In pediatric ages, the supracondylar fractures of the humerus are common and often associated with complications. In these days, the serious complications were reduced with a lot of apprehension for the treatment. While the fracture itself was healed properly, the remained deformity was frequent and it was known that this deformity was derived not from growth disturbance after fracture but from inaccurate reduction at the time of initial reduction. We have performed an anatomical study. Identical skeletal models were osteotomized at the supracondyle of the humerus and every combination of 0°,10°, 20°, 30° of each of varus, valgus tilt, internal rotation and flexion were tried at osteotomized site and were taken radiography and photographed. We measured T-C angle, carrying angle and displacement of distal radial styloid process on X-ray. We got the results as follow. 1. Simple rotational deformity of 50° have resulted in only 20% decrease of width of distal osteotomized surface in AP films in pure rotational deformity. 2. Flexion at the osteotomized site have no specific effect on the change of varus and valgus deformity. There were remarkable increase from 0° to 20° after then the changes were decreased in varus tendency according to internal rotation. 3. Among the changes of varus and valgus angle, the varus deformity was largest at the change of angle from 0° to 10° and other change of angle of varus and valgus deformity were incrersed at similar degree. 4. At the osteotomy site, without changes of varus and valgus angle, it showed that internal rotation resulted in varus defromity.
Congenital Abnormalities ; Humerus ; Osteotomy ; Radiography

The aim of the present study was to evaluate the degree of restoration of acromiohumeral distance of immediate postoperative period in patients who have rotator cuff repair surgery with large-to-massive rotator cuff tears and to find clinical and radiologic factors influencing this. Fifty four patients who had arthroscopic rotator cuff repair with available postoperative magnetic resonance images done within postoperative one week were included. Retrospective review of the medical data and radiologic images was done. It was revealed that acromiohumeral distance of immediate postoperative period was smaller in patients with larger sized rotator cuff tears, more retraction of the torn end and narrower preoperative acromiohumeral distance. The degree of inferior migration of the humeral head which could be obtained through the surgery alone was more in patients who have more difference between acromiohumeral distance measured on preoperative standing simple radiography and acromiohumeral distance measured on preoperative magnetic resonance image.
Acromion ; Humans ; Humeral Head ; Humerus ; Postoperative Period* ; Radiography ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Tears*

BACKGROUND: In 1951, Ardran reported that metastatic bone lesions could be detectable on plain radiography with 30% to 50% of decalcification. Authors performed experimental study for minimum level of decalcification to detect the osteolytic bone metastasis of long bone with recent technique of radiographs. METHODS: One pair of fibula and humerus from two cadavers was cut into specimen 1 inch in length. Distal half of specimen was dipped into hydrochloride (HCl) with 15 min interval. All 16 specimens were checked by film-type radiography (FR), computed radiography (CR), digital radiography (DR). To exclude inter-observer's variance, 3 radiologists evaluated images. Calcium amount before and after decalcification was measured and expressed in percentage of decalcification. RESULTS: Osteolytic changes were detectable with 11% to 16% of decalcification for fibula and 3% to 8% for humerus on plain radiography with FR, CR, and DR. CONCLUSIONS: Our study showed that minimum of 3% and maximum of 16% of decalcification is necessary when osteolytic metastatic bone lesions of long bone could be detected on plain radiography.
Cadaver ; Calcium ; Decalcification Technique ; Fibula ; Humerus ; Neoplasm Metastasis* ; Osteolysis ; Radiographic Image Enhancement ; Radiography*

