Dislocation of Tibial Insert after Fixed Bearing TKA using Minimal Invasive Surgery: A Case Report

Posterior instability after mobile bearing total knee replacement may be caused by gap imbalance, component malpo- sition, and delayed rupture of posterior cruciate ligament, but could not be easily considered other cause except component breakage in fixed bearing posterior cruciate substituted total knee replacement. The dislocation of tibial polyethylene insert was reported after mobile bearing total knee replacement but rare after fixed bearing total knee replacement. We report a case of dislocation of tibial polyethylene insert that have been found at a patient who had continuing posterior instability after fixed bearing posterior cruciate ligament substituted total knee replacement with a review of article.

Treatment of Subtrochanteric Fractures of the Femur with Zickel-Nail / 대한정형외과학회잡지

The treatment of subtrochanteric fracture of the femur is one of the most difficult problems. Open reduction and rigid internal fixation is the choice of treatment nowaday. Zickel(1967) reported a new fixation device to treat subtrochanteric fracture of the femur which was designed to provide more rigid fixation in both major fragments, control angulation and rotation, and permit earlier ambulation. The authors reviewed 14 cases of subtrochanteric fracture of the femur which were treated with Zickel-Nail from June, 1979 to November, 1980. The results were obtained as follows: 1. The average age of patients was 44.7 years. 2. In 10 cases without associated injury, parallel-bar walking was possible within postoperative one week. In 8 cases of these, crutch walking with partial weight bearing was possible within postoperative 2 weeks. In others, there were some benifits in bed-side care because of rigid internal fixation which was provided with Zickel-Nail. 3. There were no significant postoperative complicatons except 3 cases of technical error. 4. There was no limb shortening except one case which was old complicated nonunion with severe osteoporosis and had a new fracture during Zickel-Nail procedure. 5. There were no differences in radiological bony union between pathologic fracture and traumatic fracture except one case with liver cell carcinoma of subtrochanteric region of the femur which we could not do follow-up study.

Review of Trochanteric approach in 285 Total Hip Arthroplasties / 대한정형외과학회잡지

This paper is a consecutive series of total hip arthroplasties were performed over 6 years period by the same group surgeons utilizing the Charnley method as well as the lateral approach with trochanteric osteo. tomy. Trochanteric reattachment was accomplished in 285 hips and method of reattachment were basically standard Charnley technique which we used in most of our series. In addition, some modification of original Charnley technique which we used in early this trial were also included for this study. As far as trochanteric complications are concerned, there are 18 cases of hips where there was wire breakage, proximal drift of greater trochanter and 6 established cases of nonunion also reported. By the use of wire mash, we have performed a revisional surgery which has re-inforced of the greater trochanter. This was the case when the greater trocyhanter was very osteoporotic. Finally, biomechanical considerations of the re-attachment of the greater trochanter and new Charnley staple clamp method were introduced with review of our cases and analysed for technical failures.