Journal of Musculoskeletal Trauma

Surgical treatment using external fixator for unstable intra-articular fracture of distal radius: Chul Hong Kim, Byeong Hwan Kim, Sung Won Lee, Wook Kim; J Korean Soc Fract 2003;16(1):83-90. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.83

Abstract PDF: PURPOSE
To analyze the results of surgical treatment using external fixator for unstable intra-articular fracture of distal radius. MATERIAL AND METHODS: We investigated 38 cases of distal radius fracture from Mar. 1990 to Dec. 2000. The patients were followed up for average 18 months postoperatively. We compared the results of 22 cases, treated with open reduction and internal fixation(ORIF) to the results of 16 cases, treated with ORIF and external fixation. We evaluated the results of the mean loss of radial length, radial inclination, volar tilt and traumatic arthritis according to demerit point rating system above the Fernandez classification IV.
RESULTS
According to demerit point rating system, excellent to good results were obtained in 72.7% at ORIF and external fixator, compared to 43.8% at case of ORIF only. In the last follow up, the mean loss of radial length was 0.6mm in case of ORIF, but 0.4 mm in case of ORIF and external fixator, the mean loss of radial inclination was 2.3 and 1.5 degrees, the mean loss of volar tilt was 2.5 and 2.2 degrees, respectively (p < 0.05). Postoperative complications were developed in 9 cases. Malunion was in 4 cases of ORIF and external fixator, in 2 cases of ORIF. Metacarpal bone fracture was in 1 case of ORIF and external fixation. Traumatic arthritis was in 2 cases of ORIF.
CONCLUSION
Open reduction and internal fixation combined with external fixation was thought to be a better method than open reduction and internal fixation for the treatment of unstable intra-articular fractures of the distal radius of the Fernandez classification IV and IV, because that was more comfortable and convenient to patients and was useful to prevent late displacement.

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Treatment of Ipsilateral Femur and Tibia Fractures: Sung Keun Sohn, Kyung Taek Kim, Byeong Hwan Kim, Bum Ho Jung, Kyung Sik Hwang; J Korean Soc Fract 2000;13(4):837-846. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.837

PURPOSE
Searching for the most excellent outcome of ipsilateral fractures of femur and tibia according to the treatment methods and the combined injuries which occasionally neglected.
MATERIALS AND METHODS
We reviewed thirty cases of ipsilateral fractures of the femur and tibia, treated at the orthopaedic department of the Dong-A university hospital between February 1991 and May 1999. Children under 10 years old, treated by conservative methods were excluded in this study. Average follow-up period was 23.2 months(range, 5 to 44 months) and mean age was 34.7 years old(range, 16 to 58 years).
RESULTS
According to the measurement of the Karlstrom and Olerud, range of motion of the ipsilateral knee joint and bony union time, intramedullary nailing was the treatment of choice for both femur and tibia fracures except limited by open wound and fracture level and types(14 cases, 47%). The ipsilateral knee ligaments injury was the most common combined injury which neglected at initial trauma(8 cases, 27%).
CONCLUSION
By intramedullary nailing, the patients with ipsilateral fractures of femur and tibia could achieve early weight bearing ambulation and ipsilateral knee joint excercise, and showed the most excellent outcome. After fixation of both femur and tibia fractures, by physical examination and arthroscopic examination of ipsilateral knee joint we could detect and treat the ipsilateral knee ligaments injuries, which occasionally neglected.

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Ipsilateral Femoral Segmental and Tibial Fractures: A Case Report
Oog Jin Sohn, Chul Hyun Park, Sang Keun Bae
Journal of the Korean Fracture Society.2009; 22(3): 193. CrossRef

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Refracture of Forearm Bone after Plate Removal: Sung Keun Sohn, Byeong Hwan Kim, Sang Ki Lee; J Korean Soc Fract 2000;13(1):132-138. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.132

Abstract PDF

PURPOSE
: To evaluate the results of operative treatment for intercondylar fracture of the distal humerus in adults.
MATERIALS AND METHODS
: From February 1994 to June 1998, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 12 of them were treated by open reduction and internal fixation(dual plate for 8, screw & K-wire for 4) and 3 of them by open reduction & Ilizarov fixation. Open or closed fracture and AO classification of fracture were considerd as a prognostic factor. The functional results were analyzed by Jupiter's critera.
RESULTS
: There were 2 excellent, 2 good in C1 type, one excellent, 2 good, one fair and 2 poor in C2 type, and one excellent, 2 good, 2 poor in C3 type. And there were one good and one poor in 2 open fractures and 4 excellent, 5 good, one fair and 3 poor in closed fractures. The average range of motion of the elbow joint was 85 degrees(30 degrees-115 degrees). Overall results show excellent and good in 67%(10 of 15) and poor in 27%(4 of 15).
CONCLUSION
: It's not easy to get satisfactory results in treatment for intercondylar fracture of the distal humerus We suggest that more efforts are needed to get anatomical reduction, rigid internal fixation and early joint motion in interconylar fracture of the distal humerus.

