Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures / 대한정형외과학회잡지

PURPOSE: This goal of this study is to evaluate the clinical and radiological outcomes of proximal tibial comminuted fractures treated with medial minimally invasive percutaneous plate osteosynthesis (MIPPO). MATERIALS AND METHODS: We evaluated 43 patients who underwent medial MIPPO from February 2008 to February 2012 and were followed up for more than one year. According to the AO/OTA classification, there were 30 patients of 41-A3 and 13 patients of 41-C2. Thirty-six patients had closed fractures and seven patients had open fractures. We assessed clinical outcomes, radiologic results and postoperative complications. RESULTS: All fractures were united at an average of 18.3+/-8.1 weeks except three patients with nonunion. According to Schatzker and Lambert assessment, excellent results were achieved for 22 patients and good results were achieved for 21 patients. The average tibial plateau angle was 89.1degrees+/-2.7degrees and the average posterior tibial slope angle was 10.5degrees+/-4.6degrees. In assessment of lower limb alignment, the average femorotibial angle was 175.1degrees+/-2.9degrees and the mean deviation of mechanical axis was 46.5%+/-12.7%. In terms of complications, three patients had nonunion, but complete bony union was achieved by autogenous cancellous bone grafting. Seven patients complained of skin irritation around the plate. However, there was no skin necrosis, infection, or limited range of motion in seven patients with skin irritation. CONCLUSION: Medial MIPPO for proximal tibial comminuted fractures provides favorable clinical outcomes and good radiological alignments.

Comparison of Complete Distal Release of the Medial Collateral Ligament and Medial Epicondylar Osteotomy during Ligament Balancing in Varus Knee Total Knee Arthroplasty

BACKGROUND: During ligament balancing for severe medial contracture in varus knee total knee arthroplasty (TKA), complete distal release of the medial collateral ligament (MCL) or a medial epicondylar osteotomy can be necessary if a large amount of correction is needed. METHODS: This study retrospectively reviewed 9 cases of complete distal release of the MCL and 11 cases of medial epicondylar osteotomy which were used to correct severe medial contracture. The mean follow-up periods were 46.5 months (range, 36 to 78 months) and 39.8 months (range, 32 to 65 months), respectively. RESULTS: There were no significant differences in the clinical results between the two groups. However, the valgus stress radiograph revealed significant differences in medial instability. In complete distal release of the MCL, some stability was obtained by repair and bracing but the medial instability could not be removed completely. CONCLUSIONS: Medial epicondylar osteotomy for a varus deformity in TKA could provide constant medial stability and be a useful ligament balancing technique.

Minimally Invasive Percutaneous Plate Stabilization Using a Medial Locking Plate for Proximal Tibial Fractures: Technical Note

Minimally invasive plate osteosynthesis (MIPO) is beneficial for proximal tibial fractures since these injuries are mostly caused by high energy traumas. The advantages of MIPO are minimization of soft tissue dissection and preservation of periosteal vascularization. Lateral plating has mostly developed as MIPO for proximal tibial fractures. We introduce minimal invasive percutaneous plate stabilization using a medial locking plate as alternative treatment for proximal tibial fractures.

The Usefulness of Bone Scan in the Osteoporotic Vertebral Compression Fracture Patients Treated With Kyphoplasty / 대한척추외과학회지

STUDY DESIGN: Retrospective study. OBJECTIVES: To compare the clinical results of kyphoplasty between osteoporotic patients with compression fractures and rib hot uptake on bone scan and patients without rib hot uptake. SUMMARY OF LITERATURE REVIEW: The incidence of osteoporotic rib fractures is 0.3% in postmenopausal women. MATERIALS AND METHODS: Between July 2005 and July 2006, 72 kyphoplasties for osteoporotic vertebral compression fractures were performed, and all patients had a bone scan study. On bone scan study, 41 patients (57.7%) had hot uptake in their ribs. Results were assessed by visual analog scale (VAS). RESULTS: The incidence of hot uptake was 67.8% in thoracic fractures, 40.0% in lumbar fractures, and 72.7% in thoracolumbar fractures. Hot uptake was significantly more common with thoracic and thoracolumbar fractures than with lumbar fractures (p0.05). CONCLUSIONS: Thoracic and multiple osteoporotic compression fractures are often accompanied by rib fractures. Bone scan is a useful tool to detect rib fractures and predict the prognosis of kyphoplasty.

Irreducible Fracture of Calcaneus due to Flexor Hallucis Longus Tendon Interposition: A Case Report / 대한족부족관절학회지

In closed calcaneus fractures, the occurrence of FHL interposition in subtalar joint is relatively rare and difficult to diagnosis preoperatively. But careful physical examination and significant radiologic findings could be useful tools to diagnosis preoperatively. This findings is shearing off a superior medial fragment made up of the sustentaculum talus connected to a significant portion of the medial wall and medial aticular surface of the posterior facet.

Expression of Melanoma Antigen Gene (MAGE) and Synovial Sarcoma on X chromosome (SSX) in Ovarian Tumors

BACKGROUND: Several cancer-testis antigen genes or gene families have been isolated to date, including Melanoma Antigen Gene (MAGE) and Synovial Sarcoma on X chromosome (SSX). This study attempted to investigate the possibility of immunotherapy for ovarian cancer and to explore the prevalence of the expression of MAGE and SSX. METHODS: The fresh tissue samples were obtained from 5 cases of normal ovaries, 6 cases of non-neoplastic disease, 21 cases of benign ovarian tumors, and 12 cases of malignant ovarian tumors. The expression of MAGE A1-6 and SSX 1-9 was detected by nested reverse transcriptionpolymerase chain reaction using each common primers sets for MAGE A1-6 and SSX 1-9. RESULTS: The expression rate of MAGE 1-6 mRNA was 23.0% (5/21) for the benign ovarian tumors and 91.7% (11/12) for the malignant ovarian tumor, whereas the normal ovaries (0/5) and non-neoplastic ovarian tissues (0/6) did not express MAGE (p0.05). A relationship between the two genes was not observed (kappa coefficient=0.32). CONCLUSION: These results suggest that the gene products of MAGE and SSX can be useful for the immunotherapy of ovarian cancer patients and that MAGE can be a more promising target than SSX from the viewpoint of applicability and cancer-specificity.