The Role of Simple Radiography in the Evaluation of Intraarticular Calcaneal Fracture / 대한정형외과학회잡지

Since CT scanning was introduced in the diagnosis of calcaneal fracture, we became to understand more clearly the pathoanatomy of the injury. However we have to determine if we would or would not take CT scanning by simple radiography in the acute setting and most of the surgeons still use simple radiography in evaluating postoperative result. And also we have to determine the accuracy of reduction and position of screws by simple radiography intraoperatively. The purpose of this report is to determine the accuracy of simple radiography in assessing the pathological anatomy of the intraarticular calcaneal fracture by experimental and clinical studies. This is a combined experimental and clinical studies using four below knee amputation specimens and 15 patients with 19 displaced intraarticular calcaneal fractures treated at Hanil General Hospital between Jan. 1996 and May 1997. The lateral view of the foot was the best radiographic view for visualizing the degree of depression of the posterior facet. With regard to the location of a fracture line, findings of Broden views correlated well with findings on CT in 17 of 19 fractures. With regard to gapping between fragments, the axial view was not satisfactory in the majority of cases(15 of 19 cases). There was no case which showed more than 2 mm of discrepancy between the findings on Broden view and CT. We conclude that we may obtain most of the important informations about the pathological anatomy of the intraarticular calcaneal fracture by simple radiography.

Quality of Life after Total Knee and Total Hip Replacement

We reviewed 40 consecutive patients having a primary total hip replacement(THR) and 60 patients having a primary total knee replacement(TKR) for osteoarthritis to compare the qu;dity of hfe(QoL) before and after operation. Bilateral arthroplasties were perfomed 10 cases of THR and 25 cemes of TKR. We used a modified Harris hip score and a knee score of American knee society, the Rosser Lndex Matrix and authors eval- uation system to generate these scores. Quality of life was highly improved by Rossers and authors evalua- tion system after THR and TKR. The median values of QoL scores before and after operation were signifi- cantly different(petter than in TKR. Postoperative QoL scores for both groups were similar. Quality of life evaluated by Rossers score and authors evaluation system in bilateral THR was better than bilateral TKR. We think better quality of life in bilateral THR over bilateral TKR by authors evaluation system is because the hip joint is mcire stable and has better range of motion than knee joint. We conclude that change of life style including the use of bed, toilet seat elevation, and the use of dinning table will be neccesary after bilateral TKR.