Objective To evaluate the cl inical results of arthroscopical subtalar arthrodesis for malunion of calcaneal fractures. Methods Between July 2006 and December 2008, 12 cases of malunion of calcaneal fractures were treated witharthroscopical subtalar arthrodesis, inculding 10 males and 2 females with an age range of 38-54 years (44.8 years on average). The location was left side in 5 cases and right side in 7 cases. The injury was caused by fall ing from height in 8 cases, by traffic accident in 3 cases, and other in 1 case. It was 3-7 months from injury to operation. All cases were classified as Stephens type II. The total score was 35.68 ± 10.35 and the pain score was 8.14 ± 1.83 before operation according to Hindfoot scores system of American Orthopaedic Foot amp; Ankle Society (AOFAS). Results All incisions achieved parimary heal ing and the patients were all followed up 14-32 months (18 months on average). The X-ray films showed bony fusion after 10-14 weeks (11.5 weeks on average). The total score was 76.45 ± 9.83 and the pain score was 1.52 ± 1.48 after operation according to Hindfoot scores system of AOFAS, showing significant difference when compared with those before operation (P lt; 0.01). Conclusion Arthroscopical subtalar arthrodesis can get satisfactory fusion rate with few compl ications for malunion of calcaneal fractures.
Objective To evaluate the treatment and effects of wrist arthroscopy in tear of triangular fibrocartilage complex (TFCC). Methods Between January 2006 and December 2008, 16 patients with tear of TFCC were treated. Of 16 patients, 11 were male and 5 were female with an average age of 32.5 years (range, 25-51 years). Injury was caused by sprain in 12cases, and by fall ing in 4 cases. The locations were the left side in 10 cases and the right side in 6 cases. The mean injury duration was 3 months to 6 years and 2 months. The main cl inical symptoms included wrist powerlessness and ulnar-sided wrist pain which was aggravated with clench fist and l ifting heavy things. The results of the ulnar-sided wrist stress test were positive in 14 cases and negative in 2 cases. The preoperative values of wrist range of motion (ROM) were (45.58 ± 5.18)° at volar flexion, (41.22 ± 3.83)° at dorsal extension, (17.82 ± 2.48)° at radial deviation, (21.35 ± 4.61)° at ulnar deviation, (69.85 ± 8.36)° at pronation, and (70.13 ± 6.34)° at supination. According to Palmer standard, 10 cases of IA were treated with debridement; 3 cases of IB with suture and 1 of them failed and was partially excised; 2 cases of IC with debridment on triangular fibrocartilage disc, ulnolunate l igament, and ulnotriguetrum l igament; and 1 case of ID with trimming plastic operation. Results All incisions healed by first intention, and no compl ications of joint infection or neurovascular injury was found. All patients were followed up 14-38 months (mean, 18.5 months). Fifteen patients were restored to normal l ife and work without ulnar-sided wrist pain. One patient had no pain, but he had wrist powerless. The values of ROM at last follow-up were (50.16 ± 6.21)° at volar flexion, (45.37 ± 4.65)° at dorsal extension, (18.95 ± 3.56)° at radial deviation, (26.28 ± 5.09)° at ulnar deviation, (78.87 ± 7.69)° at pronation, and (76.46 ± 8.31)° at supination; showing significant differences when compared with preoperative values(P lt; 0.05). According to Green-O’Brien standard, the results were excellent in 9 cases, good in 6 cases, fair in 1 case, and the execellent and good rate was 93.75%. Conclusion The wrist arthroscopy not only can definitely diagnose tear of TFCC, but also is useful for treatment. In addition, the incision is small and the function is easy to recover, and the occurence of chronic ulnar-sided wrist pain can be effectively avoided.