Journal of Musculoskeletal Trauma

Computed Tomography Image Analysis of the Fusion Site of Subtalar Arthrodesis for Traumatic Arthritis after a Displaced Intraarticular Calcaneal Fracture: Hong Gi Park, Jae Ang Sim, Han Soul Kim, Byung Hoon Lee; J Korean Fract Soc 2019;32(3):121-127. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.121

Abstract PDF: PURPOSE
The study examined the fusion site and characteristics of the subtalar arthrodesis after intraarticular calcaneal fractures using computed tomography.
MATERIALS AND METHODS
The clinical results and computed tomographic analysis of the fusion site were reviewed in 18 patients who were followed-up for a minimum of six months after undergoing subtalar arthrodesis due to traumatic arthritis caused by an intra-articular calcaneal fracture from December 2012 to April 2017.
RESULTS
An evaluation of clinical results after subtalar arthrodesis revealed statistically significant improvements. In all cases, arthritis was found in the injured articular surface, which was displaced superolaterally from the initial primary fracture line of the calcaneus. Six months after arthrodesis, the subtalar fusion rate was 80.0% (16/20). Of these, 14 cases had a cannulated screw inserted in the uninjured site that is medial to the primary fracture line. Joint fusion was observed on the uninjured articular surface in 17 cases (85.0%).
CONCLUSION
Joint fusion was initially achieved at the uninjured posterior facet after subtalar arthrodesis due to traumatic arthritis caused by a displaced intra-articular calcaneal fracture. This suggests that meticulous surgical techniques and cannulated screw positioning at the uninjured site will promote joint fusion.

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Outcomes of Severe Comminuted Distal Radius Fractures with Pronator Preserving Approach: Seung Hyun Cho, Hong Gi Park, Deuk Soo Jun, Jae Ang Sim, Young Hak Roh, Yong Cheol Yoon, Jong Ryoon Baek; J Korean Fract Soc 2015;28(3):178-185. Published online July 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.3.178

PURPOSE
We investigate the outcomes of treatment of patients with severe comminuted distal radius fractures with volar plate fixation using a pronator-preserving approach.
MATERIALS AND METHODS
Fourteen patients with severe comminution of the distal radius fractures for whom anatomical reduction of the fractures was deemed difficult to achieve with traditional approaches were enrolled. The gender ratio was 8 males to 6 females, and the average age of the patients was 64.9 years. According to the AO/OTA classification of fractures, 2 patients had 23-A3 fractures, 7 patients had 23-C2, and 5 patients had 23-C3. Radial length, radial inclination, and volar tilt were measured for radiologic evaluation. Modified Mayo wrist score (MMWS) was used for clinical outcome.
RESULTS
Bony union was achieved in all 14 patients without signs of complications. The average time-to-union was 4.3 months (3-6 months). The radiological findings at the final follow-up were as follows: the average radial inclination was 20.5degrees; the average volar tilt, 7.57degrees; and the average radial length, 11.8 mm. At the final follow-up, the results of the MMWS were 'Fair' in 1 patient, 'Good' in 4, and 'Excellent' in 9.
CONCLUSION
We propose that a pronator-preserving approach is an effective treatment for severe comminuted distal radius fracture.

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Use of Miniplate for Severe Comminuted Metadiaphyseal Fractures of the Distal Radius
Jong-Ryoon Baek, Yong-Cheol Yoon, Seung Hyun Baek
Journal of the Korean Fracture Society.2019; 32(4): 204. CrossRef

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The Study for the Factors Affecting the Radiological Outcome of the Displaced Ankle Fracture over the Elderly: Hong Gi Park, Lee Hyuk Jung; J Korean Soc Fract 2002;15(4):465-469. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.465

Abstract PDF: OBJECT: This study investigated to know the factors affecting the radiological results of the ankle fracture after open reduction and internal fixation over the age 60 years. PATIENTS & METHOD: Open reduction and internal fixation on patient with closed displacement ankle fracture over the age 60 years were studied in 51 cases. Statistical analysis by t-test was used to assess the factors affecting to the post-operation radiological results among the age, sex, classification of fracture, the degree of fracture displacement, bone fragility between anatomical reduction group and non-anatomical reduction group in average 16 months, RESULTS: There are statistical significance(p<0.05) of the sex and bone fragility in post-operation radiological results.
CONCLUSION
The radiological results in old age with ankle fracture is affected by sex and bone fragility in open reduction & internal fixation.

