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Comparison of Treatment Methods in Gartland Type III Pediatric Supracondylar Humeral Fracture: Lateral Entry Pin versus Crossed-Pin Technique
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Young Hoon Jo, Tai Seung Kim, Dong Yun Kim
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J Korean Fract Soc 2015;28(3):186-193. Published online July 31, 2015
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DOI: https://doi.org/10.12671/jkfs.2015.28.3.186
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- PURPOSE
The aim of this study was to compare the results of the lateral entry pin technique and the crossed pin technique in treatment of Gartland type III humerus supracondylar fracture.
MATERIALS AND METHODS
Seventeen patients (group I) underwent surgery using the lateral entry pin technique, and 33 patients (group II) underwent surgery using the crossed pin technique for Gartland type III humerus supracondylar fracture in Hanyang University Seoul Hospital between January 2011 and January 2014. Maintenance of reduction was compared between the 2 surgical techniques by measuring changes in Baumann angle and lateral humerocapitellar angle after surgery and after pin removal in groups I and II. In addition, the final carrying angle and level of loss of functional movement were measured for comparison of clinical results between the 2 groups. Occurrence of ulnar nerve palsy in the 2 groups was also examined.
RESULTS
The mean Baumann angle and lateral humerocapitellar angle changes were 3.3degrees and 3.7 in group I and 3.1degrees and 3.4degrees in group II, respectively. No statistically significant differences were found between the 2 groups. Clinical results showed that the changes in the final carrying angle and range of motion were 2.9degrees and 2.6degrees in group I and 2.6degrees and 3.0degrees in group II, respectively, indicating no significant differences between the 2 groups. In terms of nerve damage, 1 patient in group II had temporary iatrogenic ulnar nerve palsy.
CONCLUSION
The lateral entry pin technique may be regarded as an appropriate treatment that reduces the risk of iatrogenic ulnar nerve palsy and provides satisfactory results in Gartland type III humerus supracondylar fracture patients.
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Contributing Factors of Radial Nerve Palsy Associated with Humeral Shaft Fracture
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Tae Soo Park, Joon Hwan Lee, Tai Seung Kim, Kwang Hyun Lee, Ki Chul Park
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J Korean Fract Soc 2008;21(4):292-296. Published online October 31, 2008
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DOI: https://doi.org/10.12671/jkfs.2008.21.4.292
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Abstract
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- PURPOSE
To analyze related factors of radial nerve palsy in patients with humeral shaft fractures.
MATERIALS AND METHODS
We reviewed 107 paients with humeral shaft fracture between January 2000 and June 2007. Thirteen patients had radial nerve palsy after trauma and 9 patients after the operation. We analyzed contributing factors of radial nerve palsy associated with humeral shaft fracture including the cause of trauma, location and pattern of fracture, surgical approach and tourniquet application in cases of plate fixation, the exploration for the nerve and the time for operation.
RESULTS
The difference in the incidences of radial nerve palsy after trauma and operation was not significant according to the location and pattern of fracture. The tendency of higher rate of radial nerve palsy after trauma in oblique or comminuted fractures, and after operation in spiral fractures was observed. The operation using intramedullary nailing and radial nerve exploration significantly reduced the incidence of radial nerve palsy after operation (p=0.01 and p=0.02). Posterior approach in open reduction and plate fixation showed a tendency of lower incidence of radial nerve palsy after operation (p=0.78). In logistic regression analysis, radial nerve exploration was the only significant factor that reduced the possibility of radial nerve palsy after operation (17.27: odds ratio, p=0.02).
CONCLUSION
In humeral shaft fractures, we should take into consideration whether intramedullary nailing is possible or not. In cases of anterior or anterolateral approach of open reduction and plate fixation, radial nerve should be carefully inspected. In most cases, we recommend radial nerve exploration in order to minimize the possibility of radial nerve palsy after operation.
