ABSTRACT
PURPOSE: Kimura's disease is an uncommon benign lymphoproliferative inflammatory disorder with an unknown etiology. The recurrence rate after surgical excision is relatively high and renal involvement is its only systemic manifestation. The condition mainly involves the head and neck, and peripheral involvement is extremely rare. MATERIALS AND METHODS: We encountered the case of a 28-year-old man who had a non-tender mass with mild brownish skin color changes and pruritus around the medial side of the distal arm and elbow. RESULTS: The peripheral blood investigation revealed peripheral eosinophilia and elevated serum IgE levels. Magnetic resonance imaging showed an isointensity signal relative to the muscle on the T1-weighted images and hyperintensity signal relative to the muscle on the T2-weighted images. CONCLUSION: A marginal resection of the lesion was performed and there was no recurrence at 2 years postoperatively.
Subject(s)
Adult , Humans , Arm , Elbow , Eosinophilia , Head , Immunoglobulin E , Magnetic Resonance Imaging , Muscles , Neck , Pruritus , Recurrence , SkinABSTRACT
PURPOSE: To compare the outcomes between T-locking compression plate (T-LCP) and external fixator (EF) for unstable distal radius intraarticular fractures. MATERIALS AND METHODS: We retrospectively analysed the results in 22 cases with T-LCP, 20 cases with EF. We evaluated the clinical results according to the Mayo Wrist Scoring System, radiographic results. RESULTS: The mean score was 84.6 in the T-LCP group and 80.5 in the EF group respectively. Final radiographic measurements for the T-LCP group averaged 10.5 mm radial length, 21.7degrees radial inclination, 9.8degrees volar tilt and 0.25 mm intraarticular step-off. The EF group averaged 10.1 mm radial length, 20.3 degrees radial inclination, 6.3 degrees volar tilt and 0.73 mm intraarticular step-off. CONCLUSION: Both groups showed satisfactory final clinical outcomes. But T-LCP group allowed return to daily living, resulting in early postsurgical wrist motion. By the anatomical reduction, final volar tilt, intraarticular step-off were statistically better in the T-LCP group.
Subject(s)
External Fixators , Radius , Retrospective Studies , WristABSTRACT
PURPOSE: The purpose of this study was to introduce a new surgical technique and to evaluate the preliminary results after operative treatment with using TightRope(R) for treating acute acromioclavicular joint dislocation. MATERIAL AND METHODS: We studies 10 patients who were followed up for more than 6 months after operative treatment with using an TightRope(R). A longitudinal incision approximately 4cm in length was made from 1cm medial to the acromioclavicular joint to the coracoid process, and then coracocalvicular ligament augmentation using TightRope(R) was done after splitting the deltoid. For postoperative stability, two 1.6 mm Kirschner wires were inserted temporarily across the acromioclavicular joint in all cases. The radiologic results on the serial plain radiographs and the clinical results according to the UCLA score were analyzed. RESULTS: Radiologically, 7 cases showed anatomical reduction, 2 cases showed a slightly loss of reduction and 1 case showed partial loss of reduction. Clinically, 6 cases were excellent, 3 cases were good and 1 case was fair. CONCLUSION: Coracoclavicular ligament augmentation using TightRope(R) for treating acute acromioclavicular joint dislocation is a minimally invasive, safe procedure that provides satisfactory radiologic and clinical preliminary results. Yet the long-term results have to be analyzed to determine the final results of this procedure.
Subject(s)
Humans , Acromioclavicular Joint , Bone Wires , Joint Dislocations , LigamentsABSTRACT
PURPOSE: To analyze the correlation of various factors by examining the epidemiology of lateral condylar fracture of the humerus which is the second most fracture among elbow fractures in children. MATERIALS AND METHODS: Of 158 cases treated for lateral condylar fracture of the humerus in children from April 1996 to March 2006, their age and sex distribution, the seasonal frequency, etiology, type of fracture, method of treatment, etc. were analyzed retrospectively. RESULTS: Boys were 113 cases, girls were 45 cases, and the mean age was 5.4 years. Regarding the seasonal occurrence, spring 43 cases, summer 44 cases, autumn 48 cases, and winter 23 cases had occurred. It occurred preferentially during the season when outdoor activity was most active. As its etiology, the accident in a playground was 39 cases, sports activity was 32 cases, traffic accident was 17 cases, slipping accident at home was 15 cases, falling accident at home was 14 cases, slip while playing with friends was 6 cases, a missing step while walking on stairs was 6 cases, fall from a height more than 2 floors was 4 cases, and the cases with unknown cause were 25 cases. According to the Jakob stage, the stage I was 42 cases, the stage II 77 cases, and the stage III was 39 cases. As treatment, cast immobilization was performed in 34 cases, closed reduction and percutaneous K-wire fixation was performed in 68 cases, and open reduction and K-wire fixation was performed in 56 cases. The prevalent causalities were play devices, accident during sports activity, and traffic accident, and in such cases, the displacement of fracture was severe and thus surgical treatments were performed in many cases (94%). CONCLUSION: It is thought that during the season when outdoor action is active, particularly, for kindergarten children or the lower grade primary school children, safety education is required to prevent the fracture by play devices, sports activity and traffic accident.
