Background: This study investigated the results of component asymmetry (CA) in bilateral cementless total hip arthroplasty (THA). Methods: This study included 300 patients, who underwent bilateral cementless THA between April 2000 and December 2017. They were divided into the component symmetry (CS) and CA groups; CA group was sub-classified into acetabular component asymmetry (ACA) and femoral component asymmetry (FCA). Radiologic and clinical outcomes of the CA group were compared with those of the CS group. Results: The incidence of CA was 25.7% (77/300 patients), including 55 patients with ACA, 34 patients with FCA, and 12 with both components asymmetric. The mean time interval between operations in the CA group was significantly longer than that in the CS group (p < 0.001). The mean differences in horizontal and vertical distances from teardrop to the center of rotation of the acetabular component between both hips in the ACA group were significantly larger than those in the CS group (p = 0.033 and p < 0.001, respectively). The mean femoral component alignment angle difference between both hips was significantly larger in the FCA group than in the CS group (p < 0.001). The mean Harris Hip Score at last follow-up of the CA group was similar to that of the CS group. Conclusions CA in patients undergoing bilateral cementless THA was not rare, especially with a longer time interval between operations. Regardless of CA, when stable fixation of the components was achieved, satisfactory radiologic and clinical outcomes were obtained.

BACKGROUND: This study compared the clinical and radiological outcomes of the single calcar screw plate and Polarus nail techniques for the treatment of the proximal humerus fractures. METHODS: Seventy-two patients diagnosed with displaced proximal humerus fracture were enrolled for the study. Of these, 50 patients underwent the locking plate surgery with a single calcar screw (plate group), whereas 22 patients underwent the Polarus nail surgery (nail group). The plate group was further divided into plate 1 group (with medial support), and plate 2 group (without medial support). The radiological and functional results of both groups were compared to the nail group. RESULTS: The α angle 1 year after surgery was significantly different between plate 1 and plate 2, and plate 2 and nail groups (p=0.041, p=0.043, respectively). The ratio that does not satisfy the reference value of γ angle was 2.8% in plate 1, 7.1% in plate 2 and 22.7% in nail group (p=0.007); there was a significant difference between plate 1 and nail group, and plate 2 and nail group (p=0.014, p=0.033, respectively). CONCLUSIONS: No significant differences were observed in the clinical results between locking plate and Polarus nail. However, in the plate 2 group and nail group, the rate of failure to maintain reduction during the 1-year period after surgery was statistically and significantly higher than the plate 1 group (level of evidence: level IV, case series, treatment study).
Humans ; Humeral Fractures ; Humerus* ; Reference Values

BACKGROUND: This study compared the clinical and radiological outcomes of the single calcar screw plate and Polarus nail techniques for the treatment of the proximal humerus fractures. METHODS: Seventy-two patients diagnosed with displaced proximal humerus fracture were enrolled for the study. Of these, 50 patients underwent the locking plate surgery with a single calcar screw (plate group), whereas 22 patients underwent the Polarus nail surgery (nail group). The plate group was further divided into plate 1 group (with medial support), and plate 2 group (without medial support). The radiological and functional results of both groups were compared to the nail group. RESULTS: The α angle 1 year after surgery was significantly different between plate 1 and plate 2, and plate 2 and nail groups (p=0.041, p=0.043, respectively). The ratio that does not satisfy the reference value of γ angle was 2.8% in plate 1, 7.1% in plate 2 and 22.7% in nail group (p=0.007); there was a significant difference between plate 1 and nail group, and plate 2 and nail group (p=0.014, p=0.033, respectively). CONCLUSIONS: No significant differences were observed in the clinical results between locking plate and Polarus nail. However, in the plate 2 group and nail group, the rate of failure to maintain reduction during the 1-year period after surgery was statistically and significantly higher than the plate 1 group (level of evidence: level IV, case series, treatment study).
Humans ; Humeral Fractures ; Humerus ; Reference Values

