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Operative Treatment of the Tibial Condylar Fracture
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Yong Man Cho, Kun Yung Lee, Myung Sik Park, Cheon Dong Lee, Heung Sik Kang, Gue Cherl Cho
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J Korean Soc Fract 1997;10(1):44-52. Published online January 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.1.44
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 Abstract
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- The tibial condylar fracture which involves articular surface of the proximal tibia is common in pedestrian injury of the traffic accident and often produces some disability of the knee joint because of the frequent association with ligamentous and meniscal injuries. Methods of treatment in fracture of the tibial condyles has long been a controversial problems. Recently most authors agree that the method of treatment has to be selected in each individual case and anatomical reduction of fracture and early knee motion are recommended but unsatisfactory results has been reported as between 20% and 40%.
The authors analyzed 38 cases of the tibial condylar fractures, which were treated at the orthopedic department of the Lee-Rha general Hospital from 1990 to 1994, regarding its type, treatment and results.
The results of this study were as follows.
1. According to Schatzker classification : the most common fracture was type II.
2. According to BloDers criteria, 28 cases showed satisfactory results(74%).
3. Postoperatively, early knee joint exercise like alternatively applying 90(knee flexion and extension splint were very important factors for good results).
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The Operative Treatment of Displaced Waist Fracture of Scaphoid
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Kun Yung Lee, Young Kee Lee, Yong Man Cho, Heung Sik Kang, Cheon Dong Lee, Sang Su Oh
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J Korean Soc Fract 1997;10(1):164-170. Published online January 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.1.164
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Abstract
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- The authors surveyed the clinical study of 17 cases of scaphoid fractures from March 1989 to September 1994 with minimal 1 year follow up at Department of Orthopedic Surgery, Lee-Rha general Hospital.
The following conclusions were obtained through clinical survey.
1. Of all 17 cases, they were 13 males and 4 females; Among the 13 males, 10 cases were aged between 20 and 39 years, forming 58.8% of all.
2. All 17 cases were treated by open reduction. Unions were obtained at average 11.5 weeks in 7 cases treated with Herbert screw fixation and 12 weeks in 10 cases treated with K-wire fixation.
3. Two of ten K-wire treated cases resulted in delayed union, one of seven Herbert screw treated cases resulted in delayed union.
4. Unions were obtained at average 20 weeks in 3 cases of delayed union. We concluded that open reduction and K-wire fixation were recomanded for the compatible treatment method of displaced waist fracture of scaphoid.
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A Treatment for Fracture of the Talar Neck
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Kun Yung Lee, Young Kee Lee, Yong Mann Cho, Cheon Dong Lee
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J Korean Soc Fract 1996;9(4):1009-1015. Published online October 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.4.1009
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Abstract
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- The talus has some important anatomic features. Approximately 60% of its surface is cartilage and the talus often has problems with circulation. Talar neck fracture have a high association with osteonecosis and osteoarthritis. Authors have analysed 16 cases of the talar neck fractures treated at Lee-Rha General Hospital from January 1990 to December 1995 with minimal 1 year follow up.
The results were as follows; 1. In the 16 cases, there were 14 males and 2 females, the age between 20 and 40 years old was 10 cases(63%).
2. The most common rause of injury was traffic accident(63%), with sudden hyperextension as its mechanism.
3. Associated injuries were 4 malleolar fracutres, 3 calcaneous fractures, 3 spine fractures, 3 tibiofibular fractures and 2 femur fractures.
4. According to the Hawkins classification ; 3 cases in type 1, 4 cases in type II, 5 cases in typeIII, 4 case in type IV fractures were observed.
5. The method of treatment, all 3 cases of Hawkins type I fractures were treated by closed reduction and cast immobilization, 3 cases of Hawkins type II and 1 case of Hawtins type III fracture were treated by closed reduction and internal fixation, other 9 cases were treated by open reduction and internal fixation.
6. Excellent results were observed in 8 cases, good in 5 cases, fair in 2 cases, poor in 1 case with the Hawkinstherapeutic criteria.
7. Complications were observed 3 avascular necrosis, 2 post-traumatic arthritis, 2 ankle stiffness and 1 skin necrosis.
From the above results, authors believe that early anatomical reduction & internal fixation is importent to get a satisfactory result in the treatment of tatar neck fracture.
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Treatment of the Tarsometatarsal Joint Fracture-Dislocation
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Kun Yung Lee, Young Kee Lee, Yong Man Cho, Heung Sik Kang
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J Korean Soc Fract 1996;9(3):725-732. Published online July 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.3.725
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Abstract
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- Traumatic dislocation and fracture-dislocation of the tarsometatarsal joint rare injuries. These injuries often missed because radiographs of this joint is difficult to be interpreted, so delay to be diagnosed and treated.
These injuries often leads to arthritic change with significant residual symptoms and deformities.
Tarsometatarsal joint injuries are generally managed by accurate repositioning of the displaced metatarsals and stabilization with instruments(K-wire, screws etc.).
The purpose of this study is to review the anatomical, radiological and functional results.
