STUDY DESIGN: A case report is presented of a symptomatic sacral perineural cyst with lumbar disc herniation that has reported a few case in the literature. We report the case of symptomatic perineural cyst with lumbar disc herniation. SUMMARY OF LITERATURE REVIEW: Symptomatic sacral perineural cyst is rare and some cases of sacral perineural cyst associated with disc herniation were reported. But it is not well known that the correlation between clinical symptoms caused by mass itself and concomittant lumbar disc herniation. METHODS: A 34-year-old male presented with low back pain, both leg dysesthesia and bilateral radiating pain. Clincal sign and symptom, physical examination, diagnostic imaging studies including MRI, myelography and pathologic findings of surgical specimens were evaluated. RESULTS: After the decompressive partial laminectomy and discectomy, the patient who had diapnosed with herniated nucleus pulposus of L4-5 and L5-S1 complained residual both leg paesthesia and hypoesthesia. Patient's clinical symptom was correlated with sacral perineural cyst. So we removed the cyst. Postoperatively neurologic symptoms and signs were completely relieved. Pathologically, Sacral perineural cyst composed of meningoepithelial cell and neural tissue within cystic wall were confirmed. CONCLUSION: We could find that sacral perineural cyst sufficiently evoked a clinical symptom. So, careful observation was needed in that case of sacral perineural cyst associated with disc herniation.
Adult ; Diagnostic Imaging ; Diskectomy ; Humans ; Hypesthesia ; Laminectomy ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Myelography ; Neurologic Manifestations ; Paresthesia ; Physical Examination ; Tarlov Cysts*

We have recently experienced a case of cysticercosis treated with praziquantel. The patient, 22-year-old female, with 43 cystic masses had marked clinical response to the administration of praziquantel (75 mg/kg/day) for 7 days. It seems that praziquantel, anticestodal agent, might be a safe and effective therapy for this infection.
Cysticercosis* ; Female ; Humans ; Praziquantel* ; Young Adult

Two cases of vaginal injury due to Coitus are presented. One is the case of the laceration of midportion of posterior vaginal wall with shock and the other one in the laceration of posterior vaginal fornix and pelvic peritoneum. They are all in multiparity. And a review of literature on vaginal injury due to coitus is made briefly.
Coitus* ; Female ; Lacerations ; Parity ; Peritoneum ; Shock

The major cause of early dislocation after total hip arthroplasty is malposition of acetabular cup. Therefore, radiographic evaluation of acetabular cup placement is essential in determining the postsurgical prognosis. The purpose of this study was to establish principles which would aid in checking the radiography. We evaluated 33 patients who were treated with total hip arthroplasty between Jan. 1988 and Aug. 1993 and investigated the methods of measuring the position of the acetabular cup on radiography using pelvic skeleton and acetabular cup. The results were analyzed as followings. l. After the total hip arthroplasty, the inclination of the acetabular cup shows average 37.1 degress in pelvis AP, 36.4 degrees in hip AP and 43.4 degrees in femur AP. This result means that the more X-ray beam focus is far from the acetabular cup, the more inclination of acetabular cup on radiography is incerased. 2. After the total hip arthroplasty, the difference of acetabular cup angle between pelvis AP and hip AP is average 0.7 degree, 6.4 degrees between pelvis AP and femur AP and 7.1 degrees between hip AP and femur AP. This result means that the more X-ray beam focus is far from acetabular cup, the larger difference between acetabular cup angle on radiography is.3. In experimental study with pelvic rotation, acetabular cup angle on radiography is average 45.7 degrees in neutral position, 42.8 degrees in 10 degree rotation, and 39.6 degrees in 20 degree rotation. This result means that the more rotation of pelvic bone is increased, acetabular cup angle on radiography is reversely diminished. 4. In experimental study with pelvic flexion-extension, acetabular cup angle on radiography is average 45.7 degrees in neutral position, 56.4 degrees in 20 degree pelvic flexion, and 32.3 degrees in 20 degree pelvic extension. This result means that when the pelvis is flexed, acetabular cup angle on radiography is increased, and when the pelvis is extended, acetabular cup angle is decreased than normal acetabular cup angle. 5. In experimental study with X-ray beams, acetabular cup angle on radiography is average 45.7 degrees in pelvis AP, 45.5 degrees in femur AP and 50.4 degrees femur AP. This result means that the more X-ray beam focus is far from acetabular cup, the more inclination of acetabular cup on radiography is increased. As the result of the study, radiographs which focus centered on hip demonstrated a nearly true representation of acetabular cup angle.
Acetabulum ; Arthroplasty, Replacement, Hip ; Dislocations ; Femur ; Hip ; Humans ; Pelvic Bones ; Pelvis ; Prognosis ; Radiography ; Skeleton

Fractures of the shaft of the radius and ulna occur commonly in children and are usually treated by closed reduction and plaster cast immobilization. Anatomic reduction is seldom necessary because of the remodelling potential in the child under 10 years of age, whereas the bones of children older than 10 years of age have less capacity to remodel and the diaphyseal fracture is unstable. In case of either unacceptable reduction or unstable fractures in adolescent patients, an operative treatment is required. In five children older than 12 years of age for whom conservative treatment had hailed, we treated a closed intramedullary nailing using a distal radial and proximal ulnar approach, and followed up for 1 year or more. All fractures healed within 6 weeks. No nonunion, cross-union or refrature occured. Another advantages of this method are negliable cosmestic defect and easy removal of the internal fixation device under local anesthesia. We think that closed intramedullary nailing with rush pin is a safe and reliable method to treat unstable forearm fracture in children older than 12 years of age.
Adolescent ; Anesthesia, Local ; Casts, Surgical ; Child ; Forearm ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Internal Fixators ; Methods ; Radius ; Ulna

