Journal of Musculoskeletal Trauma

Kwang Bok Lee

9 Articles

Extensive Metallosis Caused by Plate and Screw Construct for Distal Fibular Fracture - A Case Report -: Ki Tae Park, Kwang Bok Lee; J Korean Fract Soc 2013;26(2):147-150. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.147

Metallosis has been reported in the setting of weight-bearing joint arthroplasties, like the hip and knee joints. However, the prevalence of metallosis in non-articular portions is very uncommon. We report a rare case of a patient who had metallosis secondary by fibular nonunion after fixation with plate and screw. In addition, we discuss the clinical and the operative findings, as well as the outcome of this uncommon complication.

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Plate on Plate Osteosynthesis for the Treatment of Nonhealed Periplate Fractures
Georgios Arealis, Vassilios S. Nikolaou, Andrew Lacon, Neil Ashwood, Mark Hamlet
ISRN Orthopedics.2014; 2014: 1. CrossRef

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Comparison of Floating Knee according to Presence of Knee Joint Injury: Eau Sup Chung, Jong Hyuk Park, Hee Rack Choi, Joo Hong Lee, Kwang Bok Lee; J Korean Fract Soc 2012;25(4):277-282. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.277

Abstract PDF: PURPOSE
To compare the clinical outcomes of floating knee according to the presence of knee joint injury.
MATERIALS AND METHODS
Between March 2004 and March 2009, we investigated 36 patients, who underwent surgical treatment for floating knee injuries. We classified the floating knee into two groups as type I (12 cases) has no knee joint injury and type II (24 cases) has knee joint injury. We compared two groups about combined injury (orthopedics or other part), open fracture or not, neurovascular injury,union time, range of motion, and complication rate.
RESULTS
There is statistically no significant difference between two groups as type I (6 cases, 50%) and type II (13 cases, 54.2%) in orthopedic combined injury (p=0.813), and also same as type I (3 cases, 25%) and type II (12 cases, 50%) in combined injury on the other department (p=0.151), and in floating knee with open fracture as 4 type I (33%) and 12 type II (50%) of 16 cases (44%), and Gustilo-Anderson 3 type I, 4 type II, 1 IIIA, 4 IIIB, and 4 IIIC (p=0.423). There is statistically no significant difference between two groups in neurovascular injury as 1 type I (8.3%), and 3 type II (12.5%) (p=0.708). There is a statistically significant difference between two groups in the mean bone union time as 18.2+/-5.37 weeks (12~24 weeks) for type I and 24.95+/-9.85 weeks (16~33 weeks) for type II (p=0.045), and in the mean range of knee joint motion as 133+/-12.74 degree (120~150 degree) for type I and 105+/-19.00 degree (80~135 degree) for type II (p=0.012).
CONCLUSION
Floating knee with knee joint injury is severe itself and related with severe combined injuries, subsequent range of knee joint motion limitation, the delay of union time, and high complication rate. Therefore, we should take care in surgical treatment for this trauma entity.

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Injury Severity and Patterns of Accompanying Injury in Spinal Fracture: Hun Park, Kyung Jin Song, Kwang Bok Lee, Joo Hyun Sim; J Korean Fract Soc 2012;25(3):203-207. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.203

Abstract PDF

PURPOSE
To examine the relationship between injury severity and patterns of associated injury in spinal fracture.
MATERIALS AND METHODS
From March 2004 to March 2010, a retrospective study was conducted on 291 patients who had undergone surgeries due to spinal fractures. Spinal fractures were categorized as upper cervical, lower cervical, thoracic, thoracolumbar, and lumbar region, and the severity of fracture was measured using the Abbreviated Injury Scale and Injury Severity Score (ISS). We evaluated the correlation between the fracture site and the incidence and injury severity of the associated injury, and compared the neurologic damage according to the presence/absence of the associated injury.
RESULTS
Spinal fracture occurred in the thoracic (43.5%) and lower cervical (30.0%) levels, and associated injury developed in 134 patients (47%). The area of associated injury was in the extremity (41.2%), thorax (25.5%), head, neck, and face (21.9%). Lower cervical fracture (34.5%) had a lower prevalence than thoracic (81%) and lumbar fracture (61%). The average ISS of the associated injury was 17.14 for the thoracic fracture, 12.30 for the lower cervical fracture, 8.7 for the thoracolumbar fracture and 5.69 for the lumbar fracture. Neurologic damage was highly frequent in the lower cervical fracture and included 54 patients (62.1%) and was less frequent in the upper cervical fracture, which included 7 patients (17.9%) (p=0.032).
CONCLUSION
Although the associated injury was less frequent in the lower cervical spine among the spinal fractures that underwent surgical treatment, there was a high risk of neurologic damage in the case of associated injury; therefore, there is a need to pay special attention to patients that suffer damage in this area. In addition, since the degree of the associated injury in the thoracic and lower cervical fracture is significant, an appropriate management strategy for the associated injury must be considered.