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Delayed Intramedullary Nailing after Failed External fixation for Open Tibial Fractures: Jin Hong Ko, Bum Gu Lee, Do Hyun Moon, Hong Gi Park, Cheol Won Park; J Korean Soc Fract 1997;10(3):694-701. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.694

Abstract PDF: Recently, extemal fxation and unreamed intramedullary nailing are largely used for operative treatment for open long bone fractures. Extemal fixation, especially in cases of unstable fractures, blamed for complications, for example, malunion, delayed union, loss of reduction, refracture, pin tract infection. In addition, there are some problems such as long hospital stay and delayed returning to work. Some surgeons tried to treat such problems by secondary intramedullary nailing, but they came to different retults. The purpose of the current study is to evaluate our experience with secondary intramedullary nailing after failed external fixation of 4 cases of open Grade II, 8 cases of open Grade III a, and 4 cases of open Grade III b tibial fractures. The results are as follows ; 1. The external fixation had been maintained for 123 days in average. 2. The mean interval between removal of the external fixation and intramedullary nailing was 16 days except 5 immediate operation. 3. Reamed intramedullary nailing with static interlocking were done in all 16 cases. 4. In 12 cases of 16, bone union was obtained without complications, and the mean union time after intramedullary nailing was 21.7 weeks radiollogically. 5. Deep infections developed in 2 cases, which had in fracture site, and local infections in 2 cases, which had been in previous pin site of external fixator. In conclusion, delayed intramedullary nailing was a method for treatment of problematic external fixation, such as delayed union, nonunion, loss of fixation, and pin site infection, for open fractures of the tibia.

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Avulsion Fracture of the Base of the Second Metacarpal by the Extensor Carpi Radialis Longes : a Case Report: Hong Gi Park, Cheol Won Park; J Korean Soc Fract 1997;10(3):665-668. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.665

Abstract PDF: Isolated intraarticular fractures of the base of the second metacarpals are rare because of the lack of motion in these joints. Also these injuries are an avulsion fractures of the base of second metacarpals that attached the extensor carpi radialis longus(ECRL) or brevis(ECRB). Most authors reporting these cases have recommanded opertive treatment, because the keys of treatment of this fracture are to restore the integrity of the joint margin and to restore the insertion of the extensor carpi radialis tendon. We report a single case of avulsion fracture of the ECRL, which included a fracture of the large metacarpal base.

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Clinical Analysis Between Interlocking IM Nail and Plate Fixation in the Treatment of Humeral shaft Fractures: Soo Chan Lee, Beom Koo Lee, Do Hyun Moon, Jin Hong Ko, Hong Gi Park, Ki Dong Kang, Hyoung Il Kim; J Korean Soc Fract 1997;10(3):621-627. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.621

Abstract PDF: Most of the humeral shaft fractures have been treated conservatively. If operation is indicated, most surgeons used to perform an open reduction and internal fixation with plate &Treatment of the Humeral Shaft Fracture in Adult screws. But, when open reduction and internal fixation is carried out, the periosteum and soft tissue attachments must be stripped off from the bone and operative time becomes longer. Interlocking IM nailing is an attractive procedure which does not disrupt or strip off periosteum and soft tissue at the fracture site, decrease the chance of infection and allow early exercise. Authors compare the clinical result of humerus shaft fracture which were treated by plate fixation in 25 patients and interlocking IM nailing in 16 patients who were treated at the orthopedic depaunent, Joong Ang Gil Hospital from Feb. 1992 to Jan. 1995. 1. The average time of operation in interlocking IM nail was 65 minutes and that of plate fixation was 95 minutes. 2. The average time for bone union was about 14.4 weeks in interlocking IM nail and 14.2 weeks in plate fixation. 3. The complications of interlocking IM nail were 1 case of postoperative radial nerve palsy, 1 case of delayed union, 1 case of nonunion and 3 cases of pain and stiffness of shoulder. 4. the complications of plate fixation were 1 case of infectioin, 1 case of delayed union, 3 cases of nonunion, 1 case of metal failure, 2 cases of postoperative radial nerve palsy and 2 cases of pain and stiffness of elbow. In conclusion, the interlocking IM nailing is an attractive procedure or the treatment of the humeral shaft fractures.

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