Journal of Musculoskeletal Trauma

Reconstruction of a Traumatic Soft Tissue Defect: Jong Woong Park; J Korean Fract Soc 2015;28(4):256-265. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.256

Soft tissue defect combined with an open fracture is a very challenging problem to the orthopaedic surgeon. Many complicated open fractures remain with soft tissue defect, chronic osteomyelitis, and sometimes terminate with major limb amputation. Soft tissue defect should be reconstructed as soon as possible, particularly when the bone, tendon, or neurovascular structures are exposed. Exposure for longer than a week significantly increases the risk of secondary infection and tissue necrosis. For the simple soft tissue defect, negative pressure wound closure technology has been introduced and many superficial wounds have been treated successfully using this method. For the more complicated wounds, many kinds of local flaps, pedicled flaps, muscle and fascisocutaneous flaps can be indicated according to the characteristics of the wounds. The free flaps including free vascularized bone graft can be considered as a final choice for the most difficult wound problems. In this article, various reconstruction strategies for soft tissue defect after traumatic open fracture are reviewed.

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New proposal for skin grafts on tendon-exposed wounds
Jung Hwan Um, Dong In Jo, Soon Heum Kim
Archives of Plastic Surgery.2022; 49(01): 86. CrossRef
Soft Tissue Reconstruction for Open Tibia Fractures
Young-Woo Kim, Ho-Youn Park, Yoo-Joon Sur
Archives of Hand and Microsurgery.2020; 25(3): 207. CrossRef

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Treatment for Concurrent Ipsilateral Femoral Neck and Shaft Fractures Using Reconstruction Nail with Temporary K-Wires: Sang Joon Lee, Sang Hong Lee, Sang Ho Ha, Gwang Chul Lee; J Korean Fract Soc 2015;28(1):23-29. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.23

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the results of operative treatment using a reconstruction nail after temporary K-wire fixation of the femoral neck for ipsilateral femoral neck and shaft fractures.
MATERIALS AND METHODS
A total of 11 cases were treated, which were followed-up for more than two years, between August 2007 and July 2012. The average age was 51 years (29-69 years) and men were dominant counting eight cases. All cases were operated with a reconstruction nail after temporary K-wire fixation of the femoral neck. Bone union periods, alignment, etc. were evaluated by radiological methods and accompanying damage and complications were also investigated. Functional evaluation was performed in accordance with Friedman and Wyman criteria at the last follow-up.
RESULTS
The average time for union of the femoral shaft was 22.5 weeks (12-32 weeks), and femoral neck was 13.1 weeks (8-20 weeks). There was no nonunion, and four femoral shaft fractures resulted in delayed union. There was one case of leg length discrepancy more than 2 cm long, but malalignment of more than 10 degrees was not observed. Avascular necrosis of the femoral head did not occur. Functional results were good in eight cases, fair in two cases, and poor in one case.
CONCLUSION
Treatment with reconstruction nailing after temporary K-wire fixation of the femoral neck is thought to be a good method which prevents neck displacement and has low complication rates.

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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; J Korean Fract Soc 2007;20(2):172-177. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.172

Abstract PDF: PURPOSE
To evaluate the therapeutic effects of chevron olecranon osteotomy and bilateral reconstruction plate as operative treatment for distal humerus intercondylar fracture.
MATERIALS AND METHODS
Among patients operated for distal humerus intercondylar fracture in our hospital from June, 1997 to October, 2005, 26 patients were selected who could be followed-up for more than one year. The average follow-up period was 15 months. All olecranon osteotomies were chevron osteotomy and all fractures were treated with internal fixation using bilateral reconstruction plate. The ulnar nerve was checked in all cases. Three patients in which case the plate might irritate the ulnar nerve, received with ulnar nerve anterior transposition. Cassebaum's classification and Mayo elbow performance score were used to evaluate at three, six and twelve months.
RESULTS
Mean bone union period was 11.7 weeks. There were 9 excellent cases, 11 good cases, 4 fair cases and 2 poor cases. Mean flexion contracture was 11Â° and further flexion was 126Â° at last follow-up.
CONCLUSION
Bilateral reconstruction plate internal fixation using chevron olecranon osteotomy showed strong fixation and good clinical results and it is possible for early rehabilitation treatment.