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The Clinical Effects of Complex Korean Medicine Treatment in Patients with Cervical Spine Fracture Caused by Traffic Accident: A Report of 2 Cases
Si-Hoon Han, Gi-Eon Lee, Kyeong-Sang Jo, Da-Young Byun, Min-Seok Oh
Journal of Korean Medicine Rehabilitation.2018; 28(2): 113. CrossRef
Clinical results of early stabilization of spine fractures in polytrauma patients
Ki-Chul Park, Ye-Soo Park, Wan-Sik Seo, Jun-Ki Moon, Bo-Hyun Kim
Journal of Critical Care.2014; 29(4): 694.e7. CrossRef

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Is CT Angiography a Reliable Tool for Diagnosis of Traumatic Vessel Injury in the Lower Extremities?: Jong Hyuk Park, Kwang Bok Lee, Hyuk Park, Jun Mo Lee; J Korean Fract Soc 2012;25(1):26-30. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.26

Abstract PDF: PURPOSE
Computed tomographic (CT) angiography is the first choice of diagnosis in traumatic vessel injury in the lower extremities, replacing angiography. The purpose of this study was to investigate the clinical reliability of CT angiography through a retrospective study.
MATERIALS AND METHODS
Seventeen patients underwent CT angiography before surgery for traumatic vessel injury in the lower extremities from 2009 to 2010, and a comparative analysis of operative findings in all patients with a positive predictive value and sensitivity were measured.
RESULTS
In all patients, 16 artery ruptures and 1 compartment syndrome occurred. In 15 artery ruptures, preoperative findings of CT angiography and surgical findings were consistent, and the positive predictive value was 93.8%. One patient with posterior tibial artery rupture was revealed as normal in CT angiography; thus, sensitivity was 93.8% (15/16 patients), and the accuracy rate was 88.2% (15/17 patients).
CONCLUSION
Though CT angiography is a reliable tool for diagnosis in traumatic vessel injury in the lower extremities, a more invasive test will be needed, especially peripheral angiography or diagnostic exploration, in cases of relatively small vessel injuries around the ankle or compartment syndrome because of low accuracy.

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Atlanto-occipital Assimilation Can be Misdiagnosed as Atlantoaxial Dislocation: A Case Report: Kwang Bok Lee, Sang Rim Kim, Kwang Hoon Jung; J Korean Fract Soc 2005;18(4):470-473. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.470

Abstract PDF: We present a rare case that atlanto-occipital assimilation can be misdiagnosed as C1-2 anterior subluxation. This is a lack of familiarity in orthopedic surgeon that was not used to manage the upper cervical spine injury. So the treatment of this entity need to get careful diagnosis and attention.

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Analysis for the Factors Influencing Bone Union in Segmental Tibial Shaft Fractures Treated with Interlocking Intramedullary Nailing: Kyung Jin Song, Kwang Bok Lee, Byung Yun Hwang; J Korean Fract Soc 2004;17(2):153-159. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.153

Abstract PDF

PURPOSE
To find the factors influencing bone union in segmental tibial shaft fractures treated with interlocking intramedullary nailing, and to find the special attentions during operation based on this factors.
MATERIALS AND METHODS
This retrospective study made to investigate the medical records and plain radiograms of 32 patients who treated with interlocking intramedullary nailing. We statistically analyzed the correlation between bone union time and factors influencing bone union, including fracture site, fracture pattern, Melis type, open fracture, nail diameter, reaming, postoperative gap, postoperative angulation.
RESULTS
The factors that showed the significant difference statistically were fracture site, Melis type, open fracture, postoperative gap, postoperative angulation. The factors that showed no significant difference statistically were fracture pattern, nail diameter, reaming.
CONCLUSION
We recommend that surgeons should be considered the site and type, open fracure in preoperative stage. During operation, try to reduce it accurately without angulation and gap if possible. And so, the careful planing of treament can be expected with a high rate of union and a low rate of complication.

