Journal of Musculoskeletal Trauma

Bone Union Time of Simple Distal Femur Fractures in the Elderly according to Fracture Gap after Treated with Minimally Invasive Plate Osteosynthesis: Young Ho Cho, Sangwoo Kim, Jaewook Koo; J Korean Fract Soc 2023;36(4):133-138. Published online October 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.4.133

Abstract PDF: Purpose
This study examined the difference in bone union time according to the fracture gap after minimally invasive plate osteosynthesis (MIPO) for simple distal femoral fractures in elderly patients.
Materials and Methods
From January 2010 to December 2019, patients aged 60 years or older who underwent surgical treatment for distal femoral fractures due to a low-energy injury were investigated retrospectively. Forty patients were enrolled in the study. The patients were divided into two groups according to the fracture gap after reduction: no more than 2 mm (Group A) and more than 2 mm (Group B) in the anteroposterior and lateral plane. The demographic, operation time, presence or absence of cerclage wiring, plate screw density, plate span ratio, plate length, bone union period, non-union, and complications were evaluated.
Results
No statistical differences in operation time, cerclage wiring, plate screw density, plate span ratio, and plate length were observed between the two groups, and the bone union was achieved in all patients without complication. The bone union period was 17.24±1.48 weeks in Group A and 24.53± 5.20 weeks in Group B, which was statistically significant (p<0.001).
Conclusion
The bone union time in treating geriatric simple distal femur fractures using the MIPO tech-nique was significantly shorter in the 2 mm or less fracture gap than in the greater than 2 mm group.

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Treatment of Wide Gap Non-Unions in Lower Extremities: Doohoon Sun, Byeong Seop Park, Taehyeon Jeon, Seung Koo Rhee; J Korean Fract Soc 2017;30(1):1-8. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.1

Abstract PDF: PURPOSE
To analyze the end results of the treatment for patients with wide gap non-unions of the long bones in the lower extremities.
MATERIALS AND METHODS
A total of 62 cases of wide gap unions, with a mean age of 38 years, were included for analysis. Study cohort included six children under the age of seven years. The average size of established bone defect was 7 cm (4-23 cm). Bone defects under 7 cm were treated with plating and various bone grafts, and those over 7 cm were managed with vascularized fibular graft (VFG), distraction-osteogenesis, tibial strut, plating and etc. Two boys with a defect of the whole tibia but with an intact fibula were treated with tibialization of intact fibula and with rotation-plasty of the leg. Their end results were evaluated by the time of bony union in accordance with the treatment of defect size of the long bone as well as their age.
RESULTS
Bony unions were obtained for an average period of at least 27 months. Fifty-one cases showed an average leg-length discrepancy of 2.8 cm, and 11 cases showed no leg-length discrepancy. The VFG, distraction-osteogenesis, and tibial cortical-strut graft and plating were the most effective methods for non-unions of wide, long bone defections (>7 cm). The prognosis was more favorable in children, muscular femur, and in cases with tibial defect but intact fÃ bula.
CONCLUSION
Various bone union techniques should be considered carefully, considering the ages of patients and the size of bone defects. Due to severe physical and mental disabilities of patients during the long-treatment period, specialized orthopedic doctors for trauma and mental care were necessary.

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Effect of Fracture Gap on Biomechanical Stability of Compression Bone-Plate Fixation System after Bone Fracture Augmentation: Duk Young Jung, Sung Jae Lee, Seon Chil Kim, Jong Keon Oh; J Korean Fract Soc 2010;23(2):220-226. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.220

Abstract PDF: PURPOSE
The goal of this study using the biomechanical test was to evaluate the mechanical stability of the bone-plate fixation system according to changes of the fracture gap sizes and widths.
MATERIALS AND METHODS
For mechanical test, four types with different fracture models simulating the clinical situations were constructed depending on the gap size (FGS, mm) and the gap width (FGW, %) at the fracture site: 0 mm/0%, 1 mm/100%, 4 mm/100%, 4 mm/50%. For analyzing the effects of fracture gap on the biomechanical stability of the bone-plate fixation system, 4-point bending test was performed under all same conditions.
RESULTS
It was found that the fracture gap sizes of 1 and 4 mm decreased mechanical stiffness by about 50~60% or more. Furthermore, even without fracture gap size, 50% or more fracture gap width considerably decreased mechanical stiffness and suggested the possibility of plate damage through strain results.
CONCLUSION
Our findings suggested that at least 50% contact of the fracture faces in a fracture surgery would be maintained to increase the mechanical stability of the bone-plate fixation system.

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A Finite Element Analysis of Biomechanical Stability of Compression Plate Fixation System in according to Existing of Fracture Gap after Bone Fracture Augmentation: Duk Young Jung, Bong Ju Kim, Jong Keon Oh; J Korean Fract Soc 2010;23(1):83-89. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.83

Abstract PDF

PURPOSE
This study using the finite element analysis (FEA) focused on evaluating the biomechanical stability of the LC-DCP in accordance with existing of the fracture gap at the facture site after bone fracture augmentation.
MATERIALS AND METHODS
For FEM analysis, total eleven types with different fracture models considering clinical fracture cases were constructed according to the fracture gap sizes (0, 1, 4 mm)/widths (0, 25, 50, 75, 100%). Limited contact dynamic compression plate (LC-DCP) fixation system was used in this FEM analysis, and three types of load were applied to the bone-plate fixation system: compressive, torsional, bending load.
RESULTS
The results in FEM analysis showed that the 1, 4 mm fracture gap sizes and 75% or more fracture gap widths increased considerably the peak von Mises stress (PVMS) both the plate and the screw under all loading conditions. PVMS were concentrated on the center of the LC-DCP bone-plate, and around the necks of screws.
CONCLUSION
Based on the our findings, we recommend at least 50% contact of the fracture faces in a fracture surgery using the compression bone-plate system. Moreover, if x-ray observation after surgery finds 100% fracture gap or 50% or more fracture gap width, supplementary measures to improve biomechanical stability must be taken, such as restriction of walking of the patient or plastering.

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Application of Patient-Specific 3D-Printed Orthopedic Splint for Bone Fracture in Small Breed Dogs
Kwangsik Jang, Eun Joo Jang, Yo Han Min, Kyung Mi Shim, Chunsik Bae, Seong Soo Kang, Se Eun Kim
Journal of Veterinary Clinics.2023; 40(4): 268. CrossRef

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Fracture of Olecranon Treated by K-wire and Tension Band Wiring Technique in Adults: Hak Yeong Jeong, Seung Wook Yang, Jae Woong Shim, Beyong Seon Kong; J Korean Soc Fract 1997;10(3):651-657. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.651

Abstract PDF: Displaced fractures of olecranon in adults require operative treatment. The goal of treatment is to rigidly fix the fracture fragment, to anatomically restore the joint surface and to allow range of motioin early. Authors treated fractures of olecranon by open reduction and internal fixation using K-wire and tension band wiring technique in 38 adult patients from April 1989 to October 1995 at the Department of Orthopedic Surgery, Maryknoll Hospital. This article documents the study of relationship between the treatment result and involvement of articular surface, articular step-off and gap of articular surface. The results were as follows ; 1. The clinical results were good or fair in 31 cases(82%) according to the criteria by Helm et al. 2. Involvement of articular surface, step-off and gap of articular surface affected the results. 3. The clinical results were satisfactory in patients with postoperative step-off less than 2mm and postoperative gap of articular surface less than 2mm. 4. The clinical results were satisfactory in patients with articular involvement less than 60%.

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