• 제목/요약/키워드: Ligament fixation

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후방십자인대 견열 골절의 관절경적 정복술(증례 보고) (Arthroscopic Fixation for Avulsion Fracture of the Posterior Cruciate Ligament(Cases Report))

  • 김경택;손성근;양성욱
    • 대한관절경학회지
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    • 제2권2호
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    • pp.173-176
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    • 1998
  • Isolated posterior cruciate ligament injuries are rare and their management is controversial. But, there is general concept that a bony avulsion of posterior cruciate ligament should be repaired. The treatments for the bony avulsion of posterior cruciate ligament were conservative treatment, open reduction and internal fixation and arthroscopic fixation. We report 2 cases of posterior cruciate ligament avulsion fractures, which were arthroscopically reduced and stabilized with cannulated screws and Kirschner wires, and introduce the arthroscopic fixation technique.

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자가 확장형 전방십자인대 고정장치의 고정 특성에 대한 연구 (A Study on the Fixation Characteristics of a Self-expansion Type ACL Fixation Device)

  • 김종대;김홍건
    • 한국생산제조학회지
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    • 제18권3호
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    • pp.321-327
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    • 2009
  • This paper studied the influences of the main design parameter-the expansion angle and the material properties of the self-expansion anterior cruciate ligament fixation device on the contact condition with the bone and the initial stability of the device. Using finite element analysis, the stress distributions of the ring part of the device and the wall of the bone tunnel were calculated. And the micro-migration of the device by the pull-out force was calculated. From the analysis results, it was found that when designing the self-expansion type anterior cruciate ligament fixation device, it is desirable to use the material having higher Young's modulus and to design the fixation device that all wedges uniformly maintain contact with bone to obtain initial stability after operation.

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족관절 골절과 동반된 전하 경비 인대 견열 골절의 치료 (Treatment of Anteroinferior Tibiofibular Ligament Avulsion Fracture Accompanied with Ankle Fracture)

  • 정형진;배서영;김만영
    • 대한족부족관절학회지
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    • 제15권1호
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    • pp.13-17
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    • 2011
  • Purpose: To evaluate the clinical results of anteroinferior tibiofibular ligament avulsion fracture accompanied ankle fractures treated with anatomical reduction and internal fixation. Materials and Methods: From January 2007 to April 2010, 30 cases with anteroinferior tibiofibular ligament avulsion fracture that treated with anatomical reduction and internal fixation were analyzed. The average follow-up period was 26 months (minimum 6 months). We have reviewed the bony union, complication and subjective satisfaction according to the fracture classification and method of internal fixation. Results: Among 30 cases, 28 cases were occurred in Lauge-Hansen classification supination-external rotation type, one case was fracture-dislocation and one case was Maisonneuve fracture. We have performed internal fixation with Mini screw in 11 cases, K-wire in 10 cases, repair in six cases and Mini screw & K-wire in three cases. In all cases bony union was completed. two cases in Mini screw, one case in K-wire, two cases in repair and one case in Mini screw & K-wire revealed LOM of ankle joint. Skin irritation and superficial peroneal nerve irritation happened in one case each. Other cases show good subjective satisfaction. Conclusion: Anteroinferior tibiofibular ligament avulsion fracture accompanied with ankle fracture is a good clinical outcome with internal fixation. So we should not miss out the anteroinferior tibiofibular ligament avulsion fracture in radiologic evaluation or operation room.

사체 아킬레스건을 이용한 경골관통터널방식의 후방십자인대 재건술 - 간섭나사 및 이중고정핀 방식에 따른 초기연신 및 활주율 평가 - (The Posterior Cruciate Ligament (PCL) Reconstruction by the Transtibial Tunnel Method using Cadaveric Achilles Tendon Grafts - Evaluation of the Initial Lengthening and the Slippage Ratio due to the Interference Screw Fixation and Double Cross-Pin Fixation -)

  • 김철웅;배지훈;오동준
    • 대한기계학회논문집A
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    • 제33권4호
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    • pp.430-439
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    • 2009
  • Posterior Cruciate Ligament (PCL) plays an important role in knee extension. Rotational instability due to injured PCL can be restored by various PCL reconstruction methods. In this study, the initial lengthening affected by fixation device and location was demonstrated, and furthermore, the slippage and the relationship between lengthening ratio and slippage ratio in the calcaneus and soft tissue fixation methods was newly suggested. Eight specimens of proximal tibia and Achilles tendon grafts were harvested from four cadavers and divided into four groups in regard to the four different types of transtibial fixation techniques. The cyclic load ranged from 50 N to 250 N applied to each graft fixed to proximal tibia in 55 degrees. The initial lengthening ratio to the total elongation has been approximately constant regardless of the fixation methods. The soft tissue fixation method with an interference screw showed about 56.4% slippage ratio to the total elongation and the same method with a double cross-pin presented about 45.4% slippage ratio. The soft tissue fixation method with an interference screw demonstrated approximately 2 mm less total elongation and about 13% more slippage than lengthening because of poor fixation compared to the same method with a double cross-pin.

