Posterior Ring Apophysis Fracture Associated with Lumbar Disc Herniation Treated by Immobile Bony Fragment Excision: A Case Report

STUDY DESIGN: A case report. OBJECTIVES: We report a case of posterior ring apophysis fracture (PRAF) with lumbar disc herniation treated by immobile bony fragment excision. SUMMARY OF LITERATURE REVIEW: PRAF causes severe radiculopathy, so treating with surgery is common. MATERIALS AND METHODS: A 30-year-old male diagnosed with PRAF with lumbar disc herniation was treated with discectomy, but his clinical symptoms were not relieved. Consequently, bony fragment excision, extended laminectomy and interbody fusion were also done. RESULTS: Radicular pain was relieved and showed good clinical outcome. CONCLUSIONS: When treating PRAF, bony fragment excision and extended laminectomy should be considered even if an immobile bony fragment exists.

Result of Surgical Treatment for the Femoral Head Fracture

PURPOSE: This study analyzed the clinical and radiological long-term follow-up results of patients with femoral head fracture who received surgical treatments. MATERIALS AND METHODS: Retrospective evaluation was performed for 20 patients with femoral head fracture who received surgical treatments between December 1997 and May 2010. According to Pipkin's classification, there were five type I, six type II, one type III, and eight type IV fractures. RESULTS: The average Merle d'Aubigne'-Postel score was 12.8 (12.80+/-3.53). According to surgical method, the score for the bony fragment excision group was 9.8 (9.83+/-2.79), and that for the open reduction and internal fixation group was 13.9 (13.92+/-3.07). Depending on Thompson-Epstein criteria, two patients were good, two were fair, and two were poor in the bony fragment excision group. Four patients were excellent, six were good, and three were poor in the open reduction and internal fixation group. CONCLUSION: Bony fragment excision should be performed with caution in patients with femoral head fracture. Considering fragment size, location, and presence of acetabular fracture, better outcome can be expected using the open reduction and internal fixation method in comparison with excision.

New Method for Removing Involuted Bony Fragment in Reduction Angleplasty of Mandible

Oriental women, in general, have prominent mandibular angles and short chins that are thought to be unattractive, square and muscular appearance. Therefore, mandibular ostectomy is one of the most common aesthetic facial bone contouring surgery in oriental and intraoral approach has been used commonly. After the angle ostectomy via intraoral approach, it is not easy for unexperienced surgeons to remove the involuted bony fragment due to the limited view and operation access. This report describes a new method for removal of involuted bony fragment in reduction mandibular angleplasty Thirty eights Case of reduction mandibular angleplasty has been operated from February 2003 to June 2005. We have experienced the involuted bony segment in 12 cases after angle ostectomy. We have adopted periosteal cottle elevator and 18 gauze spinal needle as new methods of extracting the involuted bony fragment. The institutes were used to push the involuted bone segment. We could easily extract the bony fragment with new methods involuted 12 patients mandibular angle within 5 minutes. No major complications were occurred.