Journal of Musculoskeletal Trauma

Separation of the Symphysis Pubis during Childbirth: Dong Ju Shin, Young Soo Byun, Se Ang Chang, Ok Rang Park, Shin Yoon Kim, Dae Hee Hwang, Sung Rak Lee, Dong Young Kim; J Korean Fract Soc 2006;19(4):412-417. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.412

Abstract: PURPOSE
To evaluate the clinical features and incidence of separation of the symphysis pubis during childbirth, and to evaluate the risk factors of the lesion and the outcome of treatment.
MATERIALS AND METHODS
Seventy two cases of separation of symphysis pubis among 66,721 delivery between January 1992 and December 2004 was selected. The control group was composed of 498 cases without separation of symphysis pubis during childbirth. Several factors increasing the risk of this lesion were assessed using Ï‡

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Development and Accuracy Test of a Robot-arm Type Image-guided Surgery System for Percutaneous Screw Fixation of the Sacro-iliac Joint: Jin Sup Yeom, Won Sik Choy, Hayong Kim, Jong Won Kang, Kwang Won Lee, Whoan Jeang Kim, Jae Hoon Ahn, Seong Kyu Park, Jong Hwa Won, Hyungmin Kim, Namkug Kim; J Korean Fract Soc 2005;18(2):191-197. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.191

Abstract PDF: PURPOSE
To develop a robot-arm type image-guided surgery system for percuatneous screw fixation of the sacro-iliac joint and to evaluate its accuracy.
MATERIALS AND METHODS
We have developed an image-guided surgery system using a three-dimensional digitizer (Microscribe 3-D G2, Immersion, USA) and a personal computer. The registration error and target localization error at fiducial registration were measured 30 times for each using a phantom made with plastic pelvic bone model (Sawbones, USA). Sixteen 6.5 mm cannulated screws were inserted into four plastic bone models, and the accuracy was evaluated.
RESULTS
The target localization error was 1.46+/-0.47 mm while the registration error was 0.73+/-0.23 mm. All of the 16 screws were inserted well across the sacro-iliac joint, and there was neither cortical breach nor collision between screws or washers.
CONCLUSION
The accuracy of the developed system was similar to that of optical tracker-based navigation systems, and its helpfulness and usefulness was proven with simulation surgery using plastic bone models.

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The Results of Surgical Treatment of Acute Acromio-clavicular Separation, Type III: Sung Ho Hahn, Bo Kyu Yang, Seung Rim Yi, Shun Wook Chung, Dong Ho Lee, Min Seok Kim; J Korean Soc Fract 2003;16(2):235-243. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.235

Abstract PDF: PURPOSE
The purpose of this study is to compare the Phemister technique with the modified Phemister technique for the patients with Rockwood type 3, acromio-clavicular separation.
MATERIALS AND METHODS
The 45 cases of 45 patients received surgical treatment for Rockwood type 3, acute acromio-clavicular separation in our hospital from Feb. 1992 to Aug. 2001 later with the follow-up study were selected as subjects. The average ages were 28.1 years old, male and female were 42, 3 persons, respectively. Physical examination and plain radiography were used for their diagnosis and the intervals between injury and surgical treatment were 7.8 days. In intraoperative finding, we performed Phemister technique in 15 cases according not to be able to repair coraco-clavicular ligament (group I), modified Phemister technique in 30 cases according to be able to repair that (group II). The average follow up period was 16.2 months, and the UCLA shoulder scoring system and the acromio-clavicular separation scoring system were used to obtain clinical results.
RESULTS
Only in Group II, the complication after surgery were associated with superficial infection in two cases and K-wire migration in one case. At last follow up, there were no pain and limitation of range of motion in all cases, and two cases in Group II were found to be subluxation in radiography. Clinical results revealed excellent was 93.3%, good was 6.7% in UCLA shoulder scoring system in both groups, and excellent was 90%, good was 10% for group II in acromio-clavicular separation scoring system.
CONCLUSION
The results are considered to be good with only Phemister technique in type 3, acute injury occurred in working ages.

