Healing potential of the transected posterior cruciate ligament of the rabbit / 대한정형외과학회잡지

PURPOSE: This study was undertaken to elucidate the natural healing potential in posterior cruciate ligament (PCL) injury using histological and biomechanical methods. MATERIALS AND METHODS: PCLs of 92 rabbits were cut partially or completely cut on one side. In Group I, 75% of the PCL was cut preserving the synovium partially. In Group II, the PCL and synovium were completely severed. Investigations were performed by gross inspection, histological examination after Hematoxylin-Eosin (HE) staining and tensile stress testing using an Instron. RESULTS: Continuity of the ligaments began to appear at 2 weeks in group I and at 12weeks in group II. Proliferation of fibroblasts and vessels were observed in HE stained ligaments at 6 and 12 weeks in both groups. The ultimate tensile strength in group I was .3% and in group II 33.1% at 12 weeks. CONCLUSION: Although the mechanical properties of the regenerated ligaments were poor, this study demonstrats that the rabbit PCL has healing potential irrespective of the degree of injury.

Modified Lateral Approach to the Distal Humerus Fractures / 대한정형외과학회잡지

PURPOSE: Internal fixation of distal humerus fracture is problematic. A modified lateral approach was assessed to determine its role in the surgical management of these injuries. MATERIALS AND METHODS: From 1994 to 1998, we had operated 15 patients with distal humerus fracture. Eight patients who had intraarticular fracture were classified into group A, and seven patients who had transitional zone fracture were classified into group B. Both groups were operated by modified lateral approach. In group A, triceps muscle was elevated from medial and lateral intermuscular septum. Functional outcome was assessed with Broberg and Morrey's functional rating scale and anatomical measurement was also performed. RESULTS: All fractures united without complication. The results of functional rating scale were as follows; 3 exellent, 9 good and 3 fair. Anatomical measurement of the average proximal extent of the plate from the lateral epicondyle was 16 +/- 2.7 cm (range 12.3 to 19.8 cm) and in 3 patients, more than 70% of the entire length of the humerus. CONCLUSION: On the bases of these results, intraarticular fracture and transitional zone fracture of the distal humerus can be operated successfully with the modified lateral approach.

The surgical treatment of tibial avulsion fracture of the posterior cruciate ligament: Results between fixation methods and usefulness of arthroscopic exam / 대한정형외과학회잡지

PURPOSE: To introduce the results of surgical methods in tibial avulsion fracture of the posterior cruciate ligament (PCL) and arthroscopic exam as useful therapeutic one. MATERIALS AND METHODS: 32 cases with tibial avulsion fracture of the PCL were received surgical treatment and followed up at least 12 months. Clinical results were evaluated with IKDC score and posterior laxity test with Telos device. The posterior approach was performed in 31 cases (19 screw fixation, 12 pullout suture) and arthrosco-pic reduction and fixation in one. Since 1995, arthroscopic exam was performed on the beginning of operation in all cases and combined injury was treated simultaneously. RESULTS: The IKDC scores were A (normal) in 8, B (nearly normal) in 21, C (abnormal) in 2, D (severe abnormal) in 1 and two of C and D showed posterior instability. 7 of 17cases from 1995 had a combined injury and all revealed above B. The result of compar-ison of screw fixation and pullout suture technique showed no difference between them. CONCLUSION: The results were favorable regardless of surgical methods and arthroscopy was useful in diagnosis and treatment of combined injury.