• Journal of Korean Foot and Ankle Society
• /
• v.7 no.1
• /
• pp.119-125
• /
• 2003

Purpose: The purpose of this study fracture. Materials and Methods: The clinical and radiological analysis were performed on 19 cases of the talus neck fractures who had been treated with conservative treatment or variable methods of operative treatment. Each cases followed up more than 1 year and 6 months from May 1989 to June 2001. The clinical results were analyzed according to the age, cause of injury, fracture type of Hawkins classification, associated soft tissue injury, method of treatments, complications, and Hawkins scoring system. Results: According to Hawkins classification, type I was 6 cases(32%), type II was 5 cases(26%), typeIII was 7 cases(37%), and typeIV was 1 case(5%). In all cases, complete bony union was obtained. According to the Hawkins scoring system, 8 cases(42%) were excellent and good. Avascular necrosis was 4 cases(25%). Traumatic arthritis was 10 cases which were occurred in type II, III and IV. An ankle fusion was 1 case. Conclusion: In talar neck fractures, non-displaced fracture treated by the cast immobilization and displaced fracture treated by early open reduction and internal fixation were expected good results. The complications were 77% of traumatic arthritis and 31% of avascular necrosis in type II, III and IV. We should preoperatively explain to the patient for high complication rates of traumatic osteoarthritis and avascular necrosis in the talus neck fractures.

• Clinics in Shoulder and Elbow
• /
• v.24 no.2
• /
• pp.72-79
• /
• 2021

Background: A midshaft clavicle fracture is a common fracture that typically responds well to open reduction and internal fixation (ORIF). However, refracture can occur after implant removal (IR). This study aimed to analyze the rate of refracture and related factors after removal of the locking compression plate (LCP) for displaced midshaft clavicle fractures. Methods: We retrospectively reviewed the medical records of 201 patients who had undergone ORIF with LCP for midshaft clavicle fractures after IR after bony union from January 2011 to May 2018 at our institute. We evaluated basic demographic characteristics and radiographic parameters. All patients were treated with an LCP for primary fracture. The patients were divided into two groups: a refracture group that experienced a second fracture within 1 year after IR and a no-fracture group. Results: There were four cases (1.99%) of refracture; three were treated conservatively, while one was treated surgically. All patients achieved bony union. The average interval between refracture and IR was 64 days (range, 6-210 days). There was a significant difference in classification of fractures (AO Foundation/Orthopaedic Trauma Association [AO/OTA] classification) between the two groups. However, other patient demographics and radiographic measurements between refracture and IR, such as bone diameter, showed no significant difference between the two groups. Conclusions: This study showed that one in 50 patients suffered from refracture after removal of the LCP. Thus, if patients desire IR, the surgeon should explain that there is a relatively higher possibility of refracture for cases with simple or segmental fractures than for other types of fracture.

• Journal of Korean Foot and Ankle Society
• /
• v.8 no.1
• /
• pp.46-51
• /
• 2004

Purpose: Problematic late sequelae are common following a calcaneal fracture regardless of the initial treatment. We retrospectively evaluated the painful conditions and reviewed the results of the operative treatment in patients with previously treated calcaneal fractures. Materials and Methods: Between October 1996 and September 2001, forty-three patients who underwent subsequent surgical treatment for late sequelae of calcaneal fracture were reviewed. The initial treatment consisted of only immobilization in a cast in 7 patients, closed reduction with pin fixation (Essex-Lopresti technique) in 22 and open reduction and internal fixation in 14. Painful conditions in the hind foot included subtalar arthritis in 31 patients, calcaneofibular impingement in 13, peroneal tendinitis in 6, displaced posterior bony fragment in 3, sural neuritis in 2, subtalar and midtarsal arthritis in 1 and displaced plantar bony fragment in 1. The surgical procedures for the late complications were performed at a mean of 19 months (range, 6 to 35 months) after the injury and consisted of lateral wall ostectomy and in situ subtalar fusion in 28 patients, only lateral wall ostectomy in 5 patients, lateral wall ostectomy and subtalar distraction arthrodesis in 3, removal of displaced posterior bony fragment in 3, sural nerve transposition in the peroneus brevis in 2, triple arthrodesis in 1 and removal of displaced plantar bony fragment in 1. Mean postoperative follow up period was 57 months (range, 33 to 82 months). The results of treatment were evaluated on the basis of pain, improvement in the ability to perform activities of daily living, to return to work or to a pre-injury level of activity. Results: Pain was partially relieved in 38 patients (88%), but not relieved in 5. Function improved in 34 patients (79%), and 32 (74%) returned to work or to a pre-injury level of activity. There was a trend that the longer the interval between the injury and the operation, the longer the subsequent interval until the patient returned to full activities or work. Conclusion: Meticulous physical examination and intensive prompt treatment for remaining pain after initial treatment of calcaneal fractures are recommended for patient's satisfaction and returning to work.

• Journal of Korean Foot and Ankle Society
• /
• v.17 no.4
• /
• pp.325-328
• /
• 2013

Fracture of os peroneum can occur, but the fracture fragments are seldom displaced. Complete rupture of peroneus longus through the fracture of the os peroneum causing displacement of the fracture fragments is not well reported in the literature. Differential diagnosis with bipartite os peroneum or calcific tendinitis is important because misdiagnosis of the tendon rupture can lead to serious sequela including chronic pain, ankle instability, and peroneal compartment syndrome. We report a case of complete rupture of peroneus longus associated with fracture of the os peroneum with a review of the literature.

