No Abstract Available.

The types of patellar component of total knee replacement prostheses are dome-shape, metalbacked, anatomically shaped, and press fit condylar type, etc. The fixation of inset patella type is achieved with bone cement supplemented by a central peg and a small extended flange around the circumference, providing resistance to torsional and shear loads. From October 1990 to June 1992, 53 cases in 40 patients had total knee arthroplasties. Ortholoc II implant was used in all patients. Cementless femoral and tibial component were used. But, cement was used in patellar component. The average follow up was 29 months(range 21-40 months). There were 37 women and 3 men and the average age was 51 years(range 22-71 years). The diagnosis of 40 patients was osteoarthritis in 25, rheumatoid arthritis in 9, infection sequelae in 6. For alignment of the patellar and congruency of the patellofemoral joint, additional retinacular release was done in 7 cases. The average preoperative Hospital for Special Surgery(H.S.S) knee rating score was 50.7 point, which improved to 89.4 point at last follow up. Postoperative patellar pain was 4 cases. In the roentgenorgraphic follow up, ratellar subluxation was 2 cases and lateral tilting of the patella was 5.9 degrees in 10 cases. The average patellar depth was 20.8mm preoperatively and 21.6mm postoperatively. In the Merchant's view, the preoperative lateral patellofemoral angle of Laurine was average 14.3 degree, which changed to average 16.4 degree at last follow up, and the preoperative Merchant's congruence angle was average 14 degrees, which decreased to average
Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteoarthritis ; Patella ; Patellofemoral Joint ; Prostheses and Implants

Patellofemoral complications are the most frequent problems in total knee arthroplasty. In the literature, the subject of patella resurfacing and nonresurfacing is controversial. Twenty-seven osteoarthritic patients who received bilateral total knee prostheses were studied to evaluate the advantages and disadvantages of patella resurfacing prospectively. Only patients with mild patellofemoral disease were included in the study. The Ortholoc modular implant was used in all cases. Cementless femoral and tibial component were used. But, if we resurfaced the patella, cement was used. In all patients, patella resurfacing had been done in the left knee but not in the right knee. For the clinical analysis, We used Knee Rating Score of the Hospital for Special Surgery(HSS), For the roentgenographic analysis, We used Laurin's lateral patellofemoral angle & Merchant's congruence angle. In the follow up, blind test for patellar pain was performed to compare between right and left knee joint clinically. The average age was 61 years(range 28-72 years) and the average follow up was 21 months(range 12-27 months). Preoperative ROM was 104.4 degrees in right side and 106.7 degrees in left side. Postoperative ROM was 112.7 degrees in right side and 109.6 degrees in left side. Preoperative HSS Knee Rating Score was 53.1 point in right side and 54.8 point in left side. Postoperative HSS Knee Rating Score was 81.5 point in right side and 81.2 point in left side. In the plain knee AP view, preoperative tibiofemoral angle was varus 7.0 degrees in right side and varus 5.6 degrees in left side. Postoperative tibiofemoral angle was valgus 5.1 degrees in right side and valgus 4.9 degrees in left side. Preoperative Merchant's congruence angle was 14.9 degrees in right side and 15.3 degrees in left side. Postoperative Merchant's congruence angle was
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Knee Prosthesis ; Patella ; Prospective Studies ; Range of Motion, Articular

A 16-year-old girl was transferred to the department of thoracic and cardiovascular surgery because of a spontaneous pneumothorax with prolonged air leakage. Chest computed tomography demonstrated a cystic lesion measuring 2×3 cm and involving the left upper lobe. Left upper lobectomy was performed via video-assisted thoracoscopic surgery. A pathologic examination of the specimen revealed a mesenchymal cystic hamartoma. Despite the rarity of pulmonary mesenchymal cystic hamartoma, it should be considered a potential cause of pneumothorax for patients with a large pulmonary cyst. Further, surgical resection must be considered because serious complications such as hemothorax, hemoptysis, and malignant transformation have been reported.
Adolescent ; Female ; Hamartoma* ; Hemoptysis ; Hemothorax ; Humans ; Lung* ; Pneumothorax ; Thoracic Surgery, Video-Assisted ; Thorax

The Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is comprised of vaginal atresia with other variable Mullerian duct abnormalities. Its features include an absent or very short vagina and a uterus that can be absent or immaturely formed. Female with MRKH syndrome have functioning ovaries, normal external genitalia and the typical 46, XX, karyotype. MRKH syndrome is the second most common cause of primary amenorrhea, usually remains undetected until the patient presents with primary amenorrhea despite normal sexual female development. We report a case of MRKH syndrome, associated with ovarian follicular cyst, in a 14-years-old girl who visited for primary amenorrhea and sexual precosity.
Amenorrhea* ; Female ; Follicular Cyst ; Genitalia ; Humans ; Karyotype ; Ovary ; Uterus ; Vagina

No abstract available.
Metacarpophalangeal Joint* ; Palmar Plate*

Purpose: To analyze the repeatability of manual measurement of foveal avascular zone (FAZ) area in an optical coherence tomography angiography (OCTA) image in high myopia. Methods: This study comprised patients with high myopia and controls. Two consecutive FAZ areas of the superficial and deep capillary plexus were obtained using OCTA. The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were assessed, and univariate and multivariate generalized linear mixed models were conducted to identify factors related to repeatability. Results: Thirty eyes with high myopia and 34 eyes of healthy subjects were included in the study. The mean age in high myopia and control subjects was 55.5 and 60.8 years, respectively, the mean spherical equivalent was −9.98 and −0.55 diopters, and the mean axial length was 28.0 and 23.9 mm. The ICCs of FAZ area of the superficial capillary plexus (SCP) were 0.891 and 0.919, while the CVs were 8.8% and 8.5%. In measurement of the deep capillary plexus, the ICCs were 0.788 and 0.907, while the CVs were 11.2% and 11.0%, which were acceptable but exhibited lower repeatability than those of SCP. Multivariate analyses showed that older age (p = 0.030) and greater axial length (p = 0.005) were significantly associated with lower repeatability of SCP FAZ area measurements. In addition, greater axial length (p = 0.044) was a significant factor for lower repeatability of deep capillary plexus FAZ area measurements. Conclusions Manual measurement of FAZ area using OCTA exhibited relatively good repeatability for high myopia. Age and axial length affected repeatability and should be considered when analyzing FAZ areas in high myopia patients.

