Incidence and Risk Factors of Ipsilateral Foot and Lower Limb Reamputation in Diabetic Foot Patients / 대한족부족관절학회지

PURPOSE: To evaluate the incidence and risk factors of ipsilateral reamputation after lower limb amputation in the patient with diabetic foot lesions. MATERIALS AND METHODS: Between May 2005 and June 2009, 88 patients who underwent lower limb amputation were analyzed. Group 1 consisted of 73 patients who didn't have a ipsilateral reamputation after lower limb amputation and group 2 consisted of 15 patients who underwent reamputation. We compared several factors between two groups, such as age, gender, BMI, ABI, Wagner classification, wound culture, site of amputation, vascular surgery, the period of diabetes mellitus, chronic renal failure. RESULTS: Fifteen (17%) of 88 patients had a ipsilateral limb reamputation and 13 patients (87%) of them underwent reamputation within 6 months. When we compared the two groups, average age was 59.3 (range, 48-74 years); 62.9 (range, 44-78 years). Age was significantly associated with reamputation rate (p=0.02) and no reamputation after initial amputation above ankle joint was found. Other factors did not show statistically difference between both groups. CONCLUSION: There were no significant difference between diabetic limb amputation and reamputation group in our concerned risk factors except age and amputation level. There should be careful consideration when determine level of amputation in diabetic foot lesions especially in elder patients.

Multiple Bilateral Thoracic Perineural Cysts: A Case Report

STUDY DESIGN: Case report OBJECTIVES: We report a case of relatively rare multiple bilateral perineural cysts. SUMMARY OF LITERATURE REVIEW: Tarlov cysts, also known as perineural cysts are most often found in the sacral region, but there are a few cases reported in the thoracic region. In particular, there are very few cases of multiple bilateral thoracic perineural cysts. MATERIALS AND METHODS: A woman aged 65 years with perineural cysts in the bilateral T10-T11 and T11-12 neural foramens, underwent a T10-11-12 decompressive laminectomy and resection of the cyst. RESULTS: Satisfactory results were obtained for the patient after surgery. CONCLUSIONS: For more detailed and definitive treatment of thoracic perineural cysts, additional cases are required.

Treatment for the Lumbosacral Soft Tissue Defect after Spine Surgery

The lumbosacral area is one of the most frequently operated spine regions because of the prevalence of disease in that area. Although a lumbosacral soft tissue defect after surgery due to inflammation and other causes is rare, such soft tissue defects are difficult to treat. Therefore, suitable methods for treating lumbosacral soft tissue defects are necessary. Therefore, this study introduces a case-treated with a transverse lumbosacral rotational flap.

Multiple Noncontiguous Fractures in Cervical Spine: Cases Report

STUDY DESIGN: Cases report OBJECTIVES: We report 2 cases of relatively rare cervical fracture. SUMMARY OF LITERATURE REVIEW: Although numerous studies in the literature have investigated cervical spine injuries, patients with multiple-level cervical fractures have not been commonly described. Multiple non-contiguous cervical fractures are distinctively unusual. MATERIALS AND METHODS: First case was a girl aged 8 years and 4 months who had multifocal compression fracture of C3, 5, 6 & T7, 8 without spinal cord injury. Second case was a thirty nine-year-old female who had Type I Hangman's fracture and compression fractures of C3, 7. RESULTS: We had satisfactory results of them treated nonsurgically. CONCLUSIONS: We should remind that cervical spinal column can incur multiple injuries in variant patterns.

Total Ankle Replacement in Pigmented Villonodular Synovitis of Ankle Joint (A Case Report) / 대한족부족관절학회지

Pigmented villonodular synovitis (PVNS) is a rare proliferative disease affecting joint synovium, tendon sheaths, bursae. The usual treatment for PVNS is a surgical excision. If destructive joint lesions have occurred, complete resections must be performed followed by arthrodesis or arthroplasty. We report a case of a pigmented villonodular synovitis involving an ankle joint which was treated by total ankle replacement for recurrence after simple synovectomy.

