Journal of Musculoskeletal Trauma

Complications of Femoral Peritrochanteric Fractures Treated with the Gamma Nail: Seok Hyun Kweon, Churl Hong Chun, Jung Hwan Yang, Jin Young Park, Kyu Hwan Bae; J Korean Fract Soc 2009;22(2):85-90. Published online April 30, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.2.85

PURPOSE
We analyzed the complications of femoral peritrochanteric fractures treated with the Gamma nail to reduce its complications.
MATERIALS AND METHODS
We evaluated the complications among the 96 patients who were treated with the Gamma nail from January 2000 to May 2005. Mean follow-up period was 17.8 months and mean age was 75.2 years. We analysed the relationship between the complication and the fracture pattern, postoperative reduction status, position of the lag screw, bone density, displacement and tip-apex index (TAD).
RESULTS
The complications were presented in 12 cases (12.5%). Cut-out of lag screw were in 5 cases, varus deformity with short lag screw in 2 cases, metal breakage of distal screw in 1 case, breakage of drill bit intraoperatively in 1 case, superficial infection in 2 cases and deep infection in 1 case. 5 cases (4.2%) were required reoperation. All of the cut-out of lag screw showed increased TAD (tip apex distance) above 25 mm.
CONCLUSION
To reduce the complications of the Gamma nail, we need exact surgical technique, good positioning of the lag screw and choice of appropriate length for the lag screw.

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Effectiveness of the Valgus Reduction Technique in Treatment of Intertrochanteric Fractures Using Proximal Femoral Nail Antirotation
Ji-Kang Park, Hyun-Chul Shon, Yong-Min Kim, Eui-Sung Choi, Dong-Soo Kim, Kyoung-Jin Park, Byung-Ki Cho, Jung-Kwon Cha, Sang-Woo Kang
Journal of the Korean Orthopaedic Association.2013; 48(6): 441. CrossRef

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Intramedullary Nail on the Humeral Fracture: Jin Young Park, Jung Hwan Oh, Duk Hwan Kho, Jae Kyoung Jung; J Korean Fract Soc 2008;21(3):244-254. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.244

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No abstract available.

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Comparing the Use of Single and Double Interlocking Distal Screws on a Polarus Intramedullary Nail for Humeral Shaft Fractures
Hee Seok Yang, Jeong Woo Kim, Hong Je Kang, Jung Hyun Park, Yong Chan Lee, Kwang Mee Kim
Clinics in Shoulder and Elbow.2015; 18(2): 91. CrossRef
A Separate Approach and Cephalo-Diaphyseal Plate Fixation for the Comminuted Metadiaphyseal Fractures of the Proximal Humerus
Sung-Weon Jung
Journal of the Korean Fracture Society.2013; 26(1): 8. CrossRef
Polarus Intramedullary Nail for Proximal Humeral and Humeral Shaft Fractures in Elderly Patients with Osteoporosis
Youn-Soo Hwang, Kwang-Yeol Kim, Hyung-Chun Kim, Su-Han Ahn, Dong-Eun Lee
Journal of the Korean Fracture Society.2013; 26(1): 14. CrossRef
Minimally Invasive Anterior Plating of Humeral Shaft Fractures
Hyun-Joo Lee, Chang-Wug Oh, Do-Hyung Kim, Kyung-Hyun Park
Journal of the Korean Fracture Society.2011; 24(4): 341. CrossRef

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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; J Korean Fract Soc 2008;21(1):24-30. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.24

Abstract PDF

PURPOSE
To evaluate the outcomes of distal tibial open fractures treated by two-staged delayed minimally invasive percutaneous plate osteosynthesis (MIPPO) technique.
MATERIALS AND METHODS
25 cases of distal tibial open fractures were treated with temporary ring fixation and two-staged delayed MIPPO. A mean age was 46 years old, follow-up was 23 months. The type of fracture was evaluated using the AO/OTA classification. The type of open fracture was evaluated using the Gustilo-Anderson classification that revealed 6 cases of type I, 9 cases of type II, 8 cases of type IIIA and 2 cases of type IIIB. We analyzed the radiologic results and postoperative complications. The clinical and functional result were evaluated by using Teeny and Wiss scores.
RESULTS
The average time of bone union was 18 weeks in 24 cases. There were three delayed union that achieved union twenty weeks after second operation, and 1 case underwent bone graft with additional plate fixation. 6 cases of skin necrosis were treated with skin graft, 2 cases were treated with flap. The clinical and functional assessment showed that 6 cases were excellent, 16 cases were good, 2 cases were fair, and 1 case were poor results.
CONCLUSION
Two-staged MIPPO technique for distal tibia open fractures seems to be a good procedure to obtain bone union.

