Rare Case of Anterior Compartment Syndrome after Achilles Tendon Rupture

Suenghwan Jo,Jung Woo Lee,Sung Hun Yang,Kyung Hoon Sun 조선대학교 의학연구원 2017 The Medical Journal of Chosun University Vol.42 No.4

The management of acute Achilles tendon rupture has been well established and is often treated with interrupted tenorrhaphy. While surgical site infection, rerupture and ankle contracture has been reported as potential complications, the tendon often heals uneventfully, and reports of complication other than mentioned above are extremely rare. We report a case of a common peroneal nerve injury which occurred after Achilles tendon repair surgery. The injury may have occurred following compartment syndrome from the anteriorly place long leg splint. To our knowledge, this is the first report in the literature.

경골 원위 간단부 골절에서 골수강 내 금속정 고정 시 Blocking Screw의 유용성

조승환(Suenghwan Jo),이상홍(Sang Hong Lee),이준영(Jun Young Lee),전용철(Yong Cheol Jun) 대한정형외과학회 2017 대한정형외과학회지 Vol.52 No.3

목적: 경골 원위 골간단부 골절에서 골수강 내 금속정 고정 시 blocking screw의 유용성에 관하여 알아보고자 하였다. 대상 및 방법: 2012년 1월부터 2014년 12월까지 원위 경골 골간단부 골절 환자로 골수강 내 금속정 고정과 blocking screw를 사용한 환자 중 최소 1년 이상 추시한 18예를 대상으로 하였으며, 후향적 연구를 시행하였다. 개방성 골절은 7예가 있었으며, 족관절면까지 골절선이 연장된 경우는 4예가 있었다. Blocking screw의 위치는 술 전 골절의 형태에 따라 미리 정하였고 술 전 및 술 후 정렬을 측정하였다. 술 후 주기적인 영상학적 검사를 시행하였으며, 골유합이 된 시기와 불유합의 빈도를 기록하였다. 임상적 결과는 modified functional Kalstrom-Olerud score를 이용하여 분석하였다. 결과: 모든 예에서 불유합 없이 골유합을 얻었고 평균 골유합 시기는 17.7주였다. 술 전 alignment는 관상면상 평균 6.4도, 시상면상 평균 alignment 4.8도였으며, 술 후 2.5도, 1.9도로 좋아졌으며, 골유합 시까지 유지되었다. 합병증으로 anterior knee pain은 3예였으며, blocking screw에 의한 합병증 및 감염 등의 창상 관련 합병증은 없었다. Modified functional Kalstrom-Olerud score에서 good에서 excellent까지는 83.4%였다. 결론: Blocking screw는 경골 원위 골간단부 골절에서 골수강 내 금속정 고정 시 정복 및 정렬에 도움이 된다. Purpose: To evaluate the usefulness of blocking screws in distal tibial metaphyseal fractures treated with intramedullary nailing. Materials and Methods: A total of 18 patients with distal tibial metaphyseal fractures, who underwent intramedullary nailing treatment with blocking screws between January 2012 and December 2014 and had a minimum follow-up of 1 year, were retrospectively reviewed for analysis. There were 7 patients with open fracture and 4 patients with intra-articular fracture. The location of the blocking screws was previously determined according to the fracture pattern. Moreover, the preoperative and postoperative angular alignment was measured. Patients received regular postoperative radiographic check-up, and the time-to-bone union and the incidence of nonunion were recorded. The clinical outcome was evaluated using the modified functional Kalstrom-Olerud score. Results: All fractures healed completely without nonunion at an average of 17.7 weeks. The mean coronal/sagittal alignment improved from 6.4/4.8 degrees preoperatively to 2.5/1.9 degrees postoperatively. The alignment was maintained until complete union. There were 3 cases of anterior knee pain but no complications related to the blocking screw and wound infection. Using a modified functional Karlstrom-Olerud score, the outcome was considered good to excellent in 83.4% of the patient cohort. Conclusion: We conclude that the blocking screws may help the maintenance of reduction and alignment in distal tibial metaphyseal fractures treated with intramedullary nailing.

경골 천정 골절에서 추가 소형 잠김 금속판을 이용한 치료 결과

조승환 ( Suenghwan Jo ),이준영 ( Jun Young Lee ),김보선 ( Boseon Kim ),류강현 ( Kang Hyeon Ryu ) 대한골절학회 2017 대한골절학회지 Vol.30 No.2