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Outcomes and Analysis of Factors Affecting Bone Union after Interlocking Intramedullary Nailing in Segmental Tibia Fractures
Sang Soo Park, Jun-Young Lee, Sang-Ho Ha, Sung-Hae Park
Journal of the Korean Fracture Society.2013; 26(4): 275. CrossRef

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Results of Surgical Treatment in Schatzker Type VI Tibial Plateau Fracture: Kyung Jin Song, Kwang Bok Lee, Seung Jin Moon, Joo Hong Lee; J Korean Fract Soc 2004;17(1):32-37. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.32

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the factors influencing the results for the treatment of the Schatzker type VI tibial plateau fractures.
MATERIALS AND METHODS
Twenty-two cases of the 21 patients in Schatzker type VI tibial plateau fractures were analyzed. Treatment results were analyzed according to the type of fracture (open vs closed), method of operative treatment, angulation more than 5 degree and status of infection. The functional results was evaluated by Hohl's functional criteria. Student t-test was used for the statistical analysis.
RESULTS
Functional outcome demonstrated 5 excellent, 8 good, 6 fair and 3 poor results. There was no significant difference in the treatment results between type of fracture, method of operative treatment and status of infection. Among 9 cases with angular deformity of more than 5 degree, 2 showed excellent or good result and 7 showed fair or poor result (p<0.05). There was no significant difference between rate of postoperative infection and the mean period of the clinical bone union (p=0.66).
CONCLUSION
Accurate anatomical reduction and rigid fixation is essential for the treatment of Schatzker type VI tibial plateau fractures for the prevention of the angular deformity. And early weight bearing exercise should be controlled for the prevention of loss of reduction and loss of alignment leading to angular deformity.

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Treatment of Segmental Fractures Associated with Periarticular Fracture of the Tibia by Ilizarov External Fixator: Jung Ryul Kim, Moon Ki Choi, Kwang Bok Lee, Jong Hyuk Park, Ju Hong Lee, Jun Mo Lee, Kyung Jin Song, Byung Yun Hwang; J Korean Soc Fract 2003;16(4):504-510. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.504

Abstract PDF: PURPOSE
We analyzed the results and complications of the treatment of segmental fractures of the tibia associated with periarticular fracture by using Ilizarov external fixator.
MATERIALS AND METHODS
We reviewed 17 patients of segmental fractures of the tibia were treated by Ilizarov external fixator and were followed for a minimum one year. There were twelve closed fractures, three type 3A, and two type 3B open fractures. According to Melis classification, there were five type I, four type II, and eight type III. All closed fractures were reduced and fixed with Ilizarov external fixator within seven days. Open fractures were performed immediate wound irrigation and radical debridement and fixed with Ilizarov external fixator. Autogenous iliac bone graft was done in five severe comminuted fractures. Average time in bone graft was 7.5 weeks after operation. We analyzed bony union time according to configuration and site of the fractures, results of the treatment, and complications. The functional outome was assessed with rating system of Tucker.
RESULTS
In all cases, bony union was obtained, and average union time was 20.5 weeks. According to modified Melis classification, our results showed no difference between each criteria with respect to bony union and there was no difference bony union time between proximal and distal fracture site. There were two leg-length discrepancy less than 2 cm, one partial ankylosis of the knee joint, and ten pin tract infections. The functional results was excellent in 11 cases, good in 5 cases, and fair in one case.
CONCLUSION
Ilizarov external fixator can be useful method for the treatment of segmental fractures of the tibia associated with juxtaarticular fracture in respect of bony union and functional results.

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Treatment of Distal Tibial Fractures by Interlocking Intramedullary Nailing: Jung Ryul Kim, Hyung Suk Lee, Moon Ki Choi, Kwang Bok Lee, Jong Hyuk Park, Jun Mo Lee; J Korean Soc Fract 2003;16(3):348-355. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.348

Abstract PDF

PURPOSE
To analyze the result of treatment for distal tibial fractures by interlocking intramedullary nailing.
MATERIALS AND METHODS
Eighteen patients who underwent interlocking intramedullary nailing for distal tibial fracture were followed up for more than one year. We analyzed the fracture configuration, presence of fibular fracture, angular deformity and bone union by follow-up radiograph, and complications. The functional results were assessed by Baird's ankle scoring system.
RESULTS
According to Robinson classification, there were 4 type I fractures, 12 type IIA fractures, and 2 type IIB fractures. All cases were combined with fibular fracture. The mean union period of 18 cases were 21.9 weeks. There were three complications with 3 cases of valgus deformity. In functional outcome according to Baird's ankle scoring system, 15 patients (83%) showed satisfactory results.
CONCLUSION
We concluded that interlocking intramedullary nailing is effective method for the treatment of the distal tibial fractures. However, to avoid valgus deformity of the distal tibia when combined distal fibular fracture, fibular reduction and rigid fixation should be needed.

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Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques
Oog-Jin Shon, Ji-Hoon Shin, Chul-Wung Ha
Journal of the Korean Fracture Society.2013; 26(1): 50. CrossRef
Interlocking Intramedullary Nail in Distal Tibia Fracture
Oog Jin Shon, Sung Min Chung
Journal of the Korean Fracture Society.2007; 20(1): 13. CrossRef

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