PURPOSE: To evaluate the usefulness of fractal analysis for diagnosis of periodontitis. MATERIALS AND METHODS: Each 30 cases of periapical films of male mandibular molar were selected in normal group and patient group which had complete furcation involvement. They were digitized at 300 dpi, 256 gray levels and saved with gif format. Rectangular ROIs (10X20 pixel) were selected at furcation, interdental crest, and interdental middle 1/3 area. Fractal dimensions were calculated three times at each area by mass radius method and were determined using a mean of three measurements. We compared fractal dimensions at furcation and interdental crest area of normal group with those of patient group. And then we compared ratio of fractal dimensions at furcation area, interdental crest area to interdental middle 1/3 area. RESULTS: Fractal dimension at interdental crest area of normal group was 1.979+/-0.018 and that of patient group 1.971+/-0.012 (p>0.05). Fractal dimension at furcation area of normal group was 1.986+/-0.024 and that of patient group 1.974+/-0.015 (p<0.05). The ratio of fractal dimension at interdental crest area to interdental middle 1/3 of normal group was 1.003+/-0.015 and that of patient group<0.993+/-0.018 (p<0.05). The ratio of fractal dimension at furcation area to interdental middle 1/3 of normal group was 1.006+/-0.018 and that of patient group 0.994+/-0.018 (p 0.05). CONCLUSION: The ratio of fractal dimension at interdental crest and furcation area to interdental middle 1/3 area showed a statistically significant difference between normal and patient group. In conclusion, it is thought that fractal analysis might be useful for the diagnosis of periodontitis.
Diagnosis* ; Fractals* ; Humans ; Male ; Molar ; Periodontitis* ; Radiography ; Radius

PURPOSE: Multiple hereditary exostoses of the forearm typically form in the distal ulna, causing disturbances in the growth of the ulna and functional disability. Multiple hereditary exostoses inhibit the growth of the ulna, leading to an acquisition of a varus deformity in the radius, which sometimes leads to dislocation of the radial head, the development of limitations in the pronation-supination of the forearm, and cosmetic problems. MATERIALS AND METHODS: We retrospectively reviewed the cases of four patients who had deformities of the forearm with radial head dislocation associated with multiple hereditary exostoses, and evaluated the radiologic and clinical results of excision of the osteochondromas from the distal ulna and gradual ulnar lengthening with an Ilizarov external fixator. RESULTS: Good clinical and radiological results were obtained after a mean follow-up of 25 months. At the most recent follow-up, radial bowing, ulnar shortening, carpal slip, and the pronation/supination arch of the forearm had improved. There was little change in terms of preoperative radial articular angle and the flexion/extension arch of the elbow by the most recent follow-up. CONCLUSION: Treatment of four forearms from four patients by excision of osteochondromas and gradual lengthening of the ulna with an Ilizarov external fixator spontaneously reduced dislocations of the radial heads without the need for any additional operative intervention. All patients were satisfied with the final results.
Adolescent ; Child ; Child, Preschool ; Exostoses, Multiple Hereditary/*radiography/surgery ; Female ; Humans ; Male ; Radius/radiography ; Retrospective Studies ; Ulna/radiography ; Young Adult

PURPOSE: There remains uncertain whether to fix or not an ulnar styloid fracture acommpanied by distal radius fracture. Fixation might be required in cases of the fracture involving a fovea of ulnar head, an attachment site of deep triangular fibrocartilage, which is thought to be important to distal radioulnar joint stability. We analyzed a fovea involvement of an accompanied ulnar styloid fracture in patients with distal radius fracture by simple radiograph and three-dimensional computed tomography (3D CT). METHODS: We retrospectively reviewed 168 patients who underwent surgery with volar locking plate for distal radius fracture in our hospital from January 2005 to March 2015 and evaluated a fovea involvement of ulnar head by simple radiographs and 3D CT respectively, and compared. RESULTS: On simple X-ray, 64 cases (38%) were ulnar styloid fovea fractures; however, 21 cases of these revealed non-fovea fractures by 3D CT. And 7 out of 104 cases determined as non-fovea fracture by simple radiographs were diagnosed as fovea fractures by 3D CT. Sensitivity, specificity and accuracy of evaluation by simple radiograph were 86%, 82% and 83% respectively, when compared with those of 3D CT based evaluation. CONCLUSION: Accuracy of evaluating an accompanied ulnar styloid fovea fracture in patients with distal radius fracture by simple radiograph, when compared with 3D CT, was 83%; therefore, we recommend using the 3D CT based evaluation instead of simple radiograph based one for determination of fovea involvement of ulnar head.
Head ; Humans ; Joints ; Radiography* ; Radius Fractures ; Retrospective Studies ; Sensitivity and Specificity ; Triangular Fibrocartilage

