Journal of Musculoskeletal Trauma

Bipolar Hemiarthroplasty for the Treatment of Displaced Femoral Neck Fracture in Elderly Patients: Uncemented versus Cemented femoral stems: Jae Yeul Choi, Kyung Chul Kim, Hwa Jae Jeong, Bon Seop Koo, Ho Joong Lee; J Korean Soc Fract 1999;12(2):195-202. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.195

Abstract PDF: Forty five patients above the age of 60 with displaced femoral neck fractures were treated by bipolar hemiarthroplasty in Kangbuk Samsung hospital from January 1990 to January 1995. We evaluated these patients for comparison of the results between the cemented and uncemented femoral fixation, especially in elderly patients with medical illness or osteoporosis. During a follow up period of more than two years, the authors found less thigh pain(5.2% versus 38%) and slightly higher Harris hip scores(84.5 versus 80.0 points) in the cemented group in comparison with the uncemented group. Radiographic examination showed less radiolucent zones in the cemented group. Comparing the operative time(86.2 versus 83.8 minutes), hospital stay(4.7 weeks versus 5.3 weeks), blood loss(385 versus 381 ml) during the operation. The postoperative mortality rate was 2%, and the follow-up mortality rate was 11% in the first year. There was no significant difference between two groups in mortality rate. Thus in bipolar hemiarthroplasty in elderly patients with displaced femoral neck fracture, we have obtained satisfactory results despite of poor bone condition and osteoporosis except thigh pain. But the follow up period was too short to assess the late complications of the hemiarthroplasty such as acetabular erosion, implant loosening, so long-term follow up will be necessary

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A comparison of fixation with Ender nail and sliding screw plate in intertrochanteric fractures of elderly patients: Joo Hyoun Song, Yong Koo Kang, Han Yong Lee, Hae Seok Koh, Kee Won Rhyu, Kwang Won Lee; J Korean Soc Fract 1999;12(2):203-211. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.203

Abstract PDF: In order to investigate the correlation between morbidity of the elderly patients and method of fixation, we analyzed 39 elderly patients had undergone internal fixation with Ender nail or sliding screw plate for the intertrochanteric fractures of the femur from January 1992 through December 1995. Among the 39 patients, 20 patients and 20 fractures were treated with Ender nail. Mean follow-up period was 26 months and average in age was 76.2 years Remaining 19 patients, 19 fractures were treated with sliding screw plate Mean follow-up period was 25 months and average in age was 75.4 years. The results obtained were as follows : 1. In the cases where Ender nails were used, the average operation time took in the average of 45 minutes and whereby, in the cases where sliding screw plates were used, took in the average of 110 minutes. 2. During the operation time, the amount of hemorrhage in the cases of Ender nail was about 100ml and the sliding screw plate resulted in about 350 ml. And the average amount of transfusion was 0.9 pints in cases of Ender nail and 2.3 pints in cases of sliding screw plate. 3. Among 20 patients fixed with Ender nail, only 2 patients had to be cared at ICU, but 9 of 19 patients had to be cared at ICU in the cases of sliding screw plates. 4. In the cases of Ender nail, the radiologic bony union time was about 13.4 weeks and they could walk with supports with in a week. But, in the cases of sliding screw plate the radiologic bony union time was about 16.2 weeks and they could walk with orthrosis at 28.4 days postoperatively. 5. Most patients treated with Ender nail were suffered from the problem at knee and protrusion of Ender nail into the hip joint, backing out of nail through the entry, coxa valga deformity were major complications after the operation. In the cases of sliding screw plates, loosening of sliding screw with coxa vara deformity, wound infection and delayed union were major complications. 6. Despite of many complications, if the indication is chosen well, the fixation with Ender nail will result in a benefical treatment method in the elderly patients for its advantages in general condition of the patients.

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The Operative Treatment of Acetabular Fracture: Deuk Soo Hwang, Kwang Jin Rhee, Jun Young Yang, Jang Ik Lee; J Korean Soc Fract 1999;12(2):212-219. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.212

Abstract PDF: PURPOSE
To analysis clinical and radiological result of surgically treated acetabular fractures and to present appropriate surgical approach for fracture type. MATERIAL AND METHODS: A review of 51 surgically treated acetabular fractures, treated between April 1988 and October 1996, using single surgical exposures and combined surgical exposures was conducted. The classification was used Judet & Letournel,s classification and the surgical approach was applied Kocher-Langenbeck, Ilioinguinal, and Combined approach according to fracture aspect. The result was rated on a radiographic as well as a clinical result scale based on Matta,s.
RESULTS
The most common fracture was 14 posterior wall fracture and 7 transverse fracture. the surgical approach was applied Kocher-Langenbeck 29 cases, ilioinguinal 10 cases, and combined approach 8 cases, triradiate approach 2 cases and Extended iliofemoral approach 1 case. A satisfactory reduction was obtained in 87% of the cases (concentric, gap < 3mm). Clinical results were excellent in 28%, good in 54%, fair in 12%, and poor in 6%. Radiologic results at followup indicated 40% excellent results, 35% good results, 16% fair results, and 9% poor results. Postoperative complications appeared in 7 cases including posttraumatic arthritis 2 cases. Two patients later required total hip arthroplasty for avascular necrosis of femoral head and posttraumatic arthritis.
CONCLUSION
Ilioinguinal approach was good method for access to the anterior wall and column fracture, but in case of severe comminuted medial wall fracture company with anterior column, internal fixation is impossible. So, accurate assesment of the fracture pattern by careful radiologic analysis is essential. The posterosuperior dome fracture is important to anatomical reduction because of high risk of posttraumatic arthritis. In case of Transverse fracture, T-shape fracture, and both column, the more displaced column was reduced first, followed by opposite column after reduction identify by intraoperative radiography. We can be attained satisfactory reduction. Therefore, combined approach was good surgical method for this complex fracture.

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Treatment of Femoral Neck Fracture with Multiple Pinning: Sang Won Park, Jong Ryoon Baek, Sang Seok Han; J Korean Soc Fract 1999;12(2):220-230. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.220

Abstract PDF

The incidence of femoral neck fracture is increasing because of the lengthening of human life span and a rising incidence of industrial trauma. Despite of the advance in treatment, femoral neck fracture presents poor prognosis and high rate of complications such as avascular necrosis or non- union due to anatomical consideration. It still remains one of the unsolved fracture as far as treatments and results are concerned. The purpose of this paper is to study the clinical results and factors predisposing to complication after multiple pin pixation of femoral neck fracture. The authors reviewed 50 cases of femoral neck fracture treated by multiple pin fixation at the Department of Orthopedic Surgery, Korea University Hospital from January 1989 to December 1996 with followed up period of more than 1 year and analyzed the relationship between the clinical results and age, degree of displacement, degree of osteoporosis, interval between onset of injury and operation, reducibility and complications. The results obtained were as follows: 1. The functional results by Lunceford criteria were excellent in 15 cases (30%), good in 13 cases(26%), fair in 9 cases(18%), and poor in 13 cases(26%) 2. Union occurred in 36 cases (72%) and the mean duration of union was 6.1 months. 3. There were 12 cases (24%) of avascular necrosis, 2 cases(4%) of non- union, 2 cases (4%) of malunion and 1 case of traumatic osteoarthritis. 4. Poor results were noted in cases of displaced fracture, osteoporotic bone under the Singh index 3, reduced in varus or valgus. Above results suggest that there was a relationship between the prognosis and bone density, degree of displacement and type of reduction, but the interval between the onset and operation within one month, and age distribution did not influence the end result.

