Morphological analysis of coronoid process fracture in terrible triad of elbow based on Adams classification / 中华创伤杂志

Objective:To explore the morphology of coronoid process fracture in terrible triad injury based on Adams classification.Methods:A retrospective cross-sectional study was used to analyze the three-dimensional CT data of 51 patients with terrible trind injury treated at First Affiliated Hospital of Fujian Medical University from January 2013 to August 2021, including 33 males and 18 females, aged 18-88 years [(44.7±12.0)years]. The model of ulna coronoid process fracture was established by three-dimensional CT reconstruction technology and was classified according to Adams coronoid process fracture classification. Type I was the coronoid process tip fracture, type II the coronoid process transverse fracture, type III the base fracture of the coronoid process, type IV anterior internal fracture the anteromedial oblique fracture of the coronoid process, and type IV anterior external fracture the anterolateral oblique fracture of the coronoid process. According to the characteristics of the coronoid fracture fragment, type IV anterior external fracture was divided into two subtypes: α subtype involving the coronoid tip and β subtype without involving the coronoid tip. Then, the proportion, height, surface area and volume of different types of coronoid fractures were measured. The proportion, height, surface area and volume of fracture fragments of two subtypes of type IV anterior external fracture were measured, as well as the area of ulnar trochlear joint, area of trochlear joint of ulnar fracture fragment, proportion of the area of trochlear joint affected by the ulnar fragment, area of proximal radioulnar joint, area of proximal radioulnar joint of ulnar fracture fragment and proportion of the area of proximal radioulnar joint affected by the ulnar fragment.Results:Among the patients with terrible triad injury, the ulnar coronoid process fracture was Adams type I in 17 patients (33%), type II in 4 (8%), type III in 4 (8%), type IV anterior internal fracture in 4 (8%) and type IV anterior external fracture in 22 (43%). The height of fracture fragment of type I, type II, type III, type IV anterior internal fracture and type IV anterior external fracture was (3.7±1.9)mm, (10.8±1.1)mm, (14.4±1.2)mm, (5.2±2.4)mm and (6.7±2.6)mm, respectively; the surface area was 63.7(21.4, 221.0)mm 2, 1 086.8(606.8, 1 434.2)mm 2, 1 658.8(1 335.6, 1 695.4)mm 2, 437.3(185.6, 437.3)mm 2 and 511.8(198.8, 646.5)mm 2, respectively; the volume was 46.3(21.4, 180.5)mm 3, 938.7(629.8, 1 011.3)mm 3, 1 797.4(1 520.2, 1 903.7)mm 3, 429.3(138.1, 992.4)mm 3 and 461.9(144.9, 707.1)mm 3, respectively. There were significant differences in the height, surface area and volume of coronoid process fracture with different Adams classification (all P<0.01). Among 22 patients with type IV anterior external fracture, 12 patients were with α subtype and 10 with β subtype. The fracture height of α and β subtypes was (8.6±2.6)mm and (5.0±2.4)mm, respectively; the surface area was 633.2 (530.3, 727.4)mm 2 and 181.4 (136.7, 450.3)mm 2, respectively; the volume was 692.8 (477.6, 778.0)mm 3 and 128.0 (74.2, 405.1)mm 3, respectively. The height, surface area and volume of fracture fragment were significantly different between the two subtypes (all P<0.01). The area of ulnar trochlear joint of α and β subtypes were 901.4(755.1, 1 060.6)mm 2 and 835.2(767.7,909.3)mm 2, respectively; the area of trochlear joint of α and β subtype fragment was 104.1(79.4, 139.9)mm 2 and 38.8(21.3, 58.1)mm 2, respectively; the proportion of the area of trochlear joint affected by α and β subtype fragment was 0.12(0.09, 0.15) and 0.05(0.03, 0.07), respectively. There was no significant difference between α and β subtypes in the area of trochlear joint of ulna ( P>0.05), but the area of trochlear joint of α subtype fragment and proportion of the area of trochlear joint affected by α subtype fragment were higher than those of β subtype fragment (all P<0.01). The area of proxima radioulnar joint of α and β subtypes was 147.9(111.7,164.2)mm 2 and 137.0(118.7,166.7)mm 2, respectively; the area of proximal radioulnar joint of α and β subtypes fragment was 17.7(13.4, 52.2)mm 2 and 6.1(2.6, 20.0)mm 2, respectively; the proportion of the area of proximal radioulnar joint affected by α and β subtypes fragment was 0.12(0.10, 0.35) and 0.05(0.03, 0.15), respectively. There were no significant differences between the two subtypes in proximal radioulnar joint damage (all P>0.05). Conclusions:Adams type IV fracture of the coronoid process of the ulna occupies a large proportion in terrible triad injury, and the type IV anterior external fracture is the main type containing two subtypes with differences in fragment size and shape. However, the injuries to the proximal radioulnar joint surface are similar for the two subtypes, so the injuries of type IV anterior external fracture with different sizes to the proximal radioulnar joint surface should not be neglected in clinical treatment.

