Journal of Musculoskeletal Trauma

Joon Soon Kang

11 Articles

Result of Surgical Treatment for the Femoral Head Fracture: Joon Soon Kang, Kyoung Ho Moon, Tong Joo Lee, Jong Hyuck Yang; J Korean Fract Soc 2014;27(3):198-205. Published online July 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.3.198

Abstract PDF: PURPOSE
This study analyzed the clinical and radiological long-term follow-up results of patients with femoral head fracture who received surgical treatments.
MATERIALS AND METHODS
Retrospective evaluation was performed for 20 patients with femoral head fracture who received surgical treatments between December 1997 and May 2010. According to Pipkin's classification, there were five type I, six type II, one type III, and eight type IV fractures.
RESULTS
The average Merle d'Aubigne'-Postel score was 12.8 (12.80+/-3.53). According to surgical method, the score for the bony fragment excision group was 9.8 (9.83+/-2.79), and that for the open reduction and internal fixation group was 13.9 (13.92+/-3.07). Depending on Thompson-Epstein criteria, two patients were good, two were fair, and two were poor in the bony fragment excision group. Four patients were excellent, six were good, and three were poor in the open reduction and internal fixation group.
CONCLUSION
Bony fragment excision should be performed with caution in patients with femoral head fracture. Considering fragment size, location, and presence of acetabular fracture, better outcome can be expected using the open reduction and internal fixation method in comparison with excision.

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Analysis of the Factors Involved in Failed Fixation in Elderly Intertrochanteric Femoral Fracture: Joon Soon Kang, Ryuh Sup Kim, Bom Soo Kim, Young Tae Kim, Seung Hyun Hong; J Korean Fract Soc 2012;25(4):263-268. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.263

Abstract PDF: PURPOSE
To analyze the causes of internal fixation failure in elderly intertrochanteric femoral fractures.
MATERIALS AND METHODS
We retrospectively analyzed 93 intertrochanteric femoral fractures that were treated by internal fixation. The follow-up period was at least 24 months. The mean age was 73 years. We analyzed the classification of the fracture, screw position, reduction state of the fracture, and neck-shaft angle.
RESULTS
Internal fixation failure occurred in 12 cases (12.9%). The causes of internal fixation failure were one case (1.0%) of head perforation, 7 cases (7.5%) of excessive slippage of a screw, and 4 cases (4.3%) of varus deformity. Significant factors infixation failure were displacement of the posterolateral fragment more than 8 mm in anteroposterior radiograph, anterior displacement of a fragment, or more than 20-degree angulation in lateral radiography. Thirty-three cases had a screw in the middle position and 4 of these cases (12.1%) had fixation failure. Notably, 14 cases had a screw in the posteromedial position and 6 of these cases had fixation failure (42.8%).
CONCLUSION
Accurate reduction of the posteromedial fragment is essential in unstable intertrochanteric fracture and anterior displacement or angulation should be avoided to prevent fixation failure. The tip apex distance of the screw and central location of the screw in the femoral head is also an important factor.

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Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis: Comparative Analysis between Cementless Stem and Cemented Stem: Joon Soon Kang, Kyoung Ho Moon, Rhu Seop Kim, Sang Ho Lee, Jong Min Choi; J Korean Fract Soc 2011;24(1):16-22. Published online January 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.1.16

Abstract PDF: PURPOSE
We evaluated the usefulness of the cementless stem in treating hip fracture patients older than 70.
MATERIALS AND METHODS
We studied elderly osteoporotic hip fractures in the neck and intertrochanter area who had received hip arthroplasty with over 2 years of follow up period. Among those, we analyzed the clinical and radiological results of hip arthroplasty with cemented stem (group 1) and hip arthroplasty with cementless stem (group 2). Each group was consists of fifty hips.
RESULTS
The mean age at surgery was 75 years and mean follow-up period was 40 months (minimum 24 months). The admission period was 28.68+/-8.8 days for group 1 and 28.05+/-8.7 days for group 2 (p>0.05) and the average operation time was 87+/-21.2 minutes, and 80+/-17 minutes (p>0.05) and the total blood loss was 611+/-141.3 cc and 557+/-120.5 cc (p>0.05) respectively. There was no statistically significant difference in all aspects. One case of pulmonary embolism occurred in group 1. Stem loosening was not observed in both groups at the last follow-up radiologic study.
CONCLUSION
The hip arthroplasty with cementless stem for the osteoporotic hip fractures showed a competent results clinically and radiologically in short term follow up as compared with the cemented stem.