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Combined minimally invasive external and internal fixation in the treatment of pilon fractures
AhmedSh Rizk, MohamadS Singer, MohamadE Al-Ashhab
The Egyptian Orthopaedic Journal.2014; 49(3): 259. CrossRef
Staged Protocol in Treatment of Open Distal Tibia Fracture: Using Lateral MIPO
Oog Jin Sohn, Dong Hwa Kang
Clinics in Orthopedic Surgery.2011; 3(1): 69. CrossRef
Management of Open Fracture
Gu-Hee Jung
Journal of the Korean Fracture Society.2010; 23(2): 236. CrossRef
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

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Open Intramedullary Nail with Tension Band Sutures & Lock Sutures on Proximal Humeral Three-part Fracture: Jin Oh Park, Jin Young Park, Sung Tae Lee, Hong Keun Park; J Korean Fract Soc 2007;20(1):45-52. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.45

Abstract PDF

PURPOSE
To evaluate the results according to the difference of age and bone mineral density (BMD) of the surgical treatments using open intramedullary nail with tension sutures and lock suture on proximal humeral three part fracture.
MATERIALS AND METHODS
30 patients treated by open intramedullary nail with tension band and lock suture technique on proximal humeral fractures were reviewed. After treatment, average follow up periods was 50 months (range; 17~143 month). Postoperative clinical outcome was evaluated using ASES functional score, Neer score and constant score.
RESULTS
Bony union were obtained all except one case. Range of motion, mean forward elevation was 142Â°, mean external rotation was 56Â°, mean external rotation at 90Â° abduction was 68Â°. Average pain score of visual analog scale was 1.5. Average functional score of American Shoulder and Elbow Society was 86. Average Neer score was 89. Constant score was 85. Pain and functional score of group I were better than those of group, however, there was no statistically significant difference (p>0.05). In the comparison between group III and group IV, the results were same (p>0.05).
CONCLUSION
The patients treated using open intramedullary nailing, tension band and lock suture could enable early ROM exercise and show good clinical results. This treatment method will be useful in old age osteoprorotic patients.

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Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures
Chung Hee Oh, Joo Han Oh, Sae Hoon Kim, Ki Hyun Jo, Sung Woo Bin, Hyun Sik Gong
Journal of the Korean Fracture Society.2008; 21(3): 213. CrossRef

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Treatment of Intercondylar Fractures of Humerus with Y-plate: Jin Young Park, Joong Bae Seo, Ji Yong Chun, Myoung Ho Kim, Sang Hyuk Min, Joo Hong Lee; J Korean Fract Soc 2006;19(4):443-448. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.443

Abstract

PURPOSE
To evaluate the results of the treatment of intercondylar fractures of the humerus using Y-plate.
MATERIALS AND METHODS
The subjects were 17 patients with intercondylar fracture of humerus who were treated using the Y-plate. Nine cases were C1 type, 4 were C2 type, and the remaining 4 were C3 type. 11 subjects had accompanying fractures of another part of the body. The average age was 48.8. The average follow up period was 33 months. We used Mayo Elbow Performance Score and Risborough-Radin's rating score for each patient as the methods of rating.
RESULTS
The average range of motion of the elbow was 105 degrees (50~150 degrees). According to Cassebaum's classification for elbow range of motion, 7 cases were rated very good, 1 cases were good, 4 cases were fair, and 1 cases were poor. According to Mayo Elbow Performance Score, 7 were excellent, 7 were good, 2 fair, and 1 poor. Of the 3 patients who were fair or poor in Mayo Elbow Performance Score, 2 were type C3 fractures, and all 3 had major accompanying fractures. No significant postoperative complications developed in all cases.
CONCLUSION
The fixation with Y-plate can still be a relatively good modality of treatment for interconylar fractures of the humerus in selected cases, in spite of the known mechanical weakness of the Y-plate. The patients with severe intra-articular comminution showed relatively poor results. And we think that the age of the patient and the energy of the injury have more or less influence on the results of treatment.