Subject(s)
Child , Female , Humans , Accidents, Traffic , Education , Elbow , Epidemiology , Friends , Humerus , Immobilization , Retrospective Studies , Seasons , Sex Distribution , Sports , WalkingABSTRACT
Although vascular injury after clavicular fracture is a extremely rare, it is a complication which is serious problem. Vascular injury associated with the fracture can be immediate or delayed. We report a case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture and include a review of the literature.
Subject(s)
Brachial Artery , Cicatrix , Subclavian Artery , Subclavian Steal Syndrome , Vascular System InjuriesABSTRACT
PURPOSE: To compare the roentgenographic results between Image-free navigation system-assisted total knee arthroplasty (TKA) using the OrthoPilot(R) and conventional TKA. MATERIALS AND METHODS: Of 120 primary TKA that operated by one surgeon, 60 cases were operated with a Image-free navigation system (OrthoPilot(R) 4.0, Aesculap, Tuttlingen, Germany) (group A) and 60 cases were operated with conventional method (manual alignment system) (group B). The alignment of the lower extremity and the position of the components were determined on postoperative long-leg standing anteroposterior radiogram and lateral radiogram. RESULTS: Mechanical axis was significantly more accurate in group A than group B(95% compared with 80%). The coronal inclination of femoral component to mechanical axis (theta) was significantly more accurate in group A than group B(96.7% compared with 80%). There were no significant differences between two groups in the sagittal inclination of femoral component(gamma), the coronal inclination of tibial component (beta) and the sagittal inclination of tibial component(delta). In all five measurements being excellently implanted, a significantly higher number was in group A(60% compared with 40%). CONCLUSION: Image-free navigation system-assisted TKA using the OrthoPilot(R) led to significantly increased precision of restoration of the alignment of the lower extremity and the position of the components compared with the conventional method. Potential benefits in long-term outcome and functional improvement require further investigation.
Subject(s)
Arthroplasty , Axis, Cervical Vertebra , Knee , Lower ExtremityABSTRACT
PURPOSE: To evaluate clinical and radiographic results associated with the use of autogenous bone graft with preservation of cortical bone in the patients with severe bone defect of the proximal medial tibia in total knee arthroplasty. MATERIALS AND METHODS: From January 2000 to June 2003, thirty three primary total knee arthroplasty were performed with autogenous bone graft for severe peripheral defect of the proximal medial tibia. After sclerotic bone of defect site was removed by the burr, reconstruction of medial wall was done by use of resected bone, which was fixed by wedge-shaped bone. Autogenous cancellous bone was grafted in the central type bone defect area. We reviewed the result using the HSS knee rating scores and observed the radiographic changes. RESULTS: The mean HSS knee rating score was 43.5 preoperatively and was 91.3 at last follow-up. Radiologically, union of the tibial bone grafts were impossible to determine, but there were no evidence of the displacement of grafted bone, osteolysis and loosening of the inserted implants. CONCLUSION: The method of autogenous bone graft applied with preservation of cortical bone and wedge bone graft could be supposed as useful in the reconstruction of the tibial bone defects as well as in the stability of the tibial component.
Subject(s)
Humans , Arthroplasty , Follow-Up Studies , Knee , Osteolysis , Tibia , TransplantsABSTRACT
PURPOSE: To assess clinical difference between total knee replacement (TKR) performed with tourniquet and diluted adrenine infiltration without tourniquet. MATERIALS AND METHODS: We analyzed the postoperative transfusion amount, intraoperative blood loss, operation time, range of motion and postoperative thigh pain in 60 cases. 30 cases (group I) were performed TKR with tourniquet and the others (group II) were performed TKR using diluted adrenaline (2.5mg of 1:1000 epinephrine diluted in 500 ml of normal saline) infiltration without tourniquet. Closed suction drainage was not used in all patients. RESULTS: In gruop I, the intraoperative blood loss was average 407.6 ml, pre- and postoperative hemoglobin average 12.6 and 9.4 g/dl, postoperative transfusion average 1.83 unit, operative time average 116.5 minutes and range of motion (at preoperative, at 7days and 6 weeks after the operation) average 116.3 degrees, 90.7degrees and 103.4degrees. In group II, the intraoperative blood loss was average 398.2 ml, pre- and postoperative hemoglobin average 13.1 and 9.7 g/dl, postoperative transfusion amount average 1.76 unit, operative time average 118.3 minutes and range of motion average 113.6 degrees, 89.2 degrees, and 105.7degrees. But average postoperative thigh pain score was significantly higher in group I (average 3.7) than group II (average 0.9). CONCLUSION: There was no significant difference in intraoperative blood loss, pre- and postoperative hemoglobin, postoperative transfusion amount, operative time and range of motion between the two groups. But we could decrease the thigh pain after TKR, not using the tourniquet.
