• Title/Summary/Keyword: 관절 고정술

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Arthroscopic Anterior Talofibular Ligament Repair for Grade II Chronic Ankle Instability - Two Cases Report - (족관절 중등도 불안정성의 관절경적 전거비인대 봉합 - 증례 보고 -)

  • Song, Baek-Yong;Young, Ki-Won;Kim, Jin-Su;Park, Young-UK;Kim, Tae-Won;Lee, Kyung-Tai
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.22-27
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    • 2011
  • The modified Brostrom procedure is first considered for the treatment of chronic ankle instability (CAI). Recently, ankle arthroscopy is also recommended for the treatment of concomitant intra-articular lesions during the open repair of the lateral ligaments. We arthroscopically repaired the anterior talofibular ligament with a use of bio suture anchor for CAI as well as performing the multiple drilling procedure for combined osteochondral lesion of talus. We report the cases with a review of the literature.

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Surgical Treatment Using Anchor Suture of Coracoid Process Fracture with Acromioclavicular Joint Dislocation - A Case Report - (견봉-쇄골관절 탈구를 동반한 오구 돌기 골절의 봉합나사를 이용한 수술적 치료 - 증례 보고 -)

  • Jeong, Woon-Seob;Lee, Sang-Soo;Yoo, Yon-Sik;Kim, Do-Young;Park, Keun-Min
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.240-244
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    • 2009
  • Purpose: This study examined the outcomes of closed reduction and fixation of the coracoid process fracture using a suture anchor in a patient with combined acromioclavicular dislocation for which the coraco-clavicular ligament was intact. Materials and Methods: A 26 year-old male patient with a coracoid process fracture that was associated with a type III acromioclavicular joint dislocation was operated on with anchor suture fixation. This is the first trial of this operative procedure. Results: At the postoperative follow-up at 3 months, complete union of the coracoid process fracture was seen. The shoulder had a full range of motion and the shoulder function was normal. Conclusion: Closed reduction and fixation using one suture anchor for treating coracoid process fracture is a safe, effective procedure.

Surgical Treatment for Pathologic Fracture of Skeletal Metastatic Lesion of the Proximal Femur: Comparison of Clinical Outcomes for Prosthetic Joint Replacement and Osteosynthetic Fixation (근위 대퇴골에 발생한 전이성 골종양의 병적 골절의 수술적 치료: 종양대치 인공관절 치환술과 골절 고정술의 치료 성적 비교)

  • Shin, Duk-Seop;Kim, Ui-Sik;Kwak, Hae-Jun;Ko, Young-Jin
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.1
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    • pp.44-50
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    • 2011
  • Purpose: To compare clinical outcomes of the tumor prosthetic replacement and osteosynthetic fixation for pathologic fracture of skeletal metastatic lesion of the proximal femur. Materials and Methods: From 1994 May to 2009 May, medical records of 22 patients who underwent tumor prosthetic replacement with tumor resection (group 1) and 15 others (16 hips) who underwent osteosynthetic fixation without tumor resection (group 2) were reviewed. The mean age of overall patients were 59 (group 1) and 60 (group 2). Mean follow up periods were 23 and 11 months. The oncological and functional results were evaluated with Kaplan-Meier methods and Musculoskeletal Tumor Society (MSTS) scoring system, 1993. The statistical evaluation was assessed with Log rank test and t-test. Results: The mean survival periods were 24 months in group 1 and 11months in group 2. The 1 year survival rates were 86% in group 1 and 50 % in group 2, and 2 year survival rates were 29.7% in group 1 and 9.4% in group 2. The mean MSTS functional score were 26.4 (19-30), 87.9% in group 1 and 15.3 (10-23), 51.0% in group 2. Conclusion: The results of tumor resection and prosthetic replacement in selected cases was better than osteosynthetic fixation without tumor resection for metastatic bone tumors around proximal femur in oncological and functional aspects.

