Journal of Musculoskeletal Trauma

Irreducible Dislocation of the Interphalangeal Joint of the Thumb: A Case Report: Phil Hyun Chung, Suk Kang, Chung Soo Hwang, Jong Pil Kim, Young Sung Kim, Kwang Uk An; J Korean Fract Soc 2008;21(2):165-168. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.165

Abstract PDF: Dislocations of the interphalangeal joint of the thumb are rather uncommon as a result of the inherent stability of the interphalangeal joint. Irreducible dislocations of these joint are rare. The authors report a case of irreducible dislocation of the interphalangeal joint of the thumb with interposed palmar plate, and reduced by open reduction.

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Double Tension Band Wiring for Olecranon Fractures: Suk Kang, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Jin Wook Chung, Jong Pil Kim; J Korean Fract Soc 2008;21(2):130-134. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.130

PURPOSE
To evaluate the clinical results of double tension band wiring for communited olecranon fractures involving proximal 1/3.
MATERIALS AND METHODS
We reviewed 9 cases of communited olecranon fractures involving proximal 1/3 treated with double tension band wiring followed for minimum 10 months. There were 2 cases of olecranon fractures involving only proximal 1/3, 6 cases of olecranon fractures involving from proximal 1/3 to middle 1/3 and 1 case of olecranon fractures involving from proximal 1/3 to distal 1/3. We analyzed the bone union time, radiologic results for gap, reduction loss, pin migration, pain, range of motion, complications and functional outcomes at last follow up.
RESULTS
All patients had solid bone union without additional surgery and average union time was 10.3 weeks. Anatomical reduction could be obtained in 8 of 9 cases but there was 1 mm step off in one case. 36 pins were used to fix the fractures, 1 pin of 18 distal pins and 2 pins of 18 proximal pins were migrated to backward but there was no reduction loss. Only 1 distal pin needed early removal due to skin irritation. Average range of motion ranged from flexion contracture 3.3 degrees to further flexion 137.8 degrees. On functional analysis, we got 8 cases of good result, 1 case of fair result and there was no poor result.
CONCLUSION
Double tension band wiring for comminuted olecranon fracture involving proximal 1/3 was concluded to give a firm fixation of the fracture site as bone union could be acquired without serious pin problems.

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Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates
Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon
Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
Olecranon Nonunion after Operative Treatment of Fracture
Ho-Jung Kang, Ji-Sup Kim, Myung-Ho Shin, Il-Hyun Koh, Yun-Rak Choi
Journal of the Korean Fracture Society.2015; 28(1): 30. CrossRef

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Treatment of Subtrochanteric Femur Fractures Using Intramedullary Devices: Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Chong Suk Park, Sang Ho Lee; J Korean Fract Soc 2008;21(1):13-18. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.13

Abstract PDF

PURPOSE
The purpose of this study is to compare the result between closed reduction and minimal open reduction in case of difficult reduction for subtrochanteric fractures fixed with intramedullary nail.
MATERIALS AND METHODS
From Jan. 2001 to May 2005, 35 cases of subtrochanteric femur fracture treated by intramedullary nail and followed up for more than a year were selected out of 42 subtrochanteric femur fractures. Fielding classification and Russel-Taylor classification were used, and according to the fracture classification and method of reduction, the patients were grouped into closed or open reduction group. Fracture with minimal displacement or anatomical reduction was fixed by closed reduction, but in case of failed closed reduction or loss of reduction, minimal incision was made for open reduction and internal fixation, and the result between two groups were compared.
RESULTS
In total of 35 cases, 15 cases were fixed by closed reduction and the rest 20 cases required open reduction. Operation time, amount of transfusion, total hospital days, partial weight bearing ambulation, and union time did not show significant differences between two groups. Ambulation and range of motion after the operation were satisfying in both groups.
CONCLUSION
In treatment of subtrochanteric femur fracture with intramedullary nail, both closed and open reduction shows satisfying result, therefore when anatomical reduction is difficult to achiev by closed reduction, minimal incision open reduction and additional fixation is strongly recommended to obtain anatomical reduction and firm fixation.

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Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
Hip & Pelvis.2014; 26(2): 107. CrossRef
Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques
Chul-Hyun Park, Chul-Wung Ha, Sang-Jin Park, Min-Su Ko, Oog-Jin Shon
Journal of the Korean Fracture Society.2013; 26(2): 112. CrossRef
Treatment of Subtrochanteric Nonunion with a Blade Plate
Youn-Soo Park, Jin-Hong Kim, Kyung-Jea Woo, Seung-Jae Lim
Journal of the Korean Orthopaedic Association.2011; 46(1): 42. CrossRef

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Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture: Suk Kang, Jong Pil Kim, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Sang Ho Lee, Jin Wook Chung; J Korean Fract Soc 2007;20(4):339-344. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.339

Abstract PDF: The complications following paediatric femur fracture are leg length discrepancy, angulation deformity, rotational deformity, ischemic limb. But, stiff knee is rarely expressed after trauma like paediatric femur fracture. We report a case of stiff knee due to entrapment of quadriceps femoris tendon at displaced fracture site after conservative treatment by Russel traction and hip spica cast in paediatric femur fracture. We treated successfully by resection of distal end of proximal segment of femur and release of quadriceps femoris tendon for flexion contracture of the knee.

