Journal of Musculoskeletal Trauma

Results of Treatment of Fracture-Dislocations of Elbow: Dong Soo Kim, Soon Ho Hwang, Chil Soo Kwon, Jong Kuk Ahn, Byung Hyun Jung, Yerl Bo Sung, Jae Kwang Yum, Hyung Jin Chung; J Korean Soc Fract 2000;13(1):178-185. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.178

Abstract PDF: PURPOSE
: This study analyzed clinical and biomechanical data from patients with elbow fracture dislocation to correlate long-term objective result with the specific injury type and treatment rendered. This can provide a basis for the management of this difficult injuries.
MATERIALS AND METHODS
: Fifteen patients with elbow dislocation were studied from October, 1992 to October, 1997 in Sang-Gye Paik Hospital. The average duration of follow up was 4.2 years.
RESULTS
: On the basis of an objective functional grading score that included elements of pain, motion, strength, and stability, the results were excellent in five(33%), good in five(33%), fair in one(7%), poor in four(27%). Prolonged immobilization greater than four weeks was associated with poor results. The results were closely related to the combined injuries and duration of immobilization. In case of radial head fractures, the best result was obtained in patients with Mason type II fractures treated by open reduction and internal fixation using Herbert screw and early complete radial head excision. SUMMARY AND CONCLUSION : The most common combined injury is radial head fracture. Early complete radial head excision and encouraging early ROM had more satisfactory result than delayed radial head excision or internal Fixation for Mason type III fracture.

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The Result After Surgical Treatment on Lateral Condyle Fracture of Humenu in Children: Dong Soo Kim, Kook Jin Chung, Jong Guk Ahn, Byung Hyun Jung, Yeol Bo Sung, Hyung Jin Chung, Chil Soo Kwon; J Korean Soc Fract 1999;12(4):1034-1039. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.1034

Abstract PDF: Fracture of the lateral condyle of humerus in children are common injury next to supracondylar fracture in children, account for 10 to 15% about the elbow and 18 to 20% about distal humerus fractures. This is the one fracture that can be overlooked clinically and that has a high potential for nonunion and cubitus valglls deformity. Sixty children treated by closed or open reduction with internal fixation on the lateral condyle fracture of humerus from January 1994 to August 1997, were reviewed. Almost fractures were treated within 12 hours after injury for the purpose of prevention of further displacement and occurrence of complication. According to Hardacre et als criteria, most patients showed excellent and good results. We report the result after surgical treatment on the laterdl condyle fracture of humerus in children.

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Compartment Syndrome Complicating Avulsion Fractures of the Tibial Tubercle: Yerl Bo Sung, Jin Hyok Kim, Hyung Jin Chung, Dong Soo Kim, Byung Hyun Jung, Jong Guk Ahn, Chil Soo Kwon, Kook Jin Chung, Bong Gyun Kang; J Korean Soc Fract 1999;12(2):284-289. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.284

Abstract PDF: Avulsion of the tibial tubercle is an uncommon physeal injury. Complications from this fracture have rarely been reported and seldom affect the long-term outcome. Three adolescent boys who sustained avulsion fracture of the tibial tubercle, were complicated by compartment syndrome and treated at Inje University Sang-Gye Paik Hospital from September 1989 to February 1995. Injury to the soft tissue surrounding the tibial tubercle avulsion may be more extensive than is usually appreciated. The anatomy of the proximal tibia and the tibial tubercle with nearby branches of the anterior tibial recurrent artery suggest a predisposing factor for the development of compartment syndrome. So, compartment syndrome should be added to the list of possible complications of this type of fracture.

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Interlocking Intramedullary Nailing of Femoral Shaft Fractures in Adolescents: Chil Soo Kwon, Jong Kuk Ahn, Jin Hyok Kim, Byung Hyun Jung, Yerl Bo Sung, Hyung Jin Jung, Jong Deuk Rha, Woo Chun Lee, Hyun Soo Park, Myung Ho Lee, Bu Maan Kim; J Korean Soc Fract 1996;9(4):914-920. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.914

Abstract PDF: Although treatment of femoral shaft fractures by traction and casting satisfactory in young children, it is less useful in obtaining and maintaining satisfactory alignment in adolescent patients. Residual angulation, malrotation. and leg length inequality is well documented. The options for surgical treatment of femoral shaft fractures in adolescents include extemal fixation, plate fixation, and intramedullary nailing. Surgical treatments carry the-risks of growth plate damage and infection, but these risks are very low. Recently, it is generally anepted that adolescent femoral shaft fractures are preferably treated by intramedullary nailing with care taken to avoid damaging the distal femoral physis. The authors experienced 9 femoral shaft fractures in 8 patients treated with interlocking intramedullary nails from August 1989 to May 1994, and followed up for more than 18 months(range from 18 to 45 months). The results were as follows: 1. There were 6 cases in male, 2 cases in female. Average age at the time of injury was 13 years(range, 11-14). 2. All fractures were united, and the nails were removed at an average 13.3 months after operation: no refracture or femoral neck fracture has since occured. 3. None had angular or rotational malunions, infection and avascular necrosis of femoral head. The average leg-length discrepancy at the last follow-up was 0.5cm(range, 0-1.0cm) and all were clinically acceptable. Coxa valga due to premature closure of trochanteric apophysis was not found. The average femoral neck-shaft angle was 133(130~138) at the last follow-up. So, interlocking intramedullary nailing is a reasonable alternative for the treatment of femoral shaft fracture in adolescents.

