Journal of Musculoskeletal Trauma

Use of Miniplate for Severe Comminuted Metadiaphyseal Fractures of the Distal Radius: Jong Ryoon Baek, Yong Cheol Yoon, Seung Hyun Baek; J Korean Fract Soc 2019;32(4):204-210. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.204

Abstract PDF: PURPOSE
This study investigated the clinical and radiological outcomes of patients undergoing provisional fixation in conjunction with locking plate fixation. Miniplates were used as the reduction plates for the surgical treatment of severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius.
MATERIALS AND METHODS
The radial length, radial inclination, volar tilt, and radial intra-articular step-off were measured preoperatively, postoperatively, and at one year after surgery in 12 patients (eight males, four females, mean age 55.4 years old). The patients underwent volar locking plate fixation with miniplate as a reduction plate for severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius. Clinical evaluations were conducted using the modified Mayo wrist score (MMWS).
RESULTS
Bone union was achieved in all cases. The mean MMWS was 81.8 points, including two excellent, three good, and seven fair cases. Radiological improvements were observed in the average radial length (preoperative, 6.4 mm; postoperative, 11.8 mm), average radial inclination (10.2Â° to 22.4Â°), average volar tilt (âˆ’4.5Â° to 10.6Â°), and average radial intra-articular step-off (4.8â€“0.8 mm) (all, p<0.05). Radiographic measurements obtained immediately after surgery and at the final follow-up revealed insignificant decreases in radial length (0.6 mm), radial inclination (0.4Â°), and volar tilt (0.9Â°) (all, p>0.05).
CONCLUSION
Miniplate fixation can be an effective treatment option as a reduction plate for the treatment of distal radial fractures, which is challenging to reduce and maintain due to severely comminuted metadiaphysis fractures with the intra-articular fracture.

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Comparative Analysis of Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Intramedullary Nailing in Distal Tibial Metaphyseal Fractures: Gwang Chul Lee, Jun Young Lee, Sang Ho Ha, Hong Moon Sohn, Yi Kyu Park; J Korean Fract Soc 2012;25(1):20-25. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.20

PURPOSE
To compare results between minimally invasive plate osteosynthesis using a periarticular plate and intramedullary nailing in distal tibial metaphyseal fractures in two treatment groups.
MATERIALS AND METHODS
Sixty-one cases of distal tibial metaphyseal fractures from December 2008 to December 2009 were evaluated. The minimal follow-up period was 12 months. Thirty patients treated by minimally invasive plate osteosynthesis using a periarticular plate were Group A; 31 patients treated by intramedullary nailing were Group B. We compared and analyzed the results of each group by radiological and clinical assessments.
RESULTS
The mean bony union time was 16.4 weeks in Group A and 17.2 weeks in Group B. The mean operation time was 45 minutes in Group A and 48 minutes in Group B. The mean radiation exposure times were 4.2 minutes and 4.8 minutes, respectively. VAS scores were 0.7 points and 0.5 points in each respective group. In Group A, the VAS score was 1.7 points when we applied pressure on the skin around the plate. The mean Olerud and Molander Ankle Score was 87.4 points and 86.3 points, respectively. A superficial wound infection occurred in 1 case in each group, and angular deformities more than 5 degrees occurred in 2 Group B cases.
CONCLUSION
No significant differences in results were observed between the two groups. However, a higher incidence of angular deformity was seen in the intramedullary nailing group. Therefore, we must be careful during surgery.

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Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures
Ho-Min Lee, Young-Sung Kim, Jong-Pil Kim, Phil-Hyun Chung, Suk Kang, Kaung Suk Jo
Journal of the Korean Fracture Society.2018; 31(3): 94. CrossRef
A Comparison of the Results between Intramedullary Nailing and Minimally Invasive Plate Osteosynthesis in Distal Tibia Fractures
Chul-Hyun Park, Chi-Bum Choi, Bum-Jin Shim, Dong-Chul Lee, Oog-Jin Shon
Journal of the Korean Orthopaedic Association.2014; 49(4): 285. CrossRef

