Purpose: This study investigated the clinical and radiologic outcomes of partial trapeziectomy and suspensionplasty with a suture button for thumb carpometacarpal (CMC) joint osteoarthritis over a 2-year follow-up period. Methods: This retrospective study involved 17 patients with thumb CMC joint osteoarthritis (Eaton and Littler stage II or III) treated with partial trapeziectomy and suspensionplasty using a suture button. Clinical outcomes were evaluated using a visual analog scale for pain, the Quick DASH score, pinch and grip strength, and thumb range of motion. The trapezial space ratio (TSR) was used as a radiologic parameter to evaluate radiologic outcomes immediately postoperatively, at 6 months, and at the final follow-up. Results: The study included 17 patients (female, 16 and male, 1) with an average age of 63.2 years (range, 56–70 years). Surgery was performed on the dominant hand in nine cases and the nondominant hand in eight. Significant improvements were observed in clinical outcomes. The TSR significantly decreased up to 6 months postoperatively, but there was no significant change from 6 months onward. Complications included button irritation (n=1), a metacarpal fracture (n=1), and flexor carpi radialis tendon rupture (n=1), which were subsequently treated. At the last follow-up, significant improvements in functional outcomes were observed in comparison to the preoperative status. Conclusion The procedure demonstrated significantly improved clinical outcomes over a 2-year follow-up. This method is less invasive than other surgical techniques because it preserves part of the trapezium, making it a favorable surgical option in patients with early basal thumb arthritis (below Eaton stage III).

Purpose: This study investigated the clinical and radiologic outcomes of partial trapeziectomy and suspensionplasty with a suture button for thumb carpometacarpal (CMC) joint osteoarthritis over a 2-year follow-up period. Methods: This retrospective study involved 17 patients with thumb CMC joint osteoarthritis (Eaton and Littler stage II or III) treated with partial trapeziectomy and suspensionplasty using a suture button. Clinical outcomes were evaluated using a visual analog scale for pain, the Quick DASH score, pinch and grip strength, and thumb range of motion. The trapezial space ratio (TSR) was used as a radiologic parameter to evaluate radiologic outcomes immediately postoperatively, at 6 months, and at the final follow-up. Results: The study included 17 patients (female, 16 and male, 1) with an average age of 63.2 years (range, 56–70 years). Surgery was performed on the dominant hand in nine cases and the nondominant hand in eight. Significant improvements were observed in clinical outcomes. The TSR significantly decreased up to 6 months postoperatively, but there was no significant change from 6 months onward. Complications included button irritation (n=1), a metacarpal fracture (n=1), and flexor carpi radialis tendon rupture (n=1), which were subsequently treated. At the last follow-up, significant improvements in functional outcomes were observed in comparison to the preoperative status. Conclusion The procedure demonstrated significantly improved clinical outcomes over a 2-year follow-up. This method is less invasive than other surgical techniques because it preserves part of the trapezium, making it a favorable surgical option in patients with early basal thumb arthritis (below Eaton stage III).

Purpose: This study investigated the clinical and radiologic outcomes of partial trapeziectomy and suspensionplasty with a suture button for thumb carpometacarpal (CMC) joint osteoarthritis over a 2-year follow-up period. Methods: This retrospective study involved 17 patients with thumb CMC joint osteoarthritis (Eaton and Littler stage II or III) treated with partial trapeziectomy and suspensionplasty using a suture button. Clinical outcomes were evaluated using a visual analog scale for pain, the Quick DASH score, pinch and grip strength, and thumb range of motion. The trapezial space ratio (TSR) was used as a radiologic parameter to evaluate radiologic outcomes immediately postoperatively, at 6 months, and at the final follow-up. Results: The study included 17 patients (female, 16 and male, 1) with an average age of 63.2 years (range, 56–70 years). Surgery was performed on the dominant hand in nine cases and the nondominant hand in eight. Significant improvements were observed in clinical outcomes. The TSR significantly decreased up to 6 months postoperatively, but there was no significant change from 6 months onward. Complications included button irritation (n=1), a metacarpal fracture (n=1), and flexor carpi radialis tendon rupture (n=1), which were subsequently treated. At the last follow-up, significant improvements in functional outcomes were observed in comparison to the preoperative status. Conclusion The procedure demonstrated significantly improved clinical outcomes over a 2-year follow-up. This method is less invasive than other surgical techniques because it preserves part of the trapezium, making it a favorable surgical option in patients with early basal thumb arthritis (below Eaton stage III).