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Citations
Citations to this article as recorded by  - Treatment of Radial Nerve Palsy Associated with Humeral Shaft Fracture
Soo-Hong Han, Jin-Woo Cho, Han-Seung Ryu
Archives of Hand and Microsurgery.2020; 25(1): 60. CrossRef - Associated Factors of Radial Nerve Palsy Combined with Humerus Shaft Fracture
Si-Wuk Lee, Chul-Hyun Cho, Ki-Choer Bae
Journal of the Korean Fracture Society.2014; 27(3): 185. CrossRef - Polarus Intramedullary Nail for Proximal Humeral and Humeral Shaft Fractures in Elderly Patients with Osteoporosis
Youn-Soo Hwang, Kwang-Yeol Kim, Hyung-Chun Kim, Su-Han Ahn, Dong-Eun Lee
Journal of the Korean Fracture Society.2013; 26(1): 14. CrossRef
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Traumatic Pseudoaneurysm of Posterior Tibial Artery in a Child: A Case Report
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Tai Seung Kim, Kuhn Sung Whang, Woo Young Seo
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J Korean Fract Soc 2007;20(1):83-85. Published online January 31, 2007
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DOI: https://doi.org/10.12671/jkfs.2007.20.1.83
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- Pseudoaneurysm is one of the complications of arterial injuries by trauma. The case report in children is rare, although not in adult. A 7-year and 10-month girl was visited with the complaints of pain and a mass in her right leg. At first, the radiograph of right tibia showed a remarkable cortical erosion from without, suggesting mass effect by a soft tissue tumor. She had a history of fracture of right tibia, and then manipulative reduction and K-wire fixation at 11 months ago. Arteriography showed a formation of the pseudoaneurysm originated from the posterior tibial artery. The operation was done through the ligation of artery at proximal and distal to pseudoaneurysm, and then excision of mass. At 5 year follow-up, the configuration and function of right foot was normal. Eventually, the cause of the mass formation is thought by the trauma of fracture fragment at the time of accidents, but the possibility of penetrated injuries by K-wire should be ruled out, which is used frequently in children's fracture. We experienced a case of traumatic pseudoaneurysm of posterior tibal artery with tibial fracture, especially occurred in pediatric patient, and presented the result of long-term follow-up.
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Citations
Citations to this article as recorded by - Coil Embolization of a Pseudoaneurysm of the Anterior Tibial Artery: A Case Report
Tae-Hyun Wang, Hyung-Lae Cho, Ki-Bong Park, Duc-Hee Kim
Journal of Korean Foot and Ankle Society.2016; 20(1): 43. CrossRef
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Surgical Treatment of the Myositis Ossificans in Supracondylar Fracture of the Humerus in Children: A Case Report
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Tai Seung Kim, Kee Cheol Park, Seung Pyo Seo
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J Korean Fract Soc 2006;19(4):482-485. Published online October 31, 2006
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DOI: https://doi.org/10.12671/jkfs.2006.19.4.482
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Abstract
- Supracondylar fracture of the humerus is a common injury in the pediatric patient. A less common complication is the development of myositis ossificans. Although frequently cited as a possible complication, there are few reported cases of this occurring in the pediatric patient. We present a case report of a 8 year old boy who developed myositis ossificans after a supracondylar fracture of the humerus. After one year of the injury, we could ascertained radiologically complete maturation of the mass which developed in front of the distal humerus and markedly made motion of the elbow joint limited. We could obtain further motion through the surgical resection and then physical therapy. Now, eleven months have lapsed since the mass was removed, the range of motion is almost normal, and the recurrence of myositis ossificans is not existed.
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Citations
Citations to this article as recorded by - Recent Trends in Treatment of Supracondylar Fracture of Distal Humerus in Children
Soon Chul Lee, Jong Sup Shim
Journal of the Korean Fracture Society.2012; 25(1): 82. CrossRef
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131
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Birth Injury
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Tai Seung Kim, Khun Sung Whang, Joo Hak Kim
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J Korean Soc Fract 2003;16(2):292-298. Published online April 30, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.2.292
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Abstract
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Birth injury is any condition that affects the fetus adversely during the labor or delivery. These traumatic injuries are subdivided further into those from hypoxia and mechanical factors. Risk factor of birth injuries have been reported to breech presentation, forcep delivery, cephalopelvic disproportion, dystocia, and high birth weight. But, because of preterm care and development of delivery method and Cesarian section, recently the rate of birth injury was decreasing and the articles about birth injuries in orthopaedic fields have not been much. We analyzed the data about birth injuries occurred during recent 11 years.
MATERIALS AND METHODS
We reviewed the charts and patients the 17 patients (20 cases) of birth injuries including fracture, nerve injury during the delivery at Hanyang University hospital from Jan. 1991 to Dec. 2001. But, we excluded birth injury of head and abdomen.
