Regardless of the method of treatment, as many as 5% of all pelvic fractures result in malunion or nonunion of the pelvis. However, there is not much information in the literature on the management of these late complications. Because they cause disabling symptoms and socioeconomic problems, some patients with malunion or nonunion of pelvic fractures need to undergo surgery. We report our experience with satisfactory results of surgery for pelvic malunion and nonunion in four patients. The key to successful reconstruction is thorough preoperative planning and methodical surgical intervention.
Adult ; Female ; Fracture Fixation, Internal/*instrumentation/*methods ; Fractures, Malunited/radiography/*surgery ; Fractures, Ununited/radiography/*surgery ; Humans ; Pelvic Bones/injuries/radiography/*surgery

PURPOSE: The modified subureteral transurethral injection(STING) has been reported to increase the success of endoscopic treatment of high grade vesicoureteral reflux(VUR). This study was performed to assess the efficacy of the modified STING procedure compared to conventional STING in the setting of high grade VUR. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 40 consecutive children(46 ureters) with a median age of 5.32 years (range 1 to 10 years) who underwent endoscopic treatment of grade IV to grade V VUR between February 2004 and December 2006. The modified STING was performed by applying a direct pressure stream of irrigation fluid into the ureter in order to define the injection site within the ureteral submucosa. The needle was then placed in the ureteral tunnel, and a dextranomer/hyaluronic acid copolymer(Dx/HA) was injected into the submucosal intraureteral space, tracking along the entire length of the detrusor tunnel. Modified STING was performed in 27 ureters(grade IV: 13, grade V: 14), and conventional STING was performed in 19 ureters (grade IV: 12, grade V: 7). Follow-up voiding cystourethrography(VCUG) was performed 3 months later. RESULTS: Complete resolution occurred in 82%(22/27 ureters) of the patients undergoing modified STING, including 92%(12/13) of grade IV patients and 71%(10/14) of grade V patients. Three ureters required a second injection to correct VUR. Conventional STING had a success rate of 63%(12/19), [75%(9/12) in grade IV and 43%(3/7) in grade V]. The mean injected volume for the modified STING was 1.23+/-0.3ml, while that for the conventional STING was 0.95+/-0.2ml(p=0.03). Conclusions: The modified STING was markedly more successful in the treatment of high grade VUR and carried no significant adverse effects.
Child ; Male ; Female ; Humans ; Bites and Sting

Renal lymphangiomatosis is a rare developmental malformation of the perirenal lymphatic system, and this can result in the development of cystic masses in the peri-pelvic or peri-renal areas. This is difficult to differentiate from other cystic renal disease on imaging studies. We present here a case of metachronous bilateral renal lymphangiomatosis that was falsely diagnosed as a simple renal cyst. A 47 year-old man was referred for a large amount of drainage after right renal cyst marsupialization. The abdominal computed tomography(CT) findings and fluid analysis were compatible with a lymphangiomatosis. After 6 month, he presented with flank pain on his left side and CT showed intracystic hemorrhage on the left renal lymphangiomatosis. Percutaneus drainage and conservative management were done.
Male ; Humans ; Cysts

Renal lymphangiomatosis is a rare developmental malformation of the perirenal lymphatic system, and this can result in the development of cystic masses in the peri-pelvic or peri-renal areas. This is difficult to differentiate from other cystic renal disease on imaging studies. We present here a case of metachronous bilateral renal lymphangiomatosis that was falsely diagnosed as a simple renal cyst. A 47 year-old man was referred for a large amount of drainage after right renal cyst marsupialization. The abdominal computed tomography(CT) findings and fluid analysis were compatible with a lymphangiomatosis. After 6 month, he presented with flank pain on his left side and CT showed intracystic hemorrhage on the left renal lymphangiomatosis. Percutaneus drainage and conservative management were done.
Male ; Humans ; Cysts