Journal of Musculoskeletal Trauma

Decompressive Sacral Foraminotomy for Nerve Root Injury during Conservative Treatment of Sacral Fracture: A Case Report: Jung Gil Lee, Jae Hyuk Shin, Kwon Kim, Sang Min Choi, Moon Soo Park, Ho Guen Chang; J Korean Fract Soc 2017;30(1):24-28. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.24

Abstract PDF: A 35-year-old woman visited the emergency department for a pedestrian traffic accident. Severe tenderness was noted at the posterior sacrum area, without open wound or initial neurologic deficit. Fracture of the left sacral ala extended to the S1 foramen, anterior acetabulum, and pubic ramus. Two weeks after the injury, she presented aggravating radiculopathy with the weakness of the left great toe plantar flexion. The S1 nerve root was compressed by the fracture fragments in the left S1 foramen. Decompressive S1 foraminotomy was performed. The postoperative follow-up computed tomography scan showed successful decompression of the encroachment, and the patient recovered well from the radiculopathy with motor weakness. She was able to resume her daily routine activity. We suggest that early decompressive sacral foraminotomy could be a useful additional procedure in selective sacral zone II fractures that are accompanied by radiculopathy with a motor deficit.

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Salvage Therapy from Traumatic Ischemic Finger Necrosis via Prostaglandin E1 Assisted Conservative Treatment: A Case Report: Jae Hyuk Shin, Ho Guen Chang, Cheol Jung Yang, Jungtae Ahn; J Korean Fract Soc 2015;28(4):245-249. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.245

Abstract PDF: Prostaglandin E1 (PGE-1) is a potent vasodilator, which also inhibits platelet aggregation, affects the blood flow viscosity, and fibrinolysis. The compound also excerts anti-inflammatory effects by inhibiting the monocyte and neutrophil function. PGE-1 has been widely administered following microvascular flap surgery, along with perioperative antithrombotic agents such as low molecular weight heparin or aspirin, showing excellent results. We report a case showing successful salvage recovery from post-traumatic ischemic necrosis of the finger via PGE-1 assisted conservative treatment.

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Periprosthetic Fracture after Proximal Humeral Intramedullary Nail, Treated by Functional Bracing: A Case Report: Jae Hyuk Shin, Ho Guen Chang, Young Woo Kim, Nam Kyou Rhee, Yong Bok Park, Yong Kuk Kim; J Korean Fract Soc 2011;24(2):185-190. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.185

Periprosthetic fracture following a proximal humeral intramedullary (IM) nailing is rarely reported neither for its occurrence nor for its treatment. Proximal humeral IM nail (Acumed, LLC, Hillsboro, OR, USA) has been increasingly reported of its successful treatment outcomes, yet there is paucity of data describing its complications. Here we report a 26 year-old female patient, who sustained a proximal humerus fracture which was initially successfully treated by proximal humeral IM nail, and was complicated by a periprosthetic fracture distal to the nail tip at postoperative 4 months. Serial application of U-shaped coaptation splint, hanging cast, and functional bracing resulted in satisfactory clinical outcome. Periprosthetic fracture after proximal humerus IM nail can occur by a low energy injury, which need to reminded in treating young and sports-active patients.

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Locking compression plate fixation of periprosthetic distant humeral fracture after intramedullary nail for humeral shaft fracture: A case report
Mei-Ren Zhang, Kui Zhao, Jiang-Long Guo, Hai-Yun Chen
Trauma Case Reports.2022; 37: 100565. CrossRef
Distal Humeral Fixation of an Intramedullary Nail Periprosthetic Fracture
Hiren M. Divecha, Hans A. J. Marynissen
Case Reports in Orthopedics.2013; 2013: 1. CrossRef

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Vertebroplasty for the Treatment of Painful Osteoporotic Compression Fractures: Young Woo Kim, Ho Guen Chang, Kee Byoung Lee, Yong nam Ji, Yong Beom Lee, Jeong Mo Ku; J Korean Fract Soc 2004;17(1):49-54. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.49

Abstract PDF

PURPOSE
To evaluate results regarding pain relief, spinal stabilization, and complication after treatment with percutaneous vertebroplasty.
MATERIALS AND METHODS
108 patients (12 men, 96 women; aged 42~84 years) underwent 156 percutaneous injections of surgical cement into a vertebra (vertebroplasty) with fluoroscopic guidance in 119 procedures. All patients had severe pain,osteoporotic fractures and had failed medical therapy. Immediate and long-term pain response, spinal stability, and complications were evaluated. Assessment criteria were the changes over time (Days 3, 30, 90, 180) in visual analogue scale (VAS: 0~100 mm) and McGill-Melzack scoring system. The height of vertebral body was checked at three portions (anterior, middle, posterior) with lateral view of plain radiographs.
RESULTS
A statistically significant decrease of both VAS and McGill-Melzack scoring system was observed at Day 3. The results were also significant at Days 30, 90, and 180 both scales. We observed no adverse event, but 26 vertebral fractures had occured in the adjacent level during 12 months of follow-up. The leakage of cement was observed in 57 vertebral bodies (36.5%). But there was no neurological symptoms associated with cement leakage. The vertebral body height was increased after vertebroplasty.
CONCLUSION
Vertebroplasty is safe and effective, and have a useful role in the treatment of painful osteoporotic vertebral compression fractures that do not respond to conventional treatments. Continuous management of osteoporosis and patient education is mandantory to prevent subsequent fracture of the adjacent vertebral bodies.

