RESUMEN
Traumatic dislocation of the peroneal tendon is an infrequent injury. This injury is caused by forceful dorsiflexion of the foot accompanied by a powerful contraction of the peroneal muscles. This mechanism of injury tears the superior peroneal retinaculum and allows the tendons to snap anteriorly. We experienced a case of chronic recurrent dislocation of the peroneal tendon, which was treated by bone block surgery using autograft of lateral fibula and reattachment of the superior peroneal retinaculum. The clinical result was satisfactory.
Asunto(s)
Autoinjertos , Luxaciones Articulares , Peroné , Pie , Músculos , TendonesRESUMEN
PURPOSE: Carpal tunnel decompression with limited one-incision technique has been reported that it is possible to achieve a sufficient decompression without significant complications. We evaluated the clinical effectiveness of this method. MATERIALS AND METHODS: Forty-two cases of twenty-eight patients of carpal tunnel syndrome were retrospectively evaluated, which were treated with limited one-incision technique less than 2 cm in length, from January 1997 to September 1999. RESULTS: According to Cseuz's criteria, 36 cases (85.7%) were excellent or good. CONCLUSION: Carpal tunnel decompression with limited one-incision technique can provide sufficient decompression with small skin incision. It is not necessary of special eqipment. It has less copmplications and no difference of clinical results comparing with classic open method or endoscopic method. Therefore, this method can be a good method in the surgical treatment of carpal tunnel syndrome. But this method can't be performed in the patient with abnormal anatomical structure or tumorous conditions in carpal tunnel and complication rates are not zero. Therefore operator should pay attention to the selection of patients and the technique.
Asunto(s)
Humanos , Síndrome del Túnel Carpiano , Descompresión , Estudios Retrospectivos , PielRESUMEN
STUDY DESIGN: The lumbar segmental motions were analysed in asymptomatic volunteers. OBJECTIVES: To obtain normative data on flexibility and Graf's instability degree in sagittal plan of the normal lumbar spine. SUMMARY OF LITERATURE REVIEW: Although several clinical and radiological measurement tech niques are available, little is known about the normal range of lumbar spine motion. As a consequence, the diagnostic evaluation of radiographs are frequently based on subject opinions rather than object reality. MATERIALS AND METHODS: The authors have checked lumbar flexion-extension Yiews of 95asymptomatic volunteers who were divided into 5 groups by the age, and then their flexibility and Graf's instability degree were calculated by Graf's method with using Graf/Bar Mark II(digitalizing table) and personal computer program(RachisR). Evaluation of the sexual difference and comparison of the difference of each age group in spine level were done RESULTS: 1. There were significant differences in flexibility among age groups(p0.05). 3. Graf's instability degree was not different among 5 age groups(p>0.05), and between male and female(p>0.05). 4. The mean Craf's instability degree was below 8o in L2-3, L3-4, and L4-5 segment, but above 8 in L5-S1 segment(male: 11.62+/-9.27 , female. 11.11+/-8.70). CONCLUSIONS: Although we observed small subjects, these results are the basic steps toward more objective and careful interpretation of flexibilty and Graf's instability degree.
Asunto(s)
Femenino , Humanos , Masculino , Microcomputadores , Docilidad , Valores de Referencia , Columna Vertebral , VoluntariosRESUMEN
Meralgia paresthetica is a syndrome of pain or dysesthesia, or both, of the anterolateral thigh caused by entrapment or metabolic neuropathy of the lateral femoral cutaneous nerve. Many cases of meralgia paresthetica have been presented for a century. We have experienced a case of meralgia paresthetica which was misdiagnosed as lumbar radicu- lopathy at other hospital, of a 53-year-old man who had developed painful paresthesia and dysesthe- sia of the anterolateral thigh caused by soft tissue tuberculosis of oblique abdominal muscles just proximal to the lateral inguinal ligament where the lateral femoral cutaneous nerve passes. We report a case of unilateral meralgia paresthetica secondary to soft tissue tuberculosis with review of literatures because it has not previously been reported.
Asunto(s)
Humanos , Persona de Mediana Edad , Músculos Abdominales , Ligamentos , Parestesia , Muslo , TuberculosisRESUMEN
It had been reported by many authors that the incidence of delayed or nonunion in fracture of clavicle was higher in open reduction and internal fixation than conservative treatment. The purpose of this study is to verify the gratification of the reconstruction plate in fracture of clavicle which needed internal fixation. From March 1993 to September 1995, 32 clavicular fractures were underwent open reduction and internal fixation with reconstruction plate for the wide gap, soft tissue interposition and comminuted fracture etc. The results were as follows 1. The range of motion of the shoulder was returned to normal range within 1.5 weeks except one case who had brachial plexus injury. 2. All cases had bony union. Average time to clinical union was 2.9 weeks and the bony union 7.8 weeks. 3. By functional evaluation of shoulder by Weitzman, final results were excellent in 27, good in 4 and fair in l. 4.Fixation and maintenance of clavicular fragment by reconstruction plate was recommendable for wide separated, soft tissue interposed, comminuted fracture of the clavicle. We concluded that reconstruction plate in fracture of clavicle could be recommended as one of the device for internal fixation.
