Journal of Musculoskeletal Trauma

Hwa Sung Lee

8 Articles

A Comparison of the Results between Internal Fixation and External Fixation in AO C Type Distal Radius Fractures: Yoon min Lee, Hwa Sung Lee, Seok Whan Song, Jae Hoon Choi, Jong Tae Park; J Korean Fract Soc 2018;31(3):87-93. Published online July 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.3.87

PURPOSE
The purpose of this study was to evaluate the radiological and clinical results of plate fixation and external fixation with additional devices for treating distal radius fracture in AO type C subtypes, and propose a treatment method according to the subtypes.
MATERIALS AND METHODS
Two hundred and one AO type C distal radius fracture patients were retrospectively reviewed. Eighty-five patients in group 1 were treated with volar or dorsal plate, and 116 patients in group 2, were treated with external fixation with additional fixation devices. Clinical (range of mtion, Green and O'Brien's score) and radiological outcomes were evaluated.
RESULTS
At the 12-month follow-up, group 1 showed flexion of 64.4Â°, extension of 68.3Â°, ulnar deviation of 30.6Â°, radial deviation of 20.8Â°, supination of 76.1Â°, and pronation of 79.4Â° in average; group 2 showed flexion of 60.5Â°, extension of 66.9Â°, ulnar deviation of 25.5Â°, radial deviation of 18.6Â°, supination of 73.5Â°, and pronation of 75.0Â° in average. The mean Green and O'Brien score was 92.2 in group 1 and 88.6 in group 2. The radial height of group 1 and group 2 was 11.6/11.4 mm; radial inclination was 23.2Â°/22.5Â°; volar tilt was 11.6Â°/8.7Â°; and the ulnar displacement was 1.27/0.93 mm.
CONCLUSION
Judicious surgical techniques during device application and tips for postoperative management during external fixation can produce similar clinical results compared with internal fixation patients.

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Intra-articular fracture distal end radius external fixation versus locking volar radius plate: A comparative study
S.P.S Gill, Manish Raj, Santosh Singh, Ajay Rajpoot, Ankit Mittal, Nitin Yadav
Journal of Orthopedics, Traumatology and Rehabilitation.2019; 11(1): 31. CrossRef

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Traumatic Bladder Rupture in Pelvic Fracture - Case Report: Soon yong Kwon, Woung Kyun Woo, Hwa Sung Lee, Jong Chul Kim, Yong Sik Kim; J Korean Soc Fract 2002;15(1):77-81. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.77

Abstract PDF: Pelvic fracture and bladder rupture resulted in bladder wall entrapment in the fracture site of a patient involved in a fall down accident. Although hematuria and bladder rupture are known to occur after fracture of the pelvis, our literature review showed no reports of this type injury or management. Abscess was drainaged and sepsis was managed with fluid and antibiotics treatment. Bladder extravasation was managed with primary repair and surgical extraction of catheter drainage. We report a case of a patient who presented with traumatic bladder rupture in pelvic fracture.

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Peritalar Dislocations or Fracture-Dislocations: Seung Koo Rhee, Hwa Sung Lee, Jong Bum Park, Jin Wha Chung, Eui Yong Um, Whi Ju Whang; J Korean Soc Fract 2001;14(4):689-697. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.689

Abstract PDF: PURPOSE
To find the proper way and timing of treatment for minimizing the posttraumatic complication of peritalar dislocation or fracture-dislocation.
MATERIALS AND METHODS
We reviewed total 12 cases of peritalar dislocation or fracture-dislocation that consist of 9 cases of subtalar joint dislocations, I case of talonavicular joint dislocation and 2 cases of talar fracture-dislocations. Closed reduction was performed for subtalar dislocation without suturing the torn ligaments. The average follow up period was 25 months.
RESULTS
Of 9 subtalar dislocations, 8 cases presented acceptable results. But 1 case of a 28-year-old male patient with prolonged heavy sports activity history presented pain and mild limping. The other 3 cases of talo-navicular joint dislocation and talar fracture-dislocations presented acceptable results except one complaining of scar contracture.
CONCLUSION
Complications such as early skin necrosis or neurovascular damage could be prevented by early closed reduction for peritalar dislocations or fracture dislocations, and the repair of torn ligaments of ankle joint in peritalar dislocations did not affect the end results.

