No abstract available.

Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.
Elbow ; Exercise ; Fracture Fixation ; Joints ; Methods ; Olecranon Process* ; Range of Motion, Articular ; Tendons ; Traction

Purpose: To evaluate the results of blade plate fixation and bone grafting for the treatment of failed intertrochanteric hip fractures. Materials and Methods: Eight patients were treated with 95° blade plate fixation and bone grafts were performed in 7 patients. The mean age of the patients was 73 years old and the mean follow-up period was 26 months (range, 6 to 65 months). Clinical and radiological results were evaluated based on pain, walking ability, union period, and maintenance of reduction. Results: 6 of 8 patients obtained a solid union after a median period of 20 weeks. The neck-shaft angle was changed from 118° to 133° postoperatively. One patient underwent revision of a bipolar hemiarthroplasty due to failed blade plate fixation and varus malunion occurred in one patient Conclusion: Blade plate fixation and bone grafting for failed internal fixation of intertrochanteric hip fractures can provide a solid union and a good clinical result.
Bone Transplantation ; Follow-Up Studies ; Hemiarthroplasty ; Hip Fractures* ; Hip* ; Humans ; Transplants ; Walking

No abstract available.
Humans

PURPOSE: In determining image quality of mammography,many factors are related. Selection of film and screen is one of them. Authors took phantom images of nine film-screen combinations under properly controlled conditions and compared them to evaluate their image qualities. In addition, KVp, mAs and surface dose were evaluated at each combination to deterrhine proper exposure conditions. MATERIALS AND METHODS: Using phantom,images of nine film-screen combinations composed of Fuji MI-NC, UM-MA, UM-MH films and Fuji Fine,Medium, Kodak Min-R screeens were taken. Phantom(Ackermann Mammochip Phantom) was composed of simulations for microcalcifications, fibers, nodules, lymph nodes, breast tissue and breast cancer masses. For phantom of 4.5 cm compressed breast equivalent, 28 KVp was used. For 1.5 and 3.0 cm equivalant phantoms, 24 KVp and 26 KVp was used. At each KVp, mammographic images were taken at various mAs. Among images taken by this process, best images were selected and then, according to scoring method, comparison of image quality for each combination was done. With dosimation strip, surface doses for various conditions were evaluated. RESULTS: Combination of Fuji UM-MA film and Fuji Fine screen showed best image quality regardless of KVp or phantom thickness. For the best image, 10 mAs with 26 KVp was most ideal while mAs with 24 KVp was optimal for equivalent phantom of 3.0 cm thickness breast. At this condition, surface dose was less than other combinations when combinations involving UM-MH films were used. On the other hand,when combinations involving MI-NC films were used, surface dose was higher than others. CONCLUSION: Using phantom, image quality of film-screen combinations could be evaluated and compared. Such process can contribute to best quality image with decreased exposure and can play a role in quality asurance program.
Breast ; Breast Neoplasms ; Lymph Nodes ; Research Design

Ruptures of extensor pollicis longus tendon after distal radial fractures are well-known. However, delayed flexor tendon rupture of finger as a complication of the fracture are less common. We report the case of delayed rupture of flexor digitorum profundus tendon to middle and ring fingers and flexor digitorum superficialis to ring finger in 72 year old female patient. She was treated by free tendon graft with palmaris longus tendon. After 1 year follow-up, range of motion and flexion power were recovered to nearly normal.
Aged ; Female ; Fingers ; Follow-Up Studies ; Humans ; Range of Motion, Articular ; Rupture* ; Tendons* ; Transplants

PURPOSE: To present tibial axis-talar ratio and tibia-ankle surface angle in lateral measured on standing ankle lateral radiographs of adults who did not have specific ankle pathology. MATERIALS AND METHODS: On Fifty-six radiographs without ankle osteoarthritis and malalignment, radiographic measures were performed with use of a custom dizitizing program based on PV-WAVE(R). AP ankle alignment was quantified by tibia axis-talar ratio (TTR) and tibia ankle surface angle in lateral (TLS angle). The data was compared with previously reported american data and analyzed using a t-test. RESULTS: The average TTR and TLS angle of our series were 33.9+/-3.3%, and no significant difference compared with reported american adults (p=0.152). CONCLUSION: The T-T ratio and TLS angle measured on standing ankle lateral radiographs of our series were 33.9+/-3.3% and 80.4+/-3.3 degrees. This measures appear to be a useful measure for determining AP ankle alignment.
Adult ; Ankle* ; Humans ; Osteoarthritis ; Pathology ; Tibia

The management of infected nonunion is based on a detailed evaluation of patients, the involved bone and soft tissues, stability of fixation, and type of bacterial pathogens. Preoperative surgical planning and strategies for each step is mandatory for the successful treatment of infected nonunion. The radical debridement of infected tissues, including the unstable implant, is one of the most important procedures. Adequate soft tissue coverage should be considered for the appropriate management of infection; a reconstructive procedure and stable skeletal stabilization by internal or external fixation is also necessary later. A restoration of bone defects and bony union can be accomplished with bone grafting, distraction osteogenesis, vascularized fibular grafting, and induced membrane technique.
Bone Transplantation ; Debridement ; Humans ; Membranes ; Osteogenesis, Distraction ; Transplants

The management of infected nonunion is based on a detailed evaluation of patients, the involved bone and soft tissues, stability of fixation, and type of bacterial pathogens. Preoperative surgical planning and strategies for each step is mandatory for the successful treatment of infected nonunion. The radical debridement of infected tissues, including the unstable implant, is one of the most important procedures. Adequate soft tissue coverage should be considered for the appropriate management of infection; a reconstructive procedure and stable skeletal stabilization by internal or external fixation is also necessary later. A restoration of bone defects and bony union can be accomplished with bone grafting, distraction osteogenesis, vascularized fibular grafting, and induced membrane technique.
Bone Transplantation ; Debridement ; Humans ; Membranes ; Osteogenesis, Distraction ; Transplants

PURPOSE: In the era of shock wave lithotripsy (SWL) and ureteroscopy, the majority of ureter stones are successfully managed with these less invasive treatment modalities. However, open ureterolithotomy still has a role in special situations. The efficacy of a laparoscopic retroperitoneal ureterolithotomy for large impacted ureter stones indicated for open ureterolithotomy is reported. MATERIALS AND MTHODS: Between February 1998 and December 1999, laparoscopic retroperitoneal ureterolithotomy for proximal ureter stones was performed in 5 patients who required an open ureterolithotomy. The mean size of the stones was 15mm, all of which were tightly impacted in the ureteral lumen and were associated with marked hydronephrosis. RESULTS: All but the initial operation was performed successfully via the retroperitoneal approach. Open conversion was needed in the first patient because of inexperience and the lack of anatomic perception. The mean operation time and estimated blood loss was 122 minutes and < or =50ml, respectively. A transfusion was not needed in any of the patients. Postoperative pain was well controlled with 175mg of Ketoprofen. The mean postoperative length of hospital stay was 6.3 days. There were no significant intraoperative or postoperative complications. CONCLUSIONS: A laparoscopic retroperitoneal ureterolithotomy can be considered as an alternative to conventional ureterolithotomy when open surgery is indicated.
Humans ; Hydronephrosis ; Ketoprofen ; Laparoscopy ; Length of Stay ; Lithotripsy ; Pain, Postoperative ; Postoperative Complications ; Shock ; Ureter ; Ureteroscopy