Journal of Musculoskeletal Trauma

Treatment of Periarticular Fracture of Elbow with Hinged External Fixator: Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Chang Hwa Hong, Yong Bum Joo; J Korean Fract Soc 2005;18(3):299-303. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.299

Abstract PDF: PURPOSE
To evaluate the result of the treatment with external fixator and early ROM exercise to prevent the stiffness and contracture of the elbow in unstable elbow injury.
MATERIALS AND METHODS
From Jan. 1997 to Dec. 2001, ten patients of unstable elbow injury treated with hinged external fixator and early ROM exercise were evaluated. The age was average 37 years. The patients were followed at least 1 years and motorcycle injury (4 cases) was most common. Nine cases were comminuted fractures and one case was fractures with dislocation. We estimated the result of the treatment with Mayo elbow performance index.
RESULTS
ROM exercise started in average 2 days after operation. Two cases were treated by ilizarov and eight cases treated by elbow distracter modified by the author. The result of the treatment was estimated as following: excellent in two, good in three cases, fair in eight cases, and poor in two case.
CONCLUSION
There were satisfactory results in patients treated with external fixation with early ROM exercise, whose injuries had difficulty in being fixed internally. The authors recommend hinged external fixation and early ROM exercise to prevent postoperative stiffness & contracture of elbow joint in this circumference.

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Operative Treatment of Traumatic Humeral Shaft Fracture: Comparision of Interlocking IM Nailing and Plate Fixation by Posterior Approach: Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Ho Sup Song; J Korean Fract Soc 2005;18(2):93-99. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.93

PURPOSE
To compare the results and complications of interlocking IM nailing and plate fixation by posterior approach in the treatment of traumatic humeral shaft fracture MATERIALS AND METHODS: From March 1997 to March 2003, 49 patients undergone operation due to traumatic humeral shaft fracture. Follow-up was over one year. 28 patients operated with interlocking IM nailing initially and 21 operated with plate fixation by posterior approach prospectively. Statistics were compared using clinical and radiological outcomes and complications.
RESULTS
Radiologically, bone union was observed after an average of 14.3 weeks in IM nailing, and 11.7 weeks in plate fixation. So plate fixation showed earlier bone union (p=0.012). Nonunion occurred in 4 cases (14.3%) operated with IM nailing, and 1 case (4.8%), that was open shaft fracture, with plate fixation. Nonunion occurred more frequently when operated by IM nailing. 6 cases showed limitation of shoulder movement due to damage of the rotator cuff by IM nail entry site. 1 case showed radial nerve palsy, and 1 case showed axillary nerve palsy in the case of IM nailing. Also, secondary surgery due to complications was operated in 9 cases (32.1%) in IM nailing and 1 case (4.8%) in plate fixation (p=0.03).
CONCLUSION
In the case of traumatic humeral shaft fracture plate fixation by posterior approach was more useful than IM nailing in the decrease of complications and bone union. Such approach is thought to be an excellent method for anatomic reduction and nerve exploration in the case of open and comminuted fracture which accompany nerve injuries

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Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn
The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef
Minimally Invasive Anterior Plating of Humeral Shaft Fractures
Hyun-Joo Lee, Chang-Wug Oh, Do-Hyung Kim, Kyung-Hyun Park
Journal of the Korean Fracture Society.2011; 24(4): 341. CrossRef
Result of Interlocking Intramedullary Nailing for Humeral Shaft Fracture Evaluation of Post-operative Shoulder Function
Seung Rim Park, Tong Joo Lee, Ryuh Sub Kim, Kyoung Ho Moon, Dong Seok You
Journal of the Korean Fracture Society.2007; 20(2): 166. CrossRef

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Modified Phemister Technique with Mersilene Tape Augmentation in the Acute Acromioclavicular Joint Dislocation: Hyun Dae Shin, Kwang Jin Rhee, Young Mo Kim, Kyung Cheon Kim, Choong Hui Lee; J Korean Fract Soc 2005;18(2):83-88. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.83