Observation of therapeutic effect of autologous platelet-rich plasma on joint injury / 中国输血杂志

【Objective】 To study the therapeutic effect of autologous platelet-rich plasma(PRP) on joint injury. 【Methods】 Selected patients with joint injury treated in the Department of Transfusion Medicine of General Hospital of Southern Theatre Command of PLA from 2019 to 2020 were enrolled as the research objects, including 5 patients with shoulder joint injury, 34 patients with knee joint injury and 9 patients with ankle joint injury. All patients were treated with PRP injection at the injury site. The functional score and VAS score before and after treatment were compared. 【Results】 After 6 months of treatment, the CMS score and VAS of 5 patients with shoulder joint injury after treatment were (83.00±5.39) and (1.60±0.40), better than those before treatment (60.00±7.58)and (4.20±0.49)(P<0.05); The Lysholm knee score and VAS of 34 patients with knee joint injury after treatment were (80.73±2.43) and (2.07±0.24), better than those before treatment(50.30±2.96) and (4.28±0.33) (P<0.05); The AOFAS Ankle Hindfoot Scale and VAS of 9 patients with ankle joint injury after treatment were (68.44±4.59) and (2.56±0.53), better than those before treatment (42.67±4.57) and (4.89±0.63) (P<0.05). 【Conclusion】 For common joint injury sites, the clinical effect of using PRP injection is significant, which can effectively relieve pain and improve motor function, which is worthy of clinical application.

Linoleic acid ameliorates inflammation in rheumatoid arthritis rats via regulation of TLR4/NF-κB signaling pathway / 中国药理学通报

Aim To explore the effects of linoleic acid on the joint swelling in rats caused by rheumatoid arthritis (RA), and to reveal possible mechanism underlying the inhibitory effect of linoleic acid on TLR4/NF-κB signaling pathway in RA. Methods The RA rat model was constructed and divided into control group, model group, linoleic acid (0. 1 mL) group, linoleic acid (0.2 mL) group, linoleic acid (0.4 mL) group and methotrexate (MTX) group. After the model was successfully established, the corresponding drugs were given by gavage for seven days. The control group and the model group were given normal saline. The changes of rat joint swelling were measured; joint pathological damage was assessed by HE staining; the protein expression levels and the mRNA expression levels of TNF-α, IL-1β, IL-6 and IL-10 were determined by ELISA and qRT -PCR; the protein expression levels of TLR4 and p-p65 were determined by immunohisto-chemistry and Western blot. Results Compared with model group, linoleic acid significantly alleviated the joint swelling of RA rats; linoleic acid significantly inhibited the joint pathological damage, and markedly reduced the protein expression levels and mRNA expression levels of TNF-α, IL-1β, IL-6 and IL-10; linoleic acid inhibited the protein expression levels of TLR4 and p-p65 in the TLR4/NF-κB signaling pathway. Conclusions Linoleic acid inhibits the protein expression levels of TLR4 and p-p65 in the TLR4/NF-κB signaling pathway, thereby inhibiting the expression of inflammatory factors TNF-α, IL-1β, IL-6 and IL-10.

Application of Static Characteristics of Plantar Pressure Distribution in the Assessment of Knee Joint Injury / 中国医疗器械杂志

OBJECTIVE@#This paper used plantar pressure analysis equipment to discuss the plantar pressure distribution pattern and balance ability of patients with the knee joint injury under static standing.@*METHODS@#Zebris FDM-S plantar pressure analysis equipment was used to collect plantar pressure data from subjects with the knee joint injury and healthy control subjects. We compared the pressure values in each region of pelma, and then assessing the balance ability of the subjects based on the trajectory of the overall pressure center movement.@*RESULTS@#Compared with the healthy control group, patients with knee joint injury have a significantly lower pressure in the heel areas and a significantly higher pressure in the middle foot area. And the total pressure of the injured limb foot in the patient group is lower than that in the contralateral foot. In addition, there is a significant increase in the parameters of the balance ability index in the patient group.@*CONCLUSIONS@#The plantar pressure distribution pattern of patients with knee joint injury is different from that of normal people in static standing, and the balance ability is poor. Therefore, this method has a positive guiding significance in the evaluation and application of knee joint injury.

