Isolated radial head dislocation, without an associated fracture of the ulna in adult, is rare. Two cases which can be thought as old unreduced isolated radial head dislocation were experienced in this hospital. Dislocated radial heads have not been reduced, however the cases revealed normal elbow motion including pronation and supination. We report these cases with a review of the literature.
Adult ; Dislocations ; Elbow ; Head ; Humans ; Pronation ; Supination ; Ulna

PURPOSE: To evaluate the results between open reduction and internal fixation with the plate and percutaneous reduction by towel clip and intramedullary fixation with Steinmann pin for clavicle shaft fractures in adult. MATERIALS AND METHODS: We have studied the results in 33 cases with the plate, 35 cases with the Steinmann pin among total 68 cases of clavicle shaft fracture. The patients were followed up over a period of at least 12 months. The final postoperative outcome was analyzed with the clinical outcomes using Kang's criteria, radiological union time and operation time. RESULTS: The clinical outcome that was good or excellent according to the Kang's criteria showed a distribution of 88% in the group using the plate with 29 cases out of total 33 cases, 91% in the group using the Steinmann pin with 32 cases out of total 35 cases. The mean radiological union time was 8.9 weeks in the group using the plate, 9.1 weeks in the group using Steinmann pin. The mean operation time was 72 minutes in the group using the plate, whereas was 18 minutes in the group using Steinmann pin. CONCLUSION: In the treatment of adult clavicle shaft fracture, two groups did not show a significant statistical difference in clinical and radiological outcomes. However, the operation time and postoperative functional recovery was significantly shorter and faster in the group using Steinmann pin. Additionally economic and cosmetic aspect was more satisfactory in the group using Steinmann pin.
Adult* ; Clavicle* ; Humans

This is a comparative study based on the data of legal autopsies performed at the National Institute of Scientific Investigation, Seoul, during the year of 2000. In South Korea, the pathologists usually do not attend the death scene, and the scene investigation is performed only by the law enforcement agency. The latter collects the information needed for clarifying the cause and manner of death. The authors tried to estimate the efficiency of the death investigation through the discrepancy between the presumed and the most possible cause of death. We presumed the cause of death on the ground of police investigation and external examination by the general physicians, The most possible cause of death means the best diagnosis after autopsy by pathologists, with the consideration of police information. Followings are the summary of the results. The coincidence rate with the most possible death are over 90% in presumed trauma, asphyxia, thermal injuries, electrocution, starvation/neglect, and over 80% in drowning and natural deaths. The rate was low in medical injuries(26.6%) and poisoning(67.2%). 7.3 to 8.2% were natural in presumed blunt trauma, traffic injury and fall down injuries. Among 48 cases of presumed ligature strangulation, 6 were other type of asphyxia or other injuries, and 2 unknown. The coincidence rate was only 30.8% in acute alcohol poisoning. 5.9% of presumed fire death was proved other type of violent injuries. In the field of medical practices, only 6.3% of accused general medical procedures were proved dead due to themselves. But the rate was increased up to 49.0% in presumed surgery/anesthetic deaths. 12.9% were violent death in presumed natural death, and 64.6% were dead due to violent causes in the cases of no presumable cause of death.
Asphyxia ; Autopsy* ; Cause of Death* ; Diagnosis ; Drowning ; Fires ; Humans ; Korea ; Law Enforcement ; Ligation ; Poisoning ; Police ; Seoul

Isolated avulsion of the lesser tuberosity of the humerus is a rare injury. The mechanism of injury is the avulsion of the lesser tuberosity from forced contractions of the subscapularis muscle when the arm is forced into an externally rotated position on shoulder abduction. Authors report a case for isolated avulsion of the lesser tuberosity of the humerus which was treated with open reduction and transosseous suture fixation, as well as a view of the literature.
Arm ; Humerus* ; Muscles ; Shoulder ; Sutures

