Journal of Musculoskeletal Trauma

Distal Humerus Fracture: How to Choose the Approach, Implant, Fixation and Rehabilitation: Min Ho Lee, Young Ho Lee; J Korean Fract Soc 2019;32(1):72-81. Published online January 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.1.72

Abstract PDF: Distal humerus fractures require stable fixation and early joint motion, similar to other intra-articular fractures, but are difficult to treat adequately because of the anatomical complexity, severe comminution, and accompanying osteoporosis. In most cases, surgical treatment is performed using two supporting plates. Plate fixation can be divided into right angle plate fixation and parallel plate fixation. In addition, depending on the type of fracture, surgical procedures can be performed differently, and autologous bone grafting can be required in the case of severe bone loss. The elbow joint is vulnerable to stiffness, so it is important to start joint movement early after surgery. Postoperative complications, such as nonunion, ulnar nerve compression, and heterotopic ossification, can occur. Therefore, accurate and rigid fixation and meticulous manipulation of soft tissues are required during surgery.

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Biomechanics of the Wrist: Young Ho Shin, Young Ho Lee; J Korean Fract Soc 2016;29(1):93-100. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.93

The wrist joint is a complicated structure composed of many bones and ligaments. Therefore, understanding the anatomy and the biomechanics of the wrist is important in order to administer proper treatment for patients. To easily understand the complicated structure, there were many trials to unite the complicated structure with a simple group such as the carpal row concept and the carpal column concept. Movement and load transfer along the wrist joint occurs with balanced action between carpal bones. To evaluate this static equilibrium, measuring tools such as carpal height ratio are used. When wrist flexion/extension occurs, each carpal row moves synchronously with action of the scaphoid. In contrast with flexion/extension, when wrist radial deviation/ulnar deviation occurs, the proximal carpal row moves in the sagittal plane, instead of the coronal plane. Recently, the dart throwing motion which occurred from the position of dorsiflexion with radial deviation to volar flexion with ulnar deviation is considered the main movement of the wrist joint.

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Association between carpal height ratio and ulnar variance in normal wrist radiography
Anas AR Altamimi, Monther A. Gharaibeh, Muntaser Abu Shokor, Moh’d S. Dawod, Mohammad N. Alswerki, Omar M. Al-Odat, Raghda H. Elkhaldi
BMC Musculoskeletal Disorders.2024;[Epub] CrossRef
Reliability and concurrent validity of a new iPhone® goniometric application for measuring active wrist range of motion: a cross‐sectional study in asymptomatic subjects
Mohammad Reza Pourahmadi, Ismail Ebrahimi Takamjani, Javad Sarrafzadeh, Mehrdad Bahramian, Mohammad Ali Mohseni‐Bandpei, Fatemeh Rajabzadeh, Morteza Taghipour
Journal of Anatomy.2017; 230(3): 484. CrossRef

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Double Parallel Plates Fixation for Distal Humerus Fractures: Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk Jin Lee, Joon Oh Lee, Kyu Won Oh, Hyun Sik Gong; J Korean Fract Soc 2010;23(2):194-200. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.194

Abstract PDF: PURPOSE
The purpose of this study was to review the outcome of fixation of distal humerus fractures using recently-introduced double parallel plate system in sagittal plane.
MATERIALS AND METHODS
From May 2004 to June 2008, seventeen patients with distal humerus fractures underwent primary open reduction and internal fixation with double parallel plates. According to the AO classification, there were 2 A3, 2 C1, 7 C2, and 6 C3 type fractures. Outcome assessment was performed by using the Mayo Elbow Performance index (MEPI).
RESULTS
At a mean follow up of 18 (range, 12 to 32) months, 4 patients were rated as excellent, 8 as good, and 5 as fair in terms of MEPI. The average arc of elbow flexion after primary operation was 116 (range, 90~140) degrees with a mean flexion contracture of 13 (range, 0 to 30) degrees. One patient required reoperation due to fixation failure and six patients underwent capsulolysis and three patients underwent ulnar nerve neurolysis. The time to begin elbow motion exercise had negative correlation with total elbow range of motion and multiple trauma patients had significantly lower MEPI functional score compared to those without combined injury.
CONCLUSION
Double parallel plating allowed adequate fixation for distal humerus fractures regardless of patient age and fracture pattern. Partial ankylosis and unlar nerve compression symptoms were the main causes of reoperation.

