Kimura's Disease is a very rare, chronic inflammatory disorder with an unknown etiology, and this illness is primarily seen in young Asian males. The typical clinical features consist of painless subcutaneous masses in the head or neck region, and especially in the salivary gland and submandibular region. It is often accompanied with a regional lymphadenopathy, peripheral blood eosinophilia and elevated serum IgE levels. Histologically, it is characterized by prominent germinal centers in the involved lymph nodes, together with eosinophilic infiltration in these lymph nodes. The treatment modalities for this disease are steroid therapy, radiation therapy and surgical excision. Its clinical course is of a benign nature. We report here on a case of a 28 year old man who had a soft tissue mass in his left arm. We excised this mass and the microscopy confirmed that he suffered from Kimura's disease on microscopic examination in his left distal arm.
Arm ; Asian Continental Ancestry Group ; Eosinophilia ; Eosinophils ; Germinal Center ; Head ; Humans ; Immunoglobulin E ; Lymph Nodes ; Lymphatic Diseases ; Male ; Microscopy ; Neck ; Salivary Glands

Authors report a case of cystic tuberculosis of left olecranon in a 44 year-old woman, which mimicked the bone tumor at initial presentation. She complained mild discomfort in the left elbow over a month. On examination there were no local redness, swelling, tenderness and deformity. There was no limitation of left elbow motion. After open curettage of the lesion, bone tuberculosis was confirmed by histological study. Postoperative triple chemotherapy of 12 months (Rifamcpicin, ethambutal, INH) could cure the disease.
Congenital Abnormalities ; Curettage ; Elbow ; Female ; Humans ; Olecranon Process ; Tuberculosis ; Tuberculosis, Osteoarticular

Sternoclavicular septic arthritis is a rare condition and it is usually related to predisposing conditions like intravenous drug abuse, diabetic mellitus, trauma and so on. A delayed diagnosis of this disease may cause severe complications like mediastinitis and chest wall abscess. Computed tomography or magnetic resonance imaging is needed to evaluate the complications. If the above complications are present, then joint resection should be considered. We report here on a case of a 52-year-old man who was diagnosed with primary sternoclavicular septic arthritis and he had no predisposing conditions. The pathogen on the aspiration-culture was S. aureus and it was susceptible to cefminox. The patient was cured with administering only antibiotic therapy for 6 weeks; intravenous cefminox therapy for 4 weeks followed by oral cefminox therapy for 2 weeks.
Abscess ; Arthritis, Infectious ; Cephamycins ; Delayed Diagnosis ; Humans ; Joints ; Magnetic Resonance Imaging ; Mediastinitis ; Middle Aged ; Sternoclavicular Joint ; Substance Abuse, Intravenous ; Thoracic Wall

Acromioclavicular joint injuries usually occur as a result of direct trauma to the superolateral aspect of the shoulder. Roockwood Type IV injuries are relatively uncommon, and they are easily misdiagnosed or neglected in patients who have suffered multiple traumas. Therefore, to correctly treat a patient with type IV injury, we need to take a careful physical examination and conduct proper radiologic evaluation for the acromioclavicular joint. We report here on two cases of modified Weaver-Dunn reconstruction for neglected type IV acromioclavicular joint injuries that were associated with multiple rib fractures.
Acromioclavicular Joint ; Humans ; Joints ; Multiple Trauma ; Physical Examination ; Ribs ; Shoulder

PURPOSE: The purpose of this study was to evaluate the results of eight cases of coronoid process fractures that were fixed with a plate. MATERIALS AND METHODS: Eight coronoid process fractures were treated by plating and these cases were reviewed retrospectively. Six patients were men and two were women. The average age was 41 years (range: 22-79) at the time of injury. According to Regan's classification, there were five type 2 and three type 3. According to O'Driscoll's classification, there were five anteromedial type and three base type. Open reduction and internal fixation with a plate were performed through a medial approach by splitting of the two heads of the flexor carpi ulnaris. The patients were follow-up for a mean of 15.8 months (range: 6-25). We evaluated the clinical outcomes with using the Mayo Elbow Performance Score. RESULTS: The average active motion of the elbow joint was 120 degrees. The average Mayo Elbow Performance Score was 86.9. There were 5 excellent results, 1 good result and 2 fair results. SUMMARY: Plating through a medial approach of the elbow provided stable fixation and satisfactory union for treating displaced coronoid process fractures with the unstable elbow.
Elbow ; Elbow Joint ; Female ; Follow-Up Studies ; Head ; Humans ; Male ; Retrospective Studies ; Ulna

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.
Acromioclavicular Joint ; Clavicle ; Dislocations ; Follow-Up Studies ; Humans ; Joints

