Journal of Musculoskeletal Trauma

Seok Whan Song

10 Articles

A Comparison of the Results between Internal Fixation and External Fixation in AO C Type Distal Radius Fractures: Yoon min Lee, Hwa Sung Lee, Seok Whan Song, Jae Hoon Choi, Jong Tae Park; J Korean Fract Soc 2018;31(3):87-93. Published online July 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.3.87

PURPOSE
The purpose of this study was to evaluate the radiological and clinical results of plate fixation and external fixation with additional devices for treating distal radius fracture in AO type C subtypes, and propose a treatment method according to the subtypes.
MATERIALS AND METHODS
Two hundred and one AO type C distal radius fracture patients were retrospectively reviewed. Eighty-five patients in group 1 were treated with volar or dorsal plate, and 116 patients in group 2, were treated with external fixation with additional fixation devices. Clinical (range of mtion, Green and O'Brien's score) and radiological outcomes were evaluated.
RESULTS
At the 12-month follow-up, group 1 showed flexion of 64.4Â°, extension of 68.3Â°, ulnar deviation of 30.6Â°, radial deviation of 20.8Â°, supination of 76.1Â°, and pronation of 79.4Â° in average; group 2 showed flexion of 60.5Â°, extension of 66.9Â°, ulnar deviation of 25.5Â°, radial deviation of 18.6Â°, supination of 73.5Â°, and pronation of 75.0Â° in average. The mean Green and O'Brien score was 92.2 in group 1 and 88.6 in group 2. The radial height of group 1 and group 2 was 11.6/11.4 mm; radial inclination was 23.2Â°/22.5Â°; volar tilt was 11.6Â°/8.7Â°; and the ulnar displacement was 1.27/0.93 mm.
CONCLUSION
Judicious surgical techniques during device application and tips for postoperative management during external fixation can produce similar clinical results compared with internal fixation patients.

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Intra-articular fracture distal end radius external fixation versus locking volar radius plate: A comparative study
S.P.S Gill, Manish Raj, Santosh Singh, Ajay Rajpoot, Ankit Mittal, Nitin Yadav
Journal of Orthopedics, Traumatology and Rehabilitation.2019; 11(1): 31. CrossRef

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Treatment of Humeral Shaft Fracture with Retrograde Intramedullary Nail: Ki Bum Choi, Soo Hwan Kang, Yoon Min Lee, Seok Whan Song, Youn Jun Kim; J Korean Fract Soc 2013;26(4):299-304. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.299

Abstract PDF

PURPOSE
The purpose of this study was to report the outcome of treatment of humeral shaft fracture with retrograde intramedullary nail of advanced insertion opening.
MATERIALS AND METHODS
From April 2005 and August 2012, 22 patients with a humeral shaft fracture were treated by a single surgeon using the technique of retrograde intramedullary nail at Department of Orthopedic Surgery, Yeouido St. Mary's Hospital (Seoul, Korea). To avoid causing fractures at the insertion site, the entry point was more distally located than conventionally, and was extended proximally to include the proximal marginal cortex of the olecranon fossa. The outcome was evaluated clinically and radiologically.
RESULTS
The mean period of achievement of bony was 5.8 months (4-11 months). Additional fixations were needed in one patient with intraoperative lateral condylar fracture and 2 patients with postoperative nonunion. There were no limitations of movement or pain in the shoulder joint, and 8 cases had a 6.5degrees flexion contracture on average.
CONCLUSION
This retrograde intramedullary fixation technique using a distal entry portal near the olecranon fossa is particularly useful in humeral shaft fractures without a neurovascular injury. The risk of an intraoperative fracture (supracondylar fracture or fracture around the entry portal) can be decreased using this treatment. We recommend this technique because of the safety and the satisfactory outcome.

