We reviewed retrospectively the results of stabilization of femoral neck fracture using multiple cannulated screws, in 20 patients who were treated at the department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital from January 1991 through July 1995. With the average follow up of 2 years (from 1 year to 4.5 years), we analyzed these patients with the adequacy of reduction by Garden's alignment index and the functional results of the hip by the Lunceford method. The mean age of patients was 70 years (ranged from 34 to 88 years). The types of fracture according to Garden's classification were fifteen cases of Garden stage I or II, and five cases of Garden stage III or IV. The average interval from injury to operation was four days, ranging from I to 14 days. The adequacy of reduction by Garden's alignment index were as follows: anatomic in 8, acceptable in 10 and poor in 2 cases. According to the Lunceford method, the functional results were as follows: excellent in II, good in 6, fair in 1 and poor in 2 cases, respectively. We found that good result out of the femoral neck fractures, especially for stage I and II with the anatomical and acceptable reduction, can be expected by multiple cannulated screw fixation and early ambulation as possible.
Classification ; Early Ambulation ; Femoral Neck Fractures* ; Femur Neck* ; Follow-Up Studies ; Heart ; Hip ; Humans ; Retrospective Studies

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

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

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

There are many complications after traumatic shoulder dislocation including redislocation, dislocation capsulitis especially in the older age and dislocation arthropathy. Redislocation rates have been primarily related to age at the time of initial dislocation, to lesser degree, athletic participation, length of immobilization, rehabilitative exercises, and time hefore return to sports or full activity. So we wanted to confirm the difference of the lesion between the young and the old at the initial dislocation. Arthroscopic evaluation of the twelve patients with an acute traumatic anterior dislocation of the shoulder was done to identify the intraarticular pathology within 10 days of the initial injury. All patients were taken MRI and evaluated under anesthesia. We classified these shoulders into two groups based on the age of patient. Young agegroup under 30 were seven patients and old age-group over 40 were five patients. And the following results were ohtained; 1. The detachment of the anterior labrum with the inferior glenohumeral ligament from the glenoid rim was primary finding and might cause the shoulder unstable under anesthesia in the young age-group under 30. 2. In the age-group over 40, there were the capsular tears with no labral lesion and these shoulders were stable under anesthesia 3. In acute traumatic anterior dislocation, examination under anesthesia was more closely related to the prediction of the extent of labro-ligamental detachment than MRI examination. 4. We believe that arthroscopic surgical intervention after the initial shoulder dislocation should be considered as a treatment option
Anesthesia ; Arthroscopy ; Dislocations* ; Exercise ; Humans ; Immobilization ; Ligaments ; Magnetic Resonance Imaging ; Pathology ; Shoulder Dislocation ; Shoulder* ; Sports

The incidences of posttraumatic avascular necrosis of the femoral head were variably reported. In 1980, Calandruccio reported its incidence of 14% in nondisplaced femoral neck fracture and 50% in displaced ones. In general, the prophylactic methods, such as core decompression, bone graft and trochanteric osteotomy were recommended for the treatment of early stages of femoral head avascular necrosis(Ficat-Arlet stage 1 or 2), while the primary replacement surgery for the advanced ones (Ficat-Arlet stage 3 or 4). One of our authors(Y.K. Chung) has performed five cases of corticocancellous bone grafts using combined autogenous free fibular graft and iliac cancellous bone graft, for the post-traumatic femoral head AVN from January 1985 to December 1989 at our hospital, and the following results are obtained: 1. Among the forty nine displaced adult femoral neck fractures, there were five eases of avascular necrosis(10. 2%). 2. There were three male patients and two female ones, and the average age of injury was 48 years old(30 to 57). 3. According to the type of fractures, there were four cases of subcapital fracture and one of transcervical fracture. All of the patients were performed closed reduction and internal fixation with compression hip screw system, including additional Knowles pinning in two cases. 4. Histological study with the excised femoral head, showed that there was no bony union between the grafted cancellous bone and the necrotic head, and the grafted bone has been changed to amorphous necrotic tissue. However, we found a solid consolidation of the grafted bone and the femoral neck portion.
Adult ; Decompression ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Head ; Hip ; Humans ; Incidence ; Male ; Necrosis ; Osteotomy ; Transplants

PURPOSE: To compare the short-term clinical results of mini-midvatus minimally invasive total knee arthroplasty(TKA) with quadriceps-sparing minimally invasive TKA. MATERIALS AND METHODS: Between August 2005 and February 2006, 23 bilateral (46 knees) minimally invasive total knee arthroplasties were performed simultaneously using quadriceps-sparing surgical technique at one side and mini- midvastus minimally invasive technique at the contralateral side. The same surgeon performed all the operations with the same type of prosthesis(Nexgen LPS-flex Total Knee System) using MIS quadriceps-sparing instrument. The pos- toperative clinical and radiological results were analyzed in each group. RESULTS: There were no significant differences between the two groups in the operating time, total blood loss, length of skin incision, radiological results and postoperative HSS scores at 8 weeks and 1 year follow-up(p>0.05). Also, there were no differences in the postoperative range of motion and pain score assessed by visual analog scale at 1 day, 3 days, 7 days, 14 days, 8 weeks and 1 year follow-up(p>0.05). Conclusions: Compared to quadriceps-sparing TKA, mini-midvastus minimally invasive TKA revealed no significant differences in the short-term clinical and radiological results. Therefore, it can be considered as an effective, alternative minimally invasive technique.
Arthroplasty* ; Knee Joint ; Knee* ; Range of Motion, Articular ; Skin ; Visual Analog Scale