Abstract PDF: PURPOSE
To find out the consequences of the surgical treatment of acromioclavicular joint dislocation, using modified Phemister technique with Mersilene tape augmentation.
MATERIALS AND METHODS
We chose 26 patients who were able to follow up 1 year or more among the patients who were diagnosed as acromioclavicular joint dislocation in our hospital through February 2001 to March 2003 and took modified Phemister surgery with Mersilene tape augmentation. Patients with clavicle fracture were excluded. Evaluation of the surgical results was done with the condition or pain, function, range of motion by using Imatani evaluation system, and preoperative, postoperative and last follow up radiographs.
RESULTS
Most of the cases showed satisfactory result. Clinical evaluations were 16 excellent (62%), 10 good (38%), radiological evaluations were 14 excellent (54%), 10 good (38%), 2 fair (8%), and no poor group. On the final follow up six cases showed vertical translation, but none had clinical symptoms. Seven cases showed a little inflammation at where pin were inserted, but after the removal of the pin, the inflammation was gone.
CONCLUSION
The modified Phemister surgery for acromioclavicle dislocation is simple, but we can obtain strong fixation, and there is no burden of the removal of the metal plate, or complication of re- dislocation after the removal of the pin, so it is thought as a very effective surgery.

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Operative Treatment of Metacarpal Shaft Fracture>: Comparision of Low-Profile Miniplating System and Kirschner Wire Fixation: Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Ho Sup Song; J Korean Fract Soc 2005;18(2):105-109. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.105

Abstract PDF: PURPOSE
To compare Kirschner wire fixation and low profile miniplating system in metacarpal shaft fracture.
MATERIALS AND METHODS
Patients, available at least 1 year, who received the operative treatment after being diagnosed as metacarpal shaft fracture from 1997 May to 2003 May were the subjects with the exclusion of thumb fracture and intraarticular metacarpal bone fracture and also cases involving Kirschner wire fixation on severe laceration or open fracture. On the last follow up total action motion (TAM) and plain radiographes was checked.
RESULTS
In 7 cases (38.9%) where closed reduction and Kirschner wire fixation were carried out, 8 cases (61.5%) where open reduction and Kirschner wire fixation were carried out and 24 cases (88.9%) where open reduction using miniplate and screw showed either excellent or good results on TAM. 5 cases of dorsal angulation occured in closed reduction and Kirschner wire fixation group and 4 cases of dorsal angulation in open reduction and Kirschner wire fixation group however no cases of dorsal angulation occured in open reduction and miniplate and screw fixation group, and in all cases no rotational deformity, complications through ulnar or radial angulation occured. Internal fixation was carried out on 2 cases of nonunion which had closed reduction and Kirschner wire fixation carried out, while the rest all showed bony union.
CONCLUSION
Selective use of low profile miniplate and screw fixation in the metacarpal shaft fracture is more effective than in cases of comminuted fracture which can not be achieved firm fixation by Kirschner wire fixation. Low profile miniplate and screw fixation can get more precise anatomical reduction and firm fixation so it allow early return to daily living activity and show low complication rate.

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Conservative Treatment of the Displaced Clavicular Shaft Fracture in Multiple Injury: Hyun Dae Shin, Kwang Jin Rhee, Young Mo Kim, Se Min Woo, Ho Sup Song; J Korean Fract Soc 2004;17(4):333-337. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.333

Abstract PDF: PURPOSE
To analyse the comparative clinical results between adults with multiple injury including the clavicular shaft fracture and only clavicular shaft fracture who had supportive care through retrospective aspect.
MATERIALS AND METHODS
We had 48 adult patients in this hospital with simple fracture and multiple injury including the clavicular shaft whom we were able to evaluate at least more than a year. 12 of 48 patients were with only clavicular shaft fracture and the rest of them were with multiple injury. We classified patients into two groups those who had fracture with displacement for group A (A1 for the cases with over 50% of fracture surface contact rate and A2 for less than 50% from the images of simple X-ray) and those who had comminuted fracture for B. We compared the time of bone union, nonunion rate of only clavicular fractures and multiple injury, clinical results for patients who had supportive care with retrospective aspect.
RESULTS
A1 (7 cases), A2 (4 cases), B (1 case) were prevalent in the group of only clavicular shaft fracture and A1 (8 cases) and A2 (16 cases) and B (12 cases) were prevalent in the group of multiple injury. For the cases with supportive care, we could find 1 nonunion case (8%) and 11 union cases on average 2.91 months in the group of only clavicular shaft fracture and 7 nonunion cases (19%) and 29 union cases on average 3.58 months in the group of multiple injury. The best clinical results had occurred in 8 cases (67%) of only clavicular shaft fracture group and 19 cases (53%) of multiple injury group. We could find out the union from all 8 nonunion cases that took operation afterward.
CONCLUSION
Although the choice of treatment of clavicular fracture is supportive care, but multiple injury including the clavicular fracture is a high-energy injury, so the possibility of comminuted and displacement is high, so that nonunion rate is high. The possibility of early surgery must be considered seriously.

