Journal of Musculoskeletal Trauma

Reverse V step-cut osteotomy for the correction of cubitus varus in adults: a retrospective study: Jinyoung Bang, Hyung Jun Koo; J Musculoskelet Trauma 2025;38(2):102-108. Published online April 25, 2025; DOI: https://doi.org/10.12671/jmt.2025.00045

Abstract PDF: Background
Cubitus varus deformity in adults most commonly occurs as a late complication resulting from malunion of distal humeral fractures sustained during childhood. This deformity can cause cosmetic problems and anatomical deformities that hinder normal sports activities and potentially lead to long-term complications. Although various surgical techniques exist for correcting cubitus varus, this study investigated the clinical and functional outcomes of reverse V step-cut osteotomy.
Methods
In total, 15 patients underwent surgical treatment with reverse V step-cut osteotomy between 2012 and 2023. The mean age of the patients at the time of surgery was 46.3 years (range, 20–65 years). The preoperative carrying angle was ‒11.09° of varus, which was corrected to +12.81° of valgus postoperatively. The mean preoperative lateral prominence index (LPI) was ‒10.03, and the mean postoperative LPI improved to ‒4.48. A comparison to the unaffected side showed a P-value of 0.978, indicating similarity.
Results
Preoperatively, eight patients exhibited signs of posterolateral rotatory instability, and among them, three underwent concomitant lateral ulnar collateral ligament reconstruction. Seven patients reported ulnar nerve symptoms, and all underwent concurrent ulnar nerve release. Postoperatively, improvements in elbow pain, instability, and ulnar nerve symptoms were observed. One patient required reoperation due to malunion and insufficient correction, but no other complications were noted.
Conclusions
These outcomes demonstrate that reverse V step-cut osteotomy can be an effective treatment method for cubitus varus deformity in adults. Level of evidence: IV.

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Comparison of the Surgical Treatment Results of Avulsion Fracture of the Anterior Cruciate Ligament between Children and Adults: Eun Kyoo Song, Sang Jin Park, Keun Bae Lee; J Korean Fract Soc 2007;20(2):196-201. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.196

Abstract PDF: PURPOSE
To compare the clinical and radiological results after surgical treatments of the avulsion fractures of ACL between children and adults.
MATERIALS AND METHODS
40 cases (18 cases of children, 22 cases of adults), who underwent surgical treatments after avulsion fractures of the ACL and followed up more than one year, were enrolled. Fractures were classified by modified Meyers & McKeever criteria. Range of motion, LK score, Lachman test, Pivot-Shift test, quadriceps muscle atropy and TelosÂ® stress arthrometer were compared.
RESULTS
The types of fracture in children were categorized into 8 cases of type II, 10 cases of type III, and 2, 15, 5 cases of type II, III, IV each in adult group. Mean LK score showed significant difference between 99.3 points in children and 89.5 points in adults (p<0.05). In addition, accompanied injuries and the high degree of fracture leaded low LK score. However, there was no significant difference in range of motion, Lachman test and Pivot-Shift test. Anterior laxity by TelosÂ® device showed an average of 2.0 mm in children, 2.5 mm in adults (p>0.05).
CONCLUSION
Children group showed better treatment results of avulsion fracture of ACL. Higher incidence of type II fractures and less combined injuries considered to be factors for better results.

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Conservative Treatment of the Displaced Clavicular Shaft Fracture in Multiple Injury: Hyun Dae Shin, Kwang Jin Rhee, Young Mo Kim, Se Min Woo, Ho Sup Song; J Korean Fract Soc 2004;17(4):333-337. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.333

