Journal of Musculoskeletal Trauma

The Pattern of Occurrence of Fractures in Children and Adolescents and Its Managements Based on the Database of the Health Insurance Review and Assessment Service: Yong Wook Kwon, Soon Hyuck Lee, Hyun Woo Kim, Jin Ho Hwang; J Korean Fract Soc 2014;27(4):308-314. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.308

PURPOSE
The purpose of this article is to report on the pattern of medical process and relative frequencies of fractures in children and adolescents.
MATERIALS AND METHODS
The authors retrospectively analyzed the database of the health insurance review and assessment service regarding children and adolescents under 20 years old treated from 2008 to 2010. Newly registered numbers of fractures in children and adolescents according to sex, month, institution, and anatomical location were also reviewed.
RESULTS
A total of 1,893,416 fractures occurred during three years; approximately 630,000 cases were treated during one year (approximately 562 cases among 10,000 people during one year). During one year, the most fractures occurred in June and the least in February. Senior general hospital consisted of 5.72%, 12.30% in general hospital, 19.28% in hospital, and 62.70% in clinics. Among the fracture sites, 0.05% were cervical fractures, 0.91% in sternum and thoracic vertebra, 1.35% in lumbar vertebra and pelvis, 12.79% in shoulder and upper extremities, 26.87% in lower extremities, 38.10% in wrist and hand, 1.01% in femur, 10.40% in lower extremities including ankle, and 8.52% in foot excluding ankle. The maximal incidence was age 14 years in male and 12 years in female.
CONCLUSION
The authors reviewed the pattern of medical process and relative frequencies of fractures in children and adolescents.

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Analysis of Computed Tomography Scans for Radiation Safety Management in the Republic of Korea
Min Young Lee, Ji Woo Kim, Ga Eun Oh, Geon Woo Son, Kwang Pyo Kim
Journal of Radiation Protection and Research.2024; 49(3): 141. CrossRef

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Operative Treatment of Bilateral Tibial Tuberosity Fractures in Adolescent: A Case Report: Hong Kyun Kim, Jung Han Yoo, Yong Wook Park, Jin Soo Park, Kyu Cheol Noh, Kook Jin Chung, Keun Jong Jang, Ji Hyo Hwang; J Korean Fract Soc 2010;23(3):317-320. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.317

Abstract PDF: Bilateral avulsion fractures of the tibial tubercles are extremely rare. There is no case report about this in Korean literature. We present simultaneous bilateral tibial tuberosity fractures in 14-year-old adolescent male fell on the ground during running. These fractures were managed by open reduction and screw fixation. We gained complete union and removed metal after 6 months. Functional results were excellent 6 month after surgical treatment.

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Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent: Kun Bo Park, Hoon Park, Hyun Woo Kim, Hui Wan Park, Jae Young Roh; J Korean Fract Soc 2010;23(2):206-212. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.206

Abstract PDF: PURPOSE
To evaluate the results of interlocking humeral nail for femur shaft fractures through the greater trochanter in older children and adolescent.
MATERIALS AND METHODS
Eleven femoral shaft fractures in ten patients were selected. They were consisted of 9 boys and 1 girl. Two patients had osteogenesis imperfecta and one patient had a simple bone cyst as an underlying disease. 7 cases were right side and 4 cases were left side. The mean age at the time of operation was 12 years and 7 months (8 years 11 months~15 years 7 months). The mean follow-up period was 21 months and interlocking humeral nail was inserted at the greater trochanter in all patients.
RESULTS
All patients had a complete bony union without any complication such as infection, nonunion, leg length discrepancy and metal failure. Avascular necrosis of femoral head and coxa valga were not developed in all patients.
CONCLUSION
Intramedullary nailing through the greater trochanter using interlocking humeral nail is effective and safe treatment for the femoral shaft fracture in older children and adolescents.

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The Combined Operative Treatment for Neglected Monteggia Fracture-Dislocation in Adolescent Period: Report of 2 cases: Churl Hong Chun, Sang Soo Kim, Jeong Min Yoo; J Korean Soc Fract 1998;11(4):964-969. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.964

Abstract PDF: There are various perative methods for the treatment of neglected Monteggia fracture-dislocation. ut, it is difficult to obtain good results by the onlyone operative method in the adolescent period. We reported two patients for the neglected Monteggia fracture-dislocation in adolescent period who were treated by the combined operative treatment. The combined operative method was, in regular sequence, the ulnar osteotomy, the fibrous tissus removed in the humeroradial joint, radial head reduction, Bell-Tawse annular-ligament reconstruction and fixating the radial head to the capitellum with the K-wire with neutral position. Finally, plate fixation in ulnar osteotomy site was done. After 3 weeks, we removed the K-wire and performed active ROM exercise. The clinical results were evaluated by Bruce scale at the follow-up 15 months and 53 months. The results were satisfactory without complications. So we canvass for this combined method about neglected Monteggia fracture-dislocation in adolescent period.