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Minimally Invasive Percutaneous Plate Osteosynthesis for Distal Tibial Shaft Fracture: Jun Young Yang, Kwang Jin Rhee, June Kyue Lee, Deuk Soo Hwang, Hyun Dae Shin, Hyun Ho Lee; J Korean Soc Fract 2002;15(2):286-291. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.286

Abstract PDF

INTRODUCTION: Minimally invasive percutaneous plate osteosynthesis(MIPPO) was performed to treat distal tibial shaft fracture, and the results were compared to those of open plate fixation to find appropriate treatments MATERIALS AND METHODS: Among the patients who visited the Orthopedics Department at our hospital and were diagnosed with distal tibial shaft fracture, 12 cases that received MIPPO and 14 cases receiving open plate fixation were chosen for the study. The average age of patients were 57.8 and 50.8 years, and the male:female ratio was 1:1 in both cases. The average post-operative follow up period was 18 months and 19.5 months, and simple X-ray was done to evaluate the fracture healing.
RESULTS
The cases that received MIPPO, the operation time was 46.5 minutes and the average period of hospitalization was 25.3 days. There were no Nonunion, one case of delayed union, and one case of superficial infection. In the open plate fixation group, was 115.6 minutes and 48.3 days. Nonunion was in two cases, delayed union in two cases, superficial infection in one case, and deep infection in two cases. The nonunion cases were later given autogenous bone graft and fracture healing was attained.
CONCLUSION
By performing MIPPO quicker recovery of the patient can be made. Infection and nonunion, the most important complications due to operation, can be reduced. MIPPO thus seems to be the method leading to more close physiologic bone fusion in the treatment of distal tibial shaft fracture.

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The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture
Seong-Jun Ahn, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Seong-Ho Yoo, Kwan-Taek Oh
Journal of the Korean Fracture Society.2013; 26(4): 314. CrossRef

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Effect of the Ultrasound and LASER in the fracture healing in rabbits: Jun Young Yang, Kwang Jin Rhee, June Kyu Lee, Deuk Soo Hwang, Hyun Dae Shin, Jun ho Lee; J Korean Soc Fract 2001;14(3):305-312. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.305

Abstract PDF: PURPOSE
To study the effectiveness of the ultrasound and LASER on the fracturehealing in rabbits.
MATERIALS AND METHODS
This study was performed on rabbits using the Hi-Tech 2000 (Ultrasound+LASER) which was made in our institute. After anesthesia of the rabbit, the shaft of tibia was fractured with Gigli saw under aseptic condition, and then intramedullary nailing using K-wire was performed. We evaluated left tibia as control and right tibia as experimental. we applicated ultrasound and LASER from 7 days after operation and sacrificed at 3 weeks and 5 weeks after operation. Gross findings, simple radiologic findings, and histologic findings were evaluated by modified Zorlu scoring system. With use of T-test of SAS system ( level of significance, P < 0.05 ), difference between left and right tibia were evaluated to be determined the effect of ultrasound and LASER on the fracture-healing.
RESULTS
At postoperative 3 weeks, differences were noted in 4 cases but we could detect no significant difference between left and right side. At postoperative 5 weeks, differences were noted 6 cases and significant difference was noted.
CONCLUSIONS
Seeing this results, ultrasound and LASER treatment was effective in fracture healing. However we think that additional studies for accurate quantitative and qualitative analysis, biomechanical test in callus, microangiographic study and clinical research to determine the effectiveness of ultrasound and LASER in clinical field are needed.