PURPOSE: To report the clinical results of surgical treatment of clavicle shaft fracture by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation. MATERIALS AND METHODS: This study reviewed the results of 80 cases of clavicle shaft fracture treated by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation with Steinmann pins from January 2002 to August 2010, after follow-up for 12 months or more. We evaluated the clinical results, such as union time and complications. RESULTS: Bone union was evident in all cases and the mean time for bone union to appear on radiological findings was 10.3 weeks. Using Kang's criteria, 78 of the 80 patients (97.5%) showed good results and there were no severe complications. CONCLUSION: Percutaneous reduction with towel clips and the percutaneous intramedullary pin fixation method showed good results for treating clavicle shaft fracture.
Clavicle ; Follow-Up Studies ; Humans

OBJECTIVES: SCC Ag(Squamous cell carcinoma antigen) is so far the most useful tumor marker in assisting clinical diagnosis of cervical cancer and follow-up after therapy. Elevated levels of cytokeratin 19-fragments(CYFRA 21-1) have recently been detected in large proportion of patients with non small cell cancer of the lung, and in particular those with squamous cell carcinoma. This study is to assess the clinical efficacy of CYFRA 21-1 with SCC Ag as the clinicopathologic parameter in cervical cancer. METHOD: Retrospective analysis of the serum tumor markers CYFRA 21-1 & SCC Ag in eighty cervical cancer patients was performed. RESULTS: Cut off values for SCC Ag & CYFRA 21-1 were 1.94 ng/ml, 3.11 ng/ml respectively. Using the cut-off point, the sensitivity, specificity, positive predictive value(PPV), and negative predictive value(NPV) of serum SCC were 55, 95, 97, 46%, respectively. Serum CYFRA 21-1 showed a sensitivity of 45%, specificity of 91%, PPV of 87%, and NPV of 55%. The combination of SCC and CYFRA 21-1 increased the sensitivity to 62%, with a specificity, PPV, and NPV of 72, 75, 58%. Serum levels of both markers were compared with tumor stage, lesion size and were significantly related. In FIGO stage Ib-IIa, the serum levels of SCC Ag & CYFRA were 2.2+/-3.9, 2.5+/-3.6 ng/ml and in FIGO stage IIb-IV, 12.2+/-15.2, 10.8+/-11.2 ng/ml. In < or =4cm of lesion size the serum levels of SCC Ag & CYFRA were 3.3+/-9.0, 4.5+/-7.6 ng/ml and in >4cm of lesion size, 11.8+/-11.9, 7.7+/-9.3 ng/ml. CONCLUSION: These data seems to show that serum CYFRA 21-1 may be of additional value in assessing the state of disease in some patients with cervical cancer. The prediction of recurrent cervical cancer with SCC Ag were improved by the combination with CYFRA 21-1 but further investigation is needed.
Carcinoma, Squamous Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Keratins ; Retrospective Studies ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; Biomarkers, Tumor ; Uterine Cervical Neoplasms*

PURPOSE: To evaluate clinical and radiological results of surgical treatment of femur intertrochantenric fracture using Gamma 3 nail. MATERIALS AND METHODS: With clinical study, 22 patients who were treated surgically by Gamma 3 nail were retrospectively evaluated. By postoperative radiograph and last follow up radiograph we measured Tip-apex distance, Cleveland index, Neck-shaft angle change Lag screw slippage and Union time. And By medical record review, the clinical results were evaluated with the operation time, intraperative estimated blood loss, amount of transfusion, change of mobility and complication. RESULTS: The mean change of femur neck shaft angle was 5.18 degrees. The mean lag screw sliding was 5.43 mm. The mean bone union time was 11.8 weeks. From all of these examples shows bone union. The mean operative time was 41 min, blood loss was 161 ml and the transfusion amount was 0.3 pint. In Ceder et al mobility score, it showed 0.2 point decreased and in Jensen social function score, it showed 0.6 point increased. Comparing the results before and after operation, the results were satisfactory. CONCLUSION: Using the Gamma 3 nail, the treatment of fermur intertrochanteric fractures showed good results both radiologically and clinically.
Femur ; Femur Neck ; Follow-Up Studies ; Hip Fractures ; Humans ; Medical Records ; Nails ; Operative Time ; Retrospective Studies