RESULTS
The number of fracture and nerve injuries on extrimities in our hospital were clavicle fracture 9 cases, brachial plexus injury 6 cases, femur fracture 3 cases, separation of distal femoral epiphysis 1 case, humerus fracture 1 case. Patients of clavicle fracture were born at mean intrauterine period 41.5 weeks and mean birth weight of the patients was 4.25 kg. Patients of brachial plexus injury were born at mean intrauterine period 39.5 weeks and mean birth weight of the patients was 4.42 kg. Three cases of femoral fracture were all due to breech position while cesarean operartion and one of these cases were born as ishiophagus. We found the distal femoral epiphyseal separation injury missed initially and diagnosed a kind of birth injuries through remarkable periosteal reaction.
CONCLUSION
The birth injuries including clavicle fracture and brachial plexus injury are highly related to high birth weight at birth and the femur fractures are related to delivery maneuver in C-section and breech delivery. Strict observation and monitoring are required because occasionally the paralysis might be the sign of brachial plexus injury or pseudoparalysis due to fracture. By the adequate preterm care or preterm ultrasound check up, high weight delivery could be avoided and then the birth injury must be reduced.
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Treatment of Peterson classification Type VI of Physeal Injury in Ankle Joint: 2 cases report
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Byung Il Lim, Tai Seung Kim, Kuhn sung Whang, Il Hoon Sung
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J Korean Soc Fract 2000;13(4):1061-1066. Published online October 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.4.1061
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- Peterson classification type VI, which has been reported newly on physeal injury classification, is defined as partial missing of the metaphysis and epiphysis with a portion of the physis. It has not been reported in the Republic of Korea to our knowledge. Because this is an open fracture, immediate surgery is needed in all cases. Angular deformity and leg length discrepancy occurs as a result of the formation of the physeal bar. Additional reconstuctive operation, therefore, should be necessary. We report two cases of Peterson classification type VI, both cases were open fracture at the level of ankle joint owing to pedestrian traffic accident. In our experience, Peterson classification type VI required multiple operations because progression of angular deformity with growth, and must be followed up until maturity.
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Citations
Citations to this article as recorded by - Changes in Oxygen Saturation and Walk in Relation to Smoking and Types of Shoes
Jea-Cheol Park, Jong-Man Han, Woon-Soo Cho, Yong-Nam Kim
The Journal of Korean Physical Therapy.2015; 27(1): 55. CrossRef
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Effects of Yuhan Bone Connecting Powder on the Repair of Fractures in Rats
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Il Yong Choi, Tai Seung Kim, Il Hoon Sung, Won Kyu Kim, Yun Young Choi, Kwan Hyoung Lee, Kyu Sung Hwang
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J Korean Soc Fract 2000;13(4):1067-1079. Published online October 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.4.1067
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Abstract
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We have studied the effects of Yuhan bone connecting powder on the healing process of the frauture at the osteotomized bones in rat, using bone densitometer, X-ray and morphological studies after administration of Yuhan bone connecting powder which has been reported in China as enhancing the processes of the fracture healing.
MATERIALS AND METHODS
90 Sprague-Dawley male rats were divided into the rib and tibia osteotomy groups. Each group was subdivided into the control, low dosage and high dosage groups. Rib and tibia were osteotomized under the general anesthesia with ketamin. From the next day after operation, Yuhan bone connecting powder diluted with distilled water was administrated to low(0.68g/kg) and high(1.36g/kg) dosage groups per se. Same amount of the distilled water was used to the control group. 1.5cm long rib including the osteotomy site and whole tibia were excised. Bone densitometer using dual energy X-ray absorptiometry, radiological and morphological studies with HE stain and alcian blue(pH 2.5)-PAS stain were performed.
RESULTS
BMD showed statistically significant difference between control group, low dose group and high dose group at 2weeks after treatment(p=0.035), but did not show such a good result at 1week(p=ns) and 4weeks(p=0.091) after treatment. Radiologically, after treatment for 2 weeks, the low and high dose groups showed more active callus formation than control group. Morphologically, dilated numerous blood vessels adjacent the bony trabeculae and well developed cartilagenous callus were observed in the experimental group at the 1st week. At the 2nd week, many newly formed bony trabeculae were formed from the cartilagenous callus, and at the 4th week relatively thick compact bone and bony trabeculae were connecting the both osteotomy ends.