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Interlocking Intramedullary Nailing of Femoral Shaft Fractures in Adolescents: Chil Soo Kwon, Jong Kuk Ahn, Jin Hyok Kim, Byung Hyun Jung, Yerl Bo Sung, Hyung Jin Jung, Jong Deuk Rha, Woo Chun Lee, Hyun Soo Park, Myung Ho Lee, Bu Maan Kim; J Korean Soc Fract 1996;9(4):914-920. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.914

Abstract PDF: Although treatment of femoral shaft fractures by traction and casting satisfactory in young children, it is less useful in obtaining and maintaining satisfactory alignment in adolescent patients. Residual angulation, malrotation. and leg length inequality is well documented. The options for surgical treatment of femoral shaft fractures in adolescents include extemal fixation, plate fixation, and intramedullary nailing. Surgical treatments carry the-risks of growth plate damage and infection, but these risks are very low. Recently, it is generally anepted that adolescent femoral shaft fractures are preferably treated by intramedullary nailing with care taken to avoid damaging the distal femoral physis. The authors experienced 9 femoral shaft fractures in 8 patients treated with interlocking intramedullary nails from August 1989 to May 1994, and followed up for more than 18 months(range from 18 to 45 months). The results were as follows: 1. There were 6 cases in male, 2 cases in female. Average age at the time of injury was 13 years(range, 11-14). 2. All fractures were united, and the nails were removed at an average 13.3 months after operation: no refracture or femoral neck fracture has since occured. 3. None had angular or rotational malunions, infection and avascular necrosis of femoral head. The average leg-length discrepancy at the last follow-up was 0.5cm(range, 0-1.0cm) and all were clinically acceptable. Coxa valga due to premature closure of trochanteric apophysis was not found. The average femoral neck-shaft angle was 133(130~138) at the last follow-up. So, interlocking intramedullary nailing is a reasonable alternative for the treatment of femoral shaft fracture in adolescents.

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Fatigue Fracture of the Distal Femur in Adolescence: A case Report: Nam Hong Choi, Young Sun Song, Ho Min Lee; J Korean Soc Fract 1996;9(3):809-813. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.809

Abstract PDF: Fatigue fractures have been described in almost every bone in the body, but they are more common in the bones of the lower extremities. Fatigue fractures are seen mainly in military personnel especially at basic training center, athletes, ballet dancers, laborers, and even pregnant woman. But they rarely developed at the distal femur of adolescent. We report a case of fatigue fracture of the distal femur in adolescent who was associated with neithor trauma nor sports activity.

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Management of Femoral Shaft Fractures in the Adolescent: Hyoun Oh Cho, Kyoung Kuck Kwak, Sung Do Cho, Cheol Soo Ryoo, Bub Jae Lee; J Korean Soc Fract 1995;8(3):521-527. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.521

Abstract PDF: Treatment of the femoral shaft fractures in adolescents with open physis is somewhat controversial. Historically, these fractures have been treated with nonoperative methods, but adolescents are less tolerant to the prolonged irnrnobilization than younger children. Futhermore, conservative treatment in this age group may be prone to result in more complications such as malunion and shortening than that in the younger age group. Therefore many authors prefer the operative method for femoral shaft fractures in the adoleseents. The authors reviewed 22 cases of adolescent femoral shaft fractures treated during the period from January, 1958 to June 1992. Seven cases were treated conseratively, eleven by open reduction and intenal fixation with DCP, and four by closed intramedullary nailing. The patients treated with traction and casting showed more often complications such as angular deformity and bone shortening than in the operative methods. In comparing with those cases of plating, the patients of intramedullary nailing had statistically significant shorter ansthesic time and less blood loss in operation. All of the fractures treated with the intramedullary nails healed without malunion or leg length discrepancy, and there was no evidence of growth plate arrest. Results of this study suggest that closed intramedullary nailing of femur fractures in aldolescents is an effective treatment option.

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