Two-Incision Bipolar Hemiarthroplasty for Treating Femoral Neck Fracture: Analysis of 15 Cases

INTRODUCTION: We wanted to evaluate the efficacy of bipolar hemiarthroplasty using Berger's two-incision surgical technique for patients with muscular weakness around the hip joint and/or a high risk of dislocation. MATERIALS AND METHODS: We performed bipolar hemiarthroplasty for 15 femoral neck fractures using Berger's two-incision technique between December 2005 and July 2007. The mean age of the patients was 75.2 years old. Four of them had difficulty in walking due to the sequalae after stroke and five have been treated for psychoneurologic disorders. We investigated the operation time, the length of the anterior and posterior incisions, the amount of bleeding, the time untill walking after the operation, the total hospital stay, the recovery to activities of daily living and the complications such as dislocation. RESULTS: The mean operating time was 93 minutes. The average anterior and posterior skin incision length was 6.4 cm and 7.2 cm, respectively. The mean amount of bleeding was 420 cc at the time of surgery and 230 cc postoperatively through a drain. The patients started walking at a mean of 3.3 (1 to 5) days after the operation and the mean hospitalization was 24.3 days. Fourteen patients went back to their pre-injured activities of daily living, except one case with an intraoperative periprosthetic fracture. As for complications, two cases (13.3%) of femoral fracture were intraoperatively observed and one case of skin necrosis on the anterior incision site occurred. There were not any cases of dislocation or infection. CONCLUSION: Two-incision bipolar hemiarthroplasty had advantages for rehabilitation in elderly patients who have a high risk of dislocation, as well as in the patients with muscle weakness. But the operation took a long time and it had a high complication rate.

Magnetic Resonance Imaging of the Sinus : Prevalence and Clinical Significance of Incidental Abnormal Findings in a Common Population

BACKGROUND AND OBJECTIVES: The purpose of this study is to determine the prevalence of abnormalities in the sinuses among the common population, and to correlate this with clinical data. MATERIALS AND METHODS: We retrospectively evaluated a total of five hundred patients who visited the Health Promotion Center, Asan Medical Center, to undergo MRI scan to screen for intracranial pathology from January to April, 2003. Patients who have been treated for nasal or sinus diseases and who had previous history of nasal or sinus operations were excluded. The sinus abnormalities found through the MRI were classified into 2 types as follows; sinusitis group and retention cyst group. RESULTS: Among the five hundred patients studied, ninety-six (19.2%) patients showed abnormality in one or more sinus groups; ninety patients displayed symptoms of sinusitis and nine patients exhibited signs of retention cyst. Three patients showed symptoms of both. Sinus abnormalities were most commonly observed in the maxillary sinus. Seven patients had symptoms of the sinusitis group, and one patient had symptoms of the retention cyst group. CONCLUSION: Incidental sinus abnormalities detected among the common population were relatively common. However, pathologic condition which demanded treatment among these abnormalities were rare. Therefore, it would be important not to overestimate these signs and one should evaluate their clinical correlations carefully through complete physical examinations before applying any treatment for these lesions.