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HEALING PATTERN OF INTERLOCKED INTRAMEDULLARY NAILED HUMERAL SHAFT FRACTURE
Myung-Sang Moon, Dong-Hyeon Kim, Min-Geun Yoon, Sang-Yup Lee
Journal of Musculoskeletal Research.2016; 19(04): 1650018. CrossRef

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Posterior-Posterior Dual Plates Fixation for the Distal Humerus Fractures: Yoon Min Lee, Seok Whan Song, Ki Bum Choi, Yoo Joon Sur, Sung Eun Kim; J Korean Fract Soc 2013;26(4):254-260. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.254

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PURPOSE
Fractures of the distal humerus are one of the challenging injuries due to its complex anatomy and accompanied comminution. For dual plate fixation, orthogonal or parallel plating is widely used, but the better of the two is debatable. The purpose of this study was to report another fixation technique that yielded good clinical results with early bone union of distal humerus fracture, namely, posterior-posterior plate fixation.
MATERIALS AND METHODS
From March 2003 to March 2012, 20 patients with distal humerus fractures were treated by posterior-posterior plate fixation. The triceps reflecting approach was used with anterior transposition of the ulnar nerve. The mean age at the time of injury was 45 years (range, 26 to 78 years). By AO classification of distal humerus fractures, there were one case of A2 and B3 respectively, two cases of each A3, C1 and C3, and twelve cases of C2.
RESULTS
The mean period of complete bone union was 7.1 weeks (range, 4 to 11 weeks). The mean flexion-extension range of motion of the elbow joint at last follow-up was 116.2 degrees. The mean pronation was 81.2 degrees and supination was 83.1 degrees. Plates and screws were removed at about nine months after the initial surgery. No cases showed complications or required additional operation.
CONCLUSION
Posterior-posterior dual plates fixation resulted in stable bicortical screw fixation, and insertion of lag screws were possible without interference. Posterior-posterior plating could be an easy and stable fixation method that provides good clinical results.

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Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study
Chien-An Shih, Fa-Chuan Kuan, Kai-Lan Hsu, Chih-Kai Hong, Cheng-Li Lin, Ming-Long Yeh, Wei-Ren Su
BMC Musculoskeletal Disorders.2021;[Epub] CrossRef

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Dorsal Plating for Distal Radius Fracture: Seok Whan Song; J Korean Fract Soc 2008;21(4):334-340. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.334

Abstract PDF

No abstract available.

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Anatomical Reduction with Brick-Work Technique in Comminuted Intraarticular Distal Radius Fractures
Hyoung Min Kim, Hyung Lae Cho, Jong Woo Chae, Myung Ji Shin
Journal of the Korean Fracture Society.2018; 31(1): 1. CrossRef

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Osteoporotic Distal Radius Fracture-conservative Treatment: Seok Whan Song; J Korean Fract Soc 2008;21(1):81-86. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.81

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No abstract available.

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Nonsurgical Treatment of a Distal Radius Fracture: When & How?
Young Ho Shin, Jun O Yoon, Jae Kwang Kim
Journal of the Korean Fracture Society.2018; 31(2): 71. CrossRef
The Clinical Effect of Rehabilitation Protocol for Distal Radius Fracture in Korean Medicine: A Report of 3 Cases
Won-Bae Ha, Ji-Hye Geum, Nak-Yong Koh, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2018; 28(3): 97. CrossRef
Treatment for Unstable Distal Radius Fracture with Osteoporosis -Internal Fixation versus External Fixation-
Jin Rok Oh, Tae Yean Cho, Sung Min Kwan
Journal of the Korean Fracture Society.2010; 23(1): 76. CrossRef

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Treatment of Post-traumatic Dislocation of Metacarpophalangeal Joints of the Hand: Seung Koo Rhee, Seok Whan Song, Joo Yup Lee, Chang Youn Moon, Jae Chan Oh; J Korean Soc Fract 2003;16(2):253-261. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.253