Effects of multi-block reconstructive plate on the treatment of complex tarsometatarsal joint injury / 中国综合临床

Objective To evaluate the effect of multi?plate reconstruction plate in the treatment of partial complex tarsometatarsal joint injury injuries. Methods Seven patients treated complex tarsometatarsal joint injuries with multi?plate reconstruction plate in Nanjing Hospital Affiliated to Nanjing Medical University from September 2014 to July 2016 were selected in this study. According to Myerson classification,3 cases were A type,3 cases were B type,1 case was C type. The therapeutic effects were observed. Results The patients were followed up for 6-12 months,with an average of (8. 6±2. 0) months. According to the foot scoring criteria in American Orthopedic Foot and Ankle Society ( AOFAS) ,the function of the foot was evaluated,3 cases were in excellent condition,4 cases were in good condition. Conclusion In the case of multiple metatarsal fractures of the metatarsal base involved in the joint surface, the use of multiple reconstructive plates for joint fixation reduces the iatrogenic damage of the joint surface. The fixation effect and the functional recovery are satisfactory

Classification and treatment of syndesmotic injury / 中国骨伤

The distal tibiofibular syndesmosis is a critical structure in maintaining the ankle stability. Syndesmotic injuries are usually associated with ankle fractures and high fibula fractures. Non-isolated and partially isolated syndesmotic injuries are involved in unstable injuries, which need to operative treatment. Partially isolated syndesmotic injuries belong to stable injuries, which should be treated with non-operative management. It is becoming clear that early fixation and stabilization for unstable injuries are probably better than non-treatment or delayed treatment. It still remains without consensus of accurately defining stable from unstable injuries and sufficiently differentiating between acute and chronic injuries. Because of stability, fixation type, and duration, the clinical efficacy is different. Screw fixation is a gold standard treatment of syndesmotic injury. However, it remains controversial that whether removal of the syndesmotic screw is required and effect of the level of syndesmotic screw insertion, limited micro-movement is one of disadvantages of screw fixation. Micro-movement of the distal tibiofibular syndesmosis has been paid more and more attention. Dynamic fixation is a viable alternative to the static fixation device, with lower re-operation rates and less complications, which has obtained a great short-term clinical efficacy. However, further long-term studies should be carried out to confirm this clinical efficacy. Optimized treatment strategies considering stability of syndesmotic injury, duration, and fixation type can help to improve clinical efficacy.

Comparison of the clinical efficacy of single and double locking compressing plates treatment for Schatzker type Ⅵ tibial plateau fractures / 中华老年医学杂志

Objective To compare the clinical efficacy of single and double locking compressing plates(LCP)treatment for Schatzker type Ⅵ tibial plateau fractures.Methods Patients(n=90)with Schatzker type Ⅵ tibial plateau fractures were randomly divided into two groups according to the treatment methods (single LCP group and double LCP group;45 patients in each group) and analyzed retrospectively.Operative duration,intraoperative bleeding volume,postoperative wound infection,Rasmussen anatomical score and functional score were measured and compared between the two groups.Results More favorable results were achieved in the single LCP group than in the double LCP group in operative duration [(51.4 ± 4.03)h vs.(76.2±5.5)h(t=24.514,P＜0.001)]and intraoperative bleeding volume[(173.7±8.8) ml vs.(212.4 ± 4.9) ml (t =25.911,P ＜ 0.001,respectively)].Further more,three cases of postoperative woundin fection were seen in the double LCP group,while none was observed in the single LCP group.There was no significant difference in the percentage of satisfactory Rasmussenanatomical scores and functional scores between the two groups one year afteroperation(~ =-0.442,P=0.659).Conclusions Compared with double LCP fixation,single LCP fixation is more advantageous for the treatment of Schatzker type Ⅵ tibial plateau fractures.

