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The Pattern of Occurrence of Fractures in Children and Adolescents and Its Managements Based on the Database of the Health Insurance Review and Assessment Service
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Yong Wook Kwon, Soon Hyuck Lee, Hyun Woo Kim, Jin Ho Hwang
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J Korean Fract Soc 2014;27(4):308-314. Published online October 31, 2014
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DOI: https://doi.org/10.12671/jkfs.2014.27.4.308
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The purpose of this article is to report on the pattern of medical process and relative frequencies of fractures in children and adolescents. MATERIALS AND METHODS The authors retrospectively analyzed the database of the health insurance review and assessment service regarding children and adolescents under 20 years old treated from 2008 to 2010. Newly registered numbers of fractures in children and adolescents according to sex, month, institution, and anatomical location were also reviewed. RESULTS A total of 1,893,416 fractures occurred during three years; approximately 630,000 cases were treated during one year (approximately 562 cases among 10,000 people during one year). During one year, the most fractures occurred in June and the least in February. Senior general hospital consisted of 5.72%, 12.30% in general hospital, 19.28% in hospital, and 62.70% in clinics. Among the fracture sites, 0.05% were cervical fractures, 0.91% in sternum and thoracic vertebra, 1.35% in lumbar vertebra and pelvis, 12.79% in shoulder and upper extremities, 26.87% in lower extremities, 38.10% in wrist and hand, 1.01% in femur, 10.40% in lower extremities including ankle, and 8.52% in foot excluding ankle. The maximal incidence was age 14 years in male and 12 years in female. CONCLUSION The authors reviewed the pattern of medical process and relative frequencies of fractures in children and adolescents.
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- Analysis of Computed Tomography Scans for Radiation Safety Management in the Republic of Korea
Min Young Lee, Ji Woo Kim, Ga Eun Oh, Geon Woo Son, Kwang Pyo Kim Journal of Radiation Protection and Research.2024; 49(3): 141. CrossRef
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Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating
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In Jung Chae, Sang Won Park, Soon Hyuck Lee, Won Noh, Ho Joong Kim, Seung Beom Hahn
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J Korean Fract Soc 2009;22(4):252-258. Published online October 31, 2009
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DOI: https://doi.org/10.12671/jkfs.2009.22.4.252
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To evaluate the radiologic and clinical results of treatment of the Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual incision approach and dual plating. MATERIALS AND METHODS: Twelve cases in eleven patients of Shatzker type 6 tibia plateau fracture which has been treated using the lateral and posteromedial dual incision approach and dual plating were analyzed with an average follow-up of 16 months. Times to union, alignment and reduction loss on radiograph and postoperative clinical outcome with checking the range of motion of the knee joint, Knee Society Score and UCLA activity scale were analyzed and evaluated. RESULTS: In all cases, bony union was obtained in an average fifteen weeks after the operation, and there was no reduction loss. The arc of motion of the knee joint at the latest follow-up was 132 degrees on average. Average of Knee Society Score was 85 and UCLA activity scale was decreased from 9.6 points preoperatively to 5.7 points postoperatively. CONCLUSION: The treatment of Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual approach and dual plating have shown clinically preferable results of excellent recovery of joint motion and good knee society score by early range of motion exercise after firm fixation. However, it was high energy injury, so the sports activity of patients was significantly decreased.
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- Staged Treatment of Bicondylar Tibial Plateau Fracture (Schatzker Type V or VI) Using Temporary External Fixator: Correlation between Clinical and Radiological Outcomes
Seung Min Ryu, Han Seok Yang, Oog Jin Shon Knee Surgery and Related Research.2018; 30(3): 261. CrossRef - Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures
Jae-Ang Sim, Kwang-Hui Kim, Yong-Seuk Lee, Sang-Jin Lee, Beom-Koo Lee Journal of the Korean Orthopaedic Association.2014; 49(4): 278. CrossRef - Current Concepts in Management of Tibia Plateau Fracture
Sang Hak Lee, Kang-Il Kim Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef
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Treatment of Choice in the Surgical Management of the Femoral Shaft Fractures in Children: Elastic Intramedullary Nailing
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Soon Hyuck Lee, Won Noh
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J Korean Fract Soc 2008;21(2):176-179. Published online April 30, 2008
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DOI: https://doi.org/10.12671/jkfs.2008.21.2.176
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- No abstract available.
