Most radial head fractures occur as the result of low-energy mechanisms, such as a trip or fall on the outstretched hand. These fractures typically occur when an axial load is applied to the forearm, causing the radial head to hit the capitellum of the humerus. Good results are shown with nonsurgical treatments for Mason type 2 fractures. However, if there is a limitation of elbow joint exercise or displacement of more than 2 mm, an operative treatment should be considered. We treated two patients with arthroscopic assisted bioabsorbable screw (K-METâ„¢; U&I Corporation, Uijeongbu, Korea) fixation for radial head fractures to prevent complications of open reduction and minimize radiation exposure.
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Bioabsorbable Screws Used in Hallux Valgus Treatment Using Proximal Chevron Osteotomy Woo-Jin Shin, Young-Woo Chung, Ki-Yong An, Jae-Woong Seo Journal of Korean Foot and Ankle Society.2018; 22(4): 181. CrossRef
PURPOSE To evaluate the clinical and radiologic results of the arthroscopic treatment using TightRope(R) (Arthrex, Inc, Naples, FL) for management of acute acromioclavicular dislocation. MATERIALS AND METHODS Twelve patients with acromioclavicular joint dislocation Rockwood type V are underwent the arthroscopic acromioclavicular joint reconstruction using TightRope(R) between March, 2008 and March, 2009. The average age was 40.4 years (range 25~63 years) and mean follow-up was 10 months (range 8~16 months). The shoulders were evaluated using parameters include radiologic measurements by comparing the clavicle posteroanterior and lateral radiographs with the contralateral one. Clinical evaluation was made for pain, function, and range of joint motion by Constant score and KSS (Korean Shoulder Score). RESULTS All twelve patients returned to their work without pain in 3 months after operation. The average Constant score and KSS score was 98.4 (range 97~100) and 97.8 (range 97~100) at the last follow-up. Because of technical error and indication error, two patients showed failures of TightRope(R) fixation on the coracoid side and the acromioclavicular joint was redislocated, so these cases were excluded. 10 patients were satisfied with functional results and cosmetic appearance. CONCLUSION Considering its less morbidity, less hospitalization, excellent cosmesis, early rehabilitation, this new technique offers an attractive alternative in acromioclavicular joint stabilization if the early technical error would be overcome.
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Coracoclavicular Ligament Augmentation Using Tight-Rope®for Acute Acromioclavicular Joint Dislocation - Preliminary Report - Seok Hyun Kweon, Sang Su Choi, Seong In Lee, Jeong Woo Kim, Kwang Mee Kim The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 115. CrossRef
Coracoclavicular Ligament Augmentation Using Endobutton for Unstable Distal Clavicle Fractures - Preliminary Report - Chul-Hyun Cho, Gu-Hee Jung, Hong-Kwan Sin, Young-Kuk Lee, Jin-Hyun Park The Journal of the Korean Shoulder and Elbow Society.2011; 14(1): 1. CrossRef
PURPOSE To evaluate the usefulness of wrist arthroscopic examination in patient with persistent pain after the triquetral dorsal chip fracture and also to determine its relationship with TFCC injury in the triquetral dorsal chip fracture patient manifesting persistent pain. MATERIALS AND METHODS This study is based on six cases presenting persistent pain in the ulnar aspect after the triqeutral posterior cord fracture that were treated conservatively. Wrist arthroscopy was carried out for all six cases. All were preoperatively and postoperatively evaluated using VAS pain scale, grip power, ulnar grind test, Kleinman shearing test and lunotriquetral ballottment test. RESULTS Preoperatively, ulnar grind test yielded positive results in all six cases, Kleiman shearing test proved positive in three cases and lunotriquetral ballottment test yielded positive result in one case. In the arthroscopic findings, synovitis and TFCC injury were detected in all cases, and based on Palmer classification of TFCC injury, type IA was determined in five cases and type ID in one case. Arthroscopic TFCC partial resection and synovectomy were carried out. VAS pain scale improved from an average 8 points preoperatively to 3 points postoperatively. The difference of grip power between the normal and the other side improved from average of 15 lb preoperatively to 5 lb postoperatively. Based on postoperatively physical examination at 6 weeks, all cases yielded negative results in the ulnar grind test and Kleiman shearing test. CONCLUSION We think that TFCC injury is one of the causes of persistent pain after triquetral dorsal chip fracture. We recommend an arthroscopic TFCC partial resection as a valuable treatment option.
PURPOSE To assess the results of an arthroscopic repair for traumatic peripheral tears of triangular fibrocartilage complex (TFCC, Palmer type Ib). MATERIALS AND METHODS 10 patients with traumatic peripheral TFCC tear were treated with outside-in technique with arthroscope and evaluated with an average follow-up of 19 months (range, 15 to 28 months). The clinical outcomes were assessed with investigation of pain, range of motion, grip strength, return to job and patient's satisfaction. RESULTS The arthroscopic repair of traumatic peripheral TFCC tear resulted in significant pain relief and increase in functional ability of wrist, that is, 8 excellent, 1 good and 1 fair results. At last follow-up, the average of flexion was 79° (range 76~86°), average of extension was 78° (range 70~84°), average pronation was 85° (range 75~91°) and average supination was 87° (range 79~92°). Nine patients except one were back to their original job. CONCLUSION Arthroscopic repair of traumatic peripheral TFCC tear could be used for pain relief and increase in functional ability of wrist.
