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

The recommended treatment of blow-out fracture varies greatly according to the operators. In addition, the implants used to span the orbital bony defect in blow-out fracture are various. Titanium is widely used for orthopaedic device for its good structural stability, excellent strength, eternal quality, high biocompatability, little risk of infection, malleability and easy fixation for operation. We had repaired inferior orbital wall fracture with Titanium mesh on 7 patients with large orbital inferior wall fracture in the posterior orbit in the last 2 years. All 7 patients showed improvements in extraocular ovements and the reduction of diplopia over 6 months. But one patient had persistent enophthalmos, and 2 patients complained of infraorbital numbness. For the reconstruction of orbital fracture, especially inferior wall in the posterior orbit, Titanium mesh may served as a good alloplastic implant without serious postoperative complications.
Diplopia ; Enophthalmos ; Fractures, Bone* ; Humans ; Hypesthesia ; Orbit* ; Orbital Fractures ; Postoperative Complications ; Titanium*

PURPOSE: The operative treatment for blow-out fracture involves restoration of intra-orbital soft tissue and bony structural integrity. There are several methods for reconstruction of inferior blow out fracture. We report reduction of inferior blow-out fracture with urinary balloon catheter in comparison with Medpor(R) using group to complication rate. METHODS: A retrospective study was performed on 67 patients who underwent inferior orbital blow-out fracture reconstruction with Medpor(R) implant or urinary balloon catheter following between 2003 and 2006. Hospital records were reviewed especially for preoperative and postoperative enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia between Medpor(R) implant group and balloon catheter using group. RESULTS: There was no significant statistical difference between both groups on incidence of postoperative complications of enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia. Postoperative infection, ectropion were absent in both groups. CONCLUSION: The use of urinary balloon catheter is simple, fast and inexpensive. Urinary balloon catheter is an alternative and reliable use for reduction of inferior orbital blow-out fracture.
Catheters* ; Diplopia ; Ectropion ; Enophthalmos ; Hospital Records ; Humans ; Hypesthesia ; Incidence ; Orbit ; Orbital Fractures* ; Postoperative Complications ; Retrospective Studies

BACKGROUND AND OBJECTS: Transseptal transsphenoidal hypophysectomy with nasal columellar flap is now a widely used method with acceptable morbidity, However, a considerable number of patients complain of nasal symptoms after the operation and postoperative complications are continuously reported. The authors analyzed the different types of postoperative symptoms and their incidences. OBJECTS AND METHODS: We interviewed 105 patients (39 male and 66 female) via telephone who have been followed up for more than 1 year. Interviews were proceeded by questionnaires. RESULTS: Among the postoperative symptoms, the most frequent symptom was nasal obstruction (19.0%), followed by hyposmia (17.1%), nasal crust (15.2%), rhinorrhea/headache (12.4%), and upper lip numbness (10.5%). CONCLUSION: On the basis of these clinical experiences, it would be necessary, before undergoing transeptal transsphenoid hypophysectomy, to let patients know and prepare themselves of possible postoperative nasal spnptoms.
Humans ; Hypesthesia ; Hypophysectomy* ; Incidence ; Linear Energy Transfer ; Lip ; Male ; Nasal Obstruction ; Postoperative Complications ; Surveys and Questionnaires ; Telephone

PURPOSE: Surgery for thyroid disease requires skin incisions that can result in postsurgical problems, such as prominent scars, adhesions and hypesthesia, as well as paresthesia of the neck. To overcome these problems we performed a gasless endoscopic thyroidectomy via an axillary approach. METHODS: Between November 2001 and April 2005, 141 patients underwent a gasless endoscopic thyroidectomy via an axillary approach. The surgical outcomes were evaluated in terms of the operating time, length of hospital stay and the incidence of perioperative complications. Patient opinions were assessed using a verbal response scale at two and four months after surgery. RESULTS: The mean operating time and length of hospital stay were 122.7+/-32.8 minutes and 3.4+/-0.9 days, respectively. No cases required either conversion to open surgery or involved significant intraoperative complications. Two months after surgery, 75 patients (53.2%) complained of hypesthesia or paresthesia in the anterior chest wall. The number of patients with such complaints (9.9%) had decreased 4 months after surgery (P<0.001). Four months after surgery, only 4 patients (2.8%) complained of hypesthesia or paresthesia in the neck, and 10 (7.1%) complained of discomfort while swallowing. All patients were satisfied with the cosmetic results. CONCLUSION: A gasless endoscopic thyroidectomy via an axillary approach is feasible and safe, and provides excellent cosmetic results, with a minimal degree of postoperative complaints. This procedure provides another surgical option for the treatment of benign thyroid disease in selected patients.
Cicatrix ; Conversion to Open Surgery ; Deglutition ; Humans ; Hypesthesia ; Incidence ; Intraoperative Complications ; Length of Stay ; Neck ; Paresthesia ; Skin ; Thoracic Wall ; Thyroid Diseases ; Thyroidectomy*

PURPOSE: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. METHODS: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. RESULTS: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. CONCLUSION: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.
Depression ; Displacement (Psychology) ; Facial Asymmetry ; Humans ; Hypesthesia ; Imidazoles ; Malocclusion ; Nitro Compounds ; Operative Time ; Postoperative Complications ; Skeleton ; Zygoma

PURPOSE: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. METHODS: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. RESULTS: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. CONCLUSION: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.
Depression ; Displacement (Psychology) ; Facial Asymmetry ; Humans ; Hypesthesia ; Imidazoles ; Malocclusion ; Nitro Compounds ; Operative Time ; Postoperative Complications ; Skeleton ; Zygoma

