Journal of Musculoskeletal Trauma

Minimally Invasive Anterior Approach in Open Reduction of Displaced Supracondylar Fractures of Humerus in Children: Chang Ryung Hur, Seung Woo Suh, Chang Ug Oh, In Jung Chae, Jun Gyu Moon, Chan Eung Park, Jae Young Hong; J Korean Fract Soc 2005;18(2):185-190. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.185

PURPOSE
To evaluate the outcomes of minimal anterior approach and thumb assisted technique, in children with Gartland type III supracondylar humerus fracture, who were operated by this technique.
MATERIALS AND METHODS
Forty two children with Gartland type III supracondylar fractures of the humerus with severe swelling were taken up for minimal open reduction and K-wire fixation. The technique used was a minimal incision in the cubital fossa and thumb assisted reduction of the fracture. Stabilization of fractures was done with 1.6 mm Kirschner wires.
RESULTS
The outcomes were excellent in 40 cases good in 2 cases. No complications including malunion or scar contracture were seen.
CONCLUSION
This technique is safe, effective and can be used for irreducible, displaced supracondylar fractures of the humerus in children

Citations

Citations to this article as recorded by

Supracondylar Humerus Fractures: Classification Based Treatment Algorithms
Mudit Shah, Mandar Vikas Agashe
Indian Journal of Orthopaedics.2021; 55(1): 68. CrossRef
Recent Trends in Treatment of Supracondylar Fracture of Distal Humerus in Children
Soon Chul Lee, Jong Sup Shim
Journal of the Korean Fracture Society.2012; 25(1): 82. CrossRef
Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique
H.-Y. Lee, S.-J. Kim
The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef

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The Incidence of Infection in Interlocking Intramedullary Nailing after Skeletal Traction of Distal Femur: Hyuk Woo Nam, Seung Woo Suh, Hae Reong Song, Jun Gyu Moon, Jun Ho Wang, Chan Eung Park, Jae Hyuk Yang; J Korean Fract Soc 2005;18(1):12-16. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.12

Abstract PDF

PURPOSE
The insertion site of K-wire for skeletal traction is proximal part of tibia or distal part of femur. However, people prefer proximal tibia over distal femur due to lower risk of infection rate when change to interlocking IM nailing is needed. We evaluated the infection rate of interlocking IM nailing.
MATERIALS AND METHODS
Fourty-seven patients were included in this study who underwent interlocking IM nailing due to femur shaft fracture. Traction was applied at the distal femur in 19 cases and proximal tibia in 10 cases before interlocking IM nailing. No skeletal traction was applied to the remaining 18 cases. Thirty-eight patients were male and 9 were female. The average age at the time of surgery was 36.7 years old (range, 15~17 years). The average traction period was 9.5 days (range, 3~33 days) and the average followed-up period was 17.2 months.
RESULTS
In the distal femoral traction group, 8 cases of superficial pin tract infection developed, but no case of deep infection such as osteomyelitis occurred. In the proximal tibia traction group, 2 cases of superficial pin tract infection developed, but no case of deep infection occurred. In the group that received no skeletal traction before interlocking IM nailing, no case of infection developed.
CONCLUSION
In femur shaft fracture, the distal femoral skeletal traction followed by interlocking IM nailing of femur, compared to proximal tibia skeletal traction, did not increase the risk of deep infection such as osteomyelitis.

