Journal of Musculoskeletal Trauma

Soo Hong Han

16 Articles

Open Reduction and Internal Fixation in Comminuted Radial Head Fracture: Jun Ku Lee, Tae Ho Kim, Choongki Kim, Soo Hong Han; J Korean Fract Soc 2019;32(4):173-180. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.173

PURPOSE
Radial head fractures, which account for 33% of all fractures, are treated depending on the Mason classification. In comminuted type 3 fractures, open reduction internal fixation (ORIF), and radial head arthroplasty are the treatment options. This study examined the clinical outcome of modified Mason type 3 radial head fractures using ORIF with a plate.
MATERIALS AND METHODS
The medical records and image of 33 patients, who underwent ORIF for modified Mason type 3 radial head fractures, were reviewed retrospectively. The preoperative plain radiographs and computed tomography images were used to examine the location of the fracture of the radial head, the number of fragments, union, joint alignment, and traumatic arthritis at the final follow-up. The range of motion (ROM) of the elbow at the last follow-up, pain score (visual analogue scale), modified Mayo elbow score (MMES), and complications were analyzed for the clinical outcome.
RESULTS
Of the 33 cases, 14 were men and 19 were women. The mean age was 41.8 years and the average follow-up period was 19 months. The functional ROM was divided into three groups according to the number of bone fragments: 141.2Â°Â±9.3Â° of 3 (n=20), 123.8Â°Â±18.5Â° of 4 (n=7), 100.7Â°Â±24.4Â° of more than 4 (n=6). Furthermore, the MMES were 88.2Â±2.9, 83.7Â±4.3, and 77.3Â±8.4, respectively (p=0.027). Depending on the radial head fracture location, the ROM and MMES were 130.7Â°Â±7.5Â° and 82.1Â±4.7, respectively, with poor outcomes on the ulnar aspect compared to 143.1Â°Â±3.8Â° and 89.9Â±3.2 on the radial aspect.
CONCLUSION
Various factors, such as the degree of crushing and location involved in the clinical outcome. In particular, the result was poor in the case of more than four comminuted fragments or chief position located in the ulnar aspect. In this case, radial head arthroplasty may be considered in the early stages.

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Does the coronoid fracture in terrible triad injury always need to be fixed?
Yeong-Seub Ahn, Seong-Hwan Woo, Sungmin Kim, Jun-Hyuk Lim, Tae-Hoon An, Myung-Sun Kim
BMC Surgery.2024;[Epub] CrossRef
Results of the Use of Bioabsorbable Magnesium Screws for Surgical Treatment of Mason Type II Radial Head Fractures
Chul-Hyung Lee, Seungha Woo, Hyun Duck Choi
Clinics in Orthopedic Surgery.2023; 15(6): 1013. CrossRef

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Radiologic Analysis of Distal Radius Fracture Accompanying Spontaneous Extensor Pollicis Longus Rupture: Jun Ku Lee, In Tae Hong, Young Woo Kwon, Gyu Chol Jang, Soo Hong Han; J Korean Fract Soc 2017;30(2):63-68. Published online April 30, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.2.63

Abstract PDF: PURPOSE
The spontaneous extensor pollicis longus (EPL) tendon rupture is a well-documented complication of non-displaced or minimally displaced distal radius fracture. Authors analyzed the radiographs of patients treated for closed EPL rupture after distal radius fracture.
MATERIALS AND METHODS
Twenty-eight patients (21 females, 7 males; average age of 58 years) with tendon transfer for spontaneous rupture of EPL after distal radius fracture were included. Wrist radiographs were taken at the first visit with EPL rupture. On the lateral view, posterior cortical displacement, distance from highest point in Lister's tubercle to fracture line, and height of the Lister's tubercle were measured. The distance from the lunate facet to the fracture line was measured on anteroposterior view. Radiologic change at the time of EPL rupture around the Lister's tubercle was evaluated by comparing it with the contra lateral wrist radiograph. Radial beak fracture pattern was also identified.
RESULTS
The interval between the injury and the spontaneous EPL rupture varied from 2 to 20 weeks, with an average of 6.7 weeks. There were 25 cases of non-displacement, 3 cases of mean 2.0 mm cortical displacement. The average distance from the lunate facet to the fracture line was 9.1 mm (3-12.1 mm), from the highest point in Lister's tubercle to the fracture line was 3.0 mm toward proximal radius (1.7-4.9 mm). The average height of the Lister's tubercle was 3.4 mm in the injured wrist and 3.1 mm in the opposite wrist. Radial beak fracture pattern was shown at 11 cases.
CONCLUSION
All cases presented no or minimal displaced fracture, and the fracture line was in the vicinity of the Lister's tubercle. Those kinds of fractures can highlight the possibility of spontaneous EPL rupture, depites its rarity.