We reviewed 14 children with unilateral fractures of femoral shaft who had an angular deformity after union of 10° to 25°. At an average follow-up of 32 months(15 to 65), we measured remodelling of the proximal physis, the distal physis and the femoral shaft. The average correction was 83% of the initial deformity and there was no relation between the remodelling rate and degrees of malunion. Of the correction of angulation, only 27% had occurred at the fracture site and 73% at physis. The ability of physis to remodel better than that of fracture site. In children under 13 years of age, malunion as much as 25° in flexion deformity will remodel enough to get normal alignment of the joint surfaces.
Child ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints

The purpose of this study is to demonstrate the effectiveness of arthrocopic treatment for the avulsion fracture of intercondylar eminence of the tibia and of the technique of arthroscopically assisted reduction and fixation through pull-out suture method. Between January 1995 and May 1997, three patients were underwent arthroscopic reduction and suture fixation for type 0 of avulsion fracture of intercondylar eminence of tibia and were followed up. The result of two patients were graded as normal and one as nearly normal by the criteria of the International Knee Documentation Committee(IKDC) rating scale. The advantages of this technique include no retained hardware and ability to treat comminuted fracture(type g ). We describe technique of arthroscopic reduction and suture fixasion for displaced avulsion fractures, including those with comminution of intercondylar eminence of tibia.
Humans ; Knee ; Sutures* ; Tibia

Multiple fixation techniques for arthrodesis of the ankle and hindfoot have been introduced. The cannulated screw fixation provides excellent internal compression for arthrodesis. We used 5.0 and 6.5mm cannulated screws for seven ankle, seven subtalar, four tibiotalocalcaneal, three pantalar and two triple arthrodesis between January 1994 and September 1995. No iliac bone graft was utilized. The follow-up period was from 12 to 25 months. Ages of the patients ranged from 25 to 58 years. All fused except one who was preoperatively diagnosed as pyogenic arthritis of the ankle and hindfoot. One patient with diagnosis of Streeter's disease was complicated with partial necrosis of the forefoot. We think this procedure has several advantages; 1. The leg or foot length is largely preserved because minimal subchondral bone is removed. So, the leg and foot is aesthetically pleasing and the musculature around the ankle and foot can be maintained in the normal balanced position. 2. The rate of fusion is high, because the soft tissues are minimally stripped and cannulated screw compresses the subchondral bone surface. 3. The cannulated screws rarely requires removal. So, we believe that the cannulated screw fixation for the ankle and hindfoot arthrodesis is an excellent treatment method.
Ankle* ; Arthritis ; Arthrodesis* ; Diagnosis ; Follow-Up Studies ; Foot ; Humans ; Leg ; Necrosis ; Transplants

Anterior glenohumeral instability is mainly due to the Bankart lesion and capsular stretch. The differentiation between the Bankart lesion and capsular laxity may not be readily apparent on clinical examination. So, increasing attention has been directed toward preoperative evaluation of the labral lesion and capsular laxity. MRI and MR Arthrogram of 55 shoulders, 40 stable shoulders and 15 unstable shoulders that were confirmed by arthroscopic surgery, were reviewed to evaluate the labral and capsular shapes, especially the lesions of labroligamentous complex. To evaluate and compare the capsular laxity, we measured the anterior capsular insertion type, capsular ballooning, capsular insertion angle and anterior band of inferior glenohumeral ligament. And the following results were obtained; 1) The shape of anterior labrum was varied in the superior, middle and inferior potions in 40 stable shoulders. The anterior labral lesions were shown as torn(eight cases), displaced(six cases) and no detectable labrum(one case), in 15 unstable shoulders. Also, there were a significant di fference in the evaluation of the anteior labrum shape between MRI and MR arthrography. 2) There were not a significant difference in the type III capsular insertion type, capsular ballooning and capsular insertion angle between the stable and unstable shoulders. However, it was found that the shape of the anterior band of the inferior glenohumeral ligament had definite difference between the two groups. And so, more experience and attention should be given for the accurate preoperative evaluation of the anterior labroligamentous complex in shoulder instability.
Arthrography* ; Arthroscopy ; Ligaments ; Magnetic Resonance Imaging ; Shoulder

Plantar fibromatosis, otherwise known as Dupuytrens disease of the foot, is a relatively uncommon benign lesion. It is characterized by the replacement of elements of the plantar aponeurosis with fibrous tissue, which then slowly invades the skin and the deep structures. Generally an asymptomatic lesion, plantarfibrosis may occasionally cause foot pain. We recently experienced a case of painful plantar fibromatosis. On which a wide surgical excision was done. A one year postoperatively, follow-up examination revealed neither recurrence nor walking disability.
Dupuytren Contracture ; Fibroma* ; Follow-Up Studies ; Foot ; Recurrence ; Skin ; Walking