Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.
Acromioclavicular Joint ; Acromion* ; Clavicle* ; Dislocations ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Rotator Cuff ; Tears

No abstract available.
Clavicle*

No abstract available.
Clavicle*

The 213 first ribs Koreans were measured and morphologically studied. The results were as follows. 1. On average, the internal straight length of the first rib was 53.7mm (male), 49.9mm (female) ; the external straight length was 79.7mm (male), 75.4mm (female), the maximum straight length was 87.4mm (male), 81.2mm (female) ; the breadth was 15.2mm (male), 14.4mm (female) ; and the thickness was 5.5mm (male), 5.4mm (female). 2. The proportion of the scalene tubercle to the costal breadth was 0% to 90% (average 37%). 3. The incidence of the presence of the groove for the first thoracic nerve was 7.5%. 4. The common shapes of the articular surface of the head were ball-shape(41%), cylinder-shape (25%) and plane-shape (25%) ; and those of the tubercle were cylinder-shape (44%), saddle-shape (31%) and socket-shape (14%).
Head ; Incidence ; Ribs* ; Thoracic Nerves

PURPOSE: To evaluate normal variations and thus to avoid confusion in differentiation from lesions of the accessory structures (rhomboid fossa, foramen for supraclavicular nerve, conold tubercle) of the clavicle in chest radiographs. MATERIALS AND METHODS: We studied the variations of the clavicle in 300 chest radiographs (134 men, 166 women) and 355 dry bones (right 166, left 189; 151 men, 74 women, 130 unknown sex). RESULTS: In chest radiographs, the incidence of the depressed rhomboid fossa was 229 cases (39.5%;male 52.0%, female 29.9%);the flat type was 329 cases (56.9%;male 45.7%, female 65.7%);and the elevated type was 20 cases (3.5%; male 2.4%, female 4.3%). In the dry bones, the incidence of the depressed thombold fossa was 129 cases (57.3%;male 59.6%, female 52.7%);the flat type was 65 cases (28.9%;male 24.5%, female 37. 8%) ;and the elevated type was 31 cases (13.8%;male 15.9%, female 9.5%). The incidence of the foramen for supraclavicular nerve was 0.8% in chest radiographs, and 1.4% in the dry bones. The incidence of the elevated conold tubercle was 65.1% (male 64.0%, female 65.9%) in chest radiographs, and 96.9% (male 95.4%, female 100.0%) in the dry bones. CONCLUSIONS: The incidence of the depressed rhomboid fossa in chest radiographs was higher in men and the right clavicle. The incidence of flat rhombo~d fossa in chest radiographs decreased according to increase of age. The foramen for supraclavicular nerve was occasionally found (0.8% in chest radiographs; 1.4% in the dry bones).
Clavicle* ; Female ; Humans ; Incidence ; Male ; Radiography, Thoracic* ; Thorax*

PURPOSE: To evaluate normal variations and thus to avoid confusion in differentiation from lesions of the accessory structures (rhomboid fossa, foramen for supraclavicular nerve, conold tubercle) of the clavicle in chest radiographs. MATERIALS AND METHODS: We studied the variations of the clavicle in 300 chest radiographs (134 men, 166 women) and 355 dry bones (right 166, left 189; 151 men, 74 women, 130 unknown sex). RESULTS: In chest radiographs, the incidence of the depressed rhomboid fossa was 229 cases (39.5%;male 52.0%, female 29.9%);the flat type was 329 cases (56.9%;male 45.7%, female 65.7%);and the elevated type was 20 cases (3.5%; male 2.4%, female 4.3%). In the dry bones, the incidence of the depressed thombold fossa was 129 cases (57.3%;male 59.6%, female 52.7%);the flat type was 65 cases (28.9%;male 24.5%, female 37. 8%) ;and the elevated type was 31 cases (13.8%;male 15.9%, female 9.5%). The incidence of the foramen for supraclavicular nerve was 0.8% in chest radiographs, and 1.4% in the dry bones. The incidence of the elevated conold tubercle was 65.1% (male 64.0%, female 65.9%) in chest radiographs, and 96.9% (male 95.4%, female 100.0%) in the dry bones. CONCLUSIONS: The incidence of the depressed rhomboid fossa in chest radiographs was higher in men and the right clavicle. The incidence of flat rhombo~d fossa in chest radiographs decreased according to increase of age. The foramen for supraclavicular nerve was occasionally found (0.8% in chest radiographs; 1.4% in the dry bones).
Clavicle* ; Female ; Humans ; Incidence ; Male ; Radiography, Thoracic* ; Thorax*

