Journal of Musculoskeletal Trauma

Isolated Avulsion Fracture of the Superior Border of the Scapula: A Case Report: Suk Woong Yoon, Sang Deog Kim; J Korean Soc Fract 2000;13(4):948-951. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.948

Abstract PDF: Avulsion fracture of the scapula by the indirect trauma, especially avulsion fracture of isolated superior border is very rare. We experienced a case of isolated avulsion fracture of the superior border of the scapula and report the clinical and radiographic findings in detail.

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Operative Treatment of the Tibial Pilon Fractures: Suk Woong Yoon, Tae Sung Hwang, Byung Gue Park, Sang Deog Kim; J Korean Soc Fract 1999;12(3):622-631. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.622

Abstract PDF: Pilon fracture which is defined as a comminuted intraarticular fracture of distal tibia has been known to be difficult to manage because high axial compression and rotational forces to the ankle joint result in impaction, severe comminution, metaphyseal disruption, and soft tissue trauma. Several authors have reported good results using an AO group treatment principle. However, others have documented less favorable results such as skin slough, wound infection, and osteomyelitis. Recently, satisfactory results were obtained by the treatment with open reduction and fixation using Ilizarov method. We reviewed and analyzed 22 cases of the pilon fracture treated by the two methods O.R.I.F. and fixation by Ilizarov method) and compared the results to find out the usefulness of fixation by Ilizarov method, from Feb. 1993 to Mar. 1997 at the Department of Orthopedic Surgery, Seoul Red Cross Hospital. Fixation by Ilizarov method using ligamentotaxis and occasional minimal open reduction was effective for fracture reduction. It also decreased complications such as wound infection, skin necrosis, and osteomyelitis because it did not need extensive soft tissue dissection. And, it was also useful for severe comminuted fracture, open fracture, and fracture with extensive diaphyseal extension to proximal metaphysis.

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External fixation versus percutaneous pinning for unstable Colles'fracture: Suk Woong Yoon, Tae Sung Hwang, Jong Haeng Lee; J Korean Soc Fract 1999;12(2):461-470. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.461

Abstract PDF: The twenty-three cases of unstable Colles fracture were treated from Jan. 1994 to May 1998 at the department of orthopaedic surgery of Seoul Red Cross Hospital. Among them, the sixteen cases were treated with closed reduction with percutaneous pinning, others were treated with external fixator(Ace colles quadrilateral devices, USA). A retrospective study was made and evaluated using the Modification of Gartland and Werley's scoring system. The result of this study were as follow: 1. The ratio of male to female was 9 cases(39%) to 14 cases(61%). 2. The causes were falling down from a height 12 cases(50%), slip down 8 cases(35%) and traffic accident 3 cases(13%). 3. The reduction loss did not occur with the patients treated external fixation using Ace colles qredrilateral device, however three cases of the reduction loss have occurred with the patients using percuteneous pinning. 4. According to the Modification of Gartland and Werley's scoring system, the results of exteral fixation were excellent 4 cases(58%), good 1 case(14%), fair 1 case(14%) and poor 1 case(14%). and for percutoneous pinning, excellent 6 cases(38%), good 4 cases(25%), fair 2 cases(12%) and poor 4 cases(25%). 5. The complications of cases using external fixation were pin site infection 1 case and wrist stiffness 1 case, but for percutaneous pinning, reduction loss 3 cases. pin site infection 2 cases, wrist stiffness 2 cases, and decreased external rotation of forearm 3 cases.

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Treatment of Supracondylar Fracture of the Femur using the Supracondylar intramedullary Nail under the Arthroscopy(Preliminary Report): Suk Woong Yoon, Dong Ha Kang, Tae Sung Hwang, Jeong Il An; J Korean Soc Fract 1998;11(4):778-783. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.778

Abstract PDF: Supracondylar nailing is one of the treatment methods for supracondylar fractures of the femur but it needs arthrotomy. We introduce a mew technique of supracondylar nailing under the arthroscopy without arthrotomy. It is closed reduction and intramedullary supracondylar nailing under the arthroscopic control. The potential benefits of this method are decreased unnecessary soft tissue dissection, excellent intraarticular visualization and reduction, decreased blood loss and shortened operative time and postoperative rcovery. We performed this new technique on 4 cases of supracondylar fractures of the femur. Theresults were as follows; 1. Among the 4 cases, 3 cases were AO type A and 1 case was AO type C. 2. All cases showed bony union and average range of knee motion was 110 degrees. 3. The operation time ranged from 60 minutes to 170 minutes and averaging 110 minutes.

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Treatment of High-Energy Tibial Plateau Fracture: A comparison of External Fixation with Limited Internal Fixation to Plate and Screw Fixation: Suk Woong Yoon, Tae Sung Hwang, Byoung Gue Park; J Korean Soc Fract 1998;11(4):769-777. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.769

Abstract PDF: High energy tibial plateau fractures are associated with wevere articular depression, separation of both condyles, diaphyseal comminution and dissociation & loss of integrity of the soft tissue envelop. Thus it is very difficult to treat these fractures satisfactorily and severe complications may be developed. Authors carried out plate and screw fixation in 11 patients and external fixation(Ilizarov external fixator) with limited internal fixation in 8 patientsl who sustained high-energy tibial plateau fracture between Jan. 1992 and Feb. 1996. We compared the operative results of plate and screw fixation and external fixation with limited internal fixation in high-energy tibial plateau fractures which was follow up from 12months to 28months. The results were as follows; 1. The complications such as limitation of knee motion(3 cases), traumatic arthritis(1 case), angular deformity(2 cases), superficial infection(2 cases), deep infection(1 case), instability(1 case) were observed in plate fixation group. Limitation of knee motion(1 case), traumatic arthritis(1 case), delayed union(1 case) were developed in external fixation group. 2. According to Blokker's criteria, 6 cases(55%) among 11cases of plate and screw fixation group and 5 cases(63%) among 8 cases of Ilizarov external fixator group had satisfactory results. Ilizarov external fixation with limited internal fixation is useful method of treatment for high-energy tibial plateau fractures when extensive dissection and internal fixation are contraindicated due to comminution at the fracture site and compromise of the soft tissue.