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Development of a Computer-assisted Surgery System for Screw Fixation of the Sacro-iliac Joint: Jin Sup Yeom, Won Sik Choy, Ha Yong Kim, Whoan Jeang Kim, Jong Won Kang, Yeongho Kim, Hyungmin Kim, Donghyun Seo, Seok Lee, Jae Bum Lee, Namkug Kim, Cheol Young Kim; J Korean Soc Fract 2003;16(1):1-7. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.1

Abstract PDF: PURPOSE
The purposes of this study were to develop a computer-assisted surgery system for percutaneous screw fixation of the sacro-iliac joint and to evaluate its accuracy.
MATERIALS AND METHODS
We have developed a navigation system composed of an optical tracking device (Polaris, Northern Digital, Canada) and a personal computer. The registration error and target localization error at hybrid registration were measured using a phantom. The errors were measured 30 times for each. Sixteen 6.5 mm cannulated screws were inserted into four plastic bone models (Sawbones, USA), and the accuracy was evaluated.
RESULTS
The registration error was 0.76 +/-0.33 mm, and the target localization error was 1.43 +/-0.42 mm. All of the 16 screws were inserted well across the sacro-iliac joint, and there was neither penetration of the cortical bones nor collision between screws or washers.
CONCLUSION
The accuracy of the developed system was similar to existing ones, and its usefulness and helpfulness was proven with screw insertion into plastic bone models.

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Cubitus Varus Resulted from Fracture-Separation of the Distal Humeral Epiphysis: Sung Soo Kim, Sang Hwan Park, Kyoung Sik Hwang; J Korean Soc Fract 2001;14(4):769-775. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.769

Abstract PDF: PURPOSE
We tried to find the cause of cubitus varus after treatment of fracture separation of the distal humeral epiphysis.
MATERIALS AND METHODS
We reviewed 13 cases of fracture-separation of the distal humeral epiphysis. Five cases were treated by open reduction and K-wire fixation, 8 cases were treated by closed reduction and K-wire fixation. Six cases of cubitus varus were evaluated.
RESULTS
With the average 27 months(14-96 months) of follow-up, six of 13 cases showed cubitus varus postoperatively and mean carrying angle was -6.7 degrees(range -3~-15 degrees). None of these cases showed the progression of deformity after then. Among the six cases, five cases were treated with closed reduction, and one case with open reduction. Average age of the cubitus varus cases was 31 months (14-60 months). Among the six cases, four cases were Salter-Hams type I and two cases were type II.
CONCLUSION
Incomplete reduction seems to be the cause of cubitus varus in fracture-separation of the distal humeral epiphysis, so the anatomical reduction is important to prevent the cubitus varus.

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Ankle Fracture with Syndesmosis Separation : Radiographic Landmark and Results of Trans-Syndesmotic Screw Fixation: Chong Kwan Kim, Byung Woo Ahn, Sang Guk Lee, Young Hwan Kim, Chae Ik Chung, Sik Hwang; J Korean Soc Fract 1999;12(4):948-955. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.948

Abstract PDF: In the treatment of ankle f1racture, anatomical reduction and restoration of ankle mortise is very important. But tranf-syndesmotic screw fixation for syndesmosis seperation is dependent on the condition in operation field. The purpose of this study is to analyse the radiographic and clinical relults. to evaluate the need for trans-syndesmotic screw fixaition, and to know the effectiveness of radiogrphic landmarks for diagnofis of the syndesmosis separation, retrospectively. The patients were divided into two groups. The Croup I(25cases) were treated with trant-syndetmotic screw and group II(42 cases) were treated without trans-syndesmotic screw fixation . The clinical results were excellent in 13, good 9 in group I and excellent in 19, good in 17 in group II. The radiographic results were excellent in 6, good in 8 in group I and excellent in 23, good 14 in group II. In the radiographic findings, the false negative result of tibiofibular overlap was 15.6%(M: 20.8%, F: 10.4%), tibiofibular clear space was 16.8%(M: 21.6%, F: 11.9%) and ratio of tibiofibular overlap to fibular width was 14.2%(M: 14.9%, F: 13.6%). There was no siginificant statsitical difference in the ratio of tibiofibular overlap to fibular width between male and female. We consider that the ratio of tibiofibular overlap to tibiofibular width are more reliable diagnostic criteria for syndemosis separation than the tibiofibular overlap and tibiofibular clear space. Trans-syndesmotic tcrew fixation is not alswaya required to maintain the integrity of the tibiofibular syndesmosis if the diastasis was satisfactorily reduced with rigid fixation.