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- Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent
Kun-Bo Park, Hoon Park, Hyun-Woo Kim, Hui-Wan Park, Jae Young Roh Journal of the Korean Fracture Society.2010; 23(2): 206. CrossRef
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Bipolar Hemiarthroplasty for the Femoral Neck Fractures in Elderly Patients
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Woong Kyo Jeong, Sang Won Park, Soon Hyuck Lee, Jong Hoon Park, Suk Ha Lee, Ji Hoon Kang, Gi Won Choi, Won Noh
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J Korean Fract Soc 2008;21(1):8-12. Published online January 31, 2008
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DOI: https://doi.org/10.12671/jkfs.2008.21.1.8
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To evaluate the clinical results of bipolar hemiarthroplasty in elderly patients more than 65 years of age with a femoral neck fracture. MATERIALS AND METHODS Forty-six bipolar hemiarthroplasties in 43 patients more than 65 years of age which could be followed more than 3 years were included in this study. The clinical outcomes were evaluated using Harris hip score, pain score and support score. The radiological results were analyzed by femoral stem loosening and bipolar cup migration. RESULTS The average Harris hip score was 88.7 (62~96) points. An excellent score was recorded in 34 cases, good in 7 cases, fair in 3 cases and poor in 2 cases. The average pain score was 39.3 points and there were no pain in 20 cases, slight pain in 17 cases, mild pain in 6 cases and moderate pain in 2 cases. The average support score was 9.6 points and 32 patients could walk without the use of any assistive devices. Two cases were converted to total hip arthroplasty due to femoral stem loosening with or without bipolar cup migration. CONCLUSION For the early ambulation and functional recovery of elderly patients with femoral neck fracture, bipolar hemiarthroplasty was considered as one of recommendable methods.
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Treatment of Displaced Supracondylar Fracture of the Humerus in Children
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Soon Hyuck Lee, Sang Won Park, Woong Kyo Jeong, Dae Hee Lee, Soon Yong Yoo
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J Korean Fract Soc 2006;19(4):460-465. Published online October 31, 2006
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DOI: https://doi.org/10.12671/jkfs.2006.19.4.460
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To evaluate the radiological and clinical outcomes after operative treatment of displaced supracondylar fractures in children with lateral K-wire fixation. MATERIALS AND METHODS 69 displaced supracondylar fractures treated by closed reduction and percutaneous lateral K-wire fixation were included in this study. Carrying angle and range of motion were measured and graded by the Flynn criteria. To assess the accuracy of the reduction, Baumann angle and lateral humerocapital angles were compared to the contralateral side, and to evaluate the stability of fixation both measurements were taken immediately postoperatively and after K-wire removal. RESULTS 55 cases (80%) were categorized as excellent and 12 cases (17%) as good. There were no significant statistical differences in Baumann angle and lateral humerocapital angle between postoperative and K-wire removal. Although there were 9 cases that showed differences in Baumann angle and 32 cases in lateral humerocapital angle of more than 10 degrees compared to the opposite side at the immediate postoperative radiograph, 9 cases showed satisfactory clinical results. CONCLUSION Closed reduction and lateral K-wire fixation is considered as an acceptable modality of the treatment of displaced supracondylar fractures in children, and clinical outcome is more closely correlated with carrying angle and stability of fracture site rather than rotational deformity or hyperextension of fragment measured radiographically.
