• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.106-112
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• 2012

Radial nerve palsy after surgery of humerus fracture is uncommon complication. Occasionally it needs operative treatment because of difficulty to accurate evaluation. We report this case of radial nerve palsy after surgery of humerus shaft fracture with ultrasound examination. We checked the continuity of radial nerve and radial nerve palsy was complete recovered with conservative treatment.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.44-51
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• 2009

Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2003.11a
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• pp.175-180
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• 2003

상완골 근위부 골절의 치료를 위해서 실시하는 상완골 두 치환술은 고난도의 수술이다. 그러나 수술 수기에 만전을 기하고 골절을 위해서 특별하게 고안된 치환물을 사용하면 통증을 해소되는 것은 물론이며 대부분의 견관절 기능도 회복이 가능하다고 생각한다. 또한 보다 좋은 결과를 얻기 위해서는 치환물과 수술 수기 등에 대해서 지속적인 개선이 매우 중요하다고 생각한다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 2003.09a
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• pp.110-110
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• 2003

후두기관외상은 두경부 부위의 다른 외상에 비해 흔하지 않은데, 이는 연골의 유연성과 후두의 가동성, 후두가 하악과 흉골사이에 위치하여 외상시 보호 받게 되는 해부학적 특성에 기인한다. 그러나, 후두는 호흡과 발성에 중요한 기관으로 조기 진단과 정확한 평가, 적절한 치료를 못할 경우 생명을 위협 할 수 있고 삶의 질에 지대한 영향을 줄 수 있다. 이에 저자들은 급성 후두기관손상으로 수술적 치료를 받은 환자를 대상으로 손상 기전 및 임상 양상, 손상부위, 손상 정도 치료 등을 알아보고 향후 치료에 도움을 얻고자 하였다. 1996년부터 2003년까지 급성 후두기관 손상으로 수술적 치료를 받은 10명을 대상으로 후향적으로 조사를 하였다. 손상정도는 Schaefer의 분류를 따랐으며 술후 결과는 발성과 기도유지로 평가하였다. 발성의 경우 수상전과 동일하거나 유사할 경우 성공(good)으로, 수상전과는 다르지만 기능을 하는 경우는 양호(fair)로, 거의 음성이 나지 않거나 알아들을 수 없는 경우 불량(poor)로 분류하였고, 기도유지는 수상전과 동일하거나 유사할 경우 성공(good)으로, 경한 흡인이나 운동 유발성 호흡곤란이 있는 경우(fair)로 발관이 되지 않는 경우를 불량(poor)으로 분류하였다. 남녀 성비는 8대 2였고 30～40대가 4명으로 가장 많았다. 손상의 원인은 둔상인 경우(4예) 교통사고가 2례, cloth line 손상 2례, 관통상(6례)는 모두 칼에 의한 좌상이었다 증상은 피하기종이 9례, 애성이 7례, 호흡 곤란이 6례로 많았으며 손상부위는 갑상연골 골절이 5례(50％), 기도손상과 갑상선 손상이 각각 4례에서 관찰되었다. 그 외에도 윤상 연골 골절과 윤상갑상막 손상 등이 관찰되었다. 또한 점막 손상이 7례에서 관찰되었다. 성대마비는 내원시 4례에서 관찰되었다 치료는 수상 후 조기수술을 시행하였고 수상 부위를 개방하여 손상된 연조직을 일차 봉합하거나, 골절을 정복 고정하였고 3례에서 스텐트를 삽입하였다. 술후 기도유지는 모두 성공적이었고 발성기능은 6례에서 성공(good)적이었고 4례에서 양호(fair)의 결과를 보였다. 양호의 결과를 보인 모든 예가 내원시 성대 움직임의 마비나 저하를 보인 예였다. 급성 후두기관손상환자에서 조기 진단과 적절한 수술적 치료는 환자의 생명을 유지시키고 술후 발성 지능의 보존에 양호한 결과를 보였다.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.174-174
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• 2007

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.45-52
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• 2006