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Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus
Ji-Kang Park, Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho
Journal of the Korean Fracture Society.2012; 25(2): 129. CrossRef
Operative Treatment of Distal Humeral Comminuted Fractures with Orthogonal Plating
Joong-Bae Seo, Jae-Sung Yoo
Journal of the Korean Fracture Society.2011; 24(3): 243. CrossRef
Operative Treatment of Displaced Intercondylar Fracture of the Distal Humerus with Reconstruction Plate
Ryuh Sup Kim, Tong Joo Lee, Kyoung Ho Moon, Seung Rim Park, Moon Lee
Journal of the Korean Fracture Society.2007; 20(2): 172. CrossRef

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External Fixation of Pediatric Femur Fractures: Yeung Jin Kim, Tae Kyun Kim, Hwan Deok Yang, Hyung Joon Kim, Jin Young Park, Sang Jin Eun; J Korean Fract Soc 2006;19(3):369-373. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.369

Abstract: PURPOSE
To evaluate unilateral external fixation when applied as the standard treatment of displaced femoral shaft fractures in children.
MATERIALS AND METHODS
From 2000 through 2004, we used a unilateral external fixator (Any-fix(R)) to treat 24 femoral shaft fractures. The average age of the patients was 8.3 years (range, 5.6 to 14.8). 16 fractures were isolated, and 8 were associated with polytrauma. There were 4 open fractures. Patients were followed clinically and radiologically until healing and at 1 year.
RESULTS
Average time of external fixation was 97 days (range, 57 to 130 days). All patients regained the normal range of motion of knee joint without significant residual leg length discrepancy or growth disturbance. There were no nonunion, or rotationary deformities. There were 26 pin tract infection (total pin number: 108) (24%), all of which were resolved with antibiotics. No patient developed osteomyelitis. There were two refractures after fixator removal. There was one case of reduction loss and one of valgus deformity.
CONCLUSION
The external fixation is a useful alternative for operative management of femoral shaft fractures because of minimal invasive operation, and early mobilization in prepuberty.

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Triceps-Sparing Posterior Approach for Intra-articular Fracture of Distal Humerus: Suk Ha Lee, Sung Tae Lee, Jin Young Park, Jung Sup Keum, Jong Ryun Baek, Kwang Jun Oh; J Korean Fract Soc 2006;19(1):51-55. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.51

Abstract: PURPOSE
To evaluate the therapeutic results of intra-articular fracture of distal humerus treated through triceps sparing posterior approach.
MATERIALS AND METHODS
From February 2001 to December 2003, we reviewed total 9 cases of intra-articular fracture of distal humerus, which were treated by surgical treatment and were followed more than for 12 months. According to the OTA classification, nine cases were classified as type A; two, as type C1; five, as type C2; two. Triceps sparing posterior approach was used in all nine patients. An extensile posterior incision was used over the olecranon without triceps muscle injury. Exposure of the fracture site was done by obtaining medial-lateral mobility through dissection of medial and lateral edge of triceps muscle. Therapeutic results were assessed by bone union, duration for fracture union, complication. and for functional estimation, Mayo elbow performance score was checked and analysed.
RESULTS
The range of the elbow joint motion was flexion contracture 5.2 degree to further flexion 135.5 degree on average. Clinical results using Mayo elbow performance score were as follows; six excellent, three good. Compressive neuropathy of ulnar nerve which has been done anterior transposition was observed in one patient.
CONCLUSION
Triceps sparing posterior approach is useful surgical technique that provides sufficient exposure of medial and lateral condyle without injury of triceps muscle in intra-articular fracture of distal humerus to the extent of OTA type C2.

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Elbow Dislocation Combined with Coronoid Process and Radial Head Fracture: Sung Tae Lee, Jin Hyung Choi, Joong Bae Seo, Jin Young Park; J Korean Fract Soc 2005;18(4):437-442. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.437

Abstract PDF: PURPOSE
To evaluate the clinical outcome for terrible triad injury of the elbow joint. MATERIAL AND METHODS: We reviewed consecutive 10 cases retrospectively among 12 terrible triad injuries, which had been followed up for a minimum 1 year. The average age at the time of injury was 45 years (range, 32~72). All cases were dislocated posteriorly. The 3 cases had fracture of olecranon. Combined medial and lateral approach was performed in 3 cases, medial and lateral approach after extensile posterior approach in 4 cases, transolecranon approach using existed olecranon fracture in 2 cases, and transolecranon approach in 1 case were done.
RESULTS
The average Mayo elbow performance score was 87, with 5 excellent, 4 good, and 1 poor results. Results by Riseborough and Radin's rating criteria include 9 good and 1 fair. The 8 cases were stable. But 2 cases were classified with moderate and severe instability; these cases had been performed by radial head allograft and excision respectively.
CONCLUSION
A stable, functional elbow can be restored in terrible triad injury by early active rehabilitation after anatomic reduction and firm internal fixation.