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Rectus femoris muscle atrophy and recovery caused by preoperative pretibial traction in femoral shaft fractures-comparison between traction period
D.-G. Shim, T.-Y. Kwon, K.-B. Lee
Orthopaedics & Traumatology: Surgery & Research.2017; 103(5): 691. CrossRef

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A Clinical Study about Postoperative Wound Complications In Liver Cirrhotic Patients: Seung Woo Suh, Seok Hyun Lee, Jun Kyu Moon, Young Jin Roh, Chang Woo Seok; J Korean Soc Fract 2003;16(4):577-584. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.577

Abstract PDF: PURPOSE
This study undertaken to evaluate the postoperative wound complications between Child class A liver cirrosis patients and Child class B liver cirrhosis patients.
MATERIALS AND METHODS
In a retrospective study from 1998 to 2003, fifteen patients who underwent surgical intervention for fractures were evaluated the period of wound healing, hopital day, infection, wound complications (swelling, hematoma formation, wound discharge).
RESULTS
The cases of wound complication are 6/15 (40%), in which Child class A LC patients are two (14%), and Child class B LC patients are four (50%). The cases of wound Infection are 2/15 (13%), in which Child class A LC patient is one (14%), and Child class B LC patient is one (12.5%). The average of hospital day is 28 days.
CONCLUSION
The clinical results of postoperative complications is associated with Child classification, but the ralationship between postoperative wound infection and Child classification is not observed. We thought that careful wound management needs in liver cirrhosis patients.

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Diastasis of the Symphysis Pubis During Vaginal Delivery: Woo Nam Moon, Kwan Young Joo, Seung Woo Suh; J Korean Soc Fract 2001;14(1):37-43. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.37

Abstract PDF: PURPOSE
The objectives of this study are to observe the clinical characteristics and incidence of diastasis of symphysis pubis during vaginal delivery and to evaluate the risk factors of the lesion.
METHODS
AND MATERIALS: 16,000 vaginal delivery cases of our center from 1997 to 1999 were reviewed. The severe pain in symphysis pubis and walking difficulty after delivery were used as a diagnostic criterion. Several factors that increase the risk of this lesion during delivery were reviewed and analyzed by t-test between diastasis group (n=55) and normal group (n=100).
RESULTS
Fifty-five diastasis of symphysis pubis were diagnosed out of 16,000 normal vaginal delivery cases during that period. The widening of the joint ranged from 4mm to 34mm. Sixteen cases accompanied vertical mobility. No factor was proved to increase the risk of the lesion. Initial body weight of infant had suggestive significance (P=0.051).
CONCLUSION
We couldn't prove any risk factors that increased the risk of diastasis of symphysis pubis during vaginal delivery in this study. Further prospective studies with more cases would be needed to disclose the risk factors.

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Analysis of cause of collapse and Non-union After Internal Fixation of Intertrochanteric Fracture: Seung Woo Suh, Chang Ryong Hur, Jung Ho Park, Jun Seok Hong, Woo Nam Moon; J Korean Soc Fract 1999;12(4):812-817. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.812

Abstract PDF: Sixty-five Intertrochanteric hip fractures were analyzed radiologically to study the factors affecting postoperati ye stability. Fractures were evaluated by measuring shortening and angulation, collapse of telescoping device when utilized, and migration of the fixation device within the femoral head. Fractures were classified according to their stability preoperatively and the reduction of lessor trochanteric fracture fragment postoperatively. The failure rate and postoperative stability were then compared on terms of severity of osteoporosis, type of fracture, existence of reduction of lestor trochanter fragment.
Results
indicated that the severity of osteoporosis was not related to the group of fracture, which determines stability of fracture. Regarding the rate of bone union, anatomically reduced groups showed similar rates of bone union(73.8% in average) and degree of sliding of lag screw (4.13mm in average) regardless of fixation of lesser trochanter fragment. On the other hand, malreduced group which failed to obtain anatomical reduction had 26.1% of bone union rates and 10.95mm of sliding of lag screw representing importance of anatomical reduction rather than fixation of lesser trochanteric fracture. In conclusion, there was no correlationthip between severity of oLteoporosis and type of fracture. And it is suggested that unstabae intertrochanteric fractures accompanied by large lesser trochanteric fracture fragment can be provided stability avoiding major complications such as loosening of implant or collapse of fracture fragment if it is fixed with anatomical reduction of fracture even without the fixation of lesser trochanteric fragment.

