Journal of Musculoskeletal Trauma

Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome: Seong Cheol Moon, Chul Hee Lee, Jong Hoon Baek, Nam Su Cho, Yong Girl Rhee; J Korean Fract Soc 2014;27(2):127-135. Published online April 30, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.2.127

PURPOSE
The purpose of this study is to evaluate the radiologic and clinical outcomes after tension band wire fixation of Neer type II distal clavicle fractures.
MATERIALS AND METHODS
Twenty-six patients with Neer type II distal clavicle fractures who underwent tension band wire fixation from March 2002 to May 2011 were included in the study. Fifteen cases were classified as Neer type IIa and 11 cases as type IIb. The postoperative mean follow-up period was 14.3 months. Clinical and radiologic evaluation was performed at two weeks, six weeks, three months, six months, and 12 months postoperatively.
RESULTS
Bony union on X-rays was observed at an average of 11.7 weeks (range 8-20 weeks) postoperatively. The overall visual analogue scale score for pain was 1.23+/-2.75 postoperatively. The overall postoperative University of California at Los Angeles score increased to 33.5+/-2.15 from the preoperative score of 21.6+/-1.91 (p<0.05).
CONCLUSION
Among various methods of treatment for Neer type II distal clavicle fracture, K-wire and tension band fixation was used and relatively satisfactory radiological and clinical results were obtained. This surgical method yields excellent clinical results, owing to its relatively easy technique, fewer complications, and allowance of early rehabilitation.

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Clinical and Radiologic Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Kirschner's Wire Transfixation and Locking Hook Plate Fixation
Yong Girl Rhee, Jung Gwan Park, Nam Su Cho, Wook Jae Song
Clinics in Shoulder and Elbow.2014; 17(4): 159. CrossRef

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Clinical Results of Various Surgical Techniques for Isolated Fracture of Greater Tuberosity of Humerus: Nam Su Cho, Seong Cheol Moon, Yong Girl Rhee; J Korean Fract Soc 2013;26(2):133-139. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.133

Abstract PDF

PURPOSE
To compare the clinical and radiologic outcomes of various surgical techniques for an isolated fracture of greater tuberosity of the humerus.
MATERIALS AND METHODS
From February 2001 to December 2008, 31 patients, who underwent an operation for isolated greater tuberosity fracture and were followed up for more than 1 year, were enrolled in this study. The mean age at the time of operation was 49.3 years (range, 23-73 years). The operation methods included in this study were as follows: a transosseous suture using nonabsorbable suture material (16 cases), a fixation by cannulated screws (10 cases), tension band wiring (2 cases), bony fragment excision with rotator cuff repair (2 cases), and percutaneous pinning (1 case).
RESULTS
At the last follow-up, the average Constant score was 79.4 and Korean Shoulder Score (KSS) was 81.2. Among the various operation methods used in this study, the transosseous suture had the highest scores with 82.5 in Constant score and 89.3 in KSS. Bone union was achieved at average 10.3 weeks (range, 7-15 weeks), and there were 2 cases in which the reoperation was required due to internal fixation failure. Postoperative shoulder stiffness occurred in 3 cases, and all the cases were done with the deltopectoral approach.
CONCLUSION
Clinically and radiologically satisfactory results were obtained using various operation techniques for an isolated greater tuberosity fracture of the humerus. The transosseous suture showed relatively better results than the other methods used in this study. To achieve favorable clinical and radiologic results, it is important to select an appropriate surgical approach and fixation method according to the fracture site, degree of displacement, and size of fragment.

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Biomechanical comparisons of hook plate and screw fixations in split-type greater tuberosity fractures of the humerus
Fa-Chuan Kuan, Kai-Lan Hsu, Chih-Kai Hong, Yueh Chen, Chen-Hao Chiang, Hao-Ming Chang, Wei-Ren Su
Journal of Shoulder and Elbow Surgery.2022; 31(6): 1308. CrossRef

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The role of the coronoid process fracture in the elbow dislocation: Yong Girl Rhee, Jae Ryong Cha; J Korean Soc Fract 2001;14(3):491-498. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.491