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Tension Band Fixation for Type II Fracture of the Distal Clavicle: Jin Young Park, Joong Bae Seo, Myung Ho Kim, Je Wook Yu; J Korean Fract Soc 2005;18(4):421-425. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.421

Abstract PDF

PURPOSE
To evaluate the efficacy of the tension band wire fixation for type II distal clavicle fractures.
MATERIALS AND METHODS
Twenty one patients with type II distal clavicle fractures were evaluated, who were operated with tension band fixation technique with sparing AC joint, from May 2000 to December 2003, and could be followed-up for more than 1 year after operation. Average age at injury is 40.7 years old (14~73). 13 cases were males and 8 were females. And 16 cases were classified as type IIa and 5 cases as type IIb. Judgement of union was based on plain x-ray and clinical finding and postoperative assessment was evaluated on ASES and Constant scoring system.
RESULTS
Outcomes in all patients showed more than good, average ASES score was 96.1 (88~98) and Constant score was 93.1 (82~100). Radiologic union was achieved at 11.7 (6~16) weeks postoperatively. One patient suffered from non union, and there was no other significant complications such as K-wire migrations, breakage, infection, and AC joint arthritis.
CONCLUSION
Tension band fixation technique for type II distal clavicle fracture seems to be a useful and effective method, which is relatively simple and provides rigid fixation without violating the AC joint.

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Comparison of Results of Tension Band Wire and Hook Plate in the Treatment of Unstable Fractures of the Distal Clavicle
Chul-Hyun Park, Oog-Jin Shon, Jae-Sung Seo
Journal of the Korean Fracture Society.2011; 24(1): 55. CrossRef
Modified Spring Plate for Treatment of Unstable Distal Clavicle Fractures
Sang-Myung Lee, Il-Jung Park, Hyung-Min Kim, Jae-Chul Park, Sung-Gil Cho, Yoon-Chung Kim, Seung-Koo Rhee
Journal of the Korean Fracture Society.2010; 23(1): 64. CrossRef

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Functional Evaluation of the r-nailing Treatment of Intertrochanteric Fracture Older than 60 years Old Patient: Hwan Duk Yang, Tae Kyun Kim, Young Jin Kim, Jin Young Park, Hyoung Joon Kim, Ji Wan Lee, Eun Young Kil; J Korean Fract Soc 2005;18(4):364-368. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.364

Abstract PDF: PURPOSE
To evaluate the functional status after Gamma nailing in inter-trochanteric fractures in elderly with functional recovery score (FRS).
MATERIALS AND METHODS
We reviewed 285 patients of intertrochanteric fracture treated by gamma nailing from January 1993 to May 2002 with follow up more than 3 years. We analized recovery of functional status concerned with sex, age, fracture pattern, functional recovery index.
RESULTS
The intertrochanteric fractures in elderly resulted in 15.8% loss of function after 3 years. The more functional loss was observed in female, the older age, and Boyd-Graffin type II fracture but, were not signifily related with functional loss except age.
CONCLUSION
We concluded that the age is the important factor to functional recovery to pre-injury status in elderly patients.

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Complications after Vertebroplasty of Treatment for Compression Fracture with Osteoporosis: Hee Gon Park, Myung Ho Kim, Moon Jib Yoo, Sung Chul Lee, Jin Young Park, Woo Yeon Hwang, Jin Woo An; J Korean Soc Fract 2003;16(4):534-540. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.534

Abstract PDF

PURPOSE
To evaluate the complications of percutaneous vertebroplasty using PMMA (polymethylmethacrylate) in the treatment of osteoporotic compression fractures.
MATERIALS AND METHODS
Authors reviewed 113 patients treated by percutaneous vertebroplasty from 1998 to 2001. After treatment, Simple x-ray and computed tomography were done of methods for analysis of complication, especially bone cement leakage.
RESULTS
In each case, we injected bone cement (PMMA) in one vertebra, average amount is 5.6 cc. The complications were 39 cases (34.5%): 1 case was dead by hemothorax, 1 case was arrhythmia, 12 cases were intercostals neuralgia, 7 cases were back pain, 2 cases were mild dyspnea, 14 cases were abdominal pain and 2 case were injection site pain. In follow-up x-ray and CT, bone cement (PMMA) leakage were 45 cases (39.8%).
CONCLUSION
Bone cement (PMMA) leakage can be cause of complications in vertebroplasty. We try to avoid the complication of bone cement leakage.