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Operative Treatment of Type II Distal Clavicle Fractures: Jung Ho Park, Kyung Wook Rha, Seung Woo Suh, Sung Kon Kim; J Korean Soc Fract 1998;11(3):683-689. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.683

Abstract PDF

Type II clavicle fractures have been associated with high rates of nonunion and delayed union. Many authors have supported open reduction and internal fixation of these fractures. Authors analyzed twelve cases of type II distal clavicle fractures which had been treated operatively at department of orthopaedic surgery, Korea university, Ansan and Guro Hospitals from May 1991 to September 1997 and reviewed the result of operative treatment retrospectively. The results were as follows; 1. Among the 12 cases, male was 8, fenale was 4 and the average age of them was 25.6 years. 2. According to the classification by Neer and Rockwood, type IIa was 5 cases and IIb was 7 cases. 3. We treated all the cases operatively, such as C/R with transacromial K-wire fixation in 6 cases, O/R with transacromial K-wire fixation in 4 cases, O/R with coracoclavicular screw fixation in 2 cases. 4. The average follow-up period was 17 months. The functional results were evaluated with Kona classification and showed excellent in 10 cases, good in 2 cases. In conclusion, the operative treatment revealed good functional results in all cases. Authors recommend early operative treatment in type II distal clavicle fractures.

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Treatment of Distal Clavicle Fracture Using Hook Plate
Su-Han Ahn, Hyeong-Jo Yoon, Kwang-Yeol Kim, Hyung-Chun Kim, In-Yeol Kim
Journal of the Korean Fracture Society.2011; 24(1): 48. CrossRef
Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle
Kyeong-Seop Song, Hyung-Gyu Kim, Byeong-Mun Park, Jong-Min Kim, Sung-Hoon Jung, Bong-Seok Yang
Journal of the Korean Fracture Society.2009; 22(1): 24. CrossRef

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Causative Factor for Cubitus Varus Deformity in Severely Displaced Supracondylar Fractures of the Humerus in Children : s Rotational Deformity of Distal Fragment Needed to be Acurately Reduced?: Seung Woo Suh, Jeong Ho Park, Jong Gun Oh, Seung Ju Chun, Jeong Ro Yoon, Seok Hyun Lee; J Korean Soc Fract 1997;10(3):712-717. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.712

Abstract PDF: We reviewed retrospectively 53 cases of supracondylar fracture of humerus in children which were severely displaced(Gartland type III). All patients were treated with closed reduction and percutaneous pinning. Purpose of this study is to evaluate the residual effect of incompletely reduced fragment, especially of rotation of distal fragment(represented by fish-tail sign) on clinical relults. The quality of reduction was determined by carrying angle, varus tilting, existence of fish-tail sign and medial displacement. Of the 53 elbows, fish tail signs only presented in twelve cases(50.0%), medial tilting combined with fish tail in five(20.8%) and medial displacements in seven cases(29.2%). Final results by Flynn et al. were as follows; Excellent was in 40 cases(15.9%), Good in 6(11.3%), Fair in 1(1.8%), poor in 6(11.3%). Six cases of poor outcomes resulted from cubitus varus deformed elbow, of which cubitus varus deformity developed in 5 cases of medial tilted distal fragment, one developed in medially displaced fragment, and cases presented with fish tail sign(rotation of distal fragment) had no contribution to cubitus varus deformity yielding acceptable clinical results. In conclusion, even though the quantification of fish tail sign is needed, fish tail sign only presenting on fluorscopy might be acceptable in operative room.

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Ipsilateral Monteggia Fracture and Lateral Condyle fracture of Humerus in Children: Jung Ho Park, Seung Woo Suh; J Korean Soc Fract 1997;10(3):708-711. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.708

Abstract PDF: Authors experienced a rare injury in a 5-year-old girl with Monteggia fracture and concomitant lateral condyle fracture of humerus with radial nerve injury. This combined injury has not been reported in the literature. This unusual fractures were treated by open reduction and K-wire fixation of lateral condyle fracture and transcapitellar K-wire fixation of radial head dislocation. An excellent result was obtained with operative treatment.

