Journal of Musculoskeletal Trauma

Nonsurgical Treatment of a Distal Radius Fracture: When & How?: Young Ho Shin, Jun O Yoon, Jae Kwang Kim; J Korean Fract Soc 2018;31(2):71-78. Published online April 30, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.2.71

Distal radius fractures are a common upper extremity fracture and a considerable number of patients have a stable fracture. In the treatment of distal radius fractures, there is considerable disagreement regarding the need for a strict anatomical restoration with operation in elderly patients. Therefore, nonsurgical treatment is a still important treatment option in distal radius fractures. The radiological parameters of before or after manual reduction are important for deciding whether to perform operation or not. The radiological parameters include dorsal angulation of the articular surface, radial shortening, extent of dorsal comminution, intra-articular displacement, concomitant ulnar metaphyseal fracture, shear fracture, and fracture-dislocation of the distal radio-ulnar joint. In addition, clinical situations of patients, including age, activity level, underline disease, and recovery level, which the patients wish should be considered, comprehensively. For the duration of a splint or cast, three to four weeks are recommended in impacted or minimally displaced fractures and five to six weeks in displaced fractures. After reduction of the displaced fractures, patients should undergo a radiologicical examination every week to check the redisplacement or deformity of the fracture site until two or three weeks post trauma. Arm elevation is important for controlling fracture site swelling and finger exercises, including metacarpophalangeal joint motion, are needed to prevent hand stiffness. Active range of motion exercise of the wrist should be initiated immediately after removing the splint or cast.

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The Clinical Effect of Complex Korean Medical Admission Treatment in Patients with Fractures of Distal Radius by Traffic Accident: 2 Cases Series Report
Gyu-cheol Choi, Ji-won Lee, Ji-Eun Bae, Dong-jin Kim, Jeong-su Hong, Da-hyun Kyung
Journal of Korean Medicine Rehabilitation.2021; 31(1): 187. CrossRef
The Clinical Effect of Rehabilitation Protocol for Distal Radius Fracture in Korean Medicine: A Report of 3 Cases
Won-Bae Ha, Ji-Hye Geum, Nak-Yong Koh, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2018; 28(3): 97. CrossRef

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Nonunion with a Bony Defect of the Humerus: Treatment by Shortening: Jae Sung Lee, Soo Yong Kang, Jae Hyun Yoo; J Korean Fract Soc 2008;21(1):45-50. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.45

Abstract PDF: PURPOSE
To evaluate clinical results and advantage of interposition and shortening technique for the treatment of the humeral nonunion with bone defect.
MATERIALS AND METHODS
Eight patients with the humeral nonunion with bone defect underwent interposition of fragments and shortening had been followed-up for more than one year (mean 70 months, 16~156). There were 4 men and 4 women with a mean age of 60.5 years (range, 48 to 75 years). There included 3 proximal, 3 diaphysis and 2 distal metaphysis according to the site, mean size of the bone defect was 3.3 cm (2~5). The time to union, discrepancy of upper extremity, functional results, cosmetic satisfaction and postoperative complications were assessed.
RESULTS
All patients achieved to bone union, average union time was 10.2 weeks (range 8~14). Average limb discrepancy was 2.3 cm. All had improvement in shoulder and elbow motion after operation. Seven patients were satisfied with the cosmetic result and none had functional deficit due to limb discrepancy.
CONCLUSION
Treatment by Interposition of fragments and shortening in the intractable nonunion of humerus with a bony defect can achieve not only good functional result, shortened bone union time and improved in shoulder and elbow motion.

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The Shortening and Rotational Deformity after Closed Intramedullary Nailing of Femur Shaft Fracture: According to Winquist-Hansen classification: Dong Eun Shin, Dong Hoon Lee, Chang Soo Ahn, Ki Shik Nam; J Korean Fract Soc 2007;20(4):297-301. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.297

Abstract PDF

PURPOSE
This study evaluated the shortening and rotational deformity after closed intramedullary nailing of femur shaft fracture according to Winquist-Hansen classification type.
MATERIALS AND METHODS
This study was based on 98 cases who received cloased intramedullary fixation about their femur shaft fractures between January 2000 and October 2005 with minimum 12 months follow up. The rotational deformity was analysed by Yang's method (45 cases) preoperatively and postoperatively, and the shortening by orthoradiogram (55 cases). Furthermore we analysed other complications, for example nonunion, infection, and metal failure.
RESULTS
We found more than 15 degrees anteversion difference of both femurs in 10 cases. Among them, 9 cases were classified to type 3, 4. According to Winquist-Hansen classification, rotational deformity ranged from 3.7Â° (Type 1) to 8.9Â° (Type 4). More than 2 cm leg length discrepancy (LLD) was found in 9 cases, all of them were classified as Winquist-Hansen classification type 3, 4. In the type 1, LLD was checked as 3.2 mm and type 4, 14.2 mm.
CONCLUSION
To prevent the shortening and rotational deformity after intramedullary fixation of Winquist-Hansen classification type 3, 4 femur shaft fracture, intraoperatively the exact contralateral femoral anteversion and length should be checked.

