Journal of Musculoskeletal Trauma

Treatment of Open Fractures of the Tibial Shaft by Sequential Compression technique in Ilizarov device: Suk Ku Han, In Ju Lee, Nam Yong Choi, Sung Jin Park, Gyeol Yoo, Hyo Seng Ahn; J Korean Soc Fract 1998;11(4):817-824. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.817

Abstract PDF: External skeletal fixation is used widely in the management of open or closed tibial fractures, but delayed healing is common. There is concern that this might be due not only due to the severity of injury but also to the mechanical conditions imposed at the fracture site by the fixator. Since fractures treated by external skeletal fixation can rarely be reduced to perception nor held with absolute stability, union occurs by indirect healing, which is acutely sensitive to both the charactericstics and timing of mechanical stimulation. So, the achivevment of the optimum mechanical environment is particularly important where delay in bone healing is likely. Ilizarov external fixator is useful in treating open fractures of the tibial shaft because it permits axial micromotion which enhances bridging callus formation with stable fixation as well as its complications such as infected nonunion or limb length discrepancy. The impared healing with external fixation is often caused by wrong surgical technique, such as distraction of fracture fragments by fixation device. Sequential compression at fracture site may overcome any fracture gap in external skeletal fixation and also enhance endosteal bone formation. We applied sequential compression forces at the fracture site in 18 open fractures of the tibial shaft, trated by Ilizarov external fixator with or without autogenous bone grafting. Sequential compression technique is composed of initial compression with 1 mm/wk for 4 weeks and then compression 1 mm/10 days until adequate apposition of cortex and callus formation in radiograph. We acquired successful bony union in all cases except one which had additional bone grafting in open fractures of the tibial shaft by sequential compression technique using Ilizarov device.

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The Acute surgical Treatment in Superior Peroneal Retinacular Injury in Ankle: Suk Goo Han, Nam Yong Choi, In Tak Choo, Sung Jin Park, Young Mok Kang, In Ju Lee; J Korean Soc Fract 1998;11(3):605-610. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.605

Abstract PDF: The superior peroneal retinacular injury in ankle is often diagnosed as an ankle sprain and treated conservatively because of normal bony contour in type 1,2 injury according to Eckery's classification and small bony fragment with early union, evenly displaced in type 3. But its complications such as peroneal tendinitis and recurrent subluxation or dislocation of peroneal tendons sometimes develop late. Compared to peroneal tendinitis, the surgical treatment method for recurrent subluxation or dislocation of peroneal tendons is known superor to conservative method in results. And many reconstructive methods have been reported. In spite of their good results, harmfulness to normal structures, recurrences and technical difficulties may be a problem. So we perfomed 10 cases of acute surgical repair in superior peroneal retinacular injuries in ankle from March 1993 to February 1997 and prospectively analysed their clinical and radiological results with complications. Preoperative radiological diagnosis was done by plain films, peroneal tenography with computed tomography and also postperatively evaluated with plain films and peroneal tenography. 1. The most common cause of injury was sports(6 cases) including ski injury(4 cases) and average age of the patient was 29(17-56) years. 2. 4 cases of bony avulsion(type 3) were fixed with mini-screws and mean duration of bony union was 3.6 months. 3. The incidental subluxation or dislocation of peroneal tendons was not found intraoperatively and postoperatively. 4. All patients are able to participate in active exercise postoperatively except one patient who complains of lateral ankle discomfort due to peroneal tendinitis. In conclusion, acute surgical repair of superior peroneal retinacular injury in ankle is a recommended method to prevent it's complications such as peroneal retinacular injury in ankle is a recommended method to prevent it's complications such as peroneal tendinitis and subluxation or dislocation of peroneal tendons especially, in young and active patients.

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Surgical Treatment of Stenosing Synovitis and Dislocation of Peroneal Tendon as a Complication of Calcaneal Fracture: Seong Jin Park, Suk Whan Song, Nam Yong Choi, Byung Lae Jo, In Ju Lee; J Korean Soc Fract 1997;10(1):99-103. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.99

Abstract PDF: Malunion of calcaneal fracture results in most of long-term complications such as pain and limitation of motion at hindfoot. Though it is reported that patients symptoms continue to improve during following years, some patients are disabled espicially due to pain. Among the source of pain following malunited calcaneal fracture, traumatic arthritis of subtalar joint, peroneal tendinitis with or without dislocation of tendons, compression neuropathy, and other sequelae were believed to be responsible. The authors report the result of surgical treatment of 9 patients with malunited calcaneal fracture, who had stenosing tenosynovitis(3 cases), and recurrent dislocation of peroneal tendon(6cases). key words; peroneal tendon, stenosing tendinitis, dislocation, malunion, calcaneus Excision of bone mass from the lateral wall of calcaneus and adhesiolysis relieved symptoms of stenosing synovitis. Zoellner and Clancy technique of deepening peroneal tendon groove and reconstruction of peroneal retinaculum using periosteal flap were supplemented for dislocation of peroneal tendon. Among nine patients, four needed subtalar arthrodesis. The results were favorable.

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K-wire Migration into the Thoracic Cavity after Surgery of Scapular Fracture: A Case Report: In Ju Lee, Nam Yong Choi, Young Chae Lee, Hyun Seok Song; J Korean Soc Fract 1996;9(2):326-329. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.326

Abstract PDF: The use of smooth and threaded pins for internal fixation is often complicated by component migration to a part of the body especially when employed about the acromioclavicuiar Joint. A case report of K-wire migration into the thoracic cavity following surgery of scapular fracture is presented. This phoenomenon occurred despite efforts to bend the lateral ends of the pins to prevent medial migration. If pins or wires are employed even bent at the lateral ends, chinidcal and x-ray follow up should be frequent. The pins should be removed immediately on obtaining the desired therapy.

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Surigcal Treatment for Acute Acromioclayicular Joint Dislocation: Nam Yong Choi, In Ju Lee, Moon Ku Choi, Young Chae Lee, Han Jin Kim, Chong Ook Shin; J Korean Soc Fract 1995;8(1):188-192. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.188

Abstract PDF: Thirty-one patients who had a acromioclavicular joint dislocation that were treated by surgical operation, between January 1990 and December 1993 at St. Pauls & Holy Family hospital were analyzed. The results are as follows; 1. There were twenty-five males and six females. The mean age was 33 years, ranging from 17 to 52 years old. 2. Out of thirty-one cases, twenty-six had good to excellent functional results. 3. As regards complication, wire migration occurred in two cases, wire breakage in one case, screw loosening in one, and subluxation following wire or screw removal in four.

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Problems in the use of Compression Hip Screw in the Treatment of Hip Fractures: Myung Sang Moon, In Ju Lee, Nam Yong Choi, Dong Soo Choi; J Korean Soc Fract 1990;3(1):96-102. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.96

Abstract PDF: Though compression hip screw system has many advantages over the other fixation devices in the treatment of hip fractures, surgeons were frequently encountered by the intraoperative and postoperative complications leading to poor result. In reviewing out series of hip fractures treated with this device, between January 1983 and December 1988, serious complications developed in 5 cases, Additionally, three cases who were referred to our hospital during the same period were included in this study. The authors analyzed these 8cases, and found that the complications could have been prevented in using compression hip screw system for the treatment of hip fractures. The purpose of this paper is to re-emphasize the importance of 1) strict application of indication, 2) familiarity with surgical technique and handing instruments, 3) radiologic examination during surgery, 4) good postoperative care.

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