Journal of Musculoskeletal Trauma

Han Suk Ko

6 Articles

The Treatment of Infected Non-union of Long Bones with Plate and Screws: Han Suk Ko, Yeong Hun Kang, Deok Weon Kim, Jeong Ku Ha; J Korean Fract Soc 2006;19(1):72-77. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.72

PURPOSE
To evaluate the usefulness of internal fixation with plate in treating infected nonunion of long bone.
MATERIALS AND METHODS
From March 1993 to February 2004, ten patients who underwent internal fixation with plate and cancellous bone graft on account of infected nonunion of long bone were retrospectively examined. The medical treatment were composed of thorough and adequate debridement of necrotic tissue, irrigation and plate fixation. Two patients were operated on with bridging plate method. Autologous cancellous bone graft was performed in 6 patients. In 2 cases, it was performed 4 weeks after internal fixation.
RESULTS
In 9 patients, radiographic union appeared on the average of 6.8months and infections were cured before union occurred.
CONCLUSION
Internal fixation with plate is a useful method for the solid fixation in the treatment of infected nonunion. The general concern was that the inserted hardware worsened the infection, which was overcomed with the operative techniques as bridging plate, debridement and cancellous bone graft.

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Treatment Strategy of Infected Nonunion
Hyoung-Keun Oh
Journal of the Korean Fracture Society.2017; 30(1): 52. CrossRef

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Treatement of Diastasis of the Distal Tibiofibular Syndesmosis: Woo Chun Lee, Han Suk Ko, Cheol Lee, Ki Heon Nam, Kang Hoon Ko, Jong Deuk Rha; J Korean Soc Fract 2001;14(4):677-684. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.677

Abstract PDF: PURPOSE
To investigate the indication of transfixation of distal tibiofibular syndesmosis.
MATERIALS AND METHODS
Twenty-two patients were surgically treated for diastasis of the distal tibiofibular syndesmosis and followed for more than one year. The decision to transfix the syndesmosis was made according to the result of intraoperative stress test.
RESULTS
In patients with bimalleolar fracture, good or excellent clinical results were obtained in all patients, and no widening of the medial clear space and I mm or no widening of the tibiofibular clear space was observed. In patients with deltoid ligament tear, good or excellent results were obtained in five patients, and the medial clear space was widened more than 1mm in three patients and tibiofibular clear space was widened 2mm or more in four patients.
CONCLUSION
We believe that transyndesmotic fixation is not required if anatomical bimalleolar fracture fixation is achieved, and in patients who have deltoid ligament rupture, it may be better to transfix the syndesmosis regardless of the level of fibular fracture.

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Use of Interlocking Intramedullary Nail in Treatment of Delayed Union or Nonunion of the Long Bone Fractures: Suk Kyu Choo, Byung Jik Kim, Han Suk Ko, Jeong Gook Seo, Jin Gu Kim, Jun Woo Chang; J Korean Soc Fract 1998;11(4):761-768. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.761

Abstract PDF

Of the several nonoperative and operative options described for the treatment of delayed union and nonunion of the long bone, interlocking nailing with reaming offect of internal splint, autogenous bone graft and early return to a normal way of life. The purpose of this study is to evaluate the usefulness and complication of intramedullary(IM) naling with reaming by retrospective method. We treated 34 patients with delayed union or nonunion of the tibia, femur, and humerus by interlocking nailing with reaming between January 1992 and December 1996. The results were as follows ; 1. Of the 34 cases, there were 13 tibia fracture, 17 femur fracture, 4 humerus fracture. Half of them were ununited and another half were delayed in fracture healing. 2. Previous methods of treatment were conservative treatment in 2 cases, external fixator in 2, plate & screws fixation in 8, Ender nail in 2, Kuntscher nail in 2 and interlocking nail in 7 among 24 cases of cloed fracture and external fixator in 8 and interlocking nail in 2 among 10 cases of open fracture. 3. Twenty-five patients were treated with closed nailing and 9 were treated with open nailing. Iliac bone graft was performed at 3 cases and fibulotomy was performed at 1 case. 4. Union was obtained in 33 cases and 1 case needed additional bone grafting to achieve union. 5. Postoperative complications were one nonunion, two evtry site pain, one screw breakage, one heterotopic ossification, and one postoperative infection. Interlocking nailing with reaming was associated with a high union rate(97%) in our eries. The authors believe that IM nailing with reaming is a useful option for treatment of delayed or nonunion of the long bone fracture.

