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Radiologic Analysis and Treatment of Posterior Malleolar Fractures of the Ankle
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Jae Sung Lee, Soo Yong Kang, Han Jun Lee, Young Bong Ko
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J Korean Fract Soc 2009;22(2):98-103. Published online April 30, 2009
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DOI: https://doi.org/10.12671/jkfs.2009.22.2.98
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The purpose of this study was to classify posterior malleolar fractures according to the position of fragments and to analyze radiologic features of each type. MATERIALS AND METHODS We analyzed forty-six patients of ankle fractures involving a posterior malleolus who were treated between January 2004 and December 2007. The posterior malleolar fractures were categorized into three types (posterolateral, posteromedial, shell) based on the major fracture line. In each type, we analyzed amount of displacement, involvement of articular surface, existence of subluxation and osteochondral impacted fragments. RESULTS The forty-six patients were categorized into three types: Posterolateral (PL) type (33 cases, 72%), Posteromedial (PM) type (8 cases, 17%), shell type (5 cases, 11%). Of the 8 cases with PM type, 7 cases showed displacement more than Grade II, 4 cases showed subluxation of ankle joint, and 3 cases showed osteochondral impacted fragment. Average involvement of articular surface of PM type is 35% (15~65%). CONCLUSION Posterior malleolar fractures with medial extension tended to have adverse effect on ankle stability and Preoperative CT scan is essential for evaluation of fracture type and determination of appropriate surgical approach.
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Citations
Citations to this article as recorded by 
- Treatment of Isolated Posterior Malleolus Fracture in the Ankle
Ji Hoon Kim, Seong Mu Cha, Dae Yeon Jo, Jin Soo Suh Journal of the Korean Orthopaedic Association.2014; 49(1): 29. CrossRef
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Nonunion with a Bony Defect of the Humerus: Treatment by Shortening
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Jae Sung Lee, Soo Yong Kang, Jae Hyun Yoo
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J Korean Fract Soc 2008;21(1):45-50. Published online January 31, 2008
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DOI: https://doi.org/10.12671/jkfs.2008.21.1.45
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To evaluate clinical results and advantage of interposition and shortening technique for the treatment of the humeral nonunion with bone defect. MATERIALS AND METHODS Eight patients with the humeral nonunion with bone defect underwent interposition of fragments and shortening had been followed-up for more than one year (mean 70 months, 16~156). There were 4 men and 4 women with a mean age of 60.5 years (range, 48 to 75 years). There included 3 proximal, 3 diaphysis and 2 distal metaphysis according to the site, mean size of the bone defect was 3.3 cm (2~5). The time to union, discrepancy of upper extremity, functional results, cosmetic satisfaction and postoperative complications were assessed. RESULTS All patients achieved to bone union, average union time was 10.2 weeks (range 8~14). Average limb discrepancy was 2.3 cm. All had improvement in shoulder and elbow motion after operation. Seven patients were satisfied with the cosmetic result and none had functional deficit due to limb discrepancy. CONCLUSION Treatment by Interposition of fragments and shortening in the intractable nonunion of humerus with a bony defect can achieve not only good functional result, shortened bone union time and improved in shoulder and elbow motion.
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Anatomical Assessment of the Proper Insertion Site for a Tibial Nailing
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Soo Yong Kang, Eun Woo Lee, Ki Ser Kang, Han Jun Lee, Ho Joong Jung, Pyeong Ho Jeong
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J Korean Fract Soc 2004;17(2):142-147. Published online April 30, 2004
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DOI: https://doi.org/10.12671/jkfs.2004.17.2.142
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To investigate the proper insertion site for a tibial intramedullary nail in the Korean. MATERIALS AND METHODS Forty volunteers without trauma below knee joint were studied to determine relationship between central axis of medullary canal and lateral tibial spine, patellar tendon and the proper insertion site, and to evaluation changes of proper insertion site during rotation of knee and effective diameter. RESULTS The proper insertion site located average 4.3+/-0.9 mm medial to the lateral tibial spine. The proper insertion site was in the medial 1/3 of patellar tendon in 6 knees, middle 1/3 of patellar tendon in 20 knees, and lateral 1/3 of patellar tendon in 14 knees. The proper insertion site might be changed two times in internal rotation more than in external rotation. The effective diameter was more narrow in medial slope than in lateral slope at proximal tibia. CONCLUSION The study indicates the ideal insertion site of tibial nail is the medial aspect of the lateral tibial spine in Korean. To reduce the mal-reduction from a improper insertion site, lateral insertion site might be safer than medial one. However, individual variations in the relationship between the patellar tendon and tibial medullary canal should be considered.
