Journal of Musculoskeletal Trauma

Long Term Follow up Results of the Operative Treatment of the Acromioclavicular Joint Dislocation with a Wolter Plate: Ki Ser Kang, Han Jun Lee, Jae Sung Lee, Jae Yoon Kim, Yong Beom Park; J Korean Fract Soc 2009;22(4):259-263. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.259

PURPOSE
To evaluate the long-term clinical and radiological results of the operative treatment of the acromioclavicular dislocation with a Wolter plate. MATERIALS AND METHODS: We reviewed clinical and radiological data of twenty patients (mean age: 37 years) who underwent the operative treatment of acromioclavicular joint dislocation using a Wolter plate from September, 1999 to December, 2002 with minimum of five years follow-up (average 6 years 7 months). The clinical outcomes of twenty patients were evaluated by UCLA scoring and radiological results of fifteen patients with available radiograph were evaluated by Zanca view and stress view. RESULTS: The mean UCLA score was mean 33 points (range, 27~35) at final follow up. By clinical evaluation, twelve cases (60%) were excellent, six cases (30%) were good and two cases were poor (10%). By radiological evaluation, eight cases (54%) were excellent (without displacement), five cases (33%) were good (displacement <5 mm) and two cases (13%) were poor (displacement >5 mm). Erosive change in acromioclavicular joint was seen in poor case. CONCLUSION: Wolter plate fixation may be a useful modality for treating acromioclavicular joint dislocation. Great care should be taken to make the hook hole at the appropriate position during operation for long-term prognosis.

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Clinical outcomes of bending versus non-bending of the plate hook in acromioclavicular joint dislocation
Min Su Joo, Hoi Young Kwon, Jeong Woo Kim
Clinics in Shoulder and Elbow.2021; 24(4): 202. CrossRef
Clinical Comparison of Two Types of Hook Plate in Surgical Treatment of Acromioclavicular Dislocation - AO Hook Plate and Wolter Plate -
Jea-Yeol Choi, Eugene Kim, Haw-Jae Jeong, Jin Whan Ahn, Hun-Kyu Shin, Se-Jin Park, Seung-Hee Lee, Jae-Wook Lee, Kyu-Bo Choi
The Journal of the Korean Shoulder and Elbow Society.2012; 15(2): 123. CrossRef

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The Effect of COX-2 Inhibitor on the Expression of MMP-13 during Early Fracture Healing Phase in Rats: Ki Ser Kang, Han Jun Lee, Jae Sung Lee, Ho Sung Ryu; J Korean Fract Soc 2009;22(1):45-50. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.45

Abstract PDF: PURPOSE
This study investigated the effect of COX-2 inhibitor on the expression of MMP-13 in the healing process of fracture. MATERIAL AND METHODS: Adult Sprague-Dawley rats were divided into two groups of twenty five rats each. Unilateral femoral shaft fractures were created artificially under displacement in all two groups. COX-2 inhibitor was only given to the experimental group from the postoperative day 1. At 2 weeks after fracture the rats were sacrificed and the callus from each group was used for histologic examination and real time RT-PCR for MMP-13 expression.
RESULTS
Histologically, proliferation of osteoblasts and formation of osteoid was less abundant in the experimental group. In real time RT-PCR, the mean expression of MMP-13 is 2.84+/-2.50 in the control group compared with 1.16+/-1.05 in the experimental group.
CONCLUSION
In the early stage of fracture healing, COX-2 inhibitor suppress the expression of MMP-13.

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The Usefulness of Non-operative Treatment of Distal Radius Fracture in Elderly Patients: Ki Ser Kang, Han Jun Lee, Sang Hak Lee; J Korean Fract Soc 2004;17(4):345-349. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.345

Abstract PDF: PURPOSE
To disclose the correlation between the functional and radiologic results of the treatment of distal radius fracture in elderly patients by non-operative versus operative treatment.
MATERIALS AND METHODS
From January 1995 to December 2000, 36 patients, more than 60 years old with fractures of distal radius were treated and followed up for more than one year. We classified them using the Fernandez classification and evaluated functional and radiological results according to the subjective point system of Cole & Obletz and objective evaluation by Scheck.
RESULTS
In functional result, excellent to good results were obtained in 12 cases (71%) in the non-operative group and 14 cases (74%) in the operative group, there were no evidence of statistical difference between two groups (p>0.05). In radiographic results, mean radial inclination, loss of radial length and volar tilt were 13degree, 12.3 mm, 7.2degrees in the non-operative goup and 5.2degrees, 5.1 mm, 3.3degrees in the operative group on last follw-up radiographs, there were evidence of statistical difference between two groups (p<0.05).
CONCLUSION
Operative treatment is radiographically better result in distal radius of elderly patients but functional satisfaction is not significantly related with radiographic result. When we decide the treatment of elderly patients, non-operative treatment can be useful method, considering with patient's age and activity status.