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Treatment of Humeral Shaft Fracture with Retrograde Flexible Nail: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Young Sung Kim, Sung Pock Park, Kwang Uk An; J Korean Fract Soc 2006;19(3):340-345. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.340

Abstract: PURPOSE
To evaluate and report the clinical and radiological results of the intramedullary fixation by retrograde flexible nail in the humeral shaft fracture.
MATERIALS AND METHODS
From July 2002 to May 2005, seventeen cases who had the humeral shaft fracture were treated with the intramedullary fixation by retrograde flexible nail. Fifteen cases were followed up and the clinical and radiological results were analyzed.
RESULTS
All of the cases had satisfactory fracture union, and none of the patient had limitation in shoulder or elbow joint movement, and shoulder or elbow joint pain, and average ASES was 42.86 point. There was 1 case of delayed union, and 3 cases of distal nail displacement. Another severe complications were not occurred.
CONCLUSION
Intramedullary fixation by retrograde flexible nail is one of the effective method in the humeral shaft fracture without nerve or vessel injuries, and also can avoid the complication of wide soft tissue incision or rotator cuff injury.

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Operative Treatment in Midshaft Fractures of Clavicle using Reconstruction Plate and Interfragmentary PDS Suture: Phil Hyun Chung, Suk Kang, Chung Soo Hwang, Jong Pil Kim, Young Sung Kim, Sung Pock Park, Jin Wook Chung; J Korean Fract Soc 2006;19(3):335-339. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.335

Abstract

PURPOSE
We are reporting the result of comminuted midshaft fractures of clavicle treated by reconstruction plate fixation and PDS augmentation easily fixing butterfly fragments with minimal soft tissue dissection.
MATERIALS AND METHODS
We reviewed 42 cases of operatively treated displaced comminuted midshaft fractures of clavicle at our hospital from March, 2001 to May 2004 whom were followed up for more than one year after the operation. According to Robinson classification, we grouped simple fractures as group A, and comminuted fractures as group B. Internal fixation using reconstruction plate has been chosen for type A fracture. Type B has been treated by reconstruction plate fixation with PDS augmentations. Shoulder function, union time and complications has been studied according to the fracture type retrospectively.
RESULTS
All cases had complete bone union with average union time of 8.6 weeks for type A and 8.9 weeks for type B. Weitzman functional evaluation did not show significant differences.
CONCLUSION
PDS augmentation in comminuted midshaft fracture of clavicle easily fix the butterfly fragments with least soft tissue damage and lessen the bone graft. Therefore it considered to be one of the available treatment methods for comminuted midshaft fracture of clavicle.

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Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?
Jae-Kwang Yum, Yong-Woon Shin, Hee-Sung Lee, Jae-Gu Park
Journal of the Korean Fracture Society.2011; 24(2): 138. CrossRef

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Transverse Fracture through Screw Site after Cannulated Screw Fixation in Vertical Patella Fracture: A Case Report: Suk Kang, Phil Hyun Chung, Chung Soo Hwang, Jong Pil Kim, Young Sung Kim, Chong Suck Parke; J Korean Fract Soc 2006;19(1):96-99. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.96

Abstract

Many complications after operative treatment of patella including redisplacement of fracture, refracture, weakness of extensor muscles, patellofemoral joint arthritis, metal failure, malunion, infection, avascular necrosis were reported. We report a case of transverse fracture of patella through the cannulated screw fixation site used to fix previous vertical patella fracture with a review of the literatures.

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Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef

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A Comparison according to Insertion Method for Intramedullary Nailing in Proximal Tibial Fractures: Sang Ho Moon, Byoung Ho Suh, Chung Soo Hwang, Tae Hyun Yoon; J Korean Fract Soc 2006;19(1):17-23. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.17