Posterior Instability after Posterior Cruciate Ligament Substituted TKA: Case Report / 대한정형외과학회잡지

Posterior instability after a posterior ligament substituted total knee replacement is considered impossible due to the cam and post mechanism. Therefore, it has not been considered easily as a problem necessitating revision surgery. We report two cases of posterior instability after a fixed bearing posterior cruciate ligament substituted total knee replacement with a review of relevant literature.

Anthropometric Study of Distal Femur & Compatibility of Gender Knee Prosthesis in Total Knee Replacement

PURPOSE: The new prosthesis was introduced for female recently considering anthropometric differences of distal femur between male and female. We evaluated the anthropometric measurements of distal femur and compatibility of gender knee prosthesis in total knee replacement . MATERIALS AND METHODS: The candidates were 100 female patients who underwent total knee replacement. We measured the size of resection site which was divided into 6 areas after resection of femur. According to this result, we made a decision which prosthesis would be better fit. Group 1 was whom gender knee prosthesis was used in and group 2 was whom conventional knee prosthesis was used in. RESULTS: Gender knee prosthesis was used in 58cases out of 100 cases (58%). There were significant differences in measurements between group 1 and 2 except anterior flange lengths (p<0.05). Gender knee prosthesis was chosen in 33.4% of size C, in 57.4% of size D, in 70.4% of size E. There were less than 5% discrepancies of width between components and femur. The larger the femur, the lesser the ML/AP ratio. CONCLUSION: Conventional knee prosthesis is adequate to who has smaller distal femur and gender knee prosthesis is adequate to who has larger distal femur in total knee replacement. It is thought that we may select gender knee prosthesis considering the size of femur intraoperatively.

Arthroscopic Stabilization of Acromioclavicular Joint Dislocation using TightRope(R)

PURPOSE: The proper surgical methods for treating acromioclavicular joint dislocation is still controversial. New methods should provide better early motion with sufficient strength. MATERIALS AND METHODS: We performed arthroscopic stabilization using TightRope(R) (Arthrex, Inc, Naples, FL) in 10 cases of acromioclavicular joint dislocation between April, 2007, and December, 2007, and followup for a minimum of 10 months. We performed radiologic evaluation by comparing the clavicle anteroposterior radiograph with the contralateral one. Clinical evaluation was made for pain, function, and range of joint motion by Imatani's methods. RESULTS: In clinical evaluation, 6 cases were excellent, 3 cases were good, and 1 case was poor. In radiologic evaluation, 9 cases were excellent and 1 case was poor. Redislocation occurred in 1 case. CONCLUSION: During short-term followup, 9 of 10 patients who underwent arthroscopic stabilization using TightRope(R) had excellent results in Imatini tests and radiologic evaluation, except 1 patient with redislocation.

Dislocation of Tibial Insert after Fixed Bearing TKA using Minimal Invasive Surgery: A Case Report

Posterior instability after mobile bearing total knee replacement may be caused by gap imbalance, component malpo- sition, and delayed rupture of posterior cruciate ligament, but could not be easily considered other cause except component breakage in fixed bearing posterior cruciate substituted total knee replacement. The dislocation of tibial polyethylene insert was reported after mobile bearing total knee replacement but rare after fixed bearing total knee replacement. We report a case of dislocation of tibial polyethylene insert that have been found at a patient who had continuing posterior instability after fixed bearing posterior cruciate ligament substituted total knee replacement with a review of article.

The Treatment of Failed Kidner Procedure for Adolescent Prehallux: A Case Report / 대한족부족관절학회지

Cause of flexible flat foot is predominantly idiopathic but pediatric flexible flatfoot is typically congenital. Neuromuscular disorders, tarsal coalition and prehallux are possible causes and there has been a controversy for diagnosis and surgical treatment guideline. Therefore we present 11-year old male with prehallux and flexible flat foot who was treated with Kidner procedure and subtalar arthroereisis using Kalix endoprothesis and reported good clinical outcome at 2-years follow up postoperatively.