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Avulsion of the Femoral Attachment of Anterior Cruciate Ligament Associated with Ipsilateral Femoral Shaft Fracture in Skeletally Mature Patient: A Case Report: Seong Eun Byun, Taesup Kim, Bang Hyun Kim, Jae Hwa Kim, Soo Hong Han, Wonchul Choi; J Korean Fract Soc 2016;29(3):200-205. Published online July 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.3.200

Abstract PDF: Avulsion fracture at the femoral attachment of the anterior cruciate ligament (ACL) is very rare and has been reported mostly in skeletally immature patients. Authors experienced a case of avulsion fracture at the femoral attachment of ACL in a skeletally mature, a 21-year-old male associated with ipsilateral femoral shaft fracture. Here, authors report on the case with a literature review. Care should be taken because an avulsion fracture at the femoral attachment of ACL can be accompanied by ipsilateral femoral shaft fracture in skeletally mature patients.

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Usefulness of Computed Tomography on Distal Tibia Intra-Articular Fracture Associated with Spiral Tibia Shaft Fracture: Seong Eun Byun, Sang June Lee, Uk Kim, Young Rak Choi, Soo Hong Han, Byong Guk Kim; J Korean Fract Soc 2016;29(2):114-120. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.114

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the usefulness of computed tomography (CT) for spiral tibia shaft fracture by analyzing associated distal tibia intra-articular fractures diagnosed by CT only which met the indication of surgical fixation and were fixed.
MATERIALS AND METHODS
Ninety-five spiral tibia shaft fractures with preoperative ankle plain radiographs and CT were analyzed retrospectively. The incidence and type of associated distal tibia articular fractures were evaluated by reviewing ankle plain radiography and CT. The number of fractures diagnosed by CT that correspond with the indication of fixation and that were actually fixed were analyzed.
RESULTS
Among 95 spiral tibia shaft fractures, 62 cases (65.3%) were associated with distal tibia intra-articular fracture. There were 37 cases of posterior malleolar fracture, 5 cases of avulsion fracture of the distal anterior tibiofibular ligament, 5 cases of medial malleolar fracture, and 15 cases of complex fracture. Among 52 posterior malleolar fractures including complex fracture, 20 cases were diagnosed by ankle plain radiograph. Of these 20 cases, 16 posterior malleolar fractures (80.0%) met the indication of surgical fixation, and 14 cases were actually fixed with a screw. Among 32 posterior malleolar fractures diagnosed by CT only, 26 cases (81.3%) met the indication of surgical fixation and 18 cases (56.3%) were fixed by screw.
CONCLUSION
Approximately 50% of associated fractures were diagnosed by CT only and more than 80% of associated posterior malleolar fractures met the indication of surgical fixation and among these fractures, 18 cases (56.3%) were actually fixed by screw. This result suggests that CT is useful in diagnosis and treatment of distal tibia intra-articular fracture associated with spiral tibia shaft fracture.

