Search

A sacral insufficiency fracture is a rarely reported complication after lumbosacral fusion. As the majority of those undergoing surgery are elderly patients with degenerative disease, osteoporosis is usually involved along with other reported risk factors such as female, obesity, and multi-segment fusion. Through two cases experienced by the authors, this paper reports a newly found risk factor (cement-augmented pedicle screw), and the fracture treatment process with a review of the relevant literature. [ABSTRACT FROM AUTHOR]

Anterior cruciate ligament rupture is rare in children and adolescents, and unlike in adults, it occurs as an avulsion fracture at the tibial attachment rather than a mid-substance tear. Proximal avulsion fractures are extremely rare, and bone fragments may not be observed on radiographs in children, resulting in a delayed diagnosis. This paper reports a case of avulsion fracture of femoral attachment of anterior cruciate ligament with delayed diagnosis in a seven-year-old girl. [ABSTRACT FROM AUTHOR]

Atypical femoral fracture can occur in situations of bone turnover suppression or the stress concentrations. Rarely, such fractures can also occur around an implant especially at a proximal or distal screw. This paper presents a case of an atypical femoral fracture at a proximal screw insertion site after implant removal with a literature review. [ABSTRACT FROM AUTHOR]

Purpose: This paper proposes a method to convert the measurement of the humerus from conventional two-dimensional (2D) to three-dimensional (3D) measurements and apply it to clinical environments for diagnosis and surgery to improve results. Materials and Methods: In the developed software application, reflection and registration functions were implemented to quantify the difference between both sides of the humerus. Consistent measurements of the humerus were taken by defining the reference axis based on the Principal Component Analysis and aligning the humerus model with respect to the reference axis. Subsequently, the length, volume, the largest cross-sectional area in the head and condyle region, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, and length and angle measurement between markups determined in the head and condyle region were examined. In addition, the automatic extraction of the head and groove, landmarks of the humerus proximal, was implemented. This study applied 40 humerus models (20 males and 20 females) to evaluate the measurements and automatic landmark-determination methods for humerus. Results: The measurements by this software application could provide consistent measurements of the same humerus. In addition, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, proposed through this study, provides a similar ratio regardless of gender and side. Conclusion: The software application developed in this study could measure the humerus and analyze its shape using an objective, reliable, and automatic method in a 3D environment. If the results of this study are applied to real clinical trials, diagnosis, and surgery could be conducted based on objective measurements, and improved results would be achieved. In addition, the study method could be expanded to other fields, such as orthopedics. [ABSTRACT FROM AUTHOR]

Prolotherapy is a treatment that induces tissue regeneration. Traditionally, various stimulants have been used as proliferative agents, but currently, high-concentration dextrose solutions, which have relatively excellent safety and effectiveness, are mainly used. Prolotherapy induces inflammation by injecting a proliferant into a weakened ligament or tendon enthesis and uses the process of proliferation and remodeling of the damaged tissue. The effectiveness of prolotherapy for different musculoskeletal diseases has been reported, but each author reported a different protocol because the method, number of procedures, and cycle have not been standardized. Therefore, the authors conducted a systematic literature review on prolotherapy to analyze the protocols and clinical outcomes of prolotherapy. This paper presents the current knowledge on the diseases targeted by prolotherapy and the treatment methods for each disease. [ABSTRACT FROM AUTHOR]

Anterior ankle impingement is a frequent cause of chronic ankle pain and swelling. A pathological examination has been reclassified as “anterior ankle impingement syndrome.” Soft tissue impingement is prevalent in the anterolateral compartment of the ankle, while a bony spur often causes impingement in the anteromedial compartment. Although open surgery has yielded good outcomes historically, it is associated with several complications. On the other hand, the development of ankle arthroscopy has reduced these risks significantly and has been used effectively in numerous studies to treat impingements caused by anterior bony spurs or soft tissue. An accurate preoperative clinical diagnosis and diagnostic imaging are critical for surgical planning, particularly for identifying bony spurs in front of the ankle. Narrowing joint space, large bone fragments, and other factors can influence the surgical outcomes. Computed tomography scans precisely evaluate the bony spur size, while magnetic resonance imaging scans help assess soft tissue lesions. Therefore, understanding diagnosis and treatment is important, and an accurate understanding of patient prognostic factors, such as osteoarthritis and degenerative osteoarthritis, eventually affects patient outcomes. This paper discusses the clinical symptoms, causes, diagnosis, surgical method, and postoperative rehabilitation of anteromedial and anterolateral ankle impingement syndrome and reports the results of arthroscopic surgery. [ABSTRACT FROM AUTHOR]

