The medial collateral ligament(MCL) of the knee is the well established secondary restraint to the anterior displacement of the knee joint. However, there has been no report about the estimation of the anterior displacement in combined ACL(anterior collateral ligament) and MCL injures according to period when they were treated with conservative measures. This prospective study evaluated the changes of anterior displacement over time in combined ACL/MCL injury as the MCL injury heals after initial conservative measures. 19 patients who had combined ACL/MCL injury were followed during twelve months after injury. All patient had a positive Lachman test and were evaluated the side to side differences on KT-2000 knee arthrometer(Medmetric, San Diego, California) testing under 20 Ibs anterior tibial loading at 30 degree knee flexion. The stability of the knee was assessed using KT-2000 knee arthrometer every 8 weeks with clinical examination prospectively. They were treated with CI (Combined instability) brace (Smith & Nephew, Carlsbad, California) as conservative measures. Overall, Initial side to side difference of the anterior displacement was averaged 5.21mm (range,4.0-7.0mm) and 3.30mm (range,2.0-5.5mm) finally. According to the classification of MCL injury, in Grade III groups, they had the greatest initial anterior displacement about 6.4mm, but tight- ened the most to 3.08mm finally. In Grade II and Grade I groups they showed 2.97mm and 2.13mm side to side difference (p>0.01). However in Grade I, the anterior displacement were decreased by 4 months after injury but, it were increased at 6 months after injury. In Grade II and III, the decrement of the anterior displacement were continued by 6 months after injury, but they were not changed after that. The data was analyzed by General Linear Model Procedure method. Conclusively, the anterior displacement of knee in patients with combined ACL/MCL injury was diminished with the time in the majority of patients as the MCL healed. It means that the MCL was the stabilizer to the anterior displacement of the knee under the anterior tibial loading.
Braces ; Classification ; Humans ; Knee Joint ; Knee* ; Linear Models ; Prospective Studies

The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Activities of Daily Living ; Aged* ; Female ; Freedom ; Hip Fractures* ; Hip* ; Humans ; Memory ; Orthopedics ; Quality of Life ; Range of Motion, Articular

No abstract available.
Contracture*

The use of a myomucosal flap from the buccinator muscle is a valuable reconstruction method for intraoral defects. In this paper, we report the clinical advantages of using a buccinator myomucosal flap for the treatment of partial mandibular defects caused by osteoradionecrosis. We implemented a buccinator myomucosal flap for the reconstruction of a partial mandibular defect in a 55-year-old man with tonsil cancer and partial mandibular defects caused by osteoradionecrosis. The total operating time was 90 minutes. Twelve months after the reconstruction, the patient remains free of disease. A buccinator myomucosal flap can be used for the reconstruction of partial mandibular defects caused by osteoradionecrosis. It is a reliable method for reconstructing small mandibular defects.
Humans ; Mandible* ; Mandibular Reconstruction ; Middle Aged ; Myocutaneous Flap ; Osteoradionecrosis* ; Reconstructive Surgical Procedures ; Tonsillar Neoplasms

A thyroglossal duct cyst (TGDC) is one of the most common causes of anterior midline neck mass. Successful management of a TGDC requires histopathology and an understanding of the embryogenesis of the thyroid. Traditional TGDC surgery uses a transcervical approach, which results in an external neck scar. In contrast to the surgical removal of a benign neck mass, TGDC surgery should include removal of the cyst, the hyoid bone, and the thyroid remnant track from the foramen cecum to the hyoid bone. Considering the embryological development of the TGDC, it was evident to us that an entirely transoral approach to the TGDC region was an option. Before its descent, the TGDC originates from the bottom of the tongue. The TGDC is located behind the strap muscles of the neck and the hyoid bone. Following this naturally predetermined access alongside the TGDC, we were able to develop a new surgical approach to the TGDC area and introduced the transoral TGDC excision.
Cecum ; Cicatrix ; Embryonic Development ; Female ; Hyoid Bone ; Muscles ; Neck ; Pregnancy ; Thyroglossal Cyst* ; Thyroid Gland ; Tongue

A thyroglossal duct cyst (TGDC) is one of the most common causes of anterior midline neck mass. Successful management of a TGDC requires histopathology and an understanding of the embryogenesis of the thyroid. Traditional TGDC surgery uses a transcervical approach, which results in an external neck scar. In contrast to the surgical removal of a benign neck mass, TGDC surgery should include removal of the cyst, the hyoid bone, and the thyroid remnant track from the foramen cecum to the hyoid bone. Considering the embryological development of the TGDC, it was evident to us that an entirely transoral approach to the TGDC region was an option. Before its descent, the TGDC originates from the bottom of the tongue. The TGDC is located behind the strap muscles of the neck and the hyoid bone. Following this naturally predetermined access alongside the TGDC, we were able to develop a new surgical approach to the TGDC area and introduced the transoral TGDC excision.
Cecum ; Cicatrix ; Embryonic Development ; Female ; Hyoid Bone ; Muscles ; Neck ; Pregnancy ; Thyroglossal Cyst* ; Thyroid Gland ; Tongue

No abstract available.
Child* ; Humans ; Nephrotic Syndrome*

No abstract available.
Child* ; Humans ; Nephrotic Syndrome*

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Neuroma*

Forty patients(9 male and 31 female) with tsutsugamushi disease were evaluated clinically. The diagnosis of tsutsugamushi disease was confirmed by indirect immunofluoresent test or isolation of causative agent. More than 77% of patients were over 40 years of age. After the incubation period(5 to 13 days, average 8 days) symptoms developed suddenly. The frequent symtoms were fever(100%), chill(100%), headache(100%), rnalaise(97%), and myalgia(95%). On physical exammination the rash, eschar, and lymphadenopathy were found in 97%, 82%, and 67% respectively. Eschar was observed in the trunk, especially axillary, abdominal and inguinal area. Serum transarninase(SGOT snd SGPT) was elevated(89 and 87%). Urinalysis revealed proteinuria in 35%(12/34) and hematuria in 19%(7/36). Chest roentgram and ECG demonstrated abnormalities in 39%(14/36) and 73%(26/36) respectively, The treatment with doxycycline was very effective in all cases.
Diagnosis ; Doxycycline ; Electrocardiography ; Exanthema ; Hematuria ; Humans ; Lymphatic Diseases ; Male ; Proteinuria ; Scrub Typhus* ; Thorax ; Urinalysis