No abstract available.
Elbow*

Fractures of the capitellum humeri are rare and the recommendations for treatment vary. It can involve a significant portion of the articular surface, rendering the elbow joint unstable. In this situation, it is desirable to reduce and internally fix the capitellar fragment, because this restores the articular surface and augments joint stability. We experienced two cases of capitellar fractures which one case was spontaneously anatomical reduced and the other case was treated by open reduction. In one case the capitellar fragment was spontaneous reduced to a stable position although it was noticed radiographically as an unstable displaced fracture preoperatively. The other case was treated by open reduction and internal fixation with 3.5mm, small, AO, cannulated screw and K-wire. Both cases are reported here with references.
Elbow Joint ; Joints

No abstract available.
Hyperlipidemias* ; Tarsal Tunnel Syndrome*

STUDY DESIGN: Retrospective study. PURPOSE: This study aims to investigate the clinical and radiological results of contralateral indirect decompression through minimally invasive unilateral transforaminal lumbar interbody fusion (MI-TLIF). OVERVIEW OF LITERATURE: Several studies have proposed that blood loss and operation time could be reduced through a unilateral approach, although many surgeons have forecast that satisfactory foraminal decompression is difficult to achieve through a unilateral approach. METHODS: The study included 30 subjects who had undergone single-level MI-TLIF. Visual analogue scale (VAS) and Oswestry disability index (ODI) were analyzed for clinical assessment. Disc height, segmental lordosis, and lumbar lordosis angle were examined for radiological assessment. The degree of contralateral indirect decompression was evaluated through a comparative analysis, with a magnetic resonance imaging (MRI) performed preoperatively and at one year postoperatively. RESULTS: Intraoperative blood loss volume was 308.75 mL in the unilateral approach group (UAP), and 575.00 mL in the bilateral approach group (BAP), showing a statistically significant difference. Operation time was 139.50 minutes in the UAP group, and 189.00 minutes in the BAP group, exhibiting a statistically significant difference (p<0.05). On the other hand, no significant difference was found in VAS, ODI, disc height, lordosis angles and the degree of nerve decompression in the vertebral foramen, using MRI, between the two groups (p>0.05). CONCLUSIONS: Satisfactory results were acquired with MI-TLIF conducted through the unilateral approach of contralateral indirect decompression, in alignment with the bilateral approach. Therefore, contralateral indirect decompression is thought to be a useful procedure in reducing the operation time and volume of blood loss.
Animals ; Decompression* ; Hand ; Lordosis ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Fusion ; Surgical Procedures, Minimally Invasive

Angular deformities of the distal femur occur in congenital diseases or due to acquired causes, such as malunion after a fracture of the distal femur. Angular deformities of the lower extremities affect the mechanical axis, causing changes in the weight pressure on the articular surface. As a result, angular deformities quicken the progression of osteoarthritis. Therefore, correction of deformities should be performed to prevent the progression of osteoarthritis. Distal femoral osteotomy is one of the methods to correct angular deformities in unicompartmental osteoarthritis. However, femoral supracondylar dome osteotomy with retrograde intramedullary nailing in the distal femur with a varus deformity has been rarely reported. Herein, we describe a technique for femoral supracondylar dome osteotomy with retrograde intramedullary nailing in a varus deformity after a pathologic fracture of giant cell tumor in the distal femur with a review of the relevant literature.
Axis, Cervical Vertebra ; Congenital Abnormalities ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Giant Cell Tumors ; Giant Cells ; Lower Extremity ; Methods ; Osteoarthritis ; Osteotomy

BACKGROUND: A variety of treatment options suggest that the optimal treatment strategy for lateral elbow tendinopathy (LET) is not known, and further research is needed to discover the most effective treatment for LET. The purpose of the present study was to verify the most effective position of eccentric stretching for the extensor carpi radialis brevis (ECRB) in vivo using ultrasonic shear wave elastography. METHODS: A total of 20 healthy males participated in this study. Resting position was defined as 90° elbow flexion and neutral position of the forearm and wrist. Elongation of the ECRB was measured for four stretching maneuvers (forearm supination/pronation and wrist extension/flexion) at two elbow angles (90° flexion and full extension). The shear elastic modulus, used as the index of muscle elongation, was computed using ultrasonic shear wave elastography for the eight aforementioned stretching maneuverangle combinations. RESULTS: The shear elastic modulus was the highest in elbow extension, forearm pronation, and wrist flexion. The shear elastic moduli of wrist flexion with any forearm and elbow position were significantly higher than the resting position. There was no significant difference associated with elbow and forearm positions except for elbow extension, forearm pronation, and wrist flexion positions. CONCLUSIONS: This study determined that elbow extension, forearm pronation, and wrist flexion was the most effective eccentric stretching for the ECRB in vivo.
Elastic Modulus ; Elasticity Imaging Techniques ; Elbow* ; Forearm ; Humans ; Linear Energy Transfer ; Male ; Pronation ; Tendinopathy* ; Ultrasonics ; Wrist