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Comparison of Clinical Outcomes for Femoral Neck System and Cannulated Compression Screws in the Treatment of Femoral Neck Fracture
Jae Kwang Hwang, KiWon Lee, Dong-Kyo Seo, Joo-Yul Bae, Myeong-Geun Song, Hansuk Choi
Journal of the Korean Fracture Society.2023; 36(3): 77. CrossRef
Internal Fixation for Femoral Neck Fracture in Patients between the Ages of Twenty and Forty Years
Ui-Seoung Yoon, Jin-Soo Kim, Hak-Jin Min, Jae-Seong Seo, Jong-Pil Yoon, Joo-Young Chung
Journal of the Korean Fracture Society.2010; 23(1): 1. CrossRef

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Differences of Bone Mineral Density and Fracture Threshold Between Hip Joint Fracture and the Control group: Ig Gon Kim, Jae Hyek Kim, Cul Hyun Kim, Jong Suck Kim; J Korean Soc Fract 1999;12(2):231-238. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.231

Abstract PDF: Osteoporosis represents reduced amount of bone mass per unit volume as compared with controls of the same age and sex. In this condition, bone mineral density decreases and the skeleton becomes more prone to fracture. The purpose of this study was to show how bone mineral densities of the femoral neck area decrease with aging, to in vestigate the relationship between the bone mineral densities of the control and fracture group, and to obtain fracture threshold values. This report observed BMD of femoral neck region in femoral neck and intertrochanteric fracture group was less than that of control group and the differences were significant. We measured and evaluated BMD of femoral neck region by DEXA in 234 normal volunteers(99 men and 135 women), in 105 patien ts with femoral neck fracture(41 men and 64 women) and in 103 patients with intertrochanteric fracture(40 men and 63 women) above 50 years-old. Following results were obtained: 1. The average BMD of femoral neck region in control group, femoral neck fracture group and intertrochanteric fracture group were 0.751+/-0.030 g/cm2 in male and 0.661+/-0.089g/cm2 in female, 0.660+/- 0.031g/cm2 in male and 0.557+/-0.002g/cm2 in female and 0.661+/-0.008g/cm2 in male and 0.562+/-0.005g/cm2 in 2. The BMD of the control group and fracture group decreased with aging and were higher in men than in women and there were statistically significant difference(p<0.001). 3. There were statistically significant difference between BMD of the control group and BMD of the hip fracture group(p<0.005) but no significant differences between BMD of the femoral neck fracture group and intertrochanteric fracture group. 4. Fracture threshold of the hip fracture group were 0.815g/cm2(male:0.832g/cm2, female:0.733g/cm2) according to 95 percentile.

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Surgical Treatment of Subtrochanteric Fracture of Femur with Spiral Blade Unreamed Intramedullary Femoral Nail: In Heon Park, Kyung Won Song, Seong Il Sin, Jin Young Lee, Keon Hyung Lee; J Korean Soc Fract 1999;12(2):239-244. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.239

Abstract PDF: The treatment of the subtrochanteric fracture is technically very demanding, independent of the implant material used and presents a challenge in terms of surgical management. A multitude of implants based on very different biomechanical and operative concept are employed to deal with the special conditions relating to these fractuers. The purpose of this study was to analyze the results of the surgical treatment of subtrochanteric fracture using spiral blade unreamed intramedullary femoral nail. Spiral blade unreamed intramedullary nails were applied in 9 subtrochanteric fractures. Fracture healing was uneventful and implant complications or loss of reduction were not observed. In conclusion, spiral blade unreamed intramedullary nail will be a a valuable addition to the fixation techniques available for the treatment of subtrochanteric femoral fractures.

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Ipsilateral Femoral Shaft and Neck fracture: Dong Chul Lee, Yun Seok Lee, Duk Seop Shin; J Korean Soc Fract 1999;12(2):245-252. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.245

Abstract PDF: The occurrence of ipsilateral hip and femoral shaft fracture is uncommon and this problematic combination occur in 2.5% to 6% of femoral fracture. This combination of fractures result from high energy trauma and occurs in young multiply injured patient. As most orthopedists attention is directed to the shaft fructure of femur, the neck fracture can be commonly missed initially. Ipsilateral femoral shaft and neck fracture has the characteristics that has multiple associated injuries and many complications, such at avascular necrosis and nonunion of the femur neck, coxa vara. We analysed the outcome of treatment to know the results of treatment and its complication in 10 patients who were treated at Orthopedic Department, Yeungnam University Hospital from May 1991 to May 1996. The results were as follows : 1. Sixty percent of femoral neck fracture was basicervical type; Ninty Percent of femoral shaft fracture occured in the middle one third and most of the fractures were comminuted. There was one open fracture of femoral shaft. 2. All of the causes of the fractures occurred in motor vehicle accident. Mean age was 40.3 years(range: 15-59 years). There were 24 associated injuries in ten patients: especially, the injuries around knee were most common(6 tibial condylar fractures, 3 patellar fractures, 1 ligament injuries). 3. The bone union was obtained at average 2.8 months after operation(2 months - 5 months) in femur neck fractures, at average 5.5 months after operation(4 months - 12 months) in femur shaft fractttres and weight hearing was permitted at average 2.3 months after operation(1.5 months - 5 months). 4. There were 3 cases of nonunion of femoral shaft fracture, but they were treated by autogenous iliac bone graft Early bone graft may be necessary in comminuted femoral shaft fracture.

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Treatment of Comminuted Supracondylar and Intercondylar Femoral Fractures with AO Dynamic Condylar Screw: Kyung Chul Kim, Jae Yeul Choi, Hwa jae Jeong, Bon Seep Koo, Kyung Ho Kim; J Korean Soc Fract 1999;12(2):253-258. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.253

Abstract PDF: Between 1990 and 1995, 22 comminuted supracondylar and intercondylar femoral fractures in 22 patients were treated with the AO dynamic condylar screw(DCS). Minimum twelve months of clinical and radiographic follow-up evaluation were available on all patients. All cases achieved clinical and radiographic bony union. Functional results were graded using a Schatzker and Lambert's criteria. Results were seen to be excellent to good to fair in 100% of A2 cases, 86% of C2 cases, 75% of A3 cases and 67% of C3 cases. The more comminuted fractures were found to have worse clinical results and more radiographic malunion. The ability to obtain good fixation in osteoporotic bone is distinct advantage of the DCS. The results of DCS fixation compare favorably with previous studies using other fixation devices in comminuted supracondylar and intercondylar femoral fractures