PURPOSE: The purpose of this study is to evaluate the radiographic and clinical results of patella fractures using a circumferential wiring combined with tension band wiring. MATERIALS AND METHODS: Between January 2005 and June 2012, 22 (male 14, female 8) patients with patella fracture treated with circumferential wiring combined with tension band wiring were analyzed retrospectively. The mean age of patients was 51 years (range, 28 to 72 years). Controlled passive range of motion exercise was started at three weeks from the postoperative day. The patients were evaluated using radiographs, clinical examination, and Levack's scoring system. RESULTS: All fractures healed and mean time elapsed for union was 11.5 weeks (range, 10 to 14 weeks). Complete union without displacement and full range of motion was achieved in all cases. Clinical results according to Levack's scoring system were excellent in 20 cases and good in two cases. We found broken wire in one case. In this case, results of clinical evaluation after reoperation were good. CONCLUSION: Circumferential wiring combined with tension band wiring is appropriate for patella fractures.
Female ; Humans ; Patella* ; Range of Motion, Articular ; Reoperation ; Retrospective Studies

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2004. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 3,051 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,214 cases(73%) and that of female 837(27%). Male was over twice more than female. The forties were 899 cases(29.5%), the thirties 561(18.4%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,816 cases(59.5%), natural 1,104(36.2%), and the unknown 131(4.3%). Among 1,816 unnatural deaths, suicide was 513(28.2%), homicide 414(22.8%), accident 505(27.8%), and the unclear 384(21.2%). Homicide occupied 38.4% of trauma, 62.9% of blunt force injury excluding traffic and fall-down injury, and 82.7% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 67.7% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 779 cases, occupying 42.9% of 1,816 unnatural deaths, followed by poisoning deaths(286 cases) and asphyxial deaths(283 cases). Blunt trauma was 240 cases(30.8%) and the leading cause of death in traumatic death. Poisoning was 286 cases, among which the ethanols were dominant( 76cases). Thermal injuries were 162 cases, electrocution 27 cases, and starvation/neglect 7 cases and 17 cases were directly due to medical procedures. 4. Among 1,104 natural deaths, heart diseases were 522 cases(47.3%), and vascular diseases 182(16.5%), and these two categories were added up to 704(63.8%). 5. Child deaths under the age of 10 were 147 cases. Homicide was 31 cases(51.7%) out of 60 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 48 cases(32.7%).
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Ethanol ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases

PURPOSE: To evaluate the clinical and radiographic results of the treatment of a proximal humerus fracture with a locking compression plate(LCP). MATERIALS AND METHODS: This study reviewed the results of 24 cases of a proximal humerus fracture treated with a LCP from January 2005 to April 2007, after a follow up of more than 12 months. There were 8 males and 16 females with a mean age of 68.9(33-90) years. The clinical results were evaluated using the Neer's evaluation criteria, and the radiographic results were evaluated using the bone union time and Paavoleinen method. RESULTS: The mean time for bone union was 11.9 weeks. Using the Neer's functional evaluation, 21 cases of the 24 patients (87%) showed excellent or satisfactory results. Twenty two cases (91%) showed good results according to the Paavoleinen method. The complications encountered were metal failure (1 patient), AVN of the humeral head (1 patient) and joint stiffness (1 patient). CONCLUSION: The LCP demonstrated good results in the treatment of a proximal humerus fracture and has relatively fewer complications than other internal fixators.
Female ; Follow-Up Studies ; Humans ; Humeral Head ; Humerus ; Joints ; Male