Asunto(s)
Plexo Braquial , Clavícula , Fracturas Conminutas , Incidencia , Rango del Movimiento Articular , Valores de Referencia , HombroRESUMEN
We have treated the open tibia shaft fractures, especially Gustilo type II, with unreamed interlocking intramedullary nail. In cases combined with soft tissue damage around fracture site, maintaining rigid internal fixation and preserving endoosteal blood supply is important in union of fracture and soft tissue healing. We have analyzed 18 cases of Gustilo type II open tibial shaft fractures managed with intramedullary nailing without reaming since 1991, the follow-up period was average 22 months. Most of the fractures were the result of moderate to high-energy trauma. In all 18 cases, nails were inserted via closed method. Static interlocking nailing was used in all cases. In 16 cases, union of the fracture was achieved from 16 to 25 weeks(average 23 weeks). In the other 2 cases, union was achieved in 7 months. There was no serious postoperative complication except one skin infection with skin defect managed by skin flap and one failure of the interlocking screw. These results are comparable with those obtained from other forms of fixation, including immobilization with a cast, reamed intramedullary nailing, and external fixation.
Asunto(s)
Estudios de Seguimiento , Fijación Intramedular de Fracturas , Inmovilización , Métodos , Complicaciones Posoperatorias , Piel , TibiaRESUMEN
There are many difficult problems of reduction and its maintaining in the treatment of unstable intertrochanteric fractures. Especially, in cases of elderly patients with marked osteoporosis, prolonged immobilization brings more serious complication. In order to solve these problems, in cases of unstable intertrochanteric fractures with large lesser trochanteric fragment, we have carried out anatomical reduction and rigid internal fixation with compression hip screw and additional transfixation screw on posteromedial fragment. The unstable fractures have been convrted into the stable fractures by transfixation screw. We analyzed the 1 1cases with additional transfixation screw and they showed good results in one year follow up.
Asunto(s)
Anciano , Humanos , Fracturas del Fémur , Fémur , Estudios de Seguimiento , Fracturas de Cadera , Cadera , Inmovilización , OsteoporosisRESUMEN
The main goal of spinal surgery using implant is a rigid fixation to provide the stability until solid fusion will occur. Recently, various implant fixation devices have been introduced and transpedicular screw fixation is the usual method. In the past, we obtained the implant-related complications like screw failure and rod breakage after using the modified Harrington rod. However, we obtained good results after follow up over one year using TSRH instrument. We experienced spinal surgery using TSRH instrument in 42 cases since 1991 and followed from one year to 28 months with average 16 months. We analyzed the 28 cases and evaluated the implant-related problems. The results were as follows: 1. Among 28 patients, 10 patients were operated due to fracture and 9 patients operated due to spinal stenosis. 2. The male patients were 16 cases and the female were 12 cases. 3. The TSRH instruments provided the rigid fixation with three points clamping mechanism. 4. The cross-linking plate of TSRH was found to increase stiffness and strength. 5. There were no case of screw breakage. 6. In functional results by Kirkaldy-Willis; foriteria the excellent cases were 15, and the good were 2 cases.
Asunto(s)
Femenino , Humanos , Masculino , Constricción , Estudios de Seguimiento , Métodos , Estenosis EspinalRESUMEN
Aneurysmal bone cyst uncommonly involves the pubic bone and tends to grow eccentrically and thin out overlying cortex. In the following case report, a 19-year-old male patient visited out hospital, because of dull pain in his left groin. He was diagnosed as aneurysmal bone cyst originated from the superior pubic ramus by CT guided needle biopsy. Transcatheter arterial embolization was effective in the treatment of this lesion such as complete consolidation after the procedure. At present, 2 years follow-up, no problem was noted at weight bearing as well as hip function or recurrence.
Asunto(s)
Humanos , Masculino , Adulto Joven , Aneurisma , Biopsia con Aguja , Quistes Óseos , Estudios de Seguimiento , Ingle , Cadera , Hueso Púbico , Recurrencia , Soporte de PesoRESUMEN
These days, the epidural administration. of morphine is commonly used for postoperative pain re lief because even small amount of morphine (3mg) is enough to have an effect on specific opiates receptors of the spinal canal. We report a prospective double blind study of the efficacy of a single epidural dose of morphine on pain after spinal decompression. Postoperative pain was assessed by a linear analogue pain score and by the additional require ment for systemic analgesics. The results obtained are as follows:l. In spinal decompression, the adminitration of epidural morphine is easy, effective and safe because the epidural space has been already exposured during operation. 2. After operation the epidural route of morphine administration will give pain relief for up to 12 hours excellently. 3. When epidural morphine is given at the time of operations, the use of systemic analgesics is much reduced. 4. The side effects of epidural morphine are much reduced due to the small amount of morphine required. This simple procedure is recommended as an effective and safe method of reducing postoperative pain.
