A clinical analysis was done on 129 patients (131 cases) of the ankle fractures that were admitted and treated in Orthopedic Department, Inchon Christian Hospital from January 1973 to December 1980. The following results were obtained: l. Of the 129 patients, male was 104 patients and female 25 patients, the average age of the patients was 37. 2. The main cause of the injuries was traffic accident (38.2%), and the remain causes were industrial accident (28.2%), fall down (18.3%), slip down (11.5%), and sports injury (3.8%) in order. 3. The most common type by Lauge-Hansen classification was supination-external rotation type (37.4%). 4. In method of treatment, operative treatment was done in 72 cases and nonoperative in 59 cases. 5 The average duration of the cast immobilization in nonoperative treatment was 8 weeks and operative 7 weeks. 6. The better result was obtained by operative treatment than nonoperative one. 7. The most poor result was noticed in pronation-external rotation type according to Lauge-Hansen classification. 8. We agree that the accurate reduction of the lateral malleolus make the talus in good anatomic position in ankle joint. 9. We agree that Lauge-Hansen classification is useful in diagnosis and treatment of ankle fracture.
Accidents, Occupational ; Accidents, Traffic ; Ankle Fractures ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Female ; Humans ; Immobilization ; Incheon ; Male ; Methods ; Orthopedics ; Talus

PURPOSE: To evaluate the safety and prognostic factors of intramedullary nailing of distal tibia fractures in terms of function and symptoms of the ankle joint. MATERIALS AND METHODS: We retrospectively analyzed 22 distal tibial fractures with intramedullary nailing. The mean duration of follow-up was 43 months. We reviewed medical records to describe each case. We measured radiographic parameters such as fracture configuration, arthritic change of the ankle joint and status of reduction. We also assessed clinical results by AOFAS ankle hind foot scoring system, degree of pain by VAS and range of motion to find out prognostic factors for functional result of the ankle joint. RESULTS: Bone healing was obtained in all cases without any wound complications. Mean AOFAS ankle score was 94. There were 4 cases with mild (VAS<3/10) ankle pain and 2 cases with mild limitation of ankle motion. The comminution of fracture had a significant relationship with delayed angular deformity of ankle joint (p=0.032). There was no other significant parameter affecting ankle joint function except the location of nail-end. CONCLUSION: Intramedullary nailing in distal tibia fracture is a safe and effective procedure. But further study may need to evaluate the relationship between the position of nail-end and the function of ankle joint.
Animals ; Ankle ; Ankle Joint ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Fracture Fixation, Intramedullary ; Medical Records ; Nails ; Range of Motion, Articular ; Retrospective Studies ; Tibia ; Tibial Fractures

No abstract available.
Child* ; Humans ; Infant* ; Urinary Tract Infections* ; Urinary Tract*

Ewing's sarcoma (ES)/PNET is common in both axial and appendicular skeletons, but is extremely rare in the talus. Here, we report a case of ES/PNET of the left talus in a 29-year-old male patient diagnosed by fine needle aspiration cytology, and review the literature on similar cases. The cytological smears were composed of individually dispersed small round cells and occasional clusters of loosely cohesive cells. The tumor cells were fragile, frequently exhibiting naked nuclei. Two distinct types of cells were observed. The light (chief) cells displayed round or slightly oval nuclei with frequent indentations, generally inconspicuous nucleoli, and a thin rim of cytoplasm, which sometimes harbored small vacuoles. The dark cells were smaller, displaying scanty cytoplasm with dense hyperchromatic nuclei, intermixed with chief cells, and often manifesting as small molded groups. However, no significant nuclear pleomorphisms or mitoses were noted. Tumor cells in the cell block revealed positive cytoplasmic glycogen, as determined by a PAS stain with diastase control, and also exhibited positive immunoreactivity for CD99.
Adult ; Amylases ; Biopsy, Fine-Needle ; Cytoplasm ; Fungi ; Glycogen ; Humans ; Male ; Mitosis ; Sarcoma, Ewing ; Skeleton ; Talus* ; Vacuoles

