Journal of Musculoskeletal Trauma

Ryuh Sup Kim

5 Articles

Analysis of the Factors Involved in Failed Fixation in Elderly Intertrochanteric Femoral Fracture: Joon Soon Kang, Ryuh Sup Kim, Bom Soo Kim, Young Tae Kim, Seung Hyun Hong; J Korean Fract Soc 2012;25(4):263-268. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.263

Abstract PDF: PURPOSE
To analyze the causes of internal fixation failure in elderly intertrochanteric femoral fractures.
MATERIALS AND METHODS
We retrospectively analyzed 93 intertrochanteric femoral fractures that were treated by internal fixation. The follow-up period was at least 24 months. The mean age was 73 years. We analyzed the classification of the fracture, screw position, reduction state of the fracture, and neck-shaft angle.
RESULTS
Internal fixation failure occurred in 12 cases (12.9%). The causes of internal fixation failure were one case (1.0%) of head perforation, 7 cases (7.5%) of excessive slippage of a screw, and 4 cases (4.3%) of varus deformity. Significant factors infixation failure were displacement of the posterolateral fragment more than 8 mm in anteroposterior radiograph, anterior displacement of a fragment, or more than 20-degree angulation in lateral radiography. Thirty-three cases had a screw in the middle position and 4 of these cases (12.1%) had fixation failure. Notably, 14 cases had a screw in the posteromedial position and 6 of these cases had fixation failure (42.8%).
CONCLUSION
Accurate reduction of the posteromedial fragment is essential in unstable intertrochanteric fracture and anterior displacement or angulation should be avoided to prevent fixation failure. The tip apex distance of the screw and central location of the screw in the femoral head is also an important factor.

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Operative Treatment of Displaced Intercondylar Fracture of the Distal Humerus with Reconstruction Plate: Ryuh Sup Kim, Tong Joo Lee, Kyoung Ho Moon, Seung Rim Park, Moon Lee; J Korean Fract Soc 2007;20(2):172-177. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.172

Abstract PDF: PURPOSE
To evaluate the therapeutic effects of chevron olecranon osteotomy and bilateral reconstruction plate as operative treatment for distal humerus intercondylar fracture.
MATERIALS AND METHODS
Among patients operated for distal humerus intercondylar fracture in our hospital from June, 1997 to October, 2005, 26 patients were selected who could be followed-up for more than one year. The average follow-up period was 15 months. All olecranon osteotomies were chevron osteotomy and all fractures were treated with internal fixation using bilateral reconstruction plate. The ulnar nerve was checked in all cases. Three patients in which case the plate might irritate the ulnar nerve, received with ulnar nerve anterior transposition. Cassebaum's classification and Mayo elbow performance score were used to evaluate at three, six and twelve months.
RESULTS
Mean bone union period was 11.7 weeks. There were 9 excellent cases, 11 good cases, 4 fair cases and 2 poor cases. Mean flexion contracture was 11Â° and further flexion was 126Â° at last follow-up.
CONCLUSION
Bilateral reconstruction plate internal fixation using chevron olecranon osteotomy showed strong fixation and good clinical results and it is possible for early rehabilitation treatment.

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Clinical Experiences of the Femoral Unicondylar Fractures: Ryuh Sup Kim, Suk Myun Ko, Kyu Jung Cho, Dong Hun Choi, Hyun Woo Park; J Korean Soc Fract 2000;13(3):479-487. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.479

Abstract PDF: PURPOSE
The femoral unicondylar fractures occur less frequently than the supracondylar or intercondylar femoral fractures. We document the problems and results in the treatment of these fractures.
MATERIALS AND METHODS
Eleven patients with minimal follow-up peroid of 12 months were included. In the methods of treatment, the operation with by closed or open reduction and internal fixation with screws was used for 7 cases, the conservative treatment for 4 cases. The therapeutic outcomes were rated by the Lysholm knee scoring scale.
RESULTS
The concomitant injuries including neurovascular, collateral or cruciate ligaments and capsular structures of knee to ipsilateral extremity were frequent events. The therapeutic outcomes were significantly affected by associated injuries. The only 5 cases had satisfactory result by the Lysholm knee scoring scale.
CONCLUSION
These injuries have been considered to be the result of high-energy trauma on flexed knee. The open reduction and internal screw fixation of the femoral unicondylar fractures are necessary for good results because those are unstable and easily displaced. The associated disruption of the cruciate ligament was frequently associated injury and, significantly affected to the therapeutic outcome.