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Treatment of Clavicle Fracture : Operative vs Non-operative: Seok Whan Song, Hwa Sung Lee, Young Kyun Woo, Seung Koo Rhee, Young Yul Kim; J Korean Soc Fract 2000;13(3):544-549. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.544

Abstract PDF

INTRODUCTION: The purpose of this study was to compare the final results of the patients of the clavicle fractures, treated with the conservative or surgical techniques.
MATERIALS AND METHODS
125 patients (over 15 years old, follow-up over 6 months) were reviewed. To measure the amount of shortening of the fractured clavicle, the length of clavicle was measured from the mid-point of the medial end to the lateral. Range of motion of shoulder, evaluation of functional results and subjective satisfaction, and complications were assessed.
RESULTS
In the surgical treatment group, the period of bony union was short and the shortening of the final length of the fractured clavicle, although there was no statistical significance, was rare. Overall satisfaction for the final result and range of motion of the shoulder were not significantly different between the groups. Complication rates were higher in the conservative treatment than in the surgical.
CONCLUSIONS
In most cases of the clavicle fracture, the operative treatment is recommended to decrease the complications, to shorten the treatment period, to satisfy the patients, and probably to decrease the economical burden.

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Progressive Brachial Plexus Palsy after Fixation of Clavicle Shaft Nonunion: A Case Report
Hong-Ki Jin, Ki Bong Park, Hyung Lae Cho, Jung-Il Kang, Wan Seok Lee
Journal of the Korean Fracture Society.2019; 32(2): 97. CrossRef

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Tardy Ulnar Nerve Palsy Caused by Post-Traumatic Elbow deformities: Seung koo Rhee, seok Whan Song, Hwa Sung Lee, Ho Tae Kim; J Korean Soc Fract 1998;11(2):420-426. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.420

Abstract PDF: Thirty-five patients with tardy ulnar nerve palsy caused by cubitus valgus (33 cases0 and varus (2 cases) deformities were retrospectively studied. All patients had a history of old fracture on the distal humerus during childhood. The mean interval between the previous fractures and the onset of ulnar neuropathy was 19 years. The severity of nerve palsy was classified as McGowan's grade I in 24 patients, grade II in 8 patients, and grade III in 3 patients. The mean carrying angle was average 29 degrees in 33 cases with cubitus valgus and it was decreased to average 11 degrees postoperatively, but the angle was average -23 degrees preoperatively in 2 cases with cubitus varus and it was corrected to average 9 degrees postoperatively. the cause of palsy was analysed by mechanical stetching in 11 cases, compression by a fibrous band between the two heads of flexor carpi ulnaris in 8 cases, and diffuse fibrous adhesion around the ulnar tunnel in 5 cases. All patients was treated with supracondylar closing wedge osteotomy accompanied with anterior ulnar nerve transposition in 13 patients, corrective osteotomy only in 12 patients, and anterior ulnar nerve transposition only in 10 patients. Their end results were analysed as good in 24 cases, fair in 8 cases, and poor in 3 cases within average 6 months after the operations (4 to 13 months). The poor results was obtained in 3 cases out of 9 cases with corrective osteotomy group (33.3%). Conclusively, a tardy ulnar nerve palsy caused by post-traumatic elbow deformities should be corredcted with anterior ulnar nerve transposition with or without corrective closing wedge osteotomy but not by corrective osteotomy only, because of compressive neuropathy by diffuse fibrous adhesion or bands of two heads of FCU around the ulnar tunnel in elbow.

