Clinieal Values of Single Photon Emission Computed Tomography ( SPECT ) in Ankylosing Spondylitis / 대한정형외과학회잡지

Now that ankylosing spondylitis is known to be relatively common, it is important that mild cases should be diagnosed earlier to avoid inappropriate investigation and unhelpful non-specific therapy and to improve social rehabilitation. However, difficulties in the diagnosis of ankylosing spondylitis are often encountered. To establish the clinical values of SPECT in ankylosing spondylitis, a study of radiologic evaluation, quantitative bone scan and SPECT have been carried out in 34 patients who were firmly suspected as having ankylosing spondylitis by other tests. This study showed that SPECT could improve the applicability of the imaging modality in the diagnosis and the assessment of disease activity and the capacity of early diagnosis in patients with ankylosing spondylitis. We believe that improved three dimensional localization in and around the sacroiliac joints by SPECT might overcome several diagnostic difficulties. Especially when radiographic abnormalities are not present in the early period, the diagnostic values of SPECT may be more potential.

Treatment of the Fractures of the Proximal Humerus / 대한정형외과학회잡지

The purpose of this study is to compare 76 cases of fractures of the proximal humerus both clinically and radiologically which were treated at Pusan National University Hospital from January 1987 to December 1996. According to Neers classification, among the 76 patients, there were nine one-part fractures (11.8%), forty two-part fractures (52.6%), eighteen three-part fractures (23.7%), four four-part fractures (5.3%), and five head-splitting fractures (6.6%). In terms of treatment method, among the 76 patients, 49 patients (64.5%) were treated conservatively. Thirty seven patients (75.5%) of one-part and two-part fractures were treated conservatively, and twelve patients (54.5%) of three-part and four-part fractures were treated operatively. The results of the cases were rated by the Neer s assessment, 42 patients (85.7%) had excellent or satisfactory results in one-part and two-part fracture, and 7 patients (31.8%) had unsatisfactory or failed results in three-part and four-part fracture. Total cases with complications were 14 cases (18.4%). From the viewpoint of the type of fracture, the results in two-part and three-part fractures were much better than those of fourpart fractures. The joint stiffness which was the most common complication must be prevented by allowing the early motion of the joint to obtain a better result.

Radiologic Morphology of Proximal Femur: Comparison between Normal and Diseased Hips / 대한정형외과학회잡지

Diseases involving hip may influence on the anatomy of the proximal femur, especially on the endosteal canal shape. The simple radiographic comparative study was performed between normal and diseased hips. For the diseasd hip group, 74 hips ol' femoral head AVN(avascular necrosis) (average age: 49.3 years old, patients were all male) who had limped for average l9 months were selected and 77 male hips (average age: 48.9 years old) who had no prior hip disease were selected for the normal hip group. The external shape of both group showed no significant differences except for the femoral head dimensions. Statistically significant differences were ohserved hetween two groups in the proximal endosteal canal shape and cortical thickness. The femur of the diseased hip group had wider canal from the level of distal to lesser trochanter to the level of isthmus, with a significant reduction in the metaphyseal index (the ratio hetween the canal width proximal to lesser trochanter and distal to lesser trochanter) and the canal flare index (p<0.001). Theoretically this study suggests that the optimal fit and fill to the proximal endostcal canals of normal and diseased hips cannot be obtained by oneshape cementless femoral stcms.