Background: Volar plate fixation for distal radial fractures is the most common cause of closed rupture of the flexor pollicis longus tendon (FPL). For treating a closed FPL rupture, transferring the fourth flexor digitorum superficialis or a tendon graft from the palmaris longus (PL) can be performed. This study reports the results of tendon grafting using the PL in closed FPL rupture and discusses the provision of optimal tendon tension. Methods: This retrospective study included 11 out of 20 patients who underwent PL tendon graft for closed FPL rupture between 2013 and 2022, with a follow-up period of more than 12 months. There were 4 men and 7 women, with an average age of 62 years. The average period from the date of rupture to surgery was 39 days. Ruptures occurred due to volar plate fixation in 7 cases, without a specific cause in 2 cases, and after a steroid injection for trigger thumb in 2 cases. The rupture site was in zone 2 in 4 cases and zone 5 in 7 cases. The mean follow-up period was 59 months. Optimal tension for the grafted tendon was determined by comparing the intraoperative angles of the interphalangeal (IP) and metacarpophalangeal (MCP) joints with the angles of the same joints at the final follow-up. Results: At the final follow-up, the mean IP joint motion was 61.0°, which was 81.5% of the contralateral side. The average range of motion of the MCP joint was 43.6°, which was 80.0% of the contralateral side. The pinch power was 90.8% of the contralateral side. Cases with > 70° IP joint motion were those in which the IP joint angle was > 45° during surgery. Moreover, the greater the flexion of the IP and MCP joints intraoperatively, the better the range of motion of the IP joints. Conclusions Tendon grafting using the PL is recommended as an effective surgical method to achieve 81.5% of contralateral IP joint motion in cases of closed FPL tendon rupture. Over-tensioning of the tendon graft with IP Joint flexion more than 45° during surgery is recommended.

Purpose: Commonly used surgical approaches for internal plate fixation of transcondylar distal humeral fractures may require ulnar nerve release or anterior transposition, and extensive surgical dissection can cause triceps weakness. This study reports the surgical technique and clinical outcomes of a medial and lateral approach for dual-plate fixation of transcondylar distal humeral fractures without ulnar nerve release or extensive surgical dissection. Methods: Sixteen patients (mean age, 81.25 years; range, 70–95 years) who underwent plate fixation using a medial and lateral approach for distal humeral transcondylar fractures were retrospectively reviewed. An anatomical distal humerus parallel or orthogonal locking plate was used for internal fixation. Ulnar nerve release was not performed in any patients. Surgical outcomes were evaluated 1 year postoperatively based on the level of pain, elbow range of motion, the Mayo elbow performance score, and postoperative complications. Results: The mean visual analog scale score was 0.47. The mean range of motion of the elbow joint was 13.8° for extension and 131.8° for flexion. The Mayo Elbow Performance Score was excellent in nine patients and good in seven. Bone union was achieved in all patients. There were no complications such as ulnar neuropathy, heterotopic ossification, or infection. Conclusion In transcondylar distal humeral fracture in older adults, a medial and lateral approach with dual anatomical locking plate fixation is recommended as a surgical technique that has the advantage of enabling rigid fixation without necessitating ulnar nerve release and extensive surgical dissection. Nonetheless, further research should be conducted.

Background: Volar plate fixation for distal radial fractures is the most common cause of closed rupture of the flexor pollicis longus tendon (FPL). For treating a closed FPL rupture, transferring the fourth flexor digitorum superficialis or a tendon graft from the palmaris longus (PL) can be performed. This study reports the results of tendon grafting using the PL in closed FPL rupture and discusses the provision of optimal tendon tension. Methods: This retrospective study included 11 out of 20 patients who underwent PL tendon graft for closed FPL rupture between 2013 and 2022, with a follow-up period of more than 12 months. There were 4 men and 7 women, with an average age of 62 years. The average period from the date of rupture to surgery was 39 days. Ruptures occurred due to volar plate fixation in 7 cases, without a specific cause in 2 cases, and after a steroid injection for trigger thumb in 2 cases. The rupture site was in zone 2 in 4 cases and zone 5 in 7 cases. The mean follow-up period was 59 months. Optimal tension for the grafted tendon was determined by comparing the intraoperative angles of the interphalangeal (IP) and metacarpophalangeal (MCP) joints with the angles of the same joints at the final follow-up. Results: At the final follow-up, the mean IP joint motion was 61.0°, which was 81.5% of the contralateral side. The average range of motion of the MCP joint was 43.6°, which was 80.0% of the contralateral side. The pinch power was 90.8% of the contralateral side. Cases with > 70° IP joint motion were those in which the IP joint angle was > 45° during surgery. Moreover, the greater the flexion of the IP and MCP joints intraoperatively, the better the range of motion of the IP joints. Conclusions Tendon grafting using the PL is recommended as an effective surgical method to achieve 81.5% of contralateral IP joint motion in cases of closed FPL tendon rupture. Over-tensioning of the tendon graft with IP Joint flexion more than 45° during surgery is recommended.