Journal of Musculoskeletal Trauma

Soo Kyoon Rah

9 Articles

Treatment of Comminuted Subtrochanteric Fractures of the Femur with Compression Hip Screw: You Sung Suh, Suk Bum Lim, Hyung Suk Choi, Yon Il Kim, Soo Kyoon Rah, Byung Ill Lee; J Korean Soc Fract 2001;14(2):181-188. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.181

Abstract PDF: PURPOSE
This study was performed to analyze the weight-bearing ambulation time, bony union time and complications after fixation of comminuted subtrochanteric fractures of the femur with compression hip screw and evaluate its effectiveness. MATERIAL & METHODS: From January 1993 to January 2000, 21 cases of S e i n s h e i m e r's Type IV and Type V comminuted subtrochanteric fractures of femur which were treated by compression hip screw and followed for more than 1 year were analyzed by weight-bearing ambulation time, bony union time and complications.
RESULTS
We recommended partial weight bearing ambulation from 6 weeks after operation and full weight bearing ambulation from 12 weeks after operation. All of 21 cases, primary bony union was achieved and mean time was 16 weeks(range 13 to 25 weeks). 2 cases of mechanical complications were occurred. Also 4 cases of malunion of lesser trochanter and 2 cases of nonunion of lesser trochanter were occurred, but none of them result in limitation of motion, limping nor pain.
CONCLUSIONS
We thought compression hip screw is a good implant for rigid fixation of comminuted subtrochanteric fractures, especially involve intertrochanteric region like Seinsheimer's Type IV and Type V.

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Primary Causes and Treatment of Nonunion of the Humeral Shaft Fracture: Soo Kyoon Rah, Hoon Choi, You Sung Suh, Byung Ill Lee, Yon Il Kim; J Korean Soc Fract 2000;13(4):952-959. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.952

Abstract PDF: PURPOSE
An analysis of primary causes and treatment of the nonunion of humeral shaft fracture.
MATERIALS AND METHODS
Incidence of nonunion of humeral shaft fracture among the 183 cases was 10.4%. Among 19 cases of nonunion of humeral shaft fracture from March 1994 to December 1999, 14 cases were men and 11 cases were in third to fifth decade. The causes of the fracture were mainly due to motor vehicle accident and machinery injury. The most common site of nonunion in humeral shaft was at middle 1/3 in 10 cases.
RESULTS
Underlying causes of nonunion were complex ; 9 cases of inadequate plate internal fixation, 2 cases of infection, 6 cases of poor external immobilization and 7 cases of over distraction and soft tissue interposition. Bony union was obtained by compression plate, intra medullary nail, and external fixator with autogenous bone graft in 3.5months. Post-operative complications were radial nerve palsy in 4 cases and elbow and shoulder joint contracture in 6 cases.
CONCLUSIONS
The main factors that influence the development of humeral nonunions were over distraction of the fracture, inadequate internal fixation, and infection. We should consider that enough operative exposure, the proper choice of plate and screw depending on the bone contour and fracture site, adequate period of immobilization, and rigid fixation in internal plate fixation. It is also recommanded that interposed soft tissue be removed for anatomical reduction. Union was obtained in all cases .

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Bilateral Salter-Harris Type II Proximal Tibial Epiphtyseal Fracture: A Case: Byung Ill Lee, Hoon Choi, You Sung Suh, You Il Kim, Soo Kyoon Rah, Chang Uk Choi; J Korean Soc Fract 2000;13(2):252-257. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.252

Abstract PDF: An uncommon fracture of the proximal tibial epophysis can be classified into 5 types based in the mechanism of injury and the relationship of the fracture line to the physeal plate. The separation extends along the physeal plate and then through a portion of the metaphysis, Salter-Harris type II is the most common physeal fracture. We experienced a very rare case of bilateral flexion type Salter-Harris type II fracture of the proximal tibia, which was treated by long leg cast. At six weeks fusion is complete at the proximal tibial epiphyses of both knees, and the range of motion is full at follow-up six months

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Primary Bipolar Hemiarthroplasty for the Treatment of Unstable Intertrochanteric Fractures in Elderly Patients: You Sung Suh, Sung Tae Kim, Soo Jae Yim, Yon Il Kim, Soo Kyoon Rah, Chang Uk Choi; J Korean Soc Fract 2000;13(2):222-229. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.222

