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J Musculoskelet Trauma : Journal of Musculoskeletal Trauma

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Chang Hwan Han 2 Articles
Nerve injuries complicating Monteggia lesion
Jae Duk Ryu, Chang Hwan Han, Weon Yoo Kim, Jin Hyung Sung, Jin Ho Jung, Jin Young Kim
J Korean Soc Fract 2000;13(3):591-596.   Published online July 31, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.3.591
AbstractAbstract PDF
PURPOSE
Concerns on the Monteggia lesion was concentrated on the injuries to the bone parts and largely ignores the soft tissues and the nerves in particular. We reviewed injured nerve, treatment and prognosis in the Monteggia lesion associated with nerve injury.
MATERIALS AND METHODS
From January 1990 through November 1999, 26 patients with Monteggia lesions have been treated: six of these patients had associated with nerve injuries. The age of injured patients ranged from 9 to 67 years with an average of 25.5 years.
RESULTS
All could be classified as Type 1 of Bado(anterior dislocation of the radial head), and four injuries were open and two were closed. two patients had radial-nerve palsy and four patients had posterior interosseous-nerve palsy, one of them with associated ulnar-nerve palsy. The fifth patient demonstrated complete spontaneous recovery. One patient with posterior interosseous nerve injury was absence of spontaneous return of function within 12 weeks after injury, exploration and neurolysis was performed. Complete recovery of posterior interosseous nerve function occurred in 14 weeks after exploration.
CONCLUSION
Monteggia lesions can be reduced early with ease under general anesthesia and, if necessary, even under local anesthesia. Spontaneous recovery of nerve function may occur within 12 weeks; in the absence of electromyographic or clinical evidence of return of nerve function within 12 weeks, exploration and neurolysis is indicated.
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Autogenous bone marrow injection for the treatment of delayed union of the long bone
Jin Hyung Sung, Jae Duk Ryu, Weon Yoo Kim, Chang Hwan Han, Eui Young Ohm, Jin Young Kim
J Korean Soc Fract 1999;12(4):1071-1076.   Published online October 31, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.4.1071
AbstractAbstract PDF
It is known that the Salter-Harris type I and II fractures of the distal tibial epiphysis usually For resolving problems of delayed union and non-union of long bones, many efforts was made such as autogenous graft, allogenic or artificial bone graft and electrical stimulation, but there were many complications and not sufncient fracture healing process. The purpose of this study was to investigate the effect of autograft with bone marrow on the repair or bone formation of delayed union by the serial radiogram and clinical examination. We evaluated thirty nine patients which had been treated for long bone fracture, to whom bone marrow injection was made between 3 months and 13 months after adequate fixation(average.4.8months). After bone marrow injection, clinical follow up period was from 15 months to 35 months(average 26.7months). The age distribution was from 18 years to 84 years(average 42). A total of 100- 150cc of marrow was injected at the nonunion site immediately after aspiration under the C-arm. Of 39 cases, there were improved bone healing process of 30 cases(77%) by radiographically and clinically, Of 9 cases without improvement, 5 cases were due to loosening of external fixator, 2 cases was due to chronic osteomyelitis and other 2 cases was unknown origin. No serious complications were observed other than no improvement. Although percutaneous bone marrow injection does not promote healing more rapidly than would standard operative bone grafting, it has many distinct advantages over the latter. It is safe, easy, and time saving. It is economical and involves minimal trauma. It can be done under local anesthesia and avoids the risks of general anesthesia, infection and surgery. It can be done in cases which are not fit for open bone grafting because of poor condition of the skin.
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