Journal of Musculoskeletal Trauma

Minimal Invasive Fixation Methods for the Metacarpal Fracture: Ki Youn Kwon, Jin Rok Oh, Ji Woong Kwak; J Korean Fract Soc 2022;35(1):9-15. Published online January 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.1.9

Abstract PDF: Purpose
This study compared the radiologic and clinical outcomes of metacarpal fractures treated with two minimally invasive surgical techniques: Kirschner wire (K-wire) fixation and headless screw fixation.
Materials and Methods
This study included 52 patients (46 males and 6 females; age 18-55 years) with distal metacarpal fractures (middle and distal shaft, including the neck) who had undergone K-wire fixation or headless screw fixation. All subjects were followed up for at least six months. The radiologic assessments were performed to evaluate the angular deformity and shortenings. The total active motion (TAM), grip strength, and patients’ subjective functional assessment were measured to evaluate the hand function. The time taken to return to work (RTW) and adverse events were analyzed.
Results
Of the 52 cases, metacarpal fractures treated with headless screw fixation and K-wire fixation showed a significant difference associated with early RTW (p<0.05). There were no significant differences between the subjects treated with K-wire fixation and those with headless screw fixation in terms of the radiologic measurement, hand function examinations, complications, and adverse events (p>0.05).
Conclusion
After a six-month follow-up, minimally invasive K-wire fixation and headless screw fixation produced similar clinical and radiologic outcomes in subjects with metacarpal fractures. Compared to K-wire fixation, however, headless screw fixation led to earlier functional recovery and might be a better option for treating metacarpal fractures in this regard.

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Risk Factors Affecting the Early Complications of Femoral Head Fractures: HoeJeong Chung, Jin-Woo Lee, Dong Woo Lee, Hoon-Sang Sohn; J Korean Fract Soc 2020;33(4):204-209. Published online October 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.4.204

Abstract PDF: Purpose
This study analyzed the prognostic factors in patients with femoral head fractures by comparing two groups with and without complications.
Materials and Methods
A retrospective study was performed on femoral head fracture patients who visited two different level-1 trauma centers from January 1, 2014 to June 30, 2018. Thirty-three patients with a follow-up period of more than one year were included. Early complications were defined as fair or poor in the Thompson–Epstein clinical evaluation criteria and grades 3 or 4 in the Kellgren– Lawrence classification within one year after the fracture. The patients were divided into two groups, with and without early complications. Statistical analysis was performed for the nominal variables with a Fisher’s exact test and continuous variables using a Mann–Whitney U test.
Results
Nine patients (27.3%) had early complications, and there were no significant differences according to age, sex, treatment method, combined fractures, Pipkin classification, and AO/OTA classification between the two groups.
Conclusion
The prognosis in femoral head fractures is difficult to predict. Therefore, the validation of existing classifications or a new classification is necessary.

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Femoral Head Fracture with Hip Dislocation Treated by Autologous Osteochondral Transfer (Mosaicplasty) - A Case Report -: Eui-Sung Choi, Hyun-Chul Shon, Ho-Seung Jeong, Jae-Young Yang, Seok-Hyun Hong, Byung-Hyun Ahn; J Korean Fract Soc 2020;33(2):96-100. Published online April 30, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.2.96

Femoral head fractures combined with hip dislocation are very rare injuries. In most cases, they result from high-energy trauma to the hip or lower extremity during traffic accidents. Various therapy options have been suggested to treat these injuries. Especially, different joint-preserving surgical options have been described for the treatment of traumatic osteochondral injury of the femoral head in young, active patients. In this report, we present a case that a traumatic osteochondral lesion to the femoral head after hip dislocation was treated with osteochondral autografts (OATS) from the non-weight-bearing area of the ipsilateral inferior femoral head through a surgical hip dislocation. After 1 year, the clinical and radiological outcome was satisfactory with no evidence of posttraumatic osteoarthritis and no pain of patients.

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Femoral head fracture with large crushed defect in weight-bearing area treated with autologous osteochondral transplantation (repositionplasty): A case report
Hyun-Chul Shon, Eic-Ju Lim, Jae-Young Yang, Seung-Jun Jeon
Medicine.2022; 101(52): e32569. CrossRef

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Open Reduction and Internal Fixation in Comminuted Radial Head Fracture: Jun Ku Lee, Tae Ho Kim, Choongki Kim, Soo Hong Han; J Korean Fract Soc 2019;32(4):173-180. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.173