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Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures
Young Sung Kim, Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Soon Young Park
Journal of the Korean Orthopaedic Association.2021; 56(4): 317. CrossRef

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Cannulated Screw and Wire Fixation with Predrilling for Olecranon Osteotomy in Intra-articular Comminuted Distal Humerus Fractures: Soo Hong Han, Ho Jae Lee, Woo Hyun Kim, Yong Gil Jo, Won Tae Song; J Korean Fract Soc 2015;28(2):118-124. Published online April 30, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.2.118

Abstract PDF: PURPOSE
The olecranon osteotomy in intra-articular comminuted distal humerus fractures is a suggested technique for excellent exposure of articular fractures. However, complications including delayed union, nonunion of osteotomy site have been reported. Authors have applied predrilling for cannulated screw before osteotomy for achievement of rapid and accurate reposition of separation part and added wire fixation for secure stability. The purpose of this study is to evaluate the efficacy of this fixation procedure following the olecranon osteotomy during the internal fixation of intra-articular fracture of the distal humerus.
MATERIALS AND METHODS
This study retrospectively analyzed 14 cases (9 women and 5 men) of intra-articular distal humerus fractures in which the olecranon osteotomy was applied. The mean age of patients was 53.4 years (range, 25 to 83 years), and the average follow-up period was 15.9 months. Eleven cases were classified as AO 13-C3, and the other 3 cases were AO 13-C2. Reduction accuracy, union period of osteotomy site on follow-up radiographs and postoperative complications related to olecranon osteotomy were evaluated.
RESULTS
All osteotomized parts showed no position change and solid union with normal alignment at the last follow-up. The mean period of bony union was 3.5 months (range, 2 to 5 months). There were no complications related to olecranon osteotomy except one case of non-displaced fracture of the proximal ulnar shaft at the level of cannulated screw tip caused by forceful passive physical therapy. It was managed by conservative treatment without further problem.
CONCLUSION
Predrilled cannulated screw and wire fixation following the olecranon osteotomy during internal fixation of intra-articular comminuted distal humerus fractures showed satisfactory results in the union of osteotomy site and it could be a recommendable procedure when fractures require olecranon osteotomy.

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Surgical Treatment of the Perilunate Dislocation and the Lunate Dislocation with Dorsal Approach: Soo Hong Han, Jin Myoung Dan, Dong Hoon Lee, Young Woong Kim; J Korean Fract Soc 2011;24(4):347-353. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.347

Abstract PDF: PURPOSE
To evaluate the clinical and radiologic outcomes of the perilunate dislocation and the lunate dislocation which were managed surgically through a dorsal approach.
MATERIALS AND METHODS
Retrospective reviews of the 13 patients who had minimum 1-year follow-up after surgical treatment through isolated dorsal approach for their perilunate dislocations or the lunate dislocations were performed. The case that dislocated lunate migrated proximally through the wrist was excluded in this series. We evaluated the DASH score in questionnaire method and Mayo wrist score to analyze the clinical outcomes. Radiologic results were investigated by measurement of the scapho-lunate angle, and fracture union was also evaluated in the case of trans-scaphoid dislocation.
RESULTS
The mean DASH Score was 16.3 points (range, 10.8~26.7 points) and the mean Mayo wrist score was 79 points (range, 65~90 points) at the final follow-up. There were 2 cases of excellent, 7 cases of good and 4 cases of fair in the Mayo wrist score. On the radiologic analysis, the mean scapho-lunate angle was 49.0degrees (range, 35~55degrees) and all cases were within the normal range. All cases of the trans-scaphoid perilunate dislocation achieved bone union.
CONCLUSION
Author's cases showed satisfactory outcomes in clinically and radiologically. Isolated dorsal approach could give anatomical reduction and appropriate internal fixation in treatment of the perilunate dislocations and the lunate dislocations except the rare case of proximal migration of the lunate through the wrist.

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Percutaneous Retrograde Intramedullary Pin Fixation for Isolated Metacarpal Shaft Fracture of the Little Finger: Soo Hong Han, Hyung Ku Yoon, Dong Eun Shin, Seung Chul Han, Young Woong Kim; J Korean Fract Soc 2010;23(4):367-372. Published online October 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.4.367

Abstract PDF

PURPOSE
To evaluate the anatomic and functional outcome of retrograde intramedullary single wire fixation for metacarpal shaft fractures of the little finger.
MATERIALS AND METHODS
hirty one consecutive patients with closed metacarpal shaft fractures of the little finger who have been treated with retrograde intramedullary single wire fixation were evaluated. Fracture union and angulation were analyzed radiologically, and clinical evaluations were performed including range of motion, DASH score and complications.
RESULTS
Fracture union was achieved in all cases and callus formation was obvious at postoperative 41 days. Average angulation of fracture site was 3degrees in the coronal plane and 1.2degrees in the sagittal plane at the last follow up and no measurable metacarpal shortening was observed. Mean TAM was 253degrees and DASH score was 2.6. There were two cases of pin migration as intermediate complications.
CONCLUSION
Closed reduction with subsequent percutaneous retrograde K-wire fixation produced good radiological and functional results. We recommend this minimally invasive technique which provides adequate fixation of displaced little finger metacarpal shaft fractures with good functional results and low morbidity.

