PURPOSE: Primary bone tumors of hindfoot are uncommon compared with other locations, and there have been few large-group studies. This study was designed to analyze the characteristics and the clinical results of the primary bone tumors of hindfoot. MATERIALS AND METHODS: Forty five cases in 44 patients who have been diagnosed from 1989 to 2011 were reviewed. The minimum follow-up period was 1 year. We retrospectively reviewed the medical records and images. RESULTS: Twenty six cases were male and 18 cases were female. Mean follow-up period was 33.1 months and mean age was 25.1 years. Forty four cases were benign and 1 case was malignant. Thirty six cases occurred in calcaneus and 9 cases were in talus. The most common benign bone tumor was simple bone cyst (20 cases), followed by intraosseous lipoma (12 cases), and chondroblastoma (4 cases). In calcaneus, there were 18 cases of simple bone cyst, and 12 cases of intrasosseous lipoma. In talus, there were 3 cases of chondroblastoma, 2 cases of simple bone cyst, and 2 cases of intraossesous ganglion. Many patients with hindfoot bone tumors presented with pain, but some were found accidentally. Patients received surgical procedures, such as curettage and bone graft, open reduction and internal fixation, tumor resection, and below knee amputation. CONCLUSION: Primary bone tumors of hindfoot are rare and can be misdiagnosed as ankle sprain or contusion. Although most are benign, malignant tumors cannot be ruled out, so early diagnosis and appropriate treatment is important.
Animals ; Ankle ; Bone Cysts ; Calcaneus ; Chondroblastoma ; Contusions ; Curettage ; Early Diagnosis ; Female ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Knee ; Lipoma ; Male ; Medical Records ; Retrospective Studies ; Sprains and Strains ; Talus ; Transplants

Salmonella osteomyelitis is uncommon and it often develops in patients with sickle cell anemia and other hemoglobinopathy. Especially, osteomyelitis caused Salmonella typhi in a nonsickle cell patients is a very rare event. We report three cases with review of literature.
Anemia, Sickle Cell ; Hemoglobinopathies ; Humans ; Osteomyelitis ; Salmonella typhi ; Salmonella

The incidence of the tuberculous osteomyelitis of bone and joint has been decreasing due to improvements in nutrition and medical treatment. However the resurgence of tuberculosis is observed with more frequency as an opportunistic infection. In Korea the incidence of the tuberculosis has been decreasing with rapid economic development, but it is still one of the common pathological conditions involving bone and joint. Tuberculos osteomyelitis confined only to the long bones without involving joints is very rare. The accurate diagnosis of the turberculos osteomyelitis of long bone is difficult, because of the low incidence, long duration and nonspecific radiological findings. We reviewed retrospectively a total of 521 consecutive bone and joint tuberculosis from March 1985 to December 1994. Thirty-eight cases were involved only long bones without inflicting joints. The mean duration of follow up was 16 months. The disease was most frequent in the third decade. Femur(45%) and metaphysic(79%) were the most commonly involved site of the tuberculous osteomyelitis of the long bone. Significant delay in the diagnosis and the initation of the treatment would have been avoided if the biopsy had been performed early. It was looked like that longer symptom duration, higher ESR, associated with pulmonary tuberculosis and inappropriate treatment resulted in recurrence. But when compared with primarily cured cases, these factors did not affect the recurrence statistically. In conclusion, the better results and prevention of the recurrence were observed in cases with early diagnosis, complete removal of the lesion and continuous antituberculous medication.
Biopsy ; Diagnosis ; Early Diagnosis ; Economic Development ; Follow-Up Studies ; Incidence ; Joints ; Korea ; Opportunistic Infections ; Osteomyelitis ; Recurrence ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Osteoarticular ; Tuberculosis, Pulmonary

PURPOSE: To compare clinical outcomes of the tumor prosthetic replacement and osteosynthetic fixation for pathologic fracture of skeletal metastatic lesion of the proximal femur. MATERIALS AND METHODS: From 1994 May to 2009 May, medical records of 22 patients who underwent tumor prosthetic replacement with tumor resection (group 1) and 15 others (16 hips) who underwent osteosynthetic fixation without tumor resection (group 2) were reviewed. The mean age of overall patients were 59 (group 1) and 60 (group 2). Mean follow up periods were 23 and 11 months. The oncological and functional results were evaluated with Kaplan-Meier methods and Musculoskeletal Tumor Society (MSTS) scoring system, 1993. The statistical evaluation was assessed with Log rank test and t-test. RESULTS: The mean survival periods were 24 months in group 1 and 11months in group 2. The 1 year survival rates were 86% in group 1 and 50 % in group 2, and 2 year survival rates were 29.7% in group 1 and 9.4% in group 2. The mean MSTS functional score were 26.4 (19-30), 87.9% in group 1 and 15.3 (10-23), 51.0% in group 2. CONCLUSION: The results of tumor resection and prosthetic replacement in selected cases was better than osteosynthetic fixation without tumor resection for metastatic bone tumors around proximal femur in oncological and functional aspects.
Femur ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Joints ; Medical Records ; Survival Rate

