Journal of Musculoskeletal Trauma

Treatment of Ankle Fracture and Dislocation: Chan Kang; J Korean Fract Soc 2022;35(1):38-49. Published online January 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.1.38

Abstract PDF: Ankle fractures are the most common type of foot and ankle fracture injury. Several types of fractures occur in the ankle structures (medial malleolus, lateral malleolus, posterior malleolus, and Chaput’s tubercle) with various mechanisms and extent of fracture force. Moreover, fractures can be accompanied by other injuries, such as distal tibiofibular syndesmotic injury, medial deltoid ligament rupture, and lateral ligament complex rupture. Ankle dislocation can be accompanied when an injury is caused by a greater fracture force. Non-surgical treatments or combined surgeries may be performed depending on the mechanism and fracture type. Generally, a stable fracture maintaining anatomical reduction is treated conservatively, but surgical treatment is performed when this is not the case. Furthermore, surgeries for stable fractures can be offered when the patients demand early weight bearing due to their occupation, age, and performance state. Restoring the ankle mortise in its anatomical shape before the injury and starting early rehabilitation for functional recovery simultaneously until a union is achieved is important. Traumatic arthritis can occur if the treatment focuses only on fractures and neglects ligament injuries, such as distal tibiofibular syndesmotic injury and medial deltoid ligament rupture. Shortening, angular deformation, and rotational deformation of the fibular promote the progression of traumatic ankle arthritis in the long term, which may further cause chronic ankle pain. An overlooked displaced posterior malleolus fracture also causes traumatic arthritis through anteroposterior instability of the ankle joint.

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The Treatment of Acromioclavicular Dislocation Comparison Study between Bosworth Screw and Wolter Plate Technique: Jae Do Kang, Kwang Yul Kim, Hyung Chun Kim, Kyung Chil Jung, Mun Sup Lim, Jin Hyung Kim, Seong Joo Lee; J Korean Soc Fract 2003;16(4):548-554. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.548

Abstract PDF: PURPOSE
Acromioclavicular joint dislocation are frequently seen and various operation treatment modalities have been suggested. The purpose of this study is to compare the clinical results of two operative methods, Bosworth screw procedure and Wolter plate technique.
MATERIALS AND METHODS
We have analysed 30 patients with acromioclavicular dislocations, which had been treated by Bosworth screw & Wolter plate technique from June 1996 to February, 2002 with minimal 1 year follow up. All patients were assessed clinical and radiological results by ASES Score and UCLA Score.
RESULTS
Using the Shoulder evaluation scheme of ASES and UCLA Score at the one year follow up examination, 93.4% of the patients had excellent results in Wolter plate group. In Bosworth screw group, 4 complications such as loosening of the screw, or breakage of screw were seen. 2 complicated patients were over 40 years old and then conversions to Wolter plate operation was needed and obtained good results.
CONCLUSION
Bosworth procedure has a merit not to damage acromioclavicular joint, but the technique is difficult, sometimes may be encountered loss of fixation due to overcorrection and anterior displacement of the clavicle. However, Wolter plate implant provides enough stability for active postoperative physiotheraphy, and hence accelerates rehabilitation. Therefore, this technique is thought to be a good modality in the treatment of acute acromioclavicular seperation.

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Comparison of Surgical Treatment for Acromioclavicular Joint Dislocation: Tae Woo Park, Sung Do Cho, Yong Sun Cho, Bum Soo Kim, Sogu Lew, Jong Ken Woo; J Korean Soc Fract 2002;15(1):59-64. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.59

Abstract PDF: PURPOSE
To evaluate the result of modified Bosworth method augmented with Mersilene tape(MBM) compared with modified Bosworth method(MB).
MATERIALS AND METHODS
Thirty two acromiclavicular dislocation wrer treated with MB(15cares) or MBM(17 cases) and the mean follow up period was 26 months(12-43 months). We assessed the radiological and clinical evaluation(X-Ray & Weitzman Criteria) and complications.
RESULTS
Twenty nine cases(91%)(MB 13, MBM 16) were "excellent" or "good" according to the Weitzman criteria. At last follow-up, mean difference of the coracocalvialar distance between the normal and the injured site were 1.9mm(MB) and 1.6mm(MBM) and two ceses were developed the arthritis, and then performed the distal clavicle resection.
CONCLUSION
Modified Bosworth method augmented with Mersilene tape is a good option for acromioclavicular dislocation in stabilizing the joint, even if the screw loosening occurs with early postoperative ROM.