Ischial bursitis is a relatively common cystic lesion that is palpable as a mass in the buttocks. On the other hand, hemorrhagic ischial bursitis accompanied by vascular injury is uncommon, and it can be challenging to diagnose clinically or radiologically. This paper reports a 74-year-old male patient with a cystic lesion in the right ischial tuberosity that occurred after a fall from a ladder 2 months earlier. The initial diagnosis of ischial bursitis was suggested, but conservative treatment did not lead to improvement. Subsequent follow-up showed that the condition was a hemorrhagic ischial bursitis with vascular damage involving a branch of the internal pudendal artery. The patient experienced improvement after undergoing percutaneous embolization. [ABSTRACT FROM AUTHOR]

Giant cell tumors of bone are benign tumors that tend to be locally aggressive and occasionally cause hematogenous metastasis to the lung, accounting for approximately 6% of all primary bone tumors. The occurrences in the ankle joint are approximately 4%, and cases in the distal fibula are particularly rare. This paper presents a case of a 21-year-old female patient with a giant cell tumor who treated with a bone endoscopy, a minimally invasive surgical method, and the structure of the bone was preserved. [ABSTRACT FROM AUTHOR]

An interlocking intramedullary nail is the most popular device for managing tibial shaft fractures. Interlocking screws should be inserted to prevent rotation at the fracture site, but inserting distal interlocking screws by free hand technique requires time and skill. The Brooker-Wills tibial nail was designed to stretch out distal metal fins after settling the nail in position. On the other hand, Brooker-Wills nails should be removed for reasons such as chronic osteomyelitis, and folding the distal metal fins is necessary. Nevertheless, many problems arise in this process. Usually, the removal of Brooker-Wills tibial nails is not attempted because of this trouble. The authors tried a new method and could fold the fins successfully in a 30-year-old Brooker-Wills tibial nail, which had to be removed to cure a chronic osteomyelitis around the nail. This paper reports the case of a 72-year-old male with a review of the relevant literature to suggest a useful method. [ABSTRACT FROM AUTHOR]

Coronavirus disease 19 (COVID-19) is an infectious disease and is currently a global pandemic. The disease presents mainly with respiratory symptoms, but a broad spectrum of extrapulmonary complications have also been reported in the cardiovascular, gastrointestinal, and nervous systems. Peripheral nerve injury associated with COVID-19 infections can be caused by direct viral invasion or secondary immune response to neural tissue with the same receptors as alveoli, but its clinical course is poorly understood. Anterior interosseous nerve syndrome is a pure motor neuropathy that causes paralysis of the flexor pollicis longus, the flexor digitorum profundus of the index finger, and the pronator quadratus muscles. The cause of this syndrome is not clearly understood, but may be related to viral infection, autoimmune response, or vaccination. This paper reported a case of partial recovery with conservative treatment in acute anterior interosseous nerve syndrome following COVID-19 infection. [ABSTRACT FROM AUTHOR]

The coronoid process of the ulna surrounds the distal humerus and plays a vital role in posterior dislocation and posterolateral rotational instability. Elbow stability may not be possible if there is a more than 50% loss. Anteromedial facet fractures can lead to instability, radioulnar synostosis. ulnohumeral arthrosis, severe stiffness. Therefore, surgical fixation is required to ensure adequate elbow stability and decrease the risk of posttraumatic ulnohumeral arthrosis. There are several approaches for the repair of coronoid process fractures. In most cases, the posterior approach was used to make a transosseous tunnel connecting the posterior aspect of the olecranon to fix the fracture site. During surgery, the additional dissection required to repair the coronoid might increase the infection risk, nerve injury, heterotopic ossification, and elbow stiffness. The author performed a modified suture lasso and plate fixation with good outcomes. This paper reports this case with a review of the relevant literature. [ABSTRACT FROM AUTHOR]

