• Journal of Korean Foot and Ankle Society
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• v.21 no.2
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• pp.70-74
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• 2017

Fractures and fracture-dislocations of the ankle are caused by a variety of mechanisms. In addition to fractures, injuries of soft tissue, such as ligaments, tendons, nerves, and muscles may also occur. Among these, a tibialis posterior tendon injury is difficult to be identified due to swelling and pain at the fracture site. It is difficult to observe tibialis posterior tendon injury on a simple radiograph; it is usually found during surgery by accident. There are some studies regarding irreducible ankle fracture-dislocations due to interposition of the tibialis posterior tendon; however, to the best of our knowledge, there has not been any report about interposition of injured tibialis posterior tendon. Herein, we report a case of an irreducible fracture-dislocation of the ankle due to injured tibialis posterior tendon interposition that was observed intraoperatively, interrupting the reduction of ankle fracture-dislocation. We obtained satisfactory clinical result after reduction of the trapped tendon, fracture reduction, and internal fixation; therefore, we are willing to report this case with the consent of the patient. This study was conducted with an approval from the local Institutional Ethics Review Board.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.94-100
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• 2012

Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.540-545
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• 2021

A transverse fracture is the most common type of displaced patella fracture requiring surgery. These fractures are commonly fixed with parallel Kirschner wires or screws that cross the fracture line, often with an additional tension band. Nevertheless, conventional fixation methods of patella fractures have prevalent complications caused by the protrusion of wires or pins. These complications necessitate additional surgery for hardware removal, increase medical cost, and can limit the function of the knee joint. This paper reports cases treated with a minimally invasive load-sharing percutaneous suture of the patella tendon. The procedure provides reliable fixation for transverse patella fractures, minimizes soft tissue injuries, preserves blood flow, and reduces postoperative pain. In addition, the procedure also reduces the irritation and pain caused by the internal fixture, thereby reducing the risk of restricted knee joint movement.

• Journal of Korean Foot and Ankle Society
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• v.19 no.3
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• pp.86-90
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• 2015

Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

• Journal of Trauma and Injury
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• v.29 no.1
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• pp.22-27
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• 2016

Purpose: The optimal method of fixation of symphysis pubis (SP) diastasis in pelvic ring injuries is still controversial. In this study, we investigated the radiological and the clinical results of a precontoured 4.5-mm symphysis pubis (SP) plate with tension band wiring (TBW) after an anterior pelvic injury in pelvic fractures. Methods: We treated 25 patients with traumatic SP diastasis by open reduction and internal fixation with plates and wires. We used a four-hole 4.5-mm precontoured SP plate with a tension band wiring. Results: Patients with a SP with TBW fixation achieved excellent or good results at final follow-up. Post-operative complications included two (8%) patients with metal work movement. The mean symphyseal width was smaller in 4.5 mm SP plate with TBW during 1-year follow up period. Conclusion: A precontoured symphysis pubis plate (4.5 mm) with figure-of-eight fashion tension band wiring shows favorable radiological results, excellent or good clinical outcome, and a lower complication (hardware failure and revision surgery).

• Journal of Korean Foot and Ankle Society
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• v.21 no.3
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• pp.108-112
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• 2017

The midtarsal joint is composed of the talonavicular and calcaneocuboid joints. It is also known as the Chopart joint. Midtarsal joint fracture and dislocation are relatively rare and frequently missed or misdiagnosed. A proper understanding about the anatomy of the midtarsal joint is an essential part in comprehending the mechanism of injury and rationale for treatment. Anatomical reduction of midtarsal joint with correction of the column in length and shape are important; however, it is technically challenging and may require open procedure. Herein, we described a case of initial open reduction and internal fixation for midtarsal joint fracture and dislocation with a brief literature review.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.227-230
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• 2005

The surgical treatment of craniofacial disorders, using metallic internal osteofixation system has inspired an evolution with advanced operative technique and fixation devices over past two decades. As any other surgical procedures, this procedure also associates problems such as infection, palpability, loosening, and restrict craniofacial skeleton growth, which lead to undue secondary operations for removal. These problems are improved by using bioabsorbable osteofixation system. We compared the patient's subjective symptoms using bioaborbable system versus metallic osteofixation system in zygomatic bone fracture. we should take the individual steps (postoperative 2 weeks, and 1 year) in treating fractured zygoma. From August, 2001 to August, 2003, we used bioabsorbable osteofixation system in 28 patients in zygomatic fracture ($Biosorb^{TM}FX^{(R)}$) and compared 23 patients who were treated with metallic osteofixation system. There was no significant difference in the both groups in subjective symptoms and postoperative result.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.1
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• pp.38-41
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• 2011

After closed reduction and internal fixation with proximal femoral nail for intertrochanteric fracture, some patients complained lateral hip pain. We report two cases of lateral hip pain due to tendinopathy confirmed by ultrasonography.

• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.70-72
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• 2012

Stress fractures of the proximal phalanx of the great toe are rare. This fractures have been associated with halux valgus deformity in most reports. We performed open reduction and internal fixation with distal chevron osteotomy for the stress fracture of the proximal phalanx of the great toe in a basketball player with hallux valgus, and obtained successful bony union and rapid return to sports.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.327-334
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• 2021

A transparotid approach, with a retromandibular or preauricular incision, is an alternative surgical approach for treating a subcondylar fracture and reducing the potential for complications such as injury to the facial nerves. However, retromandibular and preauricular incisions are both created far away from the parotid gland-dissection area. Thus, it is necessary to undermine the skin and retract it anteriorly to access the surgical field. Here, we introduce a modified approach wherein the incision allows for direct access to the fracture site. This approach may be adopted to shorten the incision length, reduce the retraction trauma at the surgical site, and help prevent injury to the facial nerve.