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Comparison of Outcomes of Conservative Treatment, Early Vertebroplasty, and Delayed Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures
Se-Hyuk Im, Young-Joon Ahn, Bo-Kyu Yang, Seung-Rim Yi, Ye-Hyun Lee, Ji-Eun Kwon, Jong-Min Kim
Journal of Korean Society of Spine Surgery.2016; 23(3): 139. CrossRef
The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture
Young-Do Koh, Jong-Seok Yoon, Sung-Il Kim
Journal of the Korean Fracture Society.2008; 21(1): 57. CrossRef
Compatibility of Self-setting DBM-CP Composites in Percutaneous Kyphoplasty
Jung Hee Lee
Journal of the Korean Fracture Society.2007; 20(3): 266. CrossRef

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Metacarpal Shaft Fracture Treated by Closed Reduction and Percutaneous Intramedullary K-wire Fixationv: Soo Joong Choi, Chang Kyun Lim, Ho Guen Chang, Jun Dong Chang, Chang Ju Lee; J Korean Soc Fract 1998;11(1):100-106. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.100

Abstract PDF: The metacarpal shaft fracture has been reported as a stable fracture relatively, but operative treatment is indicated when there happens reduction loss, or is in need of early exercise. Intramedullary K-wire fixation has been used for unstable transverse or long oblique diaphyseal fracture of the metacarpal bone. The fracture site is not opened and the K-wires are introduced under X-ray control. The techniques can stablize the fracture site and allow immediate exercise postoperatively. We experienced 9 cases of 4th metacarpal shaft fracture treated by percutaneous intramedullary K-wire frxation with modified technique. The K-wire was used one or two ezch metacarpal fracture. The types of fracture were 4cases of transverse, 3 of oblique, 2 of comminuted. The average clinical union period were 5 weeks. There were not severe complications in all cases.

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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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Epidemiology and treatment of The Fractures in Burned Patients: Ho Guen Chang, Woon Hwa Jeong, Ung Joo Lee, Jun Dong Chang, Won Ho Cho, Chang Ju Lee; J Korean Soc Fract 1996;9(4):1034-1038. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1034

Abstract PDF: The fractures in the burned patients is more complicated mechanism. There are controversies in the treatment of the fractures in the burned patients. We analysed the fracture incidence, the type of burn, the mode of injury, the mean burn percentage, the fracture site and the results of treatment of the if fractures in 44 patients selected from 3300 burned patients in Hangang sacred-heart hospital during recent 5 years. The incidence of the fractures in the burned patients was 1.3%, the predominant type of the burn was flame burn(72.7%), the mean burn percentage was 28.7% of the total body surface. The mode of injury mainly consisted of fall down after burn(50%). The most common fracture site was thoracolumbar spine(11 cases). In 12 long bonr fractures, 5 cases(Tibia:3 case, Femur:2 case) were treated with operative method. But, the osteomyelitis was not developed in ail cases. We concluded that the operative treatment is recommended in severe burned fracture patients for pain relief, comfortable wound manage, rigid fixation and early exercise.

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The 5th Metacarpal Neck Fracture Treated by Closed Reduction and Percutaneous Intramedullary K-wire Fixation: Soo Joong Choi, Young Ho Lee, Ho Guen Chang, Chang Ju Lee, Won Ho Cho; J Korean Soc Fract 1995;8(3):696-704. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.696

Abstract PDF

The fifth metacarpal neck fractures are unstable and often heals with angulation and deformity. So, after closed reduction and immobilization with splint or cast, they have often been lost reduction and healed with posterior angulation and cosmetic deformity. We conducted a prospective study of 11 patients who underwent percutaneous retrograde intramedullay K-wire fixation for a fracture of the neck of the fifth metacarpal during four years period. We used a closed reduction technique derived from Jahss maneuver or three point fixation maneuver. And, the fracture was maintained with two cross or parallel smooth intramedullary K-wire. The proximal side of K-wire was placed back wound side near the wrist joint. The last follow up (postoperative 14Â±2 weeks) radiographic results were dorsal angualtion 7Â±4 , corresponded to preoperative 48Â±7 , and immediately postoperative 6Â±4 The complications such as limitation of movement, increase of dorsal angulation, rotational malalignment, shortening, and depression of the head of metacarpal were not occurred. Rotational deformity was always well controlled. Correction of angulation was good and K-wire insertion and fixation technique were easy. We recommend this technique in case of over 40 dorsal angulation of fracture site due to absence of contact between the palmar fractured ends, and patients who dont accept the cosmetic deformity or want early exercise.

