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Staged Management of High Energy Proximal Tibia Fractures with Severe Soft Tissue Damage
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Seung Ryul Lee, Jae Hoon Yang, June Kyu Lee, Hyun Dae Shin, Kyung Cheon Kim, Kyu Woong Yeon, Young Mo Kim
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J Korean Fract Soc 2009;22(3):152-158. Published online July 31, 2009
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DOI: https://doi.org/10.12671/jkfs.2009.22.3.152
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To find out the efficiency of two staged operation of patients with high energy proximal tibia fracture with severe soft tissue damage, the first step being external fixation, and the second, internal fixation with plates. MATERIALS AND METHODS The study group was the 42 patients who had followed for one year out of a group of 56, performed the first step external fixation and the second step internal fixation with plates retrospectively, from March 2003 to March 2007. The average age of the study group was 51.4, 26 men, and 16 women participating in this study. The average time of follow up was 32 months. In the final follow up, investigations of the radiological assessments and functional abilities of the bony fusion were carried out along with the complications of the soft tissue. RESULTS The duration after the first step external fixation until second step internal fixation to be performed was 14.9 (6~40) days in average. The final bone fusion took about 15 weeks, and according to the final follow up, the range of motion of the knee was around 110.8 degrees (6.2~117 degrees). In 31 cases, only the internal fixation was performed, while in 11 cases, soft tissue reconstruction was carried out with the internal fixations. As for the complications there were 2 cases of deep soft tissue infection, 2 cases of nonunion, 1 case of malunion and 1 case of knee joint stiffness. CONCLUSION In cases of proximal tibia fracture with severe soft tissue damage, external fixation was important to secure the safety of the fracture, carry forward the anatomical alignment, plan the soft tissue safety and manage the wound to decrease the number of microbial in the next operation, which is the internal fixation with plates.
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Lateral Dislocation of the First Metatarsophalangeal Joint: A Case Report
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Yeong Sik Yun, Young Mo Kim, Kyung Cheon Kim, Pil Sung Kim
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J Korean Fract Soc 2008;21(4):312-315. Published online October 31, 2008
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DOI: https://doi.org/10.12671/jkfs.2008.21.4.312
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- Dislocation of the metatarsophalangeal joint is rare due to the stability of the ligaments and soft tissue surrounding the joint. The authors have experienced lateral dislocation of the first metatarsophalangeal joint, which required surgery, accompanied by complete injuries of medial collateral ligament and capsule, contributing to medial stability, differing from posterior dislocation with intersesamoid complex rupture, with a review of the relevant literature and previous reported cases.
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Citations
Citations to this article as recorded by 
- Dislocation of the first metatarsophalangeal joint concomitant with Lisfranc joint dislocation in a 45-year-old man
Kanoko Mizumoto, Tadashi Kimura, Makoto Kubota, Mitsuru Saito BMJ Case Reports.2021; 14(6): e243004. CrossRef - Rare Lateral Dislocation of the First Metatarsophalangeal Joint: A Case Report and Review of the Literature
Amir Reza Vosoughi, Pascal F. Rippstein The Journal of Foot and Ankle Surgery.2017; 56(2): 375. CrossRef
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The Operative Treatment of Radial Head or Neck Fracture: The Sub-classification of Mason Type II Fracture
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Hyun Dae Shin, Kyung Cheon Kim, Se Min Woo, Yong Bum Joo, Dong Kyu Kim
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J Korean Fract Soc 2006;19(4):449-453. Published online October 31, 2006
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DOI: https://doi.org/10.12671/jkfs.2006.19.4.449
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To evaluate the results of treatment according to the sub-classification of the Mason type II fracture. MATERIALS AND METHODS From 1999 to 2003, according to the sub-classification of the Mason type II fracture, 33 patients were treated with miniplate in displaced neck fracture (IIa), with compression screw in displaced head fracture (IIb), with miniplate and/or compression screw in displaced head and neck fracture (IIc), with compression screw and miniplate in comminution fracture (III) or excision of head in irreducible state. The clinical results were evaluated by An and Morrey's functional rating index. RESULTS Functional rate score averaged 92.7 in type IIa, 88.4 in IIb, 86.4 in IIc, 83.5 in type III with reduced fracture, 75.0 in type III with excised head, and 75.5 in type IV. Complications included heterotopic ossification (2 cases), metal loosening (1 case), malunion (1 case), partial ankylosis of elbow (3 cases), posttraumatic arthritis (1 case). CONCLUSION These results supported the recommendation for internal fixation with compression screw in isolated radial head fracture (IIb) and with miniplate in fracuture combined with displaced neck (IIa, IIc, indicated some III). We concluded that sub-classification is useful for dicision making in radial head or neck fracture's treatment.
