Journal of Musculoskeletal Trauma

Operative Treatment of Pediatric Distal Forearm Bothbone Fracture: Sang Uk Lee, Changhoon Jeong, Il Jung Park, Jaeyoung Lee, Seman Oh, Kyung Hoon Lee, Sanghyun Jeon; J Korean Fract Soc 2015;28(4):237-244. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.237

Abstract PDF: PURPOSE
Pediatric patients with distal forearm bothbone fractures of surgical indication were treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna at our institution. The purpose of this study is to evaluate clinical and radiological results.
MATERIALS AND METHODS
From February 2012 to June 2014, we retrospectively evaluated 16 out of 18 cases with distal forearm bothbone fractures treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna with at least 1-year follow-up. The average age at operation was 9.1 years (7-13 years).
RESULTS
Adequate reduction for both radius and ulna was achieved for all cases, and none of the cases showed re-displacement until the last follow-up. Mean 6.6 weeks lapsed until bony union was observed for the radius. For the ulna, the mean was 6.5 weeks. All patients gained full wrist range of motion at the last visit.
CONCLUSION
For pediatric distal forearm bothbone fractures, intrafocal Kapandji reduction and internal fixation with Kirschner wire for radius and reduction and internal fixation with a flexible intramedullary nail for ulna is the technique for handy reduction. Use of this technique can prevent re-displacement during the union process and achieve excellent clinical and radiologic results.

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Irreducible Open Dorsal Dislocation of the Proximal Interphalangeal Joint: A Case Report: Youn Tae Roh, Il Jung Park, Hyoung Min Kim, Jae Young Lee, Sung Lim You, Youn Soo Kim; J Korean Fract Soc 2015;28(1):65-70. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.65

Abstract PDF: Dorsal dislocation of the proximal interphalangeal joint is a common injury in the orthopedic department. In most cases, the joint is reduced simply by closed manipulation. However, in rare cases, the joint is not reducible by closed manipulation, therefore, surgery is required. We report on a case of irreducible open dorsal dislocation of the proximal interphalangeal joint which was surgically treated. Because the flexor tendon interposed between the head of the proximal phalanx and the base of the middle phalanx, we could reduce the joint only after repositioning of the flexor tendon.

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The Efficacy of Preserved Posterior Cortex in the Treatment of Infected Nonunion of the Tibia: Hyoung Min Kim, Il Jung Park, Youn Tae Roh, Byung Min Kang, Hyun Jin Lee, Jae Young Lee; J Korean Fract Soc 2014;27(4):301-307. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.301

Abstract PDF: PURPOSE
We studied the efficacy of preserved posterior cortex connecting to adjacent muscle or periosteum during wide debridement in the treatment of infected nonunion of the tibia.
MATERIALS AND METHODS
From January 2001 to May 2011, 12 cases of infected nonunion of the tibia with segmental defect larger than 4 cm after wide debridement were selected. The selected cases were categorized according to two groups; group 1 with preserved posterior cortex in the segmental defect site - six cases, group 2 without posterior cortex - six cases. The results were compared by assessing the size of bone defect, the interval between wide debridement and bone reconstruction, bony union time, complications, and clinical results.
RESULTS
The mean length of bone defect of group 1 was 7.6 cm (range 4.3-11.0 cm) and that of group 2 was 6.4 cm (range 4.0-12.0 cm). The interval between wide debridement and bone reconstruction was 10.0 weeks (range 5-18 weeks) for group 1, and 12.1 weeks (range 0-24 weeks) for group 2. The time for bony union of group 1 was 6.2 months (range 5-7 months), and that of group 2 was 10.8 months (range 7-18 months). In group 2, there were two cases of fatigue fracture and two cases of docking site nonunion after distraction osteogenesis.
CONCLUSION
The preserved posterior cortex after wide debridement of infected nonunion of the tibia helps bony union and reduces the treatment period.

