The authors report the case of a patient with the combination of a Type I Monteggia equivalent lesion and Essex-Lopresti injury. This combination of injury is very rare, and an associated distal radioulnar injury is often missed. We hope our experience illustrates the need to examine the wrist joint carefully and to be aware of the potential for distal radioulnar joint instability in all patients with type I Monteggia equivalent lesions.
Humans ; Joint Instability ; Wrist Joint

OBJECTIVES: To assess and compare the degree of reduction and clinical results following arthroscopic cannulated screw and K-wire fixation for type III displaced tibial intercondylar eminence fractures. METHODS: From 1991 to 1997, 20 patients with type III of intercondylar eminence fractures were arthroscopically treated (K-wire in 12 and screw in 8) and followed up 31 mo. in average. Degrees of reduction, extension loss and residual joint laxity were checked. And statistical analysis was done (Mann Whitney U-test) . Functional results were recorded by Meyers & McKeever's criteria. RESULTS: Degrees of reduction showed +2.1mm in K-wire group, and -1.3mm in screw group (avg., p<0.05) . Anterior displacements were 2.2mm and 1.7mm in stress x-rays and 3.5mm and 1.2mm in KT-1000 arthrometer, respectively (avg.,p<0.05) . Average loss of extension was 7 in K-wire group and 3 in screw group. There were excellent 9, good 3 in K-wire group and excellent 7, good 1 in screw group. CONCLUSION: Because of arthroscopic screw fixation able to compress and sink the fragment, it may showed less extension loss and residual laxity than K-wire fixtion. It is recommendable for the first choice to the treatment of type III tibial intercondylar eminence fractures with relatively large fragment.
Arthroscopy ; Humans ; Joint Instability ; Knee

PURPOSE: To evaluate appropriate rehabilitation program after ACL reconstruction using double- looped semitendonosus and gracilis graft. MATERIAL AND METHOD: ACL reconstruction using double-looped semitendinosus and gracilis tendon was performed in thirty patients from March 1997 to February 1999, and the patients were evaluated with K-T 2000 arthrometer, Lachman test, pivot shift test, mid-thigh circumference and Lysholm score. We divided the patients into three group; in group A, conservative rehabilitation after bio-absorbable screw fixation was done, in group B, aggressive rehabilitation after bioabsorbable screw fixation was done, in group C, aggressive rehabilitation after Semi-Fix fixation was done. RESULTS: Average K-T 2000 maximum manual side-to-side difference was 0.73mm in group A, 3.66mm in group B, 0.91mm in group C at 6 weeks after the operation. The difference was greater in group B than group A and C. There was no difference in mid thigh circumference and Lysholm score at one year post- operatively. Positive signs in Lachman test and pivot shift test were increased in group B than group A and group C. CONCLUSION: Rehabilitation after bioabsorbable screw fixation of double-looped hamstring tendon should be performed conservatively, because aggressive rehabilitation might increase joint laxity.
Humans ; Joint Instability ; Rehabilitation* ; Tendons* ; Thigh ; Transplants

As a common and frequently-occurring disease,glenohumeral instability is become one of disease which restrict upper limb activity. The diagnosis of this disease is easy, but it is very difficult to assess the degree of periarticular soft tissue injuries. With the development of magnetic resonance imaging and arthroscopy, MRA become the gold standard for evaluation of glenoid labrum, joint capsule and ligaments injury. The traditional manual reduction is a fast, simple method, but often can cause adverse consequences,such as rotator cuff tear,ligament relaxation,and habitual dislocation. Open operation can rebuild stability of joint,but with many new treatment methods,especially the arthroscopic reconstruction has gradually replaced the open operation, and become the mainstream trend, but for the long-term effect of capsular tightening surgery, rotator cuff gap closure is not clear,it is need further follow-up observation.
Arthroscopy ; Humans ; Joint Instability ; diagnosis ; etiology ; therapy ; Shoulder Joint

The distal radioulnar joint is not only the main load-bearing joint in the wrist, but also the pivot of the rotation of the forearm. It is one of the most important and unique joints in the body. Maintaining the stability of the distal radioulnar joint is very important for our daily life. The tissue to stabilize the distal radioulnar joint includes bone structures and soft tissue structures. Although the contribution of soft tissue structures to its stability is far exceeding that of bone structures, the influence of abnormal bone structure on the distal radioulnar joint cannot be ignored. By reviewing the relevant literatures, this article divides the bone structural abnormalities into congenital and acquired bone structural abnormalities. The effects of congenital and acquiredbone structural abnormalities on the distal radioulnar joint stability are analysized and collated in this article, and its clinical symptoms, clinical grading, clinical treatments are also summerized. The problems of distal radioulnar joint instability in clinical practicing and its future researching directions are briefly described in order to provide some suggestions for future clinical applications.
Forearm ; Humans ; Joint Instability ; Rotation ; Ulna ; Wrist ; Wrist Joint