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The Treatment Outcomes of the Metacarpal Shaft and Neck Comminuted Fractures Using Modified Percutaneous Retrograde Intramedullary Kirschner Wire Fixation
Seok Woo Hong, Young Ho Lee, Min Bom Kim, Goo Hyun Baek
Archives of Hand and Microsurgery.2018; 23(3): 175. CrossRef

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Wedge Tibial Shaft Fractures Treated with Interlocking IM Nailing: Sang Jun Song, Hyung Ku Yoon, Soo Hong Han, Hyung Kun Park, In Seok Lee; J Korean Fract Soc 2006;19(3):322-328. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.322

Abstract: PURPOSE
To investigate the bone union time of patients treated with interlocking intramedullary nailing in wedged tibial shaft fracture and to evaluate the factors that influence this result.
MATERIALS AND METHODS
32 patients treated with interlocking intramedullary nailing for wedge tibial shaft fracture were reviewed with a follow-up period of more than 1 year. Radiographic results were assessed with diameter (%) and length (mm) of wedge fragment, pre and postoperative displacement (mm) of wedge fragment. We also checked the bone union time of the main fragment and the wedge fragment (paired t-test). We investigated the bone union time acocording to the diameter, length of wedge fragment, pre and postopertvie displacement (correlation analysis).
RESULTS
Bone union time of the main fragments averaged 15.3 weeks (6~53 weeks) and that of wedge fragment averaged 24.2 weeks (8~64 weeks) (p=0.005). There was no correspondence between wedge fragment diameter and bone union time (p=0.681), but the bone union time of wedge fragment increased in proportion to its diameter (r2=0.747, p=0.031). There was no correspondence between preoperative displacement of wedge fragment and bone union time (p=0.574), but the bone union time increased in proportion to postoperative displacement of wedge fragment (r2=0.730, p=0.001).
CONCLUSION
Wedge fragments need longer time for bone union than main fragments in interlocking intramedullary nailing for wedge tibial shaft fractures. We need to pay attention to the displacemet of fragments in treating tibial shaft fractures with large wedge fragment.

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Comparison between X-ray and Three Dimensional Computed Tomography in Trimalleolar Ankle Fractures: Sang Jun Song, Hyung Ku Yoon, Dong Eun Shin, Soo Hong Han, Jae Hwa Kim, Hyung Kun Park, Yong Sub Han; J Korean Fract Soc 2005;18(2):160-164. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.160

Abstract PDF

PURPOSE
To evaluate the accuracy of X-ray evaluation in classification, displacement and size of posterior malleolar fragment, comparing with three dimensional computed tomography (3D CT) in trimallelar ankle fractures.
MATERIALS AND METHODS
20 cases of trimalleolar ankle fractures evaluated with preoperative 3D CT, and followed up periods were at least 2 years. All cases were classified according to the Danis-Weber and Lauge-Hansen classification. Displacement and size of posterior malleolar fragment were measured using PACS. The reliability between simple X-ray and 3D CT was evaluated in the Danis-Weber and Lauge-Hansen classification (kappa analysis). The correlation between simple X-ray and 3D CT was evaluated in displacement and size of posterior malleolar fragment (correlation analysis).
RESULTS
Degree of agreement of Danis-Weber classification in simple X-ray and 3D CT was 0.700 kappa value, and that of Lauge-Hansen was 0.605 kappa value. Measurement of simple X-ray and 3D CT about displaced status of posterior malleolar fragment showed statistically significant positive linear correlation (p= 0.000), but correlation of measurement of size in simple X-ray and CT was not statistically significant (p=0.102).
CONCLUSION
CT or operative field will be more accurate than simple X-ray to select the method of treatment and operation, especially when the displacement and size of posterior malleolar fragment are important to decide.

