The Tibial Condylar Fractures with Dissociation of Metaphysis and Diaphysis Treated by Surgical Methods / 대한정형외과학회잡지

The tibial plateau fracture involving the articular surface clinically is a very important injury which often can cause disabilities of the knee joint. Open reduction and internal fixation have been proposed as the optimal treatment of patient with Schatzker's type VI tibial plateau fracture because of the decrease in the functional impairment of the knee joint by allowing early motion. But the injury to the soft tissue is usually severe, which may lead to wound complications after internal fixation. Also delayed union, nonunion, and infection after such operation is not a few. Recently some authors have studied about the external fixation or minimal internal fixation as the treatment for tibial plateau fracture. The purpose of the current study was to compare the results of two different operative methods. The authors analyzed 9 cases of Schatzker's type VI tibial plateau fracture surgically treated at the Pusan National University Hospital from March 1991 to August 1994. The follow-up period ranged from 1 year to 4 year 7 months. The results were obtained as follows. 1. Of the 9 cases, 7 were male and 2 were female, the major population were the 6th and 7th decades. 2. The most common cause of this injury was traffic accident in 7 cases(78%). 3. About the fracture pattern, the most commom type was intercondylar fracture type in 5 cases(56%), the next one lateral condyle fracture type in 4 cases (44%). 4. Common associated injuries were ipsilateral fibula fracture in 8 cases(89%) and ipsilateral femur fracture in 4 cases(44%). 5. Six cases were treated by open reduction and internal fixation, and 3 cases were treated by external fixator. 6. According to Poster's criteria, the results were “Acceptable” in 7 cases(89%), “Unacceptable” in 2 cases(11%).

Radiological Assessment of Porous-coated Acetabular Component with Screw Fixation in Primary Total Hip Arthroplasty / 대한정형외과학회잡지

This is a follow up study on 124 cases of primary total hip arthroplasty with Harris-Galante porous-coated acetabular component with the line-to-line technique, performed at the Department of Orthopaedic Surgery, Pusan National University Hospital from January 1986 to February 1992. The follow-up ranged from 24 months to 92 months, the average being 53 months. The results were as follows; 1. At the last follow-up, a radiolucent line was found in 20 cases(16.1%), but the width was less than one millimeter. Among the 20 cases, the continuous radiolucent line was found in two cases(1.6%), the progressive radiolucent line in five cases(4.0%). 2. Areas of non-contact(initial gap) between the porous mesh of the acetabular component and the bone were seen on the immediate postoperative radiographs of 35 cases(28.2%) among 124 cases. A radiolucent line developed around 13 cases(34.2%) of the 35 cases that were associated with an initial gap, but a radiolucent line developed around only seven cases(7.8%) of the 89 cases(71.8%) not associated with such a gap. 3. At the last follow-up, a vertical migration was found in five cases(4.0%), an angulation change of the acetabular cup in two cases(1.6%), but a horizontal migration of the acetabular cup was not found. 4. There was no evidence of the disruption of the titanium porous mesh of the acetabular component, and loosening, bending or breakage of the screw for fixation of the acetabular cup. And there was no revision for acetabular loosening. In conclusion, because overall loosening rate was less than 5%, the results were very satisfactory. Considering an initial gap is a important factor of acetabular loosening, we think that it is important to make less initial gap during operation.