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Minimal Invasive Plate Osteosynthesis for Distal Femoral Fracture
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Seung Beom Han, In Chung Choi, Soon Hyuck Lee, Dong Hoon Suh, Hyung Joon Cho
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J Korean Fract Soc 2006;19(1):11-16. Published online January 31, 2006
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DOI: https://doi.org/10.12671/jkfs.2006.19.1.11
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To evaluate the clinical and radiologic results of minimally invasive plate osteosynthesis, We analyzed the cases of distal femoral fracture treated with this newly developed surgical technique. MATERIALS AND METHODS We reviewed 12 cases of distal femoral fracture which had been treated with minimally invasive plate osteosynthesis and each patients had been followed up for a minimum twelve months. Post-operative function was evaluated with checking the range of motion of knee joint and Knee Society Score. Union period and post-operative alignment was measured on radiograph. RESULTS In all cases, bony union was obtained in average fifteen weeks after operation without bone graft. The arc of motion of knee joint which was checked at the last follow up was 123.75 degrees on average. According to Knee Society Score, there were 9 excellent, 1 fair and 1 poor results. The post-operative complications were malunion in 1 case, soft tissue infection in 1 case and joint stiffness in 1 case. CONCLUSION The treatment of distal femoral fracture with minimally invasive plate osteosynthesis is one of the good surgical options for clinically preferable results with high union rate without bone graft and early joint motion.
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- Surgical Treatment of AO/OTA 33-C Intra-Articular Distal Femoral Fractures through Parapatellar Approach
Suk Kyu Choo, Sung Tan Cho, Hyoung Keun Oh Journal of the Korean Fracture Society.2022; 35(1): 1. CrossRef - Minimally Invasive Plate Osteosynthesis for Femoral Mid-Diaphyseal Fractures
Hyoung-Keun Oh, Suk-Kyoo Choo, Jong-In Kim, Sung-Jong Woo Journal of the Korean Fracture Society.2013; 26(2): 140. CrossRef - Minimally Invasive Plate Osteosynthesis with Locking Compression Plate for Distal Femur Fracture
Sung Won Cho, Sang Ho Ha, Gwang Chul Lee, Woong Hee Kim Journal of the Korean Fracture Society.2013; 26(3): 205. CrossRef - Treatment of Distal Femur Fracture with Minimally Invasive Locking Compression Plate Osteosynthesis
Ki-Chul Park, Kyu-Sung Chung, Joon-Ki Moon Journal of the Korean Fracture Society.2012; 25(1): 13. CrossRef
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The Treatment of Unstable Intertrochanteric Fractures with Dynamic Hip Screw and Trochanter Stabilizing Plate
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Sang Won Park, Soon Hyuck Lee, Dae Hee Lee, Jong Won Chung, Gi Won Choi
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J Korean Fract Soc 2005;18(4):359-363. Published online October 31, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.4.359
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To analyze the effect of treatment of unstable intertrochanteric fractures with dynamic hip screw and additional trochanter stabilizing plate. MATERIALS AND METHODS Among twenty three cases of unstable intertrochanteric fractures treated with DHS and additional TSP between January 2002 to December 2004, seventeen cases over sixty years old were reviewed with minimal follow up of one year. We analyzed the type of fracture by AO classification, the age of patient, sex, the cause of trauma in seventeen cases. We evaluated the lag screw slippage, the change of neck-shaft angle and lateral displacement of greater trochanter, the period of union by comparison of last follow up radiographs with immediate postoperative radiographs. The fixation failure is defined that displacement of lag screw tip is more than 3 mm or cut out of the screw from the femoral head. RESULTS The period of union was average 12.8 weeks. The lag screw slippage was average 8.22 mm. The change of neck-shaft angle was average 2.66 degree. No lateralization of greater trochanter was noted in twelve cases, but five cases showed average 0.8 mm (range: 0.5~1 mm) of lateral displacement of greater trochanter. There was not fixation failure. CONCLUSION In unstable intertrochanteric fracture, the addition of a TSP to the dynamic hip screw can decrease a change of neck shaft angle, a lag screw slippage, and prevent lateral displacement of greater trochanter.
