Journal of Musculoskeletal Trauma

Treatment of Nonunion in Femoral Supracondylar and Intercondylar Fracture: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yu, Eun No Lee, Yoon Yeup Kim; J Korean Soc Fract 1999;12(4):844-850. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.844

Abstract PDF: The femoral supracondylar and intercondylar fractures are difficult to be treated due to severe soft tissue damage, comminution, intraarticular extension of fracture and injury to the quadriceps mechanism frequently. The causes of nonunion are inadequate anatomical reduction, fixation failure, bone defect and infection occasionally, which is difficult to be treated. The authors analyzed 16 cases with nonunion of femoral supracondylar and intercondylar fracture who had been treated surgicdlly from January 1990 to December 1991 According to AO/ASIF classification in the initial fracture patterns, type A were 8 cases, type B was 1 case and type C were 7 cases. The duration between initial treatment and surgical treatment of nonunion was 6 months in average. The causes of nonunion were fixation failure due to inadequate device selection in 9 cases, inadequate anatomical reduction or surgical technique in 4 cases and infection in 3 cases. The treatmentt were internal fixation with Dynamic condylar screw(DCS) in 9 cases, internal fixation with condylar blade plate in 4 cases, monofocal lenghtening with Ilizarov in 1 case and bifocal lenghtening with Ilizarov in 2 cases. According to Schatzker classification, the good result was obtained in 11 cases(68.8%). The complications were 3 knee joint ankyloses, 2 superficial wound infections, 1 delayed union and 1 deep vein thrombosis. In conclusion, the requirement for the good result in treatment of nonunion are exact anatomical reduction, rigid fixation and autogenous bone graft.

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Treatment of the Long Term Neglected Patella Fracture Nonunion: 4 Cases Report: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Gi Lee, Yoen Sik Yu, Eun No Lee, Hong Man Cho; J Korean Soc Fract 1999;12(3):727-731. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.727

Abstract PDF: Non-union of patella fracture was rare reported. We reported our experience with four cases of non-union of patella fracture treated by surgical intervention. Surgical management by skeletal traction and tension band wiring achieved union of the fracture in all four cases. The patients also recovered an excellent range of movement and strength in the affected knees.

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Treatment of the Lateral Condyle Fractures of the Humerus in Children: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yoen Sik Yu, Eun No Lee, Nak Hoon Seong; J Korean Soc Fract 1999;12(3):667-673. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.667

Abstract PDF: The authors analysed the 40 patients of the lateral condyle fracture of the humerus in children who were admitted in Korea Veterans Hospital in Seoul from Jan. 1990 to Dec. 1997. The fracture type and the displacement was classified according to Milch type and Jakob stage. Clinical analysis was performed on 40 patients with lateral condyle fracture of humerus, who could be followed up. The patients were followed up from 12 months to 63 months with an average of 23 months. Average duration of bone union was 6 weeks after operation. The significant differences in outcome were notified from open reduction and internal fixation in comparison to closed reduction and percutaneous pinning. According to the criteria of Hardacre, we obtained excellent result in 16 cases(40%), good result in 22 cases(55%) and poor results in 2 cases(5%).

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Treatment of Supracondylar Fractures of the Humerus in Children: Duk Yong Lee, Jae Ik Shim, Taek Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yoen Sik Yu, Young Jin Park; J Korean Soc Fract 1999;12(1):179-186. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.179

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The supracondylar fracture of the humerus is the most common fracture of the elbow in children and is occasionally associated with significant residual complications such as cubitus varus deformity. Clincal analysis was performed on 32 patients with displaced supracondylar fractures of humerus, who were treated either by closed reduction and percutaneous pinning or by open reduction and internal fixation. The results were as follows : 1. The average age of the children was 6.8 years old in both sexes, and male to female was 21 : 11. 2. The extension type was 26 cases(82%), flexion type was 6 cases(18%) and the left side was more frequently involved. 3. According to Pirone classification, type II was 14 cases, type III 18 cases. 4. There was no significant difference in the mean duration of bony union between the percutaneous group and the open reduction group. 5. Cubitus varus deformity and limitation of elbow motion were more common complications in open reduction group.

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The Effect of Rotational Deformities on Cubitus Varus for Supracondylar Humerus Fractures in Children
Hyun Dae Shin, Kyung Cheon Kim, Dong Kyu Kim, Woo Yong Lee
Journal of the Korean Orthopaedic Association.2010; 45(5): 373. CrossRef

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A Comparision of Plate Fixation with Intramedullary Nailing in Treatments of Humeral Shaft Fracture: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yoo, Woo Seung Lee; J Korean Soc Fract 1998;11(3):696-702. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.696

Abstract PDF: Authors report 42 cases of humeral shaft fractures, which were treated with plate fixation in 19 cases and intramedullary(IM) nailing in 23 cases, from January 1992 to December 1996. The average time of operation in plate fixation was 100 minutes and that in Im nailing was 65 minutes. The nonunion in plate fixation was 2(10.5%)cases and that in IM nailing was 4(17.4%)cases. Other complications of plate fixation were 2 cases of wound infection and 2 cases of radial nerve palsy. Those of IM nailing were 1 case of limited motion of the shoulder and 1 case of wound infection. After reviewing above reslts, we concluded that there were no marked difference between the two operative method in bone union of humeral shaft fracture cxcept diversity of complication.

