ABSTRACT
PURPOSE: Although reports on operative treatment of osteochondral lesion of the talus (OLT) are increasing, to the best of our knowledge, there have been only a few reports on non-operative treatment of OLT. The purpose of this study is to report the prognosis of non-operative treatment for OLT patients. MATERIALS AND METHODS: This retrospective study included 104 patients (57 male, 47 female) with OLTs having a follow-up period of more than two years, between 2003 and 2013. The location, size, and stage of the OLT were confirmed by magnetic resonance imaging or computed tomography. At the final follow-up, simple radiographs confirmed the progression of osteoarthritis. We surveyed the limitations of sports activity, visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) scale, and SF-36. RESULTS: There were no patients with progression of osteoarthritis at the final follow-up. Only two patients (2.4%) complained the limitation of desired sports activity. The mean VAS significantly decreased from 4.3 (range, 0–8) to 1.1 (range, 0–4) (p<0.001). The mean AOFAS scale significantly improved from 83.3 (range, 41–100) to 92.5 (range, 65–100). Moreover, the mean SF-36 also improved from 52.6 (range, 30.0–91.0) to 72.9 (range, 40.6–97.0) (p<0.001). CONCLUSION: Sufficient non-operative treatment is initially recommended to OLT patients because pain, in general, improves in most cases despite the presence of symptoms. Moreover, it's worth noting that the progression to osteoarthritis is rare.
Subject(s)
Humans , Male , Ankle , Follow-Up Studies , Foot , Magnetic Resonance Imaging , Orthopedics , Osteoarthritis , Prognosis , Retrospective Studies , Sports , TalusABSTRACT
PURPOSE: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. MATERIALS AND METHODS: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the Olerud-Molander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. RESULTS: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. CONCLUSION: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.
Subject(s)
Humans , Male , Ankle Fractures , Ankle , Arthralgia , Classification , Exercise , Follow-Up Studies , Heel , Incidence , Joints , Ligaments , Pain, Postoperative , Rehabilitation , Retrospective Studies , Walking , Weight-BearingABSTRACT
Tumoral calcinosis is a very rare disease in which calcium deposit is accumulated on soft tissue around joints without specific metabolic disorder of calcium or predisposing illnesses. Its causes have not been revealed clearly, and the disease has been known to occur rarely among Asian patients. We report a case of a multiple giant tumoral calcinosis patient who complained of painful masses in the groin region as well as in both buttocks and sacral area. The patient was evaluated to differentiate with other causes and have been treated with surgical excision. We present this case with a review of literature.
Subject(s)
Humans , Asian People , Buttocks , Calcinosis , Calcium , Groin , Joints , Pelvis , Rare DiseasesABSTRACT
In an attempt to elucidate the morphologic changes of normal aging skin, the present study was undertaken in human facial and chest well skin of individuals aged from 4 months to 76 years old. Biopsied skin was studied with light microscope, scanning electron microscope, and transmission electron microscope, using both conventional and tannic acid staining. The morphologic changes in the skin were noted as follow: 1. Structurally, the aged epidermis gradually became somewhat thinner, with flattening of the dermoepidermal interface. The number of melanocytes also decreased. 2. Abnormalities of elastic fibers such as loss of oxytalan fibers were observed from age 30. It was the initial sign of the aging process of elastic fibers, followed by abnormal changes in elaunin and mature elastic fibers. The degree of facial skin abnormality was rather more severe than that of the chest wall skin. 3. In individuals more than 50 years old, the age related changes in mature elastic fibers were more severe. Transmission electron microscopically, the electron density in elastin was irregular. The elastic fibers also showed pores and irregular splitting with fragmentation. Fine granular materials were scattered near the elastin. 4. Scanning electron microscopically, the elastic fibers in young adult skin showd ribbon-like fibers aligned in the same direction. They were either cylindrical or elliptical, having smooth surface. In old skin, the elastic fibers ran in various directions, forming complicated networks. These were larger, more elliptical and more branched than those in young adult skin. In summary, histologic changes of aging are much more prominent in sun-exposed skin(facial skin) than in sun protected skin(chest wall skin). A completely different spectrum of elastic fiber abnormalities was found in individuals more than 30 years old. The result indicates that elastic fiber abnormalities are related to aging skin.