No abstract available.
Spine* ; Transplants*

Arthroscopic unterior cruciate ligament reconstructions using bone-patelia tendon-bone have been considered the best method by which others are compared. The notchyplasty is one of the important steps of this procedure and it is emphasiz,ed recent]y to prevent retear of the reconstrucled ACL causecl by impingement. However, until now, there is controversy ahout adequate amount of notchyplasty. Also, it is hard to examine the adequacy of notchyp]asty even in the aithroscopic field. The purpose of this paper is to describe the surgical technique of notchyplasty, using the flexible reamer and preliminary result of this procedure. In this study the results of ACL:reconstruction with notchyplasty which is made hy us were analized from January,1994 to December,1995. The results were as follows; 1. The notchyplasty with flexible reamer is the method tbat can be performed adequate amount of removal, and he obtained perfectly smooth notchplasty. 2. The range of motion of the affected knee joint was normal ROM after ppst operation 6 month. 3. In the last follow up, 2 cases were positive in anterior drawer test, 4 cases were positive in Lachmanns tesl., and Case was positive in Pivot shift test. 4. Average Lyshnlm knee scoring scale was 70 points al preoperative and 92 points at the last follow up.
Follow-Up Studies ; Knee ; Knee Joint ; Ligaments ; Range of Motion, Articular

Fractures and dislocation of the hand is a body injury involving complex structures and multiple functions, which frequently occur as they represent 10%-30% of all fractures. Such fractures and dislocation of the hand should be treated in the context of stability and flexibility; and tailored treatment is required in order to achieve the most optimal functional performance in each patient since deformation may occur if not treated, stiffness may occur with unnecessarily excessive treatment, and both deformation and stiffness may occur coincidently with inappropriate treatment. Stable injuries can be fixed with splintage whereas surgery is actively considered for unstable injuries. In addition, surgeons should keep in mind that as the surgical intervention is done aggressively, aggressive rehabilitation must be followed in correspondence with the surgical intervention. Successful outcome requires effort to prevent any potential complication including nerve hypersensitivity and infection. Finally, it is also important that the patient to know that swelling, stiffness, and pain may last for a long period of time until the recovery of fractures and dislocation of the hand.
Dislocations* ; Finger Injuries ; Hand* ; Humans ; Hypersensitivity ; Pliability ; Rehabilitation

PURPOSE: This study investigated the clinical and radiological outcomes of patients undergoing provisional fixation in conjunction with locking plate fixation. Miniplates were used as the reduction plates for the surgical treatment of severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius. MATERIALS AND METHODS: The radial length, radial inclination, volar tilt, and radial intra-articular step-off were measured preoperatively, postoperatively, and at one year after surgery in 12 patients (eight males, four females, mean age 55.4 years old). The patients underwent volar locking plate fixation with miniplate as a reduction plate for severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius. Clinical evaluations were conducted using the modified Mayo wrist score (MMWS). RESULTS: Bone union was achieved in all cases. The mean MMWS was 81.8 points, including two excellent, three good, and seven fair cases. Radiological improvements were observed in the average radial length (preoperative, 6.4 mm; postoperative, 11.8 mm), average radial inclination (10.2° to 22.4°), average volar tilt (−4.5° to 10.6°), and average radial intra-articular step-off (4.8–0.8 mm) (all, p<0.05). Radiographic measurements obtained immediately after surgery and at the final follow-up revealed insignificant decreases in radial length (0.6 mm), radial inclination (0.4°), and volar tilt (0.9°) (all, p>0.05). CONCLUSION: Miniplate fixation can be an effective treatment option as a reduction plate for the treatment of distal radial fractures, which is challenging to reduce and maintain due to severely comminuted metadiaphysis fractures with the intra-articular fracture.
Female ; Follow-Up Studies ; Fractures, Comminuted ; Humans ; Intra-Articular Fractures ; Male ; Radius ; Wrist

PURPOSE: To investigate the factors which influence on the fixation failure after the compression hip screw fixation for unstable intertrochanteric fractures. MATERIALS AND METHODS: Eighty-two patients of unstable intertrochanteric fracture of A2 and A3 type who had underwent operation with compression hip screw were evaluated at least 1 year follow-up in regard to the age, degree of osteoporosis, fracture type, diastasis of fragment, sliding of lag screw, position of lag screw and status of reduction. RESULTS: 73 patients out of 82 patients had the union and 9 patients showed fixation failure. The results of fixation failure were 6 cases of migration of lag screw and 3 cases of cut-out of lag screw. There were statistically significant correlations between fixation failure and A2.3 and A3 type. The fixation failure group showed increased medial migration of medial cortex of proximal and distal fragment, which is significantly correlated with fixation failure. There were little statistical significant correlations between age, degree of osteoporosis, status of reduction, position of lag screw, sliding of lag screw and fixation failure. CONCLUSION: Another alternative fixation method and technique have to be considered for unstable A2-3 or A3 type because compression hip screw fixation only is very insufficient with high failure rate.
Femur* ; Follow-Up Studies ; Hip Fractures ; Hip* ; Humans ; Osteoporosis

