Journal of Musculoskeletal Trauma

Treatment of the Intertrochanteric Femoral Fracture with Proximal Femoral Nail: Nailing Using the Provisional K-wire Fixation: Gu Hee Jung; J Korean Fract Soc 2011;24(3):223-229. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.223

PURPOSE
To evaluate the efficiency of provisional K-wire fixation in intertrochanteric fractures treated with proximal femoral nail (PFN).
MATERIALS AND METHODS
Twenty seven patients (by AO/OTA classification, A1 8 cases, A2 19 cases) were treated with PFN with percutaneous reduction and provisional K-wire fixation, and followed a mean 24.5 months. The adequacy of fracture reduction was assessed by Fogagnolo's classification and reestablishment of bone-to-bone contact with the medial anatomy. Functional results were evaluated by postoperative complications, Jensen's method and Harris hip score (HHS).
RESULTS
In all cases, the bone-to-bone contact with the medial anatomy was reestablished by percutaneous reduction and examination of Fogagnolo's classification showed a good reduction. The technical complications and error of starting point were not occurred. The mean HHS was 76.5 and means Jensen's grade was 2.1 grades. Complications included excessive sliding in 1 case and early cutting-out of screw in 1 case.
CONCLUSION
The provisional K-wire fixation in trochanteric fracture treated with PFN had an advantage in preventing technical complications because it facilitates a nail insertion in ideal position.

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Analysis of Low-Energy Trochanter Fracture Using the Multiplanar Computed Tomography Image: Application for Intramedullary Nail Fixation
Gu-Hee Jung, Sung-Keun Heo, Hyun-Je Seo
Journal of the Korean Fracture Society.2015; 28(3): 155. CrossRef
Morbidity and Mortality of the Elderly after Early Operation for Trochanteric Fractures
Se-Ang Jang, Young-Ho Cho, Young-Soo Byun, Ki-Hong Park, Hyun-Seong Yoo, Chul Jung
Journal of the Korean Fracture Society.2013; 26(3): 199. CrossRef

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Antegrade Intramedullary Prebent K-wire Fixation for the 5th Metacarpal Neck Fracture: Tae Hyung Kim, Bo Hyeon Kim, In Ho Jung, Dong Hyun Kim; J Korean Fract Soc 2011;24(1):67-72. Published online January 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.1.67

Abstract PDF

PURPOSE
To evaluate radiological and clinical results of the antegrade intramedullary prebent K-wire fixation for the 5th metacarpal neck fracture.
MATERIALS AND METHODS
Between January, 2006 and December, 2009, 31 patients with displaced neck fracture of the fifth metacarpal who received antegrade intramedullary prebent K-wire fixation were included in this study. Radiological and clinical outcome evaluations were performed.
RESULTS
All the fractures were completely united. In the oblique radiographs, the average of preoperative angulation was corrected from 38.9degrees to 4.4degrees. The average difference between postoperative and final follow-up was 1.2degrees. Clinical outcomes were satisfactory except for one patient who had sustained ulnar nerve dorsal branch injury during surgery.
CONCLUSION
Antegrade intramedullary prebent K-wire fixation may be preferentially considered as one of the best ways to fix the displaced neck fractures of the fifth metacarpal.

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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
Journal of the Korean Fracture Society.2021; 34(1): 23. CrossRef

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Treatment of Displaced Supracondylar Fracture of the Humerus in Children: Soon Hyuck Lee, Sang Won Park, Woong Kyo Jeong, Dae Hee Lee, Soon Yong Yoo; J Korean Fract Soc 2006;19(4):460-465. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.460

Abstract: PURPOSE
To evaluate the radiological and clinical outcomes after operative treatment of displaced supracondylar fractures in children with lateral K-wire fixation.
MATERIALS AND METHODS
69 displaced supracondylar fractures treated by closed reduction and percutaneous lateral K-wire fixation were included in this study. Carrying angle and range of motion were measured and graded by the Flynn criteria. To assess the accuracy of the reduction, Baumann angle and lateral humerocapital angles were compared to the contralateral side, and to evaluate the stability of fixation both measurements were taken immediately postoperatively and after K-wire removal.
RESULTS
55 cases (80%) were categorized as excellent and 12 cases (17%) as good. There were no significant statistical differences in Baumann angle and lateral humerocapital angle between postoperative and K-wire removal. Although there were 9 cases that showed differences in Baumann angle and 32 cases in lateral humerocapital angle of more than 10 degrees compared to the opposite side at the immediate postoperative radiograph, 9 cases showed satisfactory clinical results.
CONCLUSION
Closed reduction and lateral K-wire fixation is considered as an acceptable modality of the treatment of displaced supracondylar fractures in children, and clinical outcome is more closely correlated with carrying angle and stability of fracture site rather than rotational deformity or hyperextension of fragment measured radiographically.

