BACKGROUND: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. METHODS: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was 36.50 ± 10.22 years. The mean follow-up duration was 54.80 ± 32.50 months. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. RESULTS: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were 9.72°± 3.95°, 27.67°± 10.75°, and 6.92% ± 3.40%, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were 14.73°± 2.97°, 11.55°± 3.26°, and 11.33% ± 6.39%, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. CONCLUSIONS: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults.
Adult* ; Child ; Congenital Abnormalities* ; Elbow ; Follow-Up Studies ; Humans ; Humeral Fractures ; Osteotomy* ; Ulnar Nerve

No abstract available.
Spine*

No Abstract Available.
Allografts* ; Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Tendons*

Tentative diagnosis of meniscal pathology is very helpful for the successful operative management including arthroscopy. Conventional arthrography has long been used to meet this purpose, but it has some limitations due to complex views and some difficulties in imaging the whole anatomical structures. Recent diagnostic advancement produced post-arthrographic HRCT and MRI for the compensation of these problems of conventional arthrography. Arthrography and post-arthrographic HRCT has been carried out on 49 knees in 43 patients. 38 knees among them could be confirmed by arthroscopy and following results were obtained. 1. Diagnostic accuracies of post-arthrographic HRCT for medial and lateral meniscal injuries of knee were 94.7% and 92.1% repectively. 2. Shape, contour of torn meniscus and the relationships between the torn fragments were better demonstrated with HRCT. 3. Horizontal tear could also be suspected by HRCT. 4. Peripheral detachment could be differentiated with synovial recess on the HRCT, especially in the reformat view, but was more clearly visible in arthrography. 5. Arthrography and HRCT can be used as a good complementary study for the evaluation of meniscal injuries.
Arthrography ; Arthroscopy ; Compensation and Redress ; Diagnosis ; Humans ; Knee ; Magnetic Resonance Imaging ; Pathology ; Tears

Although joint infection with severe destruction remains a serious problem and severe bone loss is relative contraindication of arthrodesis, knee arthrodesis is most commonly a salvage procedure. Its goals are to relieve pain and restore the patient to functional level of activity. The purpose of this study is to evaluate the results and complications of Ilizarov method for knee arthrodesis in the presence of infection. We retrospectively reviewed the records of twelve patients who had managed with knee arthrodesis with Ilizarov method. Indications for the operation included a infected skeletal defect secondary severe open trauma in four patients, an infection at the site of an arthroplasty in three (with failure of previous arthrodesis with monofixator in one), an infected charcot joint in four and one pyogenic arthritis spreading from osteomyelitis of proximal tibia. The average age of the patients at the time of operation was fifty-three years (range twenty-two to eighty years). Follow-up averaged 17 months. The minimum follow up periods was 9 months. Average duration of Ilizarov fixator application was 7.2 months. In 3 cases we performed corticotomy and internal bone transport to treat large bone defect (17cm, 8cm, 6.5cm). Autoiliac bone graft was done in fusion site in two cases, and in three cases we performed bone graft at the docking site. Solid osseous union occured in each patient. There was no reinfection and nonunion. Average shortening was 3.4 cm. Complications were related to pin tract. When last seen, all patients were free of pain and could walk without cruthes or cane. Despite its pin tract problems, bulky cumbersome and expensive apparatus, the Ilizarov method is one of effective method for knee arthrodesis in the presence of infection and large bone loss especially.
Arthritis ; Arthrodesis* ; Arthropathy, Neurogenic ; Arthroplasty ; Canes ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Joints ; Knee Joint* ; Knee* ; Osteomyelitis ; Retrospective Studies ; Tibia ; Transplants

No abstract available.

Arthroscopic single-row rotator cuff repair is a well established surgical technique for the treatment of rotator cuff tears. However, the problem of postoperative retear remains a concern. Various avenues are being explored to address this problem. Some studies have suggested that restoring the anatomical footprint may improve the healing and initial strength of the repaired rotator cuff tendon. The double-row technique was introduced as a method of reconstructing the anatomical footprint. According to biomechanical studies on cadavers, this technique improved mechanical strength and reduced gap formation. However, the biological properties of reattached tendon such as tension, and vascularity have not been proved yet. Furthermore, the apparent mechanical superiority of the double-row over the single-row construction has not resulted in better functional outcomes. Therefore, the less complicated and less costly single-row technique is still the recommended treatment for rotator cuff repairs.
Arthroscopy ; Cadaver ; Rotator Cuff* ; Tendons

Except for the hallux, the human toes classically present three phalanges, distal, middle and proximal. However in 5th toe, only two phalanges are frequently observed. In this condition, known as synarthrosis of the distal interphalangeal joint, the middle and distal phalanges are fused together to appear as symphalangism or biphalangeal 5th toe. Phalanges of 5th toe was investigated in 1,187 cases of Korean radiographs. The incidence of symphalangism was found to be 74% in 1,150 adult. The bilaterality was 99%. To prove proove the genetic basis of the symphalangism, pedigree studies were performed. The symphalangism of the 5th toe was supposed to be an autosomal dominant trait. As an phenotype of recessive homozygote the triphalaneal subjects were traced to investigate their families. Pedigrees of four families in which both parents had triphalangea of 5th toe showed that their offsprings always showed the triphalangea. Therefore, it suggests the symphalangism inherit as a Mendelian dominant trait and it seems to be an example of microevolution or genetic adaptation to bipedalism.
Adult ; Genetics ; Hallux ; Homozygote ; Humans ; Incidence ; Joints ; Parents ; Pedigree ; Phenotype ; Toes*

No abstract available.

BACKGROUND: Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients. METHODS: A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher. RESULTS: Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients' mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016). CONCLUSIONS: This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.
Emergency Service, Hospital ; Factor VIIa* ; Female ; Humans ; Maternal Death ; Maternal Mortality ; Medical Records ; Organ Dysfunction Scores ; Postpartum Hemorrhage* ; Postpartum Period* ; Prognosis ; Recombinant Proteins ; Retrospective Studies