Ganglion Cyst of the Posterior Cruciate Ligament: A Case Report

This case report draws attention to the possibility of symptomatic and asymptomatic intraarticular ganglion cyst which was situated adjacent to the insertion sites of the anterior or posterior cruciate ligament. In many reports and our case, MR imaging is recommended as the modality of choice in diagnosing method and the cyst, if encountered, is successfully treated with arthroscopie technique. We report one case of symptematic ganglion cyst of the posterior cruciate ligament with review of literatures.

Clinical characteristics of Fourth Lumbar Spondylolytic Spondylolisthesis / 대한정형외과학회잡지

A most common site for the isthmic spondylolisthesis is at fifth lumbar vertebra(L5) and far less at fourth(L4). The pathogenic lesion in the pars interarticularis is essentially the same in LA and L5 isthmic spondylolisthesis, but the clinical characteristics may differ each other according to their anatomical and biomechanical differences. A retrospective review of 24 patients of LA(study group) and 27 patients of L5(control group) isthmic spondylolisthesis was undertaken for their medical records and radiographs to compare the clinical characteristics in each groups. Included in each groups were all patients who were surgically treated during the same period and followed for more than two years after surgery. In the study group, 18 of 24 patients were females having an average age of 42.5 years(ranging 34-65), while in the control group, 17 of 27 patients were males having an average age of 38,1 years (ranging 13-59). The symptoms were severe leg pain in most of the study group, but in the control group, the leg pain and back pain were equally complained. The degrees of slip were similar in two groups, but a narrowing of dise space at slip segment was more prominent in study group. The lateral radiographs taken in flexion and extension revealed more changes of slip in study group (4.7mm in study group vs 2.8mm in control group in averages), and more angular motion at slip segment in study group unless the dise space is not severely narrowed. A spinal stenosis in CT findings was disclosed in almost all patients of study group and in 18 patients of control group. The sizes of L5 transeverse process were bigger than twice as those of L4 in 17(70.8%) patients including 9(37.5%) sacralizations of L5 in suty group, while in control group they were only 8(29.6%) patients with no sacralization. The heights of intercreastal line revealed no difference in two groups. The surgical procedures in study group were fusion only in two and decompression with fusion in 22(91.7%) patients and those in control group were fusion only in 11 and decompression with fusion in 16(59.3%) paticnts. The satisfactory results of treatment were in 21(87.5%) patients of study group and 25(92.6%) patients of control group without significant difference between two groups. In conclusion, the L4 spondylolytic spondylolisthesis compared to L5 lesion was more unstable and developed spinal stenosis more often. The surgical treatment and decompression procedure were also more needed in L4 lesions particularly in agend women.

A Comparative Study of the Floating L4-5) vs Lumbosacral L4-S1) Spinal Fusions / 대한정형외과학회잡지

In cases of L4-5 spinal fusions, L5-S1 segment used to be included in the fusion traditionally for fear of progressive deterioration of the lumbosacral motion segment after fusion above. The purpose of this study was to evaluate the advisability of extension to L5-S1 segment in cases of L4-5 fusion for an isolated pathologic condition in L4-5 sement. A retrospective review of 72 patients with spinal fusion for an isolated pathologic condition in L4-5 segment was undertaken to compare the clinical results and adverse effects in two groups. One group consisted of 39 patients with floating L4-5 fusion(SF), and the other group consisted of 33 patients with L4-S1 fusion(LSF). The age, pathologic condition at L4-5, and the fusion method(lateral fusion) were matched in two groups. The mean follow-up period was 43.6 months(ranging 24-69 months). Comparisons were made for operative problems, post-operative complications, the amount of changes in angular motion at the adjacent segments to fusion at the last follow-up compared to the pre-operative motion, and the clinical results of treatment. The LSF group took 38 more minutes and lost 245 grams of more blood in averages to complete the additional surgical procedures compared with those in SF group. Several considerable post-operative complications were one deep infection in SF group and three metal failures of sacral fixation with subsequent two fusion failures in LSF group which were mostly concerned with the sacral fixations. The changes of angular motion at follow up compared to pre-operative motion in SF group were 1.5° gain in average (ranging 3° loss-6° gain) in L3-4 segment and 0.6° gain in average (ranging 5° loss-5° gain) in the L5-S1 segment. Those in L3-4 segment of LSF were 2.8° gain in average (ranging 2°-loss 9° gain). Therefore the higher stress and subsequent degeneration are more likely expected above the L4-S1 fusion rather than below the L4-5 fusion. The satisfactory clinical results were 89.7% in SF group and 87.9% in LSF group without significant difference between two groups. In conclusion there is no need to include the L5-S1 segment in the L4-5 fusion when the pathology is limited to L4-5 segment.

Treatment of tibial shaft fractures using functional braces / 대한정형외과학회잡지

No abstract available.

Effects of intracerebroventricular angiotensin II on the response to hemorrhage in conscious normotensive and hypertensive rats / 대한내분비학회지

No abstract available.

A Clinical Study on the Causes of the Nerve Entrapment in the Degenerative Spondylolisthesis / 대한정형외과학회잡지

The degenerative spondylolisthesis is one of the most common causes of the prominent central and recess stenosis which are produced by the hypertrophy of the facet joints and anterior slipping of the posterior arch. The resulting neurogenic symptoms in the legs are the major causes of the surgical treatment in the degenerative spondylolisthesis and the complete decompression is indicated for these types of spinal stenosis. The decompression procedures performed in the degenerative spondylolisthesis makes more unstable and induce the late instability and the post

A Clinical Experience of Fractures in Rickets / 대한정형외과학회잡지

Vitamin D deficient ricket is now a rare disease in the developed countries because of the generally improved nutrition and medical awareness but occasional cases are found in the special susceptible populations. The ricket is characterized pathophysiologically by a failure of the normal mineralization of bones and epiphyseal cartilages and is susceptible to the fractures because of the weakness and increased plasticity of bones. The fractures occurred in rickets are known to be delayed in union but it should be normal if the ricket is effectively treated. Authors reviewed 7 cases of fractures occurred in the vitamin D deficient rickets which were managed at Daegu Fatima Hospital during the years from 1980 to 1986 and the following results were obtained. 1. The cases were 4 boys and 3 girls having ages from 6 to 11 years who were all in the same group of restricted population of poor nutrition. 2. 10 fractures noted in 7 cases including two cases of multiple fractures and a case of refracture and most of the fractures occurred in femurs except for a humerus and a forearm bones. 3. The causes of fractures were uncertain because the definite histories were unable to obtain but any violent trauma was not suggested. 4. The fractures were treated by the usual methods of skin tractions or cast immobilizations and daily doses of 2,000 U. or 5,000 U. of vitamin Dwere given as soon as the rickets are recognized. 5. The normal healing of the fractures and rickets occurred in the cases who were given vitamin D initially when the diagnosis of rickets were made. 6. The healing of fractures were very delayed in 2 cases who were missed to recognize the rickets initially and vitamin D was not given.