Journal of Musculoskeletal Trauma

Irreducible Ankle Fracture Dislocation due to Dislocated Tibialis Posterior Tendon - A Case Report -: Seungyup Shin, Bum-Soo Kim, Ji-Won Lee, Euisun Yoon; J Korean Fract Soc 2023;36(2):52-56. Published online April 30, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.2.52

Abstract PDF: An irreducible ankle dislocation is a rare injury. The cause is a dislocation of the distal fibula anteriorly or posteriorly or the insertion of soft tissue, such as the deltoid ligament or posteromedial tendon. The tibialis posterior tendon can be dislocated through distal tibiofibular diastasis and prevent reduction of the ankle joint. The authors experienced anterolateral ankle fracture dislocation with a diastasis of the distal tibiofibular joint, and reduction was impossible because of impingement of the tibialis posterior tendon dislocated anteriorly through the distal tibiofibular diastasis. This paper reports the treatment of this injury.

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Demographic and Radiographic Parameters as Predictors of Reduction Loss after Conservative Treatment of Distal Radius Fractures in Adults: Kyu Jin Kim, Dae Won Shin, Seong Kee Shin; J Korean Fract Soc 2023;36(2):45-51. Published online April 30, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.2.45

Abstract PDF: Purpose
This study examined the demographic and radiological risk factors for later reduction loss of distal radius fractures treated conservatively. Materials and Methods This study enrolled patients treated for distal radius fractures between January 2017 and December 2019. Seventy-eight patients were included in the analysis and divided into two groups. The patients who showed minimal reduction loss within an acceptable radiologic angle after initial manual reduction were classified as Group A. The patients who showed reduction loss out of an acceptable radiologic angle and finally malunited or converted to surgical treatments were classified as Group B. The patient’s age and bone marrow density were used as demographic data. The initial X-ray images were evaluated to determine the fracture type. Various radiological parameters were measured. Results The 78-patient study cohort consisted of nine men and 69 women with a mean age of 67 years. Forty-eight cases were sorted into Group A, and 30 cases into Group B. On logistic regression analysis, the age of 80 or older was a risk factor for later fracture displacement among the demographic factors (p=0.037, odds ratio=4.937). Among the radiographic factors, the presence of distal ulnar fracture and dorsal cortical comminution were disclosed as risk factors of later displacement (p=0.049, 0.003, odds ratio=3.429, 7.196). Conclusion When conservative management for distal radius fracture is decided in patients more than 80 years of age or accompanied by a distal ulnar fracture or with dorsal cortical comminution, the possibility of later displacement of the distal radius should be considered.

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Usefulness of Reduction and Internal Fixation Using a 2.4 mm Hand Plating System in Type AO 33-A3 Distal Femur Fracture - Technical Note -: Bong-Ju Lee, Ja-Yeong Yoon, Seungha Woo; J Korean Fract Soc 2023;36(1):25-28. Published online January 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.1.25

Abstract PDF: Open reduction in an AO 33-A3 class distal femur transverse and comminuted fracture is often difficult due to frequent reduction loss during surgery, leading to longer operative time and increased blood loss intra-operation. In this study, the authors report a case in which the use of an offset grid plate (OsteoMed, USA) using 2.4 mm HPS (hand plating system) eased the process of fracture reduction and achieved a stable internal fixation, ultimately leading to successful osteosynthesis. The authors experienced no need for temporary fixation devices such as K-wires or screws, which are otherwise required to stabilize the reduction. The fracture reduction was stable throughout the primary fixation of the fracture using a locking plate and screws. The authors report that the advantage of the HPS plate is fitting into the cortical contour and providing stable maintenance of fracture reduction intra-operation, which would be beneficial in certain distal femoral fracture patterns.

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Clinical Outcomes of Customized Staple Fixation Using K-wire in Metacarpal Base or Neck Fractures: Hong-ki Jin, Hyoung Min Kim, Yong Seung Oh, Jihoon Kim; J Korean Fract Soc 2021;34(1):23-29. Published online January 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.1.23

Abstract PDF

Purpose
This study was designed to evaluate the radiological and clinical outcomes of a new surgical technique—customized staple fixation using K-wire—in displaced metacarpal neck or base fractures. Materials and Methods: From November 2016 to May 2017, 13 unstable metacarpal neck and base fractures (10 patients) were treated with II-shaped customized K-wire staples fixation, after performing open reductions through minimal dorsal incisions. The radiological and clinical outcomes were retrospectively evaluated. Results: A mean of 2.6 staples were used for each fracture fixation. Preoperative angulation of 36.3°was reduced to 3.1° postoperatively. A week after surgery, the volar short arm splint was replaced with a dorsal splint to initiate active range of motion exercise, and the splint was subsequently removed after 3 weeks. The radiologic union was achieved at a mean of 5.1 weeks, and total active motion was recovered at a mean of 7.4 weeks. On a mean, K-wire staples were removed at 16.5 weeks after the surgery, and the mean treatment took 18.6 weeks. At the final follow-up (at mean 27.3 weeks), no significant difference was observed for total active motion of the digits and grip strength, when compared to the contralateral hand. Complete union was achieved in all fractures without deformity, or complications such as infection or nerve injury. All patients were satisfied with the cosmetic and functional outcomes. Conclusion: K-wire stapling is an effective alternative modality in treating unstable displaced metacarpal neck or base fractures. It requires minimal incision to enable open reduction. In addition, early mobilization is ensured through the rigid fixations. Moreover, it prevents postoperative joint stiffness and reduces the time needed for treatment.

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Individualized herbal prescriptions for delayed union: A case series
Jiyoon Won, Youngjin Choi, Lyang Sook Yoon, Jun-Hwan Lee, Keunsun Choi, Hyangsook Lee
EXPLORE.2023; 19(2): 260. CrossRef

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Primary Open Reduction and Plate Fixation in Open Comminuted Intra-Articular Distal Radius Fracture: Jun-Ku Lee, Soonchul Lee, Weon Min Cho, Minkyu Kil, Soo-Hong Han; J Korean Fract Soc 2021;34(1):16-22. Published online January 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.1.16