Abstract PDF

PURPOSE
Radial head fractures, which account for 33% of all fractures, are treated depending on the Mason classification. In comminuted type 3 fractures, open reduction internal fixation (ORIF), and radial head arthroplasty are the treatment options. This study examined the clinical outcome of modified Mason type 3 radial head fractures using ORIF with a plate.
MATERIALS AND METHODS
The medical records and image of 33 patients, who underwent ORIF for modified Mason type 3 radial head fractures, were reviewed retrospectively. The preoperative plain radiographs and computed tomography images were used to examine the location of the fracture of the radial head, the number of fragments, union, joint alignment, and traumatic arthritis at the final follow-up. The range of motion (ROM) of the elbow at the last follow-up, pain score (visual analogue scale), modified Mayo elbow score (MMES), and complications were analyzed for the clinical outcome.
RESULTS
Of the 33 cases, 14 were men and 19 were women. The mean age was 41.8 years and the average follow-up period was 19 months. The functional ROM was divided into three groups according to the number of bone fragments: 141.2Â°Â±9.3Â° of 3 (n=20), 123.8Â°Â±18.5Â° of 4 (n=7), 100.7Â°Â±24.4Â° of more than 4 (n=6). Furthermore, the MMES were 88.2Â±2.9, 83.7Â±4.3, and 77.3Â±8.4, respectively (p=0.027). Depending on the radial head fracture location, the ROM and MMES were 130.7Â°Â±7.5Â° and 82.1Â±4.7, respectively, with poor outcomes on the ulnar aspect compared to 143.1Â°Â±3.8Â° and 89.9Â±3.2 on the radial aspect.
CONCLUSION
Various factors, such as the degree of crushing and location involved in the clinical outcome. In particular, the result was poor in the case of more than four comminuted fragments or chief position located in the ulnar aspect. In this case, radial head arthroplasty may be considered in the early stages.

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Does the coronoid fracture in terrible triad injury always need to be fixed?
Yeong-Seub Ahn, Seong-Hwan Woo, Sungmin Kim, Jun-Hyuk Lim, Tae-Hoon An, Myung-Sun Kim
BMC Surgery.2024;[Epub] CrossRef
Results of the Use of Bioabsorbable Magnesium Screws for Surgical Treatment of Mason Type II Radial Head Fractures
Chul-Hyung Lee, Seungha Woo, Hyun Duck Choi
Clinics in Orthopedic Surgery.2023; 15(6): 1013. CrossRef

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Avulsion Fracture of the Posterior Cruciate Ligament from Femoral Insertion Occurred in a Patient with Residual Poliomyelitis: A Case Report: Wonchul Choi, Taesup Kim; J Korean Fract Soc 2018;31(4):149-153. Published online October 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.4.149

Abstract PDF: Avulsion fracture of the posterior cruciate ligament from its femoral insertion is quite rare, particularly in adults, and the treatment guidelines have not been established. A 68-year-old female patient with residual poliomyelitis presented with an avulsion fracture of the femoral insertion of the posterior cruciate ligament after a falling accident and was treated with arthroscopic headless compression screw fixation and pull-out suture of the avulsed ligament. We report this case with a relevant discussion of this type of injury.

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Pediatric Cartilaginous Tibia Eminence Fracture Overlooked on Plain Radiograph: A Report of Two Cases: Seong Eun Byun, Yunseong Choi, Wonchul Choi; J Korean Fract Soc 2017;30(1):29-34. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.29

Abstract PDF: In children with open physis, avulsion fracture of the tibia eminence, as an anterior cruciate ligament (ACL) injury, is more commonly observed than an ACL rupture. Pure cartilaginous avulsions of the ACL tibia insertion seldom occurs. In such case, cartilaginous lesion is frequently overlooked or misdiagnosed on plain radiograph and may result in a less favorable treatment outcome. We report two cases of cartilaginous tibia eminence fractures of the children that were initially overlooked from plain radiographs, and then diagnosed by magnetic resonance imaging, which was ultimately treated by arthroscopyassisted headless compression screw fixation.

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The Short Term Results of Radial Head Arthroplasty with Unipolar Loose Fit Stem: Su Keon Lee, Kyeong Seop Song, Seung Hwan Lee, Sang Pil Yoon, Sang Youn Lim; J Korean Fract Soc 2015;28(2):125-131. Published online April 30, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.2.125

Abstract PDF: PURPOSE
We report short-term results of radial head prosthesis using a unipolar loose fit stem in ten patients.
MATERIALS AND METHODS
Ten patients with Mason type three radial head fracture, who received unipolar radial head arthroplasty from February 2010 to June 2011, were evaluated (mean follow-up: 22 months, range: 18-30 months). Subjects consisted of five men and five women. Range of elbow motion was measured. Mayo elbow performance index (MEPI) score was used for functional evaluation and periodic radiological imaging was performed to evaluate the stability of implant.
RESULTS
After an average follow-up of 22 months, elbow stability was maintained in all cases, and the average range of motion of elbow flexion and extension was 6 to 130 degrees. Average range of pronation and supination was 66 and 74 degrees, respectively. MEPI score was evaluated as excellent in seven cases, and good in three cases. On final follow-up, radiological assessment showed implant stability in all cases without evidence of dislocation, subluxation, arthritis, periprosthetic osteolysis or heterotopic ossification.
CONCLUSION
Based on our short-term follow-up, radial head arthroplasty with unipolar loose fit stem is a useful method for obtaining satisfactory outcome for unreducible comminuted radial head fractures.

