The Ewha Medical Journal

"Suk-Joong Lee"

Original Articles

[English]

Straightforward, safe, and efficient interlocking screw insertion during intramedullary nailing using a Steinmann pin and hammer: a comparative study: Maria Florencia Deslivia, Hee-June Kim, Sung Hun Kim, Suk-Joong Lee; Ewha Med J 2024;47(3):e39. Published online July 31, 2024; DOI: https://doi.org/10.12771/emj.2024.e39

Abstract
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Objectives: Accurately targeting distal nail holes and placing distal interlocking screws pose challenges during intramedullary nailing. This study proposes a straightforward technique for distal locking screw insertion using a Steinmann pin, eliminating the need to reposition the pin or drill bit.

Methods: We utilized 18 Sawbones femur models and intramedullary femur nails. A first-year resident created two distal locking holes on each model, employing both the conventional freehand technique and a novel method involving a Steinmann pin and hammer under image intensification. These techniques were evaluated based on three parameters: (1) the time required to create distal locking holes, measured from the moment the pin was positioned at the center of the hole until the far cortex was drilled through the interlocking hole; (2) the radiation dose (in mrem/h), as estimated with a personal gamma radiation dosimeter; and (3) the number of failures, defined as the creation of more than one hole in the near and far cortex.

Results: The new technique was associated with a lower radiation dose (P=0.0268) and fewer failures (P=0.0367) than the conventional approach. Additionally, the time required to establish distal holes was shorter using the new technique compared to the conventional method (P=0.0217).

Conclusion: The creation of distal interlocking holes with a Steinmann pin and hammer is accurate, efficient, and cost-effective.

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Unresolved policy on the new placement of 2,000 entrants at Korean medical schools and this issue of Ewha Medical Journal
Sun Huh
The Ewha Medical Journal.2024;[Epub] CrossRef

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[English]

The use of the bicipital groove as an intraoperative landmark for proximal humeral rotation during fracture fixation: Hyun-Joo Lee, Sanghyun Joung, Erica Kholinne, Suk-Joong Lee, Jong Pil Yoon, Jun Tan, In-Ho Jeon; Ewha Med J 2024;47(2):e25. Published online April 30, 2024; DOI: https://doi.org/10.12771/emj.2024.e25

Abstract
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Objectives:

This study aimed to quantify the relationship between proximal humeral rotation and the lateral border of the bicipital groove on fluoroscopic imaging.

Methods:

A composite normal humerus with a marker placed on the lateral border of the bicipital groove was affixed to a custom rotation device at the proximal cut segment. Consecutive fluoroscopic images were captured from −60° to 60° in 5° increments and from −15° to 15° in 1° increments. The index value was calculated by taking the ratio of the distance from the medial boundary of the proximal humerus to the lateral border of the bicipital groove to the distance between the medial and lateral boundaries of the proximal humerus. The correlation between the humeral rotation and the index value was determined.

Results:

The index value showed a strong positive linear correlation position during internal rotation of the humerus across the entire range (r=0.998, P<0.001), as well as when the humerus was externally rotated, ranging from 15° of internal rotation to 15° of external rotation (r=0.991, P<0.001).

Conclusion:

The lateral border of the bicipital groove may serve as a useful intraoperative landmark for assessing proximal humeral rotation. This could potentially enhance the outcomes of humeral fracture repair and upper arm arthroplasty.