Abstract PDF: Purpose
There are no standard surgical treatments for open distal radius fractures (DRFs), and the fracture fixator is chosen by the surgeon’s own experience. This study compared the outcomes of open reduction and volar locking plating (OR VLP) between closed and open AO-OTA type C3 DRFs. Materials and Methods: Patient data were retrospectively collected between January 2010 and December 2018. Only patients aged >18 years with AO-OTA C3 DRFs were included. After further exclusion, the patients with DRFs were divided into two groups: 13 patients with open DRFs in Group 1 and 203 patients with closed DRFs in Group 2. Data on the patient characteristics and treatment-related factors were further investigated. For the radiological evaluation, the radial height, volar height, and volar titling were measured based on the final plain radiography, and the union time was measured. The wrist range of motion (ROM), pain visual analogue scale score, and modified Mayo wrist score for function were measured at the final outpatient follow-up. Finally, the complications associated with OR VLP fixa-tion were investigated. Results: In the demographic comparison, the patients with open fractures were older (mean age, 62years) than those with closed fractures (mean age, 57 years), without a statistically significant differ-ence. The patients with open DRFs had longer antibiotic therapy and hospital stay durations. Although they presented a higher radial inclination, with statistical significance, the clinical implication was low with a mean difference of 3°. No significant differences were observed for the remaining radiological parameters, wrist ROM, and functional scores. An open DRF did not increase the complication rates,including deep infection. Conclusion: Depending on the expertise of the operating surgeon, the primary OR VLP fixation in open intra-articular comminuted DRF did not increase the incidence of deep infections and yielded similar outcomes to a closed intra-articular comminuted DRF.

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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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Simulation for Reduction of Transverse Acetabular Fractures in Sawbones Models: Seongeun Byun, Cyril Mauffrey, Jehyun Yoo, Changwon Park, Jihyo Hwang; J Korean Fract Soc 2019;32(4):196-203. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.196

Abstract PDF

PURPOSE
The transversely oriented fracture lines are very difficult to reduce during operations, even after clear exposure of the fracture site, in acetabular fractures. The purpose of this study is to verify the quality of reduction between the different subtypes (transtectal, juxtatectal, and infratectal) of transverse fractures. This study also determined the proper type of clamps to use and the proper zone for achieving accurate reductions in Sawbones models.
MATERIALS AND METHODS
Six fractures in 3 different subtypes of transverse fractures were artificially created. Ten different reduction clamps were applied for reduction of the fractures. Twelve holes around the fracture were drilled for the maintenance of the clamps. The fracture displacements were measured at the extra-articular area and the intra-articular joint portion. The pictures of the intra-articular fracture displacements were taken by a camera and these were uploaded and analyzed by the TraumaCadÂ® computer program (Brainlab).
RESULTS
The reduction quality was poor in order of transtectal, juxtatectal and infratectal. The intraarticular opening was more prominent in the transtectal subtype. The safe zone, when giving consideration of the neurovascular bundles, was a quadrilateral surface of the ilium. Drill holes are useful for maintenance of the reduction clamps. Reduction clamps with points (Weber clamp) were the best for maintenance and accurate reduction. Regarding the concerns of placement of clamps, the middle to posterior combination was the best. The upper hole among the posterior holes in the ilium was the most likely to well reduce the intra-articular opening.
CONCLUSION
Transtectal was the more complicated subtype in the aspect of reduction quality. The Weber type reduction clamp was the best for reduction by centrally located holes in the quadrilateral surface and posteriorly located iliac holes in transverse acetabular fractures. The upper hole, among the posterior holes in the ilium, was the best for reduction of the fracture displacements in the intraarticular portion of acetabulum.

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Surgical outcomes of transverse acetabular fractures and risk factors for poor outcomes
Jae Hoon Jang, Nam Hoon Moon, Seung Joon Rhee, Seok Jin Jung, Tae Young Ahn
BMC Musculoskeletal Disorders.2021;[Epub] CrossRef

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The Effects of Extramedullary Reduction in Unstable Intertrochanteric Fracture: A Biomechanical Study Using Cadaver Bone: Young Chang Park, Soon Phil Yoon, Kyu Hyun Yang; J Korean Fract Soc 2018;31(3):79-86. Published online July 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.3.79

Abstract PDF

PURPOSE
To prevent excessive sliding and subsequent fixation failures in unstable intertrochanteric fractures with posteromedial comminution, extramedullary reduction through overlapping of the anteromedial cortices of both proximal and distal fragments as a buttress has been introduced. The purpose of this study was to compare the biomechanical properties between two reduction methods-intramedullary reduction and extramedullary reduction-in treating unstable intertrochanteric fractures with posteromedial comminution (AO/OTA classification 31-A2.2).
MATERIALS AND METHODS
Eight pairs of frozen human cadaveric femora were used. The femora of each pair were randomly assigned to one of two groups: the intramedullary reduction group or the extramedullary reduction group. A single axial load-destruction test was conducted after cephalomedullary nailing. Axial stiffness, maximum load to failure, and energy absorbed to failure were compared between the two groups. Moreover, the pattern of mechanical failure was identified.
RESULTS
The mean axial stiffness in the extramedullary reduction group was 27.3% higher than that in the intramedullary reduction group (422.7 N/mm vs. 332.0 N/mm, p=0.017). Additionally, compared with the intramedullary reduction group, the mean maximum load to failure and mean energy absorbed to failure in the extramedullary group were 44.9% and 89.6% higher, respectively (2,848.7 N vs. 1,966.5 N, p=0.012 and 27,969.9 NÂ·mm vs. 14,751.0 NÂ·mm, p=0.012, respectively). In the intramedullary reduction group, the mechanical failure patterns were all sliding and varus deformities. In the extramedullary reduction group, sliding and varus deformities after external rotation were noted in 3 specimens, sliding and varus deformities after internal rotation were noted in 3 specimens, and medial slippage was noted in 2 specimens.
CONCLUSION
In unstable intertrochanteric fractures with posteromedial comminution, the biomechanical properties of extramedullary reduction are superior to those of intramedullary reduction. Anteromedial cortex could be the proper buttress, despite a comminuted posteromedial cortex. It could help enhance the stability of the bone-nail construct.