OBJECTIVE: To introduce an arthroscopic "inlay" Bristow procedure based on the Mortise-Tenon joint structure concept using suture button fixation, and to evaluate its clinical and radiology results postoperatively with a minimal 3-year follow-up. METHODS: A total of 56 patients who received arthroscopic "inlay" Bristow procedure with suture button fixation between June 2015 to June 2016 were eventually enrolled in this study. Radiological assessment on the 3D CT scan was performed preoperatively, immediately after operation, and postoperatively at the end of 3 months, 6 months and the final follow-up. Complications postoperatively were also recorded. RESULTS: A total of 56 patients were finally included in this study. The mean follow-up time was (36.1±3.7) months. Coracoid grafts (middle point) were positioned at about 4 o'clock (123.8°±12.3°) in the En-face view. In the axial view, 95% (53/56) of the grafts positioning were measured as flush, 5% (3/56) as medial. Bone union rate was 96.4% at the final follow-up. At the end of 3 months, 6 months, and the final follow-up, the length of the coracoid graft was 96.9%±4.9%, 91.9%±6.2%, and 91.6%±6.6% of the immediate postoperative length, respectively. Compared with the immediate postoperative length, the length measured at the end of 3 months shortened not significantly (t=2.12, P > 0.05). The coracoid graft shortened more pronouncedly 6 months postoperatively (t=4.98, P < 0.05) and then remained almost constant over time (t=-0.75, P > 0.05), with all grafted coracoid graft retaining more than 90% of their initial length by the 3-year follow-up. And new bone formation at the junction between the coracoid graft and glenoid neck in the axial view were obviously noted in 25 cases. The quantitative evaluation showed that the glenoid area in En-face view was significantly increased at the final follow-up than that immediately after surgery [(9.72±1.22) cm² vs. (9.42±1.11) cm²]. No degenerative changes were noted on CT images in all the patients at the final follow-up. CONCLUSION This study reported a series of "inlay" Bristow procedure with suture button fixation for recurrent shoulder dislocation, providing satisfactory union rate and excellent graft positioning. And using suture button fixation instead of screw can reduce osteolysis and complications related to hardware implantation. Moreover, the bone remodeling between the coracoid process and glenoid could be beneficial to restoring the anterior stability of shoulder joint in a long term follow-up.
Arthroscopy ; Humans ; Joint Instability ; Radiology ; Shoulder Dislocation ; Shoulder Joint ; Sutures

Arthroscopy ; Humans ; Joint Diseases ; Joint Instability ; Shoulder ; Shoulder Dislocation ; Shoulder Joint/surgery*

Chronically unreduced elbow dislocation has commonly been described in underdeveloped countries. This is a very rare type of injury, and only two cases have been reported in Korea. Due to the potentially conflicting goals of restoring elbow stability and satisfactory function, successful treatment is a challenge even for experienced trauma surgeons. Herein, we described two cases of chronically unreduced elbow dislocation treated with open reduction and additional bony fixation using hinged external fixator and transarticular pin fixation.
Dislocations* ; Elbow* ; External Fixators* ; Joint Instability ; Korea ; Surgeons

PURPOSE: This report is comprehensive results of our clinical series in which we report theoretical advantages and indication of recycling autograft following extracorporeal irradiation in malignant bone and soft tissue tumors. MATERIALS AND METHODS: We have treated in 24 patients by en bloc resection, extracorporeal irradiation and reimplantation of irradiated bone from june 1994 to june 1999. All patients were evaluated radiologiccal union, functional results and complication. RESULTS: The radiologiccal union of junctional sites had appeared at 9.1 months postoperatively. The mean functional results was 73%, we used the criteria of Enneking et al.. There are 10 cases (47.6%) of complication, witch were nonunion, epiphyseal collapse, joint instability, infection, local recurrence and metal failure. CONCLUSION: The recycling autograft following extracorporeal irradiation is a useful method on minimal bony destruction, preserving joint function as osteoarticular autograft, using bone with soft tissue (ligament and tendon) attachment in periarticular tumor and biological spacer in immature skeletal age.
Autografts* ; Humans ; Joint Instability ; Joints ; Recurrence ; Recycling* ; Replantation

PURPOSE: We analyzed the results of lateral retinacular release(LRR) and proximal realignment for recurrent patellar instability after trauma according to the anatomical predisposing factors. MATERIALS AND METHODS: Twelve patients of fifteen cases of recurrent patellar instability had been evaluated. Clinical assessment were performed by Q-angle, apprehension test, passive patellar tilt test and general joint laxity. The anatomical predisposing factors assessed by plain radiographs included patella alta, sulcus angle, femoral trochlear dysplasia, genu valgum and patellar dysplasia. Clinical results were assessed by Kujala scoring system. Radiographic results were assessed by congruence angle. The results were analyzed according to the predisposing factors. RESULTS: Patella alta was observed in eight, increased sulcus angle in six, trochlear dysplasia in twelve, genu valgum in five and patella dysplasia in four cases. The result of treatment (Kujala score / congruence angle) was 85.8 / 9.7degrees in group A(predisposing factors > or = 3) and 91.4 / -5.3degrees in group B (predisposing factors<3)(p=0.036). We had 4 cases of recurrence after operation and genu valgum was related with recurrence rate. CONCLUSION: The clinical results of LRR and proximal realignment for recurrent patellar instability developed after trauma were worse in cases with more anatomical predisposing factors.
Causality* ; Genu Valgum ; Humans ; Joint Instability ; Patella ; Recurrence