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Interposition of Periosteum in Distal Tibial Physeal Fractures of Children: Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Jae Woo Cho; J Korean Fract Soc 2011;24(1):73-78. Published online January 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.1.73

Abstract PDF: PURPOSE
To evaluate the factors influencing periosteal interposition in distal tibial physeal fractures of children.
MATERIALS AND METHODS
34 cases of distal tibial physeal fractures were analysed. We confirmed the presence of periosteal interposition with MRI in all cases and accessed the relationship between periosteal interposition and gender, age, cause of injury, type of fracture, degree of initial displacement and after closed reduction.
RESULTS
9 (26.5%) of 34 fractures had interposed periosteum. There was no statistically significant correlation between periosteal interposition and gender, age, cause of injury (p>0.05). 5 (83.3%) of 6 pronation-eversion-external rotation type of fractures according to Dias-Tachjian classification had interposed periosteum and that was a statistically significant correlation (p=0.006). As Salter-Harris type was toward to high degree, there were decreasing tendency of periosteal interposition (p=0.026). There was high rate of periosteal interposition in case of displacement more than 2 mm in each initial and after closed reduction (p<0.05).
CONCLUSION
There was high incidence of periosteal interposition in pronation-eversion-external rotation type with displacement more than 2 mm in distal tibial physeal fractures of children. But, periosteal interposition could occur in fractures with mild displacement less than 2 mm, if initial fracture displacement was more than 2 mm, the methods of treatment should be decided after confirm the presence of periosteal interposition with MRI after closed reduction.

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Epiphyseal Fractures of the Distal Radius in the Children: Hui Taek Kim, Myung Soo Youn, Jong Seo Lee, Young Jun Choi, Yoon Jae Seong; J Korean Fract Soc 2008;21(3):225-231. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.225

Abstract PDF

PURPOSE
To evaluate the long-term results of treatment of epiphyseal fractures of the distal radius in children.
MATERIALS AND METHODS
23 cases of distal radial epiphyseal fracture, treated by two methods: group 1, closed reduction (CR) plus cast (6 cases); group 2, CR and K-wire fixation (under anesthesia due to marked translation of the distal fragment and swelling) plus cast (17 cases), were selected for this study. All patients were followed up for more than 1 year (average: 3.2 years). Postoperatively, epiphyseal displacement and epiphyseal angulation were measured on anteroposterior and lateral radiographs. At follow-up, the affected and normal sides were compared. Final results were classified by radiologic (radial inclination, volar tilting and radial shortening) and clinical (limitation of ROM, wrist pain, grip strength and wrist deformity) criteria.
RESULTS
Group 1 had 5 good, 1 fair result; group 2 had 14 good, 2 fair and 1 poor - there was no statistically significant difference between two groups. All cases where the epiphyseal displacement was less than 30% had good results. A poor case showed a radial shortening, wrist deformity and pain due to premature epiphyseal closure. Premature epiphyseal closure was treated by bar resection and free fat, along with corrective osteotomy when necessary and lengthening of radius with or without epiphysiodesis of the ulna.
CONCLUSION
Remodeling can be expected in epiphyseal fractures of the distal radius. Repeated forceful attempts to achieve accurate reduction should be avoided to prevent secondary physeal injury.

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How long does it to achieve sagittal realignment of the displaced epiphysis in Salter-Harris type II distal radial fracture when treated by manual reduction?
Seung Hoo Lee, Hyun Dae Shin, Eun-Seok Choi, Soo Min Cha
Journal of Plastic Surgery and Hand Surgery.2023; 57(1-6): 346. CrossRef

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Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator: Suk Kyu Choo, Kyung Wook Nha, Hyoung Keun Oh, Dong Bong Lee; J Korean Fract Soc 2007;20(4):323-329. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.323