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Radiologic Reduction Loss after Surgical Treatment of Distal Radius Fracture: Heun Guyn Jung, Jin Bae Choi, Seung Yong Seo, Yong Soo Choi; J Korean Fract Soc 2006;19(4):454-459. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.454

Abstract: PURPOSE
To compare and analyse radiologic reduction loss between fixation with K-wire only group and fixation with K-wire and external fixator group for surgical treatment of distal radial fracture.
MATERIALS AND METHOD
We analysed 60 patients who received the operative treatment with K-wire fixation only or K-wire and external fixator and also were in regular follow up at least one year. We compared radiologic reduction loss of radial length, radial inclination and volar tilt between immediate post-operative radiograph and latest follow up radiograph according to operative methods, fracture patterns and age groups.
RESULTS
Reduction loss of volar tilt was greater in fixation with K-wire only group than fixation with K-wire and external fixator group (p<0.05). Reduction losses of radial length and radial inclination were more in intra-articular subgroup than extra-articular subgroup in fixation with K-wire only group (p<0.05). No significant difference of reduction loss was noted between intra-articular and extra-articular subgroups in fixation with K-wire and external fixator group.
CONCLUSION
More radiologic reduction loss can be expected in fixation with K-wire only group for intra-articular distal radius fracture compared with extra-articular distal radius fracture. Additional external fixation should be added in intra-articular distal radius fracture to reduce radiologic reduction loss.

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

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

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Intramedullary K-wire Fixation for Displaced Fracture of Distal Radius: Byung Woo Ahn, Chong Kwan Kim, Jong Youl Lee, Chae Ik Chung, Jong Ho Yoon, Young Min Kim, Jin Woo Jin, Kang Hoon Kim, Guk Sang Chung, Dong Wook Kim; J Korean Fract Soc 2005;18(1):54-59. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.54

Abstract PDF: PURPOSE
To evaluate indications and effectiveness of intramedullary K-wire fixation for distal radial fractures.
MATERIALS AND METHODS
Twenty one fractures of distal radius treated with intramedullary K-wire fixation from April 2001 to September 2002 were evaluated. The mean age was 67.8(range 46~82). Severely comminuted intra-articular fractures and Barton's fractures were excluded. One or two K-wires were added percutaneously. To assess the functional result, we used Green and O'Brien score system. The radiographic assessment included a scoring system based on measurements of radial length, radial inclination, volar tilt and step-off of the radial articular surface.
RESULTS
Average follow up period was 13.5 months. In functional result, excellent and good result were obtained in 18 cases (86%). In radiologic result, mean loss of radial length, radial inclination and volar tilt were 0.9 mm, 1.4degrees, 0.9degrees, respectively.
CONCLUSION
The advantages of intramedullary K-wire fixation were relatively simple procedure, low occurrence of soft tissue complications and early wrist motion. Intramedullary K-wire fixation was good to maintaining reduction in osteoporotic bone.

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Treatment of Tibial Shaft Fractures in Children Using K-wires Fixation: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Ho Jun Cheon; J Korean Fract Soc 2004;17(4):384-388. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.384

Abstract PDF: PURPOSE
To report the effectiveness of Kirschner wire fixation for the treatment of unstable tibial shaft fractures in children.
MATERIALS AND METHODS
We analyzed 15 cases of pediatric tibial shaft fractures treated at our hospital with fixation using K-wire and followed up for more than 1 year from July 1998 to January 2002. The subjects included 11 boys and 4 girls. The ages ranged from 3 to 10 years at the time of injury, with the average age being 7.9 years. We examined the presence of angulation, leg length discrepancy, joint motion limitation, and complications.
RESULTS
Bony fusion was obtained in all patients by an average of postoperative 9.5 weeks. At the time of last follow-up (by an average of postoperative 1 year and 4 months), anterior and posterior radiographs showed an average of 4.2degree angulation, and lateral radiographs showed an average of 4.4degree angulation. The affected leg was extended by an average of 3.7 mm compared to the opposite leg according to Bell-Thompson's radiographs. As for complications, infection was developed around the pin in 3 cases but treated with the administration of oral antibiotics and sterilization around the site without progressing to deep infection. We could not observe joint motion limitation, pain and difficulties related with discrepancy in leg length.
CONCLUSION
We concluded that fixation using K-wire for children with tibial shaft fractures was a safe and effective method of surgery that could be performed easily, did not require secondary surgery to remove the wire, and showed sufficient stability after fixation.

