BACKGROUND: To evaluate the radiological, clinical results in patients with open distal tibia factures, who were treated with a staged treatment protocol using the lateral minimally invasive plate osteosynthesis (MIPO) technique. METHODS: From January 2007 to June 2009, 10 patients with open distal tibia fractures (Gustilo-Anderson classification II, 3; IIIA, 1; IIIB, 6) were treated using a staged treatment protocol. The initial debridement and application of an external fixator were performed within 24 hours and the mean interval from injury to definitive surgical treatment was 15 days (range, 6 to 52 days). Eight weeks later, an additional bone graft was performed in 3 patients. The follow-up duration was more than 1 year. RESULTS: The mean fracture healing time was 21 weeks (range, 17 to 28 weeks), and the average Iowa ankle rating score was 84.5 points. At the last follow-up, there was no non-union, angular deformity > 5degrees, shortening > 10 mm or infection. In 10 patients, 2 patients had a superficial wound infection, and another 2 patients showed limitation of ankle joint motion. CONCLUSIONS: This staged treatment protocol using a lateral MIPO technique is a useful alternative method for achieving high functional recovery with good healing and low complication rates in patients with an open distal tibia fracture.
Adult ; Aged ; Aged, 80 and over ; Ankle Injuries/*surgery ; Bone Transplantation ; Clinical Protocols ; Debridement ; External Fixators ; Female ; Fracture Fixation, Internal/*methods ; Fractures, Open/*surgery ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Therapeutic Irrigation ; Tibial Fractures/*surgery ; Treatment Outcome

Postoperative infection from total knee arthroplasty (TKA) is an issue drawing great attention, which can manifest as a local or general infection. Its development into sepsis has also occasionally been reported. Such sepsis is a critical complication that can spread to various parts of the body, which can ultimately lead to mortality. However, the cases where infection has spread to the spine do not have clear clinical signs, making diagnosis difficult. These cases are not found in the literature. Therefore, this is a case study on both postoperative infection from TKA that has developed into sepsis and spread to the spine.
Arthroplasty, Replacement, Knee* ; Diagnosis ; Mortality ; Paraplegia ; Sepsis ; Spine

PURPOSE: The purpose of this study was to evaluate the efficacy of the surgical treatment through the comparison of LC-DCP (Limited Contact-Dynamic Compression Plate) versus LCP (Locking Compression Plate) fixation in the plate augmentation for the nonunion of femur shaft fractures after intramedullary nail fixation. MATERIALS AND METHODS: Twenty-four patients with the nonunion of femur shaft fractures after intramedullary nail fixation who underwent plate augmentation were evaluated from Mar. 2001 to Sept. 2005. The group with LC-DCP augmentation was done bicortical screw fixation and the group with LCP was done monocortical fixation. RESULTS: There was one case of nail breakage in LC-DCP group, but sound bony union were achieved uneventfully in all the cases of both group. LCP fixation was slightly superior to LC-DCP fixation in view of the bony union time, operating time, postoperative Hb down, amount of postoperative transfusion, but there was no statistical difference (p>0.05). CONCLUSION: We got the satisfactory results after monocortical LCP augmentation as well as bicortical LC-DCP fixation and have concluded that monocortical LCP fixation was an effective treatment option for nonunion of femur shaft fracture occurred after Intrmedullary nail fixation.
Femur ; Humans ; Nails

PURPOSE: To evaluate the radiographic, clinical results between who had intertrochnateric fracture, treated with ITST with a standard or a mini-incision. MATERIALS AND METHODS: We selected each 20 patients of intertrochanteric fracture which were treated with ITST with a standard incision or a mini-incision from June 2004 to July 2006. We compared of mean operative time, transfusion doses and postoperative VAS score between two groups. We evaluated the radiographic results by follow-up radiography and the clinical results with the mobility score of Parker and Palmer and Salvati and Wilson hip function scoring system. RESULTS: Mean operative time, transfusion doses and postoperative VAS score were significantly less in the mini-incision there were 87.8 min., 2.0 pints and 4.2 for the standard group versus 40.3 min., 1.1 pints and 3.3 for the mini group. The radiographic results were not significantly different. Decrease of mobility score of Parker and Palmer and Salvati and Wilson hip function scoring system were similar. CONCLUSION: Mini-incision significantly reduces operative time, transfusion doses and postoperative pain for fixation intertrochanteric fracture treated with ITST.
Follow-Up Studies ; Hip ; Hip Fractures ; Humans ; Operative Time ; Pain, Postoperative