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Nonunion of the Fracture of Distal One-third of Femoral Shaft treated by Interlocking Intramedullary Nailing: Su Chan Lee, Min Ho Song; J Korean Soc Fract 1999;12(2):259-266. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.259

Abstract PDF

The twelve nonunions of distal one-third fracture of femoral shaft after interlocking intramedullary nailing were teated with reaming and exchange nailing with a larger-sized nail, or reaming and exchange nailing with a larger-sized nail added with poller screw fixation. All the femoral nonunion were caused by insecure fixation of the intramedullary nailing, in which a instability of the fracture sites was verified in all cases during operation. The six of them were treated with reaming and exchange nailing. A simultaneous bone graft was performed in one of them to repair the bony defect. The other six of them were treated with reaming and exchange nailing added with poller screw fixation. The result were as follows: 1. In six cases that treated with reaming and exchange nailing, patients walked bearing full weight on the extremity with mild aching at the fracture site within 3 months and not obtained a bony union until a 12 months. 2. In one case that treated with reaming and exchange nailing added with poller screw fixation, patient walked bearing full weight on the extremity with mild aching at the fracture site within 3 months and not obtained a bony union until a 12 months. 3. In five cases that treated with reaming and exchange nailing added with poller screw fixation, patient walked bearing full weight on the extremity without aching at the fracture site within 3 months and obtained a bony union within a average of 7 months. From our experience, etiology of nonunions of distal one-third fractures of femoral shaft is thought insecure fixation of the intramedullary nailing due to wide intramedullary canal. We have found reaming and exchange nailing with poller screw fixation is more helpful treatment that reaming exchange nailing as treatment for those fractures.

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Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing
Sung-Soo Kim, Sung-Keun Sohn, Chul-Hong Kim, Myung-Jin Lee, Lih Wang
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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Bilateral Floating Knees Treated by 4 Intramedullary Nails: A Case Report: Phil Hyun Chung, Dong Ju Chae, Sang ho Moon, Ho Gyoon Bae; J Korean Soc Fract 1999;12(2):267-271. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.267

Abstract PDF: The treatment of simultaneous ipsilateral femoral and tibial fractures is a challenging therapeutic problem. Unfortunately, despites a number of reports on these fractures, guidelines for treatment have not been well established. Because the knee joint is isolated partially or completely, the term "floating knee"is used. But most of these injuries are ipsilateral and few bilateral cases were reported in the literatures. The authors reviewed a case of bilateral floating knee treated by 4 intramedullary nails without having any prolonged healing time or limited range of motion in both knee joint postoperatively.

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Reamed versus Unreamed Intramedullary Nailing after External Fixator Application in the Treatment of Open Tibial-Shaft Fracture: Dong Bae Shin, Joon Cheol Choi, Young Soo Lee, Yong Jeng Kim, Soo Hong Han, Dong Eun Shin, Yeun Ho Lee; J Korean Soc Fract 1999;12(2):272-276. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.272

Abstract PDF: The authers reviewed 15 patients of open fracture of the tibial shaft who were treated by external fixation followed by intramedullary nailing. These fractures comprised two Type-I, two Type-II, four Type-IIIa, and seven Type-IIIb injuries. Ten patients were treated with unreamed intramedullary nailing and 5 patients were treated with reamed intramedullary nailing. The results were analyzed as followings: 1. All fractures had union at 5.2 months after intramedullary nailing and 4 true osteomyelitis were developed. 2. All osteomyelitis were developed for the patients who were treated with reamed intramedullary nailing. 3. There was no osteomyelitis who were treated with unreamed intramedullary nailing. 4. Delayed conversion to intramedullary nailing after control of pin tract infection had no effect for prevention of osteomyelitis.

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Injuries of the Knee Associated with Fractures of the Tibial Shaft: Kwang Won Lee, In Sung Hwang, Seung Hun Lee, Tae Gyoo Ahn, Ha Yong Kim, Whoan Jeang Kim, Won Sik Choy; J Korean Soc Fract 1999;12(2):277-283. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.277

Abstract PDF: Two hundred and seventeen consecutive patients with two hundred and twenty five diaphyseal tibia fractures were retrospectively reviewed to evaluate the frequencies, types and the results of treatments for the associated ipsilateral knee ligaments and menisci injuries from May 1993 to Feb 1997 at Eulji Medical College Hospital. Average follow-up period was 41 months(20~65 months). Thirteen patients with knee injuries(5.8%) were diagnosed by stress X-ray & MRI evaluation and confirmed by arthroscopic examination. Eleven patients(84.6%) were diagnosed as having a ligament or meniscus injury at the time of initial management. The posterior cruciate ligament(PCL) was injured in eight patients(50%); the anterior cruciate ligament(ACL), in three; the medial collateral ligament, in three; the lateral collateral ligament, in two: the medial meniscus, in two; and the lateral meniscus, in two. There was no relationship between specific ligament damage and the cause of the injury or level of fracture. Collateral ligament injuries, two ACL, and four PCL injuries were treated conservatively and one PCL injuries were treated with pull-out suture technique and another four PCL injuries were treated with reconstruction using bone-patella tendon-bone. One ACL injury was treated with reconstruction using semitendinosus tendon. As evaluated by the method of HSS knee score, there were seven(53.9%) excellent, four(30.8%) good, and two fair(15.3%). On the basis of the results of this study, we believe that, after stabilization of a fracture of the tibial shaft, it is essential to examine the knee throughly to identify any associated ligamentous injuries.

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Compartment Syndrome Complicating Avulsion Fractures of the Tibial Tubercle: Yerl Bo Sung, Jin Hyok Kim, Hyung Jin Chung, Dong Soo Kim, Byung Hyun Jung, Jong Guk Ahn, Chil Soo Kwon, Kook Jin Chung, Bong Gyun Kang; J Korean Soc Fract 1999;12(2):284-289. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.284

Abstract PDF: Avulsion of the tibial tubercle is an uncommon physeal injury. Complications from this fracture have rarely been reported and seldom affect the long-term outcome. Three adolescent boys who sustained avulsion fracture of the tibial tubercle, were complicated by compartment syndrome and treated at Inje University Sang-Gye Paik Hospital from September 1989 to February 1995. Injury to the soft tissue surrounding the tibial tubercle avulsion may be more extensive than is usually appreciated. The anatomy of the proximal tibia and the tibial tubercle with nearby branches of the anterior tibial recurrent artery suggest a predisposing factor for the development of compartment syndrome. So, compartment syndrome should be added to the list of possible complications of this type of fracture.

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Osteochondral Avulsion Fracture in Patella after Treatment of Abscess around Knee: A Case report: Keun Soo Lee, Geon Woo Lee, Sang Ho Song, Hyun Seo; J Korean Soc Fract 1999;12(2):290-293. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.290

Abstract PDF: Osteochondral avulsion fracture of patella has been rarely reported. We experienced one case of osteochondral avulsion fracture which was developed after abscess around knee. The patient was a 16year old with the history of abscess. The presenting symptom was knee pain and loss of extension power. Radiologic and operative findings suggested that osteochondral avulsion fracture of the patella, was caused by minor trauma near the insertion site of quadriceps tendon. In usual case of quadriceps tendon rupture, the rupture occurred at the musculotendinous junction, caused by sudden contracture of the muscle without trauma history. This case was treated successfully with tension band wiring technique. Differential diagnosis between osteochondral avulsion fracture and osteomyelitis of patella was emphasized.