• Journal of Korean Foot and Ankle Society
• /
• v.3 no.1
• /
• pp.58-61
• /
• 1999

Isolated fracture dislocation of the tarsal navicular bone is extremely rare. The mechanism of injury of this fracture dislocation is known as a horizontal or axial load on plantar flexed foot. Closed or open reduction is recommended for displaced navicular fracture. We report one case of isolated fracture dislocation of the tarsal navicular which was treated with closed reduction and percutaneous K-wire fixation.

• Journal of Korean Foot and Ankle Society
• /
• v.11 no.2
• /
• pp.221-225
• /
• 2007

Purpose: To evaluate the clinical results of operative treatment of the intra-articular calcaneal fracture with injectable calcium sulfate ($MIIG^{TM}$). Materials and Methods: Between March 2004 and October 2006, a total 19 intra-articular calcaneal fracture (16 patients) with a large bony defect that underwent operative treatment with plate fixation and injectable calcium sulfate ($MIIG^{TM}$) with minimum follow-up of one year following. The mean age at time of surgery was 44.7 years (23 to 54). All of the cases were type 2 and 3 on the basis of Sanders classification. The lateral L shaped approach was used in all cases. Full weight bearing on the affected extremity was regained at an average 10 weeks postoperatively. Results: The mean Bohler angle was improved from $2^{\circ}$ ($-18.5{\sim}12.5^{\circ}$) preoperatively to $23.8^{\circ}$ ($12{\sim}37.5^{\circ}$) and the angle at last follow-up was $22.5^{\circ}$ ($11.5{\sim}37.5^{\circ}$), showing about 0.3 degree decline compared to postoperative Bohler angle. Only two case of whitish leakage of graft material but other complication were none. Conclusion: $MIIG^{TM}$ augumentation of displaced intra-articular calcaneal fracture with large bone defect seems to bo useful method for initial stabilized and plate fixation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.2
• /
• pp.145-148
• /
• 2010

Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.

• Clinics in Shoulder and Elbow
• /
• v.27 no.1
• /
• pp.39-44
• /
• 2024

Background: Displaced olecranon fractures constitute a challenging problem for elbow surgeons. The purpose of this study is to evaluate the role of suture anchor fixation for treating patients with displaced olecranon fractures. Methods: A retrospective review was performed for all consecutive patients with displaced olecranon fractures treated with suture anchor fixation with at least 2 years of clinical follow-up. Surgical repair was performed acutely in all cases with nonmetallic suture anchors in a double-row configuration utilizing suture augmentation via the triceps tendon. Osseous union and perioperative complications were uniformly assessed. Results: Suture anchor fixation was performed on 17 patients with displaced olecranon fractures. Functional outcome scores were collected from 12 patients (70.6%). The mean age at the time of surgery was 65.6 years, and the mean follow-up was 5.6 years. Sixteen of 17 patients (94%) achieved osseous union in an acceptable position. No hardware-related complications or fixation failure occurred. Mean postoperative shortened disabilities of the arm, shoulder, and hand (QuickDASH) score was 3.8±6.9, and mean Oxford Elbow Score was 47.5±1.0, with nine patients (75%) achieving a perfect score. Conclusions: Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes. Additionally, this technique resulted in high rates of osseous union without any hardware-related complications or fixation failures.

• The Academic Congress of Korean Shoulder and Elbow Society
• /
• 2009.03a
• /
• pp.200-201
• /
• 2009

• Archives of Plastic Surgery
• /
• v.38 no.2
• /
• pp.161-165
• /
• 2011

Purpose: Zygomaticomaxillary complex (ZMC) fracture is one of the most common facial injuries after facial trauma. As ZMC composes major facial buttress, it is a key element of the facial contour. So, when we treat these fractures, the operator should have a concern with the symmetry to restore normal appearance and function. But sometimes, unfavorable results may occur. The aim of this study is to analyze the unsatisfied midfacial contour after ZMC fractures reduction retrospectively and to point out the notandum. Methods: 369 patients, treated for fractures of the ZMC were included in the study. After the operation, such as open reduction and internal fixation (ORIF with titanium or absorbable materials), open reduction, and closed reduction, midfacial contour was evaluated with plain films and 3-dimensional computed tomography. And unfavorable asymmetric midfacial contours were correcterd by secondary correction and re-evaluated. Gross photographs were obtained at outpatient clinic. Results: Total of 38 patients had got a facial asymmetry and among of them 24 patients were treated secondary revisional ORIF operations for correction of unfavorable result of after primary reduction. Two of them had received tertiary operations, three patients had got osteotomy more than after one year and six patients had got minor procedures. The etiology of asymmetry were lateral displaced simple fracture of arch (n=2), lateral displaced comminuted fracture of arch (n=6), comminuted arch fracture combined posterior root fracture (n=9), and communited arch and body fracture (n=12), severely contused soft tissue (n=9). After the manipulations outcomes were acceptable. Conclusion: To prevent the asymmetry in ZMC fracture reduction, complete analysis of fracture, choice of appropriate operation technique, consider soft tissue, and secure of zygoma position are important. Especially, we should be more careful about communited fracture of zygomatic body and lateral displacement, root fracture of zygomatic arch. Because they are commom causes that make facial asymmetry. To get optimal result, ensure the definite bony reduction.