Abstract PDF: PURPOSE
To analyse the comparative clinical results between adults with multiple injury including the clavicular shaft fracture and only clavicular shaft fracture who had supportive care through retrospective aspect.
MATERIALS AND METHODS
We had 48 adult patients in this hospital with simple fracture and multiple injury including the clavicular shaft whom we were able to evaluate at least more than a year. 12 of 48 patients were with only clavicular shaft fracture and the rest of them were with multiple injury. We classified patients into two groups those who had fracture with displacement for group A (A1 for the cases with over 50% of fracture surface contact rate and A2 for less than 50% from the images of simple X-ray) and those who had comminuted fracture for B. We compared the time of bone union, nonunion rate of only clavicular fractures and multiple injury, clinical results for patients who had supportive care with retrospective aspect.
RESULTS
A1 (7 cases), A2 (4 cases), B (1 case) were prevalent in the group of only clavicular shaft fracture and A1 (8 cases) and A2 (16 cases) and B (12 cases) were prevalent in the group of multiple injury. For the cases with supportive care, we could find 1 nonunion case (8%) and 11 union cases on average 2.91 months in the group of only clavicular shaft fracture and 7 nonunion cases (19%) and 29 union cases on average 3.58 months in the group of multiple injury. The best clinical results had occurred in 8 cases (67%) of only clavicular shaft fracture group and 19 cases (53%) of multiple injury group. We could find out the union from all 8 nonunion cases that took operation afterward.
CONCLUSION
Although the choice of treatment of clavicular fracture is supportive care, but multiple injury including the clavicular fracture is a high-energy injury, so the possibility of comminuted and displacement is high, so that nonunion rate is high. The possibility of early surgery must be considered seriously.

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Operative Treatment of Intraarticular Fracture of Distal Humerus in Adults: Hyon Oh Cho, Kyoung Duck Kwak, Soo Min Sohn, Woo Keun Jeong, Jong Cheong Choi; J Korean Soc Fract 1999;12(4):975-980. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.975

Abstract PDF: The fractures around the elbow joint in adults are relatively rare in comparision with that in childeren, but the late complications are more common in adults. We have clinically and radiologically analyzed 14 cases of fractures around the elbow joint in adults from January 1995 to December 1998. All patients were treated by open reduction and application of medial and lateral bottress plates providing stable internal fixation enhance early motion. The patients were evaluated for range of motion, infection, pain, degenerative changes. The 14 patients were available for follow-up study for average of 12 months. The result were good in nine, fair in two, poor in three. Traetment of choice for the type III and IV of distal humerus fracture is open reduction with stable internal fixation with plates combined with early active motion.

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Treatment of the Humeral Shaft Fracture in Adult: Sung Keun Sohn, Silng Soo Kim, Sung Wan Kim, Jin Gu Kim; J Korean Soc Fract 1997;10(3):628-633. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.628

Abstract PDF

It has been generally agreed that most fractures of the humeral shaft are treated non-operatively, but recently the rate of operative treatment was increased due to high incidence of segmental fracture and combined injury. Authors analyzed 47 cases of the humeral shaft fracture in adults that treated from May 1990 to May 1994 at the Department of Orthopaedic Surgery, College of Medicine, Dong-A University. The results were as follows : 1) The mean age was 38.5 years and the most common cause of injury was traffic accident in 23 cases(48.9%). 2) The most common type of fracture was spiral or oblique fracture in 17 cases(36.2%). 3) Six cases were treated conservatively, 29 were treated operatively after failure of attempt to treat conservatively, and 12 were treated only operatively. 4) The mean time of the conversion from conservative treatment to operative treatment was 3.7 weeks after treatment, the causes of failure in conservative treatment were assumed incooperative on fracture care and muscular weakness in elderly patient, severe angular deformity and displacement after trauma. 5) In the conservative treatment group, clinical union was accomplished at 8.2weeks and the mean radiological union at 14.6 weeks, while in operative treatment group, the clinical union at 7.6 weeks and the radiological union at 13.5 weeks. 6) In radial verve palsy, complete or incomplete ruptures were found in 4 cases among 6 exploratioins, so we think that early exploration is considerable option.

