1.Intraosseous Epidermal Cyst of the Distal Phalanx: A Case Report.
Gyu Min KONG ; Joo Yong KIM ; Jung Han KIM ; Dae Hyun PARK ; Kwang Hun AN
The Journal of the Korean Bone and Joint Tumor Society 2014;20(1):22-26
An intraosseous epidermal cyst is a rare benign cystic lesion. It is thought to result from congenital factors or trauma and can lead to bone destruction because the cyst develops at the soft tissue around the bone. Radiological findings of intraosseous epidermal cysts are a well-defined radiolucent lesion, with cortical expansion. It is important to differentiate an intraosseous epidermal cyst with other disease developed at distal phalanx because its clinical and radiological findings are similar. We report two rare cases of intraosseous epidermal cysts that developed at the distal phalanx.
Epidermal Cyst*
2.Subtrochanteric Fracture Reduction during Intramedullary Nailing: Technical Note
Journal of the Korean Fracture Society 2019;32(2):107-111
The subtrochanteric area is the place where mechanical stress is most concentrated in the femur. When a fracture happens, bone union is delayed and nonunion often occurs. The recommended treatment for atypical fractures is an anatomical reduction of the fracture site as the frequency of nonunion is higher than that of ordinary fractures. Various reduction methods have been suggested, and good results have been obtained. On the other hand, the occurrence of posterior displacement of the distal fragment during the insertion of an intramedullary nail is often overlooked. This is probably because the bone marrow of the femur tends to form an elliptical shape in the anteroposterior direction. The author attempted to insert a blocking screw into the distal part of the fracture to prevent posterior displacement of the distal fragment while performing intramedullary nailing of the femur fracture and achieved a good reduction state easily.
Bone Marrow
;
Femur
;
Fracture Fixation, Intramedullary
;
Hand
;
Stress, Mechanical
3.Comparison of the Clinical and Radiological Outcomes of TFNA (Trochanteric Fixation Nail-Advanced) and PFNA-II (Proximal Femoral Nail Antirotation-II) Treatment in Elderly Patients with Intertrochanteric Fractures
Min Sung KWON ; Young Bok KIM ; Gyu Min KONG
Journal of the Korean Fracture Society 2022;35(4):162-168
Purpose:
Trochanteric fixation nail advanced (TFNA) was modified to compensate for the shortcomings of proximal femoral nail antirotation-II (PFNA-II). The clinical and radiological outcomes of surgeries us-ing the PFNA-II and TFNA for femoral intertrochanteric fractures were compared.
Materials and Methods:
Eighty-two patients who underwent surgeries using PFNA-II or TFNA were analyzed. Only those who were followed up for more than a year were enrolled. Bone union, shortening of the femoral neck, and the tip–apex distance of the intramedullary nail were compared in the radiological findings. Clinical outcomes, including the frequency of complications and gait ability (Koval score), were also assessed.
Results:
The mean follow-up periods were 22 and 19 months for the PFNA-II and TFNA groups, re-spectively. In the PFNA-II group, two cases of femoral head cut-out and one case of varus collapse were observed. In the TFNA group, only one case of femoral head cut-out was observed; however, there was no significant difference in the frequency of complications between the two groups (p=0.37). Ad-ditionally, both the shortening of the femoral neck and the decrease in gait ability after surgery showed relative improvement in the TFNA group compared to the PFNA-II group; however, there was no sig-nificant difference between the two groups.
Conclusion
The use of both TFNA and PFNA-II was associated with satisfactory outcomes. In patients who underwent surgeries using TFNA, the recovery of gait ability, frequency of complications, and short-ening of the femoral neck were not significantly different from PFNA-II, suggesting that both are suitable instrument choices for intertrochanteric fracture treatment. However, the clinical significance must be further assessed using a larger group of patients over a longer follow-up period in future studies.
4.Joint Depression Type of Intraarticular Calcaneal Fractures Treated with Essex-Lopresti Method.
Gyu Min KONG ; Byoung Ho SUH ; Dong Joon KIM
Journal of the Korean Fracture Society 2007;20(2):178-183
PURPOSE: To evaluate the result of joint depression type of intraarticular calcaneal fractures treated with Essex-Lopresti method. MATERIALS AND METHODS: From March 2001 to February 2005, Thirty two patients' joint depression type of intraarticular calcaneal fractures which treated with Essex-Lopresti method were clinically and radiographically evaluated retrospectively. RESULTS: According to Creighton-Nebraska Health Foundation Assessment Score (C-N score), there were 5 excellent, 11 good, 6 fair and 10 poor results. Böhler angle was corrected from 10.3 degrees to 24.5 degrees. There was a positive correlation between size of depressed fragment and C-N score (p<0.01). CONCLUSION: Essex-Lopresti method can substitute open reduction methods in joint depression type of intraarticular calcaneal fractures which have relatively large depressed joint fragments.
