Journal of Musculoskeletal Trauma

Multiple Stress Fractures Related to Low-dose Adefovir Dipivoxil Treatment in a Patient with Chronic Hepatitis B: A Case Report: Chul Hyun Park, Hyo Sae Ahn, Dong Chul Lee; J Korean Fract Soc 2014;27(4):327-331. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.327

Abstract PDF: Stress fractures typically result from repeated abnormal mechanical loading to the bones. In particular, multiple stress fractures may occur in patients with systemic disease, such as rheumatoid arthritis, osteoporosis, or osteoarthritis. Adefovir dipivoxil (ADV), a nucleotide analogue of adenosine monophosphate, very rarely causes severe hypophosphatemia when using a low dosage of 10 mg daily for treatment of chronic hepatitis B. To the best of our knowledge, in English literature, this is the first report of multiple stress fractures in a chronic hepatitis B patient who has been treated with a low dosage of ADV. We think it is important to consider that use of ADV in a patient with chronic hepatitis B could be a risk factor for stress fractures.

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Treatment and Functional Results of the Three and Four Part Fractures of Proximal Humerus: Dong Chul Lee, Hwan Jin Jeon, Jae Sung Seo; J Korean Soc Fract 2000;13(4):970-977. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.970

Abstract PDF: PURPOSE
The current study was performed to evaluate the treatment and functional results of the three and four part fractures of proximal humerus.
MATERIALS AND METHODS
Nineteen patients with displaced 3 part and 4 part fractures and fractures-dislocation were followed for more than one year and analyzed. The causes of injuries, classification of fracture, associated injuries, functions, results of treatment and complications were investigated.
RESULTS
According to Neer's classification, there were 15 cases of 3 part fracture and 4 cases of 4 part fractures. The range of motion and functional results of the shoulder in 3 part fractures (flexion 138.6degrees , abduction 124.3degrees , Constant score 60.3) were better than 4 part fractures (flexion 77.5degrees , abduction 60degrees , Constant score 29.5). We compared the humeral offset of injured side with the healthy one. In the cases of less than 4mm difference, the range of motion was 150degrees in flexion and 40.3degrees i n abduction, and the constant score was 67.3. But in the cases of more than 4mm difference, the range of motion was 84.3degrees in flexion and 58.6degrees in abduction, and constant score was 30.9 points. Clinical results was better in the cases of less than 4mm difference.
CONCLUSION
Range of motion and functional results of 3 part fractures were better than 4 part fractures and restoration of humeral offset resulted in better clinical results.

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Ipsilateral Femoral Shaft and Neck fracture: Dong Chul Lee, Yun Seok Lee, Duk Seop Shin; J Korean Soc Fract 1999;12(2):245-252. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.245

Abstract PDF: The occurrence of ipsilateral hip and femoral shaft fracture is uncommon and this problematic combination occur in 2.5% to 6% of femoral fracture. This combination of fractures result from high energy trauma and occurs in young multiply injured patient. As most orthopedists attention is directed to the shaft fructure of femur, the neck fracture can be commonly missed initially. Ipsilateral femoral shaft and neck fracture has the characteristics that has multiple associated injuries and many complications, such at avascular necrosis and nonunion of the femur neck, coxa vara. We analysed the outcome of treatment to know the results of treatment and its complication in 10 patients who were treated at Orthopedic Department, Yeungnam University Hospital from May 1991 to May 1996. The results were as follows : 1. Sixty percent of femoral neck fracture was basicervical type; Ninty Percent of femoral shaft fracture occured in the middle one third and most of the fractures were comminuted. There was one open fracture of femoral shaft. 2. All of the causes of the fractures occurred in motor vehicle accident. Mean age was 40.3 years(range: 15-59 years). There were 24 associated injuries in ten patients: especially, the injuries around knee were most common(6 tibial condylar fractures, 3 patellar fractures, 1 ligament injuries). 3. The bone union was obtained at average 2.8 months after operation(2 months - 5 months) in femur neck fractures, at average 5.5 months after operation(4 months - 12 months) in femur shaft fractttres and weight hearing was permitted at average 2.3 months after operation(1.5 months - 5 months). 4. There were 3 cases of nonunion of femoral shaft fracture, but they were treated by autogenous iliac bone graft Early bone graft may be necessary in comminuted femoral shaft fracture.

