Comparative Analysis of the Results of Fixed-angle versus Variable-angle Volar Locking Plate for Distal Radius Fracture Fixation

PURPOSE: To compare the outcomes of distal radius fractures in a fixed-angle volar locking plate group and variable-angle volar locking plate group. MATERIALS AND METHODS: Forty-one patients observed at least 6 months after surgery were included in this retrospective study. We used the range of motion, visual analogue scale score, Disabilities of the Arm, Shoulder and Hand Questionnaire score, and radiologic findings to measure the clinical results. RESULTS: No differences in clinical results or radiologic results were noted between the fixed-angle volar locking plate group and variable-angle volar locking plate group. CONCLUSION: We believe that it is important to minimize complications by using appropriate screws and plates according to the fracture type, though no differences in the surgical outcome were noted between the fixed-angle volar locking plate group and variable-angle volar locking plate group with distal radius fracture.

Lipoma Arborescens in the Hip Joint: A Case Report

Lipoma arborescens is a very rare disease in which adipocytes form a synovial villous lipoma. In addition, it has the potential for dysplastic proliferation. Hypertrophic synovial lipoma is stimulated by movement of joints, which results in joint pain, effusion, limitation of joint movement and swelling. A definite cause has not yet been proven, but trauma, rheumatic arthritis, inflammation and degenerative change are believed to be possible causes. There have been reports of lipoma arborescens in several joints, including the knee joint and elbow joint. However, it is very rare to find this disease in hip joints. In fact, only one such case has been reported in Korea. We report here on a rare case of lipoma arborescens in the hip joint along with a review of the relevant literature.

Reliability of MRI Findings of Peroneal Tendinopathy in Patients with Lateral Chronic Ankle Instability

BACKGROUND: Patients with chronic lateral ankle instability also have peroneal tendinopathy often. However, preoperative MRIs of these patients are vague in many cases. Our study was performed to see the reliability of MRI findings of peroneal tendinopathy in patients with chronic lateral ankle instability. METHODS: MRI images for 82 patients who had chronic lateral ankle instability, and had received surgical treatment between March 2006 and November 2009 were compared with impressions from operating rooms. The mean age of patients was 36.4 years (range, 15 to 64 years), 82 ankles were studied, and patients with rheumatoid diseases were excluded from the study. RESULTS: Of the 82 cases, 26 were true positives, 38 true negatives, 13 false positives and 5 false negatives. Of 39 cases of peroneal tendinopathy diagnosed from MRI, 14 had peroneal tendon partial tears, 15 tenosynovitis, 3 dislocations, 17 low-lying muscle bellies, and 6 peroneus quartus muscles. Of 31 cases of peroneal tendinopathy observed in surgery 11 had peroneal tendon partial tears, 4 tenosynovitis, 5 dislocations, 12 low-lying muscle belliess, and 1 peroneus quartus muscle. Sensitivity and specificity of peroneal tendinopathy were 83.9% and 74.5%, respectively. Positive predictive value was 66.7%. Negative predictive value was 88.4%. Accuracy rate was 78.0%. CONCLUSIONS: MRI is a useful diagnostic tool for detecting peroneal tendinopathy in patients with chronic lateral ankle instability. However, MRI is vague in many cases. Therefore, a thorough delicate physical examination and careful observation is needed.

Posterior Hip Dislocation with Ipsilateral Fractures of the Femoral Head and Intertrochanter: A Case Report

High-energy injury, as traffic accident or fall down, can cause fracture of femur head and posterior dislocation of hip joint which is accompanied with ipsilateral acetabulum fracture or femur neck fracture. But the case that femur head fracture and posterior dislocation of the hip joint coincide with ipsilateral intertrochanteric fracture of proximal femur is so uncommon that reports of the case is very rare. We hereby are to report the experienced and treated-cases of femur head fracture and posterior dislocation of the hip joint that is accompanied with ipsilateral intertrochanteric fracture.

Peroneal Tendinopathy in Chronic Lateral Ankle Instability / 대한스포츠의학회지

In patients complained of lateral ankle pain, the peroneal tendinopathy is frequently overlooked because relatively rare. In this study, types of lesion, frequency, and clinical results were analyzed in patients with peroneal tendinopathy associated in chronic ankle instability. This study reviewed the result of 22 patients. The average age was 35.1 years with an average follow-up of 20.1 months. Modified Brostrom procedure was done and peroneal tendon was explored. Peroneal tendinopathy was composed of 9 tear, 2 dislocation, 4 tendinitis, 7 low-lying muscle belly, 1 peroneal quartus. Depending on the type of peroneal tendinopathies, tubularization, groove deepening and retinaculum repair, and debridement were done. All patients had a history of repeated sprains, positive anterior drawer test, lateral ankle pain. After the last follow-up, the visual analogue scale score and American Orthopaedic Foot and Ankle Society score were evaluated. Also, almost of all patients were satisfied and anterior drawer test was improved. If the patients have chronic ankle instability and pain around the retromalleolar area, we keep in mind that the lesions are peroneal tendinopathy.

Treatment of Distal Tibia Fracture using MIPPO Technique with Locking Compression Plate: Comparative Study of the Intraarticular Fracture and Extraarticular Fracture / 대한족부족관절학회지

PURPOSE: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. MATERIALS AND METHODS: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. RESULTS: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. CONCLUSION: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.

Two Part Triplane Fracture with Extention through Medial Malleolus: Four Cases Report / 대한족부족관절학회지

The triplane fracture has been described as a fracture of the distal tibial epiphysis occurring across three planes-sagittal, transverse and coronal. The characteristic pattern of fusion of distal tibial epiphysis explains the special configuration of the fragments in the triplane fracture. According to Dias.Tachdjian classification, triplane fracture is classified two part fracture, three part fracture, four part fracture and two part fracture with extension to the medial malleolus. Among four types, two part triplane fracture with extension to the medial malleolus is a relatively rare injury and generally is not treated by closed reduction. Such fractures should have an anatomic reduction and adequate fixation to restore the joint congruity and obtain an anatomic reduction of the growth plate to prevent a future growth deformity. This is usually best accomplished with an open reduction and screw fixation or k-wire fixation. We experienced two part triplane fracture with extension to medial malleolus and check the CT to define the extent of the injury completely. And then we underwent open reduction and screw fixation for the fracture. As a result, we present four cases of two part triplane fracture with extension with review of related literatures.

Rheumatoid Pseudocyst (geodes) of Anterior Inferior Iliac Spine: A Case Report

Typically, geodes are associated with obvious joint involvement, and they are located in the subchondral portion of the joint. Radiological lucencies are produced by pannus infiltration through a disruption in the subchondral plate, and they present as round or oval cystic areas of various sizes. We report a patient with rheumatoid disease and positive antinuclear antibody who had a geode that did not involve the joint. Considering the mechanism of geode occurrence, this is a very rare report of such a manifestation. As a result, we present a rare case of geode occurrence without joint involvement in the setting of rheumatoid disease.

Combined Lunate and Triquetrum Fracture: A Case Report

We described an unusual case of a 16-year-old Taekwondo athlete who injured the left wrist when she compete with other athlete. She described a mechanism of axial loading, with the wrist in radial deviation. This unusual combined lunate and triquetrum fracture was not associated with the perilunar dislocation. We present this case with a review of the literature. In this case, internal fixation and early range of motion result in a good functional outcome.