Extramedullary (EM) reduction, defined as the medial cortex of the head–neck fragment located outside the medullary canal of the distal shaft fragment, has been introduced to prevent excessive postoperative sliding or failure of the lag screw in pertrochanteric fracture surgeries. Favorable EM reduction results have recently been reported in several clinical and biomechanical studies. Despite these efforts, maintaining the head–neck fragment in an EM position is periodically a difficult and challenging problem. Herein, the technique for reduction and maintenance of the head–neck fragment was introduced in an EM position using a Kirschner wire and partially threaded cannulated screw fixation via screw fixation from EM to the head–neck fragment, which was positioned inferior to the lag screw on the femoral calcar, also called the reduction screw. The authors utilized this reduction screw in 34 pertrochanteric fracture surgeries using a cephalomedullary nail and fracture union was acheive in all cases by a minimum one-year follow-up period without surgical complications.

PURPOSE: The study examined the fusion site and characteristics of the subtalar arthrodesis after intraarticular calcaneal fractures using computed tomography. MATERIALS AND METHODS: The clinical results and computed tomographic analysis of the fusion site were reviewed in 18 patients who were followed-up for a minimum of six months after undergoing subtalar arthrodesis due to traumatic arthritis caused by an intra-articular calcaneal fracture from December 2012 to April 2017. RESULTS: An evaluation of clinical results after subtalar arthrodesis revealed statistically significant improvements. In all cases, arthritis was found in the injured articular surface, which was displaced superolaterally from the initial primary fracture line of the calcaneus. Six months after arthrodesis, the subtalar fusion rate was 80.0% (16/20). Of these, 14 cases had a cannulated screw inserted in the uninjured site that is medial to the primary fracture line. Joint fusion was observed on the uninjured articular surface in 17 cases (85.0%). CONCLUSION: Joint fusion was initially achieved at the uninjured posterior facet after subtalar arthrodesis due to traumatic arthritis caused by a displaced intra-articular calcaneal fracture. This suggests that meticulous surgical techniques and cannulated screw positioning at the uninjured site will promote joint fusion.
Arthritis ; Arthrodesis ; Calcaneus ; Humans ; Joints ; Subtalar Joint

PURPOSE: To evaluate the radiological findings and effectiveness of radiological interventions in patientswith iatrogenic vascular injuries. MATERIALS AND METHODS: We analyzed 50 patients with iatrogenic vascularinjuries treated with radiological intervention. The causes of injuries were surgery(n=20), cardiovascularintervention(n=15), non-cardiovascular radiological intervention(n=14), and endoscopic intervention(n=1). Theinjury had resulted in hemorrhage in 35 cases. The iliac and/or femoral, hepatic, and renal vessels were commonlyinjured. Angiography, ultrasonography with Doppler examination, CT, and CT angiography were performed to diagnosevascular injuries and guide the radiological intervention. The mean follow-up period was 23 months and in 16 caseswas more than one year. RESULTS: The major radiological findings were extravasation, pseudoaneurysm,arteriovenous shunt, or vascular obstruction. To control these lesions, radiological interventions such asembolization(n=36), local urokinase administration, stent insertion, foreign body removal, ultrasonography-guidedcompression, or stent-graft insertion were performed. The clinical problems were immediately controlled by thesingle trials of radiological interventions and did not recur in 40 cases (80%). CONCLUSION: Radiologicalexaminations and interventions are useful in cases with iatrogenic vascular injuries.
Angiography ; Follow-Up Studies ; Foreign Bodies ; Hemorrhage ; Humans ; Stents ; Ultrasonography ; Urokinase-Type Plasminogen Activator ; Vascular System Injuries*

OBJECTIVE: We examined the difference between IQ(Intelligence Quotient) estimated from computerized Standard Progressive Matrices(SPM) score(SPM IQ) and Korean-Wechsler Adult Intelligence Scale(KWAIS) IQ(KWAIS IQ) in Korean patients with mental disorders in order to test the validity of SPM as a brief nonverbal intelligence test, and to find the groups that need standardization. And, we studied the method to predict KWAIS IQ more precisely from SPM test. METHODS: SPM test in Vienna test system was administered to 166 Korean patients with mental disorders. The degree of consistency and Pearson's correlation coefficient between SPM IQ and KWAIS IQ in total subjects and groups by sex, age, education, and clinical diagnosis were investigated. And, we obtained a regression equation to predict KWAIS IQ from SPM score. RESULTS: In total subjects, Pearson's correlation coefficient between SPM IQ and KWAIS IQ was as high as 0.704, and the percent of patients whose absolute value of difference between SPM IQ and KWAIS IQ is equal to or less than 10 was 54.8%. The degree of consistency between SPM IQ and KWAIS IQ was influenced by age and educational level. SPM IQ were higher than KWAIS IQ in younger age and lower education group. SPM IQ were lower than KWAIS IQ in older age and higher education group. The regression equation from SPM score, age, and education years predicted KWAIS IQ more correctly. CONCLUSION: The Computerized Standard Progressive Matrices test is validated and can be used usefully as a brief nonverbal intelligence test in patients with mental disorders. In order to provide more precise evaluation, standardized data should be prepared for age group 16 to 25 and age group 26 to 35 with lower educational level.
Adult ; Diagnosis ; Education ; Humans ; Intelligence ; Intelligence Tests ; Mental Disorders*