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Popliteal Artery Injury Associated with Fracture and/or Dislocation of the Knee: Jun Young Yang, Kwang Jin Rhee, June Kyu Lee, Deuk Soo Hwang, Ki Yong Byun, Taek Soo Jeon; J Korean Soc Fract 2000;13(3):494-500. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.494

Abstract PDF: PURPOSE
To compare the outcome in patients who have popliteal artery injury associated with fracture and/or dislocation around the knee according to treatment option.
MATERIALS AND METHODS
We have reviewed fourteen cases of popliteal artery injury patients associated with fracture and/or dislocation injury around the knee who had visited at Chungnam National University Hospital from April 1997 to July 1999.
RESULTS
Combined skeletal injuries included fracture of distal femur, fracture of proximal tibia, and dislocation of the knee. Internal or external fixation was applied for skeletal injuries. We repaired the injured popliteal artery using end-to-end anastomosis (3 cases), interposed saphenous vein graft (9 cases), prosthetic vein graft (1 case), or thrombectomy alone (1 case). The amputation rate was 21 % (3 out of 14 patients). In limb salvage cases, we evaluated the function of knee joint, and the results were as follows : good 5 cases, fair 3 cases, and poor 3 cases.
CONCLUSION
Early diagnosis and prompt management for injuries of the popliteal artery is the most important factor to save the limb. Also, complete resection of all injured portion of vessel and reconstruction of patency through interposed saphenous vein graft are most useful method.

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The Effect of External Distractor on Recovery of B hler angle in Displaced Intraarticular Calcaneal Fractures: Deuk Soo Hwang, Kwang Jin Rhee, June Kyu Lee, Jung Hee Choi; J Korean Soc Fract 2000;13(2):375-381. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.375

Abstract PDF: PURPOSE
: We had studied the results retrospectively in displaced intraarticular calcaneal fractures treated with internal fixation by screw for thalamic portion and percutaneous pinning by K-wire using minimal Ollier's lateral approach, so we had reported good results, but recovery of B hler angle loss was difficult technically. So, we used intraoperative external distractor combined with previous our method.
MATERIALS AND METHODS
: We analysed retrospectively B hler angle and clinical results on 12 cases with clcaneal fracture, who underwent an operation for displaced intraarticular calcaneal fracture by using external distractor from January 1997 to August 1998. B hler angle were measured at preoperative, postoperative and last follow-up X-ray. Surgical technique is through minimal Ollier's lateral approach, reduced and fixed with screw of displaced posterior facet and used intraoperative external distractor for restoring of deperssed calcaneal tuberosity and then did percutaneous pinning with K-wire. RESULTS : In the previous our reports, the mean preoperative and postoperative B hler angle were -0.9degrees, 19.1degreeseach other and the mean recovery of B hler angle was 20.1degrees. After we use the intraoperative external distractor, the mean preoperative and postoperative B hler angle were 0.92degrees, 26.0degreeseach other and the mean recovery of B hler angle is 26.9degrees. It is nearly normal range of korean's B hler angle (31.1degrees+/-0.4 degrees). Also there is no complication such as intraoperative calcaneal tuberosity fracture and soft tissue injury(skin necrosis, neurovascular injury).
CONCLUSION
: We obtained enough restoration of B hler angle to normal range by using our previous method combined with intraoperative external distractor.

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Scaphocapitate Fusion for Kienbock disease: Jun Young Yang, Hyun Dae Shin, Sang Ro Ahn, Kwang Jin Rhee, Jun Kue Lee, Jung Hee Choi; J Korean Soc Fract 1999;12(2):446-451. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.446

Abstract PDF

We reviewed 14 patients treated with scaphocapitate fusion for Kienb.. ock's disease(Lichtman stage III) with mean follow-up of 26 months (ranging from 1 years to 5 year). There were five mens and nine womens. The mean age of patients at the time of operation was 46.1 years (ranging from thirty one to sixty). According to Lichtman's classification, All patients were stage III. Clinical assessments were evaluated using by pain relief, limitation in range of motion and clinical improvement. Radiologic assessment was evaluated by carpal height ratio. The mean range of motion is flexion 30 degree, extension 41 degree preoperatively, and flexion 29 degree, extension 41 degree postoperatively. The mean carpal height ratio is 0.49 preoperatively and 0.48 postoperatively. All of cases are relief of pain. Therefore radiographic and clinical satisfactory results were obtained. In conclusion, scaphocapitate fusion appear to be a very effective method for Lichtman stage III of symptomatic Kienb.. ock's disease.