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- Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation
Ui Seoung Yoon, Jin Soo Kim, Jae Sung Seo, Jong Pil Yoon, Seung Yub Baek Journal of the Korean Fracture Society.2010; 23(3): 270. CrossRef
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Remodelling of Angular Deformity in Birth-Associated Femoral Shaft Fracture
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Soon Hyuck Lee, Sung Tae Lee, In Rok Yoo, Seoung Joon Lee
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J Korean Fract Soc 2005;18(3):330-334. Published online July 31, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.3.330
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To find out the process of bone remodelling and risk factors in birth-associated femoral fracture. MATERIALS AND METHOD We evaluated the four femoral fractures in three neonates about the obstetric and family history, and measured the angulation at the fracture site and the angle between the proximal and distal epiphysis of the femur on the radiographies taken at regular intervals. RESULTS The incidence of birth-associated femoral fracture was 0.06%. In two cases, fracture angulation and interepiphyseal angle had been decreased. However the angular deformity was worsened in two cases, but the interepiphyseal angle had been decreased regardless to the change of fracture angulation. So the alignment of epiphyseal plate came to normal alignment of joint surface. CONCLUSION The underlying disorder should be searched, because of its rarity. The physeal reorientation that makes joint alignment near normal irrespective of amount of angular deformity is assumed as the predominant mechanism in remodelling process of the angular deformity.
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Fixation Failure of Unstable Intertrochanteric Fracture of the Femur Using Compression Hip Screw
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Sang Won Park, Soon Hyuck Lee, Jong Ryoon Baek, Sung Jun Park, Jong Won Chung
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J Korean Fract Soc 2005;18(1):1-5. Published online January 31, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.1.1
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To investigate the factors which influence on the fixation failure after the compression hip screw fixation for unstable intertrochanteric fractures. MATERIALS AND METHODS Eighty-two patients of unstable intertrochanteric fracture of A2 and A3 type who had underwent operation with compression hip screw were evaluated at least 1 year follow-up in regard to the age, degree of osteoporosis, fracture type, diastasis of fragment, sliding of lag screw, position of lag screw and status of reduction. RESULTS 73 patients out of 82 patients had the union and 9 patients showed fixation failure. The results of fixation failure were 6 cases of migration of lag screw and 3 cases of cut-out of lag screw. There were statistically significant correlations between fixation failure and A2.3 and A3 type. The fixation failure group showed increased medial migration of medial cortex of proximal and distal fragment, which is significantly correlated with fixation failure. There were little statistical significant correlations between age, degree of osteoporosis, status of reduction, position of lag screw, sliding of lag screw and fixation failure. CONCLUSION Another alternative fixation method and technique have to be considered for unstable A2-3 or A3 type because compression hip screw fixation only is very insufficient with high failure rate.
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Displaced Supracondylar Fractures of the Humerus in Children Treated by Percutaneous Lateral K-wire Pinning
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Soon Hyuck Lee, Sang Won Park, Kwang Suk Lee, Jong Ryoon Baek, Sang Won Lee
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J Korean Soc Fract 2003;16(3):392-398. Published online July 31, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.3.392
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For the treatment of displaced children supracondylar fractures, closed reduction and lateral pinning were performed consecutively and their results were analyzed. MATERIALS AND METHODS During the period from January 1997 to May 2001, all children with displaced supracondylar fractures of the humerus were treated by closed reduction and lateral K-wire pinning. Among them, 44 fractures with more than 1 year follow up were selected. Carrying angle and range of motion were measured. Baumann angle and lateral humerocapital angles were measured from the anteroposterior and lateral radiograph 3 times (immediate post op, K-wire removal, last follow up). RESULTS Results were graded according to the criteria of Flynn et al. using both cosmetic and functional evaluation. According to the cosmetic factor, 36 cases (82%) were excellent and 8 cases (18%) were good. According to the functional factor, 39 cases (88%) were excellent and 5 cases (12%) were good. No statiscally significant differences, as seen on Baumann and humerocapital angle, between immediate post operative films and films taken at the time of K-wire removal (p=0.082, p=0.27). There was no significant differences in Baumann and humerocapital angle at the time of K-wire removal and last follow up (p=0.19, p=0.27). CONCLUSION Closed reduction and lateral K-wire pinning is considered as an acceptable modality of the treatment of displaced children supracondylar fractures.
