The purpose of this study was to evaluate the results and complications in difficult periarticular fractures of the knee treated with a circular(Ilizarov) external fixator. The mean follow-up period was 34 months(range: 12-55 months). Of the 27 cases, 12 cases involved fractures of distal femur (two M ller type A3, four type C2, six type C3) and 15 cases involved fractures of the proximal tibia (one Schatzker type V, eight type VI, two segmental, four metaphyseal comminuted fractures). Twenty-two cases(81%) were open fractures and most of the cases were open intra-articular comminuted fractures. The average duration of external fixation was 7.7 months (9.8 months for the distal femur cases, 6.5 months for the proximal tibia cases and 11.5 months for the cases which required lengthening, and 6 months in the non-lengthening group). In 8 cases, in which bone lenthening was done, no leg length discrepancy occurred after lengthening. The mean length gained was 5.9 cm and the mean healing index was 1.8 months/cm (1.8months/cm in distal femur cases and 1.9 months/cm in proximal tibia cases). According to Neers criteria, the treatment results for cases involving distal femur fracture were as follows: six satisfactory, three unsatisfactory, three failures; cases with proximal tibia fractures had these results: nine excellent, three satisfactory, three unsatisfactory. Average range of motion was 67 degrees in distal femur fracture cases and 114 degrees in proximal tibia fracture cases. According to Paleys complication grading system, six problems, six obstacles, and eight com- plications occurred. In conclusion, the Ilizarov external fixator can be a useful treatment method in periarticular fractures of the knee with severe intra-articular or metaphyseal comminution, bone loss, severe soft tissue injury, or multiple associated injury. Its use can reduce the associated complications such as leg length discrepancy, infection, and nonunion.
External Fixators* ; Femur ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Open ; Knee* ; Leg ; Range of Motion, Articular ; Soft Tissue Injuries ; Tibia

No abstract available.
Hip Joint* ; Hip*

Hereditary angioedema is a rare genetic disease transmitted with a autosomal dominant trait result of a quantitative or functional defect of Cl inhibitor. We report three cases of heriditary angioedema from the same famly respectively the 35-year-old sister, the younger bn)ther of 32, and the younger sister of 20 The older sister died due to her airway being obstructel by acute laryngeal edema, and her you igirbrother and sister experienced recurrent episodes oswelling on the hand and forearm. The ore we examined the two patients serum complement levils to confirm diagnosis. In both, the r;ults showed decreased levels of Cl inhibitor and C4 which are the evidence of hereditary a giedema. The younger sister has been administered danazol (600mg/day) to prevent angioedem or 8 weeks, and we have not yet found a recurrenc of he symptoms. However, well cont ol the dosage of danazol because amenorchea has developec.
Adult ; Angioedema ; Angioedemas, Hereditary* ; Complement System Proteins ; Danazol ; Diagnosis ; Forearm ; Hand ; Humans ; Laryngeal Edema ; Siblings

No abstract available.

No abstract available.

Although a closing wedge high tibial osteotomy can decrease the posterior tibial slope, there are no reports of severe genu recurvatum after a closing wedge osteotomy that required corrective surgery. A 54-year-old male with medial compartment osteoarthritis and genu varum was treated with a closing wedge high tibial osteotomy in another hospital, which led to severe recurvatum because of surgical failure. He complained of knee pain and a severe deformity, but of which were corrected by an open wedge corrective osteotomy, a two-wedge bicortical autograft reconstruction, and double plate fixation. Surgeons should pay close attention to both varus deformity correction and changes in the posterior tibial slope during a closing wedge high tibial osteotomy.
Congenital Abnormalities ; Genu Varum ; Humans ; Knee ; Male ; Middle Aged ; Osteoarthritis ; Osteotomy

BACKGROUND: In spite of frequent nasal surgery, the importance of preoperative medication has not been examined carefully(CAREFULLY). OBJECTIVE: To identify the effect of premedication, we investigated the effect of premedication on postoperative pain in nasal surgery under local anesthesia. MATERIALS AND METHOD: We studied 120 cases, composed of 60 cases of unilateral sinus surgery and 60 cases of septoplasty. The patients were divided into four groups. We analysed 4 groups each consisted of 30 patients(N=120). The first group consisted of patients who received atropine preoperatively. The second group received atropine and ketolorac tromethamine. The third group received atopine and diazepam. The fourth group received atropine, ketorolac trimethamine and atropine. To evaluate the postoperative pain, we made the protocol listed according to Verbal Rating Pain Scores(VRP), Visual Analogue Pain Scores(VAS), -2, 4, 6, 12, 24 and 48 hours- and a global postoperative pain using the VAS. RESULTS: In septoplasty group, pain-relief effects showed postoperative pain of ketorolac tromethamine during postoperative 6-hours in the second & fourth groups. In sinus surgery group, Ketorolac tromethamine was effective on postoperative pain at postoperative 2-hour. CONCLUSION: We concluded that preoperative ketorolac tromethamine was effctive on septoplasty group than sinus surgery group.
Anesthesia, Local ; Atropine ; Diazepam ; Humans ; Ketorolac ; Ketorolac Tromethamine ; Nasal Surgical Procedures* ; Pain, Postoperative* ; Premedication* ; Tromethamine

