Journal of Musculoskeletal Trauma

Outcomes of Minimally Invasive Surgery in Intra-Articular Calcaneal Fractures: Sanders Type III, Joint Depressive Type Calcaneal Fracture: Je Hong Ryu, Jun Young Lee, Kang Yeol Ko, Sung Min Jo, Hyoung Tae Kim; J Korean Fract Soc 2023;36(3):85-94. Published online July 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.3.85

Abstract PDF: Purpose
To evaluate the radiologic and clinical outcomes of a minimally invasive technique using the tarsal sinus approach in the management of Sanders type III, joint depressive type calcaneal fractures.
Materials and Methods
Between July 2011 and September 2019, data of 29 patients who underwent a minimally invasive procedure with the sinus tarsi approach for Sanders type III joint depressive intra-articular calcaneal fractures, and were followed up for more than 1 year were analyzed. We evaluated the radiologic outcomes by assessing the radiologic parameters (Böhler angle, Gissane angle, calca-neal length, calcaneal height, calcaneal width). We also evaluated the clinical outcomes based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the complications associated with the technique.
Results
The radiological results showed an improvement in the Böhler angle from 2.5° to 18.6° and the Gissane angle from 132.4° to 119.1° after the operation. The mean AOFAS score during the clini-cal evaluation was 79.5. We observed 13 cases of posttraumatic arthritis, 1 case of subtalar arthrodesis, and no case of wound complication.
Conclusion
Minimally invasive technique for Sanders type III joint depressive calcaneal fractures resulted in relatively satisfactory radiologic and clinical outcomes. Open reduction and internal fixation through the sinus tarsi approach reduce complications including wound problems. This approach offers satisfactory results without long-term complications.

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Paratricipital Approach for AO/OTA Type C2 Intra-Articular Fracture of Distal Humerus: Chul Hyung Lee, Doo Hun Sun, Deukhee Jung, Chung Han An; J Korean Fract Soc 2019;32(3):128-134. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.128

Abstract PDF: PURPOSE
The aim of this study was to determine the outcomes of fixation of AO/OTA type C2 fractures among intra-articular fractures of the distal humerus using the paratricipital approach (side to side retraction of the triceps).
MATERIALS AND METHODS
From June 2008 to January 2018, 12 patients underwent an open reduction and internal fixation with the paratricipital approach and were followed-up for more than 10 months after surgery. According to the AO/OTA classification, type C2 fractures were chosen among the intraarticular distal humerus fractures. An extended posterior incision was used over the olecranon in the prone position, preserving the insertion site of the triceps brachii muscle. The fracture site was exposed by retracting the muscle side-to side through a dissection of the medial and lateral intermuscular septum of the triceps brachii muscle. The therapeutic results were assessed by the anatomical reduction of the articular surface and integrity of the metaphyseal contour in postoperative simple radiographs, complications, such as neuropathy or non-union, and the Mayo elbow performance score (MEPS) were checked to estimate the functional outcome.
RESULTS
In the postoperative simple radiographs, no case showed more than 1 mm step-off and the disrupted contour of the distal humerus was recovered to normal alignment in most cases. The range of elbow joint motion in the last follow-up was 133.8Â° on average with a mean flexion contracture of 5.0Â°. The clinical results depending on the MEPS were excellent, except for two cases, which were good. Neuropathy of the ulnar nerve was observed in one patient, which was resolved after metal removal.
CONCLUSION
The paratricipital approach is useful technique in AO/OTA type C2 intra-articular distal humerus fractures that provides sufficient exposure of the surgical field, without injury to the triceps brachii muscle and postoperative complications associated with the trans-olecranon approach.

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Orthogonal Locking Compression Plate Fixation for Distal Humeral Intraarticular Fractures: Hyoung Keun Oh, Suk Kyu Choo, Kyoung Hwan Koh, Ji Woong Yeom; J Korean Fract Soc 2016;29(3):178-184. Published online July 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.3.178

Abstract PDF: PURPOSE
To investigate the surgical outcomes of orthogonal locking compression plate fixation for distal humeral intraarticular fractures.
MATERIALS AND METHODS
This study included 18 patients presenting a distal humeral intraarticular fracture who were treated with orthogonal locking compression plate fixation. According to the AO/OTA classification, there were eight C2 and ten C3 fractures. We evaluated radiologic outcomes, clinical results with range of motion, operation-related complications, and functional score by Mayo elbow performance score (MEPS).
RESULTS
The a verage u nion t ime was 3.5 months, and there was no c ase of r eduction l oss of a rticular f racture at t he last follow-up. Additional surgical procedures were needed in the three cases of C3 fractures. There was one case of heterotrophic ossification and one case of K-wire irritation. The average range of motion of elbow joint was 7Â° to 122Â°, and functional results were graded as 14 excellent, three good, and one fair by MEPS.
CONCLUSION
Anatomical reduction and internal fixation with orthogonal locking compression plate could provide satisfactory surgical outcomes for the treatment of distal humeral intraarticular fracture.

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Comparison of Outcomes for Unstable Distal Radius Intraarticular Fractures: T-locking Compression Plate versus External Fixator: Chul Hyun Cho, Su Won Jung, Sung Won Sohn, Chul Hyung Kang, Ki Cheor Bae, Kyung Jae Lee; J Korean Fract Soc 2008;21(1):51-56. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.51

Abstract PDF

PURPOSE
To compare the outcomes between T-locking compression plate (T-LCP) and external fixator (EF) for unstable distal radius intraarticular fractures.
MATERIALS AND METHODS
We retrospectively analysed the results in 22 cases with T-LCP, 20 cases with EF. We evaluated the clinical results according to the Mayo Wrist Scoring System, radiographic results.
RESULTS
The mean score was 84.6 in the T-LCP group and 80.5 in the EF group respectively. Final radiographic measurements for the T-LCP group averaged 10.5 mm radial length, 21.7degrees radial inclination, 9.8degrees volar tilt and 0.25 mm intraarticular step-off. The EF group averaged 10.1 mm radial length, 20.3 degrees radial inclination, 6.3 degrees volar tilt and 0.73 mm intraarticular step-off.
CONCLUSION
Both groups showed satisfactory final clinical outcomes. But T-LCP group allowed return to daily living, resulting in early postsurgical wrist motion. By the anatomical reduction, final volar tilt, intraarticular step-off were statistically better in the T-LCP group.

