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How Difficult Is It to Surgically Treat AO-C Type Distal Humerus Fractures for Inexperienced Orthopedic Surgeons?
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Seong Ho Yoo, Suk Woong Kang, Moo Ho Song, Young Jun Kim, Hyuck Bae
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J Korean Fract Soc 2018;31(2):45-49. Published online April 30, 2018
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DOI: https://doi.org/10.12671/jkfs.2018.31.2.45
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Twenty early surgical management cases of distal humerus type-C fractures were analyzed. MATERIALS AND METHODS This study analyzed 20 early patients, who received surgical management of distal humerus type-C fractures, and could be followed-ups for more than one year between March of 2013 and May of 2015. The operative time, bone union time, and elbow range of motion were analyzed. The Mayo's functional score was used to evaluate their postoperative function. The primary and secondary complications of each patient immediately after each of their surgery were also reviewed. RESULTS All patient groups achieved bone union within an average period of 16.4 weeks. Based on the Mayo functional score, 6, 10, and 4 patients scored excellent, good, and fair, respectively. The average range of motion was a flexion contracture of 14.5° with a follow-up improvement averaging 120.7°. Six patients received nine revision operations due to major and minor complications. Two patients received revision fixation from an inadequate fixating power, and another patient received an ulnar nerve transposition. Other complications included olecranon osteotomy site displacement, superficial operational site infection, and pin loosening. CONCLUSION Distal humerus fractures of the AO-C type can cause a range of complications and has a very high rate of revision due to its difficult nature of surgical manageability. Therefore, it is imperative for a surgeon to expect various complications beforehand and a careful approach to their postoperative rehabilitation is essential.
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The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture
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Seong Jun Ahn, Suk Woong Kang, Bu Hwan Kim, Moo Ho Song, Seong Ho Yoo, Kwan Taek Oh
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J Korean Fract Soc 2013;26(4):314-320. Published online October 31, 2013
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DOI: https://doi.org/10.12671/jkfs.2013.26.4.314
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To evaluate the efficacy of surgical treatment through retrospective comparison of minimally invasive percutaneous plate osteosynthesis (MIPPO) vs open plate fixation in the treatment of the distal femur fractures. MATERIALS AND METHODS Thirty-one patients with distal femur fractures from January 2002 to December 2010 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 17 patients treated with MIPPO, and group B was comprised of 14 patients treated with open plate fixation. Clinical outcomes including operation time, transfusion rate, rehabilitation, range of motion, and interval change of postoperative C-reactive protein (CRP) were evaluated to assess postoperative inflammatory reaction, postoperative complications and clinical results with the use of Sanders criteria. RESULTS The operative time was 86/135 min and transfusion volume was 0.8/1.9 unit respectively. The postoperative 3-day and 7-day CRP were 7.4/1.5 mg% in group A and 10.3/2.4 mg% in group B, showing more minimal tissue injury and early recovery in group A. There were no significant differences in clinical results by Sanders criteria in both groups. CONCLUSION Both MIPPO and open plate fixation for the treatment of distal femur fractures showed comparably good results. However, the MIPPO technique is superior to group B in view of minimal tissue injury and operation time and was proven to lessen the transfusion rate.
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- Usefulness of Reduction and Internal Fixation Using a 2.4 mm Hand Plating System in Type AO 33-A3 Distal Femur Fracture: Technical Note
Bong-Ju Lee, Ja-Yeong Yoon, Seungha Woo Journal of the Korean Fracture Society.2023; 36(1): 25. CrossRef
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The Diagnosis of Osteoporotic Occult Vertebral Fracture and Vertebroplasty
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Seong Jun Ahn, Bu Hwan Kim, Moo Ho Song, Seong Ho Yoo, Yeong Joon Kim
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J Korean Fract Soc 2012;25(3):208-214. Published online July 31, 2012
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DOI: https://doi.org/10.12671/jkfs.2012.25.3.208
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To evaluate the effectiveness of magnetic resonance imaging (MRI) for the diagnosis and usefulness of vertebroplasty in osteoporotic occult vertebral fractures. MATERIALS AND METHODS Of 472 osteoporotic vertebral fractures treated from May 2003 to July 2009, 45 patients were diagnosed with occult osteoporotic vertebral fracture. Their medical charts and radiographs were reviewed. The degree of vertebral body collapse was graded by a semiquantitative method. In order to increase the reliability, interpretation was based on radiographic diagnoses from 3 orthopedic surgeons. Vertebroplasty was performed at 31 of the 45 patients, for whom conservative treatment failed. Pre-operatively and post-operatively, pain was evaluated using a visual analog scale (VAS). RESULTS We observed 55 occult fractures in 45 patients. Forty vertebrae (72.7%) among the 55 vertebrae were just adjacent to an old vertebral fracture with deformation of the vertebral body. The rediagnosis rate of occult fracture attempted without MRI was only 21.8%. The average pre-operative VAS score of 8.07 (6~9) was improved to 2.43 after surgery and showed no delayed vertebral body collapse. CONCLUSION Gadolinium enhancement of MRI is critical to the diagnosis of occult vertebral fractures, which are 9% of whole osteoporotic vertebral fractures. Seventy-two point seven percent of occult vertebral fractures were just adjacent to an old vertebral fracture with collapse of the vertebral body. This means that if vertebroplasty is performed without thorough MRI examination, it may fail.
