Acroosteolysis of Scleroderma Associated with a Felon / 대한정형외과학회잡지

The Scleroderma is a chronic inflammatory disease of the connective tissue with involvement of the skin and other organs. It can be a manifestation of various disorders and occasionally acroosteolysis in the phalanges. Acroosteolysis is characterized by bone resorption or destruction in the phalanges, while the base is preserved. The pathogenesis of acroosteolysis in patients with scleroderma is a blood-flow disorder that is mainly associated with an abnormal accumulation of collagen in all tissues, microangiopathy and infections in the phalanges. The phalanges in patients with scleroderma are prone to continuous infections as a felon or skin ulcers due to atrophy of the subcutaneous tissue, dry and sclerotic skin, or a disorder of the immune system. We experienced a patient who had acroosteolysis with scleroderma of the phalanges, and this was associated with a felon. We report on this case along with a brief review of the literature.

Peroneus Longus Dislocation associated with Trimalleolar Fracture: A Case Report / 대한족부족관절학회지

Traumatic dislocation of the peroneus longus tendon is an often unrecognized injury which has been reported to occur most commonly during sports activity. Most acute cases with early detection can be treated by simple repair of the tendon or retinaculum using one of several procedures available. Accurate treatment through a comprehensive evaluation of the ankle injury prevents suboptimal and sometimes unrecorrectable outcomes. The authors experienced concomitantly the peroneus longus tendon dislocation associated with a trimalleolar fracture of the ankle. We report this case a brief review of the literature.

Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail

PURPOSE: To evaluate the result of forearm shaft fracture treated by modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA). MATERIALS AND METHODS: 15 patients with fracture of radius, ulna, radio-ulna shaft treated by modified interlocking intramedullary nail from December 2003 to February 2007 were analyzed. Modified interlocking intramedullary nail has paddle blade tip and fluted rod, so the distal screw fixation was not needed but had relatively firm fixation. It has advantages including short operation time, small operation scar. The average follow up period was 8.3 months (range, 5~15 months). We analyzed the results by average union time and the functional results according to Anderson's criteria. RESULTS: The mean duration of union was 9.8 weeks in radius and 11.4 weeks in ulna. The average range of motion of forearm was 74.6 degree in supination and 72 degree in pronation.. Functional results assessed by Anderson were rated excellet in 12 cases, satisfactory in 3 cases. We found no complications such as delayed union, non-union, neurovascular injury and infection. CONCLUSION: Modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA) is a viable therapeutic alternative in the management of forearm shaft fracture.

Operative Treatment of Chronic Recurrent Dislocation of Peroneal Tendon: A Case Report / 대한족부족관절학회지

Traumatic dislocation of the peroneal tendon is an infrequent injury. This injury is caused by forceful dorsiflexion of the foot accompanied by a powerful contraction of the peroneal muscles. This mechanism of injury tears the superior peroneal retinaculum and allows the tendons to snap anteriorly. We experienced a case of chronic recurrent dislocation of the peroneal tendon, which was treated by bone block surgery using autograft of lateral fibula and reattachment of the superior peroneal retinaculum. The clinical result was satisfactory.

Usefulness of MRI in Distal Femoral Intra-articular Fracture

PURPOSE: Preoperative recognition of an associated injuries including ligament disruptions of the knee and Hoffa fracture in the cases of the intra-articular distal femoral fractures affects surgical planning. The purpose of this study is to identify the usefulness of MRI in distal femoral intraarticular fracture. MATERIALS AND METHODS: Over a 7 years period from January 1995 to December 2001, all patients with an intra-articular fracture of the distal femur were collected from a prospectively designed orthopaedic database and reviewed. Seventy five patients with intra-articular distal femoral fractures were collected. There were 49 male and 26 female patients ranging from 15 to 91 in age. Because these injuries usually result from high-energy trauma, we should also exclude associated injuries of pelvis, hip, patella, tibial plateau fractures, popliteal vessel injuries, and ligament disruptions of the knee. So we checked knee MRI of patients with distal femoral fractures to rule out associated knee injuries. RESULTS: There were 12 Hoffa's fractures, 6 anterior cruciate ligament injuries, 6 posterior cruciate ligament injuries, 10 medial collateral ligament injuries and 3 lateral collateral ligament injuries. Five patients of 12 Hoffa's fractures associated with intra-articular distal femoral fractures that were not diagnosed in patients with conventional radiographs were confirmed after MRI evaluation. CONCLUSION: Knee MRI for intra-articular distal femoral fracture is necessary to rule out associated ligament injuries and Hoffa fractures in case of high-energy trauma patients.