Résumé
PURPOSE: We analyzed outcomes after management of enchondroma involving short tubular bones of the hand and foot by curettage and grafting using allogenic bone or bone substitutes. MATERIALS AND METHODS: Twenty-two patients (allogenic bone 15 and bone substitutes 7 patients) were recruited. Clinical results were assessed by pain, cosmetic problem, range of motion of joint and the power of grasp. Radiographic outcomes were analyzed by degree of bone defect. RESULTS: Clinically, 19 patients were classified as excellent and 3 patients as good. Three patients with K-wire fixation had pain with local irritation, which was easily controlled by removal of the K-wires. There were no complications including deep infection, delayed or nonunion, refracture. Radiographically, 20 cases were classified as group 1 (bone defect smaller than 3 mm) and the 2 remaining cases were classified as group 2 (bone defect 4-10 mm). CONCLUSION: Curettage and graft using allogenic bone or bone substitute is an effective modality of treatment for enchondroma involving short tubular bones of the hand and foot. When combined with pathologic fracture, early surgical management could shorten duration of immobilization. Surgical management might be considered for the lesion involving the foot when discovered because of high incidence of pathologic fracture.
Sujets)
Humains , Substituts osseux , Chondrome , Curetage , Pied , Fractures spontanées , Force de la main , Main , Immobilisation , Incidence , Articulations , Amplitude articulaire , TransplantsRésumé
BACKGROUND: Many shoulder diseases are related to glenohumeral joint synovitis and effusion. The purpose of the present study is to detect effusion within the biceps long head tendon sheath as the sign of glenohumeral joint synovitis using ultrasonography, and to evaluate the clinical meaning of effusion within the biceps long head tendon sheath. METHODS: A consecutive series of 569 patients who underwent ultrasonography for shoulder pain were reviewed retrospectively and ultimately, 303 patients were included. The authors evaluated the incidence and amount of the effusion within the biceps long head tendon sheath on the ultrasonographic short axis view. Furthermore, the authors evaluated the correlation between the amount of effusion within the biceps long head tendon sheath and the range of motion and the functional score. RESULTS: The effusion within the biceps long head tendon sheath was detected in 58.42% of the patients studied: 69.23% in adhesive capsulitis, 56.69% in rotator cuff tear, 41.03% in calcific tendinitis, and 33.33% in biceps tendinitis. The average amount of the effusion within the biceps long head tendon sheath was 1.7 +/- 1.6 mm, and it was measured to be the largest in adhesive capsulitis. The amount of effusion within biceps long head tendon sheath showed a moderate to high degree of correlation with the range of motion, and a low degree of correlation with the functional score and visual analogue scale for pain in each type of shoulder disease. CONCLUSIONS: The effusion within the biceps long head tendon sheath is closely related to the range of motion and clinical scores in patients with painful shoulders. Ultrasonographic detection of the effusion within the biceps long head tendon sheath might be a simple and easy method to evaluate shoulder function.
Sujets)
Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Amplitude articulaire , Études rétrospectives , Articulation glénohumérale/physiopathologie , Synovite/imagerie diagnostique , Tendons/imagerie diagnostiqueRésumé
As the healthcare environment has changed both socially and politically importance of public health doctors' roles has increased and ongoing revision of their roles is also needed in Korea. However, many problems have decreased the job satisfaction of public health doctors. This study aims to determine the factors that influence public health doctors' satisfaction. The survey was conducted over the course of 2 months by questionnaire methodology. A total of 881 respondents (response rate, 90.1%) participated and 778 valid responses were analyzed using SAS version 9.1. Items about arranged organization, work task, employee welfare and services, education, public health doctor's system, and the role of public health doctors were included in the questionnaire. It was found that the satisfaction of many respondents was not high and they had negative perceptions of arranged organization, work, environment, employee welfare and services, education, system, and their own role. Although the public health doctors have professional knowledge of healthcare, they were not satisfied with their role because they were required to do inappropriate work, improperly arranged and found performing work difficult when treated unfairly or not paid fairly. Therefore, policies focused on financial compensation or system improvement must be established to increase the satisfaction of public health doctors. This study's limitation was that the survey was done through two modalities. However, it is meaningful that issues related to the public health doctors were dealt with more comprehen-sively in this study than other studies.