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Comparative Analysis of the Results of Fixed-angle versus Variable-angle Volar Locking Plate for Distal Radius Fracture Fixation
Seung-Do Cha, Jai-Hyung Park, Hyung-Soo Kim, Soo-Tae Chung, Jeong-Hyun Yoo, Joo-Hak Kim, Jung-Hwan Park
Journal of the Korean Fracture Society.2012; 25(3): 197. CrossRef
Treatment for Unstable Distal Radius Fracture with Osteoporosis -Internal Fixation versus External Fixation-
Jin Rok Oh, Tae Yean Cho, Sung Min Kwan
Journal of the Korean Fracture Society.2010; 23(1): 76. CrossRef

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The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures: Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Sueng Hwan Jo; J Korean Fract Soc 2007;20(3):227-232. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.227

Abstract PDF

PURPOSE
To evaluate the relationship between radiographic parameters and clinical results after operative treatment of the displaced intra-articular calcaneal fractures.
MATERIALS AND METHODS
We analyzed 35 patients of unilateral displaced intraarticular calcaneal fractures who had operative treatment with minimum follow up of 1 year. At the last follow up, we measured the radiographic parameters including Bohler angle, Gissane angle, heel height, calcaneal length, talocalcaneal angle, talar declination angle, subtalar incongruity between normal and affected site. Clinical results were measured by Creighton-Nebraska Health Foundation Assessment Score (CNH). The correlation between the radiographic parameters and the clinical results were analysed by Pearson correlation method.
RESULTS
Among the all radiographic parameters we analyzed, only subtalar incongruity shows strong negative linear correlation with clinical results. The average difference of subtalar incongruity between normal and affected site was 0.54 mm (0~2.5) and the correlation coefficients with CNH score was -0.784 (p=0.002).
CONCLUSION
We suggest that the subtalar incongruity is significantly correlated with the clinical results after operative treatment of the displaced intraarticular calcaneal fractures.

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Results in Operative Treatment of Open Calcaneal Fracture
Ba Rom Kim, Jun Young Lee, Donghyuk Cha
Journal of Korean Foot and Ankle Society.2021; 25(3): 133. CrossRef
Measurement of Normal Calcaneus in Korean Cadavers: A Preliminary Report
Jung-Han Kim, Heui-Chul Gwak, Jeon-Gyo Kim, Yang Hwan Jung
Journal of Korean Foot and Ankle Society.2014; 18(1): 14. CrossRef

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Treatment of High-energy Distal Tibia Intraarticular Fractures with Two-staged Delayed Minimal Invasive Plate Osteosynthesis: Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Jae Won You, Sang Hong Lee, Kwang Chul Lee; J Korean Fract Soc 2007;20(1):19-25. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.19

Abstract PDF

PURPOSE
To evaluate the short-term results of two-staged delayed minimal invasive plate osteosynthesis in high-energy intraarticular fractures of the distal tibia.
MATERIALS AND METHODS
Thirteen patients, who underwent two-staged delayed minimal invasive plate osteosynthesis for intraarticular fractures of the distal tibia between January 2002 and July 2004, were followed for more than one year. The mean interval time between first stage and second stage of the procedures was 28.6 days (range, 14~34 days). By Ruedi-Allgower classification, there were two cases in type I, three cases in type II, and eight cases in type III. There were six cases in type B and seven cases in type C patients according to AO/OTA classification. Radiographs were graded by the criteria of Burwell and Charnley and ankle functions were graded by the criteria of Mast and Teipner. Union time and postoperative complications were also analysed.
RESULTS
Average union time was 16.9 weeks (range, 14~20 weeks) in twelve of the thirteen fractures, but there was one fracture resulting in soft tissue complication and infected nonunion. At the latest follow-up, review of the radiographic results showed that ten cases of fractures (77%) achieved an anatomic reduction, two cases (15%) achieved fair reduction and one case (8%) achieved a poor reduction. And clinical functional assessment showed that nine cases (69%) were good results, three cases were (23%) fair results and one case (8%) was poor result.
CONCLUSION
Two-staged delayed minimal invasive plate osteosynthesis is an excellent option for the treatment of high-energy intraarticular fractures of the distal tibia.

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Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures
Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn
Journal of the Korean Fracture Society.2010; 23(3): 289. CrossRef
The Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Proximal and Distal Tibia Fracture
Joon Soon Kang, Seung Rim Park, Sang Rim Kim, Yong Geun Park, Jae Ho Jung, Sung Wook Choi
Journal of the Korean Fracture Society.2010; 23(2): 172. CrossRef
Two-staged Delayed Minimally Invasive Percutaneous Plate Osteosynthesis for Distal Tibial Open Fractures
Jung Hwan Yang, Seok Hyun Kweon, Jeung Woo Kim, Jin Young Park, Hyun Jun Kim, Chul Min Lim
Journal of the Korean Fracture Society.2008; 21(1): 24. CrossRef

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Operative Treatment of Intraarticular Calcaneal Fracture: Comparison of Outcomes between Open Reduction and Closed Reduction: Chang Hun Sung, Byeong Mun Park, Kyeong Seop Song, Hyung Gyu Kim, Jong Min Kim, Tae Eun Kim; J Korean Fract Soc 2005;18(2):170-175. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.170

Abstract PDF

PURPOSE
To evaluate the clinical outcomes and radiographic results of operative treatment for intraarticular calcaneal fracture.
MATERIALS AND METHODS
We reviewed 57 cases of intraarticular calcaneal fracture managed with operative treatment, from January, 2000 to June, 2003. The type of intraarticular calcaneal fracture is classified by the Essex-Lopresti classification and Sanders by computed tomography. The 20 cases were managed by open reduction, 37 cases by closed reduction.
RESULTS
On clinical outcomes in the case of open reduction and internal fixation, above good in 13 cases, poor in 2 cases; closed reduction, above good in 16 cases, poor in 10 cases. Averages of Bohler angle were increased from 11degrees (preoperative state) to 21degrees (last follow up) in open reduction, and from 14degrees to 20.9degrees in closed reduction.
CONCLUSION
Open reduction was considered to be one of good treatment option if the anatomical reduction and stable fixation can be obtained.