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Result of Surgical Treatment for the Femoral Head Fracture: Joon Soon Kang, Kyoung Ho Moon, Tong Joo Lee, Jong Hyuck Yang; J Korean Fract Soc 2014;27(3):198-205. Published online July 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.3.198

Abstract PDF: PURPOSE
This study analyzed the clinical and radiological long-term follow-up results of patients with femoral head fracture who received surgical treatments.
MATERIALS AND METHODS
Retrospective evaluation was performed for 20 patients with femoral head fracture who received surgical treatments between December 1997 and May 2010. According to Pipkin's classification, there were five type I, six type II, one type III, and eight type IV fractures.
RESULTS
The average Merle d'Aubigne'-Postel score was 12.8 (12.80+/-3.53). According to surgical method, the score for the bony fragment excision group was 9.8 (9.83+/-2.79), and that for the open reduction and internal fixation group was 13.9 (13.92+/-3.07). Depending on Thompson-Epstein criteria, two patients were good, two were fair, and two were poor in the bony fragment excision group. Four patients were excellent, six were good, and three were poor in the open reduction and internal fixation group.
CONCLUSION
Bony fragment excision should be performed with caution in patients with femoral head fracture. Considering fragment size, location, and presence of acetabular fracture, better outcome can be expected using the open reduction and internal fixation method in comparison with excision.

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Surgical Management of Comminuted Avulsion Fracture of the Proximal Fibula with Lateral Collateral Ligament Injury: Technical Note: Jong Min Kim, Byeong Mun Park, Sang Hoo Lee, Seung Ju Jeon, Jun Beum Shin, Kyeong Seop Song; J Korean Fract Soc 2013;26(1):77-80. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.77

Abstract PDF

Anteromedial force to the knee in an extended position can cause an avulsion fracture of the proximal fibula with combined injuries to the posterolateral ligaments. Avulsion fractures of the proximal fibula are rare and current management of these fractures is based on few descriptions in literature. Various surgical methods of fixation for these fractures have been reported, but there is still no standard treatment modality. Anatomic reduction of these fractures is technically difficult, and failure of reduction may cause posterolateral instability, secondary arthritis and other complications. We present our experience with two such cases of comminuted avulsion fractures of the proximal fibular with posterolateral ligament ruptures surgically fixated with a locking compression hook plate and non absorbable sutures.

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Fixation of fibular head avulsion fractures with the proximal tibiofibular screw: Technique guide and clinical experience
Ryan A. Paul, Shu Yang Hu, Ananya Pathak, Ryan Khan, Daniel B. Whelan
Trauma Case Reports.2025; 57: 101175. CrossRef
Treatment of avulsion fractures around the knee
Jeong-Hyun Koh, Hyung Keun Song, Won-Tae Cho, Seungyeob Sakong, Sumin Lim
Journal of Musculoskeletal Trauma.2025; 38(2): 63. CrossRef
Treatment of Avulsion Fractures around the Knee
Sumin Lim
Journal of the Korean Fracture Society.2024; 37(2): 117. CrossRef

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Osteochondral Autograft Using Head of Proximal Phalanx of Toe for Partial Osteochondral Defect of Proximal Interphalangeal Joint: A Case Report: Tong Joo Lee, Kyung Ho Moon, Yoon Sang Jeon, Do Seung Kwon; J Korean Fract Soc 2010;23(3):321-325. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.321

Abstract PDF: Osteochondral injury due to the trauma of the hand is relatively common. If the size of the osteochondral fracture fragment is large, open reduction and internal fixation are often feasible in treating these problems. However, arthroplasty using osteochondral graft is more preferred when the particle is small and articular surface is comminuted or fully defected. There are many reports of osteochondral graft using the costal osteochondral graft but the osteochondral graft using the interphalangeal joint of the toe is rarely reported. Thoroughly reviewed with relevant articles, this report presents a case of a 33 year old male who was successfully treated with osteochondral autograft using the proximal interphalangeal joint of the toe due to the traumatic osteochondral defect in the head of the second proximal phalanx.

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Posterior Hip Dislocation with Ipsilateral Fractures of the Femoral Head and Intertrochanter: A Case Report: Jai Hyung Park, Hyung Soo Kim, Soo Tae Chung, eong Hyun Yoo, Joo Hak Kim, Seung Do Cha, Tae Woo Lee; J Korean Fract Soc 2010;23(1):113-117. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.113

Abstract PDF

High-energy injury, as traffic accident or fall down, can cause fracture of femur head and posterior dislocation of hip joint which is accompanied with ipsilateral acetabulum fracture or femur neck fracture. But the case that femur head fracture and posterior dislocation of the hip joint coincide with ipsilateral intertrochanteric fracture of proximal femur is so uncommon that reports of the case is very rare. We hereby are to report the experienced and treated-cases of femur head fracture and posterior dislocation of the hip joint that is accompanied with ipsilateral intertrochanteric fracture.

