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Featured researches published by Chun-Ying Cheng.


Arthroscopy | 2008

Arthroscopic suture fixation of tibial eminence avulsion fractures.

Tsan-Wen Huang; Kuo-Yao Hsu; Chun-Ying Cheng; Lih-Huei Chen; Ching-Jen Wang; Yi-Sheng Chan; Wen-Jer Chen

PURPOSE This study presents the clinical results of a procedure for treating tibial eminence fractures of the anterior cruciate ligament (ACL) using arthroscopic reduction and No. 5 Ethibond sutures (Ethicon, Somerville, NJ). METHODS This prospective study analyzed 36 patients who underwent arthroscopic reduction and suture fixation for image-proven ACL avulsion fractures of the tibial eminence. The classification of Meyers and McKeever identified 6 type II, 16 type III, and 14 type IV fractures. The mean follow-up period was 34.4 months (range, 24 to 91 months). Follow-up assessment included Lysholm knee score, Tegner activity score, International Knee Documentation Committee (IKDC) score, and KT-1000 arthrometer (MEDmetric, San Diego, CA) and radiographic evaluation. RESULTS The mean preoperative Lysholm score in the 36 knees was 38 (range, 28 to 54); the mean postoperative Lysholm score was 98 (range, 83 to 100). The mean preinjury and preoperative Tegner scores in the 36 knees were 7.5 +/- 1.5 (range, 5 to 9) and 3 +/- 1.7 (range, 2 to 5), respectively. The mean postoperative Tegner score was 7.3 +/- 1.7 (range, 5 to 9). At final follow-up, 34 patients (94.5%) were classified by IKDC score as normal or nearly normal (grade A or B). The IKDC classification was abnormal (grade C) in 2 patients (5.5%). All 36 fractures achieved union within 3 months. No significant complications, such as arthrofibrosis, loss of initial fixation, or wound infection, were noted. CONCLUSIONS Treating ACL avulsion fracture by arthroscopic suture fixation by use of 4 No. 5 Ethibond sutures can restore ACL length, stabilize fragments, promote early motion, and minimize morbidity. LEVEL OF EVIDENCE Level IV, therapeutic case series.


Arthroscopy | 2013

Arthroscopy-Assisted Reduction of Posteromedial Tibial Plateau Fractures With Buttress Plate and Cannulated Screw Construct

Chih-Hao Chiu; Chun-Ying Cheng; Min-Chain Tsai; Shih-Sheng Chang; Alvin Chao-Yu Chen; Yeung-Jen Chen; Yi-Sheng Chan

PURPOSE To present the radiologic and clinical results of posteromedial fractures treated with arthroscopy-assisted reduction and buttress plate and cannulated screw fixation. METHODS Twenty-five patients with posteromedial tibial plateau fractures treated by the described technique were included in this study. According to the Schatzker classification, there were 5 type IV fractures (20%), 2 type V fractures (8%), and 18 type VI fractures (72%). The mean age at operation was 46 years (range, 21 to 79 years). The mean follow-up period was 86 months (range, 60 to 108 months). Clinical and radiologic outcomes were scored by the Rasmussen system. Subjective data were collected to assess swelling, difficulty climbing stairs, joint stability, ability to work and participate in sports, and overall patient satisfaction with recovery. Secondary osteoarthritis was diagnosed when radiographs showed a narrowed joint space in the injured knee at follow-up in comparison with the films taken at the time of injury. RESULTS The mean postoperative Rasmussen clinical score was 25.9 (range, 18 to 29), and the mean radiologic score was 15.8 (range, 10 to 18). All 25 fractures achieved successful union, and 92% had good or excellent clinical and radiologic results. The 3 fracture types did not significantly differ in Rasmussen scores or rates of satisfactory results (P > .05). Secondary osteoarthritis was noted in 6 injured knees (24%). CONCLUSIONS Arthroscopy-assisted reduction with buttress plate and cannulated screw fixation can restore posteromedial tibial plateau fractures of the knee with well-documented radiographic healing, good clinical outcomes, and low complication rates. LEVEL OF EVIDENCE Level IV, therapeutic case series.