Cubitus varus, which includes deformities of varus, hyperextension and internal rotation, is the most common complication of supracondylar fracture of the humerus in children. For correction of cubitus varus deformity, many operative methods have been reported but postoperative results are not always satifactory. For the purpose of detection of the reason of postoperative residual deformity, we reviewed AP roentgenography of 22 patients of cubitus varus deformity in the view point that change of longitudinal axis of forearm contribute the residual deformity. The results are summerized as follows: 1. Degree of cubitus varus deformity was more severe in the patients whose interval between the injured time and visiting hospital for cubitus varus was longer. 2. Average proximal radial shaft angle was 10.99degrees +/-3.48degrees in normal limb and 15.72degrees+/-4.03degrees in affected limb and average ulnar shaft angle was 7.86degrees+/-3.60degrees, 10.54degrees +/-4.02degrees (P<0.05), respectively which were all significant value statistically (P<0.05). Average distal radial shaft angle was 10.21degrees 2.37 in normal limb and 11.21degrees +/-1.51degrees in affected limb and statistically insignificant (P>0.05). 3. More severe cubitus varus deformity revealed more change of proximal radial shaft angle of attected limb compare to normal limb. Based on these results, we concluded that correction of the cubitus varus deformity should not be delayed in order to minimize the secondary change of longitudinal axis of foream bones and to obtain satisfacotry cosmetic outcome.
Axis, Cervical Vertebra* ; Child ; Congenital Abnormalities* ; Extremities ; Forearm ; Humans ; Humerus ; Radiography ; Radius* ; Ulna*

PURPOSE: This study was conducted to compare the efficiencies of the supination to the hyperpronation method in reducing radial head subluxations. METHODS: This randomized, prospective study was done in a tertiary urban emergency medical center from January 2003 through December 2003. Inclusion criteria included age < 7 years with a clinical diagnosis of radial head subluxation. Exclusion criteria included point tenderness, echymosis, edema, deformity, and persistent pain. Patients were randomized for trearment by using either the supination or the hyperpronation method. The initial method was repeated if elbow function did not return 15 minutes after the reduction attempt. If the second attempt also failed, radiography of the elbow was performed. If the patient revisited the emergency medical center or orthopedic outpatient department within 24 hours with same complaint, we considered the attempt to be a failure. RESULTS: A total of 140 patients were enrolled in the study. The demographic characteristics of the two groups were similar. Seventy-two of the 75 patients (96%) randomly chosen for hyperpronation were reduced successfully on the first attempt versus 53 of 65 patients (81.5%) randomly chosen for supination (p=0.043). Seventy-four of 75 patients (98.7%) in the hyperpronation group were reduced successfully versus 61 of 65 patients (95.4%) in the supination group (p=0.183). For five patients, 4 patients in the supination group and 1 patient in the hyperpronation group, the reduction failed. CONCLUSION: Overall, in the reduction of radial head subluxations, there was no difference of success rate between the supination method and the hyperpronation method. However, the success rate of the hyperpronation method on the first attempt was superior to that of the supination method. We suggest that emergency physicians had better use the hyperpronation method rather than the supination method.
Congenital Abnormalities ; Diagnosis ; Edema ; Elbow ; Emergencies ; Head* ; Humans ; Orthopedics ; Outpatients ; Pronation ; Prospective Studies ; Radiography ; Radius ; Supination

Adolescent ; Child ; Epiphyses ; injuries ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Radiography ; Radius Fractures ; diagnostic imaging ; therapy

PURPOSE: The purpose of this study was to make an assessment of distal radioulnar joint (DRUJ) instability after the treatment of intra-articular fractures of the distal radius using computed tomography (CT) including contralateral normal wrist. MATERIALS AND METHODS: Twenty-seven intra-articular fractures of the distal radius in twenty-seven patients who had had the surgical treatment were evaluated at follow-up of mean 17.9 months (range, 10-36 months). The DRUJ was assessed with clinical examination, plain radiography, and bilateral CT. CT scans were obtained in 70degrees pronation, neutral, and 70degrees supination. The radioulnar ratio and the subluxation ratio which was modified radioulnar line method were used to measure DRUJ instability. RESULTS: Eight patients were diagnosed as DRUJ instability based on CT assessment. Nine patients were considered to have DRUJ instability in clinical examination, but 4 patients of them were confirmed to have DRUJ instability based on CT measurements. Nonunions of ulnar styloid or malunions of the distal radius were not found to have statistical correlation with DRUJ instability (p>0.05). CONCLUSION: In patient with suspicious DRUJ instability following distal radius fractures, we recommend computed tomography scans of both the injured and uninjured wrists in pronation, neutral, and supination position for objective assessment.
Follow-Up Studies ; Humans ; Intra-Articular Fractures* ; Joint Instability* ; Joints* ; Pronation ; Radiography ; Radius Fractures ; Radius* ; Supination ; Tomography, X-Ray Computed ; Wrist

OBJECTIVETo provide the basic knowledge of wrist joint for diagnosing of these morphological change in pathological condition by measuring the posteroanterior X-ray films of different types of distal radius fracture by AO classification.

