Bizarre Parosteal Osteochondromatous Proliferation (Nora's lesion) of the Big Toe. (A Report of Two Cases and Review) / 대한족부족관절학회지

Bizarre parosteal osteochondromatous proliferation (BPOP) is an rare benign tumor which involve mostly tubular bones of feet and hand. BPOP has clinical, radiographic, and histologic similarities with osteochondroma.Radiologically, BPOP has not central continuity with underlying osseous medulla. Histologically, the lesion has marked proliferative activity, and enlarged, bizzare, and binucleated chondrocytes.Despite the high risk of recurrence, treatment of choice is surgical resection. This report presents two cases of BPOP of the big toe with reviews of clinical, radiographic, and histological characteristics.

Cerebral oxygenation monitoring of patients during arthroscopic shoulder surgery in the sitting position / 대한마취과학회지

BACKGROUND: Cerebral hypotension and desaturation can occur during shoulder surgery in the seated position. We evaluated the correlation of cerebral oxygen saturation (rSO2) using near infra-red spectroscopy (NIRS) and mean arterial pressures (MAP) (at the levels of the brain and heart). METHODS: Fifty patients, scheduled for the arthroscopic shoulder surgery in the seated position, were enrolled to monitor the rSO2, bispectral Index (BIS), and MAPs at the levels of the brain and heart. The values of each parameter were collected at 5 min after intubation, immediately after placing the patient in the sitting position, 5 min after the patient was seated, immediately after the surgical incision, and every 30 min after incision. RESULTS: A correlation between the cerebral rSO2 and the MAP at the level of brain were statistically significant. Cerebral rSO2 and MAP after a change of posture from supine to sitting position were significantly decreased, compared to the baseline value. CONCLUSIONS: Monitoring cerebral rSO2 and MAP at the level of brain can be helpful to detect the possibility of cerebral deoxygenation earlier.

Prospective Comparative Study of Arthroscopic Repair Versus Debridement for the Full-Thickness Tear of Upper Subscapularis

PURPOSE: To evaluate the results from arthroscopic repair versus debridement for full-thickness tears of the upper subscapularis tendon. MATERIALS AND METHODS: Ninety-nine patient outcomes were evaluated and compared prospectively. Sixty-nine patients with full-thickness tears of the upper subscapularis tendon underwent arthroscopic repair (group I) and thirty patients underwent simple debridement (group II) between May 2003 and October 2007. In all patients, the tear was localized to the superior one third of the upper subscapularis tendon. The results of the treatment were assessed by evaluating the UCLA, ASES, and VAS for pain and internal rotation strength scores before and after the operation. RESULTS: In groups I and II, UCLA, ASES, VAS, and internal rotation muscle power (perfect score = 5) scores were improved after surgery. In comparing group I and group II, the UCLA and VAS scores were not significantly different (p>0.05), while the ASES and internal rotation strength scores were significantly different (p<0.05). CONCLUSION: The arthroscopic repair of full-thickness tears of the upper subscapularis tendon was a better surgical method than simple debridement.

Arthroscopy Assisted Percutaneous Reduction and Screw Fixation of a Displaced Intra-articular Glenoid Fracture: A Case Report

PURPOSE: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. MATERIALS AND METHODS: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. RESULTS: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. CONCLUSION: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.

A Comparison of the Short-term Results between the PCL Sacrificing Medial Pivot Knee and Nexgen(R) LPS Total Knee Arthroplasty

PURPOSE: We wanted to compare the clinical and radiological results after performing total knee arthroplasty (TKA) with the PCL sacrificing (PS) Medial Pivot Knee (MPK) and the Nexgen(R) LPS. MATERIALS AND METHODS: Seventy knees in 48 patients after TKA with the PS ADVANCE(R) MPK (group I) and 67 knees in 45 patients with the Nexgen(R) LPS (group II) were retrospectively evaluated. All the patients were followed up for more than 2 years. The evaluations included the preoperative and postoperative range of motion (ROM), the Knee Society (KS) scores, the tibiofemoral angle and the postoperative complications. RESULTS: For group I, the ROM increased from a mean flexion contracture of 6.3degrees and further flexion of 116.4degrees to 1.9degrees and 120.5degrees, respectively, and for group II, from 12.6degrees and 117.6degrees to 0.9degrees and 123.0degrees, respectively. For group I, the KS knee and function scores increased from 46 and 37 to 87 and 83, respectively, and for group II, from 50 and 48 to 87 and 83, respectively. For group I, the tibiofemoral angle changed from varus 4.0degrees to valgus 5.5degrees, respectively, and for group II, from varus 4.1degrees to valgus 5.3degrees, respectively. The complications were 2 knees (2.8%) with periprosthetic patellar fractures and 1 knee (1.4%) with a tibial component failure in group I, and 1 knee (1.5%) with early femoral component failure and 1 knee with arthrofibrosis (1.5%) in group II. CONCLUSION: The minimum 2-year follow-up results of PS MPK TKA were comparable to those of Nexgen(R) LPS TKA. However, we think that the MPK system has the advantage of more bony preservation at the femoral intercondylar notch area.

Fracture of the Fifth Proximal Metatarsal Bone in Soccer Players / 대한스포츠의학회지

The purpose of this study was to evaluate correlation between lower limb varus and fracture of proximal 5th metatarsal bone occurred to soccer players and clinical results of treatment. Twenty soccer players (21 cases) were included and the average age of patients is 20.7 years. The average of follow up is 25 months. Fifteen cases were treated with intramedullary screw and 6 cases by conservative method. Union time, time of returning to exercise, lower extremity varus and complications were evaluated. In surgically treated group, the 14 cases gained radiological union in 7 weeks and the average time of returning to exercise was 3.4 months. In conservatively treated group, the 4 cases gained radiological union in 11 weeks and the average time of returning to exercise was 4.5 months. Radiological lower limb varus was observed in 17 cases. Lower limb varus may be one of predisposing factors to developing the fracture of proximal 5th metatarsal bone. And the surgical treatment was recommended than conservative treatment for better clinical outcomes.