Calcific tendinitis of the shoulder joint is common disease causing acute pain, mainly involving the supraspinatus or infraspinatus muscle, and less frequently the teres minor or subscapularis muscle. This study reports on the satisfactory arthroscopic removal of calcium deposits as well as infraspinatus and supraspinatus muscle repair without relapse via minimal incision using suture anchors. This was a case of atypically extensive calcific tendinitis involving the infraspinatus muscle, with a bursal side partial rupture of the supraspinatus muscle in a 61-year-old female whose chief complaint was chronic pain of the right shoulder exacerbated by limited movement.
Acute Pain ; Calcium ; Chronic Pain ; Female ; Humans ; Middle Aged ; Recurrence ; Rupture ; Shoulder Joint ; Shoulder* ; Suture Anchors ; Tendinopathy*

Intraneural ganglion is a relatively rare clinical entity that is commonly found in the peripheral nerves in the upper and lower extremities. It is commonly manifested by motor deficits, pain and sensory changes due to nerve entrapment and compression of the involved nerve. An intraneural ganglion of the tibial nerve is very rare. We present here a rare case of intraneural ganglion of the tibial nerve in the popliteal fossa and the patient had a neurologic deficit, and this was all treated successfully. We review the clinical course of the patient and the relevant issues are discussed together with a thorough review of the relevant literature.
Ganglion Cysts ; Humans ; Lower Extremity ; Nerve Compression Syndromes ; Neurologic Manifestations ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Tibial Nerve

Vascular complication of hip arthroplasty is relatively rare, and usually involves iatrogenic injury or thrombus formation of main vessels. No case of vascular injury associated with closed suction drainage has been reported. The current report describes an injury of a branch from the lateral circumflex femoral artery caused by a trocar of closed suction drainage in a 72-year-old man who had been treated with bipolar hemiarthroplasty because of a femoral neck fracture. We report on this case with a review of the literature in order to avoid similar complications.
Aged ; Arthroplasty ; Femoral Artery ; Femoral Neck Fractures ; Hemiarthroplasty* ; Hip* ; Humans ; Suction* ; Surgical Instruments* ; Thrombosis ; Vascular System Injuries

Injury of the femoral artery with a femoral intertrochanteric fracture is rare, and usually occurs on the deep femoral artery during surgery. We experienced a case of preoperative injury of the superficial femoral artery by a lesser trochanteric fragment. We repaired the femoral artery through an anterior approach before internal fixation.
Femoral Artery ; Femur

STUDY DESIGN: A retrospective study PURPOSE: This study examined the reliability of the MRI findings in detecting symptomatic extraforaminal disc herniation in the lumbar spine. OVERVIEW OF LITERATURE: There are no reports of the characteristics and reliable MRI findings of extraforaminal disc herniation. METHODS: Thirty age-and gender-matched asymptomatic volunteers and 30 patients with symptomatic extraforaminal disc herniation, who underwent surgery between March 2006 and Dec 2008, were enrolled in this study. All subjects underwent spinal MRI. The following parameters were evaluated: the presence or absence of focal eccentricity of the disc, change in the diameter of the nerve root, and displacement of the nerve root at the extraforaminal zones. Radiologic studies were reviewed blindly and independently by 3 spine surgeons. RESULTS: The overall agreement in determining the presence or absence of a symptomatic extraforaminal disc herniation between the three reviewers was 89.4% (161/180). The consensus showed focal eccentricity of the disc in 33 cases (55%), a change in diameter in the nerve root in 31 cases (51.7%), and a displacement of the nerve root in 23 cases (38.3%). An assessment of the paired intraobserver and interobserver reliability revealed mean Kappa statistics of 0.833 and 0.667 for focal eccentricity of the disc, 0.656 and 0.556 for a change in the diameter of the nerve root, and 0.669 and 0.020 for a displacement of the nerve root, respectively. CONCLUSIONS: There are three possible MRI findings that can be used to determine the presence or absence of symptomatic extraforaminal disc herniation. Among these MRI findings, focal eccentricity of the disc was found to be the most reliable.
Consensus ; Displacement (Psychology) ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine

We would like to report a case of treating a segmental fracture of ulnar shaft, with a concomitant olecranon fracture. The patient was treated using tension band wiring and intramedullary nailing procedures. Based on the nature of the olecranon, we believe this should be a recommended treatment method that minimizes complications for the patient that has multiple fractures and a dislocation of the forearm.
Dislocations ; Forearm ; Fracture Fixation, Intramedullary ; Humans ; Olecranon Process