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- Treatment of displaced supracondylar fractures of the humerus in children by a pin leverage technique
H.-Y. Lee, S.-J. Kim The Journal of Bone and Joint Surgery. British volume.2007; 89-B(5): 646. CrossRef
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Analysis of Elbow Injuries 'pattern in Children
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Soon Hyuck Lee, Jong Woong Park, Sang Won Park, Kwang Suk Lee, Dang Jae Im, Tae Ha Kim, Sang Won Lee
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J Korean Soc Fract 2003;16(1):98-103. Published online January 31, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.1.98
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The purpose of this report is to describe the pattern of elbow injuries and the incidence of the different fracture types in children. MATERIALS AND METHODS The records of 445 in-patient children treated for the elbow injuries for 5 years were reviewed and analyzed statistically. RESULTS The average age of 445 children was 6.7 years. The average age of boys(6.9 years) was about 1 year older than girls(5.9 years). The age group of 4 - 7 years is the majority(50%), followed by the age group of 8 - 11 years(22%). The boy to girl ratio was approximately 2:1. The male predominance changed with the age and appeared dramatically in the age group of 12-16 years( 6.7:1 ). Left elbow was injured more frequently(60%). Left side predominance was accentuated in girls compared to boys(69% vs 55%), especially in the age group of 8 - 16 years (80% vs 50%). Thirty percent of the fractures occurred during the summer, followed by 27% the autumn, 26% the spring months and 17% the winter. The most common fracture was the supracondylar fractures of the humerus(52.3%), followed by lateral condylar fractures(25.4%), olecranon fractures(5.3%), radial head fractures(4.8%), medial epicondyle fractures(4.6%), transphyseal fractures(2.8%) and Monteggia fractures(2.2%). Medial condylar fractures(1.1%) and elbow dislocation(0.8%) were rare injuries. The average age was higher in radial head fracture(10.6 years) and medial epicondylar fracture(12.4years). Closed reduction and percutaneous pinning was the method of treatment in more than half(52%). Open reduction was performed in 32%. Sixteen percent was treated by closed reduction and cast immobilization. CONCLUSION The incidence and pattern of elbow injuries in children, which needed operative treatment in the majority, occured closely correlated with the amount of injury prone play and the pattern of behavior during the causative accidents.
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The Effectiveness of Bone Scintigraphy of Femur neck fracture
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Sang Won Park, Seung Beom Han, Soon Hyuck Lee, Woong Kyo Chung, Seung Yong Wang
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J Korean Soc Fract 2001;14(3):323-330. Published online July 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.3.323
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To evaluate the effectiveness of bone scintigraphy using 99mTc-methylene diphosphonate(99mTc-MDP) for prediction of viability of femoral head in femur neck fracture that have been treated with osteosynthesis. MATERIALS AND METHOD Thirty two patients were included in this study who underwent preoperative and postoperative bone scintigraphy using 99mTc-MDP following femur neck fracture. The uptake of istope was estimated visually as either normal or reduced compared with the opposite side. The complications as avascular necrosis and non-union were checked and compared with the preoperative and postoperative bone scintigraphy and the predictive values of positive and negative scintigraphy were calculated. RESULTS Among thirty-two patients, bone union occured in nineteen patients except 12 avascular necrosis and 1 non-union. Average bone union peried was 4.4 months and 50% was occured between 3 and 6 months. In seventeen patients who showed reduced isotope uptake, twelve patients developed complications and predictive value of positive scintigraphy was calculated as 0.76. In fifteen patients shown normal isotope uptake, none developed complications and predictive value of negative scintigraphy was calculated as 1.00. CONCLUSION Preoperative bone scintigraphy using 99mTc-MDP was useful method to evaluate the viability of femoral head following femur neck fracture and to choose the treatment modality of displaced femur neck fracture especially in elderly person.
