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Anteromedial force to the knee in an extended position can cause an avulsion fracture of the proximal fibula with combined injuries to the posterolateral ligaments. Avulsion fractures of the proximal fibula are rare and current management of these fractures is based on few descriptions in literature. Various surgical methods of fixation for these fractures have been reported, but there is still no standard treatment modality. Anatomic reduction of these fractures is technically difficult, and failure of reduction may cause posterolateral instability, secondary arthritis and other complications. We present our experience with two such cases of comminuted avulsion fractures of the proximal fibular with posterolateral ligament ruptures surgically fixated with a locking compression hook plate and non absorbable sutures.
Arthritis ; Collateral Ligaments ; Fibula ; Knee ; Ligaments ; Rupture ; Sutures

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Heterotopic Ossification around Patellar Tendon Following Treatment of Patellar Fracture: A Case Report.

Sang Jin LEE ; Ji Wan KIM ; Dong Hyun LEE ; Jae Young LIM

Journal of the Korean Fracture Society.2013;26(1):73-76. doi:10.12671/jkfs.2013.26.1.73

Heterotopic ossification around the patellar tendon is known to be extremely rare. A 42-year-old man had a transverse fracture of the left patella. Open reduction and tension band wiring were performed. At four weeks, plain radiographs showed an extensive ossification around the patellar tendon and the patient presented limitation of flexion and pain in kneeling position. We just encouraged active and passive ranges of motion exercises and performed one manipulation under anesthesia. At the final follow-up (10 months post-operatively), he was able to flex his knee by 140 degrees. We present a case of heterotopic ossification around the patellar tendon with limitation of knee flexion that was successfully treated with nonoperative treatment.
Anesthesia ; Exercise ; Follow-Up Studies ; Humans ; Knee ; Ossification, Heterotopic ; Patella ; Patellar Ligament

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A Case of Surgically Treated by Transperitoneal Approach in Delayed Neurological Deficit after Sacral Fracture: A Case Report.

Young Soo JANG ; Jong Seok LEE ; Jae Hyuk CHOI ; Sung Ju BAE ; Chan Il BAE

Journal of the Korean Fracture Society.2013;26(1):69-72. doi:10.12671/jkfs.2013.26.1.69

This study reviews a case of sacral fracture with delayed onset neurological deficit that showed good results after decompressive surgery. The delayed neurological deficit appeared at 4 weeks after injury and it was treated with anterior decompression through transperitoneal approach. A 23-year-old woman was injured in a car accident and had bilateral pubic rami fractures and fractures of the sacral ala on the right side. She was treated with external fixation devices for approximately four weeks, but complained of pain and numbness. The dorsiflexion and plantalflexion of the right ankle was weakened and graded as grade 2. Preoperative pelvic and sacral radiographs, computed tomography, magnetic resonance imaging and electromyelography, and nerve conduction study were performed to identify the region of neurological deficit, and we decided to implement neurological decompression. By transperitoneal approach, we performed bone curratage and decompression around the region of sacral alar slope and S1 foramen. The pain and numbness of the right foot cleared up. Dorsiflexion and plantalflexion of the right ankle improved to grade 5. Anterior decompression by transperitoneal approach proved to bring satisfactory results in a patient, who presented delayed neurological deficit after sacral fracture.
Animals ; Ankle ; Decompression ; External Fixators ; Female ; Foot ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Neural Conduction ; Succinates

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Interposition of Extensor Pollicis Longus Tendon in Smith's Fracture in a Child: A Case Report.

Seung Ju JEON ; Haeng Kee NOH ; Do Yeon KIM ; Sung Hoon JUNG ; Jun Beum SHIN ; Ho Seung JEON

Journal of the Korean Fracture Society.2013;26(1):65-68. doi:10.12671/jkfs.2013.26.1.65

Entrapment of the extensor pollicis longus tendon is reported rarely on Smith's fractures in children. In our case, a 15 year old boy with Smith's fracture received treatment of closed reduction at another hospital. When he visited our hospital, a wide gap at the fracture site was detected on radiograph and the thumb movement was limited. We have doubt the entrapment of the soft tissue, especially the tendon. We decided on open reduction. In the operation field, entrapment of the extensor pollicis longus tendon at the gap of the fracture site was found through dorsal approach. In addition, fracture treatment with K-wire fixation after reduction of extensonr pollicis longus tendon reduction was done. Therefore, we report this case with a review of the literatures.
Child ; Humans ; Tendons ; Thumb

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Costoclavicular Syndrome Secondary to Nonunion of a Displaced Fracture of the Clavicle, Misdiagnosed as a Simple Muscle Strain: A Case Report.