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Effect of Unreduced Lesser Trochanteric Fracture on Stability in Intertrochanteric Fracture of Femur: Seung Woo Suh, Jeong Ho Park, Jong Kun Oh, Kyung Wook Nah, Tae Hyeon Kim, Woo Nam Moon; J Korean Soc Fract 1997;10(3):529-533. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.529

Abstract PDF: Unstable intertrochanteric hip fractures are characterized by comminution of the posteromedial cortex, resulting in a fragment of variable size containing the lesser trochanter. Stability can be provided by transfixion of the lesser trochanteric fracture fragment with a screw. However, fixation of lesser trochanteric fragment is difficult, time-consuming, and often unsuccessful. Controversy exists as to whether it is necessary to perform reduction and fixation of this fragment. A radiological review of 61 intertrochanteric fractures treated with compression screw was made to study the effect of unreduced lesser trochanteric fracture on fracture healing and stability in unstable intertrochanteric fractures accompanied by lessor trochanteric fracture. Analysis were made on terms of rate of bone union, maintenance of reduction by comparing between anatomically reduced group with/without lesser trochanteric fracture and malreduced group with lesser trochanteric fracture. Anatomically reduced groups with/without lessel trochanteric fracture showed similar rates of bone union(88.3% in average) and degree of sliding of lag screw(3.74mm in average) regardless of fixation of lesser trochanter. On the other hand, unreduced group had 33.3% of bone union rates and 9.80mm of sliding of lag screw representing importance of anatomical reduction rather than fixation of lesser trochanteric fracture. In conclusion, it is suggested that unstable intertrochanteric fractures accompanied by large lesser trochanteric fracture fragment can be treated without fixation of lesser trochanteric fragment avoiding major complicatioins such as loosening of implant or collapse of fracture fragment.

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Treatment of the Femur Shaft Fractures using Interlocking Nail: Jong Keon Oh, Soon Hyuck Lee, Seung Woo Suh, Young Soo Byun; J Korean Soc Fract 1997;10(2):289-294. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.289

Abstract PDF: A series of forty patients who had forty femoral shaft fractures that were treated with static interlocking nailing were analyzed to determine the incidence of union of the fracture without planed conversion from static to dynamic intramedullary fixation as a technique to stimulate healing of the fracture. All of the forty cases were nailed using closed method under the guide of a image intensifier. The time to full weight was individualized for each patient and depend on the degree of comminution, the postoperative cortical contact between the major fragments, the presence of bridging callus as seen on follow up x-rays, and the patients mobility according to the associated injuries. Healing occurred in thirty nine(97%) of the forty fractures of the femoral shaft that had been treated with static interlocking nailing without dynamizaton. Only one patient needed conversion from static to dynamic interlocking fixation to promote fracture healing. This patient had a delayed union after closed interlocking nailing of Gustilo type I open midshaft fracture associated with Winquist type II comminution. We concluded that static interlocking nailing for femoral shaft fractures does not seem to inhibit the fracture healing process, and that conversion to dynamic intramedullary fixation is needed only for exceptional cases of delayed union.

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Operative Treatment of Intraarticular Fractures of the Distal Raidus: Jong Keon Oh, Seung Woo Suh, Woo Nam Moon, Sung Joon Hong; J Korean Soc Fract 1996;9(1):1-7. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.1

Abstract PDF: The intraarticular fracture of the distal radius is one of the most common fractures in the orthopaedic field and physicians have considered the results of the treatment to be favorable. But recently investigations into the pathomechanics of these injuries highlight the peoblems of arthritis, pain, swelling, weakness, limited ranges of motion and instability associated with nonanatomic reduction of both intraaetocular fragments and their associated ligaments. So the treatment of intraarticular fractures of the distal radius has been altered into more aggressive pattern using the open reduction and internal fixation, open reduction or closed reduction and internal fixation, closed reduction and percutaneous pinning. The authors reviewed 37 cases(34 patients)of intraarticular fractures of the distal radius treated using operative methods from February 1989 to May 1994 in the department of orthopaedic surgery, Ansan Hospital, Korea University: We analyzed the correlation between the radiologic parameters(articular conguity, radial height loss, adial angulation, palmar angulation)and the end results.