Cubitus varus, which includes deformities of varus, hyperextension and internal rotation, is the most common complication of supracondylar fracture of the humerus in children. For correction of cubitus varus deformity, many operative methods have been reported but postoperative results are not always satifactory. For the purpose of detection of the reason of postoperative residual deformity, we reviewed AP roentgenography of 22 patients of cubitus varus deformity in the view point that change of longitudinal axis of forearm contribute the residual deformity. The results are summerized as follows: 1. Degree of cubitus varus deformity was more severe in the patients whose interval between the injured time and visiting hospital for cubitus varus was longer. 2. Average proximal radial shaft angle was 10.99degrees +/-3.48degrees in normal limb and 15.72degrees+/-4.03degrees in affected limb and average ulnar shaft angle was 7.86degrees+/-3.60degrees, 10.54degrees +/-4.02degrees (P<0.05), respectively which were all significant value statistically (P<0.05). Average distal radial shaft angle was 10.21degrees 2.37 in normal limb and 11.21degrees +/-1.51degrees in affected limb and statistically insignificant (P>0.05). 3. More severe cubitus varus deformity revealed more change of proximal radial shaft angle of attected limb compare to normal limb. Based on these results, we concluded that correction of the cubitus varus deformity should not be delayed in order to minimize the secondary change of longitudinal axis of foream bones and to obtain satisfacotry cosmetic outcome.
Axis, Cervical Vertebra* ; Child ; Congenital Abnormalities* ; Extremities ; Forearm ; Humans ; Humerus ; Radiography ; Radius* ; Ulna*

A extragonadal malignant teratoma of the extremity is a rare pheonemenon. We describe a extremely rare case of malignant teratoma of the left proximal humerus in a 14-yr-old female. Radiologic evaluations, including magnetic resonance imaging, suggested a malignant bone tumor, but a pathological examination revealed an immature bony teratoma. Bone scintigraphy and positron emission tomography computed tomography scan showed increased uptake of proximal humerus but no other abnormal lesion.
Adolescent ; Bone Neoplasms/*diagnosis/pathology/radiography ; Female ; Humans ; *Humerus/radiography ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Teratoma/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed

A 7-yr-old girl presented with progressive shortening of the right upper arm and limitation of shoulder motion. Pseudohypoparathyroidism associated with Albright's hereditary osteodystrophy was diagnosed by biochemical, hormonal and radiographic studies. Her condition was complicated by severe humerus varus on the right side. Proximal humeral valgization osteotomy and concomitant humeral lengthening resulted in an improvement of the shoulder joint motion and activity in daily life.
Bone Diseases/*complications/*diagnosis ; Bone Diseases, Developmental/diagnosis ; Bone Lengthening ; Child ; Female ; Foot/radiography ; Hand/radiography ; Humans ; Humerus/*radiography ; Joint Deformities, Acquired/diagnosis ; Osteotomy ; Pseudohypoparathyroidism/*complications ; Time Factors

PURPOSE: The purpose of this study was to evaluate the usefulness of MR imaging of pathologic fractures of the long bones. MATERIALS AND METHODS: In 18 patients aged between four and 75 (mean, 25.8) years with histologically confirmed pathologic fractures of the long bones, plain radiographs and MR images were retrospectively analyzed. The former were examined with regard to location and type of fracture, and the presence or absence of underlying disease causing fracture; and the latter in terms of underlying disease, extraosseous mass formation, and soft tissue change. RESULTS: The long bones involved were the femur in nine patients, the humerus in six, and the tibia in three. Underlying diseases were metastatic tumor (n=6), benign bone tumor (n=5), primary malignant bone tumor (n=4), osteomyelitis (n=2), and eosinophilic granuloma (n=1). Plain radiographs showed the fracture site as the metaphysis in ten cases, the diaphysis in five, and the metadiaphysis in one. Fractures were either transverse (n=10), oblique (n=3), spiral (n=1), vertical (n=1), or telescopic (n=1). In two cases, the fracture line was not visible. MR images revealed underlying diseases in all cases. A solid mass was present in all cases of malignant bone tumor, and an extraosseous mass in five such cases. Two benign bone tumors took the form of a cystic mass, two were a cystic mass containing an enhanced solid portion, and one was a solid mass. A soft tissue hematoma was seen in three cases. CONCLUSION: Where pathologic fracture of a long bone had occurred, or a pathologic fracture in which the findings of plain radiography were equivocal, MR imaging was useful for evaluating the pattern and extent of an underlying lesion.
Diaphyses ; Eosinophilic Granuloma ; Femur ; Fractures, Spontaneous* ; Hematoma ; Humans ; Humerus ; Magnetic Resonance Imaging* ; Osteomyelitis ; Radiography ; Retrospective Studies ; Tibia