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Operative Treatment in Midshaft Fractures of Clavicle using Reconstruction Plate and Interfragmentary PDS Suture: Phil Hyun Chung, Suk Kang, Chung Soo Hwang, Jong Pil Kim, Young Sung Kim, Sung Pock Park, Jin Wook Chung; J Korean Fract Soc 2006;19(3):335-339. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.335

Abstract

PURPOSE
We are reporting the result of comminuted midshaft fractures of clavicle treated by reconstruction plate fixation and PDS augmentation easily fixing butterfly fragments with minimal soft tissue dissection.
MATERIALS AND METHODS
We reviewed 42 cases of operatively treated displaced comminuted midshaft fractures of clavicle at our hospital from March, 2001 to May 2004 whom were followed up for more than one year after the operation. According to Robinson classification, we grouped simple fractures as group A, and comminuted fractures as group B. Internal fixation using reconstruction plate has been chosen for type A fracture. Type B has been treated by reconstruction plate fixation with PDS augmentations. Shoulder function, union time and complications has been studied according to the fracture type retrospectively.
RESULTS
All cases had complete bone union with average union time of 8.6 weeks for type A and 8.9 weeks for type B. Weitzman functional evaluation did not show significant differences.
CONCLUSION
PDS augmentation in comminuted midshaft fracture of clavicle easily fix the butterfly fragments with least soft tissue damage and lessen the bone graft. Therefore it considered to be one of the available treatment methods for comminuted midshaft fracture of clavicle.

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Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?
Jae-Kwang Yum, Yong-Woon Shin, Hee-Sung Lee, Jae-Gu Park
Journal of the Korean Fracture Society.2011; 24(2): 138. CrossRef

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Two-Stage Reconstruction of Infected Nonunion of Long Bones using Antibiotics-Impregnated Cement Beads: Se Hyun Cho, Soon Taek Jeong, Hyung Bin Park, Sun Chul Hwang, Yong Chan Ha, In Hwan Hwang; J Korean Fract Soc 2004;17(4):395-400. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.395

Abstract PDF

PURPOSE
To evaluate treatment results between internal and external fixation groups in two-stage reconstruction of infected nonunion of long bones using antibiotics-impregnated cement beads.
MATERIALS AND METHODS
In the first stage, preexisting hardwares were removed and radical debridement was done. The dead space was filled with antibiotics -impregnated cement beads and the nonunion site was immobilized by external fixation, cast or skeletal traction. In the second stage, all cases were divided into two groups; the nonunion was fixed by internal fixation in group I versus external fixation in group II. The intervening period between the first and second stage was average 8.7 weeks (range, 3~23 weeks).
RESULTS
The follow-up period was average 45 months (range, 16~71 months). Infection control and bone union were achieved in all 13 cases of group I. Infection recurred in two of 28 cases in group II, one underwent above-knee amputation and the other case was lost in follow-up. The mean number of supportive operations including repeated curettage, augmentation and change of infected pins, angular correction, and soft tissue flap was average 2 and 6.2 times respectively in group I and group II. Bony union period was average 19.3 and 23.1 weeks in each group. According to Paley's classification, group I was similar to group II in bony and functional result (p>0.05).
CONCLUSION
Antibiotics-impregnated cement beads provided positive effect on infection control. Internal fixation group showed less number of additional operations and earlier bony union than external fixation group.

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Treatment of Infected Nonunion
Sang-Ho Ha
Journal of the Korean Fracture Society.2007; 20(2): 206. CrossRef

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The Operative Treatment of Nonunions of Midshaft Clavicular Fractures: Reconstruction Plate Fixation and Bone Grafting: Young Soo Byun, Chan Hoon Yoo, Hyug Su An, Seong Gun Moon, Dong Ju Shin, Jun Woo Park; J Korean Soc Fract 2003;16(2):222-229. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.222

Abstract PDF: PURPOSE
The purpose of this study is to present our experience with open reduction, 3.5-mm reconstruction plate fixation, bone-grafting, and postoperative early mobilization for nonunions of midshaft clavicular fractures.
MATERIALS AND METHODS
Sixteen patients were treated operatively for nonunions of the midshaft of the clavicle from 1997 to 2001. Ten nonunions were atrophic and six were hypertrophic. Nonunion had been present for an average of 6.5 months. The operative technique included removing the fibrous tissue from the nonunion site and opening the medullary canal, reduction of the fracture and fixation with a 3.5-mm reconstruction plate, and bone-grafting. Postoperative mobilization started within one week.
RESULTS
The average duration of follow-up was 22.0 months. All fractures were united in an average of 10.0 weeks. All patients had full range of motion of the ipsilateral shoulder, but 3 out of 6 patients who were more than 50 years old complained occasional pain in the ipsilateral shoulder at the final follow-up examination. There were no major complications of postoperative infection, metal failure of the plate, loss of fixation, nonunion, and refracture after removal of the implant.
CONCLUSION
The technique of open reduction, reconstruction plate fixation, and bone-grafting is a safe and reliable method to allow early rehabilitation by stable fixation and to predict a high rate of union for nonunions of midshaft clavicular fractures.

