Journal of Musculoskeletal Trauma

Cause and Treatment of Extraarticular Proximal Tibial Nonunion: Sung Soo Kim, Sung Keun Shon, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Lih Wang, Im Sic Ha; J Korean Fract Soc 2008;21(4):279-285. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.279

Abstract PDF: PURPOSE
To analyze the factors affecting the nonunion of extraarticular proximal tibial fracture and the outcome of nonunion treatment.
MATERIALS AND METHODS
We investigated 51 cases of extraarticular proximal tibial fractures from June 2002 to May 2006. The nonunion rate was assessed in relation to several risk factors and the treatment outcome of nonunion using plate fixation with bone graft was assessed by Klemm and BOrner functional rating system.
RESULTS
6 cases of nonunion (11.8%) was noted among 51 cases, and the risk factors examined, OTA A3 comminuted fracture was associated with a high nonunion rate with statistical significance and initial bone graft had a significant effect in bone healing. Excellent and good results were obtained in 5 cases (83.3%) and bone union was achieved in all nonunion cases.
CONCLUSION
Comminution was found to be an important factor affecting the nonunion in extraarticular proximal tibial fracture, and bone graft in primary operation could reduce the chance of nonunion. Accurate plate fixation with bone graft is a reliable option in nonunion treatment.

Extra-articular Triplane Fracuture of the Distal Tibia in Children: Yeo Hun Yun, Hoon Jeong, Yi Kyoung Shin, Sung Gu Yeo; J Korean Fract Soc 2005;18(4):459-461. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.459

Abstract PDF: PURPOSE
To demonstrate the effectiveness of the conservative treatment which was introduced to the extraarticular triplane fractures of the distal tibia.
MATERIALS AND METHODS
We reviewed radiographs and medical records of eight patients with extraarticular triplane fractures of the tibia. Four patients were treated with closed reduction and internal fixation and the others with closed reduction and plaster.
RESULTS
In all patients, the union of fractures was obtained. Although the physes were closed early, there was no angular deformity or leg length discrepancy.
CONCLUSION
In case of extraarticular triplane fracture, except for open fracture or failure of closed reduction, conservative treatment yield good result.

Treatment of Intercondrlar Fracture of Elbow using Y-Plate through Extraartieular Olecranon Osteotomy in the Posterior Approach: Ho Guen Chang, Sang Su Lee, Eung Ju Lee, Jun Dong Chang, Won Ho Cho, Chang Ju Lee; J Korean Soc Fract 1996;9(4):1118-1124. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1118

Abstract PDF: Iniercondylar fractures of the distal humerus in adults are rare and notoriously difficult to treat. We treated 8 patients by open reduction and internal fixation using Y-plate with extraarticular olecranon osteotomy in posterior approach. L-shaped osteotomy was performed at the extraarticular portion of olecranon with triceps tendon insertian remained to proximal portion of it, using air-saw. The follow-up period ranged from 12 to 30 months with average of 19.7 months. The fractures were dassified according to AO classification. The results were evaluated using Jupiter et al grading system. 1) There was no loosening of fixation Cevice of humeral condyle and olecranon. 2) Niether delayed union nor nonunion of olecranon and humeral condyle were found. 3) Exellent grade was achieved in 4 patients(50%), three(38%) had good, and one(12%) poor. Flexion-extension arc ranged from 60 degree to 120 degree with mean of 98.8 degree. 4) Complications included postoperatile neuritis in one, myositis ossificance in one, and heterotopic bone in one patient. Authors would introduce the method and result of extraarticular olecranon osteotomy in posterior approach for the intercondylar fracture of distal humerus, as a new technique.

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