Abstract: PURPOSE
To compare clinical and radiological results between standard insertion method and semiextended method which was designed to improve proximal fixation and alignment in proximal tibia fracture.
MATERIALS AND METHODS
A retrospective review from May 2000 to February 2004, identified 24 extraarticular fractures in proximal tibia, initially treated with locked intramedullary nails at least 1 year follow up. There were 12 open injuries, 4 segmental, 3 butterfly fragments and 17 comminuted. Semiextended method was used in 10 fratures and standard insertion method which is cephalad to tibial tubercle in 14. Follow up clinical assessment consisted of review of associated injuries and complications and these two methods were compared by postoperative angulation and displacement in anteroposterior and lateral radiographs. Data were analysed by t-tests.
RESULTS
In semiextended group, average angulation was 2.3 degrees in coronal and 2.8 degrees in sagittal plane and average displacement was 4.5 mm in coronal and 5.3 mm in sagittal. In ordinary group, average angulation was 5.1 degrees in coronal and 7.4 degrees in sagittal plane and average displacement was 6.1 mm in coronal and 5.3 mm in sagittal. In semiextended group, there were significant reduction in coronal angulation (p=0.006) and sagittal angulation (p=0.001), but there was no significant difference in coronal (p=0.344) and sagittal (p=0.99) displacement. Both groups showed anterior, valgus angulation and posterolateral displacement in most cases. There were 14 associated injuries and one patient developed nonunion and was treated by nail exchange with autogenous bone graft.
CONCLUSION
Our retrospective analysis demonstrated that semiextended method is effective for reducing coronal and sagittal angulation, but is not helpful for reducing displacement in both planes.

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Interlocking Intramedullary Nailing in Distal Tibial Metaphyseal Fractures: Young Sung Kim, Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Ho Min Lee; J Korean Fract Soc 2005;18(3):269-274. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.269

Abstract PDF

PURPOSE
To evaluate and compare the outcome in fracture of distal tibial metaphyseal fractures involving ankle joint and not involving the ankle joint treated by interlocking imtramedullary nailing.
MATERIALS AND METHODS
Twenty six cases of distal tibial metaphyseal fractures treated by interlocking intramedullary nailing whom were able to follow up for more one year were selected and 10 cases involved ankle joint and the rest 16 cases did not. In all cases, more than 2 distal locking screws were inserted after reaming for the nailing, and cannulated screws or K-wires fixation were inserted for 8 cases of fractures involving ankle joint out of 10. We analyzed preoperative fracture type, union time, function of joint, and complications at final follow up.
RESULTS
According to Robinson's classification for distal tibial metaphyseal fractures, there were 9 cases of type I, 7 of 2A, 4 of 2B, 6 of 2C. Union time taken for distal tibial fractures involving ankle were average of 17 weeks (12~20 weeks) and for the fractures not involving ankle joint were average of 19 weeks (12~28 weeks). Klemm and Borner's functional evaluation showed above good in 8 cases (80%) of fracture involving ankle joint and 13 cases (81%) of fracture not involving the ankle joint, and functional evaluation did not show significant differences as well as the complication rate in both group.
CONCLUSION
Interlocking intramedullary nailing is one of the effective methods for treatment of distal tibial metaphyseal fracture involving articular surface of the ankle.

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Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures
Young Sung Kim, Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Soon Young Park
Journal of the Korean Orthopaedic Association.2021; 56(4): 317. CrossRef
Comparative Analysis of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Distal Tibia Fractures
Ho-Min Lee, Young-Sung Kim, Jong-Pil Kim, Phil-Hyun Chung, Suk Kang, Kaung Suk Jo
Journal of the Korean Fracture Society.2018; 31(3): 94. CrossRef
Intramedullary Nailing of Distal Tibial Fractures with Percutaneous Reduction by Pointed Reduction Forceps
Jae-Kwang Hwang, Chung-Hwan Kim, Young-Joon Choi, Gi-Won Lee, Hyun-Il Lee, Tae-Kyung Kim
Journal of the Korean Fracture Society.2014; 27(2): 144. CrossRef
Comparative Study of Intramedullary Nailing and Plate for Metaphyseal Fractures of the Distal Tibia
Hoon Jeong, Jae-Doo Yoo, Young-Do Koh, Hoon-Sang Sohn
Journal of the Korean Fracture Society.2007; 20(2): 154. CrossRef

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Treatment of Tibial Shaft Fractures in Children Using K-wires Fixation: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Ho Jun Cheon; J Korean Fract Soc 2004;17(4):384-388. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.384

Abstract PDF: PURPOSE
To report the effectiveness of Kirschner wire fixation for the treatment of unstable tibial shaft fractures in children.
MATERIALS AND METHODS
We analyzed 15 cases of pediatric tibial shaft fractures treated at our hospital with fixation using K-wire and followed up for more than 1 year from July 1998 to January 2002. The subjects included 11 boys and 4 girls. The ages ranged from 3 to 10 years at the time of injury, with the average age being 7.9 years. We examined the presence of angulation, leg length discrepancy, joint motion limitation, and complications.
RESULTS
Bony fusion was obtained in all patients by an average of postoperative 9.5 weeks. At the time of last follow-up (by an average of postoperative 1 year and 4 months), anterior and posterior radiographs showed an average of 4.2degree angulation, and lateral radiographs showed an average of 4.4degree angulation. The affected leg was extended by an average of 3.7 mm compared to the opposite leg according to Bell-Thompson's radiographs. As for complications, infection was developed around the pin in 3 cases but treated with the administration of oral antibiotics and sterilization around the site without progressing to deep infection. We could not observe joint motion limitation, pain and difficulties related with discrepancy in leg length.
CONCLUSION
We concluded that fixation using K-wire for children with tibial shaft fractures was a safe and effective method of surgery that could be performed easily, did not require secondary surgery to remove the wire, and showed sufficient stability after fixation.