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Decoding the behaviour of extracapsular proximal femur fracture- dislocation - A systematic review of a rare fracture pattern
Keyur B. Desai
Journal of Clinical Orthopaedics and Trauma.2021; 18: 157. CrossRef

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Alterations in Serum Levels of Receptor Activator of Nuclear Factor-kappa B Ligand and Osteoprotegerin in Patients with Head Injury and Fracture: Shin Young Park, Kuen Tak Suh, Chang Hoon Ryu, Seung Hun Woo, Jung Sub Lee, Seong Gang Kim; J Korean Fract Soc 2008;21(2):145-150. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.145

Abstract PDF

PURPOSE
Receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG) have been shown to be important regulators of osteoclastogenesis during bone remodeling, and their expressions were examined during fracture healing in a mouse model of tibial fracture. However, studies linking RANKL and OPG in patients with head injury and fracture are lacking. We evaluated the changes in serum levels of RANKL and OPG in patients with head injury and fracture (head injury group) and in patients with fracture (fracture group) and compared these with levels found in healthy control subjects.
MATERIALS AND METHODS
18 male patients of head injury and fracture and 20 male patients of fracture alone were enrolled. 20 healthy men were recruited to serve as controls. Within the first few hours of admission to hospital, at 4, 8 and 12 weeks after injury 20 ml of blood were obtained from 18 patients with head injury and fracture and 20 patients with fracture only.
RESULTS
RANKL levels were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury. OPG levels were significantly higher in the head injury group than in the fracture group at 4, 8 and 12 weeks after injury. RANKL/OPG ratios were significantly lower in the head injury group than in the controls immediately after and 4, 8 and 12 weeks after injury, and were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury.
CONCLUSION
We have shown changes in the profiles of RANKL, OPG and RANKL to OPG ratio. The altered RANKL, OPG and RANKL/OPG ratio in the head injury group lasted longer than in those of the fracture group.

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Affirmative Effect of Hwaweo-jeon (Huayu-jian) in Osteoblast Cells and Tibia Fracture-induced Mice
Soo-Hwan Lee, Kira Parichuk, Yun-yeop Cha
Journal of Korean Medicine Rehabilitation.2020; 30(1): 13. CrossRef

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The Operative Treatment of Radial Head or Neck Fracture: The Sub-classification of Mason Type II Fracture: Hyun Dae Shin, Kyung Cheon Kim, Se Min Woo, Yong Bum Joo, Dong Kyu Kim; J Korean Fract Soc 2006;19(4):449-453. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.449

Abstract: PURPOSE
To evaluate the results of treatment according to the sub-classification of the Mason type II fracture.
MATERIALS AND METHODS
From 1999 to 2003, according to the sub-classification of the Mason type II fracture, 33 patients were treated with miniplate in displaced neck fracture (IIa), with compression screw in displaced head fracture (IIb), with miniplate and/or compression screw in displaced head and neck fracture (IIc), with compression screw and miniplate in comminution fracture (III) or excision of head in irreducible state. The clinical results were evaluated by An and Morrey's functional rating index.
RESULTS
Functional rate score averaged 92.7 in type IIa, 88.4 in IIb, 86.4 in IIc, 83.5 in type III with reduced fracture, 75.0 in type III with excised head, and 75.5 in type IV. Complications included heterotopic ossification (2 cases), metal loosening (1 case), malunion (1 case), partial ankylosis of elbow (3 cases), posttraumatic arthritis (1 case).
CONCLUSION
These results supported the recommendation for internal fixation with compression screw in isolated radial head fracture (IIb) and with miniplate in fracuture combined with displaced neck (IIa, IIc, indicated some III). We concluded that sub-classification is useful for dicision making in radial head or neck fracture's treatment.

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Elbow Dislocation Combined with Coronoid Process and Radial Head Fracture: Sung Tae Lee, Jin Hyung Choi, Joong Bae Seo, Jin Young Park; J Korean Fract Soc 2005;18(4):437-442. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.437

Abstract PDF: PURPOSE
To evaluate the clinical outcome for terrible triad injury of the elbow joint. MATERIAL AND METHODS: We reviewed consecutive 10 cases retrospectively among 12 terrible triad injuries, which had been followed up for a minimum 1 year. The average age at the time of injury was 45 years (range, 32~72). All cases were dislocated posteriorly. The 3 cases had fracture of olecranon. Combined medial and lateral approach was performed in 3 cases, medial and lateral approach after extensile posterior approach in 4 cases, transolecranon approach using existed olecranon fracture in 2 cases, and transolecranon approach in 1 case were done.
RESULTS
The average Mayo elbow performance score was 87, with 5 excellent, 4 good, and 1 poor results. Results by Riseborough and Radin's rating criteria include 9 good and 1 fair. The 8 cases were stable. But 2 cases were classified with moderate and severe instability; these cases had been performed by radial head allograft and excision respectively.
CONCLUSION
A stable, functional elbow can be restored in terrible triad injury by early active rehabilitation after anatomic reduction and firm internal fixation.