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Reconstruction of the coronoid process using a graft from the olecranon of the same side for chronic posterior dislocation of the elbow: Jin Ho Kim, Seung Taek Song, Young Jin Sohn; J Korean Soc Fract 2002;15(3):410-413. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.410

Abstract PDF: It is reported when posterior dislocation of the elbow with the fracture of the coronoid process is occurred, if they can 't achieve the reduction of coronoid process, the patient would have the elbow instability. That is required to open reduction of coronoid process. Limitation of the elbow motion and persistent posterior dislocation of the elbow result from failure of reduction of coronoid process in acute injury. That patients have been treated by distraction arthroplasty, total elbow replacement, arthrodesis, and coronoid process reconstruction. We experienced one case that had a excellent result from reconstruction of the coronoid process using a graft from the olecranon of same side in 28 years old man.

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Operative Treatment with the Reconstruction Plate for the Displaced Clavicle Shaft Fracture of Adults: Ig Gon Kim, Jae Hyek Kim, Ryong Hwang, Young Ill Hong; J Korean Soc Fract 2000;13(4):941-947. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.941

Abstract PDF

PURPOSE
The purpose of this study was to know the usefulness of bony union and faster recovery of shoulder motions by the open reduction and internal fixation with the reconstruction plate for the displaced clavicle shaft fracture of adults. MATERIAL AND METHOD: From January 1993 to December 1997, for 5 years, we analyzed 28 cases which underwent for a year of displaced clavicular shaft fracture over 11mm after open reduction and internal fixation with the reconstruction plate and supplementary iliac bone graft.
RESULT
At all 28 cases, there were united without delayed union for average 7.2 weeks after operation. Motion of the shoulder joint were returned to normal within 1.8 weeks except two cases who had combined humerus fracture and partial gastrectomy for peptic ulcer.
CONCLUSION
It seems that operative treatment with the reconstruction plate and supplementary bone graft for the displaced clavicle shaft fracture of adults showed effective union and faster recovery of shoulder motions.

Citations

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Does cerclage wiring interfere with fracture healing of osteosynthesis in comminuted midshaft clavicle fractures? A multicenter study
Hyo Jin Lee, Yong Bok Park, Chang Heon Shim, Young Min Noh
Orthopaedics & Traumatology: Surgery & Research.2021; 107(8): 103091. CrossRef
Anatomical Reduction of All Fracture Fragments and Fixation Using Inter-Fragmentary Screw and Plate in Comminuted and Displaced Clavicle Mid-Shaft Fracture
Kyoung Hwan Koh, Min Soo Shon, Seung Won Lee, Jong Ho Kim, Jae Chul Yoo
Journal of the Korean Fracture Society.2012; 25(4): 300. CrossRef
Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?
Jae-Kwang Yum, Yong-Woon Shin, Hee-Sung Lee, Jae-Gu Park
Journal of the Korean Fracture Society.2011; 24(2): 138. CrossRef

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Comparision of Operative Treatment Methods of AO type C2-C3 Fractures of the Distal Femur: Beom Koo Lee, In Ho Seong, Min Ho Song; J Korean Soc Fract 2000;13(4):861-867. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.861

Abstract PDF: PURPOSE
To evaluate the advantages of transarticular reconstruction and fixation of metaphysis by MIPO technique for AO type C2-C3 fractures of the distal femur. MATERIAL AND METHODS: In a retrospective study conducted from January 1996 to December 1997, AO type C2-C3 fractures of the distal femur were treated using three techniques; 1) A group-MIPO technique and medial parapatellar arthrotomy for the direct reduction of the condylar block(10 cases), 2) B group-conventional AO technique(8 cases) 3) C group-closed supracondylar nailing(4 cases). Minimal followup time was 12 months.
RESULTS
Time to bone healing was 15 weeks in A group, 20 weeks in B group, and 16 weeks in C group. complication rate was 0% in A group, 50% in B group, and 50% in C group. normal alignment between 0 & valgus 9 degrees was 100% in A group, 75% in B group, and 50% in C group. Neer score was 90% excellent or satisfactory in A group, 75% in B group, and 50% in C group respectively. The results of A group was better than those of B and C group.
CONCLUSION
Transarticular joint reconstruction and MIPO technique for AO type C2-C3 fractures of the distal femur is an excellent technique to obtain more rapid bony union with less complications.