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Surgical Treatment of Fractures of the Distal Radius in Patients Older Than 65 Years: Jeung Tak Suh, Dae Woong Kim, Chong Il Yoo; J Korean Soc Fract 2003;16(4):563-569. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.563

Abstract PDF

PURPOSE
To analyze the results of surgical treatment of the displaced distal radius fractures in elderly patients over 65 years old who were treated with percutaneous K-wire fixation only and percutaneous K-wire fixation with external fixation. MATERIAL AND METHOD: We evaluated 24 cases of the distal radius fracture in patients older than 65 years from January 1998 to December 2001. The patients were followed up at least 12 months postoperatively. We compared the surgical results of 14 cases, treated with percutaneous K-wire fixation only with the surgical results of 10 cases, treated with percutaneous K-wire fixation with external fixation. We evaluated the functional results according to demerit point system and the radiographic results (radial length, radial inclination, volar tilt).
RESULTS
According to demerit point system, the mean score of demerit point was 9.9 in the group of percutaneous K-wire fixation and 5.3 in the group of percutaneous K-wire with external fixation respectively (p<0.05). In radiographic results, the percent of the mean loss of radial length, radial inclination and volar tilt were 23.2%, 12% and 41.7% in the group of percutaneous K-wire fixation and 11%, 5.9% and 27.4% in the group of percutaneous K-wire with external fixation respectively (p<0.05).
CONCLUSION
Percutaneous K-wire with external fixation showed better functional and radiographic results than percutaneous K-wire fixation only for the treatment of the displaced distal radius fractures in elderly patients older than 65 years and percutaneous K-wire with external fixation is thought to be a one of the most effective treatment of the displaced distal radius fractures in elderly patients.

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Osteoporotic Distal Radius Fracture-conservative Treatment
Seok-Whan Song
Journal of the Korean Fracture Society.2008; 21(1): 81. CrossRef

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Flexion-type Humerus Supracondylar Fractures in Children: Jae Do Kang, Kwang Yul Kim, Hyung Chun Kim, Moon Sup Lim, Shin Kwon Choi, Hyun Soo Park; J Korean Soc Fract 2002;15(4):601-606. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.601

Abstract PDF: PURPOSE
We investigated the treatment modality and clinical results in flexion-type supracondylar fractures of the humerus in children.
MATERIALS AND METHODS
11 cases of flexion-type supracondylar fractures of the humerus(3 type I, 5 type II, 3 type III) were treated, 3 fractures(3 type I) with extension cast, 6 fractures(5 type II, 1 type III) with two lateral percutaneous K-wire fixation, 2 fractures(2 type III) with open reduction and crossed pin fixation. The K-wire were removed after 4-6 weeks of operation and the follow-up period ranged from 12 months to 26 months, averaging 18 months.
RESULTS
By Flynn 's functional and cosmetic criteria, nine cases were good and excellent results, one case (type III with two lateral percutaneous pin fixation) is fair result.
CONCLUSION
As the same methods of the extension-type supracondylar fractures, the K-wire fixation is useful method in the treatment of flexion-type supracondylar fractures of the humerus in children.

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Treatment of Displaced Supracondylar Fracture of the Humerus in Children -Open Reduction with Minimal Incision of the Manually Irreducible Fracture: Kyeong Jin Han, Soo Ik Awe, Eung Suck Park, Shin Young Khang; J Korean Soc Fract 2002;15(4):587-594. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.587