Abstract PDF

PURPOSE
: The purpose of this paper was to present the clinical and roentgenographic results were obtained with bipolar hemiarthroplasty as a primary treatment for comminuted unstable intertrochanteric fracture in elderly patients with severe osteoporosis. The goal of this treatment is early ambulation with early weight bearing to prevent the complications such as a deep vein thrombosis, pulmonary embolism, pneumonia or atelectasis, and pressure sore.
MATERIALS AND METHODS
: Twenty consecutive patients who were more than seventy years old with severe osteopotosis and had an comminuted unstable intertrochanteric fractures were treated by primary bipolar hemiarthtoplasty from January 1995 through January 1998 at the Department of Orthopaedic Surgery of Soonchunhyang University Hospital. If there were fractured at the lesser or the greater, a circlage wire or Dall-Miles system (trochanter cable grip system) was passed through the lesser and the greater trochnater to permit its subsequent fixation to the medial and the lateral side of the femoral component. The functional results were judged according to the hip rating scale of Merle d' Aubigne.
RESULTS
: The mean age at operation was 79.8(70 to 92) years old. The most common type according to the Evans classification system was I -d(10 cases, 50%). Singh index was case(5%) of Grade I , 7 cases(35%) of Grade II, 10 cases(50%) of Grade III and 2 cases(10%) of Grade IV. The mean bone mineral density(BMD) was -4.24(-6.95 - -3.17). The functional results in 75% of the patients were rated as excellent, very good, or good and in 25% as fair, poor, or bad.
CONCLUSION
: Primary bipolar hemiarthroplasty for the treatment of comminuted unstable intertrochanteric fractures in elderly patients with severe osteoporosis could return these patients to their pre-injury level of activity quickly, thus obviating the postoperative complications caused by immobilization.

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A STUDY OF PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY OF HIP IN ELDERLY PATIENTS WITH OSTEOPOROTIC, UNSTABLE INTERTROCHANTERIC FRACTURE
Maheshwar Lakkireddy, Radhakrishna Rapaka, Naveen Gouru, Shivaprasad Rapur
Journal of Evidence Based Medicine and Healthcare.2015; 2(35): 5447. CrossRef

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Checkrein deformity of the lesser toes following comminuted fracture of calcaneus : A Case Report: Hee Kwon, Dong Wook Kim, Dong Jin Kim, Chi Soo Sohn, Joon Min Song, Soo Kyoon Rah; J Korean Soc Fract 1998;11(4):806-810. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.806

Abstract PDF

Checkrein deformity of the great toe may occur after fracture of the distal third of tibia. It is due to adhesion of flexor hallucis longus muscle to callus. Charachteristic finding is shaply flexed great toe at ankle dorsiflexion and complete interphalangeal joint extension at ankle plantar flexion. We experienced a patient who had severe flexion deformity on the 2nd, 3rd, 4th toe and diagnosed as checkrein deformity of the lesser toes arised from calcaneal fracture. We can't find any report of checkrein deformity after fracture of calcaneus and we think this is very rare case. In operative field, we found fibrous contracture of quadratus plantae muscle which was adhered to flexor digitorum longus tendon. And we performed tenolysis, adhesiolysis and flexor digitorum longus tendon lengthening. 11 months after operation the patient showed excellent result with correction of the deformity.

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Dynamic Positional Deformity of the Hallux
Byung-Ki Cho, Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Ji-Kang Park, Jung-Wook Oh
The Journal of Foot and Ankle Surgery.2014; 53(6): 791. CrossRef
Checkrein Deformity by Incarcerated Posterior Tibial Tendon and Displaced Flexor Hallucis Longus Tendon following Ankle Dislocation - A Case Report -
Su-Young Bae, Hyung-Jin Chung, Man-Young Kim
Journal of the Korean Fracture Society.2011; 24(3): 271. CrossRef

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Swanson Prosthesis Replacement of the Comminuted Radial Head Fracture Associated with Posterior Dislocation of the Elbow: 3 Cases Experienced: Soo Kyoon Rah, Jin Il Kim, Chi Soo Sohn, Yon Il KIm, Chang Uk Choi; J Korean Soc Fract 1998;11(1):47-55. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.47

Abstract PDF: Radial head resection is the accepted treatment of comminuted radial head fractures in adults, but the results are not always satisfactory. a number of well-known problems can ensue. These include chronic elbow and wrist pain, limited of motion, cubitus valgus, proximal radial migration, and new bone formation at the site of excision. Prosthetic replacement of radial head after excision offers theoretical advantages in the prevention of these problems. We are reporting three cases of patients, who had treated Swanson silastic prosthesis after comminuted radial head fracture associated posterior dislocation of the elbow.

