Treatment of Transverse Patellar Fracture with Cannulated Screws

PURPOSE: To assess the indication and effect of screw fixation in the transverse patellar fractures. MATERIALS AND METHODS: We analysed the results of 14 transverse patellar fractures fixed with screws from January 1991 to May 2005. Mean follow-up period was 47 months (range, 12~143 months). We analysed the radiologic union, operation time, ROM and postoperative Lysholm score. RESULTS: All fractures healed uneventfully. The mean displacement was decreased from 2.2 mm preoperatively to 0.3 mm postoperatively (p=0.001, Wilcoxon signed rank test). The mean operation time was 34 minutes (range, 20 to 60 minutes). Normal range of motion was achieved in 13 knees (92.9%). Average Lysholm score was 95.9 at final follow-up. CONCLUSION: Screw fixation seemed to be useful for treatment of transverse patellar fracture even in comminuted fractures with large fragments. The advantage of this technique was the preservation of extensor mechanism, simplicity, short operation time and good cosmesis.

Clinical results of Anterior Cruciate Ligament(ACL) Reconstruction: Bone-patellar Tendon-bone Autograft Versus Allograft

PURPOSE: To compare the clinical results of anterior cruciate ligament(ACL) reconstruction between the bone-patellar tendon-bone(BPTB) autograft and the allograft. MATERIALS AND METHODS: The clinical results of thirty-three patients of BPTB autograft and thirty-six patients of BPTB allograft performed between the periods of May 1994 and March 2004 were compared retrospectively in terms of Lysholm score, IKDC knee rating system, Tegner scale, physical examination, and KT-1000 arthrometry. Minimum follow-up period was 2 years(range: 24 to 144 months, average: 51.9 months). RESULTS: The postoperative Lysholm score at final follow-up was 89.4 in autograft group and 90.1 in allograft group on average. The difference between the two groups was not significant statistically in postoperative Lysholm score, IKDC knee rating system, and Tegner scale. Twenty-seven cases(81.8%) of autograft group had a negative Lachman test versus thirty-one cases(86.1%) of allograft goup, postoperatively. There was no significant difference in Lachman test, flexion-rotation-drawer(FRD) test, pivot shift test, and KT-1000 arthrometry between the two groups. CONCLUSION: The clinical results of ACL reconstruction using the BPTB autograft or allograft was equally good without statistically significant difference.

The Thickness of Normal and Repaired Rotator-cuff Measured in MRI

Purpose: To compare the thickness of the repaired full-thickness rotator-cuff tear to that of normal rotator-cuff in young and old persons and evaluate the relationship between the tear size and the repaired thickness in the full-thickness tear using MRI. Materials and Methods: The thickness of the rotator-cuff of the repaired full thickness tear(age: 45~77, mean 63.3 years, 19 patients: group 1) were compared with those of old intact patients (age: 46~69, mean 57.9 years, 23 patients: group 2) and young intact patients (age: 18~30, mean 23.3 years, 22 patients: group 3). The tear length and width was measured in oblique coronal and oblique sagittal view of MRA, respectively, and the thickness was measured in coronal oblique view 15mm anterior to the posterolateral margin of the glenoid. Correlation between the preoperative tear size (the bigger one between the length and the width) and the postoperative thickness in group 1 was also evaluated statistically. Results: The postoperative rotator-cuff thickness in group 1 was 3.0 mm in average, which was inversely proportional to the preoperative tear size (P<0.001). The rotator-cuff thickness was 3.9mm in group 2 and 5.0mm in group 3, and there was statistically significant difference among the three groups(P<0.05). Conclusion: The rotator-cuff thickness decreases with age and the postoperative thickness in the full-thickness tear was inversely proportional to the tear size, smaller than that of the intact rotator-cuff.

Posterior Lumbar Interbody Fusion Using Laminar Bone and Titanium Block / 대한척추외과학회지

STUDY DESIGN: A retrospective study to analyze the results of posterior lumbar interbody fusion, using laminar bone and titanium block, with pedicle screw instrumentation. OBJECTIVES: To evaluate the clinical and radiological results of posterior lumbar interbody fusion, using laminar bone and titanium block, with pedicle screw instrumentation. SUMMARY OF LITERATURE REVIEW: Several studies have demonstrated the results of posterior lumbar interbody fusion, there has been no report on our method. MATERIALS AND METHODS: From March 2001 to May 2002, seventeen patients were treated by posterior lumbar interbody fusion, using laminar bone block, from spinous process and titanium block. All patients were clinically followed up over 12 months. The mean age of the patients and follow-up were 58 years and 15 months, respectively. The clinical results were evaluated by Kim's criteria and radiological union, and the subsidence of disc space and change of the lordotic curve were assessed by a simple Xray. RESULTS: The satisfactory clinical result and radiological union rates were 83.3 and 90.4%, respectively. The mean subsidence of the disc space and change of the lordotic curve were 0.8 mm and 1.6 degrees, respectively. There was one complication of a wrong insertion of the pedicle screw to the disc space. CONCLUSION: Posterior lumbar interbody fusion using laminar bone and titanium block showed an acceptable radiological union rate and clinical results. This could be a good alternative method for obtaining initial stability and bony union without taking a bone graft from the posterior ilium in various spinal lesions.