Arthroscopic Assisted Bioabsorbable Screw Fixation for Radial Head Fractures: A Report of Two Cases

Most radial head fractures occur as the result of low-energy mechanisms, such as a trip or fall on the outstretched hand. These fractures typically occur when an axial load is applied to the forearm, causing the radial head to hit the capitellum of the humerus. Good results are shown with nonsurgical treatments for Mason type 2 fractures. However, if there is a limitation of elbow joint exercise or displacement of more than 2 mm, an operative treatment should be considered. We treated two patients with arthroscopic assisted bioabsorbable screw (K-MET™; U&I Corporation, Uijeongbu, Korea) fixation for radial head fractures to prevent complications of open reduction and minimize radiation exposure.

Arthroscopic Assisted Bioabsorbable Screw Fixation for Radial Head Fractures: A Report of Two Cases

Most radial head fractures occur as the result of low-energy mechanisms, such as a trip or fall on the outstretched hand. These fractures typically occur when an axial load is applied to the forearm, causing the radial head to hit the capitellum of the humerus. Good results are shown with nonsurgical treatments for Mason type 2 fractures. However, if there is a limitation of elbow joint exercise or displacement of more than 2 mm, an operative treatment should be considered. We treated two patients with arthroscopic assisted bioabsorbable screw (K-MET™; U&I Corporation, Uijeongbu, Korea) fixation for radial head fractures to prevent complications of open reduction and minimize radiation exposure.

Arthroscopic Reduction and Transportal Screw Fixation of Acetabular Posterior Wall Fracture: Technical Note / 대한고관절학회지

Acetabular fractures can be treated with variable method. In this study, acetabular posterior wall fracture was treated with arthroscopic reduction and fixation using cannulated screw. The patient recovered immediately and had a satisfactory outcome. In some case of acetabular fracture could be good indication with additional advantages of joint debridement and loose body removal. So, we report our case with technical note.

Intercarpal Ligament Injuries Associated with Distal Radius Fractures: Relation with the Radiographic Findings and Arthroscopic Treatment / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to analyze the relationship between intercarpal ligament injuries associated with distal radius fracture and the fracture patterns and radiologic parameters, and to report on the clinical results of arthroscopic treatment for these injuries. MATERIALS AND METHODS: Fifty-two patients who underwent arthroscopic surgery for intercarpal ligaments injuries associated with distal radius fracture and who had a minimum 1 year follow-up were enrolled. There were 44 patients who sustained scapholunate interosseous ligament injury (SLIL) and 30 patients who sustained lunotriquetral interosseous ligament (LTIL) injury. Among them, 22 patients had both SLIL and LTIL injuries. The carpal ligament injuries were graded according to the Geissler classification and they treated with arthroscopic debridement only for a grade I and II injury and arthroscopic reduction and percutaneous pinning for a grade III and IV injury. The patients were divided into two groups and we assessed the functional and radiological outcomes: Group 1 consisted of the patients with a grade I and II injury and group 2 consisted of the patients with a grade III and IV injury. RESULTS: The preoperative mean radial inclination of group 2 with lunotriquetal interosseous ligament injury was 15.1+/-9.9degrees, which was significantly different from 20.4+/-5.1degrees of group 1, and the extra-articular type injury was more common in group 2 (p<0.05). On the follow-up radiographs, the mean scapholunate interval measured 2.1+/-0.5 mm in group 1 and 1.7+/-0.5 mm in group 2, which was significantly different (p<0.05). CONCLUSION: The grade of LTIL injury combined with distal radius fractures is associated with the loss of radial inclination and the extra-articular fracture type at the time of initial presentation. Complete tears of the SLIL can be stabilized with arthroscopic reduction and percutaneous pinning.

Management of Comminuted Intra-articular Fractures of the Distal Radius: Arthroscopically Assisted Reduction and Pin Fixation Supplemented with External Fixation / 대한정형외과학회잡지

PURPOSE: Here we report the clinical results of arthroscopically assisted reduction and pin fixation supplemented with an external fixator for the treatment of comminuted intra-articular fractures of the distal radius. MATERIALS AND METHODS: Thirty-seven patients with a minimum follow-up period of 1 year were enrolled. Radiographs obtained immediately after surgery and those obtained after osseous union were compared and analyzed. The objective and subjective function of the wrist were evaluated. The overall outcomes were assessed using a modified Green and O'Brien system. RESULTS: Eleven patients had an excellent outcome, 20 good, 4 fair and 2 poor. Loss of radial shortening, radial inclination, step-off, and a gap between the radiographs obtained immediately after surgery and at osseous union were not significant. The volar tilt angle of the final follow-up evaluation averaged 4.6degrees, which was significantly different compared to the contralateral side. The mean range of motion of the wrist ranged from 73% to 92%. The mean grip strength was 73% compared to the uninjured contralateral wrist. The mean DASH and PRWE outcome scores were 49.2 (range 35-67) and 31.0 (range 13-73), respectively. CONCLUSION: Arthroscopic reduction and pin fixation supplemented with an external fixator, for the treatment of comminuted intra-articular fractures of the distal radius, allows for accurate articular reduction to be established and maintained.

Arthroscopic Reduction and Internal Fixation of distal Femoral Intraarticular Unicondylar Fractures: Report of Three Cases / 대한정형외과학회잡지

Intraarticular distal femoral unicondylar fractures are uncommon. Anatomical reduction is the point of the good result of the treatment. Non displaced or minimally displaced fractures can be treated nonoperatively, but must be followed closely for loss of reduction. Displaced unicondylar fractures require surgical fixation to prevent the complications of axial malalignment, post-traumatic arthritis, knee stiffness and instability frequently reported after nonoperative treatment. We present a case report discribing an alternative treatment method, namely, arthroscopic reduction and internal fixation (ARIF), of displaced intraarticular distal femoral unicondylar fractures. There are several potential benefits of less pain, fewer complications (bleeding, arthrofibrosis), quick recovery, better cosmesis and shorter hospital days.

Arthroscopic Reduction and Internal Fixation of Bony Avulsion of the Posterior Cruciate Ligament

Bony avulsion fractures of the posterior cruciate ligament of the tibia have commonly been treated by open reduction and intemal fixation through posterior approach. However this approach using prone position make it difficult to investigate and treat other combined injuries of the knee joint. We report a case of the posterior cruciate ligament avulsion of the tibia that was arthroscopically reduced and firmly fixed with two cannulated screws and also, detection of concomitant injury was possible The posterior sag was absent after operation and the result was excellent.

Arthroscopic Assisted Management of Displaced Intraartieular Calcaneal Fractures / 대한정형외과학회잡지

Although the management of fractures of the calcaneus still remains controversial, open reduction and internal fixation is gaining in popularity as the method of choice for the treatment of displaced intraarticular calcaneal fractures. However, open methods can make several complications such as neurovascular injury and infection. Thus we have performed the new technique of arthroscopic reduction and minimal internal fixation for displaced intraarticular calcaneal fractures in 5 cases. The results were evaluated between 12 and 16 months after surgery. A Bohler angle was restored to 25degrees-40degrees in all cases. Anatomical reduction of articular surface were obtained from 4 cases out of 5. No complications were found except 1 peroneal tendinitis. The clinical results by Creighton-Nebraska health foundation assessment for fractures of the calcaneus were 3 excellent, 1 good and 1 fair. Even though this was a few case and a short term follow-up study, the arthroscopic assisted management of displaced intraarticular calcaneal fracture induced a little complications and satisfactory results.