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PURPOSE
To evaluate whether the size of the coronoid process fracture influence on elbow instability, to recognize the requirement of surgery and to report the final results after operation.
MATERIALS AND METHODS
We performed the operative treatment for 10 cases among 17 coronoid process fractures with elbow dislocation from December 1995 to January 1999, and evaluated operative cases. According to Reagan & Morrey classification, 3 cases(30%) belong to type I, 4 cases(40%) type II and 3 cases(30%) type III. The major mode of injury was fall down accident(70%) and most common associated injury was radial head fracture(70%). In all case, the elbow was inevitably subluxated when flexed beyond 45degreesregardless the size of the fragment segment. This lead us to performed the fixation of coronoid process fracture and the reconstruction of the ruptured articular capsule. Two patients who had had recurrent posterolateral instability due to severe capsular damage at initial injury and previous excision of the radial head underwent the total elbow replacement.
RESULTS
According to Mayo elbow performance index, results were graded as excellent in 7 cases(70%), good in 1 cases(10%), and at two case of radial head excision had been performed previously, the results had been graded as poor, but after total elbow replacement they were good. At final results, all of them resulted in more than good. Postoperative range of motion averaged 6 degrees in extension and 128 degrees in forward flexion and there was significantly a tendency for less motion of a forward flexion with more involvement of coronoid fragment.
CONCLUSION
In cases of the elbow dislocation, instability of the elbow is correlated with the severity of the damaged articular capsule and ligament regardless of the size of the coronoid process fracture. The early excision of the fractured radial head should be avoided not to run into total elbow replacement.

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Surgical Outcomes after Olecranon Plating with Retrograde Coronoid Process Screw Fixation through the Plate Hole in the Bifocal Fracture of the Proximal Ulna
Seong-Eun Byun, Ho-Jae Lee, Junhyun Kim, Sang-June Lee, Uk Kim, Soo-Hong Han
Journal of the Korean Orthopaedic Association.2016; 51(5): 403. CrossRef

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Treatment of Periprosthetic Fracture Following Total Elbow arthroplasty: Myung Chul Yoo, Yong Girl Rhee, Yoon Je Cho, Kang Il Kim, Young Lin Cho; J Korean Soc Fract 2000;13(1):193-199. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.193

Abstract PDF

PURPOSE
: To classify the pattern of periprosthetic fracture after total elbow replacement(TER) and introduce the principles of treatment in various fracture patterns.
MATERIALS AND METHODS
: Four patients(1 man and 3 women) were evaluated, who had periprosthetic fractures following total elbow arthroplasty, form July 1997 to October 1998. The incidence of fracture among TERs was 6%(4/62) and the average follow-up period was 1 year 6 months. The locations of periprosthetic fractures were classified according to Hanyu et al. The result were analyzed about the treatment modalities, the period to bony union, elbow motion and complication.
RESULTS
: Type2 and type 3 fractures were treated with closed reduction and hanging splint, whereas type 1 fracture showing loosening of humeral component was treated with revision arthroplasty. Type 4 fracture was treated with open reduction and internal fixation. The period to bone union was 5 months in average. The elbow motion ranged between 7.5degrees to 106.2degrees at the last follow-up. Type 3 showed anterior angulation deformity of 20degrees.
CONCLUSION
: Fracture pattern, stability, and loosing of component should be considered to select treatment modality. In transverse fracture proximal to the humeral stem tip(type 3), open reduction and internal fixation is recommended because of difficulties in maintaining alignment of fracture fragment. Postoperative rehabilitation program is very important to prevent limitation of elbow motion

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Treatment of Periprosthetic Fracture after Total Elbow Replacement Arthroplasty
Hyunseok Seo, Jin-Hyung Im, Joo-Yup Lee
Journal of the Korean Fracture Society.2020; 33(2): 110. CrossRef

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Treatment of Tibial Defect by Fibular Transposition using Ilizarov: Chung Soo Han, Yong Girl Rhee, Chang Hyun Cho, Moo Song Park, Dong Jun Shin; J Korean Soc Fract 1999;12(4):943-947. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.943

Abstract: Treatment of large segmental defect of tibia is difficult because of associated infection, shortening of limb, nonunion and soft tissue reconstruction. There has been a few options for the reconstruction of segmental tibial defect including vascularized or nonvascularized fibular graft, vascularized iliac bone graft, compression-distraction osteosynthesis and allograft. Tibialization of the ipsilateral fibula for 5 patients who had large tibial defect was successfully achieved by fibular transposition using Ilizarov apparatus at our hosipital . The average defect of tibia was 10.4cm in length. The average time of Ilizarov fixation was 10.3 months. Although one patient required bone grafts, most of them achieved good bony union. The clinical and radiological features and their results were also addressed. Fibular transposition using Ilizarov may be a satisfactory method of treatment for the large segmental tibial defect associated with severe soft tissue injury or vascular compromise.