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External monofixator in open tibia fractures: Soon Hyuck Lee, Seung Woo Suh, Young Soo Byun, Yoon Sung Chung; J Korean Soc Fract 1994;7(2):571-579. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.571

Abstract PDF: Tibia fracture is often accompanied by soft tissue injury. There is controversy about the treatment of open tibia fractures, but the extemal fixator is most widely used as a initial treatment. Especially in open tibia fractures treated by extemal fixator, early secondary conversion to internal fixation device are suggested by some authors, but without risks of complication. In contrast others suggest that bone union problems are not due to external fixator itself and different types of bone union are observed according to the stability of fracture site. The purpose of this study is to assess the clinical results with its affecting factors and to observe the morphological pattern of union in tibial open fractures treated by external fixator without significant soft tissue problems. Authors analyzed 16 cases with tibial open fracture managed by external fixator in Ansan hospital, College of medicine, Korea University from May, 1988 to Sept., 1993 with follow-up period more than 11 months. 1. The tibial open fractures are mainly occurred in young active age group(20-50 yrs). 2. The union rate in accurate reduction and stable fixation cases was 90%, in contrast non-union rate in unstable fixation was 50%, and these non-union cases were managed by additional procedure(intramedullary nailing or autogenous bone graft). 3. In stable fuation, mode of fracture healing was mainly primary osteonal bone healing mechanism. 4. External fixator could be used in open tibial fracture with accurate reduction and stable fixation not as a temporary fixation but as a treatment modality.

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Surgical Treatment of Acetabular Fracture: Sung Kon Kim, Seung Woo Suh; J Korean Soc Fract 1994;7(2):422-430. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.422

Abstract PDF

Acetabular fracture results from high-enegy trauma that cause considerable displacement of the fracture fragments as well as to articular surface of the acetabulum. The goal of surgical treatment is to prevent post-traumatic arthritis and avascular necrosis of femoral head by reconstructing the articular surface accurately and restoring the contact areas between the acetabular and femoral head. We analyzed 15 patients who were treated with surgical method at Korea University Ansan Hospital from May 1989 to July, 1992 and followed up more than 1 year. The results were as follows: 1. The most common type was posterior wall fracture in 5 cases(33.3%), transverse fracture in 4 cases(26.7%), both column fracture in 4 cases(26.7), anterior column fracture in 2 cases(13.3%) in sequeuce according to Letournel classification. 2. The most common cause of injury was traffic accident in 13 cases(86.6%), and 2 cases(13.4%) were passengers. 3. There were 9 cases(60.0%)operated within 7th day after injury, 4 cases(26.7%) between the 7th day and 14th day, 2 cases(13.3fo)at the 21st day. 4. The employed surgical approaches were the extended ilio-femoral approach in 7cases(46.7%), the Hocker-Langenbeck approach in 6 cases(40.0%), the ilioinguinal approach in 2 cases(13.3%). 5. The result of treatment was satisfactory in 13 cases(87.7%) and the complications were post traumatic arthritis in 2 cases(15.4%), ectopic ossification in 1 case(6.7%), and avascular necros of femoral head in 0 case.

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Comparative Results of Acetabular Both Column Fracture According to the Fixation Method
Kyung-Jae Lee, Byung-Woo Min, Eun-Seok Son, Hyuk-Jun Seo, Jin-Hyun Park
Hip & Pelvis.2011; 23(2): 131. CrossRef

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