ABSTRACT
Spinal dural arteriovenous fistulas are rare abnormal connections of arteries and veins on the surface of the dura. A male presenting with myelopathy, which had a slowly progressive course for about 28 months, was diagnosed by magnetic resonance imaging and selective angiography. After surgical coagulation and excision, his symptoms were mildly improved. We report here on a man who underwent a surgical procedure for his myelopathy that was due to spinal arteriovenous fistula. Although it is unusual, spinal arteriovenous fistula should be considered when making a differential diagnosis of myelopathy.
Subject(s)
Humans , Male , Angiography , Arteries , Arteriovenous Fistula , Central Nervous System Vascular Malformations , Diagnosis, Differential , Magnetic Resonance Imaging , Spinal Cord Diseases , VeinsABSTRACT
Lipoma is the most common soft tissue tumor, but among the rarest tumors of the bone. The first case, reported by Cornil and Renvier in 1868 was a lipoma in the diaphysis of the femur. In Korea, 12 cases of intraosseous lipoma have been reported. A 42-year-old woman presented with a radiolucent lesion that was well marginated, lobulated, and had a sclerotic border by radiographic findings of the proximal humerus taken after a traffic accident. Magnetic resonance imaging and biopsy were performed for diagnosis. Histologically, the lesion was compatible with intraosseous lipoma. Intralesional curettage with a bone graft was performed. No recurrence was evident at the 1 year follow-up. We report a case of intraosseous lipoma that arose in the proximal humerus and include a review of the literature.
Subject(s)
Adult , Female , Humans , Accidents, Traffic , Biopsy , Curettage , Diagnosis , Diaphyses , Femur , Follow-Up Studies , Humerus , Korea , Lipoma , Magnetic Resonance Imaging , Recurrence , TransplantsABSTRACT
There has been considerable controversies in the method of the treatment of dislocation of the acromioclavicular joint, especially in grade III injury. It is hard to give a direct firm repair having a short ruptured coracoclavicular ligament. Thats why there are lots of difficulties in the treatment. Therefore, in operative treatment, the authors make use of cotton tape on coracoid process and clavicle as a reconstructive technique, because we have thought a simple fixation of acromioclavicular joint adding to a firm fixation of clavicle and coracoid process is inevitable. From January 1991 to December 1995, twenty-nine cases of grade III acromio-clavicular dislocation were treated by the modified Phemister method with using the cotton tape. Twenty-four patients were followed for an average of fifteen months and the following results were obtained. 1. The clinical results were evaluated by Weitzman criteria after average fifteen months follow up. An excellent result was obtained in 19 cases (79.2%), a good result in 3 cases (12.5%) and a fair result in 2 cases (8.3%), consecutively. 2. Clinical result in patients over 60-year old were bad. 3. The comparison of the coracoclavicular interval ratio before surgery with that after surgery facilitated the evaluation of effectiveness of the coracoclavicular ligament reconstruction. 4. The operative technique is through temporary fixation using K-wires which endows horizontal stability, and it fixes clavicle and coracoid process using cotton tape which endows vertical stability.
Subject(s)
Humans , Middle Aged , Acromioclavicular Joint , Clavicle , Joint Dislocations , Follow-Up Studies , LigamentsABSTRACT
PURPOSE: The purpose of this study is to illustrate MR patterns of signal intensity of proximal femur in normal subjects according to the age distribution. METHOD AND MATERIAL: Tl-weighted MR images of the proximal femur in 125 subjects, aged 13 days to 25 years, were retrospectively analyzed. Age distribution was classified to 4 groups;below 4 months, 5 months to 4 years, 5 years to 14 years, and 15 years to 25 years. RESULTS: By the age of 4 months, the non-ossified femoral epiphysis was seen as intermediate-signal-intensity cartilage. At 5 months-4 years, the ossified fernoral capital epiphysis was seen within intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow surrounded by a rim of low-signal-intensity cortical bone. At 5-14 years, the ossified femoral capital and greater trochanteric epiphysis were seen within the intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow. At 15-25 years, the proximal metaphyseal marrow showed increased signal intensity. Four patterns of the metaphyseal marrow were recognized by Ricci et al. The frequency of pattern la progressively decreased with age. Pattern 2 and 3 were visible in the 15-25 years age group. CONCLUSION: An understanding of the spectrum of normal age-related change of the proximal femoral cartilage and marrow patterns serves as the foundation for interpretation of proximal femur pathologies.
