ABSTRACT
PURPOSE: This study was conducted for comparison of clinical and second look arthroscopic results between early and delayed reconstruction of acute anterior cruciate ligament (ACL) injuries. MATERIALS AND METHODS: Thirty-six patients who underwent ACL reconstruction between March 2008 and October 2011 were enrolled in this study. We divided the patients into two groups, those in the early reconstruction group underwent surgery before one week, and those in the delayed reconstruction group underwent surgery after three weeks, before six weeks. We checked clinical results and second look arthroscopic results and analyzed correlation of clinical and second look arthroscopic results. RESULTS: At the final follow up, the Lysholm, International Knee Documentation Committee, and Tegner score were not statistically different between the two groups (p=0.173, p=0.154, p=0.109). No difference for the range of motion (p=0.808, p=0.680), Lachman test (p=0.377), and pivot shift test (p=0.894) was observed between the groups. In the results of second look arthroscopy, there was no difference in graft continuity (p=0.936), tension (p=0.944) and synovial coverage (p=0.789). No statistical clinical correlation was observed between clinical and second look arthroscopic results (p>0.05). CONCLUSION: We obtained satisfactory clinical and second look arthroscopic results in both the early and delayed ACL reconstruction groups. Therefore, early reconstruction of ACL performed before one week could be a treatment options for acute ACL injury.
Subject(s)
Humans , Anterior Cruciate Ligament , Arthroscopy , Follow-Up Studies , Knee , Range of Motion, Articular , TransplantsABSTRACT
A 68-year-old woman who suffered from polycythemia vera presented at our clinic with the chief complaints of pain, swelling, and a warm sensation in her left thigh. She had undergone a left bipolar hemiarthroplasty following a hip fracture 24 days prior to this presentation. Her erythrocyte sedimentation rate and C-reactive protein (CRP) levels were elevated. In addition, a postoperative infection was suspected in the 3-phase bone scan; therefore, she received intravenous antibiotic therapy. This approach proved to be ineffective and she was subsequently diagnosed with a deep vein thrombosis via color Doppler ultrasonography. It is interesting to note that a deep vein thrombosis can present with symptoms similar to those of a postoperative infection. Furthermore, an elevated CRP level is frequently observed in patients suffering from polycythemia vera. Therefore, the two conditions, which require completely different treatments, can be confused. We report on this case with a review of the relevant literature.
Subject(s)
Aged , Female , Humans , Blood Sedimentation , C-Reactive Protein , Hemiarthroplasty , Hip , Polycythemia Vera , Sensation , Thigh , Ultrasonography, Doppler, Color , Venous ThrombosisABSTRACT
PURPOSE: This study was performed to compare the clinical results and complications of bipolar hemiarthroplasty and internal fixation using proximal femur nail antirotation (PFNA) for unstable elderly femoral intertrochanteric fractures. MATERIALS AND METHODS: From May 2008 to September 2010, 74 patients older than 65 years who underwent bipolar hemiarthroplasty(33 patients) or PFNA(41 patients) and followed for more than 1 year after surgery were enrolled in this study. The mean blood loss during operation, mean operation time, radiological results, clinical results, and complications were analyzed by the Student t-test and Chi-square test to compare the two groups. RESULTS: The volume of blood loss during the operation was statistically lesser in the PFNA group (P<0.05) and operation time was not statistically different between the two groups (p=0.73). The bipolar hemiarthroplasty group showed a statistically better outcome than the PFNA group in the beginning of weight bearing (p<0.05), the hospital stay (p<0.05). The degradations of Koval score and modified Harris hip score of the bipolar hemiarthroplasty group were statistically better than those of the PFNA group (p=0.03, p=0.02). The bipolar hemiarthroplasty group showed a statistically lower incidence of mechanical(9.1%, p=0.01) and general(12.1%, p=0.00) complications than the PFNA group. CONCLUSION: In elderly patients, bipolar hemiarthroplasty is thought to be one of the effective treatments for unstable femoral intertrochanteric fracutures when considering complications and clinical outcomes.
Subject(s)
Aged , Humans , Femur , Hemiarthroplasty , Hip , Hip Fractures , Incidence , Length of Stay , Nails , Weight-BearingABSTRACT
There are few reports on intraneural ganglion, and this malformations mainly occurs in peripheral nerves of the upper and lower extremities. In the lower extremity, it often occurs in the common peroneal nerve, with neurologic symptoms such as motor weakness and sensory changes. We experienced a case of intraneural ganglion of the common peroneal nerve around the fibular head and this was associated with neurologic symptoms, including weakness of the motor power in the ankle and great toe dorsiflexion and sensory change in the foot dorsum. It was successfully treated by complete excision. We report here on this unusual case and we review the relevant literature.
