yong In, Won Jong Bahk, Oh Soo Kwon, Chae Gwan Kong, Ju Young Kim
J Korean Soc Fract 2003;16(4):490-495.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.490
AbstractAbstract PDF
PURPOSE
The purpose of this study is to evaluate by arthroscopy the incidence of meniscal injury and the result of its treatment in fractures of the tibial plateau.
MATERIALS AND METHODS
From March 2000 to July 2002, twenty-three patients with tibial plateau fractures were examined and treated by arthroscopy before reduction of the fractures. Following the classification by Schatzker, there were 3 pure cleavage fractures (type I), 7 with cleavage and depression (type II), 4 with pure central depression (type III), one medial condyle fracture (type IV) and 8 with meta-diaphyseal fractures (type VI). Meniscal injuries were treated by meniscectomy or meniscal repair. Second look arthroscopy for patients treated with meniscal repair were performed at 6 months after operation or at time of the fixative removal.
RESULTS
Thirteen knees (56%) were found to have meniscal injuries. There were 11 lateral meniscal tears, eight of which were periphral and repaired. There were 3 complex lateral meniscal tears which required partial meniscectomy. The five medial meniscal tears were required all partial meniscectomy. Six of the eight patients who were repaired the meniscal tears evaluated by second look arthroscopy. Five patient showed complete healing and one showed incomplete healing.
CONCLUSION
Every effort should be made to repair the meniscal tears in tibial plateau fractures.
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Birth Injury
Tai Seung Kim, Khun Sung Whang, Joo Hak Kim
J Korean Soc Fract 2003;16(2):292-298.   Published online April 30, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.2.292
AbstractAbstract PDF
PURPOSE
Birth injury is any condition that affects the fetus adversely during the labor or delivery. These traumatic injuries are subdivided further into those from hypoxia and mechanical factors. Risk factor of birth injuries have been reported to breech presentation, forcep delivery, cephalopelvic disproportion, dystocia, and high birth weight. But, because of preterm care and development of delivery method and Cesarian section, recently the rate of birth injury was decreasing and the articles about birth injuries in orthopaedic fields have not been much. We analyzed the data about birth injuries occurred during recent 11 years.
MATERIALS AND METHODS
We reviewed the charts and patients the 17 patients (20 cases) of birth injuries including fracture, nerve injury during the delivery at Hanyang University hospital from Jan. 1991 to Dec. 2001. But, we excluded birth injury of head and abdomen.
RESULTS
The number of fracture and nerve injuries on extrimities in our hospital were clavicle fracture 9 cases, brachial plexus injury 6 cases, femur fracture 3 cases, separation of distal femoral epiphysis 1 case, humerus fracture 1 case. Patients of clavicle fracture were born at mean intrauterine period 41.5 weeks and mean birth weight of the patients was 4.25 kg. Patients of brachial plexus injury were born at mean intrauterine period 39.5 weeks and mean birth weight of the patients was 4.42 kg. Three cases of femoral fracture were all due to breech position while cesarean operartion and one of these cases were born as ishiophagus. We found the distal femoral epiphyseal separation injury missed initially and diagnosed a kind of birth injuries through remarkable periosteal reaction.
CONCLUSION
The birth injuries including clavicle fracture and brachial plexus injury are highly related to high birth weight at birth and the femur fractures are related to delivery maneuver in C-section and breech delivery. Strict observation and monitoring are required because occasionally the paralysis might be the sign of brachial plexus injury or pseudoparalysis due to fracture. By the adequate preterm care or preterm ultrasound check up, high weight delivery could be avoided and then the birth injury must be reduced.
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Fracture of Vertebral Body in Flexion-Distraction Injury of Thoracolumbar Spine
Young Do Koh, Jong Oh Kim, Yeo Hon Yun, Jae Doo Yoo, Jun Mo Jung
J Korean Soc Fract 2003;16(2):262-269.   Published online April 30, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.2.262
AbstractAbstract PDF
PURPOSE
To evaluate the configuration of vertebral body fractures in flexion-distraction injuries of thoracolumbar spine.
MATERIALS AND METHODS
We investigated the location of fractures, anterior or posterior vertebral body height, kyphotic angle of injured segments, canal encroachment and severity of comminution on radiologic examinations of 21 cases.
