Removal of Neglected Foreign Body in Upper Extremities

PURPOSE: To describe the clinical manifestations, diagnosis, and treatments in the patients with delayed diagnosis after foreign body injury. MATERIALS AND METHODS: Seventeen patients with foreign body injury, who had delayed diagnosis more than two months, from January 2000 to August 2008, were enrolled in the present study. The clinical manifestation, materials, locations of foreign bodies, and diagnostic methods were assessed in this study. In addition, we investigated the treatment in the all patients. RESULTS: The interval between injury and removal surgery varied from two months to 16 years. The most common clinical manifestations were foreign body sensation and tenderness (13/17). Glasses (9/17), woods (3/17), needles (2/17), and pencil leads (2/17) were the common foreign bodies. In addition, the most common location of foreign body was palm (7/17), followed by finger (4/17) and wrist (3/17). In the major portion of patients (13/17), the diagnosis was made by simple roentgenogram at the time of presentation. Ultrasonogram (US) or magnetic resonance imaging (MRI) was performed in the residual four radiolucent foreign bodies. In the all 17 patients, surgical removal was performed. CONCLUSIONS: A doctor should perform the scrupulous history taking and physical examination when diagnosing injury by foreign body. In patients with history of prior surgical treatment due to laceration or penetration by foreign body, active examination, radiological diagnosis including roentgenogram, US, and MRI, and surgical removal are recommended.

Operative Treatment for Nonunions of Distal Radial Fracture: A Report of 7 Cases / 대한정형외과학회잡지

PURPOSE: To report the treatment results of 7 cases of distal radius nonunion with a review of the relevant literature. MATERIALS AND METHODS: Seven patients treated with an autoiliac bone graft and rigid internal fixation for nonunion of the distal radius were analyzed retrospectively for the cause of injury, the factors affecting nonunion, radiological findings, treatment method and complications. The results were analyzed radiologically using Kreder's method and functionally using the Anderson' protocols. RESULTS: Union was achieved in all cases after a mean period of 19 weeks. The functional result of treatment at the last follow-up was excellent in 4 cases and satisfactory in 3 cases. The probable factors of nonunion were instability of the fracture site in three cases, type II or III open fracture in 2 cases, postoperative infection in one case and idiopathic in one case. CONCLUSION: Infection control using a stepwise operation, rigid internal fixation and autogenous iliac bone graft showed satisfactory results in distal radius nonunion, which had developed in those with severe open fractures, postoperative infection, instability on the fracture site and associated distal ulnar fracture.

Segmental Cystic Disease of the Kidney: A Case Report

Segmental cystic disease of the kidney is a rare form of cystic disease of the kidney that manifests as variable sized, numerous cysts that are localized in a segment of one kidney. Morphologically and pathologically, it is indistinguishable from autosomal dominant polycystic kidney disease except for its unilateral localization, the lack of an autosomal dominant genetic background and the progressive deterioration of the renal function. We experienced a case of surgically confirmed segmental cystic disease of the kidney in a 49-year-old patient and we report on its ultrasonographic and CT findings, along with a brief review of the relevant literature.

Hypotensive Splenic Infarction: A Case Report

Splenic infarction occurs when parenchymal ischemia of the spleen is evoked by an occlusion of the arterial or venous circulation. The most common causes include infiltrative hematological disease and thromboembolic conditions, but a hypotensive splenic infarction may be a rare cause of splenic infarction. A 62-year-old female patient presented with a hypotensive splenic infarction after massive bleeding. CT showed geographic low-density lesions in the central part of the spleen on the tissue equilibrium phase of dynamic CT. Usually, a depressed scar occurs in the course of healing of a splenic infarction. However, in this case recovery of blood flow and regeneration of the infarcted spleen was seen during the follow-up CT scans. We report a case of hypotensive splenic infarction with a review of the literature.

Role of Arm Swing on Gait

OBJECTIVE: The aim of this study was to speculate the role of arm swing during gait through the comparison of energy consumption and kinematic data between the arm restriction and free arm swing METHOD: 20 healthy male adults were recruited as subjects. The kinematic data including upper trunk and oxygen consumption were compared at three different walking speeds (2 km/hr, 4 km/hr, 6 km/hr) between with and without arm restriction. RESULTS: The oxygen consumption rate with arm restriction was significantly increased at fast speed walking (6 km/hr) comparing that without arm restriction. We found the significant difference of anterior-tilt angle, range of motion (ROM) in the coronal and transverse plane of upper trunk, anterior pelvic tilting angle, ROM of pelvis in coronal and transverse plane, maximal flexion angle of hip, ROM of hip in the coronal plane, and the external rotation angle at single support time in the transverse plane of hip between with and without arm restriction at fast walking speed (p<0.05). CONCLUSION: These results revealed that arm restriction while walking resulted in the minimal, significant changes of energy consumption, and kinematic data. Therefore, arm swing on gait was considered to have roles on energy conservation at fast walking, and on getting better limb advancement and stability.

Genu Varum, Both

No abstract available.