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- Bipolar Hemiarthroplasty for the Femoral Neck Fractures in Elderly Patients
Woong-Kyo Jeong, Sang-Won Park, Soon-Hyuck Lee, Jong-Hoon Park, Suk-Ha Lee, Ji-Hoon Kang, Gi-Won Choi, Won Noh Journal of the Korean Fracture Society.2008; 21(1): 8. CrossRef
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A Clinical Analysis of Treatment of the Fracture of the Proximal Humerus
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Sang Won Park, Soon Hyuck Lee, Seung Bum Han, Byung Taek Lee
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J Korean Soc Fract 2000;13(2):397-405. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.397
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: Fracture of proximal humerus is adjacent to shoulder joint which has an almost global range of motion, thus respond satisfactorily to conservative treatment, but displaced fracture needs accurate diagnosis and proper treatment. We analyzed the type of treatments and results of proximal humeral fractures MATERIALS AND METHODS : Fifty nine cases of fractures of the proximal humerus which were treated from January 1992 to February 1998 were analyzed according to Neer's classification. RESULTS : Among the 59 cases, 26 cases were treated conservatively, 19 cases(73.1%) had excellent or satisfactory results and 33 cases were treated operatively, 23 cases(69.7%) had excellent or satisfactory results. All one-part fractures(6 cases) were treated conservatively and had excellent or satisfactory results. but in three-part fracture(17 cases), 3 cases(42.8%) who were treated conservatively and 7 cases(70.0%) who were treated operatively had excellent or satisfactory results and no significant difference was shown according to method of operation All four-part fractures(3 cases) were treated operatively, and only 1 cases(33.3%) had satisfactory results. CONCLUSION : We can treat conservatively or operatively in one-part or two-part fractures but consider the percutaneous pin fixation or minimal soft tissue dissection in three-part fractures.
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Treatment of the Femur Shaft Fractures using Interlocking Nail
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Jong Keon Oh, Soon Hyuck Lee, Seung Woo Suh, Young Soo Byun
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J Korean Soc Fract 1997;10(2):289-294. Published online April 30, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.2.289
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- A series of forty patients who had forty femoral shaft fractures that were treated with static interlocking nailing were analyzed to determine the incidence of union of the fracture without planed conversion from static to dynamic intramedullary fixation as a technique to stimulate healing of the fracture.
All of the forty cases were nailed using closed method under the guide of a image intensifier. The time to full weight was individualized for each patient and depend on the degree of comminution, the postoperative cortical contact between the major fragments, the presence of bridging callus as seen on follow up x-rays, and the patients mobility according to the associated injuries. Healing occurred in thirty nine(97%) of the forty fractures of the femoral shaft that had been treated with static interlocking nailing without dynamizaton. Only one patient needed conversion from static to dynamic interlocking fixation to promote fracture healing. This patient had a delayed union after closed interlocking nailing of Gustilo type I open midshaft fracture associated with Winquist type II comminution. We concluded that static interlocking nailing for femoral shaft fractures does not seem to inhibit the fracture healing process, and that conversion to dynamic intramedullary fixation is needed only for exceptional cases of delayed union.
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Closed Reduction and Percutaneous K-wire Fixation in Supracondylar Fractures of the Humerus in Children
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Soon Hyuck Lee, Jung Ho Park, Young Soo Byun
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J Korean Soc Fract 1995;8(2):423-429. Published online April 30, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.2.423
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- We evaluated the clinical results of the closed reduction and percutaneous K-wire fixation for supracondylar fracture of the humerus in thirty patients who were treated from Jan 1990 to Nov 1993. We analyzed the relationships between non-anatomical reduction and occurrence of varus deformity in displaced supracondylar fractures of the humerus in children.
The following results were obtained: 1. There were twenty-two males and eight females, twelve cases of type IIB and eighteen cases of type IIIfractures by Gartland classification. Posteromedial displacement and fractures through the olecranon fossa were most common pattern.
2. After closed reduction, eleven rotations and three medial displacements of distal fragment, and three angular deformities of medial cortex were observed in eleven cases.
