Fracture healing in the hand is not an isolated goal. The functional end result is of paramount importance. When the correct techniques are used, miniplate fixation for metacarpal and phalangeal fractures of the hand provides rigid internal fixation, stabilizes the skeleton, preserves the gliding tissue, and therefore allowing immediate active range of motion exercise as well as minimizing joint and tendon complications. The authors have reviewed 39 patients, 52 cases of metacarpal and phalangeal fractures of the hand which were treated with miniplate in the department of orthopaedic surgery, Chang Ang Gil hospital from Sep. 1989 to Feb. 1993. The following results were obtained. 1. Miniplate fixation, in terms of fracture reduction and maintenance, allows on accurate anatomic reduction with rigid fixation which in turn affords on early mobilization without loss of reduction alignment. 2. The roentgenographic union was obtained within 15.1 weeks in average. The mean total acitve motion at the fractured finger was 230°. The complication rate was 11.5%. 3. In the treatment of metacarpal and phalangeal fractures of the hand, especially fractures of metacarpal bones, fixation with miniplate is considered to be an useful method in terms of getting fracture union and good range of motion with relative low complication rates.
Early Ambulation ; Fingers ; Fracture Healing ; Hand ; Humans ; Joints ; Metacarpal Bones ; Methods ; Range of Motion, Articular ; Skeleton ; Tendons

No abstract available.
Pulmonary Artery*

Total elbow arthroplasty is a relatively rare procedure compared with total knee or total hip arthroplasty. Total elbow arthroplasty for bony ankylosis is even rarer, and the results are often unsatisfactory. We report a patient who gained good mobility of the elbow after total elbow arthroplasty for the treatment of fractured arthrodesis site with which the patient had lived with for 12 years.
Ankylosis ; Arthrodesis* ; Arthroplasty* ; Arthroplasty, Replacement, Hip ; Elbow* ; Humans ; Knee

No abstract available.
Anxiety* ; Depression* ; Headache*

No abstract available.
DNA* ; Herpesvirus 4, Human* ; Nasopharyngeal Neoplasms* ; Polymerase Chain Reaction*

No abstract available.
Mucocele*

No abstract available.
Cerebellopontine Angle*

PURPOSE: The goal of this study was the early diagnosis of ABCB11 spectrum liver disorders, especially those focused on benign recurrent intrahepatic cholestasis and progressive familial intrahepatic cholestasis. METHODS: Fifty patients presenting neonatal cholestasis were evaluated to identify underlying etiologies. Genetic analysis was performed on patients suspected to have syndromic diseases or ABCB11 spectrum liver disorders. Two families with proven ABCB11 spectrum liver disorders were subjected to genetic analyses to confirm the diagnosis and were provided genetic counseling. Whole exome sequencing and Sanger sequencing were performed on the patients and the family members. RESULTS: Idiopathic or viral hepatitis was diagnosed in 34%, metabolic disease in 20%, total parenteral nutrition induced cholestasis in 16%, extrahepatic biliary atresia in 14%, genetic disease in 10%, neonatal lupus in 2%, congenital syphilis in 2%, and choledochal cyst in 2% of the patients. The patient with progressive familial intrahepatic cholestasis had novel heterozygous mutations of ABCB11 c.11C>G (p.Ser4*) and c.1543A>G (p.Asn515Asp). The patient with benign recurrent intrahepatic cholestasis had homozygous mutations of ABCB11 c.1331T>C (p.Val444Ala) and heterozygous, c.3084A>G (p.Ala1028Ala). Genetic confirmation of ABCB11 spectrum liver disorder led to early liver transplantation in the progressive familial intrahepatic cholestasis patient. In addition, the atypically severe benign recurrent intrahepatic cholestasis patient was able to avoid unnecessary liver transplantation after genetic analysis. CONCLUSION: ABCB11 spectrum liver disorders can be clinically indistinguishable as they share similar characteristics related to acute episodes. A comprehensive genetic analysis will facilitate optimal diagnosis and treatment.
Biliary Atresia ; Choledochal Cyst ; Cholestasis ; Cholestasis, Intrahepatic ; Diagnosis ; Early Diagnosis* ; Exome ; Genetic Counseling ; Hepatitis ; High-Throughput Nucleotide Sequencing ; Humans ; Hyperbilirubinemia ; Jaundice ; Liver Transplantation ; Liver* ; Metabolic Diseases ; Parenteral Nutrition, Total ; Syphilis, Congenital

Intussusception is the most common cause of intestinal obstruction in early childhood and characterized by periodic colicky abdominal pain or irritability, vomiting, current jelly stool, and sausage-like abdominal mass. Meckel's diverticulum is common intestinal anomaly presenting with painless rectal bleeding during first 2 year of age. It is recognized as a common leading point of intussusception in childhood. Hematemesis is the rare clinical manifestation of both intussusception and Meckel's diverticulum. A 7-year-old girl presented with hematemesis was diagnosed as having intussusception by abdominal ultrasonography. Meckel's diverticulum was the leading point of intussusception in this case.
Abdominal Pain ; Child ; Female ; Hematemesis* ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception* ; Meckel Diverticulum* ; Ultrasonography ; Vomiting

PURPOSE: To analyze clinical results of the cases diagnosed and treated as acute patella dislocation. MATERIALS AND METHODS: Thirteen cases diagnosed as acute patella dislocation between March 2000 and May 2006, were enrolled for this study. The mean follow-up period was 28 months. Preoperatively plain radiographs and MRIs were taken, and operative treatment was performed in 11 cases with osteochondral fragments or patella malalignment after reduction. Clinical results were assessed by the range of motion and the Lysholm score. For radiologic assessment, patella tilt by lateral patellofemoral angle and patella subluxation by congruence angle were observed. RESULTS: In all cases(100%), bone contusion was observed on MRIs. Osteochodral injury was found in six cases (46.1%). The postoperative mean range of motion was from 0 degree to 130 degrees, and the mean Lysholm score was 86 points. The congruence angle was recovered to -10.9 degrees from 1.7 degrees in 12 cases except one case. No case presented lateral patella tilt when the lateral patellofemoral angle was measured. CONCLUSION: Bone contusion on MRIs was helpful in diagnosing acute traumatic patella dislocation. Operative treatment is considered necessary for the cases with remained patellofemoral malalignment or osteochondral fragments after reduction.
Contusions ; Diagnosis ; Dislocations* ; Follow-Up Studies ; Magnetic Resonance Imaging ; Patella* ; Range of Motion, Articular