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Experience with Bipolar Hemiarthroplasty in Femoral Neck Fracture in the Elderly Patients: Correlation Between Preoperative Medical Conditions and Postoperative Functional Results of Hip: Kwang Hee Lee, Se Dong Kim, Dong Chul Lee, Duk Seop Shin; J Korean Soc Fract 1998;11(1):143-152. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.143

Abstract PDF

The displaced femoral neck fracture remains a major challenge to orthopedic surgeons, as the elderly population is increasing. Elderly patients with femoral neck fractures often have other medical conditions, fragile bones, and poor compliance. Thus, for elderly patients who need early ambulation and funtional recovery, bipolar prosthesis is accepted as an appropriate treatment. We report a study of 58 cases of bipolar hemiarthroplasty with a femoral neck fracture and a physiologic age older than 65 years from January 1991 to May 1996. The purpose of this study is to evaluate the functional outcome of bipolar hemiarthroplasty and correlation between preoperative medical conditions and Harris hip score in femoral neck fractures in the elderly patients. The results obtained were as followings. 1. 90% of patients had uncontrolled medical conditions. Cardiovascular and pulmonary disease were main preexisting medical conditions. 2. The preoperative medical conditions were important deteminants for the functional results after bipolar hemiarthroplasty. 3. Dislocated bipolar prosthesis needed open reduction or revision to total hip arthroplast due to disassembly of the prosthesis caused by attempted closed reduction.

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Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis - Comparative Analysis between Cementless Stem and Cemented Stem -
Joon Soon Kang, Kyoung Ho Moon, Rhu Seop Kim, Sang Ho Lee, Jong Min Choi
Journal of the Korean Fracture Society.2011; 24(1): 16. CrossRef

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Results of Operative Treatment in Fracture of the Proximal Tibial Plateau: Yong yeun Kim, Dong Chul Lee, Jong Chul Ahn; J Korean Soc Fract 1997;10(4):823-831. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.823

Abstract PDF

The tibial plateau fractures commonly result from high energy trauma such as traffic accidents or falls, and it is can produce the disability of the knee joint because it is frequently accompanied by the soft tissue injury such as ligaments and menisci. Even if accurate anatomical reduction and rigid internal fixation with early motion can decrease the complications, recent study show unacceptable results from 20 to 40 persents of cases. We have analysed 44 cases of tibial condylar fracture which were treated with operative method at Yeungnam University Hospital from Feb. 1990 to Apr. 1996. The results were as follows : 1. The type of fracture by Schatzker classification revealed in type 17 cases(16%) type II 4 cases (9%), the III 8 cases(18%), type IV 5 cases(11%), type V 13 cases(30%), type VI 7 cases(16%), and the main causes of injury were traffic accident(35 cases;80%), and fall(6 cases). The associated injury occured in 30 cases(68%) . Half of them (57%) were ipsilateral fibular fracture in 9 cases, ipsilateral patellar fracture in 8 cases, and ipsilateral femoral fracture in 8 cases. 2. The Clinical evaluation by Hohl criteria revealed in 76.8 scores fair in average in 44 cases, those were excellent in 2 cases(5%), good in 27 cases(62%) and poor in 5 cases(11%). The Subjective evaluation of the patients were more than good in 13 cases(29%), and less than fair in 31 cases (71%). The clinical averge score according to the type of fracture by Hohl evaluation were 79 in type I, 81 in type II, 81 in type III, 74 in type IV, 84 in type V and 72 in type VI. 3. The clinical results according to the adeqacy of reduction of depressed joint surface after operation were more than good(score>80) when the anatomic or adequate reduction of joint surface were performed. 4. The most complication was limitation of motion in 11 cases(25%), the other complications showed angular deformity in 6 cases(15%), infection in 5 cases, traumatic arthritis in 5 cases, and pernoneal palsy in 4 cases.

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Second-look arthroscopy after surgical treatment of Schatzker type II plateau fractures through the lateral submeniscal approach
Han-Jun Lee, Ho-Joong Jung, Eui-Chan Chang, Jae-Sung Lee, Hyoung-Seok Jung
Archives of Orthopaedic and Trauma Surgery.2014; 134(4): 495. CrossRef
Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures
Jae-Sung Lee, Yong-Beom Park, Han-Jun Lee
Journal of the Korean Fracture Society.2008; 21(2): 124. CrossRef

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Treatment of Unstable Intraarticular Fracture of Distal Radius with External Fixator and Minimal open Reduction: Jae Sung Seo, Jin Myeung Dan, Dong Chul Lee, Se Dong Kim; J Korean Soc Fract 1996;9(2):283-289. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.283

Abstract PDF: The distal radius fracture is one of the most common fracture in orthopedics, but their optimal treatment has not been delineated, especially in unstable intraarticular fracture. The unstable intraarticular fracture is increasig due to high energy injury following industrialization and increasing traffic accidents. The unstable intraarticular facture of the distal radius comprises distince subgroups that are difficult to manage and are associated with a high frequency of posttraumatic arthritis. Authors treated 6 cases of unstable intraarticular fracture of distal radius using external fixator and minimal open reduction to improve anatomical and functional results. Six patient were followed up more than one year (mean 19.3 month) and the patients were assessed functional results by Green and 0Briens score and anatomical results by Stewarts scale. Using the external firator and minimal open reduction, is thought to be a useful method for treatment of unstable intraarticular fracture of the distal radius.

