Arthroscopic Repair for Acute Rupture of the Anterior Cruciate Ligament

The anterior cruciate ligament(ACL) is one of the most important structure for maintenance of the sta- bility of the knee joint. Chronic instability as a result of insufficiency can lead to functional disability, pain, meniscal tears, and degenerative change in articular cartilage. The incidence of injuries of this liga- ment is increasing tendency due to development of vehicle system, industrial system and sports activities. Different authors have recommended both operative and nonoperative treatment for anterior cruciate ligament injuries. Variable methods for functional recovery of anterior cruciate ligament were introduced and argued about ideal method. As arthroscopic techniques improve, surgeons are more inclined to rec- ommend surgical treatment. The methods of repair of acute rupture of the anterior cruciate ligament through the arthrotomy tech- nique have been used widely, but the arthroscopic repair is a relatively new technique. This arthroscopic technique is idealy applicable for rupture at femoral and tibial attachment site. A arthroscopic repair of anterior cruciate ligament was performed with use of the arthroscopy, in 15 consecutive, selected anterior cruciate ligaments that were ruptured at femoral or tibial attachment site, and within 2 weeks after injury. The 15 patients were followed for a minimum of one year(mean, eighteen months; maximum, thirty-eight months). The mean age of the 15 patients at the operation was thirty years(range, seventeen to forty-eight years). The results of arthroscopic repair of anterior cruciate ligament in 15 cases were satisfactory, and as fol- lows. l. All of the 15 cases, the laxity of repaired anterior cruciate ligaments were decreased. 2. The average Lysholm Knee Score Scale was increased from 16 points preoperatively to 89 points postoperatively. Five of the patients(33%) were rated as excellent, and ten patients(67%) were rated as good. 3. The range of motion of the repaired knee joints were from Oo to 135o that results were achieved at postoperative 6 months.

Problems after Interlocking Intramedullary nailing for Long Bone Fracture / 대한정형외과학회잡지

Interlocking intramedullary nailing has many advantages for long bone fracture. However, we can meet many problems during the operative procedure. Among the patients who were treated with interlocking intramedullary nailing from March, 1990 to December, 1991, forty-eight patients(49 cases) of femur and tibia fracture who were followed up more than twelve months(average 14months: 12months 18months) were included in this study. 1) Forty-nine cases consisted of 20 cases(41%) of femur fracture and 29 cases(59%) of tibia fracture. 2) Two cases of proximal protrusion were developed because of inadequate implant length. 3) Operative complications were encountered with 3 cases of new fracture line, 1 case of new fragmentation, 1 case of reduction loss, 2 cases of failure of proximal targeting, 3 cases of failure of distal targeting, 2 cases of distraction of fracture site more than 3 mm, 1 case of sciatic nerve injury due to excessive traction and 1 case of tibial inlet error. 4) Postoperative complications were encountered with 1 case of distal targeting screw failure, 4 cases of infection and 8 cases of delayed union. 5) According to the result, sufficient planning and confirmations(preoperatively, intraoperatively and postoperatively) can diminish the complications. And then the interlocking intramedullary nailing will be useful method in the case of long bone fracture when the operator has extensive experiences.

Clinical study on open fracture of the tibia / 대한정형외과학회잡지

No abstract available.