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Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures
Seung Hun Woo, Hyung-Jin Chung, Su-Young Bae, Sun-Kyu Kim
Journal of the Korean Orthopaedic Association.2017; 52(1): 49. CrossRef
Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method
Gyu Min Kong, Byoung Ho Suh, Dong Joon Kim
Journal of the Korean Fracture Society.2007; 20(2): 178. CrossRef
Treatment of Calcaneus Fractures: Recent Trend for Acute Fractures and Complications
Woo-Chun Lee
Journal of the Korean Fracture Society.2007; 20(4): 361. CrossRef

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Mechanical Properties of F Plate in Intraarticular Calcaneal Fractures: Kyu Hyun Yang, Young Hee Park, Jung Hoon Won, Dae Ya Kim; J Korean Fract Soc 2004;17(2):167-172. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.167

Abstract PDF

PURPOSE
We evaluated the mechanical properties of F plate fixation comparing with Y plate and a screw fixation for the intraarticular calcaneal fractures using synthetic bones.
MATERIALS AND METHODS
Using 12 synthetic calcaneal bones, newly designed F plate was compared with the Y-plate, most commonly used, regarding the change of Bohler angle and the displacement of the thalamic fragments of the calcaneus after axial compressive loading by Instron 6022.
RESULTS
Y plate fixation lost 8degrees of Bohler angle in average after axial compressive load and 2.6degrees in F plate fixation. Thalamic fragments were displaced 1.72 mm in average in Y plate fixation group and 0.73 mm in F plate fixation group.
CONCLUSION
F plate offered more firm fixation than Y plate in the intraarticular calcaneal fracture in the aspect of maintaining the Bohler angle and preventing displacement of the thalamic fragments of calcaneus against axial compressive loading.

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The Effect of Temporary K-wire Fixation in the Plate Fixation for Displaced Intra-articular Calcaneal Fracture
Kiwon Young, Jin Su Kim, Jinseon Moon
Journal of Korean Foot and Ankle Society.2014; 18(3): 119. CrossRef
Treatment of Displaced Intra-articular Calcaneal Fractures Using a F-plate
Kyu Hyun Yang, Jae Bong Chung, Han Kook Yoon, Si Young Park, Hang Seob Yoon
Journal of the Korean Fracture Society.2007; 20(1): 1. CrossRef

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Usefulness of CT Scan in Treatment of Calcaneal Fracture: Hak Jun Kim, Kwon Ick Ha, Jeong Ro Yoon, Jae Ik Shim, Taik Seon Kim, Young Bae Kim, Woo Seung Lee, Jae Hyuck Choi; J Korean Soc Fract 2003;16(4):526-533. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.526

Abstract PDF

PURPOSE
Accurate fracture classification is difficult because of its complex bony architecture and there is no definitive treatment modality according to fracture pattern or classification. We evaluated the fracture pattern using simple radiography and CT scan simultaneously and then the result according to treatment modalities and fracture classification.
MATERIALS AND METHODS
We evaluated 24 patients (26 cases) who suffered intraarticular calcaneal fracture were treated with closed reduction and axial pinning or open reduction and plate fixation. There were had taken CT scan. Fractures were classified with two different manner using both plain radiography and CT scan. Essex-Lopresti classification was made with plain radiography and Sanders classification was made with CT scan. Radiographic results were measured of preoperative and postoperative Bohler angle on plain x-ray. 16 patients (17 cases) were analyzed for clinical outcomes by Salama's criteria focused on pain, patients' satisfaction, walking abilities and usage of orthosis.
RESULTS
Mean followed-up period was 6 years (range 1~8.8 years). 8 cases were classified into tongue type intraarticular calcaneal fractures by plain radiography and 9 cases into joint depression type. According to Sanders classification by CT scan, 5 cases were classified into type IIA, 1 case IIC, 4 cases type IIIA, 4 cases IIIB and 3 case type IV. 12 fractures were reduced by closed reduction and axial fixation and 5 cases by open reduction and internal fixation. There was no correlation between clinical outcomes and treatment modality but there was linear correlation between clinical outcomes and postoperative Bohler angle (correlation coefficient = 0.04). In 8 cases of tongue type by plain radiography, sanders type IIC was only 1 case which calcaneal tuberosity connected to articular facet but articular involvements were observed in remaining cases.
CONCLUSION
Accurate eavaluation of articular facet in calcaneal fracture by CT scan is necessary to determining to select the treatment option.

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Physiological Characteristics and Anti-Obesity Effect of Lactobacillus plantarum K6 isolated from Kimchi
Seulki Kim, Sang-Dong Lim
Journal of Milk Science and Biotechnology.2017; 35(4): 221. CrossRef

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Arthroscopically Assisted Fixation of Intraarticular Distal Radial Fractures: Won Young Lee, Byung Mun Park, Dae Eu Lim, Kyung Sub Song, Jung Woo Hong; J Korean Soc Fract 2003;16(3):399-406. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.399

Abstract PDF

PURPOSE
To investigate the results of arthroscopically assisted reduction of intraarticular fracture of distal radius with percutaneous K-wires and external fixation.
MATERIALS AND METHODS
We reviewed 12 intraarticular distal radial fractures of 11 patients treated arthroscopically assisted reduction in Orthopedic Department of Sung-Ae hospital between January, 2001 and August, 2001. The mean length of follow-up was 14 months. Analysis of them revealed that B3 was 1 case, C2 4 cases and C3 7 cases according to the AO classification. All cases were treated by 2.7 mm arthrosopic devices and percutaneous K-wires pinning with external fixation, but additionally invasive reductional technique was not used. We removed the osteochondral flap in the joint space and detected the carpal ligaments and triangular fibrocartilage complex tears but not treated. The K-wires were removed at 4 weeks, external fixation was 7 weeks, respectively.
RESULTS
The mean active range of movement in the affected wrist was total arc of the flexion-extension 72% of the opposite side. Radiographically mean volar tilt, radial inclination and radial length were 5.7 degrees, 22.4 degrees, and 12.3 mm. The mean articualar step-off was 2 mm or less. Post-operative compartment syndrome and fracture collapse were not occured during follow-up period. According to the Gartland and Werley demerit-point system, eleven cases were a excellent or good and one was a fair result.
CONCLUSION
Arthroscopically assisted fixation is a useful method for reducing the soft tissue injuries and preventing the articular surface incongruency by anatomically reduction in cases of intraarticular comminution.