Using the Arthroscopic Remplissage of Anterior Shoulder Instability with Hill-Sachs Lesion (전방 견관절 불안정성에서 Hill-sachs 병변의 관절경적 Remplissage)

  • Ko, Sang-Hun;Jung, Kwang-Hwan;Shin, Seung-Myeong;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.53-58
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    • 2011
  • Purpose: We evaluated the minimal 1 year follow-up results (shoulder stability and the clinical and functional results) for the Remplissage technique to fill a Hill-Sachs lesion. Materials and Methods: The subjects were 12 patients who could be followed up for more than 12 months after the "Remplissage" procedures in our hospital from December 2008 to November 2009. Their mean age was 27.9 years old and the mean follow-up was 19 months. The evaluations included the ROM, the ASES score, the KSSI score, the ROWE score and postoperative MRI. Results: On the postoperative functional evaluation after an average of 16 months, the ASES score improved from 50.8 preoperatively to 78.3 postoperatively, the KSSI score improved form 44.5 preoperatively to 81.0 postoperatively and the ROWE score improved from 40.2 preoperatively to 84.3 postoperatively. After an average 14 months for all the cases, the range of movement was nearly in the normal range, which is 178.6${\pm}$18.6 (165~180) degrees for forward flexion and 49.3${\pm}$10 (43~60) degrees for external rotation. Conclusion: For recurrent shoulder instability with a large Hill-Sachs lesion, the Remplissage technique has a good outcome after more than 1 year follow-up in terms of the shoulder stability and the clinical and functional results.

Intercalary Tricortical Iliac Bone Graft in the Surgical Treatment of Nonunion of Midshaft Clavicular Fractures (쇄골 간부 불유합에서의 개재 삼면피질 장골 이식술)

  • Cho, Chul-Hyun;Jang, Hyung-Gyu
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.32-36
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    • 2012
  • Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after intercalary tricortical iliac bone graft with plate fixation for the nonunion of midshaft clavicular fractures. Material and Methods: Between September 2007 and May 2011, 10 patients who were treated by the intercalary tricortical iliac bone graft, with plate fixation for clavicle nonunion, were studied. The mean follow-up period was 30.7 (12~57) months. After the sclerotic bone was excised to the bleeding cortical bone, we interposed the tricortical iliac bone to provide structural support and restore clavicle length, and then fixed the plate and screws. The radiologic outcomes on the serial plain radiographs and clinical outcomes, according to UCLA, ASES and Quick DASH scores, were analyzed. Results: Bony union was obtained in all cases (100%) and the average union time was 18.4 (14~24) weeks. The average respective UCLA and ASES scores improved from 16.7 and 52.1 preoperatively to 27.4 and 83.6 postoperatively (p<0.05). The average Quick DASH score was 40.5, at the final follow-up. Complications were 2 shoulder stiffness, and one case had removal of device and arthroscopic surgery at 11 months, postoperatively. There were no implant failure or infection. Conclusion: Intercalary tricortical iliac bone graft, with plate fixation for the nonunion of midshaft clavicular fractures, is a good option that can provide structural support and restore clavicle length, as well as high union rate.

Treatment of Distal Clavicular Fracture by Reconstruction Plate and Wire Fixation (쇄골 원위부 골절에 대한 재건 금속판과 강선 고정술을 이용한 치료)

  • Suh, Mu-Sam;Kim, Sang-Hyo;Park, Hyeong-Taek
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.58-62
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    • 2006
  • Purpose: To evaluate the result of operative treatment with plate and wire fixation for fractures of the distal clavicle. Materials and Methods: We assessed 9 cases of fractures of the distal clavicle that were treated by plate and wire fixation from March 2001 to July 2003 and followed up over 1year. We used the reconstruction plate as a buttress and performed cerclage wiring to fix comminuted fracture site. The functional result of shoulder was evaluated by the scoring system of Rowe. Results: The average periods of bony union was 9 weeks in all cases. According to Rowe scoring system, the functional result was exellent in 7 cases and good in 2 cases. There was no LOM of shoulder and traumatic arthritis in AC joint. But there was skin irritation in 1 case. Conclusion : The operative method by reconstruction plate and wire fixation for distal clavicular fracture was useful when there were comminuted fracture. This method seems to be simple and satisfactory in terms of improvement of range of motion of shoulder, restoration of function and rare complication.