METHODSEleven radiographic indexes were measured including following 7 new parameters of 83 cases of distal radius fracture: ulnar styloid length (USL), ulnar head length (UHL), ulnar head diameter (UHD), maximal distal radius width (MDRW), proximal distal radius width (PDRW), sigmoid notch length (SNL) and sigmoid notch width (SNW) by Pacs system in standard X-ray films. The indexes were defined by the ratio of these parameters to the length of the third metacarpal. Statistical significance of indexes and correlations of parameters were analyzed by SPSS 16.0.

RESULTSIt was found that indexes of 11 parameters and 27 pairs of indexes had significantly different. Compared the indexes of 14 groups with normal group existed statistical significance, 62 pairs value of 11 parameters had correlations.

CONCLUSIONThe study provides additional radiographic index that will be helpful to more careful diagnosis and treatment of the distal radius fractures and their associated injuries such as ulnar wrist injuries or carpal instability.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Radius ; diagnostic imaging ; Radius Fractures ; diagnostic imaging ; Wrist Joint ; diagnostic imaging ; Young Adult

BACKGROUND: Distal radius fracture is the most common fracture of the upper extremity, and approximately 60,000 distal radius fractures occur annually in Korea. Internal fixation with an anatomical volar locking plate is widely used in the treatment of unstable distal radius fractures. However, most of the currently used distal radius anatomical plate systems were designed based on the anatomical characteristics of Western populations. Recently, the Korean-type distal radius anatomical volar plate (K-DRAVP) system was designed and developed based on the anatomical characteristics of the distal radius of Koreans. The purpose of this study was to evaluate the preliminary results of the new K-DRAVP system, and to compare its radiologic and functional results with those of the other systems. METHODS: From March 2012 to October 2012, 46 patients with acute distal radius fractures who were treated with the K-DRAVP system at three hospitals were enrolled in this study. Standard posteroanterior and lateral radiographs were obtained to assess fracture healing, and three radiographic parameters (volar tilt, radial inclination, and radial length) were assessed to evaluate radiographic outcomes. The range of motion and grip strength, the Gartland and Werley scoring system, and the disabilities of the arm, shoulder and hand (DASH) questionnaire were used to assess clinical and functional outcomes. RESULTS: All radiologic parameters were restored to normal values, and maintained without any loosening or collapse until the time of final follow-up. Grip strength was restored to 84% of the value for the unaffected side. The mean range of motion of the wrist at final follow-up was restored to 77%-95% of the value for the unaffected side. According to the Gartland and Werley scoring system, there were 16 excellent, 26 good, and 4 fair results. The mean DASH score was 8.4 points. There were no complications after surgery. CONCLUSIONS: The newly developed K-DRAVP system could be used to restore and maintain good anatomical parameters, and provide good clinical outcomes with low complication rates. This system is a promising surgical option for the treatment of distal radius fractures in the Korean population.
Adult ; Aged ; Aged, 80 and over ; *Bone Plates ; Female ; Fracture Fixation, Internal/*instrumentation ; Humans ; Male ; Middle Aged ; Radius/radiography/surgery ; Radius Fractures/radiography/*surgery ; Range of Motion, Articular ; Republic of Korea ; Volar Plate

OBJECTIVETo analyze the radiological parameters of the conservatively in treating distal radius fracture and investigate whether the final re-displacement can be predicted after primary reduction.

METHODSFrom January 2013 to June 2014,212 patients with distal radial fracture conservatively were treated in our hospital, 107 patients of them were excluded because of their incomplete radiological parameters;the remaining 105 patients were available for radiological were assessed after injury, there were 56 male patients and 49 female patients in this study, the average age of the patients was 51 years old (ranged from 22 to 80 years). According to AO classification, there were 47 cases of type A2 and C1, and 58 cases of type A3, C2, C3. All patients were treated by closed reduction and below-elbow cast immobilization for 4 to 6 weeks. All patients were followed up for 3 to 6 months (means 4.5 months) by X-ray, all fractures were healed. Standard AP and lateral radiographic examination was conducted before reduction and after reduction and bony consolidation,the dorsal angulation and the radial angle were measured at each time point. The linear regression was used for the analysis to find out whether the final re-displacement can be predicted after primary reduction.

RESULTSAmong 105 patients,the significant correlations were found for the dorsal angulation between the reduction time and the end time (r = 0.82) and for the radial angulation between the reduction time and end time (r = 0.85).

CONCLUSIONThe dorsal angulation and the radial angulation after complete healing can be predicted from linear the regression functions. Due to the possibility of predicting the end result, whether the fracture should receive further conservative treatment or surgical treatment can be decided immediately.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Radiography ; Radius Fractures ; diagnostic imaging ; therapy