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Arthroscopic Repair for Traumatic Peripheral Tear of Triangular Fibrocartilage Complex
Seung-Ju Jeon, Chan-Sam Moon, Ho-Seung Jeon, Haeng-Kee Noh, Sung-Hwan Kim
Journal of the Korean Fracture Society.2007; 20(4): 330. CrossRef

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Surgical treatment using external fixator for unstable intra-articular fracture of distal radius: Chul Hong Kim, Byeong Hwan Kim, Sung Won Lee, Wook Kim; J Korean Soc Fract 2003;16(1):83-90. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.83

Abstract PDF: PURPOSE
To analyze the results of surgical treatment using external fixator for unstable intra-articular fracture of distal radius. MATERIAL AND METHODS: We investigated 38 cases of distal radius fracture from Mar. 1990 to Dec. 2000. The patients were followed up for average 18 months postoperatively. We compared the results of 22 cases, treated with open reduction and internal fixation(ORIF) to the results of 16 cases, treated with ORIF and external fixation. We evaluated the results of the mean loss of radial length, radial inclination, volar tilt and traumatic arthritis according to demerit point rating system above the Fernandez classification IV.
RESULTS
According to demerit point rating system, excellent to good results were obtained in 72.7% at ORIF and external fixator, compared to 43.8% at case of ORIF only. In the last follow up, the mean loss of radial length was 0.6mm in case of ORIF, but 0.4 mm in case of ORIF and external fixator, the mean loss of radial inclination was 2.3 and 1.5 degrees, the mean loss of volar tilt was 2.5 and 2.2 degrees, respectively (p < 0.05). Postoperative complications were developed in 9 cases. Malunion was in 4 cases of ORIF and external fixator, in 2 cases of ORIF. Metacarpal bone fracture was in 1 case of ORIF and external fixation. Traumatic arthritis was in 2 cases of ORIF.
CONCLUSION
Open reduction and internal fixation combined with external fixation was thought to be a better method than open reduction and internal fixation for the treatment of unstable intra-articular fractures of the distal radius of the Fernandez classification IV and IV, because that was more comfortable and convenient to patients and was useful to prevent late displacement.

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Operative Treatment of Intraarticular Calcaneal Fractures Combined with Multiple Injuries using Closed Reduction and Cannulated Screw Fixation: Dae Moo Shim, Tae Kyun Kim, Soo Uk Chae, Seok Hyun Kweon; J Korean Soc Fract 2002;15(4):439-445. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.439

Abstract PDF: PURPOSE
To evaluate the radiological and clinical results of closed reduction and cannulated screw percutaneous fixation of intraarticular calcaneal fractures combined with multiple injuries.
MATERIALS AND METHODS
We reviewed 15 cases of 13 patients intraarticular calcaneal fractures combined with multiple injuries which were treated with closed reduction and cannulated screw percutaneous fixation between June 1998 to June 2001 and minimum follow up period of 12 months(12-27 months). The results were based on the assessment criteria of Salama and the analysis of Bohler 's angle, states of subtalar joint and deformities of calcaneus. Based on the Sanders classification, there were 2 cases(13%) of type I, 9 cases(60%) of type II and 4 cases(27%) of type III.
RESULTS
The preoperative Bohler 's angles were between 5 degrees to 35 degrees, postoperative Bohler 's angles were between 15 degrees to 45 degrees and the last follow up Bohler 's angles were between 15 degrees to 40 degrees . The postoperative complication of subtalar arthritis were developed in 5 cases and deformities of calcaneus were developed in 4 cases. Based on the assessment criteria of Salama, the functional results were excellent in 2 cases, good in 8 cases, fair in 3 cases, and poor in 2 cases.
CONCLUSION
The closed reduction and cannulated screw percutaneous fixation of intraarticular calcaneal fractures combined with multiple injuries was thought to be a useful method of treatment at the state of not delayed operating time and not position changing.

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External fixation of distal radius fracture: Deok Weon Kim, Moon Ki Kim; J Korean Soc Fract 2002;15(2):258-263. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.258

Abstract PDF: PURPOSE
In the treatment of an unstable intraarticular distal radius fracture, we report the result of a retrospective study of reduction maintaining effect of external fixation.
MATERIALS AND METHODS
During the period from May 1996 to May 1999, 19 patients 20 cases with AO type C2, C3 distal radius fracture were treated by external fixation and followed-up for 2 years or longer. Six had AO type C2 fracture, and fourteen type C3. We evaluated immediate postoperative & follow-up radiological evaluation by volar tilt, radial inclination, radial length difference. As combined treatment, additional reduction maintaining effect of bone graft or internal fixation was evaluated also.
RESULT
Mean reduction loss of 2 years or longer follow-up after external fixation was volar tilt 7.2 degrees, radial inclination 4.3 degrees, radial length 3.1 mm. As additional reduction maintaining effect, internal fixation had statistically significant effect(p <0.05)-especially radial length maintenance, but bone graft not significant.
CONCLUSIONS
In unstable intraarticular distal radius fracture, after open reduction or bone graft etc. for intraarticular anatomic reduction, we consider external fixation or combined internal fixation for reduction maintenance.

