STUDY DESIGN: A retrospective study. PURPOSE: To evaluate the prevalence and risk factors of asymptomatic cervical or thoracic lesions in elderly patients who have undergone surgery for lumbar spinal stenosis. OVERVIEW OF LITERATURE: Concurrent multiple spinal lesions have been reported in many studies with a varied prevalence, and described the characteristics of the disease and its treatment options. However, the cervical or thoracic lesions without apparent symptoms in patients with symptomatic lumbar stenosis had not been evaluated. METHODS: A total of 101 elderly patients (aged 65 or more), who had undergone surgery for lumbar spinal stenosis from January 2005 to December 2005, were enrolled in this study. All patients underwent lumbar magnetic resonance imaging (MRI) along with T2-weighted cervical and thoracic sagittal MRI prior to surgery. The concurrent cervical or thoracic lesions were classified according to the disease entity, and the severity of the lesions was graded from grade 0 (no lesion) to grade 4 (any lesion compressing the cord with a signal change). The prevalence of concurrent cervical and thoracic lesions was then analyzed. In addition, the risk factors for the development of concurrent lesions were evaluated, and the risk factors affecting the severity of the concurrent lesion were analyzed individually. RESULTS: Seventy-seven (76.2%) and 30 (29.7%) patients had a concurrent cervical and thoracic lesion, respectively. Twenty-six patients (25.7%) had both a cervical and thoracic lesion. There was a positive correlation between the symptom duration of lumbar stenosis and the prevalence of both cervical (p = 0.044) and thoracic (p = 0.022) lesions. CONCLUSIONS: The incidence of asymptomatic cervical or thoracic lesions is apparently high in elderly patients who have undergone surgery for lumbar spinal stenosis, particularly in those with longer symptom duration. This highlights the need for a preoperative evaluation of the cervical and thoracic spine in these patients.
Aged ; Constriction, Pathologic ; Humans ; Incidence ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spine

PURPOSE: We report short-term results of radial head prosthesis using a unipolar loose fit stem in ten patients. MATERIALS AND METHODS: Ten patients with Mason type three radial head fracture, who received unipolar radial head arthroplasty from February 2010 to June 2011, were evaluated (mean follow-up: 22 months, range: 18-30 months). Subjects consisted of five men and five women. Range of elbow motion was measured. Mayo elbow performance index (MEPI) score was used for functional evaluation and periodic radiological imaging was performed to evaluate the stability of implant. RESULTS: After an average follow-up of 22 months, elbow stability was maintained in all cases, and the average range of motion of elbow flexion and extension was 6 to 130 degrees. Average range of pronation and supination was 66 and 74 degrees, respectively. MEPI score was evaluated as excellent in seven cases, and good in three cases. On final follow-up, radiological assessment showed implant stability in all cases without evidence of dislocation, subluxation, arthritis, periprosthetic osteolysis or heterotopic ossification. CONCLUSION: Based on our short-term follow-up, radial head arthroplasty with unipolar loose fit stem is a useful method for obtaining satisfactory outcome for unreducible comminuted radial head fractures.
Arthritis ; Arthroplasty* ; Dislocations ; Elbow ; Female ; Follow-Up Studies ; Head* ; Humans ; Male ; Ossification, Heterotopic ; Osteolysis ; Pronation ; Prostheses and Implants ; Range of Motion, Articular ; Supination