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Internal Fixation of Clavicle Lateral and Fracture with Mini T-plate: Byung Woo Ahn, Jong Ho Yoon, Chong Kwan Kim, Sung Won Chung, Young Il Kwan, Young Ho Lee, Chan Wan Park; J Korean Fract Soc 2005;18(4):410-414. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.410

Abstract PDF

PURPOSE
To evaluate the effectiveness of a mini T-plate fixation in clavicle lateral end fractures.
MATERIALS AND METHODS
We reviewed eleven cases of calvicle lateral end fracture which were treated with open reduction and internal fixion with mini T-plate from May 2000 to December 2004. The follow up period was 12 months minimum. The radiologic result, pain and shoulder function were evaluated by the ASES shoulder score.
RESULTS
All cases showed satisfactory results. Seven cases (63%) were excellent, and four (37%) cases were good. There were no fair or poor results. All cases showed radiologic union by the fifteenth week. No complications such as metal breakage, limited motion, infections were seen.
CONCLUSION
This study demonstrates that using a mini T-plate fixation which is easy and induces no injury of acromiocalvicular joint, contributes to provide stable fixation in clavicle lateral end 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
The Surgical Outcomes of Clavicle Lateral End Fractures Fixed with the Oblique T Locking Compession Plate
Seung-Oh Nam, Young-Soo Byun, Dong-Ju Shin, Jung-Hoon Shin, Chung-Yeol Lee, Tae-Gyun Kim
Journal of the Korean Fracture Society.2011; 24(1): 41. CrossRef
Comparison of Results of Tension Band Wire and Hook Plate in the Treatment of Unstable Fractures of the Distal Clavicle
Chul-Hyun Park, Oog-Jin Shon, Jae-Sung Seo
Journal of the Korean Fracture Society.2011; 24(1): 55. CrossRef

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Effect of Alternative Splinting at Extension and 90degrees Flexion on Range of Motion after Open Reduction and Internal Fixation of Distal Femur Fracture: Chong Kwan Kim, Jong Ho Yoon, Byung Woo Ahn, Chin Woo Jin, Dong Wook Kim, Young Il Kwan, Young Ho Lee; J Korean Fract Soc 2005;18(2):144-148. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.144

Abstract PDF

PURPOSE
To evaluate the usefulness of early range of motion exercise by using 90degrees knee flexion splint after open reduction and internal fixation in fracture of distal femur.
MATERIALS AND METHODS
We reviewed twenty-six cases of distal femur fractures which were treated with open reduction and internal fixation from February 2002 to November 2003. One group (group A) were treated by using 30degrees knee flexion splint, the other group (group B) were treated by using 90degrees flexion and full extension splint alternativley by post-operative 1 week. The follow up period was minimally 12 months. The range of motion and Schatzker and Lambert criteria were evaluated.
RESULTS
The mean period to gain 90degrees knee flexion was 11.4 (7~14) weeks in group A, and 6.6 (3~8) weeks in group B. Mean range of motion was 94.7degrees (average flexion contracture 9.5degrees ) in A group and 108.7degrees (average flexion contracture 6.3degrees ) in B group at 12 weeks follow-up. According to Schatzker and Lambert criteria, excellent result was achieved in 10 cases (38%), good result in 13 cases (50%), fair result in 3 cases (12%).
CONCLUSION
This study demonstrates that alternative splinting at extension and 90degrees flexion contribute to early recovery of range of motion in distal femur fractures treated with internal fixation.

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Treatment of Femur Supracondylar Fracture with Locking Compression Plate
Seong Ho Bae, Seung Han Cha, Jeung Tak Suh
Journal of the Korean Fracture Society.2010; 23(3): 282. CrossRef

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Operative treatment of humeral shaft fracture: Comparision of plate fuation and intramedullary nailing: Sang Ho Ha, Jae Won You, Sang Hong Lee, Dong Min Shin, Young Bae Pyo, Byoung Ho Lee, Min Hyok Choi; J Korean Soc Fract 1999;12(3):712-719. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.712

Abstract PDF

PURPOSE
Examine a humeral shaft fracture which had been treated with a plate and screw fixation or intramedullary nailing and compare these two methods with each other according to clinical and radiologic results and access the clinical avaliablity.
MATERIALS AND METHODS
Take 116 cases of humeral shaft fracture which had been treated with plate and screw fixation(73 cases) or intramedullary nailing(43 cases) and compare these two methods with each other according to bone union time, average operation time and nonunion rate.
RESULTS
Bony union in plate fixation was achieved 1.2 weeks earlier than intramedullary nailing(P>0.05). The average time of operation in intramedullary nailing was 58 minutes, which was shorter than that in plate fixation(P<0.05). The prevalence of nonunion was higher in intramedullary nailing than that in plate fixation, which was thought due to the fanning relaxation, fracture site distraction and/or inappropriate operative technique. Limitation of shoulder motion occasionally occurred in intramedullary nailing, so approriate device selection and surgical technique should be considered.
CONCLUSIONS
We concluded that the results of interlocking IM nailing were not superior to the results of plate fixation. But it is an attractive technique for the rapid closed stabilization of polytrauma patients and segmental and communited fractures.