Simple bone cyst was first described by Virchow over a century ago and has been the subject of numerous articles. Nevertheless considerable confusion still exists regarding its etiology. clinical behavior and optimal management. Eighteen cases of pathologically proven simple bone cyst were treated in the Department of Orthopedic Surgery, Seoul National University Hospital during the thirteen year period from June 1966 to May 1979, and following results were obtained. 1. Age distributions were between five and forty-three years (Average ; seventeen years), and 72.2% (thirteen cases) were during first two decades of life. 2. Male to female ratio was 2.6 to 1 3. The most frequently involved location was proximal humerus followed by proximal femur. 4. Pathologic fracture, pain, incidental roentgenography and swelling were the first clues of diagnosis in our series. 5. In twelve cases curettage and fresh autogenous iliac bone graft was performed and good results were obtained in all of them. Of five cases only curettage had been done, no case recurred, another case showed residual cystic area, and the rest healed without further event. In one case with huge cyst curettage, iliac and fibular bone graft and bone cementing was performed with satisfactory result. 6. Bone shortening was noticed in two cases of active bone cysts in proximal humerus 2cm and 3cm, respectively.
Age Distribution ; Bone Cysts ; Curettage ; Diagnosis ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Humerus ; Male ; Orthopedics ; Radiography ; Seoul ; Transplants

BACKGROUND: We conducted this radiographic study in the elderly population with proximal humeral fracture aiming to evaluate 1) the serial changes of neck-shaft angle after locking plate fixation and 2) find relationship between change in neck shaft angle and various factors such as age, fracture pattern, severity of osteoporosis, medial support and initial reduction angle. METHODS: Twenty-five patients who underwent surgical treatment for proximal humeral fracture with locking plate between September 2008 and August 2010 are included. True anteroposterior and axillary lateral radiographs were made postoperatively and at each follow-up visit. Measurement of neck shaft angle was done at immediate postoperative, 3 months postoperative and a final follow-up (average, 11 months; range, 8 to 17 months). Severity of osteoporosis was assessed using cortical thickness suggested by Tingart et al. RESULTS: The mean neck shaft angles were 133.6degrees (range, 100degrees to 116degrees) at immediate postoperative, 129.8degrees (range, 99degrees to 150degrees) at 3 months postoperative and 128.4degrees (range, 97degrees to 145degrees) at final follow-up. The mean loss in the neck-shaft angle in the first 3 months was 3.8degrees as compared to 1.3degrees in the period between 3 months and final follow-up. This was statistically significant (p = 0.002), indicating that most of the fall in neck shaft angle occurs in the first three months after surgery. Relationship between neck shaft angle change and age (p = 0.29), fracture pattern (p = 0.41), cortical thickness (p = 0.21), medial support (p = 0.63) and initial reduction accuracy (p = 0.65) are not statistically significant. CONCLUSIONS: The proximal humerus locking plate maintains reliable radiographic results even in the elderly population with proximal humerus fracture.
Aged ; Aged, 80 and over ; Analysis of Variance ; *Bone Plates ; Female ; Fracture Fixation, Internal/instrumentation/methods ; Humans ; Humerus/radiography/*surgery ; Male ; Shoulder Fractures/radiography/*surgery

This report was designed to investigate a rare case that brachialis tear and hematoma caused by acute elbow posterior dislocation. We studied a 20-year-old male patient with right elbow joint pain after outstretched injury. Physical examination showed instability of hright elbow joint and simple radiography indicated a posterolateral dislocation of right elbow joint. Computed tomography taken after closed reduction using Parvin technique revealed a few small bone fragment located on posterior humerus capitulum. Magnetic resonance imaging showed complete tear of brachialis and anterior articular capsule with hematoma. The patient was managed with long arm splint and hinge brace for an elbow dislocation with brachialis rupture and hematoma. The elbow joint range of motion was recovered to be in a normal range, and pain was diminished. There are few reported cases of acute elbow posterior dislocation combined with brachialis rupture and hematoma. The patient showed good clinical outcome after conservative treatment.
Arm ; Braces ; Dislocations* ; Elbow Joint ; Elbow* ; Hematoma* ; Humans ; Humerus ; Joint Capsule ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Radiography ; Range of Motion, Articular ; Reference Values ; Rupture ; Splints ; Young Adult