Journal of Musculoskeletal Trauma

Hong Jun Han

12 Articles

Hybrid External Fixation and Limited Internal Fixation for Severe Open Tibial Shaft Fractures: Hong Jun Han, Soo Uk Chae, Ul Oh Jeung; J Korean Soc Fract 2003;16(1):52-58. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.52

Abstract PDF: PURPOSE
To evaluate the radiographic and clinical results of severe open tibial shaft fracture treated by hybrid external fixation and limited internal fixation.
MATERIALS AND METHODS
We reviewed 25 patients open tibial shaft fracture(> or =Gustillo classification type II) which were treated with hybrid external fixation(AnyFixR) that was invented by authors and limited internal fixation between June 1998 to June 2001. 20 males and 5 females were minimum follow up period of 12 months(12-27 months). The mean age was 45 old years(11-72 old years). The results were based on the assessment radiographical analysis with duration of bony union, delayed union including of states of nonunion and malunion, clinical analysis with pain, joint range of motion, wound infection and skin & soft tissue coverage. All fractures were classified according to the Gustilo classification, there were 6 cases of type II, 9 cases of type IIIa and 10 cases of type IIIb. The cause of injury, there were 18 cases of motor vehicle accident, 5 cases of direct trauma and 2 cases of fall from height.
RESULTS
In twenty-five cases, fifteen had union, the average time of bone union was 6.8 months and additional bone graft without change of external fixator performed in ten cases, but one case have failed and then change of intramedullary nail with bone graft. In the group of bone graft, bone union was completed at mean 8.7 months. According to the clinical analysis, no pain in the fracture site, in complications, there were 2 cases of mild joint range of motion that has acceptable result and 2 cases of wound infection were treated with effective antibiotics theraphy and wound dressing. Five cases need to coverage of the open wound, 3 cases were flap operation and each case were muscle transfer, skin graft without change of external fixator.
CONCLUSION
The use of hybrid external fixation and limited internal fixation in severe open tibial shaft fracture to be successful for the stabilization of fracture and subsequent plastic and/or orthopaedic procedure for muscle and skin coverage, bone grafting are more easily accomplished without change of external fixator.

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Hybrid External Fixation for Periarticular or Segmental Fractures of Tibia: Hong Jun Han, Yeung Jin Kim, Jae Myoung Kim; J Korean Soc Fract 2001;14(1):44-51. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.44

Abstract PDF: PURPOSE
To analyze the clinical outcomes of the hybrid external fixation which is more comfortable and simply appliable than Ilizarov fixator MATERIAL AND METHOD: 28-patients of periarticular or segmental tibia fracture from may 1998 to october 1999 were treated with hybrid external fixator (AnyFixÂ®)that was invented by authors. It consists of two rings at epiphysis(full or 2/3 ring), 3 or 4 rods connecting 2 rings, K-wires, half pins, and specially designed push pins and crane pins which can be used as a reduction device and fixation pins. And it was used as a definitive modality. Joint exercise was started immediately after operation and partial weight bearing was permitted 4 weeks after initial application.
RESULT
The average time of bone union was 4.7 months, articular step-off of all cases were less than 1 mm. As a complication, there was no limitation of range of motion except one case of 10Â° dorsiflexion limitation of the ankle, and 1 case of deep wound infection. Clinical assesments of knee and ankle joint showed 14 cases of excellent, 9 cases of good, 3 cases of fair in total 26 cases of proximal or distal tibia fracture except 2 infected non-union.
CONCLUSION
Hybrid external fixation is effective method for periarticular or segmental tibia fracture and it gives simple applicability, firm stability and much less discomfort.

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Mechanical Properties of External Fixator according to Its Arrangement and Structure: Hong Jun Han, Byung Chang Lee, Yeung Jin Kim, Byung Soo Jin, Gun Hyee Lee; J Korean Soc Fract 2000;13(1):38-45. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.38

Abstract PDF: PURPOSE
To obtain the accurate knowledge of the fundamental mechanical properties of the external fixator affected by variations in arrangements and structures. We used newly developed external fixator, Anyfix, universal testing machine and plastic padding bone model which had similar structural properties to human tibia. The measured performance for seven different configurations of external fixators was its ability to control the motion of the bone fragment at the fracture site. Based on a unit of applied load, the corresponding displacement measured at the fracture site was used to described the stiffness of the fixation device for each load. Three stiffness moduli can be determined as axial stiffness, anterior posterior bending stiffness and lateral bending stiffness.
RESULTS
In basic configuration, all three stiffnesses for unilateral two plane external fixator showed marked increase than those for unilateral one plane model. Axial compression stiffness and bending stiffness were increased when ring component were located far from the fracture site. In modified configuration, all three stiffnesses were increased when the number of pin was increased and small sized ring was used.
CONCLUSION
The stiffness of the external fixator can be substantially increased by using unilateral two plane, locating the ring at far portion from the fracture site, using a small sized ring and increasing the number of pins.