PURPOSE: The purpose of this study is to identify the incidence of clavicle fracture in birth trauma associated with delivery, fetal presentation, birth weight and to identify the difference of the prognosis of clavicle fracture when immobilization was performed or not. MATERIALS AND METHODS: Among the 12,738 live births from March 1996 to December 2000, we reveiwed retrospectively the medical records and radiographs of 39 cases of clavicle fracture which were followed for more than 6 months. Statistical analysis was measured P-value. Except 11 cases that diagnosis was delayed, 27 cases were treated with figure of 8-bandage, and 1 case, which was combined with humerus fracture, was treated with long arm cast. RESULTS: Among 39 cases infants of clavicle fracture, 36 cases (0.57%) were delivered through vaginal delivery, 3 cases (0.04%) through ceasarean section. Fetal presentations were cephalic presentation in 29 cases, shoulder dystocia in 8 cases, breech presentation in 2 cases. The mean birth weight was 3.8 kg, the high prevalence (8.5%) was identified on large birth weight infants more than 4 kg (p<0.05). The fracture site was proximal portion in 12 cases, middle portion in 27 cases and right clavicle in 24 cases, left clavicle in 13 cases and both clavicle in 1 case. The combined injuries were the brachial plexus palsy (2 cases), skull fracture (1 case) and cephalhematoma (1 case). Finally all cases of clavicle fracture were shown radiographically bony union within 3 weeks. CONCLUSION: The newborn clavicle fractures were remarkably low incidence in cesarean section delivery and were easily neglected, and were detected accidentally on simple chest X-ray that was performed for upper respiratory infection. As a conclusion, it is necessary of screening test through careful physical examination and X-ray interpretation.
Arm ; Birth Weight ; Brachial Plexus ; Breech Presentation ; Cesarean Section ; Clavicle* ; Diagnosis ; Dystocia ; Female ; Humans ; Humerus ; Immobilization ; Incidence ; Infant ; Infant, Newborn* ; Labor Presentation ; Live Birth ; Mass Screening ; Medical Records ; Paralysis ; Parturition ; Physical Examination ; Pregnancy ; Prevalence ; Prognosis ; Retrospective Studies ; Shoulder ; Skull Fractures ; Thorax

PURPOSE: The purpose was to describe comparative analysis of the surgical outcome of percutaneous K-wire fixation of bony mallet fingers reduced with towel clip and 18-gauge needle. METHODS: We analyzed the bony mallet finger patients with more than twelve months follow-up after percutaneous K-wire fixation. The patients were randomly divided into two groups. Eighteen fingers were treated with closed reduction using towel clip and 18 other fingers were treated with closed reduction using 18-gauge needle. RESULTS: Radiographs showed bony union and no subluxation in all cases after K-wire removal. The average extension lag was 2.8degrees/1.9degrees, and range of motion of distal interphalangeal joint was 70.3degrees/75degrees respectively. According to Crawford's criteria, excellent results were obtained in 9/11 fingers, good results in 8/7 fingers, and poor result in 1/0 finger, respectively. CONCLUSION: 18-gauge needle reduction in percutaneous K-wire fixation is considered less invasive and useful method for treatment of bony mallet finger with comparable results with towel clip reduction.
Fingers ; Follow-Up Studies ; Humans ; Joints ; Needles ; Range of Motion, Articular

Simultaneous bilateral proximal femoral fractures are extremely rare, and a few have been reported in and outside the country. It may have various causes, and most cases were associated with major trauma, repetitive minor trauma, seizure, parathyroid or renal dysfunction, and anti-epileptic medications. We experienced a case of simultaneous bilateral proximal femoral fractures after generalized tonic-clonic seizure in a 70-year-old female. Herein, we report it with a review of the literature.
Aged ; Female ; Femoral Fractures ; Femur Neck ; Hip ; Hip Fractures ; Humans ; Seizures

No abstract available.
Administration, Oral ; Aged ; Anti-Bacterial Agents/*administration & dosage ; Bone Diseases, Infectious/diagnosis/*drug therapy/microbiology ; Drug Therapy, Combination ; Female ; Hospitals, University ; Humans ; Joint Diseases/diagnosis/*drug therapy/microbiology ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Republic of Korea ; Staphylococcal Infections/diagnosis/*drug therapy/microbiology ; Staphylococcus aureus/*drug effects/isolation & purification ; Treatment Outcome