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Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn
The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef

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Treatment of fracture-dislocation of talar neck or body: Byoung Ho Lee, Sang Ho Ha, Min Hyuk Choi; J Korean Soc Fract 1999;12(2):307-313. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.307

Abstract PDF: From January 1992 to December 1996, authors analyzed 26 cases of fracture-dislocation of talar neck or body, treated at Chosun University Hospital retrospectively. There were 20 males and 6 females and the average age was 34 years old. The follow up period was at least 14 months. There were 19 neck fracture-dislocations, 6 body fractures and total dislocation of talus. Three type I talar neck fractures were treated conservertively. In six cases, in which either three cases of severe open type III talar neck fracture or three cases of severly comminuted talar body fracture, primary fusion was performed. Other seventeen cases of fracture-dislocation were treated by open reduction and internal fixation. Excellent results were observed in 6 cases, good in 7 cases, fair in 11 cases and poor in 2 cases. The result of primary arthrodesis for severe injury of talus was relatively good. Complications were avascular necrosis in 7 cases, posttraumatic arthritis in 5 cases, skinnecrosis in 3 cases, wound infection in 2 cases and malunion in 2 cases.

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The Comparative Sturdy of Treatment between the Skeletal Traction and the Operation of the Supracondylar Fracture in Children: Eu Sub Chung, Young Kee Lee, Byoung Ho Lee; J Korean Soc Fract 1998;11(4):970-976. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.970

Abstract PDF: The most common fracture about the elbow joint in children is supracondylar fracture. That treatment has many fitsfalls and had writtened about its method and the prevention of serious complication such as Volkmann ischemic contractre and cubitus varus deformity. the authors analyzed the follow-up results of 58 cases of supracondylar fractures treated by skeletal traction, percutaneous pinning and open reductionin Persbyterian Medical Center from March 1992 to November 1996. The average follow-up was 20 months(12-54 months). The results were as follows. 1. The mean age was 7.8 years, ranged from 1 year to 15 years, and the male and the female ratio was 1.9:1. 2. Seventeen cases were treated with skeletal traction group, thirty cases with closed reduction and percutaneous pinning group, eleven cases with open reduction and internal fixation group. 3. The average duration of admission in skeletal traction group was 23.5 days, 5.2 days in percutaneous pinning group and 14.7 days in open reduction and internal fixation group. 4. The ration of hospital cost to that in the skeletal group were 0.85+/-0.18 in the percutneous pinning group, and 1.43+/-0.21 in the open reduction and internal fixation group. 5. According to the Mitchell and Adams' criteria, the results of skeletal tracion group were excellent in 58.8%, good in 35.3% and poor in 5.9%; the results of percutaneous pinning group were excellent in 60%, good in 36.7% and poor in 3.3% ; and those of open reduction group were excellent in 54.5%, good in 27.3% and poor in 18.2%, respectively, on mean follow-up of 1 year and 8 month. So, our result indicated that the closed reducion and percutaneous pinning is a simple and cost-effective method for treatment of supracondylar fractures of the humerus in children, but some instances, the skeletal traction might be another treatment method in supracondylar fractures.

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Treatment of Long Bone Fracture Using LC-DCP: Byoung Ho Lee, Sang Ho Ha, Seung Kim; J Korean Soc Fract 1997;10(1):37-43. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.37

Abstract PDF: LC-DCP is the latest plate and screw system developed by AO-ASIF group. There are many merits of LC-DCP with its unique contour and material. : Reduction of surface contact between plate and bone result in preserved vascularization and then improved bone consolidation. Compression can be achieved in either longitudinal direction and a lag screw can be inserted at greater inclination. In addition, pure titanium as an LC-DCP material display optimal biocompatibility and reduce the spread of bacteria and increase resistance against infection. Between June 1994 and September 1995, 39 patients with 40 long bone fractures were treated using LC-DCP.(24 femur, 13 humerus, 3 tibia) Follow-up averaged 12 months : Bone union was achieved in 32 cases(80%) The complications were 7 cases of metal failure, 7 cases of limited joint motion, 2 cases of nonunion,2 cases of delayed union and 2 cases of deep infection.