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Comparison between Interlocking IM Nail and Ender Nail in the Treatment of Shaft Fracture of the Tibia: Dong Chul Lee, Sang Ho Lee, Se Dong Kim; J Korean Soc Fract 1995;8(4):830-840. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.830

Abstract PDF: The shaft of tibia is prone to the open wounds owing to the subcutaneous location and poor muscular envelope. The open wounds frequently result in the severe complications and major disabilities, such as infection, delayed union and nonunion. The choice of treatment should be considered cautiously. The intramedullary fixation of the shaft has the advantage of early weight bearing as well as relative firm fixation. Sixty four cases of fracture of the tibia shaft were treated with interlocking IM nail(38 cases) or Ender nail(26 cases) from December 1985 to January 1993. 1. The most common causes of the tibia fracture were the pedestrian injury and motorcycle accident. 2. There was no difference in operation time between interlocking IM nail group and 5 weeks in Ender nail group. the average time of operation was about 70 minutes. 3. The mean time of cast support was 2.5 weeks in interlocking IM nail group and 5 weeks in Ender nail group. The mean duration of nonweight bearing was 7.6 weeks in interlocking IM nail group,9.2 weeks in Ender nail group. 4. The mean duration of bone union was 18.7 weeks in interlocking IM nail group,21.4 weeks in Ender nail group. The interlocking IM nail group seemed to obtain earlier bone union(2.5 weeks) than Ender nail group, but there was no significance in statistical analysis in the bone union time between two groups. 5. Angular deformities were found in 3 cases in interlocking IM nail group and 4 cases in Ender nail group, which occured in the communited fracture and both ends fracture of the tibia shaft, segmental fractures. Delayed union was also occured in 5 cases in Ender nail group and 3 cases in interlocking IM nail group.

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A Comparison study of the Gamma nail and the Dynamic Hip Screw for Peritrochanteric Fractures: Dong Chul Lee, Sang Jae Lee; J Korean Soc Fract 1994;7(2):616-627. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.616

Abstract PDF

The peritrochanteric fractures had been very troublesome due to its complication in the treatment of the old patients in the pastdays. The Dynamic Hip Screw and the Gamma nail made the patients to mobilize early and decreased the complications. We have treated 44 cases of the peritrochanteric fractures using Gamma nail(25 cases) and Dynamic Hip Screw (19 cases) between Aug. 1989 and Nov 1993, and compared the results of each group. And obtained results were as follows 1. The traffic accident was constituted about one third proportion and unstable types of the peritrochanteric fractures were 25 cases among 44 cases(57%). 2. The Mean union time of the Gamma nail group was 10.4 weeks and the Dynamic Hip Screw group was about 13 weeks. There was statistically no significance in the mean union time between both groups. 3. There revealed significance(P<0.05) by statistical analysis in operation time, admission day, blood transfusion between both groups. 4. There revealed no signicance (p<0.05) by statistical analysis in degree of sliding of the lag screw and change of neck-shaft angle. 5. The complications in the Gamma nail group were varus in 3 cases and infection in 1 case, and in the Dynamic Hip Screw group there were varus in 3 cases, delayed union in 2 cases and refracture in 1 case.

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The Efficiency of Additional Fixation of the Alternative Bone Substitute in Unstable Intertrochanteric Fractures of Femur Treated with Gamma Nail
Jong-Oh Kim, Young-One Ko, Mi-Hyun Song
Journal of the Korean Fracture Society.2011; 24(1): 1. CrossRef

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Treatment of the Fractures of the Humeral Shaft with the Non-reamed True/Flex Humerus Rod: Dong Chul Lee, Jae Sung Seo, Sang Don Kim; J Korean Soc Fract 1994;7(1):122-130. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.122

Abstract PDF: Recently, surgical intervention of the fractures of the humeral shaft was increased due to the severe trauma occuring in the traffic accident and industrial accident, even if closed treatment was appropriate in the humeral diaphysis. In order to obtain the early mobilization prevention of the nonunion and joint stiffness, rigid fixation of the fracture is needed. To reduce the complication of the open reduction (nonunion, infection, radlal neue palsy), closed intramedullary nail fixation techlnques without opening the fracture site were used. Eight cases of the fractures of the humeral shaft were treated with nonreamed True/Flex humerus rod system(intramedullary fixation) between Nov.1992 and Apr.1993. And the obtained results were as follows. 1. The normal healing cases were S and its average healing time Is post-op. 9.2 weeks. There were nonunion in 1 case and delayed union in 2 cases. 2. The causes of the injury were traffic accident in 6 cases fall down in 1 case, belt injury in 1 case. 3. The causes of the nonunion and delayed union were as follows distraction(by inappropriate selection of the rod and physical treatment) in 2 cases, insufficient immobilzation in 1 cases. 4. The True/Flex humerus rod seemed to recommand to the patients with multiple, open, segmental fractures and poor qeneral condition.

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