OBJECTIVETo evaluate the methods and results of arthroscopy-assisted ankle arthrodesis.

METHODSFrom January 2001 to May 2009, 25 patients with end-stage ankle joint pathology were treated with arthroscopy-assisted ankle arthrodesis. There were 18 males and 7 females with an average age of 47.5 years (ranged, 32 to 70 years). The locations were left ankle in 10 cases and right ankle in 15 cases, including 13 cases of post-traumatic osteoarthritis, 10 cases of Kaschin-Beck disease and 2 cases of rheumatoid arthritis. At pre- and post-operation, the 10-point VAS score for ankle pain was obtained; the ankle functional was evaluated by the American Orthopaedic Foot & Ankle Society ankle and hindfoot score, which include pain, activity limitations, maximum walking distance, walking surfaces, gait abnormality, sagittal motion, hindfoot motion, ankle-hind-foot stability, and alignment.

RESULTSAll the patients were follow-up,with a mean period of 27.5 months (ranged, 20 to 35 months). All the patients were free of pain and the gait was improved. There were no complications, such as neurovascular injuries, infection or hardware failure. All the patients achieved fusion in a mean of 11.7 weeks (ranged, 8 to 15 weeks). Overall, the mean 10-point visual analog scale (VAS) score decreased from (8.60 +/- 0.96) preoperatively to (1.20 +/- 0.82) postoperatively (t=27.326, P=0.000). After operation, the items of pain, activity limitations, maximum walking distance, walking surfaces, gait abnormality, sagittal motion, hindfoot motion, ankle-hind-foot stability, and alignment improved. AOFAS score was significantly increased from (36.44 +/- 9.90) points preoperatively to (82.44 +/- 4.96) points postoperatively (t=-19.178, P=0.000).

CONCLUSIONArthroscopy-assisted ankle arthrodesis offered minimal trauma, high fusion rates, rapid recovery and low morbidity. This study confirmed the efficacy of the arthroscopy-assisted ankle arthrodesis for ankle joint pathology.

Adult ; Aged ; Ankle Joint ; surgery ; Arthrodesis ; methods ; Arthroscopy ; methods ; Female ; Humans ; Male ; Middle Aged

PURPOSE: Digits injured by punch press machines show peculiar types with segmental loss of middle part of digits. Although the distal parts of finger survived, thr results is frequently unfavorable with respect to function and appearance after inappropriate reconstruction. METHODS: From August 2008 to February 2013, five digits injured by punch press machines in four patients were managed. Pinch strength, two-point discrimination and active range of motion were measured to evaluate finger function. RESULTS: Three digits with a preserved amputated segment underwent replantation. Partial necrosis occurred in one digit in which local flap was performed. Secondary tendon graft was performed in the other digits. Two digits without segment was reconstructed by arthrodesis after shortening the length. The patients were generally satisfied with function and appearance. CONCLUSION: Reconstruction of digits injured by punch machines are technically difficult. Replantation is the best method in cases of preserved segment, while arthrodesis with shortening is appropriate in cases without segment.
Amputation ; Arthrodesis ; Discrimination (Psychology) ; Fingers ; Humans ; Methods ; Necrosis ; Pinch Strength ; Range of Motion, Articular ; Replantation ; Tendons ; Transplants

The method of ankle arthrodesis is variable but compression arthrodesis has been widely used because of better results than non-compression arthrodesis. Twenty-one cases of ankle arthrodesis were carried out at department of orthopaedic surgery of Korea Veterans Hospital from January 1980 to June 1986, and were analysed clinically. The results obtained were as follows; l. Among 11 cases of compression arthrodesis, Charnleys method was done in 8 cases and Monofixateur in 3 cases. 2. Among 10 cases of non-compression arthrodesis, Chuinard-Peterson method was done in 7 cases and anterior 'sliding graft in 3 cases. 3. The average duration of immobilization after ankle arthrodesis was 11.7 weeks, and average 4.2 weeks were less needed in the compression arthrodesis than non-compression arthrodesis. 4. The postoperative complications were developed in 8 cases (38%): wound infection in 4 cases,skin necrosis in 3 cases and incisional neuroma in 1 case. 5. Bony union was obtained in 20 cases(95.2%) out of 21 cases at average 15.7 weeks, and in the non-compression arthrodesis and in the cnmpression arthrodesis, respectively, 90% at 17.7 weeks and 100% at 13.9 weeks.
Ankle Joint ; Ankle ; Arthrodesis ; Hospitals, Veterans ; Immobilization ; Korea ; Methods ; Necrosis ; Neuroma ; Postoperative Complications ; Transplants ; Wound Infection

