Résumé
BACKGROUND: Among the many causes of rotator cuff tears, scapular morphology is associated with the accelerating degenerative process of the rotator cuff. Acromion index (AI) was previously introduced and compared in two populations. METHODS: We enrolled 100 Korean patients diagnosed with full-thickness rotator cuff tears by magnetic resonance imaging and intraoperative arthroscopic findings between January and December 2013. Another 100 Korean patients with an intact rotator cuff tendon identified on magnetic resonance imaging and other shoulder diseases, such as frozen shoulder and instability, were enrolled as controls. We retrospectively compared these 100 rotator cuff tear patients (mean age, 63 years) and 100 controls (mean age, 51 years) in this study. Two independent orthopedic surgeons assessed the AI on radiographs. We performed an interobserver reliability test of the AI assessment, and then compared the AI between two groups. RESULTS: The measurement of the AI showed excellent reliability (intraclass correlation coefficient, 0.82). The mean AI in the rotator cuff tear group was 0.68 and it was significantly different between groups (p<0.001, 95% confidence interval). The AI was not related to tear size. CONCLUSIONS: Our study showed that the AI was an effective predictive factor for rotator cuff tears in a Korean population.
Sujets)
Humains , Acromion , Bursite , Imagerie par résonance magnétique , Orthopédie , Pronostic , Études rétrospectives , Coiffe des rotateurs , Épaule , Chirurgiens , Larmes , TendonsRésumé
PURPOSE: This study aimed at investigating the role of albumin as a boundary lubricant in the lubrication of the Co-Cr femoral head of artificial hip implants by measuring the tribological parameters of the Co-Cr femoral head with Atomic Force Microscope (AFM) techniques. MATERIALS AND METHODS: Samples were prepared from the main wear region of a Co-Cr femoral head from revision hip surgery. Two types of solutions were prepared as lubricants: PBS (Phosphate Buffered Saline) as a control solution and BSA (Bovine Serum Albumin) as a lubricant at concentrations of 10, 20, 30 and 40 mg/ml in PBS solution. RESULTS: There were statistically significant differences in the frictional coefficients (micron) of a Co-Cr head between the PBS control and all the concentrations of BSA (10, 20, 30, 40 mg/ml) (P<0.001). Similarly, there were statistically significant differences for the micron between the BSA concentrations of 10, 20, 30 and 40 mg/m for all the cases except between the BSA of 30 and 40 mg/ml (P<0.01). CONCLUSION: There exists a maximum protein concentration of BSA to play a role as an effective boundary lubricant through adsorption on the surface of Co-Cr femoral head.
Sujets)
Adsorption , Arthroplastie , Friction , Tête , Hanche , LubrificationRésumé
PURPOSE: This study examined the outcomes of closed reduction and fixation of the coracoid process fracture using a suture anchor in a patient with combined acromioclavicular dislocation for which the coraco-clavicular ligament was intact. MATERIALS AND METHODS: A 26 year-old male patient with a coracoid process fracture that was associated with a type III acromioclavicular joint dislocation was operated on with anchor suture fixation. This is the first trial of this operative procedure. RESULTS: At the postoperative follow-up at 3 months, complete union of the coracoid process fracture was seen. The shoulder had a full range of motion and the shoulder function was normal. CONCLUSION: Closed reduction and fixation using one suture anchor for treating coracoid process fracture is a safe, effective procedure.
Sujets)
Humains , Mâle , Articulation acromioclaviculaire , Luxations , Études de suivi , Ligaments , Amplitude articulaire , Épaule , Ancres de suture , Matériaux de sutureRésumé
Acromioclavicular joint injuries usually occur as a result of direct trauma to the superolateral aspect of the shoulder. Roockwood Type IV injuries are relatively uncommon, and they are easily misdiagnosed or neglected in patients who have suffered multiple traumas. Therefore, to correctly treat a patient with type IV injury, we need to take a careful physical examination and conduct proper radiologic evaluation for the acromioclavicular joint. We report here on two cases of modified Weaver-Dunn reconstruction for neglected type IV acromioclavicular joint injuries that were associated with multiple rib fractures.
Sujets)
Humains , Articulation acromioclaviculaire , Articulations , Polytraumatisme , Examen physique , Côtes , ÉpauleRésumé
PURPOSE: This study compared the results of external fixation with those of flexible intramedullary nailing using Ender nails in pediatric femoral shaft fractures. MATERIALS AND METHODS: Twenty-eight children with pediatric femoral shaft fractures were enrolled in the study. The children's ages ranged from 6 to 11 years, and the average period of follow-up was 27.2 months. Fifteen patients underwent flexible intramedullary nailing (FIN) using Ender nails and thirteen patients underwent external fixation (EF). The outcomes were assessed based on the clinical and radiology findings. RESULTS: The healing time averaged 9.8 weeks in the FIN group and 11.2 weeks in the EF group. In the FIN group, one patient suffered pin migration. In the EF group, three patients had a pin site infection, one patient had refracture after removing the external fixator and one patient had pin breakage 8 weeks after surgery. The broken pin was removed and the condition was stabilized with internal fixation using a plate. CONCLUSION: Flexible intramedullary nailing with Ender nails is an effective treatment option for treating femoral shaft fractures in children because it has fewer complications than external fixation does.