Journal of Musculoskeletal Trauma

Kyu Yeol Lee

14 Articles

Treatment of Periprosthetic Femoral Fractures Following Total Knee Arthroplasty: Lih Wang, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Jin Soo Hwang, Sun Hyo Kim; J Korean Fract Soc 2014;27(1):42-49. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.42

PURPOSE
The purpose of this study is to compare the treatment results of fracture fixations by using two minimal invasive techniques for patients with periprosthetic femoral fractures following total knee arthroplasty.
MATERIALS AND METHODS
We reviewed 36 patients (5 males, 31 females) of periprosthetic femoral fractures whom were treated surgically between January 2005 and January 2011. Mean patient age was 68.9 years (range, 43 to 81 years) old and the follow-up period averaged 41 months (range, 18 to 72 months). Nineteen patients were treated with minimal invasive locking plate fixations (group I) and 17 patients with retrograde intramedullary nailing (group II). Clinical and radiological outcomes in each group were comparatively analyzed.
RESULTS
Successful bone unions occurred in all patients and the mean time to bone union was 3.7 months in group I and 4.2 months in group II. There were no statistical differences between the two groups according to mean operative time and mean intraoperative blood loss. There were also no statistical differences between two groups according to clinical outcomes but the valgus deformity was apparent in group II and radiological outcomes revealed significant differences between the two groups.
CONCLUSION
For the treatment of periprosthetic femoral fractures after total knee arthroplasty, two minimal invasive techniques have shown good clinical results. However, the minimal invasive plate fixation showed better results in the radiological alignments.

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The Result of Treatment of Femoral Periprosthetic Fractures after Total Knee Arthroplasty
Jun-Beom Kim, In-Soo Song, Dong-Hyuk Sun, Hyun Choi
Journal of the Korean Orthopaedic Association.2014; 49(6): 446. CrossRef

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Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture: Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun; J Korean Fract Soc 2010;23(3):303-309. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.303

Abstract PDF

PURPOSE
To evaluate the surgical outcomes of open reduction and internal fixation of AO calcaneal plate in displaced intra-articular fractures of the calcaneus.
MATERIALS AND METHODS
From January 2004 to July 2007, 25 patients with 27 displaced intra-articular calcaneal fractures were treated by open reduction and internal fixation using the AO calcaneal plate. Preoperative, postoperative evaluations and a follow-up after 1 year were done radiologically by the Bohler angle, Gissane angle, heel height and width among all patients. Their functional status was assessed by means of the Maryland foot score.
RESULTS
The mean Bohler angle, Gissane angle, heel height and width were restored comparing with preoperative data. However, in Sanders type IV, some losses of reduction occurred at 1 year follow-up (p<0.05). The mean Maryland foot scores were 85 points in type II, 82 points in type III and 63 points in type IV. Sanders types significantly affected the clinical results (p<0.05).
CONCLUSION
The AO calcaneal plate fixation using extensile L-shpaed lateral approach shows satisfactory radiologic and clinical results in the treatment of displaced intra-articular calcaneal fractures.

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Surgical Treatment of Calcaneal Fractures of Sanders Type II and III by A Minimally Invasive Technique with 6.5 mm Cancellous Screw
Yong Seung Oh, Kyung Ho Lee, Jung Ho Kim, Myoung Jin Lee
Journal of Korean Foot and Ankle Society.2019; 23(3): 116. CrossRef
Usefulness of Treatment with 6.5 mm Cancellous Screw and Steinmann Pin Fixation for Calcaneal Joint Depression Fracture
Gi-Soo Lee, Chan Kang, Deuk-Soo Hwang, Chang-Kyun Noh, Gi-Young Lee
Journal of Korean Foot and Ankle Society.2015; 19(1): 11. CrossRef

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Clinical Outcome of Surgical Treatment for Intra-articular Distal Humerus Fracture: Myung Jin Lee, Hyeon Jun Kim, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Chul Hong Kim, Lib Wang, Hyun Woo Sung; J Korean Fract Soc 2010;23(2):201-205. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.201