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Which side should be taken care of when positioning a lag screw in intertrochanteric femoral fracture: right or left?
Min Uk Do, Kyeong Baek Kim, Sang-Min Lee, Hyun Tae Koo, Won Chul Shin
European Journal of Trauma and Emergency Surgery.2025;[Epub] CrossRef
Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs
Aytek Hüseyin Çeliksöz, Büşra Tokmak, Ali Okan Tarlacık, Servet Igrek
Scientific Reports.2025;[Epub] CrossRef
The effect of anterior support screw (AS2) in unstable femoral trochanteric fractures: A multicenter randomized controlled trial
Takashi Maehara, Takashi Hayakawa, Shunsuke Mukoyama, Yoshihisa Anraku, Takahiro Hamada, Hiroyuki Suzuki, Takeshi Doi, Tomohiko Shimizu, Masanori Yorimitsu, Hidefumi Teramoto, Takao Mae, Yasunori Okamoto, Jun Hara, Kazushi Mihara, Koichi Kanekasu
Injury.2024; 55(10): 111725. CrossRef
Anteromedial cortical support reduction of intertrochanteric fractures–A review
Wenjun Xie, Liu Shi, Cheng Zhang, Xueliang Cui, Xiangxu Chen, Tian Xie, Sheng Zhang, Hui Chen, Yunfeng Rui
Injury.2024; 55(12): 111926. CrossRef
Anteromedial Cortical Support in Reduction of Trochanteric Hip Fractures
Wei Mao, Chen-Dong Liu, Shi-Min Chang, Ao-Lei Yang, Choon Chiet Hong
Journal of Bone and Joint Surgery.2024; 106(11): 1008. CrossRef
Five states of reduction in OTA/AO A1.3 intertrochanteric fractures of the femur a biomechanical study
Shu Li, Yong-Gang Bao, Rong-Hua Tian, Chun-Yang Meng, Hai-Bin Wang, Bin Wu, Xian-Min Bu
BMC Musculoskeletal Disorders.2024;[Epub] CrossRef
Intramedullary Impaction of the Basicervical Component Is Determinant of Fixation Failure in a Simple Two-Part Pertrochanteric Fracture
Seok Ha Hong, Kang Hun Yu, Seung Beom Han
Journal of Orthopaedic Trauma.2024; 38(4): 220. CrossRef
Flexible reamer use to overcome entry point errors in proximal femoral nail application in severe obese intertrochanteric fracture patients
Levent Horoz, Ali Ihsan Kilic, Cihan Kircil, Mehmet Fevzi Cakmak
BMC Musculoskeletal Disorders.2024;[Epub] CrossRef
Risk Factors Associated with Fixation Failure in Intertrochanteric Fracture Treated with Cephalomedullary Nail
Hyung-Gon Ryu, Dae Won Shin, Beom Su Han, Sang-Min Kim
Hip & Pelvis.2023; 35(3): 193. CrossRef
Positive or negative anteromedial cortical support of unstable pertrochanteric femoral fractures: A finite element analysis study
Qin Shao, Yue Zhang, Gui-Xin Sun, Chen-Song Yang, Na Liu, Da-Wei Chen, Biao Cheng
Biomedicine & Pharmacotherapy.2021; 138: 111473. CrossRef
Clinical and Radiologic Outcome of Intertrochanteric Fracture Treatment Using TFNA (Trochanteric Fixation Nail-Advanced)
Hyeon Joon Lee, Hyun Bai Choi, Ba Rom Kim, Seung Hwan Jo, Sang Hong Lee
Journal of the Korean Fracture Society.2021; 34(3): 105. CrossRef
Factors Associated with Mechanical Complications in Intertrochanteric Fracture Treated with Proximal Femoral Nail Antirotation
Oog-Jin Shon, Chang Hyun Choi, Chan Ho Park
Hip & Pelvis.2021; 33(3): 154. CrossRef
Additional Reduction Screw Fixation Technique for Pertrochanteric Hip Fractures: A Novel Method to Prevent Excessive Sliding in Cephalomedullary Nail Surgery
Chul-Ho Kim, Han Soul Kim, Dou Hyun Moon
Hip & Pelvis.2021; 33(3): 162. CrossRef
Comparison of sliding distance of lag screw and nonunion rate according to anteromedial cortical support in intertrochanteric fracture fixation: A systematic review and meta-analysis
Eic Ju Lim, Seungyeob Sakong, Whee Sung Son, Jae-Woo Cho, Jong-Keon Oh, Chul-Ho Kim
Injury.2021; 52(10): 2787. CrossRef
A new fluoroscopic view for evaluation of anteromedial cortex reduction quality during cephalomedullary nailing for intertrochanteric femur fractures: the 30° oblique tangential projection
Shi-Yi Chen, Shi-Min Chang, Rujan Tuladhar, Zhen Wei, Wen-Feng Xiong, Sun-Jun Hu, Shou-Chao Du
BMC Musculoskeletal Disorders.2020;[Epub] CrossRef
New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail
Junyoung Kim, Kihong Choi, Kyu Hyun Yang
Journal of the Korean Orthopaedic Association.2020; 55(3): 193. CrossRef
Effect of a synthetic osteoconductive bone graft substitute with zeta potential control (geneX®ds) in the treatment of intertrochanteric fracture: A single center experience of 115 consecutive proximal femoral nail antirotations
Won Chul Shin, Jae Hoon Jang, Jae Yoon Jeong, Kuen Tak Suh, Nam Hoon Moon
Journal of Orthopaedic Science.2019; 24(5): 842. CrossRef

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The Cause of Primary Reduction Failure in Hip Dislocation with or without Hip Fracture: Hee Gon Park, Yong Eun Shin, Sung Hyun Kim; J Korean Fract Soc 2017;30(1):9-15. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.9

Abstract PDF

PURPOSE
A rapid and accurate reduction is important for hip dislocated patients to avoid various potential complications, including avascular necrosis of the femoral head. We analyzed hip dislocation cases, ones that particularly failed during the primary reduction trial.
MATERIALS AND METHODS
Eighty-seven patients with hip dislocation, who visited the emergency department between January 2007 and September 2015, were retrospectively analyzed. Of them, 68 patients were successfully treated in the first closed reduction trial, and the remaining 19 patients were unsuccessful. Of the 19 unsuccessful first trial, 12 patients were successfully treated in the second closed reduction; however, in the remaining 7 patients, open reduction was performed in the operation room with general anesthesia. Every closed reduction was practiced by at least 2 orthopedic doctors, and open reduction was performed by a single senior author.
RESULTS
The rate of first reduction failure was higher, with statistical significance, in patients aged under 50 years, male gender, and those with combined around hip fractures, including femoral head and acetabular fracture (p<0.05). In particular, the presence of impacted fracture fragment in the hip joint and large size of the impacted fracture fragment was highly related to the failure of second closed reduction trial requiring open reduction. Conversely, the method of reduction, Thompson-Epstein classification, Pipkin classification were not related to the failure of closed reduction statistically (p>0.05).
CONCLUSION
To evaluate the patients with hip dislocation, realizing the type of dislocation, presence of accompanied fracture, location and size of fracture fragment, age, as well as gender of patients is important. If the fracture fragment is impacted in the hip joint and the size of the fragment is large, then the operative treatment is considered, rather than the repetitive trial of closed reduction by constraint.

