Journal of Musculoskeletal Trauma

Comparison of the Clinical and Radiological Outcomes of TFNA (Trochanteric Fixation Nail-Advanced) and PFNA-II (Proximal Femoral Nail Antirotation-II) Treatment in Elderly Patients with Intertrochanteric Fractures: Min Sung Kwon, Young Bok Kim, Gyu Min Kong; J Korean Fract Soc 2022;35(4):162-168. Published online October 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.4.162

Purpose
Trochanteric fixation nail advanced (TFNA) was modified to compensate for the shortcomings of proximal femoral nail antirotation-II (PFNA-II). The clinical and radiological outcomes of surgeries us-ing the PFNA-II and TFNA for femoral intertrochanteric fractures were compared.
Materials and Methods
Eighty-two patients who underwent surgeries using PFNA-II or TFNA were analyzed. Only those who were followed up for more than a year were enrolled. Bone union, shortening of the femoral neck, and the tip–apex distance of the intramedullary nail were compared in the radiological findings. Clinical outcomes, including the frequency of complications and gait ability (Koval score), were also assessed.
Results
The mean follow-up periods were 22 and 19 months for the PFNA-II and TFNA groups, re-spectively. In the PFNA-II group, two cases of femoral head cut-out and one case of varus collapse were observed. In the TFNA group, only one case of femoral head cut-out was observed; however, there was no significant difference in the frequency of complications between the two groups (p=0.37). Ad-ditionally, both the shortening of the femoral neck and the decrease in gait ability after surgery showed relative improvement in the TFNA group compared to the PFNA-II group; however, there was no sig-nificant difference between the two groups.
Conclusion
The use of both TFNA and PFNA-II was associated with satisfactory outcomes. In patients who underwent surgeries using TFNA, the recovery of gait ability, frequency of complications, and short-ening of the femoral neck were not significantly different from PFNA-II, suggesting that both are suitable instrument choices for intertrochanteric fracture treatment. However, the clinical significance must be further assessed using a larger group of patients over a longer follow-up period in future studies.

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Clinical and Radiological Outcomes of Unstable Intertrochanteric Fractures Treated with Trochanteric Fixation Nail-Advanced and Proximal Femoral Nail Antirotation-II: Correlation between Lateral Sliding of the Helical Blade and Lateral Trochanteric Pain
Sung Yoon Jung, Myoung Jin Lee, Lih Wang, Hyeon Jun Kim, Dong Hoon Sung, Jun Ha Park
Journal of the Korean Orthopaedic Association.2024; 59(3): 208. CrossRef

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Subtrochanteric Fracture Reduction during Intramedullary Nailing: Technical Note: Gyu Min Kong; J Korean Fract Soc 2019;32(2):107-111. Published online April 30, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.2.107

Abstract PDF: The subtrochanteric area is the place where mechanical stress is most concentrated in the femur. When a fracture happens, bone union is delayed and nonunion often occurs. The recommended treatment for atypical fractures is an anatomical reduction of the fracture site as the frequency of nonunion is higher than that of ordinary fractures. Various reduction methods have been suggested, and good results have been obtained. On the other hand, the occurrence of posterior displacement of the distal fragment during the insertion of an intramedullary nail is often overlooked. This is probably because the bone marrow of the femur tends to form an elliptical shape in the anteroposterior direction. The author attempted to insert a blocking screw into the distal part of the fracture to prevent posterior displacement of the distal fragment while performing intramedullary nailing of the femur fracture and achieved a good reduction state easily.