One hundred eighty-eight patients with avascular necrosis of the femoral head in adults, who were admitted and treated in Department of Orthopedic Surgery, Seoul National University Hospital between January of 1965 and May of 1985 are investigated in terms of the history, clinical data and laboratory examinations. And, the following results were obtained. 1. The incidence was higher in the 5th decade and the sex ratio between male and female was 3.3:l. 2. 106 cases (56%) had the bilateral hip involvement. 3. The most frequent etiological factor was alcohol (72 cases, 38%), followed by trauma (35 cases, 19 %), and steroid (32 cases, 17%). 4. Underlying diseases in steroid-induced avascular necrosis of the femoral head were dermopathy (9 cases), nephropathy (4 cases), pain over other joints (5 cases), systemic lupus erythematosus (2 cases), etc. 5. The time intervals between etiological events and appearances of clinical symptoms were 2 years and 3 months in the steroid induced cases, 1 year and 1 month in trauma induced ones, 2 years and 1 month in femur neck fracture cases, 2 years and 2 months in Caissons disease, and 3 years in post-irradiation 6. Bone scan was valuable in the early diagnosis of avascular necrosis of the femoral head. 7. Selective femoral head angiography show narrowing of lateral femoral circumflex artery, narrowing or obstruction of medical femoral circumflex artery, and obstruction of superior retinacular artery. 8. It is suggested that minor trauma and osteoporosis could make micro-fracture, resulting avascular necrosis of the femoral head, and the vascular change is secondary to the avascular necrosis.
Adult ; Angiography ; Arteries ; Early Diagnosis ; Female ; Femoral Neck Fractures ; Femur ; Head ; Hip ; Humans ; Incidence ; Joints ; Lupus Erythematosus, Systemic ; Male ; Necrosis ; Orthopedics ; Osteoporosis ; Seoul ; Sex Ratio

No abstract available.
Graft vs Host Disease*

Hereditary angioedema is a rare genetic disease transmitted with a autosomal dominant trait result of a quantitative or functional defect of Cl inhibitor. We report three cases of heriditary angioedema from the same famly respectively the 35-year-old sister, the younger bn)ther of 32, and the younger sister of 20 The older sister died due to her airway being obstructel by acute laryngeal edema, and her you igirbrother and sister experienced recurrent episodes oswelling on the hand and forearm. The ore we examined the two patients serum complement levils to confirm diagnosis. In both, the r;ults showed decreased levels of Cl inhibitor and C4 which are the evidence of hereditary a giedema. The younger sister has been administered danazol (600mg/day) to prevent angioedem or 8 weeks, and we have not yet found a recurrenc of he symptoms. However, well cont ol the dosage of danazol because amenorchea has developec.
Adult ; Angioedema ; Angioedemas, Hereditary* ; Complement System Proteins ; Danazol ; Diagnosis ; Forearm ; Hand ; Humans ; Laryngeal Edema ; Siblings

STUDY DESIGN: Retrospective case series. OBJECTIVES: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). SUMMARY OF LITERATURE REVIEW: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. MATERIALS AND METHODS: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. RESULTS: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the follow-up period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p < 0.05). Complications were not reported in any cases. CONCLUSIONS: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.
Back Pain ; Consensus ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Nerve Block ; Quality of Life ; Retrospective Studies ; Treatment Outcome