BACKGROUND: The purpose of our study was to evaluate the accuracy of reduction based on postoperative computed tomography (CT) images after arthroscopic stabilization using tightrope system for unstable distal clavicle fracture. METHODS: Twelve patients with distal clavicle fracture combined with coracoclavicular (CC) ligament injury (type II, V) who received arthroscopically assisted fixation using a flip button device were evaluated for accuracy of reduction using 3-dimensional postoperative CT scan by measuring the degree of distal clavicular angulation and clavicular shortening. RESULTS: Immediate postoperative plain radiograph confirmed restoration of the CC distance (CCD) in 10 patients. At final follow-up, the CCD remained reduced anatomically on plain radiographs in these patients. All patients showed excessive posterior angulation and shortening compared to the opposite side. The average Constant score recovered to 94.8 at final follow-up. CONCLUSIONS: Indirect reduction and arthroscopic subacromial approach with flip button fixation of unstable distal clavicle fractures demonstrated favorable clinical results despite unavoidable posterior angulation of distal clavicle and shortening the total length of clavicle.
Arthroscopy ; Clavicle ; Follow-Up Studies ; Humans ; Ligaments ; Tomography, X-Ray Computed

No abstract available.
Congenital Abnormalities* ; Humerus* ; Osteotomy*

Sinus lifting was introduced for prosthetic reconstruction in 1960 decades by Boyne and is specifically used for implant surgery in maxillary posterior region with insufficient bony height and has been indicated for reconstruction of oro- antral and palato-alveolar cleft. We report that subtotal maxillectomy using sinus lifting and skin graft in mild maxillary cancer cases results in good prevention of oro-antral and oro-nasal fistula by preserving intact maxillary sinus mucosa and improves better functional outcome after maxillectomy.
Fistula* ; Lifting* ; Maxillary Sinus ; Mucous Membrane ; Skin* ; Transplants*

Airway Obstruction ; Child ; Cicatrix ; Head ; Hemangioma ; Humans ; Injections, Intralesional ; Lymphangioma ; Lymphatic System ; Mouth Floor ; Neck ; Picibanil ; Sclerosing Solutions ; Sex Distribution ; Tongue

Benign fibrous hitiocytoma of the infrapatella fat pad is very rare. It has usually do not induced a pain or a symptom because it was located deep tissue. So it was very difficult to be diagnosed. We experienced a case of deep benign fibrous histiocytoma in a 53-year-old woman. It was diagnosed by MRI. Diagnostic arthroscopic procedure was performed and the lesion was completely resected by open excision. We report a rare case of benign fibrous hitiocytoma presenting as an intra-articular tumor in the joint causing pain and limitation of movement.
Adipose Tissue ; Female ; Histiocytoma, Benign Fibrous ; Humans ; Joints ; Knee

PURPOSE: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp. METHODS: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak grade(R)(Smith & Nephew). The statistical analysis was performed by SPSS 12.0. RESULTS: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp. CONCLUSION: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.
Alopecia ; Arm* ; Cicatrix ; Contracture ; Folliculitis ; Humans ; Scalp ; Skin* ; Tissue Donors ; Transplants*

PURPOSE: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp. METHODS: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak grade(R)(Smith & Nephew). The statistical analysis was performed by SPSS 12.0. RESULTS: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp. CONCLUSION: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.
Alopecia ; Arm* ; Cicatrix ; Contracture ; Folliculitis ; Humans ; Scalp ; Skin* ; Tissue Donors ; Transplants*

Return of facial nerve function is important in patients with facial nerve paralysis by trauma. Sometimes, delay in diagnosis of facial nerve paralysis make recovery of facial nerve function difficult. Traumatic facial palsy mostly occur after temporal bone fracture in unilateral. Temporal bone fracture after head trauma are divided into the three group; longitudinal fracture, transverse fracture and mixed fracture. The most common symptoms are hearing impairment, bloody otorrhea, loss of consciousness and facial nerve paralysis. The early care of temporal bone fracture involves facial nerve paralysis. And there has been many discussion and study in the treatment of the immediate or delayed facial palsy ; examply, surgical approach, time and methods. We have managed a patient with unilateral facial nerve paralysis after longitudinal temporal bone fracture in mastoid process and conservative facial nerve decompression was performed. We have obtained good result and report this case with review of literatures.
Craniocerebral Trauma ; Decompression* ; Diagnosis ; Facial Nerve* ; Facial Paralysis* ; Hearing Loss ; Humans ; Mastoid ; Paralysis ; Temporal Bone ; Unconsciousness

OBJECTIVE: We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. METHODS: We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. RESULTS: PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were 3.6+/-2.9 and 5.4+/-6.4 in the unresected PARS group, 5.8+/-2.1 and 11.3+/-7.1 in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. CONCLUSION: The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.
Arthrodesis ; Body Mass Index ; Humans ; Neurologic Manifestations ; Spine

In this study, we report that an acute phase reactant, serum amyloid A (SAA), strongly inhibits dendritic cell differentiation induced by GM-CSF plus IL-4. SAA markedly decreased the expression of MHCII and CD11c. Moreover, SAA decreased cell surface GM-CSF receptor expression. SAA also decreased the expression of PU.1 and C/EBPα, which play roles in the expression of GM-CSF receptor. This inhibitory response by SAA is partly mediated by the well-known SAA receptors, Toll-like receptor 2 and formyl peptide receptor 2. Taken together, we suggest a novel insight into the inhibitory role of SAA in dendritic cell differentiation.
Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Interleukin-4 ; Receptors, Formyl Peptide ; Receptors, Granulocyte-Macrophage Colony-Stimulating Factor* ; Serum Amyloid A Protein* ; Toll-Like Receptors