Abstract PDF

PURPOSE
We evaluated the results of the displaced supracondylar fractures in children treated by closed reduction and cast immobilization, closed reduction and crossed K-wires fixation or open reduction with minimal incision and crossed K-wires fixation.
MATERIALS AND METHOD
We retrospectively reviewed the results after 1 year of the treatment of 71 extension-type fractures (Gartland type II - 19 cases, type III - 52 cases) of supracondylar humeral fractures in children under age of 8 years. Closed reduction was impossible in 20 cases (1 type II, 19 type III) and we performed open reduction with minimal incision and cross percutaneous pinning. We measured Baumanns angle and range of motion of elbow and evaluated the results by Flynns criteria.
RESULT
By Flynns criteria, 91.5 % of satisfactory (excellent, good) results in cosmetic factor and 97.2 % in functional factor. The result of closed reduction and percutaneous pinning is more excellent in functional factor and that of the minimal open reduction and percutaneous pinning in cosmetic factor but over all satisfactory results were similar.
CONCLUSION
The treatment of the displaced supracondylar humeral fractures in children needs accurate and delicate reduction and firm fixation to prevent deformity and to preserve function of the elbow. Open reduction with minimal incision instead of general incision for the manually irreducible supracondylar humeral fractures would be a reliable and convenient method for the treatment of supracondylar humeral fractures in children.

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Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique
H.-Y. Lee, S.-J. Kim
The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef

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Treatment of Supracondylar Fracture of the Humerus in Children: by Immediate Closed Reduction & Lateral Percutaneous K-Wire Fixation: Byung Woo Ahn, Chong Kwan Kim, Jeong Hwan Kim, Chae Ik Chung, Jae Kyu Park, Young O Kim, Jong Ho Yoon; J Korean Soc Fract 2001;14(4):753-761. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.753

Abstract PDF: PURPOSE
To analyze children with displaced supracondylar fractures of the humerus that were treated by immediate closed reduction and then maintained by lateral percutaneous K-wire fixation.
MATERIALS AND METHODS
70 cases of supracondylar fractures of the humerus(5 type I, 19 type II, 46 type III) were treated, 14 fractures(5 type I, 7 type II, 2 type III) with cast, 49 fractures(12 type II, 37 type III) with lateral percutaneous pinning, 7 fractures(7 type III) with open reduction and internal fixation. The K-wire were removed after averaging 6.2 weeks of operation in out patient clinic. The follow-up period ranged from 6 months to 28 months, averaging 13 months.
RESULT
By Flynn's functional and cosmetic criteria, 47 fractures(95.9%) among 49 fractures, treated with immediate closed reduction and lateral percutaneous pinning, resulted in satisfactory criteria. Only one fracture was reoperated due to reduction loss.
CONCLUSION
Immediate closed reduction and lateral percutaneous K-wire fixation appears to be safe and reliable option for the treatment of supracondylar fractures of the humerus in children.

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Percutaneous K-wire fixation for Unstable Fracture of distal radius: Chol Yong Jung, Young Chan Son, Jun Bum Bae, Moon Do Choi; J Korean Soc Fract 2000;13(4):996-1002. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.996

Abstract PDF: PURPOSE
To evaluate the clinical validity of the percutaneous K-wire fixation in applying to unstable extraarticular fracture of distal radius of patients who are older than 50 years. MATERIAL AND METHODS: The validity of K-wire fixation was examined, using subjective study of Cole and Oblelz and objective study of Scheck, on the 20 cases of unstable extraarticular fracture of distal radius of patients older than 50 years, who were treated with percutaneous K-wire fixation and followed up more than 1 year, out of 160 patients with distal radius fracture, treated in the department of orthopedic surgery of our hospital from January 1994 to August 1998.
RESULTS
The result was examined with subjective study of Cole and Oblelz and objective study of Scheck. Combined judgement was made by adding up the scores of both objective and subjective study. 5 excellent cases and 12 good cases were brought forth by subjective study. Objective study achieved the result of average 18 degree of radial angle, 9.8mm of radial length and 3.6 degree of volar angle. Combined judgement achieved a good result of 3 excellent cases, 14 good cases and 3 fair cases.
CONCLUSION
Percutaneous K-wire fixation is expected to be a simple, less invasive, more effective and valuable operation method in the treatment of extraarticular fracture of distal radius with severe comminution

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The Additional Use of External Fixator after Percutaneous K-Wire Fixation for Intra-articular fractures of The Distal Radius: Chang Woo Kim, Ja Seong Gu, Gi Tae Jeong, Su Yeong Jeon, Tae Hoon Jeong, Jang Won Hur, Yeon Park; J Korean Soc Fract 2000;13(1):139-145. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.139