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Clinical Assessment after the Volar Locking Plate Removal of Distal Radius Fracture: Hee Chul Gwak, Joo Yong Kim, Gyu Min Kong, Jung Won Kim, Jae Yong Kwak, Dong Gyun Kim; J Korean Fract Soc 2014;27(1):23-28. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.23

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the clinical outcomes after removing the volar locking plate for distal radius fracture.
MATERIALS AND METHODS
We reviewed retrospectively the medical records of 34 patients, 36 cases after removing the plates among 150 patients, with 162 cases that underwent open reduction and internal fixation using the volar locking plate between January 2006 and May 2011. We performed preoperative and postoperative clinical assessments using the quick-disabilities of the arm, shoulder and hand (Q-DASH), the visual analog scale (VAS) score, and the range of motion on wrist, grip and pinch power.
RESULTS
The major reason for plate removal was the time to remove the plate according to the fracture union and the patient's demand without other specific complaints (28 cases). The mean preoperative VAS score was 1.78 and the mean postoperative VAS score 1.81 (p=0.64). The mean preoperative Q-DASH score was 30.02 and the mean postoperative Q-DASH score 38.46 (p<0.001). The mean preoperative grip and pinch power were 18.14 kg and 7.67 kg. The mean postoperative grip and pinch power were 15.27 kg and 6.94 kg (p=0.23).
CONCLUSION
The removal of the volar locking plate for distal radius fracture should be decided by considering the patient's clinical and socioeconomic conditions carefully.

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Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis: Ki Chan An, Gyu Min Kong, Jang Seok Choi, Hi Chul Gwak, Joo Yong Kim, Sung Yub Jin; J Korean Fract Soc 2013;26(4):248-253. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.248

Abstract PDF: PURPOSE
To determine the influence of osteoporosis on the results of percutaneous K-wire fixation for distal radius fractures.
MATERIALS AND METHODS
Between March 2007 and February 2011, Fifty seven patients who underwent fixative surgery with K-wires after closed reduction and those available for follow-up for at least 6 months were reviewed. They were divided into the two groups of T score -3 or more (group 1) and T score less than -3 (group 2). These groups were compared by the range of motion of the wrist and Disabilities of the Arm, Shoulder and Hand (DASH) score. Radiologic evaluations consisting of radial length, radial inclination and volar tilt were compared. In group 1 with 34 cases, the average age was 65.4 years (50 to 78 years) and T score was -1.97 (-0.1 to -2.93). In group 2 with 23 cases, the average age was 74 years (54 to 89 years) and T score was -4.11 (-3.1 to -6.97).
RESULTS
There was no statistical difference between group 1 and group 2 in terms of range of motion, DASH score and radiologic evaluations.
CONCLUSION
In the case of no volar side cortical comminution, percutaneous K-wire fixation can be applied for the treatment of distal radius fracture with osteoporosis.

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Comparison of Bone Mineral Density in Elderly Patients according to Presence of Intertrochanteric Fracture: Sang Ho Moon, Byoung Ho Suh, Dong Joon Kim, Gyu Min Kong, Hyeon Guk Cho; J Korean Fract Soc 2007;20(3):222-226. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.222

Abstract PDF

PURPOSE
To analyze difference in bone mineral density (BMD) between intertrochanteric fracture and control group and to explore the predictive value of BMD for intertrochanteric fracture.
MATERIALS AND METHODS
57 patients who were over 60-year-old with intertrochanteric fracture were examined. For control group, 110 patients who did not have any fracture were selected. Dual energy X-ray absorptiometry was studied at 1, 2, 3, 4 lumbar vertebrae, femoral neck, trochanter and Ward's triangle. BMD was compared at each site between two groups statistically.
RESULTS
Fracture group consisted of 16 male, 41 female and was average 70.8 year old. Control group consisted of 21 male, 89 female and was average 68.1 year old. There was no differences in sex and age between two groups (p>0.05). BMD of L1, L2 and mean lumbar area were significantly less in fracture group than control group (p<0.05). There was no difference between two groups in BMD of another sites (p>0.05).
CONCLUSION
BMD of L1, L2 and mean lumbar area in fracture group had lower value significantly, but had no differences between two groups at another sites. BMD of L1, L2 and mean lumbar area might be used as the most sensitive predictive indicator for risk of osteoporotic fractures including intertrochanteric fracture in elderly patient.

