• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.207-212
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• 2006

Purpose: To evaluate the results of ankle lateral malleolar fractures classified as Danis-Weber type B accompanying osteoporosis that were treated with lag screw. Materials and Methods: 15 cases of Danis-Weber type B ankle lateral malleolar fractures that had T score of less than -2.5 in BMD(bone mineral density) test were selected from June 2003 to December 2005. 10 cases were males and 5 cases were females with mean age of 59 years. The main injury mechanism was supination and external rotation. Mean follow-up period was 16 months. Clinical and radiologic evaluation was done according to Meyer and Kumler's criteria. Results: All cases showed satisfying result and mean radiologic bone union period was 3 months. Anatomic reduction and bone union was acquired in all cases without complications including wound infection, skin necrosis, delayed union and nonunion Conclusions: Lag screw fixation seem to be excellent treatment of Danis-Weber type B lateral malleolar fractures with osteoporosis as it can minimize soft tissue injury and enable anatomic reduction with firm fixation.

• Journal of Korean Foot and Ankle Society
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• v.2 no.2
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• pp.82-87
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• 1998

The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. And so the goals of operative treatment for ankle fractures are to obtain an anatomical reduction that is maintained by stable fixation, resulting in a healed fracture and recovery of normal function. The 64 patients who had ankle fractures were treated by arthroscopic reduction(20 cases) and open reduction (43 cases) in Konkuk university hospital from February 1991 to October 1997 and the results were analyzed in clinical and radiological aspects. The following results were obtained. According to the criteria of Meyer, arthroscopic assisted reduction group had good or excellent results in 18 cases (90%) and open reduction group good or excellent in 35 cases (83%). The difference of the results was not significant statistically, but arthroscopic assisted reduction technique has several advantages over open technique; the best assessment of articular surface, lower wound problem, postoperatively faster rate of rehabilitation and minor discomfort.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.51-58
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• 1997

The purpose of this study is to evalute the efficacy af the Ilizarov external fixation for the surgical treatment. of the tibial plafond fractures. We reviewed retrospectively fourteen cases of tibial plafond fractures with moderate to severe soft. tissue damage, which were fixed with Ilizarov external fixator. Using the AO Muler classification, there were four Type C1 fractures, six Type C2 and four Type C3. In most, of the cases, the ankles were operated on with other associated fractures within a few days after injury. We reduced the fracture indirectly by soft issue taxis and fixed externally across the ankle joint. using the circular external fixator with tensioned wires and ankle hinge. In cases of inadequate closed reduction, we applied limited open reduction and internal fixation. Range of motion exercise began immediately. Postoperative follow-up averaged fourteen months (ranges, 8-30 months). Overall clinical results rated good or excellent in 7 cases, fair in 4 and poor in 3. There were three cases of pin tract infection which were resolved with short-term antibiotics and local care; one delayed wound closure in a patient. whose fracture was associated with Type III open wound; one wound slough in a patient associated with Type II open wound, which was closed later by skin graft; and one osteoarthritis. From this review, we concluded that cross-ankle circular external fixation with tensioned wires with or without. limited open reduction is a reasonable alternative for the treatment of the tibial plafond fractures with severe soft tissue damage.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.79-86
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• 2012

Calcaneal fractures account for 2% of all fractures and approximately 60 to 70% of tarsal fractures. These fractures typically are the result of high-energy injury, such as a motor vehicle accident or a fall from a height. The potential for disabling malunion following intrarticular displaced calcaneal fracture is high, regardless of treatment. Fracture displacement typically results in loss of hindfoot height, varus and widening of the hindfoot, with possible subfibular impingement and irritation of the peroneal tendon and/or sural nerve. Frequently, subtalar joint develops posttraumatic arthritis. In symptomatic patients with calcaneal malunion, systemic evaluation is required to determine the source of pain. Nonsurgical treatment, such as activity and shoe modification, bracing, orthoses, and injection, is effective in many patients. Surgical treatment may involve simple ostectomy, subtalar arthrodesis with or without distraction, or corrective calcaneal osteotomy. A high rate of successful arthrodesis and of patient satisfaction has been reported with surgical manamgent.

• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.23-27
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• 2013

Purpose: The optimal management for ankle fracture in elderly patients remains controversial. This study was undertaken to review the results of surgical treatment of ankle fracture in the elderly and to compare with other studies. Materials and Methods: The participants in this study were 33 patients over the age of 65(average 71.5 years) who underwent surgical treatment of ankle fracture from January 2004 to December 2011. The study was a retrospective review of outcomes after open reduction and internal fixation (ORIF) of ankle fractures. To measure the clinical outcomes, we assessed postoperative complications, the pre- and post-operative mobility status, fracture union status, the time of fracture union and the AOFAS (American Orthopaedic Foot and Ankle Society) Ankle-Hindfoot scale. The level of patient satisfaction was also identified. Results: Delayed wound healing occurred in three patients(9.1%) but their wounds healed with repeated dressings without additional surgical treatment. Malunion occurred in one patient(3%). One patient(3%) had postoperative infection but healed with antibiotic treatment. 24 patients(96%) returned to preoperative mobility status. VAS score was lower than 2 in all patients. Bone union occurred with the 3.8 months (average months) after the surgery in all patients. Average AOFAS score was 87.4 and these were similar results as other studies of young patients. All patients were satisfied with surgical outcomes according to interviews. Conclusion: Surgical treatment of ankle fractures in the elderly can carry a significant risk of delayed wound healing and infection but incidence is relatively low. Internal fixation of ankle fractures in the elderly can be undertaken safely and the majority of patients can expect good outcome.

• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.79-83
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• 2013

Calcaneus is largest tarsal bone and the fracture of calcaneus is most common tarsal fractures. Calcaneal fractures are divided into extra-articular and intra-articular fractures. Intra-articular calcaneal fractures could be classified as tongue type and joint depression type using simple lateral radiograph (Essex-Lopresti classification), but Sanders suggested new classification according to involving the posterior facet of calcaneus using computed tomography. The involvement of posterior facet was revealed as more complicated than Essex-Lopresti classification. The principle purpose of treatment of calcaneal fractures are restoration of calcaneal height (B$\ddot{o}$hler angle), width, axis, anatomical reduction of joint and restoration of function through the stable fixation. Good visualization of joint and anatomical reduction could be achieved by extended lateral approach. But, skin problem could be occurred after of extended lateral approach.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.153-158
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• 2011

Purpose: This study was performed retrospectively and to compare the clinical outcomes of the surgical management using Antiglide plating and lateral plating for Danis-Weber type B isolated lateral malleolar fractures. Materials and Methods: Between March 2004 and March 2009, 92 patients were followed up for more than 6 months after surgical treatment. 49 patients were treated with Antiglide plating, whereas the remaining 43 patients underwent lateral plating. The results of the two groups were analyzed both radiographically and clinically using Ankle scoring system. Results: Both groups were comparable for age, sex distribution, time to surgery, and operation time. Bone union was noted at average of 8 weeks in all fractures. The mean ankle score was similar in both groups (94% versus 93%). Conclusion: Antiglide plating for Danis-Weber type B isolated lateral malleolar fracture is one of the good methods which has some advantages such as early ankle motion, ambulation and smaller operative incision.

• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.187-194
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• 2011

Ankle injuries may involve the distal tibiofibular syndesmosis and can be associated with a variable degree of trauma to the soft tissue and osseous structures that play an important role in ankle joint stability. Ankle syndesmotic injury may occur solely as a soft tissue injury or in association with variable ankle fractures. Ankle syndesmotic injury does not necessarily lead to ankle instability; however, the coexistence of deltoid ligament injury critically destabilizes the ankle joint. The prevalence of these injuries may be higher than previously reported. The diagnosis of syndesmotic injury as not always easy because isolated ankle sprains may be missed in the absence of a frank diastasis and syndesmotic instability may be unnoticed in the presence of bimalleolar ankle fractures. Controversies arise at almost every phase of treatment includings : type of fixation(screw size, type of implant), number of cortices required for fixation and of need for hardware removal. Regardless of controversies, the most important goal should be restore and maintain the normal tibiofibular relationship to allow for healing of the ligamentous structures of the syndesmosis.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.94-98
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• 2005

Purpose: To compare the radiographic evaluations between two radiographic views (AP and lateral views) and four radiographic views (AP, lateral and both oblique views) in ankle fractures. Materials and Methods: From January 2000 to June 2002, 60 cases of ankle fractures were treated with open reduction and internal fixation and its followed up periods were at least 2 years. All cases were classified into three groups according to the method of preoperative radiographic evaluation. Two radiographic views (AP and lateral views) were taken in group A and four radiographic views (AP, lateral and both oblique views) were taken in group B. 12 Cases were evaluated with three dimensional computed tomography (3D CT). Four radiographic views and 3D CT were taken in group C. All cases were classified according to the Danis-Weber and Lauge-Hansen classification. Displacement of fracture fragment of medial, lateral, posterior malleolus and size of fracture fragment of posterior malleous were measured using picture archiving communication system (PACS). Results: Although kappa value between two or four radiographic views were good or excellent in Danis-Weber classification and Lauge-Hansen classification of ankle fractures, the displacements of medial and lateral malleoli were statistically different. Four radiographic views evalulated the degree of displacement of medial and lateral fragments more accurately compared to two radiographic views. Conclusion: Four radiographic views will be more useful than two radiographic views to decide the method of treatment and operation considering the displacement of fracture fragment.

• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.84-92
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• 2013

Quite high prevalence of acute and chronic complications of calcaneal fractures has been reported. Acute complications include blisters, wound necrosis or infection. Late complications include subtalar arthritis, calcaneal malunion, lateral subfibular impingement, tendon problems, sural nerve complications. There are many surgical or nonsurgical treatment modalities to manage those complications. However strategic initial surgical approach with gentle soft tissue handling accompanied by comprehensive understanding about numerous complications might be the best tool to achieve pain free and functional heel after treating calcaneal fractures.