목적: 경골 천정 골절에서 2.7 mm 추가 소형 잠김 금속판을 이용한 내고정의 결과를 알아보고자 하였다. 대상 및 방법: 2012년 9월부터 2014년 4월까지 경골 천정 골절 21명의 환자를 대상으로 하였다. 남자 14예, 여자 7예였으며, 평균 나이는 43.85세, 평균 추시는 16.6개월이었다. Burwell과 Charnley 체계를 이용하여 방사선적 결과를 평가하였으며, 시각통증등급 및 미국 족부족관절정형외과학회 족관절-후족부 기능평가를 이용하여 임상 결과를 평가하였다. 결과: 평균 골유합은 14.3주였다. 최종 추시 방사선 검사 결과는 해부학적 정렬 16예, 보통 4예, 불량 1예였으며, 임상 결과는 시각통증등급 평균 3.4점, 미국 족부족관절정형외과학회족관절-후족부 기능평가 평균 81.8점이었다. 추시 중 3예에서 외상 후 골 관절염이 발생하였으며 표재성 감염이 1예에서 발견되었다. 결론: 경골 천정 골절의 치료에서 2.7 mm 추가 소형 잠김 금속판을 이용하여 관절의 일치성 및 골유합을 용이하게 획득하였고 좋은 결과를 얻을 수 있어 천정 골절의 치료에서 유용한 방법들 중 하나로 생각된다. Purpose: We evaluated the usefulness of an additional, 2.7 mm mini-locking plate for tibial pilon fractures. Materials and Methods: We studied 21 patients (14 males and 7 females), who were treated with a 2.7 mm mini-locking plate via the anterolateral approach for tibial pilon fractures between September 2012 and April 2014. The mean age was 43.85 years, and the mean follow-up period was 16.6 months. The radiologic outcomes were graded by the Burwell and Charnley modified system and clinical outcomes were evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot score and visual analogue scale (VAS) score. Results: The mean union period was 14.3 weeks. At the final follow-up, radiologic results showed 16 excellent results, 4 fair results, and 1 poor result. The average VAS was 3.4 points; the average AOFAS score was 81.8 points. During the follow-up period, there were three cases of posttraumatic osteoarthritis and one case of superficial skin infection. Conclusion: Additional anterolateral, 2.7 mm mini-locking plate may be a good treatment method to manage tibial pilon fractures.

Subscapularis tendon tears

박상하,Suenghwan Jo,Mohamed Attia,Young Lae Moon 대한정형외과 스포츠의학회 2015 Arthroscopy and Orthopedic Sports Medicine Vol.2 No.2

The subscapularis is a powerful internal rotator which contribute significantly to the shoulder motion but its pathology has only recently been recognized. The injury can occur after trauma or by degenerative aging process. The diagnosis can be made with careful patient assessment including physical examinations and the advanced imaging. The management of the subscapularis tear is dependent on the size and clinical findings but the functional demand of the patient should be considered. Nonoperative treatment is sufficient for partial injury in older patients. However, the patient with full thickness tears with functional loss is need for surgical repair. The prompt dagnosis and the early operation could provide excellent results.

Perioperative complications of the modified Stoppa approach for the treatment of pelvic bone fractures: a single-institution review of 48 cases

( Hyeonjoon Lee ),( Suenghwan Jo ),( Gwangchul Lee ),( Yongjin Cho ) 대한외상학회 2022 大韓外傷學會誌 Vol.35 No.1

Purpose: The current study aimed to report the perioperative complications of the modified Stoppa approach for the treatment of pelvic bone fractures. Methods: We analyzed 48 consecutive operations in 45 patients who were treated with internal fixation using the modified Stoppa approach between March 2016 and July 2018. This included three revision operations. The mean age of the patients was 54.5 years, and the patients included 35 male patients and 10 female patients. All fractures occurred as a consequence of high-energy trauma and 70.3% had associated injuries at the time of the fracture. The mean Injury Severity Score was 9.03±5.60. The perioperative complications found during and immediately after surgery were recorded and were classified into three categories: vascular injuries, nerve injuries, and other complications. Results: Overall, 14 perioperative complications (29.2%) in 14 cases were identified. The most common complications were nerve injuries, which occurred in seven cases, all involving the obturator nerve. Uncontrollable vascular injuries occurred in six cases, which required additional incisions and support of vascular surgeons or postoperative interventions. Additionally, one case of peritoneal tearing occurred, which required help from an abdominal surgeon. Conclusions: While the modified Stoppa approach seems to be a viable method to treat pelvic fractures, significant perioperative complications may occur, suggesting that surgeons should pay careful attention to minimize the damage to other structures and that appropriate support from other surgical departments is paramount.

