Stress fractures have been well documented in the lower extremity. Stress fractures of the upper extremities are uncommon. We report a case of an ulna stress fracture in a 32 year old female non-professional golfer.
Female ; Fractures, Stress ; Humans ; Lower Extremity ; Ulna ; Upper Extremity

After reconstruction of anterior cruciate ligament, increased idameter of femoral or tibia1 bone tunnel has been obsened on plain radiogram. The etiology of radiographic tunnel enlargement is not well understood and the significance of this tunnel enlargement is unknown. This retrospective study reviewed tibial tunnel diameter in 34 cases of anterior cruciate ligament reconstructions. And we evaluated the correlation between the tibial tunnel enlargement and the position of screw fixation, instability, choice of graft, and clinical results at 1 year postoperatively. AII operation was per formed using a single incision technique. After 3 or 4 months and one year after operation, the diameter of tibial tunnel was measured with digital caliper on the plain radiogram. Tibial tunnel sclerotic margins were measured in the level Of medial tibial plateau on the lateral view of knee. Average tunnel enlargement of 3 allografts was 1.62mm and that of 15 autografts was 2.03mm. No significant difference was seen in KT-10000 arthrometer measurements between enlarged group (amount of enlage-ent >+1 S.D) and not-enlarged group (less than +1 S.D). No coelation was present between the increased tunnel diameter and Lysholm score. Cases with 10mm or more vertical distance between the most proximal point of tihial interference screw and the level of m4eial tibial plateau had average 1.15mm tibial tunnel enlargement and cases with less than 10mm vertical distance ha & I average 2.52mm tibial tunne] enlargement;the difference was not significant (P>0.05). The tibial tunnel enlargement was not correlated with position of screw, clinical results, stability of knee. The tibial tunnel enlargement was not caused hy only mechanical factor such as motion of intra-tunnel portion of graft-tendon.
Allografts ; Anterior Cruciate Ligament* ; Autografts ; Knee ; Retrospective Studies ; Transplants

The original technique for endoscopic anterior cruciate ligament reconstruction has several potential complications because of constraints imposed by working through the tibial tunnel: improper femoral tunnel placement, violation of the femoral tunnel posterior wall, femoral interferenc screw divergence, graft laceration during screw insertion, and distal tibial bone block prr>trusion. We performed 25 endoscopic anterior cruciate ligament reconstructions with bone-tendon-bone graft using a mo3ified technique that minimizes each of these problems, through the use of a anteromedial portal more centrally and distally placed than the original that portal. Postoperative radiographic review showed femoral screw divergence in 20% of cases (2 in the anteroposterior plane, 2 in the lateral plane and 1 in both planes), but the average angles (AP: 0.52+- 1.85, Lateral: 1.48+-3.30) were insignificant. There was no graft damage during screw insertion or grafttunnel mismatch. We concluded that this modified technique allows simplified, reproducible tunnel and interference screw placement.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Knee ; Lacerations ; Transplants

To evaluate the intra-articular pathology of popliteal cysts of knee, we performed arthroscopy on patients with popliteal cysts between February 1992 and February 1995. Thirty-one patients (32 cases) have been treated by excision of cyst after arthroscopy. Mean duration of follow-up was 15 months (13-19 months). Location of cysts was in the right knee in 17 cases, in the left knee in 13 cases, and bilateral in one case. Pain or swelling was present in 12 (38%), giving-way was reported by 4 cases. Three cases revealed quadryceps atrophy. The McMurray test was postive in 6 cases. After arthroscopy, the cysts were excised. Ninteen cases (59%) had associated intra-articular lesions: seven medial meniscal tears, two lateral meniscal tears, seven had chondral damages, one had medial plica syndrome, and one had rheumatoid arthritis, Communication between the cyst and the knee was present in 7 cases (22%), all of whom were over 40 years of age. Thirteen cases was younger than 30 years of age, and 11 cases of these cases had no intra-articular pathology. Two other cases had lateral meniscal tears and medial plica syndrome, respectively. We recommend arthroscopy in middle and older aged patients with popliteal cysts for evaluating and treating intra-articular lesions.
Arthritis, Rheumatoid ; Arthroscopy* ; Atrophy ; Follow-Up Studies ; Humans ; Knee* ; Pathology ; Popliteal Cyst*

BACKGROUND: Although the culture of urethral discharge using a cutton swab is regarded as one of the most sensitive and reliable diagnostic methods of gonorrhea, it may give pain or diagnostic methods of gonorrhea, it may give pain or discomfort to patients, and its detection rate may be influenced by the examiner's technical ability. OBJECTIVE: The purpose of this study was to compare the positive culture rates between ure4thral discharge and urinary sediment for the diagnosing of Neisseria gonorrheae. METHODS: We compared this technique with the culture of urethral discharge using the specimens from 357 male patients with gonococcal infection at VD clinic of Jungku Pvblic Health center in Seoul from Jan 1991 to Jun 1993. RESULTS: The culture of urinary sediment was positive in 339 of 357(94.95), whereas the culture of urethral discharge was positive in 346 of 357(96.95). However, these data have no statistical significance(P<0.05). The obe observed sensitivity and specificity of culture of urinary sediment comjpared to culture of urethral discharge were 97.75 and 90.9%, respectively. The predictive value of positive and negative test compared to the culture of urethral discharge were 99.7% and 55.65, respectively. As our data showed low negative predictive value, a negative culture result of urinary sediment does not always imply a negative culture result of urethral discharge. CONCLUSION: Therefore, at present, the previous method of the culture of urethral discharge is more highly recommended and further studies for this diagnostic and/or new method of gonorrhea based on larger group of patients is encouraged.
Gonorrhea ; Humans ; Male ; Neisseria gonorrhoeae* ; Neisseria* ; Sensitivity and Specificity ; Seoul