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Citations
Citations to this article as recorded by 
- Three-dimensional analysis of the intramedullary canal axis of tibia: clinical relevance to tibia intramedullary nailing
Sang Jun Song, B. O. Jeong Archives of Orthopaedic and Trauma Surgery.2010; 130(7): 903. CrossRef - Three Dimensional Analysis for the Intramedullary Canal Axis of the Proximal Tibia: Clinical Relevance to Total Knee Arthroplasty
Sang Jun Song, Choong Hyeok Choi The Journal of the Korean Orthopaedic Association.2007; 42(3): 345. CrossRef
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Surgical Treatment of Displaced Intra-articular Fracture of the Calcaneus using a Y-plate
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Han Jun Lee, Soo Yong Kang, Jong Won Kim
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J Korean Soc Fract 2002;15(4):433-438. Published online October 31, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.4.433
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To investigate the results of surgical treatment of displaced intra-articular fracture of the calcaneus using a Y-plate. MATERIALS AND METHOD We have studied 22 patients who underwent surgical treatment of displaced intra-articular fracture of the calcaneus in our hospital from March, 1998 to August, 2000. The fractures were identified according to Eastwood classification, there were 8 cases of type I, 10 cases of type II and 4 cases of type III. The axial and Bohler angle of lateral views were compared preoperative and postoperative period. Functional evaluation was measured by Carr 's method. RESULT The average Bohler angle before the operation was 5 degrees and after the operation it has been up to 28 degrees. In functional evaluation, 3 cases were excellent, 15 cases were good, and 4 cases were fair. CONCLUSION Fixation using a Y-plate can be used easily for restoration of anatomical dimension of the calcaneus in the operative treatment of displaced intra-articular fracture. It could be helpful for firmer fixation of the posterior facet.
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Citations
Citations to this article as recorded by 
- Joint-Sparing Surgical Management of Sanders IV Displaced Intra-Articular Calcaneal Fractures
Thomas S. Roukis Clinics in Podiatric Medicine and Surgery.2019; 36(2): 251. CrossRef - Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef - Treatment of Displaced Intra-articular Calcaneal Fractures Using a F-plate
Kyu Hyun Yang, Jae Bong Chung, Han Kook Yoon, Si Young Park, Hang Seob Yoon Journal of the Korean Fracture Society.2007; 20(1): 1. CrossRef
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Treatment of Transolecranon Fracture-Dislocation of the Elbow
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Soo Yong Kang, Han Jun Lee, Jung Nam Han, Kyoung Hwan Kim
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J Korean Soc Fract 2001;14(1):99-105. Published online January 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.1.99
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We conducted this study to discriminate transolecranon fracture-dislocation of the elbow from the anterior Monteggia lesion and to validate the differences of method of treatment. MATERIALS AND METHOD From March, 1998 to May, 1999, 3 cases of the transolecranon fracture-dislocation of the elbow were treated by open reduction and internal fixation.One of the three patients had simple oblique fracture of the olecranon combined with capitellum fracture and two had complex comminuted fracture of the olecranon. Functional outcome was assessed with elbow performance rating system of Broberg and Morrey. RESULTS At a minimum follow-up of 12 months, overall outcome was rated as exellent in two patients, fair in one. Average bone union peoriod was three months. CONCLUSION Stable restoration of the accurate contour and dimension of the trochlear notch of the olecranon and early ROM exercise will lead to good result in transolecranon fracture-dislocation cases.