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The Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing in the Treatment of the Proximal and Distal Tibia Fracture: Joon Soon Kang, Seung Rim Park, Sang Rim Kim, Yong Geun Park, Jae Ho Jung, Sung Wook Choi; J Korean Fract Soc 2010;23(2):172-179. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.172

Abstract PDF

PURPOSE
To compare the efficacy of the surgical treatment through the comparison of Minimally Invasive Plate Osteosynthesis (MIPO) and Intramedullary (IM) nailing in the treatment of the tibial shaft fractures expended to metaphysis retrospectively.
MATERIALS AND METHODS
Patients with proximal or distal third fracture of tibial shaft from May 2003 to Aug. 2006 were divided into two groups depending on the surgical method. Group A consisted of 30 patients treated with IM nailing, Group B was 29 patients treated with MIPO. The clinical outcomes were evaluated retrospectively from the time for bone union and callus formation confirmed by X-ray, functional score of knee or ankle joint, and complications including nonunion, malalignment and infection.
RESULTS
Bone union was seen radiologically at a mean of 17.4 weeks in group A, and 17.0 weeks in group B. In postoperative complications, group A showed two nonunion, two delayed-union, six malalignment, and two wound infection while group B showed only one delayed-union and one wound infection.
CONCLUSION
There were no significant differences in the time for bony union and functional score between IM nailing and MIPO. Conventional IM nailing with only interlocking technique showed higher incidence of malalignment and deformity than MIPO for the treatment of the proximal or distal third fracture of the tibial shaft.

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Effect of Korean Medicine Treatments in Patients with Proximal Tibia Fracture: A Retrospective Observational Study
Jung Min Lee, Eun-Jung Lee
Journal of Korean Medicine Rehabilitation.2020; 30(3): 141. CrossRef

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Avulsion Fracture of The Medial Meniscus: A Case Report: Hyoung Soo Kim, Seung Rim Park, Joon Soon Kang, Woo Hyeong Lee, Kil Seok Ko; J Korean Soc Fract 2000;13(1):109-112. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.109

Abstract PDF: Post-traumatic meniscal ossicle due to avulsion fracture of medial meniscus was very rare. They were often associated with meniscal tear, but caused symptoms without a tear, by mass effect from protruding meniscal contour. so it had to be differential diagnosised with free loose body in the knee joint. We experienced a symptomatic meniscal ossicle due to post-traumatic avulsion fracture of the posterior horn of medial meniscus, and managed with open reduction, internal fixation with screw and washer after arthroscopic examination. We report a rare case of meniscal ossicle in detail with literature

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Assessments of Reduction for Supracondylar Humerus fractures in Children: Comparison of Clinical carrying angle, Baumanns angle and Metaphyseal-diaphyseal angle: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Seong Hwan Kim; J Korean Soc Fract 1999;12(3):660-666. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.660

