Although epidural fibrosis after laminectomy is considered to be the cause of pain in a number of patients, the exact relationship of postoperative scar tissue and symptoms remains controversial. However it is generally accepted that epidural fibrosis after surgical decompression of neural tissue has to be avoided. To diminish the likelihooa that such a scar will form, fat grafts have been used to create an interpositional membrane. Compression of a nerve after the use of a fat graft is rare; postoperative cauda equina syndrome, resulting from compression by a grafted fat. We report the case of a patient who had this complication.
Cauda Equina* ; Cicatrix ; Decompression, Surgical ; Fibrosis ; Humans ; Laminectomy* ; Membranes ; Polyradiculopathy* ; Spine* ; Transplants*

No abstract available.
Female ; Laparoscopy* ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*

Pigmented villonodular synovitis (PVNS) is a relatively rare condition. The disorder almost always involves a single joint and the knee is most commonly affected. We report on three cases of localized PVNS that involved the patella fat pad and synovium. Diagnostic and therapeutic arthroscopies were performed, and typical findings of localized PVNS were found. Complete resection of the lesions were performed arthroscopically. Arthroscopy can be used as an effective diagnostic and therapeutic tool for identification and resection of intraarticular localized PVNS of the knee.
Adipose Tissue ; Arthroscopy ; Joints ; Knee* ; Patella ; Synovial Membrane ; Synovitis, Pigmented Villonodular*

Total hip replacement arthroplasty (THRA) is widely performed, and is a successful orthopedic treatment method. Osteolysis, which often happens after THRA, causes a chronic inflammation stage due to wear debris in the artificial articular surface, leading to bone loss or loosening of implants. Osteolysis eventually results in shortening the lifespan of the joint. Afterwards, many researchers reported on the basis of experiments with tissue cultivation that due to the influence of wear particles, the surrounding tissues of the implants as obtained during replacement and the surrounding cells of the implants are secreting enzymes, prostaglandin, cytokine, and the like that stimulate the formation of fibrous tissues or bone resorption by osteoclasts. At this time, THRA was a main cement fixation method, so researchers thought that the loose particles of cement were the cause of osteolysis and aseptic loosening, and so they named these symptoms "cement disease". However, despite the advancement of cement techniques and the use of cement-free implants, the osteolysis problem continued to rise, leading to polyethylene wear particles being regarded as the main cause of osteolysis, and naming these symptoms "particle disease". In this way attention was drawn to new wear particles, now that it is revealed that ultra-high-molecular-weight-polyethylene (UHMWPE) or metal particles constitute the main cause. However, because no symptoms arise until serious bone defects or loosening occurs, it is difficult to diagnose or treat the disease early on. Thus, based on updated hypotheses and theories, this study examines the pathophysiology of osteolysis following THRA, as well as the diagnosis and treatment of osteolysis in the acetabular and femoral regions.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Bone Resorption ; Inflammation ; Orthopedics ; Osteoclasts ; Osteolysis ; Polyethylene

No abstract available.
Angiolipoma*

We report here-in a case of benign hemangioendothelioma occurring in a 2 day-old male neonate on central portion of lumbar area. The lesion was movable, and elevated firm nodule, measuring 1.5x2.0 cm in size. For the purpose of diagnosis and therapy, excisional biopsy was performed, which revealed typical histopathologic pictures in the deep dermis and subcutaneous area. The lesion showed no recurrence at follow-up check after 6 months.
Biopsy ; Dermis ; Diagnosis ; Follow-Up Studies ; Hemangioendothelioma* ; Hemangioma ; Humans ; Infant, Newborn ; Male ; Recurrence

No abstract available.
Pressure Ulcer*

STUDY DESIGN: The authors retrospectively analysed the difference of clinical natures in contained vs. ruptured HIVD. OBJECTIVE: To compare contained HIVD with ruptured HIVD in respect of clinical symptoms, signs and the result after surgery. SUMMARY OF LITERATURE REVIEW: In contained disc herniation, the disc material remains beneath tile intact outer annulus. But, once disc material penetrates through the limit of posterior annulus, it is a ruptured herniation or disc extrusion/sequestration. There is few report concerning the clinical characteristics related to type of herniation. MATERIALS AND METHODS: Forty-six patients, treated by open discectomy from March 1990 to December 1994, were followed up for minimum two years. The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR, and severity of radiating pain were periodically followed up on the predesigned protocol. Result: Twenty patients had contained disc and remaining 26 had ruptured disc. The mean age of contained disc was 31.4 years and that of ruptured disc was 43.3 years. In preoperative examination, 18/26 cases of patients with ruptured discs, developed pain in less than 3 months, compared with 7/20 cases of does with contained ones. Motor deficit was positive in 25/26 cases (96.2%) of ruptured discs and 12/20 cases (60%) of contained ones. 23/26 cases (80.8%) of patients with ruptured discs, had sensory deficit compared with 12/20 cases (60%) of those with contained ones. There was no significant difference in SLR and DTR change between ruptured and contained disc. CONCLUSIONS: Factors such as age, motor and sensory deficits and duration of symptoms had correlation with the type of herniation, but SLR and DTR change showed no statistical difference in this study. Clinical outcome showed no significant difference between two groups, but in ruptured group, the results were getting worse with the time goes. On the basis of this study, we concluded that the clinical symptoms and signs were different between the two groups, but surgical results showed no statistical difference.
Diskectomy ; Humans ; Retrospective Studies

No abstract available.
Ankle Fractures* ; Ankle*

Hip fracture is much more common after the age of 65 year old, and this malady has increased because to the longer average life span with the advances of medical care. Despite the development of the treatments and rehabilitation techniques, hip fracture is well known for having high rates of complications and mortality. The risk factors, mechanisms of injury and the underline disease of hip fracture are also well known, and this has helped these patients to recover as soon as possible and to walk and move earlier after appropriate surgical operations. Most fractures must be treated by an open operation and performing rigid internal fixation or arthroplasty. We report here on the major operational treatments for femur neck fracture and intertrochanter fracture.
Arthroplasty ; Femoral Neck Fractures ; Femur ; Hip ; Hip Fractures ; Humans ; Risk Factors