Fractures of the distal radius are one of the most common injuries met in the orthopedic field. Once it was thought that good function comes despite of poor anatomic restoration in the distal radius fractures. But now there are wide consensus that more aggressive surgical treatments are needed in such complex fractures to fulfill the better clinical results. We reviewed 56 consecutive distal radius fractures of 54 patients treated surgically in Orthopedic Department of Asan Medical Center between October 1989 and July 1994. The mean length of follow-up was 29.2 months. Clinical end results were statistically analyzed according to each anatomi- cal variables and state of distal ulna, and anatomies and results were analyzed according to different surgical modalities in each fracture classes. Radial length and radial inclination was significantly correlated with clinical results. The clinical results were significantly worse when dorsal tilt exceeded 10. In intraarticular type of fractures, residual articular incongruency seems to be the significantly affecting factor of development of arthritis and the clinical result. The associated fracture of distal end of the ulna did not significantly affect the result. In same type of fracture class, achievement and loss of reduction, arthritis, and Demerit score show no significant differences between groups of different surgical modalities. Probably this is due to proper choice of modalities in each different situations.
Arthritis ; Chungcheongnam-do ; Consensus ; Follow-Up Studies ; Humans ; Orthopedics ; Radius Fractures ; Radius ; Ulna

Some baseball pichers have the symptom-complex of the elbow joint due to repetitive throwing. The Hyperextension overload syndrome is symptom-complex caused by impingement between olecranon tip and fossa during hyperextension of the elbow. The patients of hyperextension overload syndrome is have some pathology of his elbow such as bony spur on olecranon tip, intra-articular loose body or degenerative arthritis. And they complaint of pain or limitation of extension. The authors diagnosed and treated five cases of hyperextension overload syndrome. All of them had flexion contracture. Three cases of them had cubitus valgus. But no had medial instability of the elbow. Three cases of them had tenderness on the olecranon tip. Four patients treated by excision of osteophyte or loose body with arthroscopic or open operative technique.
Baseball ; Contracture ; Elbow Joint ; Elbow ; Humans ; Olecranon Process ; Osteoarthritis ; Osteophyte ; Pathology

Periosteal chondroma is a slowly growing cartilage tumor of limited size, which develops within and beneath the periosteal connective tissue and characteristically erodes and induces sclerosis of the contiguous cortical bone. The typical morphology of this tumor consists of an area of outer cortex scalloping involving the metaphyseal lesion of a long bone with slightly overhanging edges and a small amount of cartilage calcified matrix adjacent to the scalloping. Histologically this benign tumor can mimic chondrosarcoma. Awareness of this fact is important in order to avoid overdiagnosis and resultant overtreatment of the benign lesion. We report three cases of periosteal chondromas arising in the phalangeal bones of the hand. All were treated by curettage. No local recurrence was seen following this treatment.
Cartilage ; Chondroma ; Chondrosarcoma ; Connective Tissue ; Curettage ; Cytochrome P-450 CYP1A1 ; Hand ; Medical Overuse ; Pectinidae ; Recurrence ; Sclerosis

Twenty nine cases of wrist tuberculosis were reviewed(19 joint involvement cases and 4 tendon involvement cases) and twenty three cases were followed up more than one and half years. The mean follow up period was 26.7 months. Synovectomies were not satisfactory in cases of joint involvement and they were useful only in cases of tendon involvement. Arthrodesises were used for 16 cases of joint involvement and were satisfactory in 87,5 percent by Robin's criteria. Finger stiffness was most serious complication(initially, 8.7 percent and finally, 34.8 percent) and it is suggested that early motion of fingers after arthrodesis can prevent this complication.
Arthrodesis ; Fingers ; Follow-Up Studies ; Joints ; Tendons ; Tuberculosis ; Wrist

From 1981 to 1993, one hundred and thirty eight patients had been treated by free flap or island flap, for the tissue defects of the extremities. Among these 138 patients, vascularized bone graft was 29 cases, soft tissue free flap 40, replantation 22, local island flap 45, and lymphovenous shunt 2. Average age at the time of operation was 27 years(1-66 years), and men were 110, women 28. Average duration of follow-up was 2 years and 8 months(4 months-11 years and 8 months). Twenty nine cases of vascularized bone graft was consisted of fibular graft in 15 patients, ilium 8, joint transplantation 4, thumb reconstruction using big toe 1, and rib 1. Four of them were failed. Among 40 patients of soft tissue free flap, latissimus dorsi flap was 12 cases, dorsalis pedis flap 11, scapular flap 8, wraparound procedure 7 and gracilis flap 2. Seven of them were failed. The levels of replantations were both lower extremities in one patient, leg 1, arm 2, distal forearm 2, and finger(s) 16. In six patients, replantation was nor successful. Among 45 patients of local island flap, lateral supramalleolar island flap was performed in 8 patients, dorsalis pedis flap 2, Chinese flap 10, reverse ulnar artery flap 4, reverse posterior interosseous artery flap 3, neurovascular island flaps for fingers 14, and others 4. Two of them were failed. Two cases of lymphovenous shunt for the treatment of lymphedema were successful. As a whole, 119 cases were successful(86%) among 138 cases including local island flap 45 cases.
Arm ; Arteries ; Asian Continental Ancestry Group ; Extremities ; Female ; Fingers ; Follow-Up Studies ; Forearm ; Free Tissue Flaps ; Hallux ; Humans ; Ilium ; Joints ; Leg ; Lower Extremity ; Lymphedema ; Male ; Replantation ; Ribs ; Superficial Back Muscles ; Surgical Flaps ; Thumb ; Transplants ; Ulnar Artery

