15 cases of acute dislocation of the elbow were treated at Department of Orthopaedic Surgery, Capital Armed Forces General Hospital, Seoul, Korea during the period of March, 1985. To June, 1986 were analysed. The length of follow-up period ranged from 6 months to 16 months, with a mean of 9 months. The results were as follows; 1. 7 cases had been surgically treated, and they revealed rupture of the medial collateral ligament in all. So, we think that the medial collateral ligament of the elbow plays an important role in elbow stability. 2. The average immobilization period for the patient with non-operative treatm ent was 2 weeks. And normal ran ge of motion was obtained at 8 weeks. So, there was no. significant difference from other reports in the duration of recovery. 3. The period of recovery in operated patients was 14 weeks, and it was 6 weeks longer than non-operatively treated patients. 4. There was no chronic elbow instability in all 15 patients, but 3 cases with non-operative treatment complained of medial elbow pain on vigorous exercise.
Arm ; Collateral Ligaments ; Dislocations ; Elbow Joint ; Elbow ; Follow-Up Studies ; Hospitals, General ; Humans ; Immobilization ; Korea ; Rupture ; Seoul

PURPOSE: The effect of female sex hormones in urinary stone formation has not been known. Sexual difference in the incidence and crystaline composition of urinary stones in human are well known, especially calcium oxalate stone occurs more frequently in men than women. These findings imply that sex hormone may be related to the pathogenesis of urolithiasis. The present study was conducted to investigate the effects of estrogen on stone formation by using an ethylene glycol (EG) and ammonium chloride-induced urolithiasis model in rat. MATERIALS AND METHODS: Adult Sprague-Dawley female rats were divided into 3 groups, containing 8 rats each. Group I were fed with normal diet for 7 days. Group II were fed with the 0.8% EG and 1.0% ammonium chloride for 7 days. Group III were oophorectomized and 7 days later were fed with the 0.8% EG and 1.0% ammonium chloride for 7 days more. Right kidneys were used for examining the crystal deposits by polarizing microscope and left kidneys were used for tissue calcium content. RESULTS: The concentration of estradiol in group III is lower than that of group I and II (p<0.05). There was a significant difference between control (179.03+/-45.46microgram/g) and lithogenic diet groups in tissue calcium contents (p<0.05). Also, there was a significant difference of tissue calcium contents between group II (318.68+/-46.86microgram/g) and group III (703.05+/-121.51microgram/g) (p<0.05). CONCLUSIONS: These data suggest that estrogen can inhibit calcium oxalate stone formation in EG and ammonium chloride diet rats.
Adult ; Ammonium Chloride ; Ammonium Compounds ; Animals ; Calcium Oxalate* ; Calcium* ; Diet ; Estradiol ; Estrogens* ; Ethylene Glycol ; Female ; Gonadal Steroid Hormones ; Humans ; Incidence ; Kidney* ; Male ; Rats* ; Rats, Sprague-Dawley ; Urinary Calculi ; Urolithiasis

BACKGROUND: To evaluate the clinical outcomes and associated repair integrity in patients treated with arthroscopic repair for a transtendinous rotator cuff tear followed by resection of the remnant rotator cuff tendon. METHODS: Between July 2007 and July 2011, we retrospectively reviewed patients who were treated for transtendinous full-thickness tears in the tendinous portion of the rotator cuff by arthroscopic repair. Clinical outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA), the Constant-Murley score, a visual analogue scale (VAS) pain score, and range of motion (ROM). The repair integrity was determined by magnetic resonance imaging or ultrasonography. RESULTS: There were 19 shoulders with transtendinous full-thickness tears in the tendinous portion of the rotator cuff. The ASES, UCLA, Constant-Murley, and VAS pain scores showed significant improvements in function and symptoms (all p<0.001). The active ROM for forward flexion and abduction was also significantly improved (p=0.002 and p<0.001, respectively). The postoperative radiological examination showed cuff integrity without a re-tear in 68.4% of patients. However, the UCLA, ASES, and Constant-Murley scores were not significantly different between healed and re-torn group (p=0.530, p=0.885, and p=0.262, respectively). CONCLUSIONS: Although repair of transtendinous rotator cuff tears followed by resection of the remnant rotator cuff tendon in the footprint has a relatively high re-tear rate, no significant difference was observed in the short-term clinical results between the re-tear and healed groups.
Arthroscopy ; California ; Elbow ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Surgeons ; Tears* ; Tendons ; Ultrasonography