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Reconstruction of Neglected Traumatic Radial Head Dislocation in Children: Dong Yeon Lee, Tae Joon Cho, In Ho Choi, Chin Youb Chung, Young Jin Sohn; J Korean Soc Fract 2000;13(4):1024-1032. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1024

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the clinical result of surgical reconstruction of the old traumatic radial head dislocation in children, and to delineate the optimal surgical procedure for it.
MATERIALS AND METHODS
Fifteen cases of the old traumatic radial head dislocation were included in this study, which had surgical reconstruction at the age of 15 years or less. Preoperative and postoperative clinical symptom, range of joint motion, and radiologic findings were reviewed. Reconstructions were performed by combination of various procedures, and the advantages and disadvanges of each procedures were analyzed.
RESULTS
All the preoperative complaints were relieved by the operation. In twelve cases out of 15, the radial head reduction was well maintained. The reasons for the loss of reduction were non-union of ulnar osteotomy site, and the neglected angular deformity at the proximal radius. Although forearm pronation was decreased in most cases, they did not affect most of the daily activities except in cases where the radioulnar osseocartilaginous bridge were complicated.
CONCLUSION
Our results justify the surgical reconstruction of neglected traumatic radial head dislocations in children. Complete clearing of radiocapitellar joint, accurate bony realignment and rigid fixation, appropriate annular ligament reconstruction, and temporary fixation with transcapitellar pin may ensure satisfactory result.

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Surgical Treatment of Acromioclayicular Joint Dislocation with Coracoclavicular Ligament Reconstruction using Coracoacromial Ligament: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyung Lee, Joo Hyung Lee, Min Seon Rim; J Korean Soc Fract 1997;10(4):949-955. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.949

Abstract PDF: Several treatment methods for complete acromioclavicular(AC) joint dislocation have been recommended. This study was performed to evaluate the results of the injuries that had been treated operatively with Bosworth technique combined with coracoclavicular ligament reconstruction using coiacoacromial ligament. Between September 1992 and October 1995, 19 cases were treated with this method. We made an assessment of the results suggested by Taft. Subjectively, fifteen patients had no pain or stiffness. 17 patients had normal strength and full range of motion objectively. On the roentgenographic bases, 16 cases showed normal findings and one showed the subluxation of the AC joint. The overall Taft score was 10.8 points and 84 % of the patients showed good or excellent results. The advantages of this method include anatomical reduction of the AC joint and early motion of shoulder. Ligament reconstruction enables early removal of the lag screw which precludes joint stiffness and metal problems. We conluded that this method was a good surgical method for complete AC joint dislocation.

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Reconstruction for Rupture of Popliteal Artery: Kwang Suk Lee, Young Soo Byun, Soon Hyuk Lee, Kyung Hwan Ha; J Korean Soc Fract 1997;10(1):16-24. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.16

Abstract PDF: The injury of popliteal artery is commonly produced by fracture or dislocation around the knee. Well established protocol for urgent diagnosis and treatment is essential to avoid amputation. The 14 cases of popliteal artery injury, treated between April 1987 and June 1995 at the Department of Orthopedic Surgery Korea University Hospital, were reviewed. The results were as follows. 1. In all 14 cases, 4 extremities(28%) were amputated. The amputation rate was closely correlated with the ischemic time since the accident. 2. The use of Doppler flowmeter after physical examination and emergency arteriography before exploration was recognized to be an exellent method in determination of arterial injury, 3. Among the patients who could avoid amputation(10 cases), the vein graft was performed in 8 cases(80%) and primary repair by end to end anastomosis in 2 cases(20%). 4. External fixation is recommended for its simplicity and low infection rate to provide the fixation and collateral circulation of fracture site. 5. The patients who were injured with the wide soft tissue defect by crushing could be treated by latissimus dorsi free flap transfer to avoid amputation.

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The treatment of acromiclavicular ligament injury using coracoacrom ial ligament transfer with acromial bone block report of fourcases: Duck Yun Cho, Jai Gon Seo, Eung Ha Kim, Eun Sung Koh; J Korean Soc Fract 1992;5(1):22-27. Published online May 31, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.1.22

Abstract PDF: No abstract available.

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Supracondylar osteotomy for cubitus varus deformity in adult: Ik Dong Kim, Poong Taek Kim, Byung Chul Park, Young Goo Lyu, Il Hyung Park, Byung Guk Min; J Korean Soc Fract 1991;4(1):22-29. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.22

Abstract PDF: No abstract available.

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