Abstract PDF: PURPOSE
: To evaluate the role of the additional external fixator in maintenance of reduction with was known as an important prognostic factor for the treatment of intra-articular distal radius frctures. MATERIAL AND METHOD : Thirty cases of unstalbe intra-articular fractures of the distal radius, which were treated by operative method, were classified by Frykman's method and grouped in two(group A and B). The group A was treated by closed reduction and percutaneous K-wire fixation and long arm cast immobilization. The group B was treated by treated by closed reduction and percutaneous K-wire fixation with use of additional external fixator. The end results were evaluated by the Demerit Point Rating System(by Sarmiento) & radiologic evaluation(radiologic index : radial length, radial tilt, volar tilt) RESULTS : By the Demerit point rating system, excellent and good results were rated by 45.5% in group A and 75% in group B and poor results were found in 3 cases which were Frykman type VII or VIII in group A. Radiologically, radial length loss was rated by 11%, radial tilt loss by 10.8% and volar tilt loss by 47% in group A and 3.1%, 6.8%, 29% each in group B(p<0.05).
CONCLUSION
: We think that additional use of external fixator, after percutaneous K-wire fixation, may have an important role in maintenance of reduction and group prognosis for the treament of intra-articular distal radius fractures.

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Simultaneous Fracture-Dislocation of the Carpometacarpal and Metacarpophalangeal joint of the Thumb: Ho Rim Choi, Sung Jun Han, Sang Seon Lee, Chi won Lee, Byeong Lok Jin; J Korean Soc Fract 1999;12(4):1031-1033. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.1031

Abstract PDF: Simultaneous multiple dislocation of the thumb is a very rare injury. We experienced a case of simultaneous fracture-dislocation of the carponletacarpal and metacarpophalangeal joint of the thumb which was treated by closed reduction and percutaneous K-wire fixation. The clinical retult was satisfactory.

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Management of Displaced-Extension Type Supracondylar Fractures of Humerus in Children: Suk Myun Ko, Myung Ku Kim, Kyoung Ho Moon, Ryuh Sup Kim, Kyu Jung Cho, Dong Hun Choi; J Korean Soc Fract 1999;12(2):351-360. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.351

Abstract PDF: From June 1996 to February 1998, we reviewed the cases of 27 patients who had a displaced - extension type supracondylar fracture of the humerus retrospectively. The mean length of follow-up was 1.3 years. According to Gartland classification, type II was 7 cases (26%), type III-A was 11 cases (41%), type III-B was 9 cases (33%). We treated with three different methods, including closed reduction and percutaneous Kirschner-wire fixation, skeletal traction, and cast application after closed reduction. In type II fractures, we used two parallel lateral pins. In type III fractures, we used 2 lateral parallel pins followed by 1 medial crossed pin predominantly. The results of treatment were assessed using the criteria of Flynn et al. We graded cosmetic and functional factors separately. Satisfactory results were achieved by percutaneous K-wire fixation(96%). There were seven neural lesions. These were the result of injury and not of the treatment, with exception of one case. Neural injuries spontaneously resolved at a mean of 2.5 months(range 1.5 to 5 months) after injury. Varus deformity was present in one patient. There was no Volkman's ischemic contracture. Percutaneous Kirschnerwire fixation is advocated as the method of choice for the majority of displaced-extension type supracondylar humerus fractures in children.

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The Results of the Percutaneous K-wire Fixation for the Supracondylar Fractures of the Humerus in Children: Chil Soo Kwon, Jong Kuk Ahn, Byung Hyun Jeong, Jin Chung, Ho Cheol Rhee; J Korean Soc Fract 1999;12(1):187-193. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.187

Abstract PDF: The cases of 160 patients who had a displaced supracondylar fracture of the humerus were reviewed retrospectively. According to the Flynn's criteria, the results of treatment were excellent 33%, good 53%, fair 10%, poor 4%. No neurovascular complication was appeared. In two cases, cubitus varus deformity was appeared to be related with incorrect reduction. We believe that percutaneous k-wire fixation is excellent method in treatment of the displaced supracondylar fractures in children. There was no significant difference of clinical results among methods of percutaneous K-wire fixation but lateral 2 and medial 1 cross pinning has advantages : easy technique in insertion of lateral 2 pins, biomechanical stability and removal of medial pin in the irritation of ulna nerve without significant influence of stability.

