Journal of Musculoskeletal Trauma

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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Distal Radioulnar Joint Injuries Associated with Intra-articular Fracture of Distal Radius: Woo Sik Kim, Yong Sang Kim, Whan Yong Chung, Woo Suk Lee, Taek Soo Jeon, Seung Ryul Ryu; J Korean Fract Soc 2006;19(2):221-227. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.221

PURPOSE
To evaluate the significance of distal radioulnar joint injury which may affect the postoperative radiologic and clinical results of AO classification, type C distal radius fractures.
MATERIALS AND METHODS
From October 2000 to October 2005, 58 patients of AO classification, type C distal radius fracture, who had been treated with operative methods were studied. They are thirty-six men and twenty-two women. The average follow up period was 14 months. The patients were divided into five groups. In the first group (13 cases), there was no distal radioulnar joint injuries. In the second group (20 cases), there were ulnar styloid fractures. In the third group (11 cases), there were separation of distal radioulnar joint. In the fourth group (9 cases), there were ulnar styloid fractures with separation of distal radioulnar joint. In the fifth group (5 cases), there were displacement of ulna in sagittal plane. We measured the radial length, radial inclination and volar tilt in plain radiograph in each group and analyzed the results through Scheck's methods. To analyzed the clinical results, we used the Demerit Point System by Sarmiento.
RESULTS
There was no significant differences in radiologic and clinical results among the five groups.
CONCLUSION
According to compairing the radiologic results of each group which was suspicious of distal radioulnar joint injuries, in the intraarticular comminuted fractures of distal radius, the distal radioulnar joint injuries did not affect the results of treatment when anatomical reduction of distal radius was achieved.

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Treatment of Distal Radioulnar Joint Injuries Associated with a Distal Radius Fracture
Ki-Bum Choi, Sung-Woo Huh, Seong-Eun Kim, Jung-Woo Lee, Seok-Whan Song, Seung-Koo Rhee
Journal of the Korean Society for Surgery of the Hand.2012; 17(4): 147. CrossRef

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Treatment of Comminuted Subtrochanteric Fractures of the Femur by High-Energy Trauma: Taek Soo Jeon, Woo Sik Kim, Sang Bume Kim, Cheol Mog Hwang, Kyu Tae Kim, Sun Hong Kim; J Korean Fract Soc 2006;19(2):135-140. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.135

Abstract

PURPOSE
The purpose is to evaluate the effectiveness of open reduction and internal fixation in comminuted subtrochanteric fractures caused by high energy trauma at a non-osteoporotic young age.
MATERIALS AND METHODS
Of all cases of subtrochanteric fractures caused by high energy trauma under 60 years old from February 2000 to February 2004, we analyzed 16 patients who had severe comminuted fractures (Seinsheimer classification type IV, V). The mean age is 43.5 (31~54) years old. Mean follow-up period was 22 (14~38) months. We tried to reduce anatomically as much as possible and fixed firmly using a compression hip screw in all cases. Additional procedures such as interfragmentary screw fixation, cerclage wiring or lateral stabilization plating were performed in 13 cases. Bone grafting was performed in 8 cases. We evaluated bony union rate, time to union, status of reduction, varus deformity and rate of implant failure using a simple X-ray. We also analyzed the clinical result using the Harris hip score including range of motion, pain and limping gait, so on.
RESULTS
In all 16 cases, bony union was achieved and the mean time to union was 24 (20~32) weeks. There was no intra-operative complication. Postoperative complications such as loss of reduction, varus deformity, implant failure or infection did not occur. Clinically, the Harris hip score was 98.9 (97~100) points.
CONCLUSION
Optimal open reduction and firm internal fixation with or without additional fixation was thought to be a recommendable method of treatment for comminuted subtrochanteric fractures of the femur caused by high energy trauma at a young age.