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Lunate Excision and Tendon Ball Implantation in Lichtman Stage IIIB Kienböck's Disease in Middle-Aged Patients
Sang Jin Cheon, Dong Ho Lee, Shi Hwan Park, Woong Ki Jeon
Journal of the Korean Society for Surgery of the Hand.2015; 20(3): 110. CrossRef

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The Treatment of the displaced Distal Radius fractures-Prospective study-: Jun Young Yang, Hyun Dae Shin, Kwang Jin Rhee, Jun Kyu Lee, Deuk Soo Hwang, Jang Ik Lee, Jung Hee Choi; J Korean Soc Fract 1999;12(2):411-421. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.411

Abstract PDF: Fractures of the distal end of the radius, including Colles'fractures, represent the most common fractures of the upper extremity. Over the past years, many clinicians had thought of fractures of the distal radius as being a group of injuries with a relatively good prognosis. Today, fractures of the distal radius are recognized as very complex injuries with variable prognosis that depend upon the fracture type and the treatment given. We performed a prospective study in 51 patients(52 cases), by using treatment protocol of Palmer, we treated each fracture according to physiological age, activity, X-ray findings and stability after closed reduction. Final outcomes were evaluated by modified clinical scoring system, criteria for anatomical results and combined functional and anatomical results. Results by using modified clinical scoring system were excellent; 8 cases, good; 16 cases, fair; 22 cases, and poor; 6 cases. Results by using criteria for anatomical results were excellent; 8 cases, good; 26 cases, fair; 10 cases; and poor; 8 cases. In wrist rating scales of New York Orthopaedic Hospital, excellent; 7 cases, good; 32 cases, fair; 6cases, and poor; 7 cases. In our study, fractures of the distal radius were occurred frequently in active young male with high energy injuries. Criteria about acceptable range of reduction in treatment protocol of Palmer were too wide to obtain satisfactory results. Results from many assessment systems did not matched with each other because of differences of point of views. The results of this study proposed that even acceptable reduction is obtained, better outcomes will be brought by operative modality due to decreased frequency of reduction loss and radial shortening. And also, physical therapy after fracture treatment is considered as one of the important factors influencing functional results and the satisfaction of patients themselves.

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The Operative Treatment of Acetabular Fracture: Deuk Soo Hwang, Kwang Jin Rhee, Jun Young Yang, Jang Ik Lee; J Korean Soc Fract 1999;12(2):212-219. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.212

Abstract PDF: PURPOSE
To analysis clinical and radiological result of surgically treated acetabular fractures and to present appropriate surgical approach for fracture type. MATERIAL AND METHODS: A review of 51 surgically treated acetabular fractures, treated between April 1988 and October 1996, using single surgical exposures and combined surgical exposures was conducted. The classification was used Judet & Letournel,s classification and the surgical approach was applied Kocher-Langenbeck, Ilioinguinal, and Combined approach according to fracture aspect. The result was rated on a radiographic as well as a clinical result scale based on Matta,s.
RESULTS
The most common fracture was 14 posterior wall fracture and 7 transverse fracture. the surgical approach was applied Kocher-Langenbeck 29 cases, ilioinguinal 10 cases, and combined approach 8 cases, triradiate approach 2 cases and Extended iliofemoral approach 1 case. A satisfactory reduction was obtained in 87% of the cases (concentric, gap < 3mm). Clinical results were excellent in 28%, good in 54%, fair in 12%, and poor in 6%. Radiologic results at followup indicated 40% excellent results, 35% good results, 16% fair results, and 9% poor results. Postoperative complications appeared in 7 cases including posttraumatic arthritis 2 cases. Two patients later required total hip arthroplasty for avascular necrosis of femoral head and posttraumatic arthritis.
CONCLUSION
Ilioinguinal approach was good method for access to the anterior wall and column fracture, but in case of severe comminuted medial wall fracture company with anterior column, internal fixation is impossible. So, accurate assesment of the fracture pattern by careful radiologic analysis is essential. The posterosuperior dome fracture is important to anatomical reduction because of high risk of posttraumatic arthritis. In case of Transverse fracture, T-shape fracture, and both column, the more displaced column was reduced first, followed by opposite column after reduction identify by intraoperative radiography. We can be attained satisfactory reduction. Therefore, combined approach was good surgical method for this complex fracture.