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Treatment of Supracondylar Fracture of the Humerus in Children: by Early Closed reduction & K-Wire Fixation: Jong Sup Shim, Won Hwan Oh; J Korean Soc Fract 1998;11(3):634-643. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.634

Abstract PDF: We treated supracondylar fracture of the humerus in children by early closed reduction and K-wires fixation using two lateral parallel K-wires for partially displaced fractures(Gartland Ib, II) and three K-wires,two lateral and one additional medial crossed K-wire for type III fractures. This study is to analyze our method for the treatment of supracondylar fracture of the humerus in children. Sixty-two fractures(4 type Ib, 20 type II and 38 type III) underwent K-wires fixation after closed reduction of the fracture from October 1994 to April 1997 were included in this study. The patients age ranged from 2 years and 2 months to 12 years and 7 months, averaging 6 years and 2 months. All the fractures were treated within 24 hours after arrival in the hospital. After general anesthesia, each fracture was reduced manually and fixed by K-wires under fluoroscopic control. Two lateral parallel K-wire were used for fixation of all type Ib and II fractures. We tried to keep the gap between two K-wires be 1 cm or more. In type III fractures, fractures were fixed by two parallel lateral K-wires and followed by one medial crossed K-wire. The K-wires were removed after averaging 3.2 weeks after operation in out patient clinic. The follow-up period ranged from 6 months to 34 months. averaging 14 months. By Flynn's functional and cosmetic criteria, 37 fractures (97.4%) among 38 type III fractures resulted in satisfactory criteria. All of the type I and II fractures (100%) resulted in satisfactory criteria. In conclusion, our decision is considered as safe and reliable option for the treatment of supracondylar fractures of the humrus in children.

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The Results and Complications After Treatment of Open Tibia Fractures in Children: Chung Nam Kang, Jong Ho Kim, Dong Wook Kim, Young Do Gho, Jae Doo You, Jin Chang; J Korean Soc Fract 1998;11(2):464-470. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.464

Abstract PDF

We describe the results of treatment and complication of open tibial fractures in 44 children. There were 30 males and 14 females with an average age of the 6.7 years(range 3~2 years). The mean follow up period was 15 months(range 1.4~28month). According to the classification of Gustilo et al, Type I were 17 cases, Type II were 13 cases, Type IIIA were 9 cases and Type IIIB were 5 cases. All patient received tetanus prophylaxis, and systemic thirty-four with minimal soft tissue injury were closed primarily. The other 10 were initially left open; of these, 7 wounds were allowed to heal secondarily and 3 larger wounds required split skin grafts. The average time to healing of the fracture was 12.9weeks(range 6.9~22.4weeks). The complication included superficial infection(7%), malunion(5%), delayed union(2%), synostosis(2%), and leg length discrepancy(5%): these incidences are similar to those reported in adult. The osteomyelitis, compartment syndrome, and vascular injury didn't developed at any case. The K-wire fixation of open tibia fractures of the childrens is very useful to prevent the displacement and to care for the openwound without the risk of deep infection.

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Analysis of Treatment Outcomes for Open Fractures of the Tibia in Children
Jong-Hyuk Park, Jung Ryul Kim, Dong Hun Ham, Hyung Suk Lee, Sung Jin Shin
Journal of the Korean Orthopaedic Association.2010; 45(6): 440. CrossRef

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Metacarpal Shaft Fracture Treated by Closed Reduction and Percutaneous Intramedullary K-wire Fixationv: Soo Joong Choi, Chang Kyun Lim, Ho Guen Chang, Jun Dong Chang, Chang Ju Lee; J Korean Soc Fract 1998;11(1):100-106. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.100

Abstract PDF: The metacarpal shaft fracture has been reported as a stable fracture relatively, but operative treatment is indicated when there happens reduction loss, or is in need of early exercise. Intramedullary K-wire fixation has been used for unstable transverse or long oblique diaphyseal fracture of the metacarpal bone. The fracture site is not opened and the K-wires are introduced under X-ray control. The techniques can stablize the fracture site and allow immediate exercise postoperatively. We experienced 9 cases of 4th metacarpal shaft fracture treated by percutaneous intramedullary K-wire frxation with modified technique. The K-wire was used one or two ezch metacarpal fracture. The types of fracture were 4cases of transverse, 3 of oblique, 2 of comminuted. The average clinical union period were 5 weeks. There were not severe complications in all cases.

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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
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