• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.9-14
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• 2006

Purpose: The proximal tibial sarcoma patients, especially in their growing ages have problems of reconstruction. This study is to devise a methodology which can circumvent this limitations. Materials and Methods: Four cases of proximal tibial osteosarcoma underwent hemiarthroplasty. The mean age was 13 years (11~15) with a mean follow-up of 64 months (47~89). The procedure consists of ultrahigh molecular weight polyethylene (UHMWPE) liner as an substitute for the joint surface and this piece was fixed to the remaining tibial bone stock with Ender nail and bone cement. Results: Final functional score was 23.5 (78.3% of control) by MSTS criteria. All the cases showed stable joint without pain. Hemiarthroplasty related complications were absent. By saving the femoral physis, expected leg length discrepancy could be minimized by this procedure. Conclusions: Hemiarthroplasty of proximal tibia can be an option in pediatric sarcoma patients.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.148-153
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• 2000

Purpose : This study was conducted to analyze the results of arthroscopic ankle arthrodesis and to verify the advantages of the technique compared to open ankle arthrodesis. Materials and Methods : Between October 1992 and August 1996, the arthroscopic ankle arthrodesis had been performed in five patients(six ankle joints): two patients with seropositive rheumatoid arthritis(one patient surgically treated bilaterally), two with osteoarthritis and one with tuberculous arthritis. There were one man and 4 women. Average age was 48 years ranging from 38 to 65 years. Follow up period was average 45 months(range, $12\~80$). Results : All patients were successfully treated with ankle joint arthrodesis under arthroscopic control. The mean time to fusion was 10 weeks(range, $6\~15$). There was a $100\%$ fusion rate without any complication. Conclusion : The arthroscopic ankle arthrodesis was successful in all cases with less morbidity and short hospital stay. It was technically feasible with excellent predictability.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.644-646
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• 2009

A 5-year-old intact male black gibbon (Hylobates concolor) was referred for evaluation of the right pelvic limb lameness following a fight against other black gibbons. Fractures of the right tibia and fibula were suspected on physical examination and palpation of the right pelvic limb, but no other injuries or abnormalities were detected. While the black gibbon was sedated, pelvic limb radiographs were taken, which revealed diaphyseal oblique fractures of the right tibia and fibula. Open reduction of the fractures was performed. The tibial fracture was repaired by use of an internal fixation technique that included a tubular dynamic compression plate and cortical screws secured along the craniomedial aspect of the tibia. There were no complications during the postoperative rehabilitation period. At 9 weeks, radiographs revealed that bridging callus was well formed over the cortices of the tibial and fibular fracture area. The cast was removed 9 weeks after surgery. The black gibbon exhibited no evidence of lameness and was released back into the group. Presently, there are no published reports of internal fracture fixation in a black gibbon where a tubular dynamic compression plate and cortical screws provided excellent stabilization of the tibia and complete fracture healing allowing normal ambulation.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.45-52
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• 2006

Purpose: We evaluated the results of operative treatment of tibial plateau fractures using both arthroscopy and fluoroscopy. Materials and Methods: From May 1999 to February 2003, tibial plateau fractures were treated with arthroscopy. Tweenty seven patients are followed up over two years and the average follow-up period was fourty one months. We classified the fractures according to the Schatzker classification. We reduced the fracture over 2mm depression and displacement on articular surface in simple radiologic finding. Firstly, we treated the associated injuries and reduced the fractures using Steinmann pins. Then, we accomplished internal fixation or external fixation. Both the postoperative clinical and radiological results were evaluated by Rasmussen system. Results: In all tweenty seven cases, the fractures were healed completely in average fourty one months. According to Rasmussen classification, we obtained the excellent or good results in 23 cases. An average range of motion was between 2.5 degrees and 130 degrees. However, postoperative infection developed in one case and the other had loss of reduction. Conclusions: We consider that arthroscopically assisted operative treatment of tibial plateau fracture is a useful method. We can reduce joint surface correctly and treat associated injuries with arthroscopy. There are less complications.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.502-505
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• 2012

An 8-month-old, 3.5 kg intact female Toy Poodle was presented for non-weight-bearing lameness on left hindlimb. In radiological testing, left proximal tibal type II Salter-Harris physeal fracture and fibular fracture were seen. Following open reduction, the fracture was stabilized with cross-pins, tension band wires, and a hinged transarticular external skeletal fixator (HTAESF). The range of the HTAESF was increased to $25^{\circ}$ at 7 days postsurgery and to $70^{\circ}$ at 14 days post-surgery. The HTAESF was removed 3 weeks after surgery. At 6 weeks post-surgery, the fracture was successfully healed with no complications and the patient recovered a normal gait. Seven months post-surgery, the patient had a normal gait and a normal stifle joint range of motion compared to the contralateral normal limb. This is a case in which the combined use of cross-pins, tension band wires, and HTAESF was successful for treatment of a proximal tibial physeal fracture in a dog. It is thought that these methods are beneficial for stability of fracture site and recover of joint's normal range of motion through early joint movement.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.120-123
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• 2004

Benign and malignant bone tumors occur most commonly around the knee. The proximal tibia is the most technically demanding site for limb salvage surgery. The most difficult problem using an endoprothesis for proximal tibial resection has been reconstruction of the extensor mechanism. After excision of proximal tibia, we resected distal femur and made a composite with resected distal femur, low heat treated autogenous proximal tibia and endoprothesis. Patella was fixed into the resected down-loaded distal femur. This article shows the new technique and the results of reconstruction of extensor mechanism after prosthetic replacement of the proximal tibia.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.97-101
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• 1999

