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The purposes of this study were (1) to confirm the disparity of the measured thickness at the lateral hinge between anterior–posterior (AP) radiograph and 3D CT image, (2) to evaluate the affecting factors, and (3) to evaluate the differences between uniplanar and biplanar osteotomies. From 2012 to 2014, a prospective comparative study was performed with 30 patients who received uniplanar osteotomy (group I) and 35 patients who received biplanar osteotomy (group II). For measurement of the proximal wedge, postoperative AP radiograph and 3D CT images were used. In the AP radiograph, medial and lateral bony bridge thicknesses were measured. In the 3D CT, the anterior and posterior images parallel to the coronal plane were selected for the evaluation. Coronal osteotomy slope was measured with the anterior image of the 3D CT scan. Sagittal osteotomy slope was measured with the sagittal section of the CT scan. Differences between the lateral bony bridge thicknesses measured in AP radiograph and the posterolateral posterolateral bony bridge thicknesses measured in 3D CT were statistically significant in both groups. Negative correlation was observed in the biplanar osteotomy group. Differences of the sagittal osteotomy slope from the native tibial slope showed negative correlation in the biplanar osteotomy group. Thickness of the posterolateral bony bridge was smaller compared to the observed thickness on the AP radiograph image that is routinely used for the follow-up. The thickness would be getting smaller if osteotomy is performed with an abrupt angle on the coronal plane and reverse slope on the sagittal plane. Therefore, osteotomy with abrupt angle on the coronal plane and reverse slope on the sagittal plane should be avoided for the proper thickness of the posterolateral bony bridge. III.

Purpose To evaluate the accuracy of the posterior cruciate ligament (PCL) fovea landmark against conventional fluoroscopic pin placement retrospectively using 3-dimensional computed tomography (3D CT). Methods This retrospective comparison focused on the tibial tunnel locations determined in consecutive 26 patients using the fluoroscopic imaging technique (group I) and in consecutive 23 patients using the PCL fovea landmark technique without the help of the fluoroscopy (group II) for tibial tunnel formation. The 3D surface-modeled CT images that appropriately located the position of the PCL fovea on the tibial plateau were used. Ratios between total length of the fovea and length of the tunnel center from the medial border (coronal) and posterior edge (sagittal) were evaluated. Results The ratios between sagittal tunnel length and total sagittal length for groups I and II were 35.4% ± 12.2% and 44.1% ± 23.1%, respectively ( P = .07). The ratios between the coronal tunnel lengths and total coronal lengths for groups I and II were 47.3% ± 9.2% and 57.3% ± 18.1%, respectively: group II showed a more laterally positioned tibial tunnel than did group I ( P = .03). Conclusions A more laterally located tibial tunnel was produced using the PCL fovea landmark technique. However, the differences in centers were small and probably not clinically relevant. Therefore, the PCL fovea landmark technique might be an alternative method to the fluoroscopic imaging technique for locating the anatomic tibial tunnel during transtibial PCL reconstruction. Level of Evidence Level III, retrospective comparative study.

Purpose: The purpose was to describe comparative analysis of the surgical outcome of percutaneous K-wire fixation of bony mallet fingers reduced with towel clip and 18-gauge needle. Methods: We analyzed the bony mallet finger patients with more than twelve months follow-up after percutaneous K-wire fixation. The patients were randomly divided into two groups. Eighteen fingers were treated with closed reduction using towel clip and 18 other fingers were treated with closed reduction using 18-gauge needle. Results: Radiographs showed bony union and no subluxation in all cases after K-wire removal. The average extension lag was 2.8°/1.9°, and range of motion of distal interphalangeal joint was 70.3°/75° respectively. According to Crawford’s criteria, excellent results were obtained in 9/11 fingers, good results in 8/7 fingers, and poor result in 1/0 finger, respectively. Conclusion: 18-gauge needle reduction in percutaneous K-wire fixation is considered less invasive and useful method for treatment of bony mallet finger with comparable results with towel clip reduction.

원위 요골 골절은 상지에서 발생하는 가장 흔한 골절 중 하 나로 과거에는 비수술적 치료로 좋은 결과를 얻을 수 있다고 인식되어 왔으나, 최근의 연구 결과를 통하여 잠김 금속판 (locking plate)의 원리가 원위 요골 골절 고정용 금속판까지 적용됨으로써 고령의 골다공증성 골절이나 관절면을 침범한 분쇄 골절도 수술적 치료를 통하여 효과적인 골유합의 결과를 보이고 있다. 잠김 금속판은 원위 요골 골절의 안정성 유지 를 위해 그 사용이 증가하고 있으며, 최근 잠김 금속판의 형태 도 개선되어 원위 요골의 해부학적 구조가 반영되어 있는 것 (pre-bent, near-anatomical)이 특징이며, 아주 얇게 디자 인(low-profile)되어 관절면에 가깝게 위치시킬 수 있다. 하 지만, 신전건과 굴곡건의 파열, 정복의 소실, 불유합, 수근관 증후근, 혈관계 합병증 등이 보고되었다. 수장측 잠김 금속 판의 파손과 잠김 나사 파손은 매우 드문 합병증으로 드물게 보고되고 있다. Failure of Distal Locking Screws in an Intraarticular Distal Radius Fracture Treated with Volar Locking Plate Fixation