The Comparison of Loss of Reduction at the Thoracolumbar Fracture According to Insertion of Screw Including Fractured Vertebra or not in Short Segment Posterolat Fusion / 대한척추외과학회지

STUDY DESIGNS: Retrospective analysis of the surgical treatment in patients of thoracolumbar spine fractures. OBJECTIVES: To measure by modified Cobb method the correction angle of thoracolumbar vertebral fractures and to comparison the difference between short segment pedicular fixation with fractured vertebra(group A) and without fractured vertebra (group B). SUMMARY OF LITERATURE REVIEW: The major treatment of thoracolumbar spine fractures is surgical correction of kyphotic angle by posterior decompression and posterolat. fusion at one level or more. MATERIALS AND METHODS: The materials are the patients who visited due to trauma beween 1991.1 and 2000.12. and treated by post. decompression and short segment posterolat. fusion with iliac bone graft. The number were A group, 28 persons and B group, 15 persons. The method of radiologic measurement is done by the modified Cobb method. The follow up time is till 2001.7. and the duration are minimal 6 months and maximal 77 months. The age was between 17 old and 60 old. The neurologic abnormalities in patients are 12 persons. The fractures were classified by the Denis classification. There are compressive fracture are 3 persons and bursting fracture type A are 18 persons, type B are 22 persons. The materials were confirmed by radiologic union and excluded if more than one vertebra fusion is needed. RESULTS: The most fractures were due to falldown injury. The most fracture site was T-L level (T12-L3). The one case was complicated by deep infection and treated and the other case was reduction loss due to metallic failure. The results of the loss of correction were A group, 5.3 degree and B group, 6.2 degree. (P>0.05). The relative correction loss were A group, 42%, and B group, 54%. (P<0.05). CONCLUSION: The mean correction angle and loss of correction are more good results in the group of short segment pedicular fixation with fracture vertebra. But to get more good results, our study do more long term follow-up and rule out other statistical errors and consecutive radiologic follow-up.

Peroneal Nerve Palsy after Total Knee Arthroplasty

PURPOSE: To evaluate prognosis and causative factors of the peroneal nerve palsy that occurred after total knee arthroplasty. MATERIALS AND METHODS: From April 1994 till Feb. 2002, we performed 637 cases(449 patients) of total knee arthroplasty (TKA). Among them we experienced 9 cases(9 patients,1.4%) of peroneal nerve palsy postoperatively. For evaluation of suggestive causes of peroneal nerve palsy, we compared these paralytic group with the control group (628 cases: 440 patients) which has no peroneal nerve palsy after TKA. We analyzed basic patients factors including age, sex, body weight, preoperative diagnosis, and preoperative degree of flexion contracture and tibiofemoral angle, intraoperative tourniquet time, preoperative functional knee scores (HSS and TKSCRS). RESULTS: Eight cases were recovered completely within 12 months after TKA. A case has no change in 1 and 1/2 years after operation so we considered it as a permanent damage. There were no statistical differences between two groups. CONCLUSION: Almost all cases of peroneal nerve palsy were completely recovered spontaneously within 12 months after operation and within 6 months, clinincal sign of improvement was appeared. Until now, we couldn't find any definite causes of peroneal nerve palsy after TKA, so its causes would be multifactorial and further studies may be necessary.