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A Comparison of Vertebroplasty Versus Conservative Treatment in Osteoporotic Compression Fractures: Sang Ho Moon, Dong Joon Kim, Chung Soo Hwang, Sang Eon Lee, Se Won Park; J Korean Fract Soc 2004;17(4):374-379. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.374

Abstract PDF

PURPOSE
To compare clinical and radiological results between vertebroplasty and conservative treatment in osteoporotic compression fractures of thoracolumbar spine.
MATERIALS AND METHODS
34 patients were reviewed with at least 1 year follow up. Vertebroplasty was used in 14 and conservative treatment was done in 20 fractures. These groups were compared by clinical results which were evaluated by the scoring system according to pain, mobility and analgesic usage at preoperative, postoperative 1 month and postoperative 1 year. And also compared by the increment of kyphosis and loss of vertebral body height in lateral films at the same time. We compared duration of hospitalization between two groups.
RESULTS
Vertebroplasty group showed statistically significant less pain and mobility than conservative treatment (p<0.05), but there was no differences in analgesic usage at postoperative 1 year while significant difference at 1 month. In radiological comparison, vertebroplasty showed less increment of kyphosis and loss of body height significantly (p<0.05). Also vertebroplasty group had shorter hospitalization stay significantly (p<0.05).
CONCLUSION
Our retrospective analysis demonstrated that vertebroplasty provided significant pain relief, improvement of motion and reduction of analgesic usage and also provided considerable spinal stabilization that prevented further kyphosis and collapse.

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Outcome Comparison between Percutaneous Vertebroplasty and Conservative Treatment in Acute Painful Osteoporotic Vertebral Compression Fracture
Hwa-Yeop Na, Young-Sang Lee, Tae-Hoon Park, Tae-Hwan Kim, Kang-Won Seo
Journal of Korean Society of Spine Surgery.2014; 21(2): 70. CrossRef
Large Pulmonary Embolus after Percutaneous Vertebroplasty - A Case Report -
Sang Ho Moon, Soo Won Lee, Byoung Ho Suh, Sung Hwan Kim
Journal of Korean Society of Spine Surgery.2009; 16(1): 46. CrossRef

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Treatments of the Nonunion of Femoral Shaft Fractures after Interlocking Intramedullary Nailing: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Jae Sang Park; J Korean Fract Soc 2004;17(2):95-102. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.95

Abstract PDF: PURPOSE
To investigate and analyze the clinical result in the treatment of aseptic nonunion of femoral shaft fracture after interlocking intramedullary nailing MATERIALS AND METHODS: We reviewed 23 cases of aspetic nonunion of femoral shaft fracture after interlocking intramedullary nail from March 1995 to February 2003 and follow up more than one year. 8 cases were treated by metal exchange, 3 cases by autogenous bone graft and the rest 12 cases by metal exchange and bone graft on the basis of fracture gap and type of nonunion. We evaulated nonunion type, union time and clinical result. Those patients were treated by interlocking intramedullary nail with or without bone graft. Union were accepted when the radiographic evidences showed bridging callus on both end of femoral shaft fracture with clinical evidences showing abscence of pseudomotion or pain.
RESULTS
All patients were united by one operation. Average union time were 4.8 months in metal exchange group, 3.9 months in metal exchange with autograft bone graft group, and 4.3 months in bone graft group. 15 patients (65.2%) showed hypervascular nonunion including 7 Elephant foot types (46.7%) and 8 oligotrophic types (53.5%), and 8 patients (34.8%) showed avascular nonunion according to Weber-Brunner classification CONCLUSION: Based on our analysis on clinical outcome and stability of nonunion occuring after initial interlocking intramedullary nailing in femoral shaft fracture, interlocking intramedullary nailing with bone graft made early ambulation possible and promoting returning to normal daily life much earlier, thus based on this data, we recommend interlocking intramedullary nailing for treating femoral shaft fracture along with bone graft.

