We describe an extra-articular triplane fracture of distal tibia in a twelve-year-old boy. This variant of the triplane fracture has been largely ignored in the literature. The clinical significance of recognizing this fracture is that, although it constitutes an epiphyseal fracture, it remains extra-articular. We treated this case by open reduction and internal fixation of both distal tibia and fibula. However, unlike the standard triplane fracture that exits through the tibiot alar joint, this variant may be treated acceptably with less that an anatomical reduction, therefore avoiding the need for surgical management.
Fibula ; Humans ; Joints ; Male ; Tibia

BACKGROUND: The purpose of this study is to assess the range of shoulder motion using an indirect evaluation method without physical examinations of patients based on questionnaires regarding several specific arm postures referenced by patient's own body parts. METHODS: Nine criteria of specific shoulder motion including 4 forward flexion, 2 external rotation, and 3 internal rotation were decided as reference position which can represent a certain shoulder motion. Flexion contains postures such as lifting arm to waist-height, shoulder-height, eye-height, and raising arm above head with arm touching ears. External rotation comprises grasping ears and placing hands on back of the head. Vertebral height in internal rotation is determined by calculating the samples' motions, which are holding on to trouser belts, opposite-elbow, and scapula. These postures are included in questionnaires for patients to evaluate the validity and effectiveness of this indirect method. RESULTS: The range of flexion was 77degrees (60degrees to 100degrees), 96degrees (87degrees to 115degrees), 135degrees (115degrees to 150degrees), and 167degrees (150degrees to 175degrees) when arms go up to waist, shoulder, eye, and high vertically. Range of external rotation was 39.6degrees (30degrees to 50degrees) when grasping ears and 69.2degrees (60degrees to 80degrees) with the hands on the back of the head. Range of internal rotation was L4 when placing trouser belts, T12 for holding opposite elbow, and T9 for reaching scapula. The mismatch rates of flexion, external rotation, and internal rotation were 11.6%, 9.6%, and 7.8%. CONCLUSIONS: The range of shoulder motion using this method is expected to be applied to an established shoulder scoring system which included shoulder motion evaluation item.
Arm ; Ear ; Elbow ; Hand ; Hand Strength ; Head ; Human Body* ; Humans ; Lifting ; Physical Examination ; Posture ; Range of Motion, Articular ; Scapula ; Self-Assessment ; Shoulder Joint ; Shoulder* ; Telephone ; Surveys and Questionnaires

No abstract available.
Drug Monitoring ; Mycophenolic Acid

No abstract available.
Toxicology

No abstract available.
Cysticercosis* ; Spine*

No abstract available.
Animals ; Cautery* ; Cryosurgery* ; Dogs* ; Femur* ; Phenol*

No abstract available.
Ankle Fractures* ; Ankle*

Nine typical cases of ossifying fibroma in the tibia or fibula were retrospectively reviewed for clinical and histopathological aspects of this disease. Along with the case analysis, light and polarized microscopic examinations were performed in each case. Differential points with monostotic fibrous dysplasia were as follows; 1) ossifying fibroma begins in the significantly younger age, which is in most cases below 10 years of age, 2) it is confined to diaphysis of tibia or fibula, 3) radiologically, multilocular osteolytic destructive change in eccentric pattern is usually combined with anterior or anterolateral bowing deformity, 4) microscopically, characteristic findings are presence of osteoblastic rimming, peripheral maturation, and zonal phenomenon. In the treatment of ossifying fibroma, definitive surgical treatment should be delayed until skeletal maturity, when segmental resection in wide margin including periosteum might be preferred.
Congenital Abnormalities ; Diagnosis ; Diaphyses ; Fibroma, Ossifying ; Fibrous Dysplasia, Monostotic ; Fibula ; Fluconazole ; Osteoblasts ; Periosteum ; Retrospective Studies ; Tibia

The methods of treatment of spondylolisthesis range from posterior fusion to instrumentation, and circumferential fusion. Combined anterior and posterior fusion with instrumentation had been carried out in one or two stages and satisfactory results were obtained in nighteen cases with follow-up period of one year to four years at department of orthopedic surgery of Ewha Womans University Hospital from 1987 to 1991. The results were as follows: 1. Of 19 patients, 7 patients were male and 12 patients were famale. 2. The isthmic type was 12 cases (63.1%) and the 5th lumbar vertebral involvement is common (12 cases, 63.1%). 3. The operative treatment was as follows: Posterior fusion with instrumentation was 8 cases, and anterior fusion with instrumentation was 11 cases. 4. The combined anterior and posterior fusion with instrumentation had been carried out in one stage operation at 8 cases, and two stage operation was done at 11 cases. 5. The average operation time was 3.0 hrs in one stage operation, 3.1 hrs in two stage operation, and the average amount of blood loss was 22cc/Kg in one stage, 17cc/Kg in two stage. 6. The satisfactory results were obtained in 19 cases, but there was no specific difference between one stage and two stage operation.
Female ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Spondylolisthesis

Kyphotic deformity of thoracic or lumbar spine is generally developed as a consequence of Scheuerman's kyphosis, ankylosing spondylitis, congenital kyphosis, tuberculous kyphosis, spinal tumor, senile kyphosis, trauma and extensive laminectomy etc. The method of treatment is usually conservative. However, in severe kyphosis, gross abnormaility and neurologic complications, and the compression of cardiopulmonary system are resulted and then surgery may be indicated. Since the report of spinal osteotomy by Smith-Peterson, several treatment options have been reported. Despite improved techniques for treating spinal kyphotic deformities, correction of severe and acutely angled deformities are less effective and resulting many complications. We propose the use of a new method of posterior closing spinal osteotomy for the treatment of severe and acutely angled kyphotic deformity to minimize the complications and for effective correction. We report the technique and results of this method in two cases of tuberculous kyphosis and a case of ankylosing spondylitis.
Congenital Abnormalities ; Kyphosis ; Laminectomy ; Methods ; Osteotomy ; Spine ; Spondylitis, Ankylosing