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Refractures of the Upper Extremity in Children
Hui Wan Park, Ick Hwan Yang, Sun Young Joo, Kun Bo Park, Hyun Woo Kim
Yonsei Medical Journal.2007; 48(2): 255. CrossRef

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Ipsilateral Fractures of Femoral neck and Shaft: Byeong Hwan Kim, Sung Keun Sohn, Soo Jin Park; J Korean Soc Fract 1999;12(1):13-20. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.13

Abstract PDF: Ipsilateral fractures of the femoral neck and shaft are uncommon injuries with the difficulties in diagnosis and treatment. The femoral neck fracture of this injury is commonly missed on initial evaluation. The overlooked femoral neck fracture may lead to higher risk of complications such as avascular necrosis of the femoral head, nonunion and coxa vara. The authors reviewed nine cases of ipsilateral femoral neck and shaft fracture treated in our clinic from June 1990 to March 1997, and average follow-up period was 39 months(range, 16 to 97 months). The results obtained were as follows ; 1. The cause of injury was traffic accident and one femoral neck fracture was missed initially. 2. The most common site of femoral neck fracture was basicervical in 7 cases and that of shaft fractures was middle 1/3 shaft in 6 cases. 3. Two cases were treated with femoral reconstruction nail, seven with multiple neck pinning and dynamic compression plate for shaft fracture. 4. There were complication such as 2 cases of delayed union of femoral shaft, 1 case of nonunion of femoral shaft. 5. It should be treated with anatomical and rigid internal fixation in femoral neck fracture having first priority.

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Clinical study of Supracondylar Fractures of the Humerus in Children: Sung Keun Sohn, Kyu Yeol Lee, Byeong Hwan Kim; J Korean Soc Fract 1995;8(1):106-115. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.106

Abstract PDF: The supracondylar fracture of the humerus is the most common elbow fracture in children. There are much controversies for the treatment and variable and frequent complication such as cubitus varus and joint stiffness, etc. For the period of 3 years and 10 months from Mar. 1990 to Dec. 1993, 62 patients with supracondylar fracture of humerus were admitted and treated at the Department of Orthopaedic surgery, College of Medicine, Dong-A University Among them,34 patients who were followed up more than 6 months were reviewed retrospectively. The results are as follows 1. The average age was 6.4 years and sex ratio of male to female was 3.9:1. 2. The extension type was 79.4%, and flexion type was 20.6%. The ratio of left to right was 1.43:1 3. The most common cause of injury is fall from a height in 18 cases (52.9%). 4. The mean duration of bone union was 42.3 days. 5. According to the Holnlberg classification, 3 cases belong to group I(8.8%), 9 to Group II(26.5%),10 to Group III (29.4%), and 12 to Group IV(35.3%). 6. By Flynns criteria, the satisfactory results was in 31 cases(91.2%), and unsatisfactory in 3 cases (6.3%). In Holmberg classification, the higher severity, the higher joint stiffness made the prognosis worse. 7. In conclusion, we believe that percutaneous pinning was a simple, effective method for treatment of displaced supracondylar fractures of the humerus, and the accurate anatomical reduction was required to prevent cubitus varus deformity, which is one of the most serious complication.

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A Clinical study of the Tibial Condylar Fractures: Jung Yoon Lee, Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Byeong Hwan Kim; J Korean Soc Fract 1994;7(2):269-278. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.269

Abstract PDF: The tibial condylar fracture which involves articular surface of the proximal tibia is common in traffic accident and often produces some disability of the knee joint because it is frequently accompanied by injuries to ligaments and menisci. There are much controversies in the method of treatment in the fractures of the tibial condyle. Although the anatomical reduction and rigid internal fixation with early knee motion are reconmanded to obtain good results, unsatisfactory results have been reported as 20-40% of cases. The authors analyzed 36 cases of tibial condylar fractures that treated at the Department of Orthropaedic Surgery, College of Medicine, Dong-A University from March 1990 to March 1993. The results were as follows: 1. The sex ratio was 2.3: 1 in male to female and most common age group was 4th decade. 2. The most common cause of injury was traffic accident in 25 cases(69.4%). 3, According to Schatzkers classification, the most common type was type II in 10 cases(27.8%). 4. The most common associated injuries were ligament injury in 10 cases(27.8%) and fibular fracture in 30 cases(27.8%). 5. By Porters criteria, 8 cases(80%) among 10 conservative cases and 18 cases(69.2%) among 26 operative cases had acceptable results. 6. The complications were most common in type II(5 cases) and type IV(5 cases). 7. The factors of poor results were as follows : displaced comminuted fracture, fracture associated with severe soft tissue injury or with ligamentous and meniscal injury.

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