Subject(s)
Animals , Ankle , Foot , Ganglion Cysts , Head , Lower Extremity , Neurologic Manifestations , Paralysis , Peripheral Nerves , Peroneal Nerve , ToesABSTRACT
Percutaneous vertebroplasty for osteoporotic compression fractures or malignant osteolytic spinal tumors provides pain relief. A pulmonary embolism caused by polymethylmethacrylate migration after this procedure is rare and its major complication, pulmonary infarction, involves necrosis of the lung parenchyme, resulting from interference with the blood supply. We report a case of a large pulmonary embolus (diameter 2 cm) after cement vertebroplasty for an osteoporotic vertebral compression fracture and successful management with anticoagulation only.
Subject(s)
Embolism , Fractures, Compression , Lung , Necrosis , Polymethyl Methacrylate , Pulmonary Embolism , Pulmonary Infarction , Spine , VertebroplastyABSTRACT
PURPOSE: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. MATERIALS AND METHODS: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale)&ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. RESULTS: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). CONCLUSIONS: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.
Subject(s)
Animals , Humans , Ankle , Diaphyses , Fracture Fixation, Intramedullary , Imidazoles , Nails , Nitro CompoundsABSTRACT
PURPOSE: To evaluate risk factors of falls and related injuries for home-staying elderly people in a rural community, and to provide basic data to minimize injuries after falls. MATERIALS AND METHODS: We surveyed for 479 subjects aged 65 or more in the region of two cites of Kyungbuk, and analyzed risk factors of falls, which more divided into intrinsic and extrinsic variables. RESULTS: Of the participants, 219 (45.7%) fell during past year. Most falls occurred during walking (50.2%), on the road (28.8%), at sunset (36.1%), and in winter (44.7%). Of 219 people, 72.6% were injured in falls, 31.5% sustained serious injuries including fractures (14.6%). The lower extremities (35.2%) were most frequently injuried. 14.6% were admitted to hospital. 76.6% who experienced falls were afraid of recurrence, and 39.7% reduced physical activity after falls. CONCLUSION: Up to these days, we have only treated patients who visited hospital, but from now on we must make effort for preventive activity. We suggest that more systemic prevention and study for intrinsic and extrinsic factors of falls are needed to minimize a degree of injury after falls in elderly people.
Subject(s)
Aged , Humans , Lower Extremity , Motor Activity , Recurrence , Risk Factors , Rural Population , WalkingABSTRACT
In this study, I made researches of 510 mothers who breed their infants in total (256 boys & 254 girls), among which 410 in urban area and 100 in the rural area, as an object of the investigation so as to make an intensive examination and analysis of the actual state of feeding nutritive method, grasp several related factors, and finally suggest the elementary data for both campaign encouraging breast feeding and the infant feeding education. 1. Mothers showed the meaningful local differences as in an education and income level at 1% and as in a delivery type at 5%. 2. To have decided the feeding conditions according to the residences by the Kaup index distribution (P<0.05) resulted in a meaningful difference according to regions and also made us be more thoughtful of the overnutrition in the urban area than in the rural area, and it didn't showed a meaningful difference the nutritive state according to the infant feeding method thought desirable (P<0.01). 3. The feeding methods consist of breast feeding at 21.8%, artificial feeding at 48.8%, and the mixed one at 29.4%. As for the feeding method thought desirable, breast feeding was 52%. Even though they were thinking that breast feeding is better, the breast feeding case didn't go beyond 32.5% only and as for the actual feeding methods it showed a meaningful difference according to the feeding method thought desirable (P<0.01). 4. Regarding the reasons why they chose breast milk, it was 64%, the most because mother's milk contains the immune system, 63.1% for the baby's health, 52.3% because of its most because breast milk is of little quantity, 37.8% because of the mother's occupation, 14.1% because they have fed the baby artificially from the beginning and so on. Considering the reasons why they chose the mixed feeding, it was 70.7%, the most because the amount of breast milk a little, 27.3%, the next one, because of the mother's occupation and so on. 5. The respondents who answered that how to increase the number of breast feeding population depends on the reinforcement of breast feeding education for the women were 190 (37.3%), the most among all 150 persons and those who had the opinion that they should spread and actualize the temporary childcare rest (from office) system for the women who have jobs were the secondly most, 107 (21%).