PURPOSE: To compare the early clinical and radiographic results including patient's satisfaction after total knee arth- roplasty(TKA) using a mobile bearing knee prosthesis with fixed-bearing device. MATERIALS AND METHODS: From February 2002 to March 2004, author performed 30 posterior cruciate-retaining mobile bearing TKA and 39 posterior cruciate-retaining fixed bearing TKA. Clinical results were evaluated with knee score, patient's satisfaction by WOMAC score and range of motion. Radiographic analysis including tibio-femoral angle was also done. RESULTS: 1) The average knee score improved from 41.9 to 88.6 in mobile bearing group and from 44.3 to 87.6 in fixed bearing group respectively. The improvement of functional score were similar that 49.7 in mobile bearing group, 50.2 in fixed bearing group. 2) The average WOMAC score improved from 85.2 to 12.5 in mobile bearing group and from 85.3 to 13.9 in fixed bearing group. 3) The average range of motion of knee improved from 106.2 to 120.5 in mobile bearing group and from 105.2 to 118.8 in fixed bearing group. 4) The average tibio-femoral angle improved from 5.0 varus to 5.7 valgus in mobile bearing group and from 5.6 varus to 5.7 valgus in fixed bearing group. 5) Two of mobile and one of fixed bearing group complained persistent knee pain and two of mobile and one of fixed bearing group complained giving way sensation. CONCLUSION: This study shows that no significant difference in ROM, function, subjective evaluation and radiologic analysis for patients between two groups after minimum two-year follow-up.
Arthroplasty* ; Follow-Up Studies ; Humans ; Knee Prosthesis ; Knee* ; Range of Motion, Articular ; Sensation

PURPOSE: To evaluate the radiological and clinical results including the patient's satisfaction after total knee arthroplasty (TKA) using two differently designed system for both knees in the same patient. MATERIALS AND METHODS: From January 2002 to January 2003, thirty-two bilateral TKAs were prospectively performed using two differently designed systems. One side TKA was performed using a mobile bearing (PFC RP, Dupey) system, and the other side was performed using a fixed bearing system (PFC, Dupey). All 32 patients were followed up for an average of 51.4 months. The mean age of the study group was 67 years (range 54-75). The clinical results were evaluated from the Knee Score, WOMAC score for the patient's satisfaction and range of motion. Radiological analysis including the tibiofemoral angle was also carried out. An independent T-test was used for statistical analysis. RESULTS: The preoperative average knee score improved to 87.3 from 42.5 in the mobile bearing group and to 86 from 39 in the fixed bearing group respectively. The preoperative average WOMAC score decreased to 11.2 from 84.9 in the mobile bearing group and to 16 from 85.5 in the fixed bearing group. The average preoperative range of knee motion improved to 114.5degrees from 104.5degrees in the mobile bearing group and to 113.8degrees from 104.7degrees in the fixed bearing group. The average preoperative tibiofemoral angle improved to 5.3degrees valgus form 4.5degrees varus in the mobile bearing group and to 6degrees valgus from 3.8degrees varus in the fixed bearing group. The only result statistically significant was the WOMAC score (p<0.05). CONCLUSION: The two differently designed TKA system produce similar outcomes except for the subjective satisfaction in the mid-term clinical and radiological evaluation.
Arthroplasty ; Humans ; Knee ; Prospective Studies ; Range of Motion, Articular ; Ursidae