Abstract PDF: PURPOSE
To analyse the obstacles to prevent the reduction for dislocation of the metacarpophalangeal (MP) joints of the hand and evaluate the relationship between the sex and dislocation type in closed reduction case.
MATERIALS AND METHODS
Total 27 cases of MP joint dislocation of the hand (11 cases of thumb, and 14 index and 2 little finger) were reviewed retrospectively. The anatomical structures to prevent the reduction were confirmed at operation and the cases which were reduced immediately were also analysed for their ages and differences of damaged structures, and finally their complications or outcome were reviewed for average 7 months after reduction.
RESULTS
In 11 cases of thumb MP joint dislocations, the complex dorsal dislocations in which the protruded metacarpal neck was caught by buttonhole of torn anterior joint capsule, volar plate and FPB were reduced by open method in 8 cases, and closed reduction was done in 2 cases but one old case required arthrodesis. In other finger MP joint dislocations, the Kaplan's concept to prevent the reduction was confirmed. But reduction of torn volar plate and incision of transverse metacarpal ligament were sufficient to reduce the dislocation with gentle longitudinal traction during the operation. In two cases of little finger MP joint dislocation, the ruptured radial collateral ligaments were noted after open reduction and it must the repaired to prevent the finger instability later. Their overall end results were good without any significant restriction of MP joints motions and finger instabilities.
CONCLUSION
One or two times of closed reduction with proper local anesthesia could be tried, but simple reducible dislocation can be converted to complex irreducible ones by the inappropriate traction method, and so proper reduction technique by closed or even in open way is important with the knowledge of anatomical obstacles to prevent the reduction of the metacarpophalangeal joints.

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Treatment of Clavicle Fracture : Operative vs Non-operative: Seok Whan Song, Hwa Sung Lee, Young Kyun Woo, Seung Koo Rhee, Young Yul Kim; J Korean Soc Fract 2000;13(3):544-549. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.544

Abstract PDF

INTRODUCTION: The purpose of this study was to compare the final results of the patients of the clavicle fractures, treated with the conservative or surgical techniques.
MATERIALS AND METHODS
125 patients (over 15 years old, follow-up over 6 months) were reviewed. To measure the amount of shortening of the fractured clavicle, the length of clavicle was measured from the mid-point of the medial end to the lateral. Range of motion of shoulder, evaluation of functional results and subjective satisfaction, and complications were assessed.
RESULTS
In the surgical treatment group, the period of bony union was short and the shortening of the final length of the fractured clavicle, although there was no statistical significance, was rare. Overall satisfaction for the final result and range of motion of the shoulder were not significantly different between the groups. Complication rates were higher in the conservative treatment than in the surgical.
CONCLUSIONS
In most cases of the clavicle fracture, the operative treatment is recommended to decrease the complications, to shorten the treatment period, to satisfy the patients, and probably to decrease the economical burden.

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Progressive Brachial Plexus Palsy after Fixation of Clavicle Shaft Nonunion: A Case Report
Hong-Ki Jin, Ki Bong Park, Hyung Lae Cho, Jung-Il Kang, Wan Seok Lee
Journal of the Korean Fracture Society.2019; 32(2): 97. CrossRef

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Treatment of Die-punch fractures in Unstable Distal Radius Fractures: Seung koo Rhee, Seok Whan Song, Yang Guk Chung, Wha Seong Lee, Seung Joon Ryoo; J Korean Soc Fract 1999;12(4):1012-1020. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.1012

Abstract PDF: Die-punch fracture is a comminuted intra-drticular fracture on the distal radius with depressed articular fragments caused by impaction of carpal bones, mainly lunate or scaphoid. As in the other intra-articular fractures, the accurate rehtoration of congruent articular surface is necessary to get good functional results. The purpose of this study is to review the results in a series of 24 die-punch fracturef according to the type of fractures dnd the method of treatments. During the 5 year period after July, 1993, total 24 die-punch fractures in 22 patients were treated by surgery(22 cases) or closed method(2 cases) and were followed up for average 29 months. On the last follow-up examination, radiographic changes of grade 1 or 2 of post-traumatic arthritis were seen in twelve wrists and ten of them comptained of pain at wrists. Mean range of motion of wrist joints were 62 of flexion, 64 of extension, 80 of pronation, 77 of supination, 17 of radial deviation and 27 of ulnar deviation. According to the Demerit point system. total 22 of 24 cases(91.7%) showed excellent or good result and there were no poor results. From these results, we concluded the die-punch fractures are so unstable comminuted intraarticular fracture on the distal radius with displaced postero-medial fracture fragments on the radiolunate joint, that if we only reduce them anatomically, mostly by open reduction, internal fixation with or without bone grafts, then we could obtain good results.

