Cubital tunnel syndrome is the second most common compressive neuropathy. Its diagnosis is largely based on clinical findings. It has been well known that patients with mild to moderate grade of cubital tunnel syndrome have a high chance of spontaneous resolution, while those with severe degree do not. Thus, the former is treated with conservative methods initially, and the latter is indicated for surgical intervention. There are three types of surgical techniques for cubital tunnel syndrome. Of these, in-situ decompression technique has been gaining popularity as it is simpler and shows similar efficacy with less complications compared to other techniques. In this review, we deal with current concepts of the cubital tunnel syndrome pertaining to the primary clinical practice.
Cubital Tunnel Syndrome ; Decompression ; Diagnosis ; Humans ; Ulnar Nerve ; Ulnar Neuropathies*

External fixation with or without ancillary K-wire fixation, once being one of the most popular methods of surgery for unstable distal radius fractures, is now losing its position due to a recent surge in the use of volar locking plates. However, these changes are not firmly grounded on scientific evidence. Recent clinical trials showed that a similar wrist function was achieved when the use of external fixation was compared with that of volar locking plates at 1 year after surgery for the treatment of unstable distal radius fractures, even though the rate of functional recovery was slower in the former. In addition, it is still a question whether additional costs and time paid for volar locking plates can be justified by such a small gain in wrist function. We will review recent studies comparing external fixation with volar locking plates regarding wrist function and costs, and discuss current indication of external fixation for unstable distal radius fractures.
Radius Fractures* ; Wrist

The aim of our study is to achieve complete periodontal tissue regeneration by the application of BMP and resorbable membrane. Three beagle dogs aged over one and half years and weighed 14 to 16 kg were used in this study. Mandibular 1st, 2nd premolars were extracted bilaterally. Horizontal furcation defects were induced around 3rd, 4th premolars bilaterally. BMP-4 were applied in the right side with resorbable membranes and only resorbable membranes were applied in the left side respectively. Each animal was sacrificed at 2, 4, and 8weeks, after regenerative surgery. Specimens were prepared with Hematoxylin-Eosin stain and Goldner's modified Masson Trichrome stain for light microscopic evaluation. The results were as follows: 1. At 2 weeks after regenerative surgery, downgrowth of junctional epithelium was observed both in the membrane-applied site and BMP-4-and-membrane-applied site. 2. At 4 weeks after regenerative surgery, resorbable membranes were completely resolved, therefore would not prevent downgrowth of junctional epithelium. New bone formation, new cementum formation and Sharpey's fiber were observed in BMP-4-and-membrane-applied site. 3. At 8 weeks after regenerative surgery, downgrowth of junctional epithelium was observed in the membrane-applied site. But, new cementum formation was observed in the same site. The extensive regeneration of new bone, new cementum and remarkable formation of Shapey's fiber were showed in BMP-4-and-membrane-applied site. 4. Resorbable membranes were resolved via the cell-mediated processes. 5. Periodontal tissue regeneration were better achieved in the BMP-4-and-membrane-applied site than in the membrane-applied site. Within the above results, BMP-4 may have the strong capability to form the new bone and resorbable membrane may be able to prevent the bony ankylosis. However, resolution rate of resorbable membrane may not be enough to protect rapid epithelial downgrowth for ideal periodontal regeneration. In conclusion, I suggest BMP-4 may have the strong possibility to be utilized in the clinical periodontal treatments.
Animals ; Ankylosis ; Bicuspid ; Dental Cementum ; Dogs ; Epithelial Attachment ; Furcation Defects ; Membranes* ; Osteogenesis ; Regeneration*

Cortical blindness means visual loss caused by bilateral destruction of visual cortex. Cortical blindness can develop after cerebral angiography due to hypertonic contrast medium which open the blood-brain barrier and then alternate the function of visual cortex transiently. About 30 minutes after injection of contrast medium (Ultravist 370(R)) during cerebral angiography, the patient complained of decrease of visual acuity. And 3 hours later, evaluation revealed that she could not see even the light. But her vision began to improve after 19 hours and recovered completely after 7 days. MRI taken at 12 hours after cerebral angiography showed high signal intensities in the both occipital lobes. But in repeated MRI study, which was taken after 3 days, previously noted high densities were completely disappeared. So we diagnosed this case as cortical blindness caused by hypertonic contrast medium.
Blindness, Cortical* ; Blood-Brain Barrier ; Cerebral Angiography* ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Visual Acuity ; Visual Cortex

Cortical blindness means visual loss caused by bilateral destruction of visual cortex. Cortical blindness can develop after cerebral angiography due to hypertonic contrast medium which open the blood-brain barrier and then alternate the function of visual cortex transiently. About 30 minutes after injection of contrast medium (Ultravist 370(R)) during cerebral angiography, the patient complained of decrease of visual acuity. And 3 hours later, evaluation revealed that she could not see even the light. But her vision began to improve after 19 hours and recovered completely after 7 days. MRI taken at 12 hours after cerebral angiography showed high signal intensities in the both occipital lobes. But in repeated MRI study, which was taken after 3 days, previously noted high densities were completely disappeared. So we diagnosed this case as cortical blindness caused by hypertonic contrast medium.
Blindness, Cortical* ; Blood-Brain Barrier ; Cerebral Angiography* ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Visual Acuity ; Visual Cortex

