A Minimal-Incision Technique in Total Hip Arthroplasty : Early Postoperative Results and Learning Curve

Purpose: We hereby would like to compare on the basis of the initial 12 hips and latter 18 hips by analyzing the initial results of the minimal incision total hip arthroplasty of 30 hips we experienced. Materials and Methods: For the period of December 2004 through June 2005, we performed the total hip arthroplasty with minimal incision in 10cm or shorter using the posterolateral approach on 25 patients (30 hips) whose BMI(body mass index) is 30 or lower. We compared by analyzing results of the initial 12 cases and 18 latter cases. Results: The average BMI was 23.7. There weren`t statistically meaningful differences the change in the hemoglobin value of pre-op and post-op, necessity of blood transfusion, position of component, and the Harris hip score 6 weeks after operation. But, the average initial operation time of 124 minutes was remarkably reduced to 65 minutes in average in the latter operation and the length of a skin incision was reduced from the average 9.2 cm in the initial operation to an average of 8.1cm in the latter operation. There wasn't the malposition of acetabular cup and femoral stem. Conclusion: Although we need more statistical data through more cases and the analysis of long-term results, we think that, to surgeons with much experience in the conventional total hip arthroplasty, the total hip anthroplasty using minimal incision for patients with BMI of 30 or below would be a useful approach having the advantage in a cosmetic aspect.

Extra-articular Triplane Fracuture of the Distal Tibia in Children

PURPOSE: To demonstrate the effectiveness of the conservative treatment which was introduced to the extraarticular triplane fractures of the distal tibia. MATERIALS AND METHODS: We reviewed radiographs and medical records of eight patients with extraarticular triplane fractures of the tibia. Four patients were treated with closed reduction and internal fixation and the others with closed reduction and plaster. RESULTS: In all patients, the union of fractures was obtained. Although the physes were closed early, there was no angular deformity or leg length discrepancy. CONCLUSION: In case of extraarticular triplane fracture, except for open fracture or failure of closed reduction, conservative treatment yield good result.

Evaluation of Rotational Displacement of the Posterior Facet on the Sagittal Plane in Computed Tomographic Images of Calcaneal Fractures

PURPOSE: To find out whether or not the computed tomographic (CT) classification systems of the calcaneal fracture are efficient in illuminating displaced posterior facet fragment and the degree of displacement can be evaluated by analyzing serial CT images. MATERIALS AND METHODS: Seventy-seven hundred calcaneal fractures were classified by CT classification systems including Sanders classification, and the sagittal rotation angle of the posteior facet fragment was measured on the plain lateral radiograph. Among the serial axial CT images, a number of images with the cortical bone embedded in the cancellous portion were recorded and any significant relationship between each data were evaluated. RESULTS: The conventional CT classification systems are rather insufficient in illuminating the extent of sagittal rotatory displacement. However, the number of CT images in which the cortical radiodensity was observed showed a significantly related with the degree of displacement. CONCLUSION: The conventional CT classification of the calcaneal fractures is unsatisfactory in expressing the degree of sagittal rotatory displacement of the posterior facet fragment; this problem may be alleviated by observing the number of axial CT images in which cortical radiodensity was revealed within the calcaneal body.

Arthroscopic Reduction and Pull-out Suture Fixation for the Intercondylar Eminence Fracture of the Tibia

PURPOSE: Meyers-McKeever and Zaricznyj proposed a classification for intercondylar eminence fractures of the tibia. Type III and IV classifications are generally accepted as surgical indications for the fractures. The purpose of the present study was to evaluate the effectiveness of arthroscopic reduction and multiple pull-out suture fixation for displaced intercondylar eminence fractures of the tibia. MATERIALS AND METHODS: Twenty two cases were examined, with a average age of 14(5~23) years, and the average follow-up was 34 months(24 months~6 years). Patients were evaluated according to the Meyers and McKeever criteria, and were scored at 6 weeks, 4 months, 8 months, each year and at the last follow-up. Patients underwent the following evaluations: radiological, range of motion, Lachman test, pivotshift test and the KT 2000 arthrometer. RESULTS: The average union time was postoperative week 9.3(6~12 weeks). According to the Meyers and McKeever criteria, the cases showed the following outcomes at the final follow-up: 19(86.4%) excellent, 2(9.1%) good and 1(4.5%) poor. CONCLUSION: Using the short- and mid-term arthroscopic reduction and multiple pull-out suture fixation procedure for displaced intercondylar eminence fractures of the tibia resulted in 95.5%(19) of cases showing good or excellent outcomes, indicating this procedure is effective.