The authors analysed the 25 cases with injuries of the tarsometatarsal joint treated of the department of Orthopaedic Surgery, Lee-Rha general hospital from March 1989 to September 1994, which showed the following results.
1. The most common cause of the injury was traffic accident(76%).
2. According to the Hardcastles classification, the injuries were classified as follows:partial incongruity in 16 cases(64%), total incongruity in 6 cases(24%), and divergent congruity in 3 cases(12%).
3. Three cases were treated with closed reduction and case immobilization, thirteen cases were treated with closed reduction and percutaneous K-wire fixation. Nine cases were treated with open reduction and K-wire fixation as follows:reduction failure in 3 cases, entrapment of anterior tibial tendon in 2 cases, severe soft tissue injury in 4 cases.
4. The anatomic reduction and its maintenance were considered as most important factor of prognosis.
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A Treatment of Unreamed Intramedullary Nailing of Open Fracture of the Tibia
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Keun Kwon Kang, Jang Jung Kim, Kun Yung Lee, Myung Kon Nam, Myung Sik Park
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J Korean Soc Fract 1995;8(3):551-556. Published online July 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.3.551
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Abstract
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- The tibial fracture was the most common fracture of the long bone fractures, especially there were many controversies in the treatment of open fracture by high energy injury.
The authors analyzed retrospectively 32 patients of tibial open fracture who underwent unlearned intramedullary nailing at the Department of Orthopedic Surgery, Lee-Rha general hospital from September 1992 to August 1994 with minimal 1 year follow up.
In 32 cases, the average age was 37.5 years old and the most common injury was traffic accident(25 cases,78%). Twenty seven cases were male(84.4%) and 5 cases female(15.5%). There were 17 cases of Type A fracture(53%),12 cases Type B(37.5%) and 3 cases Type C(19.5%) by A-O classification, and 11 cases were Type I open fracture(34%) by Gustilo - Anderson classification, 15 cases, Type B (47%) and 6 cases, Type III (19%). The average bone union time was 14.8 weeks except one case of infected non-union.
We concluded that unlearned intramedullary nailing is recommended for the compatible treatment metnod of tibial open fractures.
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A Treatment of Humeral Shaft Fracture with Closed Interlocking Nailing
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Kun Yung Lee, Myung Sik Park, Keun Kwon Kang
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J Korean Soc Fract 1995;8(1):159-166. Published online January 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.1.159
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Abstract
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- The ideal treatment of acute fractures of the humeral shaft remains controversial. It is generally accepted that conservative treatment is best for isolated closed fractures of the humerus shaft. But recently, in case of surgical management, intramedullary nailing treatment has reported good results.
Authors have analysed 20 cases of the humeral shaft fractures treated with closed intramedullary nailing at the department of orthopedic surgery, Lee-Rha general hospital from June 1991 to December 1993 with minimal 1 year follow up. The results were as follows 1. In the 20 cases, the age between 20 and 40 years old was taken place 60% and the most common cause of injury was traffic accident (75%) 2. It was worthwhile to define the relationship between union time and Winquist-Hansen classification which used in femoral shaft fracture. And the average bone union time was 8 weeks except 3 cases, especially delayed union was found in type 3 of Winquist-Hansen classification. But 2 cases were united after 9 monthes follow up without secondary procedure.
3. Problem in Seidel nailing was flilure of expansion of distal portion and in Russel-Taylor nailing was impairement of internal rotation of shoulder and delayed union due to iatrogenic distraction at the fracture level during operation.
In according to the above results to treat the humeral shaft fracture, closed intramedullary inter-locking nailing was satisfactory enough to obtain bone union and early recovery of shoulder motion. Also, the Winquist-Hansen classification is useful guide to find the bone union time in the treatment of humeral shaft fracture with interlocking nail.
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The Treatment of Acromioclayicular Dislocation Comparison Study between Modified Bosworth and Phemister Technique
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Kun Yung Lee, Myung Sik Park, Keun Kwon Kang, Myung Kon Nami
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J Korean Soc Fract 1995;8(1):193-198. Published online January 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.1.193
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Abstract
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- Acromioclavicular joint injuries are frequently seen with increase of traffic & industrial accidents & sports injury recently, There are many procedures which described for the treatment of acromioclavicular dislocation, but there are still controversies concerning the best treatment of the injuries.
We have analysed 35 patients with acromioclavicular dislocations had been treated by modified Bosworth & Phemister technique at the department of orthopedic surgery Lee-Rha general hospital from June 1990 to December 1993 with minimal 1 year foll up The authors had obtained following results as modified Phemister technique and modified Bosworth technique treatment for acromioclavicular joint.
1. The complications were as follows: superficial infection at insertion site of k-wire and migration of k-wire in modified Phemister technique and loosening of screw and erosion of clavicle noted in modified Bosworth tecnique. But, there were no specific difference between two groups for pain and motion of shoulder joint.
2. In modified Bosworth technique, it was not necessary to fix the acromioclvicular joint with k-wire and also possible to perform early mobilization of shoulder joint than modified Phemister tecnique.
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