CONCLUSION
BMD at the osteotomy site seemed to be increased after administration with Yuhan bone connecting powder to rats, and this finding was supported radiologically at 2weeks after treatment. Morphologically, at the early stage of the fracture healing, numerous dilated blood vessels were distributed and many bony trabeculae were formed from the cartilagenous callus. At the remodelling stage relatively thick compact bone was connecting the both ends of the osteotomy site. So it is suggested that Yuhan bone connecting powder would induce enhancing the healing process of the osteotomized bone in rat through active vascularization, mineralization of the cartilage matrix, endochondral ossification and remodelling.
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Ulnar nerve palsy After Percutaneous Pinning in Childrens Supracondylar fracture
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Tai Seung Kim, Jay Rim Choi, Kuhn Sung Whang
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J Korean Soc Fract 1999;12(3):674-678. Published online July 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.3.674
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- Many authors have described percutaneous pinning techniques as the treatment of choice for most supracondylar fractures. But little information is available concerning ulnar nerve injury resulting from pinning techniques. When the surgeon is faced with a postoperative ulnar nerve palsy, it can be the result of unrecognized preoperative palsy, manipulation during surgery, or damage to the nerve by one of the medial pin placements. The options for management include exploration, medial pin removal, or observation.
We reviewed our hospital records on the 132 supracondylar elbow fractures that we treated in children from 1991 to 1998 There were 16 palsies found with normal preoperative and abnormal postoperative ulnar nerve function. Normal nerve function returned without exploration and early medial pin removal in all cases. We recommand that observation is the appropriate way to manage these postoperative ulnar nerve palsies in most cases.
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The Problems on Removal of the tibial intramedullary nails
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Tai Seung Kim, Seong Pil Lee, Khun Sung Whang
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J Korean Soc Fract 1999;12(2):301-306. Published online April 30, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.2.301
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- Closed intramedullary nailing with interlocking screws has been a widely accepted method for the fixation of fractures of the long bones. As a rule, the nail can be removed during the second year. Before the operation, solid healing of the fracture must be demonstrated by x-rays in two planes. When solid bone healing of the fracture has occurred, a connective tissue interface forms around the foreign body. This connective tissue can ossify later and make it difficult to remove the nail after it has been in place for a number of years. Theoretically, removal of the nail should be an uncomplicated procedure. Occasionally, one runs into problems, however, and every surgeon who has had enough experience with intramedullary nailing can remember cases in which removal of the nail was more difficult than its insertion. So, we tried to review our cases for problems on removal of the tibial nails and to discuss its etiologies.
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Conservative Treatment of Moderately Displaced S-H type II Injury in Distal Radius : a Report of 5 Cases
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Tai Seung Kim, Ye Soo Park, Duck Keun Kim, Jae Lim Cho
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J Korean Soc Fract 1997;10(3):718-725. Published online July 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.3.718
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- Epiphyseal injury in children is most frequently developed in distal radius. Type II injury in Salter Harris classification is known to be most common. In most cases of Salter Harris type II injury, the conservative treatment such as closed reduction and cast immobilization is reported to be effective. However, in moderately displaced epiphyseal injury, repeated manipulation would give further damage to the epiphyseal plate and then results in premature closure of the epiphyseal plate and growth arrest. We experienced five cases of moderately displaced S-H type II injury of distal radius, which had been reduced immediately after injury by closed method at privatic clinic, but redisplaced. We did not try to get realignment because it had passed 6 to 14 days since fracture occurred. Rather, we thought maintaining of present position could be best. After the conservative treatment for five cases, we have evaluated follow up results over one year. The results were excellent. We hereby report it with literature review.