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A Prospective Study of Fractures of the Tibial Shaft Treated with Intramedullary Interlocking Nail : Comparing One versus Two Distal Screws
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Eun Woo Lee, Ki Ser Kang, Soo Yong Kang, Eui Chan Jang, Jin Woo Lee
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J Korean Soc Fract 1997;10(2):303-308. Published online April 30, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.2.303
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- In non-randomized prospective study, 67 tibial fractures were treated with intramedullary inter-locking nail. Patients were divided into 2 groups based on the number of distal locking screw. Group I was consisted of 33 fractures treated with one distal locking screw Group II was consisted of 34 fractures treated with two distal locking screws. The patients were followed up for an average of 12 months. There was no statistically significant difference between group I and II with regard to total operation time, fracture union time. However fluoroscopic time was significantly longer at group II than group I. Serial radiographs of patients in both group were analyzed for change of hardware and fracture healing postoperatively. No significant difference was found between two groups in fracture union time, hardware failure and complications in proximal and middle tibial fracture. But the angulation and locking screw breakage were significant in group I in distal tibia fracture. We concluded that fracture of the proximal and middle third of the tibia that require interlocking nail can be successfully treated with a single distal locking screw. However, in fractures of the distal one third, two distal locking screws should be required to prevent of angular deformity in sagittal plane and for stablefixaton. The use of a single distal locking screw reduces operation time, radiation exposure, local soft tissue discomfort and cost without compromizing fracture union.
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Thirty-five Degree Internal Oblique Radiographs in Assessment of Tibial Fracture Healing
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Eun Woo Lee, Ki Ser Kang, Soo Yong Kang, Jin Woo Lee
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J Korean Soc Fract 1996;9(2):475-479. Published online April 30, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.2.475
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- For the assessment of fracture healing, tomogram, computerized sonometry, resonant frequency analysis etc. were introduced recently, but most of orthopedic surgeons depend on plain X-ray and clinical experience. The progress of tibial fracture healing may be difficult to assess through routine radiological examination(AP and lateral).
So, we intended to assess the healing of tibial fracture with 35° internal oblique view as well as AP and lateral. Five orthopedic surgeons assested the tibial fracture heating with only AP and lateral (group 1), and AP. lateral and 35° internal oblique view(group 2) in 45 tibial fractures. In the percent agreement of their assessment, Group 1 was 60% and group 2 was 76%. Group 2 was higher than group 1, especially in IM nailing and bone graft groups.The change of judgement between the two group was 18.7%, and it was higher in the distal tibial fracture, posterolateral bone graft and external device groups. In 11 Cases, the fibular fractures were overlapped with tibiai fracture in laterai view, in which cases 35° intelnal oblique view was useful for assessing the tibial fracture healing. We recommand 35° internal oblique view for assessment of tibial fracture healing before using more tophisticated and expensive procedure, especialiy in patients with posterolateral bone graft, distal libial fracture and combined fibular fracture, and probably in IM nailing and external device.
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External Fixation and Limited Internal Fixation in AO Type C Pilon Fracture: Report of Five Cases
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Eun Woo Lee, Soo Yong Kang, Il Seok Kim
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J Korean Soc Fract 1995;8(1):243-247. Published online January 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.1.243
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- Techniaue of biologic fixation and external fifation are playing an crucial role in the management of the severe comminuted fracture with soft tissue injuries.
To evaluate the treatment of severe pilon fracture by a conbination internal and external fixation, five high Pilon fractures with open or severs soft tissue injries were treated by a medial external fixator with an articulated ankle hinge(EBI) and limited internal flxation. Two AO C2 fractures and three AO C3 fractures were followed for a minimum of 1 year. All fractures united and had good functional results without any serious complication.
We believe that external fixation and limited internal fixation using biologic principle is an excellent alternative method in high energy, complex fracture with diaphyseal comminution.
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