The Allis maneuver is the most commonly used method for reducing posterior hip dislocation. The authors experienced an iatrogenic proximal tibiofibular fracture in a 91-year-old male who underwent total hip arthroplasty while reducing posterior hip dislocation with the Allis maneuver. The hip was safely reduced under spinal anesthesia with a fracture table. Open reduction and internal fixation with a locking plate were done for the proximal tibia fracture.

The Allis maneuver is the most commonly used method for reducing posterior hip dislocation. The authors experienced an iatrogenic proximal tibiofibular fracture in a 91-year-old male who underwent total hip arthroplasty while reducing posterior hip dislocation with the Allis maneuver. The hip was safely reduced under spinal anesthesia with a fracture table. Open reduction and internal fixation with a locking plate were done for the proximal tibia fracture.

The Allis maneuver is the most commonly used method for reducing posterior hip dislocation. The authors experienced an iatrogenic proximal tibiofibular fracture in a 91-year-old male who underwent total hip arthroplasty while reducing posterior hip dislocation with the Allis maneuver. The hip was safely reduced under spinal anesthesia with a fracture table. Open reduction and internal fixation with a locking plate were done for the proximal tibia fracture.

Myasthenia gravis is an autoimmune disease in which autoantibodies affect the neuromuscular junction, leading to muscle loss. Steroids are the primary immunosuppressive treatment for this condition. Since steroids affect the immune system and are effective in most subtypes of myasthenia gravis, they are often used for long-term maintenance treatment. This increases the probability of steroidassociated side effects such as decreases in bone mineral density and increased risk of fractures. The authors successfully treated an 18-year-old female who had been using steroids for a long time after being diagnosed with myasthenia gravis using teriparatide for osteoporotic multi-segment thoracolumbar compression fractures that occurred without trauma with satisfactory outcomes. Since there have been no reports of osteoporotic multi-segmental thoracolumbar compression fractures and treatment in juvenile myasthenia gravis patients caused by long-term steroid use, we report this case along with a review of the literature.

Methods: Consecutive patients whose BMD had been checked using dual-energy X-ray absorptiometry at Gwangmyung Sungae Hospital were recruited. Patients were divided into two groups according to the presence of type 2 DM. Risk factors of OVCF including age, BMI, current smoking status, current alcohol consumption, and presence of osteoporosis were analyzed separately in the type 2 DM group and control group. Results: A total of 1,130 patients were enrolled in this study. The mean age was 63.2 years. BMI was positively correlated with lumbar BMD in the control group (r =0.284) and in the diabetic group (r =0.302). In subgroup analysis, BMI and age were significant risk factors of OVCF in the type 2 DM group. In multiple linear regression analysis, type 2 DM (β =0.035; 95% confidence interval [CI], 0.005–0.065; p =0.024) and BMI (β =0.015; 95% CI, 0.012–0.018; p <0.001) were positively correlated with lumbar BMD, and age was negatively correlated with BMD (β =−0.006; 95% CI, −0.007 to −0.004; p <0.001). Conclusions BMI was positively correlated with lumbar BMD and was higher in type 2 diabetic patients. Age was negatively correlated with lumbar BMD.

No abstract available.
Humans ; Physicians, Family*

An avulsion fracture of the anterolateral tibial epiphysis or Tillaux fracture is commonly seen in adolescents, reported first by Paul Jules Tillaux in 1892. Adolescent Tillaux fracture occurs during the period when the lateral physis is still open and the anterior-inferior tibiofibular ligament is stronger than the physis, so rarely occurs in adults. An avulsion fracture of the posterior inferior tibiofibular ligament, Volkmann fracture, occurs counterpart of Tillaux fracture. In this study, a tennis player injured during sliding and diagnosed as the rare simultaneous Tillaux-Chaput fracture and Volkmann fracture, is reported with the mechanism of injury, clinical importance of syndesmosis, sprain, and fracture of the ankle joint.

Methods: In this study, 30 patients with DS with checked standing dynamic radiographs of the lumbar spine in Gwangmyeong Sungae Orthopedic Clinic were recruited. Standing lateral radiographs were evaluated in extension, 45° of flexion (mid-range) and 90° of flexion (terminal-range) of the lumbar spine. Instability was defined as sagittal translation greater than 3 mm from the extension position. Patients were divided into three groups: a control group, an MI group, and a terminal-range instability (TI) group. Radiographic outcome (stenosis grade) and clinical outcome were compared between the three groups. Results: The average sagittal translation of the lumbar spine was 5.2 mm in extension, 6.6 mm in mid-range, and 7.2 mm in endrange. MI was observed in eight patients (26.2%) and TI was seen in 12 patients (40%). Of eight patients with MI, three patients did not have instability at terminal-range (occult patients) and five patients had instability at terminal-range (typical patients). Body weight and body mass index (BMI) was significantly higher in the MI group as compared to the control group. BMI was positively correlated with slippage to mid-range. There was no significant difference in stenosis grade, Visual Analog Scale, and Oswestry Disability Index. In the TI group, there was no significant difference in radiographic clinical parameters as compared to the control group. Conclusions MI was demonstrated in 25% of DS patients. Mid-range motion was increased with BMI. Mid-range lateral radiography can reveal occult instability in patients with DS, particularly in obese patients.

OBJECTIVES: To determine the relationship between lumbar disc degeneration and back muscle degeneration.SUMMARY OF LITERATURE REVIEW: In the degenerative cascade of the spine described by Kirkaldy-Willis, degeneration of the disc and of the facet joint co-occur with aging. However, the muscles of the back are not included in this model. Several studies have reported significant correlations between back muscle degeneration and facet joint arthritis. The purpose of our study was to evaluate relationships between lumbar disc degeneration and fatty degeneration of the back muscles. MATERIALS AND METHODS: In this study, 65 patients over the age of 50 years who had undergone lumbar spine MRI in our orthopaedic clinic were recruited. Fatty degeneration of the back muscles was qualitatively graded from I to III by the degree of the fat signal in the muscle layer, including both the multifidus and erector spinae. Lumbar disc degeneration was graded from I to V according to the Pfirrmann grade. Correlations between the back muscle degeneration grade and radiological parameters were analyzed. RESULTS: The degeneration grade of the multifidus correlated positively with age and the grade of disc degeneration. Correlations with other radiologic parameters were not significant. The degeneration grade of the erector spinae correlated positively with age. Other radiologic parameters were not significant. CONCLUSIONS There was a significant correlation between lumbar disc degeneration and multifidus degeneration. Erector spinae degeneration was correlated with age, but not with lumbar disc degeneration. The degenerative cascade of the spine was accompanied by fatty changes of the multifidus with aging.