Subject(s)
Humans , Arthroplasty, Replacement, Knee , Epinephrine , Operative Time , Range of Motion, Articular , Suction , Thigh , TourniquetsABSTRACT
PURPOSE: To evaluate the midterm result of patients who underwent rotational acetabular osteotomy for the treatment of acetabular dysplasia. MATERIALS AND METHODS: The clinical and radiographic outcomes of 36 patients, who underwent rotational acetabular osteotomy between January 1987 and September 1998, were evaluated after a minimum followup of five years. The mean follow-up period was 8.6 years. The clinical evaluation included recording the level of pain, the ambulation status and range of motion according to the d'Aubigne and Postel system. Radiographic analysis included the C-E angle of Wiberg, the acetabular roof obliquity, and arthritis grade of Tonnis. RESULTS: The average Postel score increased from 12.5 points preoperatively to 15.7 points at the final follow up. All the radiologic indices improved after surgery. In five hips (13.1%), there was a progression of arthritis prior to surgery. CONCLUSION: Rotational acetabular osteotomy is a valuable procedure for preventing the progression of early osteoarthritis in patients with a dysplastic hip. However the results were unsatisfactory for hips with more advanced osteoarthritis.
Subject(s)
Humans , Acetabulum , Arthritis , Follow-Up Studies , Hip Joint , Hip , Osteoarthritis , Osteotomy , Range of Motion, Articular , WalkingABSTRACT
PURPOSE: To assess the mode of a polyethylene liner failure in total hip replacement using a Harris-Galante II acetabular component. MATERIALS AND METHODS: A retrospective review was performed and 128 consecutive primary total hip arthroplasties were analyzed in 111 patients who had a second-generation Harris-Galante cup. All patients were followed up for a minimum of five years, with a mean follow up of 7.4 years (range, 5 to 12.9 years). A total of 26 cups (20.2%) were revised at the time of the latest follow up. The medical records, radiographs, surgical notes, and retrieved components were analyzed in order to determine the precise causes of the revision. RESULTS: Twenty-two cases (17.3%) were found to have experienced problems with the polyethylene liner. Three types of liner failure were identified; metallosis associated with polyethylene liner wear (14 cases), excessive wear without metallosis necessitating a revision (6 cases), and polyethylene liner dissociation without gross evidence of wear (2 cases). CONCLUSION: This study find that polyethylene liner failure is the main cause of the revision of this component. Early surgical intervention needs to be performed before fatal metal damage occurs in order to avoid metallosis, and severe bone stock damage in cases of excessive polyethylene wear.
Subject(s)
Humans , Acetabulum , Arthroplasty , Arthroplasty, Replacement, Hip , Follow-Up Studies , Hip , Medical Records , Polyethylene , Retrospective StudiesABSTRACT
PURPOSE: To assess the clinical comparison of closed suction drainage group and non drainage group after simultaneous bilateral total knee arthroplasty MATERIALS AND METHODS: We analyzed the thigh circumference, ecchymosis, wound infection, transfusion amount, knee score and range of motion in 100 cases(50 patients) done with PFC or PFC-sigma model between 1998 and 2000. Fifty cases of them(group I) were inserted hemo vac and the others(group II were not inserted hemo vac. RESULTS: The average thigh circumference in group I was 42.9 cm (preooperative), and 46.1cm (postoperative), in group II was 43.7 cm (preoperative) and 47.6 cm(postoperative). The knees that had no drains had a higher incidence of ecchymosis. However, the final result of knee score and range of motion of knee joint were not affected significantly by nonuse of closed suction drainage. There were no infection sign in both groups. CONCLUSION: The clinical comparison of closed suction drainage group and non drainage group after simultaneous bilateral total knee arthroplasty was not significantly different in wound healing, clinical and rehabilitation course. The use of suction drainage must be carefully selected after primary total knee arthroplasty.