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Scapholunate Dissociation Associated with Intra-articular Fractures of Distal Radius: Bon Seop Koo, Kyung Chul Kim, Hun Kyu Shin, Jin Heon Kwak; J Korean Soc Fract 2001;14(4):733-738. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.733

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the risk factors in the occurrence of scapholunate dissociation in relation to the intra-articular fracture of distal radius.
MATERIALS AND METHODS
We performed a retrospective evaluation of 170 cases of the fractures. Average age was 52 years(range, 24-85 years). We reviewed both medical records and radiographic films and analyzed the data according to age, width of the medullary cavity of the third metacarpal bone and fracture morphology.
RESULTS
Nine cases(5.3%) of scapholunate dissociation, mean age of 56 years, all had widened medullary cavity, radial styloid process fracture with radial displacement, a vertical fracture line invading articular surface, depression of scaphoid facet(6 cases) and lunate facet(3 cases). Degree of fracture displacement was not significant.
CONCLUSION
In distal radius intra-articular fracture which occurred in old patient with widened metacarpal medulla and had a radially displaced radial styloid fracture, an articular surface involving vertical fracture line and a depression of scaphoid or lunate facet, we should be careful in the concurrence of scapholunate dissociation.

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Operative Treatment of Intraarticular Calcaneus Fractures with extensile lateral approach: Dong Kyu Shin, Yong Woon Kim; J Korean Soc Fract 2001;14(3):440-449. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.440

Abstract PDF: PURPOSE
Through the analysing intraarticular calcaneal fractures operated with extensile lateal approach and lateral plate fixation we tried to find the factors related to the result and to prove the usefulness of this treatment method. MATERIAL AND METHOD: We reviewed 50 intraarticular calcaneal fractures which were treated with this method between July 1995 and December 1998. We analysed the relationship between the fracture type and the accuracy of posterior facet reduction and between the accuracy of reduction and the clinical result. We also analysed the complication rate.
RESULT
We gained anatomical reduction in 64% among all cases. There was significant relationship statistically between the Sanders fracture type and accuracy of reduction(p=0.001). There were also significant relationship statistically between the Sanders fractrure type and the clinical result(p=0.045) and between the accuracy of reduction and clinical result(p=0.001). It was also possible to regain the calcaneal height, width and Bohler angle through this treatment method. There was only one wound complication which was skin necrosis and was treated with dressing and finally skin graft.
CONCLUSION
Sanders classification was very useful and reasonable for this kind of fracture. The accuracy of reduction of posterior facet was very important to clinical result. This treatment method for the calcaneal fracture was useful in the term of regain of anatomical components of calcaneus such as posterior facet congruency, calcaenal height, width and Bohler angle with acceptable rate of serious complication.

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The Effect of External Distractor on Recovery of B hler angle in Displaced Intraarticular Calcaneal Fractures: Deuk Soo Hwang, Kwang Jin Rhee, June Kyu Lee, Jung Hee Choi; J Korean Soc Fract 2000;13(2):375-381. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.375

Abstract PDF: PURPOSE
: We had studied the results retrospectively in displaced intraarticular calcaneal fractures treated with internal fixation by screw for thalamic portion and percutaneous pinning by K-wire using minimal Ollier's lateral approach, so we had reported good results, but recovery of B hler angle loss was difficult technically. So, we used intraoperative external distractor combined with previous our method.
MATERIALS AND METHODS
: We analysed retrospectively B hler angle and clinical results on 12 cases with clcaneal fracture, who underwent an operation for displaced intraarticular calcaneal fracture by using external distractor from January 1997 to August 1998. B hler angle were measured at preoperative, postoperative and last follow-up X-ray. Surgical technique is through minimal Ollier's lateral approach, reduced and fixed with screw of displaced posterior facet and used intraoperative external distractor for restoring of deperssed calcaneal tuberosity and then did percutaneous pinning with K-wire. RESULTS : In the previous our reports, the mean preoperative and postoperative B hler angle were -0.9degrees, 19.1degreeseach other and the mean recovery of B hler angle was 20.1degrees. After we use the intraoperative external distractor, the mean preoperative and postoperative B hler angle were 0.92degrees, 26.0degreeseach other and the mean recovery of B hler angle is 26.9degrees. It is nearly normal range of korean's B hler angle (31.1degrees+/-0.4 degrees). Also there is no complication such as intraoperative calcaneal tuberosity fracture and soft tissue injury(skin necrosis, neurovascular injury).
CONCLUSION
: We obtained enough restoration of B hler angle to normal range by using our previous method combined with intraoperative external distractor.

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Operative Treatment of Intraarticular Fracture of Distal Humerus in Adults: Hyon Oh Cho, Kyoung Duck Kwak, Soo Min Sohn, Woo Keun Jeong, Jong Cheong Choi; J Korean Soc Fract 1999;12(4):975-980. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.975

Abstract PDF: The fractures around the elbow joint in adults are relatively rare in comparision with that in childeren, but the late complications are more common in adults. We have clinically and radiologically analyzed 14 cases of fractures around the elbow joint in adults from January 1995 to December 1998. All patients were treated by open reduction and application of medial and lateral bottress plates providing stable internal fixation enhance early motion. The patients were evaluated for range of motion, infection, pain, degenerative changes. The 14 patients were available for follow-up study for average of 12 months. The result were good in nine, fair in two, poor in three. Traetment of choice for the type III and IV of distal humerus fracture is open reduction with stable internal fixation with plates combined with early active motion.

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Essex-Loprestis Axial Pinning in the Treatment of Intraarticular Calcaneal Fracture: Hyung Koo Yoon, Kwang Pyo Jeon, Kyung Hoon Kang, Jin Il Kim, Dong Soo Kim, Kyung Soub Song; J Korean Soc Fract 1999;12(2):344-350. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.344

Abstract PDF

Fracture of the calcaneus is the most commonly encountered among fracture of tarsal bone and it is difficult to obtain accurate reduction because the calcaneus has cancellous trabecular enclosed with thin cortical bone. In the past, the result of treatment was poor. Recently, closed reduction and axial pin fixation for tongue type fracture and open reduction and internal fixation for joint depression type fractures are considered as generally accepted treatment methods. The purpose of this study is to evaluate the efficacy of axial pin fixation in joint depression(group A) and tongue type(group B). Retrospective study was performed in 20 patient(23 feet) with intraarticular calcaneal fractures which were treated with axial pin fixation from July 1993 to June 1996. Minimum follow up period was 1 year(average 20 months). The obtaining results were as follows : 1. Cause of injury was fall down in the 18 cases(90%). 2. We obtained excellent or good results from the performance of operation within 2 weeks on trauma patient, in the 16 cases(69%). And we obtained excellent or good results in the 14 cases, showing above 20degreesof postoperative B.. ohler angle. 3. In fracture of joint depression type, there is no relationship between clinical result and degree of joint depression in follow up CT. 4. The complications were subtalar arthritis and two neuroma in sural nerve. We propose our experience obtained in 23 cases that axial pin fixation was a good method for treatment of intraarticular fracture, joint depression type as well as tongue type.