No abstract available.
Airway Resistance* ; Respiration*

The authors conducted an in-Vivo experimental study using sciatic nerve of 200-300 grammed rats to verify clinical applicability of Silicone cuffing method, by which scar adhesion of repaired nerve in crushed limb is assumed hopefully to be reduced. The following observations were obtainable. 1. Nerve conduction velocity was noted faster in Silicone cuff group than in control group significantly after 6 weeks postoperatively. 2. Adhesion of repaired nerve with surrounding scar tissue was far less present in Silicone cuff group than in control group when observed grossly. 3. The amount of scar formation and axonal degeneration were noted reduced remarkably in Silicone cuff group than in control group after 3 weeks postoperatively. 4. The intraneural vascularity was noted reduced either in Silicone cuff group and in control group, but definitely less reduced in the former than in the latter. Clinical relevance: Above results may be taken as an experimental basis supporting clinical applicability of Silicone cuff wrapping method for neurorraphy in crushed limb.
Animals ; Axons ; Cicatrix ; Extremities ; Methods ; Neural Conduction ; Peripheral Nerves ; Rats ; Sciatic Nerve ; Silicon ; Silicones

PURPOSE: The purpose of this prospective study is to examine the anatomical variations of the branches of the medial antebrachial cutaneous nerve in Koreans encountered during cubital tunnel surgery. METHODS: Ninety two patients with cubital tunnel syndrome were treated with a standard approach from December 2008 to July 2012. The position of the branches of medial antebrachial cutaneous nerve was evaluated based on the medial humeral epicondyle with the elbows fully extended. RESULTS: At least one medial antebrachial cutaneous nerve branch was found during the surgeries in all patients. The average number of crossing medial antebrachial cutaneous nerve branches per patient was 1.6. Thirty-eight percent of the cases showed that the medial cutaneous nerve branches cross proximal to the medial humeral epicondyle within 1 cm. Eighty-two percent showed that the medial antebrachial cutaneous nerve branches cross distal to the medial humeral epicondyle within 1.9 cm. CONCLUSION: When using standard approach during cubital tunnel surgery, more than one medial forearm cutaneous nerve is found. Therefore, understanding the general position of medial antebrachial cutaneous nerve branches helps avoid iatrogenic damage to this nerve during cubital tunnel surgery.
Cubital Tunnel Syndrome ; Elbow ; Forearm ; Humans ; Prospective Studies

PURPOSE: The authors applied modified Bilhaut-Cloquet procedure to convergent type of Wassel type IV duplicated thumb. In order to avoid secondary Z-deformity and dysfunction of the reconstructed thumb, the authors modified operative techniques of Bilhaut-Clopuet procedure. METHODS: Fourteen patients received Bilhaut-Cloquet procedures to correct duplicated thumbs from October 2008 to May 2013. Five patients were balanced type and nine patients were unbalanced type. Mean age at the operation was 20.1 month-old (range, 12-52 month-old). Angular deformity, joint stability, range of joint motion and cosmetic outcome were estimated based on Tada score. Postoperative subjective satisfaction score of the parents was evaluated using a 100-points scale. RESULTS: Mean subjective satisfaction score was 75 points at 28 months after the operation. Radiologic study showed bony union of proximal phalangeal bone and stable joint in all patients. Mean range of motion was 20 degrees in interphalangeal joint and 73 degrees in metacarpophalangeal joint. Based on Tada score, the results were good in ten patients (72%), fair in two (14%) and poor in two (14%). Seven patients who were able to follow up for a long term showed no significant difference in length of proximal and distal phalangeal bones compared to the opposite thumb. CONCLUSION: Modified Bilhaut-Cloquet procedure can be applied not only to balanced type of convergent Wassel type IV duplicated thumb, but also to unbalanced type, that focused on functional reconstruction and cosmetic improvement.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Metacarpophalangeal Joint ; Parents ; Range of Motion, Articular ; Thumb*