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Tardy Ulnar Nerve Palsy Caused by Post-Traumatic Elbow deformities: Seung koo Rhee, seok Whan Song, Hwa Sung Lee, Ho Tae Kim; J Korean Soc Fract 1998;11(2):420-426. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.420

Abstract PDF: Thirty-five patients with tardy ulnar nerve palsy caused by cubitus valgus (33 cases0 and varus (2 cases) deformities were retrospectively studied. All patients had a history of old fracture on the distal humerus during childhood. The mean interval between the previous fractures and the onset of ulnar neuropathy was 19 years. The severity of nerve palsy was classified as McGowan's grade I in 24 patients, grade II in 8 patients, and grade III in 3 patients. The mean carrying angle was average 29 degrees in 33 cases with cubitus valgus and it was decreased to average 11 degrees postoperatively, but the angle was average -23 degrees preoperatively in 2 cases with cubitus varus and it was corrected to average 9 degrees postoperatively. the cause of palsy was analysed by mechanical stetching in 11 cases, compression by a fibrous band between the two heads of flexor carpi ulnaris in 8 cases, and diffuse fibrous adhesion around the ulnar tunnel in 5 cases. All patients was treated with supracondylar closing wedge osteotomy accompanied with anterior ulnar nerve transposition in 13 patients, corrective osteotomy only in 12 patients, and anterior ulnar nerve transposition only in 10 patients. Their end results were analysed as good in 24 cases, fair in 8 cases, and poor in 3 cases within average 6 months after the operations (4 to 13 months). The poor results was obtained in 3 cases out of 9 cases with corrective osteotomy group (33.3%). Conclusively, a tardy ulnar nerve palsy caused by post-traumatic elbow deformities should be corredcted with anterior ulnar nerve transposition with or without corrective closing wedge osteotomy but not by corrective osteotomy only, because of compressive neuropathy by diffuse fibrous adhesion or bands of two heads of FCU around the ulnar tunnel in elbow.

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Management of the Intraarticular and Periarticular Fracture Using a Herbert bone screw: Clinical analysis of Technical Probleus of Surgery and Complications: In Kim, Young Kyun Woo, Ju Hae Chang, Yong Sik Kim, Seok Whan Song, Soon Yong Kwon, Whan Kun Yoo; J Korean Soc Fract 1995;8(1):216-227. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.216

Abstract PDF: 32 cases of intraarticular and periarticular fractures treated with the Herbert bone screw were analyzed retrospectively by radiographic and functional assessment in the department of orthopaedic surgery of Catholic University Medical College from 1989 to 1994. 1. According to the anatomical distribution, there were various fracture sites as follows: 11 cases of carpal scaphoid, 7 cases of distal humerus, 4 cases of proximal radius, 3 cases of proximal humerus, 3 cases of femoral head,2 cases of distal radius, metacarpal head and medial malleolus in each 1 case. 2. Early and late radiographic assessment showed some complications as follows: 1) Through early radiographic assessment, there were 2 cases of inaccurate reduction of fracture fragment,2 cases of inappropriate fixation (out of bone) and 1 cases of insecure fixation followed by displacement of fracture fragment. 2) Through late radiographic assessment, there were 3 cases of posttraumatic arthritis, 2 cases of avascular necrosis of the osteochondral fracture fragment ; Of 3 cases of posttraumatic arthritis, 2 cases were related to the progressive protrusion of screw head resulting from degenerative thinning of the articular cartilage. Through this study, it was stressed that 1. Fracture personality must be evaluated for the appropriate use of Herbert screw, considering the fracture pattern and sites. 2. The head including a trailing thread must be inserted into the subchondral bone to prevent the protrusion of screw head, being aware of the progressive thinning of cartilage resulting from the inevitable posttraumatic arhritis or avasculsr necrosis of fracture fragment. 3. In the cases of osteochondral fracture deserving the shear force by musculotendinous pulling and joint motion, Herbert screw seems to be undesirable. 4. The Herbert screw is effective method, but needs skill and experience if errors are to be avoided.

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