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Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method
Gyu Min Kong, Byoung Ho Suh, Dong Joon Kim
Journal of the Korean Fracture Society.2007; 20(2): 178. CrossRef

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Comparison of the conservative and operative treatment of the intraarticular calcaneal fractures: Chang Woo Kim, Min Young Chung, Ki Tae Jung, Eun Hwan Bae, Seong Ho Park, Ho Keun Park, Tae Hoon Jeong; J Korean Soc Fract 1999;12(2):335-343. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.335

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The calcaneal fracture, which is considered to be the most common tarsal bone fracture, has rather difficulty in accurate diagnosis, classification and proper treatment. Furthermore, its prognosis is not good, either. The authors analysed 68 intraarticular calcaneal fractures (Sanders type II & III only) out of 147 cases, which were treated operatively or conservatively from June 1990 to May 1997, and found out that the results of conservative and operative treatment were approximately the same. The length of follow-up ranged from one year to four and half years (mean, 2.7years). The results were as follows: Of the 24 conservatively treated group, seven had excellent; eleven good; four fair; and two poor result. Of the 44 operatively treated group, eleven had excellent; twenty seven good; five fair; and one poor result. The sum of excellent and good results in conservative and operative treatment group were 75.0% and 86.4% each other, and these were not meaningful statistically (p=0.400). Therefore, the authors recommend a conservative treatment as an effective alternative method for the intraarticular calcaneal fracture.

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Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography
Joon-Sang Eom, Young-Deuk Joo, Seong-Jun Kim, Min-Ho Shin, Dong-Oh Lee, Hong-Geun Jung
Journal of Korean Foot and Ankle Society.2014; 18(4): 165. CrossRef
Treatment of Intra-articular Calcaneal Fractures Using Minimally Invasive Sinus Tarsi Approach in Diabetic Patients
Hong-Moon Sohn, Sang-Ho Ha, Sang-Hong Lee, Jun-Young Lee, Jeong-Ho Kim, Sang-Jun Lee
Journal of the Korean Fracture Society.2008; 21(3): 195. CrossRef

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The prognostic factors in Tongue shaped calcaneal fractures treated by Essex-Lopresti method: Jong Oh Kim, Dong Wook Kim, Young Do Koh, Jae Doo Yoo, Dong Wook Lee; J Korean Soc Fract 1999;12(2):328-334. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.328

Abstract PDF: There is a great difference in opinion regarding the treatment of intraarticular fractures of the calcaneus. In Essex-Lopresti method, a heavy Steinmann pin is introduced into the cancellous part of tongue fragment and the fracture is reduced by lifting the fragment by the level effect of the Steinmann pin. The authors had treated 38 cases in 36 patients with displaced intraarticular tongue shaped fractures using Essex-Lopresti axial fixation at our hospital from 1993 to 1997. We obtained the following results. 1. Of 36 patients, 31 patients were male and 5 female 2. The main cause of fractures were fall from height in 86 percent of cases and spine injury was associated in 8 cases(22%). 3. The favorable result was obtained in 29 cases(76%). 4. The poor prognostic factors in functional outcome were old age, comminution of fracture, osteoporosis and the loss of correction in B.. ohler angle at postoperative and follow up Xrays.

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Treatments of Intraarticular Calcaneal Fracture: Based on CT Classification and Comparison of Treatments: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Ju Sik Park; J Korean Soc Fract 1999;12(1):103-112. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.103

Abstract PDF: The treatment modality of the displaced intraarticular calcaneal fractures is still controversial. The objectives of this study are to classify intraarticular fractures based on computed tomography and to compare the treatment results according to the classification and to consider the influence of Bohler angle to the prognosis of this injuries. From October 1989 to March 1997, 62 fractures(58 patients) who had been treated after calcaneal CT(computed tomography) were selected. The interval between the trauma and the last follw-up was mean 3.3 years(1.1-5.2 years). They had been treated with one of the three methods, that is, open reduction and internal fixation(OR/IF), Essex Lopresti or simple cast immobilization. The fracture was classified as type I(non-displced), type I(two part or split), type III(three part or split depression), type IV (four part or highly comminuted) based on CT according to Sanders et. al. The calcaneal scoring system proposed by Kerr et. al. was applied to the assessment of the treatment results, which may be more appropriate for non-parametric statistical test. The type I fractures had been treated only with cast immoobilization with or without manual reduction and all of the 4 cases(100%) have shown favorable(excellent or good) results. The OR/IF group(favorable results for 15 of 18 cases(83.3%) in type II and for 11 of 13(84.6%) in type III) have shown better results than those of other two group(P<0.05). The results between other two groups, that is, Essex-Lopresti operation group(favorable results for 4 of 8 cases(50%) in type II and for 1 of 3(33.3%) in type III)and cast immobization(2 of 5 cases(40%) in type II and for 0 of 2(O%) in type III) have made no significant differences(p>0.5). In type IV, there were no significant differences among the results of the three methods(p>0.1) and worse results than type II, III (p <0.05) probably due to difficulty in reduction of highly comminuted articular facets. The Bohler angle has given no significant influence to the final results(p>0.1). In conclusion, OR/IF has shown better results than closed modalities in the treatment of displaced intraarticular calcaneal fractures and may be the primary choice of treatment for these fractures. We have used Kruskal-Wallis H test and its approximation to chi-square distribution for comparison of three groups and Mann-Whitney U test and its approximation to normal distribution for two groups and have been aided by the computer program, SPSS in statistical calculations. The p-value was 0.05.