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Comparison of the Size of the Posterior Malleolar Fragment in Trimalleolar Ankle Fractures Measured Using Lateral Plain Radiography and Three-Dimensional Computed Tomography
Gun-Woo Lee, Dong-Min Jung, Woo Kyoung Kwak, Keun-Bae Lee
Journal of the Korean Fracture Society.2022; 35(3): 91. CrossRef

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Reduction of Pediatric Forearm Diaphyseal Fractures by Pin Leverage Technique: Soo Hong Han, Duck Yun Cho, Hyung Ku Yoon, Byung Soon Kim, Sung Hoon Kang, Tae Hyung Kim; J Korean Fract Soc 2004;17(1):59-63. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.59

Abstract PDF

PURPOSE
Although the majority of children's forearm diaphyseal fractures may be treated conservatively with closed reduction and cast immobilization, unstable or irreducible fractures are usually treated by surgical management. Authors performed percutaneous pin leverage reduction technique for irreducible displaced diaphyseal fractures. The aim of this study is to determine the efficacy of pin leverage technique in pediatric forearm diaphyseal fractures MATERIALS AND METHODS: In this retrospective study, we reviewed 22 cases of forearm diaphyseal fractures reduced by percutaneous pin leverage technique between 1997 and 2002. We analyzed radiographs, operation time, hospital stay and immobilization period, range of motion, postoperative complications and functional results by Thomas.
RESULTS
Average length of follow up was 28 months with mean age of 10.5 years. All fractures in this series healed less than 2 degrees of diaphyseal angulation. Average operation time including anesthesia was 42 minutes and hospital stay was 4.6 days. Time to union was 49.6 days in average and range of motion and functional results were satisfactory in all cases except one case of congenital radioulnar synostosis. There was one case of superficial pin track infection as complication.
CONCLUSION
In operative treatment of children's diaphyseal fractures of forearm bones, percutaneous pin leverage reduction technique is a good alternative method prior to open reduction in case of difficult closed reduction.

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Pediatric Forearm Bone Fractures Treated with Flexible Intramedullary Nail
Suk Kyu Choo, Jin Hwan Kim, Hyung Keun Oh, Dong Hyun Kim
Journal of the Korean Fracture Society.2007; 20(2): 190. CrossRef

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The Correlation between Surgical Timing and Perioperative Complications in the Treatment of Displaced Supracondylar Humeral Fractures of Children: Soo Hong Han, Duck Yun Cho, Hyung Ku Yoon, Byung Soon Kim, Jae Hwa Kim, Hyung Kun Park, Se Hyen Kim; J Korean Soc Fract 2003;16(2):278-283. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.278

Abstract PDF: PURPOSE
Even though emergent percutaneous pinning after closed reduction is the popularized treatment of the displaced type II and type III pediatric supracondylar fractures of the humerus, the timing of pinning still presents controversy. The purpose of this study is to suggest an appropriate surgical time without significant perioperative complications.
MATERIALS AND METHODS
From April 1995 to January 2002, 179 consecutive patients who had undergone surgical treatment were selected. They were divided to 5 groups [A group: 8 hours or less following injury (24 cases), B group: from 9 to 16 hours (63 cases), C group: from17 hours to 24 hours (63 cases), D group: from 25 hours to 48 hours (18 cases), and E group: from 49 hours to 72 hours (11 cases)] and reviewed retrospectively to analyze perioperative complications and operation time.
RESULTS
There was no significant difference between each group with respect to surgical wound infection, iatrogenic ulnar nerve injury, VIC, operation time and the necessity of reoperation (p>0.05).
CONCLUSION
Within the parameters outlined in our study, we could not find the any meaningful correlation between surgical timing and occurrence of perioperative complications and also, we think that the timing of percutaneous pinning can be delayed to the time when a surgeon considers it appropriate.

