Journal of Musculoskeletal Trauma

Retrograde Nailing in Femur Supracondylar Fracture: Jin Woo Kwon, Sung Ho Shin, Won Ho Cho, Ki Ho Sung, Ki Han Kim, Kyong Tae Sohn, Sang Hoon Lee, Se Won Park, Jong Moon Bae, Tae Woo Kwon; J Korean Soc Fract 2003;16(4):465-473. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.465

PURPOSE
We retrospectively analysed the result of retrograde supracondylar nail fixation in femur supracondylar fractures and evaluate the clinical effectiveness of this method.
MATERIALS AND METHODS
Since October 1998 we have treated 14 supracondylar fractures (AO type: A2-6, A3-1, C1-3 and C2-4) by retrograde intramedullary nailing technique through trans-patellar tendon approach from October 1998 to June 2001 and followed more than 1 year.
RESULTS
Among 14 cases, 5 cases were excellent, 6 good, 3 fair according to Schatzker functional result. The complications were 1 distal locking screw loosening, 1 delayed union and 1 fracture around proximal locking site.
CONCLUSION
Even though the retrograde nailing may damage the knee joint because it is inserted by opening up the joint, it provided the necessary stable fixation with short operation time, low blood loss, minimal soft tissue injury. Thus we believe that retrograde nailing is useful operative technique for the management of supracondylar fracture in osteoporotic, communited fractures, or open fractures.

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Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail
Moon-Jib Yoo, You-Jin Kim, Jin-Won Lee
Journal of the Korean Fracture Society.2008; 21(1): 19. CrossRef

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The significance of distal radioulnar joint injury in distal radius fracture: Jin Woo Kwon, Sung Ho Shin, Won Ho Jo, Dong Hyun Kim; J Korean Soc Fract 2002;15(2):251-257. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.251

Abstract PDF: PURPOSE
To evaluate the effectiveness of operative treatment in distal radius fracture with distal radioulnar joint injury. MATERIAL AND METHOD: From January 1992 to January 2000, 66 cases of distal radius fracture with distal radioulnar joint injury who had been treated with conservative or operative methods were analyzed the final state of radius articular surface and distal radioulnar joint.
RESULT
In operatively treated cases(42 cases), the average of volar tilt was 3.74 degrees, ulnar inclination 21.9 degrees, radial length 9.74mm. In conservatively treated cases(24 cases), The average of volar tilt was 1.75 degrees, ulnar inclination 15.1 degrees, radial length 7.67mm. The state of distal radioulnar joints were as follows; In operatively treated cases, anatomical reduction 37(88%), joint widening 5, In conservatively treated cases, anatomical reduction 17(70%), joint widening or ulnar impingement syndrome 7.
CONCLUSION
In treatment of distal radius fracture with distal radioulnar injury, operative treatment is probably more effective in restoration of radius articular surface and distal radioulnar joint healing.

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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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Treatment of the Proximal Humeral Fracture by Bent Semitubular Plate: Choong Gil Lee, Jin Woo Kwon, Jae Hyum Park, Sung Ho Shin, Wan Eub Kim; J Korean Soc Fract 1997;10(3):634-639. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.634

Abstract PDF: There is no consensus on the best way to treat complicated fractures of the proximal humerus. Open reduction and internal fixation with plate is one of the most popular method, but it has several disadvantages. Thus we used bent semitubular plates to fix the proximal humeral fractures, which were reported by Szabo and Sehr. Moda etc. This method provided relatively firm fixation and then early ROM exercise was possible even in case of osteoporotic or severely comminuted fractures. We treated 9 cases of proximal humerus fractures which were with bent semitubular plates from January 1992 to June 1996 and followed up more than 6 months. The following results were obtained. 1. The bent semitubular piate fixation was useful method even in treatment of comminuted or osteoporotic proximal humerus fractures. 2. The mean duration of radiologic bone union was postoperative 10 weeks. 3, Complications developed in 2 cases ; one case was plate failure and the other was humeral head penetration by blade portion. 4, According to Neer criteria 5 cases were excellent, 2 cases satisfactory, 1 case unsatisfactory and 1 case failure.

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Treatment of Ankle Fractures in Children: Choong Gil Lee, Jin woo Kwon, young Dae Park, Jae Hyum Park, Sung Ho Shin; J Korean Soc Fract 1995;8(3):637-644. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.637

Abstract PDF: The purpose of this study is to find the effective treatment method by evaluating the frequency and causes of complication in each Salter-Harris types. The materials were 26 ankle physeal injuries treated from 1989 to 1994 with least follow-up of 12 months(ranged 12 to 62 months). The results were as follows. 1. There were 14 boys and 12 girls with an average age of 11 years(range,3-15years) 2. According to Dias and Tachdjian classification, mechanisms of injury were pronation-eversion external rotation type in 7, supination-inversion type in 6, supination-plantar flexion type in 4, supination-external rotation type in 2, Tillaux in 3, unclassified in 4. 3. Amomg 26 cases operative treatment was done in 11 cases that include 4 cases of closed reduction & percutaneous pinning and 7 cases of open reduction & internal fixation. 4. Among 26 cases, complication occurred in 4 cases, in which 3 cases were treated by closed reduction and cast irnrnobilization only or with percutaneous pinning. 5. It is most important for prevention of complication that Salter-Harris type II, III, IV fractures were to be reduced accurately and fixed adequately. 6. Because Tillaux fracture ocurs near the age of epiphyseal closure, there were no clinically significant deformity after long term follow up. In 3 cases of Tillaux fracture, the resluts were good.

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Posterior Fracture Dislocation of the Hip with Fracture of the Femoral Head: Choong Gil Lee, Jin Woo Kwon, Jun Wan Park, Young Dae Park, Sung Ho Shin; J Korean Soc Fract 1994;7(2):302-307. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.302

Abstract PDF: The femoral head rarely is fractured in fracture-dislocation of the hip and probably result from forces transmitted axially along the femoral shaft with the hip flexed 60 degrees or less in neutral abduction and adduction. Pipkin subclassified Epstein-Thompson type 5 fracture-dislocations into four additional subtypes according to head fragment location and presence of neck, acetabulum fracture. Hougaard and Thomsen reviewed 203 posterior hip dislocations and found that 13 patients with a fracture of the femoral head(Pipkin type 1,2). 1 with fractures of femoral head and neck(Pipkin type 3), 2 with fractures of femoral had and acetabulum(Pipkin type 4). Epstein, Wiss, and Cozen reported that 11 cases of Pipkin type 1,26 of type 2,8 of type 3, and 10 of type 4. We experienced 2 cases of Pipkin type 3 and 3 of type 4 from January, 1990 and the results obtained were as follows. 1. By Pipkin classification, type 3 was 2 cases and type 4 was 3 cases. 2. In 2 cases of type 3, was treated by primary bipolar endoprosthesis due to comminution of head, neck and the other was by emergency open reduction of dislocation, multiple Knowles pinning of neck fracture, screw fixation of large head fragmnt, multiple knowles pinning of neck fracture, screw fixation of large head fragment, and quardratus femoris pedicled bone graft. 3. In 3 cases of type 4, one was reduced successfully by manipulation and treated conservatively. Two cases were initially treated by closed reduction and delayed open screws fixation of large acetabular rim fragments, during which head fragments were not removed. 4. There had been no clinical or radiological evidence of avascular necrosis of femoral head at 17 months follow up, but increased isotope uptake on bone scanning in type 3 patient. 5. All type 4 patients had not complained of hip pain and no evidence of radiological avascular necrosis of femoral heads at average 29 months follow up.

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