A Clinical Study on Fracture of Femoral Neck in Children

Park, Yong Man; Dauh, Ka Hong

Abstract

Attempt to treat degenerative arthritis of the knee by surgical means have been limited. Patellectomy or patelloplasty may be done in the presence of symptomatic patellofemoral arthritis; and joint debridement, including removal of loose bodies, large osteophytes, and damaged menisci, is occasionally used. Most patients with degenerative arthritis of the knee bear more of their weight on one tibial condyle than on the other. As the articular cartilage degenerates over the tibial condyle that bears the most weight, the natural varus or valgus deviation increases and a vicious cycle is set up in which increasing deformity creates increasing degenerative change. If weight-bearing and other stresses could be increased on this more normal area and decreased on the involved portion, it would been that pain might be relieved and the useful life-span of the knee joint considerably prolonged. The tibia in degenerative arthritis of the knee has become the preferred site for the osteotomy because of restriction of knee motion. The osteotomy is increasingly performed proximal, rather than distal, to the attachment of the patellar tendon at the tibial tuberosity because healing occurs faster in the cancellous bone of the metaphysis as compared with the cortical bone of the diaphysis, and particularly as the quadriceps extensor mechanism stabilizes the osteotomy. We have had 4 cases of modified high tibial osteotomy in the degenerative arthritis patients by division of proximal tibio-fibular ligament instead of removal of fibular head. And the follow-up resutts are "good" in all cases without any complication.