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Common Modes of Fixation Failure with a Sliding Hip Screw encountered Unstable Intertrochanteric Fracture: Byung Soon Kim, Duck Yun Cho, Hyung Ku Yoon, Dong Eun Sin, Soo Hong Han, Jae Hwa Kim, Dong Jun Kim; J Korean Soc Fract 2003;16(1):15-21. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.15

Abstract PDF

The purpose of this study was to evaluate the common modes of fixation failure in unstable intertrochanteric fractures , related risk factors and the prevention of fixation failure. Between 1995 and 2001, 44 patients who had sustained an unstable intertrochanteric fractures were assigned to be treated with a sliding hip screw. Men in 14 cases ( 32% ), women in 30 cases ( 68% ) , the average age at the operation was 65(22-90) years and the average duration of follow up was 12(8-22) months. We classified the fracture patterns with Evans system and used Singh 's index for osteoporosis. And we examined the common modes of fixation failure with postoperative X-ray. The fixation failure in unstable intertrochanteric fracture was 8 cases (18.2 % ); varus collapse of the proximal fragment with cutout of the lag screw was 3 cases (6.8%), varus collapse of the proximal fragment with excessive sliding of the lag screw was 4 cases (9.1%) and loss of fixation of the plate-holding screws was 1 case (2.3%). The authors think that inadequate anatomical reduction of comminuted posteromedial fragment and severity of osteoporosis are main causes of fixation failure. During operation for unstable intertrochanteric fractures, the most important point is accurate reduction of posteromedial fragment and the intramedullary hip screw like proximal femoral nail ( PFN ) may be considered to avoid fracture of lateral cortex that enter the lag screw, causing fixation failure.

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The Antero-medial Cortex Overlapped Reduction of Unstable Intertrochanteric Fractures
Chae-Geun Kim, Suc-Hyun Kweon, Hong-Jun Han, Jae-Seon Hwang
Hip & Pelvis.2013; 25(4): 280. CrossRef

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The Efficacy of Dynamization of Static Interlocking Intramedullary Nailing as A Trial Leading to Bony Union of Femur Shaft Fracture: Byung Soon Kim, Duck Yeon Cho, Hyung Ku Yoon, Soo Hong Han, Jin Yong Kim, Yong Wook Kim; J Korean Soc Fract 2002;15(2):138-145. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.138

Abstract PDF: PURPOSE
To evaluate the efficacy of dynamization of static interlocking intramedullary nailing as a trial leading to bony union of femur shaft fracture, delayed union of femur shaft fracture underwent dynamization were investigated. MATERIALS & METHODS: Between april 1995 and December 2000, 162 patients were treated static interlocking intramedullary nailing, 14 patients were selected who had underwent dynamization. The average age was 39 years old (range 24 to 61), they were 11 men and 3 women. The type of fractures were two communited, seven segmental and five simple fractures. Dynamization were done by removal of proximal or distal interlocking screw. We defined complete bony union as radiological and clinical bony union. Also we measured leg length discrepancy and angulation by radiologic parameters.
RESULTS
Of the 14 patients who showed delayed union, 7 patients were noted successful bony union by dynamization, and of the 7 patients who failed union by dynamization, 6 patients were noted bony union by supportive operative treatments(bone graft : 4 patients, nail exchanging : 1 patient, both method 1 patient). One patient was seen nonunion state because of patient's refusal of treatment. 7 patients who were noted successful bony union by dynamization had 2 degrees~6 degrees(average 4.14 degrees) varus-valgus angulation and 4 degrees~9 degrees(average 6 degrees) AP angulation, and 3 of the 7 patients showed leg length discrepancy(LLD) greater than 2 cm. The other 7 patients had 2 degrees~5 degrees(average 3.57 degrees) varus-valgus angulation and 3 degrees~7 degrees(average 5 degrees) AP angulation, and 2 of the 7 patients showed LLD greater than 2cm. Of the 14 patients, 5 patients showed limping.
CONCLUSION
Dynamization of intramedullary nainling is a simple and valuable method for improving bony union of femur shaft fracture in the case of delayed union. But if the delayed unions are seen due to large bone defect, supportive operative treatments (bone graft, nail exchanging etc.) to avoid significant complica-tion(shortening and angulation) is needed.

