BACKGROUND: The consensus is that a bony Bankart lesion shorter than 25% of the length of glenoid does not affect the clinical result; hence, such lesions were often neglected. However, small bony Bankart lesions are associated with various types of capsulolabral lesions. METHODS: A total of 82 patients who had undergone arthroscopic capsulolabral lesion repair surgery for anterior shoulder dislocation were reviewed. The prevalence rates of early and late type of capsulolabral lesions were compared between a group of patients with and a group without small bony Bankart lesions. In addition, the types of accompanying capsulolabral lesion were analyzed according to the type of bony Bankart lesion. Finally, the clinical outcomes were evaluated (active range of motion, American Shoulder and Elbow Surgeons score and Rowe's score). RESULTS: Among the 13 patients who had small bony Bankart lesions, the prevalence rate of early and late type of capsulolabral lesions was 38.5% and 61.5%, respectively. Among the 69 patients without bony Bankart lesion, the prevalence rates of early and late type of capsulolabral lesions were 74% and 26%, respectively. Significantly worse clinical outcome was observed for the group of patients with both small bony Bankart lesions and late type of capsulolabral lesion. CONCLUSIONS: More severe type of small bony Bankart lesion appears to be associated with late type of capsulolabral lesion. The significantly worse clinical outcome for patients with both small bony Bankart lesion and late type of capsulolabral lesion indicates that small bony Bankart lesions cannot always be neglected.
Consensus ; Elbow ; Humans ; Prevalence ; Range of Motion, Articular ; Shoulder Dislocation* ; Shoulder*

No abstract available.
Intercostal Nerves*

Orthopaedic wire has been used widely as a good internal fixator in cases of fracture, the ligament reconstruction, and for the stabilization of cervical spine. But if it is used inappropriately, a wire can be easy to fail by elongation, untwisting, or breakage. Among them, the most common failure of wire is breakage. To clarify the mechanism and the causes of wire failure, the authors analysed serial roentgenograms and scanning electronmicroscopic findings of broken wire in total 13 cases, which were experienced at the department of orthopaedic surgery, St. Mary's Hospital, Catholic University Medical College From January 1981 to December 1987. The results obtained were as follows :1. The mechanism of wire failure were classified into the 4 types ; minor continual flexing motion in 6 cases, repeated minor back and forth torsion in 1 case, tension failure in 2 cases and combined type in 4 cass. 2. The causes of wire failure were in appropriate use and inadequte application, a lack of s ufficient mechanical strength, micromotion due to inadequate postoperative imm obilization, early mobilization before tissue healing as well as certain injuries to the wire during handling in operation.
Early Ambulation ; Fatigue ; Internal Fixators ; Ligaments ; Spine

The displacement of patellar components, such as dislocation or subluxation, causes polyethylene wear and further induces metallosis of the metal-backed patella. We compared two different patellar components, onset(Miller-Galante I) and inset(Whiteside-Ortholoc I)type, to understand the differences in patellar tracking according to their designs. Patellar prosthesis position in 43 primary total knee arthroplasties was evaluated with patellar tilt, patellar displacement from the center of the trochlear groove, medial placement, patellar thickness, and joint line height. For the MG(Miller-Galante I)group, the patellar displacement was laterally 50.0% and for the Ortholoc group, it was 33.3%. In the MG group, 4 cases of revision of the patellar component due to excessive polyethylene wear were performed, but there was no excessive wear of polyethylene in Ortholoc group. One of the primary factors which influence tracking of the patellofemoral joint is the difference in design between the patellar component and the femoral component. But in the opinion of the authors, the slope or lateral displacement of the patellar component have no correlation with each other under radiological measurements. However, the inset-type patellar component is a design that maintains the bony flange within the lateral flange, therefore relieving the shear stress and rotational forces loaded on the patellofemoral joint and protecting the metal-backing from exposure. Thereby, even if dislocation or subluxation of the patellar component should occur, polyethylene wear or metallosis caused by excessive wearing can be minimal.
Arthroplasty* ; Dislocations ; Joints ; Knee* ; Patella ; Patellofemoral Joint ; Polyethylene ; Prostheses and Implants

Seventy consecutive ipsilateral fracture of the femur and tibia in sixty-eight patients from December 1974 through December 1984 treated at Severance Hospital were analysed in clinical and radiological aspect. 1. Fifty-nine patients were male and nine patients were female. The male patients were more injured in the ratio of 6: 1. The avarage age was 34. 2. The main cause of injuries were traffic accidents; 59 patients. (86.8%). 3. The majority of the fractures were shaft fracture; for example, femur shaft 57% and tibia shaft 47%, The open fracture of the tibia was 34% and the femur was 17%. 4. There were 24 cases of concomitant fracture and dislocation of other sites. A fat embolism was disgnosed in 4% of the patients. Four patients had died one month after sustaining injuries. 5. Over-all, a good or excellent functional result was achieved in 76% of the patients treated with internal fixation of both fracture, 65% of the patients with intexnal fixation for the femur fracture only and 35% of the patients managed conservatively.
Accidents, Traffic ; Dislocations ; Embolism, Fat ; Female ; Femur ; Fractures, Open ; Humans ; Male ; Tibia