PURPOSE: The purpose was to evaluate the efficiency of vein repair on flap survival in distally based avulsion flap injury of the hand and forearm. METHODS: Sixteen cases of distally based avulsion flap injury larger than 30 cm2 in size of the hand and forearm in which vein repair was done were enrolled. All had a avulsion injury by rolling machine. To survive the flap, extensive debridement was done to reduce the size of distally based flap injury as little as possible. Thereafter, an average of 1.4 vein were repaired. Postoperatively, hyberbaric oxygen therapy was performed for 2 weeks. The flap survival was assessed at three weeks after operation. RESULTS: When comparing the size of distally based avulsion flap injury and flaps that survived after operation, excellent results were observed in 12 cases, and good results in 4 cases. Additional operation was required including split thickness skin graft in 4 cases. A reverse island fasciocutaneous flap was performed in one case, and elbow joint arthrolysis was performed in another one. CONCLUSION: Treatment of distally based avulsion flap injury of the hand and forearm using vein repair lead to relatively satisfying results in flap survival by allowing earlier motion of the joint, providing favorable functional results.
Debridement ; Elbow Joint ; Forearm* ; Hand* ; Joints ; Oxygen ; Skin ; Transplants ; Veins*

PURPOSE: To analyze the clinical outcome for primary ring flexor digitorum superficialis transfer with open carpal tunnel release in extreme carpal tunnel syndrome. METHODS: Ring flexor digitorum superficialis transfer with open release of the transverse carpal ligament was performed on 23 patients who were diagnosed with extreme carpal tunnel syndrome between September 2008 and August 2013. All patients had visibly severe atrophies, with no sign of compound muscle action potential (CMAP) of abductor pollicis brevis from electromyography. They wanted simultaneous reconstruction of the function of the hand as well as recovery of the numbness. We evaluated the clinical results using key-pinch, hand grip abilities, disability of the arm, shoulder and hand (DASH) scores, Kapandji scores. RESULTS: Key-pinch and hand grip abilities had no significant difference after the surgery compared with before, but DASH scores were significantly different, averaging 18.6 after, compared with 39.8 before surgery. And Kapandji scores increased significantly from 4.8 before, to 9.3 after the surgery. Numbness and pain in hands were also markedly improved with a different score on VAS each. CONCLUSION: Primary ring flexor digitorum superficialis opponensplasty with open carpal tunnel release is a very practical and useful way of treating extreme carpal tunnel syndrome in thenar weakness.
Action Potentials ; Arm ; Atrophy ; Carpal Tunnel Syndrome* ; Electromyography ; Hand ; Hand Strength ; Humans ; Hypesthesia ; Ligaments ; Shoulder ; Tendon Transfer

Eosinophilic myelitis (EM) or atopic myelitis is a rare disease characterized by a myelitic condition in the spinal cord combined with allergic process. This disease has specific features of elevated serum IgE level, active reaction to mite specific antigen and stepwise progression of mostly the sensory symptoms. Toxocariasis can be related with a form of EM. This report describes two cases of cervical eosinophilic myelitis initially considered as intramedullary tumors. When a differential diagnosis of the intramedullary spinal cord lesion is in doubt, evaluation for eosinophilic myelitis and toxocariasis would be beneficial.
Diagnosis, Differential ; Eosinophils ; Hypersensitivity ; Immunoglobulin E ; Mites ; Myelitis ; Rare Diseases ; Spinal Cord ; Toxocariasis