We used skeletal scintigraphy which had a high sensivity in the diagnosis of acute fractures in clinically suspected scaphoid fracture to elevate diagnostic accuracy, and then evaluated the results. From February 1993 to April 1994, twenty patients with a clinical suspicion of a scaphoid fracture in spite of normal skeletal films had been examined with skeletal scinigraphy of the wrist Sensitivity was 100%, specificity 30.8%, positive predictable value 43.8%, and negative predictable value 100%. The patients with positive scintigraphy and normal x-ray were free from symptoms in 4-6 weeks in spite of no treatment. In conclusions, Skeletal scintigraphy is of major importance in carpal trauma to rule out scaphoid fracture. Information obtained through scintigraphy often proved a prerequisite both for the retrospective identification of the fracture and for repeat directed skeletal view. The lesions in the distal radius and other carpal bones may clinically mimic a scaphoid fracture. and the authors feel to need further specific diagnostic tools such as MRI in cases with carpal injuries and scinitigraphic uptake indicative of a fracture when even skeletal views turn out normal. However, scintigraphy doesn't seem to be a guide of trament in these patients.
Carpal Bones ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Radionuclide Imaging ; Radius ; Retrospective Studies ; Sensitivity and Specificity ; Wrist

Arthroscopically assisted anterior cruciate ligament(ACL) reconsturction provide a technique with less morbidity, less pin, less sacr, lower ris k of sepsis. The magnification offered by arthroscopic visualization also provide a clearer view, more precise location of anatomical landmarks, and the ability to place the graft in the exact anatomic sites. However, in order to accomplish all these goals, the surgeon must possess a high level of psychomotor skills, which take time and practice to develop. Wile this learning curve is being completed, there are occasion when complications will occur, and, realistically these may be difficult to avoid. The purpose of this study is to evaluate author's cases in which complication occurred during the endoscopic one-incision ACL reconstruction using the patellar tendon and to offer some tips on how to avoid them and how to salvage the situation if they do occur. We reviewed 22 complications (11 patients) out of 40 ACL reconstructions performed between May 1994 and December 1995. The complications were divergence(6), graft-tunnel mismatch(5), too anterior tibial tunnel(3), too anterior femoral tunnel(2), too posterior femoral tunnel(2), rotation of screw around the graft(2), guide pin breakage(1), bone plug retraction into the joint(1). It is suggested that arthroscopist should constantly try to avoid the intraoperative complications of arthroscopically assisted ACL reconstruction and follow the precautions and preventive measures recommended.
Intraoperative Complications ; Knee ; Learning Curve ; Patellar Ligament ; Sepsis ; Transplants

The types of the synovial plicae were classified according to the classification of Kim and Choe(1997). The purpose of this study was to evaluate the diagnostic ability of MRI for synovial plicae. We retrospectively reviewed the MR findings of the knee in 95 cases of 91 patients. In all 95 cases, findings of arthroscopy and MR images were available. MRI was performed with a 1.5 Tesla Magnetom(Siemens) using a round surface coil. Pulse sequence were Tl weighted image(TR 650ms /TE 20ms) and T2 weighted image(TR 2000ms/TE 70ms). MR images could not show the infrapatella plicae and lateral plicae clearly, but some suprapatellar plicae were shown in T2 weighted MR images (37.5% of hole type, 80% of complete type, 26% of medial type). In 20(22%) of the 90 cases with medial patella plicae proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on T2 weighted MR images. These 20 cases included 3 of fenestra type, 9 of wide shelf type and 8 of medial shelf type. The low intensity band seen on T2-weighted MR images and its anatomical relation to the medial femoral condyle are helpful in diagnosing the presence of medial shelf type and wide shelf type of medial plicae.
Arthroscopy* ; Classification ; Femur ; Humans ; Knee* ; Magnetic Resonance Imaging* ; Patella ; Retrospective Studies

No abstract available.
Fractures, Open*

Granular cell tumor is one of the rare tumorous condition. At present there are estimated 600 reported examples of the tumor in the medical literature. Malignant granular cell tumor is a well established but extremely rare entity that is found in appr- oximately 2 % of all granular cell tumor. Diagnosis should be restricted to neoplasms that are similar in their histological appearance to benign granular cell tumors but can be seperated on the basis of cellular pleomorphism, mitotic activity, and, most importantly, their capacity to produce metastases. The authors had experienced that a 55 years old male patient had two large malignant granular cell tumors at the left thigh and left inguinal area with metastatic lesion.
Diagnosis ; Granular Cell Tumor ; Humans ; Male ; Neoplasm Metastasis ; Thigh