Abstract PDF: PURPOSE
We analyed the mid-term results of distal tibial fractures treated with ilizarov external fixator and functional results according to delayed metaphyseal healing and fracture pattern.
MATERIALS AND METHODS
We reviewed 23 distal tibial fractures treated with ilizarov external fixator followed for minimum two year (mean 53 months). There were 10 A fractures, 2 B fractures, and 11 C fractures according to the AO classification. Radiographically, we analyzed bony union time according to translation of diaphyseal-metaphyseal fracture line and assessed arthritic score. Functional results was assessed with AOFAS score and analyzed according to delayed healing and fracture pattern.
RESULTS
Average union time was 21 weeks. Delayed healing of metaphyseal fracture line was associated translational displacement >3 mm (p=0.01). AOFAS scrore was averaged to 68 and there was no stastical significance between delayed metaphyseal healing and functional results (p=0.31). But, low AOFAS score and arthritis score was related to fracture type (p=0.02). In 11 C fractures, radiographic arthritic change were developed in 6 cases (55%).
CONCLUSION
The main prognosis of distal tibial fractures depends on articular involvement and to shorten the external fixation time, metaphyseal fracture should be reduced within 3mm.

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Percutaneous Transphyseal Intramedullary K-wire Fixation for the Diaphyseal Forearm Fractures in Children: Jung Hoei Ku, Young Chul Go, Man Jun Park; J Korean Fract Soc 2006;19(3):374-377. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.374

Abstract: PURPOSE
Although the standard treatment of diaphyseal forearm fractures in children is conservative treatment with closed reduction and cast immobilization, unstable or irreducible fractures are usually needed by surgical intervention. The aim of this article is to determine the efficacy of the percutaneous transphyseal intramedullary K-wires fixation for the forearm diaphyseal fractures in children.
MATERIALS AND METHODS
In this retrospective study, we reviewed 18 cases of forearm diaphyseal fractures in children, which were treated with percutaneous transphyseal intramedullary nailing using K-wires from January 2001 to December 2004. We analyzed the period for radiologic bone union and the complications until the last follow-up.
RESULTS
The average period of follow-up was 15 months with mean age of 7.8 years. The average time to bone union was 6.2 weeks and nonunion, malunion, radio-ulnar synostosis and refracture were not found, just 2 local pin site infections were seen but healed by conservative treatment. Postoperative scar was small and the complications until the last follow-up were not found.
CONCLUSION
In the operative treatment of the forearm diaphyseal fractures in children, we think percutaneous transphyseal intramedullary K-wire fixation is one of the effective methods because of the minimal invasiveness, simplicity and easiness in removal.

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Lateral Plate Fixation of Distal Tibial Metaphyseal Fracture Using Minimally Invasive Plate Osteosynthesis Technique: Ki Do Hong, Sung Sik Ha, Nam Sik Chung, Jae Cheon Sim, Sang Cheon Ahn; J Korean Fract Soc 2006;19(1):24-28. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.24

Abstract

PURPOSE
To evaluate the efficiency of lateral plate fixation using minimally invasive plate osteosynthesis (MIPO) technique as a treatment of distal tibial metaphyseal fracture.
MATERIALS AND METHODS
Among the patient who were treated from March, 2002 to September, 2004, the cases of twenty patients with distal tibial metaphyseal fracture treated by lateral plate fixation using MIPO technique who were able to be followed up for at least one-year period were reviewed in this study. According to AO/OTA classification, five were type A1, twelve cases were type A2 and other three cases were type A3, and among them two cases were open fracture type I according to the Gustillo-Anderson classification. Radiologic studies and clinical assessment described by Daniel et al and complication following the treatment were evaluated.
RESULTS
At a mean of 16.4 weeks (range 11 to 23), all fractures united without secondary procedures. According to clinical assessment, all cases had good and excellent result, and there were no complications.
CONCLUSION
The lateral plate fixation using MIPO technique of distal tibial metaphyseal fracture is an efficient method of treatment with high functional recovery rate which minimize soft tissue damage, decreases the risk of infection and incidence of nonunion at the same time as the classic MIPO technique does, and it is a useful alternative method when there is a anteromedial soft tissue damage.

