Baker's Cyst Filled with Hematoma at the Lower Calf

Baker's cyst is a distension of the gastrocnemius-semimembranosus bursa of the knee, which communicates with the posterior portion of the joint capsule. Baker's cyst is commonly located in the inferomedial or superficial layers of the knee joint and rarely extends laterally or proximally. Complications of Baker's cysts are dissection, rupture, pseudothrombophlebitis, leg ischemia, nerve entrapment, and compartment syndrome. However, hematomas in the Baker's cyst have not been reported in Korea. We report a rare case of hematoma in the Baker's cyst with subfascial extension into the calf. The hematoma was demonstrated by magnetic resonance imaging and removed by mass excision.

Influence of Posterior Tibial Slope on Stability and Second-Look Arthroscopic Findings after Anterior Cruciate Ligament Reconstruction / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to analyze the influence of posterior tibial slope on stability in clinical and second-look arthroscopic evaluation after anterior cruciate ligament (ACL) reconstruction. MATERIALS AND METHODS: From 2000 to 2011, 124 patients who underwent ACL reconstruction using an allogaft were enrolled in this study. A posterior tibial slope between 0degrees and 4degrees was found in 28 patients (group A), between 5degrees and 9degrees in 64 patients (group B), and greater than 10degrees in 32 patients (group C). We evaluated stability using the Lachman test and a KT-2000 arthrometer. In second-look arthroscopy, grafted tendons were evaluated based on the tension, rupture, and synovial coverage. RESULTS: In clinical evaluation for stability, mean KT-2000 arthrometer and Lachman test at last follow-up showed no statistically significant differences depending on posterior tibial slope. Second-look arthroscopic findings showed no statistically significant difference between groups A and B (p=0.91). However, statistically significant relations were observed between groups A and C (p=0.03), and between groups B and C (p=0.02). CONCLUSION: The results of this study suggest that patients who underwent ACL reconstruction with higher posterior tibial slope (> or =10degrees) have more lax tension in second-look arthroscopy, but not in clinical stability tests.

Deformity Correction by Femoral Supracondylar Dome Osteotomy with Retrograde Intramedullary Nailing in Varus Deformity of the Distal Femur after Pathologic Fracture of Giant Cell Tumor

Angular deformities of the distal femur occur in congenital diseases or due to acquired causes, such as malunion after a fracture of the distal femur. Angular deformities of the lower extremities affect the mechanical axis, causing changes in the weight pressure on the articular surface. As a result, angular deformities quicken the progression of osteoarthritis. Therefore, correction of deformities should be performed to prevent the progression of osteoarthritis. Distal femoral osteotomy is one of the methods to correct angular deformities in unicompartmental osteoarthritis. However, femoral supracondylar dome osteotomy with retrograde intramedullary nailing in the distal femur with a varus deformity has been rarely reported. Herein, we describe a technique for femoral supracondylar dome osteotomy with retrograde intramedullary nailing in a varus deformity after a pathologic fracture of giant cell tumor in the distal femur with a review of the relevant literature.

The Influence of Sevoflurane on the Autonomic Nervous System / 대한마취과학회지

BACKGROUND: Sevoflurane is a new inhalation anesthetic, which shows stable hemodynamic features, and does not have a pungent odor, so that it can be used as an inhalational induction agent. But mask ventilation can make patients anxious, and can stimulate the sympathetic nervous system. Therefore, we evaluated the effect of midazolam administered right before inhalation induction with sevoflurane on the autonomic nervous system using power spectral analysis. METHODS: We studied 28 patients undergoing elective surgery. They were assigned to one of two groups to receive either sevoflurane with midazloam (M group) or sevoflurane alone (S group). Anesthesia was induced with 6% sevoflurane and 0.03 mg/kg midazolam or 6% sevoflurane alone. Midazolam was administered immediately before induction with sevoflurane. An electrocardiogram was applied to all patients and connected to a computer, for power spectral analysis. Power values were recorded on arrival, pre-intubation, post-intubation and pre-incision, and compared between two groups. RESULTS: Power values at low frequency were lower, and the time to loss of eye lash reflex and induction were shorter in the M group than in the S group. CONCLUSIONS: The administration of midazolam before induction with sevoflurane reduced the activity of the sympathetic nervous system versus induction with sevoflurane alone.