경골 종지부를 분리하지 않은 자가슬괵건을 이용한 관절경적 전방십자인대 재건술 (Arthroscopic Anterior Cruciate Ligament Reconstruction Using Autogenous Hamstring Tendon Graft Without Detachment of the Tibial Insertion)

  • 김성재;이윤태;김현곤
    • 대한관절경학회지
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    • 제1권1호
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    • pp.81-85
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    • 1997
  • This article describes a modified arthroscopic technique of anterior cruciate ligament (ACL) reconstruction using quadrupled hamstring tendon graft. The autogenous semitendinosus and gracilis grafts are harvested without detachment of the tibial insertion. To obtain longer graft, the accessory tibial insertions of the hamstring tendons are dissected. The EndoButton(Acupex Microsurgical, Andover, MA) is used for femoral fixation and two spiked staples are used for tibial fixation in a belt buckle fashion. Then the residual anterior laxity is restored by additional absorbable interference screw fixations. In this technique. more viable graft is obtained and firmer distal fixation is achieved by preservation of the tibial insertion of hamstring tendons.

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Comparison of Ulnar Collateral Ligament Reconstruction Techniques in the Elbow of Sports Players

  • Moon, Jun-Gyu;Lee, Hee-Dong
    • Clinics in Shoulder and Elbow
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    • 제23권1호
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    • pp.41-47
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    • 2020
  • Ulnar collateral ligament injuries have been increasingly common in overhead throwing athletes. Ulnar collateral ligament reconstruction is the current gold standard for managing ulnar collateral ligament insufficiency, and numerous reconstruction techniques have been described. Although good clinical outcomes have been reported regarding return to sports, there are still several technical issues including exposure, graft selection and fixation, and ulnar nerve management. This review article summarizes a variety of surgical techniques of ulnar collateral ligament reconstructions and compares clinical outcomes and biomechanics.

Coracoclavicular Ligament Suture Augmentation with Anatomical Locking Plate Fixation for Distal Clavicle Fracture

  • Lim, Tae Kang;Shon, Min Soo;Ryu, Hyung Gon;Seo, Jae Sung;Park, Jae Hyun;Ko, Young;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • 제17권4호
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    • pp.175-180
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    • 2014
  • Background: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. Methods: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. Results: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder ($8.2{\pm}7.9mm$ versus $7.3{\pm}3.4mm$, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. Conclusions: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.

전방십자인대 재건술 시 이식건의 선택과 고정 (Graft Selection and Fixation in Anterior Cruciate Ligament Reconstruction)

  • 김두한;배기철;최병찬
    • 대한정형외과학회지
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    • 제55권4호
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    • pp.294-304
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    • 2020
  • 전방십자인대 재건술은 수술의 시기, 수술 기법, 이식건의 선택 및 고정 방법, 재활 등 각각의 수술 과정을 성공적으로 수행해야하는 수술이다. 여러 과정들 중에서 이식건의 선택과 고정 방법은 아주 중요한 과정 중에 하나이지만 아직 술자들 간에 많은 논쟁의 여지가 있다. 이식건의 장단점에 관해 많은 연구들이 진행되고 있지만 여전히 이상적인 건에 대한 결론은 없다. 이와 유사하게 대퇴터널 및 경골터널 고정 방법에 대해서도 최근 많은 방법들이 개발되고 소개되고 있지만 그중에서 가장 좋은 방법을 찾지 못한 상태이다. 그래서 술자는 다양한 이식건과 고정 방법에 대하여 익숙해져야 하며 각각의 방법에 대한 장단점을 잘 알고 있어야 할 것이다. 따라서 본 종설은 전방십자인대 손상에서 이식건의 선택과 고정 방법에 대하여 지금까지 밝혀진 연구들을 분석하고 이에 관해 논의하고자 한다.

Open Posterior Approach versus Arthroscopic Suture Fixation for Displaced Posterior Cruciate Ligament Avulsion Fractures: Systematic Review

  • Song, Jae-Gwang;Nha, Kyung-Wook;Lee, Se-Won
    • Knee surgery & related research
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    • 제30권4호
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    • pp.275-283
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    • 2018
  • Purpose: To compare the clinical outcomes between the open posterior approach and arthroscopic suture fixation for displaced posterior cruciate ligament (PCL) avulsion fractures. Methods: A literature search was performed on MEDLINE, EMBASE, and the Cochrane Library databases. The inclusion criteria were as follows: papers written in English on displaced PCL avulsion fractures, clinical trial(s) with clear description of surgical technique, adult subjects, a follow-up longer than 12 months and modified Coleman methodology score (CMS) more than 60 points. Results: Twelve studies were included with a mean CMS value of 72.4 (standard deviation, 7.6). Overall, 134 patients underwent the open posterior approach with a minimum 12-month follow-up, and 174 patients underwent arthroscopic suture fixation. At final follow-up, the range of Lysholm score was 85-100 for the open approach and 80-100 for the arthroscopic approach. Patients who were rated as normal or nearly normal in the International Knee Documentation Committee subjective knee assessment were 92%-100% for the open approach and 90%-100% for the arthroscopic approach. The range of side-to-side difference was 0-5 mm for both approaches. Conclusions: Both arthroscopic and open methods for the treatment of PCL tibial-side avulsion injuries resulted in comparably good clinical outcomes, radiological healing, and stable knees.