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Diagnosis and Management of Ligament Injuries of the Wrist
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Ki Tae Na, Joo Yup Lee
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J Korean Fract Soc 2016;29(2):160-170. Published online April 30, 2016
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DOI: https://doi.org/10.12671/jkfs.2016.29.2.160
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 Abstract
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- The wrist joint is formed by the distal end of the radius and ulna proximally, and eight carpal bones distally. It has many ligaments to maintain stability of the complex bony structures. The incidence of ligament injuries of the wrist has increased due to sports activities. However, diagnosis and management of these injuries are sometimes difficult because of the anatomic complexity and variable injury patterns. Among them, scapholunate ligament injury and triangular fibrocartilage tears are the two most common injuries resulting in chronic disabling wrist pain. Thorough understanding of the wrist anatomy and physical and radiologic examination is mandatory for proper diagnosis and management of these conditions. This article will briefly discuss the wrist joint anatomy and biomechanics, and review the diagnosis and management of the scapholunate ligament injury and triangular fibrocartilage injury.
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Lateral Approach for Internal Fixation of the Distal Humeral Shaft Fractures
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Seung Koo Rhee, Joo Yup Lee, Yoo Joon Suh, Joon Ho Lee, Nong Kyoum Ahn
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J Korean Fract Soc 2004;17(2):83-89. Published online April 30, 2004
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DOI: https://doi.org/10.12671/jkfs.2004.17.2.83
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Abstract
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- PURPOSE
To investigate the efficacy and advantages of the lateral approach for internal fixation of the distal humeral shaft fractures.
MATERIALS AND METHODS
Twelve patients with distal humeral shaft fractures who underwent open reduction and internal fixation using plate and screws by lateral approach from January, 1997 to May, 2002 were investigated. Postoperative results after a minimum 1 year follow-up were assessed using union rate, elapsed time to union, postoperative complications such as iatrogenic radial nerve palsy, range of motion of the elbow joint. Clinical outcomes were evaluated with Mayo elbow performance scoring system.
RESULTS
Union was achieved in all cases. The average time to union was 9 weeks (range, 7~12 weeks). Four cases of preoperative radial nerve palsy were revealed as contusion of the intact nerve and resolved completely by three months. The mean elbow range of motion was from 5 to 138 degrees. The average Mayo elbow performance score was 91 points; 9 cases ranked as excellent and 3 as good.
CONCLUSION
Distal humeral shaft fractures can be treated successfully through open reduction and internal fixation using plate and screws. Lateral approach is recommended to stabilize distal humeral shaft fractures without compromising the range of motion of the elbow, and to protect or explore the injured radial nerves easily
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Citations
Citations to this article as recorded by  - Modified anterolateral approach for internal fixation of Holstein–Lewis humeral shaft fractures
Ho Min Lee, Young Sung Kim, Suk Kang, Min Young Lee, Jong Pil Kim
Journal of Orthopaedic Science.2018; 23(1): 137. CrossRef - Posterior Dual Plating for Distal Shaft Fractures of the Humerus
Chul-Hyun Cho, Kwang-Yeung Jeong, Beom-Soo Kim
Journal of the Korean Fracture Society.2017; 30(3): 117. CrossRef
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Treatment of Post-traumatic Dislocation of Metacarpophalangeal Joints of the Hand
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Seung Koo Rhee, Seok Whan Song, Joo Yup Lee, Chang Youn Moon, Jae Chan Oh
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J Korean Soc Fract 2003;16(2):253-261. Published online April 30, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.2.253
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Abstract
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- PURPOSE
To analyse the obstacles to prevent the reduction for dislocation of the metacarpophalangeal (MP) joints of the hand and evaluate the relationship between the sex and dislocation type in closed reduction case.
MATERIALS AND METHODS
Total 27 cases of MP joint dislocation of the hand (11 cases of thumb, and 14 index and 2 little finger) were reviewed retrospectively. The anatomical structures to prevent the reduction were confirmed at operation and the cases which were reduced immediately were also analysed for their ages and differences of damaged structures, and finally their complications or outcome were reviewed for average 7 months after reduction.
RESULTS
In 11 cases of thumb MP joint dislocations, the complex dorsal dislocations in which the protruded metacarpal neck was caught by buttonhole of torn anterior joint capsule, volar plate and FPB were reduced by open method in 8 cases, and closed reduction was done in 2 cases but one old case required arthrodesis. In other finger MP joint dislocations, the Kaplan's concept to prevent the reduction was confirmed. But reduction of torn volar plate and incision of transverse metacarpal ligament were sufficient to reduce the dislocation with gentle longitudinal traction during the operation. In two cases of little finger MP joint dislocation, the ruptured radial collateral ligaments were noted after open reduction and it must the repaired to prevent the finger instability later. Their overall end results were good without any significant restriction of MP joints motions and finger instabilities.
CONCLUSION
One or two times of closed reduction with proper local anesthesia could be tried, but simple reducible dislocation can be converted to complex irreducible ones by the inappropriate traction method, and so proper reduction technique by closed or even in open way is important with the knowledge of anatomical obstacles to prevent the reduction of the metacarpophalangeal joints.
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Delayed Management of Supracondylar and Intercondylar Fracture of the Femur Using the Composite Graft(Autograft+Processing Allograft)
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Young Kyun Woo, Seung Koo Rhee, Soen Yong Kwon, Hwa Sung Lee, Joo Yup Lee
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J Korean Soc Fract 1996;9(4):951-957. Published online October 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.4.951
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Abstract
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- 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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