RESULTS
There were 11 compression fractures and 9 burst fractures. 85% of fractures were located in the inferior vertebrae of injured segments. Anterior vertebral height decreased by 27% on average with decrease of 18% in compression fractures and 40% in burst fractures. Posterior height decreased by 1% on average with increase of 1% in compression fractures and decrease of 4% in burst fractures. The average kyphotic angle of injured segments was 19.5 degrees with 15.4degrees in compression fractures and 26.8 degrees in burst fractures. The canal encroachment in 9 burst fractures was 27% on average, and the comminution of vertebral body was mild in 74%.
CONCLUSION
The fracture of vertebral body in flexion-distraction injuries of thoracolumbar spine was very common, and located on the inferior vertebrae of injured segment. The decrease of vertebral height, canal encroachment and severity of comminution was relatively less than the estimated from mechanism of injury, with offset effect of distraction force.

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  • Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures
    Chung-Shik Shin, Eea-Sub Chung, Chang-Eon Yu, Byeong-Yeol Choi
    Journal of Korean Society of Spine Surgery.2012; 19(2): 47.     CrossRef
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The significance of distal radioulnar joint injury in distal radius fracture
Jin Woo Kwon, Sung Ho Shin, Won Ho Jo, Dong Hyun Kim
J Korean Soc Fract 2002;15(2):251-257.   Published online April 30, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.2.251
AbstractAbstract PDF
PURPOSE
To evaluate the effectiveness of operative treatment in distal radius fracture with distal radioulnar joint injury. MATERIAL AND METHOD: From January 1992 to January 2000, 66 cases of distal radius fracture with distal radioulnar joint injury who had been treated with conservative or operative methods were analyzed the final state of radius articular surface and distal radioulnar joint.
RESULT
In operatively treated cases(42 cases), the average of volar tilt was 3.74 degrees, ulnar inclination 21.9 degrees, radial length 9.74mm. In conservatively treated cases(24 cases), The average of volar tilt was 1.75 degrees, ulnar inclination 15.1 degrees, radial length 7.67mm. The state of distal radioulnar joints were as follows; In operatively treated cases, anatomical reduction 37(88%), joint widening 5, In conservatively treated cases, anatomical reduction 17(70%), joint widening or ulnar impingement syndrome 7.
CONCLUSION
In treatment of distal radius fracture with distal radioulnar injury, operative treatment is probably more effective in restoration of radius articular surface and distal radioulnar joint healing.
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Nerve Injury in Posterior Hip Fracture-Dislocation
Hyung Ku Yoon, Byung Moon Park, Young Kwan Koh, Han Joon Cho
J Korean Soc Fract 2002;15(2):192-200.   Published online April 30, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.2.192
AbstractAbstract PDF
PURPOSE
To assess the relationship between the type of hip fracture-dislocation and nerve injury, the relationship between the treatment of hip fracture-dislocation and nerve recovery and the effectiveness of electromyography(EMG)-nerve conduction study(NCV) for the diagnosis of nerve injury and clinical result.
MATERIALS AND METHODS
We reviewed 8 cases associated with nerve injury of 52 cases which were diagnosed and treated for hip fracture-dislocation from March 1993 to December 1999 with an average follow up period 18.1 months. Mean age was 36.1 years. We assessed the diagnosis of nerve injury through physical exam at emergency room and follow up EMG-NCV. The clinical results of nerve recovery were evaluated according to the Clawson-Seddon classification.
RESULT
The cause of injury was motor vehicle accident in all cases. The outcome of the nerve injury was analyzed as 4 complete recovery, 3 partial recovery, 1 no recovery for 31 months follow up. The clinical result was analyzed as 7 satisfactory and 1 unsatisfactory. The latter was complete sciatic nerve injury, seemed to be recovered at follow up EMG-NCV but unsatisfactory for clinical result.
CONCLUSION
The nerve injury of the posterior hip fracture-dislocation was not rare and the rate of nerve injury was relatively good. The limitation as a clinical outcome was revealed in the EMG-NCV because one case which seemed to be recovered at follow up EMG-NCV was unsatisfactory for clinical result. In future, we think to require non-invasive, more reliable method for the diagnosis and follow up of the nerve injury and the study of the factor, can improve the nerve recovery.