No abstract available.
Dislocations* ; Talus*

No abstract available.
Gaucher Disease*

PURPOSE: To investigate whether simple measurements made on conventional pelvis plain film could predict hip fractures independently of bone mineral density. MATERIALS AND METHODS: The authors analyzed the simple radiographs and dual x-ray absorptiometry scan of women over the age of 60 years who had sustained a neck fracture (n=40), trochanteric fracture (n=40) and non-fracture volunteers (n=40). RESULTS: In an age-adjusted univariate logistic regression model, the most reliable risk factor of hip fracture in bone mass was bone mineral density of the femoral neck. In the measurements of bone architecture, the most important risk factor was Singh index and in bone geometric measurements, it was hip axis length. There were no statistical differences in the measurements between neck fractures and trochanteric fractures. In a multivariate model, these three variables were shown to be significant improvements in the assessment of hip fracture risks. CONCLUSIONS: The authors concluded that simple measurements of proximal femoral geometry made on pelvic radiographs could predict hip fracture as well as bone density of the hip.
Absorptiometry, Photon ; Axis, Cervical Vertebra ; Bone Density ; Female ; Femur Neck ; Femur* ; Hip Fractures* ; Hip* ; Humans ; Logistic Models ; Neck ; Pelvis ; Risk Factors* ; Volunteers

We examined the factors which may serve as predictors of success or failure of amputation in lower extremity for vascular obstructive diseases in 52 consecutive patients who were treated at the Department of Orthopaedic Surgery and Yonsei Cardiovascular Center from January 1st, 1990 to December 31st, 1994. The minimum follow up period was 10 months. The population was divided into two groups, group of success of primary amputation and group of failure. The results were as follows, male and female ratio was 42:10 and the average age was 57.5 years old. Among total 52 cases, there were 22 cases of arteriosclerosis obliterans, 15 cases of Buerger's diseases, 12 cases of vasculitis, 3 cases of acute arterial embolism. Complications after primary amputation included 9 cases of superficial wound infections, 7 cases of marginal wound necroses. Sixteen cases belonged to the group in which reamputation were performed because of intractable poor wound healing. Preoperative value of hemoglobin, hematocrit, serum albumin and serum creatinine which had been generally known as prognostic factors in wound healing were not related to the necessity of reamputation (Multivariate Regression Test, P>0.05). And also age, blood pressure and smoking history and level of amputation didn't show any difference between two groups but existence of lower extremity infection and uncontrolled diabetes mellitus were related to the prognosis of reamputation (Multivariate Regression Test, P<0.05).
Amputation* ; Arteriosclerosis Obliterans ; Blood Pressure ; Creatinine ; Diabetes Mellitus ; Embolism ; Female ; Follow-Up Studies ; Hematocrit ; Humans ; Lower Extremity* ; Male ; Necrosis ; Prognosis ; Risk Factors* ; Serum Albumin ; Smoke ; Smoking ; Vasculitis ; Wound Healing ; Wound Infection ; Wounds and Injuries

Early diagnosis of persistent abnormal reflexes may be of great significance to a more effective functioning of the cerebral palsied child. It is important to know the normal and abnormal reflex responses and their effect upon motor development for providing a basis for evaluation in the diagnosis and treatment of the cerebral palsied child. We studied 28 cerebral palsied children, between 1 to 12 years old, who were treated at Sam Yook Childrens Rehabilitation Center from May 1975 to December 1977. The pathologic reflexes were checked, and the relationship between pathologic reflexes and walking was compared. The following results were obtained. 1. The following were the most important pathologic reflexes in non-walking fgroup: a. Positive supporting reaction b. Protective extensor thrust c. Moro reflex 2. If they are present, the prognosis for walking ambulation was bad and surgery will not improve for the chances of walking.
Child ; Diagnosis ; Early Diagnosis ; Humans ; Prognosis ; Reflex ; Reflex, Abnormal ; Reflex, Startle ; Rehabilitation Centers ; Walking

A giant cell tumor of bone is a benign bone tumor, but has very high local recurrence rate and, very rarely metastasizes to the lung or a distant area. We report a case of a 29-year-old male patient presenting with a metastatic giant cell tumor of the soft tissue of the chest wall, who underwent a total resection of the radius for recurrence of the giant cell tumor. The tumor was not related to any bony structure of the thorax. We resected the tumor with a wide surgical margin. No evidence of malignancy was seen in the frozen and permanent pathological report.
Adult ; Giant Cell Tumor of Bone ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Lung ; Male ; Radius ; Recurrence ; Thoracic Wall* ; Thorax