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A Review of Korean Medicine Treatment for Managing the Thoracolumbar Compression Fractures: A Retrospective Observational Study
Min-Jin Cho, Jiyun Lee, Myeong-Jong Lee, Hojun Kim, Kyungsun Han
Journal of Korean Medicine Rehabilitation.2023; 33(4): 109. CrossRef
Clinical and radiological outcomes of denosumab and teriparatide treatment in elderly patients with osteoporotic spinal compression fracture without vertebroplasty
Joo Young Jung, Byoung Hun Lee, Jong Young Lee, Hong Jun Jeon, Byung Moon Cho, Su Yeon Kim, Se Hyuck Park
Journal of Korean Society of Geriatric Neurosurgery.2021; 17(2): 69. CrossRef
A Retrospective Clinical Survey of Vertebral Compression Fractures
Ji Hye Oh, Yun Kyu Lee, Jae Soo Kim, Hyun Jong Lee, Sung Chul Lim
Journal of Acupuncture Research.2018; 35(4): 219. CrossRef
Survival Analysis of Conservative Treatement in Osteoporotic Vertebral Fracture
Young Do Koh, Jong-Oh Kim, Rag Gyu Kim, Dae Youn Kim, Nam-Ki Kim, Dong Jun Kim
Journal of Korean Society of Spine Surgery.2012; 19(4): 138. CrossRef
Factor Analysis Affecting the Leakage of Bone Cement After Vertebroplasty
Jae-Hoon Kim, Kyung-Jin Song, Tai-Seung Kim, Jae-Lim Cho, Ye-Soo Park
Journal of Korean Society of Spine Surgery.2010; 17(1): 13. CrossRef

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Muller Type C Intercondylar Fractures of Femur : Comparative Analysis by Surgical Approach: Hong Geun Jung, Myung Ho Kim, Moon Jib Yoo, Suk Joo Yoo, Sung Churl Lee, Jin Young Park, Sang Hyuk Min; J Korean Soc Fract 2000;13(1):64-73. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.64

Abstract PDF: PURPOSE
The purpose of this study is to compare the functional results of Muller type C intercondylar fractures treated by 2 different surgical approaches : lateral and extensile approach.
MATERIALS AND METHODS
The study is based on 20 patients 21 knees of Muller type C intercondylar fractures. Two surgical approaches, i.e. 13 cases with lateral and 8 cases with extensile approach were used. The functional evaluation of results was done with criteria by Schatzker and Lambert. Excellent and good was grouped superior while fair and failure was grouped inferior.
RESULTS
Comparative analysis by surgical approach showed that among total 10 cases of C2 fractures, 6 cases(85.7%) of lateral approach and 2 cases(66.7%) of extensile approach were categorized in inferior group. Among the 8 cases in type C3 fractures, 3 cases treated surgically using the lateral approach showed fair and failure results and 3 cases(60%) of the remaining 5 cases using the extensile approach showed good results.
CONCLUSION
There was no significant result difference between lateral and extensile approach in type C2 fractures, but in C3 fracture, cases with extensile approach showed better results. Therefore the extensile approach should be recommended in C3 intercondylar fractures with intra-articular comminution.