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Treatment and Complications of Lateral Humeral Condylar Fractures in Children: Young Bae Pyo, Sang Ho Ha, Byoung Ho Lee, Gyoo Bum Cho; J Korean Soc Fract 1997;10(1):188-194. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.188

Abstract PDF: In dealing with lateral humeral condylar injuries, the chance of having a poor functional result with inappropriate management is much greater. Therefore, careful attention in treatment is required in order to reduce additional damage caused by excessive manipulation and firm internal fixation with accurate anatomical reduction is recommended for the prevention of complications even if displacement is not severe. The authors analyzed 29 fractures of the lateral condyle of humerus in children who were treated from Jan. 1990 to Dec. 1994. The results were as follows ; 1. All of fractures were Milch type II and Jakobs stage II was most common in 14 cases(48.3%). 2. They were treated with cast immobilization in 5 cases(17.2%), with percutaneous K-wires pinning in 5 cases(17.2%) and with open reduction and internal fixation in 19 cases(65.5%). 3. The complications were 12 cases of bony spur, 8 cases of bony overgrowth. 2 cases of premature epiphyseal fusion, 1 case of cubitus valgus with extension limitation, 1 case of pin site infection. 4. According to the criteria of Hardacre, we obtained excellent result in 10 cases(34.5%), good result in 17 cases(58.6%) and poor result in 2 case(6.9%).

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Femur Neck Fracture during Closed Nailing of Femur Shaft Fracture: Keun Woe Kim, Ui Seong Yoon, Yong Hoon Kim, Hak Jin Min, Jin Sup Yeom, Young Ho Lee; J Korean Soc Fract 1996;9(4):936-942. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.936

Abstract PDF

Closed intramedullary nailing has become increasingly popular in the management of fractures of the femur because of a high rate of union, a low rate of infection, and excellent return of function. But it requires good availability of equipment and surgeons skill and experience. Iatrogenic femur neck fracture can occur as a complication of closed intramedullary nailing of femur shaft fracture. The authors report five cases of this complication and analyze these five cases in the viewpoint of causal technical errors and suggest some technical points to avoid this complication.

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Some Series of Honey-Comb Spaces
Elena Barbieri, Alberto Cavicchioli, Fulvia Spaggiari
Rocky Mountain Journal of Mathematics.2009;[Epub] CrossRef

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Treatment of Carpal Scaphoid Fracture: Byoung Ho Lee, Dong Min Shin, Sang Ho Ha; J Korean Soc Fract 1996;9(2):274-282. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.274

Abstract PDF: We reviewed 32 cases of scaphoid fracture, treated from June, 1989 to June, 1994. The average follow up period from operation was 13 months. We analyed clinical result according to fracture classification and method of treatment. Nonsurgical treatment of displaced fracture generall gave poor result. In scaphoid fracture associated with complex injury open anatomic reduction and ligament repair was significantly better than conservative treatment. In the treasradial-styloid scaphoid fracture, anatomic reuduction and fixation of radial stloid is neccessory. To protect the misplacenlent of hardware, procisional K-wirc fixation and radiological confirmation will be indispellsable.

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The 5th Metacarpal Neck Fracture Treated by Closed Reduction and Percutaneous Intramedullary K-wire Fixation: Soo Joong Choi, Young Ho Lee, Ho Guen Chang, Chang Ju Lee, Won Ho Cho; J Korean Soc Fract 1995;8(3):696-704. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.696

Abstract PDF

The fifth metacarpal neck fractures are unstable and often heals with angulation and deformity. So, after closed reduction and immobilization with splint or cast, they have often been lost reduction and healed with posterior angulation and cosmetic deformity. We conducted a prospective study of 11 patients who underwent percutaneous retrograde intramedullay K-wire fixation for a fracture of the neck of the fifth metacarpal during four years period. We used a closed reduction technique derived from Jahss maneuver or three point fixation maneuver. And, the fracture was maintained with two cross or parallel smooth intramedullary K-wire. The proximal side of K-wire was placed back wound side near the wrist joint. The last follow up (postoperative 14Â±2 weeks) radiographic results were dorsal angualtion 7Â±4 , corresponded to preoperative 48Â±7 , and immediately postoperative 6Â±4 The complications such as limitation of movement, increase of dorsal angulation, rotational malalignment, shortening, and depression of the head of metacarpal were not occurred. Rotational deformity was always well controlled. Correction of angulation was good and K-wire insertion and fixation technique were easy. We recommend this technique in case of over 40 dorsal angulation of fracture site due to absence of contact between the palmar fractured ends, and patients who dont accept the cosmetic deformity or want early exercise.