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Minimally Invasive Plate Osteosynthesis for Fractures of Distal Tibia
Tae Hun Kim, So Hak Chung
Kosin Medical Journal.2014; 29(1): 23. 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
Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture
Oog Jin Shon, Dae Sung Kim
Journal of the Korean Fracture Society.2010; 23(1): 42. CrossRef

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Interlocking Intramedullary Nailing in Distal Tibial Metaphyseal Fractures: Young Sung Kim, Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Ho Min Lee; J Korean Fract Soc 2005;18(3):269-274. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.269

Abstract PDF

PURPOSE
To evaluate and compare the outcome in fracture of distal tibial metaphyseal fractures involving ankle joint and not involving the ankle joint treated by interlocking imtramedullary nailing.
MATERIALS AND METHODS
Twenty six cases of distal tibial metaphyseal fractures treated by interlocking intramedullary nailing whom were able to follow up for more one year were selected and 10 cases involved ankle joint and the rest 16 cases did not. In all cases, more than 2 distal locking screws were inserted after reaming for the nailing, and cannulated screws or K-wires fixation were inserted for 8 cases of fractures involving ankle joint out of 10. We analyzed preoperative fracture type, union time, function of joint, and complications at final follow up.
RESULTS
According to Robinson's classification for distal tibial metaphyseal fractures, there were 9 cases of type I, 7 of 2A, 4 of 2B, 6 of 2C. Union time taken for distal tibial fractures involving ankle were average of 17 weeks (12~20 weeks) and for the fractures not involving ankle joint were average of 19 weeks (12~28 weeks). Klemm and Borner's functional evaluation showed above good in 8 cases (80%) of fracture involving ankle joint and 13 cases (81%) of fracture not involving the ankle joint, and functional evaluation did not show significant differences as well as the complication rate in both group.
CONCLUSION
Interlocking intramedullary nailing is one of the effective methods for treatment of distal tibial metaphyseal fracture involving articular surface of the ankle.

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Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures
Young Sung Kim, Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Soon Young Park
Journal of the Korean Orthopaedic Association.2021; 56(4): 317. CrossRef
Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures
Ho-Min Lee, Young-Sung Kim, Jong-Pil Kim, Phil-Hyun Chung, Suk Kang, Kaung Suk Jo
Journal of the Korean Fracture Society.2018; 31(3): 94. CrossRef
Intramedullary Nailing of Distal Tibial Fractures with Percutaneous Reduction by Pointed Reduction Forceps
Jae-Kwang Hwang, Chung-Hwan Kim, Young-Joon Choi, Gi-Won Lee, Hyun-Il Lee, Tae-Kyung Kim
Journal of the Korean Fracture Society.2014; 27(2): 144. CrossRef
Comparative Study of Intramedullary Nailing and Plate for Metaphyseal Fractures of the Distal Tibia
Hoon Jeong, Jae-Doo Yoo, Young-Do Koh, Hoon-Sang Sohn
Journal of the Korean Fracture Society.2007; 20(2): 154. CrossRef

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Minimally Invasive Plate Osteosynthesis for Distal Tibial Metaphyseal Fracture: Ki Chul Park, Ye Soo Park; J Korean Fract Soc 2005;18(3):264-268. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.264

Abstract PDF

PURPOSE
To retrospectively reviewed the outcomes and advantages of minimally invasive plate osteosynthesis (MIPO) technique as a new treatment of distal tibial metaphyseal fracture.
MATERIALS AND METHODS
Nineteen distal tibial metaphyseal fractures were treated by MIPO technique and evaluated radiologically and functionally. A mean age was 46 years old (range 20~69 years) and a mean follow-up was 15 months (range 6~37 months). Sixteen fractures were not extended into ankle joint (AO/OTA type A1;4, A2;8, A3;4) and three fractures were extended into ankle joint (AO/OTA type C1;2, C2;1). Two cases were open fractures (type I;1, type III-A;1) according to the Gustilo-Anderson classification.
RESULT
At a mean of 18 weeks (range 12 to 24), all fractures united without secondary procedures. A mean score was 94.2 point by Baird ankle scoring system. There were no complications including shortening over 1 cm, mal-alignment over 5 degrees, deep infection, or implant failure.
CONCLUSION
MIPO technique of distal tibial metaphyseal fracture is a worthwhile method with good unions and functional recovery.

