Journal of Musculoskeletal Trauma

The Clinical Results of Opening Wedge Osteotomy in the Volarly Malunited Distal Radius: Seoung Joon Lee, Jin Ho Choi; J Korean Fract Soc 2014;27(1):29-35. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.29

Abstract PDF: PURPOSE
To report the clinical results of opening wedge osteotomy graft in the volarly malunited distal radius.
MATERIALS AND METHODS
Ten patients with volarly malunited distal radius fractures treated by opening wedge osteotomy were included in this study. Grip power, range of motion of the wrist, radiographic parameter and Mayo wrist scores were retrospectively evaluated.
RESULTS
At the final follow-up, the rotation of the forearm, the range of motion of wrist, and the grip power were improved. The average radial inclination improved to 22.2degrees, the average volar tilting improved to 5.6degrees, and the average ulnar variance improved to 0.8 mm. The average Mayo wrist score was improved to 85.6.
CONCLUSION
Opening wedge osteotomy for volarly malunited distal radius was considered as one of the good treatments to restore anatomy of the distal radius and distal radioulnar joint and also to improve the function of the wrist joint.

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Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint: Kwang Jun Oh, Jin Ho Choi; J Korean Fract Soc 2013;26(3):184-190. Published online July 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.3.184

Abstract PDF: PURPOSE
To evaluate the radiological and clinical outcomes of intrapelvic anterior plate fixations for Day Classification Type II crescent fracture-dislocations of sacroiliac joints.
MATERIALS AND METHODS
Ten patients who had undertaken the surgical treatment for the sacroiliac joint from 2006 to 2012 were enrolled in this study. All cases fell into Type II by Day Classification for sacroiliac joint injuries. For surgical treatments, the plate fixation through the intra-pelvic anterior approach was first performed for all cases and anterior ring fixation was performed in 4 cases with more severely displaced anterior pelvic ring injuries. Then, radiological and clinical evaluation was implemented.
RESULTS
The bone union was observed from all patients whom performed the surgical fixation. In the radiological results, 9 cases with the anatomic and nearly-anatomic reductions were observed. Out of the 10 cases which performed the rotational displacement analysis, there were 3 excellent cases, 6 good cases and 1 fair case. The 10 cases that performed the deformity index and vertical displacement analysis, less variations were observed in the anterior ring fixations after intra-pelvic anterior plate fixation group. According to the clinical results, 4 excellent cases, 3 good cases, and 3 moderate cases were observed.
CONCLUSION
In the Type II crescent fracture-dislocation of sacroiliac joint, the intrapelvic anterior plate fixation achieved satisfactory anatomical reductions, radiological stabilities and clinical results.

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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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Biomechanical Analysis of Korean Radiolucent Carbon/Graphite Ring Fixator: In Ho Choi, Jun kyung Kim, Kui won Choi, Chin Youb Chung, Tae Joon Cho, Ki Seok Lee; J Korean Soc Fract 2000;13(1):1-12. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.1

Abstract PDF

PURPOSE
The mechanical stiffness of Korean radiolucent carbon/graphite ring fixator(KRCRF) was analyzed and compared with those of conventional stainless steel Ilizarov system and the Smith- Nephew carbon fiber circular external fixator.
MATERIALS AND METHODS
The transfixing olive pins of the circular fixator on the acryl pylon were assembled in 90degrees- 90degrees and 135degrees- 45degrees configuration, respectively. And the fixator-pylon model was loaded with Instron model No. 8500 in three testing modes: axial compression, anteroposterior(AP) bending and lateral bending.
RESULTS
As compared with stainless steel Ilizarov fixator, the KRCRF was significantly more stiff on the axial compression test regardless of the ring size(140 mm and 200 mm diameters) and transfixation configuration. But, it was less stiff on the anteroposterior(AP) and lateral bending tests. When compared with the Smith-Nephew carbon fiber circular external fixator, the KRCRF was generally more stiff on the axial compression, AP and lateral bending tests regardless of the ring size(140 mm and 180 mm diameters) and configuration, except the AP bending stiffness in 90degrees- 90degrees configuration and lateral bending stffness in 135degrees- 45degrees configuration on the 180 mm diameter frame.
CONCLUSION
Considering the radiolucency, weight and biomechanical stffness, we think that the KRCRF is an excellent substitute for the imported circular fixators made of stainless steel or carbon/graphite.

