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Closed Reduction and External Fixation of Displaced Fractures of the Proximal Humerus
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Seung Ju Jeon, Ho Seung Jeon, Kye Nam Cho, Jae Ho Choi, Joon Yong Lee
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J Korean Fract Soc 2004;17(1):43-48. Published online January 31, 2004
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DOI: https://doi.org/10.12671/jkfs.2004.17.1.43
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 Abstract
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- PURPOSE
This is a retrospective study to analyze the functional results of closed reduction and external fixation of unstable fractures of the proximal humerus.
MATERIALS AND METHODS
Ten unstable proximal humerus fractures were managed with closed reduction and external fixation in which other operative methods are not proper due to comminution, osteoporosis or poor general condition of patients. 4 cases of 2-part and 6 cases of 3-part fracture were included. Radiologically union of fracture, malunion and the evdence of avascular necrosis of humeral head were assessed and the functional results were analyzed with Neer scoring system.
RESULTS
Radiologically all fractures were healed but in 2 cases malunion was resulted because of reduction loss in proximal fragment. Pin site infection was developed in 7 cases and oral antibiotics were needed. The functional results were excellent in 4, satisfactory in 3 and unsatisfactory in 3 cases. 2 cases with malunion and one case with lack of postoperative cooperation resulted in functionally unsatisfactory.
CONCLUSION
External fixation is an alternative method in the treatment of unstable proximal humerus fractures in which open reduction or percutaneous pinning are not proper due to comminution, osteoporosis or poor general condition of patient.
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Closed Reduction and Percutaneous Fixation in the Treatment of Proximal Humerus Fractures
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Seung Ju Jeon, Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Hyung Sam Kim
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J Korean Soc Fract 2002;15(2):173-180. Published online April 30, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.2.173
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Abstract
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- PURPOSE
This is a retrospective study to analyze the functional results of closed reduction and percutaneous fixation of displaced unstable proximal humerus fractures.
MATERIALS AND METHODS
We report 23 patients, 20 with 2-part and 3 with 3-part proximal humerus fractures that can be reduced closed but remain unstable in which percutaneous fixation was performed. The fixation methods were multiple pinning in 10, multiple cannulated screw fixation in 8, Rush pin fixation in 3 and Rush pin combined with other methods in 2. The functional rusults were analyzed with Neer,scriteria.
RESULTS
The functional rusults were excellent in 14, satisfactory in 4 and unsatisfactory in 5. No significant difference was not noted in the long term follow-up results according to the fixation methods but Rush pin resulted in impingement and displacement of greater tuberosity.
CONCLUSION
Closed reduction and percutaneous fixation is a useful alternative to open reduction and internal fixation for the displaced 2-part or 3-part proximal humerus fractures that can be reduced closed but remain unstable.
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Treatment of Tibial Plateau Fractures by Cannulated screw Fixation
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Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Seung Ju Jeon, Kang Woo Chung
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J Korean Soc Fract 2001;14(1):73-78. Published online January 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.1.73
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Abstract
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The results of treatment of tibial plateau fractures by extensive soft tissue exposure were less satisfactory even if anatomical reduction was achieved. The purpose of this study is to assess the functional and radiological results of the treatment of tibial plateau fractures by cannulated screw fixation to decrease soft tissue injury and operation time.
MATERIALS AND METHODS
From January 1996 to February 2000, 19 patients were treated by limited open reduction and internal fixation by cannulated screw. According to scoring of Rasmussen, the functional results were rated.
RESULTS
In all cases, Bony union was obtained and according to scoring of Rasmussen, excellent in 1 case, good in 14, fair in 4 cases. There were 2 cases of limitation of joint motion and 2 cases of persistant pain as sequale.
CONCLUSION
We considered that if accurate preoperative evaluation was done, Cannulated screw fixaction was easier and faster method than other methods for treatment of tibial plateau fractures.
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Surgical Treatment of Symptomatic Clavicular Nonunion
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Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Hong Gweon Han
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J Korean Soc Fract 2000;13(1):113-119. Published online January 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.1.113
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Abstract
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: The nonunion after mid-shaft clavicular fracture is predisposed by refracture, interposition of the soft tissue, complete displacement of the fracture fragment and bony defect with comminuted fracture by the high-energy trauma. Symptomatic nonuions may need surgical treatment. The purpose of this study is to assess the functional and radiological results of the surgical treatment of the symptomatic nonunion of the clavicle.
MATERIALS AND METHODS
: We reviewed 10 cases of symptomatic clavicular nonunions managed with surgical treatment from January, 1994 to May, 1997. The age at operation ranged from 26 to 60 years old( average 46.5 years ). The average length of follow-up was 1.7 years( range, 1 to 3 years ). According to the scoring system of Rowe, the function of the shoulder was evaluated.