Abstract PDF

PURPOSE
The object of this retrospective study is to verify Baumanns angle as assessment methods of reduction for supracondylar fracture of the humerus in children and to confirm what is the more accurate assessment methods of supracondylar fracture of the humerus between Baumanns and metaphyseal-diaplyseal angle.
MATERIALS AND METHODS
34 cases of more than 1 years follow up after closed reduction and pinning were reviewed. Simple linear regression has been used for statistical analysis and Pearsons correlation coefficient(rho) has been used for comparison of Baumanns angle and metaphy seal-diaphyseat angle.
RESULTS
The results form simple linear regression, about a 10 change in Baumanns angle contributes to a change in the carrying angle of approximately 3.7 on the uninjured(=-0.372, r=-0.750, P<0.001) and injured( =-0.365, r=-0.759, P<0.001) arms. In comparison of Baumanns angle and metaphyseal-diaphyseal angle to predict final carrying angle, the correlation coefficient between Baumanns angle and carrying angle(r=-0.759) was higher than that between metaphyseal-diaphyseal angle and carying angle(r=-0.495) with statistical significant using Fishers rho(P<0.05).
CONCLUSION
The Baumannss angle after reduction can be reliably used to predict accurately the final carrying angle and is more accurate than the metaphyseal-diaphyseal angle to predict the final carrying angle.

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Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture
Yoon Hae Kwak, Dong Jou Shin, Kun Bo Park
Journal of the Korean Fracture Society.2010; 23(1): 90. CrossRef

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Treatments of Intraarticular Calcaneal Fracture: Based on CT Classification and Comparison of Treatments: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Ju Sik Park; J Korean Soc Fract 1999;12(1):103-112. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.103

Abstract PDF: The treatment modality of the displaced intraarticular calcaneal fractures is still controversial. The objectives of this study are to classify intraarticular fractures based on computed tomography and to compare the treatment results according to the classification and to consider the influence of Bohler angle to the prognosis of this injuries. From October 1989 to March 1997, 62 fractures(58 patients) who had been treated after calcaneal CT(computed tomography) were selected. The interval between the trauma and the last follw-up was mean 3.3 years(1.1-5.2 years). They had been treated with one of the three methods, that is, open reduction and internal fixation(OR/IF), Essex Lopresti or simple cast immobilization. The fracture was classified as type I(non-displced), type I(two part or split), type III(three part or split depression), type IV (four part or highly comminuted) based on CT according to Sanders et. al. The calcaneal scoring system proposed by Kerr et. al. was applied to the assessment of the treatment results, which may be more appropriate for non-parametric statistical test. The type I fractures had been treated only with cast immoobilization with or without manual reduction and all of the 4 cases(100%) have shown favorable(excellent or good) results. The OR/IF group(favorable results for 15 of 18 cases(83.3%) in type II and for 11 of 13(84.6%) in type III) have shown better results than those of other two group(P<0.05). The results between other two groups, that is, Essex-Lopresti operation group(favorable results for 4 of 8 cases(50%) in type II and for 1 of 3(33.3%) in type III)and cast immobization(2 of 5 cases(40%) in type II and for 0 of 2(O%) in type III) have made no significant differences(p>0.5). In type IV, there were no significant differences among the results of the three methods(p>0.1) and worse results than type II, III (p <0.05) probably due to difficulty in reduction of highly comminuted articular facets. The Bohler angle has given no significant influence to the final results(p>0.1). In conclusion, OR/IF has shown better results than closed modalities in the treatment of displaced intraarticular calcaneal fractures and may be the primary choice of treatment for these fractures. We have used Kruskal-Wallis H test and its approximation to chi-square distribution for comparison of three groups and Mann-Whitney U test and its approximation to normal distribution for two groups and have been aided by the computer program, SPSS in statistical calculations. The p-value was 0.05.

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The Treatment of Comminuted Fractures of Distal Humerus with Rigid Internal Fixation and Early Motion: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Joo Hyung Lee, Seung Jun Park; J Korean Soc Fract 1998;11(1):28-33. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.28

Abstract PDF

Comminuted fractures of distal humerus are difficult fracures to treat because of their rarity and associated significant comminution. The results of managing theses fractures non-operatively are limited by failure to get anantomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudoarthrosis. The goals of open reduction are to preserve articular surface and restore elbow function. Hence an operative management with anatomical reduction of fragments becomes the treatment of choice for these fractures. Authors analyzed 17 patients, with 30 months follow-up on an average, who were treated with open reduction and rigid internal fixation followed early mobilization during the period from jan. 1991 to Dec. 1996. Following results were obtained. 1. According to the Muller's classification, type A was 4 cases(23.5%), type B was 4 (23.5%), and type C was 9(53%) 2. Excellent or good results were obtained in 12 cases(71%) by the criteria of Aitken and Rorabeck. 3. There were limitation of full extension over 5degreein all cases and no other severe complications causing disability of elbow.