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Anatomical Plate Fixation for Distal Femur Fracture: Eun Sun Moon, Keun Bae Lee, Jong Wook Jeong; J Korean Soc Fract 1999;12(2):294-300. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.294

Abstract PDF

The fractures of the distal femur which involve supracondylar or intercondylar region are difficult to manage because occasionally, severe soft tissue damage, comminution, intra-articular extension of fracture and injury to the quadriceps mechanism lead to unsatisfactory results in many case. Recently, early anatomical reduction, rigid internal fixation and early exercise of the knee joint has been recommended. A clinical and radiological analysis was performed on 48 cases with fractures of distal femur who had been treated by anatomical plate and followed for minimum 1 year from April 1990 to July 1997. According to AO classification, 22 cases(45.8%) were type A, 1 case(2.1%) were type B and 25 cases(52.1%) were type C. The functional results by Sanders-Swiontkowski-Rosen-Helfet rating system were showed excellent in 15(31.3%), good in 17(35.4%), fair in 13(27.0%) and poor in 3 cases(6.3%). The overall results were seen to be excellent or to be good in 32 cases(66.7%) and results were worse in type C, old age, open fractures. The most common complication was limited range of motion of the knee under 90 degrees in 10 cases, including nonunion caused by loosening of screw in 1 case, metal failure in 1 case and shortening in 1 case. And other complications were delayed union in 4 cases and angular deformity in 2 cases. In conclusion, ideal indication for anatomical plating may be a metaphyseal fracture of distal femur with or without involvement of articular surface in young adult. Anatomical plate may be alternative one among the fixation devices for distal femur fractures.

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Surgical Treatment of AO/OTA 33-C Intra-Articular Distal Femoral Fractures through Parapatellar Approach
Suk Kyu Choo, Sung Tan Cho, Hyoung Keun Oh
Journal of the Korean Fracture Society.2022; 35(1): 1. CrossRef
Treatment of Femur Supracondylar Fracture with Locking Compression Plate
Seong Ho Bae, Seung Han Cha, Jeung Tak Suh
Journal of the Korean Fracture Society.2010; 23(3): 282. CrossRef
The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Kwang-Hee Park, Yoon-Ho Choi
Journal of the Korean Fracture Society.2009; 22(4): 246. CrossRef

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The Problems on Removal of the tibial intramedullary nails: Tai Seung Kim, Seong Pil Lee, Khun Sung Whang; J Korean Soc Fract 1999;12(2):301-306. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.301

Abstract PDF: Closed intramedullary nailing with interlocking screws has been a widely accepted method for the fixation of fractures of the long bones. As a rule, the nail can be removed during the second year. Before the operation, solid healing of the fracture must be demonstrated by x-rays in two planes. When solid bone healing of the fracture has occurred, a connective tissue interface forms around the foreign body. This connective tissue can ossify later and make it difficult to remove the nail after it has been in place for a number of years. Theoretically, removal of the nail should be an uncomplicated procedure. Occasionally, one runs into problems, however, and every surgeon who has had enough experience with intramedullary nailing can remember cases in which removal of the nail was more difficult than its insertion. So, we tried to review our cases for problems on removal of the tibial nails and to discuss its etiologies.

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Treatment of fracture-dislocation of talar neck or body: Byoung Ho Lee, Sang Ho Ha, Min Hyuk Choi; J Korean Soc Fract 1999;12(2):307-313. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.307

Abstract PDF: From January 1992 to December 1996, authors analyzed 26 cases of fracture-dislocation of talar neck or body, treated at Chosun University Hospital retrospectively. There were 20 males and 6 females and the average age was 34 years old. The follow up period was at least 14 months. There were 19 neck fracture-dislocations, 6 body fractures and total dislocation of talus. Three type I talar neck fractures were treated conservertively. In six cases, in which either three cases of severe open type III talar neck fracture or three cases of severly comminuted talar body fracture, primary fusion was performed. Other seventeen cases of fracture-dislocation were treated by open reduction and internal fixation. Excellent results were observed in 6 cases, good in 7 cases, fair in 11 cases and poor in 2 cases. The result of primary arthrodesis for severe injury of talus was relatively good. Complications were avascular necrosis in 7 cases, posttraumatic arthritis in 5 cases, skinnecrosis in 3 cases, wound infection in 2 cases and malunion in 2 cases.

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Percutaneous Fixation in Medial Malleolar Fracture: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Ki Se Nam, Ho Kyun Bae; J Korean Soc Fract 1999;12(2):314-320. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.314

Abstract PDF: Fracture of the ankle is one of the most common fractures. Usually medial malleolar fractures, when non-displaced or minimally displaced, have been treated by closed reduction and cast immobilization for long period, so stiffness and osteoporosis of ankle were frequently inevitable. We investigated the result of percutaneous pinning or screw fixation and early mobilization in the treatment of medial malleolar fracture of the ankle. With clinical and radiological data, authors analysed 17 patients(17 ankles) who were treated with closed reduction and percutaneous pinning or screw fixation between August 1991 and May 1997. and following results were obtained. One case of pin site infection was noted and no nonunion or loss of fixation was identified and average duration of bone union was 12 weeks. According to Burwell's protocol, the good result are 16 cases, the fair is 1 case and the poor result is not observed. From the viewpoint of rehabilitation, authors consider percutaneuos pinning is an excellent plan of treatment of medial malleolar fractures, when non-displaced or minimally displaced.

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Result of Surgical Treatment of Calcaneal Fractures Using Extensile Lateral Approach: Sung Do Cho, Yong Sun Cho, Bum Soo Kim, Tae Woo Park, Gi Bong Kim, Key Yong Kim; J Korean Soc Fract 1999;12(2):320-327. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.320

Abstract PDF

Thirty-eight calcaneal fractures were treated with open reduction and internal fixation using extensile lateral approach from Jun. 1993 to Dec. 1996 and were followed more than a year. According to the Essex-Lopresti classification, there were 28 cases of joint depression type and 10 cases of tongue type. According to the Sanders classification, there were 20 cases of type II, 13 cases of type III and 5 cases of type IV. The purpose of this study is to analyze the results of surgical treatment of calcaneal fractures using extensile lateral approach and its complications. The results were as follows; 1. B.. ohler angle was improved from -2.4degrees to 20.5degrees and Gissane angle was improved from 114.5degrees to 120.4degreesafter the operation. The height of the calcaneus was improved from 75% to 95% and the width of the calcaneus was reduced from 119% to 106% of contralateral side. 2. yThe postoperative reduction status of the articular surface was analyzed by computed tomography(CT) in 18 patients and was found to be less than 2 mm of step-off in 10 cases, between 2 and 5 mm in 7 cases and more than 5 mm in 1 case. 3. Based on the assessment criteria of Salama et al., the functional results were excellent in 10 cases, good in 14 cases, fair in 10 cases, and poor in 4 cases. Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. 4. Fourteen cases (36.8%), developed postoperative complications such as heel pain, causalgia and numbness, subtalar arthritis, marginal necrosis of wound, lateral subfibular impingement and heel bulging. In conclusion, Because of high incidence of postoperative complications, careful and meticulous exposure technique in doing extensile lateral approach are necessary for a satisfactory outcomes.