Eighty primary Harris-Galante Porus (HGP) total hip replacements were performed at Severance Hospital from January 1986 to January 1989. A minimum of 18 months follow-up was available for 80 hips in 72 patients, whose mean age was fifty two years. The most common presenting diagnosis was avascular necrosis (47.5%) followed by fused hips (10%), tuberculosis (10%), rheumatoid arthritis (7.5%). Complications included three calcar cracks and two immediate dislocations and 6 cases of mild myositis ossificans. There were no infections and no revisions. The mean Harris hip score was 93 points (range, 74–100 points) at two years. The thigh pain was in nine patients (11 per cent) at one year and in three patients (3 per cent) at two years postoperatively. Radiographic analysis revealed that, a progressive radiodense femoral line developed in 21 hips (26 per cent); a progressive acetabular line in 3 hips (4 per cent); and decreased proximal femoral density in 28 hips (35 per cent). There were no position change of the acetabula and femoral compent. We conclude that the early overall clinical results of HGP total hip replacements are encouraging, at average 30 months. The prognostic significance of the radiographic changes such ar radiodense lines, the changes of the proximal femur and cortical thickening, have to be determined with longer follow-up. Long term follow-up of uncemented HGP total hip replacement is necessary to evaluate the efficacy of such implants.
Acetabulum ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Diagnosis ; Dislocations ; Femur ; Follow-Up Studies ; Hip ; Humans ; Myositis Ossificans ; Necrosis ; Thigh ; Tuberculosis

We performed twenty three cementless total hip arthroplasties(THA) on seventeen patients, all of whom were diagnosed with steroid-induced avascular necrosis of the hip (AVN). The average age of the patients was 41years, mean follow-up period was 41months (24-74months). The final average Harris hip score was 94 and overall results were excellent. On radiographic evaluation, 17 femoral components met the criteria for bone ingrowth(spot weld) but it was somewhat delayed. There was no evidence of loosening of the femoral and acetabular components. The results of this study suggest that long term steriod treatment does not prevent bone ingrowth. Cementless total hip arthroplasty appears to be a reasonable therapeutic option for steroid-induced avascular necrosis of the hip.
Acetabulum ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip ; Humans ; Necrosis

Liquid crystal thermography is a new diagnostic imaging method detecting the temperature change by the physiologic disturbance as compared with the radilogic method detecting the anatomical distortion. We have used liquid crystal thermography in 54 patients with complaining low back pain during the period form 2nd. March 1989 to 30th. April 1989. Of these 54 patients, 35 had myelography and C-T scan, 23 had EMG, and 13 were operated upon. 1. There were 35 clinically positive patients on whom concomitant myelography and C-T scan was performed; 32 patients(91%) had a positive myelography and C-T scan, and 30 patients (86%) had a positive thermography. Of these 35 patients, 23 had EMG concomitantly; 17 patients(74%) had a positive EMG and 18 patients(78%) had a positive thermography. 2. Liquid crystal thermography correlated with myelography and C-T scan in 31 patients(89%), EMG in 18 patients(78%). 3. Concomitant thermography, myelography and C-T scan, and surgery were performed on 13 patients among them EMG was added on 5 patients; Myelography and C-T scan had 100% accuracy, thermography had 92% accuracy, and EMG had 80 % accuracy. 4. Liquid crystal thermography is non-invasive method, dose not involve the use of ionizing radiation, and correlates well with clinical and surgical findings and other diagnostic methods, and costs relatively low. So, liquid crystal thermography is useful and reliable diagnostic method in patients with low back pain.
Diagnostic Imaging ; Humans ; Liquid Crystals ; Low Back Pain ; Methods ; Myelography ; Radiation, Ionizing ; Thermography

PURPOSE: Authors reviewed CT and MR findings of patients with parapharyngeal masses, and their incidence and characteristic findings were studied. MATERIALS AND METHODS: We reviewed 27 CT and 9 MR of pathologically proven 29 patients with primary parapharyngeal mass Neurogenic tumor (17 cases) and other rare masses (3 carotid body tumors, 2 pleomorphic adenomas, 2 cavernous hemangiomas, 1 cavernous lymphangioma, 2 carotid artery pseudoaneurysms, 1 non-Hodgkin's lymphoma, 1 idiopathic cervical fibrosis) were included and the characteristic CT and MR findings were studied. RESULTS: Neurilemmoma was seen as a well-demarcated, solid mass of heterogeneous attenuation or intensity, so that pleomorphic adenoma of minor salivary gland origin could not be differentiated by demarcation, attenuation, or signal intensity of the tumor itself. The direction of carotid artery displacement was not constant in cases of neurilemmomas while the styloid process was constantly displaced laterally in all cases. Characteristic CT and MR findings of other rare tumors were described. CONCLUSION: Neurogenic tumor is the most common parapharyngeal space mass and the direction of displacement of styloid process might be helpful in differential diagnosis from pleomorphic adenoma. Other rare tumors showed very characteristic CT and MR finidings and could be differentiated easily.
Adenoma, Pleomorphic ; Aneurysm, False ; Carotid Arteries ; Carotid Body Tumor ; Diagnosis, Differential ; Hemangioma, Cavernous ; Humans ; Incidence ; Lymphangioma ; Lymphoma, Non-Hodgkin ; Neurilemmoma ; Salivary Glands, Minor

Paragonimus westermani mainly infests the lung parenchyma, and it is also causes ectopic parasitism of various sites, such as brain, liver and subcutaneous tissue but there have been no reports in literature about paragonimiasis infesting lumbar epidural space. A 58-year-old housewife complained of lumbago and radiating pain to both lower extremities for 20 years. Calcified extradural masses were found by preoperative plain X-ray, myelogram, and CT scan. Intraoperatively, cystic mass in the epidural space at L2-3 was found and confirmed to be paragonimiasis by histopathological study. A case of ectopic paragonimiasis in the lumbar epidural space at L2-3 level is presented.
Brain ; Epidural Space ; Humans ; Liver ; Low Back Pain ; Lower Extremity ; Lung ; Middle Aged ; Paragonimiasis ; Paragonimus westermani ; Subcutaneous Tissue ; Tomography, X-Ray Computed