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Delayed Management of Supracondylar and Intercondylar Fracture of the Femur Using the Composite Graft(Autograft+Processing Allograft): Young Kyun Woo, Seung Koo Rhee, Soen Yong Kwon, Hwa Sung Lee, Joo Yup Lee; J Korean Soc Fract 1996;9(4):951-957. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.951

Abstract PDF: There are many difficuties and problems to get anatomical reduction and rigid internal fixation in treatment of supracondylar and intercondylar fracture of the fumur. Authors reviewed and clinically analysed 7 patients w.ith svpracondylar and intercondylar fracture of the femur treated by delayed reconstruction from August 1993 to Decfmber 1995. Of 1 cases, there were 5 cases of open and 2 cases of closed fracture. According to AO classification, 7 cases were classified as followed; A3 type-l case, C2 type-4 cases, and C3 type-2 cases. They underwent surgical treatment at average 35 days after injury(range from 25 days to 58 days). Main causes of delay in surgical treatment were poor preoperative condition associated with mulliple injuries in 3 cases, wound problems at the site of open fracture in 3 cases and the combined state in 1 case. For internal fixation of fractures, a supracondylar nail in 4 cases and a dynamic condylar screw in 3 cases were used, and the bony defective area of fracture site in all 1 cases was replaced by the composite graft made of the autogenous cancellous bone and the processing allograft(Tutoplast). The period of follow up was from 8 months to 30 months(average time 14.8 months). There were no infection or allograft-rejection postoperatively. Clinical union was achieved from 6 months to 10 months in 6 cases, and nonunion associated with incomplete incorporation of graft bone was developed in 1 case. In 6 cases of clinical union, clinical assessment estimated by Schatzker and Lamberts criteria was fair in 1 case and failure in 5 cases, and change of tibiofemoral alignment occurred in 2 cases. The above poor clinical results could be considered to be derived from the delayed operative intervention resulting in joint stiffness due to soft tissue contracture, arthritis and large bony defect. In conclusion, even if it showed poor clinical results, the composite graft made of the autogenous cancellous bone and the pmcessing allograft could serve as a possible alternative for restoration of large bony defect in delayed management of supracondylar and intercondylar fracture of the fumur.

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Proximal Row Carpectomy for Disease of the Proximal Carpal Bone: Seung Koo Rhee, Hyoung Min Kim, Soon Young Kwon, Hwa Sung Lee, Hang Kyu Lee; J Korean Soc Fract 1996;9(2):311-318. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.311

Abstract PDF: The management of pain, stiffness and weakness of the wrist following unsuccessful conservative treatment of fractures of the scaphoid or of Kienbocks disease and so on is a difficult problem. Despite the recommendation by Cotton in 1924 and subsequently by others that the proximal row of carpal bones should be removed in the presence of disease, arthrodesis or various stabilizing procedures continue to be recommended. But, although a radiocarpal fusion, when successful, leads to a painless, stable wrist, the loss of the normal motion of the wrist inevitably results in some loss of function of the hand. The purpose of this study is to evaluate the efficacy of the proximal-row carpectomy. Since 1987, five patients were studied following proximal-row carpectomy. The lesions for which the operation was done included two Kienbocks disease, one crushing injury, one transscaphoid volar lunar dislocation, and one scapholunate dissociation. Their end results after average 74 months of follow-up showed less pain than before operation and a reasonable range of flexion/extension which varied between 65% and 85% of normal, the average being 74%, Postoperative grip strength was from 70 to 90% fo normal, the average being 78%. In conclusion, excision of the proximal row of tile carpus is a useful procedure, with a limited application in patients with Kienbocks disease, dislocation of the lunate bone, scapholunate dissociation and similar injuries which do not respond to conservative management.

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Reduction and Percutaneous Pinning of Displaced Supracondylar Fracture of the Humerus in Children: Won Yoo Kim, Jin Young Kim, Kun Young Park, Chong Hoon Park, Hwa Sung Lee; J Korean Soc Fract 1994;7(2):471-479. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.471

Abstract PDF: Closed reduction and percutaneous pinning of displaced supracondylar fractures of the humerus in children yielded simple fracture management, less neurological and vascular complications, reduced hospitalization day and increased satisfactory out-comes. We treated twenty-seven cases of these fractures(extension type : twenty-five cases) by such a method. The accurate closed reduction of a supracondylar fracture could be obtained and confirmed by image intensifier. The maintanence of a reduction was stabilized by application of K-wires. Our study showed that the limitation of range of motion of the elbow joint was not signifiint(three cases, below ten degrees extension block and changes of carrying angle was also minimal three cases, below ten degrees). In twenty-seven cases, excellent results were recorded in 93% on at least on year follow-up.

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