PURPOSE To evaluate the clinical results of the pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation. MATERIALS AND METHODS This is a retrospective study of the clinical result, bone union, complication and postoperative ankle function of 22 pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation between January 1999 to March 2004. RESULTS Clinical follow up averaged 16 months, with an average age of 39.2. All patients with type 1 and 2 fracture had excellent or good score by Ovadia and Beals criteria. Closed fractures healed within 13 weeks and open fractures within 16 weeks after surgery in average. Average range of motion of the ankle was 12o dorsiflexion (0~20 degree) and 25o plantar flexion (15~35 degree). CONCLUSION Minimal soft tissue dissection and anatomical reduction are very important factor for minimizing complication and satisfactory ankle function. So, arthroscopically assisted limited open reduction and Ilizarov external fixation is an effective treatment option for tibial pilon fractures.
PURPOSE To investigate the results of arthroscopically assisted reduction of intraarticular fracture of distal radius with percutaneous K-wires and external fixation. MATERIALS AND METHODS We reviewed 12 intraarticular distal radial fractures of 11 patients treated arthroscopically assisted reduction in Orthopedic Department of Sung-Ae hospital between January, 2001 and August, 2001. The mean length of follow-up was 14 months. Analysis of them revealed that B3 was 1 case, C2 4 cases and C3 7 cases according to the AO classification. All cases were treated by 2.7 mm arthrosopic devices and percutaneous K-wires pinning with external fixation, but additionally invasive reductional technique was not used. We removed the osteochondral flap in the joint space and detected the carpal ligaments and triangular fibrocartilage complex tears but not treated. The K-wires were removed at 4 weeks, external fixation was 7 weeks, respectively. RESULTS The mean active range of movement in the affected wrist was total arc of the flexion-extension 72% of the opposite side. Radiographically mean volar tilt, radial inclination and radial length were 5.7 degrees, 22.4 degrees, and 12.3 mm. The mean articualar step-off was 2 mm or less. Post-operative compartment syndrome and fracture collapse were not occured during follow-up period.
According to the Gartland and Werley demerit-point system, eleven cases were a excellent or good and one was a fair result. CONCLUSION Arthroscopically assisted fixation is a useful method for reducing the soft tissue injuries and preventing the articular surface incongruency by anatomically reduction in cases of intraarticular comminution.
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Arthroscopic Repair for Traumatic Peripheral Tear of Triangular Fibrocartilage Complex Seung-Ju Jeon, Chan-Sam Moon, Ho-Seung Jeon, Haeng-Kee Noh, Sung-Hwan Kim Journal of the Korean Fracture Society.2007; 20(4): 330. CrossRef
A variety of surgical modalities for fractures of patella have been described. We used arthroscopic reduction and percutaneous screw fixation for six cases of longitudinal fracture of patella. Ages of the patients ranged from 25 to 33 years. the postoperative regimen was one week long leg splint for reducing the pain, followed by continuous passive range of motion exercise of the knee including active one and quadriceps strengthening exercise until the full range of motion was gained, with progressive partial to full weight bearing with crutches. The follow-up period was from 12 to 54 monhts. Results were assessed subjectively and objectively with retrograde study. The full range of knee motion was recovered from 20 to 35 days postoperatively, The radiographic bone union was achieved from 31 to 42 days. And all patient had good results according to Lysholm and Gillquist scoring system. We had no experience of complication except one which is prominence of screw end. So, we believed that the arthroscopic reduction and percutaneous cannulated screw fixation for longitudinal fractures of patella is the useful surgical method.
Isolated fractures of the anterior malleolus of the ankle are uncommon. They most often result from vertical loading or from posterior displacement of the tibia on a planted foot. Fracture of the tibial plafond with a large anterior tibial(anterior malleolus) fragment may require open reduction with internal fixation. Anatomic reduction of the articular surface can be ensured by visualizing the articular surface using an arthroscope during reduction. Two cases wherein this technique has proven effective were described.
Meyers and Mckeever proposed a classification of intercondylar eminence fractures based on the degree of displacement. Zaricznyj added type IV comminuted avulsion fracture. Type III and IV of tibial spine fractures are considered an indication for surgery. The purpose of this study is to evaluate the result of arthroscopic treatment for displaced intercondylar eminence fractures. In all of the cases, the displaced fragments were reduced arthroscopically in effective, and fixed by K-wires, pull-out sutures or pull out wiring. At last follow-up above 12 months, all 22 cases(100%) were evaluated as above good by Meyers and Mckeever criteria.
The goals in the treatment of a tibial plateau fracture are to obtain a stable, aligned, mobile and painless joint and to minimize the risk of post-traumatic osteoarthritis. Most recently the management of tibial plateau fractures has been via arthroscopy. Proponents of arthroscopic techniques advocate their use not only to better visualize the surface of the tibia but also to evaluate the rest of the joint. This retrospective study compared the results of arthroscopic and conventional treatment of tibial plateau fractures from January 1988 through April 1995. Forty-seven knees of tibial plateau fractures were involved in this study.
Sixteen of these patients were treated with arthroscopic reduction and autogenous bone graft with or without internal fixation, while the remaining 31 underwent open reduction, bone graft and internal fixation.
The results are as follows: 1. The average time to full weight bearing was 10.2 weeks (range 7-14 weeks) in the arthroscopic group and 13.5 weeks(7.2-18 weeks) in the open reduction group.
2. The incidence of lateral meniscus tear was 56%(9/16) in the arthroscopic reduction group and 29%(9/31) in the open reduction group.
3. Flexion of at least 130 was obtained in 81%(13/16) of arthroscopic reduction group, while only Tabl 58%(16/31) in the open reduction group. Full extension was obtained in 93%(15/16) of arthroscopic reduction group, and in 83%(26/31) in the open reduction group.
4. Complications occurred more frequently in the open reduction group than in the arthroscopic reduction group.