Biodegradable Internal Fixation For Displaced Non: Comminuted Malleolar Fracture / 대한정형외과학회잡지

Displaced fracture of the ankle are probably the most common skeletal injury managed today by open reduction and internal fixation. But, it is recommended that metallic implant might be removed to restore normal biomechanical forces on hone and to reduce discomfort directly under the skin. in order to reduce the resources needed for the removal of metallic fixation devices, absorbable impiants of biodegradable synthetic polymers were deveioped. However reports of clinical application of such implants have so far been very few. This prospective study represents the good resuits in 15 displaced non-comminuted closed malleolar fractures of the ankle treated using hiodegradahle internal fixation in department of orthopedic surgery of Kwang Myung Sung Ae general hospitai from June I 995 to December 1996. The results were as follows 1. All cases were united and the average time for union was 7.6 weeks. 2. As a results of comparison with normal side, a restriction of 10 degrees or more of dorsiflexion of the ankle joint was present in 4 cases, a restriction of 20 degrees or more of plantar tlexion was present in 2 cases, a restriction of supination was present in 3 cases and a restriction of plantar flexion was present in 4 cases. 3. According to Phillips functional scoring scale, 4 cases were excellent, 7 cases good, 4 cases fair and no cases were poor. 4. There were no complications in all cases.

Clinical Analysis of Primary Hyperparathyroidism

Primary hyperparathyroidism is a rare disease that can be accurately diagnosed and effectively treated in most patients. The diagnosis is established by a persistent elevation of serum calcium and parathyroid hormone and by clinical evaluation. With the introduction of a biochemical screening test for calcium and the development of radiologic techniques, the detection of hyperparathyroidism has increased slightly. However, the parathyroidectomy is still not a common operation in Korea.Twenty-eight patients with primary hyperparathyroidism comprised of 14 males and 14 females, were treated by operation from January 1986 to December 1995 at Kyunghee University Hospital and the data were analyzed retrospectively. The results are as follows: 1) The sex distribution was 14 males & 14 females, and the age distribution was from 14 to 79 years. 2) The clincal manifestations were renal symptoms (42.9%), skeletal symptoms (28.6%), a neck mass (10.7%), pancreatitis (7.1%), no symptoms (7.1%), polydipsia (3.6%) in order of frequency. 3) Most of the patients showed hypercalcemia above 11mg/dl, but five patients had calcium levels which were either slightly increased or in the upper normal range . 4) The preoperative localization methods were mainly combinations of sonography, C.T.,and Tl-Tc subtraction scans and showed high sensitivity & specificity (above 90%). 5) The main tumor locations were the Rt. lower pole in 10 cases, the Rt. upper pole in 5 cases, the Lt. upper pole in 3 cases, the Lt. lower pole in 7 cases; there were 2 cases of ectopic location and 1case of hyperplasia at the Rt. upper & the Lt. lower pole. 6) The pathologic findings revealed a solitary adenoma in 25 patients, a carcinoma in two patients, and hyperplasia associated with MEN2a in 1 patient. 7) We experienced one case of recurrence after primary excision at the Rt. lower pole. Reoperation for a missed gland, after the primary operation, was performed in one patient; the excision of the tumor was performed successsfully. 8) We performed surgical excisions and 17 patients showed hypocalcemia postoperatively. Most of the hypocalcemia was transient and disappeared after ingestion of oral calcium agents or usuage of Vit. D3.

A Reconstructive Transbasal Approach to Tumors Involving the Anterior Skull Base

An en bloc bilateral osteotomy of the orbital roofs and frontal sinus for large or deeply situated anterior skull base tumors offers less brain retraction and a wide exposure. The authors describe en bloc bilateral osteotomy of the orbital roofs and frontal sinus, with skull base reconstruction using inner table of the patient's own frontal bone flap. The approach in this report offers the advantage of wide exposure, one-site operation and short operation time.