Endoscopy versus Open Bursectomy of Lateral Malleolar Bursitis; Comparative Study / 대한족부족관절학회지

PURPOSE: To compare the result of endoscopic versus open bursectomy in lateral malleolar bursitis, which was not treated conservatively. MATERIALS AND METHODS: Between January 2008 and October 2009, We divided to two groups, endoscopy (group A) 11 cases, open bursectomy (group B) 11 cases. The average follow up period was 15 months (range, 12 to 18), the mean age was 66 (range, 38 to 79). We compared patients satisfaction, complete healing time, operation time, complications and recurrence. RESULTS: Group A had significant difference in terms of the clinical satisfactions, complete healing time. operation time, complications. Group A showed satisfaction (excellent 9, good 2), mean complete healing time 11.9 (8~14) days, operation time 37 (25~45) minutes, 1 case recur. Group B showed satisfaction (excellent 4, good 3, fair 1, poor 3), complete healing time 32.7 (14~98) days, operation time 22 (18~26) minutes. complication were one case of skin necrosis, one case of wound dehiscence, two cases of superficial peroneal nerve injury, no recurrence. Significant advantages of endoscopic method include lower morbidity and rapid wound healing period (p<0.05). CONCLUSION: Endoscopic resection of the lateral malleolar bursitis is a promising technique and shows favourable results compared to the open resection. Significant advantages of this method include lower morbidiy and rapid wound healing.

End Stage Ankle Arthritis with Ankle Instability Patients Treatment Results Using Autograft Ligament Reconstruction with Total Ankle Arthroplasty / 대한족부족관절학회지

PURPOSE: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. MATERIALS AND METHODS: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. RESULTS: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average 8.2+/-0.9 (range, 7~10) to 2.7+/-1.7 (range, 0~6) and the AOFAS score improved from 46.4+/-14.6 points (range, 23~69) to 80.1+/-9.3 points (range, 65~95) at final follow-up. Anterior draw test improved 15.2+/-3.4 mm (range, 12~23 mm) to 8.8+/-2.6 mm (range, 6~13mm),varus stress test improved from 13.9+/-4.6degrees (range,10-18degrees) to 6.2+/-4.7degrees (range,2-18degrees) at final follow up. CONCLUSION: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.