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The Treatment of Mason Type II Radial Head Fractures using Closed Reduction and K-wire Fixation: Byung Ki Kwon, Song Lee, Dong Ki Ahn, Joon Seong Park, Sang Kyu Cha; J Korean Fract Soc 2004;17(3):277-282. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.277

Abstract PDF: PURPOSE
To analyze the clinical results of the treatment of Mason type II radial head fractures using closed reduction and K-wire internal fixation under C-arm guide by radiologically and functionally.
MATERIALS AND METHODS
Between March 2001 and October 2003, 7 patients with Mason type II radial head fracture were treated by closed reduction and internal fixation using K-wires under C-arm guide. The average age of the patients was 38 (5 to 57) years old, and average duration of follow up was 20 (5 to 36) months. At last follow up, we evaluated the radiological results and functional results by classifying excellent, good, fair and poor according to functional rating system of Broberg and Morrey.
RESULTS
The range of motion of the elbow at last follow up, average flexion contracture was 1.4 (0 to 10) degrees, further average flexion was 146.4 (140 to 150) degrees, average supination was 74.2 (70 to 80) degrees and average pronation was 75 (70 to 80) degrees. In the functional results, 6 cases were excellent and 1 case was good. In the radiological evaluations, the average time of union was 5 (4 to 6) weeks after the operation and no serious complication was occurred in any cases.
CONCLUSION
In the treatment of Mason type II radial head fracures, closed reduction and K-wire internal fixation under C-arm guide was an effective method of treatment with satisfactory results and no complications.

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Clinical Applications of Autologous Cultured Osteoblasts: Case Report: Seok Jung Kim, In Young Ok, Cheong Ho Chang, Young Sik Kim, Jae Deog Jang, Won Jong Bahk, Joo Hyung Lee; J Korean Fract Soc 2004;17(2):197-201. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.197

Abstract PDF: We treated 3 cases of fracture and 1 case of avascular necrosis of femoral head using autologous cultured osteoblasts injection. The stromal cells from the bone marrow were cultured to differentiate to osteoblasts for 4 weeks. The fracture sites of each patients were right ulnar shaft, left radial shaft, and left 5th metatarsal base. All of the fractures showed callus formations after 1 week of osteoblasts injection to the fracture site. After 4 weeks, callus formations were progressed. Avascular necrosis of femoral head was bilateral and both were Ficat stage II. Core decompression and allograft impaction were performed to the left, and core decompression and autologous cultured osteoblasts injection percutaneously after 4 weeks of the decompression operation were done to the right femoral head. CT images of 1 year from the operations showed trabecular bone formation and well maintained femoral head contour of the right femur, but resorption of the grafted bone for the left.

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Fracture of the Medial Epicondylar Apophysis of Distal Humerus with Subluxation of the Radial Head: A Case Report: Han Yong Lee, Kee Won Rhyu, Jin Young Jeong, Joo Hyoun Song, Hae Seok Koh, Yong Koo Kang, Mun Ik Sohn; J Korean Soc Fract 2003;16(2):304-307. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.304

Abstract PDF: It has been known that fracture of medial epicondylar apophysis of distal humerus may be isolated or associated with elbow dislocations. We have experienced a case which medial epicondylar fracture of the distal humerus was associated with subluxation of the radial head. Initially, we had tried reduction of subluxated radial head by closed method, but failed. Finally open reduction had been performed. At 6 month after open reduction, clinical and radiological result were excellent. As it is difficult for those associated injuries to occur simultaneously and the similar cases never have been reported yet, we would like to present this case with a review of the literature.

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Treatment of bone cystic change with femoral head fracture in Neurofibromatosis patient: Jae Do Kang, Hyung Chun Kim, Chi Wook Kyoung, Hyun Chul Seo; J Korean Soc Fract 2002;15(3):427-431. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.427

Abstract PDF: Cystic change on femoral head and neck in neurofbromatosis patient is rare case. Scoliosis is the most common bony lesion. Others are appeared at changes of out feature in long bone shaft. Bone cyst with bone fracture are treated with non operation or external fixation, osteotomy, curettage, partial and complete excision of cyst capsule, steroid injection therapy, bone graft, internal fixation, arthroplasty. We have experienced a case of bone cystic change on femoral head and neck with femoral head fracture and acetabular lesion in neurofibromatosis patient treated with total hip arthroplasty who was acceptable result.

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Adverse Effect of the Absorbable Rods in Treatment of the Radial Head & Neck Fractures: Weon Ik Lee, Jun Dong Chang, Soo Joong Choi, Byeong Kook Lee, Young Jin Seo, Chang Ju Lee; J Korean Soc Fract 2002;15(3):414-420. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.414

Abstract PDF: PURPOSE
We report complications occurred from 6 patients among 14 patients who received the operation for their radial head and neck fractures by using the absorbable rod made by poly-glycolic acid(PGA).
MATERIALS AND METHODS
We analyze the postoperative results of 14 patients who recieved fixation by absorbable rod for the radial head and neck fractures from March 1991 to March 2000. All of the fractures were are reducible and modified Mason 's type II.
RESULTS
After average 15 months follow up, flexion contracture was average 20 degrees and full flexion was average 130 degrees. Complications were occurred in 6 cases. Osteolysis was occurred in 3 cases and in 2 cases among theses 3 cases, radial head excision was performed. Synovitis was occured in other 3 cases and in one case joint fluid was drainaged from operation wound for 2 weeks and in other 2 cases, synovitis was progressed to arthritis.
CONCLUSION
The absorbable rod made of PGA in radial head and neck fracture have relatively high rate of adverse tissue responses. So surgeon should consider adverse tissue response of PGA. Development of more biocompatible absorbable and slow degrading material should be needed.