Abstract PDF

PURPOSE
To evaluate functions of the elbow joint according to surgical approach, time to exercise, and type of fracture after surgical treatment for the intra-articular comminuted fracture of the distal humerus.
MATERIALS AND METHODS
27 patients with the intra-articular comminuted fractures of the distal humerus underwent surgery from March, 2000 to January, 2007. We investigated the surgical approach, time for union, time to exercise and age. We also evaluated postoperative functions of the elbow joint according to the flexion contracture, the range of motion and the Mayo elbow performance score.
RESULTS
The average follow-up period was 37 months and the average time for union was 14 weeks. The average range of flexion was 115 degrees, the average flexion contracture was 10 degrees, and the Mayo elbow performance score with average value of 85 point showed good clinical results. There were no statistically significant differences in functions of the elbow joint according to the operative method and age. However, patients with early postoperative exercise within 6 days showed statistically better outcomes than patients with postoperative exercise after 7 days. Type C1, 2 fractures showed statistically better results than the type C3 fracture.
CONCLUSION
Stable fixation and early exercise are required to prevent postoperative complications and restore functions of the elbow joint with an intra-articular comminuted fracture of the distal humerus.

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Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus
Ji-Kang Park, Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho
Journal of the Korean Fracture Society.2012; 25(2): 129. CrossRef

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Cause and Treatment of Extraarticular Proximal Tibial Nonunion: Sung Soo Kim, Sung Keun Shon, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Min Soo Kang, Lih Wang, Im Sic Ha; J Korean Fract Soc 2008;21(4):279-285. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.279

Abstract PDF: PURPOSE
To analyze the factors affecting the nonunion of extraarticular proximal tibial fracture and the outcome of nonunion treatment.
MATERIALS AND METHODS
We investigated 51 cases of extraarticular proximal tibial fractures from June 2002 to May 2006. The nonunion rate was assessed in relation to several risk factors and the treatment outcome of nonunion using plate fixation with bone graft was assessed by Klemm and BOrner functional rating system.
RESULTS
6 cases of nonunion (11.8%) was noted among 51 cases, and the risk factors examined, OTA A3 comminuted fracture was associated with a high nonunion rate with statistical significance and initial bone graft had a significant effect in bone healing. Excellent and good results were obtained in 5 cases (83.3%) and bone union was achieved in all nonunion cases.
CONCLUSION
Comminution was found to be an important factor affecting the nonunion in extraarticular proximal tibial fracture, and bone graft in primary operation could reduce the chance of nonunion. Accurate plate fixation with bone graft is a reliable option in nonunion treatment.

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Classification and Treatment of Unstable Intertrochanteric Fracture according to the Existence of Posterior Fragment : Preliminary Report: Lih Wang, Sung Keun Shon, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Chul Won Lee, Sung Soo Kim; J Korean Fract Soc 2008;21(2):110-116. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.110

Abstract PDF

PURPOSE
To predict the feature and stability of intertrochanteric fractures with posterior fragment using preoperative 3D computed tomography and to investigate the importance of the posterior fragment in treatment of unstable intertrochanteric fracture.
MATERIALS AND METHODS
15 cases of unstable fractures with posterior fragment which were treated with nail only between October 2006 to August 2007 were classified into 2 groups: study group (5 cases with cannulated screw fixation of posterior fragment) and control group (10 cases without cannulated screw fixation). The average difference of neck-shaft angle, neck screw sliding distance and the complications in the two groups were compared retrospectively after a follow up of at least 3 months.
RESULTS
The average difference of neck-shaft angle in study and control group was 3.8 and 7.5 degree (p>0.05), respectively. The average difference of neck screw sliding distance was 1.6 and 6.6 mm (p<0.05), respectively. Complication which required reoperation was not noted in study group and complications of 3 cases about neck screw lateral protrusion, proximal migration and Z-effect phenomenon were noted in control group.
CONCLUSION
The recognition and fixation of the posterior wall was found to be an important predictive factor in unstable intertrochanteric fracture treatment.

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Outcomes of dynamic hip screw augmented with trochanteric wiring for treatment of unstable type A2 intertrochanteric femur fractures
Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam
Injury.2017; 48: S72. CrossRef
Additional Fixations for Sliding Hip Screws in Treating Unstable Pertrochanteric Femoral Fractures (AO Type 31-A2): Short-Term Clinical Results
Su Hyun Cho, Soo Ho Lee, Hyung Lae Cho, Jung Hoei Ku, Jae Hyuk Choi, Alex J Lee
Clinics in Orthopedic Surgery.2011; 3(2): 107. CrossRef

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Results of Operative Treatment of Distal Femoral Fracture: Sung Soo Kim, Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Chul Hong Kim, Myung Jin Lee, Hyung Seo Jang, Il Kwon Jung; J Korean Fract Soc 2005;18(3):232-237. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.232

