Journal of Musculoskeletal Trauma

Midterm Results of Treatment with a Retrograde Nail for Periprosthetic Fractures of the Femur Following Total Knee Arthroplasty: Kyung Taek Kim, Jin Hun Kang, Lih Wang, Jae Sung Hwang; J Korean Fract Soc 2007;20(4):309-314. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.309

Abstract PDF: PURPOSE
To analyze the midterm results of the treatment with a retrograde nail for periprosthetic fractures of the femur following total knee arthroplasty.
MATERIALS AND METHODS
Between Jan 1998 and Jan 2004, 11 cases in 11 patients were treated for the periprosthetic fractures following total knee arthroplasty. The mean follow-up was 42.0 (30~98) months and the mean age was 66.0 (57~79) years old. 2 were males and 9 patients were females. In all cases, retrograde nailing was done for the periprosthetic fractures. Postoperative range of motion, HSS knee rating score, femorotibial angle, the time required for union, complications were evaluated.
RESULTS
Postoperative range of motion was 103.6Â° degrees on an average, HSS knee rating score was 83.5 points on an average at the last follow up. The mean angulation on radiograph was valgus 6.3Â°. The mean time required for union was 4 months. One had a newly fracture line at proximal part of supracondylar fracture, but there was no significant in clinical course. There was no prostheses required revision.
CONCLUSION
It appears that retrograde nail is a reliable surgical technique for periprosthetic fractures of the femur following total knee arthroplasty with low complication rate. The midterm results in our study showed that none of the prostheses required revision.

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Results of Operative Treatment of Distal Femoral Fracture: Sung Soo Kim, Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Hyung Seo Jang, Il Kwon Jung; J Korean Fract Soc 2005;18(3):232-237. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.232

PURPOSE
To evaluate the result of comparative study about the cases in the fracture of the distal femur treated with plate and screw, dynamic condylar screw, blade plate, retrograde intramedullary nail and external fixator.
MATERIALS AND METHODS
The AO classification system was used. 84 cases who were preformed operation during the period from March 1996 to May 2002, were included in this study. The mean duration of follow-up was 25 months. According to Sachatzker criteria, we classified the following results to excellent, good, fair and poor.
RESULTS
Type A were excellent or good result when treated with plate and screw, dynamic condylar screw and retrograde intramedullary nail. Type B were excellent or good result when treated with cannulated screw. Type C were excellent or good result when treated with plate and screw and blade plate.
CONCLUSION
We conclude that the most important thing in operation is firmly internal fixation and to obtain this, accurately anatomical reduction and the choice of suitable instrument for the type of the fracture are needed. cannulated screw. Type C were excellent or good result when treated with plate and screw and blade plate.

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Comparison of Results of Minimally Invasive Plate Osteosynthesis according to Types of Locking Plate in Distal Femoral Fractures
Oog Jin Shon, Moon Soo Kwon, Chul Hyun Park
Journal of the Korean Fracture Society.2012; 25(4): 269. CrossRef

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Treatment of Ipsilateral Femur and Tibia Fractures: Sung Keun Sohn, Kyung Taek Kim, Byeong Hwan Kim, Bum Ho Jung, Kyung Sik Hwang; J Korean Soc Fract 2000;13(4):837-846. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.837

Abstract PDF

PURPOSE
Searching for the most excellent outcome of ipsilateral fractures of femur and tibia according to the treatment methods and the combined injuries which occasionally neglected.
MATERIALS AND METHODS
We reviewed thirty cases of ipsilateral fractures of the femur and tibia, treated at the orthopaedic department of the Dong-A university hospital between February 1991 and May 1999. Children under 10 years old, treated by conservative methods were excluded in this study. Average follow-up period was 23.2 months(range, 5 to 44 months) and mean age was 34.7 years old(range, 16 to 58 years).
RESULTS
According to the measurement of the Karlstrom and Olerud, range of motion of the ipsilateral knee joint and bony union time, intramedullary nailing was the treatment of choice for both femur and tibia fracures except limited by open wound and fracture level and types(14 cases, 47%). The ipsilateral knee ligaments injury was the most common combined injury which neglected at initial trauma(8 cases, 27%).
CONCLUSION
By intramedullary nailing, the patients with ipsilateral fractures of femur and tibia could achieve early weight bearing ambulation and ipsilateral knee joint excercise, and showed the most excellent outcome. After fixation of both femur and tibia fractures, by physical examination and arthroscopic examination of ipsilateral knee joint we could detect and treat the ipsilateral knee ligaments injuries, which occasionally neglected.

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Ipsilateral Femoral Segmental and Tibial Fractures: A Case Report
Oog Jin Sohn, Chul Hyun Park, Sang Keun Bae
Journal of the Korean Fracture Society.2009; 22(3): 193. CrossRef

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Treatment of acromioclavicular dislocation by a Phemister method: Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Sung Soo Kim, Hyung Hwan Lee; J Korean Soc Fract 1996;9(1):154-160. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.154

Abstract PDF: Acromio-clavicular joint dislocation occurs when both acromioclavicular and coracoclavicular ligaments are ruptured and brings to deformity, arthralgia and limitation of motion of the shoulder joint. The treatment of complete acromioclavicular dislocation is controversial, and both of the conservative and surgical treatment are reported to be relatively successful. But, conservative treatment have many disadvantages and now rarely advocated. Recently, there are increasing tendencies to treat the acromioclavicular dislocatioll with anatomical reduction of acromioclavicular joint and rigid internal fixation for early movement of shoulder Joint. We report the results of 16 cases of acute acromioclavicular dislocation treated with Phemister or modified Phemister method. The results are as follows. 1. Among 16 cases,14 cases were males and 9 cases were belong to 3rd decade and 4th decade. 2. The most common cause of injuries was slip down. 3. Postoperative difference in coracoclavicular distance on radiogram was 0.1 mm on average. 4. Clinical results were excellent in 14 cases, good in 1 case and acceptable in 1 case. 5. Complications were redislocation in 1 case and K-wire migration in 1 case, but there was no arhritic changes on the affected A-C joint.