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The Comparison of MIPPO vs Open Plate Fixation in the Treatment of the Distal Tibia Fracture
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Seong Ho Yoo, Seong Jun Ahn, Moo Ho Song, Bu Hwan Kim, Min Soo Lee, Jong Ha Park
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J Korean Fract Soc 2006;19(1):29-33. Published online January 31, 2006
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DOI: https://doi.org/10.12671/jkfs.2006.19.1.29
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Abstract
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To evaluate the efficacy of the surgical treatment through the comparison of MIPPO vs open plate fixation in the treatment of the distal tibia fracture retrospectively. MATERIALS AND METHODS 30 patients with distal tibia fracture from Jun. 2001 to Jun. 2004 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 15 patients treated with MIPPO, Group B was 15 patients treated with open plate fixation. The clinical outcomes were evaluated retrospectively from operation time, rehabilitation, ROM, interval change of postoperative CRP to assess postoperative inflammatory reaction, postoperative complications and clinical result with the use of McLennan and Ungersma criteria. RESULTS There were no significant differences in clinical result by McLennan and Ungersma criteria in both groups. The postoperative 3 days and 7 days CRP were 4.0mg% (0.9~7.2)/0.5 mg% (0.1~1.5) in group A and 7.97mg% (2.8~14.6)/1.0mg% (0.3~1.6) in group B, shows more minimal tissue injury and early recovery in group A. Operation time in group A was shorter than group B. Normal recovery of ROM was quicker in Group A. In complications, group A showed one superficial infection and one angular deformity and group B showed one superficial infection, one infected nonunion and two ankle stiffness. CONCLUSION There were no significant differences in clinical result and bony union. MIPPO technique is superior to group B in view of the minimal tissue injury, complications, operation time and postoperative rehabilitation.
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- Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture
Oog Jin Shon, Dae Sung Kim Journal of the Korean Fracture Society.2010; 23(1): 42. CrossRef
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Multiple Fractures of Forearm Both Bones: A Case Report of 5 Separate Sites
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Bu Hwan Kim, Moo Ho Song, Seong Jun Ahn, Seong Ho Yoo, Min Soo Lee
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J Korean Fract Soc 2005;18(4):466-469. Published online October 31, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.4.466
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- We have experienced multiple fractures of forearm both bones, which revealed the following fractures: comminuted fracture of olecranon, short oblique fracture of proximal ulnar shaft, transverse fracture of ulna mid-shaft, comminuted fracture of radial head, comminuted fracture of distal radius.
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- Treatment of a Segmental Ulnar Shaft Fracture and an Olecranon Fracture
Myoung Soo Kim, Kyu Pill Moon, Hyung Joon Cho, Jung Yun Bae, Kuen Tak Suh Journal of the Korean Orthopaedic Association.2010; 45(6): 496. CrossRef
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Comparison between Ender Nail and Interlocking Nail in The Treatment of Infra-isthmic Tibial Shaft Fracture
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Seung Wook Yang, Moo Ho Song, Hyung Taek Park, Sun Jin Choi
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J Korean Soc Fract 2001;14(4):651-659. Published online October 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.4.651
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To compare the clinical results between Ender nail and interlocking nail in the treatment of infra-isthmic tibial shaft fracture. MATERIALS AND METHODS The authors analyzed 44 cases of infra-isthmic tibial shaft fracture treated with Ender nail(23 cases) as a group 1 or interlocking nail(21 cases) as a group 2 from 1994 to 1998. Fracture type was divided by AO classification, and measured the fracture level, the time of bone union and angular deformity was checked with roentgenograms. The functional results were compared using the criteria by Klemm and Borner. RESULTS Distal end of fracture line from ankle joint shows no difference between two groups(P>0.05). Mean operation time was 96 minutes in group 1 and 140 minutes in group 2(P<0.05). Mean intraoperative blood loss was 103cc in group 1 and 254cc in group 2(P<0.05). Mean bone union time was 19.26 weeks in group 1 and 24.81 weeks in group 2. There was no significant difference between two groups in the angulation(P>0.05) and the functional results by Klemm and Borner. CONCLUSION Ender nail is a good method of treatment in infra-isthmic tibial fracture when isthmic portion of tibia is too narrow, or insertion of distal interlocking screws were too difficult to insert because of the severe soft tissue injury. The stability of fixation can be strengthened with a three point fixation as fanning of the nails in the distal fragments using more than 3 nails selecting a 1cm longer nail than the ordinary nail length for diaphyseal fracture.
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