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Traumatic obturator dislocation of the hip joint: About 2 cases and review of the literature
Z.F. Zengui, O. El Adaoui, M. Fargouch, O. Adnane, Y. El Andaloussi, M. Fadili
International Journal of Surgery Case Reports.2022; 93: 106983. CrossRef

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Arthroscopic Assisted Bioabsorbable Screw Fixation for Radial Head Fractures: A Report of Two Cases: Bong Ju Park, Ki Yong An, Yong Suk Choi; J Korean Fract Soc 2017;30(1):35-39. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.35

Abstract PDF

Most radial head fractures occur as the result of low-energy mechanisms, such as a trip or fall on the outstretched hand. These fractures typically occur when an axial load is applied to the forearm, causing the radial head to hit the capitellum of the humerus. Good results are shown with nonsurgical treatments for Mason type 2 fractures. However, if there is a limitation of elbow joint exercise or displacement of more than 2 mm, an operative treatment should be considered. We treated two patients with arthroscopic assisted bioabsorbable screw (K-METâ„¢; U&I Corporation, Uijeongbu, Korea) fixation for radial head fractures to prevent complications of open reduction and minimize radiation exposure.

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Bioabsorbable Screws Used in Hallux Valgus Treatment Using Proximal Chevron Osteotomy
Woo-Jin Shin, Young-Woo Chung, Ki-Yong An, Jae-Woong Seo
Journal of Korean Foot and Ankle Society.2018; 22(4): 181. CrossRef

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The Significance of Calcaneal Posterior Tuberosity Fragment Reduction When Treated with Open Reduction in Displaced Intra-Articular Calcaneal Fractures: Hong Ki Park, Jong Ryoon Baek, Jang Seok Choi, Sang Jin Lee, Je Won Paik; J Korean Fract Soc 2016;29(4):233-241. Published online October 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.4.233

Abstract PDF: PURPOSE
We attempt to evaluate the significance of calcaneal posterior tuberosity fragment reduction when treated with surgical open reduction in displaced intra-articular calcaneal fractures.
MATERIALS AND METHODS
A total of 90 patients with displaced intra-articular calcaneal fracture, between January 2010 and December 2015, treated with open reduction and internal fixation were enrolled in this study. At postoperative 3 months, we evaluated the reduction state of calcaneal posterior tuberosity fragment by measuring the degree of lateral displacement of the posterior tuberosity fragment on the calcaneal axial view. Moreover, we also evaluated the difference in the calcaneal length and height with the uninjured side on the lateral view of both sides. In addition, we estimated the reduction state of the posterior facet by measuring the degree of gap and step-off on the semi-coronal view of postoperative computed tomography and estimated the restoration of calcaneal angle by measuring the difference in BÃ¶hler's and Gissane angle with the uninjured side on the lateral view of both sides.
RESULTS
The correlation coefficient with 3 components for evaluating the reduction state of posterior tuberosity fragment and gap and step-off of posterior facet was r=0.538, 0.467, r=0.505, 0.456, r=0.518, and 0.493, respectively, and restoration of BÃ¶hler's and Gissane angle was r=0.647, 0.579, r=0.684, 0.630, r=0.670, and 0.628, respectively. The relationship of each component shows a significant correlation as all p-values were <0.01.
CONCLUSION
The precise reduction of calcaneal posterior tuberosity fragment developed by the primary fracture line was considered as an important process of anatomical reduction of calcaneal body, including the posterior facet and calcaneal angle restoration.

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Use of Composite Wiring on Surgical Treatments of Clavicle Shaft Fractures: Kyung Chul Kim, In Hyeok Rhyou, Ji Ho Lee, Kee Baek Ahn, Sung Chul Moon; J Korean Fract Soc 2016;29(3):185-191. Published online July 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.3.185

Abstract PDF: PURPOSE
To introduce the technique of reducing displaced or comminuted clavicle shaft fracture using composite wiring and report the clinical results.
MATERIALS AND METHODS
Between March 2006 and December 2013, 31 consecutive displaced clavicle fractures (Edinburgh classification 2B) treated by anatomic reduction and internal fixation using composite wiring and plates were retrospectively evaluated. The fracture fragments were anatomically reduced and fixed with composite-wiring. An additional plate was applied. Radiographic assessments for the numbers of fragments, size of each fragment and amount of shortening and displacement were performed. The duration for fracture union and complications were investigated retrospectively. The mean fallow-up duration was 15.9 months.
RESULTS
The mean number of fragments was 1.7 (1-3) and the mean width of fracture fragment was 7.1 mm (4.5-10.6 mm). The mean shortening of the clavicle was 20.5 mm (10.3-36.2 mm). The mean number of composite wires used in fixation was 1.9 (1-3). Radiographic union was achieved in all patients with a mean time to union of 11.6 weeks. There were no complications including metal failure, pin migration, nonunion, or infection.
CONCLUSION
The composite wiring was suitable for fixation of small fracture fragment and did not interfere with the union, indicating that it is useful for treatment of clavicle shaft fracture.

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Assessment of Coronal Plane Malalignment Following Reduction of Trochanteric Fractures-Simple Intraoperative Guideline Using Greater Trochanter Orthogonal Line: Young Cheol Yoon, Jong Keon Oh, Won Yong Shon, Han Ju Kim, Jae Woo Cho; J Korean Fract Soc 2016;29(1):1-11. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.1

Abstract PDF: PURPOSE
There is no consensus on a clear intraoperative guideline for judging the coronal plane alignment following reduction of trochanteric fractures. Complex angular measurements using fluoroscope monitors are tedious. Therefore the relation of the horizontal line from the tip of the greater trochanter (GT orthogonal) and femur head center (HC orthogonal) was studied to define this line as a criterion for predicting varus-valgus malalignment.
MATERIALS AND METHODS
We studied this relation in 200 standing orthoradiograms which included 100 males and 100 females. The images were digitally analyzed using the picture archiving and communication system. GT orthogonal line and HC orthogonal line were evaluated. The distance of these lines was measured as trochanter center distance (TCD) and its correlation with angular parameters like neck shaft angle, medial proximal femoral angle with reference to anatomical axis (aMPFA) and lateral proximal femoral angle with reference to mechanical axis (mLPFA) were analyzed.
RESULTS
In all patients, the GT orthogonal line passed either at or above the center of the head. Overall mean of TCD was 7.22 mm, ranging from 0 to 17.57 mm. TCD was found to show strong correlation with angular parameters like aMPFA, mLPFA and neck shaft angle. TCD was less than one fourth of the corresponding head diameter in around 90%. Therefore following reduction of trochanteric fractures, the GT orthogonal line should pass through the superior juxta central quadrant of the femoral head.
CONCLUSION
This line can be represented by a guide wire with fluoroscopy during surgery. The GT orthogonal line can be used intraoperatively as a simplified tool for prediction of varus/valgus malalignment following the reduction of trochanteric fractures.

