• Journal of Korean Orthopaedic Sports Medicine
• /
• v.5 no.1
• /
• pp.63-68
• /
• 2006

Purpose: To assess the effectiveness of the Locking compression plate (LCP) after open reduction for the treatment of the displaced clavicular shaft fracture, the clinical and radiologic outcome of the patients who were managed with the LCP for internal fixation after open reduction has been analyzed. Materials and Methods: We reviewed 26 cases with a displaced clavicular shaft fracture treated by internal fixation using Locking compression plate after open reduction between May 2003 and November 2004. The patients were followed up for at least six months period, and final postoperative outcome was evaluated using clinical results based on Kang's criteria, radiologic signs of fusion. Results: All fractures united by an average of 9.3 weeks without delayed union and showed fast recovery of motion fraction and shoulder function. In addition,24 cases without the fractures of proximal humerus recovered to normal range of shoulder notion within 2.9 weeks. Clinically, according to Kang's criteria, the outcome was good or better in 22 patients. The complications included shoulder joint dysfunction in two cases and keloid formation in one case, and no other complications were observed. Conclusion: The internal fixation using LCP for the treatment of displaced clavicular shaft fracture is a safe, reliable method of treatment, with few complications, and offers rapid recovery of shoulder joint function and bone union.

• Clinics in Shoulder and Elbow
• /
• v.15 no.2
• /
• pp.117-122
• /
• 2012

Purpose: To assess the effectiveness of internal fixation using a precontoured locking compression plate for the treatment of the displaced clavicle fracture by analyzing both radiological and clinical outcomes. Materials and Methods: We reviewed 34 cases of displaced clavicle shaft fracture treated by internal fixation using precontoured locking compression plates between May 2009 and February 2010. Radiological outcomes were analized on the basis of bone union and the differences between the time for bone union depending on sex and age. Clinical outcomes were analyzed on the basis of quick DASH Scores and the differences in the range of motion of the affected shoulder compared to the contralateral shoulder. Results: In the radiological evaluation, all fractures showed bone union, and the average time for bone union was 12.3 weeks, without delayed unions. Time for bone union did not differ significantly with respect to sex and age (p=0.87). In the clinical evaluation, the average final quick DASH Score was 23.5 (range, 12~42). At final follow up, the range of motion after bone union in the affected shoulder was not significantly different from that of the contralateral shoulder (p=0.69). Conclusion: The internal fixation achieved using precontoured locking compression plate in displaced clavicle shaft fracture showed effective bone union and can be considered as a reliable method with fine clinical results showing early range of motion at the shoulder joint.

• Archives of Craniofacial Surgery
• /
• v.9 no.2
• /
• pp.51-54
• /
• 2008

Purpose: The choice of open versus closed reduction for mandibular subcondylar fracture is a debatable issue. To evaluate the advantage of open approach to closed method with IMF(intermaxillary fixation), we conducted a retrospective study to compare the outcomes of each method. Methods: From 2002 to 2006, 29 patients with mandibular subcondylar fractures were treated by open or closed reduction. 17 patients were treated by open reduction and 12 patients by closed reduction and IMF. Each group was assessed for duration of mandibular immobilization, incidences of buccal palsy, malocclusion, TMJ(temporomandibular joint) pain, and deviation of the mandible on mouth opening. Results: All cases showed accurate reduction in anatomical position, no significant displacement and no deviation on mouth opening during the follow-up period. IMF period is statistically shorter in open reduction (p<0.05). Differences in incidence of other complications were not significant statistically. Conclusion: As there are significant independent morbidities associated with IMF which requires postoperative rehabilitation, prolonged temporomandibular immobilization should not be overlooked. Some patients with poor compliances will not tolerate IMF in nonsurgical treatment. In the aspect of patient's convenience and early recovery by short IMF period, open reduction would be recommended as a better treatment method.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.11 no.2
• /
• pp.87-95
• /
• 1989

The therapeutic methods and follow - up prognosis of subcondylar fractures in adults have always been sources of controversy. To improve the therepeutic results in subcondylar fractures with displacement, and especially, the bicondylar ones, the auther employ the surgical reduction using of sagittal split and oblique subcondylar osteotomy. This report is illustrated by six clinical cases.