Depression*
;
Joints*
;
Methods*
;
Retrospective Studies
5.RUNX1 Germline Mutation in a Patient with Chronic Thrombocytopenia
Yujin NAM ; Gyu Min YEON ; Seom Gim KONG
Clinical Pediatric Hematology-Oncology 2021;28(2):89-92
One of the pathophysiologic mechanism of inherited thrombocytopenia is a defect in transcription factors that regulate the expression of multiple genes required for megakaryopoiesis. Runt-related transcription factor 1 (RUNX1) binds to its heterodimeric partner, core binding factor beta (CBFβ), and forms a core binding factor that regulates the expression of various target genes. The association between RUNX1 germline mutations and familial platelet disorder with associated myeloid malignancy was first reported in 1999. Although this disease has various phenotypes and penetration, the most common symptom is a bleeding tendency due to thrombocytopenia and platelet dysfunction. Myelodysplastic syndromes or acute myeloid leukemia may also develop in 35-40% of cases. We identified a heterozygous mutation in the RUNX1 gene using diagnostic exome sequencing in an adolescent with chronic thrombocytopenia.The patient will be followed continuously for hematologic malignancies that may develop in the future. This case illustrates the importance of diagnosing inherited thrombocytopenia to provide adequate follow-up for hematologic malignancies and reduce unnecessary treatment.
6.Percutaneous Screw Fixation in a Displaced Pubic Fracture: Technical Note
The Journal of the Korean Orthopaedic Association 2021;56(4):361-365
Pelvic fractures are high-energy injuries, often accompanied by damage to the adjacent tissues and organs. For patients with pelvic trauma, active treatment is required early in the injury, because mortality can increase if appropriate treatment is not provided. In most cases, however, minimally invasive surgery is considered because extensive surgery cannot be performed due to the patient's condition. Percutaneous fixation of the pubis has been introduced because it can be applied easily to achieve the stability of the anterior part of the pelvis. Although many studies introduced percutaneous fixation of pubic bone fractures, most describe screw fixation for nondisplaced fractures. When treating displaced fractures with percutaneous screw fixation, it is difficult for the guide pin or drill bit to avoid the joint surface. Using a bent guide pin could allow easy insertion of the cannulated screw while avoiding the articular surface.
7.The Prognostic Factor of Posterolateral Fusion in Degenerative Spondylolisthesis.
Tae Woo SUNG ; Ki Chan AN ; Gyu Min KONG ; Dae Hyun PARK ; Tai Yeon YOON
Journal of Korean Society of Spine Surgery 2012;19(3):97-102
STUDY DESIGN: A retrospective analysis of the posterolateral fusion in degenerative spondylolisthesis. OBJECTIVES: Posterolateral fusion has been performed for patients about Meyerding grade1, 2 with degenerative spondylolisthesis in L4-5. We evaluated the prognostic factors of posterolateral fusion, alone for degenerative spondylolisthesis. SUMMARY OF LITERATURE REVIEW: It is reported that posterolateral fusion has almost equal postoperative clinical and radiographic results with the interbody or circumferential fusion for spondylolisthesis. However, there have been some unsatisfactory results after posterolateral fusion alone and the causes are yet unknown. MATERIAL AND METHODS: From January 2002 to July 2008, we analyzed postoperative clinical outcomes of 42 patients who were diagnosed with Meyerding 1 or 2 grade degenerative spondylolisthesis at L4-5. All the patients were classified into group I and group II, based on the clinical outcome evaluation method by Kirkaldy-Willis. Ten patients (Group I) were found to have poor or fair clinical outcomes, while 32 patients (Group II) were found to have excellent or good clinical outcomes. The mean duration of the follow up was 16.3 (12-23) months. We looked into postoperative body mass index and bone mass density, and found degenrative lumbar disc through preoperative MRI, retrospectively. We measured angular motion by dynamic radiographs and preoperative slip angle through a Taillard method. RESULTS: In group I, the average preoperative BMI was 25.7 (21.2~31.4) and the average T score of bone density was -3.0 (-1.9~-4.2). There was 1 case of Grade 3, 3 cases of Grade 4 and 6 cases of Grade 5 by preoperative Pfirmann classification. The average angular motion was 11.8 (9.1~14.2) and the average preoperative slip angle was 8.4 (6.9-9.6). In group II, the average preoperative BMI was 24.3 (20.72~28.1) and the average T score of bone density was -2.1 (-0.9~-3.1). There were 26 cases of Grade 3, 5 cases of Grade 4 and 1 case of Grade 5 by preoperative Pfirmann classification. The average angular motion was 8.8 (6.2~12.1) and the average preoperative slip angle was 6.2 (3.6-7.9). There were statistically significant differences between the two groups in BMI, stage of disc degeneration, preoperative angular motion, and slip angle. (p=0.04, 0.04, 0.05, 0.03, respectively) CONCLUSION: We concluded that posterolateral fusion has exhibited worse clinical results in cases of BMI less than -2.8, disc degeneration greater than grade 4, angular motion greater than 9.4 degrees, and slip angle greater than 7.1 degrees; as such, we need to consider other surgical methods.