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Treatment of Supracondylar-Intercondylar Femoral Fractures with a Retrograde Intramedullary Nailing: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Yong Jin Jeon; J Korean Fract Soc 2004;17(2):110-116. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.110

Abstract PDF

PURPOSE
We analyzed the cases of supracondylar-intercondylar femoral fracture treated with retrograde intramedullary nail and report the clinical results and its usefulness.
MATERIALS AND METHODS
We reviewed 17 cases of supracondylar-intercondylar femoral fracture that had been treated with retrograde intramedullary nail and each of patients had been followed up for a minimum one year. Post-operative functional assessment was performed using a scale developed by Sanders et al. The evaluation scale assesses range of motion, pain, walking ability, return to work, and alignment and shortening as measured on radiograph.
RESULTS
According to functional assessment of Sanders et al, there were 6 excellent, 9 good, 1 fair, and 1 poor results, that is, 94% showed above excellent results. Bony union was obtained in average 5 months after operation. The post-operative complications were varus deformity in 1 case, wound infection in 1 case, stiffness of knee joint in 1 case, and metal failure in 1 case.
CONCLUSION
The treatment of supracondylar-intercondylar femoral fracture with retrograde intramedullary nail is one of the good surgical options for clinically preferable results with the advantages in early joint motion and early ambulation.

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Retrograde Intramedullary Nailing or the Treatment of Segmental Femoral Shaft Fracture Including Distal Part
Jong-Ho Yoon, Byung-Woo Ahn, Chong-Kwan Kim, Jin-Woo Jin, Ji-Hoon Lee, Hyun-Ku Cho, Joo-Hyun Lee
Journal of the Korean Fracture Society.2009; 22(3): 145. CrossRef

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Treatment of Intertrochanteric Fractures of Femur Using Intramedullary Hip-Screw: Phil Hyun Chung, Chung Soo Hwang, Suk Gang, Dong Ju Chae, Jong Pil Kim, Joon Han Kim; J Korean Soc Fract 2001;14(4):575-583. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.575

Abstract PDF: PURPOSE
We analyze the results of the treatment of intertrochanteric fractures by using intramedullary hip screw.
MATERIALS AND METHODS
We reviewed 34 patients of intertrochanteric fracture who were treated by using of intramedullary hip screw from March 1998 to February 2000, and we classified the fractures by Evans system. 26 cases were treated by closed reduction and internal fixation; 8 cases were by open reduction and internal fixation. We analyzed fracture figure and stability, amount of sliding of lag screw, the change of femur neck-shaft angle, postoperative activity and postoperative complication RESULTS: Bony union was obtained in average 14.3 weeks. Gap of fracture site was formed in 2 cases and crack on entry area of nail was formed in 1 case. Postoperative wound infection occurred in laces and delayed union occurred in 1 case. The change of femur neck-shaft angle showed an average decrease 1.7 degree in stable fractures, 3.5 degree in unstable fractures. Lag screw was sided an average 1.0 mm in stable fractures, 2.6 mm in unstable fractures. Postoperative mobility were analyzed by score of Parker and Palmer, and showing from 7.6 score pretrauma to 3.37 score postoperation in 1 month, 5.0 score postoperation in 3 months, 7.48 score postoperation in 6 months and 7.5 score postoperation in one year.
CONCLUSION
Intramedullary hip screw in intertrochanteric fractures reduced the collapse by processing union of fracture site due to the less decreases of femur neck shaft angle and the shortening by sliding of lag screw

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Effects of Fibular Fixation for Interlocking Nailing of Distal Tibiofibular Fractures: Sang Ho Moon, Phil Hyun Chung, Chung Soo Hwang, Dong Ju Chae, Beom Kim; J Korean Soc Fract 2000;13(2):296-302. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.296

Abstract PDF: PURPOSE
: To compare redioiogic results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures.
MATERIALS AND METHODS
: From April 1993 to February 1999, 26 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 61 fractures fixed with nails only. Average age of patients was 41.8 years. These two groups were compared by frequency of malalignment, degree of postoperative angulation, angulation according to comminution, angulation according to fracture configuration. The statistical analysis was evaluated by t-test.
RESULTS
: Fibular fixation group had no malalignment while non-fixations had angulation of 1.2+/-1.1 degree and non-fixation had 3.0+/-2.1. So fixation had lessor angulation than non-fixation significantly(p=0.004). In lateral rediographs, each had 1.3+/- 1.1, 2.8+/-2.3 degree and showed significant difference(p=0.027). In type I and II fractures of Winquist-Hansen classification, fixation group showed lesser degree of angulation in A-P plane significantly(p=0.008) but no significant difference in lateral plane. In type III and IV, no significant difference in both planes. According to configuration of fractures, transverse and spiral fractures showed no significant differences but oblique configurations had significant differences in A-P plane(p=0.002) CONCLUSION : Interlocking intramedullary nail with fibular fixation has the advantage in maintenance of alignment during insertion of nail in distal tibiofibular fractures, especially in Winquist-Hansen classification type I and II and oblique fractures in anteroposterior plane, so it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

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Comparison between results of treatment of the Femoral Neck and Intertrochanteric Fractures : Focused on Mortality rate and Complications: Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Tae Hoon Kim, Han Chul Kim, Yong Soon Kim; J Korean Soc Fract 1999;12(4):792-802. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.792