Subject(s)
Humans , Age Distribution , Bone Marrow , Cartilage , Epiphyses , Femur , Magnetic Resonance Imaging , Pathology , Retrospective StudiesABSTRACT
False aneurysm has been recognized for many years. Incomplete severance of an artery as the result of trauma is thought to be the precipitating factors in the formation of false aneurysm. False aneurysm of the peripheral artery is presented with pulsating mass and may show extrinsic indentations of the adjacent bone with or without neurovascular symptoms, mimicking a malignant tumor. But careful history taking can reveal a proceeding deep penetrating injury variable period prior to development of symptoms. We are reporting two cases of false aneurysm of the superior gluteal artery and superficial femoral artery in each after trauma.
Subject(s)
Aneurysm, False , Arteries , Femoral Artery , Precipitating FactorsABSTRACT
No abstract available.
ABSTRACT
No abstract available.
ABSTRACT
Pronation-external rotation ankle fractures are divided into four stages by Lauge-Hansen who placed the individual components of an ankle injury in their correct sequence in time so that, when the end point is represented by a fracture, the presence of intermediary ligament injuries may be inferred. Pronation-external rotation stages 3 and 4 injuries have severe soft tissue injuries and may be too difficult to reduce with closed method and to maintain with plaster immobilization. They also require attention because of a high level fraeture of the fibula and rupture of all ligaments of the syndesmosis or a avulsion fracture of their bone insertion. If anatomical reductions and rigid internal fixations were not performed. the results were worse than other types of ankle injuries. We reviewed the results of 31 patients with pronation external rotation ankle fractures who were followed from 18 months to 7 years. All cases were managed with open reduction and internal fixation with a plate, a screw or screws, a tension band wiring and multiple K-wires. All patients were treated and followed at the Department of Orthopaedic Surgery, Keimyung University, School of Medicine, Daegu, Korea and their results were rated on a clinical and roentgenological basis. The results obtained from this study were as followings:1. Most of the patients were in the age range between 20 and 39 (64.7% ) and 58.1% of the injuries occured in traffic accidents. 2. A plating considered as an effective method to obtain maintenance of appropriate anatomical reduction and rigid internal fixation of the distal fibula was used. 3. The accuracy of the reduction affected the degree of the arthrosis in long term follow-up. 4. A degree of initial displacement is considered as one of the important factors affecting the clinical results. 5. 80.7% were rated good to excellent.
Subject(s)
Humans , Accidents, Traffic , Ankle Fractures , Ankle Injuries , Ankle , Fibula , Follow-Up Studies , Immobilization , Korea , Ligaments , Methods , Pronation , Rupture , Soft Tissue InjuriesABSTRACT
Most proximal humeral fractures respond satisfactory to simple conservative treatment. But operative treatment is recornmended in the cases that poor results are anticipated by prolonged immobilization, or because of the severe displacement and comminution. After Neer. in 1970, emphasized the need for operative treatment in displaced proximal humeral fractures, many papers reported better results with the operative management. Twenty five cases of displaced fractures and fracture dislocations of the proximal humerus treated at the department of orthopaedic surgery, Keimyung University with open reduction and internal fixation were analyzed clinically and radiologically. The following results were obtained. 1. The prevalent age distribution was the second snd third decades(average 42.6 years) and ratio of male and female was 2.1: 1. 2. In 10 of the 25 cases, wire loop was used for internal fixation, and the result was satisfactory in 8 cases. However, the disadvantage was difficulty in wire removal after bony union because the loop was buried in the callus or cortex. 3. Over-all results were excellent or satisfactory in 64% of 25 cases. There were 4 excellent and 1 satisfsctory in 5 cases of type Il fracture, 7 excellent, 2 satisfactory and 3 unsatisfactory in 12 cases of type III fracture, 1 excellent and 4 unsatisfactory in 5 cases of type 1V fracture, and 1 excellent, 1 unsatisfactory and 1 failure in 3 cases of fracture dislocation. 4. In 6 patients with four part lesions treated with open reduction and internal fixation and followed up for an average of 23 months(from 18 months to 3 years and 2 months), only one case of fracture dislocation revealed avascular necrosis with resorption of the head.
