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Percutaneous Mini-open Reduction for Mason II or III Radial Head and Neck Fracture (요골 두 및 경부 골절의 경피적 도수 정복술)

  • Lee, Jeong-Gil;Koh, Il-Hyun;Kim, Hyung-Sik;Choi, Yun-Rak;Kim, Sung-Jae;Kang, Ho-Jung
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.230-236
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    • 2010
  • Purpose: We wanted to evaluate the result of percutaneous, mini-open reduction for the treatment of Mason II or III radial head and neck fractures. Materials and Methods: 13 patients (8 male, 5 female) with Mason II or III radial head and neck fractures were treated by 1 cm percutaneous mini-open reduction under fluoroscopy. The average age of our subjects was 29 years. Follow up duration was 18 months. Results: Union was noted in all cases. Mean radial neck angulation was decreased from 33.2 degrees to 7.8 degrees. The mean change in angulation between the immediate post-operative and last follow-up was 0.7 degrees. The mean range of motion at the elbow joint was at last follow up, 133.1 degrees in flexion, 7.3 degrees in extension, 80 degrees in pronation and 84.3 degrees in supination. Postoperatively, mean Mayo Elbow Performance Index, American Shoulder and Elbow Surgeons elbow score, and Disabilities of the Arm, Shoulder and Hand score were 96.2, 97 and 1.2. Temporary posterior interosseous nerve palsy (1 case) and minimal cubitus valgus deformity (1 case) were noted. Conclusion: Selected Mason II or III radial head and neck fractures can be treated satisfactorily with percutaneous mini-open reduction.

A Clinical Analysis of Femur Neck Fracture in Elderly Patients (노년층에서 대퇴경부 골절의 치료)

  • Ihin, Joo-Choul;Ahn, Myun-Whan;Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.11-22
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    • 1985
  • Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture In itself were noted, but we have analyzed 18 femur neck fractures of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slip-down accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and Internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. 4 undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with pre-existing disease in the same hip Joint (total hip replacement).

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Radiographic Changes of the Medial Epicondyle in Little League Baseball Player (청소년기 야구선수의 주관절 내상과의 방사선학적 변화)

  • Choi Chang-Hyuk;Eum Dong-Hwan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.43-48
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    • 2002
  • Purpose : We evaluated radiographic changes and clinical manifestations of the elbow joint to identify the effects of the throwing between dominant and non-dominant arms. Materials and Methods : A hundred and five little leaguer’s baseball player in 5 elementary school and 2 middle school were evaluated for clinical symptoms and radiographic changes about elbow joint. Mean age was 12 years old and average periods of exercise were 32 months. Elbow functions were evaluated using ASES standardized assessment form and radiographic changes of medial epicondyle were examinated for enlargement, separation of the apophyses, fragmentation and irregularity. Results : Thirty seven players (35$\%$) were complained pain with throwing and the average score was 4.8 using visual analog scale. There were no significant differences in range of motion except flexion angle, valgus angle, and strength between dominant arm and non-dominant arm. Valgus laxity was more prominent in dominant arm. Ulnohumeral tenderness, radiocapitellar tenderness and medial flexor origin tenderness were in 18, 6, and 17 cases respectively in dominant arm. Medial epicondyle was enlarged in dominant arm with 13.0 by 6.3 mm compared to non-dominant arm with 11.7 by 6.1 mm. Apophyseal separation was 0.8 mm in dominant arm and 0.5 mm in non-dominant arm. Fragmentation and irregularity were 14 (13$\%$) and 25 (24$\%$) cases respectively in dominant arm. Conclusion : In little league baseball player, it needs usage of ball and bat with appropriate weight, and careful conditioning programs through throwing exercise in order to avoid elbow injuries.

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Mid-Term Results of Fixed Bearing Unicompartmental Knee Arthroplasty: Minimum 5-Year Follow-Up (고정형 슬관절 단일 구획 치환술의 중기 추시 결과: 최소 5년 추시)

  • Oh, Jeong Han;Joo, Il-Han;Kong, Dong-Yi;Choi, Choong-Hyeok
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.498-504
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    • 2018
  • Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.

Cementless Total Hip Arthroplasty Using Ceramic Femoral Head on Cross-Linked Ultra-High-Molecular Weight Polyethylene Liner in Patients Older than 65 Years: Minimum Five-Year Follow-Up Results (세라믹 대퇴 골두 및 교차결합 초고분자량 폴리에틸렌 라이너를 이용한 65세 이상 무시멘트형 인공 고관절 전치환술: 최소 5년 중기 추시 결과)

