Journal of Musculoskeletal Trauma

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

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

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

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

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Posterior Hip Dislocation with Femoral Head and Neck Fracture: You Sung Suh, Jae Hoon Lee, Soo Jae Yim, Yon Il Kim; J Korean Soc Fract 2000;13(3):423-431. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.423

Abstract PDF: PURPOSE
In the femoral head fracture associated with posterior dislocation of hip, we analyzed the clinical results according to the fracture types and treatment methods to promoting the guide of treatment.
MATERIALS AND METHODS
We used 20 cases of fractured femoral head with posterior dislocation of hip from January 1990 to December 1997, and analyzed the treatment methods and clinical results according to the Pipkin classification.
RESULTS
Among the 20 cases, male was 19 cases(95%), motor vehicle accident contributed 15 cases(75%), and the case of type II and IV of Pipkin classification were 7(35%) and 9(45%) cases. Closed reduction performed within 12 hours after injury with good results was conducted in 9 cases(60%) among the 15 cases. According to the treatment methods after closed reduction, good result was showed only 3 of 8 cases(37.5%) in the conservative treatment, whereas 8 of 12 cases(66.7%) in the operative treatment. According to the type of Pipkin classification, good result was showed 3 of 6 cases(50%) in conservative treatment and all of 3 cases in operative treatment among the 9 cases of type I and II, whereas none of 2 cases in conservative treatment and 5 of 9 cases(56%) in operative treatment among the 11 cases of type III and IV. The following complications were encounted; 2 cases of avascular necrosis, 1 case of traumatic arthritis, 1 case of peroneal nerve palsy and 1 case of nonunion CONCLUSION: Good results were obtained in patients with early, stable, and accurate reduction. The Computed Tomogram was helpful to find the small fragment and check the accurate reduction. Open method that restoration joint congruity seemed to be the better procedure than closed method.

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

Abstract PDF

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

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

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Traumatic dislocation of hip in children: A Case Report of 30 Months Followup: Soo Jae Yim, Yeon Cheol Jeong, Seung Ryool Yoon, Joong Geun Choi, You Sung Suh, Yon Il Kim; J Korean Soc Fract 1999;12(2):361-364. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.361

Abstract PDF: Traumatic hip dislocation in childhood is rare. Factors predisposing to abnormal results are delayed reduction and severe trauma. We experienced 8 year-old girl with traumatic posterior hip dislocation and treated with immediate closed reduction. At 30 months follow-up, our patient had good functional and good roentgenographic result with no posttraumatic arthritis or posttraumatic avascular necrosis. So we report this case with review of literature.

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

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

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

Abstract PDF

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

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

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Treatment of the Complete Separation of Acromioclavicular Joint by Coracoclavicular Wiring: Chang Uk Choi, Yon Il Kim, Young Ho Kim, Min Ku Lee; J Korean Soc Fract 1990;3(1):119-126. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.119

Abstract PDF: Complete dislocation of the acromioclavicular joint is not a common jnjury. But there are many methods of treating for complete separation of acromioclavicular joint. From February, 1988 to March, 1989 at Soonshunyang university hospital, 14 pateints with complete acromioclavicular separation(Allmans type3) had been treated sugically by coraco-clavicular wiring. The results are follows. 1) The most common cause of injury is fraffic accident. 2) Ages in peak incidence are 3rd and 4th decades. 3) The shoulder pain and the limitation of external rotation, which are well known problem of transacromioclavicular fixation cant be found and the functional result were excellent in 12 cases good in 1 case and fair 1 case 4) We consider that over reduction and anatomical reduction of acromioclavicular joint may be prevent complications and obtain excellent results. 5) We can Prevent the anterior displacement of clvicle from the acromion and bony erosion by passing the wire loop through the drill hole on the center of clavicle which direction is from superior to inferior portion.

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