PURPOSE: The purpose of this study was to evaluate the results of surgical treatment in patients with chronic flexor carpi ulnaris tendinopathy. MATERIALS AND METHODS: Five patients with 7 wrists underwent surgical treatment for chronic flexor carpi ulnaris tendinopathy. The degenerative tissue inside the tendon over the pisiform was debrided and partial release of the tendon was performed. The clinical outcome was evaluated using pre and postoperative visual analogue scale (VAS) pain score and modified Mayo wrist score at the final follow-up. RESULTS: The mean VAS score was 7.3 preoperatively, which was significantly improved to 3.6 at postoperative 2 weeks, 1.9 at 6 weeks, 1.1 at 3 months, 0.7 at 6 months, and 0.7 at the final visit. Modified Mayo wrist score showed 3 excellent, 3 good, and one fair result. Biopsy showed degenerative tissue findings in all cases. CONCLUSION: Chronic flexor carpi ulnaris tendinopathy is a degenerative disease and surgical treatment of refractory cases can decrease clinical symptoms in the early postoperative period and enable patients to return to activities of daily-living.
Biopsy ; Debridement ; Humans ; Postoperative Period ; Tendinopathy ; Tendons ; Wrist

A pulmonary mucinous cystadenocarcinoma is an extremely rare tumor that is considered to be a cystic variant of mucin-producing lung adenocarcinoma. We present a case of pulmonary mucinous cystadenocarcinoma in a 54-year-old woman. Chest CT scans showed a 4.3-cm-sized, lobulated, well-defined, and homogeneous mass in the right middle lobe with peripheral stippled calcifications that demonstrated low-attenuation with no enhancement after contrast administration; 18F-fluorodeoxyglucose (FDG) PET/CT demonstrated mild heterogeneous FDG uptake. The mass was diagnosed as adenocarcinoma with mucin production by transbronchial lung biopsy. Right middle lobectomy was performed, and the pathologic examination disclosed a pulmonary mucinous cystadenocarcinoma.
Cystadenocarcinoma, Mucinous/pathology/*radiography/surgery ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Lung Neoplasms/pathology/*radiography/surgery ; Middle Aged ; Positron-Emission Tomography and Computed Tomography ; Radiopharmaceuticals/diagnostic use ; Tomography, X-Ray Computed/*methods

There is increasing attention to medical problems of musicians. Many studies find a high prevalence of work-related musculoskeletal disorders in musicians, ranging from 73.4% to 87.7%, and string players have the highest prevalence of musculoskeletal problems. This paper examines the various positions and movements of the upper extremities in string players: 1) basic postures for holding instruments, 2) movements of left upper extremity: fingering, forearm posture, high position and vibrato, 3) movements of right upper extremity: bowing, bow angles, pizzicato and other bowing techniques. These isotonic and isometric movements can lead to musculoskeletal problems in musicians. We reviewed orthopedic disorders that are specific to string players: overuse syndrome, muscle-tendon syndrome, focal dystonia, hypermobility syndrome, and compressive neuropathy. Symptoms, interrelationships with musical performances, diagnosis and treatment of these problems were then discussed.
Cumulative Trauma Disorders/*etiology ; Humans ; Musculoskeletal Diseases/*etiology ; *Music ; Neuromuscular Diseases ; Occupational Diseases/*etiology

BACKGROUND/AIMS: The most common type of syncope in young adults is neurocardiogenic in origin, which is not related to organic problems and has a benign nature. Therefore, there have been few reports regarding syncope in young Korean adults. Here, we examined the causes of syncope and its clinical characteristics in young combat and auxiliary police in Korea. METHODS: We performed a retrospective study of the medical records of 193 combat and auxiliary police in Korea admitted to the National Police Hospital for syncope or presyncope between January 2004 and December 2007. RESULTS: The subjects' mean age was 21+/-1.2 years, and there were 2.8+/-2.9 episodes of syncope (mean+/-SEM). The first syncope occurred after enlistment in the police in 102 patients (52.8%). Basic diagnostic studies showed two cases of elevated creatine phosphokinase and one case of anemia to be related to syncope. Syncope-related traumatic injuries occurred in 38 patients (19.7%), and syncope was more prevalent in the summer. Head-up tilt test was performed in 175 of the 193 patients, and 123 showed a positive response. Other evaluations, including brain magnetic resonance imaging, electroencephalography, and echocardiography, were not helpful for diagnosis. Syncope was neurocardiogenic in origin in the majority of cases. Other causes of syncope were exhaustion (n=2), hyperventilation syndrome (n=2), Meniere's disease (n=1), anemia (n=1), and psychiatric problems (n=5). The causes of syncope could not be identified in 59 patients (30.5%). CONCLUSIONS: Neurocardiogenic syncope was the most common type in our study population. More than half of our patients experienced their first episode after enlisting with the police. Further studies in these groups are necessary.
Adult ; Anemia ; Brain ; Creatine Kinase ; Echocardiography ; Electroencephalography ; Humans ; Hyperventilation ; Korea ; Magnetic Resonance Imaging ; Medical Records ; Meniere Disease ; Police ; Retrospective Studies ; Syncope ; Syncope, Vasovagal ; Young Adult