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Comparison of Results According to the Type and Procedure in Unstable Fracture of the Distal Radius: Jin Young Park, Hong Geun Jung, Moon Jib Yoo, Jeong Wan Kim; J Korean Soc Fract 1998;11(2):435-441. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.435

Abstract PDF

In the treatment of an unstable fracture of the distal radius, the anatomical reduction of articular surface and the maintenance of radial length are essential. Recently, more extensive therapeutic method was introdced for reduction and maintenance of distal radius fracture. To compare the results between type C2 and C3 that were treated with pinning and the results between pinning and pinning with external fixation in type C3 according to AO classification, we analysed anatomical and functional results of unstable fracture of the distal radius from June, 1994 to september, 1996 at DanKook University Hospital. There were 12 cases of C2 type with pinning, 17 cases of C3 type with pinning and 14 cases C3 type with external fixation and pinning. Among the 43 cases, the most commom type was C3 (31cases), and open fractures were 6 (14%)cases. The following results were obtained; 1. For comparison of C2 type with C3 type that were treated with pinning, the results of C2 type were better anatomically and functionally. 2. For comparison of percutaneous pinning with percutaneous pinning and external fixation in C3 type, the results of C3 type that were treated by pinning and external fixation were better anatomically and functionally.

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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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Results Following The Surgical Treatment of Acromioclavicular Joint dislocations; A Comparison of Phemister With Bosworth Operation: Jin young Park, Suk Joo Lyu, Ki Hyuk Moon, Myung Ho Kim; J Korean Soc Fract 1998;11(1):8-15. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.8

Abstract PDF: To compare the results the Bosworth with Phemister operation, we performed the Bosworth operation in 7 case and then Phemister operation in 9 case serially from 1994 to 1997 and followed them up postoperatively. The average follow-up was 19.2 months, with the longest being 32 months, and the shortest being 12 months. The extraarticular coracoclavicular fixation was done with a cancellous screw in Bosworth operation, the transarticular fixation with two or three Kirschner wires in Phemister operation and the coracoclavicular ligaments were sutured to all patient in phemister operation group. The average immobilization period 6.8 weeks(S.D.:1.0 weeks) in Bosworth operation, 6.5 weeks(S.D.:1.4 weeks) in Phemister operation. The cancellous screw or the Kirschner wires were removed in 12.6 weeks(S.D.:1.6 weeks) postoperatively in Bosworth operation, 11.8 weeks(S.D.:1.7 weeks) in Phemister operation and physiotheraphy was progressed to obtain the full range of motion. All of the patients were evaluated on a subjective(pain, night pain, medication. instability, activities of daily living), objective(range of motion) and roentgenographic(degree of displacement) basis at last follow-up. Shoulder function was assessed according to the shoulder score devised by the American Shoulder and Elbow Surgeons. The pain of Shoulder persisted remained in 1 case of Bosworth operation and in 3 cases of Phemister operation. The night pain around acromioclavicular joint was remained in 2 cases of Phemister operation. Average shoulder function index in Bosworth operation was 95 points and in Phemister operation 87 points. Average range of motion of Bosworth operation was 176degree (S.D.:9degree in forward elevation, 68degree(S.D.:11degree in external rotation, 88.6degree(S.D.:12degree in cross-rotation at 90degreeabduction, 22cm (S.D.:11cm) in cross-body adduction and T9 in internal rotation and Phemister operation 147degree(S.D. 18degree in forward elevation, 72degree S.D.:12degree in external body adduction and T8 in internal ratation. All of the patients were satisfied for results of operation. After surgery, loss of reduction was found in 3 of 7 in Bosworth operation and all of the patients were over 40 years and then conversions to Phemister operation was needed. According to short-term follow-up we prefer the transarticular Phemister method and Bosworth operation may be avoided in patients over 40 yeras old.

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Fracture of Clavicle Accompanied by Injury of Subclavian Artery, Hemothorax and Arterial Occlusion by fhrornboembolism: Treated by Intraarterial Thrombolytic Procedure: Sung Churl Lee, Moon Jib Yoo, Suk Joo Lyu, Jin Young Park, Myung Ho Kim; J Korean Soc Fract 1995;8(4):885-888. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.885

Abstract PDF: Although most fractures of the clavicle are usually treated by closed means and heal uneventfully, serious injuries may occur and a delay in treateng these injuries may be life-threatening. One of such serious associated injuries is vascular injury. In this report, we present an unusual case in which a fracture of the clavicle was accompanied by an injury of the subclavian artery, hemothorax and concommitant arterial occlusion of upper extremity by throboernbolism. Treatment included resection of the injured part of the artery with bypass graft, thromboembolectomy and fixation of the clavicle with a plate and screws. Thereafter, the patient had suffered from repeated episodes of thrornboembolism of the upper extremity, a compartment syrdrome and a metal failure. It is critical in a patient with a clavicular fracture that a careful examination of the entire upper extremity be performed, with particular emphasis on the neurovascualr status.

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