• Journal of Korean Foot and Ankle Society
• /
• v.2 no.2
• /
• pp.82-87
• /
• 1998

The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. And so the goals of operative treatment for ankle fractures are to obtain an anatomical reduction that is maintained by stable fixation, resulting in a healed fracture and recovery of normal function. The 64 patients who had ankle fractures were treated by arthroscopic reduction(20 cases) and open reduction (43 cases) in Konkuk university hospital from February 1991 to October 1997 and the results were analyzed in clinical and radiological aspects. The following results were obtained. According to the criteria of Meyer, arthroscopic assisted reduction group had good or excellent results in 18 cases (90%) and open reduction group good or excellent in 35 cases (83%). The difference of the results was not significant statistically, but arthroscopic assisted reduction technique has several advantages over open technique; the best assessment of articular surface, lower wound problem, postoperatively faster rate of rehabilitation and minor discomfort.

• Clinics in Shoulder and Elbow
• /
• v.10 no.2
• /
• pp.212-219
• /
• 2007

Purpose: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. Materials and methods: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam's functional assessment method were used to evaluate the postoperative shoulder function. Results: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. Conclusion: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.

• Journal of Korean Foot and Ankle Society
• /
• v.14 no.1
• /
• pp.105-107
• /
• 2010

The scanty literature on distal tibiofibular synostosis includes descriptions of relatively few specific complaints. Here we report a case of a 24-year-old young soldier who sustained a left ankle lateral malleolar fracture about 6 months ago and was initially treated by the open reduction and internal fixation with plate & screw. But 6 months later, he suffered from an vague ankle pain, each time the symptoms occurred right after an active ambulation, ankle dorsiflexion, especially when he had exercised aggressively. The radiographs revealed that there was a mature distal tibiofibular synostosis. We treated the patient with surgical excision of synostosis. Post-operative condition was satisfied to all concern and the result was found to be excellent during one-year follow-up.

• Clinics in Shoulder and Elbow
• /
• v.10 no.1
• /
• pp.131-135
• /
• 2007

We report an isolated anterior dislocation of the radial head in a 23-year-old man after a fall on the outstretched arm. At the time of the injury, the patient's elbow was in a position of mild flexion and pronation which was suddenly further pronated as he fell down. The radial head was incarcerated by the lateral portion of brachialis muscle, and annular ligament was interposed between capitellum and radial head. Open reduction was performed. During 12 months follow-up, reduction of radial head was well maintained without a limitation of range of motion.

• Clinics in Shoulder and Elbow
• /
• v.13 no.2
• /
• pp.194-201
• /
• 2010

Purpose: We evaluated clinical and radiological results for open reduction and internal fixation of acromioclavicular dislocation without coracoclavicular ligament repair after removal of implants. Materials and methods: Clinical and radiological results were obtained for 53 patients who underwent open reduction and internal fixation of an acromioclavicular joint dislocation between 1998 and 2007. A total of 21 patients were treated with a modified-Phemister method and 32 patients were treated with a Hook plate method. All subjects were surveyed after removal of their implants. The Constant scoring system was administered postoperatively to evaluate clinical results. Radiologic outcomes were evaluated by both coracoclavicular intervals on plain films. Results: Constant scores were $87.59{\pm}7.8$ in the Phemister group and $89.35{\pm}5.3$ in the Hook plate group. For both groups, the mean coracoclavicular interval at preoperative radiography was 15.9 mm at the injured site and 8.0 mm at the opposite site. After metal removal, the mean difference between coracoclavicular distances between normal and injured sites were 1.0 mm for the Hook plate group and 1.2 mm for the modified Phemister method group (p>0.05). Conclusion: Open reduction and internal fixation of an acromioclavicular joint without coracoclavicular ligament repair shows good long-term clinical and radiological results.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.6 no.2
• /
• pp.126-129
• /
• 2007

An irreducible dislocation of the knee joint is quite rare. Most irreducible knee dislocations are posterolateral dislocations and result from the soft tissue interposition. To the best of our knowledge, there is no report of an irreducible knee dislocation result from interposition of the detached cartilage from the medial femoral condyle. We present a case of 51 years old female with irreducible knee dislocation which was treated with an arthroscopic debridement of the detached cartilage, result in reduction of the joint, which is failed in closed reduction. And then we perform the delayed arthroscopic reconstructions for the ruptured anterior and posterior cruciate ligaments. Debridement of the interposed structure using the arthroscope allows for reduction of the joint and good result without the need for an open procedure.