[EFFECTIVENESS COMPARISON OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION BY LONG FIBULAR MUSCLE TENDON AND HAMSTRING TENDON].

OBJECTIVE: To compare the effectiveness of anterior cruciate ligament (ACL) reconstruction between by long fibular muscle tendon and by hamstring tendon under arthroscopy after ACL rupture. METHODS: Between February 2010 and December 2012, 56 cases of ACL rupture underwent ACL reconstruction under arthroscopy. The long fibular muscle tendon was used in 26 cases (group A) and the hamstring tendon was used in 30 cases (group B). There was no significant difference in gender, age, side, disease duration, and preoperative Lachman test, Lysholm score, and the International Knee Documentation Committee (IKDC) score between 2 groups (P > 0.05). The treatment after operation was identical in 2 groups. RESULTS: Primary healing of incision was obtained after operation in 2 groups. There was no major neurovascular injury and knee synovitis. There was no significant difference in operation time, hospitalization time, and postoperative 24-hour drainage volume between 2 groups (P > 0.05). The patients were followed up 25-32 months (mean, 28 months) in group A, and 27-37 months (mean, 31 months) in group B. There was no related complication at donor site in 2 groups. MRI examination showed good ACL reconstruction. The Lysholm score and the IKDC score of group A at 6 months after operation were significantly better than those of group B (P < 0.05), but no significant difference was found between 2 groups at 2 years after operation (P > 0.05). There was no significant difference in Lachman score between 2 groups at 6 months and 2 years after operation (P > 0.05). CONCLUSION: The long fibular muscle tendon for arthroscopic reconstruction of ACL has much simpler operation, earlier knee function recovery, and better subjective satisfaction than the hamstring tendon.

[Arthroscopy-assisted treatment of severe comminuted distal radial fracture using external fixators].

OBJECTIVE: To evaluate the outcomes of arthroscopy-assisted treatment of severe comminuted distal radial fracture with external fixators and kirschner wire fixation. METHODS: Twenty-seven cases of severe comminuted distal radial fracture treated between March, 2010 and January, 2012 were reviewed. During the operation, the carpal joint space was expanded with the external fixator, and the fracture was fixed by Kirschner wire after open reduction. The carpal joint was observed intraoperatively with arthroscopy to ensure full reduction, and the distal posterior interosseous nerve was then severed. The results of postoperative X-ray and wrist functional status of the carpal joints were recorded. Another 27 cases of severe comminuted distal radial fracture treated by conventional surgical approach served as the control group. RESULTS: The patients were followed up for a mean of 13.2 (5-27) months. Compared with the conventional surgical approach, arthroscopy-assisted treatment resulted in a significantly shorter operative time with better appearance of the articular surface and also better wrist function assessed using the Krimmer system (P<0.05). CONCLUSION: Arthroscopy-assisted external fixator treatment is effective for management of severe comminuted distal radial fracture and avoids the stair-like appearance of the articular surface to achieve the maximal functional recovery of the carpal joints and reduce traumatic arthritis.