PURPOSE: Autogenous fascia lata of distal thigh is the best material for repairing ptosis with poor levator function. The purpose of this study is to evaluate the complications associated with autogenous fascia lata harvesting on the distal thigh for frontalis suspension surgery. METHODS: We reviewed the medical charts of ptosis patients who underwent frontalis suspension surgery with autogenous fascia lata from March 2001 to March 2003. Fifteen patients, with at least 1-year follow-up, were included. RESULTS: Postoperative functional complications related with walking were pain on walking in 10 patients (67%), limping in 6 (40%), muscle weakness in 2 (12%), and limitation of knee motion in 1 (7%). Complications related- with the wound were tenderness in 8 patients (53%), an unsightly scar on harvesting site in 8 (53%), inflammation in 1 (7%), muscle herniation in 1 (7%), and hypoesthesia around the wound in 1 (7%). CONCLUSIONS: Except for the scar, most of postoperative complications were resolved during the early follow-up period. The only long-term complication was the cosmetic problem of an unsightly scar on the harvesting site. For which careful suture on the wound site and fascia lata harvesting on the proximal thigh are recommended.
Cicatrix ; Fascia Lata* ; Fascia* ; Follow-Up Studies ; Humans ; Hypesthesia ; Inflammation ; Knee ; Muscle Weakness ; Postoperative Complications ; Sutures ; Thigh* ; Walking ; Wounds and Injuries

OBJECTIVE: Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL. Patients underwent minimally invasive anterior decompression without fusion. This method created a space on the ventral side of the OPLL without violating global thoracic spinal stability. Via this space, the OPLL and anterior lateral side of the dural sac can be seen and manipulated directly. Then, total removal of the OPLL was accomplished. No orthosis was needed. In this article, we share our key technique and concepts for treatment of huge thoracic OPLL. METHODS: Case 1. 51-year-old female was referred to our hospital with right lower limb radiating pain and paresis. Thoracic OPLL at T6–7 had been identified at our hospital, and conservative treatment had been tried without success. Case 2. This 54-year-old female with a 6-month history of progressive gait disturbance and bilateral lower extremity radiating pain (right>left) was admitted to our institute. She also had hypoesthesia in both lower legs. Her symptoms had been gradually progressing. Computed tomography scans showed massive OPLL at the T9–10 level. Magnetic resonance imaging of the thoracolumbar spine demonstrated ventral bony masses with severe anterior compression of the spinal cord at the same level. RESULTS: We used this surgical method in 2 patients with a huge beaked-type OPLL in the thoracic level. Complete removal of the OPLL via anterior decompression without instrumented fusion was accomplished. The 1st case had no intraoperative or postoperative complications, and the 2nd case had 1 intraoperative complication (dural tear) and no postoperative complications. There were no residual symptoms of the lower extremities. CONCLUSION: This surgical technique allows the surgeon to safely and effectively perform minimally invasive anterior decompression without instrumented fusion via a transthoracic approach for thoracic OPLL. It can be applied at the mid and lower level of the thoracic spine and could become a standard procedure for treatment of huge beak-type thoracic OPLL.
Decompression* ; Female ; Gait ; Humans ; Hypesthesia ; Intraoperative Complications ; Leg ; Longitudinal Ligaments* ; Lower Extremity ; Magnetic Resonance Imaging ; Methods ; Middle Aged ; Orthotic Devices ; Paresis ; Postoperative Complications ; Spinal Cord ; Spine* ; Thoracic Vertebrae

Central nervous system involvement in primary Sjögren's syndrome (pSS) is less common and usually presents as white matter lesions, neuromyelitis optica spectrum disorder (NMOSD), or transverse myelitis. NMOSD is an immune-mediated inflammatory demyelinating disease of the central nervous system with a high rate of relapse and significant disability. Studies have shown that patients with pSS combined with NMOSD have more severe symptoms and poorer prognosis. Here, we present a case of critical illness in pregnancy-associated NMOSD combined with Sjögren's syndrome. The patient was a 30-year-old pregnant woman with a history of Sjögren's syndrome who was diagnosed with NMOSD. She received combination therapy with steroids, intravenous immunoglobulin (IVIG), and hydroxychloroquine during pregnancy, resulting in partial resolution of numbness below the waist. However, due to irregular medication adherence outside the hospital setting, she developed weakness in her right lower limb accompanied by inability to move it, while her left lower limb still had some mobility but occasional numbness along with urinary and fecal incontinence. Ten days later, she was admitted to the emergency department where an emergency cesarean section was performed to deliver a healthy baby boy. However, her condition worsened postpartum as she developed high fever accompanied by bilateral lower limb paralysis and weakness along with loss of voluntary control over urination and defecation. The patient underwent ano-ther course of treatment consisting of steroids and IVIG; however there was limited improvement in symptoms observed after this intervention. Following administration of rituximab for the first time, the patient developed urinary tract infection which was successfully managed before continuing regular infusions. In later stages the patient could walk slightly with a limp and regained control over urination and defecation, allowing her to resume normal activities. This case suggests that combination therapy with steroids, IVIG, and hydroxychloroquine should be considered for the patients with pregnancy-associated NMOSD combined with Sjögren's syndrome. Rituximab can significantly improve symptoms such as postpartum paralysis in patients with NMOSD, however, there may be a risk of infection associated with its use.
Adult ; Female ; Humans ; Pregnancy ; Cesarean Section/adverse effects* ; Critical Illness ; Hydroxychloroquine/therapeutic use* ; Hypesthesia/complications* ; Immunoglobulins, Intravenous/therapeutic use* ; Inflammation/complications* ; Neuromyelitis Optica/diagnosis* ; Paralysis/complications* ; Pregnancy Complications/therapy* ; Rituximab/therapeutic use* ; Sjogren's Syndrome/complications* ; Steroids/therapeutic use* ; Vision Disorders