• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.95-99
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• 2017

Background: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. Methods: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in $20^{\circ}$ external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in $20^{\circ}$ external rotation view. Results: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was $138^{\circ}{\pm}4^{\circ}$, and at one-year follow-up, the neck shaft angle was $137^{\circ}{\pm}5^{\circ}$. There was no significant difference between the preoperative and postoperative values (p=0.105). Conclusions: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

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

• Journal of Korean Foot and Ankle Society
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• v.2 no.2
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• pp.57-63
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• 1998

Stress or march fractures among military personnel, especially recruits, has been appreciated for many years. According to the classical references, the second metatarsal was one of the first sites identified as a focus for march fractures and radiological evidence of fracture appeared as late as several weeks. The purpose of this study was to document the clinical feature of march fractures in Korean infantry soldiers. From 1997 to 1998, at one infantry medical company of OO infantry corps in Korea, 15 (19cases) patients with march fracture were detected among infantry soldiers. There were some different finding in the fracture site and its clinical features from the previous foreign reports. 1. There were pain and local swelling in all cases as clinical manifestation. By physical examination, direct point tenderness on the location of the fractured metatarsal shaft was characteristic. 2. On roentgenographic examination, cortical fissuring or break was seen one week after onset of symptoms and external callus was seen from two weeks or at the least four weeks. Oblique view was more useful than AP view in the diagnosis of march fractures. 3. The third metatarsal was the most frequently involved site(7 cases, 48%). and the second metatarsal was Jess frequent(3 cases, 20%). This difference of frequent site with previous reports might be attributed to the relatively long shaft of the third metatarsal, but should be analyzed in further study. 4. The incidence of the development of march fracture was 1 per 104 infantry soldiers.

• Journal of Veterinary Clinics
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• v.18 no.2
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• pp.156-159
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• 2001

A 6-year-old male mongrel dog with a 7-month history of ulnar-radial nonunion fracture was treated with implantation of recombinant human bone morphogenetic protein-2 (rhBMP-2). The dog had received surgical correction three times prior to the admission but radiography of the affected limb revealed a typical figure of nonunion fracture. Glossly, the fractured ends were sclerotic and the area between the ends was filled with fibrous tissue. After debridement the shaft was fixed by an 10-hole plate. rhBMP-2 at a total dose of 256 micrograms was implanted with a synthetic carrier into the 10-mm defect formed by the debridement. Callus formation responding to rhBMP-2 was radiographically observed at 4 weeks after implantation and the defect bridged both fracture ends by 8 weeks after implantation. The plate was removed at 12 months after implantation. Any complications were not observed for 5 months after removal of the plate.

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.149-160
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• 2003

Purpose: to determine the results after open intramedullary nailing and tension band suture technique in proximal humerus fracture for improving the stability and decreasing the complications. Materials and Method: Authors reviewed 27 patients treated by open intramedullary nailing and tension band suture technique. Mean follow-up period was 39 months (24-59months). Surgical neck fracture were 6 cases, surgical neck fracture with shaft fracture were 3 cases, three part fracture with greater tuberosity fracture were 17 cases, four part fracture was 1 case and fracture and dislocation were 2 cases Results: We got the bony union in 26 cases. Average pain scale was 1 point (0-6), Neer score was 86 point(45-99) and ASES score was 85 point(40-100). We separate all cases in two groups based on age (65 years), L-spine t-score (-2.5) and Neer classification (2 and 3 part). There is no significance in pain scale, Neer score and ASES score between each group. Conclusion: As a method of surgical treatment on severe proximal humeral fractures, we recommend intramedullary nailing and tension band suture technique and it may have particular advantages in early exercise and satisfactory functional outcome.

• Clinics in Shoulder and Elbow
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• v.18 no.2
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• pp.91-95
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• 2015

Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.

• Clinics in Shoulder and Elbow
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• v.18 no.2
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• pp.75-79
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• 2015

Background: This retrospective comparative study aims to evaluate the surgical outcomes and complications of two surgical methods for simple fractures of the humeral shaft; minimally invasive anterior plating and open reduction combined with internal fixation. Methods: A total of 26 patients with humeral shaft simple fractures, who had surgery between June 2009 and September 2013 and were followed-up at least 12 months, were included in our analysis. They were divided into two groups; group 1 comprised of 12 patients who underwent minimally invasive anterior plating and group 2 comprised of 14 patients who underwent an open reduction and internal fixation. The clinical outcomes, radiological results, and complications were compared and analyzed. Results: We found that bone union was achieved in all patients, and the mean union periods were $20.7{\pm}3.34$ and $20.3{\pm}3.91$ weeks for groups 1 and 2, respectively. In most patients, we found that shoulder and elbow functions were recovered. At 12 months post-operation, we found that the Korean Shoulder Scoring system, the University of California at Los Angeles score and Mayo elbow performance score were $91.4{\pm}7.97$, $33.4{\pm}1.15$, and $90.8{\pm}2.23$ for group 1, and $95.2{\pm}1.53$, $33.3{\pm}1.43$, and $90.17{\pm}1.85$ for group 2. In terms of complications, we found that 2 patients had radial nerve palsy after open reduction and internal fixation, but all cases spontaneously resolved within 6 months. Complications such as infection and loss of fixation were not reported. Conclusions: Both minimally invasive anterior plating and open reduction with internal fixation produced satisfactory outcomes in the treatment of simple fractures of the humeral shaft.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.38 no.4
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• pp.437-442
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• 2014

The equipment or with a constant torque and a variable stress due to axial vibration such as the turbine-generator system in nuclear power plant show the fatigue fracture behavior. Thus this study whoul aim to measure the torsional stress and analyze the fatigue fracture behavior. To achieve this, we manufactured the equipment similar with turbine-generator system and applied various torsional vibration stress due to external load. In particular, the evaluation was conducted with the existing evaluation methods of the fatigue behavior of known stress-life, strain-life, crack growth assessment methods. With increasing the external load and independent methods tends to decrease the fatigue life was confirmed up to 10 times in 5 kV external load compared to without external load.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.427-432
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• 2021

Delayed treatment of volar dislocation of the distal radioulnar joint can result in wrist pain, limited rotation of the forearm, and degenerative arthritis that could be managed only by salvage procedures. A 24-year-old male patient presented with wrist pain and a loss of forearm rotation after surgery for a radial shaft fracture. The shaft of the radius was fixed with a plate and screws with a volar angulation of 7°. The ulnar head was dislocated volar to the distal radius, and the bone defect in the ulnar head was impacted into the volar rim of the sigmoid notch of the radius, preventing the head from being reduced in the joint. Corrective osteotomy of the malunited radial shaft and sliding osteotomy of the proximal ulnar head were performed to fill the distal bone defect. Pain and range of the forearm rotation were improved at postoperative 19 months.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.196-196
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• 2009