The modified Phemister technique, which fixes the acromioclavicular joint with a k-wire and fixes the coronoid process and clavicle with a sling, has often been used as surgical treatment for dislocation of the acromioclavicular joint. This technique has the advantage of allowing early rehabilitation exercises with accurate anatomical reduction and firm fixation. On the other hand, some complications have been reported, such as infection, deformation recurrence, fixation complications, erosion of the distal clavicle or fracture of the sling, and secondary arthritis. This study presents a patient who experienced shoulder pain and functional impairment after conservative treatment for a sling area insufficiency fracture that arose from using the modified Phemister technique. Locking screw plate fixation with tricortical iliac bone grafting and matchstick-shaped cancellous bone grafting were used, and successful outcomes were achieved. This paper reports this case with a review of the relevant literature. [ABSTRACT FROM AUTHOR]

An intramedullary nail is the standard surgical treatment for atypical femoral fractures. On the other hand, atypical femoral fractures usually have severe bowing of the femur and a narrow intramedullary canal, making surgery difficult. Although the bone union rate is relatively high at 85%–98%, the healing period is longer than typical femoral fractures. Atypical femoral fracture has higher functional recovery after surgery than proximal femoral fragility fractures because it occurs in a relatively active elderly population. Recently, periprosthetic atypical femoral fractures have also been reported, but the outcomes of surgical treatment are yet to be satisfactory. Complications after surgery include nonunion, peri-implant fractures, and contralateral atypical femoral fractures. To prevent these complications, a stable implant should be used to fix the entire length from the femoral head to the lower part of the femur, accurate fracture reduction should be obtained, and the correction of lower extremity alignment can be helpful if there is severe anterolateral bowing. In addition, periodic follow-up is necessary to consider the possibility of contralateral atypical femoral fracture. The authors of this paper aim to analyze the results, complications, and reoperations after the surgical treatment of atypical femoral fractures based on previously published studies. [ABSTRACT FROM AUTHOR]

The prevalence of musculoskeletal disorders in South Korea has surged due to the rapid aging of the population, emerging as a significant driver of increased healthcare costs. In particular, manual therapy is a representative non-insured treatment for musculoskeletal disorders, and according to media reports, the expenses paid by insurance companies for manual therapy exceeded 1 trillion won in 2021, making it the largest single non-insured treatment item. The National Health Insurance Service’s 2021 report on health insurance coverage identified manual therapy as a major factor contributing to declining health insurance coverage rates. Despite being recognized as an effective treatment for musculoskeletal disorders, manual therapy lacks clear criteria regarding the indications and application frequencies, and it is being performed without clear standards for specialized medical departments. Some have even raised ethical issues for medical institutions and professionals, highlighting social problems. Before December 2005, manual therapy was restricted to specialized fields, such as orthopedics, rehabilitation medicine, and neurosurgery. On the other hand, the transition of manual therapy to non-insured status in December 2005 has allowed its prescription by non-specialized medical departments for musculoskeletal disorders, leading to widespread practices even in unrelated medical specialties and contributing to over-treatment. Given these situations, establishing objective criteria for manual therapy is vital. This study aimed to establish a foundation for solving social problems by grasping the latest perspectives on manual therapy based on an extensive literature review and a survey of experts. [ABSTRACT FROM AUTHOR]

Extracorporeal shock wave therapy is one of the essential conservative treatment methods for musculoskeletal disorders. In Korea, it has been widely used since it was recognized as a non-payment item in 2005. On the other hand, there are still many controversies about the indications for use, and there are few clear standards for this in Korea. Therefore, the authors present guidelines for extracorporeal shock wave therapy by confirming the latest trends through this review and focusing on indications. [ABSTRACT FROM AUTHOR]

Lesions related to the triangular fibrocartilage complex (TFCC), the most common cause of ulnar-sided wrist pain, began to attract attention in the 1980s with the introduction of arthroscopy to the wrist joint, focusing on the forms of injury and treatment methods for such lesions. In 1993, Zachee and others introduced an arthroscopic TFCC suture technique using the outside-in method. In 1996, the insideout technique was introduced by de Araujo et al., and in the 2000s, various authors indroduced the all-inside technique. Consequently, several surgical techniques have been introduced because of the ulnar fovea and the development of arthroscopic tools. Even arthroscopic procedures for reconstructing the deep fiber of the TFCC using autografts have been introduced. On the other hand, there have been few comparative studies on each surgical technique, and it is difficult to argue the superiority of any specific surgical technique, so various surgical techniques are currently being introduced and used. This review aims to describe the arthroscopic procedures of the TFCC that are predominantly used. [ABSTRACT FROM AUTHOR]