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Citations
Citations to this article as recorded by - Epiphyseal Fractures of the Distal Radius in the Children
Hui Taek Kim, Myung Soo Youn, Jong Seo Lee, Young Jun Choi, Yoon Jae Seong
Journal of the Korean Fracture Society.2008; 21(3): 225. CrossRef
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Disseminated Intravascular Coagulation Following Septic Shock in Multiple Open Fractures : a Case Report
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Tai Seung Kim, Jae Lim Cho, Choong Hyeok Choi, Sung Hee Oh, Do Hyeung Kim, Kuhn Sung Whang
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J Korean Soc Fract 1997;10(3):583-587. Published online July 31, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.3.583
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- Disseminated intravascular coagulation is known to be a syndrome which can evoke compound derangement in the cascade mechanism of normal hemostasis, which causes depletion of coagulation factors, secondary fibrinolysis, and eventually massive and uncontrollable bleeding. Even though there still are not absolute criteria for diagnosis, some laboratory findings - platelet count, plasma fibrinogen, fibrinogen degradation product, plasma protamine test, etc - can suggest the possibility to diaglose. The basic principle in management is to eliminate the triggering mechanism as soon as possible and to cure the initial disease entities. In orthopedic point of view, disseminated intravascular coagulation can occur in the case of malignancy, massive trauma, infection, sepsis and so on. Authors report a case of disseminated intravascular coagulation occured in a 12 year 2 month old male patient who visited Hanyang university hospital in septic condition after emergency operations following multiple open fractures on his left femur. tibia and fibula in a motor-cycle accident.
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A Clinical Study of the Comminuted Fracture of Patella
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Il Yong Choi, Sung Joon Kim, Tai Seung Kim, In Mool Lee
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J Korean Soc Fract 1996;9(3):631-639. Published online July 31, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.3.631
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Abstract
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- Recently the fracture of patella especially comminuted fracture has increasing tendency due to frequent traffic accident. Because of the patella is an important functional component of the knee extensor mechanism, and proximal three-quarters of the posterior surface of the patella are covered with articular cartilage. accurate reduction and rigid fixation are important in treatment of the comminuted fracture of the patella. Some fractures were treated successfully by immobilization in a cylinder or an above-knee cast, but most patellar fractures should be treated surgically. Various techniques of internal fixation have been recommended for comminuted fractures of the patella, but best way should be selected out of various methiods case by case.
In this series, 48 comminuted patella fractures between January, 1990 and April, 1995 have been reviewed at least 9 months after injury and obtained following results.
1. Peak age was third to fifth decade and predominant in men.
2. The major causes of the comminuted patella fractures were traffic accident in over-all, and slip down in sixth and seventh decades.
3. Most fractures were accompainied by other fractures.
4. fourteen patients had postoperative complications, six had patellofemoral osteoarthritis, three metal failure, two loss of reduction, two superficial infections and one malunion.
5. In long-term follow up, the factors that related to the range of motion of the affected knee were though to not the operative method but initial severity of the comminution and accampanied injury.
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Bilateral Subtrochanteric fracture After Pin Removal in Slipped Capital Femoral Epiphysis: A Case Report
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Sung Joon Kim, Il Young Choi, Tai Seung Kim, Chung Kyu Choi
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J Korean Soc Fract 1995;8(1):68-71. Published online January 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.1.68
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- Subtrochanteric fracture of the femur has been infrequently reported after pin removal that is second operation for slipped capital femoral epiphysis and that fracture is a serious complication. We report a case of subtrochanteric fracture of the femur occured after pin removal that had been inserted for fixation of slipped capital femoral epiphysis. Its treatment was open reduction with condylar blade plate and screws. We recommend insertion of fewer pins and longer pins at higher level, early pin removal, avoidance of repeated insertion and use of cannulated pin screw instead of Knowles pin for prevention of subtrochanteric fracture after pin removal.
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A Clinical Study for the Complications Following Treatment of Children Ankle Injury
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Sung Jon Kim, Jae Lim Cho, Tai Seung Kim, Hyun Kyu Jang
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J Korean Soc Fract 1992;5(2):244-252. Published online November 30, 1992
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DOI: https://doi.org/10.12671/jksf.1992.5.2.244
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Abstract
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- The childrens ankle injury is different from that of adults in terms of the possibilities of injury to growth plate and influence to growth. Therefore accurate reduction under the knowledge of prognosis of the injured growth plate is very important. Many authors agree that the prognosls of injured growth plate is dependent on the injury type, the age of the patient at the onset of injuries, the method and accuracy of reduction. and whether the injuries open or closed. We treated 45 cases of children ankle injuries from August 1983 to June 1991 and evaluated the cases of eight children who had a injury loading to complication. Most of them had had a Salter-Harris type II or type III injury of the distal end of the tibia. Initially all the cases were treated with accurate reduction of thr physis as much as possible, but six of them developed growth disturbance including physeal arrest, temporary cessation of the growth and growth retardation, while two did growth stimulation.
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