Journal of Musculoskeletal Trauma

Pediatric Fractures around the Wrist: Gihun Kim, Kun-Bo Park; J Korean Fract Soc 2021;34(2):80-86. Published online April 30, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.2.80

Abstract PDF: Fractures around the wrist are the third most common fracture among all pediatric fractures. Furthermore, distal radius fractures, a type of wrist fracture, are the most common fractures in children. Understanding pediatric fractures around the wrist is very important considering their prevalence. There is a specific belief that pediatric fractures can heal easily because of remodeling, but not all fractures can heal without proper treatment. Complications such as growth problems, nonunion can occur if the fracture is not treated properly. This paper reviewed recent articles about distal radius fractures, Galeazzi-equivalent fractures, and carpal bone fractures, including scaphoid fractures in children and adolescents. Successful treatment can be achieved without complications when an accurate diagnosis and proper non-surgical or surgical treatment are performed based on this article.

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Treatment of Wide Gap Non-Unions in Lower Extremities: Doohoon Sun, Byeong Seop Park, Taehyeon Jeon, Seung Koo Rhee; J Korean Fract Soc 2017;30(1):1-8. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.1

Abstract PDF: PURPOSE
To analyze the end results of the treatment for patients with wide gap non-unions of the long bones in the lower extremities.
MATERIALS AND METHODS
A total of 62 cases of wide gap unions, with a mean age of 38 years, were included for analysis. Study cohort included six children under the age of seven years. The average size of established bone defect was 7 cm (4-23 cm). Bone defects under 7 cm were treated with plating and various bone grafts, and those over 7 cm were managed with vascularized fibular graft (VFG), distraction-osteogenesis, tibial strut, plating and etc. Two boys with a defect of the whole tibia but with an intact fibula were treated with tibialization of intact fibula and with rotation-plasty of the leg. Their end results were evaluated by the time of bony union in accordance with the treatment of defect size of the long bone as well as their age.
RESULTS
Bony unions were obtained for an average period of at least 27 months. Fifty-one cases showed an average leg-length discrepancy of 2.8 cm, and 11 cases showed no leg-length discrepancy. The VFG, distraction-osteogenesis, and tibial cortical-strut graft and plating were the most effective methods for non-unions of wide, long bone defections (>7 cm). The prognosis was more favorable in children, muscular femur, and in cases with tibial defect but intact fÃ bula.
CONCLUSION
Various bone union techniques should be considered carefully, considering the ages of patients and the size of bone defects. Due to severe physical and mental disabilities of patients during the long-treatment period, specialized orthopedic doctors for trauma and mental care were necessary.

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Nonunion of Humeral Intercondylar Comminuted Fracture Treated with Fibular Graft: A Case Report: Jin Rok Oh, Chang Ho Lee, Ki Yeon Kwon, Hoi Jeong Chung; J Korean Fract Soc 2010;23(1):118-121. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.118

Nonunion of comminuted distal humeral fracture is troublesome problem to orthopedic surgeon. We report a case of 59 years old woman, who suffered nonunion of comminuted distal humeral fracture previously treated by open reduction and internal fixation with plate and screws concomitantly autoiliac bone graft. We reconstructed humeral condyle with fibular inlay graft inside cortical shell of intercondylar bone fragment and obtained excellent result in radiological and functional outcome.

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Update 1 of: Destruction and Detection of Chemical Warfare Agents
Yoon Jeong Jang, Kibong Kim, Olga G. Tsay, David A. Atwood, David G. Churchill
Chemical Reviews.2015; 115(24): PR1. CrossRef

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Treatment of Proximal Tibial Non-union after IM Nailing in Conjunction with Anterior Buttress Plating: Han Jun Lee, Young Uk Park; J Korean Fract Soc 2004;17(2):138-141. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.138

Abstract PDF

PURPOSE
We investigated the results of autologous bone grafting and anterior buttress plating for non-union occurred in junction between metaphysis and diaphysis of tibia after intramedullary nailing technique.
MATERIALS AND METHODS
We reviewed six patients who suffered from non-union of proximal tibia for a minimum follow up of one year. The interval was 6 months in average between first and second surgery. The mean follow up period was 15 months in average. The surgical method was autologous bone grafting and anterior buttress plating without removal of previous nail.
RESULTS
In all patients, the tenderness and pain of non-union sites were passed at a postoperative one month. Radiologic bone union was achieved in all patients at 18 weeks in average, range from 11 weeks to 20 weeks. The complication was superficial infection in one patient without deleterious effect on union.
CONCLUSION
The described method in this study could be a good alternative technique for the treatment of proximal tibial non-union due to failed intramedullary nailing.

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Cause and Treatment of Extraarticular Proximal Tibial Nonunion
Sung Soo Kim, Sung Keun Shon, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Lih Wang, Im Sic Ha
Journal of the Korean Fracture Society.2008; 21(4): 279. CrossRef

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Treatment of the Long Term Neglected Patella Fracture Nonunion: 4 Cases Report: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Gi Lee, Yoen Sik Yu, Eun No Lee, Hong Man Cho; J Korean Soc Fract 1999;12(3):727-731. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.727

Abstract PDF: Non-union of patella fracture was rare reported. We reported our experience with four cases of non-union of patella fracture treated by surgical intervention. Surgical management by skeletal traction and tension band wiring achieved union of the fracture in all four cases. The patients also recovered an excellent range of movement and strength in the affected knees.