PURPOSE: The aim of this study is to analyze the fusion rate according to the mixture ratio and the amount of bone graft in minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). MATERIALS AND METHODS: This study included 92 subjects who underwent MI-TLIF. Patients were classified into either group I, in which patients received transplantation with only autogenous bone, group II, in which patients received transplantation with hydroxyapatite mixed with autogenous bone by more than 50%, or group III, in which patients received transplantation with hydroxyapatite mixed with autogenous bone by less than 50%. For analysis of the correlation of amount of bone graft with fusion rate, patients were divided into group A, having less than 12 ml of bone graft, and group B, having more than 12 ml of bone graft. Visual analogue scale and Oswestry disability index were used for clinical assessment, and Burkus' classification method was used for evaluation of bone fusion. RESULTS: Fusion rates of groups I, II, and III according to the mixture ratio were 90.9%, 86.5%, and 86.2%, respectively. The fusion rate increased as the autobone ratio became higher; however, no significant difference was found (p=0.16). The fusion rates were 81.5% and 92.5% in group A and group B, respectively, which were classified according to the volume of bone graft, showing a significant increase in groups with bone graft volume more than 12 ml (p=0.03). CONCLUSION: A significantly high fusion rate was observed when bone graft volume was more than 12 ml in MI-TLIF. More than 12 ml of bone graft volume is essential for achievement of a satisfactory fusion rate.
Achievement ; Durapatite* ; Humans ; Transplants*

PURPOSE: inhaled nitric oxide(iNO) is an excellent method for the postoperative pulmonary hypertension in congenital heart disease. But more detailed care is needed because of the development of rebound pulmonary hypertension after NO Withdrawal. We performed this study in order to discontinue the iNO successfully by way of presenting the adequate weaning and supplying methods. METHODS: Between January, 1998 and August, 1999 we sudied 10 patients who had rebound pulmonary hypertension(RPH) after iNO withdrawal. We completed the iNO in these patween the first the second trial of the weaning process. We tried to discover the differences between the first and second weaning process. We measured NO concentration at the start and just before NO withdrawal and during the period of weaning process. Moreover, to identify the iNO effects during the weaning of the iNO, we counted the degree of the change of PaO2/FiO2and mean PAP/SAP beween initial and at half of the initial NO concentration. RESULTS: Second weaning had a longer duration weaning process(11+/-0 cersus 5+/- hours, P<0.05), lower NO concentration just before NO withdrawal(2+/-.6 versus 4+/-ppm, P<0.05). In the change of the mean PAP/SAP and PaO2/FiO2as iNO was weaning from the initial iNO concentration to a half of the initial iNO concentration, the degree of increase in mean PAP/SAP(0.026+/-.07 versus 0.054+/-.07, P<0.05) and the degree of decrease in PaO2/FiO2(49+/-4 versus 65+/-2, P<0.05) were smaller in the second in the second weaning process than the first weaning process. CONCLUSION: A successful weaning of iNO can be performed with a low iNO concentration at the start and just before withdrawal and with the long duration iNO weaning process. Moreover, We speculate that the degree of change in the mean PAP/SAP and PaO2/FiO2at the half of the iNO weaning process are an indicator for the development of RPH.
Heart Defects, Congenital ; Humans ; Hypertension, Pulmonary ; Nitric Oxide* ; Weaning*

There is a current tendency to believe that malignant melanoma originate from epidermal melanocyte rather than from pigmented cell of the upper dermis. Approximately 15% of all malignant melanoma in the body occur in head and neck regions. The majority of the patients were in the sixth & seventh decade. A case of malignant melanoma in the occipital region in a 2-year-old girl is reported. Physical and X-ray studies showed a large brownish pigmented mass with ulcerated surface and small bony defect in the occipital region.
Child, Preschool ; Dermis ; Female ; Head ; Humans ; Melanocytes ; Melanoma* ; Neck ; Ulcer

An unstable fracture-dislocation of the spine usually results in a neurological deficit below the level of the injury. For this type of injury to occur at the mid-thoracic level without spinal cord injury is rare. This case report is of a T5-6 fracture-dislocation, without neurological deficit, which occurred in combination with a mid-clavicular fracture and a 5th rib fracture. The patient was treated by halter traction and pelvic traction for 14 days, and cervico-thoraco-lumbosacral orthosis for three months. Plain radiographs and a CT scan taken three months after trauma revealed a good healing process. At the last assessment, made two years post-trauma, the patient was completely asymptomatic with a pain-free full range of back motion, and was able to participate in various sports. In cases where an oblique shear injury of the back is suspected, and in cases of clavicular fracture, rib fracture and/or hemo-pneumothorax, more attention should be given to detecting a possible fracture-dislocation of the mid-thoracic spine without a neurological lesion.
Humans ; Orthotic Devices ; Rib Fractures ; Spinal Cord Injuries ; Spine* ; Sports ; Tomography, X-Ray Computed ; Traction