Spondyliolisthesis is the major structural changes in the spine and is more directly related to the low back pain syndrome. The many operative techniques have been used but each of them had several disadvantage as well as advantage. Since the anterior lumbar fusion in spondylolisthesis was introduced by Carpener in 1932, many authors have reported the favorable results regard to anterior arthrodesis in spine. Ideally the system of spine fixation is mechanically efficient and anatomical restoration of deformed structure. The anterior interbody fusion is more satisfactory to this deal fixation of spine than any other surgical method. We reviewed the cases of fifty seven patients who underwent anterior interbody fusion with autoiliac bone grafts for spondylolisthesis and were followed for one to twelve years. 1. The most common type was isthmic type in 61% and the degenerative type was observed in 25%. 2. The fifty lumbar vertebra slipping was observed most commonly and in two patinets, L4 and L5 vertebra slipped simultaenously. 3. In radiological results, we obtained complete fusion of grafts to vertebra in 73%, incomplete fusion in 15% and absorption of graft noticed in seven patients(12%). 4. We obtained the favorable results in 84% patients clinically. 5. The clinical results was not correlated with roentgenografic evidence of union. 6. Anterior discectomy and arthrodesis with autoiliac bone graft was a safe procedure in grade I and II spondylolisthesis but in grade III, the procedure was not recommended. 7. The simple Knight-Kim back brace was satisfactory to immobilization after anterior interbody fusion without graft union failure.
Absorption ; Arthrodesis ; Braces ; Diskectomy ; Humans ; Immobilization ; Low Back Pain ; Methods ; Spine ; Spondylolisthesis ; Transplants

Pott's paraplegia has been frequently serious complication of tuberculous spondylitis, although antituberculous drugs have improved the prognosis and healing of the disease. There are much controvercy on treatement of Pott's paraplegia, which comprises immobilization with or without anterolateral antituberculous drugs, immobilization and early posterior arthrodesis, anterolatear decompression and radical anterior decompression with anterior spinal fusion. The method of anterior decompression and anterior interbody fusion which was introduced by Hdgson since 1956 has good reults. The author analyzed 27 consecutive cases of Pott's parsplegia operated at orthopedic departement, In Je Paik Hospital from May 1980 to August 1988. The results were as follows, 1. Number of cases in child was nine(33%), both sexes were similar. 2. Regions of spine involved were most common at thoracic spine(62%). Number of affected vertebrae was averaged 3.3 vertebrae. 3. There were nineteen early(70%) and eight late(30%) paraplegia. 4. There were two complete and twenty five incomplete paraplegia. 5. In operative finding, inflammatory products and sequestrated material was extrinsic factor in early in paraplegia. 6. The recovery of the paraplegia occur in twenty cases(74%) 7. The recovery of paraplegia after treatment was far better in type of early onset, type of incomplete paraplegia less than one year duration. 8. The radical anterior decompression and anterior interbody fusion was considered as recommendable method for remove of all pathologic foci, recovery of paraplegia and healing the tuberculosis with stability.
Arthrodesis ; Child ; Decompression ; Humans ; Immobilization ; Methods ; Orthopedics ; Paraplegia ; Prognosis ; Spinal Fusion ; Spine ; Spondylitis ; Tuberculosis ; Tuberculosis, Spinal

OBJECTIVETo evaluate the functional outcomes of modified limited "L" incision beside the Achilles tendon with distraction bone block arthrodesis in treatment of subtalar osteoarthritis.

METHODSFrom March 2009 to September 2012, a total of 22 cases of old calcaneus fractures with subtalar osteoarthritis were treated with modified limited "L" incision and distraction bone block arthrodesis including 13 males and 9 females with a mean age of 35.3 years old (ranged 22 to 49). The mean time from calcaneal fracture was 21 months (ranged 11 to 32). According to the Stephens-Sanders classification, 16 cases were type II and 6 were type III. The modified-AOFAS ankle-hindfoot score was used for functional outcomes evaluation.

RESULTSThere was one incision necrosis and no infection, implant failure, bone-graft absorbed or talus necrosis was note at the follow-up time. A total of 21 cases were followed up for a mean time of 29 months (ranged from 18 to 46 months). All of the cases reached a bony union within 4 months postoperation. The mean modified-AOFAS ankle-hindfoot score was 82.6 points (ranged from 66 to 92 points),reached a significantly improvement in comparing with the mean preoperative score (50.8 points,ranged from 32 to 65 points, P < 0.01).

CONCLUSIONThe modified limited"L" incision beside the Achilles tendon with distraction bone block arthrodesis is an acceptable and alternative treatment method for subtalar osteoarthritis. This method is easy to use and with less complication. It can correct the main pathological changes and reach good functional outcomes.