Citations

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Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures
Ho-Min Lee, Young-Sung Kim, Jong-Pil Kim, Phil-Hyun Chung, Suk Kang, Kaung Suk Jo
Journal of the Korean Fracture Society.2018; 31(3): 94. CrossRef
A Comparison of the Results between Intramedullary Nailing and Minimally Invasive Plate Osteosynthesis in Distal Tibia Fractures
Chul-Hyun Park, Chi-Bum Choi, Bum-Jin Shim, Dong-Chul Lee, Oog-Jin Shon
Journal of the Korean Orthopaedic Association.2014; 49(4): 285. CrossRef
Analysis of the Result Treated with Locking Compression Plate-Distal Tibia and Zimmer Periarticular Locking Plate in Distal Tibia Fracture
Jun-Young Lee, Sang-Ho Ha, Sung-Won Cho, Sung-Hae Park
Journal of the Korean Fracture Society.2013; 26(2): 118. CrossRef
Comparative Analysis of Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Intramedullary Nailing in Distal Tibial Metaphyseal Fractures
Gwang Chul Lee, Jun Young Lee, Sang Ho Ha, Hong Moon Sohn, Yi Kyu Park
Journal of the Korean Fracture Society.2012; 25(1): 20. CrossRef
Clinical Outcomes of Locking Compression Plate Fixation through Minimally Invasive Percutaneous Plate Osteosynthesis in the Treatment of Distal Tibia Fracture
Jae-Sung Yoo, Hyun-Woo Park
Journal of the Korean Fracture Society.2012; 25(2): 117. CrossRef
Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures
Sung-Kyu Kim, Keun-Bae Lee, Keun-Young Lim, Eun-Sun Moon
Journal of the Korean Fracture Society.2011; 24(1): 33. CrossRef
Management of Fractures of Distal Tibia by Minimally Invasive Plate Osteosynthesis through an Anterior Approach
Gu-Hee Jung, Jae-Do Kim, Jae-Ho Jang, Sung-Keun Heo, Dong-won Lee
Journal of the Korean Orthopaedic Association.2010; 45(6): 473. CrossRef
Comparative Study Using of Treatment with Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Interlocking Intramedullary Nailing in Distal Tibia Fractures
Chang Hwa Hong, Jong Seok Park, Sang Seon Lee, Soo Ik Awe, Woo Jong Kim, Ki Jin Jung
Journal of the Korean Fracture Society.2010; 23(3): 296. CrossRef
A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures
Kee-Byung Lee, Si-Young Song, Duek-Joo Kwon, Yong-Beom Lee, Nam-Kyou Rhee, Jun-Ha Choi
Journal of the Korean Fracture Society.2008; 21(4): 286. CrossRef
Minimally Invasive Percutaneous Plate Osteosynthesis Using Periarticular Plate for Distal Tibial Fractures
Young Mo Kim, Jae Hoon Yang, Dong Kyu Kim
Journal of the Korean Fracture Society.2007; 20(4): 315. CrossRef
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
Journal of the Korean Fracture Society.2007; 20(1): 19. CrossRef

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Fracture in Distal Humeral Shaft and Metaphyses: Whan Yong Chung, Woo Sik Kim, Tae Hong Kim; J Korean Soc Fract 2002;15(3):404-409. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.404

Abstract PDF: PURPOSE
This is a retrospective study to analyze the clinical results of the usefulness of the lateral J plate fixations in distal humeral shaft and metaphyseal fractures.
MATERIALS AND METHODS
From October 1996 to May 2000, eleven patients with distal humeral shaft and metaphyseal fracture were treated by open reduction and internal fixations with lateral J plate fixations. The clinical results were analyzed according to Morrey 's functional rating scale. Radiological unions, complication, and range of motion of the elbow were assessed.
RESULTS
All fractures were united at 12 weeks (range, 10 ~18) in average. Finally, average range of motion of the elbow joint was flexion contracture 6 degrees in average(range, 0 ~20) to further flexion 126 degrees in average (range, 90 ~1 5 0 ) . Morrey 's functional rating scale were as follows; excellent 4, good 6, and fair 1.
CONCLUSION
Lateral J plate fixations can be a good treatment method for the transitional zone of distal humeral shaft and metaphyseal fractures.