Subject(s)
Arthroplasty , Drainage , Ecchymosis , Incidence , Knee Joint , Knee , Morinda , Range of Motion, Articular , Rehabilitation , Suction , Thigh , Wound Healing , Wound InfectionABSTRACT
PURPOSE: The aims of this review were to evaluate the usefulness of arthroscopy and to study of different types of knee pathology in children under 15 years old. MATERIALS AND METHODS: From January 1980 to January 2000, we retrospectively reviewed and analyzed 31 children (38 knees) under 15 years old, were performed arthroscopy at our department The use-fulness of arthroscopy was assessed by relating the prearthroscopic diagnosis to the intraarthroscopic findings. The procedure was classified as "not useful "when no additional information was obtained, "useful "when a doubtful diagnosis was confirmed and additional information was obtained, and "very useful "when a totally different diagnosis was reached and the cases of internal derangement. RESULTS: Total 46 lesions of 38 knees were found in arthroscopic finding. Most frequent pathology was meniscal lesions (26 cases), next were ligament injury (6 cases). Arthroscopy was found to be very useful, useful, not useful in 40%, 16%, 44%, respectively of children. CONCLUSION: In this study, the most common arthroscopic findings are meniscal lesions (57%). 56% of all cases were classified as useful and very useful. Overall, arthroscopy is an effective diagnostic and therapeutic tool that can be used safely in children.
Subject(s)
Adolescent , Child , Humans , Arthroscopy , Diagnosis , Knee , Ligaments , Pathology , Retrospective StudiesABSTRACT
PURPOSE: To know the discrepancy of rotational alignment using human femur. MATERIALS AND METHODS: We used 22 adult human femurs which were not able to distinguish age and sex and absent articular cartilage. In a horizontal plane, we made a cross-section perpendicularly at supra-condyle of femur to a mechanical axis and took a simple roentgenogram in coronal plane focusing on the center of transepicondylar axis. In terms of roentgenogram and gross specimen, the angle between per-pendicular to the anteroposterior axis and the posterior condylar axis, the angle between the transepi-condylar axis and the posterior condylar axis were measured by 5 observers. According to t-test in statisti-cal method, we figured out the difference between two angles and made a significance at p<0.05. RESULTS: About posterior condylar axis, the line perpendicular to anteroposterior axis was observed the average 4.8(+/-1.5)degree, 6.0(+/-1.9)degree external rotation in roentgenogram and gross specimen respectively. The transepicondylar axis was observed the average 3.5(+/-1.2)degree, 3.9(+/-1.4)degree external rotation in roentgenogram and gross specimen respectively. There was statistically significant difference between two angles. Moreover, angles measured by 5 observers were found that to have a line perpendicular to the anteroposterior axis has much more external rotation respectively and there was a statistically significant difference also. CONCLUSIONS: On determination of a rotational alignment using human femur, there is statistically sig-nificant difference between the anteroposterior axis and the transepicondylar axis in gross specimen as well as roentgenogram.
Subject(s)
Adult , Humans , Axis, Cervical Vertebra , Cartilage, Articular , FemurABSTRACT
The purpose of this study is the present the short rerm result of arthroscopic reconstruction for PCL injury. Since January l990, authors have implanted the synthetic polyester ligament (ABC ligament, Surgicraft, U.K) into the substance of ruptured PCL proper under arthroscopic control. The follow up period ranged from 24 months to 61 months (average,35months). The main cause of injuries were traffic accidents in 38. Thirtyfive of patient were men and three were women, range in age from 18 to 70 years (average, 37 years). 18 were acute injury and operated at average 12 days after injury and 20 knee were chronic injury and operated at average 9 months after injury. There were 25 case that had combined ligament injuries (l2 ACL injury, ]0 MCL injury, 8 LCL injury elc). In 15 knees, the tear was in the mid substance area and in 13 it was near femoral attach site and in lO it was near tibial attach site. Postoperative result were evaluated by roentgenographic evaluation of posterior sagging, KT-20 (0 arthrometer and Lysholm knee score. Difference were improved from 12.5 mm (mean: pre.op) to 3.8m (mean: post.op) on posterior drawer test. Both knee showedminimal difference on KT-20N) study (2.l mm on 201b) at the time of follow up. The average Lysholm knee score were 84.7. By Clancy criteria, the result were exceflent 9 case (24%), good in 20 case (53%), fair in 7 case (18'Po) and failui e in 2 case (5%). On based of this study, arthroscopic augmentation with ABC ligament in PCL injury is very effective treatment but more longer follow-up and more case must he needed to accept this method.
Subject(s)
Female , Humans , Male , Accidents, Traffic , Follow-Up Studies , Knee , Ligaments , Polyesters , Posterior Cruciate LigamentABSTRACT
No abstract available.
ABSTRACT
No abstract available.