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Treatment of Periarticular Fracture of Elbow with Hinged External Fixator
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Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Chang Hwa Hong, Yong Bum Joo
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J Korean Fract Soc 2005;18(3):299-303. Published online July 31, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.3.299
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To evaluate the result of the treatment with external fixator and early ROM exercise to prevent the stiffness and contracture of the elbow in unstable elbow injury. MATERIALS AND METHODS From Jan. 1997 to Dec. 2001, ten patients of unstable elbow injury treated with hinged external fixator and early ROM exercise were evaluated. The age was average 37 years. The patients were followed at least 1 years and motorcycle injury (4 cases) was most common. Nine cases were comminuted fractures and one case was fractures with dislocation. We estimated the result of the treatment with Mayo elbow performance index. RESULTS ROM exercise started in average 2 days after operation. Two cases were treated by ilizarov and eight cases treated by elbow distracter modified by the author. The result of the treatment was estimated as following: excellent in two, good in three cases, fair in eight cases, and poor in two case. CONCLUSION There were satisfactory results in patients treated with external fixation with early ROM exercise, whose injuries had difficulty in being fixed internally. The authors recommend hinged external fixation and early ROM exercise to prevent postoperative stiffness & contracture of elbow joint in this circumference.
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Operative Treatment of Metacarpal Shaft Fracture>: Comparision of Low-Profile Miniplating System and Kirschner Wire Fixation
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Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Ho Sup Song
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J Korean Fract Soc 2005;18(2):105-109. Published online April 30, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.2.105
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To compare Kirschner wire fixation and low profile miniplating system in metacarpal shaft fracture. MATERIALS AND METHODS Patients, available at least 1 year, who received the operative treatment after being diagnosed as metacarpal shaft fracture from 1997 May to 2003 May were the subjects with the exclusion of thumb fracture and intraarticular metacarpal bone fracture and also cases involving Kirschner wire fixation on severe laceration or open fracture. On the last follow up total action motion (TAM) and plain radiographes was checked. RESULTS In 7 cases (38.9%) where closed reduction and Kirschner wire fixation were carried out, 8 cases (61.5%) where open reduction and Kirschner wire fixation were carried out and 24 cases (88.9%) where open reduction using miniplate and screw showed either excellent or good results on TAM. 5 cases of dorsal angulation occured in closed reduction and Kirschner wire fixation group and 4 cases of dorsal angulation in open reduction and Kirschner wire fixation group however no cases of dorsal angulation occured in open reduction and miniplate and screw fixation group, and in all cases no rotational deformity, complications through ulnar or radial angulation occured. Internal fixation was carried out on 2 cases of nonunion which had closed reduction and Kirschner wire fixation carried out, while the rest all showed bony union. CONCLUSION Selective use of low profile miniplate and screw fixation in the metacarpal shaft fracture is more effective than in cases of comminuted fracture which can not be achieved firm fixation by Kirschner wire fixation. Low profile miniplate and screw fixation can get more precise anatomical reduction and firm fixation so it allow early return to daily living activity and show low complication rate.