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The Use of Gamma Nail in Peritrochanteric Fractures of the Femur: Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Hyung Hwan Lee; J Korean Soc Fract 1995;8(4):753-759. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.753

Abstract PDF: In old age, trochanteric fracture occurs easily by trivial external force due to osteoprosis and many kinds of treatment has been performed. The goal of treatment in elderly patients with trochanteric fractures is restoration of function to preoperative ambulatory status at the earliest possible time. For this purpose operative treatment is gernerally recommended. The success of operative treatment depends on the stable reduction and secure fixation. Gamma nail is a new intramedullary device which has been applied in the treatment of trochanteric fractures with the benefits of the closed technique such as low blood loss, low risk of infection and short operative time. The implant can be used by the method of static or dynamic. Intraoperative compression of the fracture segments can be achieved by acting on the sliding lag screw and further compression is given by weight bearing. We studied 22 cases of patient who had the trochanteric fracture and treated operatively with gamma-locking nail at the department of orthopaedic surgery, Dong-A university hospital from January 1993 to December 1994. Among 22 cases, 7 cases were stable fracture and 14 cases were unstable fracture by the Evans classification. Mean operation time was 76 minutes and mean blood loss was 303 mf and intraoperative and postoperative complicatins were encountered in 3 cases, femur shaft fracture in 2 casea and lag screw displacement on the femoral head in 1 case. Based on the above results, we have experienced limited utiliBation of the nail because of the mappropriateness between nail and femur itself and non-skillful application technique. We think that if nail shape and assembly for fixating distal screw are improved, Gamma-interlocking nail is a good interraf fixation device which allows early weight bearing ambulation.

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A Clinical study of the Tibial Condylar Fractures: Jung Yoon Lee, Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Byeong Hwan Kim; J Korean Soc Fract 1994;7(2):269-278. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.269

Abstract PDF: The tibial condylar fracture which involves articular surface of the proximal tibia is common in traffic accident and often produces some disability of the knee joint because it is frequently accompanied by injuries to ligaments and menisci. There are much controversies in the method of treatment in the fractures of the tibial condyle. Although the anatomical reduction and rigid internal fixation with early knee motion are reconmanded to obtain good results, unsatisfactory results have been reported as 20-40% of cases. The authors analyzed 36 cases of tibial condylar fractures that treated at the Department of Orthropaedic Surgery, College of Medicine, Dong-A University from March 1990 to March 1993. The results were as follows: 1. The sex ratio was 2.3: 1 in male to female and most common age group was 4th decade. 2. The most common cause of injury was traffic accident in 25 cases(69.4%). 3, According to Schatzkers classification, the most common type was type II in 10 cases(27.8%). 4. The most common associated injuries were ligament injury in 10 cases(27.8%) and fibular fracture in 30 cases(27.8%). 5. By Porters criteria, 8 cases(80%) among 10 conservative cases and 18 cases(69.2%) among 26 operative cases had acceptable results. 6. The complications were most common in type II(5 cases) and type IV(5 cases). 7. The factors of poor results were as follows : displaced comminuted fracture, fracture associated with severe soft tissue injury or with ligamentous and meniscal injury.

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A Clinical Study of the Tibia Pilon Fractures: Jung Yoon Lee, Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Dong Man Park; J Korean Soc Fract 1994;7(2):256-268. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.256

Abstract PDF: A pilon fracture, which is defined as a comminuted intraarticular fracture of distal involve the articular surface and metaphysis with occasional extension in the diaphysis. The management has been notoriously difficult due to the associated injury, intraarticular fracture, severe communition of distal tibia, joint incongruity and soft tissue trauma. Most authors has reported good results after a surgical treatment by a principle of AO group treatment. Rescently, Bone et all reports that ROM and outcomes of the severly comminuted or open fractures of the distal intraarticular tibia were very good in using the external fixator. The result of treatment of 22 cases were analysed at the Department of Orthopedic Surgery, Dong-A University hospital from Mar. 1990 to Feb. 1993. The results were as follows; 1. The incidence of pilon fracture is 8.3% of all ankle fracture treated during same period. 2. The most common cause of injury is fall down(63.3%). 3. The most frequent type is type 3 (54.6%).(by Rudei & Allgower) 4. The most common associated injury is compression fracture of spine and calcaneal fracture(4 cases). 5. There are eight cases open Pilon fracture(36.3%) 6. We had treated severe communited fracture and open fracture by using external fixator, we achived good ROM and outcomes. 7. The more accurate reduction, the better clinical result. 8. Complication of the Pilon fracutre were traumatic arthritis, non-union, malunion, wound int, etc.

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