PURPOSE: Preoperative on-screen templating is a method of using acetate templates on digital images. The aim of the present study was to evaluate the accuracy, intra- and interobserver reliabilities of preoperative on-screen templating using digital radiographs for total hip arthroplasty (THA). MATERIALS AND METHODS: Two hundred patients with hip disease who were treated with primary cementless THA were retrospectively evaluated. The accuracy of on-screen templating was assessed by comparing the predicted prosthesis sizes with the actual sizes used operatively. The inter- and intraobserver reliabilities of the templating results were also evaluated. RESULTS: The prosthesis prediction accuracy within ±one size was 96.6% for the cup size and 97.8% for the stem size. The inter- and intraobserver reliabilities for the implant size were substantial (kappa>0.70). The intra- and interobserver reliabilities for the leg length discrepancy and femoral offset difference using the intraclass correlation coefficient ranged from 0.89 to 0.97. CONCLUSION: Preoperative on-screen templating using digital radiographs showed substantial accuracy and reliability for implant prediction. It is an effective method for predicting the size of implant, correcting the leg length discrepancy and restoring the femoral offset.
Arthroplasty, Replacement, Hip* ; Hip ; Humans ; Leg ; Methods ; Prostheses and Implants ; Radiographic Image Enhancement ; Retrospective Studies

STUDY DESIGN: A retrospective study. OBJECTIVES: Using ultrasound to evaluate association of minor cutaneous stigmas with occult spinal dysraphism (OSD) according to the presence of co-morbidities. SUMMARY OF LITERATURE REVIEW: OSD can be associated with various cutaneous markers. Ultrasound of the spine is an effective, non-invasive screening method. MATERIALS AND METHODS: Over a 5-year period (2009-2013), a total of 180 infants with various skin stigmas were evaluated. Ninety-seven patients were normal infants, eighty-three had other co-morbidities. The type of skin stigmata and/or co-morbidities as well as lumbar ultrasound results were reviewed for all patients. RESULTS: Three of the 97 normal infants had abnormalities. One of the three had OSD. Eighteen of the 83 infants with congenital anomalies had abnormalities, and eleven of the 18 had OSD. Infants with congenital anomalies were 6 times more likely to have OSD than normal infants (OR 5.98, 95% CI 1.927 to 18.612, p=0.001) and there was no significant correlation between the presence of minor skin lesions and the presence of dysraphism. CONCLUSIONS: So-called minor skin lesions were not markers of OSD in normal infants. However, because of the feasibility, simplicity, and low cost of spinal ultrasound, the examination is justified by the benefits of early diagnosis.
Christianity* ; Early Diagnosis ; Humans ; Infant* ; Mass Screening ; Neural Tube Defects ; Retrospective Studies ; Skin ; Spinal Dysraphism* ; Spine ; Ultrasonography*

PURPOSE: The purpose of this study was to evaluate radiologic and functional outcomes of patients with unstable femoral intertrochanteric fractures treated with proximal femoral nail antirotation II (PFNA II). MATERIALS AND METHODS: Between August 2009 and December 2013, 108 hips (108 patients) with unstable femoral intertrochanteric fractures were treated with PFNA II and followed for at least 1 year. The mean follow-up period was 15.2 months. The radiographic outcomes, reduction state, sliding distance of the helical blade, bone union, and complications were assessed. The functional outcomes were assessed according to the Charnley hip pain scoring system, walking ability, and the Activities of Daily Living index. RESULTS: The postoperative radiograph showed a good or acceptable reduction in all cases. The mean sliding length of the blade was 4.1 mm. The mean duration of radiologic bone union was 4.8 months. There were 2 postoperative complications including nail breakage and nonunion. The mean Charnley hip pain score was 5.1 points. Preoperative walking ability was restored for 74.1% of patients. Preoperative activities of daily life were restored for 60.2% of patients. CONCLUSION: PFNA II used for treatment of unstable intertrochanteric fracture showed favorable outcomes. However, due to decreasing walking ability and delayed return to the activities of daily living, further studies are needed, focusing on functional recovery and rehabilitation to improve postoperative clinical outcomes.
Activities of Daily Living ; Femur ; Follow-Up Studies ; Hip ; Hip Fractures* ; Humans ; Postoperative Complications ; Rehabilitation ; Walking

