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

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

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

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: To compare the result between the third generation gamma nail (gamma 3 nail) and proximal femoral nail anti-rotation (PFNA) in the treatment of unstable intertrochanteric fractures. MATERIALS AND METHODS: Between March 2009 and June 2011, 47 consecutive patients with unstable intertrochanteric femoral fractures were treated with gamma 3 nail or PFNA. We reviewed 24 cases of gamma 3 nail and 23 cases of PFNA. Retrospectively, we evaluated the mean operation time, amount of bleeding, average union period, reduction status, change of neck shaft angle, Tip-apex distance, Cleveland index, sliding of lag screw and complication on set of telephone interview and outpatient. We also evaluated the postoperative capability of function and mobility, using 'Modified Koval index'. RESULTS: There were no significant differences between the groups, which were treated with gamma 3 nail and PFNA. In addition, they did not show statistical difference. We experienced 2 cases of complication (gamma 3 nail 1 case, PFNA 1 case), which were cut-out of the femoral head. CONCLUSION: The gamma 3 nail and PFNA were seen with good results in the treatment of unstable intertrochanteric fracture.
Femoral Fractures ; Hemorrhage ; Humans ; Interviews as Topic ; Nails ; Neck ; Outpatients ; Retrospective Studies

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

OBJECTIVE: To evaluate condylar head remodeling after mandibular set-back sagittal split ramus osteotomy (SSRO) with rigid fixation in skeletal class III deformities. The correlation between condylar head remodeling and condylar axis changes was determined using cone-beam computed tomography (CBCT) superimposition. METHODS: The CBCT data of 22 subjects (9 men and 13 women) who had undergone mandibular set-back SSRO with rigid fixation were analyzed. Changes in the condylar head measurements and the distribution of the signs of condylar head remodeling were evaluated by CBCT superimposition. RESULTS: The subjects showed inward rotation of the axial condylar angle; reduced condylar heights on the sagittal and coronal planes; and resorptive remodeling in the anterior and superior areas on the sagittal plane, superior and lateral areas on the coronal plane, and anterior-middle and anterior-lateral areas on the axial plane (p < 0.05). CONCLUSIONS: The CBCT superimposition method showed condylar head remodeling after mandibular set-back SSRO with rigid fixation. In skeletal class III patients, SSRO with rigid fixation resulted in rotation, diminution, and remodeling of the condylar head. However, these changes did not produce clinical signs or symptoms of temporomandibular disorders.
Axis, Cervical Vertebra ; Cone-Beam Computed Tomography ; Congenital Abnormalities ; Head ; Humans ; Male ; Methods ; Osteotomy, Sagittal Split Ramus* ; Temporomandibular Joint Disorders