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Operative treatment of displaced intraarticular fractures of the calcaneus: Ki Soo Kim, Yong Soo Choi, seung Chae Han, Kwang Soo Shon; J Korean Soc Fract 1998;11(4):894-899. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.894

Abstract PDF

As technology in imaging has improved, we have learned more of the anatomical features of these fractures, and onw several objective studies in the literature with sufficient follow up recommend surgical treatment for some displaced intraarticular fractures of the calcaneu. The purpose of this study is to report the results of the open reduction with rigid internal fixation for displaced intraarticular fractures of the calcaneus. from March 1994 to December 1996, the author managed twenty-nine displaced intraarticular fractures of the calcaneus in twenty-three patients with open reduction via extended lateral approach and internal fixation using the plate. The fractures were classified according to Essex-Lopresti with the lateral radiograph and according to Sanders with the computed tomograph. Clinical results were assessed the pain, activity, return to work, range of motion, change in shoe size and swelling from creighton-Nebraska health foundation assessment. Among the 29 cases, satisfactory results were obtained in 24 cases(82.9%). We assessed the radioolgic objective parameters such as Bohler angle, crucial angle, height and width of the calcaneus, and the arthritis of the subtalar joint. Radiologically, we showed satisfactory restoration of the calcaneal morphology and severe subtalar arthritis in 4 cases. We found the negative correation between the clinical results and the radiological subtalar arthritis(P=0.038). In managing displaced intraarticular fractures of the calcaneus, open reduction via extended lateral approach and rigid internal fixation seemed to be useful method.

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Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography
Joon-Sang Eom, Young-Deuk Joo, Seong-Jun Kim, Min-Ho Shin, Dong-Oh Lee, Hong-Geun Jung
Journal of Korean Foot and Ankle Society.2014; 18(4): 165. CrossRef

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Treatment of Intraarticular Calcaneal Fractures using Ilizarov Exteranl Fixation: Byeong Yeon Seong, Dong Seong Park, Seung Jun Park, Sang Wook Kim; J Korean Soc Fract 1998;11(3):591-596. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.591

Abstract PDF

Open reduction and internal fixation (ORIF) is gaining in popularity as method of choice for the treatment of displaced intraarticular calcaneal fracture since diagnosis and classification of computed tomography have become routine. But early weight-bearing cannot be allowed by convertional ORIF, and delayed weight-bearing may contributed to heel had pain and dystrophy. We performed combined technique of limited internal fixation and Ilizrov external fixation to ten-cases of displaced intraarticular calcaneal fractures, between February 1994 and February 1996. The follow-up period in this study was at least two years. This method can provide not only anatomical reduction, but also stable fixation. None of patients complained of heel pad pain, which was attributed to the desensitization of the heel by early weight-bearing. None of patients went on to late collapse of the posterior facet. clinical results were rated as excellent in six, good in three, and fair in one case. Pin-track infection, complicated operative technique, cumbersomeness and expensiveness of the external fixator itself were shortcomings of this method. We consider this method as one of options for the treatment of displaced intraarticular calcaneal fracture.

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A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture
Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 13. CrossRef

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Essex-Lopresti Axial Fixation for Intra-articular Calcaneal Fractures: Young Do Koh, Jong Oh Kim; J Korean Soc Fract 1998;11(2):371-377. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.371

Abstract PDF: Fracture of the calcaneus is quite common, and displace intraarticular fractures can be associated with serious and prolonged disability. However, there still a great deal of controversy regarding the treatment of intraarticular fractures of calcaneus. Authors had treated 41 cases of 32 patients with displaced intraarticular calcaneal fractures using Essex-Lopresti axial fixation at Ewha Woman's University Mokdong Hospital from September, 1993 to February, 1996, and analyzed the functional results after the minimum 2 year follow-up. The results as follows; 1. Of 41 intraarticular calcaneal fractures, 27 fractures were tongue type and 14 fractures were joint depression type according to Essex-Lopresti classification. 2. Postoperatively Bohler angle was restored to mean 24.5degree intongue type, and to mean 13.8degree in joint depression type. 3. The reduction loss of Bohler angle was 7% in tongue type and 18.8% in joint depression type at the final follow-up. 4. The satisfactory results were obtained in 77.7% of tongue type and in 49.9% of joint depression type.

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Operative Treatment of Intraarticular Fractures of the Distal Radius: Chung Nam Kang, Jin Man Wang, Kwon Jae Roh, Jong Oh Kim, Dong Jun Kim, Jong Keon Oh, Han Cheon Bang; J Korean Soc Fract 1998;11(1):56-62. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.56

Abstract PDF: Intraarticular fractures of the distal part of the radius comprise a distinct subgroup of fractures that are difficult to manage and are associated with a high frequency of complication and represent one of the greatest challenges to the orthopaedic surgeon. We reviewed 30 cases(28 patients) of intraarticular fractures of the distal radius treated surgically in orthopaedic department of Ewha medical center between January 1993 to May 1996 and analyzed the correlation between the clinical end results and radiographic parameters. The clinical end results were significantly worse when radia inclination didn't exceed 15, or radial length was less than 10mm or dorsal tilt exceeded 0. Ulna styloid fractre did adversely affect the clinical results. In our study 2mm articular step off did not show any difference in clinical results. But this is thought to be the result of relatively short period of follow up. Therefore we need to analyse this factor with long term follow up data.

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Percutaneous & Minimal Internal Fixation of Displaced Intraarticular Calcaneal Fractures: Deuk Soo Hwang, June Kyu Lee, Hong Rok Oh, Seung Jin Lee; J Korean Soc Fract 1997;10(1):233-241. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.233

Abstract PDF

A displaced intraarticular fracture of the calcaneus is difficult to reduction and to restore its function, and its management still remains controversies. Treatment recomendation ranges from conservative to operative method using percutaneous pins, bone grafting and open reduction with internal or external flxators. We analysed retrospectively 24 displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation of intraarticular fracture of posterior facet in whole 48 cases(36 person) calcaneal fractures between January 1990 to April 1996 at the Department of Orthopaedic Surgery, Chungnam National University Hospital. A single Ollier approach was used in all cases. And we did not add any bone graft on the defected portion of calcaneal fractures. The technique and the result were as follows ; 1. An approach to the sinus tarsi with only Oiliers small lateral incision made an offer a good field for open reduction to the displaced posterior facet of calcaneus and diminishes the risk of lateral soft tissue problems. 2. Even only minimal internal fixation of thalamic joint fragment and percutaneous axial pin fixation of the body is enough to prevent the calcaneal redisplacement and provides enough stability to permit functional aftercare(early exercise and weight bearing) with a good result. 3. The Bohler angle is technically difficult to restoration to normal range of angle in our minimal operative method. 4. A bone graft is an alternative and is not necessary. We proposed our experience obtained in 24 cases as a good method ofr treatment of displaced intraarticular calcaneal fracture, especially in joint depressioin type and tongue type without severe comminution.

