Journal of Musculoskeletal Trauma

Treatment of the Clavicle Lateral End Fracture by Kirschner wire and Wire fixation: Jin Woo Kwon, Seung Ho Shin, Won Ho Cho, Woo Se Lee, Ki Hwan Kim, Dong Hyun Kim, Chun Ho Kim; J Korean Soc Fract 2001;14(2):214-222. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.214

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the effectiveness of Kirschner wire and additional wire fixation in clavicle lateral end fractures.
MATERIALS AND METHODS
We reviewed 14 cases that were treated by Kirschner wire and wire fixation from January 1997 to May 1999 and followed up for more than 1 year. Average age was 42 years old(male 6, female 8). The fractures were classified according to Jager and Breitner classification : 2 cases of type 1, 5 of type 2a, 5 of type 2b, 2 of type 3. We used 3 types of fixation method : First, interfragment Kirschner wire and wire fixation in simple fracture. Second, first method was reinforced with transacromial Kirschner wire fixation in simple, but osteoporotic bone. Third, fracture was fixed by transacromial Kirschner wire and wire fixation in intraarticular or comminuted fracture.
RESULTS
Bony union was obtained in all cases with average duration of 10 weeks. The functional result of shoulder was evaluated by the scoring system of Rowe : exellent 8, good 5, fair 1 case. The complications were pin migration 2, pin infection 1, shoulder LOM 3, traumatic acromioclavicular joint arthritis 2 cases.
CONCLUSION
Appropriate use of three types of Kirschner wire and wire fixation technique according to location of fracture, degree of comminution can improve bony union rate and shoulder function.

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The Effect of Dynamization in Tibia Fracture: Jin Woo Kwon, Seung Ho Shin, Won Ho Cho, Woo Se Lee, Ki Ho Sung; J Korean Soc Fract 2001;14(1):52-59. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.52

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the effect of dynamization which was done for the treatment of delayed union or persisting fracture gap after interlocking intramedullary nailing, by radiographic and physical examination.
MATERIALS AND METHODS
We analyzed 22 cases these were treated with dynamization from 247 cases of tibia shaft fracture treated initially with static interlocking intramedullary nailing from February l990 to May 2000 and were followed up more than lyear. The result of dynamization was classified as 3 groups and we divided each results 3 categories that is effective result, uncertain result and ineffective result. Group A is cases that achived ultimate union with shortening of fracture gap and was 10 cases. Group B is that achieved ultimate union but fracture gap did not reduced and was 10 cases. Group C is that showed ultimate non-union and was 2 cases.
RESULTS
The result is that dynamization was effective only 4 cases of group A. 6 cases of group A and 4 cases of group B showed instability(radiolucent halo around nail, hypertrophied callus and leg pain), and 6 cases of group B showed no shortening of fracture gap, thus these were classified as uncertain result. Group C(2 cases) showed non-union, classified as ineffective.
CONCLUSION
Dynamization caused instability in most tibia fractures except simple mid-shaft fracture. So in the comminuted fractures and distal or proximal l/3 oblique fractures, other procedures such as bone graft, refixation should be considered rather than dynamization.

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Throwing Fractures of the Humerus: 2 Cases Report: Jin Woo Kwon, Seung Ho Shin, Won Ho Cho, Woo Se Lee, Ki Ho Sung; J Korean Soc Fract 2000;13(4):978-981. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.978

Abstract PDF: Spiral fractures of the middle or distal shaft of the humerus that occur during attempts to throw a variety of objects are not common. Many authors have reported that the cause of fracture was the results of uncoordinated muscle violence. We experienced two cases of throwing fractures of humerus, one is baseball player(catcher) preceded by arm pain during throwing motion, the other is recreational hand grenade player without prodromal arm pain.

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Radiologic Pattern of Trochlear Ossification Center: Jin Woo Kwon, Seung Ho Shin, Won Ho Cho, Woo Se Lee, Chun Ho Kim; J Korean Soc Fract 2000;13(2):216-221. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.216

Abstract PDF: PURPOSE
: The trochlear secondary ossification center may be variable in number, shape and size, thus it can be considered as fracture. The purpose of this study is to evaluate radiographic analysis of normal trochlear secondary ossification center.
METHOD
AND MATERIAL : We reviewed the 100 cases of normal elbow radiographs and classified the numbers and shapes of trochlear sencondary ossification center.
RESULT
: The number of trochear secondary ossification center was that one was 72 cases(72%), two 19 cases(19%), three 9 cases(9%). The shape of trochlear ossification center which has only one ossification center was classified as round was 11cases(15.3%), elliptical 24 cases(33.3%), irregular37(51.4%).
CONCLUSION
: The radiographic finding of trochlear secondary ossification center is variable in number, size and shape, thus authors concluded that fragmentation or bizzare shape of trochlea in painless elbow must be considered as secondary ossification center.

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Leg Length Discrepancy after Ender Nail Fixation in Children Femoral Shaft Fracture: Jin Woo Kwon, Seung Ho Shin, Won Ho Cho, Woo Se Lee, Jin Ho Park; J Korean Soc Fract 2000;13(1):172-177. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.172

Abstract PDF: PURPOSE
: The purpose of this study is to evaluate the seg length discrepancy after Ender nail fixation in children's femoral shaft fracture.
MATERIALS AND METHODS
: We reviewed 18 femoral shaft fracture that were treated with Ender nail and studied the relationship between the initial site of fracture, type of fracture and overgrowth. The age of children in this study ranged 6 to 13 years old and the average period of follow-up was 32 months.
RESULTS
: The range of leg length discrepancy was from 6 mm shortening to 16mm lengthening and average 3.4 mm lengthening. Only one patient had shortening, nine patients had limbs of equal length(less than 2 mm) and eight patients had lengthening. The average overgrowth was 1.3 mm in proximal 1/3, 7.0 mm in middle 1/3, 3.0 mm in distal 3/1 fractures. The average overgrowth was 7.3 mm in transverse, 1.3 mm in oblique and 2.3 mm in comminuted fractures.
Conclusions
: We consider closed Ender nailing in children femoral shaft fractures as a good treatment modality in the matter of leg length discrepancy.

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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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