RESULTS
: All cases were united and radiologic union was obtained at 10.2 weeks on average after surgery. On functional result. average score on pain was 9.9 (3-12), average score on stability was 24.5 (20-25), average score on function was 21.0 (10-25).
In motion, average score on abduction and forward flexion was 11.0 (7-15), average score on internal and external rotation were 3.8 (3-5), 3.3 (0-5). According to the scoring system of Rowe, excellent in 6 cases, good in 3 cases, fair in 1 case and the average of the total score were 83.8.
CONCLUSION
: We concluded that open reduction and internal fixation by plate or intramedullary device with autogenous bone graft could provide the relief of symptom and effective results of shoulder of shoulder function in the symptomatic nonunion of the clavicle
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Neurologic recovery of neural injuries associated with supracondylar fractures of the humerus in children
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Hyung Ku Yoon, Seoung Ju Jeon, Ho Seung Jun, Kye Nam Cho, Chul Won Kang
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J Korean Soc Fract 2000;13(1):158-165. Published online January 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.1.158
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Abstract
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: The purpose of our study in to determine the incidence of spontaneous recovery from neural injuries associated with supracondylar fractures of the humerus and to assess the results of electromyographic study and nerve conduction velocity.
Material & methods : The 160 displaced supracondylar fractures of the humerus which had operation at the Sung Ae general hospital between April 1994 and 1998 were reviewed. Twelve(7.5%) were associated with complete neural injuries involving 16 nerves ; 9 radial, 5 ulnar and 2 median nerves. The mean age was 7.8 years old and boys outnumbered girls by 9 to 3. The follow-up period ranged from 1 year to 5 yeras 2 months. 11 fractures were managed with closed reduction and one with open means.
All of the neural injuries were initially managed only by closed observation. At recent follow-up examination, we assessed the motor and sensory neurological status with Seddon's modification, grip strength and two-point discrimination in the autonomous zone. Electromyography(EMG) and nerve conduction velocity(NCV) were performed in 13 nerves of 10 patients who were assessed as complete recovered clinically.
Result
: Spontaneous neurological recovery occurred in 11 patients(15 nerves) at a mean of 2.4 months(range, 2 to 3.5 months.) Clinically, these nerves were assessed as normal. In the EMG and NCVs, 4 of 13 nerves resulted in adnormal findings. 2 radial and 1 ulnar nerve showed mild sensory neuropathy and 1 ulnar nerve showed mild denervation potentials in EMG and slow motor and sensory NCVs.
CONCLUSION
: We think that neural injuries associated with the displaced supracondylar fractures of the humerus tend towards spontaneous recovery within 4 months. And even though the neurologic recoveries are clinically complete, these are not always completely recovered in electromyographic study and nerve conduction velocity.
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Fracture-Dislocations of Carpometacarpal joints excluding thumb: A case report
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Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Hong Gweon Han
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J Korean Soc Fract 1999;12(1):166-169. Published online January 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.1.166
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- Fracture-Dislocations of the ulnar carpometacarpal joints is an uncommon injury. The priorities of management of other more extensive injuries often delay definitive treatment. If such a dislocation is diagnosed early, it can be reduced easily by closed means. We reviewed one case of fracture-dislocation of carpometacarpal joints excluding thumb with stable and pain free carpometacarpal joints in one year after closed reduction and internal fixation.
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Clinical Results of Cemented Bipolar Arthroplasty in Femur Neck Fractures over 70 Years
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Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Jong Wha Yi
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J Korean Soc Fract 1998;11(2):313-320. Published online April 30, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.2.313
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- There have been much controversy about prosthetic replacement or internal fixation for patients over 70 years old. Authors reviewed and analyzed 45 cases of cemented bipolar hemiarthroplasty in patient over 70 years treated at the Department of Orthopedic Surgery, Sung-Ae General hospital from January 1988 to July 1995. The purpose of this study was to analyse the clinical and radiological results and to detect the motion study of bipolar cup. Follow up period was average 26.1 months, ranged from 24 months to 37 months. The following results were obtained. 1. In clinical evaluation, excellent & good result were in 31 cases(68.6%). 2. In radiologic evaluation, acetabular erosion were in 2 cases and loosening of the femoral component was in 1 case. 3. With time elapsed, the amount of the inner bearing motion was decreasing with preservation of the total joint motion. 4. Complications were idiopathic pain 7 cases, nerve paresis 2 cases, superficial infection 2 cases, intraoperative fracture 1 case, dislocation 1 case, losening 1 case.
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