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The Fate of Butterfly Fragments in Extremity Shaft Comminuted Fractures Treated with Closed Interlocking Intramedullary Nailing
Ki-Chan An, Yoon-Jun Kim, Jang-Suk Choi, Seung Suk Seo, Hi-Chul Gwak, Dae-Won Jung, Dong-Woo Jeong
Journal of the Korean Fracture Society.2012; 25(1): 46. CrossRef
Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture
Sang Ho Ha, Jun Young Lee, Sang Hong Lee, Sung Hwan Jo, Jae Cheul Yu
Journal of the Korean Fracture Society.2009; 22(4): 225. CrossRef

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The Effect of Fibular Malreduction on Ankle Joint after Tibial Interlocking IM Nailing of Tibial and Fibular Fractures: Dong Eun Shin, Duck Yun Cho, Hyung Ku Yoon, Jin Soo Lee, Yoon Seok Lee, Hyoung Jun Kim; J Korean Fract Soc 2005;18(1):29-35. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.29

Abstract PDF

PURPOSE
To investigate the effect of fibular malreduction on ankle joint after tibia interlocking IM nailing of tibial and fibular fractures according to type of fibular fractures at preoperation.
MATERIALS AND METHODS
Thirty-nine patients who had ipsilateral tibiofibular fracture were analyzed clinically and radiographically. The talocrural angle and the distance from joint line to the tip of fibular were measured on both ankle standing AP view. The difference of angle and distance of both ankle were analyzed by paired t-test and correlation between defference and AOFAS score by Spearman correlation coefficients.
RESULTS
The difference of The talocrural angle and the distance from joint line to the tip of fibular of both ankle was statistically significant (p<0.05). The correlation between this difference and AOFAS score was statistically insignificant (p>0.05).
CONCLUSION
In tibia interlocking IM nailing of tibia and fibula fracture, malreduction of fibula could cause the change of ankle joint.

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The Risk Factors Associated with Nonunion after Surgical Treatment for Distal Fibular Fractures
Jun Young Lee, Kwi Youn Choi, Sinwook Kang, Kang Yeol Ko
Journal of Korean Foot and Ankle Society.2018; 22(3): 95. CrossRef

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The Cause of the Nonunion of the Mid-clavicle Fractures: Jung Ro Yoon, Jae Ik Shim, Taek Seon Kim, Sung Jong Lee, Young Bae Kim, Hack Jun Kim, Kuk Whan Ahn, Jae Young Chang, Myung Pyo Hong; J Korean Soc Fract 2002;15(4):538-544. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.538

Abstract PDF: PURPOSE
Because the prognosis of the mid 1/3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare.However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion.
MATERIALS AND METHODS
We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients 'chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury.
RESULTS
15 of the 63cases had developed nonunion.. The average 8.6mm(2mm-17mm) shortening and average 9.7mm(2-22mm) in the union patients. The average 14.5mm(3mm-37mm) shortening and average 17.3mm(4-25mm) in the nonunion patients. We found that initial shortening > or =1 8 m m ( Fisher's exact test, p <0.01) and initial displacement > or =16mm(Chi-square test, p <0.01) at the fracture site were siinificantly associated with the development of nonunion.
CONCLUSION
The conservative treatment with figure-8-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several weeks, osteosynthesis should be considered.

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Treatment for the Malunion of the Distal Radius: Hyoun Oh Cho, Kyoung Duck Kwak, Sung Do Cho, Cheol Soo Ryoo, Woo Keun Jung; J Korean Soc Fract 1996;9(2):290-294. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.290

Abstract PDF: Malunited fractures of the distal radius may result in adequate function of the wrist with absence of pain in elderly patients. However, posttraumatic dedormity in younger, active patients is less well toterated, especially in those engaged in heavy manual work or who require a normal range of motion of the wrist. surgical correction of the malunion of the distal radius should be considered for this group of patients. Operation for the malunited fractures of the distal radius was performed in ten cases during the periods between January, 1990 and December, 1993, who were followed for an average of 15 months.The procedures included radial osteotomy(RO) in four malunions of short duration, radial osteotomy with ulnar shortening (RO & US) in these malunions of long duration and ulnar shortening(US) in three cases. We reviewed these cases retrospectively with respect to the clinical findings(pain, grip strength, range of motion of the wrist) and radiograpic changes(volar tilt, radial articular inclination and radiul shortening). Symptoms(radioulnar or radiocarpal pain) were improved in all cases. By compairing with the opposite sides, resedual loss of grip strength was 35% in RO group, 40% in RO & US and 31% in & US group. Residual loss of motion in flexion and extension or in deviation was similar in all groups, whill loss in rotation was less in RO or RO & US group than in US group. Inclination of the radial articular surface (radial inclination and volar tilt) was restored up to the degree similar to the opposite wrist in RO or US group, while was not in US group. Radial length was restored up to the dgegrees similar to the opposite wrist in all groups. The overall results were good or very good in five among the seven cases of RO group(with or without ulnar shortening), while good only in one among the cases of US group.

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