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Treatment of Subtrochanteric Femur Fractures Using Intramedullary Devices
Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Chong Suk Park, Sang Ho Lee
Journal of the Korean Fracture Society.2008; 21(1): 13. CrossRef

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Instability of Knee Associated with Ipsilateral Femoral and Tibial Shaft Fractures: Whan Yong Chung, Woo Suk Lee, Woo Sik Kim, Yong Chan Kim, Taek Soo Jeon, Sun Hong Kim, Ji Hyuk Lim, Young Su Lim; J Korean Fract Soc 2005;18(2):136-143. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.136

Abstract PDF: PURPOSE
To establish the incidence, type and significance of knee instability in patients with ipsilateral femoral and tibial shaft fracture, comparing with the patients with femoral shaft or tibial shaft fracture alone.
MATERIALS AND METHODS
Two hundreds and seventy-nine consecutive patients were retrospectively reviewed from February 2000 to April 2004. They were composed of 80 patients with femoral shaft fracture alone, 176 patients with tibial shaft fracture alone and 23 patient with ipsilateral femoral and tibial shaft fracture. We evaluate the instability of knee based on physical examinations, plain stress films and MRI. We analyze incidence and period to diagnosis of instability, period to complete bony union and Hospital for Special Surgery (HSS) knee score respectively.
RESULTS
There were 6.3% of knee instability in femoral shaft fracture alone, 9.7% in tibial shaft fracture alone and 30.4% in ipsilateral femoral and tibial shaft fracture. The average period to diagnosis of instability, average period to complete bony union and average HSS knee score were 9.2 months, 4.7 months and 65 points in femoral shaft fracture alone, 9.1 months, 4.2 months and 69 points in tibial shaft fracture alone, 8.7 months, 5.3 months (femur), 4.7 months (tibia) and 57 points in ipsilateral femoral and tibial shaft fracture respectively.
CONCLUSION
We should consider MRI to evaluate the knee instability in patient with ipsilateral femoral and tibial shaft fracture at the time of injury and make a plan early about the treatment of knee instability.

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Sliding after Internal Fixation of Stable Intertrochanteric Fracture of the Femur: Woo Suk Lee, Whan Young Chung, Woo Sik Kim, Yong Chan Kim, Taek Soo Jeon, Sung Kwun Jo, In Tak Bae, Young Su Lim; J Korean Fract Soc 2005;18(2):110-114. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.110

Abstract PDF

PURPOSE
To evaluate the risk factors of sliding after internal fixation with sliding compression hip screw in stable intertrochanteric fracture of the femur.
MATERIALS AND METHODS
From March 2000 to April 2003, 61 stable intertrochanteric fractures (Kyle-Gustilo type II) were treated operatively with sliding compression hip screws. The patients were 40 females and 21 males with an average age of 74 (range, 54~99). We measured vertical and horizontal shortening in regard to age, sex, bone mineral density, neck-shaft angle, cancellous bone defect, and the existence of lessor trochanter fracture on postoperative 6 months.
RESULTS
The average vertical shortening was 4.1 mm (0~22 mm) and the average horizontal shortening was 7.3 mm (0~30 mm). Age, sex, bone density and neck-shaft angle were not significantly related with vertical and horizontal shortening (p>0.05). Vertical shortening was significantly greater in the group with cancellous bone defect and in the group without lesser trochanter fracture (p<0.05).
CONCLUSION
Proper management for fracture site and fixation was needed to make it stable because the stable intertrochanteric fracture with cancellous bone defect and intact lesser trochanter could be induced into unexpected sliding.

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Benefits of a Demineralized Bone Matrix in Osteoporotic Intertrochanteric Femoral Fracture Patients
Se Jin Kim, Hong-Man Cho, Myung Cheol Jung
Journal of the Korean Fracture Society.2022; 35(4): 151. CrossRef

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Intercondylar Fracture of Distal Humerus in Children: Woo Suk Lee, Whan Yong Chung, Woo Sik Kim, Yong Chan Kim, Taek Soo Jeon, Nam Hyun Kim, Kyoo Tae Kim; J Korean Fract Soc 2004;17(4):380-383. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.380

Abstract PDF

Intercondylar fractures of the distal humerus are very rare in children. The pattern of the fracture would suggest that the mechanism of injury involves a fall directly on the flexed elbow. Most agree that the undisplaced fracture can be managed conservatively. With increasing displacement and comminution, the opinions tend to differ. We suggest that closed reduction with percutaneous K wire pinning and open reduction with percutaneous K wire pinning offer a satisfactory methods by which to treat displaced intercondylar fracture in children.