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Result of Early Active Range of Motion Exercise after Bankart Repair of Traumatic Anterior Instability
Haeng Kee Noh, Jong Woong Park, Jung Il Lee, Jung Ho Park
Journal of the Korean Fracture Society.2007; 20(1): 53. CrossRef

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Operative Treatment of Elbow Fractures and Dislocations in Adults: Sang Ho HA, Sang Hong Lee, Dong Min Shin, Young Bae Pyo, Pan Ok Kim; J Korean Soc Fract 1997;10(1):119-126. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.119

Abstract PDF: The elbow is highly constrained and stable joints in the body, but dislocation is not uncommon due to trauma such as traffic accident and sports injury. The relative incidence of associated fractures in previously reported series of elbow dislocations has ranged from 12% to 62%. Post-traumatic sequelae of the elbow fractures and dislocations are joint stiffness, nerve injury, non-union and heteroDopic ossification. Operative procedures for repair and reconstruction of the injured elbow are technically demanding and require careful planning. Because of the proximity of crucial neurovascular structures, a thorough knowledge of the anatomy and extensile exposure is essential. Thirteen adult patients with elbow dislocation associated with fractures about the elbow from June 1990 to June 1995 who had taken operative treatment were studied. The results were as follows ; 1. Most common direction of dislocation is posterior(8 cases) and most common associated fracture is radial head & neck fracture(7 cases). 2. Most common and disabling complication is limitation of motion(7 cases). 3. By the Mehlhoffs criteria, with regard to limitation of motion, pain, instability and neurovascular deficit, relatively good results are obtained at 9 cases(69%). 4. For better functional results, early reduction of dislocation, stable fixation of fracture and early motion is essential option in the management of elbow fractures and dislocations.

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Multiple Knowles Pin Fixations of the Femoral Neck Fractures in Adults under 60 Years of Age: Sang Won Park, Kwang Suk Lee, Dae Gon Wie; J Korean Soc Fract 1996;9(4):859-868. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.859

Abstract PDF: Femoral neck fracture is more common in elderly even by minor trauma because of osteoporosis. In young adults, though the incidence is low, have a poor prognosis because of high incidence of non-union and aseptic necrosis. The treatment method of the femur neck fracture is widely divided into internal fination and replacelnent arthroplasty But there is still contrversies present in the treatment methods. The object of this study is to observe the relationships between the clinical outcomes and the age, the degree of displacement. the type of reduction, the time of operation and the bone density in the femoral neck fractures treated with mulliple Knowles pin fitation. The authors analyzed 29 cases of femoral neck fractures in adults under 60 years of age, who were treated with multiple pih (ixation and followed up more than 1 yearduration The results obtained were as follows; 1. The union of femoral neck fracture occured in 19 cases(65.5%) among the 19 cases and the mean duration of union was 4.8 months. 2. The complications were 8 cases(21.6%) of avascular necrosis, 2 cases(6.9%) of non-union, 2 cases of malunion and 1 case of post-traumatic arthritis. 3. The functional results by Lunceford criteria were satisfactory in 17 cases (58.6%). 4. In the patient group which were no avascular necrosis and non-union showed 89.5% of satisfactory functional end result. 5. There was a relationship between the complications such as avascular necrosis and non-union, and age of the patient, bone density, degree of initial displacement and type of reduction. But the duration between the injury and operation did not influence the complication rate. According to the above results, we concluded that multiple Knowles pin fination in femoral neck fracture is simple and safe method, and one of salvaging method of femoral head in adults under 60 years of age.

