Double Minimal Incision Release for Carpal Tunnel Syndrome: A Comparative Study to the Standard Open Technique

PURPOSE: A minimally invasive surgical technique has been introduced to treat carpal tunnel syndrome that causes less pain, minimal scaring, and a rapid recovery. This study was designed to evaluate the safety and effectiveness of the double minimal incision release compared with the open surgery technique. METHODS: A study was performed on 175 cases in 111 patients who were operated on for carpal tunnel syndrome from January 2010 to December 2014. The patients were classified into 2 groups according to the type of surgical technique: 82 cases underwent standard open surgery in group A and 93 cases underwent double minimal incision release in group B. Grip strength and postoperative pain were evaluated 4 and 8 weeks and 6 and 12 months after surgery, and the period of numbness and time needed to resume normal activities were investigated. RESULTS: Group B patients showed better outcomes during the 2 first months after surgery than those of group A patients in numbness, pain, stiffness (p0.05). CONCLUSION: Double minimal incision release offered better clinical outcomes until 2 months after surgery compared to the standard open surgery technique and reduced incipient postoperative pain and allowed for earlier resumption of normal activities.

Bilateral Idiopathic Chondrolysis of the Hip in an Adult: A Case Report and Review of the Literature / 대한고관절학회지

Idiopathic chondrolysis of the hip usually develops in adolescents and is a disease characterized by gradual degenerative changes of the hyaline cartilage surrounding the head of the femur. It eventually decreases the hip joint space and causes limitations in the hip joint range of motion due to pain. The authors had experienced an unusual case of bilateral idiopathic chondrolysis of the hip in an 54 year-old male; thus, we report the treatment results and literature reviews in this case report.

Clinical Results of Internal Fixation of Subcapital Femoral Neck Fractures

BACKGROUND: Subcapital femoral neck is known to cause many complications, such as avascular necrosis (AVN) of the femoral head or nonunion, compared with other femoral neck fractures. The purpose of this study was to analyze the incidence of AVN and fixation failures in patients treated with internal fixation using cannulated screws for the subcapital femoral neck fractures. METHODS: This study targeted a total of 84 cases of subcapital femoral neck fractures that underwent internal fixation using cannulated screws. The average follow-up time after surgery was 36.8 months (range, 24 to 148 months). RESULTS: Nine hips (10.7%) showing AVN of the femoral head and 6 hips (7.1%) showing fixation failures were observed. The factors affecting the incidence of AVN of the femoral head after sustaining fractures correlated well with fracture types in the Garden classification (p = 0.030). The factors affecting fixation failure were the degree of reduction (p = 0.001) measured by the Garden alignment index and firm fixation (p = 0.009) assessed using the technique of 3-point fixation through the inferomedial cortical bone of the femoral neck. CONCLUSIONS: The complication rates for subcapital femoral neck fractures were lower than those previously reported; hence, internal fixation could be a primary treatment option for these fractures.

Clinical Results of Dynamic External Fixation for Proximal Interphalangeal Joint Fracture Dislocation

PURPOSE: We evaluated clinical outcomes after treating patients with proximal interphalangeal (PIP) joint fracture-dislocation with dynamic external fixator with which early joint motion can be undertaken to prevent joint stiffness effectively and fixate joints firmly. METHODS: Dynamic external fixators were applied for 20 fracture-dislocation of the PIP joints in 19 patients. The joints involved were 2nd PIP joint in two patients, 3rd PIP joint in three patients, 4th PIP joint in five patients, 5th PIP joint in eight patients. One patient had both 3rd and 4th PIP joint fracture-dislocation. Surgery was performed at least within four weeks. The mean age of the patients was 30.5 years (range, 15-54 years) and the mean follow-up duration was 1.85 years (range, 1-2.3 years) years. All patients were clinically and radiologically assessed on an outpatient basis after being discharged. RESULTS: At the final follow-up, the mean range of motion of PIP joints in flexion was 100.1° (flexion range, 88°-110°), the mean extension lag was 3.0° (extension range, 0°-10°), and the mean visual analogue scale score was 0.8. On anterior-posterior and lateral radiographs, congruity of the joint was satisfactory and 1 mm step off was present in three cases. CONCLUSION: We attained satisfactory clinical outcomes on the recovery of joint movement and joint congruity after treating PIP joint fracture-dislocation injury with dynamic external fixator.

Measurement of Length between Bronchial Carina and Superior Vena Cava-right Atrial Junction for Optimal Positioning of Central Venous Catheters in the Korean Adult Population / 대한혈관외과학회지

PURPOSE: Bronchial carina (BC) is one of the landmarks often used during central venous catheter (CVC) insertion. The aim of this study is to measure the superior vena cava (SVC) length and the length between the BC and the SVC-right atrial junction (LBCSAJ), using chest computed tomography (CT) scans in the Korean adult population, and to review the optimal location for the catheter tip, during CVC access using BC. METHODS: The study subjects were 238 consecutive subjects who underwent a chest CT scan with contrast and 5 mm thickness, in Inha University Hospital, between January 2010 and December 2011. Subjects who had any lung disease were excluded before enrollment. The subjects' clinical characteristics and imaging data were reviewed. The SVC length and LBCSAJ was measured at a 3-dimension workstation (Osirix). RESULTS: The mean age was 56.69+/-4.83 years, mean body weight 61.09+/-11.12 kg, height 161.72+/-9.15 cm, and body mass index (BMI) was 23.07+/-4.45 kg/m2. The mean length of the SVC was 47.67+/-10.92 mm, and the mean LBCSAJ was 30.80+/-9.03 mm. Men have a longer SVC and LBCSAJ than women (52.80+/-10.59 vs. 42.96+/-8.72, P=0.000). The age and height were significant covariates of the SVC length and the LBCSAJ. BMI was a significant covariate of the LBCSAJ in multivariate analysis. CONCLUSION: An understanding of anatomy and the actual length of the SVC in relation to bronchial carina is important for proper placement of a central venous catheter. This study gives its basic characteristics in the Korean adult population.