  • Yun, Ho Hyun;Cheong, Ji Young;Sim, Hyun Bo;Park, Jae Hong
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.490-497
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    • 2018
  • Purpose: To evaluate the utility of ceramic-on-polyethylene articular bearing surface when cementless total hip arthroplasty is performed in patients older than 65 years through an analysis of the minimum five-year follow-up results using the ceramic femoral head and cross-linked polyethylene liner. Materials and Methods: From March 2010 to September 2012, 51 patients (56 hips) who were older than 65 years were enrolled in this retrospective study. The mean age at surgery was $70.9{\pm}5.1years$ old. A clinical assessment was analyzed using the Harris hip score. For the radiographic assessment, the cup inclination and anteversion, stem alignment, and wear amount were measured. The postoperative complications were also determined. Results: The mean Harris hip score was improved from preoperative 48 points to postoperative 87 points (p<0.05). The mean cup inclination was $40.9^{\circ}{\pm}6.4^{\circ}$ and the mean cup anteversion was $20.3^{\circ}{\pm}8.1^{\circ}$. The mean cup anteversion of the elevated liner-used group (16 cases) was $14.3^{\circ}{\pm}7.9^{\circ}$ and the mean cup anteversion of the neutral liner used group (40 cases) was $22.4^{\circ}{\pm}9.1^{\circ}$ (p<0.05). The mean stem alignment angle was $0^{\circ}$ (range, varus $4^{\circ}$-valgus $4^{\circ}$). The mean linear wear amount was $0.458{\pm}0.041mm$ and the average annual linear wear rate was $0.079{\pm}0.032mm/yr$. Six cases (10.7%) of intraoperative periprosthetic femoral fractures were encountered. Conclusion: Based on these results, the use of a ceramic-on-polyethylene articular bearing surface in elderly patients with cementless total hip arthroplasty is beneficial. On the other hand, careful effort is needed to prevent intraoperative periprosthetic femoral fractures.

A Study on the date of the black glazed bowls with "Gongyu (供御)" or "Jinzhan (進琖)" of Jian ware (건요(建窯) "공어(供御)"·"진잔(進琖)"명흑유완(銘黑釉碗)의 제작시기 문제)

  • Lee, Heegwan
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.100
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    • pp.82-110
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    • 2021
  • This study specifically examined the date of the black glazed bowls marked with "Gongyu (供御)" or "Jinzhan (進琖)" of Jian ware, one of the key research topics related to the bowls. The results of this study can be summarized as follows. Jian Kiln produced various shapes of black glazed bowls, but almost all of the inscriptions of "Gongyu (供御)" or "Jinzhan (進琖)" are found only in two certain type bowls: Type I, the Shukou type bowls (束口碗), or Type II, the Piekou type bowls (撇口碗). Of these, there are significantly more of the former in existence. For Type I bowls marked with "Gongyu (供御)" or "Jinzhan (進琖)", the mouth of the bowls is slightly evaginated outwards, and the inclination angle of the side slope is about 50°. The shape feature, Shukou (束口) is formed which is slightly indented around the bowl about 0.3~0.5cm below the mouth of bowl. And the height of the bowls is relatively low compared to other Type I black glazed bowls produced by Jian Kiln, so the height divided by the diameter is 0.5 or less. There is little difference in shape between the black glazed bowls marked with "Gongyu (供御) and those with "Jinzhan (進琖)". However, taking into consideration the excavation situation of both type bowls, the former is considered to be ahead of the latter in terms of production date. On the other hand, the black glazed bowls of Jian ware, which have the same shape features as the Type I bowls marked with "Gongyu (供御)" or "Jinzhan (進琖)" have not been found in the tombs dating from the end of the 12th to the beginning of the 13th century from which typical Jian kiln black glazed bowls of the same type were excavated. For the Hakata site (博多遺址) in Japan, the black glazed bowls with such a shape feature were excavated from early 12th century sites, rather than from the late 12th to early 13th century sites at which the typical black glazed bowls of Jian kiln were found. Considering that the black glazed bowls from Fujian province were imported into Hakata with almost no time gap, it is very unlikely that the production time of Type I black glazed bowls marked with "Gongyu (供御)" or "Jinzhan (進琖)" will deviate from the early 12th century. In conclusion, it is considered that the black glazed bowls marked with "Gongyu (供御)" or "Jinzhan (進琖)" of Jian ware were produced in the early 12th century.

Shoulder Replacement Arthroplasty after Failed Proximal Humerus Fracture (상완골 근위부 골절의 치료 실패 후 견관절 치환술)

  • Park, Jin-Young;Seo, Beom-Ho;Lee, Seung-Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.110-119
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    • 2019
  • Proximal humerus fracture can be defined as a fracture that occurs in the surgical neck or proximal part of the humerus. Despite the appropriate treatment, however, various complications and sequelae can occur, and the treatment is quite difficult often requiring surgical treatment, such as a shoulder replacement. The classification of sequelae after a proximal humerus fracture is most commonly used by Boileau and can be divided into two categories and four types. Category I is an intracapsular impacted fracture that is not accompanied by important distortions between the tuberosities and humeral head. An anatomic prosthesis can be used without greater tuberosity osteotomy. In category I, there are type 1 with cephalic collapse or necrosis with minimal tuberosity malunion and type 2 related to locked dislocation or fracture-dislocation. Category II is an extracapsular dis-impacted fracture with gross distortion between the tuberosities and the humeral head. To perform an anatomic prosthesis, a tuberosity osteotomy should be performed. In category II, there are type 3 with nonunion of the surgical neck and type 4 with severe tuberosity malunion. In type 1, non-constrained arthroplasty (NCA) without a tuberosity osteotomy should be considered as a treatment. On the other hand, reverse shoulder arthroplasty (RSA) should be considered if types 1C or 1D accompanied by valgus or varus deformity or severe fatty degeneration of the rotator cuff. In general, the results are satisfactory when NCA is performed in type 2 sequelae. On the other hand, RSA can be considered as an option when there is no bony defect of the glenoid and a defect of the rotator cuff is accompanied. In type 3, it would be effective to perform internal fixation with a bone wedge graft rather than shoulder replacement arthroplasty. Recent reports on the results of RSA are also increasing. On the other hand, recent reports suggest that good results are obtained with RSA in type 3. In type 4, RSA should be considered as a first option.