PURPOSE: To evaluate the necessity for repair of associated deltoid ligament rupture in lateral malleolar fracture. MATERIALS AND METHODS: Twenty of twenty-five patients were evaluated. Each received surgical treatment without repair of the ruptured deltoid ligament. We found that the medial clear space was widened more than 5 mm in intraoperative stress tests which had been done between May 2003 and June 2008. We did follow-up on these patients for more than 1 year after surgery. At the final follow-up, radiologic and clinical assessment were evaluated on plain X-ray and according to Olerud Molander ankle scores. RESULTS: Open reduction and internal fixation of the lateral malleolar was done in all cases and an additional transfixation screw was needed in 17 patients who had concurrent syndesmotic disruption. Average medial clear space widening before surgery was 9.28 mm (7.0-17.14 mm), at final follow-up time it was 3.43 mm (2.9-5.28 mm). And there were 8 (40%) good, 10 (50%) fair and 2 (10%) poor ratings on radiologic evaluation, but the mean clinical score was 93.75, with 17 (85%) being excellent, 2 (10%) good and 1 (5%) fair on clinical evaluation. CONCLUSION: In the treatment of lateral malleolus fracture associated with disruption of the deltoid ligament, satisfactory clinical results could be obtained including lateral joint stability, with accurate anatomical reduction and internal fixation of the lateral malleolus and distal tibio-fibular joints. Medial joint stability could be obtained without deltoid ligament repair.
Animals ; Ankle ; Exercise Test ; Follow-Up Studies ; Humans ; Joints ; Ligaments ; Rupture

No abstract available.
Bacteremia* ; Mortality*

PURPOSE: To evaluate the clinical outcomes and radiographic results of operative treatment for intraarticular calcaneal fracture. MATERIALS AND METHODS: We reviewed 57 cases of intraarticular calcaneal fracture managed with operative treatment, from January, 2000 to June, 2003. The type of intraarticular calcaneal fracture is classified by the Essex-Lopresti classification and Sanders by computed tomography. The 20 cases were managed by open reduction, 37 cases by closed reduction. RESULTS: On clinical outcomes in the case of open reduction and internal fixation, above good in 13 cases, poor in 2 cases; closed reduction, above good in 16 cases, poor in 10 cases. Averages of Bohler angle were increased from 11degrees (preoperative state) to 21degrees (last follow up) in open reduction, and from 14degrees to 20.9degrees in closed reduction. CONCLUSION: Open reduction was considered to be one of good treatment option if the anatomical reduction and stable fixation can be obtained.
Classification ; Intra-Articular Fractures

PURPOSE: To compare the result of failed internal fixation of intertrochanteric fractures treated with arthroplasty and 95degrees angled blade plate. MATERIALS AND METHODS: From June 2000 to may 2003, there were 12 cases with failed internal fixation of intertrochanteric fractures among 185 cases treated with dynamic hip screw and followed up for more than 1 year. The 4 cases were treated with bipolar hemiarthroplasty, 1 case with total hip arthroplasty, and other 7 cases were treated with 95degrees angled blade plate with allograft, evaluated clinically the operation times, blood loss, walking ability and complication. RESULTS: In the 7 cases, which treated with 95degrees angled blade plate, the average operation time was 109 minutes, the average blood loss was 431 ml. The result of keeping abreast of 1 year, no aid ambulation was 4 cases, the cane ambulation was 2 cases, the walker ambulation was 1 case, and there was no pain in 3 cases, mild pain in 4 cases, and no moderate pain. In the 5 cases, which treated with arthroplasty, the average operation time was 157 minutes, the average blood loss was 618 ml. During 1 year, no aid ambulation was 3 cases, the cane ambulation was 1 case, the walker ambulation was 1 case, and no pain in 2 cases, mild pain in 1 case, moderate pain in 1 case. CONCLUSION: Both 95degrees angled blade plate and arthroplasty can be useful for failed internal fixation of intertrochanteric fractures, and the choice of implant must be determined with caution, considering the surgical conditions of patient, as well as benefits of each devices
Allografts ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Canes ; Femur* ; Hemiarthroplasty ; Hip ; Hip Fractures* ; Humans ; Walkers ; Walking