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Anatomical Assessment of the Proper Insertion Site for a Tibial Nailing: Soo Yong Kang, Eun Woo Lee, Ki Ser Kang, Han Jun Lee, Ho Joong Jung, Pyeong Ho Jeong; J Korean Fract Soc 2004;17(2):142-147. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.142

Abstract PDF

PURPOSE
To investigate the proper insertion site for a tibial intramedullary nail in the Korean.
MATERIALS AND METHODS
Forty volunteers without trauma below knee joint were studied to determine relationship between central axis of medullary canal and lateral tibial spine, patellar tendon and the proper insertion site, and to evaluation changes of proper insertion site during rotation of knee and effective diameter.
RESULTS
The proper insertion site located average 4.3+/-0.9 mm medial to the lateral tibial spine. The proper insertion site was in the medial 1/3 of patellar tendon in 6 knees, middle 1/3 of patellar tendon in 20 knees, and lateral 1/3 of patellar tendon in 14 knees. The proper insertion site might be changed two times in internal rotation more than in external rotation. The effective diameter was more narrow in medial slope than in lateral slope at proximal tibia.
CONCLUSION
The study indicates the ideal insertion site of tibial nail is the medial aspect of the lateral tibial spine in Korean. To reduce the mal-reduction from a improper insertion site, lateral insertion site might be safer than medial one. However, individual variations in the relationship between the patellar tendon and tibial medullary canal should be considered.

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Three-dimensional analysis of the intramedullary canal axis of tibia: clinical relevance to tibia intramedullary nailing
Sang Jun Song, B. O. Jeong
Archives of Orthopaedic and Trauma Surgery.2010; 130(7): 903. CrossRef
Three Dimensional Analysis for the Intramedullary Canal Axis of the Proximal Tibia: Clinical Relevance to Total Knee Arthroplasty
Sang Jun Song, Choong Hyeok Choi
The Journal of the Korean Orthopaedic Association.2007; 42(3): 345. CrossRef

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A Prospective Study of Fractures of the Tibial Shaft Treated with Intramedullary Interlocking Nail : Comparing One versus Two Distal Screws: Eun Woo Lee, Ki Ser Kang, Soo Yong Kang, Eui Chan Jang, Jin Woo Lee; J Korean Soc Fract 1997;10(2):303-308. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.303

Abstract PDF: In non-randomized prospective study, 67 tibial fractures were treated with intramedullary inter-locking nail. Patients were divided into 2 groups based on the number of distal locking screw. Group I was consisted of 33 fractures treated with one distal locking screw Group II was consisted of 34 fractures treated with two distal locking screws. The patients were followed up for an average of 12 months. There was no statistically significant difference between group I and II with regard to total operation time, fracture union time. However fluoroscopic time was significantly longer at group II than group I. Serial radiographs of patients in both group were analyzed for change of hardware and fracture healing postoperatively. No significant difference was found between two groups in fracture union time, hardware failure and complications in proximal and middle tibial fracture. But the angulation and locking screw breakage were significant in group I in distal tibia fracture. We concluded that fracture of the proximal and middle third of the tibia that require interlocking nail can be successfully treated with a single distal locking screw. However, in fractures of the distal one third, two distal locking screws should be required to prevent of angular deformity in sagittal plane and for stablefixaton. The use of a single distal locking screw reduces operation time, radiation exposure, local soft tissue discomfort and cost without compromizing fracture union.

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Thirty-five Degree Internal Oblique Radiographs in Assessment of Tibial Fracture Healing: Eun Woo Lee, Ki Ser Kang, Soo Yong Kang, Jin Woo Lee; J Korean Soc Fract 1996;9(2):475-479. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.475

Abstract PDF: For the assessment of fracture healing, tomogram, computerized sonometry, resonant frequency analysis etc. were introduced recently, but most of orthopedic surgeons depend on plain X-ray and clinical experience. The progress of tibial fracture healing may be difficult to assess through routine radiological examination(AP and lateral). So, we intended to assess the healing of tibial fracture with 35Â° internal oblique view as well as AP and lateral. Five orthopedic surgeons assested the tibial fracture heating with only AP and lateral (group 1), and AP. lateral and 35Â° internal oblique view(group 2) in 45 tibial fractures. In the percent agreement of their assessment, Group 1 was 60% and group 2 was 76%. Group 2 was higher than group 1, especially in IM nailing and bone graft groups.The change of judgement between the two group was 18.7%, and it was higher in the distal tibial fracture, posterolateral bone graft and external device groups. In 11 Cases, the fibular fractures were overlapped with tibiai fracture in laterai view, in which cases 35Â° intelnal oblique view was useful for assessing the tibial fracture healing. We recommand 35Â° internal oblique view for assessment of tibial fracture healing before using more tophisticated and expensive procedure, especialiy in patients with posterolateral bone graft, distal libial fracture and combined fibular fracture, and probably in IM nailing and external device.

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A Simplified Technique of Distal Locking Screw Fixation of Interlocking Nail: Young Bok Jung, Ki Ser Kang, Boo Sup Kim, Han Jun Lee, Whui Jae Jin; J Korean Soc Fract 1995;8(1):248-253. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.248

Abstract PDF: Failure to determine distal femoral screw hole position can sometimes prolong operating time for placing interlocking screw and increased radiation hazard. We attempted to assess progress in the insertion of distal locking screw with target device. Insertion method of distal locking screw in femoral nail that uses target device improved the accuracy of distal screw placement and reduced the radiation exposure. The authors analyzed 30 patients(33 cases) of the femur shaft fractures that treated by interlocking IM nailing using target divice in the Department of Orthpaedic Surgery, Chung-Ang university from August 1990 to July 1994. Among these patients, except 6 cases, all of the distal femoral drill holes attempted were successfully made with the first pass of a dirll without image intensiner monitoring. Compared with the commonly used free-hand method, our target divice assisted screw placement offer a reduction in the amount of time and radiation exposure to insert distal locking femoral screws.

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