PURPOSE: The purpose of this study is to investigate the impact of the vascular endothelial growth factor (VEGF) and the hypoxia-inducible factor-1 (HIF-1) expression on clinicopathologic factors in osteosarcomas and chondrosarcomas. MATERIALS AND METHODS: Thirty-five osteosarcomas and 9 chondrosarcomas were assessed for HIF-1 and VEGF expressions with monoclonal antibodies using immunohistochemistry. The pathologic tumor grades are followed the WHO classification. RESULTS: Nineteen out of 35 osteosarcomas (54.3%) and 8 out of 9 chondrosarcomas (88.9%) showed HIF-1 expressions. The HIF-1 expressions increased with the pulmonary metastasis (p=0.020) and the tumor grades (p=0.016) in only osteosarcomas. Twenty-four out of 35 osteosarcomas (68.6%) and 6 out of 9 chondrosarcomas (66.7%) showed VEGF expressions. The extents of VEGF expression in only osteosarcomas showed positive correlation with the pulmonary metastasis (p=0.024). CONCLUSION: The HIF-1 and VEGF appear to be an important role for the development and progression of these two tumors. The HIF-1 expression in osteosarcomas seems to be poor prognostic value including aggressive tumor grades and pulmonary metastasis. The extents of VEGF immunostaining might indicate the possibility of pulmonary metastasis in osteosarcomas. However, the two gene expressions could not indicate the significant prognostic value in chondrosarcomas.
Antibodies, Monoclonal ; Chondrosarcoma* ; Classification ; Gene Expression ; Immunohistochemistry ; Neoplasm Metastasis ; Osteosarcoma* ; Vascular Endothelial Growth Factor A*

Background/Aims: The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased rapidly as a consequence of more sedentary lifestyles and a Westernized diet. Fracture is a major clinical problem in older people, but few large-scale cohort studies have evaluated the relationship between NAFLD and fracture. Therefore, we aimed to determine whether the fatty liver index (FLI), which represents the severity of NAFLD, can predict fracture risk. Methods: We analyzed the relationship between the FLI and incident fracture using multivariate Cox proportional hazards models and data for 180,519 individuals who underwent National Health check-ups in the Republic of Korea between 2009 and 2014. Results: A total of 2,720 participants (1.5%) were newly diagnosed with fracture during the study period (median 4.6 years). The participants were grouped according to FLI quartiles (Q1, 0 to <5.653; Q2, 5.653 to <15.245; Q3, 15.245 to <37.199; and Q4 ≥37.199). The cumulative fracture incidence was significantly higher in the highest FLI group than in the lowest FLI group (Q4, 986 [2.2%] and Q1, 323 [0.7%]; p<0.001). The adjusted hazard ratio indicated that the highest FLI group was independently associated with a higher incidence of fracture (hazard ratio for Q4 vs Q1, 2.956; 95% confidence interval, 2.606 to 3.351; p<0.001). FLI was significantly associated with a higher incidence of fracture, independent of the baseline characteristics of the participants. Conclusions Our data imply that the higher the FLI of a Korean patient is, the higher their risk of osteoporotic fracture, independent of key confounding factors.

OBJECTIVE: This study was performed to identify the prognostic factor for survival of patients with recurrent cervical cancer. METHODS: Sixty-eight patients were diagnosed as recurrent cervical cancer at the Seoul National University Hospital from January, 1988 to December, 1998. Recurrence was defined as new evidence of tumor after 6 months of disease free survival. Retrospective analysis was done in terms of clinical features and the Cox proportional hazard model was used to identify independent variables associated with an improved survival rate. Histopathologic types were distributed as follows; squamous cell carcinoma in 70.6%, adenocarcinoma in 11.8%, adenosquamous cell carcinoma in 11.8%, and small cell carcinoma in 1.5%. Distribution of FIGO stage was as follows; stage I in 25.0%, stage II in 66.2%, and stage III in 4.4%. Sites of recurrence were as follows; central pelvic recurrence in 44.1%, pelvic side wall recurrence in 11.8%, and distant metastasis in 44.1% and the most common site of distant recurrence was extrapelvic lymph nodes (29.4%). 29.4% of recurrences were observed within the first 12 months after initial therapy, 50.0% within 2 years and 64.7% within 3 years. RESULTS: Positive rate of SCC-Ag at initial diagnosis was 45.2% with cutoff value of 2.0 ng/ml. Positive rate of SCC-Ag at the diagnosis of recurrence was 60.0%. Overall response rate to the treatment was 29.1%. Complete response rate was higher in central pelvic recurrrence than pelvic side wall recurrence and distant metastasis (P = 0.002) and also higher in normal SCC-Ag level (< or = 2.0 ng/ml) at the diagnosis of recurrence than elevated level (P = 0.032). Cumulative survival rates of 1 year after recurrence was 66.8%, 2 year 36.7%, and 5 year 18.7%. Central recurrence showed higher cumulative survival rate than pelvic side wall or distant recurrence (P = 0.029). The patients with elevated SCC-Ag level at the time of diagnosis of recurrence showed lower cumulative survival rate than those with normal SCC-Ag level (P < 0.001). Cox proportional hazard model showed that SCC-Ag elevation at the time of diagnosis of recurrence retained significant values in predicting survival(OR = 2.56; 95% CI = [1.22-5.39]; P = 0.01). CONCLUSION: SCC-Ag elevation at the diagnosis of the recurrence is a strong independent prognostic indicator for survival of patients with recurrent cervical cancer.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Disease-Free Survival ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Uterine Cervical Neoplasms*