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Comparative Evaluation of the Efficacy of Combined Intramedullary Pinning with K-Wires Pinning in the Treatment of Fifth Metacarpal Neck Fractures versus Conventional Techniques—K-Wires Pinning and Intramedullary Pinning
Dong-Eun Kim, Tong-Joo Lee, Yeop Na, Ye-Geon Noh
Medicina.2023; 59(11): 1944. CrossRef
Modified Bouquet Technique for Treatment of Metacarpal Neck Fractures
Yong-Gyu Sung, Seok-Whan Song, Yoon-Min Lee
Journal of the Korean Society for Surgery of the Hand.2016; 21(3): 137. CrossRef
Treatment of 5th Metacarpal Neck Fracture Using Percutaneous Transverse Fixation with K-Wires
Jae-Hak Jung, Kwan-Hee Lee, Yong-Ju Kim, Woo-Jin Lee, Sung-Hyun Choi
Journal of the Korean Fracture Society.2012; 25(4): 317. CrossRef
Treatment of Metacarpal Fractures using Transverse Kirschner-wire Fixation
Nam Yong Choi, Hyun Seok Song
The Journal of the Korean Orthopaedic Association.2007; 42(5): 608. CrossRef
Bouquet Pin Intramedullary Nail Technique of the 5th Metacarpal Neck Fractures
Myung-Ho Kim, Moon-Jib Yoo, Jong-Pil Kim, Ju-Hong Lee, Jin-Won Lee
Journal of the Korean Fracture Society.2007; 20(1): 64. CrossRef

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Clinical Investigation of the Proximal Humerus Fracture: Chang Ju Lee, Won Ho Cho, Ho Guen Chang, Soo Joong Choi, Byung Il Min, Yong Jee Park; J Korean Soc Fract 1992;5(2):334-341. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.334

Abstract PDF: Proximal humerus fractures respond satisfactorily to conservative treatment, but in old age group, there are difficulties in managing it. So we analyzed 42 cases of proximal humerus fractures according to age and the method of treatment. The results were as follows; 1. Eighteen one part fractures were treated conservatively except one case and show satisfactory result except one. 2. Fifteen two-part fractures were treated by open reduction except one case and show satisfactory result except one. 3. Six three-part fractures were treated by open reduction in all cases and show satisfactory result except one. 4. Three four-part fractures were treated by open reduction or total shoulder arthroplastT 2. respectively in two ceses and show satisfactory result except one. 5. In old age group. loosenings of plate and screws were found in 2 cases. 6. In young age group, loosening of plate and screws was not found. 7. Tension band wire was not related loosening of wire in all cases.

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Clinical Investigation of the Comminuted Patellar Fracture: Chang Ju Lee, Won Ho Cho, Ho Guen Chang, Yoo Geun Ju; J Korean Soc Fract 1990;3(2):209-215. Published online November 30, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.2.209

Abstract PDF: The authors report a clinical experience of 12 cases having comminuted patellar fracture who were treated with modified tension band wiring or partial patellectomy from January 1985 to Oecember 1989 at the department of Orthopedic Surgery, Hallym University Hangang Sacred Heart Hospital. The results were as follows 1. All cases caused by direct blow. 2. Mean immobilization period was 5 weeks in modified tension band wiring, mean immobilixation was 3.3 weeks in partial patellectomy. 3. Range of motion of knee joint was 3-123 in modified tension band wiring, range of motion of knee joint was 5" -110" in partial patellectomy. 4. Quadriceps muscle weakness was developed in all of 2 cases of partial fatellectomy. 5. Extension lag of knee joint was developed in 1 case of partial patellectomy. 6. The result of modified tension band wiring was much better than partial patellectomy in comminuted patellar fracture.

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Avascular Necrosis After the Fracture of the Neck of the Talus: Chang Ju Lee, Won Ho Cho, Ho Guen Chang, Byung Il Min; J Korean Soc Fract 1989;2(2):194-201. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.194

Abstract PDF: Avascular necrosis was a frequent complication of the fracture of the neck of the talus. Hawkins described a subchondral radiolucency visible in the body of the talus six to eight weeks after fracture. This sign has proved to be a useful objective prognostic sign; the presence of this sign would not undergo avscular necrosis. In eleven patients, serial roetgenograms were examined for this phenomenon. The results were as follows: 1. Six fractures that had the Hawkins sign did not undergo avascular necrosis. 2. Also, we experienced two cases of partial Hawkins sign which developed the partial avascular necrosis.

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