Journal of Musculoskeletal Trauma

Treatment for Intractable Infected Nonunion of Lower Extremity in Elderly People using External Fixator: Seung Jun Park, Jong Sup Shim, Sung Kee Shin; J Korean Fract Soc 2004;17(2):177-183. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.177

PURPOSE
To introduce and report the results of treatment of old patients' infected nonunion using external fixator.
MATERIALS AND METHODS
Nine patients more than 60 years old were included in the study. Four cases had combined medical problems of diabetes, hypertension, and vascular disorder. We used Ilizarov fixator in eight cases and uni-lateral external fixator in one. All patients were treated with debridement, broad sequestrectomy, segmental resection, bone graft and compression of fracture site about 1~1.5 cm. We evaluated the final results by functional result and complication according to the criteria of Paley.
RESULTS
Average length discrepancy was 1.7 cm before operation by initial bone loss and final follow-up shortening was average 2.6 cm. Mean duration of fixtor removal was 5.2 months. We acquired bony union lastly in 8 cases. Final functional result was 3 excellent, 2 good, 2 fair and 2 poor. Among them, 2 good, 1 fair and 1 poor cases had medical problem.
CONCLUSION
In old patients, compression of nonunion site and early joint motion using external fixator seemed to be very useful in the treatment of intractable infected nonunion of lower extremity and in minimizing duration of treatment.

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

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Treatment of the Children's Femur Shaft Fracture by Early Spica Cast: Kwang Hoon Chung, Jong Sup Shim, Ki Sun Sung, Seung Jun Park; J Korean Soc Fract 2003;16(2):270-277. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.270

Abstract PDF

PURPOSE
To investigate the proper indication, technical point and complication of the early hip spica cast.
MATERIALS AND METHODS
Thirty-one children with thirty-two fractures more than 2-year follow up were included. The patient's average age and weight were 5 year 2 months and 19.1 Kg respectively. Spica cast was applied as follow. First short leg cast was applied, and then patient was placed on the spica cast table. During the cast incorporation, the hip and knee flexed sufficiently to maintain length and alignment of the fracture, and popliteal fossa was well molded and padded. The meticulous valgus molding of the fracture site was also needed.
RESULTS
Average bayonet overriding of the fracture was initially 1.1 cm, however it increased to 1.5 cm during cast immobilization. In the 9 patients (28.1%), cast wedging correction were needed to 3 to 14 days after initial cast immobilization and the cause of correction was related to patients weight. At the final follow up, there was no serious functional or cosmetic complications.
CONCLUSION
For the successful treatment, the proper patients selection, meticulous cast application and careful radiographic assessment after cast application were needed.

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Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture
Suk Kang, Jong Pil Kim, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Sang Ho Lee, Jin Wook Chung
Journal of the Korean Fracture Society.2007; 20(4): 339. CrossRef

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Treatment of Intraarticular Calcaneal Fractures using Ilizarov Exteranl Fixation: Byeong Yeon Seong, Dong Seong Park, Seung Jun Park, Sang Wook Kim; J Korean Soc Fract 1998;11(3):591-596. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.591

Abstract PDF

Open reduction and internal fixation (ORIF) is gaining in popularity as method of choice for the treatment of displaced intraarticular calcaneal fracture since diagnosis and classification of computed tomography have become routine. But early weight-bearing cannot be allowed by convertional ORIF, and delayed weight-bearing may contributed to heel had pain and dystrophy. We performed combined technique of limited internal fixation and Ilizrov external fixation to ten-cases of displaced intraarticular calcaneal fractures, between February 1994 and February 1996. The follow-up period in this study was at least two years. This method can provide not only anatomical reduction, but also stable fixation. None of patients complained of heel pad pain, which was attributed to the desensitization of the heel by early weight-bearing. None of patients went on to late collapse of the posterior facet. clinical results were rated as excellent in six, good in three, and fair in one case. Pin-track infection, complicated operative technique, cumbersomeness and expensiveness of the external fixator itself were shortcomings of this method. We consider this method as one of options for the treatment of displaced intraarticular calcaneal fracture.