Abstract PDF

PURPOSE
To evaluate the result of comparative study about the cases in the fracture of the distal femur treated with plate and screw, dynamic condylar screw, blade plate, retrograde intramedullary nail and external fixator.
MATERIALS AND METHODS
The AO classification system was used. 84 cases who were preformed operation during the period from March 1996 to May 2002, were included in this study. The mean duration of follow-up was 25 months. According to Sachatzker criteria, we classified the following results to excellent, good, fair and poor.
RESULTS
Type A were excellent or good result when treated with plate and screw, dynamic condylar screw and retrograde intramedullary nail. Type B were excellent or good result when treated with cannulated screw. Type C were excellent or good result when treated with plate and screw and blade plate.
CONCLUSION
We conclude that the most important thing in operation is firmly internal fixation and to obtain this, accurately anatomical reduction and the choice of suitable instrument for the type of the fracture are needed. cannulated screw. Type C were excellent or good result when treated with plate and screw and blade plate.

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Comparison of Results of Minimally Invasive Plate Osteosynthesis according to Types of Locking Plate in Distal Femoral Fractures
Oog Jin Shon, Moon Soo Kwon, Chul Hyun Park
Journal of the Korean Fracture Society.2012; 25(4): 269. CrossRef

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Severe Comminuted and Displaced Patellar Fracture Treated by Partial or Total Patellectomy: Kuen Tak Suh, Taek Geon Lee, Weon Wook Park, Chong Il Yoo, Kyu Yeol Lee, Bu Hwan Kim; J Korean Soc Fract 1997;10(4):851-859. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.851

Abstract PDF: The results of partial and total patellectomy as a treatment for severe comminuted and displaced patellar fracture were assessed retrospectively with the use of clinical criteria and radiologic findings. Sixteen patients treated with patellectomy(four total and twelve partial patellectomies) were followed up for an average of 3 years 4 months and valuated. According to the Bostmans fracture classification, there were type I In 5 cases(31%), type II in 7 cases(44%), and type III in 4 cases(25%). The results of the patellectomy were relatively good since excellent result was shown in 11(69%) among 16 cases. The comparison between partial and total patellectomy was difficult because the fracture patterns treated by these techniques were different. In this study, the result of the partial patellectomy was better than that of the total patellectomy, but their difference was not statisticaliy significant(P>0.05). The results of the study indicated that partial or total patellectomy could be one of the effective treatment methods for severe comminuted and displaced patellar fracture. However total patellectomy should be recommended only when the entire patella was too severely comminuted to function as a part of the extensor mechanism of the knee.

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A clinical study of tibial condylar fracture: Kyu Yeol Lee, Myung Soo Lee, Sung Keun Sohn; J Korean Soc Fract 1996;9(4):958-969. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.958

Abstract PDF: The tibial condyle fracture was descirbed first by Cooper in 1825, which involves articular surface of the proximal tibial and often pnduces disabilities of the knee joint due to accompanied by injuries to ligaments and menisci, frequently. There are much controversies in the method of the treatment in the fracture of the tibia condyle, but todays, the anatomical reduction and firm internal fixation is recommanded with early knee motion for good results. The authors analyzed 43 cases of tibia condylar fractures that treated at Department of Orthopaedic Surgery, College of Medicine, Dong-A University from March 1990 to May 1995. The results were obtained as follows: 1. The most common age group was 4th decade. 2. The most common cause of injury was motor vehicle accident in 28 cases(65.1%) and others were slip down, fall down and sports injury, etc. 3. According to Schatzkers classification, thr most common type was type II and VI in 10 cases(23.3%) individually. 4. The most common soft tissue injury was ligament injury in 16 cases(37.2%), and the most common associated fracture was fibular fractures(13 cases). 5. By Porters criteria, 16 cases(76.2%) among 21 conservative cases and 16 cases(12.7%) among 22 operative cases had acceptable results. 6. The most common complication was limit of motion of knee joint(8 cases) and then, traumatic arthritis, angular deformity, infection, joint instability were seen. 7. There was no different result between conseHative and operation method in our study, but we think the simple comparision was meaningless because of the degrees of injury to the objects of the two treatment methods were different. 8. The factors to effect the prognosis were as fellows; the depression, displacement of the fracture, soft tissue injury, anatomical reduction and early knee exercise, etc.