Subject(s)
Female , Humans , Male , Age Distribution , Bony Callus , Joint Dislocations , Head , Humerus , Immobilization , Necrosis , Shoulder FracturesABSTRACT
A study on the population density of crayfish intermediate hosts and infestation status of crayfish with encysted larvae of Paragonimus westermani in Ulchin county, Kyungpook province, Korea was conducted from May to October in 1986. The population density of the crayfish ranged from 1 to 13, with an average of 4 per manhour. Among the six habitats, Ducheon had a somewhat higher density than that of the others. Of eight hundred and seventeen crayfish examined, 127 or 15.5 per cent harboured the metacercarial larvae of Paragonimus westermani. The majority of the larvae were found in three parts of the body: most frequently in the cephalothorax, next in the gills, and then in the liver. The average number of metacercarial larvae per infected crayfish ranged from 1.0 to 1.9, with an average of 1.7. Summarizing the results, this study indicates that the population density of crayfish intermediate host and infestation rates for the crayfish with encysted larvae of Paragonimus westermani in Ulchin county of Kyungpook province is relatively high.
Subject(s)
Paragonimus westermani , Metacercariae , EpidemiologyABSTRACT
The fat embolism is a complication which occurs rarely in cases of long bone of lower extremity and pelvic bone fractures or after severe injury of soft tissue, and may result in an embolism in the lungs, brain, heart, kidneys and other important vessels when fat globules flow from bone marrow into such areas. There has been much adverse criticism about the pathogenesis of fat embolism including the incidence, diagnosis and treatment of it, and studies on this subject have been prevalent in recent years. The following results have been obtained through the study of 9 cases of fat embolism at the Department of Orthopaedic Surgery, Dong San Medical Center, Keimyung University during the period from 1973 to 1984. 1. By sex and age distribution, most of the patients were under the age of 40 and there were more male than female patients. 2. Seven cases were caused by traffic accidents and two were caused by falls accompanied by multiple fractures of the femur and pelvic bone. 3. Symptoms generally occured within 48 houres after trauma, however some cases were within 12 houres, some were 5 days and others 12 days. Clinical symptoms which were present at the time admission revealed increased erythrocyte sedimentation tates and decreased hemoglobin and platelete in most cases. Bilateral infiltrates and cotton ball appearances were found in all cases on thoracic radiology, but no fat globules were found in the urine or in frozen sections of clotted blood. 4. Blood gas analysis was performed in 4 cases and Pa02 under 60mmHg found in all cases increased gradually after treatment. 5. Of the 9 cases with fat embolism 6 cases completely recovered and three cases expired.
Subject(s)
Female , Humans , Male , Accidental Falls , Accidents, Traffic , Age Distribution , Blood Gas Analysis , Blood Platelets , Blood Sedimentation , Bone Marrow , Brain , Clinical Study , Diagnosis , Embolism , Embolism, Fat , Femur , Fractures, Multiple , Frozen Sections , Heart , Incidence , Kidney , Lower Extremity , Lung , Pelvic BonesABSTRACT
The Subtrochanteric fracture requires long period healing time and is difficult for treatment because it occurs in bone that is predominantly cortical and high stress concentrates in this region. The Subtrochanteric fracture is difficult for the reduction and maintenance because many of these fractures are comminuted from high velocity trauma and the angulation rotation occurs by the influence of the surrounding large and powerful muscles. During the period of February, 1980 to April, 1985, 62 cases of Subtrochanteric fractures were admitted and treated at the Department of Orthopedic Surgery, School of Medicine, Keimyung University, and results were obtained as follows: 1. Of 62 cases, 42 in man and 20 in woman and diffuse in ages. 2. Causes of Subtrochanteric fractures were 32 cases of traffic accidents, 21 cases of fall or slip down, 5 cases of others, and 3 cases of pathologic fractures. 3. Of 62 cases, Type I by Zickel classification was predominant (33 cases), and Type III-A, “three-part spiral fracture“ by Seinsheimer was predominant (24 cases). 4. The better results can be achieved through the bone graft in severe comminuted fracture and through the provision of good cortical load-bearing medially between the fragment during the reduction and fixation. 5. Earlier bone union and low complication of metallic failure and nonunion were achieved with Compression Hip Screw rather than Jewett nail. 6. The causes for the 6 metallic failure cases were comminuted fracture of medial cortical bone, failure in contact and fixation of medial free fragment, and weight bearing before complete union was achieved. 7. There was a breakage in nail-plate junction when Vitalium jewett nail was used. Also there were breakage and loosening of screws when Stainless steel Jewett nail was used. 8. Further studies in the advantages and disadvantages of Zickel nail, Ender nail, Compression Hip Screw, and Kuntscher nail treatment of subtrochanteric fracture are needed.
