PURPOSE: It has been studied prognostic factors about secondary displacement after conservative treatment of the distal radius fracture, but each study showed different results. Authors retrospectively evaluated factors known to be involved secondary displacement of the distal radius fracture to determine its significance. METHODS: One hundred eighteen cases of the radiographically unstable distal radius fractures that closed reduction was adequately performed were retrospectively studied and the radiographic images were taken at 1, 2, 3, 4, 6 weeks after closed reduction. During follow-up, dorsal tilt more than 15°, volar tilt more than 20°, ulnar positive variance more than 4 mm, radial length less than 6 mm, radial inclination less than 10° were thought of the loss of reduction. RESULTS: In 41 cases (34.7%), the loss of reduction occurred. Sex, intra-articular fracture, dorsal and volar comminution, concomitant ulnar fracture and involvement of the distal radio-ulnar joint were statistically not significant. Analysis results of the binomial logistic regression model were as follows: age (p=0.003), radial shortening (p=0.010) and ulnar positive variance (p=0.010) were statistically significant as the predictive prognostic factors. Analysis results of the multinomial logistic regression model showed age (p=0.006) as an only statistically significant factor. CONCLUSION: As the predictive prognostic factors for development of secondary displacement after conservative treatment of the unstable distal radius fracture, age was determined as most significant factor. Also radial shortening and ulnar positive variance were thought of the predictive factors for secondary displacement.
Colles' Fracture ; Follow-Up Studies ; Intra-Articular Fractures ; Joints ; Logistic Models ; Radius Fractures* ; Radius* ; Retrospective Studies

Distal radioulnar dislocation is commonly associated with radius fracture. Most common dislocation pattern is the dorsal dislocation. We present the unique case of volar dislocation of the distal radioulnar joint blocked by displaced dorsal Barton fracture of distal radius and discuss the injury mechanism and anatomic lesions.
Dislocations* ; Joints* ; Radius ; Radius Fractures

Compartment syndrome is caused by elevated pressure in a restricted compartment. It typically occurs after fractures of the extremities and usually has an acute clinical progression. Chronic compartment syndrome is another relatively well known form, typically associated with forceful exercise. Also, there are various reports of compartment syndrome not associated with typical causes. However, reports on compartment syndrome with unknown etiology are rare and there has been none in Korean literature. We report a case of compartment syndrome with no recognizable cause, hence classified as idiopathic.
Compartment Syndromes* ; Extremities ; Forearm* ; Upper Extremity

Ulnar tunnel syndrome (UTS) is a compressive neuropathy of the upper extremity that shows various clinical symptoms according to the anatomic region of the compression site. Numerous factors may cause UTS, and most publications are case reports describing various etiologies; thus, obtaining a correct diagnosis is often challenging. Giant cell tumor of the tendon sheath (GCTTS) is well described to be a common benign soft tissue tumor of the hand; however, it is rarely reported to cause UTS. We report a case of GCTTS in Guyon's canal causing UTS that was misdiagnosed as handlebar palsy.
Diagnosis ; Giant Cell Tumors* ; Giant Cells* ; Hand ; Paralysis* ; Tendons* ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies ; Upper Extremity

The differential diagnosis of hand infections is difficult because hand infections can manifest with variable clinical presentations due to the unique anatomic structures of the hand, and the significance of these infections is often overlooked. A horseshoe abscess is a rare type of deep space infection that can occur due to extension of infection through communications between the deep spaces of the hand. Although horseshoe abscesses are well known due to their anatomic characteristics, there are few clinical reports of such occurrences. Such a case has not been reported in the Korean literature. Here we report a case of horseshoe abscess of the hand after local steroid injection.
Abscess* ; Diagnosis, Differential ; Hand*

Anterior interosseous nerve is purely a motor nerve and supplies flexor pollicis longus, flexor digitorum profundus to the index finger, and pronator quadratus. The etiology and treatment option of anterior interosseous nerve syndrome remain controversial. Bilateral involvement of the anterior interosseous nerve have been described rarely; however, we found no reported case of nonsimultaneous bilateral anterior interosseous nerve palsy associated with the entrapment neuropathy. We present the unique case of delayed anterior interosseous nerve syndrome, 3 years 5 months following an identical event in the opposite extremity and literature review.
Equipment and Supplies ; Extremities ; Fingers ; Paralysis