Free vascularized tissue transfer to preserve upper extremity amputation level is uncommon but very useful procedure. To cover the below-elbow amputee stump and restore the function of the elbow, we have used a free flap as a spare part concept from the contralateral hand which was so severely damaged that amputation was inevitable.
Amputation ; Amputees* ; Elbow* ; Forearm* ; Free Tissue Flaps ; Hand ; Humans ; Upper Extremity

PURPOSE: to find out the change and limit of the changes of tibiofemoral joint line, patellar position and other related variables for improved postoperative knee function after PCL retaining TKRA. MATERIALS AND METHODS: The variables mentioned above were measured from the plain radiographs of 101 knees with PCL retaining TKRAs, correlated with clinical outcomes such as HSS score, range of motion and anterior knee pain. Then they were analyzed statistically. RESULTS: Tibiofemoral joint line, patellar height and femoral condylar size affected clinical outcomes. Excellent postoperative knee function resulted when the shift of tibiofemoral joint line position was between 5mm inferiorly to 5mm superiorly, postoperative patellar height between 15mm to 30mm, and the change of the femoral condylar size between 10mm decrease and 5mm increase. CONCLUSION: Excellent clinical results would be expected if the changes of the joint line position are kept within the range suggested in this paper.
Joints ; Knee ; Knee Joint ; Patellofemoral Joint* ; Range of Motion, Articular

We present a case of medial plantar nerve injury by screw tip after open reduction and internal fixation of intraarticular calcaneus fracture. We reviewed the risk and prevention technique of medial plantar nerve injury in fixing the calcaneus fracture.
Calcaneus* ; Tibial Nerve*

OBJECTIVE: To compare the image quality of volume isotropic turbo spin echo acquisition (VISTA) imaging method with that of the three-dimensional (3D) isotropic fast field echo (FFE) imaging method applied for ankle joint imaging. MATERIALS AND METHODS: MR imaging of the ankles of 10 healthy volunteers was performed with VISTA and 3D FFE sequences by using a 3.0 T machine. Two radiologists retrospectively assessed the tissue contrast between fluid and cartilage (F-C), and fluid and the Achilles tendon (F-T) with use of a 4-point scale. For a quantitative analysis, signal-to-noise ratio (SNR) was obtained by imaging phantom, and the contrast ratios (CRs) were calculated between F-T and F-C. Statistical analyses for differences in grades of tissue contrast and CRs were performed. RESULTS: VISTA had significantly superior grades in tissue contrast of F-T (p = 0.001). Results of 3D FFE had superior grades in tissue contrast of F-C, but these result were not statistically significant (p = 0.157). VISTA had significantly superior CRs in F-T (p = 0.002), and 3D FFE had superior CRs in F-C (p = 0.003). The SNR of VISTA was higher than that of 3D FFE (49.24 vs. 15.94). CONCLUSION: VISTA demonstrates superior tissue contrast between fluid and the Achiles tendon in terms of quantitative and qualitative analysis, while 3D FFE shows superior tissue contrast between fluid and cartilage in terms of quantitative analysis.
Achilles Tendon/*anatomy & histology ; Adult ; Ankle Joint/*anatomy & histology ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional/methods ; Magnetic Resonance Imaging/*methods ; Male ; Phantoms, Imaging ; Retrospective Studies ; Statistics, Nonparametric

INTRODUCTION: Most of the palatal fistulas develop along the suture line in a small size, so they can be corrected easily by re-palatoplasty or various flap surgery using the local mucoperiosteum. But it is very difficult to repair if the fistula is very large or located anterior to the hard palate. Buccal mucosal or vestibular mucosal flaps may settle the problems but there are many limitations on the size and location. And other extraoral distant flaps need not only many surgical steps but also cause inconvenience. But tongue flap proffers as an excellent method for the repair of large anterior palatal fistula because of highly mobility and rich blood supply and low donor site morbidity. MATERIALS & METHODS: We treated the six cases of large palatal fistulas using the distally based tongue flap. We dissected under the submucosa layer around fistula site preserving the mucoperiosteum and the elevated flap was rotated to nasal side and sutured with 4-0 Vicryl(R) for the repair of the nasal side. And then we elevated the tongue flap on the distal portion of the tongue. The elevated tongue flap was placed on the defect area and sutured with 4-0 Chromic(R). After 2 or 3 weeks, we detached the tongue flap which was placed on the fistula site. Donor site was closed with 4-0 Chromic(R). RESULTS: The mean size of palatal fistula was 7.2 cm. All of patients complained the discomforts in masticating and speaking before flap detaching operation. A wound dehiscence was observed on tongue flap sutured to defect site. But it was healed by revisionary suture. There was no donor site complication. CONCLUSION: The authors propose that the distally based tongue flap is an excellent method for the repair of large palatal fistula because of its highly mobility, rich blood supply, and few of donor site morbidit
Fistula* ; Humans ; Palate, Hard ; Sutures ; Tissue Donors ; Tongue* ; Wounds and Injuries