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Operative Treatment of Pediatric Distal Forearm Bothbone Fracture: Sang Uk Lee, Changhoon Jeong, Il Jung Park, Jaeyoung Lee, Seman Oh, Kyung Hoon Lee, Sanghyun Jeon; J Korean Fract Soc 2015;28(4):237-244. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.237

Abstract PDF: PURPOSE
Pediatric patients with distal forearm bothbone fractures of surgical indication were treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna at our institution. The purpose of this study is to evaluate clinical and radiological results.
MATERIALS AND METHODS
From February 2012 to June 2014, we retrospectively evaluated 16 out of 18 cases with distal forearm bothbone fractures treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna with at least 1-year follow-up. The average age at operation was 9.1 years (7-13 years).
RESULTS
Adequate reduction for both radius and ulna was achieved for all cases, and none of the cases showed re-displacement until the last follow-up. Mean 6.6 weeks lapsed until bony union was observed for the radius. For the ulna, the mean was 6.5 weeks. All patients gained full wrist range of motion at the last visit.
CONCLUSION
For pediatric distal forearm bothbone fractures, intrafocal Kapandji reduction and internal fixation with Kirschner wire for radius and reduction and internal fixation with a flexible intramedullary nail for ulna is the technique for handy reduction. Use of this technique can prevent re-displacement during the union process and achieve excellent clinical and radiologic results.

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Steinmann Pin Assisted Reduction of Subtrochanteric Femoral Fracture: Seung Wan Lim, Oog Jin Shon; J Korean Fract Soc 2015;28(1):17-22. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.17

Abstract PDF

PURPOSE
Nail insertion is the treatment of choice for subtrochanteric femoral fracture, but displacement of proximal bone fragment makes it difficult to find an ideal entry point. Therefore, in this study we aimed to determine the usefulness of treatment of subtrochanteric femoral fracture using Steinmann pin assisted reduction, internal fixation, and insertion of intramedullary nails.
MATERIALS AND METHODS
We evaluated 33 patients who were followed-up more than a year with a displaced subtrochanteric femoral fracture treated with closed reduction and intramedullary nail fixation between January 2008 and March 2013. In addition, we studied postoperative bone union time, postoperative reduction status, change of the femur neck shaft angle, evaluation of hip joint function, return to daily life, and complications.
RESULTS
All fractures with Steinmann pin assisted reduction were united but they included three cases of delayed union. In Fogagnolo classification, all cases were up to acceptable states and the varus change of femur neck shaft angle was 0.94degrees+/-3.1degrees; no significant difference in Harris hip score was observed between preoperative and last follow-up (p>0.05).
CONCLUSION
There were satisfactory results in bone union and reduction state with Steinmann pin assisted reduction. Therefore, Steinmann pin assisted reduction is a useful surgical technique for subtrochanteric femoral fracture.

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Percutaneous acetabular anchoring pin-assisted cephalomedullary nailing for subtrochanteric and unstable intertrochanteric fractures
Keong-Hwan Kim, Youngsik Yoon, Eic Ju Lim
Injury.2020; 51(3): 769. CrossRef

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Result of Surgical Treatment for the Femoral Head Fracture: Joon Soon Kang, Kyoung Ho Moon, Tong Joo Lee, Jong Hyuck Yang; J Korean Fract Soc 2014;27(3):198-205. Published online July 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.3.198

Abstract PDF: PURPOSE
This study analyzed the clinical and radiological long-term follow-up results of patients with femoral head fracture who received surgical treatments.
MATERIALS AND METHODS
Retrospective evaluation was performed for 20 patients with femoral head fracture who received surgical treatments between December 1997 and May 2010. According to Pipkin's classification, there were five type I, six type II, one type III, and eight type IV fractures.
RESULTS
The average Merle d'Aubigne'-Postel score was 12.8 (12.80+/-3.53). According to surgical method, the score for the bony fragment excision group was 9.8 (9.83+/-2.79), and that for the open reduction and internal fixation group was 13.9 (13.92+/-3.07). Depending on Thompson-Epstein criteria, two patients were good, two were fair, and two were poor in the bony fragment excision group. Four patients were excellent, six were good, and three were poor in the open reduction and internal fixation group.
CONCLUSION
Bony fragment excision should be performed with caution in patients with femoral head fracture. Considering fragment size, location, and presence of acetabular fracture, better outcome can be expected using the open reduction and internal fixation method in comparison with excision.

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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; J Korean Fract Soc 2014;27(2):144-150. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.144

Abstract PDF: PURPOSE
The purpose of this study is to analyze the radiographic and clinical results of intramedullary nailing after percutaneous reduction using pointed reduction forceps for spiral or oblique fractures of the distal tibia. The benefit of percutaneous reduction using pointed reduction forceps in anatomical reduction and maintenance was assessed.
MATERIALS AND METHODS
From January 2005 to December 2009, 47 cases of distal one-third tibial fracture were managed by intramedullary nailing using pointed reduction forceps. Thirty-eight cases were spiral fracture and nine cases were oblique fracture. In all cases, the percutaneous reduction was achieved using pointed reduction forceps under fluoroscopy control. While maintaining the reduction with the pointed reduction forceps, the intramedullary nail was inserted. The pointed reduction forceps were removed after insertion of proximal and distal inter-locking screws. Alignment was evaluated with anterior-posterior and lateral radiographs taken immediately post-operation and at the time of union.
RESULTS
At immediate post-operation, the mean displacement of valgus and anterior angulation was 0.57degrees and 0.24degrees, respectively. That of valgus and anterior angulation at bone union was 0.37degrees and 0.16degrees, respectively. The average duration of bone union was 16.1 weeks.
CONCLUSION
Intramedullary nailing with percutaneous reduction using pointed reduction forceps for distal tibial fractures was an easy and effective method for achievement of accurate alignment intra-operatively. Accurate alignment was successfully maintained until bone union.

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Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques: Chul Hyun Park, Chul Wung Ha, Sang Jin Park, Min Su Ko, Oog Jin Shon; J Korean Fract Soc 2013;26(2):112-117. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.112

Abstract PDF

PURPOSE
To evaluate the results of using minimally invasive reduction techniques in patients with femoral subtrochanteric fracture.
MATERIALS AND METHODS
We retrospectively analyzed 40 patients (41 cases) with subtrochanteric fracture who underwent using minimally invasive reduction techniques. The mean age was 61.4 years (15-89 years), and the mean follow-up period was 32.7 months (12-66 months). Clinical results were assessed using the Parker-Palmer mobility score and the Salvati-Wilson hip functional score. Radiographic results were evaluated using bone union time and femur neck-shaft angle.
RESULTS
No significant difference was observed in the pre- and postoperative Parker-Palmer mobility score. Salvati-Wilson hip functional score showed more than good grade in 37 cases (90%) at the last follow-up. Union was achieved in all 41 cases at an average of 22.5 weeks (18-30 weeks). The mean femoral neck-shaft angle immediately postoperatively was 128.8 degrees (120-140 degrees), and the mean difference versus contralateral sides was 2.5 degrees varus (-6-13 degrees).
CONCLUSION
Fixation of femoral subtrochanteric fracture using minimally invasive reduction techniques showed excellent clinical and radiographic results and low complication rate.