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Treatment of Intra-articular Calcaneal Fractures Using Minimally Invasive Sinus Tarsi Approach in Diabetic Patients
Hong-Moon Sohn, Sang-Ho Ha, Sang-Hong Lee, Jun-Young Lee, Jeong-Ho Kim, Sang-Jun Lee
Journal of the Korean Fracture Society.2008; 21(3): 195. CrossRef

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

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

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Comparison of the conservative and operative treatment of the intraarticular calcaneal fractures: Chang Woo Kim, Min Young Chung, Ki Tae Jung, Eun Hwan Bae, Seong Ho Park, Ho Keun Park, Tae Hoon Jeong; J Korean Soc Fract 1999;12(2):335-343. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.335

Abstract PDF

The calcaneal fracture, which is considered to be the most common tarsal bone fracture, has rather difficulty in accurate diagnosis, classification and proper treatment. Furthermore, its prognosis is not good, either. The authors analysed 68 intraarticular calcaneal fractures (Sanders type II & III only) out of 147 cases, which were treated operatively or conservatively from June 1990 to May 1997, and found out that the results of conservative and operative treatment were approximately the same. The length of follow-up ranged from one year to four and half years (mean, 2.7years). The results were as follows: Of the 24 conservatively treated group, seven had excellent; eleven good; four fair; and two poor result. Of the 44 operatively treated group, eleven had excellent; twenty seven good; five fair; and one poor result. The sum of excellent and good results in conservative and operative treatment group were 75.0% and 86.4% each other, and these were not meaningful statistically (p=0.400). Therefore, the authors recommend a conservative treatment as an effective alternative method for the intraarticular calcaneal fracture.

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Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography
Joon-Sang Eom, Young-Deuk Joo, Seong-Jun Kim, Min-Ho Shin, Dong-Oh Lee, Hong-Geun Jung
Journal of Korean Foot and Ankle Society.2014; 18(4): 165. CrossRef
Treatment of Intra-articular Calcaneal Fractures Using Minimally Invasive Sinus Tarsi Approach in Diabetic Patients
Hong-Moon Sohn, Sang-Ho Ha, Sang-Hong Lee, Jun-Young Lee, Jeong-Ho Kim, Sang-Jun Lee
Journal of the Korean Fracture Society.2008; 21(3): 195. CrossRef

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Essex-Loprestis Axial Pinning in the Treatment of Intraarticular Calcaneal Fracture: Hyung Koo Yoon, Kwang Pyo Jeon, Kyung Hoon Kang, Jin Il Kim, Dong Soo Kim, Kyung Soub Song; J Korean Soc Fract 1999;12(2):344-350. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.344

Abstract PDF

Fracture of the calcaneus is the most commonly encountered among fracture of tarsal bone and it is difficult to obtain accurate reduction because the calcaneus has cancellous trabecular enclosed with thin cortical bone. In the past, the result of treatment was poor. Recently, closed reduction and axial pin fixation for tongue type fracture and open reduction and internal fixation for joint depression type fractures are considered as generally accepted treatment methods. The purpose of this study is to evaluate the efficacy of axial pin fixation in joint depression(group A) and tongue type(group B). Retrospective study was performed in 20 patient(23 feet) with intraarticular calcaneal fractures which were treated with axial pin fixation from July 1993 to June 1996. Minimum follow up period was 1 year(average 20 months). The obtaining results were as follows : 1. Cause of injury was fall down in the 18 cases(90%). 2. We obtained excellent or good results from the performance of operation within 2 weeks on trauma patient, in the 16 cases(69%). And we obtained excellent or good results in the 14 cases, showing above 20degreesof postoperative B.. ohler angle. 3. In fracture of joint depression type, there is no relationship between clinical result and degree of joint depression in follow up CT. 4. The complications were subtalar arthritis and two neuroma in sural nerve. We propose our experience obtained in 23 cases that axial pin fixation was a good method for treatment of intraarticular fracture, joint depression type as well as tongue type.

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Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method
Gyu Min Kong, Byoung Ho Suh, Dong Joon Kim
Journal of the Korean Fracture Society.2007; 20(2): 178. CrossRef

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Management of Displaced-Extension Type Supracondylar Fractures of Humerus in Children: Suk Myun Ko, Myung Ku Kim, Kyoung Ho Moon, Ryuh Sup Kim, Kyu Jung Cho, Dong Hun Choi; J Korean Soc Fract 1999;12(2):351-360. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.351

Abstract PDF: From June 1996 to February 1998, we reviewed the cases of 27 patients who had a displaced - extension type supracondylar fracture of the humerus retrospectively. The mean length of follow-up was 1.3 years. According to Gartland classification, type II was 7 cases (26%), type III-A was 11 cases (41%), type III-B was 9 cases (33%). We treated with three different methods, including closed reduction and percutaneous Kirschner-wire fixation, skeletal traction, and cast application after closed reduction. In type II fractures, we used two parallel lateral pins. In type III fractures, we used 2 lateral parallel pins followed by 1 medial crossed pin predominantly. The results of treatment were assessed using the criteria of Flynn et al. We graded cosmetic and functional factors separately. Satisfactory results were achieved by percutaneous K-wire fixation(96%). There were seven neural lesions. These were the result of injury and not of the treatment, with exception of one case. Neural injuries spontaneously resolved at a mean of 2.5 months(range 1.5 to 5 months) after injury. Varus deformity was present in one patient. There was no Volkman's ischemic contracture. Percutaneous Kirschnerwire fixation is advocated as the method of choice for the majority of displaced-extension type supracondylar humerus fractures in children.

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Traumatic dislocation of hip in children: A Case Report of 30 Months Followup: Soo Jae Yim, Yeon Cheol Jeong, Seung Ryool Yoon, Joong Geun Choi, You Sung Suh, Yon Il Kim; J Korean Soc Fract 1999;12(2):361-364. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.361

Abstract PDF: Traumatic hip dislocation in childhood is rare. Factors predisposing to abnormal results are delayed reduction and severe trauma. We experienced 8 year-old girl with traumatic posterior hip dislocation and treated with immediate closed reduction. At 30 months follow-up, our patient had good functional and good roentgenographic result with no posttraumatic arthritis or posttraumatic avascular necrosis. So we report this case with review of literature.