PURPOSE: The purpose of this study was to compare the clinical and radiological results between patients who underwent total knee arthroplasty using the conventional method and the navigation-assisted method. MATERIALS AND METHODS: A retrospective review of was performed on 32 patients (40 knees) who underwent total knee arthroplasty between February 2004 and December 2006 and were followed-up for 8 to 10 years. Mechanical axis deviation, range of motion, radiologic position of the implants, and subjective clinical scores were measured and compared between 20 navigation-assisted total knee arthroplasties and 20 conventional total knee arthoplasties. Change in the values (α, β, γ, and δ angles) from the immediate postoperative period to the last follow-up were also calculated and compared between the two groups. RESULTS: The mean range of motion in the navigation group was improved to 121.8°±16.3° (92°–140°) at the last follow-up, and the Western Ontario McMaster Universities osteoarthritis Index (WOMAC) score was 89.8±5.4 and the Knee Society score (KSS) was 91.5±7.5. The mean range of motion in the conventional group was 112.6°±25.6° (60°–140°) at the last follow-up. The WOMAC score was 84.2±10.6, and the KSS was 81.1±14.3. The α, β, γ, and δ angles of the implants were not significantly changed until the last follow-up. In the comparison between the two groups, only the mean range of motion (p=0.018) and the KSS (p=0.038) showed statistically better results in the navigation group than the conventional group. CONCLUSION: Navigation-assisted total knee arthroplasty showed better KSS and range of motion compared with the conventional group in a cross-sectional study with 8 to 10 years of follow-up results. However, only the KSS showed a significant difference between the two groups by the amount of changes in the clinical and radiological results.
Arthroplasty ; Arthroplasty, Replacement, Knee* ; Cross-Sectional Studies ; Follow-Up Studies* ; Humans ; Knee ; Magnets* ; Methods ; Ontario ; Osteoarthritis ; Postoperative Period ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: The rotational alignment of the femoral and tibial components is closely related to the results after total knee arthroplasty (TKA). In this study, we measured the combined rotational alignment change (ΔCR) after TKA and compared the different influence of symmetric and asymmetric tibial component designs on the combined rotational alignment. MATERIALS AND METHODS: Eighty-four patients (mean age, 67.9 years) were included. A symmetric tibial component was used in 51 knees (group I), whereas an asymmetric tibial component was used in 50 knees (group II). We measured the angles of four anatomical landmarks by using preoperative and postoperative computed tomography images. The combined rotational alignment and the amount of change were calculated. The correlation between the isolated tibial component rotation (ITR) and ΔCR was analyzed by using the Spearman correlation coefficient. RESULTS: The mean ΔCR was −0.1°±6.3° in group I and −4.8°±5.7° in group II after TKA. Excluding the intercomponent rotation, the change was −1.0°±7.3° and −6.7°±6.7° in group I and group II, respectively. A correlation analysis between the ITR and tibial component rotation relative to the tibial tuberosity showed a statistically significant correlation. CONCLUSIONS: The combined lower limb rotational alignment was internally rotated in both symmetric and asymmetric tibial component designs after TKA. The asymmetric tibial component was better than the symmetric tibial component in achieving internally rotated combined lower limb rotational alignment. The internal rotation of the symmetric tibial component relative to the tibial tuberosity tip should fall within 20° to correct the externally deformed lower limb.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Humans ; Knee ; Lower Extremity ; Tibia

PURPOSE: Bilateral traumatic locked posterior dislocations of the shoulder are very rare and there has been no report on the operative treatment for this injury in the Korean medical literature. MATERIALS AND METHODS: We present here a case of bilateral locked posterior dislocations of the shoulders after trauma and this was successfully treated with open reduction and lesser tuberosity transfer on the right shoulder and subscapularis tendon transfer on the left shoulder. RESULTS AND CONCLUSION: Twenty-four months later, the clinical and radiologic results were excellent.
Dislocations ; Shoulder ; Shoulder Dislocation ; Tendon Transfer