• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.15 no.2
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• pp.75-81
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• 2020

Objectives The purpose of this study was to report the effect of Korean medicine treatment, including the application of joint mobilizing chuna, by reporting two cases after tibial plateau fracture surgery. Methods Two patients with tibial plateau fractures were treated using joint mobilizing chuna, myofascial chuna, acupuncture, and herbal medication. The effect of the treatments was evaluated using the range of motion, manual muscle test, numeric rating scale, and Korean Knee Injury and Osteoarthritis Outcome Score. Results In both cases, the range of motion, muscle strength, and pain were significantly improved. In particular, the range of motion for knee joint flexion increased by 47° in case 1 and 30° (right) and 42° (left) in case 2. Conclusions Korean medicine treatment, especially joint mobilizing chuna, may be an effective intervention for rehabilitation after tibial plateau fracture surgery.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.132-137
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• 1999

Displaced tibial spine fractures need the anatomical reduction of the displaced bone fragment to achieve normal range of motion and anterior stability of the knee joint. The purpose of this paper is to describe details of arthroscopic technique using suture hook and pull-out PDS and to evaluate the clinical results. We report 7 cases who underwent arthroscopic reduction and internal fixation using suture hook and pull-out PDS. All cases had fresh fractures generated within 3 weeks. The follow up period was at average 16.6 months. The fracture union was achieved at average 7.4 weeks. Knee exercise was started 2 weeks after the operation. One of the patients, who had combined injury of posterior cruciate ligament and lateral meniscus, showed limitation of knee movement. But he was underwent the arthroscopic fibrolysis at one year later, he returned to normal range of motion. Arthroscopic treatment of displaced tibial spine fracture using suture hook and pull-out PDS showed good results including rigid fixation and early mobilization. Therefore it is thought to be one of the effective operative techniques in treatment of the tibial spine fractures.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.192-198
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• 2006

The general consensus is that tibial eminence fractures have an excellent prognosis. But symptomatic nonunions requiring reduction and grafting have been reported. This report presents two cases of nonunion after tibial eminence fracture in eight years old boys which were treated with arthroscopy-guided reattachment and internal fixation and obtained good outcome.

• 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.10 no.1
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• pp.26-32
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• 2006

Purpose: We evaluated the result of the degree of reduction and anterior instability after arthroscopic treatment of tibial spine fractures. Materials and Methods: Thirty-two cases of tibial spine fractures treated with arthroscopic procedure could be evaluated and the mean follow-up period was $18\;(12{\sim}48)$ months. Evaluations included Lachman test, rotatory instability examination and side to side difference (SSD) using KT-2000 arthrometer. The degree of radiologic reduction was classified as accurate reduction, anterior elevation and reduction failure, according to which the degree of anterior instability was measured. Results: There were twenty three cases (71%) of accurate duction, eight cases (25%) of anterior elevation and one case (4%) of education failure. Eight (29%) of twenty eight cases with pull-out method showed anterior elevation. The SSDs of the accurate reduction and the anterior elevation group were 2.0 mm and 2.8 mm, respectively showing no significant difference. However, the percent age of grade 0 Lachman test and SSD less than 3 mm of the accurate reduction group were significantly higher. Conclusion: Accurate reduction is important in reducing anterior instability especially in unstable fractures. Therefore, arthroscopic pull-out method should be performed with great caution to avoid anterior elevation of the fracture fragment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.62-65
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• 2012

Avulsion fractures of the intercondylar eminence of the tibia are uncommon. This kind of fracture is most commonly found in adolescents, with an increasing incidence for those involved in competitive athletics. Recently, an arthroscopic procedure is preferred to reduce the operation-related morbidity. Screws, K-wires, Suture anchor have been described as fixation devices. Cannulated screw fixation is a simple method, but this instrument has the risk of causing damage to the growth plate. The authors report good results using cannulated screw in arthroscopic treatment for pediatric anterior cruciate ligament avulsion fracture.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.243-247
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• 2013

Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.