No abstract available.
Humans ; Venous Thrombosis*

Heterotrophic ossification (HO) is a reactive disease presenting the formation of mature lamellar bone in soft tissues. It is known to occur following surgery, soft tissue injury, or central nervous system anomalies. However, a definite cause has not yet been clearly addressed. During the process of approach, reduction, and fixation while conducting surgeries, partial injury of soft tissue is inevitable. Additionally, secondary injuries may be caused during the active and passive range of motion exercises that should be done for the recovery of joint motion after surgery. The authors experienced cases of HO that may occur during surgery and rehabilitation after surgery. The authors recognized that special care is required for patients complaining of severe pain during the early stage of rehabilitation immediately after surgery. This study aimed to reaffirm the principles of fracture treatment by reviewing the cases and to investigate the occurrence of HO after fracture surgery.
Central Nervous System ; Exercise ; Humans ; Joints ; Range of Motion, Articular ; Rehabilitation ; Soft Tissue Injuries

Gouty arthritis is a common crystal arthropathy, but gout tophus in the bipartite patella is a rare condition. This report presented a traumatic separation of bipartite patellar fragment caused by mild trauma in a patient with comorbid gout. When a patient with bipartite patella and underlying gouty arthritis complains of pain after trauma, clinical suspicion is needed about fragment separation of the bipartite patella.

Minimally invasive plate osteosynthesis (MIPO) is beneficial for proximal tibial fractures since these injuries are mostly caused by high energy traumas. The advantages of MIPO are minimization of soft tissue dissection and preservation of periosteal vascularization. Lateral plating has mostly developed as MIPO for proximal tibial fractures. We introduce minimal invasive percutaneous plate stabilization using a medial locking plate as alternative treatment for proximal tibial fractures.
Tibial Fractures

A few cases of femoral neuropathy that were developed after renal transplantation have been reported in western literature. The possible causes of this neuropahty that discussed in recent studies are compression of nerve by self-retaining retractor during operation, ischemia of femoral nerve by iliac muscle hematoma etc. We experienced one case of femoral nerve neuropathy after right iliac fossa renal transplantation that developed at first postoperative day without definitive etiology in all study. It was improved symptomatically after 2 weeks of postoperative day, so we reported this case with brief review of the literatures.
Femoral Nerve ; Femoral Neuropathy* ; Hematoma ; Ischemia ; Kidney Transplantation*

PURPOSE: To evaluate the advantages of reduction of lateral and posterior displacement in unstable intertrochanteric fractures of the elderly. MATERIALS AND METHODS: From January, 1997 to December, 2001, we reviewed 23 cases of unstable intertrochanteric fractures in the elderly, which underwent by reduction of lateral and posterior displacement. Using the device of internal fixation is dynamic compression hip screw (DHS), the follow up period was minimally 12 months (mean 16 months). We estimated the clinical results, the radiologic results and complications. RESULTS: The satisfactory results was regarded as walking with walking frame and 21 cases (91.3%) showed satisfactory results. The average period of radiologic union was 18 weeks. The average sliding of lag screw was 5.3 mm and the average changes of femoral neck-shaft angle was 2.6 degree. As for the complications, 2 cases showed superficial infection and 2 cases showed pain over trochanteric area. CONCLUSION: In the unstable intertrochanteric fractures of the elderly, treatment with reduction of lateral and posterior displacement can be considered one of reduction technique.
Aged* ; Femur ; Follow-Up Studies ; Hip ; Hip Fractures* ; Humans ; Walking

We evaluated the conditions required for sutures tied to a post for tibial fixation during anterior cruciate ligament (ACL) reconstruction. Harvested porcine tendon was used as a graft material and nonabsorbable suture was used for sutures. Samples were tested for ultimate tensile load and elongation according to thread numbers, knot numbers, suture techniques and stitch numbers. As thread numbers were increased, ultimate tensile load was increased and elongation was decreased. However, more than 4 strands of threads provided the sufficient ultimate tensile load more than 454 N of normal ACL for daily activities. As knot numbers were increased, ultimate tensile load was increased, but elongation was decreased. In terms of failure mode, unraveling occurred 100% in 3 and 4 knots, 81.2% in 5 knots, 54.5% in 6 knots, and 0% in 7 knots. Suture techniques and stitch numbers didn't significantly affect the ultimate tensile load and the elongation. For sutures tied to a post for tibial fixation in ACL reconstruction, more than 4 threads, more than 7 knots, and more than 4 stitches provide adequate ultimate tensile load and elongation.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction* ; Knee ; Suture Techniques* ; Sutures* ; Tendons* ; Transplants

Recently, as the elderly population increases, the incidence of total knee arthroplasty has increased, with a concomitant increase in the frequency of periprosthetic fractures. To determine the treatment plan for fractures, the treatment method should be determined by the patient's age, osteoporosis, fixation status of the implant, and type of fracture. In recent years, operative treatment with reduction and stable fixation, rather than non-operative treatment, was used to promote early joint movement and gait. On the other hand, it is necessary to select an appropriate operative method to reduce complications of surgery, such as nonunion and infection, and expect a good prognosis. In this review, periprosthetic fractures were divided into femur, tibia, and patella fractures, and their causes, risk factors, classification, and treatment are discussed.
Aged ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Classification ; Femur ; Gait ; Hand ; Humans ; Incidence ; Joints ; Knee ; Methods ; Osteoporosis ; Patella ; Periprosthetic Fractures ; Prognosis ; Risk Factors ; Tibia

Habitual dislocation of patella is a rare disorder. Sometimes it is associated with angular deformity such as genu valgum. We experienced habitual patella dislocation associated with genu valgum that was treated with corrective osteotomy of distal femur and soft tissue realignment procedure including lateral release and medial reefing.
Congenital Abnormalities ; Dislocations ; Femur ; Genu Valgum ; Osteotomy ; Patella

PURPOSE: We evaluated the clinical and radiological outcomes of double-bundle anterior cruciate ligament (ACL) reconstruction using an outside-in technique with a follow-up of two- to six-years, especially in terms of the sports activity level and radiological degeneration. MATERIALS AND METHODS: Sixty-seven patients who were available for a minimum two-year follow-up after double-bundle ACL reconstruction using an outside-in technique were retrospectively evaluated. The mean follow-up period was 43.7 months. The knee function and stability were evaluated before the operation, one year after the operation (short-term follow-up), and more than two years after the operation (last follow-up). RESULTS: Regarding the knee function, the Lysholm score, International Knee Documentation Committee (IKDC) evaluation, and hop test showed significant improvement. Regarding the stability, the Lachman test, pivot shift test, KT-2000 arthrometer data, and anterior drawer radiographs using Telos showed significant improvement. Regarding the sports activity level, the patients who returned to pre-injury level activity was 68.7% according to the Tegner activity score and 76.1% according to the Cincinnati sports activity scale score. The incidence of aggravated degeneration or development of greater than IKDC grade A degeneration after surgery was 10.4%. CONCLUSIONS: Double-bundle ACL reconstruction using an outside-in technique showed favorable clinical and radiological outcomes with respect to the knee function and stability, joint degeneraion, and, especially, return to pre-injury sports activity.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; Follow-Up Studies ; Humans ; Humulus ; Incidence ; Joints ; Knee ; Retrospective Studies ; Sports