Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report

Trochanteric entry femoral nails have been widely used for fixation of femoral shaft fractures because of easier identification of the entry point. Young patients usually request removal of the nail after healing of the fracture. We experienced a failure and difficulty in removal of the trochanteric entry nail in two adolescent patients. In the patient in which the nail could be removed with difficulty, dense compact bone was formed through the empty interlocking holes and the nail was held just like a latch. This finding was quite similar to the computed tomography findings of the patient in which the nail could not be removed. In order to remove the nail, the newly formed, dense compact bone in the interlocking holes must be broken and detached from the femur itself. We suggest that dense compact bone through the empty interlocking holes might be a clue for difficult removal of the trochanteric entry nail.

Intramuscular Lipoma of the Supraspinatus Muscle with Supraspinatus Tendon Partial Tear / 대한정형외과학회잡지

Infiltrating lipoma in supraspinatus muscle on the shoulder is very rare. We performed open excision and rotator cuff repair on a patient who had infiltrating lipoma in supraspinatus muscle with partial tear of the supraspinatus tendon. We achieved a satisfactory outcome on one-year follow-up magnetic resonance imaging. We report on the case with a review of the literature.

Bilaterally Simultaneous Medial and Lateral Discoid Menisci / 대한정형외과학회잡지

Most discoid menisci are lateral and medial discoid meniscus is very rare. Several articles have reported on bilateral lateral discoid menisci as well as bilateral medial discoid menisci, and a few articles have reported simultaneous medial and lateral discoid menisci in the same knee. Only one case of simultaneous medial and lateral discoid menisci, bilaterally, has been reported. We present another case of a male patient with bilaterally simultaneous medial and lateral discoid menisci, diagnosed with magnetic resonance imaging and arthroscopy. The patient was treated by arthroscopic partial meniscetomy.

Pancoast Syndrome Accompanied by Rotator Cuff Tear

Pancoast syndrome (PS) is characterized by a malignant neoplasm of the superior sulcus of the lung with destructive lesions of the thoracic inlet and involvement of the brachial plexus and cervical sympathetic nerves. The most common initial symptom of PS is shoulder pain; however, cough, dyspnea, and hemoptysis, signs often associated with lung cancer, are not as common. Investigation of PS can be difficult even with plain radiographs of the chest because it is surrounded by osseous structures such as the ribs, vertebral bodies, and manubrium. Due to these characteristics, orthopedic surgeons tend to make a misdiagnosis resulting in delay of appropriate treatment. Here we report on a patient who was supposed to undergo rotator cuff repair for his shoulder pain and weakness, and was eventually diagnosed with PS.

Pancoast Syndrome Accompanied by Rotator Cuff Tear

Pancoast syndrome (PS) is characterized by a malignant neoplasm of the superior sulcus of the lung with destructive lesions of the thoracic inlet and involvement of the brachial plexus and cervical sympathetic nerves. The most common initial symptom of PS is shoulder pain; however, cough, dyspnea, and hemoptysis, signs often associated with lung cancer, are not as common. Investigation of PS can be difficult even with plain radiographs of the chest because it is surrounded by osseous structures such as the ribs, vertebral bodies, and manubrium. Due to these characteristics, orthopedic surgeons tend to make a misdiagnosis resulting in delay of appropriate treatment. Here we report on a patient who was supposed to undergo rotator cuff repair for his shoulder pain and weakness, and was eventually diagnosed with PS.

Rupture of the Extensor Pollicis Longus Tendon at the Proximal Screw of Volar Plate Fixation for Distal Radius Fracture: A Case Report

As volar plate fixation of distal radius fracture becomes more common, reports of ruptured extensor pollicis longus tendon by a protruding distal screw tip are also increasing steadily. Authors have experienced a rare case of ruptured extensor pollicis longus tendon at the prominent proximal screw of fixed volar plate for distal radius fracture, and we report it herein with a review of the literature.

Intra-Articular Osteochondroma of the Patella / 대한정형외과학회잡지

Osteochondroma is one of the most common benign tumors. However, intra-articular occurrence is rare, especially in the knee joint; this is a case of osteochondroma forming bony bridge with the patella. The authors experienced a case of intra-articular osteochondroma of the left patella observed in a 58-year-old female, so we reported it with a literature review.

The Surgical Outcomes of Clavicle Lateral End Fractures Fixed with the Oblique T Locking Compession Plate

PURPOSE: The purpose of this study is to evaluate the surgical outcomes of the clavicle lateral end fracture fixed with an oblique T locking compression plate (LCP). MATERIALS AND METHODS: Fourteen clavicle lateral end fractures were fixed with the oblique T-LCP and followed up for at least 1 year after the surgery. Thirteen cases were unstable Neer type II fractures and one case was nonunion of the Neer type I fracture. The mean age was 46 years of age (range, 26~70). In ten cases, augmenting sutures with the absorbable suture material were placed in the coraco-clavicular ligament and around the plate and the clavicle to improve the stability of fracture fixation. Autogenous iliac bone graft was done in four cases. The clinical outcomes were evaluated by using UCLA scoring system and KSS (Korean Shoulder Score). RESULTS: The mean UCLA score was 33.5 and the mean KSS was 94.9. Average time of bone union was 11.9 weeks (range, 6~28), including 1 case with a delayed union. There was no complication such as loss of fixation or nonunion. CONCLUSION: Fixation with the oblique T-LCP is a good option providing reliable functional results in clavicle lateral end fractures.

Distal Intersection Syndrome of the Wrist: Three Cases Report

Distal intersection syndrome indicates simultaneous tenosynovitis or tendinosis of the second and third extensor compartment where extensor pollicis longus cross with the tendons of the second extensor compartment. We report three cases of distal intersection syndrome which differ from usual intersection syndrome.

Elbow Function and Complications after Internal Fixation for Fractures of the Distal Humerus

PURPOSE: To evaluate the functional results of the elbow and the complications after internal fixation for distal humeral fractures. MATERIALS AND METHODS: We reviewed 38 distal humeral fractures; 12 type A, 7 type B and 19 type C by AO classification. There were six low columnar fractures in type A and nine in type C. Six type C fractures were open. The fracture healing and complications were assessed and the functional result was evaluated by rating system of Jupiter et al. RESULTS: Type A fractures were healed in an average of 10.6 weeks, type B 7.7 weeks and type C 11.5 weeks. Ulnar neuropathy occurred in six cases, loss of fixation in two cases, nonunion in one case, heterotopic ossification in one case and traumatic arthritis in one case. The functional result showed excellent or good in 34 cases (89%) and fair or poor in 4 cases (11%). Open fractures showed significantly worse result than closed fractures. CONCLUSION: To obtain the satisfactory results, stable fixation followed by early motion is required in most distal humeral fractures. Ulnar neuropathy occurs postoperatively in high incidence and the result of open fractures is worse than that of closed fractures.