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Treatment for the Supracondylar Fractures of the Distal Humerus with Cannulated Screw
Jin Soo Park, Young Khee Chung, Jung Han Yoo, Kyu Cheol Noh, Kook Jin Chung, Dong Nyoung Lee
Journal of the Korean Fracture Society.2007; 20(1): 58. CrossRef

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Surgical Treatment of Acromioclayicular Joint Dislocation with Coracoclavicular Ligament Reconstruction using Coracoacromial Ligament: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyung Lee, Joo Hyung Lee, Min Seon Rim; J Korean Soc Fract 1997;10(4):949-955. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.949

Abstract PDF: Several treatment methods for complete acromioclavicular(AC) joint dislocation have been recommended. This study was performed to evaluate the results of the injuries that had been treated operatively with Bosworth technique combined with coracoclavicular ligament reconstruction using coiacoacromial ligament. Between September 1992 and October 1995, 19 cases were treated with this method. We made an assessment of the results suggested by Taft. Subjectively, fifteen patients had no pain or stiffness. 17 patients had normal strength and full range of motion objectively. On the roentgenographic bases, 16 cases showed normal findings and one showed the subluxation of the AC joint. The overall Taft score was 10.8 points and 84 % of the patients showed good or excellent results. The advantages of this method include anatomical reduction of the AC joint and early motion of shoulder. Ligament reconstruction enables early removal of the lag screw which precludes joint stiffness and metal problems. We conluded that this method was a good surgical method for complete AC joint dislocation.

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Arthroscopic Assisted Management For the Fracture Of the Tibial Intercondylar eminence Using Tension Band Technique: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyung Lee, Sung Eyu Lee, Hyun Yang Chun; J Korean Soc Fract 1997;10(1):67-72. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.67

Abstract PDF: Avulsion fracture of the intercondylar eminence of the tibia(Type III as classified By Meyers and Mckeever) can be managed by arthroscopic reduction and fixation. Recently, the different arthroscopic suturing techniques, fixation with K-wire, screw and staple fixation have been employed to treat this injuries, however, most of these techniques are complicated and they do not always achieve stable fixation enough to facilitate early rehabilitation and restore stability to the knee through a full range of motion so far. A new technique for treatment of the tibial spine fracture arthroscopically, using the tension band method is presented. The advantage of this method include : 1. to be technically less demanding. 2. to allow for stable fixation even thin or comminuted fragments. 3. to present simple and safe removal of internal fixation. 4. to facilitate early rehabilitation.

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Overgrowth and Remodelling after Femoral Shaft Fractures in Children: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Hyun Yang Chun; J Korean Soc Fract 1997;10(1):226-232. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.226

Abstract PDF: Fifty-two femoral shaft fractures in children, treated conservatively, were studied clinically and radiographically to access the overgrowth and it is related factors. Among them, we reviewed fourteen children(16 cases), who had angular deformities over 10 after union for the spontaneous correction of the angular deformity. They had an average follow-up of 40.5 months and 32.4 months. The results were as follows : 1. The average of the overgrowth was 9.9mm. 2. The overgrowth was influenced by the age, but was not promoted by other factors. 3. The average overgrowth of the age group between 4 and 9 was 10.8 +/- 2.7mm. 4. The average correction was 78% of the initial angular deformity, 77% had occurred at the physes and 23% at the fracture site. 5. There was no close relation between the remodelling rate and degrees of initial deformity.

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