Asunto(s)
Analgesia , Analgésicos , Descompresión , Método Doble Ciego , Espacio Epidural , Métodos , Morfina , Dolor Postoperatorio , Estudios Prospectivos , Canal MedularRESUMEN
Gaucher's disease is an uncommon metabolic disorder, which was first described by Gaucher in 1882, characterized by accumulation of distinctive Gaucher's cells in the reticuloendothelial system such as spleen, liver, and bone marrow. The great majority of cases have been reported in Jews, and others in negros and orientals. We are presenting two cases in homozygous twins in Korea, whose clinical manifestations are hepatosplenomegaly and bone lesions due to expansion of involved bones.
Asunto(s)
Humanos , Población Negra , Médula Ósea , Enfermedad de Gaucher , Judíos , Corea (Geográfico) , Hígado , Sistema Mononuclear Fagocítico , Bazo , GemelosRESUMEN
Clavicle fractures are frequently seen with the recent increase in traffic and industrial accidents. Recently, in adults, open reduction and internal fixation techniques are commonly performed for the patient to return earlier to their jobs. But internsl fixation technique for clavicle fractures has been a subject of controversy. We operated on 78 cases of fractures of the middle third of clavicle by the technique of intramedullary threaded Steinmann pin fixation from March 1985 to Nov. 1988. The following results were obtained. 1. The funtional results were excellent; 32 cases(41%), good; 41 cases(53%), fair ; 5 cases (6%). 2. The complications include motion limitation ; 5 cases(6%), pin tract infection ; 5 cases (6%), delayed union ; 1 case(1%) 3. The advantages of intramedullary threaded Steinmann pim fixation are as follows. 1) Early active range of motion is possible. 2) The operation procedure is simple to perform. 3) Removal of the pin is easy without anesthesia. Therefore, intramedullary threaded Steinmann pin fixation is thought to be a good operative technique for the clavicle fracture.
Asunto(s)
Adulto , Humanos , Accidentes de Trabajo , Anestesia , Clavícula , Rango del Movimiento ArticularRESUMEN
Injuries to the ligament, bone and other supporting structures of the knee joint have a tendency to increase becsuse of the increasing traffics, popularity of sports and industrial accidents. It is well known that the knee joint is burdened on motion and weight bearing and structurally it is more frequently injuried than other joints. When there is injury to the knee, it is frequently combined with injury to ligaments and other supporting structures rather than pure tibial condyle fracture. There remains a residual instability of the knee joint because of neglecting of the injured ligaments if treatment is concerned only with tibial condyle fracture. To obtain complete recovery from the injury, early diagnosis, prompt treatment and well planned exercise are important. Thirty patients with ligaments injury and tibial condyle fracture who were treated at the Depsrtment of Orthopaedic Surgery of Wallace Memorial Baptist Hospital from 1983 to 1987 have been reviewed. Through combined operative and conservative treatment, excellant and good results were obtained in 93% of the cases.
Asunto(s)
Humanos , Accidentes de Trabajo , Estudio Clínico , Diagnóstico Precoz , Articulaciones , Articulación de la Rodilla , Rodilla , Ligamentos , Protestantismo , Deportes , Soporte de PesoRESUMEN
Acromioclavicular joint injuries are frequently seen with the recent increase of traffic and industrial accidents. The treatment of complete separation of the acromioclavicular joint has been, and is still, a subject of controversy. In view of a recent trend, anatomical reduction of acromioclavicular joint, and rigid internal fixation method is preferable, especially in type 3 injury. We operated on 16 cases of complete acromioclavicular separation by the technique of coracoclavicular wiring from March 1983 to Feb. 1987. The following results were obtained. 1. The functional results were excellent; 12 cases(75%), good; 3 cases(19a%), and fair ; 1 cases(6%). 2. The complications include wire reakage ; 1 case(6%), bony erosion ; 3 cases(19%) and subluxation, 1 case(6%). 3. The advantages of coracoclavicular wiring. 1) Avoids violation of acromioclavicular joint but does not restrict rotation of the clavicle. 2) The operation is simple to perform. 3) Postoperative immobilization is minimal. 4) Removal of the wire is easy under local anesthesia. 5) This method corresponds to the coracoclavicular ligment biomechanically. Therefore, coracoclavicular wiring is thought to be a good operative method in the treatment of complete acromioclavicular separation.