Arthroscopy | 2012

Arthroscopic Suture Fixation for Avulsion Fractures in the Tibial Attachment of the Posterior Cruciate Ligament

Szu-Yuan Chen; Chun-Ying Cheng; Shih-Sheng Chang; Min-Chain Tsai; Chih-Hao Chiu; Alvin Chao-Yu Chen; Yi-Sheng Chan

PURPOSE The purpose of the study was to highlight our surgical technique of arthroscopic suture fixation for acute tibial eminence posterior cruciate ligament (PCL) avulsion fractures, clinical and radiographic outcomes, and complication rates. METHODS This prospective study enrolled patients who had undergone arthroscopic reduction and suture fixation by use of 4 No. 5 Ethibond sutures (Ethicon, Somerville, NJ) for image-proven displaced PCL attachment fractures of the tibial eminence with posterior knee instability of grade II or higher. The mean follow-up period was 36 months (range, 24 to 45 months). Follow-up assessment included 3 different functional scores, KT-1000 arthrometry (MEDmetric, San Diego, CA), and radiographic evaluation. RESULTS The mean preoperative Lysholm score in the 36 patients was 35 (range, 26 to 55); the mean postoperative Lysholm score was 95 (range, 80 to 100). The mean preinjury and preoperative Tegner scores in the 36 patients were 7.4 ± 1.6 (range, 5 to 9) and 3.2 ± 1.5 (range, 2 to 5), respectively. The mean postoperative Tegner score was 7.0 ± 1.8 (range, 5 to 9). At the final follow-up, the International Knee Documentation Committee scores were observed to be normal (grade A) or nearly normal (grade B) in 33 patients (91.7%) and abnormal (grade C) in 3 patients (8.3%). All 36 fractures achieved union within 3 months. No significant complications such as arthrofibrosis, loss of initial fixation, or wound infection were noted. CONCLUSIONS Treatment of tibial PCL avulsion fractures by arthroscopic suture fixation is a successful technique to restore tibial avulsion injuries of the PCL with well-documented radiographic healing, good clinical outcomes, and low complication rates. LEVEL OF EVIDENCE Level IV, therapeutic case series.


Journal of Trauma-injury Infection and Critical Care | 2010

Repositioning osteotomy for intra-articular malunion of distal radius with radiocarpal and/or distal radioulnar joint subluxation.

Ming-Kai Hsieh; Alvin Chao-Yu Chen; Chun-Ying Cheng; Ying-Chao Chou; Yi-Sheng Chan; Kuo-Yau Hsu

BACKGROUND Intra-articular malunion of the distal radius may be complicated with radiocarpal and radioulnar joint subluxation, which may result in joint stiffness and loss of function. Conventional corrective osteotomy emphasizes on the restoration of the articular step-off. However, little information is available concerning the restoration of a concentric functioning joint through osteotomy. METHODS From 2002 to 2007, 12 patients with chronic intra-articular distal radius fractures were evaluated at an average follow-up of 33.6 months after repositioning osteotomy. The average time from initial injury to reconstructive operation was 11.3 months. The indication for osteotomy included dorsal or volar subluxation of the radiocarpal joint, distal radioulnar joint, or both in addition to articular incongruity. A preoperative computed tomography scan or rapid prototyping (RP) models were performed as part of the surgical planning. Operation was preceded by volar, dorsal, or both approaches. Repositioning osteotomy and internal fixation were also performed. Radiographic analysis and the Disability of Arm, Shoulder and Hand score were used for the outcome assessment. RESULTS All osteotomy sites healed and all events of radiocarpal and radioulnar subluxation were corrected. The average correction was 13.8 degrees (palmar tilt of the radius) and 1.9 mm in ulnar variance. The mean Disability of Arm, Shoulder and Hand score improved from 64 to 18. DISCUSSION Conventional corrective osteotomy via an extra-articular approach was favorably performed to correct an extra-articular malalignment or nascent intra-articular malunion. Problems of abnormal architecture after an intra-articular fracture of the radius are complicated with subluxation of carpus or distal radioulnar joint, which require repositioning via precise articular approach. Both reconstructed computed tomography images and rapid prototyping models are very useful tools in preoperative planning for intra-articular osteotomy. Simulated osteotomy and joint repositioning can be performed in solid models before commencement of actual operation. CONCLUSION Repositioning osteotomy consistently restores joint alignment and achieves functional improvement either in cases of nascent simple malunion or complex intra-articular malunion.