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Adolescent Distal Humerus Fractures: ORIF Versus CRPP
Phillip Bell, Brian P. Scannell, Bryan J. Loeffler, Brian K. Brighton, R. Glenn Gaston, Virginia Casey, Melissa E. Peters, Steven Frick, Lisa Cannada, Kelly L. Vanderhave
Journal of Pediatric Orthopaedics.2017; 37(8): 511. CrossRef

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Postoperative Evaluation of Displaced Intra-articular Calcaneal Fractures by Computed Tomography: Woo Sik Kim, Kwang Kyoon Kim, Whan Yong Chung, Woo Suk Lee, Yong Chan Kim, Taek Soo Jeon, Dae Hwan Kim, Seong Jin Cho, Chul Mok Hwang; J Korean Fract Soc 2004;17(3):249-256. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.249

Abstract PDF

PURPOSE
The purpose of the present study was to define the factors that affect the treatment and clinical result of displaced calcaneal fracture with use of the pre- operative and final follow-up computed tomography scanning.
MATERIALS AND METHODS
Present study included the 17 patients(18 feet) whom we performed surgery for displaced intra-articular calcaneal fracture at our institution between March 2000 and March 2002 and had a minimum follow-up of 12 months. For all patients, the Bohler's angle and posterior facet incongruity were measured with computed tomography pre- and post-operatively. The Creighton-Nebraska Health Foundation Assessment Scale for Fractures of the Calcaneus (CN scale) was used to evaluate the clinical results.
RESULTS
Of all eighteen fractures, the clinical results were excellent in three (16.6%), good in six (33.3%), fair in six (33.3%), and poor in three (16.6%). The Bohler's angle averaged 21degrees, 15degrees, 27degrees, 25degrees at final follow-up in each above clinical result group. The step-off averaged 1.0, 1.6, 3.9 and 6.0 mm and the average range of motion of the subtalar joint at final follow-up were 85, 76, 60 and 45% of normal. CT evaluation showed intra-articular screws in the posterior subtalar joint in three (16.6%) of the eighteen fractures but their average clinical result was good (80.3 points).
CONCLUSION
The restoration of the congruity and range of motion of posterior subtalar joint are considered important factor that affect clinical result.

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Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography
Joon-Sang Eom, Young-Deuk Joo, Seong-Jun Kim, Min-Ho Shin, Dong-Oh Lee, Hong-Geun Jung
Journal of Korean Foot and Ankle Society.2014; 18(4): 165. CrossRef

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Anterolateral Approach for the Distal Metaphyseal Fracture of the Tibia: Taek Soo Jeon, Jae Woo Lim, Whan Yong Chung, Woo Suk Lee, Woo Sik Kim, Cheol Mog Hwang, Yong Chan Kim, Nam Hyun Kim, Yong Sang Kim, Sung Kwan Jo; J Korean Fract Soc 2004;17(3):243-248. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.243

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the effectiveness of anterolateral approach of the ankle for the distal tibial fracture in aspect of preventing complication and acquiring union.
MATERIALS AND METHODS
Authors reviewed 21 patients of distal metaphyseal fracture of the tibia treated by anterolateral approach and lateral plating method from February, 2000 to May, 2002. Mean follow-up period was 17 months (12~29 months). There were twelve type A, two type B, and four type C patients according to AO/OTA classification. We have analyzed the bone union rate and Ovadia`s functional scale. We also reviewed the complication rate, such as soft tissue problem and postoperative infection.
RESULTS
In all cases union was achieved and mean time to union were 16 weeks. The functional result by Ovadia's scale were 17 excellent cases and 4 good cases in objective evaluation, and 19 excellent cases and 2 good cases in subjective evaluation. Wound infection occurred in one case, but the infection was controlled after plate removal and the union was acquired through cast immobilization. There was no other complication, such as soft tissue necrosis.
CONCLUSION
The anterolateral approach is a safe and worthwhile method for distal tibia fracture while avoiding some of the complication associated with standard anteromedial approach and plating method.