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Treatment of the Distal Metaphyseal Fractures of Tibia - Comparison between Internal Fixation with a Plate and screws and External Fixation with Ilizarov Device: Sung Churl Lee, Moon Jib Yoo, Hyun Seok Seo; J Korean Soc Fract 2002;15(3):371-378. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.371

Abstract PDF

PURPOSE
The purpose of this study was to compare the results between open reduction and internal fixation with plate and screws and closed reduction and external fixation with Ilizarov device for the fracture of disatal metaphyseal fracture of tibia.
MATERIALS AND METHODS
In this study, the results in treatment of the 19 distal metaphyseal fractures of tibia with closed reduction and external fixation with Ilizarov device were compared with those in treatment of the 23 fractures with open reduction and internal fixation with a plate and screws. The cases were the patients who had been treated for the fractures at the Department of Orthopaedic Surgery, Dankook University Hospital from May 1997 to December 2000. The results of treatment were analysed using functional evaluation by Mast and Teipner and radiological evaluation by Ovadia and Beals.
RESULTS
The results were as follows: 1. The major causes of injury were motor vehecle accidents, fall-downs, and falls from a height in order. 2. Treatment of the fractures with closed reduction and external fixation with Ilizarov device showed comparable results to that with open reduction and internal fixation with a plate and screws. 3. Complications in treatment were a little more frequent in open reduction and internal fixation with a plate and screws than in closed reduction and external fixation with Ilizarov device.
CONCLUSION
Considering the results, closed reduction and external fixation with Ilizarov device is thought to be one of recommendable options in treatment of the distal metaphyseal fractures of tibia with the advantages in wound management, prevention of stiffness of ankle joint, and convenience in removal of the device.

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Mid-term Results of Distal Tibial Fractures Treated with Ilizarov External Fixator
Suk Kyu Choo, Kyung Wook Nha, Hyoung Keun Oh, Dong Bong Lee
Journal of the Korean Fracture Society.2007; 20(4): 323. CrossRef

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Treatment of distal tibia metaphyseal fractures by percutaneous plate osteosynthesis: Chang Wug Oh, Joo Chul In, Seong Man Lee; J Korean Soc Fract 2002;15(2):185-191. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.185

Abstract PDF: PURPOSE
We retrospectively reviewed the outcomes and efficacy of the percutaneous plate osteosynthesis for the distal tibia metaphyseal fracture.
MATERIALS AND METHODS
Twenty-one patients suffering from fractures of the distal tibial metaphysis, with or without minimally displaced extension into the ankle joint, were treated by percutaneous plate osteosynthesis with narrow LC-DCP. According to the AO/OTA classification, 17 fractures had no articular involvement (A1=8, A2=6, A3=3) while 4 included intraarticlar extension (C1=4).
RESULTS
At the final follow-ups(mean=20months), all the fractures healed without second procedures and the mean union time was 15.2 weeks. Only one patient had a malunion of rotational deformity due to inadequate prebending of plate, but there were no angular deformities over 5 degrees nor any shortenings of more than 1cm. There were no deep infections, nor any soft tissue compromise. Three patients had a partial limitation of ankle motion, but all the patients had excellent or satisfactory ankle function with mean OMA score of 89.1%.
CONCLUSION
Percutaneous plate osteosynthesis is a safe and worthwhile method of managing distal tibia metaphyseal fracture while avoiding some of the complications associated with conventional open plating methods.

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Salter-Harris Type IV Physeal Fracture of the Distal Radius: A Case Report: Young Soo Byun, Hong Tae Kim, Kyoung Hoon Hyun, Jun Mo Nam, Young Ho Cho; J Korean Soc Fract 2001;14(4):739-744. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.739

Abstract PDF: Physeal fractures in children are the most common in the distal radius. In the distal radius Salter-Harris type II physeal fractures occur predominantly, while type IV physeal fractures are quite rare. For type IV physeal fractures, open reduction and internal fixation are usually indicated to align both the physis and the articular surface. Growth arrest can be developed by premature physeal closure depending on multiple factors, particularly the severity of trauma. We treated a type IV physeal fracture of the distal radius with open reduction and internal fixation in an 11-year-old boy, but growth arrest with gross deformity and painful motion limitation of the wrist occurred. The deformity in external appearance was nearly corrected and symptoms were improved by surgical shortening of the ulna 3 years after injury, and the final result was satisfactory.