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Dual Plate Fixation for Periprosthetic Femur Fracture after Total Knee Arthroplasty (슬관절 전치환술 후 발생한 대퇴골 삽입물 주위 골절의 이중 금속판 고정술)

  • Kim, Dong Hwi;Cha, Dong Hyuk;Ko, Kang Yeol
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.26-33
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    • 2021
  • Purpose: This study evaluated the results of dual plate fixation for periprosthetic femur fracture after total knee arthroplasty (TKA). Materials and Methods: From October 2007 to February 2013, 23 cases of periprosthetic femur fracture after TKA were treated at the author's hospital. There were 13 cases of fixation using a medial and lateral dual plate when the stability of the fracture site could not be achieved by one side fixation with a follow-up of more than one year. The cases included no loosening of the femoral component in fractures that were categorized as Lewis-Rorabeck classification II and supracondylar comminuted fractures and elongation of the fracture line to the lateral epicondyle of the femur or stem in the medullary canal. The mean age was 72 years (65-82 years), and 11 cases were female. Three cases had a stem due to revision. The mean bone marrow density was -3.2 (-1.7 to -4.4), and the mean period from primary TKA to periprosthetic fractures was 28 months (1-108 months). The mean follow-up period was 23 months (12-65 months). The medial fracture site was first exposed via the subvastus approach. Second, the supplementary plate was fixed on the lateral side of the fracture using a minimally invasive plate osteosynthesis technique. The average union time, complications, and Hospital for Special Surgery Knee Score (HSS) at the last follow-up were evaluated. Results: The mean union time was 17.4 weeks (7-40 weeks). Two cases showed delayed bone union and nonunion occurred in one case, in whom bone union was achieved three months later after re-fixation using a dual plate with an autogenous bone graft. The mean varusvalgus angulation was 1.67 degrees (-1.2-4.9 degrees), and the mean anterior-posterior angulation was 2.86 degrees (0-4.9 degrees) at the last follow-up. The mean knee range of motion was 90 degrees, and the HSS score was 85 points (70-95 points) at the last follow-up. Conclusion: Dual plate fixation for periprosthetic femur fractures that had not achieved stability by one side plate fixation after TKA showed a good clinical result that allowed early rehabilitation.

Antegrade Interlocking Intramedullary Nailing in Humeral Shaft Fractures (상완골 간부 골절에서의 전향적 교합성 골수강내 금속정 고정술)

  • Cho, Chul-Hyun;Song, Kwang-Soon;Kim, Sin-Ki
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.1-6
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    • 2010
  • Purpose: To evaluate the results and complications of antegrade intramedullary interlocking nailing in humerus shaft fractures. Materials and Methods: We evaluated the clinical outcomes, radiologic results and complications in 47 patients with humerus shaft fracture treated with antegrade intramedullary interlocking nailing, and followed up until bony union. Bony union was confirmed by serial plain radiographs and the clinical outcomes were assessed according to the ASES scoring system. Results: Bony union was confirmed in 41 (87.2%) out of a total 47 patients, and the mean union period was 14.5 weeks. Major complications were as follows: 6 non-union, 3 delayed union, 2 intraoperative posterior cortex fracture in the distal humerus and 2 permanent shoulder pain, including 1 case of adhesive capsulitis. The clinical outcomes were as follows: 29 excellent, 11 good, 4 fair and 3 poor. Satisfactory outcomes were demonstrated in 40 patients (85.1%). Conclusion: Anterograde intramedullary interlocking nailing as treatment for humerus shaft fracture showed satisfactory bony union and clinical outcomes. It is considered an efficacious treatment, especially in patients with associated injury, such as multiple fractures and segmental fracture.