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The Treatment of Infected Nonunions of the Tibia by the Methods of Ilizarov: Chil Soo Kwon, Yong Uck Kim, Byung Hyun Jung, Kyung Seog Shin; J Korean Soc Fract 1995;8(2):347-353. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.347

Abstract PDF

Chronic infection of the shaft of tibia is one of the most perplexing dilemmas in orthopedic surgery. Difficult or resistant infection usually require more radical debridement of the septic bone and soft tissue in addition to application of stable fixation to enhance soft-tissue healing and bony union. The application of Ilizarov is possible to correct deformities, regenerate new bone tissue without the use of bone grafts, progressirely lengthen the extremity and allow weight bearing during the treatment period. Application of Ilizarov were preformed on eigtheen patients with infected nonunion of tibia between November 1989 February 1993. The result were as follows; 1. There were 16 males and 2 females with an average age of 39 years. 2. Fifteen of 18 patients had infected tibial nonunion associated with bone loss. 3. Two of 15 patients had infected nonunions associated with hemicircumferential bone loss. These tibiae were treated by hemicircumferential corticotomy and partial bone transport. 4. Twelve of 15 patients had an average 6.6cm of segmental bone loss. These were treated by coitictomy and internal bone transport. 5. The mean duration of treatment was 10.3 months. 6. The application of Ilizarov technique to diaphyseal infected nonunion and segmental defect is very encouraging. It may prove to be an excellent technique for further management of resisitant diaphyseal infection of bone.

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Bone Transport Over the Intramedullary Nail for Defects of Long Bone
Jae-Young Roh, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Byung-Chul Park, Woo-Kie Min, Joon-Woo Kim, Chang-Hyun Cho
Journal of the Korean Fracture Society.2008; 21(1): 37. CrossRef

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Treatment of Carpal Bone Fracture-Dislocation using the Small-External Fixator and Internal Fixation: Chil Soo Kwon, Young Uck Kim, Byung Hyun Jung, Kyeong Seog Kong; J Korean Soc Fract 1995;8(1):228-233. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.228

Abstract PDF: Authors reviewed 3 cases of carpal bone fracture-dislocation treated with samll-external fixator and internal fixation such as K-wires or screws from October 1991 to March 1993 with above 1 year follow up. The results were as follows; 1. Mean ages were 25 years, all patients were male. 2. The causes of injury were the fall down in 2 cases and the sports injury in 1 case. 3. Cases were a palmar transscaphoid lunate dislocation, a Neglected volar dislocation of lunate, and a doral transscaphoid perilunar dislocation. 4. Advantages are as follows 1) minimize surgical dissection 2) maintenance of reduction is easy 3) ROM: full 4) painless 5) results are excellent We would like to recomment to use the small-external fixator and limited internal fixation instead of other methods for the treatment of carpal bone fracture-dislocation.

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Treatment of Infected Nonunion of Femoral Fracture: Chil Soo Kwon, Young Uck Kim, Byung Hyun Jung, Kyeong Seog Kong; J Korean Soc Fract 1995;8(1):13-21. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.13

Abstract PDF: There are many difficult problems in the treatment of inferted nonunions of the femur, e.g, eradication of infection and osseous union even in the presence of devastating infection. To solve these diffcult problems, various methods were tried including thorugh debridement and rigid internal nxation or external fixation, and bone graft. Recently, large bone defect due to resection of infected bone was treated excellently using llizarov external fixator. Authors treated 13 cases of infected nonunions of femur with Ilizarov external fixator from september 1989 to July 1994. The results were as follows. 1. Among 13 cases of infected nonunion of femoral fracture, 1 case was treated with internal fixation and others with external fixation, and obtaned bone union in all cases. 2. Mean number of previous surgery in other hospital was 3.2(1-5) times and mean number of surgery in our hospital was 2.5(1-5) times. 3. Lengthening(including length of internal bone transport) was performed from 2.5cm to 22cm. 4. Duration of treatment was from 4 months to 27 months(Mean : 11 months). In conclusion, infected femoral nonunion in very selective cases could be treated with retention of internal fixation (Exchange of nail, or plate and screws). But converison to external fixator should be well prepared in most cases. Infected nonunion could be managed in staged surgery with use of modular external fixator like llizarov external fixator. Management of infection, malposition, and shortening could be controlled more safely and more definitely with the ring external fixator.

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