Journal of Musculoskeletal Trauma

Coracoid Process Fracture Associated with Acromioclayicular Dislocation and Partial Rupture of Coracoclavicular Ligament: A Case Report: Seok Woong Yoon, Tae Sung Hwang, Byung Gue Park, Ki Hoon Kil; J Korean Soc Fract 1999;12(3):693-697. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.693

Abstract PDF: A coracoid process fracture associated with acromioclavicular dislocation has been reported infrequently. A coracoid process fracture associated with coracoclavicular ligament rupture has been reported only in two cases. Two separated injury mechanisms seem to be involved in this instance; one is direct trauma to the shoulder girdle causing dislocation of acromioclavicular joint, and the other is sudden avulsive pull on coracoid process by the conjoined tendons of short head of biceps brachialis and coracobrachialis, and pectoralis minor muscle causing fracture of the coracoid process. We reported one case of coracoid process fracture associated with acromioclavicular dislocation and partial rupture of coracoclavicular ligament. The lesion was treated by open reduction and interanl fixation using two Kirschner - wires for the acromioclavicular joint and a cortical screw for coracoid process, and the result was satisfactory without complication.

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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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