Purpose:To evaluate the effects of proximal row carpectomy.
Materials and Methods:We performed a retrospective review of the cases of 14 patients who had undergone proximal row carpectomy between April 1996 and January 2006. All of the patients were men with an average age of 37.5 years (range, 25-64 years). The mean follow-up period was 59 months (range, 18-101months). Evaluation of results was based on x-ray analysis, pain relief, the ability to return to work, activity level, range of motion (ROM) and grip strength. Pain relief was classified as very satisfied, satisfied, dissatisfied and very dissatisfied.
Results:The subjective results of pain relief were very satisfied in 6 cases, satisfied in 7 cases, dissatisfied in 1 case. 7 cases (50%) returned to previous occupations and 11 cases (79%) had little restriction on their daily activities. The total arc was improved from average 42 degree to 59 degree. The grip strength using Jamar dynanometer was increased from average 7.8 lbs (10.5% of the unaffected side) to average 33 lbs (44% of the unaffected side). Conclusion: Proximal row carpectomy is an effective surgery with preserving ROM and function for patients with wrist pain and diminished function if it is done within proper indication.
Purpose:To report the long-term follow-up results of a free vascularized fibular graft (FVFG) for the treatment of patients with congenital pseudarthrosis of the tibia (CPT). Materials and Methods: Fourteen patients with CPT, who underwent FVFG and were followed-up for more than 4 years, were enrolled in this study. The average age at FVFG was 4.5 years (range, 1~10.6 years) with an average follow-up of 11.6 years (range, 4~26.6 years). In 11 cases, 24 additional procedures were performed due to the secondary problems, such as delayed union, nonunion, leg length discrepancy, and deformity of the tibia. The clinical and radiological data were reviewed to evaluate the outcomes of the FVFG. Results: Bone union and hypertrophy of the fibular graft was observed in all cases. The average time of union in 7 cases, in whom bone union was achieved without the aid of any supplementary procedures, was 6.7 months (range, 3.5~11 months). At the last follow-up, the mean limb length discrepancy was 2.5 cm (range, 0~8 cm), and the average anterior apex and valgus angulation of the tibial shaft were
Conclusion:FVFG is an effective procedure in congenital pseudarthrosis of the tibia which has the advantages of allowing a more aggressive resection of the abnormal bone and scar tissue and as well as resolving the bone defect after resecting the lesion. This procedure is expected to produce a better clinical result if rigid internal and external fixation are performed.
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