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Results Following The Surgical Treatment of Acromioclavicular Joint dislocations; A Comparison of Phemister With Bosworth Operation: Jin young Park, Suk Joo Lyu, Ki Hyuk Moon, Myung Ho Kim; J Korean Soc Fract 1998;11(1):8-15. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.8

Abstract PDF: To compare the results the Bosworth with Phemister operation, we performed the Bosworth operation in 7 case and then Phemister operation in 9 case serially from 1994 to 1997 and followed them up postoperatively. The average follow-up was 19.2 months, with the longest being 32 months, and the shortest being 12 months. The extraarticular coracoclavicular fixation was done with a cancellous screw in Bosworth operation, the transarticular fixation with two or three Kirschner wires in Phemister operation and the coracoclavicular ligaments were sutured to all patient in phemister operation group. The average immobilization period 6.8 weeks(S.D.:1.0 weeks) in Bosworth operation, 6.5 weeks(S.D.:1.4 weeks) in Phemister operation. The cancellous screw or the Kirschner wires were removed in 12.6 weeks(S.D.:1.6 weeks) postoperatively in Bosworth operation, 11.8 weeks(S.D.:1.7 weeks) in Phemister operation and physiotheraphy was progressed to obtain the full range of motion. All of the patients were evaluated on a subjective(pain, night pain, medication. instability, activities of daily living), objective(range of motion) and roentgenographic(degree of displacement) basis at last follow-up. Shoulder function was assessed according to the shoulder score devised by the American Shoulder and Elbow Surgeons. The pain of Shoulder persisted remained in 1 case of Bosworth operation and in 3 cases of Phemister operation. The night pain around acromioclavicular joint was remained in 2 cases of Phemister operation. Average shoulder function index in Bosworth operation was 95 points and in Phemister operation 87 points. Average range of motion of Bosworth operation was 176degree (S.D.:9degree in forward elevation, 68degree(S.D.:11degree in external rotation, 88.6degree(S.D.:12degree in cross-rotation at 90degreeabduction, 22cm (S.D.:11cm) in cross-body adduction and T9 in internal rotation and Phemister operation 147degree(S.D. 18degree in forward elevation, 72degree S.D.:12degree in external body adduction and T8 in internal ratation. All of the patients were satisfied for results of operation. After surgery, loss of reduction was found in 3 of 7 in Bosworth operation and all of the patients were over 40 years and then conversions to Phemister operation was needed. According to short-term follow-up we prefer the transarticular Phemister method and Bosworth operation may be avoided in patients over 40 yeras old.

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Operative Treatment for Acromiclavicular Joint Dislocation: Bum Soo Kim, Sung Do Cho, Ki Bong Kim; J Korean Soc Fract 1998;11(1):1-7. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.1

Abstract PDF: Acoromioclavicular dislocation occurs frequently in young athletes and recently in automobile accident victims and laborers, and there are various kinds of operative methods for this injury. Authors performed operative treatment for 45 cases of acromioclavicular dislocation: 30 cases of modified Phemister operation and 15 cases of modified Bosworth operation from March 1992 to June 1996. Authors analysed the result of the treatment and the results obtained were as follows. 1. The clinical results evaluated by Weitzman criteria were all satisfactory in both modified Phemister method and modified Bosworth method. 2. The radiologic results were evaluated by the difference of the distance from the coracoid process to the clavicle between the normal and the injured site. And the result was more satisfactory in modified Bosworth method. 3. There were less complications in modified Bosworth method.

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The Treatment of Acromioclayicular Dislocation Comparison Study between Modified Bosworth and Phemister Technique: Kun Yung Lee, Myung Sik Park, Keun Kwon Kang, Myung Kon Nami; J Korean Soc Fract 1995;8(1):193-198. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.193

Abstract PDF: Acromioclavicular joint injuries are frequently seen with increase of traffic & industrial accidents & sports injury recently, There are many procedures which described for the treatment of acromioclavicular dislocation, but there are still controversies concerning the best treatment of the injuries. We have analysed 35 patients with acromioclavicular dislocations had been treated by modified Bosworth & Phemister technique at the department of orthopedic surgery Lee-Rha general hospital from June 1990 to December 1993 with minimal 1 year foll up The authors had obtained following results as modified Phemister technique and modified Bosworth technique treatment for acromioclavicular joint. 1. The complications were as follows: superficial infection at insertion site of k-wire and migration of k-wire in modified Phemister technique and loosening of screw and erosion of clavicle noted in modified Bosworth tecnique. But, there were no specific difference between two groups for pain and motion of shoulder joint. 2. In modified Bosworth technique, it was not necessary to fix the acromioclvicular joint with k-wire and also possible to perform early mobilization of shoulder joint than modified Phemister tecnique.

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