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Operative Treatment of the Fracture of Patella: Kyu Yeol Lee, Hyung Hwan Lee, Sung Soo Kim, Sung Keun Sohn; J Korean Soc Fract 1996;9(3):622-630. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.622

Abstract PDF: The patella, the largest human sesamoid bone, is important functional component of the knee extensor mechanism and its treatment is considered to be very important because the fracture involvement to the articular surface occures in most of the cases. We report 40 cases of fractures of patella treated with operative methods from January 1990 to June 1995 at the department of orthopaedic surgery, Dong-A university hospital. The results are as follows. 1. Among 40 cases, 29 cases were male and 24 cases were belong to 3rd decade and 4th decade. 2. The most common cause of injury was slip down or fall down. 3. The pattenrs of fracture were transeverse in 21 cases, vertical in 2 and comminuted in 17. 4. The methods of surgical treatment were modified tension band wiring in 33 cases, circumferential wiring in 2, partial patellectomy in 4 and total patellectomy in 1. 5. In patient treated with modified tension band wiring, range of motion of the knee was 128 and mean duration of bone union was 9.2 weeks. 6. Complications were limitation of range of motion in 3 cases, refracture by slip down in 1 case and wire migration in 1 case.

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Treatment of acromioclavicular dislocation by a Phemister method: Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Sung Soo Kim, Hyung Hwan Lee; J Korean Soc Fract 1996;9(1):154-160. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.154

Abstract PDF: Acromio-clavicular joint dislocation occurs when both acromioclavicular and coracoclavicular ligaments are ruptured and brings to deformity, arthralgia and limitation of motion of the shoulder joint. The treatment of complete acromioclavicular dislocation is controversial, and both of the conservative and surgical treatment are reported to be relatively successful. But, conservative treatment have many disadvantages and now rarely advocated. Recently, there are increasing tendencies to treat the acromioclavicular dislocatioll with anatomical reduction of acromioclavicular joint and rigid internal fixation for early movement of shoulder Joint. We report the results of 16 cases of acute acromioclavicular dislocation treated with Phemister or modified Phemister method. The results are as follows. 1. Among 16 cases,14 cases were males and 9 cases were belong to 3rd decade and 4th decade. 2. The most common cause of injuries was slip down. 3. Postoperative difference in coracoclavicular distance on radiogram was 0.1 mm on average. 4. Clinical results were excellent in 14 cases, good in 1 case and acceptable in 1 case. 5. Complications were redislocation in 1 case and K-wire migration in 1 case, but there was no arhritic changes on the affected A-C joint.

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The Use of Gamma Nail in Peritrochanteric Fractures of the Femur: Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Hyung Hwan Lee; J Korean Soc Fract 1995;8(4):753-759. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.753

Abstract PDF: In old age, trochanteric fracture occurs easily by trivial external force due to osteoprosis and many kinds of treatment has been performed. The goal of treatment in elderly patients with trochanteric fractures is restoration of function to preoperative ambulatory status at the earliest possible time. For this purpose operative treatment is gernerally recommended. The success of operative treatment depends on the stable reduction and secure fixation. Gamma nail is a new intramedullary device which has been applied in the treatment of trochanteric fractures with the benefits of the closed technique such as low blood loss, low risk of infection and short operative time. The implant can be used by the method of static or dynamic. Intraoperative compression of the fracture segments can be achieved by acting on the sliding lag screw and further compression is given by weight bearing. We studied 22 cases of patient who had the trochanteric fracture and treated operatively with gamma-locking nail at the department of orthopaedic surgery, Dong-A university hospital from January 1993 to December 1994. Among 22 cases, 7 cases were stable fracture and 14 cases were unstable fracture by the Evans classification. Mean operation time was 76 minutes and mean blood loss was 303 mf and intraoperative and postoperative complicatins were encountered in 3 cases, femur shaft fracture in 2 casea and lag screw displacement on the femoral head in 1 case. Based on the above results, we have experienced limited utiliBation of the nail because of the mappropriateness between nail and femur itself and non-skillful application technique. We think that if nail shape and assembly for fixating distal screw are improved, Gamma-interlocking nail is a good interraf fixation device which allows early weight bearing ambulation.

