Pathologic Fracture of Unicameral Bone Cyst / 대한골관절종양학회지

PURPOSE: The purpose of this study is to observe unicameral bone cyst (UBC) outcome after the fracture has healed and if there is any identifiable prognostic factors. MATERIALS AND METHODS: 13 UBC patients with pathologic fracture from 2001 to 2010 were reviewed. The mean follow up were 26 months (3-90 months). There were 11 male and 2 female patients and the mean age of the patients were 10.2 years old (6-16 years). 9 involved proximal humerusand 2 involved humerus shaft and 1 involved proximal femur and 1 involved proximal tibia. The treatment of UBC fracture was conservative cast application to heal the fracture initially, and 1 patient was treated with primary auto bone graft and open reduction with internal fixation. 5 patients were treated with steroid injection during follow up period and 2 patients with auto bone graft. We analyzed the change of UBC during pathologic fracture healing period and prognostic factor about age, the size of UBC, the involvement of physis. RESULTS: The mean duration of the fracture healing was 8.2 months. Complete healing were occurred at 4 patients (31%). No statiscal difference was checked with age about UBC healing (p=0.42). But, more larger size about UBC and more closer to physis, the healing was difficult (p=0.05, p=0.03). CONCLUSION: While pathologic fracture of UBC was possibly healed, active treatment should be applied especially those cysts that involvescloser area of the physis or large size.

The Result of Osteosynthesis for Femur Neck Fracture in Old Age Patients

PURPOSE: We wanted to investigate the radiographic and clinical results of internal fixation with cannulated screws in elderly patients with femoral neck fracture. MATERIALS AND METHODS: We reviewed the results of 47 cases of elderly patients with femoral neck fractures that were treated by osteosynthesis from May 2000 and March 2009 and these patients could be followed up for more than one year. There were 11 males and 36 females with a median age of 72 years (65~85 years). They were classified by the Garden stage. The number of stage I and II fractures was 34 and 16, respectively. The postoperative follow up period was 24 months (12~84 months). The union time, horizontal shortening and complications were investigated. Walking ability was evaluated by Koval's scoring system and the quality of life was measured by the Korean EQ-5D. RESULTS: The average union time was 4.4 months. The complications were one case of nonunion, 6 cases of avascular necrosis and one case of subtrochanteric fracture. The average of the horizontal shortening was 6.815 mm (0~20 mm) in the fracture site. The walking ability was on average 1 step down and it was possible to walk independently using a walker for 69% of the patients. The Korean EQ-5D quality of life was reduced from 0.856 to 0.561 (P <0.01). CONCLUSION: In elderly patients with femur neck fracture, the decreased abductor moment arm may reduce the quality of life and walking ability after cannulated screw fixation.

Body Mass Index in Patients with Early Posterior Tibial Tendon Dysfunction in Korea / 대한정형외과학회잡지

PURPOSE: Posterior tibial tendon dysfunction (PTTD) is known as the most common cause of adult acquired flatfoot syndrome and is common in middle-aged obese women. The purpose of this study was to describe the relationship between BMI (body mass index) and early stage PTTD in Korea. MATERIALS AND METHODS: Between May 2005 and June 2006 we evaluated 42 patients (58 feet) who were diagnosed and treated for early stage PTTD. We analyzed demographic data such as sex, age, BMI, physical findings, radiologic findings and clinical results. RESULTS: All 42 patients were women; their mean age was 52.6 years. Of the 42, 77% were middle aged (40-69). Increased BMI was detected in 75% of the 42 patients. There was no statistical significance in age-matched comparisons of BMI in Korea (p>0.05), or in the correlation between BMI and progression (p=0.293). Non-obese patients had superior clinical results (p=0.017). CONCLUSION: Overweight and obesity are commonly seen in patients with early stage PTTD in Korea but there do not appear to be any significant correlation between obesity and early stage PTTD and also no significant correlation between obesity and progression to later stages.