Outcome of femoral head fracture with surgical hip dislocation

Na Woongchae,Jo Suenghwan 조선대학교 의학연구원 2023 Medical Bilogical Science and Engineering Vol.6 No.1

The purpose of the current study is to evaluate the outcomes of surgical dislocation in patients with femoral head fractures. Medical records of sixteen patients with femoral head fractures who underwent surgical dislocation between November 2009 and December 2014 were retrospectively analyzed. Clinical and radiological outcomes were assessed, and the mechanism of injury, time to reduction, and Pipkin classification were identified. Statistical assessment was performed to identify the risk factors that adversely affected the outcome. In the studied cohort, fractures of Pipkin types I, II, III, and IV were observed in zero, ten, one, and five patients, respectively. The mean modified Harrison Hip score at the last follow-up was 80.2±9.3, and eleven, three, and two patients showed excellent, good, and fair outcomes, respectively. Nine, five, and two patients showed Tonnis grades I, II, and III, respectively at the last follow-up. Five complications, including avascular necrosis (1 patient), post-traumatic osteoarthritis (2 patients), heterotopic ossification (1 patient), and post-operative infection (1 patient), were observed. No statistically significant risk factors for poor outcomes or for the development of complications were found. In conclusion, the patients with femoral head fracture treated with surgical dislocation showed good clinical outcomes with acceptable complication rates.

Osteoarticular cartilage transplantation to treat traumatic femoral head bone defect

Hyeon-Joon Lee,Suenghwan Jo 조선대학교 의학연구원 2020 The Medical Journal of Chosun University Vol.45 No.2

Osteochondral defect of femoral head following traumatic hip dislocation is a big challenge for the surgeon and there are limited reports on its treatment. Hereby, we report a case series of osteochondral autograft transplantation. The graft was harvested from the ipsilateral femoral head. We are reporting case series with successful outcome; and therefore we report our result with the literature review.

Clinically representative rodent model for biomedical device-associated infection

Lee Hyeongjoon,Choi Sookyung,Jo Suenghwan 조선대학교 의학연구원 2023 Medical Bilogical Science and Engineering Vol.6 No.1

Bacterial biofilms in the body commonly occur following the implantation of a biomedical device. A mature biofilm results in an extracellular matrix covering the aggregated bacteria and provides protection against antibiotics or the native immune system, rendering diagnosis and treatment difficult. Experiments to eradicate or prevent biofilm formation have been widely performed, with many showing potential for application in vivo. To test the safety and in vivo efficacy of these novel methods, a reliable preclinical animal model is necessary. Here we developed a simple animal model that can be used to recreate medical device-associated infections in vivo. Reproducible Staphylococcus aureus bacterial biofilms were formed on a titanium implant and confirmed by the counting of colony-forming units after sonication and in vivo bioluminescence measurements. We tested our strategy for developing both acute and late-onset infections and confirmed that the model successfully demonstrated bacterial biofilm formation on titanium surfaces, representing acute infection. We believe that this model will be a good option for validating the efficacy and safety of antibacterial strategies for orthopedic surgery

Review of impingements around the hip joint

Jae Hwan Lim,Kang Yeol Ko,Suenghwan Jo 조선대학교 의학연구원 2022 Medical Bilogical Science and Engineering Vol.5 No.1

Hip pain in athletes is relatively common but is often underdiagnosed. Historically, surgery has been utilized only for hips with osteoarthritis or osteonecrosis, and pain from other causes was considered to be self-limiting. However, recent studies have reported that surgical treatment may benefit patients with recalcitrant pain that is derived from impingement around the hip. The current review aims to describe the common impingement syndromes around the hip joint which can be a cause of pain, as well as detrimental to function. The review also highlights surgical methods that have recently been developed for treating such impingements.

Perioperative Comparison of Hip Arthroplasty Using the Direct Anterior Approach with the Posterolateral Approach

( Sang Hong Lee ),( Sin Wook Kang ),( Suenghwan Jo ) 대한고관절학회 2017 Hip and Pelvis Vol.29 No.4

Purpose: The aim of the current study is to report the advantage and disadvantage of total hip arthroplasty performed in direct anterior approach (DAA) by comparing it to the posterolateral approach (PLA). Materials and Methods: Twenty-five hip arthroplasty done in DAA (12 total hip arthroplasty [THA] and 13 bipolar hemiarthroplasty [BHA]) were compared with the same number done in PLA (13 THA and 12 BHA). Intraoperative assessments including operation time, anesthetic time, bleeding amount were recorded with intraoperative complications. Immediate postoperatively, position of the prosthesis and leg length discrepancy were measured and were compared between the two approaches. Results: The operation time was 22 minutes and 19 minutes longer in DAA for THA and BHA respectively while the anesthetic time difference was 26 and 10 respectively. However, these parameters showed no statistical difference. No significance was found when bleeding amount was compared. For DAA, cup alignment was within safe zone in 100% both for inclination and for anteversion while this was 83.3% and 75.0% respectively in PLA. Leg length difference was 3 mm in DAA and 5 mm in PLA but had no significant difference. Tensor fascia lata tear was the most common complication occurring in 9 patients. Conclusion: Although significant was not reached there was trend toward more operation time and anesthetic time when DAA was used. However, the trend also showed that cup and stem were likely to be in more accurate position and in adequate size which is likely due to the accurate use of fluoroscopy.