Ho Seung JEON ; Haeng Kee NOH ; Seo Goo KANG ; Jong Min KIM ; Seung Ju JEON

Journal of the Korean Fracture Society.2013;26(1):60-64. doi:10.12671/jkfs.2013.26.1.60

Thoracic outlet syndrome is a relatively common disease. However, costoclavicular syndrome as a condition secondary to nonunion of a displaced fracture of the clavicle is very rare. Most clavicular fractures in adults are united with no or minimal persistent symptoms. Also, symptomatic nonunion of a displaced fracture of the clavicle is rare. A 55-year-old male initially presented with persistent forearm pain after slip-down was initially diagnosed with simple muscle strain. However, he was given a delayed diagnosis of costoclavicular syndrome, caused by compression of the subclavian artery due to trauma in the fibrotic nonunion of the right clavicle without apparent symptoms. We obtained satisfactory results by surgical treatment. Here we report this case with a review of the literature.
Adult ; Clavicle ; Delayed Diagnosis ; Forearm ; Humans ; Male ; Muscles ; Sprains and Strains ; Subclavian Artery ; Thoracic Outlet Syndrome

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Treatment of Traumatic Posterior Dislocation of the Sternoclavicular Joint: A Case Report.

Dong Hee KIM ; Do Hoon KIM ; Seok Kwon KANG ; Eui Chul LEE

Journal of the Korean Fracture Society.2013;26(1):56-59. doi:10.12671/jkfs.2013.26.1.56

Compared with acromioclavicular dislocation, dislocation of the clavicle at its sternal end is uncommon and accounts for 3% of all injuries to the shoulder girdle. Furthermore, the posterior dislocation of the sternoclavicular joint is relatively a rare injury compared to the other types of sternoclavicular dislocation. We report this case since we have experience with similar cases of traumatic posterior dislocation at the sternoclavicular joint, which were successfully treated with x-ray guided reduction.
Clavicle ; Dislocations ; Shoulder ; Sternoclavicular Joint

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Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques.

Oog Jin SHON ; Ji Hoon SHIN ; Chul Wung HA

Journal of the Korean Fracture Society.2013;26(1):50-55. doi:10.12671/jkfs.2013.26.1.50

PURPOSE: We evaluated the clinical outcomes of tibia segmental fractures treated by intramedullary nailing using various reduction techniques. MATERIALS AND METHODS: From January 2003 to June 2009, 18 segmental tibial fracture patients treated by intramedullary nail were enrolled with a minimum 12-month follow-up. The mean follow-up was 38 months (range 15-72). According to the AO classification, the fractures were types 42C2.1, 42C2.2, and 42C2.3 in four, ten, and four patients, respectively. Ten fractures were closed and eight were open. We used various techniques for reduction during operation and investigated bone union time and complication (non-union, malunion etc.). RESULTS: Bone grafting was performed in three patients. Complete union was achieved in all patients. The mean time for union was 16.3 weeks (range 12-21), except in three delayed union patients. All radiological evaluations showed good alignment (less than 5 degree) except in two patients; and the mean deformity angle was 2.2 degree. Knee range of motion (ROM) was 129 degree, and ankle ROM was 68 degree. Local wound infection occurred in two patients. CONCLUSION: Intramedullary nailing is a successful method in the acute management of segmental tibial fractures, if accompanied by appropriate reduction technique.
Animals ; Ankle ; Bone Transplantation ; Congenital Abnormalities ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Knee ; Nails ; Range of Motion, Articular ; Tibia ; Tibial Fractures ; Wound Infection

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A Comparison between Compression Hip Screw and Intramedullary Nail for the Treatment of AO/OTA A2.2 Intertrochanteric Femoral Fracture.

Phil Hyun CHUNG ; Suk KANG ; Jong Pil KIM ; Young Sung KIM ; Ho Min LEE ; Jong Hyun KIM

Journal of the Korean Fracture Society.2013;26(1):44-49. doi:10.12671/jkfs.2013.26.1.44

PURPOSE: To compare the result between the compression hip screw (CHS) and intramedullary (IM) nail for the treatment of AO/OTA A2.2 intertrochanteric fracture. MATERIALS AND METHODS: We retrospectively reviewed 95 cases of AO/OTA A2.2 intertrochanteric fracture, which were treated with CHS or IM nail by one surgeon from March 1994 to December 2009. One group was treated with CHS (Group I, 28 cases) and the other was treated with IM nail (Group II, 67 cases). We evaluated the mean operation time, the amount of bleeding and transfusion, hospital duration, radiological results and the clinical outcome with the mobility score of Parker and Palmer. RESULTS: Radiologically, the tip-apex distance, change of neck-shaft angle, and union time were not significantly different between both groups (p>0.05). Clinically, the mean operation time, the amount of bleeding and transfusion, hospital duration and the mobility score were not significantly different (p>0.05). The post-operative complications were lag screw slippage over 25 mm (1 case) and loosening of device (1 case) in group I. In group II, there were perforation of the femoral head (1 case), nail breakage (1 case) and deep infection (1 case). CONCLUSION: There was no significant differences that are clinical and radiological results in the treatment of AO/OTA A2.2 intertrochanteric fracture, using CHS and IM nail.
Femoral Fractures ; Femur ; Fracture Fixation, Intramedullary ; Head ; Hemorrhage ; Hip ; Hip Fractures ; Nails ; Retrospective Studies

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