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Treatment of intertrochanteric fractures with bipolar hemiarthroplasty in the elderly: Kyou hyeun Kim, Duk hwan Kho, Joon ho Yang, Dong heon Kim; J Korean Soc Fract 2001;14(2):174-180. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.174

Abstract PDF

PURPOSE
To compare the timing of ambulation, complications and functional results between the autogenous femoral head graft and the calcar replacement type stem in the severe comminuted fracture of the elderly patients with unstability.
MATERIALS AND METHODS
25 intertrochanteric femoral fracture patients who had bipolar hemiarthroplasty were followed for more than 1 year. 17 patients had autogenous femoral head graft and 8 patients had calcar replacement type stem.
RESULT
The mean operating time for autogenous femoral head graft was 1.7 hours, and calcar replacement type stem was 1.3 hours. Postoperative Harris functional score was 84.1 for the autogenous femoral head graft group and 82.2 for the calcar replacement type stem group.
Discussion
: Both autogenous femoral head graft augmentation and fixation using the calcar replacement type stem result in rigid fixation, which enables the patients to ambulate early and to have low complication rate. Both techniques seem to be effective for the treatment of intertrochanteric fractures.

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Analysis of Missed Fractures by Bone Scan in Elderly Hip Fracture Patients with Osteoporosis
Tae Hun Lee, Yeong Hyun Lee, Seo Won Kang
Journal of the Korean Fracture Society.2024; 37(3): 144. CrossRef
Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -
Chae-Hyun Lim, Young-Yool Chung, Jeong-Seok Kim, Chung-Young Kim
Hip & Pelvis.2013; 25(1): 44. CrossRef
Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years - The Factors Influencing the Postoperative Mortality -
Jun-Dong Chang, Je-Hyun Yoo, Sang-Soo Lee, Tae-Young Kim, Kyu-Hak Jung, Yong-Kuk Kim
Hip & Pelvis.2010; 22(4): 283. CrossRef

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Comparison of radial head excision and open reduction & internal fixation for comminuted radial head & neck fracture: Jae Gune Jun, Chul Hyung Lee, Sung Jun Han, Sang Seon Lee, Won Tae Choi, Ho Rim Choi, Jeong Woung Lee; J Korean Soc Fract 2001;14(1):106-112. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.106

Abstract PDF: PURPOSE
The goals of the present study were to compare of radial head excision and open reduction k internal fixation for comminuted radial head & neck fracture.
MATERIALS AND METHODS
From march 1993 to February 1999, Patients with fracture of radial head (Mason type III) who were treated at Dae-Jeon Sun General hospital were enrolled in the study. The average duration of follow up was 3 years and 3 months. Six patients(Group A) were treated with radial head excision and fourteen patients(Group B) were treated with open reduction and internal fixation.
RESULTS
By functional rating index(modified After B.F. Morrey et al), in Group A, the results were classified as excellent(1 patient), good(No patient), fair(2 patients), and poor(3 patients), and in Group B, excellent(4 patients), good(5 patients), fair(3 patients), and poor(2 patients).
CONCLUSION
We concluded clinically to obtain better outcome in group which were treated with open reduction and internal fixation than radial head excision. Therefore, though the treatment of choice for Mason type III radial head fracture was total excision, in consideration of complication, procedure to preserve radial head was desirable. We must give careful consideration to possibility of open reduction and decision of radial head excision.

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Reconstruction of Neglected Traumatic Radial Head Dislocation in Children: Dong Yeon Lee, Tae Joon Cho, In Ho Choi, Chin Youb Chung, Young Jin Sohn; J Korean Soc Fract 2000;13(4):1024-1032. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1024

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the clinical result of surgical reconstruction of the old traumatic radial head dislocation in children, and to delineate the optimal surgical procedure for it.
MATERIALS AND METHODS
Fifteen cases of the old traumatic radial head dislocation were included in this study, which had surgical reconstruction at the age of 15 years or less. Preoperative and postoperative clinical symptom, range of joint motion, and radiologic findings were reviewed. Reconstructions were performed by combination of various procedures, and the advantages and disadvanges of each procedures were analyzed.
RESULTS
All the preoperative complaints were relieved by the operation. In twelve cases out of 15, the radial head reduction was well maintained. The reasons for the loss of reduction were non-union of ulnar osteotomy site, and the neglected angular deformity at the proximal radius. Although forearm pronation was decreased in most cases, they did not affect most of the daily activities except in cases where the radioulnar osseocartilaginous bridge were complicated.
CONCLUSION
Our results justify the surgical reconstruction of neglected traumatic radial head dislocations in children. Complete clearing of radiocapitellar joint, accurate bony realignment and rigid fixation, appropriate annular ligament reconstruction, and temporary fixation with transcapitellar pin may ensure satisfactory result.

