PURPOSE: This study evaluated the clinical and radiological outcomes of unstable distal clavicular fractures treated with an AO Hook plate. MATERIALS AND METHODS: From March 2009 to October 2010, sixteen patients with distal clavicular fractures underwent open plating using an AO Hook plate. The clinical outcomes were assessed by measuring the UCLA scores and KSS sores, and the radiological outcomes were evaluated using simple radiographs at the final follow-up. RESULTS: Fracture union was obtained in all patients at an average of 13.9 weeks (range, 9~20 weeks). The UCLA scoring system showed excellent results in 9 cases and good results in 7. The average KSS scores of distal clavicular fractures were 95.5. At the final follow-up, subacromial osteolysis developed in 11 cases (68.7%) of whom 3 suffered from pain around the acromion. Other complications occurred in 4 patients: one had a fracture adjacent to the plate proximally, two had a stiff shoulder with subacromial impingement, and one had hypoesthesia around the surgical wound. CONCLUSION: Unstable distal clavicular fractures treated with a Hook plate provided rigid fixation and satisfactory outcomes considering the high union rate. Nevertheless, potential postoperative complications related to morphometric properties of the plate should be considered.
Acromion ; Clavicle ; Follow-Up Studies ; Humans ; Hypesthesia ; Osteolysis ; Postoperative Complications ; Shoulder

PURPOSE: To compare the radiological and clinical results between intramedullary nailing and plate fixation in the treatment of distal tibial fractures. MATERIALS AND METHODS: 19 cases of distal tibial metaphyseal fractures within 4 cm of the ankle joint line were enrolled. Ten patients were treated with interlocking intramedullary nail and the others with plate and screws. RESULTS: The mean union time was 14 weeks in nailing group and 16 weeks in plate group. The average angulation in AP view was 4.1 degrees in nailing group and 3.1 degrees in plate group. The average angulation in lateral view was 1.7 degrees in nailing group and 2.7 degrees in plate group. The rotational deformity was 2.8 degrees in nailing group and 1.7 degrees in plate group in average. There was no implant failure and soft tissue problem. CONCLUSION: There was no difference in clinical and radiological results between intramedullary nailing and plate in the treatment of the distal tibial fractures and, considering the preservation of the soft tissue, the intramedullary nails are a reliable method for managing distal metaphyseal fractures of the tibia.
Ankle Joint ; Congenital Abnormalities ; Fracture Fixation, Intramedullary* ; Humans ; Methods ; Tibia* ; Tibial Fractures

PURPOSE: The aim of this study was to investigate the overall rate of deep infection and the risk factors for infection after primary total knee arhroplasties. MATERIALS AND METHODS: We conducted a retrospective case-control study of 229 patients (376 knees) who underwent total knee replacement (TKR) between January 2006 and June 2007 and who were followed up for more than one year. The risk factors for deep infection were determined via univariate analyses. RESULTS: The overall rate for developing infection was 1.9% (7 of 376). The risk factors were an operating theatre other than the main room (odds ratio=33.2, 95% confidence interval=1.9, 583.6) and a preoperative hemoglobin level lower than 12 mg% (odds ratio=4.3, 95% confidence interval=1.9, 9.4). CONCLUSION: The deep infection rates after TKRs might vary depending on the preoperative level of hemoglobin and the operating-room environment. Successful strategies to overcome the host and environmental risk factors are needed with the goal of preventing infection of the prosthesis.
Arthroplasty, Replacement, Knee ; Case-Control Studies ; Hemoglobins ; Humans ; Knee ; Retrospective Studies ; Risk Factors

PURPOSE: The purpose of this study is to evaluate the clinical and radiological outcomes of proximal, middle and distal third humeral fractures treated with the minimally invasive plate osteosynthesis (MIPO). MATERIALS AND METHODS: Thirty-one patients with the proximal, middle or distal third humeral fractures underwent MIPO. There were 12 men and 19 women with an average age of 46.7 years. The radiological outcomes of bony union and anatomical reduction were evaluated. The clinical outcomes were assessed by measuring the range of shoulder and elbow motion, UCLA scores, KSS sores and the postoperative complications. RESULTS: Fracture union was obtained in all patients at an average of 18.4 weeks. According to the UCLA scores, 9 were excellent and 3 were good for the proximal humeral fractures. For the middle and distal third fractures, UCLA scoring system showed excellent results in 15 cases and good results in 4 cases. The average KSS scores of proximal and shaft fracture were 92.5 and 98.6, respectively. Complications developed in 3 patients: one had radial nerve palsy, one had a fracture adjacent to the plate distally, and one had a rotational deformity. CONCLUSION: MIPO for proximal, middle and distal third humeral fractures provided satisfactory clinical and radiological outcomes considering high union rate and minor complications.
Elbow ; Female ; Humans ; Humeral Fractures ; Humerus ; Male ; Paralysis ; Radial Nerve ; Shoulder ; Shoulder Fractures

Clavicular fracture is common injury in the upper extremity, but ipsilateral proximal, distal or middle-third clavicular fractures which occur simultaneously are an extremely rare. Seven cases have been reported in the English and Japanese literatures, but it has never been reported in Korea. We report a case of ipsilateral proximal and distal clavicular fracture caused by fall from height and describe its presumed mechanism, diagnosis, treatment with a review of literatures.
Asian Continental Ancestry Group ; Clavicle ; Humans ; Korea ; Upper Extremity