Adult ; Arthrodesis ; methods ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis ; surgery ; Subtalar Joint ; surgery

OBJECTIVETo introduce the application of Ilizarov technique in ankle fusion with serious pathology and failed ankle arthrodesis.

METHODThe medical records and images of 9 cases of complex ankle fusion using Ilizarov external fixator were analyzed. Among the 9 cases, 6 received revisional ankle fusion, and 3 primary fusion for septic arthritis. All the cases were followed up for an average of 18.1 months.

RESULTSSix cases showed good results, i.e, no or mild pain, occasional limp and stable fusion and 3 cases fair results, i.e, moderate pain, persistent limp or occupational restriction, and stable fusion.

CONCLUSIONIlizarov technique is one of the effective method for the treatment of complex ankle arthrodesis.

Adult ; Aged ; Ankle Joint ; surgery ; Arthrodesis ; methods ; Female ; Humans ; Ilizarov Technique ; Male ; Middle Aged ; Salvage Therapy

Arthrodesis ; Arthroplasty, Replacement ; adverse effects ; methods ; Contraindications ; Hemiarthroplasty ; Humans ; Metatarsophalangeal Joint ; physiology ; surgery ; Range of Motion, Articular

The arthrodesis of the hip is the only certain method for eliminating pain and providing stability in young and middle aged adults. The first used arthrodesis in old congenital dislocation was reported by Heusner, Lampugnani, and Alert as early as 1885 according to Nove-Josserand. The various papers published on this operation appear to be concerned mainly with surgical methods and the frequency of bone healing, rather than with loss of function and its causes. The purpose of this study is to evaluate function of the arthrodesed hip especially the relationship between position of the hip and its daily use. The author studied arthrodesis of the hip clinically in 89 cases of arthrodesed patients, admitted to the Orthopedic Department of Severance Hospital during the 14 years from June 1957 until May 1970. The auther also studied 40 cases which confirmed sound bony ankylosis of the hip by X-ray examination. The follow-up included a careful inquiry into the patients ability to use the fixed hip in various functions of daily life. The results are as follows. 1. The average age of the patients at the time of operation was 16.9 years and tuberculosis of the hip was the most common cause 83(93%) of arthrodesis. 2. The most common type of operation in this series was intraarticular arthrodesis 67(75.3%), and the fusion rate was relatively good in intra & extraarticular arthrodesis 20(85.5%). 3. The average length of follow-up was 3.9 years. The average position of the arthrodesed hip was 37.7 degrees of flexion, 9.1 degrees of abduction and neutral rotation. Actual shortening of the leg averaged 3.8cm. 4. The gait was poor in the group which had 5cm shortening of the leg and was in 43 degrees of flexion for the arthrodesed hip. 5. The ability to sit and defecate in the ordinary toilet was satisfactory when there was 39 degrees of flexion or more for the arhrodesed hip. 6. 10 patients (25%) had back pain and 12 patients (30%) had mild scoliosis. Average Ferguson angle was 47.8 degrees and the Line of Weight Thrust showed over 40 degrees. 7. The ideal hip position of arthrodiesis in Koreans was assumed to be under 40 degrees of flexion, some degrees of abduction and no rotation.
Adult ; Ankylosis ; Arthrodesis ; Back Pain ; Dislocations ; Follow-Up Studies ; Gait ; Hip ; Humans ; Leg ; Methods ; Middle Aged ; Orthopedics ; Scoliosis ; Tuberculosis

Treatment of a paralysed or flail shoulder falls into two categories; arthrodesis and reconstructive surgery. Of these the latter is preferable in view of mobility. Most authors have tried to reconstruct the paralysed abductor by transferring the trapezius muscle only. The final result of these procedures were poor in severe paralysis of the deltoid muscle or combined paralysis of the deltoid and the rotator cuff muscles. Noting the importance of the action of the rotator cuff muscles in abduction of the shoulder, Saha, in 1967, recommended simultaneous reconstruction of tne paralysed deltoid and rotator cuff muscles. We treated a case of paralysed shoulder that followed poliomyelitis by the Saha meshod, i.e., transfer of the trapezius muscle for the paralysed deltoid, transfer of the levator scapulae muscle for the supraspinatus, transfer of the pectoralis minor muscle for the subscapularis, all in one stage. Duration of the follow up was 3 months and the initial result seemed to be good in view of stability, mobility, and abductor power.
Accidental Falls ; Arthrodesis ; Deltoid Muscle ; Follow-Up Studies ; Methods ; Muscles ; Paralysis ; Poliomyelitis ; Rotator Cuff ; Shoulder ; Superficial Back Muscles