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Proximal Tibiosbular Fracture associated with Popliteal Artery Injury: Sang Soo Kim, Hong Jun Han, Dong Churl Kim, Dae Ho Ha, Hee Jun Yoo, Suk Kyun Park; J Korean Soc Fract 1999;12(4):885-893. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.885

Abstract PDF: Injury to the popliteal artery results in amputation more frequently than any other arterial injury. The major factor in the amputated limbs was a delay in diagnosis and therapy of the arterial injury associated with blunt trauma. The proximal tibial fractures produced the highest percentage of vascular complications and indicated immediate application of therapeutic measures. The purpose of this study is to investigate the long-term results and factors that influences the results of surgical treatment in patients with combined proximal tibial fracture and popliteal artery injury. Authors reviewed the records of 24 cases treated for this injury between January 1984 and May 1997. The age of the patients ranged from 17 to 70 years(average 45 years). Nine patients presented with life threatening injuries and classical signs of acute limb ischemia. Prolonged ischemic time ranged from 3 to 6 hours 30 minutes(average 4 hours 50 minutes). The most common cause of thoses injury was traffic accident in 16 cases. Five cases had neurologic deficit ; significant soft tissue injury was present in 14 extremities. Vascular procedures included saphenous vein interposition, end-to-end anastomosis, etc. Bony procedures were accomplished by external means in 14 cases and the others treated by immediate internal fixation in 5 cases. Intraoperative fasciotomy was performed in 5 patients with lower limb ischemia. The results suggested that limb salvage was possible in 63 percent of patients with combined proximal tibial fracture and popliteal artery injuries, but a history of life-threatening condition and severe associated injury with vascular compromise was an unfavorable prognostic factor. So a well organized multidisciplinary approach is necessary to ensure life and functional limb salvage.

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Modified Dual Onlay Graft for Nonunion of the humeral Shaft: Dae Ho Ha, Hong Jun Han, Jeong In Song; J Korean Soc Fract 1998;11(3):703-708. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.703

Abstract PDF: There have been some difficulties in treatment of nonunion of the humeral shaft with osteoporosis. We report here the results on the treatment of nonunion with osteoporosis by using modified dual onlay graft method. The six cases among 34 nonunions of humeral shaft were operated by modified dual onlay graft. Initial treatments were applied one hanging arm cast, two plate fixations, three intramedullary nailings. In the 3 cases of them, we performed plate fixation and bone graft as secondary treatment. However, nonunion occurred with loosening of fixation. Modified dual anlay graft was applied from 6 to 36 months )average 12 months) after fracture of humerus. The proximal and distal humeral nonunion surface was made decorticated and flattened, and then reduction was performed. On the lateral side of nonunion site, 6 holes plate was fixed and on the medial side, fixed with 5~9 cm cortical bone which was harvested from proximal tibia. Cancellous bone graft was performed around nonunion area. Long arm splint was done for 2~4 weeks after operation. The union period was in the range of 3.5~6 months (average 4.9 months) in all six cases. Quicker bone union was achieved as the bone block got longer and the number of the fixation screw increased. We conclude that modified dual onlay graft method is the one of effective methods to treat nonunion of humeral shaft fracture with osteoporosis.

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Angulation Deformity Following Interlocking Nailing for Treaeent of Tibia Fracture: Hong Jun Han, Jae Hoon Shin, Jeong Hyu Lee; J Korean Soc Fract 1996;9(4):1002-1008. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1002

Abstract PDF: Intramedullary nailing is often the treatment of choice in the management of fractures in the tibial diaphysis. With the advent of interlocking nailing, the indication for nailing have expanded, recently. One of the most frequent but little discussed complication of tibial nailing is fracture malalignment leading to angular or rotational deformities. This retrospective study was undertaken to access the incidence of aneular malalignment after interlocking nailing for 210 tibiae(208 patients). The results obtained were as follows; 1. The incidence of angular malalignment was 12.4% 2. The incidence of angular malalignment was 15.8% in proximal one third, 4.1% in middle one third,20.7% in distal one third fractures. 3. The most frequent deformity was valgus angulation in distal one third fractures. 4. Angular deformity was developed more frequently in cases of unlearned nailing(18.9%) than reamed nailing(8.4%). 5. Angular deformity was developed more frequently in cases of double level fracture(22.2%) than single level fracture(11.5%).

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The Gamma Nail for Unstable Peritrochanteric Fractures: Hong Jun Han, Hee Jun Yu; J Korean Soc Fract 1996;9(1):76-80. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.76

Abstract PDF

The Gamma nail was designed to treat unstable intertrochanteric and subtochanteric fractures with the theoretical advantages of a load-sharing compinent which could be implanted by a semi-closed procedure. We report a retrospective study of 27 unstable peritrochanteric fractures treated by the Gamma nail. Gamma nail were implanted with an average duration of anesthesia of 84 minutes and little intra-operative bleeding by a semi-closed technique. Complications were few, and clinically not implant except one case of femoral shaft fracture at the distal end of the nail which healed well fter treatment with Gamma nail and circlage wiring.

