Diagnosis and Treatment of Pisiform Injury / 대한정형외과학회잡지

PURPOSE: To establish modality of diagnosis and treatment in pisiform injuries by analysis of its clinical experiences. Materials & Methods : Twelve fractures and one dislocation of the pisiform that were followed up for more than twelve months were reviewed retrospectively. RESULTS: Eight cases had associated injuries on the wrist or hand of ipsilateral side. Eight cases were diagnosed by routine radiography and three cases required additional special radiography such as the supinated oblique view or carpal tunnel view. One case was diagnosed by computed tomography. Cast immobilization was performed in nine cases and three cases underwent internal fixation. Pisiform was excised in one chronic dislocation case. The results were usually satisfactory but two cases showed pisotriquetral arthritis and one of them underwent excision of pisiform. CONCLUSION: The diagnosis of pisiform injury may accompany some difficulties due to associated carpal injuries. Routine radiography is sufficient for the screening of it if attention is paid and specific radiography such as supinated oblique view or carpal tunnel view may be very useful for confirmation. As conservative treatment alone shows good result, operative fixation is recommended for limited cases. The excision of pisiform is required in case of pisotriquetral arthritis or neglected chronic dislocation.

Total Knee Arthroplasty Using LCS System

PURPOSE: We evaluated the efficiency of low contact stress(LCS) system in total knee arthroplasty by analyzing clinical and radiological results. MATERIALS AND METHODS: Out of 128 cases who underwent total knee arthroplasty with meniscal bearing type LCS system, eighty one cases who were followed up for more than two years were analysed. Average follow-up period was 32,6 months(24 months-48 months). The diagnoses were six cases of degenerative arthritis, eighteen cases of rheumatoid arthritis, and two cases of avascular necrosis. Clinical analysis were performed by American Knee Society Knee Score and Hospital for Special Surgery(HSS) knee score and radiographic analysis were performed by the Knee Society Roentgenographic Evaluation and Scoring System. RESULTS: Average preoperative flexion contracture was improved from 13.4 degrees preoperatively to 1.2 degrees at final follow-up and average arc of motion was changed from 107 degrees preopeatively to 108 degrees at final follow-up without significant improvement. American Knee Society Knee Score was improved from average 55.2 preoperatively to 88.5 at final follow-up. HSS knee score also showed improvement from average 58.2 to 86.5. Tibio-femoral angle was improved from 6.3 degrees of varus preoperatively to 5.1 degrees of valgus at final follow-up. Radiolucent lines was seen most commonly at zone 1 in anteroposterior radiograph of tibia and in zone 1 in lateral radiograph of femur. Complications such as superficial wound infection, stiffness, and meniscal bearing fracture were seen in four cases. CONCLUSION: Total knee arthroplasty using LCS system showed satisfactory improvement in flexion contracture, deformity correction. Clinical and radiographic result.