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Radial Head Dislocation With Ipsilateral Radial Shaft Fracture: A Case Report: Keun Woo Kim, Yong Hoon Kim, Hak Jin Min, Ui Seoung Yoon, Hee Oh Kim, Jae Hee Kim; J Korean Soc Fract 2000;13(3):570-575. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.570

Abstract PDF

Radial head dislocation with ipsilateral radial shaft fracture is one of the reportable trauma case with very low incidence. Only 4 cases of this type injury have been reported worldwide. In 3 cases of them, good results were achieved after early closed reduction of the radial head, followed by internal fixation of the radial shaft. In the a u t h o r s'case, the patient received the same method of treatment mentioned at the previous successful 3 cases. But after that, he suffered from repeated dislocations and finally nonunion of the fracture. At last, the authors could obtain bony union and stable elbow joint after radial head resection and osteosynthesis using autologous cancellous bone graft, but resulted in limitation of motion. We report the case and the experience of treatment.

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Delayed radial head dislocation after radial shaft fracture fixation: a case report and review of the literature
Jiyong Yang, Jie Zhang, Zhengzhong Yang
BMC Surgery.2022;[Epub] CrossRef

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Posterior Hip Dislocation with Femoral Head and Neck Fracture: You Sung Suh, Jae Hoon Lee, Soo Jae Yim, Yon Il Kim; J Korean Soc Fract 2000;13(3):423-431. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.423

Abstract PDF: PURPOSE
In the femoral head fracture associated with posterior dislocation of hip, we analyzed the clinical results according to the fracture types and treatment methods to promoting the guide of treatment.
MATERIALS AND METHODS
We used 20 cases of fractured femoral head with posterior dislocation of hip from January 1990 to December 1997, and analyzed the treatment methods and clinical results according to the Pipkin classification.
RESULTS
Among the 20 cases, male was 19 cases(95%), motor vehicle accident contributed 15 cases(75%), and the case of type II and IV of Pipkin classification were 7(35%) and 9(45%) cases. Closed reduction performed within 12 hours after injury with good results was conducted in 9 cases(60%) among the 15 cases. According to the treatment methods after closed reduction, good result was showed only 3 of 8 cases(37.5%) in the conservative treatment, whereas 8 of 12 cases(66.7%) in the operative treatment. According to the type of Pipkin classification, good result was showed 3 of 6 cases(50%) in conservative treatment and all of 3 cases in operative treatment among the 9 cases of type I and II, whereas none of 2 cases in conservative treatment and 5 of 9 cases(56%) in operative treatment among the 11 cases of type III and IV. The following complications were encounted; 2 cases of avascular necrosis, 1 case of traumatic arthritis, 1 case of peroneal nerve palsy and 1 case of nonunion CONCLUSION: Good results were obtained in patients with early, stable, and accurate reduction. The Computed Tomogram was helpful to find the small fragment and check the accurate reduction. Open method that restoration joint congruity seemed to be the better procedure than closed method.

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Results of Treatment of Fracture-Dislocations of Elbow: Dong Soo Kim, Soon Ho Hwang, Chil Soo Kwon, Jong Kuk Ahn, Byung Hyun Jung, Yerl Bo Sung, Jae Kwang Yum, Hyung Jin Chung; J Korean Soc Fract 2000;13(1):178-185. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.178

Abstract PDF: PURPOSE
: This study analyzed clinical and biomechanical data from patients with elbow fracture dislocation to correlate long-term objective result with the specific injury type and treatment rendered. This can provide a basis for the management of this difficult injuries.
MATERIALS AND METHODS
: Fifteen patients with elbow dislocation were studied from October, 1992 to October, 1997 in Sang-Gye Paik Hospital. The average duration of follow up was 4.2 years.
RESULTS
: On the basis of an objective functional grading score that included elements of pain, motion, strength, and stability, the results were excellent in five(33%), good in five(33%), fair in one(7%), poor in four(27%). Prolonged immobilization greater than four weeks was associated with poor results. The results were closely related to the combined injuries and duration of immobilization. In case of radial head fractures, the best result was obtained in patients with Mason type II fractures treated by open reduction and internal fixation using Herbert screw and early complete radial head excision. SUMMARY AND CONCLUSION : The most common combined injury is radial head fracture. Early complete radial head excision and encouraging early ROM had more satisfactory result than delayed radial head excision or internal Fixation for Mason type III fracture.

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Open Reduction and AO Miniscrew Fixation of Displaced Radial Head Fractures in Adults: Jae Do Kang, Kyung Chil Jung, Chi Wook Kyoung; J Korean Soc Fract 2000;13(1):146-151. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.146

Abstract PDF: PURPOSE
: To analyze the results of open reduction and AO miniscrew fisation in displaced radial head fractures in adults. Materials & Methods : We analyzed 10 cases of displaced radial head fractures who were operated with open reduction and AO miniscrew fixation from January 1996 to March 1998. All of the fractures were classified in the Mason classification. The functional rating index was used in follow-up assessment.
RESULTS
: Average flexion was 143.5degrees, and the mean fixed flexion deformity was 3.5 degrees. The average elbow score was 95.6 points Good or excellent results were achieved in 100%. No patient had evidence of valgus instability.
CONCLUSION
: We concluded that open reduction and internal fixation in Mason type II and reparable Mason type III radial head fractures gives satisfactory range of motion and stability in the elbow joint. We suggest that anatomical reduction of fracture fragments, rigid fixation, early mobilization and proper implant placement are important for the restoration of the elbow function