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Operative Treatment of Traumatic Humeral Shaft Fracture: Comparision of Interlocking IM Nailing and Plate Fixation by Posterior Approach
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Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Ho Sup Song
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J Korean Fract Soc 2005;18(2):93-99. Published online April 30, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.2.93
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To compare the results and complications of interlocking IM nailing and plate fixation by posterior approach in the treatment of traumatic humeral shaft fracture MATERIALS AND METHODS: From March 1997 to March 2003, 49 patients undergone operation due to traumatic humeral shaft fracture. Follow-up was over one year. 28 patients operated with interlocking IM nailing initially and 21 operated with plate fixation by posterior approach prospectively. Statistics were compared using clinical and radiological outcomes and complications. RESULTS Radiologically, bone union was observed after an average of 14.3 weeks in IM nailing, and 11.7 weeks in plate fixation. So plate fixation showed earlier bone union (p=0.012). Nonunion occurred in 4 cases (14.3%) operated with IM nailing, and 1 case (4.8%), that was open shaft fracture, with plate fixation. Nonunion occurred more frequently when operated by IM nailing. 6 cases showed limitation of shoulder movement due to damage of the rotator cuff by IM nail entry site. 1 case showed radial nerve palsy, and 1 case showed axillary nerve palsy in the case of IM nailing. Also, secondary surgery due to complications was operated in 9 cases (32.1%) in IM nailing and 1 case (4.8%) in plate fixation (p=0.03). CONCLUSION In the case of traumatic humeral shaft fracture plate fixation by posterior approach was more useful than IM nailing in the decrease of complications and bone union. Such approach is thought to be an excellent method for anatomic reduction and nerve exploration in the case of open and comminuted fracture which accompany nerve injuries
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Citations
Citations to this article as recorded by 
- Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef - Minimally Invasive Anterior Plating of Humeral Shaft Fractures
Hyun-Joo Lee, Chang-Wug Oh, Do-Hyung Kim, Kyung-Hyun Park Journal of the Korean Fracture Society.2011; 24(4): 341. CrossRef - Result of Interlocking Intramedullary Nailing for Humeral Shaft Fracture Evaluation of Post-operative Shoulder Function
Seung Rim Park, Tong Joo Lee, Ryuh Sub Kim, Kyoung Ho Moon, Dong Seok You Journal of the Korean Fracture Society.2007; 20(2): 166. CrossRef
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Modified Phemister Technique with Mersilene Tape Augmentation in the Acute Acromioclavicular Joint Dislocation
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Hyun Dae Shin, Kwang Jin Rhee, Young Mo Kim, Kyung Cheon Kim, Choong Hui Lee
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J Korean Fract Soc 2005;18(2):83-88. Published online April 30, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.2.83
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To find out the consequences of the surgical treatment of acromioclavicular joint dislocation, using modified Phemister technique with Mersilene tape augmentation. MATERIALS AND METHODS We chose 26 patients who were able to follow up 1 year or more among the patients who were diagnosed as acromioclavicular joint dislocation in our hospital through February 2001 to March 2003 and took modified Phemister surgery with Mersilene tape augmentation. Patients with clavicle fracture were excluded. Evaluation of the surgical results was done with the condition or pain, function, range of motion by using Imatani evaluation system, and preoperative, postoperative and last follow up radiographs. RESULTS Most of the cases showed satisfactory result. Clinical evaluations were 16 excellent (62%), 10 good (38%), radiological evaluations were 14 excellent (54%), 10 good (38%), 2 fair (8%), and no poor group. On the final follow up six cases showed vertical translation, but none had clinical symptoms. Seven cases showed a little inflammation at where pin were inserted, but after the removal of the pin, the inflammation was gone. CONCLUSION The modified Phemister surgery for acromioclavicle dislocation is simple, but we can obtain strong fixation, and there is no burden of the removal of the metal plate, or complication of re- dislocation after the removal of the pin, so it is thought as a very effective surgery.
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The Usefulness of Blocking Screw in Intramedullary Nail on Proximal Tibial Fracture
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Jun Young Yang, June Kyu Lee, Young Mo Kim, Chang Hwa Hong, Kyung Cheon Kim, Sung Hwan Ahn
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J Korean Fract Soc 2005;18(1):17-21. Published online January 31, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.1.17
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To evaluate the effectiveness of a blocking screw in intramedullary nailing at the tibia proximal shaft fracture. MATERIALS AND METHODS 63 tibia proximal shaft fractures from January 2000 to December 2002 treated with only intramedullary nailing were referred to as group I, and 8 fractures from January 2003 to December 2003 treated with both intramedullary nailing and the blocking screw were referred to as group II. Retrospective studies were done for group I and II. The incidence of nonunion and the postoperative angular alignments were compared. Malalignment was defined as an angle of 5 degrees anteroposteriorly or mediolaterally. RESULTS There were 7 nonunion (11%) in group I in compare with none in group II. There were 21 angular malalignments (33%) in group I and 1 in group II (12%) and most of them had valgus deformity or anterior anglulation. No complications were directly due to the use of the Blocking screw. CONCLUSION The technique of the blocking screw used to be one of the option for proximal tibial nailing at tibial proximal shaft fracture helps to overcome angular malalignments of bones.
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