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Comparison of the Clinical Results Between the Plate Fixation and Intramedullary Nailing for the Diaphyseal Both Forearm Bone Fractures: Hyun Dai Shin, Kwang Jin Rhee, Jun Young Yang, Sung Ho Yun, Mun Jong Lee; J Korean Soc Fract 1999;12(1):135-144. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.135

Abstract PDF

The fractures of the forearm bone are common and the forearm has the specific movement of supination and pronation. So, the goal of the treatment of forearm fractures is the recovery of rotatory function of the forearm as well as the function of the elbow and wrist. Surgical treatment usually is not necessory in children under 10 years of age because of remodelling potential and spontaneous correction ability. But, anatomical reduction and rigid fixation is essential in fractures of adult forearm above 15 years of age because of rotational deformity and angulation after forearm fractures may result in serious functional problems of the forearm. The purpose of the our retrospective study is to compare the clinical result between the plate fixation and intramedullary nailing of the diaphyseal both forearm bone fractures in adult. We reviewed 64 patients above 15 ages who had diaphyseal both forearm bone fractures, and were treated with fixation using compression plate or Rush pin. Forty patients were treated with both plates, 7 patients with both Rush pins, and 17 patients with plate and rush pin. Galeazzi or Monteggia fractures were excluded in this study. On final follow up, we performed the radiological analysis and compared the operation interval, immobilization period after operation, bone union time, functional result and complications in these groups. Functional results was more higher in both plate fixation, and complications were high in both intramedullary nailing. In conclusion, both plate fixation is the best treatment method in the diaphyseal both forearm bone fractures in adult. Thus in both forearm bone fractures, both plate fixation is recommended, but if it is not available, at least one bone with plate fixation is necessary

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Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults
Sanglim Lee, Hee-Sung Lee, Yerl-Bo Sung, Jae-Kwang Yum
Journal of the Korean Fracture Society.2009; 22(1): 30. CrossRef
Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail
Kwang-Yul Kim, Moon-Sup Lim, Shin-Kwon Choi, Hyeong-Jo Yoon
Journal of the Korean Fracture Society.2008; 21(2): 157. CrossRef

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Radiologic Evaluation of the Ankle Joint: Comparison of Different criteria & its A vailability of Clinical Practice: Deuk Soo Hwang, Seung Ho Yune, Kwang Jin Rhee, June Kyu Lee, Je Taek Jeong; J Korean Soc Fract 1998;11(4):880-885. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.880

Abstract PDF: Generally it is Known that the best clinical results in treatment of injuries of the ankle are obtained by anatomical restoration of the joint. For objective measurements of tibiotalar joint, some investigators ued different criteria and defined the specific reference points under variable angle of internally rotated anteroposterior projection. But, occasionally we didn't acquire the accurate roentgenographic finding that was suggested by investigators. So, we check the variable angle of internal rotation film in addition to angle suggested by investigators and compare the criteria between them. The purpose of this study is to evaluate availability of internally rotated mortise view and its criteria in clinical practice. Following results was acquired. First, there was no significant difference in measuring the medical clear space on depand on variability of rotation angle. Second, the overlapping distance of tibiofibular syndesmosis decreased by increasing internal rotation angle, but was not under 1mm (ie, index of injury). A third, to measure the Weber's 3 criteria, we need to check the variable internal rotation angle, if necessary. Finally, we acquired the normal range of measurement about Tile's 2 criteria by variable internal rotation angle.

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Operative Treatment of Olecranon Fractures Using Tension Band Wiring: Hyun Dae Shin, Kwang Jin Rhee, June Kyu Lee, Joon Uoung Uang, Young Mo Kim, Mun Jong Lee, Jin Soo Kim; J Korean Soc Fract 1998;11(3):672-682. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.672

Abstract PDF

We treated 26 cases(25 patients) olecranon fractures operatively with Kirschner wire and tension band wiring technique from January 1993 to December 1995. The Kirschner wire fixation methods in our study were either bicortical fixation(15 cases) or intramedullary fixation(11 cases). We retrospectively reviewed clinical results according to Mayo elbow performance index and starting time of full range of motion(ROM) exercise. We analyzed relationship between the cli9nical results of the cases with cast immobilization and those without cast immobilization. We also compared Kirschner wire fixation methods in the respect of clinical results, full ROM exercise starting time and complications. The results were as follows. 1. Clinical results were excellent or good in 25 cases(96%) according to Mayo elbow performance index. Full ROM exercise starting time was within 2weeks in 10 cases, between 2-3weeks in 11 cases, between 5-6weeks in four cases and after 6weeks in one case. Full ROM exercise starting time was significantly different(P=0.016) with clinical results statistically and there was statistically high significant difference(P=0.0025) between clinical results and cast immobilization or not. 2. Clinical results of bicortical fixation group was ont significantly different frmo those of intramedullary fixation group and there was no significant difference between full ROM exercise starting time and Kirschner fixation methods statistically. 3. The most frequent complications were decreased ROM and loosening of the Kirschner wire. There were decreased ROM In 10 cases and loosening of the Kirschner wire in 6 cases in all cases. We encountered more higher incidence of complications related to intramedullary fixation method. The clinical results and full ROM exercise starting time of bicortical fixation group were not significantly different with those of intramedullary fixation group statistically. But more early exercise, more better clinical results and more less complications was produced in bicortical fixation group. So we thought bicortical fixation method is better than intramedullary fixation method.