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An Analysis of the Changes in Bone Mineral Density in Long-Stay Patients of a Geriatric Hospital in Relation to Physical Therapy
Sang-Min Lee, Soon-Hee Kim, Ji-Sung Kim, Joong-San Wang, Sung-Won Kim, Nyeon-Jun Kim, Sook-Hee Lee, Kyoung-Ok Min
Journal of International Academy of Physical Therapy Research.2011; 2(2): 267. CrossRef
Comparison of Bone Mineral Density in Elderly Patients over 65 Years according to Presence and Types of Hip Fracture
Myung-Ho Kim, Moon-Jib Yoo, Joong-Bae Seo, Hyun-Yul Yoo, Sang-Young Moon
Journal of the Korean Fracture Society.2010; 23(3): 263. CrossRef
The Relationship between Hip Fracture and Bone Mineral Density in Elderly Patients
Hwa Jae Jeong, Jae-Yeol Choi, Jinmyung Lee, Kyubo Choi, Byeongsam Jeon
Journal of the Korean Orthopaedic Association.2010; 45(3): 228. CrossRef
The Usefulness of Hip to Thigh Ratio as an Anthropometric Indicator for the Incidence of Hip Fracture
Jin Park, Kyu Hyun Yang, Seong Hwan Moon
Journal of the Korean Fracture Society.2009; 22(1): 1. CrossRef

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Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method: Gyu Min Kong, Byoung Ho Suh, Dong Joon Kim; J Korean Fract Soc 2007;20(2):178-183. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.178

Abstract PDF

PURPOSE
To evaluate the result of joint depression type of intraarticular calcaneal fractures treated with Essex-Lopresti method.
MATERIALS AND METHODS
From March 2001 to February 2005, Thirty two patients' joint depression type of intraarticular calcaneal fractures which treated with Essex-Lopresti method were clinically and radiographically evaluated retrospectively.
RESULTS
According to Creighton-Nebraska Health Foundation Assessment Score (C-N score), there were 5 excellent, 11 good, 6 fair and 10 poor results. BÃ¶hler angle was corrected from 10.3 degrees to 24.5 degrees. There was a positive correlation between size of depressed fragment and C-N score (p<0.01).
CONCLUSION
Essex-Lopresti method can substitute open reduction methods in joint depression type of intraarticular calcaneal fractures which have relatively large depressed joint fragments.

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Treatment of Calcaneus Fractures: Recent Trend for Acute Fractures and Complications
Woo-Chun Lee
Journal of the Korean Fracture Society.2007; 20(4): 361. CrossRef

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Treatment of Tibial Fractures In Children With Pin and Plaster Technique: Byoung Ho Suh, Gyu Min Kong, Sang Ho Moon, Dong Joon Kim, Jin Woo Kwon, Se Won Park; J Korean Fract Soc 2005;18(3):325-329. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.325

Abstract PDF: PURPOSE
To evaluate the result of tibial shaft fractures in children treated with pin and plaster method.
MATERIALS AND METHODS
From March 1998 to February 2003, Tibial shaft fractures in thirty six pediatric patients which were treated with pin and plaster method were clinically and radiologicaly evaluated retrospectively.
RESULTS
Mean bony union duration was 9.8 weeks. All fractures healed within acceptable angulations. There was neither delayed union nor nonunion. There were complications related to the pins, including superficial and deep infection, skin sloughing. There were 7 cases of tibial overgrowth but they had no functional disability.
CONCLUSION
Pin and plaster method can substitute other operative methods in tibial fractures in children which is difficult to reduce or maintain reduction by conservative treatment.

