Journal of Musculoskeletal Trauma

Flexible Intramedullary Nailing for Femoral Shaft Fracture in Children: Kwang Pyo Jeon, Kyung Hoon Kang, Jin Il Kim, Dong Soo Kim, Hyung Koo Yoon, Chul Weon Kang; J Korean Soc Fract 1999;12(4):1051-1057. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.1051

Abstract PDF: PURPOSE
: In children, fractures of the femoral shaft have been traditionally treated by immobilization in a spica cast, either immediately or after a period in traction except open fracture or for patient with head injuries. More recently, there has been a growing trend towards surgical treatment with widening of the indications including isolated femoral fractures. To evaluate the clinical, radiological results of surgical treatment for femoral shaft fractures in children, we reviewed 13 cases of femoral shaft fractures in children treated with flexible intramedullary nailing and followed for more than 12 months. MATERIALS & METHODS : The average age of the patients was 11 years and 4 months(range 10- 14 years). The average follow-up period was 1 years and 3 months(range 1 years-1 years and 8 months)after surgery. 10 cases and 3 cases were inserted through antegrade and retrograde entry, RESULTS: No major complications were found except 1 intraoperative iatrogenic fracture and 2 postoperative bursitis ;all fractures were united and radiologic union was obtained at 9.5 weeks after surgery.
CONCLUSION
: The clinical results obtained using flexible intramedullary nails for the stabilization of femoral shaft fracture in children are comparable to non-operative treatment, but with less disruption to family life and a shorter hospitalization while achieving near anatomic alingment, maintaining lengh, and allowing early active motion at the hip and knee.

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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

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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Treatment of Radial Head and Neck Fracture in Children: Hyung Ku Yoon, Kuk Hwan Oh, Kyung Hoon Kang, J I Kim, Jong Hwa Yi; J Korean Soc Fract 1996;9(3):688-694. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.688

Abstract PDF: Fracture of radial head and neck in children is a relatively rare injury and comprises 5 to 10 percent of fractures of the elbow in children. Its prognosis has been considered relatively good, but prognosis is poor in severely displaced fractures of the radial head and neck, especially types II and III by OBriens classification and have a high risk of complication. We retrospectively reviewed 8 cases of radial head and neck fractures in 1 patients, who were treated from Jan.1992 to June 1994 at Kwang Myung Sung Ae Hospital. They were followed up for more than 1 year. The results were as follows; 1. There were 4 male and 3 female patients. One patient had bilateral involvement 2. The most common cause was fall down injury (6 cases). 3. According to O'Briens classification, 3 cases were type I and 5 cases were type II Treatments included simple immobilization(3 cases), closed reduction and plaster cast (4 cases), percutaneous K-wire leverage method(1 case). 4. According to the criteria of Tibone, the clinical result was excellent in 7 cases and good in 1 case. Primary angulation was the most important factor affecting the result and early closed reduction was important to obtain the satisfactory clinical result.

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Clinical Study for Humerus Intercondylar Fracture in Adult: Hyung Ku Yoon, Kuk Rwan Oh, Kyung Hoon Kang, Jin Il Kim, Kye Sung Lee; J Korean Soc Fract 1995;8(1):93-100. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.93

Abstract PDF: The intercondylar fracture of distal humerus in adult is difficult to treat. Because it is difficult to obtain accurate anatomical reduction atd rigid internal fixation due to comminution and intraarticular components. The authors review the 13 cases of intercondylar fracture of the distal humerus in adult that were treated at the orthopaedic department of Sung Ae Hospital, from JAN 1988 to JUN 1992, and the result are as follows: 1. It was frequently occured in 3rd and 4th decades active male and old female over 60 years old. 2. We think that cast hinge elbow brace is recommendable method for improvement of elbow ROM through early active motion. 3. For accurate anatomical reduction and rigid internal fixation, transolecranon approach is recommended for the suffcient exposure of the articular surface.

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Clinical Study on Monteggia fracture in Adults: Hyung Ku Yoon, Kwang Pyo Jeon, Kuk Whan Oh, Dae Eun Jung, Kyung Hoon Kang, Nam Kil Cho; J Korean Soc Fract 1994;7(1):29-36. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.29

Abstract PDF: In 1814, Monteggia first desHribed a fracture of proximal third of the ulna with dislocation of radial head, and Bado classified and included all fracture of ulna at any level with a dislocation of radial head under the name of Monteggla lesion In 1967. In adults, the prognosis Is poor due to many complications such as nerve injury, unreduced radial head, heterotrophic ossification, nonunion and malunion. The most important factors In achieving good results in adult Monteggia lesions are early accurate diagnosis, rigid internal fixation of the ulna and complete reduction of the radial head as soon as possible. The authors reviewed 12 cases of Monteggia fracture In adults who were treatod at department of orthopaedic surgery, Sung-Ae General hospital from 1989 jan. to 1991 Dec. with 17 months mean follow-up. The results obtained were as follows: 1. Male was 10 cases and female 2 cases. 2. The causes of injury were traffic accident In 9 cases, machinery injury in 2, fall down in 1 3. Location of ulna fracture was as follows; metaphysis was 4, proximal 1/3 in 6 cases, proximal 1/3 junction in 1, metaphysls and proximal 1/3 in 1. 4. According to Bado classificatlon, type I was 58%. type II 25%, tyre III 17%, type IV 0%. 5. Treatments of dislocated radial head were closed reduction in 9 Gases open reduction in 1 case, and excision in 2 cases. 6. Fractures of ulna were all treated with open reduction and internal fixation with plate in 9 cases. IM nailing in 1 case, tension band wiring in 2 cases. 7. Palsy of posterior interosseous nerve was in 2 cases with complete recovery within 6 months. 8. The results(Bruce, et. at) 17 month follow-up in average were 2 excellent, 5 good, 2 fair and 3 poor.

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A Clinical Study of Femoral Neck Fracture Over Age of 50 Years: Hui Wan Park, Jun Seop Jahng, Koon Soon Kang, Kyung Hoon Kang; J Korean Soc Fract 1988;1(1):76-85. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.76

Abstract PDF: We clinically analysed 125 fractures of femoral neck which had been operated at the Department of Orthopedic Surgery, Yonsei University College of Medicine from January 1976 to December 1985. Of there, 45 fractures were treated with internal fixation, 43 fractures with primary hemiathroplasty, 37 freactures with total hip replacement arthroplasty. The criteria for internal fixation was fracture that could be reduced satisfactorilly and the age of the patients were under 65 years. The criteria for primary hemiarthroplasty was in elderly patient over 65 years, displaced, comminuted subcapital of trascervical fractures, irreducible fractures, pathological fractures and patients having generalised disease or senile psychosis. The criteria for total hip replacement arthroplasty was neglected fractured paients with significant medical problems and patients who had previous hip disease such as degenerative arghritis or rheumatoid arthritis. Following results were obtained. 1. Subcapital type(75%) according to anatomical classification and Graden type III,IV(80%) according to displacement were the most common type, respectively. 2. In cases of internal fixation, accurate medial cortical contact was required and redis-placement and collapse of fragments were prevented by supplementary fixation. 3. The overall rate of osteoporosis was reported to be 85%(below Singh index IV) in our series. The study should be directed not only on the fracture treatment but also on the prevention of refracture via the study of osteoporosis. 4. Good functional end results were obtained in 77% of the internal fixation group and primary hemiarthroplasy group. Internal fixation may be advantageous for femur neck fracture of elderly than arthroplasty in view of biomechanical status of hip joint.

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