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The management of patellar fractures: Yong Girl Rhee, Ki Tack Kim, Yoon Jae Cho, Yong Lak Son, Hyun Soo Han, Geon Hee Lee; J Korean Soc Fract 1993;6(2):247-254. Published online November 30, 1993; DOI: https://doi.org/10.12671/jksf.1993.6.2.247

Abstract PDF: No abstract available.

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Treatment in Supracondylar Fracture of thr Femur: Myung Chul Yoo, Yong Girl Rhee, Moon Hwan Lee, Young Ho Cho; J Korean Soc Fract 1990;3(2):163-169. Published online November 30, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.2.163

Abstract PDF: Authors experienced fifty-three patients who had had supraconlylar fracture of the femur since December, 1982. According to Schatzkers classification, Type I fracture were seventeen patients (thirty-two%) and Type II were ten patients(nineteen%) and Type III were twenty-six patients(forty-nine%). Eight patients were treated conservatively and forty-five treaed operatively. According to Schatzkers criterin, satisfactory results were obtained iin seventy-five% of patients with conservative treatment and in sixty-two% of patents with operative treatment. Satisfactory results were obtained in eighty-eight% of Type I and in seventy% of Type II and in forty-six% of Type III. Satisfactory results were obtained in seventy-three% of closed fractures and in forty-four% of open fractures. Satisfactory results were obtained in cases with early exercise of knee motion.

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Treatment of Intractable Nonunion of the Long Bone with the Invasive Electrical Stimulation: Myung Chul Yoo, Dae Kyung Bae, Yong Girl Rhee, Deok Ho Ahn, Goong Hee Cho; J Korean Soc Fract 1989;2(1):82-90. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.82

Abstract PDF: Nonunion of the long bone is one of the difficult porbloems in orthopaedic surgery. We studied the effect of the electrical stimulation. From July, 1980 to August, 1988, 30 nonunions of the long bones were treated with the invasive type electrical stimulator. The range of follow-up period was from 3 months to 7 years(average, 25 months). The results were as foloowings: 1. The good bony union has occurred in 26 cases(86.7%). 2. The previous infection was in 11 cases and its union rate was 100% 3. The average duration of bone union in over-all cases was 5. months and in previous infeted cases, was 5.5 months. 4. The average duration of bone union in open fracture was 5.5 months and in closed fracture, was 5 months. 5. The invasive electrical stimulation was a good technique to treat the intractable nonunion as the result of long bone fracture.

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Treatment of Unstable Distal Radius Fracture: Myung Chul Yoo, Yong Girl Rhee, Keun Young Lee, Dong Kee Ahn; J Korean Soc Fract 1988;1(1):11-19. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.11

Abstract PDF: The unstable distal radius fractures result in various residual disability, and the instability can be recognized by the presence of much comminution, severe dorsal angulation or extensive intraarticular involvement. It is disfficult to reduce the fracture fragments and immobilize it with classical closed rduction and cast immobilization. So many authors have tried to reduce it with invasive methods and apply supplementary fixztion. Clinical and radiological analysis was made in 29 patients of unstable distal radius fracture who treated in Kyung Hee University Hospital from Jan. 1983 to Dec, 1987. The results were as following; 1. The unstable distal radius fractures were 24% of the distal radius fractures which were treated with admission. 2. In prevalence, male was mostly young men, but female was mostly old women. 3. The most frequent Frykman type was VIII(48.3%), but it could not represent the degree of comminution and displacement sufficiently. 4. Most of the patients treated by conservative method showed poor results. But operative treatment made it possible to align the fragment anatomically, restore the congruity of articular surface and prevent the collapse of reduction, so satisfactory results were obtained. 5. The unstable factures with large cortical defect or severe comminution required internal fixation for anatomical reduction and at the same time required additional external fixation to prevent the collapse and shortening of the distal radius.

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