Purpose: Epidemiological data on injuries resulting from ice hockey and their management are lacking in Korea. A comprehensive analysis of such data is crucial for the effective prevention and management of ice hockey injuries. This study aimed to determine the epidemiological profile of ice hockey injuries and their management among elite Korean players. Methods: The descriptive epidemiological study involved three semiprofessional male ice hockey teams and used a retrospective self-reported questionnaire for assessment. The data collected included demographic characteristics such as player positions and stick-side preferences, injured body parts, injury types, treatment methods, and the decision-maker for returning to sports. Results: A total of 68 players were included in the study, of whom 58 (85.3%) experienced moderate-to-severe orthopedic injuries. Among the reported injuries, 93 (77.5%) occurred during the games, with player-to-player contact being the most frequent cause of such injuries. The decision to return to sports in 53 cases (44.2%) was made by the medical staff, whereas players and nonmedical staff made that decision in 67 cases (55.8%). The decision-making process of the medical staff for allowing players to return to sports was significantly associated with the player’s position and whether the injury required surgery. Conclusion The study emphasizes the high prevalence of orthopedic injuries among elite ice hockey players in Korea and the importance of injury prevention strategies. It also highlights the need for increased involvement of medical staff in return-to-play decisions to ensure successful recovery of players and their reintegration into the competition.

Acquired digital fibrokeratoma is very a rare, benign, fibrous, and hyperkeratotic skin tumor that develops most frequently on the finger or toe. The tumor usually occurs in adults as a solitary, dome-shaped lesion. Sometimes, it appears as a rudimentary supernumerary digit and may be misdiagnosed as an accessory nail (double nail) or verruca vulgaris. The pathophysiology of an acquired digital fibrokeratoma is unknown. On the other hand, trauma has often been proposed as a predisposing factor for an acquired type of digital fibrokeratoma. This paper reports a case of trauma-related acquired digital fibrokeratoma presenting as a supernumerary digit and nail in a 36-year-old male.This case is presented with a 0.5 cm×0.4 cm×1.3 cm sized, firm, hyperkeratotic, protruding mass over the left second finger nail.

A 36-year-old female amateur cyclist developed mononeuropathy of the deep branch of the ulnar nerve due to nerve compression adjacent to the ulnar tunnel (type II Guyon’s canal syndrome) caused by prolonged bicycle riding.The patient’s signs and symptoms persisted even after refraining from cycling for 4 weeks; thus, she underwent decompression of the deep branch of the ulnar nerve in the palm and wrist. Three months postoperation, she recovered nearly full power and function of her left hand.

BACKGROUND/AIMS: Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients. METHODS: We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age > or =65 years; mean 71.4+/-5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5+/-13.5; n=124; 177 DBEs). RESULTS: In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548). CONCLUSIONS: DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.
Aged* ; Double-Balloon Enteroscopy* ; Hemorrhage ; Humans ; Medical Records ; Retrospective Studies

BACKGROUND/AIMS: Unresectable malignant biliary obstruction has usually been treated by placement of a self-expandable metallic stent (SEMS). One of the major complications of SEMS is occlusion of the stent by the ingrowth and overgrowth of tumor. The optimal management of an occluded SEMS is still an unresolved problem. We performed this study to evaluate the usefulness of placing a second stent with using an uncovered SEMS or a covered SEMS in patients with stent occlusion. METHODS: From January 2006 to December 2007, a total of 163 patients were treated with the placement of an uncovered SEMS for treating malignant biliary obstruction, except for the cases with Klatskin's tumor. Thirty four patients were occluded and they underwent a second SEMS insertion. All the patients with an occluded uncovered SEMS were managed with placement of a covered SEMS or an uncovered SEMS by ERCP. RESULTS: The median patent duration after intervention was 98 days (range: 8~300 days) after the second covered SEMS insertion, and the median patent duration after intervention was 90 days (range: 10~643 days) after the second uncovered SEMS insertion. No significant difference in the patent period was observed between the covered SEMS group and the uncovered SEMS group (P=0.832). CONCLUSIONS: The covered SEMS group and the uncovered SEMS group had similar patent periods for the management of occluded uncovered metal stents.
Cholangiopancreatography, Endoscopic Retrograde ; Humans ; Klatskin's Tumor ; Stents

