Carpometacarpal and metacarpophalangeal joints of the thumb exhibit relatively wide range of motion, which may act as a shock absorber. So dislocation of these joints are relatively rare. Furthermore, a complete dislocation of the thumb metacarpal by simultaneous dislocation of carpometacarpal and metacarpophalangeal joints is a very rare injury, and only a few cases were reported in the English literatures. The authors will present a case of a complete dislocation of the thumb metacarpal in a 31 years old female.
Dislocations ; Female ; Humans ; Joints ; Metacarpophalangeal Joint ; Range of Motion, Articular ; Shock ; Thumb

Since the finite element method(FEM) was introduced to the orthopaedic biomechanics, it has been applied with increasing intrest to investigate bone, bone-prosthesis, and fracture fixation device, etc., in terms of stress, strain, force, and displacement. The authors implemented the FEM for the "intact" and the "fractured long bone models respectively to observe the mechanical behaviors of the plate fixation for the long bone fractures, and we observed the followings;l. In the intact model, stresses are evenly distributed and smoothly changed. 2. The maximum equivalent von-Mises stress in the fracture model is higher than that in the intact one. 3. Stresses on the plate are much higher than those on the bony surface in the fracture model. 4. Stresses for the bony surface beneath the plate in the fracture model are much lower than those in the intact model;however, stresses are highly concentrated around the screws. 5. Although two-thirds of total compressive load is transmitted through the fracture site area, maximum von-Mises stress in the fracture site is much lower than that in the plate. 6. High stresses are found at the areas between the plate holes and the screw heads. 7. Shearing forces of the screws are higher at the near and end screws from the fracture site.
Fracture Fixation ; Fractures, Bone ; Head

PURPOSE: Primary central nervous system lymphoma (PCNSL) is defined as lymphoma limited to the cranial-spinal axis without evidence of systemic disease and its incidence has risen threefold during the last fifteen years among apparantly healthy population. This study was intended to analyze the clinicopathologic features and treatment outcome of the patient with PCNSL. MATERIALS AND METHODS: Twenty one patients were diagnosed and treated for the PCNSL limited to brain parenchyme at Asan Medical Center between March 1989 and December 1996. We reviewed clinical records of these patients and analyzed clinicopathologic features, treatment response, survival time and prognostic factors. RESULTS: The ratio of male to female was 1.3: 1 and the most prevalent age group was the 4th decade. Most patients had diffuse large cell (19/21) and B-cell type (8/8). Seventeen (94.4%) among 18 evaluable patients achieved complete remission (CR) as initial response, but 53% of patients showed recurence of the disease. Median times of disease-free and overall survival were 40 and 50 months, respectively and 5 year overall survival rate was 35.3 %. Prognostic factors such as age and performance status, had a statistically significant influence on the overall survival but not on disease-free survival. CONCLUSION: CR rate of the patients with PCNSL was high, but relapses were frequent. There fore further studies are needed to define the pmgnostic factors and to decrease relapse rate.
Axis, Cervical Vertebra ; B-Lymphocytes ; Brain ; Central Nervous System* ; Chungcheongnam-do ; Disease-Free Survival ; Female ; Humans ; Incidence ; Lymphoma* ; Male ; Recurrence ; Survival Rate ; Treatment Outcome