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Treatment of Humerus Fracture using Ilizarov External Fixator: Suk Myun Ko, Myung Gu Kim, Ryuh Sup Kim, In Suk Oh, Joung Yoon Lee, Hyeok Chae Jeong; J Korean Soc Fract 2000;13(1):30-37. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.30

Abstract PDF

PURPOSE
Recently, the incidence of humerus fracture not allowing open reduction and internal fixation has been increased with increment of traffic accident and industrial accident. But, there have been a few reports in the use of Ilizarov external fixator. The purpose of this study is to report the authors'experience with Ilizarov external fixation for the treatment of the patients with fractures of the humerus.
MATERIALS AND METHODS
From June 1996 to July 1998, we reviewed sixteen patients with humeral fracture who were treated by the Ilizarov external fixator. Three fractures were in the middle third of the shaft; two, in the proximal third; two, in the distal third; seven, in the proximalmiddle; two, in the middle-distal. The fractures that were located within the joint of the shoulder or the elbow were excluded. Five fractures had been open and six had been associated with multiple trauma. Two had been initially treated by open reduction and internal fixation but failed : one, because of infection; the other, because of loss of fixation. We performed the Ilizarov external fixator procedure in the case of soft tissue trauma so severe that internal fixation was impossible, and in the case of the comminution too extensive and severe for internal fixation.
RESULTS
The average time to radiologic union was 12.7 weeks. According to Stewart and Hundley's functional assessment system, excellent or good results were obtained in 14 cases. There was no poor result.
CONCLUSION
Although the Ilizarov external fixator was a technically demanding procedure, it was a good method comparing with any other operative methods for the treatment of fractures of the humerus not allowing the open reduction and internal fixation.

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Contributing Factors of Radial Nerve Palsy Associated with Humeral Shaft Fracture
Tae-Soo Park, Joon-Hwan Lee, Tai-Seung Kim, Kwang-Hyun Lee, Ki-Chul Park
Journal of the Korean Fracture Society.2008; 21(4): 292. CrossRef

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Management of Displaced-Extension Type Supracondylar Fractures of Humerus in Children: Suk Myun Ko, Myung Ku Kim, Kyoung Ho Moon, Ryuh Sup Kim, Kyu Jung Cho, Dong Hun Choi; J Korean Soc Fract 1999;12(2):351-360. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.351

Abstract PDF: From June 1996 to February 1998, we reviewed the cases of 27 patients who had a displaced - extension type supracondylar fracture of the humerus retrospectively. The mean length of follow-up was 1.3 years. According to Gartland classification, type II was 7 cases (26%), type III-A was 11 cases (41%), type III-B was 9 cases (33%). We treated with three different methods, including closed reduction and percutaneous Kirschner-wire fixation, skeletal traction, and cast application after closed reduction. In type II fractures, we used two parallel lateral pins. In type III fractures, we used 2 lateral parallel pins followed by 1 medial crossed pin predominantly. The results of treatment were assessed using the criteria of Flynn et al. We graded cosmetic and functional factors separately. Satisfactory results were achieved by percutaneous K-wire fixation(96%). There were seven neural lesions. These were the result of injury and not of the treatment, with exception of one case. Neural injuries spontaneously resolved at a mean of 2.5 months(range 1.5 to 5 months) after injury. Varus deformity was present in one patient. There was no Volkman's ischemic contracture. Percutaneous Kirschnerwire fixation is advocated as the method of choice for the majority of displaced-extension type supracondylar humerus fractures in children.

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