Simultaneous Bilateral Quadriceps Tendon Rupture in a Patient with Chronic Renal Failure

Bilateral quadriceps tendon rupture is an unusual injury, but may be encountered in patients with various chronic diseases after minor trauma. This article presents a case of bilateral quadriceps tendon rupture of a 38-year-old woman with chronic renal failure. Surgical repair was performed using a bone tunnel technique with a nonabsorbable suture and a suture anchor. Postoperative magnetic resonance imaging confirmed complete healing of the repair site, and clinically active extension with 120 degrees of range of motion was achieved.

The Effect of Sacral Alar Screw on Long-level Fusion Including Lumbosacral Segment

STUDY DESIGN: This is a retrospective study. OBJECTIVES: To evaluated the clinical and radiological effectiveness of sacral alar screws for augmentation of S1 pedicle screws in long-level fusion including L5-S1 segment. SUMMARY OF LITERATURE REVIEW: The fusion rates of lumbosacral junction in long-level fusion are various when S1 pedicle screws are used without augmentation. But, reports of sacral alar screw augmentation are rare. MATERIAL AND METHODS: From 1996 to 2005, 63 patients performed more than two-level fusion including lumbosacral junction were reviewed. 47 patients underwent lumbosacral fusion with S1 pedicle screws only (S1 group), and 16 patients with sacral alar screws augmentation in addition to S1 pedicle screws (S1-2 group). Radiologically, bony union, halo sign, and breakage of implants were evaluated. Clinically, complications associated with screw placement and general complications were evaluated. RESULTS: Bony union was obtained in 56 cases(89%) at postoperative 4.3 months. Nonunion was observed in 7 cases(11%, S1 group:5, S1-2 group:2). Loosening of S1 pedicle screw was observed in 32 cases(89%) of S1 group and in 4 cases(25%) of S1-2 group. It showed statistical significance between two groups. Sacral alar screw loosening occurred in 8 cases(50%) of S1-2 group. Metal breakage was developed in 2 cases of S1 group without nonunion or loosening. Postoperative infection occurred in 7 cases(11%, S1 group:5, S1-2 group:2). CONCLUSIONS: Sacral alar screw augmentation was effective on protecting the loosening of S1 pedicle screw. Additional sacral alar screw can improve the rate of fusion for lumbosacral junction despite no statistical significance.

Minimum 5 Year Results of Posterior Lumbar Interbody Fusion with Cages in Lumbar Spondylolisthesis / 대한척추외과학회지

STUDY DESIGN: A retrospective study OBJECTIVES: To examine the mid term clinical and radiologic findings of patients treated by Posterior Lumbar Interbody Fusion (PLIF) with cages in spondylolisthesis. LITERATURE REVIEW: The clinical result of PLIF with cages is satisfactory. PLIF with cages is a useful treatment for spondylolisthesis. MATERIALS AND METHODS: Forty-two patients were followed up for more than 5 years. Their mean age was 53 years and the mean follow-up period was 68 months. Twenty-one cases were the isthmic type, and 21 cases were the degenerative type. The low back pain score, Lin s clinical result, perioperative value of slippage, anterior intervertebral disc space height, radiological change in the adjacent level and complications were evaluated. RESULTS: The preoperative lower back pain score improved from 46.7 to 86.4 points at the last follow-up (p.0.05). Thirty-eight patients (91%) showed excellent or good results. The preoperative value of slippage improved from 17.5% to 5.7% (p.0.05). The anterior intervertebral disc space height increased from 10.0 to 14.5 mm (p.0.05). There were changes in the above and lower adjacent segments in 12 cases (28%). Two of these cases required surgery. CONCLUSIONS: PLIF with cages might be an effective method in spondylolisthesis. However, the long-term follow-up showed changes in the adjacent segment.