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

Abstract PDF

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

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

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The Change of Kyphotic Angle and Anterior Vertebral Height after Posterior or Posterolateral Fusion with Transpedicular Screws for Thoracolumbar Bursting Fractures: Jae Sung Ahn, June Kyu Lee, Deuk Soo Hwang, Young Mo Kim, Won Jung Kim, Kyu Hwan Byun; J Korean Soc Fract 1999;12(2):379-387. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.379

Abstract PDF

The purposes of this study are to make an operative treatment option of thoracolumbar burst fractures by the degree of initial kyphotic deformity or by the degree of initial loss of anterior vertebral height. We analyzed sixty-three cases of one segmental thoracolumbar bursting fractures treated surgically by posterior or posterolateral fusion with short segmental transpedicular screws fixation method using Diapason or CD from January, 1992 to October, 1996. Indications of operative treatment were that the degree of initial kyphotic deformity was above 15degreesor initial loss of anterior vertebral height was above 30%. Minimum follow-up period was 12 months and the results were as follows : 1. Entirely, mean kyphotic angle was 21.6degreesinitially, 11.3degreespostoperatively and 14.2degrees at the end of follow-up. Mean anterior vertebral height was 59.6% initially, 83.8% postoperatively and 80.8% at the end of follow-up. So 10.3degrees , 24.2% was corrected postoperatively and loss of correction was 2.9degrees , 3% at the end of follow-up. 2. In the respect of the degree of initial kyphotic deformity, when compared above 30degrees with below 30degrees , loss of correction was 7.3degrees , 1.4degrees at the end of follow-up respectively and this result had significant difference between these two groups statistically. 3. In the respect of initial loss of anterior vertebral height, when compared above 55% with below 55%, loss of correction was 7.7%, 2.2% at the end of follow-up respectively and this result had significant difference between these two groups statistically. 4. In the respect of time interval from injury to operation, when compared within 2 weeks with after 2 weeks, respectively loss of correction was 1.7-2.2degrees , 3-3.9% and 4.1degrees , 6.7% at the end of follow-up and this results had significant difference between these two groups statistically. These data suggested if initial kyphotic angle is below 30degrees or initial loss of anterior vertebral height less than 55%, short segmental transpedicular screw fixation provide sufficient stability but if initial kyphotic angle is above 30degrees or initial loss of anterior vertebral height is above 55%,additional anterior interbody fusion may be considered.

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Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures
Jin Young Han, Ki Youn Kwon
Journal of the Korean Fracture Society.2020; 33(1): 1. CrossRef
Nonfusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Jae-Jung Jeong, Young-Chan Cha, Ji-Kang Park
Spine.2011; 36(2): 170. CrossRef
Efficiency of Implant Removal for Treatment of the Thoraco-lumbar Unstable Fractures - Multi Segments Fixation · Single Segment Fusion -
Heui-Jeon Park, Young-Jun Shim, Wan-Ki Kim, Tae-Yeon Cho, Sung-Min Kwon
Journal of Korean Society of Spine Surgery.2011; 18(3): 103. CrossRef
Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level
Jeong-Gook Seo, Jong-Ho Park, Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 39. CrossRef
Clinical Efficacy of Implant Removal after Posterior Spinal Arthrodesis with Pedicle Screw Fixation for the Thoracolumbar Burst Fractures
Kyung-Jin Song, Kyu-Hyung Kim, Su-Kyung Lee, Jung-Ryul Kim
The Journal of the Korean Orthopaedic Association.2007; 42(6): 808. CrossRef
Results of Non-fusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Seong Choi, Hyun-Chul Shon, Kyoung-Jin Park, Kyeong-Il Jeong, Young-Chan Cha, Hu-Shan Cui
Journal of Korean Society of Spine Surgery.2005; 12(2): 132. CrossRef
Relationships between Posterior Ligament Complex Injury and Plain Radiograph in Thoracolumbar Spinal Fracture
Heui-Jeon Park, Phil-Eun Lee, Byung-Ho Lee, Myung-Soon Kim
Journal of Korean Society of Spine Surgery.2005; 12(2): 140. CrossRef

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

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

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Treatment of Two-part, Displaced Surgical Neck Fracture of the Proximal Humerus with Modified Ender Nail and Tension Band Technique: Kwang Won Lee, In Sung Hwang, Seung Hun Lee, Tae Gyoo Ahn, Ha Yong Kim, Whoan Jeang Kim, Won Sik Choy; J Korean Soc Fract 1999;12(2):395-401. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.395

Abstract PDF

Operative treatment of two-part, displaced surgical neck fractures of the proximal humerus is used when satisfactory closed reduction cannot be achieved or maintained. Recently, we modified the Ender nails by making an additional hole above the slot for wire incorporation. The purpose of this study was to assess the effects of stabilization of displaced and unstable surgical neck fractures of the humerus by Ender nailing and tension band technique. We reviewed the data of fourteen consecutive patients (10 women and 4 men) who had been treated with Ender nailing and tension band wiring between from Aug 1996 and Oct 1997 at Eulji Medical College Hospital. The average age of patients was 54 years (range, 38 to 79 years), and the average follow-up period was 18 months (range, 12 to 24 months). Bone union was observed at 6.3 weeks (range, 5.5 to 10 weeks), except one case of delayed union. There were no infections and nonunions. The average ranges of shoulder elevation and abduction were 140 degrees(100 degrees to 170 degrees) and 126 degrees(100 degrees to 160 degrees), respectively. The median value of the thumb to vertebral distance was L1, with a range of T6 to L5 for internal rotation, external rotation was 48 degrees (30 degrees to 70 degrees) . Radiography revealed one case of medial shift greater than 5mm, and 4 cases of lateral shift greater than 5mm of the humeral shaft. The average varus angulation of the humeral neck was 8.5o(0 degree to 34 degrees). Four patients (28.6%) were excellent (34 to 35), six patients (42.8%) were good (28 to 33), four patients (28.6%) were fair (21 to 27) in UCLA shoulder rating scale. In conclusion, Ender nailing and incorporation of the tension band wire loops provided additionally rotational and longitudinal stability in two-part displaced surgical neck fracture of the proximal humerus associated with osteoporosis.

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Treatment with Modified Steinmann Pins and Tension Band Wiring Technique in Proximal Humeral Comminuted Fractures with Osteoporosis
Soo-Tai Chung, Joo-Hak Kim, Hyung-Soo Kim, Sang-Joon Park
Journal of the Korean Fracture Society.2007; 20(2): 184. CrossRef

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Management for Postoperative Infection of Fractures: Eui Hwan Ahn, In Whan Chung, Jeong Hwan Oh, Seong Tae Lee, Duk Hwan Kho; J Korean Soc Fract 1999;12(2):402-410. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.402

Abstract PDF

It is often difficult to eradicate infection and achieve bony union in postoperative infection after fracture fixation. Authors treated 14 such cases from February 1992 to February 1998, and followed up for 6 to 35 months. The purpose of this study is to review the clinical features of the postoperative infection and assess the treatment modality which influence the time required for attaining bony union and healing of infection. The results were as follows : 1. Primary fixation were left in place in 5 cases of stable fixation, and new external fixation and/or another fixations were required in 8 cases of unstable fixation. 2. Time required for achieving union was 4.7 months for stable primary fixation and 12.8 months for unstable primary fixation. 3. Time required for healing in infection was 3.5 months for stable primary fixation and 14.4 months for unstable primary fixation. 4. Bony union was delayed as the number of surgical procedures were increased. 5. Antibiotic cement beads were inserted for 5 cases into bony defect and dead space after curettage and sequestrectomy, and pus discharge was stopped after 8.8 weeks in average.

