1.Acute Heart Failure Across the Ejection Fraction Spectrum: Phenotypes, Management, and Outcomes From Nationwide KorHF III Registry
Huijin LEE ; Eung Ju KIM ; Seong Woo HAN ; Seong-Mi PARK ; Hyung-Seop KIM ; Myung-Chan CHO ; Hyo-Suk AHN ; Mi-Seung SHIN ; Seok-Jae HWANG ; Jin-Ok JEONG ; Dong Heon YANG ; Junho HYUN ; Jin Oh CHOI ; Hae-Young LEE ; Byung-Su YOO ; Seok-Min KANG ; Dong-Ju CHOI ; Hyun-Jai CHO ;
International Journal of Heart Failure 2026;8(1):43-55
Background and Objectives:
Clinical characteristics and outcomes in acute heart failure (AHF) vary by phenotype. We assessed phenotype-specific features, treatment patterns, and outcomes in a nationwide Korean cohort.
Methods:
The Korean Heart Failure III registry prospectively enrolled 7,351 AHF admissions at 47 hospitals. Among 6,777 patients with available left ventricular ejection fraction (EF), phenotypes were defined as heart failure with reduced EF (HFrEF, ≤40%), mildly reduced EF (HFmrEF,41–49%), or preserved EF (HFpEF, ≥50%). The primary endpoint was a 12-month composite of all-cause death or heart transplantation, evaluated from index admission and, among hospital survivors, from discharge. We used inverse probability weighting (multinomial generalized boosted models with stabilized, trimmed weights) and weighted Cox proportional-hazards models to estimate hazard ratios (HRs).
Results:
Phenotype distribution was 58.9% HFrEF, 13.6% HFmrEF, and 27.5% HFpEF. Crude 12-month composite rates from index admission were 13.4% (HFrEF), 12.7% (HFmrEF), and 16.8% (HFpEF). After weighting, from index admission, HFmrEF (HR, 0.892; 95% confidence interval [CI], 0.731–1.088) and HFpEF (HR, 1.101; 95% CI, 0.939–1.291) did not differ from HFrEF; from discharge, HFpEF had modestly higher risk (HR, 1.207; 95% CI, 1.008–1.445) whereas HFmrEF did not (HR, 1.039; 95% CI, 0.844–1.279). Hyponatremia and chronic kidney disease were consistent adverse markers, while angiotensin-converting enzyme inhibitor/ angiotensin II receptor blocker use at discharge was protective.
Conclusions
Across the EF spectrum, phenotypes showed distinct profiles and risk. Postdischarge risk was modestly higher in HFpEF, supporting phenotype-tailored care and systematic discharge optimization in Korean patients with AHF.
2.Humerus Shaft Fracture Caused by Arm Wrestling Injury in South Korean Military:Surgical Outcome and Radiologic Analysis
Yoo-Sun WON ; Tae-Hong MIN ; Woo Kyoung KWAK ; Jong Seop KIM ; Byung Hyun AHN ; Cheungsoo HA
The Korean Journal of Sports Medicine 2025;43(1):23-29
Purpose:
Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers.
Methods:
This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed.
Results:
The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed.
Conclusion
Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.
3.Humerus Shaft Fracture Caused by Arm Wrestling Injury in South Korean Military:Surgical Outcome and Radiologic Analysis
Yoo-Sun WON ; Tae-Hong MIN ; Woo Kyoung KWAK ; Jong Seop KIM ; Byung Hyun AHN ; Cheungsoo HA
The Korean Journal of Sports Medicine 2025;43(1):23-29
Purpose:
Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers.
Methods:
This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed.
Results:
The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed.
Conclusion
Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.