Radical Necrotic Bone Resection and Ilizarov Technique for Infected Nonunion of the Tibia

PURPOSE: To evaluate the clinical results of radical necrotic bone resection and distraction osteogenesis for the treatment of infected nonunion of tibia using the Ilizarov technique. MATERIALS AND METHODS: 32 patients who were followed up at least 1 year after the treatment of infected nonunion of tibia from March 1995 to March 2001 were evaluated. Their mean age was 43 years and mean duration of follow-up was 37 months. The results were divided into bone results and functional results and analyzed by grading to excellent, good, fair, and poor. RESULTS: The average amount of bone lengthening was 5.3 cm (range, 2~10 cm) and the average healing index was 61.5 days/cm (range, 52.7~70.4 days/cm). Bony union was obtained at average 10.3 months in all cases. The bone result was excellent in 9 cases, good 18, and fair 5. The functional result was excellent in 8 cases, good 16, fair 7, and poor 1 case. CONCLUSION: Ilizarov technique is an effective method in the treatment of infected nonunion of tibia for early range of motion exercise, weight bearing and correction of limb shortening.

Sesamoids and Accessory Bones of the Forefoot in Normal Korean Adults / 대한족부족관절학회지

PURPOSE: To determine the locations and incidences of sesamoids and accessory bones of the forefoot in normal Korean adults. MATERIALS AND METHODS: The plain radiographs of the forefoot of 400 volunteers, 200 males and 200 females, were taken. The three orthopedic surgeons participated in the radiographic evaluation independently. Persons who had history of foot problem or injury were excluded. RESULTS: Sesamoids of first metatarsophalangeal joint were nearly always present; medial 99% and lateral 100%. The bipartite sesamoid was more common in medial (9.8%) and in female (17.0%) than in lateral (0.3%) and in male (2.5%). Sesamoids of the interphalangeal joint of the first toe were seen in 35.8%. Sesamoids of metatarsophalangeal joints in other four toes were rarely observed. Their incidences were 5% in second toe, 0.8% in third, 0% in fourth, and 2.8% (lateral) and 7.5% (medial) in fifth. Sesamoids of interphalangeal joint in four lesser toes were not observed except two cases (0.5%) in the fifth toe. Accessory bone was very rarely observed. Os vesalianum was observed in five feet (1.3%), Os intermetatarseum in 14 feet (3.5%), and Os cuneo-metatarsal I tibiale in none. CONCLUSION: We determined the location and incidences of sesamoids and accessory bones of the forefoot, and we expected this to help to diagnose the forefoot problem.

Sesamoids and Accessory Bones of the Forefoot in Normal Korean Adults / 대한족부족관절학회지

PURPOSE: To determine the locations and incidences of sesamoids and accessory bones of the forefoot in normal Korean adults. MATERIALS AND METHODS: The plain radiographs of the forefoot of 400 volunteers, 200 males and 200 females, were taken. The three orthopedic surgeons participated in the radiographic evaluation independently. Persons who had history of foot problem or injury were excluded. RESULTS: Sesamoids of first metatarsophalangeal joint were nearly always present; medial 99% and lateral 100%. The bipartite sesamoid was more common in medial (9.8%) and in female (17.0%) than in lateral (0.3%) and in male (2.5%). Sesamoids of the interphalangeal joint of the first toe were seen in 35.8%. Sesamoids of metatarsophalangeal joints in other four toes were rarely observed. Their incidences were 5% in second toe, 0.8% in third, 0% in fourth, and 2.8% (lateral) and 7.5% (medial) in fifth. Sesamoids of interphalangeal joint in four lesser toes were not observed except two cases (0.5%) in the fifth toe. Accessory bone was very rarely observed. Os vesalianum was observed in five feet (1.3%), Os intermetatarseum in 14 feet (3.5%), and Os cuneo-metatarsal I tibiale in none. CONCLUSION: We determined the location and incidences of sesamoids and accessory bones of the forefoot, and we expected this to help to diagnose the forefoot problem.