It is well known that small heat shock proteins play a role as molecular chaperone. However, during normal development of the cerebellum, expression and distribution of HSP27 and alphaB-crystallin (alphaBC) which are small heat shock proteins have not been reported. To verify the protective role of HSP27 and alphaBC in neurons and glial cells, we examined the expression and distribution of HSP27 and alphaBC in the developing chick cerebellum using immunoblot, immunohistochemical and double immunofluorescence staining. Expression of both HSP27 and alphaBC was first identified in the cerebellum of the embryonic day 14 (E14) embryo, and was increased at E18. Double immunofluorescence analysis with myelin-basic protein (MBP) demonstrated that alphaBC positive (+) cells were mature myelinating oligodendrocytes. alphaBC+ cells were observed in the white matter of the E14 cerebellum. At E18, there were a number of alphaBC+ cells in the white matter and a few cells in the granular layer of the gray matter. On the other hand, HSP27+ cells were observed in the white matter and the Purkinje cell layer at E14. At E18, HSP27+ signals were observed in Purkinje cells and neurons of cerebellar nucleus as well as oligodendrocytes in the white matter and the granular layer. The results that HSP27 and alphaBC were expressed in specific neurons and glial cells in the developing cerebellum suggest that HSP27 and alphaBC may be involved in the protective mechanism for the apoptosis of neurons and the physiological stress occurred in oligodendrocyts during cell maturation.
Apoptosis ; Cerebellar Nuclei ; Cerebellum* ; Embryonic Structures ; Fluorescent Antibody Technique ; Hand ; Heat-Shock Proteins, Small ; Molecular Chaperones ; Myelin Sheath ; Neuroglia ; Neurons ; Oligodendroglia ; Purkinje Cells ; Stress, Physiological

Desmoplastic infantile astrocytoma is a huge cystic tumor, typically occurring in the cerebral hemispheres of infants. The authors report a 4-month-old baby presented with increased head circumference, bulging fontanel, and the setting-sun sign. Magnetic resonance imaging revealed a round mass with huge cystic component in the right cerebral hemisphere. Microsurgical gross total resection of the tumor was performed and pathological examination of the specimen showed features of desmoplastic infantile astrocytoma. The postoperative course was complicated by subdural hygroma which was managed by the placement of subduroperitoneal shunt. Although desmoplastic infantile astrocytomas are rare, it must be distinguished from other hemispheric tumors in infancy or childhood because of good prognosis.
Astrocytoma* ; Cerebrum ; Head ; Humans ; Infant ; Magnetic Resonance Imaging ; Prognosis ; Subdural Effusion

BACKGROUND: Major orthopedic surgical procedures, including spinal fusions, require 2 or 3 units of transfusion. In this study, we evaluated the usefulness of autologous transfusion by comparing the postoperative infections, the pre- and postoperative serological changes, the amount of transfusion during the operation and the segmented estimated blood loss of the patients who received spinal fusion surgery. METHODS: We analyzed 106 patients who were undergoing spinal fusion surgery and among them, 69 patients were operated on with using autologous transfusion, while 37 cases were operated on with using homologous transfusion. RESULTS: The segmental estimated blood loss was approximately 574.4+/-131.8 mL in group 1 and 635.3+/-250.1 mL in group 2. The mean number of transfused units in the autologous transfusion group was 2.1+/-0.3 units and this was 3.5+/-0.6 units in the homologous transfusion group. There was no significant statistical difference in the hemoglobin level or the complications between the two groups, yet the duration of fever in the group with homologous transfusion was 3.0+/-0.4 days, which was increased compared to that of group 1 (1.4+/-1.3 days). CONCLUSION: The total amount of transfusion and blood loss for the patients who were operated on using autologous transfusion were less, as compared to those for the patients who were operated on with homologous transfusion, and the patients with homologous transfusion showed a significantly decreased duration of fever. It seems that autologous transfusion is a way to shorten the duration of fever and increase the satisfaction of the patients.
Blood Donors ; Fever ; Hemoglobins ; Humans ; Orthopedic Procedures ; Spinal Fusion

No Abstract Available.
Acanthoma*

Purpose: This study analyzed the prognostic factors in patients with femoral head fractures by comparing two groups with and without complications. Materials and Methods: A retrospective study was performed on femoral head fracture patients who visited two different level-1 trauma centers from January 1, 2014 to June 30, 2018. Thirty-three patients with a follow-up period of more than one year were included. Early complications were defined as fair or poor in the Thompson–Epstein clinical evaluation criteria and grades 3 or 4 in the Kellgren– Lawrence classification within one year after the fracture. The patients were divided into two groups, with and without early complications. Statistical analysis was performed for the nominal variables with a Fisher’s exact test and continuous variables using a Mann–Whitney U test. Results: Nine patients (27.3%) had early complications, and there were no significant differences according to age, sex, treatment method, combined fractures, Pipkin classification, and AO/OTA classification between the two groups. Conclusion The prognosis in femoral head fractures is difficult to predict. Therefore, the validation of existing classifications or a new classification is necessary.