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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
Journal of the Korean Fracture Society.2008; 21(2): 130. CrossRef

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Operative Treatment of the Intercondyle of the Humerus in adults: Hyun Dae Shin, Kwang Jin Rhee, June Kyu Lee, Won Sok Lee, Seung Jin Lee; J Korean Soc Fract 1998;11(2):345-353. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.345

Abstract PDF: We had studied the results of operative treatments in twenty-seven interconylar fractures of the distal end of the humerus over a ten-year period retrospectively. From march 1989 to February 1996, 27 patients were included in this study. The fracture patterns were classified according to the system of Muller et al. and evaluated the results of the involved elbow by Jupiter's scale. The mean follow-up was 47.8 months. The operation method was open reduction by wide exposure and transolecranon approach and internal fixation between two condyles by cancellous screw or Hebert screw and two reconstruction plate rectangularly each other. Among 27, 17 were men and left elbow were 15. The mean average age was 50.2 (23- 72)years old. The most common injury mechanism was direct trauma in 18 cases(62.9%). By Muller classification C3 type were 12 cases(44.4%), while C1 were 5 cases and C2 were 5 cases and C2 were 10 cases. At last follow-up the elow ROM was average flexion angle 107 degrees(18 to 125 degrees). Except intolerable pain and partial stiffness of elbow, the postoperative complications were 4 cases ; dsyesthia of ulnar nerve were 2, infection were 1, and heterotopic ossification was 1 case. The results of excellent and good were 20 cases(74.1%). In 7 cases of fair and poor results, C3 were 4 cases and C2 were 2 cases. It was concluded that the transolecranon approach and dual-plate fixation on humerus for fractures of the intercondyle of the humerus was satisfactory and necessary to effort of rigid fixation and a early rehabilitation after operation as possible.

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The Problem of Screw Failure at the Interlocking Nailing using AO Unlearned Tibial Nail(UTN) in the Treatment of the Tibial Shaft Fractures: Ki Young Byun, Kwang Jin Rhee, Jun Kye Lee, Deuk Soo Hwang, Chan Hee Park, Hyeong Seong Kim; J Korean Soc Fract 1996;9(2):480-488. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.480

Abstract PDF: Recently, the interlocking intramedullary nailing is being regarded as one of the best method using static or dynamic UTN(Unlearned Tibial Nail) in the treatment of the tibial shaft fractures. However it has made the locking screw break because the early weight bearing and exercise for the early bony union and the delayed removal of the static locked screw. Failure of the locking screw has not resulted in loss of reduction, but broken screw can make nail removal difficult. The authors have clinically analysed 17 patients of open tibial shaft fractures treated with static or dynamic interlocking intramedullary nailing using UTN followed by more than 6 months at Chung Nam National University Hospital from January 1993. to February 1995. 1. In all 17 cases, nails were inserted via closed method and early weight bearing was encouraged. 2. Among 17 cases, 4 cases of proximal static screw were broken, and all screw failures were occurred in static hole of proximal portion of AO UTN. 3. Among 17 cases, secondary dynamization was tried at POD 4 wks for early bony union in only one case and that revealed good result. So, We recommand that the locking screw of the proximal lowest hole should be removed before weight bearing because of its mechanical weakness, and that the start of weight bearing should be considered according to AO Groups principles including the character of the patient and fractures.