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Use of the Ilizarov Technique for Treatment of Infected Non-Union: Sung Taek Jung, eun Kyoo song, Bong suk Bae; J Korean Soc Fract 1998;11(2):398-404. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.398

Abstract PDF: We reviewed infected non-union of tibia and femur which had been treated by radical resection of the necrotic bone and Ilizarov method in thirty-nine patients. All patients had either one-segment or two segment lengthening of bone with a technique of bone transport. The size of the bone defect that was bridged averaged 5.7cm (range, 2 to 16cm). All cases attained bone union and the infection was eradicated in all pattints before the fixator was removed. The mean duration of external fixator was 14 months(range, 4-28months). The mean external fixation index was 1.6 months/cm and the mean distraction index was 23.2 days/cm. The functional results were exellent in 3 patients, good in 19, fair in 9, poor in 8. The bone results were excellent in 5 patients, good in 20, fair in 10, poor in 4. Complication were pin tract infection in 15 patients, equinus contracture of ankle in 2, knee flexion contracture in 1, transient sensory change in 1, axial deviation in 2, premature consolidation in 2, delayed union in 2, and leg length discrepancy in 2, and refracture in 1. In conclusion, the Ilizarov method is very effective for treatment of infected non-union with bone loss, limb shortening and soft tissue defect.

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Infected non-union of the Tibia: Kwon Ik Ha, Seung Ho Kim, Kyoung Ho Yoon, Sang Ho Moon; J Korean Soc Fract 1997;10(4):812-815. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.812

Abstract PDF: There are two major problems in the management of infected non-union of the tibia: how to treat the infection; and how to obtain bony union. The previous treatment as debridement and antibiotic therapy often failed. Multiple hospitalization, many operative procedures, and prolonged treatments with parenteral antibiotics cause not only functional disability but also economic hardship and loss of self-esteem. The authors reviewed a case of infected non-union of the tibia who has received 12 operations and prolonged intravenous antibiotic therapy. It is suggested that if appropriate drainage, complete excision of necrotic tissues and rigid fixation is provided, prolonged intravenous antibiotic therapy seems to be unnecessary.

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Surgical Treatment of Non-Union of the Carpal Scaphoid by Modified Matti-Russe Technique: Chearl Hyoung Kang, Chang Soo Kang, Young Sik Pyun, Kwang Soon Song, Byung Woo Min, Yo Han Choi; J Korean Soc Fract 1994;7(2):538-544. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.538

Abstract PDF: Although 90% of fresh carpal scaphoid fracture heals with adequate treatment, the rate of non-union is higher in untreated or misdiagnosed at the time of injury leading to carpal collapse and degenerative arthritis. We have treated these non-unions by modified Matti-Russe technique and all cases showed uneventful healing, but range of motion of the wrist joint decreased in some cases. We studied 18 patients of non-union of the carpal scaphoid treated modified Matti-Russe technique from November,1988 to December, 1992 and the results were as follows: 1. Among the 18 patients, the ratio of male and female was 16:2, and mean age was 23.0 years old. 2. Dominant hand was involved in 14 cases. 3. The fracture was most commonly situated at the waist of the scaphoid. 4. Bony union was obtained in all cases and the average time to radiological union was 18.0 weeks. 5. According to Maudsleys assessment, the results revealed as 7 cases of excellent, 9 cases of good and 2 cases of fair.

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Clinical Results of the Delayed & Non-union of the Long Bones with Interlocking Intramedullary Nailing: Han Suk Go, Yoon Seong Yoon, Eung Sun Ahl; J Korean Soc Fract 1994;7(1):167-173. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.167

Abstract PDF: Delayed & non-union are common complications of the fracture of long bones. Many kinds of treatment modalities for delayed & non-union have been reported, but rigid fixation and bone graft have been the most common accepted method. The interlocking Intramedullary nailing technique has advantages which the rigid internal fixation and bone grafting effect of reaming debris. We treated nine cases of delayed & non-union of femur and tibia at the Department of Orthopedic Surgery, Seoul Paik Hospital from Jan. 1990 to Octo. 1992 and results were as follows. 1. Nine cases of the delayed & non-union were consisted by 7 cases of femur and 2 cases of tibia. 2. Causes of delayed & non-union were failure of implants in 4 cases, inadequate and inappropriate immobilization in 3 cases, and persistent gap in 2 cases. 3. Union was achieved in 7 cases and union rate is 77.8%.

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Treatment of Bone Loss by Local Bone Transportation: A report 3 eases: Sung Joon Kim, Kuhn Sung Whang, Hyun Kee Chung, Ye So Park; J Korean Soc Fract 1992;5(2):410-416. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.410

Abstract PDF: We experienced the local bone transportation in 3 cases. with a dynamic axial fixator, which had been effected the large bone defects because of the loss of the bony segment or infected non-union. The 2 patients showed the large femoral bone defect after motorcycle accident and the other patient. The tibial infected nonunion with large bone defect. The two femoral bone defects were treated by callotasis, and the tibial bone defect by chondrodiatasis. The size of bony defects were 12.Ocm and 6.5cm and the amount of bony transportation were 10.Ocm, 9.4cm and 5.9cm in orthoroentgenogram. These local bone transportations induced excellent osteogenesls and it filled up the defects We suggest that local bone transportation might be one of the best ways for the treatment of the large bone defects.

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