Abstract PDF

The incidence of femoral neck and intertrochanteric fractures has steadily increased with lengthening of the life span. It is well known that anatomical characteristics of femoral neck may evoke complications such as nonunion and avascular necrosis. And there are many problems in the treatment of femoral intertrochanteric fractures due to osteoporosis, unstable pattern of fracture and poor general condition in elderly patients. The author analyzed 56 cases(56 patients) of femoral neck fractures and 63 cases(61 patients) of femoral intertrochanteric fractures which we have been able to follow up more than 1 year from March 1991 to March 1997. The purpose of this study is 1) to analyze results of treatment, predisposing factors, complications and mortality rates, and so 2) to reduce the mortality rate and complication in these fractures. The results were as follows , 1. The difference in union time between both type of fractures was not significant. 2. The mortality rate during admission was 1.8% in femoral neck fractures and 6.3% in intertrochanteric fractures. 3. The mortality rate during 1 years was 3.6% in femoral neck fractures and 9.5% in femoral intertrochanteric fractures. 4. The predisposing factors associated with postoperative mortality rate were malnutrition. chronic obstructive pulmonary disease, previous contralateral hip fracture, and operation within 3 days.

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Anesthetic considerations for surgical treatment of geriatric hip fracture
Dong Kyu Lee, Seunguk Bang, Sangseok Lee
Anesthesia and Pain Medicine.2019; 14(1): 8. CrossRef
A Comparison of Clinical Results between Compression Hip Screw and Proximal Femoral Nail as the Treatment of AO/OTA 31-A2.2 Intertrochanteric Femoral Fractures
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, In Hwa Back, Kyeong Soo Eom
Journal of the Korean Orthopaedic Association.2016; 51(6): 493. CrossRef
Postoperative Mortality and the Associated Factors in Elderly Patients with Hip Fracture
You-Sung Suh, Yong-Beom Kim, Hyung-Suk Choi, Hong-Kee Yoon, Gi-Won Seo, Byung-Ill Lee
Journal of the Korean Orthopaedic Association.2012; 47(6): 445. CrossRef
One-Year Mortality Rate of Patients over 65 Years Old with a Hip Fracture
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Young Hwa Choi
Hip & Pelvis.2011; 23(2): 137. CrossRef

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Percutaneous Fixation in Medial Malleolar Fracture: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Ki Se Nam, Ho Kyun Bae; J Korean Soc Fract 1999;12(2):314-320. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.314

Abstract PDF: Fracture of the ankle is one of the most common fractures. Usually medial malleolar fractures, when non-displaced or minimally displaced, have been treated by closed reduction and cast immobilization for long period, so stiffness and osteoporosis of ankle were frequently inevitable. We investigated the result of percutaneous pinning or screw fixation and early mobilization in the treatment of medial malleolar fracture of the ankle. With clinical and radiological data, authors analysed 17 patients(17 ankles) who were treated with closed reduction and percutaneous pinning or screw fixation between August 1991 and May 1997. and following results were obtained. One case of pin site infection was noted and no nonunion or loss of fixation was identified and average duration of bone union was 12 weeks. According to Burwell's protocol, the good result are 16 cases, the fair is 1 case and the poor result is not observed. From the viewpoint of rehabilitation, authors consider percutaneuos pinning is an excellent plan of treatment of medial malleolar fractures, when non-displaced or minimally displaced.

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Treatments of Tibial Condylar Fractures: Yong Bum Park, Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Dong Ju Chae, Han Chul Kim, Sang ho Moon, Seung Hun Lee, Tae Young Kim, Sun Hyun Yun; J Korean Soc Fract 1998;11(4):790-797. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.790

Abstract PDF: The tibial condylar fractures are characterized by intra-articular extension of fracture line and associated soft tissue injuries, and could affect knee alignment, stability, adn range of motion after treatments. Therefore, anatomical reduction and rigid internal fixation is mandatory to get satisfactory results. But this method of treatment can not be always possible due to technical dimend of surgical sklls and high risk of postoperative infection. The authors analyzed 43 cases of tibial condylar fractures, which were treated at the orthopaedic department of the Dongguk University Hospital from March 1990 to May 1996. Males were 34, and females were 9. Average age of patients was 41.4 years, and average follow up period was 18 months. The most common causes of injuries were traffic accidents (36 cases), and most common type of fracture was Schatzker type I. associated soft tissue injuries were observed in 21 cases. Treatment methods were chosen by degree of displacement of fracture fragment and associated soft tissue injuries. Conservative treatments were done in 23 cases and operative treatments in 20 cases. Satisfactory results were obtained in overall 32 cases(74%) regardless of the methods of treatment. Unsatisfactory results were observed in patients who had associated soft injuries and significant displacement of fracture. Conclusively, satisfactory results could be obtained in patients with tibial condylar fractures by appropriate selection of treatments according to displacement of fracture and associated soft tissue injuries.

