Risk Factors for Cardiac Implantable Electronic Device-Related Infections

Purpose@#This study aimed to investigate the risk factors for cardiac implantable electronic device (CIED)-related infections within the first post-procedural year after CIED insertion. @*Methods@#This study included 509 adult patients undergoing CIED implantation procedures between January 1, 2011 and December 31, 2015. The data were analyzed by t-test, chi-square test, Fisher’s exact test, and logistic regression analysis using SPSS/WIN 23.0. @*Results@#Fifteen infections and 494 non-infections were examined. The CIED-related infection rate was 2.9%; patients with 14 pocket infections and one bacteremia were included in the CIED-related infection. The risk factors of CIED-related infections were the estimated glomerular filtration rate (eGFR) of ≤ 45 mL/min/1.73 m2 (Odds ratio [OR] = 4.03, 95% confidence interval [CI],1.15-14.10) and taking a new oral anticoagulant (NOAC) (OR = 4.50, 95% CI 1.09-18.55). @*Conclusion@#These results identified the CIED infection rate and risk factors of CIED-related infection. It is necessary to consider these risk factors before the CIED implantation procedure and to establish the relevant nursing interventions.

Hemarthrosis Occurred after Arthroscopic Rotator Cuff Repair in a Chronic Renal Failure Patient with a Stenosis in an Ipsilateral Arteriovenous Fistula / 대한정형외과학회잡지

Hemarthrosis occurring after arthroscopic surgery for lesions of the shoulder joint is a very rare complication that can develop due to an injury to the blood vessels when an anterior portal is formed. This is a complication that rarely develops in patients who are taking antithrombotic drugs or who do not have associated diseases, such as thrombocytopenia. We report a case of hemarthrosis that occurred after performing arthroscopic surgery to repair a rotator cuff tear in a patient with a stenosis in an arteriovenous fistula for hemodialysis in the ipsilateral upper arm.

Delayed Rupture of the Extensor Pollicis Longus Tendon Following Intramedullary Nailing of Radial Shaft Fracture / 대한정형외과학회잡지

Delayed rupture of the extensor pollicis longus tendon mostly occur after plate fixation of distal radius fracture. However, delayed rupture of the extensor pollcis longus tendon following intramedullary nailing of radial shaft fracture is very rare. We report one case of delayed rupture of the extensor pollicis longus tendon following intramedullary nailing, presenting abnormal signs from adhesion of the extensor pollicis longus with extensor indicis at the nail insertion site.

Radiologic Assessment of Postoperative Stability in Unstable Intertrochanteric Fracture Using Lateral Radiograph

PURPOSE: The purpose of this study was to compare the sliding distance of lag screw in patients with unstable femoral intertrochanteric fractures treated with intramedullary fixation using a cephalomedullary nail with a fixed angle between the neck and shaft of the femur in relation to reduction type by lateral radiographs. MATERIALS AND METHODS: Between January 2009 to October 2013, 86 cases (86 patients) with unstable femoral intertrochanteric fractures were treated with intramedullary fixation using a metal nail with a fixed neck-shaft angle and followed for at least 6 months. We used AO/OTA classification, and all cases were unstable fractures. Twenty cases were 31-A22, 54 cases were 31-A23, and 12 cases were 31-A3. There were 30 men and 56 women. Average patient age was 73.7 years (range, 47-97 years). We classified reduction types into three groups as postoperative lateral radiologic findings. Group 1 showed no displacement, group 2 showed anterior displacement of the femur neck, and group 3 showed posterior displacement of the femur neck. The radiological assessment compared the sliding distance of the lag screw between postoperative X-ray and last follow-up X-ray. RESULTS: Forty-two cases were in group 1, 22 cases were in group 2, and the other 22 cases were in group 3. There was no significant difference in the patient characteristics of each group. The sliding distances of the lag screw were 4.9±3.2 mm, 4.6±3.6 mm, and 8.5±4.9 mm, respectively, and group 3 showed a significant result (p<0.0001, p=0.024). CONCLUSION: In cases treated with intramedullary fixation using a cephalomedullary nail with a fixed neck-shaft angle, appropriate reduction with a lateral radiograph before screw fixation is needed to prevent excessive lag screw sliding.

A Case of Gait Disturbance due to Chronic Bilateral Subdural Hematoma Mimicking Cervical Spondylotic Myelopathy / 대한정형외과학회잡지

Cervical spondylotic myelopathy (CSM) is a spinal cord dysfunction involving compression of the vascular and neural structures due to bony spurring or soft tissue hypertrophy in patients with degenerative cervical disorders. It presents initially as subtle gait disturbance with gradual deterioration. An elderly patient presenting with gait disturbance due to spasticity and motor weakness of both lower extremities without mental change can be easily misdiagnosed as CSM. We report on a case of gait disturbance due to chronic bilateral subdural hematoma mimicking CSM.

Milwaukee Shoulder Syndrome in a Eldery Female Patient: A Case Report / 대한정형외과연구학회지

Milwaukee shoulder syndrome is a rare clinical entity that is a rapid destructive shoulder arthropathy associated with deposition of calcium hydroxyapatite crystals. It mainly affects elderly women. It is characterized by the presence of large amount of noninflammatory synovial fluid containing calcium hydroxyapatite crystals, a complete tear of the rotator cuff and progressive degenerative changes at the humeral head, leading to almost complete functional impairment. We present a case of a 65-year-old woman suffered by Milwaukee shoulder syndrome with literature view.