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Effects of Yuhyangjeongtong-san on Fracture Healing in Rats
Ki-Tae Kim, Na-Young Jo
Journal of Korean Medicine.2019; 40(4): 61. CrossRef
Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
Hip & Pelvis.2014; 26(2): 107. CrossRef

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Interposition of Extensor Pollicis Longus Tendon in Smith's Fracture in a Child: A Case Report: Seung Ju Jeon, Haeng Kee Noh, Do Yeon Kim, Sung Hoon Jung, Jun Beum Shin, Ho Seung Jeon; J Korean Fract Soc 2013;26(1):65-68. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.65

Abstract PDF: Entrapment of the extensor pollicis longus tendon is reported rarely on Smith's fractures in children. In our case, a 15 year old boy with Smith's fracture received treatment of closed reduction at another hospital. When he visited our hospital, a wide gap at the fracture site was detected on radiograph and the thumb movement was limited. We have doubt the entrapment of the soft tissue, especially the tendon. We decided on open reduction. In the operation field, entrapment of the extensor pollicis longus tendon at the gap of the fracture site was found through dorsal approach. In addition, fracture treatment with K-wire fixation after reduction of extensonr pollicis longus tendon reduction was done. Therefore, we report this case with a review of the literatures.

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Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques: Oog Jin Shon, Ji Hoon Shin, Chul Wung Ha; J Korean Fract Soc 2013;26(1):50-55. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.50

Abstract PDF: PURPOSE
We evaluated the clinical outcomes of tibia segmental fractures treated by intramedullary nailing using various reduction techniques.
MATERIALS AND METHODS
From January 2003 to June 2009, 18 segmental tibial fracture patients treated by intramedullary nail were enrolled with a minimum 12-month follow-up. The mean follow-up was 38 months (range 15-72). According to the AO classification, the fractures were types 42C2.1, 42C2.2, and 42C2.3 in four, ten, and four patients, respectively. Ten fractures were closed and eight were open. We used various techniques for reduction during operation and investigated bone union time and complication (non-union, malunion etc.).
RESULTS
Bone grafting was performed in three patients. Complete union was achieved in all patients. The mean time for union was 16.3 weeks (range 12-21), except in three delayed union patients. All radiological evaluations showed good alignment (less than 5 degree) except in two patients; and the mean deformity angle was 2.2 degree. Knee range of motion (ROM) was 129 degree, and ankle ROM was 68 degree. Local wound infection occurred in two patients.
CONCLUSION
Intramedullary nailing is a successful method in the acute management of segmental tibial fractures, if accompanied by appropriate reduction technique.

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Treatment of Tibial Plateau Fractures Using a Locking Plate and Minimally Invasive Percutaneous Osteosynthesis Technique: Hee Gon Park, Dae Hee Lee, Kyung Joon Lee; J Korean Fract Soc 2012;25(2):110-116. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.110

Abstract PDF: PURPOSE
To acknowledge the importance of precise reduction of articular surface of tibial plateau fractures and to make a guideline of treatment by evaluating outcomes and effectiveness of using locking plate and minimally invasive percutaneous osteosynthesis technique.
MATERIALS AND METHODS
Twenty-nine patients who underwent surgery for tibial plateau fracture from November 2005 to March 2010 were enrolled with 12 months follow-up in a retrograde manner. The Shatzker classification was used to classify fractures, and we used lateral submeniscal approach to make a precise reduction of articular surface. Radiologic evaluation was determined by presence of bone union, malalignment, and reduction loss or joint depression of articular surface. Post-operative infection, time of active movement of the knee joint, time of partial weight loading, and range of motion (ROM) of knee joint were evaluated. Lysholm Knee Score was used for functional evaluation.
RESULTS
Bone union took place in all but one case that developed osteomyelitis. Angulation deformity of more than 10degrees and reduction loss or joint depression of more than 5 mm were not observed. There was one case of osteomyelitis and one case of superficial surgical site infection. There were satisfactory clinical results, with an average time of active knee joint movement and weight loading of 6 weeks. The average ROM of knee joint was 125degrees in the last follow up. As for functional evaluation using Lysholm Knee Score, cases showed an average Lysholm Knee Score of 94 which was a satisfactory result.
CONCLUSION
In cases of tibial plateau fractures, if a surgeon accurately reduces the articular surface of joint and use minimally invasive locking plate it will help in bone union biologically, reducing the incidence of soft tissue injuries, and biomechanically maintaining the articular surface of the joint, proving itself to be a useful method of treatment.

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Surgical Techniques for Percutaneous Reduction by Towel Clips and Percutaneous Intramedullary Fixation with Steinmann Pins for Clavicle Shaft Fractures: Ki Do Hong, Jae Chun Sim, Sung Sik Ha, Tae Ho Kim, Jong Hyun Kim, Jong Seong Lee; J Korean Fract Soc 2012;25(1):31-37. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.31

Abstract PDF

PURPOSE
To report the clinical results of surgical treatment of clavicle shaft fracture by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation.
MATERIALS AND METHODS
This study reviewed the results of 80 cases of clavicle shaft fracture treated by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation with Steinmann pins from January 2002 to August 2010, after follow-up for 12 months or more. We evaluated the clinical results, such as union time and complications.
RESULTS
Bone union was evident in all cases and the mean time for bone union to appear on radiological findings was 10.3 weeks. Using Kang's criteria, 78 of the 80 patients (97.5%) showed good results and there were no severe complications.
CONCLUSION
Percutaneous reduction with towel clips and the percutaneous intramedullary pin fixation method showed good results for treating clavicle shaft fracture.