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  • Traumatic Bilateral Anterior Hip Dislocation: A Case Report
    Sung-Taek Jung, Hyun-Jong Kim, Myung-Sun Kim, Young-Jin Kim, Sang-Kwan Cho
    Journal of the Korean Fracture Society.2008; 21(1): 62.     CrossRef
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Treatment of Distal Clavicle Fractures with Coracoclavicular ligament Injury
Nam Yong Choi, Suk Ku Han, Seong Jin Park, Ki Ho Na, Young Hun Kim, Hyun Seok Somg, Yong Jin Kwon
J Korean Soc Fract 2002;15(1):21-27.   Published online January 31, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.1.21
AbstractAbstract PDF
PURPOSE
To evaluate the radiological and clinical results of the treatment of distal clavicular fractures with coracoclavicular ligament injury by coracoclavicular fixation with plating or repair of coracoclavicular ligament.
MATERIALS AND METHODS
Sixteen cases with minimum six months of follow-up were included in our study. Male was twelve and average age was 43(28-80). Ten cases of Craig type 2 were treated with coracoclavicular screw fixation with plating. Six cases of Craig type 5 were treated with coracoclavicular screw fixation with repair of coracoclavicular ligament. The radiologic assessment including coracoclavicular distance and union time and the clinical assessment including range of motion and degree of pain were evaluated.
RESULTS
Fifteen cases were united, but one case developed osteomyelitis and nonunion. Full range of motion was achieved in fifteen cases at last follow-up. Average coraco- clavicular distance compared to contralateral site in AP view was 2.1 mm increase in patients with plate fixation and 1.3 mm increase in patients with ligament repair. Average union time was 14.3 weeks and little differenece was noted between two groups(P>0.05).
CONCLUSION
Coracoclavicular screw fixation with plating or repair of coracoclavicular ligament were a useful method to treat distal clavicular fractures combined with coracoclavicular ligament injury.
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Case Report
Treatment of Peterson classification Type VI of Physeal Injury in Ankle Joint: 2 cases report
Byung Il Lim, Tai Seung Kim, Kuhn sung Whang, Il Hoon Sung
J Korean Soc Fract 2000;13(4):1061-1066.   Published online October 31, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.4.1061
AbstractAbstract PDF
Peterson classification type VI, which has been reported newly on physeal injury classification, is defined as partial missing of the metaphysis and epiphysis with a portion of the physis. It has not been reported in the Republic of Korea to our knowledge. Because this is an open fracture, immediate surgery is needed in all cases. Angular deformity and leg length discrepancy occurs as a result of the formation of the physeal bar. Additional reconstuctive operation, therefore, should be necessary. We report two cases of Peterson classification type VI, both cases were open fracture at the level of ankle joint owing to pedestrian traffic accident. In our experience, Peterson classification type VI required multiple operations because progression of angular deformity with growth, and must be followed up until maturity.

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  • Changes in Oxygen Saturation and Walk in Relation to Smoking and Types of Shoes
    Jea-Cheol Park, Jong-Man Han, Woon-Soo Cho, Yong-Nam Kim
    The Journal of Korean Physical Therapy.2015; 27(1): 55.     CrossRef
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Original Articles
Nerve injuries complicating Monteggia lesion
Jae Duk Ryu, Chang Hwan Han, Weon Yoo Kim, Jin Hyung Sung, Jin Ho Jung, Jin Young Kim
J Korean Soc Fract 2000;13(3):591-596.   Published online July 31, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.3.591
AbstractAbstract PDF
PURPOSE
Concerns on the Monteggia lesion was concentrated on the injuries to the bone parts and largely ignores the soft tissues and the nerves in particular. We reviewed injured nerve, treatment and prognosis in the Monteggia lesion associated with nerve injury.
MATERIALS AND METHODS
From January 1990 through November 1999, 26 patients with Monteggia lesions have been treated: six of these patients had associated with nerve injuries. The age of injured patients ranged from 9 to 67 years with an average of 25.5 years.
RESULTS
All could be classified as Type 1 of Bado(anterior dislocation of the radial head), and four injuries were open and two were closed. two patients had radial-nerve palsy and four patients had posterior interosseous-nerve palsy, one of them with associated ulnar-nerve palsy. The fifth patient demonstrated complete spontaneous recovery. One patient with posterior interosseous nerve injury was absence of spontaneous return of function within 12 weeks after injury, exploration and neurolysis was performed. Complete recovery of posterior interosseous nerve function occurred in 14 weeks after exploration.