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A Study on the Development of the Off-Line Software for Regulating the 6 D.O.F. Circular Fixator
Bum-Seok PARK, In-Ho CHOI, Jin-Woo KIM, Seung-Yeol LEE, Chang-Soo HAN
JSME International Journal Series C.2006; 49(4): 1123. CrossRef

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Biomechanical Analysis of Translucent Hexagonal External Fixator: Duk Yong Lee, In Ho Choi, Chin Youb Chung, Tae Joon Cho, Yoon Keun Park; J Korean Soc Fract 1997;10(2):379-387. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.379

Abstract PDF: The mechanical stiffness of 4 configurations of the Translucent Hexagonal External Fixator(THEF) was analyzed and compared with conventional Ilizarov system in vitro. The advantage of the THEF was that it is less expensive, radio-translucent because it was made of carbon fiberepoxy. Stiffness in axial compression, torsion, A-P bending and lateral bending were measured in both fixators. The fixators were assembled into 90-90 and 45-135 configurations, respectively. In each configurations, two types of pin, smooth pins and olive pins, were used for transfixion. As compared with the Ilizarov fixator, the THEF was less stiff in axial compression when the two smooth pins were used for transfixion regardless of configuration, but was also less stiff in A-P and lateral bending except A-P bending when the smooth wires were assembled in 90-90 configuration, and lateral bending when the olive wires were assembled in 45-135 configuration. However, the THEF was more stiff in torsion regardless of configuration and type of wires used. When the olive wires were used, the THEF was more stiff than the Ilizarov fixator regardless of wire configuration in all loadiilg mode except AP bending. Changing the pin configuration from 90-90 to 45-135 decreased all stiffness of the Ilizarov fixator. However, lateral bending and axial compression stiffness with smooth wire and A-P bending stiffness regardless of types of wires were decreased in the THEF. Changing the smooth wires to olive wires increased the A-P and lateral bending stiffness in the Ilizarov fixator, while it increased all stiffnesses in the THEF. We believe that the results originated from the weakness of the material used. THEF may be an effective alternative for osteosynthesis, deformity correction in complex construct because of its radiolucency in spite of less favorable biomechanical properties in some loading mode.

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Analsis of the Distal Tibial Physeal and Epiphyseal Injury: In Ho Choi, Choon Ki Lee, Duk Yong Lee, Se Il Suk, Song Choi, Yong Hoon Kim, Suk Kee Tae, Seong Il Kim; J Korean Soc Fract 1989;2(2):164-173. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.164

Abstract PDF: We have reviewed 21 cases of physeal and epiphyseal fracture of the distal tibia including one case of juvenile Tillaux fracture and four cases of triplane fracture. The patterns of fracture were correlated with the mechanism of injury using the modified Lauge-Hansen method and sysemic classification of the triplane frature was proposed. Treatment included closed reduction and cast(9 cases), closed reduction and percutaneous pin fixation(4 cases), and open reduction(8 cases). Two of the nine patients treated by means of closed reduction and cast had ankle joint incongruity or progressive varus deformity requiring corrective ost eotomy. These two patients had either Salter-Harris Type III ro Type IV fracture after supination-inversion injury. In one patient, who had 100 per cent displacement of the distal tibial epiphysis and degloving injury of the ankle, premature physeal arrest developed after open reduction and internal fixaion for Salter-Harris Type Tyre I fracture. If there are triagular metaphseal ledge along with the juvenile Tillaux fracture-like vertical epiphyseal fracture line on the antero-posterior view and Salter-Harris Type II or Type IV frature on the lateral view, a certain type of triplane fracture is strongly suggested. Plain radiographs, however, could not accurately demontrate the detailed configuration of the triplane fracture, instead computerized axial tomography was very helpful us to analyse the true dimensions of the triplane fracture. We agree that displace Salter-Harri Type III or Type IV and transitional fractures with a fracture gap of more than two millimeters in the weight-bearing portion of the epiphysis regure open reduction.

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