Ganglion Cyst of the Dorsal Aspect of the Lumbar Facet Joint: a case report / 대한정형외과학회잡지

Ganglion cyst of the spinal facet joint is rare. It is believed that ganglion cysts on the dorsal aspect of the facet joints are asymptomatic and therefore are not clinically appreciated. But we have experienced a patient who had severe low-back and buttock pain and diagnosed as ganglion cyst located on the dorsal aspect of the right side facet joint between the fourth and fifth lumbar vertebrae. The treatment was surgical excision of the cyst and resulted in a satisfactory recovery. The differential diagnosis involving herniated lumbar intervertebral disc should not exclude ganglion cyst of the dorsal aspect of the lumbar facet joint.

Cauda Equina Syndrome Following Lumbar Spine Surgery: 6 Cases Report / 대한정형외과학회잡지

The cauda equina syndrome is a relatively uncommon, but serious complication. And it can have grave long-term consequences for the patient. The purpose of the study is to analyse the causes, clinical courses and to find the methods of prevention of cauda equina syndrome following lumbar spine surgery. We reviewed 6 cases among 287 patients wbo had been operated on and followed for minimum 12 months at Seoul Adventist Hospital from March 1991 to March 1996. The obtained results were as follows. 1. All six cases was noted only in patients who had operative procedures for spinal stenosis and possible causes were 3 cases of epidural hamatoma, 1 case of unrecognized and recurred disc herniation, 1 case of retained ligament flavum and 1 case of pseudomeningocele formation due to unrecognized dura tear. 2. Progressive neurologic deficits, decreased perianal sensation and loss of anal wink were present in all cases and were diagnostic. 3. Only three cases which were occurred within 24 hours and early treated within 12 hours, had no specific residual neurologic deficits. In conclusion, it is recommended that operators should be very cautious during the spine surgery. And also early recognition and surgical decompression is very important. During early postoperative periods, only repeated and regular neurologic examinations will enable early diagnosis and treatment to reduce permanent neurological damage.

Clinical Analysis of Unstable Thoracolumbar Fracture and Fracture-dislocation Using Transpedicular Screws and Harrington distration rod / 대한정형외과학회잡지

Transpedicular Screw fixation and Harrington distraction rod are effective means of managing unstable thoracolumbar fracture and fracture dislocation. The authors analysed the 52patients who were treated with above 2methods from March 1986 to February 1993. The results were as follows: 1. Most of patients were in 5th decade compare to younger group and most common cause of injury was fall down, but traffic accident is increasing. 2. The most commonly involved sites were T12and L1 vertebrae and most common type of injury is bursting fracture. 3. Postoperative anterior and posterior column of vertebrae body correction rate were 35.0%/34.4% in ISF group and 29.3%/27.9% in Harrington group. Postoperative correction loss rate were 0.13/0.04 in ISF group and 0.06/0.04 in Harrington group. 4. Postoperative correction of kyphosis angle were average 18 in ISF goup and average 15° in Harrington group. Loss of correction angle was average 23° in ISF group and average 4.4° in Harrington group. 5. Range of spinal fixation was average 3.1 segments in ISF group and average 6.2 segments in Harrington group. 6. There was no significant difference in neurologic recovery between ISF group and Harrington group. The patients who had been recovered neurologically more than 1 grade were 28.6% in Harrington group and 29.2% in ISF group. 7. ISF has some benefit in spnal vertebral body height correction and in maintenance of correction compare to Harrington group. Nevertheless disadvantages of ISF group such as long operative time and possibility of cord compression by pedicular screw, ISF has advantages of almost anatomical reduction and the least spinal fusion.

Meniscal cysts of Knee Joint: Report of 2 Cases / 대한정형외과학회잡지

A meniscal cyst is not common disease of knee joint. Many cases have been reported but its cause and origin are still pooly understood. We experienced two cases of the cysts on the lateral meniscus. They were treated by arthroscopic partial menisectomy and extraarticular excision of the cyst. The good results were obtained.

Cleidocranial Dysostosis One Case Report / 대한정형외과학회잡지

Cleidocranial dysostosis is a rare herditary disorder affecting bones that develop by intramembranous formation. The classical features include exaggerated development of the transverse diameter of the skull, delay in the ossification of the fontanels, aplasia of the clavicles, and hereditary transmission. Authors report a case of cleidocranial dysostosis in 8 years old boy with brief review of the literatures.

Treatment for Fracture of the Humeral Neck Using a Device of External Fixation / 대한정형외과학회잡지

Fractures of the humeral neck are relatively common, but their anatomical complexities make closed reduction difficult sometimes, and in case of reduction it is tough to maintain the position. Even open reduction of the fracture also faces multiple problems including poor functional recovery of the shoulder joint. The Department of Orthopedic Surgery of Seoul Adventist Hospital developed a device of external fixation for 13 humeral neck fractures. We used this method for displaced and unstable fractures of humeral neck from December 1987 to March 1989. Satisfactory results were obtained in 11 cases and poor results in 2 cases. We think our method is a effective useful way of treatment for humeral neck fractures, and its main advantages are as follows:1. Using proximal and distal bars, fracture can be easily reduced and firmly maintained. 2. Active motion exercise can be started early and functional recovery of the shoulder joint can be highly predictable. 3. It is quite convenient for treating combined fracture or external wound of same extremity.

The Statistical Study of The Lateral Tibio / 대한정형외과학회잡지

The study was conducted to determine the lateral tibio-articular angle of ankle joint in 100 korean adults(160 cases) ranging from second to eight decades of age. The authors have defined as the lateral tibio-articular angle of ankle joint, that is the sharp angle between the lateral tibial axis which is the lateral longitudinal line through each midpoints of the upper and lower one third of the tibia, and the line to connect the anterior and posterior tips of the tibial articular surface of ankle joint. 1. It was 79.3°±3.4°in all cases. 2. It was 79.2°±3.6°in male and 79.6°±2.7°in female. It was reduced in male approximately 0.4°compared with female. 3. It was 79.1°±3.1°in the left side and 79.5°±3.6°in the right side. It was reduced approximately 0.4°in the left side compared with the right side. 4. It was reduced approximately 0.9°in the left side compared with both sides of the same person.

A Case Report of Surgical Treatment in Mulitple Tophaceous Gout / 대한정형외과학회잡지

The gout is a hereditary condition of disturbed uric acid metabolism. There are medical and surgical management in tophaceous gout for prevention of recurrence of acute attack and creation of a negative uric acid balance. The surgical management is removal of tophaceous material in the soft tissue and osseous structure. Aditionally, the resection of bone and joint, arthrodesis and bone graft improve the functional capacity of the gouty patients. A 53 years old man was managed by removal of tophaceous materials in both prepatellar area, left olecranon area and both feet and arthrodesis of left first metatarsophalangeal joint with autogenous iliac bone graft and supportive medication with probenecid and indomethacine, and was followed up from March, 1986 to April, 1987. There was no significant difference in duration between the union of nonpathologic fracture and the union of arthrodesis area in this gouty patient. We found the progressive recovery of normal trabeculation in previous destructive bone lesions with drug therapy, but there was no specific change in the soft tissue lesions.