PURPOSE: The purpose of this study was to investigate the efficasy of dorsal percutaneous Acutrak screw fixation for acute stable or unstable scaphoid fractures. MATERIALS AND METHODS: We assessed 7 cases of acute scaphoid fracture from January 2001 to Febrary 2002, 5 cases were of acute stable fracture (Herbert type A2) and 2 cases were of unstable minimal displaced fracture (Herbert type B2). All were treated by dorsal percutaneous Acutrak screw fixation. The postoperative management protocol involved removing the splint at postoperative 1 week, this was followed by active and strengthening exercise. Patients returned to work at a postoperative 2 weeks, and a follow-up study 7cases from 12 to 20 months (average 15.8 months). RESULTS: According to tenderness at the anatomical snuff box, pain during range of motion of the wrist joint and the Maudsley scale, 6cases (Herbert type A2: 5 case, Herbert type B2: 1 case) were excellent and one case (Herbert type B2) was good. CONCLUSION: Dorsal percutaneous Acutrak screw fixation is useful method for acute stable or minimal displaced scaphoid waist fractures, because it reduces complications due to prolonged cast immobilization.
Follow-Up Studies ; Humans ; Immobilization ; Range of Motion, Articular ; Splints ; Tobacco, Smokeless ; Wrist Joint

OBJECTIVES: We examined the association between social expenditures of the local government and the mortality level in Korea, 2004 to 2010. METHODS: We used social expenditure data of 230 local governments during 2004 to 2010 from the Social Expenditure Database prepared by the Korean Institute for Health and Social Affairs. Fixed effect panel data regression analysis was adopted to look for associations between social expenditures and age-standardized mortality and the premature death index. RESULTS: Social expenditures of local governments per capita was not significantly associated with standardized mortality but was associated with the premature death index (decline of 1.0 [for males] and 0.5 [for females] for each expenditure of 100 000 Korean won, i.e., approximately 100 US dollar). As an index of the voluntary effort of local governments, the self-managed project ratio was associated with a decline in the standardized mortality in females (decline of 0.4 for each increase of 1%). The share of health care was not significant. CONCLUSIONS: There were associations between social expenditures of the local government and the mortality level in Korea. In particular, social expenditures per capita were significantly associated with a decline in premature death. However, the voluntary efforts of local governments were not significantly related to the decline in premature death.
Databases, Factual ; Female ; Financing, Government/*economics ; Health Expenditures/*statistics & numerical data ; Humans ; Local Government ; Male ; Mortality/*trends ; Mortality, Premature/*trends ; Regression Analysis ; Republic of Korea

We evaluated the safety and stability of the less-invasive submuscular bar fixation method in the Nuss procedure. One hundred and thirteen patients undergoing the Nuss procedure were divided into three groups according to the bar fixation technique employed. Group 1 consisted of 25 patients who had undergone bilateral pericostal bar fixation, group 2 consisted of 39 patients with unilateral pericostal one, and group 3 included 49 patients with bilateral submuscular one. The patients' age ranged from 2 to 25 yr, with an average of 7.2+/-5.67 yr. Bar dislocation occurred in 1 patient (4%) in Group 1, 2 patients (5.1%) in Group 2, and 1 patient (2.0%) in Group 3 (p=0.46). Hemothorax was noted in 2 patients (8%) in Group 1, 2 (5.1%) in Group 2, and none (0%) in Group 3 (Group 1 vs. Group 3, p=0.028). The mean operation time was shorter in Group 3 than Group 1 (50.1+/-21.00 in Group 3 vs. 67.2+/-33.07 min in Group 1, p=0.041). The submuscular bar fixation results in a decrease in technique-related complications and operation time and is associated with favorable results with regard to the prevention of bar dislodgement.
Treatment Outcome ; Thoracic Surgical Procedures/*instrumentation/*methods ; Surgical Procedures, Minimally Invasive/instrumentation/methods ; Ribs/surgery ; Reconstructive Surgical Procedures/*instrumentation/*methods ; *Prostheses and Implants ; Male ; Humans ; Funnel Chest/*surgery ; Female ; Child, Preschool ; Child ; Adult ; Adolescent ; Abdominal Muscles/surgery