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Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA)
Myung-Sik Park, Young-Jin Lim, Young-Sin Kim, Kyu-Hyung Kim, Hong-Man Cho
Journal of the Korean Fracture Society.2009; 22(2): 91. CrossRef
Treatment of Senile Osteoporotic Intertrochanteric Fracture using Proximal Femoral Nail
Dong-Hui Kim, Sang-Hong Lee, Young-Lae Moon, Jun-Young Lee, Kun-Sang Song
Journal of the Korean Fracture Society.2007; 20(3): 215. CrossRef

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Treatment of Neglected Fracture-Dislocation of the Ankle Using llizarov Device: A case report: Hong Jun Han, Dong Churl Kim, Seong Ho Lee; J Korean Soc Fract 1995;8(3):615-619. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.615

Abstract PDF: There was a close correlation between the final clinical result and the quality of reduction of the fracture fragments. Fracture-dislocations of the ankle are relatively rare and unstable injuries in which anatomical reduction and difficult by closed method. More recently, anatomical reduction, secure internal fixation and early motion have been advocated as principle of treatment for a success ful clinical outcome in fracture-dislocation of the ankle. We reviewed the result of a case of the neglected ankle fracture-dislocation that have been reduced anatomically by closed method using a Ilizarov device. Clinical and radiographic results of the technique were satisfactory after length of follow-up thirty-eight months.

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The IliBarov Technique in the Treatment of Nonunions of Long Bone: Hong Jun Han, Dae Moo Shim, Sang Hoon Cha; J Korean Soc Fract 1995;8(1):254-261. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.254

Abstract PDF: Orthopaedic surgeons have employed many different techniques for the management of nonunion of long bone. But, nonunion of long bone continued to challenge ouhopaedic surgeons. We used llizarov apparatus for the chronic infected nonunions or nonunions with large bone defect to achieve union, to correct deformity, to eradicate infection and to eliminate bone defect. Twenty-eight patients were treated for nonunions of long bone with llizarov apparatus by the same surgeon between 1990 March and 1992 August. Followings are the summary of the results. 1. 21 patients achieved solid bony union. The average duration of application of apparatus was 10.12 months. 2. 8 patients with less than 2cm shortening were treated by monofocal compression osteosynthesis, with an average healing time of 6.3 months. None of these 8 cases had infection. 3. 14 patients with infection and less than 2cm bone defect were also treated by monofocal compression osteosynthesis, with an average healing time of 8.7 months. 4. 6 patients with more than 2cm shortening or bone defect were treated by bone lengthening or bone transport. The average length gain was 5.6cm. 5. We have not any significant complications with llizarov method. The most common complication was a superficial pin tract infection in 12 patients(43%). 6. If the bony defect was not large, it was thought to be better to change B, or B, type nonunion to B, type to improve bony contact and healing. We find ourselves capable of solving increasingly more difficult problems with a level of sucess rarely, if ever, achieved with other conventional method.

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Diagnosis of Pelvic Bone Fractures: Hong Jun Han; J Korean Soc Fract 1994;7(1):5-11. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.5

Abstract PDF

No abstract available.

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Deep-learning-based pelvic automatic segmentation in pelvic fractures
Jung Min Lee, Jun Young Park, Young Jae Kim, Kwang Gi Kim
Scientific Reports.2024;[Epub] CrossRef

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Idiopathic Fever following Childrens femur Fractures: Hong Jun Han, Hyun Lee, Sang Soo Kim; J Korean Soc Fract 1990;3(2):280-283. Published online November 30, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.2.280

Abstract PDF: Not infrequently, Orthopaedic surgeons notice that fever following childrens femur fractures does not coincide with the laboratory findings. The authors agree that knowledge of the frequency, time of onset, duration, and magnitude would be helpful in accessing the significance of fever in the postinjury period. The authors reviewed 65 childrens femur fractures without infection under the 15 years old from March 1984 to December 1989 and following observations were made. 1. Fever developed in 32 patients(49%), but only in 7 patients(11%) significant fever elevation was found. 2. The mean onset of fever was 4 days after trauma, and the mean duration was 3 days. 3. The rate of fever occurrence increased In accordance with age. 4. Fever was least common in patients having oblique fracture. 5. Associated injuries were found more commonly in the febrile group.

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The Calcaneal Trabecular Pattern as an Index of Osteoporosis and the Role of Osteoporosis in Ankle Joint Fractures: Ju O Kim, Hong Jun Han, Young Suk Kim, Sang Soo Kim; J Korean Soc Fract 1989;2(1):101-106. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.101

Abstract PDF: To provide another effective method of surveying osteoporosis, authors introduced the calcaneal trabecular pattern as an index of osteoporosis. We reviewed the roentgenograms of 144 patients with ankle or hip joint fracture. The trabecular pattern in the cacaneum(expressed as the calcaneal index) and that in the upper end of the femur(Singhs index) were well correlated, and both indices have a inverse correlation with age. The calcaneal index did not reveal any correlation with the type of ankle joint fractures, but it was estimated to provide useful information for ankle joint fractures in selection of treatment mode including fixation method and prediction of the prognosis.

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