The Open Orthopaedics Journal | 2016

Outcomes and satisfaction with endoscopic carpal tunnel releases and the predictors - a retrospective cohort study

Alvin Chao-Yu Chen; Meng-Huang Wu; Chun-Ying Cheng; Yi-Sheng Chan

Background: Patient’s final satisfaction with endoscopic carpal tunnel release (ECTR) is still unpredictable. The study aims to find the predictive factors for satisfaction in patients with carpal tunnel syndrome (CTS) treated by ECTR using the Boston CTS questionnaire. Methods: We conducted a retrospective chart review of 37 patients (55 hands) who received ECTR and completed Boston carpal tunnel questionnaire at preoperative visit, 1 month and 6 months after operation while a telephone interview was conducted at 2 years after operation. Independent risk variables, including mean symptom severity scale, functional status scale, each item in questionnaire at all the time points, ASA physical status scale, age, gender, dominant site lesion, bilateral lesions, duration of symptoms and anesthesia method were recorded. Final outcome was determined by the patient’s satisfaction at the interval of 2 years. Predictors to outcome were analyzed by stepwise multiple regression analysis and tested with Pearson correlation test. A p value of less than 0.05 was considered significant. Results: The severity of hand or wrist numbness during the daytime (Q6, explained 6.5% variances), the severity of numbness or tingling at night (Q9, explained 16.2% variances), the functional status of writing (q1, explained 13.9% variances), carrying grocery bags (q7, explained 13.6% variances) had significant predictive value (p<0.001). Other factors were not significant in the analysis including ASA, gender, age, dominant site lesion, bilateral lesions, anesthesia method and duration of symptoms. Conclusions: Boston questionnaire is a simple and reliable tool with high predictive values to evaluate patient’s outcome and satisfaction in ECTR.


The Open Orthopaedics Journal | 2017

Results of arthroscopic repair of peripheral triangular fibrocartilage complex tear with exploration of dorsal sensory branch of ulnar nerve

Alvin Chao-Yu Chen; Chun-Jui Weng; Chih-Hao Chiu; Shih-Sheng Chang; Chun-Ying Cheng; Yi-Sheng Chan

Background: Ulnar-sided approach in arthroscopic triangular fibrocartilage complex (TFCC) repair may jeopardize treatment success by exposing the dorsal sensory branch of ulnar nerve (DSBUN) in risk of injury. We aim to conduct a follow-up assessment of arthroscopic outside-in TFCC repair and efficacy of sensory nerve exploration. Methods: We conducted a retrospective chart review of 58 patients (59 wrists) who received arthroscopic repair of the peripheral attachment of the TFCC. Ulnar-sided skin incision and exploration of DSBUN were performed before arthroscopy setting. Arthroscopic outside-in repair through pullout suture ligation was performed. Functional survey at 6 months and 1 year postoperatively was based on Mayo Modified Wrist Score (MMWS), and compared to the preoperative assessment. A p-value of less than 0.05 was considered significant as calculated using paired t-test. Results: Postoperative MMWS averaged 74.32±11.50 at 6 months, and 84.41±9.52 at one year; both showed significant difference as compared to preoperative status. Significant improvement was noted in all 4 individual items except motion retrieval between 6 months and 1 year. Totally, 45 (76%) cases achieved good or excellent results at one year; however, less patients resumed pre-injury activity level when treatment delay was more than 6 months than those treated earlier (41% vs. 57%). Complication included 6 transient paresthesia; 1 anchor migration and 1 distal radioulnar arthrosis. No more nerve complication was found after modification of perineural dissection. Conclusion: Arthroscopy is effective in obtaining both correct diagnosis and treatment of peripheral TFCC tear. Modified perineural dissection can minimize sensory nerve complications.