Subject(s)
Female , Humans , Accidents, Traffic , Classification , Clinical Study , Femur , Fractures, Comminuted , Fractures, Spontaneous , Hip , Hip Fractures , Muscles , Orthopedics , Stainless Steel , Transplants , Weight-BearingABSTRACT
Synovial chondromatosis is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue which disintegrates into the joint and continues to grow. Of the eight cases of synovial chondromatosis seen by the authors, three cases involved the knee, two of these were bilateral, three cases involved the elbow, one the hip joint and one the proximal phalanx of the right middle finger. The diagnosis of synovial chondroamtosis was made by histopathological findings of the excised mass. Most synovial chondromatosis cases obtained favorable results by removing masses from the joint and at the same time performing a partial synovectomy, except one case in which degenerative arth ritis had developed proeoperatively.
Subject(s)
Cartilage , Chondromatosis, Synovial , Connective Tissue , Diagnosis , Elbow , Fingers , Hip Joint , Joints , KneeABSTRACT
Dupuytren's contracture is characterized by progressive fibroplasia and contracture of palmar fascia with resultant deformity of hands and fingers. Recently it has been shown that the cellular element, called myofibroblast, contributes significantly in the process of contracture. Among the 6 patients we have seen during the last few years, there was a total of 9 hands with Dupuytren's contracture. Seven of these were treated by a partial fasciectomy or by a dermofascietomy with a full thickness skin graft and the results of these two procedures were compared. Electron microsconic studies were done in 3 of the 6 patients and myofibroblasts were found in 2 of them.
Subject(s)
Humans , Biopsy , Clinical Study , Congenital Abnormalities , Contracture , Dupuytren Contracture , Fascia , Fingers , Hand , Myofibroblasts , Skin , TransplantsABSTRACT
A buttonhole deformity of the finger is characterized by flexion of the pmximal interphalangeal joint and hyperextension of the terminal interphalangeal joint. When the central slip of the extensor tendon and the triangular ligament are ruptured,(or severed) on the base of the middle phalanx, buttonhole deformity will result.This article is based on clinical and follow up studies of 5 patients with buttonholedeformities. Five cases were treated by the modified Littler method and were followed from 4 months to 24 months postoperatively and good results were obtained in all cases.
Subject(s)
Humans , Congenital Abnormalities , Fingers , Follow-Up Studies , Joints , Ligaments , Methods , TendonsABSTRACT
The majority of fractures of the distal humerus in adults involves the articular surface and also shows the shape of T or Y type and comminuted fracture, this type of fracture is rare in human fractures. The fracture of the distal humerus occurs more frequently in adults than children and has more complications and is more difficult to treat. There are various rnethods of treatments. The Orthopedic Surgery dept of Keimyung Univ. School of medicine has carried out the follow-up studies among 26 cases of inpatients with comminuted fractures, of the distal humerus (who have been admitted to the hospital) from the period beginning Jan, 1978 to May, 1983, and the results are as follows: 1. There were more frequently occured in male (53.8%), and mean age was 43.5 years. 2. There were no bilateral fractures and more common in right side (57.7%) 3. Traffic accidents were the most frequent cause (46.1%), followed by slipping down(38.5%), falls from height, and athletic injuries. 4. The Tyte IIl (50.0%) was most common by Riseborough and Radin classification followed by the order of type IV, type II and type I . 5. In the case of operative treatment, the duration of immobilization took a shorter period than with conservative treatment and the former showed a relatively good prognosis. 6. Better prognosis was obtained by using K-wire fixation, especially in the case of severe comminuted type IV fracture.