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Importance of maintenance medial buttress in treatment of supra-condylar and inter-condylar(T-condylar) fracture of the femur: Seung Ho Yune, Kwang Jin Rhee, Chan Hee Park, Ki Yong Byun, Sang Yong Lee, Seung Kwon Rho; J Korean Soc Fract 1996;9(1):50-58. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.50

Abstract PDF

Recently, treatment of supracondylar and intercondylar(T-condylar) fracture of the femur has been changed from conservative treatment to do open reduction and internal fixation. Principles of anatomical reduction, rigid internal fixation and early knee joint exercise are recommended, but there are many difficulties and problems to get anatomial reduction and rigid internal fixation. we observed 3 cases of malunion & nonunion that were treated by ORIF. In these cases, there is a failure in restoring medial buttress of distal femur due to inadequate reduction and internal fixation. Dynamic condylar screw(DCS) or blade plate were usually used through lateral approach and laterally applying method can not always restore the medial buttress of the fracture site. In these cases, early exercise and early weight bearing have to be postponed,and the results were poor. So we want to emphasize the principles in open reduction and internal fixation of the supra-and inter-condylar fracture fo the femur. To get anatomecal reduction is very important, but if is not possible in severely comminuted fractures, we have to try to maintain medial buttress by another methods such as double plating(to add a medial auxiliary buttress plate to lateral internal fixation) or auxiliary external fixations instead of medial anatomical contact.

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Medial Plating of Distal Femoral Fracture with Locking Compression Plate-Proximal Lateral Tibia: Cases' Report
Se-Ang Jang, Young-Soo Byun, In-Ho Han, Dongju Shin
Journal of the Korean Fracture Society.2016; 29(3): 206. CrossRef
The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Kwang-Hee Park, Yoon-Ho Choi
Journal of the Korean Fracture Society.2009; 22(4): 246. CrossRef

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Chondrodiatasis of the Distal Femur: Report of 2 cases: Kwang Jin Rhee, Chan Hee Park, Jin Sun Jeong, Cheol Se Ahn; J Korean Soc Fract 1995;8(1):39-45. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.39

Abstract PDF: Chondrodiatasis is a limb lengthening technique involving slow, controlled, symmetric epiphyseal distraction. The technique has significant advantages over other correction methods that involves osteotomies. We have used this methods with other surgical technique to lengthen limbs in 2 children with leg-length discrepancies or with angular deformities. Shortely after initial lengthening, the growth plate seemed maintain its function. But, several years later, the growth plate fused. In spite of many report that chondrodiatasis having many complications, there was no special complications in our cases. In the absence of definite proof, we decide to use this technique clinically almost during the last two years of the growth period.

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Management of Acetabular Fracture: Kwang Jin Rhee, Jyun Kyu Lee, Chan Hee Park, Ho Suk Lee, Kyoung Tai Kim; J Korean Soc Fract 1994;7(1):137-143. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.137

Abstract PDF: Acetabulum consisting of the hip joint is the most important weight bearing portion in the lower extremity But if fractures of acetabulum are not accurately evaluated, classified, and reduced anatomically, major sequalae and complication are frequently developed. Because of complicated anatomy, difficulty with surgical exposure, frequent associated injury, the treat ment of acetabular fractures between conservative and surgical methods is still controversal. We studied roentgenographic finding, associated inlury, method of treatment and result of treatment. We reviewed forty cases of acetabular fracture from May 1985 to July 1993. The results was as follows; 1. The pervalent age was from second decade to forth decade. 2. We classified 40 cases by Letournel classification. The most common type was posterior wall fracture, the second was anterior column fracture. 3. Most common associated injury was pelvic bone fractures. 4. Surgical approaches were decided by the fracture type and duration from injury to operation. 5. In nonoperative treatment group, 73.3% of cases were excellent and good result, and in operative treatment group 88.0% of cases were excellent and good result. 6. The complications were occured in 12 cases(48.0%) of 25 cases of operative reatment group.

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Late open reduction and ligament reconstruction of old unreduced palmar lunate dislocation report of 2 cases: Sang Rho Ahn, Seung Ho Yune, Kwang Jin Rhee, Keun Baek Lee, Jun Young Yang; J Korean Soc Fract 1993;6(1):85-91. Published online May 31, 1993; DOI: https://doi.org/10.12671/jksf.1993.6.1.85

Abstract PDF: No abstract available.

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A clinical study of ankle fracture: Kwang Jin Rhee, Deuk Soo Hwang, Young Ahn Jin; J Korean Soc Fract 1991;4(1):63-74. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.63

Abstract PDF: No abstract available.

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