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Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing
Sung-Soo Kim, Sung-Keun Sohn, Chul-Hong Kim, Myung-Jin Lee, Lih Wang
Journal of the Korean Fracture Society.2007; 20(2): 141. CrossRef

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Internal Bone Transport for Treatment of Infected Non-union of Long Bone: Han Suk Ko, Byung Jik Kim, Young Lim, Jeong Gook Seo, Jin Ku Kim, Dong Hun Lee; J Korean Soc Fract 1998;11(3):623-628. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.623

Abstract PDF: Infected nonunion of long bone frequently accompanies with bone loss, because of the outcome of initial trauma or iatrogenic result from sequestra resection. In this study, infected and ununited long bone fracture was treated with internal bone transport technique which was first discribed by G.A. Ilizarov. There were eleven tibial and two femural nonunion. The mean number of admission was 2.8 times; mean number of operation was 8 times; mean duration of average healing index was 1.95 month/cm. All infections were cured and all nonunions were united. Functional result was excellent in 5 cases (of 13 cases), good in 5, fair in 2, and 1 had poor result. Many complication had been observed. All had infection of pin site and pain at least one time, 5 had stiff knee, 9 had stiff ankle, early consolidation(1), delay consolidation(3), tibiofibular synostosis(5), nerve injury(1), refracture after union(1), angular deformity over 5 degree(7), rotational deformity over 10 degree(2).

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Surgical Treatment of Comminuted Distal Radius Fracture using External Fixators: Suk Kyu Choo, Byung Jik Kim, Han Suk Ko, Young Lim, Jeong Gook Seo, Jae Kie Shin; J Korean Soc Fract 1996;9(2):303-310. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.303

Abstract PDF: Comminuted fractures of distal radius are usually unstable and complex injuries, which require prolonged treatment and often result in some degree of permanent disability. Previous treatment was mainly closed reuction and cast immobilization, and operative treatment of accurate open reduction, internal fixation and bone graft when needed. But recently ligamentotaxis of the fracture using external fixation device has been widely employed. Which could be followed up for 12 cases of comminuted fractured of distal radius operated with external fixators, more than 1 year, during the period of September 1990 to September 1994 at Seoul Paik Hospital was reviewed. According to Frykmalls classification, the most common type was type VIII (7 cases, 58.3%). There was 1 open fracture, and 7 combined injuries of ipsilateral upper extremity. According to AO classification, 9 cases(75%) were type C2 and C3. The most common cause was failing down from a height(6 cases). Additional limited internal fixation was done in 5 cases, all 12 cases were treated external fixators. Results were defined with modified Gartland & Werleys demerit pointing system, exellent was 6 cases(50fr), good wa,i 4 cases(33.3F)), poor was 2 cases. Surgical treatment using external fixators and/or limited open reduction was good Inethod for comminuted distal radius.

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Comparison between Intramedullary and Plate Fixation for Subtrochanteric Fracture of the Femur: Han Suk Ko, Byung Jik Kim, Suk Kyu Choo, Jae Sung Choi; J Korean Soc Fract 1994;7(2):352-363. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.352

Abstract PDF: Management of subtrochanteric fractures of the femur is difficult because it occurs in bone that is predominantly cortical and high stress concentrates in this region. The subtrochanteric fracture is difficult for the accurate reduction and maintenance because many of these fractures are cmminuted from high velocity trauma and its proximal fragment is severely displaced by adjacent strong muscles pooling. Therefore, as a rule we prefer to treat subtrochanteric fractures by operative means if possible. Many internal fixation devices have been recomended for use in subtrochanteric fractures and their selection should be based on the individual fracture anatomy. In recent years, generally accepted two methods are intramedullary nailing and plate fixation. We have reviewed our experience using the intramedullary fixation on 14 cases of subtrochanteric femur fracture and compared the result with those of 14 cases of plate fixation. All the 28 cases were treated at the Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University in the period from March 1988 to March 1993. Intramedullary fixation were implanted with shorter operating time, smaller incisions, and less intraoperative bleeding. The intramedullary fixation group had a shorter covalescence and earlier full weight-bearing but no significant difference in fracture union rate with plate fixation group. We conclude that with careful surgical technique, the intramedullary fixation was a more suitable method for the treatment of the subtrochanteric femoral fractures.

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