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Comparative Evaluation of the Efficacy of Combined Intramedullary Pinning with K-Wires Pinning in the Treatment of Fifth Metacarpal Neck Fractures versus Conventional Techniques—K-Wires Pinning and Intramedullary Pinning
Dong-Eun Kim, Tong-Joo Lee, Yeop Na, Ye-Geon Noh
Medicina.2023; 59(11): 1944. CrossRef
Modified Bouquet Technique for Treatment of Metacarpal Neck Fractures
Yong-Gyu Sung, Seok-Whan Song, Yoon-Min Lee
Journal of the Korean Society for Surgery of the Hand.2016; 21(3): 137. CrossRef
Treatment of 5th Metacarpal Neck Fracture Using Percutaneous Transverse Fixation with K-Wires
Jae-Hak Jung, Kwan-Hee Lee, Yong-Ju Kim, Woo-Jin Lee, Sung-Hyun Choi
Journal of the Korean Fracture Society.2012; 25(4): 317. CrossRef
Treatment of Metacarpal Fractures using Transverse Kirschner-wire Fixation
Nam Yong Choi, Hyun Seok Song
The Journal of the Korean Orthopaedic Association.2007; 42(5): 608. CrossRef
Bouquet Pin Intramedullary Nail Technique of the 5th Metacarpal Neck Fractures
Myung-Ho Kim, Moon-Jib Yoo, Jong-Pil Kim, Ju-Hong Lee, Jin-Won Lee
Journal of the Korean Fracture Society.2007; 20(1): 64. CrossRef

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Treatment of Fracture - Dislocation of Tarsometatarsal Joint: Byoung Ho Lee, Dong Min Shin; J Korean Soc Fract 1995;8(3):606-614. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.606

Abstract PDF

We reviewed and clinically analysed 23 cases of tarsometatarsal joint injuries, which were treated at the orthopaedic department of Chosun university hospital during the period from January 1989 to December 1993, and the following results were obtained. 1. The clinical results of tarsornetatarsal joint injuries did not correlate with the mechanism and classification of injuries. 2. Anatomical reduction and its maintenance, whether treated by closed or open methods, seemed to lead to normal appearance and function. 3. In many cases of our series. early closed reduction was unlikely to succeed because of soft tissue interposition, marked comminution. or a large articular fragment, or because of many concomitant injuries involving the same foot. 4. We recommend early aggressive open reduction and K-wire fixation if the closed reduction is inadequate. 5. For maintenance of stable reduction, only two K-wires(one through the 1st metatarsal base into the first cuneiform, and the other through the fifth metatarsal into the cuboid) are insufficient especially in direct injury, so we recommend that fixation of displaced individual metatarsal and the base of second metatarsal with multiple K-wires.

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Fractures of the Tarsal Bone
Young Hwan Park, Hak Jun Kim, Soo Hyun Kim
Journal of the Korean Fracture Society.2016; 29(4): 276. CrossRef

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The Treatment of Pathologic Troehanterie Fracture of the Femur by Solitary Bone Cyst in Children: Sang Ho Ha, Sang Hong Lee, Byoung Ho Lee; J Korean Soc Fract 1992;5(2):394-399. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.394

Abstract PDF: Generally, pathologic fracture with solitary bone cyst was treated by plaster immobilization to stabilize the fracture site and there-after local steroid injection and curettage and bone graft in the remaining cyst. However, pathologic fracture involving weight bearing bone such as trochanter of the femur showed many complications : coxa, vara, avascular necrosis of femoral head, osteochondritis dissecans if they are treated by conservative method. We treated operatively for two unstable pathologic fractures of the trochanteric region of femur with large solitary bone cyst by primary curettage and autogenous bone graft with internal fixation and obtained satisfactory results.

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Surgical treatment of olecranon fracture: Sang Ho Ha, Jae Won You, Dong Min Shin, Young Bae Pyo, Byoung Ho Lee; J Korean Soc Fract 1991;4(2):320-325. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.320

Abstract PDF: No abstract available.

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