Proliferation change and significance of osteoclasts in osteoarthritis / 重庆医学

Objective To explore the proliferative changes and clinical significance of osteoclasts (OC) in various stages of osteoarthritis (OA). Methods Twenty healthy adult male SD rats were made the model by modified Hulht procedure,the left knee served as the control group and the right knee as the OA model group. The total knee joint (n=5) was collected at postoperative 1, 2,4,8 weeks, fixed at 4 ℃ 4% poly formaldehyde (PFA) liquid, embedded by paraffin for conducting sections, and stained by TRAP,toluidine blue(TB) and safranine O (Saf O)fast staining. Then the cartilage morphology change was observed and OC positive cells number with TRAP staining were semi-quantitatively detected,the OA cartilage destruction progression was evaluated by Mankin's method and SPSS17.0 statistics software was used to conduct statistical analysis. Results OC in the two groups showed the transient change of rapidly increasing and then decreasing. The OC number at 1 week in the control group (left knee) was (65.20±4.12) cells/mm2 ,and was gradually reduced at 2,4 weeks,which were (47.20±4.31) cells/mm and (26.20±3. 87) cells/mm2 ,which at 8 weeks was almost invisible, the number of cells was (7.00 ± 2.28) cells/mm2 ;the OC number at 1 week in the OA model group (right knee) was (70.40 ± 5.46) cells/mm2 ,increased to (86.20± 5.42)cells /mm2 at 2 weeks, reduced to (38. 0 ± 3.16) cells/mm2 at 4 weeks , was almost invisible at 8 weeks, the number of cells was (6.21 ± 2.93 ) cells/mm2 . The OC number at 2,4 weeks in the model group was significantly higher than that in the control group, the difference had statistical significance (P<0.05). Conclusion Large numbers of osteoclasts are proliferated in the early and middle stages of rat knee osteoarthritis, which indicating that OC might be involved in the formation of osteoarthritis.

Comparison of the clinical effect of closed reduction internal fixation and open reduction internal fixation in the treatment of joint injury / 中国基层医药

Objective To compare the clinical effect of two ways of the closed reduction internal fixation and open reduction internal fixation in the treatment of joint injury.Methods According to the digital table,84 patients with joint injury were randomly divided into control group and treatment group,42 cases in each group.The control group was given closed reduction and internal fixation,and the treatment group was given open reduction and internal fixation.Results The total time of operation,postoperative hospitalization time,postoperative joint function recovery time of the treatment group were (78.51 ±10.20)min,(13.35 ±2.46)d,(88.43 ±5.27)d,those of the control group were (118.73 ±25.71)min,(19.72 ±3.57)d,(107.42 ±10.33)d,the differences were statistically signifi-cant(t =9.424,9.522,10.613;P =0.000,0.000,0.000).The excellent and good rate of the treatment group was 90.48%,which was higher than 71.43% of the control group,the difference was statistically significant(χ2 =4.941, P =0.026).The treatment group had 1 case of adverse reaction,the control group had 8 cases of adverse reaction, there was statistically significant difference between the two groups(χ2 =6.098,P =0.014).After treatment,the VAS pain score in the treatment group was (2.11 ±0.68)points,which was lower than (4.98 ±1.35)points in the control group,the difference was statistically significant(t =12.305,P =0.000).Conclusion The application effect of closed reduction and internal fixation for patients with joint injury disease is very obvious.

Treatment of Lisfranc joint injury with the operation of the Kirsehnerwlres and screw / 中国综合临床

Objective To summarize the clinical experience of operation treatment of Lisfranc fracture dislocation,and evaluate its clinical effect.Methods Thirty-nine patients with Lisfranc joint injuries (46 sides) were managed with open reduetlon as well as internal fixation with serews and Kirsehnerwlres.Results All the patients were followed up from12.0 to 42.0 months,the average was (21.1 ± 1.8) months.Evaluated the clinical effect according to the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score standard,there were 29 cases of excellent,8 cases of good,and 3 cases of aceeptable.Conclusion By Kirschner wire combining with screw fixation,open reduction and internal fixation may achieve satisfactory clinical results for the treatment of Lisfranc joint injurie.The operation is simple and fast,small trauma,less complications and can obtain good effects.

Lisfranc Joint Injuries: Diagnosis and Treatment

Injuries to the Lisfranc joint are relatively rare, but they are often misdiagnosed or inadequately treated, resulting in poor long-term outcomes. Understanding of anatomical structure and injury mechanism, careful clinical and radiographic evaluations are needed to recognize and treat Lisfranc joint injuries. In this article, we review the anatomy, biomechanics, injury mechanisms, injury classification, clinical presentation, radiographic evaluation, treatment, outcome, and complications of Lisfranc joint injuries.