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Treatments of the delayed Union or Nonunion of Tibial Shaft Fracture Fixed with Interlocking IM nail: Yong Bum Park, chung Soo Hwang, Phil Hyun Chung, Suk Kang, Dong Joo Chae, Han Chul Kim, Sang Ho Moon, Jong Phil Kim, Dae Jin Kim; J Korean Soc Fract 1998;11(3):552-559. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.552

Abstract PDF: Interlocking intramedullary nailing has been the first choice treatment of most tibial shaft fractures because its rigidity of fixation allows early ROM and weight bearing. Although most interlocking nailing procedures are performed with closed reduction that preserve periosteal blood supply, delayed union or nonunion is often occurs. so secondary procedures, such as bone graft, dynamization, nail exchange, are necessary to achieve fracture healing. We analyzed 25 cases of delayed union or nonunion from 432 tibial shaft fractures fixed initially with static interlocking intramedullary nailing since January 1990 till January 1996. Overall incidence of delayed union or nonunion is 5.8%(25/432). Secondary procedures included mainly iliac bone graft or dynamization. Average time to achieve bone union after secondary procedure is 6.1 months. The more distracted or displaced fracture ends after interlocking nailing or the more comminuted fracture fragments led to the more delayed bone union. Careful attention to minimize distraction or displacement during interlocking nailing is necesary to decrease the incidence of delayed union or nonunion. And appropriate procedures should be performed when delayed union or nonunion is predicted, which result in success in most cases.

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Osteofibrous Dysplasia of The Femoral Shaft: Chung Soo Hwang, Phil Hyun Chung, Dong Ju Chae, Jung Yong Hong, Seung Hun Lee; J Korean Soc Fract 1997;10(4):761-765. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.761

Abstract PDF: Osteofibrous dysplasia is a rare benign fibrosseous lesion that occurs predominantly in children. It is almost always occurs in the tibia, occasionally in both tibia and fibula or only in the fibula. It is distinguished from fibrous dysplasia by the osteoblastic rimming of the bony trabeculae and the presence of lamellar bone and radiographically by its cortical location rather than medullary location. We are now reporting a case of an eleven-year-old male patient who had a osteofibrous dysplasia of the femoral shaft with pathological fracture.

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Intra-Articular Fractures of the Calcaneus: Open reduction and internal fixation via extended lateral transcalcaneal approach: Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Yong Min Kim, Hyung Ho Oh, Dong Joo Chae, Min Hyo Park, Jee Hong Kim, Yun Chul Cho; J Korean Soc Fract 1996;9(3):733-741. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.733

Abstract PDF: Fractures with displaced articular facet of subtalar joint occupies 60-75% of whole calcaneal fractures. Nowadays, general principle of treatment for displaced intraarticular fracture has become anatomical reduction of joint surface and rigid fixation of the fracture. However, it had been difficult to apply this principle in cases of calcaneus due to various obstacles such as anatomical characteristics, therefore outcomes were not satisfactory in many cases. Extended lateral approach, which was designed by Letournel and Benirschke, contributed greatly in overcoming those obstacles. From August 1992 to April 1994, the author managed fifteen displaced intraarticular fractures of the calcaneus in fourteen patients with open reduction of displaced intraarticular fragment via extended lateral approach and internal fixation using reconstruction plate. The fractures were examined preoperatively with Brodens view and classified according to Eastwood(1992) with 2-plane CT. All the fractures united within postoperative 20 weeks(average 10.9 weeks). Final results were assessed by the clinical criteria for calcaneal fracture designed in Greighton Nebraska Health Foundation. Among the 15 cases, excellent results were obtained in eight cases, good in six, fair in one. There were no remarkable complications at the latest follow-up. In managing displaced intraarticular fractures of calcaneus, open reduction of displaced intraarticular fragment via extended lateral approach and internal fixation using reconstruction plate seemed to be very useful and harmless method.

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Failure after Operative Fixation of Fracture in Rigid Cerebral Palsy: Report of 2 Cases: Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Yong Min Kim, Hyung Ho Oh, Dong Ju Chae, Seung Hoon Lee; J Korean Soc Fract 1996;9(1):229-234. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.229

Abstract PDF: In the management of fractures in patients with cererbral palsy, pre-existing contracture of joint and muscles, difficulty in maintenance of reduction partly because of involuntary motion of muscles are obstacles to the orthopaedic surgeons. Furthermore, disuse osteopenia in long term bed-ridden patients may be a Predisposing factor of refracture. Failures such as refracture were reported to occur 19 times more in cerebral palsy patients. Those failures usually result in malunion, which may be a cause of severely deformed extremities. Among various types of cerebral palsy, rigid type is rare and involuntary muscle contraction is rigid. Therefore, fractures in these patients may be more difficult to manage and be accompanied by more complications, such as refracture compared even to spastic type. We experienced fractures in two patients with rigid cerebral palsy. An 11 year-old boy(proximal femoral shaft fracture) and a 45 year-old man(humerus shaft fracture) were treated with open reduction and internal fixation using plate and screws. Initial fixation was thought to be enoughly stable, but within 3 weeks postoperatively, maintenance of reduction in both fractures failed eventually. Because of the rarity of cases and difficulty in maintenance of reduction, we report these two cases after reviewing of the literatures.

