Journal of Musculoskeletal Trauma

The Mid-Term Result after Osteosynthesis of Intra-Articular Fractures of Distal Femur: Sam Guk Park, Jeong Jae Moon, Oog Jin Shon; J Korean Fract Soc 2016;29(4):242-249. Published online October 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.4.242

PURPOSE
This study was to evaluate the radiological and clinical mid-term results and the presence of post-traumatic osteoarthritis after osteosynthesis in patients under the age of 50 years undergoing osteosynthesis for distal femur intra-articular fractures (AO/OTA 33-B & C) from high-energy trauma.
MATERIALS AND METHODS
Between January 2008 and January 2013, a total of twenty-one patients with more than three years of follow-up were enrolled. Recovery of the alignment of the lower extremity, union period, and the presence of post-traumatic osteoarthritis were confirmed by follow-up radiographs. Clinically, the range of motion, pain on fracture lesion, and Knee Society score (KSS) were evaluated.
RESULTS
The average duration of union was 18.2 weeks (10-28 weeks), and the alignment of the lower extremity was within normal range in all patients. Seven patients showed post-traumatic osteoarthritis at the final follow-up after more than three years. The presence of post-traumatic osteoarthritis was associated with the classification of fractures, coronal plane fracture, and age. The average range of motion, knee score among KSS, and function score at the last follow-up were 128.7Â°, 86.1, and 85.1, all showing a greater improvement when compared with the one-year follow-up scores.
CONCLUSION
The mid-term result was radiologically and clinically satisfactory. Furthermore, only 33.3% of patients showed a slight progress of post-traumatic osteoarthritis, which critically effects the prognosis.

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Incidence of nonunion after surgery of distal femoral fractures using contemporary fixation device: a meta‐analysis
Byung-Ho Yoon, In Keun Park, Youngwoo Kim, Hyoung-Keun Oh, Suk Kyu Choo, Yerl-Bo Sung
Archives of Orthopaedic and Trauma Surgery.2021; 141(2): 225. CrossRef

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Cannulated Screw and Wire Fixation with Predrilling for Olecranon Osteotomy in Intra-articular Comminuted Distal Humerus Fractures: Soo Hong Han, Ho Jae Lee, Woo Hyun Kim, Yong Gil Jo, Won Tae Song; J Korean Fract Soc 2015;28(2):118-124. Published online April 30, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.2.118

Abstract PDF: PURPOSE
The olecranon osteotomy in intra-articular comminuted distal humerus fractures is a suggested technique for excellent exposure of articular fractures. However, complications including delayed union, nonunion of osteotomy site have been reported. Authors have applied predrilling for cannulated screw before osteotomy for achievement of rapid and accurate reposition of separation part and added wire fixation for secure stability. The purpose of this study is to evaluate the efficacy of this fixation procedure following the olecranon osteotomy during the internal fixation of intra-articular fracture of the distal humerus.
MATERIALS AND METHODS
This study retrospectively analyzed 14 cases (9 women and 5 men) of intra-articular distal humerus fractures in which the olecranon osteotomy was applied. The mean age of patients was 53.4 years (range, 25 to 83 years), and the average follow-up period was 15.9 months. Eleven cases were classified as AO 13-C3, and the other 3 cases were AO 13-C2. Reduction accuracy, union period of osteotomy site on follow-up radiographs and postoperative complications related to olecranon osteotomy were evaluated.
RESULTS
All osteotomized parts showed no position change and solid union with normal alignment at the last follow-up. The mean period of bony union was 3.5 months (range, 2 to 5 months). There were no complications related to olecranon osteotomy except one case of non-displaced fracture of the proximal ulnar shaft at the level of cannulated screw tip caused by forceful passive physical therapy. It was managed by conservative treatment without further problem.
CONCLUSION
Predrilled cannulated screw and wire fixation following the olecranon osteotomy during internal fixation of intra-articular comminuted distal humerus fractures showed satisfactory results in the union of osteotomy site and it could be a recommendable procedure when fractures require olecranon osteotomy.

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A Retrospective Comparative Study of Internal Fixation with Reconstruction Plate Versus Anatomical Locking Compression Plate in Displaced Intercondylar Fractures of Humerus: Tong Joo Lee, Young Tae Kim, Dae Gyu Kwon, Ju Yong Park; J Korean Fract Soc 2014;27(4):294-300. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.294

Abstract PDF: PURPOSE
To analyze the clinical result of a conventional reconstruction plate (CRP) fixation and locking compressive plate (LCP) fixation on the surgical treatment of an adult's displaced intercondylar fracture of humerus.
MATERIALS AND METHODS
A total of 40 patients enrolled in the study were treated between August 2002 and May 2012. Fixation with a CRP was performed in 20 patients (group A) and anatomical locking compression plate fixation was performed in 20 patients (group B). The clinical and functional evaluation was performed according to the Mayo elbow performance score and Cassebaum classification of elbow range of motion (ROM), disabilities of the arm, shoulder and hand score.
RESULTS
The Mayo elbow functional evaluation scores, eight cases were excellent, 10 cases were good, and two cases were fair in group A, and 12 cases were excellent, seven cases good, and one case fair in group B; both groups showed satisfactory results. The durations of attaining 90 to 120 degrees of the ROM of joints postoperatively were 8.3 days on average (6 to 15 days) in group A and 5.5 days on average (5 to 9 days) in group B, demonstrating a significant difference between the two groups (p=0.04). Although the correlations of clinical results according to the difference of bone mineral densities (BMDs) were not statistically significant between the two groups (p=0.35), loss of fixation occurred due to loosening of screws in two patients with low BMDs in whose operations reconstruction plates were used.
CONCLUSION
The use of locking compressive plate on the surgical treatment of an diaplaced intercondylar fracture of humerus have a good clinical results because that permits early rehabilitation through good fixation and reduces the complications such as loosening of screws.