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Clinical study of Supracondylar Fractures of the Humerus in Children: Sung Keun Sohn, Kyu Yeol Lee, Byeong Hwan Kim; J Korean Soc Fract 1995;8(1):106-115. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.106

Abstract PDF: The supracondylar fracture of the humerus is the most common elbow fracture in children. There are much controversies for the treatment and variable and frequent complication such as cubitus varus and joint stiffness, etc. For the period of 3 years and 10 months from Mar. 1990 to Dec. 1993, 62 patients with supracondylar fracture of humerus were admitted and treated at the Department of Orthopaedic surgery, College of Medicine, Dong-A University Among them,34 patients who were followed up more than 6 months were reviewed retrospectively. The results are as follows 1. The average age was 6.4 years and sex ratio of male to female was 3.9:1. 2. The extension type was 79.4%, and flexion type was 20.6%. The ratio of left to right was 1.43:1 3. The most common cause of injury is fall from a height in 18 cases (52.9%). 4. The mean duration of bone union was 42.3 days. 5. According to the Holnlberg classification, 3 cases belong to group I(8.8%), 9 to Group II(26.5%),10 to Group III (29.4%), and 12 to Group IV(35.3%). 6. By Flynns criteria, the satisfactory results was in 31 cases(91.2%), and unsatisfactory in 3 cases (6.3%). In Holmberg classification, the higher severity, the higher joint stiffness made the prognosis worse. 7. In conclusion, we believe that percutaneous pinning was a simple, effective method for treatment of displaced supracondylar fractures of the humerus, and the accurate anatomical reduction was required to prevent cubitus varus deformity, which is one of the most serious complication.

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A Clinical Study of the Tibia Pilon Fractures: Jung Yoon Lee, Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Dong Man Park; J Korean Soc Fract 1994;7(2):256-268. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.256

Abstract PDF: A pilon fracture, which is defined as a comminuted intraarticular fracture of distal involve the articular surface and metaphysis with occasional extension in the diaphysis. The management has been notoriously difficult due to the associated injury, intraarticular fracture, severe communition of distal tibia, joint incongruity and soft tissue trauma. Most authors has reported good results after a surgical treatment by a principle of AO group treatment. Rescently, Bone et all reports that ROM and outcomes of the severly comminuted or open fractures of the distal intraarticular tibia were very good in using the external fixator. The result of treatment of 22 cases were analysed at the Department of Orthopedic Surgery, Dong-A University hospital from Mar. 1990 to Feb. 1993. The results were as follows; 1. The incidence of pilon fracture is 8.3% of all ankle fracture treated during same period. 2. The most common cause of injury is fall down(63.3%). 3. The most frequent type is type 3 (54.6%).(by Rudei & Allgower) 4. The most common associated injury is compression fracture of spine and calcaneal fracture(4 cases). 5. There are eight cases open Pilon fracture(36.3%) 6. We had treated severe communited fracture and open fracture by using external fixator, we achived good ROM and outcomes. 7. The more accurate reduction, the better clinical result. 8. Complication of the Pilon fracutre were traumatic arthritis, non-union, malunion, wound int, etc.

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A Clinical study of the Tibial Condylar Fractures: Jung Yoon Lee, Sung Keun Sohn, Kyung Taek Kim, Kyu Yeol Lee, Byeong Hwan Kim; J Korean Soc Fract 1994;7(2):269-278. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.269

Abstract PDF: The tibial condylar fracture which involves articular surface of the proximal tibia is common in traffic accident and often produces some disability of the knee joint because it is frequently accompanied by injuries to ligaments and menisci. There are much controversies in the method of treatment in the fractures of the tibial condyle. Although the anatomical reduction and rigid internal fixation with early knee motion are reconmanded to obtain good results, unsatisfactory results have been reported as 20-40% of cases. The authors analyzed 36 cases of tibial condylar fractures that treated at the Department of Orthropaedic Surgery, College of Medicine, Dong-A University from March 1990 to March 1993. The results were as follows: 1. The sex ratio was 2.3: 1 in male to female and most common age group was 4th decade. 2. The most common cause of injury was traffic accident in 25 cases(69.4%). 3, According to Schatzkers classification, the most common type was type II in 10 cases(27.8%). 4. The most common associated injuries were ligament injury in 10 cases(27.8%) and fibular fracture in 30 cases(27.8%). 5. By Porters criteria, 8 cases(80%) among 10 conservative cases and 18 cases(69.2%) among 26 operative cases had acceptable results. 6. The complications were most common in type II(5 cases) and type IV(5 cases). 7. The factors of poor results were as follows : displaced comminuted fracture, fracture associated with severe soft tissue injury or with ligamentous and meniscal injury.

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