PURPOSE: The purpose of this study was to introduce a new surgical technique and to evaluate the preliminary results after operative treatment with using TightRope(R) for treating acute acromioclavicular joint dislocation. MATERIAL AND METHODS: We studies 10 patients who were followed up for more than 6 months after operative treatment with using an TightRope(R). A longitudinal incision approximately 4cm in length was made from 1cm medial to the acromioclavicular joint to the coracoid process, and then coracocalvicular ligament augmentation using TightRope(R) was done after splitting the deltoid. For postoperative stability, two 1.6 mm Kirschner wires were inserted temporarily across the acromioclavicular joint in all cases. The radiologic results on the serial plain radiographs and the clinical results according to the UCLA score were analyzed. RESULTS: Radiologically, 7 cases showed anatomical reduction, 2 cases showed a slightly loss of reduction and 1 case showed partial loss of reduction. Clinically, 6 cases were excellent, 3 cases were good and 1 case was fair. CONCLUSION: Coracoclavicular ligament augmentation using TightRope(R) for treating acute acromioclavicular joint dislocation is a minimally invasive, safe procedure that provides satisfactory radiologic and clinical preliminary results. Yet the long-term results have to be analyzed to determine the final results of this procedure.
Acromioclavicular Joint ; Bone Wires ; Dislocations ; Humans ; Ligaments

PURPOSE: We compared the results of arthroscopic Bankart repair using metal and biodegradable anchor fixation. MATERIALS & METHODS: We reviewed 26 patients with anterior shoulder instability treated by arthroscopic Bankart repair from October, 2006, to March, 2007, 15 patients with metal anchors and 11 patients with biodegradable anchors. The average age was 27.4 years old (range: 17~55) and mean follow-up was 14 months (range: 12~17 months). Functional outcome was evaluated using the Korean Shoulder Score for Instability (KSSI), Rowe's Bankart Grading scale (RBGS), ASES score, and UCLA scores. RESULTS: In the metal-anchor group, the improvements of mean KSSI, ASES, UCLA score, and RBGS were 20.6, 24.0, 4.0, and 45.5, respectively. In the biodegradable anchor group, improvements of mean KSSI, ASES, UCLA score, and RBGS were 21.0, 23.6, 4.6, and 48.9. The improvements in final outcomes were not significantly different (p>.05). One metal problem and one traumatic redislocation occurred in the metal group. CONCLUSION: Both techniques produced satisfactory outcomes in the treatment of traumatic anterior instability. The biodegradable anchor group could also avoid problems with metal anchors.
Follow-Up Studies ; Humans ; Shoulder

PURPOSE: We wanted to evaluate the results of surgical treatment for fracture of the scapular body MATERIALS AND METHODS: The subjects of this study were seven patients with fracture of the scapular body and all these patients were managed surgically. We considered the operative indications as being 100% translation of the lateral border, or 25 degrees of angular deformity of the glenoid, or 1cm medialization or the variant of the double disruption of the superior scapular suspensory complex. There were five males and two females, and their ages ranged between 40 and 58 years (mean age: 49) with average follow up of 11 months (6~24 months). Two patients sustained multiple fractures of the ribs and spines. The surgical results were evaluated according to the subjective satisfaction, the UCLA score and the Korean shoulder score. RESULTS: The mean UCLA score was 29 (17~33) and the mean Korean shoulder score was 86 (63~94). The self assessment for subjective satisfaction was 7.7 (4~9). There were two complications; one case of screw pull-out without the loss of the fracture fixation and the other case with screw penetration of the glenoid cavity. CONCLUSION: Surgical treatment may be effective for the management of severely displaced fracture of the scapular body in order to prevent the impairment of the shoulder function caused by the altered glenohumeral and scapulothoracic kinematics.
Congenital Abnormalities ; Female ; Follow-Up Studies ; Fracture Fixation ; Humans ; Male ; Ribs ; Self-Assessment ; Shoulder ; Spine

PURPOSE: Our purpose was to retrospectively analyze clinical results of subpectoral tenodesis of the proximal biceps tendon using an interference screw. MATERIALS AND METHODS: We reviewed 23 cases of patients receiving tenodesis of the proximal biceps tendon between January 2008 and January 2009 for whom we had follow-up data for at least 1 year. Twenty-three cases were operated on using subpectoral tenodesis; 16 of these cases had a rotator cuff tear. The results were judged using a visual analog scale (VAS), ASES, tenderness on the biceps groove, fixation failure and the degree of deformity (BAD). RESULTS: VAS and ASES scores were significantly improved in all patients by the time of the final observation. There were no significant complications or fixation failures. The patients without a tear of the rotator cuff had a better result than patients with a tear of the rotator cuff, but the difference between the two groups was not significant (p>0.05). CONCLUSION: In patients with pathology of the long head of the biceps brachii, benefits of subpectoral interference screw tenodesis include pain relief, maintenance of functional biceps, muscle strength, and cosmesis. Subpectoral biceps tenodesis using interference screw fixation appears to be a promising, reproducible, reliable technique for addressing anterior shoulder pain related to pathology of the long head of the biceps brachii.
Congenital Abnormalities ; Follow-Up Studies ; Head ; Humans ; Muscle Strength ; Retrospective Studies ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Tendons ; Tenodesis