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Treatment of Femoral Neck Fractures in the Elderly Patients Aged over 60 years: Comparative Study between Osteosynthesis and Bipola Arthroplasty: You Sung Suh, Byung Woo Kim, Kyung Dae Min, Chi Soo Son, Soo Kyoon Rah, Chang Uk Choi; J Korean Soc Fract 1998;11(1):153-158. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.153

Abstract PDF: STUDY DESIGN: Seventy femoral neck fractures in the elderly patients aged over 60 years treated with osteosynthesis or primary biploar arthroplasty were assessed on complication and functional outcome at final follow up. OBJECTIVE: To compare the results of femoral neck fractures in the elderly patients aged over 60 years treated with osteosynthesis or primary bipolar arthroplasty retrospectively. To know the indications of each method. SUMMARY OF BACKGROUND DATA: Althrough the osteosynthesis method had preservation of hip joint, primary osteosynthesis method had possibility of major complications as nonunion and avascular necrosis of femoral head.
METHODS
Seventy patients with intra-articular femoral neck fracture were treated with osteosynthesis in 33 patients(group 1) and primary biploar arthroplasty in 37 patients(group 2). A comparartive analysis of age, sex, type of fracture, initial displacement of fracture, method of treatment, fixation device type, quality of reduction, operative time, blood loss at operation, complication and functional outcome at final follow up were performed.
RESULTS
The female was more three times than male. The mean ages were 70.1 years old in group 1 and 73.3 years old in group 2. In group 1, complications such as non-union and avascular necrosis of femoral head were significantly greater in the subcapital fractures and Garden's stage 3,4 than the transcapital fractures and Garden's stage 1,2. In operative method, blood loss and operative time were significantly greater in the group 2 than in the group 1. Seven major complications (avascular necrosis: 6 cases, non-union: 1 case) occurred in group 1, two major complications(death: 2 cases) occurred in group 2. The functional outcomes were superior to the group 2, but it may be due to high complication rates in group 1.
CONCLUSIONS
This study suggests that the important factors that influenced the clinical results were type of fracture, initial displacement of fracture, quality of reduction. So in relatively poor arthroplasty.

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Metal Failure after Plate Fixation for Femur Fracture: Hee Kwon, Dong Wook Kim, Chi Soo Sohn, Seung Ryeol Yoon, Joon Min Song, Soo Kyoon Rah, Chang Uk Choi; J Korean Soc Fract 1997;10(2):371-378. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.371

Abstract PDF

From January 1991 to August 1996, we experienced 17 cases of metal failure among 150 cases of plate fixation of femur fracture. We analyzed the cases and obtained the following results: 1. Among 17 cases, 15 cases were closed fracture and 2 cases were open fracture. In 11 cases, the fractures were located on the midshaft of femur and most of them was segmental or comminuted. According to AO classification, 14 cases(82%) were type B(B1:1, B2:4) and C(C1:7, C3:2). 2. The interval between initial operation and metal failure was 8 months on average. 3. The cause of metal failure were bone defect remaining after initial operation, fragment necrosis due to periosteal denuding of large free bone fragments, early weight bearing, selection of inappropriate implants and improper operation technique. 4. Plate breakages were occured in 11 cases and screw fractures and screw loosening in 6 cases. Most of plate breakage was due to remaining bone defects, and most of screw fractures and loosening was due to inappropriate implants and improper operation techinque. In conclusion, accurate preoperative evaluation on the fracture site, fracture pattern and appropriate selection of internal fixative are important for proper bone healing. Based upon our result, we suggest semiopen technique with minimal soft tissue injury and initial early bone graft for bone defect.

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The Surgical Treatment of Distal Femur Medial Condyle Fracture Using Lateral Anatomical Plate of Opposite Side through Medial Approach
Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Kwang-Hee Park, Yoon-Ho Choi
Journal of the Korean Fracture Society.2009; 22(4): 246. CrossRef

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Comparison between Transolecranon Approach and Posterior Approach in Comminuted Intercondylar Fracture of the Distal Humerus: Soo Kyoon Rah, Sang Ki Kim, Joong Geun Choi, Yon Il Kim, Chang Uk Choi; J Korean Soc Fract 1996;9(4):1069-1075. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1069

Abstract PDF

The comminuted iniercondyiar fractvre of the distal humeruf is rather uncommon injury. Because of anatomic complexity of the distal humerus, any incongrousness makes loss of function of the elbow joint. Hence, for the complete restoration of the articular surface and joint nlotion, wide exposure is necessary, while stable internal fixation and early post operative exercise should be conducted. With the frefuency of comminution and displacement, this intraarticular fracture is difficult to treat. But the fabrication of new implants and development of surgical approach method has increased the reliability of operative stabilization. The authors compared 36 patients of distal humeral fracture treated with transolecranon approach and Campbells posterior approach at the Department of Orthopaedic Surgery. College of Medicine, Soonchunhyang University from Dec. 1991 to Oct. 1994 and following results were obtained. In transolecranon approach, the operation time was slightly longer with technical difficulties. However, we had excellent exposure of posterior aspect of lower end of the humerus and had a good range of motion, especially in flexion contracture compared with posterior approach. Also, we hardly observed complications of fracture of the olecranon in transolecranon approach.

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Clinical Outcome of Surgical Treatment for Intra-articular Distal Humerus Fracture
Myung Jin Lee, Hyeon Jun Kim, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Chul Hong Kim, Lib Wang, Hyun Woo Sung
Journal of the Korean Fracture Society.2010; 23(2): 201. CrossRef

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