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Correlation of the Clinical Outcome and Radiographic Measurement of the Calcaneal Fractures: Dong Eun Shin, Jin Yong Kim, Dong Bae Shin, Yong Jung Kim, Soo Hong Han, Young Je Soung; J Korean Soc Fract 2001;14(4):698-705. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.698

Abstract PDF

PURPOSE
To evaluate the prognostic factors associated with the clinical outcome, which analysed with use of the Pearson correlation method in AOFAS score and radiographic measurement between normal and the affected site after operative treatment of the calcaneal fractures.
MATERIALS AND METHODS
We evaluated 13 patients(13 cases) who had unilateral calcaneal fractures. At the latest follow-up, we calculated the mean differences of the Bohler angle, gissane angle, heel height, calcaneal width, calcaneal length, talocalcaneal angle, talar declination angle, subtalar incongruity between normal and affected site on the lateral view of ankle and tangential view of the calcaneus. And then the correlation between radiographic measurement and the clinical outcome analysed by Pearson correlation method.
RESULTS
Heel height(correlation coefficient = 0.827, p-value<005) and subtalar incongruity(correlation coeffidient = -0.764, p-value<0.05) were closely correlated with the clinical outcome and the B hler angle showed lower correlation coefficiency(correlation coefficiency = 0.470, p-value : 0.104) compare to the heel height.
CONCLUSION
We suggested that restoration of the heel height and subtalar incongruity was significantly correlated to the clinical outcome after operative treatment of the calcaneal fractures.

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The Comparison of Radiographic Parameters and Clinical Results after Operative Treatment of Displaced Intraarticular Calcaneal Fractures
Hong Moon Sohn, Jun Young Lee, Sang Ho Ha, Sueng Hwan Jo
Journal of the Korean Fracture Society.2007; 20(3): 227. CrossRef

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PROPER SCREW LENGTH FOR FIXATION OF THE MEDIAL MALLEOLAR FRACTURE OF ANKLE: Dong Bae Shin, Soo Hong Han, Seung Soo Jeon; J Korean Soc Fract 2000;13(3):522-528. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.522

Abstract PDF: PURPOSE
There is rare report about screw length in ankle fracture in spite of the anatomical characteristic that distal densest area can give enough purchase of screw threads for fixation of medial malleolar fragment. Purpose of the current study is to evaluate the results of screw fixation and to estimate proper screw length in medial malleolar fracture.
MATERIALS AND METHODS
Authors retrospectively reviewed 136 cases of medial malleolar fracture which had been performed from Janurary 1985 to December 1997. The patients were divided into 3 groups according to screw length ; under 34mm screw length (9 cases), between 35mm and 45mm (76 cases), over 46mm (50 cases). Each group was evaluated bone union time, clinical outcomes and radiological results by Meyer and Kumler.
RESULTS
Good and excellent results were achieved 121 cases (89%) on clinical result and 125 cases (91.9%) on radiological result by Meyer criteria. There were no statistical differences between three group, but the 35mm-45mm screw length group showed slightly faster union tendency.
CONCLUSION
In the treatment of medial malleolar fracture, around 40mm length screw is sufficient for fixation and it doesn,t need to use the screw over 45mm length for more rigid fixation.

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Reamed versus Unreamed Intramedullary Nailing after External Fixator Application in the Treatment of Open Tibial-Shaft Fracture: Dong Bae Shin, Joon Cheol Choi, Young Soo Lee, Yong Jeng Kim, Soo Hong Han, Dong Eun Shin, Yeun Ho Lee; J Korean Soc Fract 1999;12(2):272-276. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.272

Abstract PDF: The authers reviewed 15 patients of open fracture of the tibial shaft who were treated by external fixation followed by intramedullary nailing. These fractures comprised two Type-I, two Type-II, four Type-IIIa, and seven Type-IIIb injuries. Ten patients were treated with unreamed intramedullary nailing and 5 patients were treated with reamed intramedullary nailing. The results were analyzed as followings: 1. All fractures had union at 5.2 months after intramedullary nailing and 4 true osteomyelitis were developed. 2. All osteomyelitis were developed for the patients who were treated with reamed intramedullary nailing. 3. There was no osteomyelitis who were treated with unreamed intramedullary nailing. 4. Delayed conversion to intramedullary nailing after control of pin tract infection had no effect for prevention of osteomyelitis.

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