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A Review of Domestic and International Clinical Research Trends on Pharmacopuncture Treatment for Fractures
Hea Sun Chun
Journal of Physiology & Pathology in Korean Medicine.2023; 37(6): 185. CrossRef

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The Treatment of the displaced Distal Radius fractures-Prospective study-: Jun Young Yang, Hyun Dae Shin, Kwang Jin Rhee, Jun Kyu Lee, Deuk Soo Hwang, Jang Ik Lee, Jung Hee Choi; J Korean Soc Fract 1999;12(2):411-421. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.411

Abstract PDF: Fractures of the distal end of the radius, including Colles'fractures, represent the most common fractures of the upper extremity. Over the past years, many clinicians had thought of fractures of the distal radius as being a group of injuries with a relatively good prognosis. Today, fractures of the distal radius are recognized as very complex injuries with variable prognosis that depend upon the fracture type and the treatment given. We performed a prospective study in 51 patients(52 cases), by using treatment protocol of Palmer, we treated each fracture according to physiological age, activity, X-ray findings and stability after closed reduction. Final outcomes were evaluated by modified clinical scoring system, criteria for anatomical results and combined functional and anatomical results. Results by using modified clinical scoring system were excellent; 8 cases, good; 16 cases, fair; 22 cases, and poor; 6 cases. Results by using criteria for anatomical results were excellent; 8 cases, good; 26 cases, fair; 10 cases; and poor; 8 cases. In wrist rating scales of New York Orthopaedic Hospital, excellent; 7 cases, good; 32 cases, fair; 6cases, and poor; 7 cases. In our study, fractures of the distal radius were occurred frequently in active young male with high energy injuries. Criteria about acceptable range of reduction in treatment protocol of Palmer were too wide to obtain satisfactory results. Results from many assessment systems did not matched with each other because of differences of point of views. The results of this study proposed that even acceptable reduction is obtained, better outcomes will be brought by operative modality due to decreased frequency of reduction loss and radial shortening. And also, physical therapy after fracture treatment is considered as one of the important factors influencing functional results and the satisfaction of patients themselves.

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Surgical Treament for Unstable Intra-articular Fracture of the Distal Radius with Rayhack's Transulnar Percutaneous Pinning Technique: Eui Chan Jang, Ho Sung Ryu, Jae Sung Lee, Jung Nam Han; J Korean Soc Fract 1999;12(2):422-428. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.422

Abstract PDF: There has been many treatment modalities in the distal radius fracture. Although there is no doubt that external fixators have a role in the treatment of some highly displaced distal radius fractures, many unstable distal radius fractures may be treated adequately with far less complicated and intrusive percutaneous pinning technique. The purpose of this study was to evaluate indication and effectiveness of Rayhack's transulnar percutaneous pinning technique. Authors reviewed the unstable intra-articular fracture of the distal radius of 15 cases treated with Rayhack's transulnar percutaneous pinning technique between March 1994 and February 1997. At the final follow-up examination, the mean loss of radial length, radial inclination and volar tilt was respectively 0.4mm (3.9%), 2.0 (10.6%), 2.1 (14.7%). Posttraumatic arthritis was occurred in 1 case (11.1%) of less than 1mm residual articular step-off, 2 cases (40%) of more than 1mm and less than 3mm residual articular step-off, 1 case (100%) of more than 3mm residual articular step-off. Distal radioulnar joint synostosis by percutaneous pinning was not found. According to Demerit point rating system, excellent to good results were obtained in 73.3%. Authors suggest that Rayhack's pinning technique can be applied in terms of simple procedure, cost-effectiveness and functional outcome.

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Treatment of Humeral Shaft Fracture with AO Unreamed Humeral Nail: In Heon Park, Kee Byoung Lee, Kyung won song, Jin Young Lee, Min Choi; J Korean Soc Fract 1999;12(2):429-434. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.429

Abstract PDF: We performed a retrospective study of nine humeral shaft fractures which were treated by interlocking intramedullary nailing, the AO UHN (Unreamed Humeral Nail) system between March 1996 and February 1997 with more than one year of follow up. AO UHN inserted by either antegrade or retrograde technics through limited incisions followed by insertion of 2 proximal and distal Interlocking screws. Compression between fractured fragments was achieved in the non-comminuted and indicated cases. Immediate postoperately, soft shoulder immobilizer was applied and rehabilitation was started with active shoulder motion exercise few days to 1 week postoperately as soon as patient could tolerate pain. Union occurred at average of 13 weeks except one expired case with pathologic fracture due to advanced metastatic cancer. Pain relief and functional restoration were rated as good to excellent in most cases. Interlocking intramedullary nailing using AO UHN for the humeral shaft fractures usually provides immediate stability of the fracture and can be accomplished with a closed technique, minimum morbidity, with a resultant early return of function of the extremity. Therefore we recommend AO UHN for the treatment of the humeral shaft fractures if available without hesitation.

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Results of Treatment for Fractures of the Talar Neck: Kyung Jin Song, Jung Ryul Kim, Moon Kyu Kim, Byung Yun Hwang; J Korean Soc Fract 1999;12(2):435-439. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.435

Abstract PDF: The purpose of this investigation was to evaluate the clinical results and to suggest appropriate treatment modality in the treatment of the fracture of talar neck. Twelve patients who had the fracture of talar neck were managed from October 1988 to April 1996 and followed more than 24 months. We reviewed the results according to the method of treatment, and complications following surgery. Three were treated with closed reduction and casting, one with closed reduction and K-wire fixation, eight were treated with open reduction and internal fixation. The functional result was excellent in 58.3 % and good in 33.3 % according to Hawkins criteria. Overall, there were three complications, one with skin necrosis on the incision site and the other two with subtalar arthritis. The treatment results were affected by the severity of trauma at the time of injury. Anatomical reduction by closed or open method, and stabilization with cast or rigid internal fixation could facilitate early mobilization and minimize postoperative complications in the treatment of talar neck fractures.

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Volar Perilunate Dislocation: A case report: Sung Soo Kim, Sung Keun Sohn, Dae Hee Lee; J Korean Soc Fract 1999;12(2):440-445. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.440

Abstract PDF

Perilunar dislocation is not a common injury. When it occurs it is usually dorsal. Only a few isolated cases have been reported of volar perilunar dislocation, in which the capitate is displaced volar to the palmar flexed lunate. Like its more common dorsal counterpart, volar perilunate dislocation usually requires either a concomitant fracture of the scaphoid or scapholunate dissociation. Many authors have been proposed the mechanism of injury, forced hyperflexion, hyperextension with supination of the forearm and violent trauma with extensor tendon rupture. The diagnosis is most easily made on the lateral view. Closed reduction using finger-trap traction should be the initial step in management. Although successful treatment has been reported with a closed reduction alone, open reduction is probably indicated in most cases to align and stabilize the bones. We are reporting on a patient of volar perilunar dislocation without a fracture of the scaphoid or scapholunate dissociation of the right hand associated with extensor tendon rupture.