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Clinical analysis of fractures around the elbow joint in adults: Duck Yun Cho, Joong Myung Lee, Hee Chun Kim, Hyeong Jin Kim; J Korean Soc Fract 1995;8(2):430-438. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.430

Abstract PDF

The fractures around the elbow joint in adults are relatively rare in comparision with that in children, but the late complications are more common in adult. So, it is important to select the appropriate early management to prevent the late sequelae. Complications are joint contracture, persistant pain, nonunion, deformity, neurologic symptom, infection. etc. Among them limited range of joint motion is the main problem. We, authors have clinically and radiologically analyBed 48 cases of fracture around the elbow joint in adults over the age of 20 years, treated at the Department of Orthopaedic Surgery in National Medical Center from January 1984 through December 1993. The results are as follows: 1. The age incidence was higher in active young persons and the male to female ratio was 3:2. 2. The most common cause of the injury was slip-down(46%), followed by traffic accident(29fo), falling, and athletic injury. 3. In total 48 cases, olecranon fractures were 29 cases, fractures of distal humerus 13 cases, radial head fractures 5 cases, and multiple fractures (including olecranon, radial head and intercondyle) was 1 case, Among them. open fractures were 5 cases. 4. Closed reduction with cast immobilization or K-wire fixation was performed in 8 cases, and open reduction and internal fixation was performed in 37 cases. In 3 cases. radial head resection was done. 5. The most common complication was limited range of the joint motion (9cases), followed by nerve injury(3 cases), infection(3 cases) and nonunion(1 cases). 6. Development of limited range of joint motion was increased in case of old age over 60 years(33%), open fracture(60%), longer immobilization period over 6 weeks(27%). Though fracture around the elbow joint in adult is reletively rare. it frequently results in limitation of the joint motion and has poor prognosis For prevention of limitation of joint motion, rigid fixation and shortening of immobilization period and early rehabilitation are necessary.

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Treatment of Ulnar Olecranon Fracture Using Acutrak Screw
Hyungchun Kim, Kwangryul Kim, Moonsup Lim, Youngil Park, Inhwan Hwang, Jihoon Lee
Journal of the Korean Fracture Society.2009; 22(4): 270. CrossRef

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Clinical Study on Monteggia fracture in Adults: Hyung Ku Yoon, Kwang Pyo Jeon, Kuk Whan Oh, Dae Eun Jung, Kyung Hoon Kang, Nam Kil Cho; J Korean Soc Fract 1994;7(1):29-36. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.29

Abstract PDF: In 1814, Monteggia first desHribed a fracture of proximal third of the ulna with dislocation of radial head, and Bado classified and included all fracture of ulna at any level with a dislocation of radial head under the name of Monteggla lesion In 1967. In adults, the prognosis Is poor due to many complications such as nerve injury, unreduced radial head, heterotrophic ossification, nonunion and malunion. The most important factors In achieving good results in adult Monteggia lesions are early accurate diagnosis, rigid internal fixation of the ulna and complete reduction of the radial head as soon as possible. The authors reviewed 12 cases of Monteggia fracture In adults who were treatod at department of orthopaedic surgery, Sung-Ae General hospital from 1989 jan. to 1991 Dec. with 17 months mean follow-up. The results obtained were as follows: 1. Male was 10 cases and female 2 cases. 2. The causes of injury were traffic accident In 9 cases, machinery injury in 2, fall down in 1 3. Location of ulna fracture was as follows; metaphysis was 4, proximal 1/3 in 6 cases, proximal 1/3 junction in 1, metaphysls and proximal 1/3 in 1. 4. According to Bado classificatlon, type I was 58%. type II 25%, tyre III 17%, type IV 0%. 5. Treatments of dislocated radial head were closed reduction in 9 Gases open reduction in 1 case, and excision in 2 cases. 6. Fractures of ulna were all treated with open reduction and internal fixation with plate in 9 cases. IM nailing in 1 case, tension band wiring in 2 cases. 7. Palsy of posterior interosseous nerve was in 2 cases with complete recovery within 6 months. 8. The results(Bruce, et. at) 17 month follow-up in average were 2 excellent, 5 good, 2 fair and 3 poor.

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Bipolar hemiarthroplasty as secondary procedure for femoral neck fractures in young adults: Sung Joon Kim, Il Yong Choi, Heung Ryong Oh; J Korean Soc Fract 1991;4(2):237-242. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.237

Abstract PDF: No abstract available.

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