4.Comparison between Suture-Button Technique with Syndesmotic Repair and Screw Fixation Technique for Complete Ankle Syndesmotic Injury: Biomechanical Cadaveric Study
Hong Seop LEE ; Sung Hwan KIM ; Ki Won YOUNG ; Woo Jong KIM ; Dong-Il CHEON ; Sung Hun WON ; Sang Heon LEE ; Seung Jin CHOI ; Young Koo LEE
Clinics in Orthopedic Surgery 2025;17(2):324-330
Background:
The tibiofibular syndesmosis is essential for preserving the stability of the ankle. Acute syndesmotic injuries with evident or latent instability usually warrant surgical interventions. This cadaveric study examines and compares biomechanical characteristics between the following treatments for syndesmosis injuries: suture-button fixation plus syndesmotic repair and screw fixation.
Methods:
The lower extremities of 10 cadavers disarticulated at the knee joints were used, yielding 20 feet. Ten feet underwent surgery using the suture-button fixation with syndesmotic repair, while the remaining 10 feet underwent surgery using screw fixation. Before surgical treatment of syndesmosis injuries, each cadaveric lower limb underwent preliminary physiological cyclic loading, which was followed by a series of postfixation cyclic loading tests after the surgical procedure.
Results:
Our principal finding is that suture-button fixation with syndesmotic repair provided torsional strength comparable to that of screw fixation. The mean failure torque did not differ between the 2 groups, but the rotational stiffness was significantly lower in the suture-button fixation/augmentation group.
Conclusions
Suture-button fixation/augmentation facilitates flexible (physiological) syndesmosis movement and may be a useful alternative treatment for ankle syndesmosis injury.
5.Humerus Shaft Fracture Caused by Arm Wrestling Injury in South Korean Military:Surgical Outcome and Radiologic Analysis
Yoo-Sun WON ; Tae-Hong MIN ; Woo Kyoung KWAK ; Jong Seop KIM ; Byung Hyun AHN ; Cheungsoo HA
The Korean Journal of Sports Medicine 2025;43(1):23-29
Purpose:
Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers.
Methods:
This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed.
Results:
The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed.
Conclusion
Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.
6.Humerus Shaft Fracture Caused by Arm Wrestling Injury in South Korean Military:Surgical Outcome and Radiologic Analysis
Yoo-Sun WON ; Tae-Hong MIN ; Woo Kyoung KWAK ; Jong Seop KIM ; Byung Hyun AHN ; Cheungsoo HA
The Korean Journal of Sports Medicine 2025;43(1):23-29
Purpose:
Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers.
Methods:
This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed.
Results:
The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed.
Conclusion
Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.
7.Humerus Shaft Fracture Caused by Arm Wrestling Injury in South Korean Military:Surgical Outcome and Radiologic Analysis
Yoo-Sun WON ; Tae-Hong MIN ; Woo Kyoung KWAK ; Jong Seop KIM ; Byung Hyun AHN ; Cheungsoo HA
The Korean Journal of Sports Medicine 2025;43(1):23-29
Purpose:
Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers.
Methods:
This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed.
Results:
The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed.
Conclusion
Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.
8.Comparison between Suture-Button Technique with Syndesmotic Repair and Screw Fixation Technique for Complete Ankle Syndesmotic Injury: Biomechanical Cadaveric Study
Hong Seop LEE ; Sung Hwan KIM ; Ki Won YOUNG ; Woo Jong KIM ; Dong-Il CHEON ; Sung Hun WON ; Sang Heon LEE ; Seung Jin CHOI ; Young Koo LEE
Clinics in Orthopedic Surgery 2025;17(2):324-330
Background:
The tibiofibular syndesmosis is essential for preserving the stability of the ankle. Acute syndesmotic injuries with evident or latent instability usually warrant surgical interventions. This cadaveric study examines and compares biomechanical characteristics between the following treatments for syndesmosis injuries: suture-button fixation plus syndesmotic repair and screw fixation.
Methods:
The lower extremities of 10 cadavers disarticulated at the knee joints were used, yielding 20 feet. Ten feet underwent surgery using the suture-button fixation with syndesmotic repair, while the remaining 10 feet underwent surgery using screw fixation. Before surgical treatment of syndesmosis injuries, each cadaveric lower limb underwent preliminary physiological cyclic loading, which was followed by a series of postfixation cyclic loading tests after the surgical procedure.