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Combined Lunate and Triquetrum Fracture: A Case Report
Joo-Hak Kim, Hyung-Soo Kim, Soo-Tae Chung, Jeong-Hyun Yoo, Seung-Do Cha, Joong-Hyo Lee, Jai-Hyung Park
Journal of the Korean Fracture Society.2008; 21(4): 320. CrossRef

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Scaphocapitate Fusion for Kienbock disease: Jun Young Yang, Hyun Dae Shin, Sang Ro Ahn, Kwang Jin Rhee, Jun Kue Lee, Jung Hee Choi; J Korean Soc Fract 1999;12(2):446-451. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.446

Abstract PDF

We reviewed 14 patients treated with scaphocapitate fusion for Kienb.. ock's disease(Lichtman stage III) with mean follow-up of 26 months (ranging from 1 years to 5 year). There were five mens and nine womens. The mean age of patients at the time of operation was 46.1 years (ranging from thirty one to sixty). According to Lichtman's classification, All patients were stage III. Clinical assessments were evaluated using by pain relief, limitation in range of motion and clinical improvement. Radiologic assessment was evaluated by carpal height ratio. The mean range of motion is flexion 30 degree, extension 41 degree preoperatively, and flexion 29 degree, extension 41 degree postoperatively. The mean carpal height ratio is 0.49 preoperatively and 0.48 postoperatively. All of cases are relief of pain. Therefore radiographic and clinical satisfactory results were obtained. In conclusion, scaphocapitate fusion appear to be a very effective method for Lichtman stage III of symptomatic Kienb.. ock's disease.

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Lunate Excision and Tendon Ball Implantation in Lichtman Stage IIIB Kienböck's Disease in Middle-Aged Patients
Sang Jin Cheon, Dong Ho Lee, Shi Hwan Park, Woong Ki Jeon
Journal of the Korean Society for Surgery of the Hand.2015; 20(3): 110. CrossRef

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T-plate Fixation of Distal Radius Fractures in the Elderly: Ik Su Choi, Woo Il Kim, Su In Roh, Hong Ju Ha, Jin Goo Kang, Seung Chan Ko; J Korean Soc Fract 1999;12(2):452-460. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.452

Abstract PDF: Recently, distal radius fractures are recognized as very complex injuries with a variable prognosis according to the fracture type and the treatment. Especially, there are several problems, including joint stiffness and skin necrosis due to a long term immobilization, radial shortening and collapse due to the loss of reduction in the elderly. Thus, the anatomical reduction and rigid internal fixation and early rehabilitation were recommanded. We analyzed 16 patients with distal radius fractures in the elderly, who were treated with open reduction and internal fixation with T-plate from January, 1991 to June, 1997 and were followed up for more than 12 months. The results were as follows ; 1. According to the Fernandez classification, 3 cases were type I, 3 cases were type II, 7 cases were type III, 1 case was type IV and 2 cases were type V. 2. As complications, there were 2 cases of arthritic change, 3 cases of radial shortening, and 1 case of screw loosening. 3. Anatomically satisfactory results were obtained in 75%(12 cases). 4. Functionally and clinically satisfactory results were obtained in 87%(14 cases). 5. In the treatment of distal radius fractures in the elderly, three dimensional structure and recovery of joint congruency were related to the clinical prognosis.

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External fixation versus percutaneous pinning for unstable Colles'fracture: Suk Woong Yoon, Tae Sung Hwang, Jong Haeng Lee; J Korean Soc Fract 1999;12(2):461-470. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.461

Abstract PDF: The twenty-three cases of unstable Colles fracture were treated from Jan. 1994 to May 1998 at the department of orthopaedic surgery of Seoul Red Cross Hospital. Among them, the sixteen cases were treated with closed reduction with percutaneous pinning, others were treated with external fixator(Ace colles quadrilateral devices, USA). A retrospective study was made and evaluated using the Modification of Gartland and Werley's scoring system. The result of this study were as follow: 1. The ratio of male to female was 9 cases(39%) to 14 cases(61%). 2. The causes were falling down from a height 12 cases(50%), slip down 8 cases(35%) and traffic accident 3 cases(13%). 3. The reduction loss did not occur with the patients treated external fixation using Ace colles qredrilateral device, however three cases of the reduction loss have occurred with the patients using percuteneous pinning. 4. According to the Modification of Gartland and Werley's scoring system, the results of exteral fixation were excellent 4 cases(58%), good 1 case(14%), fair 1 case(14%) and poor 1 case(14%). and for percutoneous pinning, excellent 6 cases(38%), good 4 cases(25%), fair 2 cases(12%) and poor 4 cases(25%). 5. The complications of cases using external fixation were pin site infection 1 case and wrist stiffness 1 case, but for percutaneous pinning, reduction loss 3 cases. pin site infection 2 cases, wrist stiffness 2 cases, and decreased external rotation of forearm 3 cases.

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Radiological and Clinical Results After Closed Reduction in Colles'Fracture: Song Kon Kim, Koung Wook Rha, Jong Ho Park; J Korean Soc Fract 1999;12(2):471-478. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.471

Abstract PDF: Colles'fracture is a common injury encountered in emergency room. It is generally agreed that closed reduction of the fracture may not be difficult, but it is difficult to maintain the closed reduction. Twenty eight patients with Colles'fracture were treated with closed reduction and splinting method, followed up more than 1 year from January 1996 to August 1997 at the Korea university Ansan Hospital. The purpose of this study is to evaluate the radiological and functional results after closed reduction with splinting of Colles'fracture. The results of this study were as follows: 1) Of the 28 cases, type I were 3 cases, type II 16 cases, type III 9 cases by the universal classification. 2) Reduction loss was radial angle 2.25, volar angle 327, radial shortening 2.6mm. 3) The overall assessment were excellent in 8 (28.5%), good in 13 cases (46.5%), poor in 7 cases (25.0%) under the functional assessment of Garland and Werley and simple radiographic assessment of Scheck. 4) Complications were median nerve palsy 5 cases, osteoarthritis of wrist in 2 cases and hand stiffness in 2 cases. In conclusion, if there occured loss of reduction after closed reduction with splinting in elderly patients, closed reduction and internal fixation should be considered.

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Arthroscopic Treatment of Isolated Anterior Malleolar Fracture of the Ankle: Dong Wha Lee, Kyoo Seog Shin, Jong Soon Kim, Yong Whee Kim; J Korean Soc Fract 1999;12(2):477-480. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.477

Abstract PDF: Isolated fractures of the anterior malleolus of the ankle are uncommon. They most often result from vertical loading or from posterior displacement of the tibia on a planted foot. Fracture of the tibial plafond with a large anterior tibial(anterior malleolus) fragment may require open reduction with internal fixation. Anatomic reduction of the articular surface can be ensured by visualizing the articular surface using an arthroscope during reduction. Two cases wherein this technique has proven effective were described.

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