Journal of Musculoskeletal Trauma

Traumatic Pseudoaneurysm of Posterior Tibial Artery in a Child: A Case Report: Tai Seung Kim, Kuhn Sung Whang, Woo Young Seo; J Korean Fract Soc 2007;20(1):83-85. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.83

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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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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Intramedullary Nailing in Distal Tibial Meta-Diaphyseal Fracture: Kee Cheol Park, Young A Cho, Young Ho Kim, Tae Soo Park, Ye Soo Park, Il Hoon Sung, Kuhn Sung Whang; J Korean Soc Fract 2003;16(2):201-207. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.201

Abstract PDF: PURPOSE
This study was undertaken in order to evaluate the efficiency of the closed intramedullary nailing in 18 cases of distal tibial fractures.
MATERIALS AND METHODS
From May 1999 to June 2001, eighteen patients were treated by closed intramedullary nailing for distal tibial meta-diaphyseal fracture. According to Robinson classification, there were 7 type 1 fractures, 7 type 2A fractures, 1 type 2B fractures, and 2C type fractures. The mean distance between distal end of fracture and tibial plafond was 2.6+/-1.1 cm (0~5 cm). We evaluated both clinical and radiographic parameters.
RESULTS
Plate fixation of distal fibular fracture was performed in 7 cases. Poller screw was used in 4 cases which showed malalignment after insertion of nail. The mean score was 92.5 point by Blaird ankle scoring system. All patients got the bone union at average of 20 weeks (12~40 weeks). One patient had a antecurvatum deformity of 9 degrees.
CONCLUSION
Intramedullary nailing for distal tibial fractures is one of the safe and reliable method for managing these injuries.

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Treatment of nonunion of proximal tibia: Treatment using external fixator: Kuhn Sung Whang, Il Hoon Sung, Jun Sic Park; J Korean Soc Fract 2002;15(2):129-137. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.129

Abstract PDF: PURPOSE
To evaluate causes, treatment methods, outcomes and usefulness of external fixator after we have treated patients with proximal tibial nonunion successfully using external fixator.
MATERIALS AND METHODS
We treated the 10 patients with proximal tibial nonunion between December, 1991 and December, 2000. Mean follow-up period was 18.5 months. We analyzed numbers of operations, operative methods and causes of nonunion, and rated bony and functional results according to Paley's classification.
RESULTS
The causes of nonunion were infection in 6 cases, insecure fixation in 4 cases. Bony union was achieved in all 10 cases. The mean time of union was 12.9 months. Complications were developed in 8 cases. Pin site infection occurred in 7 cases, pain in 8 cases, joint stiffness in 2 cases, angular deformity in 2 cases. Functional results were excellent in one, good in four, fair in three, poor in two.
CONCLUSIONS
We concluded that external fixation method using external fixator such as Ilizarov in treating nonunion of proximal tibia was very useful because of offering advantages of bony shortening and compression, bony lengthening, bone grafting and early weight bearing in patient with infected nonunion and bone defect with many complications

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Treatment of Peterson classification Type VI of Physeal Injury in Ankle Joint: 2 cases report: Byung Il Lim, Tai Seung Kim, Kuhn sung Whang, Il Hoon Sung; J Korean Soc Fract 2000;13(4):1061-1066. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1061

Abstract PDF

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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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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Results of Judet Quadricepsplasty in Knee Stiffness: Kuhn Sung Whang, Ki Chul Park, Kyung Sik Kim; J Korean Soc Fract 2000;13(1):96-102. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.96

Abstract PDF

PURPOSE
: We performed this study to evaluate the proper indication and complication of the Judet quadricepsplasty in the stiff knee.
MATERIALS AND METHODS
: Authors analyzed 15 cases in 14 patients treated by Judet quadricepsplasty from July 1990 to may 1998. There were 9 male and 5 female with an average age of 32.0 years. The average follow-up was 3 years 7 months. Causes of stiff knee sere femoral distal fracture in 7 cases, femoral midshaft fracture in 5 cases, tuberculosis osteomyelitis in 3 cases. The average interval between injury and quadricepsplasty was 1 year 10 months. We check the preoperative and last follow up range of motion in involved knee, and check the postoperative and last follow up extension lag and complication.
RESULTS
: By the Judet' classification, last follow up results were shown to be 5 cases in excellent, 5 cases in good, 5 cases in poor. Complications were patella fracture in 3 cases, infection in 1 case, femoral artery rupture in 1 case, and these 5 cases were shown to be poor results. Three patella fractures were arisen at the insertion of Quadriceps muscle. Infection was secondary type by the hematoma results from inappropriate hemostasis. Femoral artery rupture was arisen by the severe fibrosis at the surrounding arteries and tissues results from chronic infection due to long term application of Ilizarov apparatus. In the excellent and good results, average preoperative range of motion were 36.0 degrees, average last follow up range of motion were 96..5 degrees, average flexion gain were 60.5 degrees. Postperative extension lag were 16.5 degrees in 7 cases(70%), but last follow up extension lag were 8.7 degrees in 4 cases(40%).
CONCLUSION
: Judet quadricepsplasty was excellent method to solve the extra-articular stiff knee in the proper indication. Inappropriate indication were thought to severe intra-articular adhesion, severe osteoporosis of patella, severe fibrosis in the medial aspect of distal thigh. Postoperative early ROM exercise using CPM were thought to improve the range of motion of involved knee.