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Treatment of Lateral Malleolar Fractures using Minimally Invasive Plate Osteosynthesis Technique: Dong Joon Kim, Byoung Ho Suh, Jin Woo Kwon, Gyu Min Kong, Sang Ho Moon, Jong Moon Bae; J Korean Fract Soc 2005;18(3):286-290. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.286

Abstract PDF

PURPOSE
To evaluate the efficacy and complication of minimally invasive plate osteosynthesis (MIPO) technique for lateral malleolar fracture.
MATERIALS AND METHODS
From January 2001 to December 2003, we had treated 13 cases of lateral malleolar fracture (AO-OTA classification, type A: 4, type B: 9) by MIPO technique and followed them up more than 1 year. Operation time, union time, radiologic alignment, range of motion of the ankle joint, functional results according to criteria of Meyer and complication were evaluated.
RESULTS
After the final follow-up, all the fractures were healed without any second procedure, full-weight bearing ambulation was started in average 10 weeks. Any malunion was not observed by the inadequate bending of plate. Two patients felt a discomfort of ankle because the location of plate was lower than the tip of the lateral malleolus, but all the patients had excellent or satisfactory ankle functions. No deep infection or soft tissue compromise were observed at the last follow up.
CONCLUSION
Minimally invasive plate osteosynthesis technique is safe and worthwhile method in management of lateral malleous fractures while avoiding the complications associated with conventional open plating methods.

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Percutaneous Plating of Weber B Fibular Fractures
Amol Saxena, Andrew Yun
The Journal of Foot and Ankle Surgery.2017; 56(2): 366. CrossRef
Minimally invasive percutaneous plate osteosynthesis for ankle fractures: a prospective observational cohort study
Robinson Esteves Santos Pires, Cyril Mauffrey, Marco Antônio Percope de Andrade, Leonardo Brandão Figueiredo, Vincenzo Giordano, João Carlos Belloti, Fernando Baldy dos Reis
European Journal of Orthopaedic Surgery & Traumatology.2014; 24(7): 1297. CrossRef

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Differences of Bone Mineral Density between Spine and Hip in Osteoporotic Patients: Gyu Min Kong, Sang Eon Lee, Dong Jun Kim, Tae Hyun Yoon; J Korean Fract Soc 2005;18(2):181-184. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.181

Abstract PDF

PURPOSE
To evaluate differences and correlations of spine and hip region BMD in osteoporotic patients with or without spine fracture.
MATERIALS AND METHODS
From January 1999 to December 2002, We measured and evaluated BMD of L3 and hip by DXA in 52 patients with spine fracture (fracture group) and 96 osteoporotic patients without spine fracture (non-fracture group) above 60 years.
RESULTS
The average age of patients with spine fracture is 72.1 years and without spine fracture is 66.9 years. There were no statistical significant differences of BMD of spine, neck of femur and trochanteric area between 2 groups. But the BMD of Ward triangle of fracture group decreased significantly in statistics. The correlation coefficient between the lumbar spine and trochanteric area were 0.674 in fracture group and 0.794 in non-fracture group. They had statistical significance (<0.01).
CONCLUSION
The BMD of Ward triangle of fracture group had lower value, but the BMD of lumbar spine had no differences between 2 groups. Therefore in these persons who have decreased BMD in Ward triangle should be concerned about high vertebral compression fracture risk vertebral compression fracture.

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Comparison of vertebral and femoral bone mineral density in adult females
Han Seong Choe, Jae Hong Lee, Dong Ki Min, So Hong Shin
Journal of Physical Therapy Science.2016; 28(6): 1928. CrossRef
Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis
Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin
Journal of the Korean Fracture Society.2013; 26(4): 248. CrossRef
Comparison of Bone Mineral Density in Elderly Patients over 65 Years according to Presence and Types of Hip Fracture
Myung-Ho Kim, Moon-Jib Yoo, Joong-Bae Seo, Hyun-Yul Yoo, Sang-Young Moon
Journal of the Korean Fracture Society.2010; 23(3): 263. CrossRef
Comparison of Bone Mineral Density in Elderly Patients according to Presence of Intertrochanteric Fracture
Sang Ho Moon, Byoung Ho Suh, Dong Joon Kim, Gyu Min Kong, Hyeon Guk Cho
Journal of the Korean Fracture Society.2007; 20(3): 222. CrossRef

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