The advances in the knowledge of anatomy, surgical techniques, and fixation devices have led to the improvement of anterior cruciate ligament (ACL) reconstruction over the past 10 years. Nowadays, double bundle and anatomical single bundle ACL reconstruction that more closely restores the normal anatomy of the ACL are becoming popular. Although there is still no definite conclusion whether double bundle ACL reconstruction provides better clinical results than single bundle reconstruction, the trend has shifted to anatomic reconstruction regardless of single bundle or double bundle techniques. We could not find any significant differences in the clinical outcomes and stability after ACL reconstruction according to the type of graft or fixation device. Therefore, surgeons should select an ideal ACL reconstruction according to the patient's condition and surgeon's experience.
Purpose:The purpose of this study is to evaluate the results and the advantages of the operative treatment of metastatic pathologic fractures in long bones using locking compression plates. Materials and Methods: Twenty-five patients (28 cases) who underwent open reduction and internal fixation with a locking compression plate with or without cement augmentation for pathologic fractures in long bones resulting from metastatic cancer between 2004 and 2013 were reviewed retrospectively. Mean age at the time of surgery was 62.8 years. Pathologic fractures occurred in 11 cases in the humerus, 11 cases in the femur, and 6 cases in the tibia. Functional analysis of Musculoskeletal Tumor Society (MSTS) scores, functional restoration condition of patients with upper extremity involvements, and interval to wheelchair ambulation in patients with lower extremity involvements was performed. Pain relief (visual analogue scale, VAS) and operation time, postoperative satisfaction with individuals, and complications were evaluated. Results: Mean operation time was 81.3 minutes and mean MSTS scores were 19.8. Mean time from operation to wheelchair ambulation was 3.3 days. Mean VAS improved from 8.1 preoperatively to 2.9 at 1 week postoperatively. Most patients reported that they were more than 'satisfied'. One transient radial nerve palsy and one late complication of screw breakage and reduction loss had occurred at postoperative 3 months. Conclusion: Internal fixation with a locking compression plate in metastatic pathologic fractures can be an effective treatment option in the meta or diaphyseal area of long bones.
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