PURPOSE: To evaluate the radiographic, clinical results and the complications between who had intertrochanteric fracture, treated with the ITST or the PFN. MATERIALS AND METHODS: We selected each 30 patients of intertrochanteric fracture which were treated with ITST or PFN from July 2002 to November 2005. We evaluated the radiographic results by follow-up radiography and the clinical results with the mobility score of Parker and Palmer, Salvati and Wilson hip function scoring system and Jensen index. RESULTS: The mean distance of lag screw sliding was 4.1 mm at the ITST group and 6.6 mm at the PFN group. Decrease of mobility score of Parker and Palmer, Salvati and Wilson hip function score were similar. Patients complaint pain over lateral thigh area in 5 cases (ITST group) and 8 cases (PFN group). CONCLUSION: The ITST nail and PFN were seen good results in treatment of stable and unstable intertrochanteric fracture.
Femur* ; Follow-Up Studies ; Hip ; Hip Fractures* ; Humans ; Radiography ; Thigh

The ipsilateral femoral segmental and tibial fractures seldom occur such as traffic accidents needed high energy mechanisms. For these fractures, surgical stabilization and early mobilization of joint produce can be the best clinical outcomes. We have experienced a case of ipsilateral femoral segmental and tibial fracture and gained good clinical results with surgical treatment. We have reported here on this case and included a review of the relevant literature.
Accidents, Traffic ; Early Ambulation ; Joints ; Tibial Fractures

Arthroscopic synovectomy is a widely-used method to treat septic knee arthritis. To date, many authors have reported minimal complications related to arthroscopic treatment, especially vascular injuries. A three-dimensional computed tomography angiography revealed a pseudoaneurysm that arise from the popliteal artery near the arthroscopic site in septic arthritis patients with atherosclerosis and neurofibromatosis. A careful arthroscopic procedure via the posteromedial or posterolateral portal is recommended for the prevention of this complication. We, therefore, recommend close observation after arthroscopic procedure, despite the occurrence of complications; nonetheless, early diagnosis and treatment are important. We report a case of pseudoaneurysm of the popliteal artery with a complicating arthroscopic synovectomy in septic arthritis with literature review.
Aneurysm, False ; Angiography ; Arthritis ; Arthritis, Infectious ; Arthroscopy ; Atherosclerosis ; Debridement ; Early Diagnosis ; Humans ; Knee ; Methods ; Neurofibromatoses ; Popliteal Artery ; Vascular System Injuries

PURPOSE: To compare clinical and radiographic results of anterior cruciate ligament (ACL) reconstruction using modified transtibial technique (mTT), anteromedial (AM) portal technique and outside-in (OI) technique. MATERIALS AND METHODS: From March 2007 to December 2012, ACL reconstruction was performed using the mTT, AM portal technique and OI technique in 20 patients each. Anteroposterior and rotational stability were assessed using the GNRB arthrometer and pivot-shift test. Femoral tunnel obliquity was measured on the anteroposterior and lateral radiographs. RESULTS: Tegner score, Lysholm score, International Knee Documentation Committee score, pivot-shift test were improved at final follow-up in all three groups. However, statistical difference was not shown. Side-to-side difference in GNRB arthrometer was average of 1.4 mm, 1.0 mm and 0.9 mm in mTT, AM and OI group, showing the signicant difference between mTT and AM/OI groups (p<0.001). The mean femoral tunnel obliquity was 56.4degrees in the mTT group, 39.4degrees in the AM group and 33.6degrees in the OI group, showing significant intergroup difference (p<0.001). It showed the significant difference among three groups (p<0.001). CONCLUSIONS: Clinical results were improved in all three groups. Femoral tunnel obliquity in AM and OI were more horizontal on the coronal plane. They are thought to have more benefits in oblique positioning of the grafted ACL in rotational stability; however, there was no significant difference among three techniques in pivot-shift test to assess the rotational stability in this study.
Anterior Cruciate Ligament ; Follow-Up Studies ; Humans ; Knee ; Transplants