Clinical research on the effect of isokinetic training on knee injury patients’ recovery function / 中国医学装备

Objective: To analyze the Effect of isokinetic training on knee injury patients’ recovery function. Methods: Choose knee injury patients between October 2012 to October 2013 as research object, randomly divided into control group received conventional training, and observe group received isokinetic training, each with 49 cases, detecting knee function after training, stretching flexor muscle strength, range of motion. Results: 1) After training ,both groups of patients inflammation Lysholm knee function scores were higher than before,and observation group patients Lysholm knee function score were significantly higher; 2)After training, both groups extensor flexor muscle strength were higher than before,and the observation group patients’ stretched flexor PT, AP, MRTW level were higher; 3)After eight weeks of training and 16 weeks, observation group patients’ knee extension, knee flexion angles were significantly higher.Conclusion:Isokinetic exercise training can improve knee joint function in patients, improve muscle strength while expanding its range of motion, improve the quality of life of patients.

Bone morphogenetic protein 2 expression in rabbit radial defect site with different lengths / 中国组织工程研究

BACKGROUND:It has been studied that the distribution of bone morphogenetic protein 2 is regular under bone defect situation. OBJECTIVE:To observe the expression of bone morphogenetic protein 2 in rabbit radial defect site with different lengths. METHODS:Forty-eight New Zealand rabbits were divided into two groups randomly, 0.5 cm bone defect and 3.0 cm bone defect were made by wire saw at the middle part of radius bone after anaesthesia. RESULTS AND CONCLUSION:Western blot results showed that in the 0.5 cm bone defect group, the expression of bone morphogenetic protein 2 of the tissues in the bone defect site was increased gradual y at 1, 3, 4 weeks after operation, and the expression in each defect group was increased when compared with that immediately after injury (P<0.05). In the 3.0 cm bone defect group, the expression of bone morphogenetic protein 2 of tissues in bone defect site was increased gradual y and reached to its peak at 3 weeks after the operation (P<0.05), and the peak value in the 3.0 cm bone defect group was significantly higher than that in 0.5 cm bone defect group (P<0.05). The peak value was maintained in high level. The comparison of bone cal us formation showed that the bone cal us formation of 3.0 cm bone defect group was less than that of the 0.5 cm bone defect group at 3 and 4 weeks after operation (P<0.05). The results indicate that expression of the bone morphogenetic protein 2 in 3.0 cm bone defect site is increased significantly, but the expression level cannot make the bone defect heal itself.

Acetabular trabecular direction between different species / 中国组织工程研究

10.3969/j.issn.2095-4344.2013.26.001

Analysis of different methods of internal fixation of ankle fractures / 中国综合临床

Objective To investigate the treatment effects of different fixation for fracture and dislocation of ankle joint and to sum up the experience for clinical treatment.Methods One hundred and fifty patients with fracture and dislocation of ankle joint using 5 different internal fixation surgeries were involved with this research:simple cross Kirschner wire fixation,intramedullary fixation ordinary screws,cancellous lag screw fixation,4 holes common plate fixation,tension band fixation.Patients were followed up and evaluated by the American Orthopedic Foot and Ankle Society Score for scoring,and investigated the postoperative recovery and the occurrence of postoperative infections and complications in patients.Results After followed up from 12 to 24 months with an average follow-up time of 19 months,of 150 patients,there were 29 cases with excellent result,65 cases with good result,44 cases with general and 12 cases with poor result,the excellent and good rate was 62.6％ (94/150).One case with nonunion,6 cases with malunion,7 cases with traumatic arthritis,10 cases with wound pain,the incidence of postoperative complications was 16.0％ (24/150).There were 10 cases with shallow infection,5 cases with deep infection,and 11 cases with severe skin irritation; The incidence of postoperative infection was 17.3％ (26/150).Conclusion Surgical treatment is the main treatment of fracture and dislocation of ankle joint,5 different methods of internal fixation of ankle fractures had good therapeutic effect.

Early Intervention of Systematic Rehabilitation for Elbow Joint Dysfunction after Trauma / 中国康复理论与实践

@# Objective To investigate the early rehabilitation for elbow joint dysfunction after trauma.Methods26 cases who accepted rehabilitation 7～30 d after trauma were determined as Group A,other 20 cases who accepted rehabilitation more than 30 d after trauma as Group B.They were evaluated with Mayo Elbow-Performance Score and range of motor(ROM)after systematic rehabilitation.ResultsThe scores of Mayo Elbow-Performance Score and the ROM were better in group A than in group B(P<0.05).ConclusionEarly rehabilitation is important for the elbow joint function recovery after trauma.