PURPOSE: This study reports on the results of clinical and radiological evaluation of arthroscopic synovectomy in hemophilic ankle arthropathy. MATERIALS AND METHODS: Between September 2006 and December 2008, arthroscopic synovectomy was performed on 35 ankle joints in 33 patients with hemophilic ankle arthropathy. The mean follow-up period was 30 months. The range of motion of joint and frequency of intra-articular bleeding and factor dose were evaluated for this study. American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot score and subjective satisfaction were used for clinical assessment. Arnolf and Hilgartner classification was used for radiological assessment. RESULTS: The mean dorsiflexion and plantar flexion were 10.1degrees, 30.1degrees, respectively, at preoperation and 11.3degrees, 28.2degrees, respectively on the final day of follow-up with no significant difference in the range of motion. The mean frequency of hemarthrosis decreased significantly to 0.6 times per month postoperative (p<0.05). The mean amount of factor replacement decreased from 5,320 units/mo preoperative to 4,568 units/mo postoperative with no significance difference. AOFAS ankle and hind foot score was improved to 90 points postoperative with significance. On radiologic evaluation, 33 cases showed no significant changes, while two cases had progressed at the last follow-up. CONCLUSION: Arthroscopic synovectomy for recurrent hemarthrosis in hemophilic ankle arthropathy is a useful method for familiar procedure, decreasing bleeding episodes and subjective satisfaction.
Ankle Joint ; Ankle* ; Classification ; Follow-Up Studies ; Foot ; Hemarthrosis ; Hemophilia A ; Hemorrhage ; Humans ; Joints ; Range of Motion, Articular

PURPOSE: The aim of this study is to report on the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of large bone and soft tissue defect combined with infection by open tibia fracture. MATERIALS AND METHODS: During the research period, lasting from December 2002 to June 2008 (Kyung Hee University Medical Center), data were collected from three patients who underwent IVFT after free flap. We analyzed the successiveness and persistency of the infection using free flapping, bone union, and hypertrophy between transposed fibula and tibia. RESULTS: Regarding free flap, successive results were observed in all examples. In the final follow-up results, transposed fibulas all survived, having hypertrophy similar to that of adjacent tibia. CONCLUSION: Reconstruction of tibia defect with free flap followed by IVTF is a useful and safe method for avoidance of the potential risk of infection for patients with a large tibial bone defect and soft tissue defect associated with infection.
Fibula ; Follow-Up Studies ; Free Tissue Flaps* ; Humans ; Hypertrophy ; Lower Extremity* ; Methods ; Tibia

PURPOSE: The purpose of this study was to evaluate clinical results for open reduction and internal fixation of unstable extraarticular metacarpal fractures using low profile titanium plates. METHODS: Sixty-two consecutive patients (76 metacarpals) with unstable extraarticular metacarpal fractures who prospectively underwent internal fixation with plating were enrolled. Minimum follow-up was 1 year. There were 48 males and 14 females; average age was 39 years (range, 15-71 years). The location of the fractures was shaft in 65 metacarpals and the type was transverse in 22 cases, oblique in 46 cases, and communited in 8 cases. Of the 62 patients, 11 were open; 9 of these had additional soft tissue injury. The surgical outcome was assessed by clinical and radiographic outcomes and complications. RESULTS: Bone union was successfully achieved in all patients on the average period of 6.4 weeks. The final range of total active motion was excellent for 64 cases, good for 6 cases, fair for 5 cases, and poor for 1 case. Postoperative complications occurred in 9 patients (15 metacarpals). Statistical analysis revealed that patient age, occupation, multiple metacarpal fractures, and soft tissue injury were significantly correlated with incidence of complications at last follow-up. CONCLUSION: Low profile titanium plating showed the low complication rate and good results in treating unstable extraarticular metacarpal fractures.
Follow-Up Studies ; Humans ; Incidence ; Male ; Metacarpal Bones ; Occupations ; Postoperative Complications ; Prospective Studies ; Soft Tissue Injuries ; Titanium

Treatment of giant cell tumor of distal radius can be treated in several ways according to the aggressiveness of the tumor. The management of giant cell tumor involving subchondral bone of the distal radius has always been a difficult problem and whether preserving joint function should be considered. In these circumstances, wrist arthroplasty using free vascularized fibular head grafting can be considered as one of available options to preserve the wrist joint motion. However, the reports for final outcomes of wrist arthroplasty using vascularized fibular head have been variable and there have been several debates about its techniques. The purpose of this article is to discuss the several considerations in wrist arthroplasty using free vascularized fubular head graft for giant cell tumors of the distal radius.
Arthroplasty ; Giant Cell Tumors* ; Giant Cells* ; Head* ; Joints ; Radius* ; Transplants* ; Wrist ; Wrist Joint