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Delayed Intramuscular Hematoma in Iliacus after Blunt Trauma to the Pelvis: Case Report: Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Yong Min Kim, Hyung Ho Oh, Min Hyo Park, Yoon Chul Cho; J Korean Soc Fract 1995;8(3):705-710. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.705

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Intramuscular hematoma in inner pelvic wall may not be a common problem for orthopaedic surgeons. It may be associated with fractures of pelvic bone, or bleeding tendency from various reasons.Usually these hematomae are managed conservatively because they have no harmful effect to the patient, their position makes it difficult to approach. Furthermore, the diagnosis of the hematomae is not simple, so suspicion is important for its diagnosis. We experienced one case of delayed intramuscular hematoma in iliacus muscle in a 16-year old boy who had suffered blunt trauma to the pelvic area five weeks before. MRI had a significant role in the diagnosis of the hematoma. After evacuation of the hematoma, the patient recovered to normal status. Concerning about its unusual course and diagnostic significances of MRI, we report this case after reviewing of the Iiteratures.

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Muscular Injury of Iliacus and Gluteus Maximus after Mountain Climbing
Ho Seung Jeon, Young Kyun Woo, Suk Ha Hwang, Seung Pyo Suh, Joon Kyung Lee
The Korean Journal of Sports Medicine.2014; 32(1): 65. CrossRef

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Dislocation of First Metatarsophalangeal and farsornetatarsal Joint: Case Report: Chung Soo Hwang, Yong Min Kim, Hyung Ho Oh, Young Un An, Jong Pil Kim; J Korean Soc Fract 1995;8(2):386-390. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.386

Abstract PDF

Dislocation of first metatarsophalangeal joint is a rare condition. Anatomically, the head of first metatarsal is stabilized by various soft tissue structures associated with the sesamoid bones. When the metatarsal head was entrapped underneath the sesamoid complex, it might be impossible to gain reduction via closed method. We experienced a case of dorsal dislocation of first metatarsophalangeal joint and associated dislocation of larsornetatarsal joint in a 32 year old man who was injured by ftll from height. Closed reduction fEiled even under spinal anesthesia. Open reduction via medial approach revealedbuttonholingof the metatarsal head under the sesamoid complex, which had made colsed reduction impossible. Concerning about the rarity and anatomical characteristic of these injuries, we report this case with reviewing of the literatures.

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Lateral Dislocation of the First Metatarsophalangeal Joint: A Case Report
Yeong-Sik Yun, Young-Mo Kim, Kyung-Cheon Kim, Pil-Sung Kim
Journal of the Korean Fracture Society.2008; 21(4): 312. CrossRef

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Treatment of Lateral Humeral Condylar Fractures in Children using Closed K-wire Fixation and Intraoperative Arthrogram: Chung Soo Hwang, Kyung Chul Kim, Phil Hyun Chung, Suk Kang, Eung Nam Cha, Yong Min Kim, Young Un An, Min Hyo Park; J Korean Soc Fract 1995;8(1):116-125. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.116

Abstract PDF: Lateral condylar fracture of humerus is the secondly most common elbow injury in childhood. Compared to the most common supracondylar fracture which is fracture of metaphysis around olecranon fossa, lateral condylar fracture is intraarticular, epiphyseal injury and easily displaced by extensor muscle pull. Therefore, lateral condylar fractures are reduced and fixed more frequently by open method than supracondylar fractures are. In spite of affording more accurate reduction, however, open treatment of fracture can be complicated by infection, avasular necrosis, disfiguring scars, etc. So, it is more desirable that accurate reduction and rigid fixation can be achieved by closed method. Sine July 1992, We manged 10 children with lateral condylar fractures of elbow using closed reduction, percutaneous K-wire fixation and intraoperative arthrogram for confirming the reduction status of articular margin. The fractures united and K-wires were removed within postop. 7 weeks(mean) in all cases. The patients were followed up for from 9 months to 2 years and 2 months postoperatively, revealed no great differences in carrying angle, range of motion and physical activity compared with contralateral elbow. Radiologic evaluation showed no definite complications except mild spur formation. Closed reduction and fixation followed by intraoperative arthrogram seemed tobe one of the useful method in the management of lateral humeral condylar fractures in children, especially in mildly displaced cases.

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