Treatment of acute osteochondral fractures of the talus using autologous osteochondral transplantation / 中国矫形外科杂志

[Objective]To study the clinical results of treatment of local osteochondral fracture lesions on the talus dome associated with ankle fracture using autologous osteochondral transplantation.[Method]There were 18 patients with osteochondral fracture defects of the talus dome associated with ankle fracture, male 10, female 8, with the average age 33.5 years (18~49 years). Transplantation procedure was osteochondral cylinders from non-weight bearing surface of the ipsilateral knee and implant the donor graft into the recipient holes of talus cartilaginous defects with press-fit technique. The outcomes were assessed on the basis of ankle functional rating score, radiographic findings and MRI findings.[Result]The patients were followed up for 17 to 40 months (mean, 28 months). The ankle functional rating score was measured by the Baird and Jackson functional rating score system. The averaged scores was 96.3?3.5,excellent in 14 cases, good in 3 cases and fair in 1 case. The rate of being excellent and good was 94.4%.The rate of posttraumatic arthritis was 5.6% (1/18) and osteochondritis dissecans was 5.6% (1/18).[Conclusion]Autogenous osteochondral transplantation using ipsilateral knee osteochondral grafts is an effective surgical procedure on treating acute local osteochondral fracture lesions of the talus associated with ankle fracture.

RELATIONSHIP BETWEEN MAJOR JOINT INJURY AND GENERAL JOINT LAXITY IN COLLEGIATE AMERICAN FOOTBALL PLAYERS / 体力科学

A preparticipation examination for athletes should be performed to prevent severe athletic injury by examining physical characteristics related to various injuries. The general joint laxity test has been included among the check-up items considering as relating factor of joint injury. Authors investigated the relationship between the score of general joint laxity for freshmen examination and the incidence of major joint injury, during the succeeding 5 athletic seasons, in eighty-seven collegiate American football players.<BR>Significant higher scores were observed in athletes affected by shoulder injury, and slightly higher scores in those affected by knee joint injury. But, the scores were similar between athletes with and without elbow or ankle injury.<BR>The degree of laxity was associated with shoulder and knee joint injury in a comparison of incidence of these injuries among tight, medium and lax groups.<BR>Authors concluded that general joint laxity is related to the incidence of shoulder and knee joint injury.

Changes about joint injuries caused by train in recent years / 中华创伤骨科杂志

Objective To analyze the recent changes in features of joint injury caused by the fast running railroad train. Methods 1279 joint injuries o f the 10214 cases of train injury after the speeding up of the railway services from 1997 to 2003 were analyzed to find out their particular causal conditions, the severity of the injury, and the classification of the injuries, the correlat ion between which and recovery was also tested by AIS-ISS grading. Results Afte r the speeding up of the railway services, the incidence of joint injuries rose from 33.54% to 34.12%,the mortality rose from 22.88% to 30.33%,the multipl e joint severances rose from 19.84% to 34.19%,the open joint injury rose from 31.71% to 63.15%,and the mortality caused by multiple joint severances rose from 21.19% to 49.07%. Conclusions The incidence of multiple traumas resulted from the train is much higher than those resulted from other causes. Multiple t raumas caused by train are very difficult to deal with. The multiple organ dysfu nction syndrome (MODS) is a main factor to cause the death.

Clinical analysis of Acromioclavicular and Coracoclavicular Ligament Injury / 대한정형외과학회잡지

The acromioclavicular and coracoclavicular ligament are usually injured by traffic accident or during sports. So, various methods of treatment has been introduced. Fourty four cases of acromioclaviclar and coracoclavicular ligament injuries were admitted and treated at Koryo General Hospital from March 1985 to February 1989. 26 cases were treated by operative method, 18 cases by conservative method in Grade 1, 2 and 3 injuries. The following results were obtained. 1. These injuries were more prevalent in male and more in left side. 2. The most common cause of injuries was traffic accident. 3. Among 44 cases, 13 cases were Grade 1, 9 cases Grade 2 and 22 cases Grade 3 by Allman's classification. 4. 18 cases were treated conservatively and 26 cases operatively. Conservatively treated 18 cases include 15 cases by Kenny-Howard sling and 3 cases by skillful neglect. And operatively treated 25 cases include 12 cases by modified Phemister method(46.2%), 2 cases by modified Bosworth method(7.7%), 2 cases by acromioclavicular plate method(7.7%), 2 cases by Stewart method(7.7%) and one case by Mumford method(3.8%). 5. There were good functional results with the K-wire fixation method after the acurate diagnosis by operative method in the Grade 2 injury. And in the Grade 3 injury we could get the functional results with the modified Phemister method.