Indian Journal of Orthopaedics | 2017

Distal radius fractures: Minimally invasive plate osteosynthesis with dorsal bicolumnar locking plates fixation

Alvin Chao-Yu Chen; Ying-Chao Chou; Chun-Ying Cheng

Background: Controversy still exists regarding the current treatment modalities for unstable distal radius fractures. There are yet few articles investigating the efficacy of bicolumnar dorsal plating technique, which is designed to minimize tissue dissection while providing sufficiently secure fixation. A clinical study was performed to evaluate the feasibility of the minimally invasive plate osteosynthesis (MIPO) technique using a modified dorsal approach for the treatment of distal radius fractures. Materials and Methods: Thirty patients with unilateral distal radius fracture who underwent bicolumnar plate fixation with a minimally invasive dorsal approach between September 2008 and December 2010 were included in this retrospective study. Twenty four patients (8 men and 16 women) with a mean age of 53 years (range 18-85 years) were available for followup of at least 1 year or more were included in final study. Herein, we report the functional radiological outcomes of the study. There were three cases of AO Type A fracture, five cases of AO Type B fracture, and 16 cases of AO Type C fracture. Results: The union was achieved in all the patients. The functional results at one-year followup, assessed using the modified Gartland and Werley scoring system, were excellent in 14 patients, good in seven patients, and fair in three patients. The average correction of deformity was 4.1 mm for radial height, 7.6° for radial inclination, and 20.7° for volar tilt. Conclusions: MIPO with a dorsal approach is a feasible option for the management of displaced distal radius fractures and can result in favorable surgical outcomes.


Formosan Journal of Musculoskeletal Disorders | 2014

Clinical Outcomes of Medial Patellofemoral Ligament Reconstruction Using Semitendinosus Autograft for Recurrent Patellar Dislocation

Sheng-Hsun Lee; Shih-Sheng Chang; I-Jung Chen; Chun-Ying Cheng; Chih-Hao Chiu; Min-Chain Tsai; Kuo-Yao Hsu; Yi-Sheng Chan

Background: Recurrent patellar dislocation is a rare but complex issue. Medial patellar stabilizer insufficiency, particularly with the medial patellofemoral ligament (MPFL), is commonly present in these patients. There are several surgical methods to address this problem. Purpose: To evaluate the clinical outcome of MPFL reconstruction when using a semitendinosus autograft and a novel tendon fixation technique to treat recurrent patellar dislocation. Methods: Twelve consecutive patients (5 males, 7 females) who failed in conservative treatment were enrolled into this prospective study. They were treated with MPFL reconstruction using a semitendinosus autograft. The mean follow-up time was 16.7 months (range, 14-22 months). Preoperative and postoperative radiographic parameters, functional scores (e.g., Lysholm knee scoring scale and Kujala scale), and postoperative complications were evaluated. Results: Eleven of twelve patients (91.7%) had good-to-excellent outcomes. There were statistically significant improvements in the Lysholm knee scoring scale (p<0.001) and Kujala scale (p<0.001). Additionally, the postoperative tilt angle improved significantly (p<0.001). Conclusions: Using a semitendinosus autograft with Bioscrew fixation and an additional pull-out suture during MPLF reconstruction is a safe and effective method for treating recurrent patellar dislocation in selective patients.


Chang Gung medical journal | 2010

Short- to medium-term outcomes of radial head replacement arthroplasty in posttraumatic unstable elbows: 20 to 70 months follow-up.

Chien Hy; Alvin Chao-Yu Chen; Huang Jw; Chun-Ying Cheng; Kuo-Yao Hsu


Chang Gung medical journal | 2011

Clinical results of all-inside meniscal repair using the FasT-Fix meniscal repair system.

Chih-Wei Chiang; Chung-Hsun Chang; Chun-Ying Cheng; Alvin Chao-Yu Chen; Yi-Sheng Chan; Kuo-Yao Hsu; Wen-Jer Chen

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