Results:
Our principal finding is that suture-button fixation with syndesmotic repair provided torsional strength comparable to that of screw fixation. The mean failure torque did not differ between the 2 groups, but the rotational stiffness was significantly lower in the suture-button fixation/augmentation group.
Conclusions
Suture-button fixation/augmentation facilitates flexible (physiological) syndesmosis movement and may be a useful alternative treatment for ankle syndesmosis injury.
9.Comparison between Suture-Button Technique with Syndesmotic Repair and Screw Fixation Technique for Complete Ankle Syndesmotic Injury: Biomechanical Cadaveric Study
Hong Seop LEE ; Sung Hwan KIM ; Ki Won YOUNG ; Woo Jong KIM ; Dong-Il CHEON ; Sung Hun WON ; Sang Heon LEE ; Seung Jin CHOI ; Young Koo LEE
Clinics in Orthopedic Surgery 2025;17(2):324-330
Background:
The tibiofibular syndesmosis is essential for preserving the stability of the ankle. Acute syndesmotic injuries with evident or latent instability usually warrant surgical interventions. This cadaveric study examines and compares biomechanical characteristics between the following treatments for syndesmosis injuries: suture-button fixation plus syndesmotic repair and screw fixation.
Methods:
The lower extremities of 10 cadavers disarticulated at the knee joints were used, yielding 20 feet. Ten feet underwent surgery using the suture-button fixation with syndesmotic repair, while the remaining 10 feet underwent surgery using screw fixation. Before surgical treatment of syndesmosis injuries, each cadaveric lower limb underwent preliminary physiological cyclic loading, which was followed by a series of postfixation cyclic loading tests after the surgical procedure.
Results:
Our principal finding is that suture-button fixation with syndesmotic repair provided torsional strength comparable to that of screw fixation. The mean failure torque did not differ between the 2 groups, but the rotational stiffness was significantly lower in the suture-button fixation/augmentation group.
Conclusions
Suture-button fixation/augmentation facilitates flexible (physiological) syndesmosis movement and may be a useful alternative treatment for ankle syndesmosis injury.
10.Comparison between Suture-Button Technique with Syndesmotic Repair and Screw Fixation Technique for Complete Ankle Syndesmotic Injury: Biomechanical Cadaveric Study
Hong Seop LEE ; Sung Hwan KIM ; Ki Won YOUNG ; Woo Jong KIM ; Dong-Il CHEON ; Sung Hun WON ; Sang Heon LEE ; Seung Jin CHOI ; Young Koo LEE
Clinics in Orthopedic Surgery 2025;17(2):324-330
Background:
The tibiofibular syndesmosis is essential for preserving the stability of the ankle. Acute syndesmotic injuries with evident or latent instability usually warrant surgical interventions. This cadaveric study examines and compares biomechanical characteristics between the following treatments for syndesmosis injuries: suture-button fixation plus syndesmotic repair and screw fixation.
Methods:
The lower extremities of 10 cadavers disarticulated at the knee joints were used, yielding 20 feet. Ten feet underwent surgery using the suture-button fixation with syndesmotic repair, while the remaining 10 feet underwent surgery using screw fixation. Before surgical treatment of syndesmosis injuries, each cadaveric lower limb underwent preliminary physiological cyclic loading, which was followed by a series of postfixation cyclic loading tests after the surgical procedure.
Results:
Our principal finding is that suture-button fixation with syndesmotic repair provided torsional strength comparable to that of screw fixation. The mean failure torque did not differ between the 2 groups, but the rotational stiffness was significantly lower in the suture-button fixation/augmentation group.
Conclusions
Suture-button fixation/augmentation facilitates flexible (physiological) syndesmosis movement and may be a useful alternative treatment for ankle syndesmosis injury.

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