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Operative Treatment of the Humeral Shaft Fracture: Suk Woong Yoon, Tae Sung Hwang, Bo Keun Jeon; J Korean Soc Fract 1997;10(4):904-911. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.904

Abstract PDF: Most humeral shaft fractures can be managed nonoperatively. Recently improved results have been reported after internal fixation of the humeral shaft fractures, followed by early elbow and shoulder motion. Authors carried out True/Flex intramedullary nail in 14 patients and interlocking intramedullary nail in 12 patients and plate & screw fixation in 18 patients who sustained humerus shaft fracture between February 1992 and August 1996. We compared the operative results of intramedullary nailing and plate and screw fixation in humeral shaft fractures which was follow-up from 12 months to 21 months. The results were as follows ; 1) The mean union time was at 16.5 weeks in True/Flex group, at 16 weeks in interlocking nail group, and at 15.7 weeks in plate fixation group. 2) The complications such as angulation(3 cases), rotation(1 case), limitation of shoulder motion(2 cases), and delayed union(1 case) were observed in True/Flex group. Angulation(1 case), rotation(1 case), limitation of shoulder motion(3 cases), and nonunion (1 case) in interlocking nail group. Angulation (1 case), limitation of elbow motion(2 cases), nonunion(1 case), soft tissue infection(2 cases), and iatrogenic radial nerve palsy (2 cases) were developed in plate fixation group.

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Treatment of the Difficult Supracondylar Fracture of the Femur with the Intramedullary Supracondylar Nail: Bum Gu Lee, Yong Ju Kim, Suk Woong Yoon, Shin Young Kang, Jae Hee Cho, Myong Se Jang; J Korean Soc Fract 1996;9(4):943-950. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.943

Abstract PDF: Open reduction and internal fixation should be considered for the AO classification type C supracondylar fracture of the femur. However serious complications such as infection and nonunion can occur after extensive stripping of the soft tissue. We will analyze the usefulness of the intramedullary supracondylar nail for treatment of the 1 cases of the difficult supracondylar fracture such as AO type C fracture, nonunion and supracondylar fracture associated with ipsilateral hip fracture. Follow up period of 7 cases was at least 18 months. 1. 5 cases of 7 were AO type C and 2 cases of 7 were associated with ipsilateral hip fracture. 2. 2 cases of 1 rere nonunion and 2 cases of 7 were grade III open fracture in Gustilo classification. 3. 5 cases of 7 had bone union and average range of motion of the knee was 90 degree. 4. There was no infection, but t case was complicated with the femoral shaft fracture near the proximal nail tip, and 2 cases were complicated with the metal failure at the fracture site resulting nonunion. 5. Intramedullary supracondylar nail was very useful tool for the very difficult supracondylar fracture of the femur due to minimal incision, minimal soft tissue dissection and rigid fixation. But this nail was not available for the proximally extended fracture of the femoral shaft.

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Femoral Shaft Fracture Treated with Flexible Intramedullary Ender Nail: Beom Koo Lee, Young Ju Kim, Suk Woong Yoon, Jae Hee Cho, Byung Gug Lee; J Korean Soc Fract 1995;8(4):792-798. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.792

Abstract PDF: Various methods have been used in the treatment of femoral shaft fractures. Recently closed intramedullary interlocking nailing is recommended as one of the most successful methods, but its use is technically demanding and much exposure to radiation is needed. In comparison, flexible intramedullary nail such as Ender nail is easy to use and cause less damage to the patient. We used the Ender nail in the treatment of femoral shaft fracture from 1989 to 1993 and the result were as follows; 1. Average patient age is 38.2 years old and major cause of the fracture was traffic accident. 2. Bony union was obtained in 14 cases of 17 cases with primary operation. Average bony union time was 14.2 weeks. 3. Mean operative time was 40 minutes in Winquist-Hansen type I and II ,90 minutes in Winquist-Hanserl type III and IV. 4. Ender nail migration over 10mm was noted in 9 of 17 cases. Average migration was 10mm in knee and 24mn in trochanteric area. 5. Complication were as follows ; Nail migration causing pain in 9 cases, delayed union 4 cases, non-union 3 cases, varus deformity in 3 cases, shortening in 4 cases. In Winquist-Hansen type III and IV ,76.9% of cases suffered from some complication. 6. Flexible intramedullary nail was easy to apply but we thought that Ender nail is inadequate treatment method for Winquist-Hansen type III and IV because of high complication rate.

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Supracondylar Fracture of the Femur Treated by Ender Nail: Yong Ju Kim, Suk Woong Yoon, Bum Goo Lee, Sung Il Shin; J Korean Soc Fract 1990;3(1):62-70. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.62

Abstract PDF: The supracondylar fracture of the femur is very difficult to treat regardless of whether non-surgical of surgical methods are selected. Recent advance of device for internal fixation such as AO angle plate and Judet plate improved the result of the operative treatment. But the operative technizue is difficult and in elderly patient rigid fixation can not be obtained due to osteoporsis and comminution of the fracture. So intramedullary nailing such as Zickel supracondylar element were treated with the Ender anil with distal screw in Red Cross Hospital from September 1987 to December 1988. Ender nailing appear to be a promising treatment of the supracondylar fracture of the femur, especially elderly patient, because the operaive technique is easy, blood loss is minimal and fixation is adequate to allow early exercise of the knee.

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