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Operative Treatments of the Tibial Pilon Fractures: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suck Ha Lee, Dong Ki Lee, Yong Chan Lim, Jae Joon Shin; J Korean Soc Fract 1998;11(2):390-397. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.390

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Treatment of tibial pilon fractures is difficult to manage because of its comminuted pattern of the intra-articular fracture of the ankle, the articular incongruity, associated with soft tissue injury and its complication. The modern concept of fracture mordality are the open anatomical reduction, stable internal fixation with correct length of fibula and functional aftercare. We analyzed 17 cases which underwent open reduction and internal fixation for the tibial pilon fracture at the Korea Veterans Hospital from March 1990 to September 1996. 1. The most common type was type III according to Ruedi and Allgower's classification. 2. The treatment was open reduction and internal fixation in all cases and the results were above fair by Ovadia and Beals criteria in 16 cases. 3. The union of fracture was taken in all cases and the duration of union was average 14 weeks. 4. The most common complication was the limitation of ROM in the ankle joint.

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Towards the synthesis of amphidinolide B. An intramolecular Stille coupling approach
M.Belén Cid, Gerald Pattenden
Tetrahedron Letters.2000; 41(38): 7373. CrossRef

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Treatment of Chronic Uncontrolled Infected Nonunion of Femur and Knee with the Ilizarov Instrument: 3 cases reports: Duk Yong Lee, Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suck Ha Lee, Hyung Gon Jee; J Korean Soc Fract 1997;10(4):801-811. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.801

Abstract PDF: We analysed three cases, repectively. The first case was chronic uncontrolled infected nonunion of femur due to open type III fracture which had been operated unsuccessfully at least 5 times. The second case was a infected nonunion and shortening of leg due to infecton of soft tissue surgery and then after knee arthrodesis. The third case was result from the total knee arthroplasty failure and then after knee arthrodesis. Ilizarov instrument was applied to this case for the knee joint arthrodesis. All cases showed bony union after average 14.6 months. The exact bony lengthening in the two cases after treatment was 11cm and 13cm and the healing index was 49.Odays/cm and 50.8days/cm The complications included the pin tract infection in all three cases and pin breakage in 2 of the cases. We achieved bony lengthening and bony union with relief of infection in 3 cases of chronic uncontrolled infected nonunion of femur treated with extensive saucerizaton and fixation using the Ilizarov instrument. These are the results of our treatment of chroic uncontrolled infected nonunion of femur using the Ilizarov instrument.

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Biomechanical Analysis of Translucent Hexagonal External Fixator: Duk Yong Lee, In Ho Choi, Chin Youb Chung, Tae Joon Cho, Yoon Keun Park; J Korean Soc Fract 1997;10(2):379-387. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.379

Abstract PDF: The mechanical stiffness of 4 configurations of the Translucent Hexagonal External Fixator(THEF) was analyzed and compared with conventional Ilizarov system in vitro. The advantage of the THEF was that it is less expensive, radio-translucent because it was made of carbon fiberepoxy. Stiffness in axial compression, torsion, A-P bending and lateral bending were measured in both fixators. The fixators were assembled into 90-90 and 45-135 configurations, respectively. In each configurations, two types of pin, smooth pins and olive pins, were used for transfixion. As compared with the Ilizarov fixator, the THEF was less stiff in axial compression when the two smooth pins were used for transfixion regardless of configuration, but was also less stiff in A-P and lateral bending except A-P bending when the smooth wires were assembled in 90-90 configuration, and lateral bending when the olive wires were assembled in 45-135 configuration. However, the THEF was more stiff in torsion regardless of configuration and type of wires used. When the olive wires were used, the THEF was more stiff than the Ilizarov fixator regardless of wire configuration in all loadiilg mode except AP bending. Changing the pin configuration from 90-90 to 45-135 decreased all stiffness of the Ilizarov fixator. However, lateral bending and axial compression stiffness with smooth wire and A-P bending stiffness regardless of types of wires were decreased in the THEF. Changing the smooth wires to olive wires increased the A-P and lateral bending stiffness in the Ilizarov fixator, while it increased all stiffnesses in the THEF. We believe that the results originated from the weakness of the material used. THEF may be an effective alternative for osteosynthesis, deformity correction in complex construct because of its radiolucency in spite of less favorable biomechanical properties in some loading mode.

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Analsis of the Distal Tibial Physeal and Epiphyseal Injury: In Ho Choi, Choon Ki Lee, Duk Yong Lee, Se Il Suk, Song Choi, Yong Hoon Kim, Suk Kee Tae, Seong Il Kim; J Korean Soc Fract 1989;2(2):164-173. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.164

Abstract PDF: We have reviewed 21 cases of physeal and epiphyseal fracture of the distal tibia including one case of juvenile Tillaux fracture and four cases of triplane fracture. The patterns of fracture were correlated with the mechanism of injury using the modified Lauge-Hansen method and sysemic classification of the triplane frature was proposed. Treatment included closed reduction and cast(9 cases), closed reduction and percutaneous pin fixation(4 cases), and open reduction(8 cases). Two of the nine patients treated by means of closed reduction and cast had ankle joint incongruity or progressive varus deformity requiring corrective ost eotomy. These two patients had either Salter-Harris Type III ro Type IV fracture after supination-inversion injury. In one patient, who had 100 per cent displacement of the distal tibial epiphysis and degloving injury of the ankle, premature physeal arrest developed after open reduction and internal fixaion for Salter-Harris Type Tyre I fracture. If there are triagular metaphseal ledge along with the juvenile Tillaux fracture-like vertical epiphyseal fracture line on the antero-posterior view and Salter-Harris Type II or Type IV frature on the lateral view, a certain type of triplane fracture is strongly suggested. Plain radiographs, however, could not accurately demontrate the detailed configuration of the triplane fracture, instead computerized axial tomography was very helpful us to analyse the true dimensions of the triplane fracture. We agree that displace Salter-Harri Type III or Type IV and transitional fractures with a fracture gap of more than two millimeters in the weight-bearing portion of the epiphysis regure open reduction.

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