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Additional fixation using a metal plate with bioresorbable screws and wires for robinson type 2B clavicle fracture
Woo Jin shin, Young Woo Chung, Seon Do Kim, Ki-Yong An
Clinics in Shoulder and Elbow.2020; 23(4): 205. CrossRef
A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture
Seong-Ho Yoo, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Yeong-Joon Kim, Gyu-Taek Park, Chang-Hun Kwack
Journal of the Korean Orthopaedic Association.2017; 52(1): 1. CrossRef

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Surgical Treatment of the Perilunate Dislocation and the Lunate Dislocation with Dorsal Approach: Soo Hong Han, Jin Myoung Dan, Dong Hoon Lee, Young Woong Kim; J Korean Fract Soc 2011;24(4):347-353. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.347

Abstract PDF: PURPOSE
To evaluate the clinical and radiologic outcomes of the perilunate dislocation and the lunate dislocation which were managed surgically through a dorsal approach.
MATERIALS AND METHODS
Retrospective reviews of the 13 patients who had minimum 1-year follow-up after surgical treatment through isolated dorsal approach for their perilunate dislocations or the lunate dislocations were performed. The case that dislocated lunate migrated proximally through the wrist was excluded in this series. We evaluated the DASH score in questionnaire method and Mayo wrist score to analyze the clinical outcomes. Radiologic results were investigated by measurement of the scapho-lunate angle, and fracture union was also evaluated in the case of trans-scaphoid dislocation.
RESULTS
The mean DASH Score was 16.3 points (range, 10.8~26.7 points) and the mean Mayo wrist score was 79 points (range, 65~90 points) at the final follow-up. There were 2 cases of excellent, 7 cases of good and 4 cases of fair in the Mayo wrist score. On the radiologic analysis, the mean scapho-lunate angle was 49.0degrees (range, 35~55degrees) and all cases were within the normal range. All cases of the trans-scaphoid perilunate dislocation achieved bone union.
CONCLUSION
Author's cases showed satisfactory outcomes in clinically and radiologically. Isolated dorsal approach could give anatomical reduction and appropriate internal fixation in treatment of the perilunate dislocations and the lunate dislocations except the rare case of proximal migration of the lunate through the wrist.

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Operative Treatment in the Delayed Diagnosed Fracture and Dislocation of Hamatometacarpal Joint: Suk Ha Lee, Jong Wong Park, Jin Il Kim, Seoung Joon Lee; J Korean Fract Soc 2011;24(3):249-255. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.249

Abstract PDF

PURPOSE
The purpose is to evaluate and report the results that treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint.
MATERIALS AND METHODS
We evaluated 12 cases that had been treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint. The mean interval between injury and operation was 34 days (21~60 days), the mean age of 12 cases was 28.1 years old, and mean follow-up period was 18 months. The computer tomography was done in all cases and the fracture and dislocation types were classified by Cain's classification. For the evaluation of results, pain scale, grasping power, range of motion of wrist and metacarpophalangeal joint were analyzed preoperatively and at final follow up, and the arthritic change of the hamatometacarpal joint was also checked.
RESULTS
According to Cain's classification, type Ia was one case, type Ib was two, type II was six, and type III was three. The pain scale was improved from 7.75 preoperatively to 0.92 at last follow up. The mean grasping power was improved up to 97.5% of normal. The preoperative range of motion of the wrist joint measured to be 60 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 75 degrees in extension and 80 degrees in flexion. The preoperative range of motion of the metacarpophalangeal joint measured to be 0 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 0 degrees in extension and 85 degrees in flexion. Carpometacarpal arthritis was developed in two cases.
CONCLUSION
The open reduction and internal fixation is considered as one of good treatment option in the delayed diagnosed hamatometacarpal fracture and dislocation.

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Reliability of classification of ring and little finger carpometacarpal joint fracture subluxations: a comparison between two-dimensional computed tomography and three-dimensional computed tomography classifications
J. H. Kim, S.-S. Kwon, S. J. Moon, J. S. Choe, H. I. Kwak, S. Y. Lee, H. J. Le, J. Y. Kim
Journal of Hand Surgery (European Volume).2016; 41(4): 448. CrossRef
Fourth and Fifth Metacarpal Base Arthrodesis for Posttraumatic Arthritis of Fifth Carpometacarpal Joint
Chul-Hyung Kang, Eun-Sok Son, Chul-Hyun Cho
Journal of the Korean Society for Surgery of the Hand.2013; 18(4): 184. CrossRef

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Anatomically Percutaneous Wiring Reduction in Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures: Young Mo Kim, Chan Kang, Deuk Soo Hwang, Yong Bum Joo, Woo Yong Lee, Jung Mo Hwang; J Korean Fract Soc 2011;24(3):230-236. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.230

Abstract PDF: PURPOSE
To report the method of anatomical reduction and its maintenance by percutaneous wiring reduction in minimally invasive plate osteosynthesis for distal tibial fractures.
MATERIALS AND METHODS
17 cases that were diagnosed oblique, spiral or transverse fracture of distal tibia from August 2007 to February 2010 and were able to anatomically reduce by the method of percutanous wiring reduction in minimally invasive plate osteosynthesis were included in this study. Mean age was 50, and mean follow up period was 18 months. We investigated the period until bone union was achieved, degree of angulation angle, and complications. For postoperative evaluation, Olerud and Molander ankle score and VAS pain score in daily living were checked.
RESULTS
The mean varus/valgus angulation after bone union on AP radiograph was 0.9 degrees and the mean anterior/posterior angulation on lateral radiograph was 2.0 degrees The mean Olerud and Molander ankle score was 89.4, and mean pain score due to walk adjacent to metal plate was 0 points.
CONCLUSION
By the method of percutaneous wiring reduction in distal tibial fracture, anatomical reduction is easily acquired, and only by wire itself, reduction could be maintained, so that without additional manual reduction, plate could be easily fixed.

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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; J Korean Fract Soc 2011;24(2):138-143. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.138

Abstract PDF

PURPOSE
A technique of cerclage wire fixation in comminuted fracture of the clavicle shaft is thought to interfere the fracture healing, so authors studied radiographically and clinically about the cases of cerclage wiring of the fracture fragments with the plate and screws fixation in the comminuted fracture of the shaft of the clavicle.
MATERIALS AND METHODS
According to following inclusion criteria, total 18 patients (male: 15, female: 3) were investigated; Patients who visited hospital due to clavicle shaft comminuted fracture from February 2005 to April 2009, who underwent surgery utilizing more than 2 cerclage wire fixation for the fragments when open reduction and plate fixation were operated and who could be follow-up over one year. The duration for fracture union, functional outcome and complications were investigated retrospectively.
RESULTS
Radiological bone union was accomplished in average 13.3 weeks (12~16 weeks) and there was no complication such as nonunion, delayed union or infection. Range of motion of ipsilateral shoulder joint was recovered in all patients except one at the final follow-up.
CONCLUSION
The clinical and radiographical results of the plate and screws fixation with cerclage wiring of the fragments in comminuted clavicle shaft fracture showed that the cerclage wiring does not interfere the fracture healing, so authors think that this method is a good alternative operation if it is performed carefully to minimize soft tissue dissection.