PURPOSE: The purpose of this study was to compare with general characteristics affecting ambulatory recovery at one-year after the fixation of intertrochanteric fracture with proximal femoral nail (PFN) of elderly patients over the age of 65 years. MATERIALS AND METHODS: Between September 2008 and September 2015, 152 patients were diagnosed with femoral intertrochanteric fracture in Dong-Eui Medical Center. Of these patients, 75 were available in this retrospective study. Multivariate linear regression analysis, using a stepwise selection method, were performed to identify the prognostic factors affecting one-year postoperative recovery of ambulatory status, such as pre-injury ambulatory status, gender, age, fracture type, associated underlying disease, American Society of Anesthesiologists (ASA) grade, dementia, and complication. RESULTS: A decrease in the one-year postoperative ambulatory status was 68% and pre-injury ambulatory status was regained in 32% of patients. The pre-injury ambulatory status was the most important determinant of one-year postoperative recovery of ambulatory status. The ASA grade and complication were also predictors of recovery of ambulatory status. CONCLUSION: Pre-injury ambulatory status, ASA grade and complication were prognostic factors associated with one-year postoperative recovery of ambulatory status after fixating the intertrochanteric fracture using PFN in elderly patients over the age of 65 years.
Aged* ; Dementia ; Humans ; Linear Models ; Methods ; Retrospective Studies

PURPOSE: The aim of this study was to analyze the clinical symptoms and function and the nerve electrophysiological changes between the pre-operative and long-term post-operative states of patients who underwent surgical treatment with endoscopic release of the carpal tunnel for idiopathic carpal tunnel syndrome. MATERIALS AND METHODS: This study was performed in 48 patients and 88 wrists with idiopathic carpal tunnel syndrome. All patients were treated with endoscopic carpal tunnel release using a single portal. The preoperative and the 3 years 5 months long-term postoperative clinical symptoms and function were evaluated using the Boston carpal tunnel questionnaire. The nerve electrophysiological status was evaluated using the Bland grade system. RESULTS: When the preoperative Bland grade was 2, 3, 4, 5, and 6, the range of the change of the symptom severity score was 1.38, 1.68, 2.40, 1.61 and 1.28, respectively, and the range of the change of the functional status score was 0.60, 1.34, 1.58, 0.93 and 0.88, respectively, at the long-term follow-up. The clinical symptoms were signifi cantly improved at the fi nal follow-up when the preoperative Bland grade was 2, 3, 4 and 5. The function was signifi cantly improved for all the preoperative Bland grades. On the nerve electrophysiological study, there was statistical improvement of the distal motor latency of the motor nerve and the nerve conduction velocity and amplitude of the sensory nerve. When the preoperative Bland grade was 2, 3, 4, 5 and 6, the extent of improved grade was 0.60, 0.75, 2.17, 2.87 and 4.25, respectively, at the long-term follow-up, and the Bland grade was signifi cantly improved when the preoperative Bland grade was 3, 4, 5 and 6. However, there was no statistical signifi cance between the Bland grade and the clinical state at the long-term follow-up. CONCLUSION: The clinical and nerve electrophysiological states were significantly improved at the long-term follow-up after endoscopic carpal tunnel release. When the preoperative Bland grade was 3, 4 and 5, the clinical symptoms, function and the nerve electrophysiological states were signifi cantly improved at the long-term follow-up.
Boston ; Carpal Tunnel Syndrome ; Follow-Up Studies ; Humans ; Neural Conduction ; Surveys and Questionnaires ; Wrist

Restoration of the hip biomechanics, including the femoral offset and leg length, are the desired goals when performing total hip arthroplasty. A leg length discrepancy following total hip arthroplasty is a significant source of back pain and sciatica, gait disorders, general dissatisfaction and dislocation. Significant lengthening of the leg can be a risk factor for nerve injury and it is a relatively common cause of litigation. There is a fundamental interrelationship between leg length and stability when performing hip arthroplasty. There are a multitude of situations in which achieving both stability and perfectly equal leg lengths is simply not possible. Stability is the primary objective, and the surgeon may need to sacrifice leg length equality on the altar of stability. Although a leg length discrepancy cannot be eliminated after hip arthroplasty, it can be minimized through a series of steps, including a physical examination, radiographic evaluation, preoperative templating and intraoperative confirmation of the preoperative plan.
Arthroplasty ; Back Pain ; Biomechanics ; Dislocations ; Gait ; Hip ; Jurisprudence ; Leg ; Physical Examination ; Risk Factors ; Sciatica

Flexion contracture deformities, as well as severe varus and valgus deformities of the knee joint, accompany osteoarthritis or rheumatoid arthritis (RA). In particular, severe flexion contracture deformity of the knee joint is often found in patients with RA, which renders them nonambulatory. This report describes a 26-year-old female patient diagnosed with RA 10 years ago. She had chronic joint pain, severe flexion contracture, valgus deformity in both knees, and limited range of motion in both knees and became nonambulatory. She underwent a total knee arthroplasty (TKA) and serial casting and physical therapy to restore stable joint movement and correct knee joint deformity. Her pain was successfully relieved, and she was able to walk after surgery. Here, we report the excellent results of TKA in this RA patient with severe flexion contracture of both knees.
Adult ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Contracture ; Female ; Humans ; Joints ; Knee Joint ; Knee ; Osteoarthritis ; Range of Motion, Articular