PurposeThe purpose of this study was to compare preoperative clinical outcomes before occurrence of periprosthetic femoral fracture (status before trauma) with postoperative clinical outcomes (status after operation) in patients with periprosthetic femoral fracture after hip arthroplasty.Materials and MethodsA retrospective review was performed of all periprosthetic femoral fracture after hip arthroplasty treated surgically at our institution from January 2010 to January 2014. Among 29 patients who underwent surgical treatment for periprosthetic femoral fracture after hip arthroplasty, 3 patients excluded because of non-union of the fracture site. The clinical outcomes were determined by using visual analogue scale for pain (VAS), Harris hip score (HHS), and ambulatory ability using Koval classification. VAS, HHS and ambulatory ability was assessed for all the included patients at the last follow-up of status before trauma and after operation.ResultsThe mean VAS, HHS and ambulatory ability at the last follow-up of status before trauma was 2.2 (range, 0-4), 78.9 (range, 48-92) and 1.9 (range, 1-5), respectively. The mean VAS, HHS and ambulatory ability at the last follow-up of status after operation was 3.1 (range, 1-5), 68.4 (range, 46-81) and 2.9 (range, 2-6), respectively. The clinical outcome of VAS, HHS and ambulatory ability were significantly worsened after surgical treatment for periprosthetic femoral fracture (P=0.010, P=0.001, and P=0.002, respectively).ConclusionPatients with periprosthetic femoral fracture after hip arthroplasty could not return to their status before trauma, although patients underwent appropriate surgical treatment and the fracture union achieved.

Hip arthroscopy is currently being leveraged in the diagnosis and treatment of a wide range of hip joint problems. In fact, great advancements in hip arthroscopy have resulted in an ever-expanding number of indications to which it is being applied. Minimally invasive hip arthroscopy allows for quicker initiation of rehabilitation and has attracted much attention as the field becomes increasingly focused on surgeries designed to preserve joints. This review aims to summarize the recent advances, applications, and impact of hip arthroscopy.

Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation.

Category: Ankle, Trauma Introduction/Purpose: To report the results of applying heel open (figure 8) short leg cast on foot & ankle trauma or disease patients requiring short leg casts. Methods: 380 patients who were confirmed and treated by diagnosed of foot & ankle trauma or diseases were included between November 2014 and July 2016. Comprised of 222 males and 158 females, their mean age was 46 years old. The bottom of the figure 8 cast covered the metatarsal head to half portion of the medial longitudinal arch, while leg portion covering consisted from the prominence of the both malleolus to halfway of the lower leg, resulting in complete exposure of the heel and distal portion of the achilles tendon. After application of the figure 8 cast, changes in the ROM in active ankle dorsiflexion & plantarflexion, passive foot inversion & eversion, and foot internal & external rotation were measured. Results: In all cases, measurements of active ankle dorsiflexion & plantarflexion was less than 5 degrees, measurements of passive foot inversion & eversion was less than 5 degrees, foot internal & external rotation was less than 0 degrees, and were stably held without skin or soft tissue injury until cast removal. Notable were 22 cases of foot & ankle fractures treated with conservative therapy with figure 8 short leg cast resulting in bone union and stabilization without surgery. VAS discomfort score was an average of 2.6 (0~5) and figure 8 short leg cast was selected in all cases requiring a short leg cast. Conclusion: The use of figure 8 short leg cast in patients of foot & ankle trauma and diseases requiring short leg cast provides safety and prevention of skin necrosis and pressure sores from open heels while providing high patient satisfaction in daily life, such as heel touch. We believe that figure 8 short leg cast could replace the traditional short leg cast, if the safety of the figure 8 cast could be proven through long-term follow up study with various patient and cases.

Category: Ankle, Trauma Introduction/Purpose: The current clinical standard for the surgical treatment of lateral ankle instability remains the modified Broström procedure. Almost surgeons are using non-absorbable suture material because of their strength & permanent. But this has several complications such as irritation, surface tenderness, etc. So we compare the clinical result between nonabsorbable and absorbable suture material. Methods: All patients who underwent the modified Broström operation of the anterior talofibular ligament and/or the calcaneofibular ligament by a single surgeon between July 2011 and May 2015 were included in this study. A total of 96 patients were included in this study: 63 men and 33 women (mean age, 33.16 years; range, 14-72 years). Non-absorbable suture(2-0 Fiberwire®, Arthrex, Naples, FL) patient were 50 (33 men, 17 women) and absorbable suture(0-Vicryl®, Ethicon, Sommerville, NJ) patient were 46(30 men, 16 women). Mean follow-up duration was 2.5 years (range, 1.0-4.7 years). Patients completed a subjective questionnaire. Outcomes measures included the Foot and Ankle Disability Index (FADI), American Orthopaedic Foot and Ankle Society (AOFAS) and Reoperation cases by the recurred lateral ankle instability. All data were collected prospectively and reviewed retrospectively. Results: In non-absorbable suture group, The mean talar tilt angle in preoperative talar tilt test was 14.4 and in absorbable suture group, 13.7, respectively. The mean talar tilt angle in postoperative talar tilt test was 5.3 and in absorbable suture group, 6.1, respectively. There were no significant differences between non-absorbable suture method and absorbable suture method with talar tilt angle in varus stress x-ray (P > .05). There was no significant difference in FADI (87 vs 91; P = .553), AOFAS (83 vs 87; P = .372) score between non-absorable suture method group and the absorbable suture method group. During follow up, Except of 2 patients, they were no clinical symptom. Each one patient in non-absorbable and absorbable suture group underwent revision lateral ligament surgery. Conclusion: As compared with non-absorbable suture in open modified Broström procedure, absorbable suture method produced similarly favorable outcomes.