Spinal Arachnoid Cyst: Treated with Pars Osteotomy and Recapping Laminoplasty: Report of 5 Cases / 대한척추외과학회지

Spinal arachnoid cysts are a rare disease with an unknown origin. Because of their broad base, a total laminectomy with or without fusion has been the treatment of the choice. We encountered 5 patients with a spinal arachnoid cyst who were treated by recapping laminoplasty after pars osteotomy. This procedure has not been reported in Korea. All patients showed neurological recovery with no recurrence of the cyst. The findings on the stressed plain film confirmed bony union and stability of the posterior element.

Surgical Treatment of Partial Closure of Growth Plate: Physeal Bar Resection and Free Fat Graft / 대한정형외과학회잡지

PURPOSE: To evaluate the results of physeal bar resection and free fat graft as a treatment method for partial epiphyseal closure. MATERIALS AND METHODS: Thirteen cases of partial epiphyseal closure (4 of the distal femur, 8 of the distal tibia and one of the distal radius) were subjected to physeal bar resection. All of the cases were caused by trauma. The physeal bar was central in 3 cases, peripheral in 9, and mixed (central-peripheral) in 1. Mean patient age at surgery was 10.7 years and mean follow-up period was 47 months. Final results were evaluated by a modified Williamson-Staheli classification. RESULTS: Results at final follow-up were as follows: 6 satisfactory (3 excellent and 3 good) and 7 unsatisfactory (5 fair and 2 poor). Satisfactory results according to location and region of the physeal bar were as follows: distal tibia, 5 of 8 cases; distal femur, 1 of 4; central, 1 of 3; peripheral, 4 of 9; and mixed, 1 of 1. When considered by areal extent, physeal bars occupying 30% or less of the bone's cross-sectional area showed satisfactory results in 5 of 7 cases, while in 6 cases with the physeal bar over 30%, 5 were unsatisfactory. CONCLUSION: Accurate preoperative evaluation of the size and type of the physeal bar, and meticulous surgical technique, are important predictors of satisfactory outcome of physeal bar resection. Cases where the physeal bar extent exceeded 30% had mostly unsatisfactory results.

Treatment of Distal Radius Fractures Using the Percutaneous K-wire Reduction-Fixation and External Fixator

PURPOSE: To analyse the results of treatment of unstable intra-articular distal radius fractures using the percutaneous K-wire reduction-fixation and external fixator. MATERIALS AND METHODS: A retrospective follow-up study of 22 cases was carried out. With use of the system of AO classification 9 cases were in C1 and 7 in C2, and 6 in C3. The average duration of follow-up for all fractures was 35 months. We evaluated the radiologic results, the functional results according to clinical evaluation scoring system by Green and O'Brien and osteoarthritis grade according to arthritic grading system by Knirk and Jupiter. RESULTS: Excellent and good results were rated in 17 cases (77%) of all cases. At last follow-up the mean loss of radial length, radial inclination and volar tilt were 1.4 mm, 1.0o, and 1.4o respectively. Also 7 patients had grade I, 1 patient grade II, and 1 patient grade III arthritis. CONCLUSION: We think that percutaneous K-wire reduction-fixation and external fixation is useful treatment method for the unstable intra-articular distal radius fracture. But severely comminuted AO type C3 fractures would need additional treatments such as open reduction and bone graft to acquire and maintain the articular reduction for better results.

Multifocal Pott's Disease: A Report of Two Cases / 대한정형외과학회잡지

Modern imaging methods including plain radiography, computed tomography (CT), magnetic resonance imaging (MRI) and bone scan improve the diagnostic accuracy of Pott's disease. However, atypical forms of Pott's disease are often misdiagnosed. There are a few reports available on multifocal Pott's disease. To the authors' knowledge, there are no domestic reports of multifocal Pott's disease with a concomitant spinal involvement of the posterior element. This article describes two rare cases of multifocal Pott's disease, with a review of the relevant literature.

The Change of Cobb Angle According To Position in Adolescent Idiopathic Scoliosis / 대한척추외과학회지

STUDY DESIGN: Consecutive, prospective, radiographic review of adolescent idiopathic scoliosis (AIS) patients. OBJECTIVE: To analyze the change of Cobb angle according to position in AIS. SUMMARY OF BACKGROUND DATA: Cobb angle on standing radiographs was corrected spontaneously while the patients were in the supine position. However, there are few reports on Cobb angle in standing versus supine position in AIS. MATERIALS AND METHODS: We checked AP plain radiographs of 101 AIS patients, 18 male and 83 female, in standing and supine position. Sixty-three cases were under Risser stage V and 38 were Risser stage V. In standing plain radiograph, 27 cases were in Cobb angle 10-19 degrees, 35 in 20-29 degrees, 15 in 30-39 degrees, and 24 over 40 degrees. According to curve pattern, 31 curves were classified as King type I, 32 as type II, 8 as type III, 11 as type IV, 17 as type V, 1 thoracolumbar curve and 1 lumbar curve. Cobb angle reduction was measured on AP radiographs from each group, according to sex, maturation, Cobb angle and curve pattern. RESULTS: Average reduction of Cobb angle was 8.2 degrees(range, 1-21 degrees ), 6.4 degrees for male and 8.6 degrees for female (p=0.19). The reduction value according to maturation was 8.3 degrees for the growing group and 8.0 degrees for the grown group (p=0.73). The average reduction value in Cobb angle 10-19 degrees was 5.4 degrees(40.3%), 20-29 degrees was 7.1 degrees(30.9%), 30-39 degrees was 8.6 degrees(25.7%) and over 40 degrees was 12.8 degrees (23.6%) (p=0.001). The reduction rate decreased in proportion to Cobb angle measured in standing position. The reduction value was 8.2 degrees in King type I curves, 8.6 degrees in type II, 9.1 degrees in type III, 9.1 degrees in type IV and 6.2 degrees in type V (p=0.238). CONCLUSION: An average 8 degrees Cobb angle reduction in supine position, compared with standing position, can influence treatment strategy in AIS patients, because a Cobb angle change more than 5-6 degrees is a threshold value to decide curve worsening. Thus, serial Cobb angle measurement should be performed in standing position.