• Title/Summary/Keyword: Intraarticular

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Limited Posterior Approach for the Surgical Treatment of Intraarticular Fracture of Calcaneus (제한적 후방 도달법을 이용한 관절내 종골 골절의 치료)

  • Hyun, Yun-Seok;Song, Kyung-Won;Shin, Sung-Il;Lee, Jin-Young;Lee, Seung-Young;Kim, Gab-Lae;Shin, Kun-Ho;Seo, Eun-Ho;Ban, Tae-Seo
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.79-85
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    • 2007
  • Purpose: To evaluate the clinical efficacy of the limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2000 to February 2006, we studied retrospectively 186 patients, 203 cases who were treated with open reduction and internal fixation through limited posterior approach and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared $B{\ddot{o}}hler$ angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 2 was 86.4, type 3 was 74.3, type 4 was 62.4. And by circle draw test, type 2 was 8.9 cm, type 3 was 7.2 cm, type 4 was 5.9 cm. $B{\ddot{o}}hler$ angle and Gissane angle were $7.6^{\circ}$, $102.4^{\circ}$, and it increased to $23.5^{\circ}$, $128.6^{\circ}$ after postoperative 1 year. Conclusion: Limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus was considered to an effective treatment modality.

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Operative Treatment of Intraarticular Calcaneal Fracture According to the Fracture Type (관절 내 종골 골절의 골절양상에 따른 수술적 치료)

  • Rha, Jong-Deuk;Park, Hyun-Su;Lim, Chang-Suk;Jang, Young-Soo;Park, Sang-Won;Chung, Tae-Won;Jeon, Yong-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.176-181
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    • 2004
  • Purpose: We evaluated the clinical results of operative treatment of the intraarticular calcaneal fracture according to fracture classification. Materials and Methods: There were 25 cases (24 patients) which had at least one year follow up, 17 men and 7 women who were treated from June 1997 to March 2003. We have analysed the Bohler's angle, cruciate angle, width and posttraumatic osteoarthritis in radiological evaluation, and evaluated clinical results according to the Creighton-Nebraska health foundation score. Results: Excellent results were noted in 7 cases, good results in 6 cases, fair results in 4 cases and poor results in 8 cases. Radiological changes showed as follows: Bohler angle $17^{\circ}$, Crucial angle $0.1^{\circ}$, Width 6mm. Conclusion: Type II showed satisfactory results and type IV showed unsatisfactory results in Sanders classification. Proper evaluation of the intraarticular calcaneal fracture by X-ray and CT scan is necessory to predict prognosis and decise method of operative treatment.

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Operative Treatment of Intraarticular Calcaneal Fractures using Extensile Lateral Approach (광범위 외측 도달법을 이용한 관절내 종골 골절의 수술적 치료)

  • Chung, Hyung-Jin;Ahn, Jong-Kuk;Bae, Su-Young;Jung, Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.60-67
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    • 2009
  • Purpose: This study was designed to investigate the usefulness of extensile lateral approach for accurate reduction and rigid internal fixation in comminuted intraarticular fractures of calcaneus. Materials and Methods: From October 2002 to May 2007, we managed 55 patients (62 cases) with open reduction and internal fixation using extensile lateral approach. Among these, 38 patients (43 cases) who underwent preoperative and postoperative CT scan were enrolled. All patients were evaluated over 24 months after surgery. Bohler angle and Gissane angle on plain X-ray, displacement and step-off of articular surface of calcaneus on CT scan were measured and we compared the difference between preoperative and postoperative value of them. Clinical results were assessed by using AOFAS Ankle-Hindfoot Scale. Results: The average Bohler angle was restored from $6.8^{\circ}$ to $23.5^{\circ}$ and Gissane angle was improved from $116.4^{\circ}$ to $113.5^{\circ}$ after operation. The average distance of displacement was restored from 4.2 mm to 1.4 mm and step-off of articular surface was recovered from 5.1 mm to 1.3 mm. Clinical results were excellent in 17 cases, good in 18 cases, fair in 3 cases, and poor in 5 cases. 10 cases developed postoperative complications such as skin necrosis, heel pain, limitation of motion of ankle and subtalar arthritis. Conclusion: The extensile lateral approach is valuable for the comminuted intraarticular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint.