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A Modified Thompson Quadricepsplasty for Extension Contracture Resulting From Femoral and Periarticular Knee Fractures
Mohammad H. Ebbrahimzadeh, Ali Birjandi-Nejad, Said Ghorbani, Mohammad Reza Khorasani
Journal of Trauma: Injury, Infection & Critical Care.2010; 68(6): 1471. CrossRef

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Ulnar nerve palsy After Percutaneous Pinning in Childrens Supracondylar fracture: Tai Seung Kim, Jay Rim Choi, Kuhn Sung Whang; J Korean Soc Fract 1999;12(3):674-678. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.674

Abstract PDF: 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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Disseminated Intravascular Coagulation Following Septic Shock in Multiple Open Fractures : a Case Report: Tai Seung Kim, Jae Lim Cho, Choong Hyeok Choi, Sung Hee Oh, Do Hyeung Kim, Kuhn Sung Whang; J Korean Soc Fract 1997;10(3):583-587. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.583

Abstract PDF: 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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Divergent Dislocation of elbow with Ipsilateral CollesFracture: Report of One Case: Sung Joon Kim, Kuhn Sung Whang, Jong Sun Leem, Oh Jae Kwon; J Korean Soc Fract 1995;8(2):419-422. Published online April 30, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.2.419

Abstract PDF: Divergent dislocation of divergent elbow is very rare and this in jury has been reported only 7 cases in English literatures. This injury was affected in the disruption of all three joints of elbow, such as the radiocapitellar, the ulnotrochlear and the proximal radioulnarjoint. According to Stimsons classification, there are two types ; anteroposterior and mediolateral. We experienced a case of the divergent dislocation of elbow with ipsilateral Collesfracture which were treated by closed reduction and cast immobilization. We obtained satisfactory result.

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Operative Treatment of Carpal Scaphoid Fractures with Herbert Screw: Sung Joon Kim, Kuhn Sung Whang, Jong Sun Leem; J Korean Soc Fract 1995;8(1):206-215. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.206

Abstract PDF: Carpal scaphoid fracture is most common in carpal bone injury, but its not easy to diagnose this fracture after affecting the damage, and also is not rane induced avasular neeresis and/or non-union. 13 cases of carpal scaphoid fractures (5 displaced fresh fractures and 8 non-unions) were treated by open reduction and internal fixation with Herbert screw and also cancellous bone graft taking from distal radius were performed on the cases of non-union. The results and conclusions were follows 1. Bony union takes average 11.8 weeks in displaced fresh fractures and average 14.4 weeks in non-unions. 2. By final assessment, excellent result was taken in 10 and good in 3. 3. It might be effective procedure for which cancellous bone was harvested from distal radius of same operative site. 4. Herbert srrew would be one of the good and rigid internal fixation device for the treatment of scaphoid fracture.

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Treatment of Bone Loss by Local Bone Transportation: A report 3 eases: Sung Joon Kim, Kuhn Sung Whang, Hyun Kee Chung, Ye So Park; J Korean Soc Fract 1992;5(2):410-416. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.410

Abstract PDF: We experienced the local bone transportation in 3 cases. with a dynamic axial fixator, which had been effected the large bone defects because of the loss of the bony segment or infected non-union. The 2 patients showed the large femoral bone defect after motorcycle accident and the other patient. The tibial infected nonunion with large bone defect. The two femoral bone defects were treated by callotasis, and the tibial bone defect by chondrodiatasis. The size of bony defects were 12.Ocm and 6.5cm and the amount of bony transportation were 10.Ocm, 9.4cm and 5.9cm in orthoroentgenogram. These local bone transportations induced excellent osteogenesls and it filled up the defects We suggest that local bone transportation might be one of the best ways for the treatment of the large bone defects.

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A Clinical Study of the Surgical Treatment of Patellar Fracture: Sung Jun Kim, Il Yong Choi, Choong Hyeok Choi, Kuhn Sung Whang; J Korean Soc Fract 1990;3(2):216-222. Published online November 30, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.2.216

Abstract PDF: No abstract available.

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