PURPOSE: This study evaluated the minimum ten-year result of primary total hip arthroplasty with a non-cemented Multilock femoral stem. MATERIALS AND METHODS: Fifty five total hip replacements in forty-four patients using a non-cemented Multilock femoral stem and Harris-Galante 2 acetabular component were performed between January 1992 and December 1994. Forty-four hips in thirty-six patients were available for follow up for an average of eleven years (range, ten to twelve years). The clinical results were evaluated based on the Harris hip scores. A detailed radiography analysis was performed by an evaluation of the radiolucent lines, femoral osteolysis, and fixation stability by Engh Method. RESULTS: The average Harris hip score improved from 54.3 points preoperatively to 93.6 points postoperatively. Non-progressive radiolucencies < 2 mm in width were observed in nine (20.5%), and femoral osteolysis was observed in thirteen cases (29.5%). For the fixation stability, osseous ingrowth was noted in thirty nine cases (88.6%) and fibrous ingrowth was observed in two (4.5%). There were three (6.8%) cases with unstable fixation. Two hips underwent revision. The survival rate of the femoral component was 93.2% (forty one cases) after a minimum ten-year follow up. CONCLUSION: The non-cemented Multilock femoral component provided excellent clinical and radiographic results. However, the rate of femoral osteolysis was relatively high (mostly restricted to zone 1 and 7).
Acetabulum ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies* ; Hip ; Humans ; Osteolysis ; Radiography ; Survival Rate

PURPOSE: To evaluate the effectiveness of a polylactic acid bioresorbable film in the prevention of tendon adhesion after tendon repair. MATERIALS AND METHODS: Twenty-four adult rabbits (48 cases) were used in this study. In the first (control) group, the flexor tendons of the third toe were cut and a tenorrhaphy was performed. The 2nd group was injected with hyaluronic acid between the tendon and tendon sheath after suturing. The 3rd group underwent an enveloping of the tendon with polylactic acid film, followed by tenorrhaphy. The test animals were euthanized at 1, 2, 3, and 6 weeks after surgery, and the histology and biomechanics were evaluated. RESULTS: Microscopic evaluations revealed fibrosis to be most apparent in group 1, while groups 2 and 3 showed no significant differences. The biomechanical tests, which were carried out using a Universal Testing Machine, revealed that an increase in adhesion strength with time. At 6 weeks after surgery, group 1 exhibited an adhesion strength that was 2.5-3 times greater than that exhibited by groups 2 and 3. Group 2 had a higher adhesion strength than group 3, but this difference was not statistically significant. CONCLUSION: Increases in granulation tissue and fibrosis during the healing of sutured tendons were observed, and the tested polylactide resorbable film was found to be effective in reducing the level of adhesion formation after tendon repair.
Adult ; Animals ; Fibrosis ; Granulation Tissue ; Humans ; Hyaluronic Acid ; Rabbits ; Tendons* ; Toes

PURPOSE: To investigate the results of percutaneous repair technique of Achilles tendon ruptures, and to describe the surgical technique. MATERIALS AND METHODS: We retrospectively analyzed the outcomes of 73 patients with ruptured Achilles tendon from October 1995 to September 2009. 28 patients were excluded due to short follow up period. 34 patients were male and 11 patients were female. The mean patient age was 37.19 (10~62) years. The location of rupture site was 6.58 cm proximal to the tendon insertion into the calcaneus on average. Mean follow up period was 55 months and All patients were surgically repaired using percutaneous technique with sural nerve isolation. RESULTS: Arner-lindholm score were excellent in 32 (71%), good in 12 (27%), poor in 1 (2%) case. 44 cases (98%) had the score more than good. Mean American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot function score was 92.93 (67~100). We had 1 case of superficial infection, 1 case of soft tissue irritation by suture knot. CONCLUSION: Percutaneous repair with sural nerve isolation in treating ruptured Achilles tendon showed low complication rate and reliable clinical outcome.
Achilles Tendon ; Animals ; Ankle ; Calcaneus ; Female ; Follow-Up Studies ; Foot ; Humans ; Male ; Organic Chemicals ; Orthopedics ; Retrospective Studies ; Rupture ; Sural Nerve ; Sutures ; Tendons

Pseudoaneurysm of the anterior tibial artery is a rare cause of pain and swelling of the lower leg and the foot following minor sports injuries. When there is no definite musculoskeletal cause of pain, it is important to consider pseudoaneurysm. Early diagnosis and management are essential for the successful outcome. MRI and angiogram are useful for early diagnosis. We report a case of pseudoaneurysm of the anterior tibial artery following minor sports injury. The patient experienced complete relief of the symptoms after resection of the pseudoaneurysm.
Aneurysm, False* ; Athletic Injuries ; Early Diagnosis ; Foot ; Humans ; Leg ; Magnetic Resonance Imaging ; Tibial Arteries*

PURPOSE: We attempt to evaluate the significance of calcaneal posterior tuberosity fragment reduction when treated with surgical open reduction in displaced intra-articular calcaneal fractures. MATERIALS AND METHODS: A total of 90 patients with displaced intra-articular calcaneal fracture, between January 2010 and December 2015, treated with open reduction and internal fixation were enrolled in this study. At postoperative 3 months, we evaluated the reduction state of calcaneal posterior tuberosity fragment by measuring the degree of lateral displacement of the posterior tuberosity fragment on the calcaneal axial view. Moreover, we also evaluated the difference in the calcaneal length and height with the uninjured side on the lateral view of both sides. In addition, we estimated the reduction state of the posterior facet by measuring the degree of gap and step-off on the semi-coronal view of postoperative computed tomography and estimated the restoration of calcaneal angle by measuring the difference in Böhler's and Gissane angle with the uninjured side on the lateral view of both sides. RESULTS: The correlation coefficient with 3 components for evaluating the reduction state of posterior tuberosity fragment and gap and step-off of posterior facet was r=0.538, 0.467, r=0.505, 0.456, r=0.518, and 0.493, respectively, and restoration of Böhler's and Gissane angle was r=0.647, 0.579, r=0.684, 0.630, r=0.670, and 0.628, respectively. The relationship of each component shows a significant correlation as all p-values were <0.01. CONCLUSION: The precise reduction of calcaneal posterior tuberosity fragment developed by the primary fracture line was considered as an important process of anatomical reduction of calcaneal body, including the posterior facet and calcaneal angle restoration.
Calcaneus ; Humans ; Intra-Articular Fractures