3. Radiologically, the differences of carrying angle compared with normal side were decreased in twenty-one cases, no changes in three cases, and increased in six cases.
4. Two cubitus varus deformities were developed in decreased cases more than six degrees of carrying angle with residual rotation and medial displacement.
5. We obtained relatively good results in supracondylar fracture of the humerus in children treated by closed reduction and percutaneous K-wire fixation with grossly normal carrying angle.
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External monofixator in open tibia fractures
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Soon Hyuck Lee, Seung Woo Suh, Young Soo Byun, Yoon Sung Chung
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J Korean Soc Fract 1994;7(2):571-579. Published online November 30, 1994
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DOI: https://doi.org/10.12671/jksf.1994.7.2.571
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- Tibia fracture is often accompanied by soft tissue injury. There is controversy about the treatment of open tibia fractures, but the extemal fixator is most widely used as a initial treatment. Especially in open tibia fractures treated by extemal fixator, early secondary conversion to internal fixation device are suggested by some authors, but without risks of complication. In contrast others suggest that bone union problems are not due to external fixator itself and different types of bone union are observed according to the stability of fracture site.
The purpose of this study is to assess the clinical results with its affecting factors and to observe the morphological pattern of union in tibial open fractures treated by external fixator without significant soft tissue problems.
Authors analyzed 16 cases with tibial open fracture managed by external fixator in Ansan hospital, College of medicine, Korea University from May, 1988 to Sept., 1993 with follow-up period more than 11 months.
1. The tibial open fractures are mainly occurred in young active age group(20-50 yrs).
2. The union rate in accurate reduction and stable fixation cases was 90%, in contrast non-union rate in unstable fixation was 50%, and these non-union cases were managed by additional procedure(intramedullary nailing or autogenous bone graft).
3. In stable fuation, mode of fracture healing was mainly primary osteonal bone healing mechanism.
4. External fixator could be used in open tibial fracture with accurate reduction and stable fixation not as a temporary fixation but as a treatment modality.
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Ipsilateral Fractures of the Hip Joint and Femoral Shaft
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Sang Won Park, Soon Hyuck Lee, Jung Ho Park, Hong Kun Lee
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J Korean Soc Fract 1990;3(1):88-95. Published online May 31, 1990
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DOI: https://doi.org/10.12671/jksf.1990.3.1.88
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- Ipsilateral fractures of the hip joint and femoral shaft, which generally occur by severe trauma, are frequently associated with multiple fractures and other injuries.
Initially overlocked femur neck fracture may lead unpredicted complications, and femoral shaft fractures, usually comminuted, could be complicated with malunion, infection, limb shortening and limited ROM of knee joing. It is difficult to determine the type of fixation device and priority of fracture in treatment according to the variation of the site and pattern of fracture.
Eleven pateints with ipsilateral fractures of hip joint and femoral shaft were treated at Korea university Haehwa hospital from Jan. 1984 to Oct. 1988. Among them, nine pateints were followed up more than twelve months. There were eight male and one female. The ages ranged from twenty-two to fifty-three years, the average being 37.6 years. Seven cases caused by traffic accident and fall down trauma in two cases.
1. The levels of hip joint fractures were 6 femoral neck, 1 basal neck-intertrochanteric, and 2 intertrochanteric region.
2. The levels of femoral shaft fractures were 3 proximal one-third and 6 middle one-third.
3. Eight fractures of the femoral shaft except one were comminuted or segmented.
4. Six patients has other fractures or organ injuries.
5. All nine pateints had operation. In six patients with femoral neck and shaft fractures, the femoral shaft fractures were first reduced and fixed, and femoral neck fractures were stabilized later, In three pateints with femoral shaft and basal neck or intertrochanteric fractures, both fractures reduced and fixed simultaneously.
6. Several devices were used according to the site and patterns of fractures.
7. There were complications in three cases:one coxa vara, limb shortening, and infection, knee joint sitffness, and avascular necrosis in one case.
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