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Operative treatment of diaphyseal fractures of both forearm bones in adults: Eui Hwan Ahn, Sung Tae Lee, Ja Heon Koo; J Korean Soc Fract 2001;14(2):245-252. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.245

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the effectiveness of operative methods for diaphyseal fractures of both forearm bones in adults.
MATERIALS AND METHODS
Forty five cases with diaphyseal fractures of both forearm bones over 18 year old that are treated by operative methods from January 1994 to December 1998 were followed and analyzed. The most common age group was 3rd and 4th decade(each, 24.4%). Traffic accident was the most common cause of injuries(31.2%). Among both the radius and ulna, middle 1/3 was the most common level of fractures(60%, 57.8%). In operative methods, open redeuction and internal fixation with dynamic compression plate(D.C.P.) and screws were performed in 39 cases, closed reduction and internal fixation with Rush pin were performed in 5 cases, And another 1 case was performed with D.C.P. and Rush pin simultaneously.
RESULTS
According to simple X-ray and physical examinations, The average of bone union periods was 12.7 weeks in radius, 13.5 weeks in ulna. The range of bone union periods according to the level of fractures was from 12.4 weeks to 14.1 weeks. For the functional results assessed by Grace and Eversmann method, excellent was 48.9%, good was 35.6%, acceptable was 11.1% and unacceptable was 4.4%.
CONCLUSION
The functional result was satisfactory in 84.5%. So the operative method of diaphyseal fractures of both forearm bones, if proper operative method had been selected and meticulous surgical technique had been performed, was considered as recommendable method.

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Treatment of a Segmental Ulnar Shaft Fracture and an Olecranon Fracture
Myoung Soo Kim, Kyu Pill Moon, Hyung Joon Cho, Jung Yun Bae, Kuen Tak Suh
Journal of the Korean Orthopaedic Association.2010; 45(6): 496. CrossRef

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Effects of Fibular Fixation for Interlocking Nailing of Distal Tibiofibular Fractures: Sang Ho Moon, Phil Hyun Chung, Chung Soo Hwang, Dong Ju Chae, Beom Kim; J Korean Soc Fract 2000;13(2):296-302. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.296

Abstract PDF: PURPOSE
: To compare redioiogic results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures.
MATERIALS AND METHODS
: From April 1993 to February 1999, 26 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 61 fractures fixed with nails only. Average age of patients was 41.8 years. These two groups were compared by frequency of malalignment, degree of postoperative angulation, angulation according to comminution, angulation according to fracture configuration. The statistical analysis was evaluated by t-test.
RESULTS
: Fibular fixation group had no malalignment while non-fixations had angulation of 1.2+/-1.1 degree and non-fixation had 3.0+/-2.1. So fixation had lessor angulation than non-fixation significantly(p=0.004). In lateral rediographs, each had 1.3+/- 1.1, 2.8+/-2.3 degree and showed significant difference(p=0.027). In type I and II fractures of Winquist-Hansen classification, fixation group showed lesser degree of angulation in A-P plane significantly(p=0.008) but no significant difference in lateral plane. In type III and IV, no significant difference in both planes. According to configuration of fractures, transverse and spiral fractures showed no significant differences but oblique configurations had significant differences in A-P plane(p=0.002) CONCLUSION : Interlocking intramedullary nail with fibular fixation has the advantage in maintenance of alignment during insertion of nail in distal tibiofibular fractures, especially in Winquist-Hansen classification type I and II and oblique fractures in anteroposterior plane, so it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

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Treatment of Distal Tibial Epiphyseal fracture Salter-Harris Type I & II: Sung Ho Hahn, Bo Kyu Yang, Seung Rim Yi, Sung Hwan Yoo; J Korean Soc Fract 1999;12(4):1065-1070. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.1065

Abstract PDF

It is known that the Salter-Harris type I and II fractures of the distal tibial epiphysis usually can be treated by conservative method. But according to Spiegel, unpredictable group(type II) fractures might have more complications than expected when treated by conservative method without accurate reduction. Eleven cases in type I or II fractures were treated at the National Police Hospital between March 1992 and March 1997. If more than 2mm displacement was present compared to contralateral side after closed reduction, open reduction and internal fixation method was done and in those all cases, periosteal interposition was found on the operative field that might interrupt anatomical reduction and cause late complications such as angular deformity.

