Reduction of Pediatric Forearm Diaphyseal Fractures by Pin Leverage Technique

PURPOSE: Although the majority of children's forearm diaphyseal fractures may be treated conservatively with closed reduction and cast immobilization, unstable or irreducible fractures are usually treated by surgical management. Authors performed percutaneous pin leverage reduction technique for irreducible displaced diaphyseal fractures. The aim of this study is to determine the efficacy of pin leverage technique in pediatric forearm diaphyseal fractures MATERIALS AND METHODS: In this retrospective study, we reviewed 22 cases of forearm diaphyseal fractures reduced by percutaneous pin leverage technique between 1997 and 2002. We analyzed radiographs, operation time, hospital stay and immobilization period, range of motion, postoperative complications and functional results by Thomas. RESULTS: Average length of follow up was 28 months with mean age of 10.5 years. All fractures in this series healed less than 2 degrees of diaphyseal angulation. Average operation time including anesthesia was 42 minutes and hospital stay was 4.6 days. Time to union was 49.6 days in average and range of motion and functional results were satisfactory in all cases except one case of congenital radioulnar synostosis. There was one case of superficial pin track infection as complication. CONCLUSION: In operative treatment of children's diaphyseal fractures of forearm bones, percutaneous pin leverage reduction technique is a good alternative method prior to open reduction in case of difficult closed reduction.

Correlation between Osteoporosis and Lumbar Disc Degeneration in Postmenopausal Low Back Pain Patients / 대한척추외과학회지

STUDY DESIGN: The degenerative changes in plain X-ray and bone mineral density of the lumbar spine of postmenopausal women was evaluated retrospectively. OBJECTIVE : We analyzed the correlation between degenerative arthritis and osteoporosis of lumbar spine, which are common senile spinal disorders in old age. SUMMARY OF LITERATURE REVIEW: Inverse relationship has been reported between osteoporosis and osteoarthritis in the studies of hip fractures. MATERIALS AND METHODS: For 108 female patients older than 50 years of age, the degenerative change of lumbar spine was evaluated by scoring with Kellgren's classification of disc degeneration and with Nathan's classification of osteophyte from radiographs of lumbar spine. Bone mineral density of lumbar spine was measured with dual energy X-ray absorptiometry. Osteoporotic fracture of vertebral body was scored by Renier's index. The correlation between the data of degenerative changes and bone mineral density was analyzed. RESULTS: Kellgren's score of disc degeneration had positive correlation with lateral lumbar bone mineral density suggested that disc degeneration decreases osteoporosis. CONCLUSION: Osteoporosis and osteoarthritis of senile spine had an inverse relationship, and was not simply the end result of normal aging. Understanding of relationship of two disorders would be helpful in treatment decision.

Sacral Perineural cyst: report of 3 cases / 대한정형외과학회잡지

Sacral perineural cyst is one group of extradural meningeal cyst at the sacral region. These lesions are distinguished from other spinal cysts because perineural cyst does not communicate with subarachnoidal space. Fluid filled cysts may compress adjacent nerve roots causing low back pain and sciatica which are dramatically improved by surgical excision. Differential diagnosis from other cysts can be accomplished by failure of collection of dye into cyst by initial myelography. C-T myelography rules out other mass lesions and often reveals communication of perineural cyst that filled with contrast medium. Magnetic resonance imaging well demonstrates three dimensinnal configures of an intraspinal cystic mass in initial study. However it is important to recognize that these cysts are one of causes of radiculopathy. We report three cases of sacral perineural cysts with radiculopathy.

Open Reduction and Internal Fixation of Intraarticular Calcaneal Fractures by the Extended Lateral Approach / 대한정형외과학회잡지

The operative treatment of intraarticular calcaneal fractures has three principal aims; restoration of the height and width of the calcaneus, reconstruction of the subtalar and calcaneocuboid joint surfaces, and stable osteosynthesis. The purpose of this study is to demonstrate the effectiveness of the open reduction and internal fixation by the extended lateral approach for the treatment of the intraarticular calcaneal fractures. Twenty-one calcaneal fractures of 20 patients were treated by open reduction and internal fixation using an extended lateral approach from April, 1993 to March, 1994. The autogenous iliac bone graft was done in all patients. These patients were evaluated from 12 to 24 months (average 15.2 months) after surgery. The following results were obtained; 1. Seventecn cases (80%) out of 21 were estimated as good or excellent result. 2. Preoperative Bohler's angles, Gissane's angles and inclination angles were observed as average -0.5degrees, 101degrees and 38degrees respectively, and these were improved as average 23.3degrees, 117degrees and 54degrees, postoperatively. 3. There were two cases of skin necrosis as complication. In conclusion, the extended lateral approach is one of the good methods for the treatment of intraarticular calcaneal fractures. We think that accurate reduction of the posterior facet, acceptable recovery of Bohler's angle and early postoperative mobilization are the most important things for the best result of the intraarticular calcaneal fracture surgery.

Total knee replacement arthroplasty in hemophilic arthritis: 2 cases report / 대한정형외과학회잡지

No abstract available.

Experimental Study of Disodium Etidronate for the Growth of MC3T3-E1 Osteoblastic Cell Line / 대한정형외과학회잡지

In the general, Disodium estdronate (EHDP) had effects of inhibition in bone resorption, dissolution of hydroxyapatite crystal and decreasing the turn over rate in Paget's disease. Clinically it is used as the drug of treatment for the osteoporosis, heterotropic ossificatiom and Paget's disease inspite of some, controvesies, but there is few article about the effect of EHDP on osteoblast. Authors tries to observe the effect of EHDP on osteoblast using the MC3T3-El osteoblast cell line which has very similar chrateristics with human osteoblast and evaluate the effect by the criteria of changes of morphology, number of osteoblast, and alkaline phosphatase activity. The results are obtained as following: l. EHDP has direct inhibitory effect on the proliferation of osteoblast. 2. EHDP increase the alkaline phosphatase activity in vitro.