CONCLUSION
Monteggia lesions can be reduced early with ease under general anesthesia and, if necessary, even under local anesthesia. Spontaneous recovery of nerve function may occur within 12 weeks; in the absence of electromyographic or clinical evidence of return of nerve function within 12 weeks, exploration and neurolysis is indicated.
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AMRI Study of Associated Soft Tissue Injury in Tibial Plateau Fractures
Jang Suk Choi, Young Chang Kim, Sung Suk Seo, Ki Chan Ahn, Chang Sub Lee, Jae Sang Choi
J Korean Soc Fract 2000;13(3):501-506.   Published online July 31, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.3.501
AbstractAbstract PDF
Tibial plateau fractures can occur concomitent with injuries to the collateral, cruciate ligament and mensci. The purpose of this article is to demonstrate the frequency of soft tissue injuries associated with tibial plateau fractures and analyze the pattern of fracture more accurately by magnetic resonance imaging(MRI). Thirty one plateau fractures were evaluated in this study. MRI was more accurate in determining the classification of the fracture and measuring the displacement and depression of fragment. There was a 71%(22 of 31) frequency of associated soft tissue injuries in this series of tibial plateau fractures. The medial collateral ligaments were injured in 32.3%(10 of 31), the anterior cruciate ligaments in 29%(9 of 31), the posterior cruciated ligament in 22.5%(7 of 31), the lateral collateral ligament in 19.4%(6 of 31), and the menisci in 39%(12of 31). Schatzker type II and IV fracture patterns were associated with the highest frequency of soft tissure injuries. Medial collateral ligament injuries were most commonly associated with Schatzker type II fracture patterns. Menisci were most commonly injured with Schazker type IV fracture patterns. Most of the patients with acute tibial plateau fracture were commonly associated with ligamentous and meniscal injuries. MRI can aid in accurate evaluation of tibial plateau fracture patterns and decision of treatement plan.
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Popliteal Artery Injury Associated with Fracture and/or Dislocation of the Knee
Jun Young Yang, Kwang Jin Rhee, June Kyu Lee, Deuk Soo Hwang, Ki Yong Byun, Taek Soo Jeon
J Korean Soc Fract 2000;13(3):494-500.   Published online July 31, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.3.494
AbstractAbstract PDF
PURPOSE
To compare the outcome in patients who have popliteal artery injury associated with fracture and/or dislocation around the knee according to treatment option.
MATERIALS AND METHODS
We have reviewed fourteen cases of popliteal artery injury patients associated with fracture and/or dislocation injury around the knee who had visited at Chungnam National University Hospital from April 1997 to July 1999.
RESULTS
Combined skeletal injuries included fracture of distal femur, fracture of proximal tibia, and dislocation of the knee. Internal or external fixation was applied for skeletal injuries. We repaired the injured popliteal artery using end-to-end anastomosis (3 cases), interposed saphenous vein graft (9 cases), prosthetic vein graft (1 case), or thrombectomy alone (1 case). The amputation rate was 21 % (3 out of 14 patients). In limb salvage cases, we evaluated the function of knee joint, and the results were as follows : good 5 cases, fair 3 cases, and poor 3 cases.
CONCLUSION
Early diagnosis and prompt management for injuries of the popliteal artery is the most important factor to save the limb. Also, complete resection of all injured portion of vessel and reconstruction of patency through interposed saphenous vein graft are most useful method.
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Knee Fractures and Ligament Injuries Associated with Ipsilateral Femoral Shaft Fractures: Mechanism of Injury, Site of th Knee Fracture and Ligament Injury
Dong Ju Chae, Phyl Hyun Chung, Won Suk Chae
J Korean Soc Fract 2000;13(2):230-235.   Published online April 30, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.2.230
AbstractAbstract PDF
PURPOSE
: To establish the incidence and type of knee fractures, injury of knee ligament associated with ipsilateral femoral shaft fractures. What is the most common mechanism of these combined injuries? MATERIALS AND METHODS : From March 1995 to February 1999, evaluation of one hundred and twenty consecutive patients with fracture of the femoral shaft showed fractures and injuries of the ligaments of the ipsilateral knee in thirty-five(29%) of them. Of those thirty-five, nineteen patients had injured their knees and femoral shaft fractures by the dashboard injury. Twelve injuries were caused in a motor cycle accident, and two patients occurred in pedestrians struck by cars. Two injuries were caused by falls.
