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The purpose of this study was to determine and compare the prevalence of anterolateral ligament abnormality and associated injuries among patients with complete and partial anterior cruciate ligament tears. In addition, the prevalence of associated injuries with anterolateral ligament abnormality was further analyzed. Of the 158 patients diagnosed with acute anterior cruciate ligament tear, 82 patients were diagnosed with acute complete anterior cruciate ligament confirmed by magnetic resonance imaging (MRI) and arthroscopic procedures (Group C), and 74 patients were diagnosed with acute partial anterior cruciate ligament tears confirmed by MRI (Group P). The status of the anterolateral ligament, collateral ligaments, menisci, and osseous lesions was assessed. There was a significantly higher prevalence of anterolateral ligament abnormalities in Group C than Group P (36.6 vs. 4.1%, p  < 0.001). Medial collateral ligament, lateral collateral ligament, Segond fracture, osseous lesion at the fibular head, lateral tibial plateau, lateral femoral condyle, and medial tibial plateau were significantly associated with anterolateral ligament abnormality. Furthermore, severity of osseous lesion at the lateral tibial plateau, lateral femoral condyle, and medial tibial plateau was significantly associated (with linear correlation) with anterolateral ligament abnormality. The prevalence of anterolateral ligament abnormality was significantly higher in patients with complete anterior cruciate ligament tear (36.6%) than those with partial anterior cruciate ligament tear (4.1%), but with noticeable prevalence of anterolateral ligament abnormality in the partial anterior cruciate ligament tear group. Associated lesions significant to anterolateral ligament abnormality were tears in both collateral ligaments, lateral-sided osseous lesions, and osseous lesion of the medial tibial plateau., Competing Interests: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Objective: The aims of this prospective study were to determine the prevalence of posttraumatic stress disorder (PTSD) in a population of young male military conscripts who experienced an extremity long-bone fracture, and to evaluate whether injury-related variables are associated with the development of PTSD., Design: Prospective, nonrandomized comparative study., Setting: Level 1 trauma center., Patients and Methods: A total of 148 men (age older than 18 years) who had 1 or more acute long-bone extremity fractures within 12 months and were seen at the Seoul Regional Military Manpower Center for examination of military conscripts from March 2013 to March 2014, were enrolled. The Korean version of the posttraumatic disorder scale was used to identify aspects of PTSD. The injury-related variables assessed included injury mechanism, fracture location and multiplicity, fracture severity, and the occurrence of joint ankylosis and secondary osteoarthritis., Results: Of the 148 participants, 40 (27.0%) met the criteria for the diagnosis of PTSD. Multivariate logistic linear analysis confirmed that lower extremity fracture, multiple fractures, and a higher pain visual analog scale score were significantly (P = 0.042, P = 0.043 and P < 0.001, respectively) related to the occurrence of PTSD., Conclusions: Lower extremity fracture, multiple extremity fractures, and higher pain visual analog scale scores were significantly related to the occurrence of PTSD. To achieve an optimal recovery after orthopaedic injury, clinicians must address both physical and psychologic needs of their patients., Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Study Design: The incidence and risk factors of postoperative delirium were retrospectively examined in patients who had spine surgery for degenerative lumbar disease., Objective: The aim of this study is to examine the incidence, pre- and postoperative risk factors and clinical results of postoperative delirium after spine surgery., Summary of Background Data: Postoperative delirium is of great concern in older patients. Patients with postoperative delirium tend to have delay in functional restoration and difficulty in postoperative care. But to author's knowledge this is the first report to postoperative delirium after spine surgery in South Korean population., Methods: Eighty-one patients over 70 years of age, who underwent spinal fusion for degenerative lumbar disease from November 2000 and March 2007 were selected. We analyzed the relation between postoperative delirium and such variables as operation time, intraoperative blood loss and transfusion, fusion level, comorbidity and laboratory data checked before surgery and at 1 day after surgery., Results: Postoperative delirium was found in 11 patients (13.6%). There were significant relationships between postoperative delirium and comorbidity such as cerebral vascular disease and gastric ulcer. Hemoglobin and hematocrit levels at 1 day after surgery and albumin level before surgery was significantly lower than in control group. Oswestry disability index was improved from 50.4% to 27.6% in delirium group and from 48.5% to 24.9% in control group. Hospitalization period was significantly longer in delirium group., Conclusion: History of cerebral vascular disease, low hemoglobin and hematocrit levels at 1 day after surgery, and bad nutritional status were risk factors for delirium. As it is of great concern in older patients, careful observation is necessary for the management of patients with risk factors for delirium.