PURPOSE: To review the clinical and radiological results after an open reduction and internal fixation with a T-shaped LCP for unstable distal clavicle fractures. MATERIALS AND METHODS: From February 2005 to June 2006, ten patients with distal clavicle Neer type II fractures were treated with an open reduction and internal fixation with a T-shaped LCP. Bony union was identified by plain radiography. The clinical results were analyzed according to the UCLA scoring system. RESULTS: The mean time to fracture union was 9weeks and union was achieved in all cases. The mean UCLA score was 33.4 (30-35); excellent in 8 cases and good in 2 cases. In one case, loosening of one distal screw was occured and mild AC joint subluxation was observed in another case. CONCLUSION: 3.5 mm T-shaped LCP fixation is a useful technique for treating unstable distal clavicle fractures. This procedure provide stable fixation with no further AC joint injury.
Clavicle ; Humans ; Joints

PURPOSE: To evaluate the effect of smoking on the union time of the long bone shaft fractures. MATERIALS AND METHODS: We retrospectively analysed eighty-four patients with a long bone shaft fracture who were treated during the last four years. Patients with polytrauma, severe comminuted fracture, open fracture over grade III, ESRD or other internal diseases were excluded. In this study we separated the groups into smoking and non-smoking groups. Also we observed whether there was any significant difference in the union time and other factors such as the age, sex, fracture location and configuration, and method of fixation by using medical records and radiographs. RESULTS: A significant difference in union time was found between the smoking group and the non-smoking group (p=0.041), especially in the tibia. The average union time was 12.54+/-1.62 weeks in the smoking group and 11.53+/-2.59 weeks in non-smoking group. There were three non-union cases in the smoking group and one in the non-smoking group. Other factors appeared to have no significant influences. The negative effect of smoking was more obvious in patients in their 5th and 6th decades with a distal tibia shaft fractures. CONCLUSION: It seems highly beneficial that patients be recommend to quit smoking while being treated for a fracture, because smoking prolongs the healing time.
Fracture Healing* ; Fractures, Comminuted ; Fractures, Open ; Humans ; Kidney Failure, Chronic ; Medical Records ; Multiple Trauma ; Retrospective Studies ; Smoke* ; Smoking* ; Tibia

Granular cell tumor is characterized by large eosinophilic cells with granular appearances. These are mostly benign. Approximately 1~2% are malignant, and establishment of reliable criteria for diagnosing malignant granular cell tumor has been difficult to establish because of the rarity. Reports on the cytologic features of this neoplasm are hardly found in Korea. We report a case of rarely-occurring granular cell tumor in the lower leg of a 40-year-old male, diagnosed on fine needle aspiration cytology, together with a review of the literature regarding significant adverse histology and prognostic factors. The aspirates revealed cellular smears of isolated cells, syncytial clusters, and occasionally stripped nuclei in a fine, bluish-purple, granular background. Tumor cells were polygonal, rounded, or slightly spindled, and showed ill-defined granular cytoplasm. Nuclei were small and round or oval, with inconspicuous or small, prominent nucleoli. The nuclei showed rare intranuclear cytoplasmic invagination. Occasionally, there were mild to moderate nuclear pleomorphisms with vesicular nuclei, with large, prominent nucleoi, but no mitosis. The immunocytochemical stain for S-100 was strongly positive in the cytoplasm of tumor cells with occasional nuclei.
Adult ; Biopsy, Fine-Needle* ; Cytoplasm ; Eosinophils ; Granular Cell Tumor* ; Humans ; Korea ; Leg* ; Male ; Mitosis