Body Mass Index
;
Bone Density
;
Follow-Up Studies
;
Humans
;
Intervertebral Disc Degeneration
;
Retrospective Studies
;
Spondylolisthesis
8.Differences of Bone Mineral Density between Spine and Hip in Osteoporotic Patients.
Gyu Min KONG ; Sang Eon LEE ; Dong Jun KIM ; Tae Hyun YOON
Journal of the Korean Fracture Society 2005;18(2):181-184
PURPOSE: To evaluate differences and correlations of spine and hip region BMD in osteoporotic patients with or without spine fracture. MATERIALS AND METHODS: From January 1999 to December 2002, We measured and evaluated BMD of L3 and hip by DXA in 52 patients with spine fracture (fracture group) and 96 osteoporotic patients without spine fracture (non-fracture group) above 60 years. RESULTS: The average age of patients with spine fracture is 72.1 years and without spine fracture is 66.9 years. There were no statistical significant differences of BMD of spine, neck of femur and trochanteric area between 2 groups. But the BMD of Ward triangle of fracture group decreased significantly in statistics. The correlation coefficient between the lumbar spine and trochanteric area were 0.674 in fracture group and 0.794 in non-fracture group. They had statistical significance (<0.01). CONCLUSION: The BMD of Ward triangle of fracture group had lower value, but the BMD of lumbar spine had no differences between 2 groups. Therefore in these persons who have decreased BMD in Ward triangle should be concerned about high vertebral compression fracture risk vertebral compression fracture.
Bone Density*
;
Femur
;
Femur Neck
;
Fractures, Compression
;
Hip*
;
Humans
;
Neck
;
Osteoporosis
;
Spine*
9.Comparison of Bone Mineral Density in Elderly Patients according to Presence of Intertrochanteric Fracture.
Sang Ho MOON ; Byoung Ho SUH ; Dong Joon KIM ; Gyu Min KONG ; Hyeon Guk CHO
Journal of the Korean Fracture Society 2007;20(3):222-226
PURPOSE: To analyze difference in bone mineral density (BMD) between intertrochanteric fracture and control group and to explore the predictive value of BMD for intertrochanteric fracture. MATERIALS AND METHODS: 57 patients who were over 60-year-old with intertrochanteric fracture were examined. For control group, 110 patients who did not have any fracture were selected. Dual energy X-ray absorptiometry was studied at 1, 2, 3, 4 lumbar vertebrae, femoral neck, trochanter and Ward's triangle. BMD was compared at each site between two groups statistically. RESULTS: Fracture group consisted of 16 male, 41 female and was average 70.8 year old. Control group consisted of 21 male, 89 female and was average 68.1 year old. There was no differences in sex and age between two groups (p>0.05). BMD of L1, L2 and mean lumbar area were significantly less in fracture group than control group (p<0.05). There was no difference between two groups in BMD of another sites (p>0.05). CONCLUSION: BMD of L1, L2 and mean lumbar area in fracture group had lower value significantly, but had no differences between two groups at another sites. BMD of L1, L2 and mean lumbar area might be used as the most sensitive predictive indicator for risk of osteoporotic fractures including intertrochanteric fracture in elderly patient.
Absorptiometry, Photon
;
Aged*
;
Bone Density*
;
Female
;
Femur
;
Femur Neck
;
Humans
;
Lumbar Vertebrae
;
Male
;
Middle Aged
;
Osteoporotic Fractures
10.Surgical Treatment of Diaphyseal Fractures of Both Forearm Bones in Adolescents.
Gyu Min KONG ; Byoung Ho SUH ; Sung Hwan KIM ; Mid Um JEAGAL
Journal of the Korean Society for Surgery of the Hand 2011;16(4):198-203
PURPOSE: To evaluate the results of surgical treatment for diaphyseal fractures of both forearm bones in adolescents. MATERIALS AND METHODS: Between March 2005 and February 2009, fifteen adolescents with diaphyseal fractures in both forearm bones were treated with a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures. They were clinically and radiologically evaluated retrospectively. RESULTS: The mean time for radiological bone union was 9.2 weeks. At the last follow up, the rotational deformity and angulation were within seven degrees and evaluations of the functional results were excellent in all cases. One patient had a refracture of the ulna after plate removal, which was treated with a long-arm cast. CONCLUSION: The use of a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures can be an effective method for unstable displaced diaphyseal fractures of both forearm bones in adolescents.
Adolescent
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Congenital Abnormalities
;
Follow-Up Studies
;
Forearm
;
Humans
;
Ulna