BACKGROUND: Bioprosthetic devices for treating cardiovascular diseases and defects may provide alternatives to autologous and homograft tissue. We evaluated the mechanical and physical conditions of a porcine pericardial bioprosthesis treated with Glutaraldehyde (GA), Ethanol, or Sodium dodecylsulfate (SDS) before implantation. MATERIAL AND METHOD: 1) Thirty square-shaped pieces of porcine pericardium were fixed in 0.625%, 1.5% or 3% GA solution. 2) The tensile strength and thickness of these and other bioprosthesis, including fresh porcine pericardium, fresh human pericardium, and commercially produced heterografts, were measured. 3) The tensile strength and thickness of the six treated groups (GA-Ethanol, Ethanol-GA, SDS only, SDS-GA, Ethanol-SDS-GA and SDS-Ethanol-GA) were measured. RESULT: 1) Porcine pericardium fixed in 0.625% GA the thinnest and had the lowest tensile strength, with thickness and tensile strength increasing with the concentration of GA solution. The relationship between tensile strength and thickness of porcine pericardium increased at thicknesses greater than 0.1 mm (correlation-coefficient 0.514, 0<0.001). 2) There were no differences in tensile strength or thickness between commercially-produced heterografts. 3) Treatment of GA, ethanol, or SDS minimally influenced thickness and tensile strength of porcine pericardium, except for SDS alone. CONCLUSION: Porcine pericardial bioprosthesis greater than 0.1 mm thick provide better handling and advantageous tensile strength. GA fixation did not cause physical or mechanical damage during anticalcification or decellularization treatment, but combining SDS-ethanol pre-treatment and GA fixation provided the best tensile strength and thickness.
Bioprosthesis ; Cardiovascular Diseases ; Ethanol ; Glutaral ; Handling (Psychology) ; Humans ; Pericardium ; Sodium ; Tensile Strength ; Transplantation, Heterologous ; Transplantation, Homologous

BACKGROUND/AIMS: The catheter probe endoscopic ultrasonography (EUS) system is widely used to evaluate upper gastrointestinal tract lesions. The depiction of the esophageal wall by probe EUS remains problematic due to the difficulty of the filling of water in the esophageal lumen. In addition, filling the esophagus with water can be associated with an increased risk of aspiration. To resolve such problems, we recently applied the use of probe EUS with the jelly-filled method for the evaluation of subepithelial lesions. The procedure is characterized by filling the esophageal lumen with jelly. In this study, we evaluated the efficacy of probe EUS by using the jelly-filled method for esophageal subepithelial lesions. METHODS: We analyzed the records of the patients with suspected subepithelial lesions at the time of endoscopy that was performed from November 2005 to June 2007. Esophageal subepithelial lesions with both EUS findings and pathological reports were retrospectively compared. RESULTS: The study included 181 patients (96 males, 85 females), with an average age of 55.5 years (age range, 29~78 years). Sixty-eight patients had lesions in the upper esophagus, 60 patients had lesions in the middle esophagus and 53 patients had lesions in the lower esophagus. Secondary layers of esophageal lesions were predominant (91/181) in the cases. Pathological findings were available for 34 patients. Compared with the pathological findings, the diagnostic accuracy of EUS was 91.1%. CONCLUSIONS: Probe EUS by using the jelly-filled method is convenient and safe to perform and provides clear and full-circumferential imaging of a lesion. It is an alternative method to use in place of previously used probe-EUS procedures for the assessment of esophageal subepithelial lesions.
Catheters ; Endoscopy ; Endosonography ; Esophagus ; Humans ; Hypogonadism ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Retrospective Studies ; Upper Gastrointestinal Tract