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The Additional Use of External Fixator after Percutaneous K-Wire Fixation for Intra-articular fractures of The Distal Radius: Chang Woo Kim, Ja Seong Gu, Gi Tae Jeong, Su Yeong Jeon, Tae Hoon Jeong, Jang Won Hur, Yeon Park; J Korean Soc Fract 2000;13(1):139-145. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.139

Abstract PDF: PURPOSE
: To evaluate the role of the additional external fixator in maintenance of reduction with was known as an important prognostic factor for the treatment of intra-articular distal radius frctures. MATERIAL AND METHOD : Thirty cases of unstalbe intra-articular fractures of the distal radius, which were treated by operative method, were classified by Frykman's method and grouped in two(group A and B). The group A was treated by closed reduction and percutaneous K-wire fixation and long arm cast immobilization. The group B was treated by treated by closed reduction and percutaneous K-wire fixation with use of additional external fixator. The end results were evaluated by the Demerit Point Rating System(by Sarmiento) & radiologic evaluation(radiologic index : radial length, radial tilt, volar tilt) RESULTS : By the Demerit point rating system, excellent and good results were rated by 45.5% in group A and 75% in group B and poor results were found in 3 cases which were Frykman type VII or VIII in group A. Radiologically, radial length loss was rated by 11%, radial tilt loss by 10.8% and volar tilt loss by 47% in group A and 3.1%, 6.8%, 29% each in group B(p<0.05).
CONCLUSION
: We think that additional use of external fixator, after percutaneous K-wire fixation, may have an important role in maintenance of reduction and group prognosis for the treament of intra-articular distal radius fractures.

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CT Classification and Surgical Treatment of Intra-Articular Fracture of the Calcaneus: Gi Sik Hong, Eu Seup Chung, Seong Ku Chee; J Korean Soc Fract 1997;10(1):91-98. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.91

Abstract PDF: Computed tomography was used in the evaluation of intra-articular fractures of the calcaneus to develop and reasonable treatment program and predict prognosis. Seventeen fractures of the calcaneus in the sixteen patients were shown to involve the posterior facet and classified by the images of coronal CT scan; Type I(non-displaced), Type II(displaced) and Type III(comminuted). There were one Type I, ten Type II, and six type III fractures. All of which were treated with open reduction and internal fixation, with or without bone graft. The length of follow-up period ranged from thirteen to fourty-five months(mean : 24 months). The results were graded by a predetermined point system. The one type I had an excellent result. Of the ten type 2 fractures ; three had excellent result, four good result, two fair result, and one poor result. Ofthe six type 3 fracture, one had good result, three fair result, two poor result. On the basis a our study, we believed that open reduction and internal fixation was a good method of treatment for the displaced or mildly comminuted intraarticular fracture of the calcaneus

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Surgical Treatment of Intra-articular Fracture of the Os Calcis: Soo Kil Kim, Young Gyu Kim, Bum Gu Lee, Jin Hong Ko, Su Chan Lee, Young Kim; J Korean Soc Fract 1996;9(2):354-365. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.354

Abstract PDF: Intra-articular fractures involving the posterior facet of the subtalar joint are associated with significant and prolonged disability. But, the treatment of choice for displaced intra-articular calcaneal fractures remains controversial. We treated 30 displaced intra-articular fractures of the calcaneus by open 1eduction and internal fixation through the lateral approach with autogenous bone graft at the Department of Orthopaedic Surgery, Choong-ang Gil and Dong Inchon Gil Ceneral Hospital from January 1990 to October 1994 The clinical and radiographic analyses were as follows. 1. Of 26 patients, 20 patients were male and 6 patients were female. 2. The main cause fractures of calcaneus was a fall from a height in 23 cases(88%) and most of associ ated fractures were spine injury in 6 patients. 3. Fracture was classified according to Essex-Lopresti classification. 13 cases were tongue type, 17 cases were joint depression type. 4. Alt Open reduction and internal fixation through the laterl approach with bone graft was performed in joint depression type and tongue type. 5. The preoperative ayerage Bohlers angle was - 5. The postoperative avereage Bohlers angle was -24, Which was increased significantly. 6. Complications were 12 cases ; included heel pad pain in 8 caLes, osteomyelitis and superficial wound infection in 2 cases, transient sensory hypesthesia on the lateral side of the foot in 2 cases. 7. Based on assessement of Salama, the results were excellent in 5 cases, good in 1 Teases, fair in 6 cases, poor in 2 cases.

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Intra-Articular Fractures of the Calcaneus: ORIF via Lateral Approac: Ik Dong Kim, Jo Chul Ihn, Poong Taek Kim, Byung Chul Park, Young Goo Lyu, Il Hyung Park, Sung Jung Kim; J Korean Soc Fract 1992;5(2):199-204. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.199

Abstract PDF: The os calcis is one of the most commonly injured tarsal bone and fractures involving the subtalar joint may cause serious and persistent disabilities. We treated 12 intra-artlcular calcaneal fractures in 11 patients from June, 1998 to April, 1992 by plate fixation after lateral approach. The Sanders fracture classification system was applied to out study which classify the fractures according to the number of the fractured segments and direction of the fracture lines after computerized axial tomography of the posterior facetal joint. The follow-up evaluation included questioning the patient about pain during activity and rest, the ability to walk and stand, range of subtalar motion and ability to return to work according to the assessment sheet for calcaneal fractures of Creighton Nebraska Health Foundationl We experienced 8 excellent and 2 good results among 12 cases and there was little complication.

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