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A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture
Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 13. CrossRef

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Operative Results in AO Type C3 of Tibial Pilon Fracture: Limited Internal Fixation and Hybrid External Fixation: Byeong Yeon Seong, dong Seong Park, seung Jun Park, Sang Wook Kim, Taek Geon Lee; J Korean Soc Fract 1998;11(3):576-584. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.576

Abstract PDF: The intraarticular fractures of the distal tibia has been the most difficult problem due to severe comminution of itself, little bone mass and poor circulation of soft tissue. Recently limited internal fixation with hybrid external fixation has been reported to provide a good clinical results for the severely commnuted or open pilon fractures as a AO type C3. From February 1994 to February 1996, the authors analyzed the clincal and radiological results of 2 year follow-up in 7 cases of the AO type C3 pilon fractures who were treated with combination of limited internal fixation and hybrid externalfixation. 6 cases had good or excellent clinical and radiological results without any serious complications such as skin sloughs, skin infection, malunion and nonunion, but one case had a nonunion who were treated with internal fixation and autogenous iliac bone graft. We believe that the combination of limited internal fixation and hybrid external fixation that does not cross the ankle joint, provides the good clinical results in AO type C3 pilon fractures by early ankle joint motion.

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The Treatment of Comminuted Fractures of Distal Humerus with Rigid Internal Fixation and Early Motion: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Joo Hyung Lee, Seung Jun Park; J Korean Soc Fract 1998;11(1):28-33. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.28

Abstract PDF

Comminuted fractures of distal humerus are difficult fracures to treat because of their rarity and associated significant comminution. The results of managing theses fractures non-operatively are limited by failure to get anantomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudoarthrosis. The goals of open reduction are to preserve articular surface and restore elbow function. Hence an operative management with anatomical reduction of fragments becomes the treatment of choice for these fractures. Authors analyzed 17 patients, with 30 months follow-up on an average, who were treated with open reduction and rigid internal fixation followed early mobilization during the period from jan. 1991 to Dec. 1996. Following results were obtained. 1. According to the Muller's classification, type A was 4 cases(23.5%), type B was 4 (23.5%), and type C was 9(53%) 2. Excellent or good results were obtained in 12 cases(71%) by the criteria of Aitken and Rorabeck. 3. There were limitation of full extension over 5degreein all cases and no other severe complications causing disability of elbow.

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Treatment for the Supracondylar Fractures of the Distal Humerus with Cannulated Screw
Jin Soo Park, Young Khee Chung, Jung Han Yoo, Kyu Cheol Noh, Kook Jin Chung, Dong Nyoung Lee
Journal of the Korean Fracture Society.2007; 20(1): 58. CrossRef

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The Clinical Result of Operative Treatment of the Comminuted Patellar Fractures : A Comparison of Clinical Results According to the Operative Methods and the Postoperative Cares: Byeong Yoen Seong, Jong Hoon Lee, Seung Jun Park; J Korean Soc Fract 1997;10(3):604-613. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.604

Abstract PDF: Approximately one third of patellar fractures require surgery and stellate and comminuted frachres of the patella has been increased. Operative treatment of the patella should be achieved to ensure continuity of the extensor mechanism, to preserve patellar function and reduce the incidence of complications related to articular fracture. Various techniques of internal fixation have been recommended for comminuted fracture of De patella, but there are some complications including loss of fragment position, reoperation, nonunion, loss of range of motion and loss of extensor mechanism strength. The evaluation of the clinical results in rigid fixation group which was made postoperative excercise from postoperative 2 weeks without cylinder cast application, was needed for the purpose whether or not to decrease those complications. We reported 46 cases of comminuted patellar fracture who were operated various methods with or without cylinder cast as postoperative care, from Jun 1990 to Dec 1995 at the department of orthopaedic surgery, Dongrae Bongsaeng hospital. In conculsions, rigid fixation as using Kirschner wires with modified anterior tension band and a circumferential wiring and early motion without cylinder cast for the comminuted patellar could be increased the fusion rate and range of motion and recovered function of the knee joint.

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