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Surgical Management of Comminuted Midshaft Clavicle Fractures Using Reconstruction Plate and Circumferential Wiring: Does the Circumferential Wiring Interfere with the Bone Union?
Kyung-Tae Kim, Chung-Shik Shin, Young-Chul Park, Dong-hyun Kim, Min-Woo Kim
Journal of the Korean Orthopaedic Association.2021; 56(3): 245. CrossRef
Supplementary Technique for Unstable Clavicle Shaft Fractures: Interfragmentary Wiring and Temporary Axial K-Wire Pinning
Jinmyoung Dan, Byung-Kook Kim, Ho-Jae Lee, Tae-Ho Kim, Young-Gun Kim
Clinics in Orthopedic Surgery.2018; 10(2): 142. CrossRef
Use of Composite Wiring on Surgical Treatments of Clavicle Shaft Fractures
Kyung Chul Kim, In Hyeok Rhyou, Ji Ho Lee, Kee Baek Ahn, Sung Chul Moon
Journal of the Korean Fracture Society.2016; 29(3): 185. CrossRef
TO EVALUATE THE SURGICAL OUTCOME OF NON-UNION CLAVICLE USING PLATE AND SLIVERS OF AUTOLOGOUS ILIAC CREST CORTICOCANCELLOUS BONE GRAFT
Mohammed Tauheed, Shashi Kumar Yalagach, Vivek Purushothaman, Anwar Shareef Kunnath K
Journal of Evidence Based Medicine and Healthcare.2016; 3(25): 1121. 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

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Minimally Invasive Plate Osteosynthesis for the Upper Extremity Fracture Using a Lumbar Spreader: Surgical Technique: Gu Hee Jung, Chyul Hyun Cho, Jae Do Kim; J Korean Fract Soc 2011;24(1):83-86. Published online January 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.1.83

Abstract PDF: The minimally invasive plate osteosynthesis (MIPO) which is extensively performed, is very dependent on the indirect reduction technique to prevent the exposure of fracture sites. Indirect reduction with the use of the femoral distractor is a much more efficient technique to restore the length in the fracture of lower limbs. However, the femoral distractor cannot be used for fracture of upper limbs, and other instruments for indirect reduction have not yet been reported. Therefore, we introduce the novel indirect reduction technique with the use of the lumbar spreader for the MIPO of upper limbs.

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Related Factors of Ligamentotaxis with Posterior Instrumentation for the Surgical Treatment of Thoracolumbar Bursting Fracture: Sang Bum Kim, Taek Soo Jeon, Seung Hwan Kim, Han Chang, Cheol Mog Hwang; J Korean Fract Soc 2010;23(2):213-219. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.213

Abstract PDF: PURPOSE
To investigate factors influencing the amount of indirect reduction by ligamentotaxis according to timing of surgery, extent of surgery, and characteristics of fractures.
MATERIALS AND METHODS
We reviewed 22 cases of thoracolumbar fracture which had been performed posterior instrumentation and fusion using pedicle screw system. We divided patients into each group according to timing of surgery, number of fusion segment, insertion of screw on fractured vertebra, and rupture of posterior ligament complex, and Denis type. We measured changes of kyphotic angle, anterior vertebral height and wedge angle on plain radiographs, and we compared spinal canal area before and after operation using computed tomographic scans.
RESULTS
Kyphotic angle, anterior vertebral height, wedge angle, and area of spinal canal showed significant improvement postoperatively. The wedge angle improved significantly operated within 3 days after injury, however, kyphotic angle and anterior vertebral height had no correlation with variable factors except the rupture of posterior ligament complex. The amount of restoration of spinal canal also affected only by rupture of posterior ligament complex.
CONCLUSION
There is little relationship between timing of surgery and canal restoration, so we cannot conclude that prompt operation helps reduction of narrowed spinal canal. Otherwise narrowed spinal canal had much less restored by ligamentotaxis when there were rupture of posterior ligament complexes.

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Intra-articular Calcaneal Fractures Treated with Open Reduction and Internal Fixation: A Comparative Study between Groups with and without Bone Graft: Hong Moon Sohn, Sang Ho Ha, Jun Young Lee, Sung Hwan Jo, Hoon Yang; J Korean Fract Soc 2010;23(2):180-186. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.180

Abstract PDF

PURPOSE
This study compares the clinical results of open reduction and internal fixation with and without bone graft for the treatment of intra-articular calcaneal fractures.
MATERIALS AND METHODS
Twenty-five patients who had open reduction and internal fixation for intra-articular calcaneal fractures and available for at least 1 year of follow-up were included in this study. Fifteen cases were operated with bone graft. Period to bone union and functional evaluation score were compared between both groups with analysis of complications.
RESULTS
Bone union was achieved in all cases with average bone union time of 11.6 weeks and 12.8 weeks in group with and without bone graft respectively. Creighton-Nebraska Health Foundation (CNHF) functional score was 86.5 points and 80.3 points respectively. The period to bone union and the CNHF score in the comparison of two groups were statistically insignificant. Complications were observed in four cases of group without bone graft and 5 cases of group with bone graft.
CONCLUSION
This study indicates that bone graft does not play a significant role in bone union and functional outcome when intra-articular calcaneal fractures are treated with open reduction and internal fixation.

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Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures
Chul Hyun Park, Oog Jin Shon
Journal of the Korean Fracture Society.2016; 29(3): 221. CrossRef

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Unstable Intertrochanteric Femoral Fracture Treated with Mini-incision Reduction Technique and Intramedullary Nail: Oog Jin Shon, Dae Sung Kim; J Korean Fract Soc 2010;23(1):13-19. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.13

Abstract PDF: PURPOSE
To evaluate the efficacy of mini-incision reduction technique in unstable intertrochanteric femoral fracture treated with intramedullary nail.
MATERIALS AND METHODS
From January, 2005 to December, 2007, we selected 26 patients of unstable intertrochanteric femoral fracture which underwent anatomic reduction by mini-incision reduction technique using various instruments, and treated with intramedullary nail. We evaluated the radiological results with the union time, change of femoral neck-shaft angle and distance of lag screw sliding by follow-up radiography, and the clinical results with the mobility score of Parker and Palmer, Salvati and Wilson hip function scoring system and Jensen index.
RESULTS
The mean union time was 18.9 weeks. The mean changes of femoral neck-shaft angle was 4.1 degree. The mean distance of lag screw sliding was 4.4 mm. Decrease of mobility score of Parker and Palmer, Salvati and Wilson hip function score was showed, and social function score of Jensen maintained 54% compared with preoperative score.
CONCLUSION
Mini-incision reduction technique using various instruments showed satisfactory clinical and radiological results, and we believe that it is a recommendable method in unstable intertrochanteric femoral fracture which manual reduction is difficult.

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