Purpose : The purpose of this study is to prevent thc graft-tunnel mismatch by measuring the patellar tendon length, intertunnel distance, tibial tunnel length and by obtaining appropriate bone block length. Materials and Methods : Authors analyzed 15 patients who had taken the anterior cruciate ligament reconstruction from March 1997 to June 1999. Tibial guide was always set on the "endo" $40^{\circ}$ position(Acufex, MA, USA). We measured the following indices, intertunnel distance(X), tibial tunnel length(T), patellar tendon length(N), tibia bone plug length(Y). Both of the femoral tunnel length(F) and the patellar bone plug length(P) were made in 25mm. The appropriate tibial bone plug length was simply calculated by subtracting the patellar tendon length from the sum of the intertunnel distance and thc tibial tunnel length(Y=X+T-N). Results : The average indices were as follows ; the intertunnel distance(X) was $23.4{\pm}1.4mm$, the tibial tunnel length(T) was $43.6{\pm}1.7mm$, the patellar tendon length was $40{\pm}2.4mm$, and the tibia bone plug length was $27{\pm}2.4mm$. Conclusion : In authors' endoscopic technique, establishment of individually determined optimal tibial bone plug length, based on total tunnel length and patellar tendon length could prevent the problem of graft-tunnel mismatch.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.148-153
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• 2005

Purpose: To analyze the clinical result of the arthroscopic reduction and fixation for the displaced tibial spine fractures in children and report the utility of the arthroscopic treatment with the review of the literature. Methods: Between December 2000 and July 2004, five patients (average age 9.1 years) received an arthroscopic reduction and fixation of displaced tibial spine fracture. A male-to-female ratio was 3:2 and mean follow-up was 38.2$(13{\sim}56)$ months. All five patients were classified type III by Movers and McKeever classification. The average period from injury to operation was 4.8 days $(3{\sim}8days)$, the avulsed fragment was reduced by operative arthroscopy and fixated by pull-out suture in 3 patients and by cannulated screw in 2 patients. Postoperatively long leg cast was applied for 2 weeks, and then gradual range-of-motion exercise was permitted. Full weight-bearing ambulation was permitted after 6 weeks. The clinical evaluation was performed by range of motion, Lachman and pivot shift test, KT-1000 arthrometer, Lysholm knee score and the modified Feagin score. Results: All five patients had no symptom and recovered full range of motion of the affected knees. Lachman test was positive finding of 1+ laxity in one patient, the others were negative, and all patients were negative findings for pivot shift test. The result of KT-1000 arthrometric assessment is mean maximum side-to-side differences 1.9 mm. Average Lysholm knee score was 99.4. All patients had excellent results in modified Feagin score. Conclusion: Arthroscopic reduction and fixation of displaced tibial spine fracture in children showed excellent result without complication. Both pull-out suture fixation and cannulated fixation provide an effective treatment option for fixation of the displaced anterior tibial spine fracture.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.195-199
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• 2002

This article is to report a new technique for reconstruction of the anteromedial and posterolateral bundles of anterior cruciate ligament by separate tensioning and fixation of the each bundle. Method : Tibial and femoral tunnels were made with conventional technique of anterior cruciate ligament reconstruction. Tibial tunnel was enlarged $5\~7$ mm in anterior-posterior direction to make oval it in cross section. When preparing the Achilles tendon allograft, bone plug portion was trimmed as the conventional technique. The tendinous portion was trimmed as two separate bundles by dividing the tendinous portion longitudinally, so the graft is shaped like 'Y'. The bone plug portion of allograft was inserted into the femoral tunnel and fixed with absorbable cross pins. Two ligamentous portionss of the distal part of the grafts were tensioned separately at the external orifice. Anteromedial bundle was fastened under maximum tension with the knee flexed 90 degrees by post-tie method. The posterolateral bundle was fixed by the same technique with the knee in full extension. Then, an absorbable interference screw was inserted between the two bundles upto the upper end of the tibial tunnel, to get more initial rigidity of the reconstructed graft as well as to locate the two bundles in more anatomic position.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.127-131
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• 1999

Avulsion fractures of the intercondylar eminence of the tibia are not uncommon. In the displaced avulsion fracture, anatomical reduction and firm fixation of fracture fragments are needed but the most of the conventional operative techniques including arthroscopic technique are relatively complex and need. The results were not always satisfactory due to the risk of postoperative complications such as wound infection, premature epiphyseal closure and loss of fixation after early motion etc. So we describe a simple and safe modified method of arthroscopic reduction and fixation for avulsion fractures of the intercondylar eminence of the tibia. In our thirteen cases, we achieved anatomical reduction and secure fixation using cannulated screw through the three arthroscopic portals (anterolateral, medial mid-patellar and central). Postoperatively, immediate limited range of motion of the knee and partial weight bearing were possible. Additional use of the washer afforded safe fixation of comminuted avulsion fracture. The advantage of this technique includes its technical simplicity, easy removal of hardware, ability to treat comminuted type IV fracture with washer, no additional skin incision, no damage to growing plate in growth children and less morbidity.