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Operative Treatment of Radial Head Fracture of Mason type III: Ho Jung Kang, Moon Soo Park, Sang Jin Shin, Eung Shick Kang, Byeong Mun Park; J Korean Soc Fract 1999;12(3):732-740. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.732

Abstract PDF: The treatment of choice for Mason type III radial head fracture was total excision. But, open reduction and internal fixation of fractures of the radial head has become a commonplace as the result of both improvements in the techniques and implants for the fixation of small articular fragments as well as increasing recognition of the important role that the radial head plays in the stability of the forearm and elbow, particularly in the face of acute combined osseous and ligamentous injury. To date, reports of radial head fixation have made little mention on Mason type III fracture. From January 1993 to September 1997, 10 patients with fracture of radial head(Mason type III) were treated at Yong-dong Severance Hospital, Yonsei University College of Medicine. There were 6 males and 4 females with average age of 30 years(range 16 to 47). All of the fractures were comminuted and Mason type III. Seven fractures were the results of falling down and two slipping down and one pedestrian injury. Six fractures(60%) were evaluated as good or excellent by Bruces criteria. The heterotopic ossification was complicated in two cases. The nonunion of radial head fracture occured in two cases. The radial nerve palsy occured in one case. The partial ankylosis of elbow developed in three cases. Kirschners wires migrated in four cases. Open reduction and internal fixation increased the range of motion and decreased the subjective pain and did not cause any proximal migration of radius, impingement of ulnar carpal and radiocapitellar joint and could be a good treatment modality. The further evaluation should be directed to camparison between the open reduction and internal fixation and prosthetic replacement after total excision of radial head.

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Bioresorbable Implant Fixation for the Treatment of Radial Head and Neck Fractures: Coo Hyun Baek, Young Jin Sohn, Choon ki Lee, Moon Sang Chung; J Korean Soc Fract 1998;11(1):70-77. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.70

Abstract PDF: Between March 1988 and March 1995, 10 patients with displaced Mason type II, type III, or type IV fracture of the radial head or neck were treated by open reduction and internal fixation using bioresorbable pins. The average age of the patients was 38 years (22 to 70), and average follow-up period eas 14 months (12 to 18). There were 4 type II, 4 type III, and 2 type IV fractures. According to the functional rating system of Broberg and Morrey, the clinical results were reviewed at an average follow-up of 14 months. The functional results were 4 excellent, 5 good, and 1 fair. Fixation of displaced radial head or neck fracture using bioresorbable pins, was considered as one of the good methods.

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Swanson Prosthesis Replacement of the Comminuted Radial Head Fracture Associated with Posterior Dislocation of the Elbow: 3 Cases Experienced: Soo Kyoon Rah, Jin Il Kim, Chi Soo Sohn, Yon Il KIm, Chang Uk Choi; J Korean Soc Fract 1998;11(1):47-55. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.47

Abstract PDF: Radial head resection is the accepted treatment of comminuted radial head fractures in adults, but the results are not always satisfactory. a number of well-known problems can ensue. These include chronic elbow and wrist pain, limited of motion, cubitus valgus, proximal radial migration, and new bone formation at the site of excision. Prosthetic replacement of radial head after excision offers theoretical advantages in the prevention of these problems. We are reporting three cases of patients, who had treated Swanson silastic prosthesis after comminuted radial head fracture associated posterior dislocation of the elbow.

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Surgical Treatment of Avulsion Fracture of the Fibular Head Associated with Lateral Instability of the Knee: Min Young Chung, Won Suck Lee, Soo Myung Lee, Won Cheul Song, Chang Woo Kim, Kwang Min Jung; J Korean Soc Fract 1997;10(3):597-603. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.597

Abstract PDF

Though avulsion fracture of the fibular head rarely occurs, it frequently associates with lateral compartment injury of the knee which resulls in lateral instability. Some authors preferred to internally fixing avulsion fracture of the fibular head to prevent and restore lateral instability of the knee. Our purpose was to suggest that lateral instability of the knee be restored by internal fixation of the fibular head in these cases. We reviewed 6 cases of avulsion fracture of the fibular head associated with lateral instability of the knee which were treated surgically from January, 1993 to December, 1994 with average 2-year-over follow-up. We evaluated each cases using the Knee Ligament Standard Evaluation Form proposed by International Knee Documentation Committee. The results were as follows. The average displacement of the fibular head was 8.4mm. The activity level and overall grade were A(normal) in 4 cases, B(nearly normal) in 1 case, D(severe abnormal) in 1 case. Lateral instability of the knee was satisfactorily restored by internal fixation of the fibular head and repair of ligamentous injuries in cases of avulsion fracture of the fibular head associated with lateral instability of the knee.

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Establishment of Classification of Tibial Plateau Fracture Associated with Proximal Fibular Fracture
Zhan‐le Zheng, Yi‐yang Yu, Heng‐rui Chang, Huan Liu, Hui‐lin Zhou, Ying‐ze Zhang
Orthopaedic Surgery.2019; 11(1): 97. CrossRef

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