The Short Term Results of All-inside Arthroscopic Repair of the Triangular Fibrocartilage Complex Type 1B Tear by Knotless Suture Anchor

PURPOSE: We studied the short term results of the arthroscopic repair of 1B type triangular fibrocartilage complex (TFCC) tear using a knotless suture anchor. METHODS: We evaluated 23 patients who underwent all-inside arthroscopic TFCC repair using a knotless suture anchor. The average follow-up duration was 6.6 months (range, 3-10 months). Mean duration of symptom was 10.9 months (range, 1 week-7 years). The arthroscopic finding documented 15 type 1B, 2 1B with 1D, and 6 1B with 2C lesions. All showed the positive hook test. The concomitant pathologies were 16 scapholunate injuries and 10 lunotriquetral injuries. TFCC tears were repaired by the knotless suture anchor. The Wafer procedure was done for 2C lesions. RESULTS: According to Mayo modified wrist score, the result was excellent in 4, good in 14 and fair in 5. Nineteen patients (82.6%) could return to his job or hobby. CONCLUSION: The all-inside arthroscopic repair using knotless suture anchor for TFCC 1B tear can provide good results. The appropriate management should be done for the concomitant pathologies for the better results.

Extensor Pollicis Longus Rupture after Distal Radius Fracture

PURPOSE: To evaluate the cause and surgical outcome of extensor pollicis longus rupture after distal radius fractures. MATERIALS AND METHODS: Nineteen cases in which the patients underwent surgical treatment for rupture of the extensor pollicis longus after distal radius fractures were followed for more than one year. Among the nineteen cases, fourteen extensor pollicis longus ruptures occurred after conservative treatment, four occurred after closed reduction with K-wire fixation, and one occurred after open reduction and internal fixation with a plate. All cases were treated by extensor indicis proprius transfer. RESULTS: Extensor pollicis longus ruptures were caused by K-wire irritation in two, by a protruding screw tip in one, and by a callus in one. In the conservative treatment group, tendon ruptures were diagnosed at an average of 3.1 months (0.7~17). Tendon ruptures were detected in the surgical treatment group at an average of 12.8 months (1~48). All the patients showed favorable recovery of the extension capability of the thumb at the final follow-up. CONCLUSION: The main cause of extensor pollicis longus rupture after distal radius fracture was ischemic damage. Therefore, during the surgery, the length and direction of screws and K-wires should be fixed carefully to avoid such damage. Distal radius fracture also requires careful observation of the extensor pollicis longus during follow-up. Furthermore, extensor indicis proprius transfer is considered to be an effective method for extensor pollicis longus rupture.

Extraskeletal Mesenchymal Chondrosarcoma in the Axillary Region: Reports of Two Cases

Extraskeletal mesenchymal chondrosarcomas (EMCs) are relatively uncommon, and a location in the upper extremity, especially in the shoulder or axillary region, is rare. Furthermore, the radiographic findings of EMCs do not show any features that distinguish them from other neoplasms, and therefore, definitive diagnoses are made based on histological features. EMC is an aggressive tumor with a poor prognosis, and requires wide surgical excision. However, its treatment may involve peculiarities such as a difficulty in obtaining a proper surgical margin in the axillary region or shoulder. In this report, the authors present two rare cases of EMCs in the axillary region.

Short-Term Outcomes of Miller Galante(R) Fixed-Bearing Unicondylar Knee Arthroplasty: A Comparative Study in Outcomes according to Postoperative Correction Angle / 대한정형외과학회잡지

PURPOSE: To evaluate short-term clinical and radiographical results of fixed bearing unicondylar knee arthroplasty (UKA) comparing results between over-corrected group and under-corrected group. MATERIALS AND METHODS: Clinical and radiographical outcomes of 47 Miller-Galante(R) UKAs with a minimum of 4-year follow-up were evaluated. We also compared both clinical and radiographical results between over and under corrected groups, which were divided by 2degrees varus of mechanical axis postoperatively. RESULTS: HSS and WOMAC scores improved from 75.4 and 57.7 preoperatively to respectively, 95.2 and 12.1 at the last follow up. Radiographically, the mechanical axis changed from 7.2degrees varus preoperatively to 2.8degrees varus at the last follow-up. A partial radiolucent line on the medial side of the tibia was observed in 23% of the 47 cases. Degenerative changes in the lateral compartment and the patellofemoral joint were observed, respectively, in 23% and 26%. There were no significant differences between the two groups in clinical and radiographical results (p>0.05). In the undercorrected group, three cases converted to total knee arthroplasty because of medial tibial collapse. CONCLUSION: Miller-Galante(R) UKA showed good outcomes in short-term follow-up with the exception of three failures. There were no significant differences between more than 2degrees varus corrected and under 2degrees varus corrected groups in clinical and radiographical results. However, all 3 conversions to total knee arthroplasties occurred in the undercorrected group.

Metastatic Pathologic Fractures in Lower Extremities Treated with the Locking Plate / 대한골관절종양학회지

PURPOSE: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. MATERIALS AND METHODS: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. RESULTS: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). CONCLUSION: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.