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Fracture-Separation of the Distal Humeral Epiphysis in Young Children: Hyoun Oh Cho, Kyoung Duck Kwak, Byung Yong Kim, Su Min Sohn, Pill Whan Oh; J Korean Soc Fract 1999;12(2):365-371. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.365

Abstract PDF: We have reviewed seven cases of fracture-separation of the distal humeral epiphysis, two of which were initially misdiagnosed as a fracture of the lateral condyle and one as a fracture of the supracondyle. The four cases were treated by closed reduction and cast immobilization, and three cases by open reduction and internal fixation. The one case with conservative treatment had cubitus varus, other were good result. To distinguish the fracture-separation from a fracture of lat. condyle and from a dislocated elbow is impossible using clinical signs alone. For reducing misdiagnosis, it is important to consider age and there could be need further evaluation such as arthrogram, USG, CT and MRI.

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Fracture-separation of the Distal Humeral Epiphysis in Children: Yeo Hon Yun, Jong Keon Oh; J Korean Soc Fract 1998;11(4):977-984. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.977

Abstract PDF: We retrospectively reviewed twelve cases of the fracture-separation of the distal humeral epiphysis, which were treated during the period from 1989 to 1996. The incidence of this injury was about 3 % from 266 pediatric elbow fractures. Four cases were remained misdiagnosed as the lateral or medial humeral condylar fracture until the authors reviewed their radiographs. Though eleven fractures were extension type injury with typical posteromedial displacement, we identified a rare flexion type injury with anterolateral displacement. This case was a 12+7 year old boy, who was the oldest in our series. Cubitus varus deformity of more than 10 developed in five patients, and cubitus rectu intwo patients. One patient underwent osteotomy for the in the literature. The major problem of this fracture was the possibility of misdiagnosis. Whichever reament modality onr may choose, careful evaluation of the carrying angle after reduction is mandatory to avoid residual cubitus varus deformity.

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Fracture-Separation of The Distal Humeral Epiphysis: Hak Yeong Jeong, Seung Wook Yang, Jae Woong Shim, Seung Joon Shin, Jeong Tae Kim; J Korean Soc Fract 1998;11(3):650-657. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.650

Abstract PDF: A fracture-separation of the distal humeral epiphysis in children is an extremely rare injury and presents problems in diagnosis, radiographic interpretation and management. From June 1992 to December 1996, Authors experienced the 5 cases of Salter - Harris type II injury of the distal humeral epiphysis at Department of Orthopedic Surgery, Pusan Maryknoll General Hospital. The patient were followed up from one year nine months to three years four months. The two cases were treated by closed reduction and percutaneous K-wire fixation and the three cases by open reduction and internal fixation with K-wires. There were 4 cases of complication seldom reported following fracture-separation of the distal humeral epiphysis. This complications consist of 4 dissolutions of trochlea, which is one, frank avascular necrosis of trochlea. In 3 cases with open reduction developed the cubitus varus & dissolution of trochlea. We speculate that this complications results from avascular necrosis of distal end of humerus. Attention to change of carrying angle and radiographic change of distal humeral end are important in detection of complication & evaluation of etiology of dissolution of distal humeral end.

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Fracture of the Coracoid Process: Sung Ho Hahn, Bo Kyu Yang, Chi Hong Kim, Tae Won Ahn, Dong Hyun Kim; J Korean Soc Fract 1996;9(4):1085-1089. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1085

Abstract PDF: Fractures of the coracoid process arf rare and those associated with a complete acromioclavicular separation and clavicular shaft fracture are even more rare. The mechanism of injury may be by direct trauma or by avulsion when there is sudden and violent contraction of the biceps, corachobrachilalis, and pectoralis minor muscle. The fracture occurs most commonly through the base. Conservative treatment can produce good result. Unusually open reduction is indicated for marked displacement associating acromioclavicular dissociation or compiession of the brahial plexus. The authors report 2 cases of coracoid process fracture. one case combined with acromioclavicular separation and the other with fracture of clavicular mid shaft.

