Incidentally Diagnosed Asymptomatic Pneumoparotid / 대한두경부종양학회지

Pneumoparotid is a rare cause of parotid gland swelling, and is caused by retrograde air reflux from the oral cavity, into the parotid gland via Stensen's duct. Most patients complained of painless swelling in the parotid region. Herein, we report a rare case of pneumoparotid, incidentally diagnosed without symptoms on CT, for follow-up of parotid lymph node enlargement.

The Effect of the Acromion Shape on Rotator Cuff Tears / 대한정형외과학회잡지

PURPOSE: The shape of the acromion was analyzed radiologically to assess the effect on rotator cuff tears. MATERIALS AND METHODS: The rotator cuff tear group consisted of 91 patients with a mean age 55.6 years (range, 27-85 years) and the normal shoulder articular disease (control) group consisted of 100 subjects with a mean age of 42.9 years (range, 18-72 years). The lateral extension of the acromion and the lateral acromial angle were measured on an oblique coronal MRI, and the anterior covering of the acromionon was measured on a supraspinatus outlet view. RESULTS: The lateral extension of the acrominon of the rotator cuff tear group of patients and the control group of subjects was 0.70+/-0.07 and 0.64+/-0.10, respectively. The lateral acromial angle was 72.6+/-6.5degrees and 76.4+/-6.5degrees, respectively, and the anterior covering of the acromion was measured to be 0.55+/-0.13 and 0.51+/-0.14, respectively. In a comparison with the control group of subjects, the lateral extension of the acrominon of the rotator cuff tear group of patients was larger and the lateral acromial angle was smaller; these findings were statistically significant (p<0.001). In addition, the correlation coefficients of the lateral extension of the acromion to the lateral acromial angle in the rotator cuff tear group of patients and in the control group of subjects was -0.44 and -0.46, respectively; a statistically significant correlation was seeen (p<0.001). CONCLUSION: The results suggest that the measurement of the lateral extension of the acromion and the lateral acromial angle determines the shape of the acromion, and thus it may represent a useful marker to confirm the interrelationship of a rotator cuff tear.

Treatment of Chronic Ankle Lateral Instability using Modified Brostrom Procedure / 대한정형외과학회잡지

Purpose: To analyze the results of modified Brostrom procedure for chronic ankle lateral instability. Materials and Methods: Twenty six patients were followed up for more than 1 year after performing the modified Brostrom procedure. The mean age was 35.3 years, and the mean follow-up period was 2.4 years. Anterior and varus stress radiographs were taken in all cases, and a preoperative MRI was taken in 22 cases. Clinically, the Karlsson scale and Sefton grading were used. The effects of age, injury pattern and associated injury such as osteochondral fracture on the clinical results were analyzed. Results: Radiologically the difference in anterior displacement between the affected side and contralateral side was 3.1 mm, and that of the varus tilt was 4.2degrees. At the last follow-up, the Karlsson scale had increased from preoperative 47.5 points to 90.3 points. There were 14 excellent, 8 good, 3 fair and 1 poor results according to the Sefton grading. The results were significantly worse in patients over 50 years of age. An osteochondral fracture or degenerative changes also lowered the level of patient satisfaction. Conclusion: The modified Brostrom procedure appears to be a safe and highly satisfactory procedure. However, a more careful approach is needed for patients over 50 years of age or with associated degenerative changes.

Clinical Outcome of Conservative Treatment for Osteoporotic Compression Fractures in Thoracolumbar Junction / 대한척추외과학회지

STUDY DESIGN: A retrospective study. OBJECTIVES: To validate a treatment plan by analyzing the clinical outcome of conservative treatment for patients with osteoporotic vertebral compression fractures at thoracolumbar junctions. SUMMARY OF LITERATURE REVIEW: Osteoporotic vertebral compression fractures, without neurological symptoms, have been treated by conservative management; however, serious sequelae of the osteoporotic vertebral compression fractures have been reported by many investigators. MATERIALS AND METHODS: We evaluated 83 cases; 68 patients had an average age of 71.1 years (58 to 99 years). After conservative treatment of the osteoporotic compression fractures, and based on the clinical outcome derived from a 10-point pain rating scale at last follow up, the group was sub-divided into two groups. Group A (N=28): had a score of above five points on the pain scale. Group B (N=55): had a score of less than five points on the pain scale. Evaluation of the correlation between the clinical outcome and factors affecting outcome such as vertebral body height loss, change in height loss, BMD and bracing were recorded at the initial and follow up assessment. RESULTS: The mean VAS score was 3.20+/-1.62, and the mean compression ratio was 24.74+/-12.03% at injury and 21.68+/-11.43% at the last follow-up. The mean compression ratio at injury was 27.67+/-10.50% in group A and 23.25+/-10.57% in group B. The mean compression ratio at the last follow-up was 53.43+/-13.31% for group A and 42.86+/-13.74% for group B. The change in compression ratio was 25.76+/-12.68% in group A and 19.60+/-10.25% in group B. The mean BMD was -3.63+/-1.16 for group A and -2.80+/-1.10 for group B. The compression ratio at last follow-up, change of compression ratio and BMD were significantly different in comparisons between group A and B (p=0.001, 0.031, 0.003, respectively). CONCLUSION: The clinical outcome of osteoporotic compression fractures was related to the compression ratio, and the compression ratio was related with BMD. Patients with osteoporotic compression fractures with a compression ratio of more than 30% and a T-score from the BMD of less than -3.5 require active treatment.