RESULTS
: There were twenty fractures of th knee and fifteen injuries of the ligament. Seventeen of the twenty fractures were in the patella, two in the bicondyle of the proximal tibia and one in the lateral condyle of the proximal tibia. Eleven of seventeen fractures of the patella were open fractures. Of fifteen injuries of the ligament, there were six posterior cruciate ligament tears (including 2 partial tears and 1 avulsion fracture), three posterior cruciate ligament tears with medial or lateral collateral ligament disruption , three anterior cruciate ligament tears(2 tibial spine fractures and 1 partial tear), two lateral collateral ligament disruptions and one medial collateral ligament tear. The locations of femoral shaft fracture were proximal in four patients, middle in thirty, and distal in one patient.
CONCLUSION
: We conclude that there is a high incidence of ipsilateral fracture of the patella and posterior cruciate ligament tears in patients with femoral shaft fractures. The dashboard injury is the most common mechanism of the ipsilateral knee fractures and ligament tears with femoral shaft fractures.
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Factors influencing the results of treatment in Lisfranc injury of the foot
Hyoun Oh Cho, Kyoung Duck Kwak, Soo Min Sohn, Woo Kun Jung, Pill Hwan Oh, Dai Hwan Lim
J Korean Soc Fract 1999;12(4):961-967.   Published online October 31, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.4.961
AbstractAbstract PDF
PURPOSE
: The purpose of this study is to detect the factors influencing the results of treatment for Lisfranc injuries of the foot.
MATERIALS and METHODS
: We assessed the correlation between the AOFAS Scale and each of the variables which might influence the results of treatment in 25 cases of Lisfranc injuries, using the SPSS version 7.5.
RESULTS
The mean AOFAS Scale rated 81.48 points. The degrees of initial soft tissue injury had close correlation with the AOFAS Scale; while time from injury to operation, accuracy of reduction such as the alignment of the tarsometatarsal joints, gap between the first and the second metatarsal bases, and the foot arch angles had moderate correlation with AOFAS Scale(p<0.05). The age at operation, types of fractures, joint space of the tarsometatarsal joints had little or fair degrees of correlation with the AOFAS Scale(p>0.05).
CONCLUSION
: The factorf influencing the results of treatment for Lisfranc injuries included initial deree of soft tissue injury, time form injury to operation, and variables related to the accuracy of reduction such as the alignment of tarsometatarsal joints, gap between the first and the second metatarsal bases, and the maintenance of the foot arch.
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Proximal Tibiosbular Fracture associated with Popliteal Artery Injury
Sang Soo Kim, Hong Jun Han, Dong Churl Kim, Dae Ho Ha, Hee Jun Yoo, Suk Kyun Park
J Korean Soc Fract 1999;12(4):885-893.   Published online October 31, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.4.885
AbstractAbstract PDF
Injury to the popliteal artery results in amputation more frequently than any other arterial injury. The major factor in the amputated limbs was a delay in diagnosis and therapy of the arterial injury associated with blunt trauma. The proximal tibial fractures produced the highest percentage of vascular complications and indicated immediate application of therapeutic measures. The purpose of this study is to investigate the long-term results and factors that influences the results of surgical treatment in patients with combined proximal tibial fracture and popliteal artery injury. Authors reviewed the records of 24 cases treated for this injury between January 1984 and May 1997. The age of the patients ranged from 17 to 70 years(average 45 years). Nine patients presented with life threatening injuries and classical signs of acute limb ischemia. Prolonged ischemic time ranged from 3 to 6 hours 30 minutes(average 4 hours 50 minutes). The most common cause of thoses injury was traffic accident in 16 cases. Five cases had neurologic deficit ; significant soft tissue injury was present in 14 extremities. Vascular procedures included saphenous vein interposition, end-to-end anastomosis, etc. Bony procedures were accomplished by external means in 14 cases and the others treated by immediate internal fixation in 5 cases. Intraoperative fasciotomy was performed in 5 patients with lower limb ischemia. The results suggested that limb salvage was possible in 63 percent of patients with combined proximal tibial fracture and popliteal artery injuries, but a history of life-threatening condition and severe associated injury with vascular compromise was an unfavorable prognostic factor. So a well organized multidisciplinary approach is necessary to ensure life and functional limb salvage.
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J Musculoskelet Trauma : Journal of Musculoskeletal Trauma
© The Korean Orthopaedic Trauma Association.
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