Comparison of the Results between Cadaveric and Radiological Measurements of Calcaneus / 대한족부족관절학회지

PURPOSE: We wanted to compare the results between cadaveric and radiological measurements of calcaneus. MATERIALS AND METHODS: Sixty three calcaneus of 33 cadavers donated between December 2012 and December 2014 were actually measured. Computed tomography (CT) images of 244 calcaneus in 122 patients of the same age group with cadavers were radiologically measured. Maximum length, maximum width, maximum height, Bohler angle, Gissane angle, Fowler-Phillip angle, and tala-articular angle were measured. RESULTS: In cadaveric measurement, the mean maximal height, length, and width were 41.8+/-3.3 mm, 73.3+/-3.4 mm, and 40.7+/-2.2 mm, respectively. In radiological measurement, the mean maximal height, length, and width were 38.5+/-4.3 mm, 74.0+/-5.7 mm, and 44.7+/-1.4 mm, respectively. In cadaveric measurement, the mean Bohler angle, Gissane angle, Fowler-Phillip angle, and tala-articular angle were 32.1degrees+/-6.2degrees, 110.8degrees+/-8.1degrees, 55.8degrees+/-6.8degrees, and 59.7degrees+/-4.6degrees, respectively. In radiological measurement the mean Bohler angle, Gissane angle, Fowler-Phillip angle, and tala-articular angle were 32.6degrees+/-3.8degrees, 113.7degrees+/-5.7degrees, 62.2degrees+/-3.9degrees, and 61.6degrees+/-6.3degrees, respectively. The mean maximal height was significantly higher in the cadaveric measurement group (p<0.001) and the mean maximal length and width were significantly higher in the radiologic measurement group (p<0.001, p<0.001). The mean Gissane angle, Fowler-Philip angle, and Bohler angle were significantly higher in the CT group (p=0.001, p<0.001, p=0.016, respectively). There was no significant difference in the mean tala-articular angle (p=0.352). CONCLUSION: Significant differences in length parameters were observed between the cadaveric measurement group and the radiologic measurement group. However, no significant differences in angular measurements were observed between the two groups. The authors carefully conclude that radiological measurement values may be different from actual values in the calcaneus.

Failure of Reduction for Ankle Fracture-Dislocation Caused by Tibialis Posterior Tendon Interposition: A Case Report / 대한족부족관절학회지

Fracture and fracture-dislocation of the ankle may be caused by a variety of mechanisms. In addition to the fracture, injury of soft tissue such as ligaments, tendons, nerves, and muscles may occur. Among these, tibialis posterior tendon injury is difficult to identify due to swelling and pain at the fracture site. There is no clear finding in radiological examination, therefore, it is found during surgery. In this case, irreducible fracture-dislocation of the ankle due to tibialis posterior tendon interposition was observed after the primary operation. The authors obtained satisfactory results in performance of a secondary operation assisted with arthroscopy.

The Fate of Butterfly Fragments in Extremity Shaft Comminuted Fractures Treated with Closed Interlocking Intramedullary Nailing

PURPOSE: For conservative treatment of shaft fractures, the butterfly fragments that were somewhat larger in the closed intra-medullary (IM) nailing. The results of treatment were monitored using radiography separately for the weight-bearing femur and non-weight-bearing humerus. MATERIALS AND METHODS: 27 from Group I and 31 from Group II. In the two groups, the displacement and angulation changes in the fragments, and the degree of improvement of these two factors, were compared using follow-up radiography. RESULTS: The mean angulation of fragments in Groups I and II were 9.2degrees and 9.6degrees, and the mean degree of displacement of the fragments in Groups I and II were 16.7 mm and 21.2 mm, respectively. Follow-up radiography showed that the above factors improved in both groups. The degree of displacement was significantly lower in the normal cases than in the complicated cases (p=0.001). CONCLUSION: Displacement and angulation gradually improved in both groups. It was found that the degree of displacement after the initial reduction is more important than the influence of anatomical position or weight bearing. This indicates that care should be taken when inserting IM nails to prevent displacement or angulation.

A Case of Kartagener's syndrome combined with congenital nystagmus / 대한이비인후과학회지

Primary ciliary dyskinesia results in characteristic clinical symptoms, including chronic pansinusitis, recurrent infections of the respiratory tract, and infertility. Kartagener's syndrome is clinically distinguishable by the presence of situs inversus from this group of diseases. Other otolaryngological manifestations of primary ciliary dyskinesia which have been reported include otitis media with effusion, tympanosclerosis, keratosis obturans, and chronic cholesteatoma. Congenital nystagmus is another otological symptom characterized by ocular oscillation, which usually appears in the early infancy, and is often associated with visuosensory abnormalities. Recently, we experienced a 13 year-old boy with congenital nystagmus in addition to all other manifestations of Kartagener's syndrome. Although the clinical implication is not clear, it is possible that two diseases share the same developmental abnormality.

A Case of Acquired Transient Laryngomalacia Associated with Diabetic Ketoacidosis / 대한이비인후과학회지

Collapse of epiglottis during inspiration is an unusual cause of upper airway obstruction. It is usually classified as a congenital anomaly but several acquired cases have been reported to occur in patients who have lost pharyngeal airway support by head injury and coma. Recently, we experienced a case of laryngomalacia that was associated with diabetic ketoacidosis and compromised the airway. A tracheotomy was first needed to maintain the respiration, then conservative management including diabetes control was enough to restore the patient's condition. This case supports the neuromuscular dysfunction theory which purports laryngomalacia as its cause.