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Computed Tomographic Classification and Operative Treatment of Intraarticular Calcaneal Fractures (관절내 종골 골절의 전산화 단층촬영에 따른 분류 및 수술적 치료)

  • Roh, Jae-Young;Bae, Su-Young;Kim, Sung-Dug
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.149-155
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    • 2002
  • Purpose: To propose a new comprehensive classification system of intraarticular calcaneal fracture based on CT images. Materials and methods: Fourty intraarticular calcaneal fractures which were treated operatively were evaluated retrospectively. We classified fracture types according to severity of comminution on the posterior facet and calcaneocuboid joint by CT images. And we evaluated postoperative results of each fracture types in terms of the quality of fixation and reduction by the postoperative plain radiograghs. Results: By the classification of the posterior facet, 18 cases were P-I, 15 were P-II, and 7 were P-III. Among the P-I cases, 7 were P-IA, 9 were P-IL, 1 was P-IM and 2 were P-IT. According to the classification of calcaneocuboid joint, II cases were C-I, 18 were C-II and 11 were C-III. Qualities of fixation were excellent in 27 cases (67.5%), fair in 9(22.5%) and poor in 4(10%). Qualities of reduction were excellent 23 cases(57.5%), fair in 11(27.5%) and poor in 6(15%). Conclusion: Our new classification system based on the CT images could provide informations about the fracture configuration and severity of comminution around calcaneocuboid joint as well as the posterior facet. And the high grade fractures such as type P-III are need to be taken care of fixation of articular surfaces.

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Intraarticular Migration of the Staple Used for Extraarticular Lateral Collateral Ligament Repair - A Case Report - (슬관절 외측 측부인대 복원술시 사용된 staple의 관절내 이동 - 증례 보고 -)

  • Yoo, Jae-Chul;Bae, Sang-Wook;Kim, Byung-Kwan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.184-186
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    • 2006
  • Isolated lateral collateral ligament injury has been reported as avulsion fracture of attachment site or intrasubstance tear. The treatment of avulsion fracture of lateral collateral ligament was primary repair with anchor or staple. There are some reports about loosening or migration of staple which used in repairing meniscus of knee. There is, however, no report about loosening or migration of staple which was used for lateral collateral ligament repair. We report a case of migrated staple that was used for lateral collateral ligament repair, which was migrated to intraarticular posterolateral corner of the knee.

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The Operative Treatment using Mini-open Sinus Tarsi Approach for Displaced Intraarticular Calcaneal Fractures (전위성 관절내 종골 골절에서 최소 침습적 족근동 도달법 및 압박나사 내고정술을 이용한 수술적 치료)

  • Kim, Yong-Min;Cho, Byung-Ki;Shon, Hyun-Chul;Park, Ji-Kang;Jeong, Ho-Seung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.247-256
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    • 2012
  • Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using mini-open sinus tarsi approach for displaced intraarticular calcaneal fractures. Materials and Methods: We studied 18 cases (16 patients) of intraarticular calcaneal fractures who were treated with sinus tarsi approach by same surgeon. The mean age of patients was 44.8 years, and mean follow-up period was 17.2 months. The measurement of B$\ddot{o}$hler angle, Gissane angle, the degree of articular surface depression, and the period to union were performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: B$\ddot{o}$hler angle and Gissane angle had improved significantly from preoperative average $9.8^{\circ}$, $117.6^{\circ}$to average $22.4^{\circ}$, $113.4^{\circ}$ immediate postoperatively, and had maintained to average $21.8^{\circ}$and $114.2^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 5.2 mm to 1.2 mm at the last follow-up. All cases achieved bone union, and the period to union was average 10.5 weeks. AOFAS score was average 86.2 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the CNHF scale. Therefore, 16 cases (88.8%) achieved satisfactory results. Conclusion: The minimally invasive sinus tarsi approach using headless compression screw seems to be an effective surgical method for displaced intraarticular calcaneal fractures, because of the possibility of accurate restoration of articular surface and the low risk of postoperative soft tissue complications.

Intra-articular Giant Cell Tumor of Tendon Sheath Arising from Posterior Cruciate Ligament - Arthroscopic Excision Using Posterior Trans-septal Portal - (후방 십자 인대에서 발생한 건초성 거대 세포종 - 후격막 통과 도달법을 이용한 관절경적 절제 -)

  • Ahn, Jin Hwan;Seo, Jai Gon;Ha, Chul Won
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.97-100
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    • 1998
  • The giant cell tumor of tendon sheath is very rarely present inside the knee joint. The authors report a case of intraarticular giant cell tumor of tendon sheath arising from posterior cruciate ligament which was successfully excised arthroscopically using posterior trans-septal portal at the time of arthroscopic reconstruction of anterior cruciate ligament.

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