Journal of Musculoskeletal Trauma

Operative Treaeent of Hohl II, III Plateau Fracture by Small Incision and Bone Window: Jin Woo Kwon, Kyoung Tae Sohn, Sung Ho Shin, Woo Se Lee, Won Ho Jo, Jae Il Kim; J Korean Soc Fract 1999;12(3):593-600. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.593

Abstract PDF: Severely depressed plateau fractures, especially Hohl I, III, can not be reduced by ligamentotaxis and require elevation through a cortical window, bone grafting, and fixation with either cancellous screws or a buttress plate. But traditional long lateral parapatellar incision and plate fixation method caused frequent wound dehiscence and deep infection. Thus to reduce the soft tissue problem we treated Hohl II, III plateau fractures by small anterolateral L-shaped incision, submeniscal exposure, reduction of depressed plateau and bone graft through bone window, and then cancellous screws fixation beneath the subchondral bone of elevated plateau. We anayzes 22 cases with Hohl II, III plateau fractures, which were treated by these method from February 1990 to December 1997 and followed more than 1 year. Males were 17, and females were 5. Average age of patients was 44.7 years. The most common cause of injury was traffic accidents(17 cases), and fracture type according to the Hohl classification was 14 cases of type II, 8 of type III. The associated injuries were 18 cases of meniscus tear, 13 of ligament injury(6 ACL, 7 MCL). The clinical results by Blokkers criteria were satisfactory 19 cases(86.3%) and unsatisfactory 3 cases(13.7%). We concluded that this method has following advantages; relatively firm fracture fixation, short operation time, low soft tissue problem.

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The Problems of Locked Intramedullary Nailing in the Proximal Shaft Fractures of the Tibia: Jin Woo Kwon, Kyoung Tae Sohn, Seung Ho Shin, Jae Il Kim; J Korean Soc Fract 1999;12(1):76-82. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.76

Abstract PDF: Proximal shaft fractures of the tibia have a high incidence of complication and often result in poor outcomes. Plate fixation and locked intramedullary nailing are the most common methods of treatment, but now the latter is more popular because of soft tissue problem, osteomyelitis etc.. The purpose of this study is to evaluate the results of locked intramedullary nailing in the treatment of proximal shaft fractures of the tibia and to draw a conclusion that what type of fracture patterns are the appropriate indication of nailing. We analyzed 18 proximal shaft fractures of the tibia which were treated by locked intramedullary nailing from October 1991 to March 1997 and followed more than 12 months. The results were as follows ; The complications were occurred in 12 cases(66.6%); 4 cases of delayed or non-union, 8 of angular deformity, 1 of leg length discrepancy. Delayed or non-unions were caused by fracture site comminution and bone defect. 5 anterior angular deformities were due to the pulling of the knee extensor mechanism and 3 valgus deformities were due to medially located entry portal. In conclusion, since locked intramedullary nailing in proximal tibial fractures causes a high incidence of complications, it is recommended in transverse or undisplaced fractures. And plate fixation and bone graft will be recommended in comminuted or displaced oblique fractures, if soft tissue condition is permitted.

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Combined Injuries of Pubic Ramus Fracture : The Role of Computerized Tomography: Choong Gil Lee, Jin Woo Kwon, Kyoung Tae Sohn, Seung Ho Shin, Jun Wook Park; J Korean Soc Fract 1999;12(1):40-46. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.40

Pelvic fractures in general can be divided into two major types, based on the amount of energy involved : low-energy mechanisms are usually fractures of individual bones of the pelvic ring and high-energy mechanisms results in more severe injury to the pelvic ring, generally producing pelvic ring disruption. Pelvic fractures resulting from low-energy mechanism are usually fractures of individual bones of the pelvic ring that do not damage the true integrity of the ring structure. These include avulsion fractures, isolated fractures of the sacrum, and iliac wing fracture. Computerized tomography permits confirmation of findings noted on plain film and delineates injury to the posterior ring. It facilitates subclassifying the fracture according to degree of severity, as in the Young classification. The purpose of this study is to evaluate the role of CT, which is to identify the combined injuries of pubic ramus fractures. The sacrum impacted fracture and sacroiliac joint injury are often unidentified and diagnosed as an isolated fracture to the pubic ramus. The 42 cases of pubic ramus fractures on conventional radiography were simultaneously performed CT from June 1996 to February 1998. The results of associated injuries were as follows. 1. In 34 cases (81%) posterior pelvic ring injuries (sacral fractures 28 cases, anterior sacroiliac joint widening 6 cases) were observed. 2. CT was very useful to diagnose the posterior pelvic injury and to determine the mechanisms of injury.

Citations

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Deep-learning-based pelvic automatic segmentation in pelvic fractures
Jung Min Lee, Jun Young Park, Young Jae Kim, Kwang Gi Kim
Scientific Reports.2024;[Epub] CrossRef

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Aorto-Innominate Venous Fistula after percutaneous kirschner wire fixation of the Sternoclavivular Joint Anterior Dislocation: A case report: Choong Gil Lee, Jin Woo Kwon, Kyoung Tae Sohn, Seung Ho Shin, Jong Cheon Park; J Korean Soc Fract 1998;11(4):953-957. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.953

Abstract PDF: Kirschner wire fixation in sternoclavicular dislocation poses a considerable risk of serious early or late complications. We report a case of Kirschner wire penetration into the innominate vein and aorta, which caused aortovenous fistula and congestive heart failure.

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Complications of Interlocking Intramedullary Nailing for the Humeral Shaft Fractures: Choong Gil Lee, Jin Woo Kwon, Kyoung Tae sohn, Seung Ho Shin, Jong Cheon Park; J Korean Soc Fract 1998;11(2):254-261. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.254

Abstract PDF: Locked intramedullary nailing has been used as a popular method in treating humeral shaft fracture because of relatively less invasive procedure, good stability and allowing early rehabilitation. However many problems such as rotator cuff injury, iatrogenic fracture, difficult distal locking at operation and painful limitation of shoulder motion due to protrusion of the nail above the greater tuberosity, frequent delayed or nonunion were reported. We reviewed our experience with 26 cases of humeral shaft fractures that were treated by interlocking intramedullary nailing to evaluate the pitfalls and the complications of this technique. the results were as follows. 1. In five cases(19.2%) iatrogenic fractures occured during nail insertion. Three were in the site of inlet and two were in the original fracture site. 2. In four cases(15.4%) painful limitation of shoulder motion was persisted for 2 months. Two were caused by subacromial impingement due to nail protrusion and two were by intraoperative rotator cuff injury. 3. Nonunion occured in two cases(7.7%) which were middle one third transverse fractures and were not fixed with distal locking screws. 4. Intraoperative and postoperative complication rate was 42.3%.

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