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Modified Spring Plate for Treatment of Unstable Distal Clavicle Fractures: Sang Myung Lee, Il Jung Park, Hyung Min Kim, Jae Chul Park, Sung Gil Cho, Yoon Chung Kim, Seung Koo Rhee; J Korean Fract Soc 2010;23(1):64-68. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.64

Abstract PDF: PURPOSE
Unstable distal clavicle fractures should be treated surgically but may be difficult in firm fixation because of small distal fragment. Although a variety of fixation methods have been currently used, none of the methods seem to be firm fixation and little pain. We present a new technique using a spring plate which was modified from one third tubular plate and report the early results.
MATERIALS AND METHODS
Modified spring plate was made from one third tubular plate and the distal hole of the plate was cutting and sharpened by rasp. The sharp edge was bent just like an animal claw (C shape). Between May 2007 and June 2009, a total of six patients with distal clavicle fracture were treated using modified spring plate. A sling was applied in the immediate post operative period for six weeks and exercises were started immediately.
RESULTS
Union was achieved in all cases with excellent results without complication (mean Constant score, 96). All patients had returned to ordinary daily activities but mild limitation of abduction (150 degrees ) by seven weeks after surgery. After six months, the plate was removed.
CONCLUSION
The modified spring plate has provided stable fixation for unstable distal clavicle fixation without disturbance to the acromioclavicular joint, subacromial space, or rotator cuff.

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Free Vascularized Fibular Grafts for Treatment of Infected Nonunion of the Tibia: Hyoung Min Kim, Il Jung Park, Youn Soo Kim, Kee Haeng Lee, Chan Woong Moon, In Ho Jeong, Changhoon Jeong; J Korean Fract Soc 2006;19(2):163-169. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.163

Abstract

PURPOSE
To analyze the result of free vascularized fibular grafting for treatment of infected nonunion of the tibia with radical bone and soft tissue defect.
MATERIALS AND METHODS
17 patients with infected nonunion of the tibia who underwent a reconstruction using free vascularized fibular grafting were reviewed retrospectively. The mean follow-up period was 70.3 months. We analyzed the results radiographically which included the time of bone union, the amount of hypertrophy of grafted bone and complications.
RESULTS
The average length of bone defect was 8.8 cm (5~15 cm), and the average length of fibular graft was 14.1 cm (10~17.5 cm). Bony union was achieved in 11 of 17 cases and the average time of bone union was 5.2 months (4~6 months). There were 6 cases of nonunion. All nonunions developed at the proximal end of graft in patients who underwent fixation using pin and external fixator. Union was eventually achieved in all cases in 6.0 months (5~8 months) after the cancellous bone graft and plate internal fixation. Hypertrophy of grafted bones with more than 20% developed only in 4 cases out of 17. There were 3 cases of stress fracture, however there was no recurrence of infection or serious donor site morbidity.
CONCLUSION
Free vascularized fibula grafting is one of the most effective reconstruction options for the infected nonunion of the tibia with radical bone and soft tissue defect. Strong internal fixation using plate and screws is required to reduce the rate of nonunion and stress fracture of grafted fibulas.

Citations

Citations to this article as recorded by

Treatment Strategy of Infected Nonunion
Hyoung-Keun Oh
Journal of the Korean Fracture Society.2017; 30(1): 52. CrossRef

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Treatment of Subtrochanteric Fractures with Compression Hip Screw: Kee Haeng Lee, Hyoung Min Kim, Youn Soo Kim, Chang Hoon Jeong, Il Jung Park, Ill Seok Park, Chan Woong Moon; J Korean Fract Soc 2006;19(1):1-5. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.1

Abstract

PURPOSE
To evaluate the effectiveness of the compression hip screw, we reviewed the clinical results of cases of femoral subtrochanteric fracture which were treated with compression hip screw.
MATERIALS AND METHODS
From May 1997 to June 2004, 20 cases of femoral subtrochanteric fracture, which were treated with compression hip screw and followed up more than 12 months, were reviewed. By the Seinsheimer's classification, there were 1 case of type IIa, 4 cases of type IIb, 2 cases of type IIIa and IIIb, 4 cases of type IV and 7 cases of V. We analyzed the treatment results by bony union time, range of motion, ambulation status and complications.
RESULTS
All 20 cases were gained bony union without serious complications and secondary operation. The average bony union time was 19.8 weeks. 17 of 20 cases were recovered pre-injury ambulatory status level.
CONCLUSION
The compression hip screw may be effective in treatment of the femoral subtrochanteric fracture with very narrow intramedullary canal, proximal femoral deformity, comminuted fracture with large butterfly fragment, long spiral fracture with medial cortical comminution and combined intertrochanteric fracture.

Citations

Citations to this article as recorded by

The stabilising effect by a novel cable cerclage configuration in long cephalomedullary nailing of subtrochanteric fractures with a posteromedial wedge
Pavel Mukherjee, Jan Egil Brattgjerd, Sanyalak Niratisairak, Jan Rune Nilssen, Knut Strømsøe, Harald Steen
Clinical Biomechanics.2019; 68: 1. CrossRef
Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
Hip & Pelvis.2014; 26(2): 107. CrossRef

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