ABSTRACT
Inappropriate treatment of the injury of the lateral collateral ligaments of the ankle produce residual instability, which causes serious disability. There is considerable divergence of opinion as to whether fresh rupture of the lateral ligaments of the ankle are best treated by conservative or opreative method. We have conducted a trial to analyze thirty patients, who were treated by immediate open surgical rupair of rupture of the lateral ligaments of the ankle between April 1991 and February 1992. The results were as follows: 1. All patients were active, young men, Injuries to left ankle were three times more than right side. The most common cause of injury is occurred during sports, especially association football. 2. The decision to operate was based on 1)Talar tilt angle of the injured ankle measures 8-10 degrees more than that of the stress uninjured ankle. 2)A positive arthrogram showing contrast leakage into peroneal tendon she-aths & anterolateral aspect of the lateral malleolus. 3. Diagnostic accuracy rate of arthrography is 94.5%, stress radiography 61.1 %. Arthrography is more reliable than stress radiography in the diagnosis of acute injuries to the lateral ligament of the ankle. 4. At operation, isolated rupture of anterior talofibular ligament was in 5 cases, isolated rupture of middle calcaneofibular ligament in 3 cases, concomittant ruptures of anterior talofibular and middle calcaneofibular ligements in 22 cases. 5. Location of tears of anterior talofibular ligament was mostly mid-portion, middle calcaneofibular ligament in mid-portion or distal portion. 6. On radiologic results, average angle of talar tilt was 14.4° preoperatively, 5.2 preoperatively. There was correction of talar tilt angle of average 9.2°. 7. Clinical results of treatment were excellent in 9 patients, good in 6 patients, fair in 4 patients, poor in 2 patients by authors rating system. The satisfactory result was achieved in 15 patients(71.4%). 8. Postoperative complication was reduced mobility in 4 cases, functional instability 1 case, neuroma in operation scar in 2 cases, minor sensory loss in 4 cases. 9. Primary surgical repair gave good results in the aspect of radiologic & fun ctional instability, but clinical results were not satisfactory, due to high incidence of postoperative complication.
Subject(s)
Humans , Male , Ankle , Arthrography , Cicatrix , Collateral Ligaments , Diagnosis , Football , Incidence , Lateral Ligament, Ankle , Ligaments , Methods , Neuroma , Postoperative Complications , Radiography , Rupture , Sports , Tears , TendonsABSTRACT
Histologic reactions of bone and soft tissue to CFRE were explored, and biomechanical properties of both CFRE plate and stainless steel plate were tested and compared. Six achilles tendons of albino rabbits were replaced with CFRE implant after artificial rupture and serial histologic examination of neotendon and histologic response in vivo were done during 8 weeks. Proximal tibia of twelve albino rabbit was selected, subjected the tibia a single osteotomy and internal fixation with CFRE plate in six cases, and stainless steel plate in the others. And then, consequent radiographic and histologic change was observed during 8 weeks. Objectives in this paper is to provide basic data of CFRE in its biomechanical and biologic response in vivo. The results were as follows :1. Foreign body reaction and fibroblast were decreased at 7-8 weeks after operation. Early formation of collagen, which is similar to that found in the normal side, was shown. So, CFRE seems to be ideal material in the aspect of tissue tolerance among biocomaptibility factors. 2. In biomechanical test, CFRE plate is lower than stainless steel plate in flexural strength and flexural modulus. This means that CFRE plate is semirigid in nature. 3. While external callus formation is marked after fixation of CFRE, internal callus for mation is marked after fixation of stainless steel plate. In CFRE plated tibia, the resorption-cavity is much smaller than stainless steel plated, and there is some formation of woven bone beneath the plate. In conclusion, CFRE is ideal material in the aspect of its biomechanical compatibility and tissue tolerance. Further efforts on production and varying design of CFRE make it to use widely in clinical application, Such as internal fixator of fracture and temporary replacement of tendon or ligament.