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A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture
Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 13. CrossRef

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Intra-Articular Fractures of the Calcaneus: Open reduction and internal fixation via extended lateral transcalcaneal approach: Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Yong Min Kim, Hyung Ho Oh, Dong Joo Chae, Min Hyo Park, Jee Hong Kim, Yun Chul Cho; J Korean Soc Fract 1996;9(3):733-741. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.733

Abstract PDF: Fractures with displaced articular facet of subtalar joint occupies 60-75% of whole calcaneal fractures. Nowadays, general principle of treatment for displaced intraarticular fracture has become anatomical reduction of joint surface and rigid fixation of the fracture. However, it had been difficult to apply this principle in cases of calcaneus due to various obstacles such as anatomical characteristics, therefore outcomes were not satisfactory in many cases. Extended lateral approach, which was designed by Letournel and Benirschke, contributed greatly in overcoming those obstacles. From August 1992 to April 1994, the author managed fifteen displaced intraarticular fractures of the calcaneus in fourteen patients with open reduction of displaced intraarticular fragment via extended lateral approach and internal fixation using reconstruction plate. The fractures were examined preoperatively with Brodens view and classified according to Eastwood(1992) with 2-plane CT. All the fractures united within postoperative 20 weeks(average 10.9 weeks). Final results were assessed by the clinical criteria for calcaneal fracture designed in Greighton Nebraska Health Foundation. Among the 15 cases, excellent results were obtained in eight cases, good in six, fair in one. There were no remarkable complications at the latest follow-up. In managing displaced intraarticular fractures of calcaneus, open reduction of displaced intraarticular fragment via extended lateral approach and internal fixation using reconstruction plate seemed to be very useful and harmless method.

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The Results of the Treatment with Circular External Fixator for Severely Comminuted Intraarticular Fractures involving the Knee: Gang Wook Lee, Je Hoon Lee, Byung Yun Hwang; J Korean Soc Fract 1996;9(2):424-430. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.424

Abstract PDF: In treating the patients having the intraarticular condylar fractures of the distal femur and the proximal tibia, many aulhors have recommended accurate anatomical reduction and rigid internal fixaion with early mobiliEation of the thee. But we cant often reduce the displaced bony fragments into the anatomical position and also fix them rigidly in severely comminuted and displaced fractures in proctice. Furthermore open wound makes surgeons face with some difficulties in using internal fixatives due to postoperative osteomyelitis. We treated 16 cases of severely comminuted intraarticular fractures involving the knee with circular fikator from March, 1992 to October 1994. Those were composed of 8 intraarticular femoral condylar fractures in which 7 cases were classified as C3 by AO classification and 6 cases had open wound, and 8 intraarticular tibil condylar fractures in which 8 cases were classified as type VI by Schatzkers classification and 6 cases showed open fractures. We could get bony union in all cases but we were not satisfied with the functional results of the treatment. So, we recommend the circular external fixation as a method for the treatment of these severely comminuted fractures involving the knee, and we think that further study for improving the functional results will be needed.

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Treatment of Unstable Intraarticular Fracture of Distal Radius with External Fixator and Minimal open Reduction: Jae Sung Seo, Jin Myeung Dan, Dong Chul Lee, Se Dong Kim; J Korean Soc Fract 1996;9(2):283-289. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.283

Abstract PDF: The distal radius fracture is one of the most common fracture in orthopedics, but their optimal treatment has not been delineated, especially in unstable intraarticular fracture. The unstable intraarticular fracture is increasig due to high energy injury following industrialization and increasing traffic accidents. The unstable intraarticular facture of the distal radius comprises distince subgroups that are difficult to manage and are associated with a high frequency of posttraumatic arthritis. Authors treated 6 cases of unstable intraarticular fracture of distal radius using external fixator and minimal open reduction to improve anatomical and functional results. Six patient were followed up more than one year (mean 19.3 month) and the patients were assessed functional results by Green and 0Briens score and anatomical results by Stewarts scale. Using the external firator and minimal open reduction, is thought to be a useful method for treatment of unstable intraarticular fracture of the distal radius.

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The Ilizarov Method for the Treatment of Open Intraarticular Fractures around the Knee Joint: Clinical Analysis of 6 Cases: Chang Hyouk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Yong Joo Kim; J Korean Soc Fract 1996;9(1):119-128. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.119

Abstract PDF: There are many difficulties in treating open intraarticular fracture around the knee joint because of its combined neurovascular injury and comminution of fracture site. The difficulties lie in choosing a fixation method, postoperative care, and analyzing the results of the treatment. Recently there is growing preference in using Ilizarov apparatus. The merits of Ilizarov in fracture treatment are early weight bearing and easy compression and distraction. In cases of this study, difficulties were subclassified into problems, obstacles. and complications. Six cases of open intraarticular fracture around the knee joint were treated from Mar., 1993 to Aug.,1994 and the average follow up period was twenty months and the results were as follows: 1. Of the six patients, there were five males and one female patients. 2. The cause of the fractures was traffic accident in five and crushing injury in one. 3. Of the six cases, five cases were combined femoral and tibial fractures and one case was only femoral condylar fracture. 4. In follow up study, there was thirty cases of difficulties such as pin site problem, pain, limitation femotion, and nonunion etc. 5. Of the seventy-four wires, pin site problem occurred at twenty pins but open wounds were cured without infection evidence. 6. The results were poor in all cases. 7. The Ilizarov technique requires adequate implantation and management to reduce an overall complication rate and improve functional results.

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