Purpose: We evaluated the results of operative treatment of tibial plateau fractures using both arthroscopy and fluoroscopy. Materials and Methods: From May 1999 to February 2003, tibial plateau fractures were treated with arthroscopy. Tweenty seven patients are followed up over two years and the average follow-up period was fourty one months. We classified the fractures according to the Schatzker classification. We reduced the fracture over 2mm depression and displacement on articular surface in simple radiologic finding. Firstly, we treated the associated injuries and reduced the fractures using Steinmann pins. Then, we accomplished internal fixation or external fixation. Both the postoperative clinical and radiological results were evaluated by Rasmussen system. Results: In all tweenty seven cases, the fractures were healed completely in average fourty one months. According to Rasmussen classification, we obtained the excellent or good results in 23 cases. An average range of motion was between 2.5 degrees and 130 degrees. However, postoperative infection developed in one case and the other had loss of reduction. Conclusions: We consider that arthroscopically assisted operative treatment of tibial plateau fracture is a useful method. We can reduce joint surface correctly and treat associated injuries with arthroscopy. There are less complications.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.142-149
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• 2009

Purpose: We wanted to assess the radiological and clinical results and the prognostic factors after an operation for capitellar fractures associated with/without other injury around the elbow. Materials and Methods: Among the 25 patients (mean age: 49 years-old) who underwent open reduction and internal fixation for capitellar fractures, there were nineteen type 1 fractures and six type 3 fractures. The mean follow up period was 14.8 months. We assessed the factors affecting the radiological and functional results, such as the fracture pattern, the patient age and the surgical approaches. Results: In 24 of 25 patients, bony union was achieved at postoperative 1 year. There were eighteen excellent, four good, two fair and one poor functional results according to the Broberg and Morrey elbow score. The most common type was type 1 and the most common associated injury was lateral condylar fracture. The patients with type 1 fracture rather than the patients with type 3 fracture and the patients who had an extraarticular associated fracture rather than an intraarticular associated fracture had better clinical outcomes. Conclusion: 22 (88%) of the patients were satisfied at the result. The type of capitellar fracture and an associated intraarticular elbow fracture were shown to be important prognostic factors in this study.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.220-226
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• 2007

Purpose: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. Materials and Methods: The subjects were 8 patients(average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. Results: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. Conclusion: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.123-128
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• 2006

Purpose: Surgical reconstruction is usually indicated for type II distal clavicle fracture due to high rate of nonunion and delayed union. We report the clinical outcome of a surgical technique for type II distal clavicle fracture using Mersilen tape and K-wire. Materials and Methods: From 1999 through 2003, this technique has been used on 11 patients with type II distal clavicle fracture. The procedure consist of fracture reduction with a Mersilene tape, repair of torn coracoclavicular ligament, and K-wire fixation of the fracture fragment. All patients with at least 12 months of complete postoperative follow-up were included for functional and radiographic evaluation. We used simple X-ray and UCLA scoring system and constant scoring system for evaluation at last follow up in OPD. Results: Solid union of the fracture could be achieved at 11 weeks after operation in all patients. All patients could return to the same level of preinjury activity. Good and excellent results were obtained in all patients according to UCLA system. Conclusion: This technique was simple procedure and allowed for stable fixation with early mobilization and early return to work and sports.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.190-198
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• 2007

Purpose: The current study reports the clinical results of total elbow arthroplasties (TEA) which were Performed on patients with poor clinical and radiological results after initial surgeries for elbow fractures or dislocations. Materials and Methods: The clinical outcomes of twelve consecutive patients who underwent TEA after failed surgeries for elbow fractures or dislocations from january, 1995 to December, 2005 were evaluated. The initial diagnoses were distal humeral fractures in 8 cases and fracture-dislocations in 4 cases. The Mean period from the initial operations to the TEAs was 12 months. The mean folloow up period after TEA was 43 months. Results: The mean range of motion, in terms of active extension, activeflexion, supination, and pronation, improved from $14.2^{\circ}$, $96.7^{\circ}$, $50.8^{\circ}$ and $53.3^{\circ}$ to $5.4^{\circ}$, $122.1^{\circ}$, $63.3^{\circ}$ and $67.5^{\circ}$, respectively (p<0.05). RAdiolucent lines were found in 3 cases, which were 1 case of type 3, and 2 cases of type 4. All three loosening cases underwent revision TEAs. The mean postoperative Mayo elvow performance score was 79 point. There were 6 cases of excellent, 2 cases of good, and 4 cases in poor. Conclusion: Good clinical results were obtained after TEA performed in failed surgeries for elbow fractures of dislocations.