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Delayed Brachial Plexus Palsy due to Clavicular Fracture: A Case Report: Woo Suk Lee, Whan Yong Chung, Taek Soo Jeon, Yong Sang Kim, Nam Hyun Kim; J Korean Soc Fract 2003;16(2):230-234. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.230

Abstract PDF

The brachial plexus palsies secondary to nonunion of the clavicle fracture are extremely rare. The nonunions are hypertrophic and usually in the middle third of the clavicle. Hypertrophic callus produced during healing process will cause a compression of the neurovascular bundle. This lesion requires operative treatment for decompression of the brachial plexus and internal fixation of nonunion. We present a case of delayed brachial plexus palsy due to nonunion and excessive callus formation of a clavicular fracture.

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Progressive Brachial Plexus Palsy after Fixation of Clavicle Shaft Nonunion: A Case Report
Hong-Ki Jin, Ki Bong Park, Hyung Lae Cho, Jung-Il Kang, Wan Seok Lee
Journal of the Korean Fracture Society.2019; 32(2): 97. CrossRef

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Treatment of Distal Clavicle Type II Fracture using K-Wires and Tension Band Wiring: Whan Yong Chung, Woo Suk Lee, Taek Soo Jeon, Dae Hwan Kim, Kwang Kyoon Kim, Jae Woo Lim; J Korean Soc Fract 2003;16(2):215-221. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.215

Abstract PDF

PURPOSE
This is a retrospective study to analyze the clinical results of the usefulness of K-wires and tension band wiring that fix the fracture fragment directly without passing the acromioclavicular joint in distal clacivle type II fractures.
MATERIALS AND METHODS
From May 2000 to May 2001, eleven patients with distal clavicle type II fracture were treated by open reduction and internal fixation with K-wires and tension band wiring. The clinical results were analyzed according to modified shoulder rating scale for distal clavicle freacture. Radiological union, complication, and range of motion of the shoulder were assessed.
RESULTS
All fractures were united at 10 weeks (8~12 weeks) in average. Finally, full range of motion of the shoulder joint was achieved in all patients. No complication was found and the modified shoulder rating scale for distal clavicle fracture were as follows: excellent 9 and good 2.
CONCLUSION
K-wires and tension band wiring can be a good treatment method for distal clavicle type II fractures.

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Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome
Seong Cheol Moon, Chul Hee Lee, Jong Hoon Baek, Nam Su Cho, Yong Girl Rhee
Journal of the Korean Fracture Society.2014; 27(2): 127. CrossRef

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Popliteal Artery Injury Associated with Fracture and/or Dislocation of the Knee: Jun Young Yang, Kwang Jin Rhee, June Kyu Lee, Deuk Soo Hwang, Ki Yong Byun, Taek Soo Jeon; J Korean Soc Fract 2000;13(3):494-500. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.494

Abstract PDF: PURPOSE
To compare the outcome in patients who have popliteal artery injury associated with fracture and/or dislocation around the knee according to treatment option.
MATERIALS AND METHODS
We have reviewed fourteen cases of popliteal artery injury patients associated with fracture and/or dislocation injury around the knee who had visited at Chungnam National University Hospital from April 1997 to July 1999.
RESULTS
Combined skeletal injuries included fracture of distal femur, fracture of proximal tibia, and dislocation of the knee. Internal or external fixation was applied for skeletal injuries. We repaired the injured popliteal artery using end-to-end anastomosis (3 cases), interposed saphenous vein graft (9 cases), prosthetic vein graft (1 case), or thrombectomy alone (1 case). The amputation rate was 21 % (3 out of 14 patients). In limb salvage cases, we evaluated the function of knee joint, and the results were as follows : good 5 cases, fair 3 cases, and poor 3 cases.
CONCLUSION
Early diagnosis and prompt management for injuries of the popliteal artery is the most important factor to save the limb. Also, complete resection of all injured portion of vessel and reconstruction of patency through interposed saphenous vein graft are most useful method.

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