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Fracture-SeFaration Involving the Entire Distal Humeral Epiphysis in a Young Child(Salter-Harris type I injury): A Case Report: Jong Ho Jang, Seung Gyun Cha, Kyoung Hoon Kim, Jeon Oh Kang; J Korean Soc Fract 1996;9(3):674-677. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.674

Abstract PDF: Fracture-separation of the distal humeral epiphysis is a rare injury, frequently misdiagnosed as a fracture of the lateral humeral condyle, a supracondylar fracture of the humerus or a dislocation of the elbow. Roentgenographic evaluation reveals posteromedial displacement of the distal epiphysis. Single contrast arthrography is performed in order to confirm diagnosis. Treatment is first directed toward prompt recognition of the injury. A manipulative closed reduction is usually recommended. We experienced a case of fracture-separation involving the entire distal humeral physis treated by closed reduction and percutaneous pinning. The result was excellent.

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Fracture-separation of the Distal Humeral Epiphysis: A Case Report: Kwon lck Ha, Sung Ho Hahn, Bo Kyu Yang, Chi Hong Kim, Tae Sung Kim; J Korean Soc Fract 1995;8(1):101-105. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.101

Abstract PDF: The fracture-separation of the distal humeral epiphysis is considered to be a rare injury. It presents problems in diagnosis, radiologic interpretation and management. It is frequently misdiagnosed as a dislocation of the elbow or a fracture of the lateral humeral condyle because the cartilagenous distal portion of the humerus in the children is not visible on roentgenograms. A knowledge of when the ossification centers appear about the elbow is absolutely necessary in the diagnosis of the elbow injury. We experienced 1 case, a 22 month-old girl with Salter-Harris type I[ injury of the distal humeral epiphysis.

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Frarture-Separation of the Distal Humeral Epiphysis in Children: Dong Wo Lee, Se Dong Kim; J Korean Soc Fract 1994;7(1):72-78. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.72

Abstract PDF: We have reviewed thirteen cases of fracture-separation of the distalk humeral epiphysis, one of which was initially misdiagnosed as a fracture of the lateral condyle. There were some difficulties in making the correct diagnosis. The injury must be distinguished from anelbow dislocation and a fracture of the lateral humeral condyle. All thirteen patients revealed posteromedial displacement of the distal humeral epiphysis on initial x-rays nine patients were treated by colosed reduction and cast Immobilizatlon, and four patients by open reduction and internal fixation All nine patients with conservative treatment had slight cubitus varus under 5 degrees. Two patients with operative treatment had significant deformities of the elbow, one 25 degrees of valgus and one 20 degrees of varus. In treatment of these injuries, accurate evaluation of the state of reduction is important but difficult to obtain. We got acceptable results with conservative treatment.

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Treatment of the Complete Separation of Acromioclavicular Joint by Coracoclavicular Wiring: Chang Uk Choi, Yon Il Kim, Young Ho Kim, Min Ku Lee; J Korean Soc Fract 1990;3(1):119-126. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.119

Abstract PDF: Complete dislocation of the acromioclavicular joint is not a common jnjury. But there are many methods of treating for complete separation of acromioclavicular joint. From February, 1988 to March, 1989 at Soonshunyang university hospital, 14 pateints with complete acromioclavicular separation(Allmans type3) had been treated sugically by coraco-clavicular wiring. The results are follows. 1) The most common cause of injury is fraffic accident. 2) Ages in peak incidence are 3rd and 4th decades. 3) The shoulder pain and the limitation of external rotation, which are well known problem of transacromioclavicular fixation cant be found and the functional result were excellent in 12 cases good in 1 case and fair 1 case 4) We consider that over reduction and anatomical reduction of acromioclavicular joint may be prevent complications and obtain excellent results. 5) We can Prevent the anterior displacement of clvicle from the acromion and bony erosion by passing the wire loop through the drill hole on the center of clavicle which direction is from superior to inferior portion.

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