PURPOSE: The purpose of this study was to evaluate the early results of clinicoradiological outcomes after cementless total hip arthroplasty (THA) for displaced femoral neck fracture in elderly patients. MATERIALS AND METHODS: A total of 44 cementless THA procedures performed between January 2008 and January 2012 for displaced femoral neck fracture in patients older than 65 years of age were enrolled in this study and all patients presented normal cognitive ability preoperatively and were followed for more than two years after surgery. We evaluate the clinical and radiological results. The mean age was 72 years (range 65-81 years), 34 patients were female, and 10 patients were male. The mean follow-up period was 30.7 months. RESULTS: Clinically, at the last follow-up, the mean Harris hip score was 96.5 points. Walking ability was recovered postoperatively in 79.5% of cases (35 cases), and activities of daily living were achieved in 66% of cases (29 cases). Radiographically, none of the acetabular cups showed evidence of migration, loosening, or osteolysis. All cases showed excellent or good fixation postoperatively and stable bony fixation of the femoral stem, with the exception of one case, who presented with a periprosthetic fracture during follow-up. There were no cases of osteolysis, significant alignment change or progressive subsidence. Postoperative dislocation occurred in two cases (4.5%), but no re-dislocations were observed after closed reduction. CONCLUSION: Short-term outcomes proved to be satisfactory in elderly patients older than 65 years of age, who presented with normal cognitive ability preoperatively, undergoing cementless THA for displaced femoral neck fractures.
Acetabulum ; Activities of Daily Living ; Aged* ; Arthroplasty, Replacement, Hip* ; Dislocations ; Female ; Femoral Neck Fractures* ; Femur Neck ; Follow-Up Studies ; Hip ; Humans ; Male ; Osteolysis ; Periprosthetic Fractures ; Walking

BACKGROUND/AIMS: In 2010, the American Diabetes Association (ADA) adopted glycated hemoglobin (HbA1c) as a new diagnostic criterion for diabetes mellitus. However, HbA1c values may differ among races. We determined whether this criterion could be applied to Korean diabetics. METHODS: Between January 2000 and January 2010, 1,862 patients among Konyang University Hospital visitors in which the 75 g oral glucose tolerance test (OGTT) and HbA1c were checked at the same time were enrolled. We excluded patients with acute disease, an Hb < or = 10 g/dL, a Cr > or = 2 mg/dL, those prescribed oral hypoglycemic agents or insulin, and those who were pregnant. RESULTS: After applying the exclusion criteria, 1,474 Korean patients were enrolled. All had common features of Korean diabetics for body mass index and homeostatic model assessment of insulin resistance values. Using the 0 and 120 minute glucose levels of the OGTT from the receiver operating characteristic curve, the HbA1c cutoff value was 6.25%. The cutoff value to diagnose diabetes with the presence of diabetic retinopathy was 6.75%. CONCLUSIONS: Our study showed a difference between the HbA1c values for diagnosing diabetes and the new diagnostic criterion from the ADA. Considering that the HbA1c characteristics may be influenced by race or culture, larger studies on diabetes complications are needed to identify the appropriate HbA1c value for Korean diabetics.
Acute Disease ; Body Mass Index ; Continental Population Groups ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Retinopathy ; Glucose ; Glucose Tolerance Test ; Hemoglobins ; Humans ; Hypoglycemic Agents ; Insulin ; Insulin Resistance ; Korea ; ROC Curve

PURPOSE: This retrospective study was performed to investigate the prevalence of the idiopathic osteosclerosis (IO) in Korean malocclusion patients according to age, sex, and the Angle's classification of malocclusion. MATERIALS AND METHODS: This study consisted of 2,001 randomly selected patients from the Department of Orthodontics at the Gangneung-Wonju National University Dental Hospital, Korea. The prevalence of IO in Korean malocclusion patients was recorded using their panoramic radiographs, and the following parameters were surveyed; age, sex, and the Angle's classification of malocclusion. The chi-square test was analyzed to determine the statistical significance of differences in the prevalence of IO between age, sex, and the Angle's classification of malocclusion. RESULTS: The prevalence of IO in the jaws was 6.7% in a total of 2,001 examined orthodontic patients. The majority of IO was found in the mandible (96.58%). The 30-39 age group showed the highest prevalence of IO (9.60%). There was a higher prevalence in females (6.89%) than in males (6.45%). The prevalence of IO in Angle Class I group (7.07%) was the most frequent, followed by Angle Class II group (6.72%), and Angle Class III group (6.40%). However, there was no statistical significance in sex and Angle's classification of malocclusion. CONCLUSION: The prevalence of IO in malocclusion patients showed the differences between various age groups and most of them were found in the mandibular posterior area. However, sex and the type of malocclusion are not to be considered as a contributing factor of IO.
Female ; Humans ; Jaw ; Korea ; Male ; Malocclusion ; Malocclusion, Angle Class I ; Malocclusion, Angle Class II ; Malocclusion, Angle Class III ; Mandible ; Orthodontics ; Osteosclerosis ; Prevalence ; Radiography, Panoramic ; Retrospective Studies