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Interposition of Periosteum in Distal Tibial Physeal Fractures of Children
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Jae Woo Cho
Journal of the Korean Fracture Society.2011; 24(1): 73. CrossRef

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Injuries of the Knee Associated with Fractures of the Tibial Shaft: Kwang Won Lee, In Sung Hwang, Seung Hun Lee, Tae Gyoo Ahn, Ha Yong Kim, Whoan Jeang Kim, Won Sik Choy; J Korean Soc Fract 1999;12(2):277-283. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.277

Abstract PDF: Two hundred and seventeen consecutive patients with two hundred and twenty five diaphyseal tibia fractures were retrospectively reviewed to evaluate the frequencies, types and the results of treatments for the associated ipsilateral knee ligaments and menisci injuries from May 1993 to Feb 1997 at Eulji Medical College Hospital. Average follow-up period was 41 months(20~65 months). Thirteen patients with knee injuries(5.8%) were diagnosed by stress X-ray & MRI evaluation and confirmed by arthroscopic examination. Eleven patients(84.6%) were diagnosed as having a ligament or meniscus injury at the time of initial management. The posterior cruciate ligament(PCL) was injured in eight patients(50%); the anterior cruciate ligament(ACL), in three; the medial collateral ligament, in three; the lateral collateral ligament, in two: the medial meniscus, in two; and the lateral meniscus, in two. There was no relationship between specific ligament damage and the cause of the injury or level of fracture. Collateral ligament injuries, two ACL, and four PCL injuries were treated conservatively and one PCL injuries were treated with pull-out suture technique and another four PCL injuries were treated with reconstruction using bone-patella tendon-bone. One ACL injury was treated with reconstruction using semitendinosus tendon. As evaluated by the method of HSS knee score, there were seven(53.9%) excellent, four(30.8%) good, and two fair(15.3%). On the basis of the results of this study, we believe that, after stabilization of a fracture of the tibial shaft, it is essential to examine the knee throughly to identify any associated ligamentous injuries.

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Analsis of the Distal Tibial Physeal and Epiphyseal Injury: In Ho Choi, Choon Ki Lee, Duk Yong Lee, Se Il Suk, Song Choi, Yong Hoon Kim, Suk Kee Tae, Seong Il Kim; J Korean Soc Fract 1989;2(2):164-173. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.164

Abstract PDF: We have reviewed 21 cases of physeal and epiphyseal fracture of the distal tibia including one case of juvenile Tillaux fracture and four cases of triplane fracture. The patterns of fracture were correlated with the mechanism of injury using the modified Lauge-Hansen method and sysemic classification of the triplane frature was proposed. Treatment included closed reduction and cast(9 cases), closed reduction and percutaneous pin fixation(4 cases), and open reduction(8 cases). Two of the nine patients treated by means of closed reduction and cast had ankle joint incongruity or progressive varus deformity requiring corrective ost eotomy. These two patients had either Salter-Harris Type III ro Type IV fracture after supination-inversion injury. In one patient, who had 100 per cent displacement of the distal tibial epiphysis and degloving injury of the ankle, premature physeal arrest developed after open reduction and internal fixaion for Salter-Harris Type Tyre I fracture. If there are triagular metaphseal ledge along with the juvenile Tillaux fracture-like vertical epiphyseal fracture line on the antero-posterior view and Salter-Harris Type II or Type IV frature on the lateral view, a certain type of triplane fracture is strongly suggested. Plain radiographs, however, could not accurately demontrate the detailed configuration of the triplane fracture, instead computerized axial tomography was very helpful us to analyse the true dimensions of the triplane fracture. We agree that displace Salter-Harri Type III or Type IV and transitional fractures with a fracture gap of more than two millimeters in the weight-bearing portion of the epiphysis regure open reduction.

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