Comparative study of tissue reaction following local-made plating and imported plating of long bone fracture.

BACKGROUND: In the medical field, local made implants have been widely used throughout the country. However there is less available information regarding the quality and standard of the implant. OBJECTIVE: To compare the occurrence of biologic tissue reactions between the uses of imported versus local plates. MATERIAL AND METHOD: Between September 2004 and July 2006, 40 united tibia fractures with satisfactory outcomes and radiographic union were evaluated for tissue reaction. Twenty patients were fixed with local plates and the other twenty patients were fixed with imported plates (AO brand). Informed consent was obtained The evaluation was performed blinded by one pathologist. Fibrosis, foreign body reaction, inflammation, and the presence of metal particles were classified on a modified four-point scale, as described by Mathiesen et al. RESULTS: There are 38 males and two females. The average age was 30.2 years (local) and 32 years (imported). Four patients, two with imported plate and two with local plate, showed significant discoloration of soft tissue adjacent to the plate. Histologically there was no significant difference between imported and local plates by Chi-square test. CONCLUSION: The current study emphasizes the clinical significance of corroded effects following metal fixation. The present study did not reveal any significant difference in biologic reaction between local plate and imported plate.

Operative results of adolescent idiopathic scoliosis in Lerdsin Hospital.

OBJECTIVE: Evaluate the results of the posterior instrumentation for the correction of adolescent idiopathic scoliosis (AIS) in Lerdsin Hospital. MATERIAL AND METHOD: A retrospective study was conducted to determine the effectiveness of surgical treatment of idiopathic scoliosis in Lerdsin Hospital. The pre-operative, immediate post operative, and the most recent follow-up (minimum 2 years) x-ray of 17 patients were evaluated for curve correction and spinal balance. RESULT: The present study found that the curvatures in thoracic King type II and III were corrected by about 58% post operatively. The curve progressed 3 degrees (5%) at the end of 2 years. For lumbar curve in King types I and II, there was the correction of 51% and 59%. After 2 years, the curve progressed around 6 degrees (7%) and 8 degrees (14%). Trunk balance was corrected by 60% in King type III. Degrees of thoracic kyphosis was decreased about 4 degrees. CONCLUSION: Frontal and sagittal thoracic and lumbar curve correction can be satisfactorily obtained by posterior spinal correction with instrumentation.

The relationship of facet tropism to lumbar disc herniation.

SUMMARY OF BACKGROUND DATA: The association between the facet tropism and the development of lumbar disc herniation has been studied; however the results remain controversial. OBJECTIVE: To determine the association between the facet tropism and the development of lumbar disc herniation. STUDY DESIGN: A cross-sectional study. MATERIAL AND METHOD: MRI of 34 patients with lumbar disc herniation was evaluated. Two orthopedic surgeons measured facet joint angle and determined the degenerative status of L3-4, L4-5, and L5-SI. Facet tropism was defined as the difference between the angle of the right and left facet more than 5 degrees. RESULTS: The average difference of facet joint angle of HNP group was higher than normal group in the same level. There was no statistically significant correlation between the facet tropism and lumbar disc herniation. CONCLUSION: These results do not indicate any relationship between the facet tropism and lumbar disc herniation.

Bilateral extraordinary huge, multi-compartmental tuberculous abscesses: a case report.

OBJECTIVE: To illustrate computerized tomography (CT) and magnetic resonance imaging (MRI) findings of tuberculous spondylitis with extensive abscess collections. METHOD: A review of one patient with tuberculous spondylitis and extensive paraspinal, subligamentous, retroperitoneal, and subcutaneous abscesses including pertinent history, important physical examination, CT and MR imaging findings was performed. RESULT AND CONCLUSION: This case demonstrates multiple patterns of tuberculous abscess formation secondary to spinal tuberculosis; included are paraspinal, subligamentous, retroperitoneal, and subcutaneous locations. The extension of the abscess should be kept in mind when treating a patient with tuberculous spondylitis. MR imaging is a modality of choice to illustrate full extension of the disease process, which is necessary for therapeutic decision making and planning.