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Clinics in Orthopedic Surgery

Ju-Eun Kim, Dae-Jung Choi
Foraminal decompression using a minimally invasive technique to preserve facet joint stability and function without fusion reportedly improves the radicular symptoms in approximately 80% of patients and is considered one of the good surgical treatment choices for lumbar foraminal or extraforaminal stenosis. However, proper decompression was not possible because of the inability to access the foramen at the L5-S1 level due to prominence of the iliac crest. To overcome this challenge, endoscopy-based minimally invasive spine surgery has recently gained attention...
December 2018: Clinics in Orthopedic Surgery
Sang Bum Kim, Youn Moo Heo, Cheol Mog Hwang, Tae Gyun Kim, Jee Young Hong, You Gun Won, Chang Uk Ham, Young Ki Min, Jin Woong Yi
Background: The sagittal alignment of the spine and pelvis is not only closely related to the overall posture of the body but also to the evaluation and treatment of spine disease. In the last few years, the EOS imaging system, a new low-dose radiation X-ray device, became available for sagittal alignment assessment. However, there has been little research on the reliability of EOS. The purpose of this study was to evaluate the intrarater and interrater reliability of EOS for the sagittal alignment assessment of the spine and pelvis...
December 2018: Clinics in Orthopedic Surgery
Emrah Caliskan, Evrim Karadag Saygi, Zeynep Kardelen Gencer, Hizir Kurtel, Bulent Erol
Background: Advances in surgical techniques, implant technology, radiotherapy, and chemotherapy have increased the recovery chances of patients with bone sarcomas. Accordingly, patients' expectations on life quality have also increased, highlighting the importance of objective evaluation of the functional results of reconstruction. Methods: Thirteen patients with distal femoral endoprosthesis, who had been followed for an average of 2.9 years were evaluated. Postural stability, daily energy expenditure, muscle power, and range of motion were the four parameters analyzed in this study...
December 2018: Clinics in Orthopedic Surgery
Eo Jin Kim, Hyuk Soo Shin, Jae Hee Lee, Min Gyu Kyung, Hyo Jeong Yoo, Won Joon Yoo, Dong Yeon Lee
Background: The use of three-dimensional multi-segment foot models (3D MFMs) is increasing since they have superior ability to illustrate the effect of foot and ankle pathologies on intersegmental motion of the foot compared to single-segment foot model gait analysis. However, validation of the repeatability of the 3D MFMs is important for their clinical use. Although many MFMs have been validated in normal adults, research on MFM repeatability in children is lacking. The purpose of this study is to validate the intrasession, intersession, and interrater repeatability of an MFM with a 15-marker set (DuPont foot model) in healthy children...
December 2018: Clinics in Orthopedic Surgery
Ki Won Young, Hong Seop Lee, Seong Cheol Park
Background: We developed a modified proximal scarf osteotomy technique for moderate to severe hallux valgus in an attempt to obtain better correction of the deformity. In addition, we compared the clinical and radiographic results of this modified technique with those of the classic scarf osteotomy reported in other studies. Methods: Between December 2004 and July 2009, 44 cases of modified proximal scarf osteotomy was performed in 35 patients with moderate hallux valgus...
December 2018: Clinics in Orthopedic Surgery
Kwang Gi Kim, Chan Soo Park, Suk Ha Jeon, Eui Yub Jung, Jiyun Ha, Sanglim Lee
Background: The restriction of wrist motion results in limited hand function, and the evaluation of the range of wrist motion is related to the evaluation of wrist function. To analyze and compare the wrist motion during four selected tasks, we developed a new desktop motion analysis system using the motion controller for a home video game console. Methods: Eighteen healthy, right-handed subjects performed 15 trials of selective tasks (dart throwing, hammering, circumduction, and winding thread on a reel) with both wrists...
December 2018: Clinics in Orthopedic Surgery
Bong Cheol Kwon, Joon Kyu Lee, Suk Yoon Lee, Jae Yeun Hwang, Jang-Hyeon Seo
Background: Significant discrepancy exists between anatomical plate designs and the anatomy of the native distal radius, which may be attributable to considerable morphometric variations in the volar aspect of the distal radius. We aimed to evaluate the degree of variability in the morphometry of the distal radius and identify factors associated with this variability. Methods: We measured the volar surface angle (VSA) of the intermediate and lateral columns and the volar surface width (VSW) in the distal radius from three-dimensional computed tomography scans acquired from 81 cadaveric forearms...
December 2018: Clinics in Orthopedic Surgery
Jae-Sung Yoo, Kang Heo, Soon-Min Kwon, Dong-Ho Lee, Joong-Bae Seo
Background: Surgical-site, multimodal drug injection has recently evolved to be a safe and useful method for multimodal pain management even in patients with musculoskeletal trauma. Methods: Fifty consecutive patients who underwent plating for mid-shaft and distal clavicular fractures were included in the study. To evaluate whether surgical-site injections (SIs) have pain management benefits, the patients were divided into two groups (SI and no-SI groups). The injection was administered between the deep and superficial tissues prior to wound closure...
December 2018: Clinics in Orthopedic Surgery
Dong-Yeong Lee, Young-Jin Park, Sang-Youn Song, Sun-Chul Hwang, Kun-Tae Kim, Dong-Hee Kim
Background: Traumatic spinal cord injury (SCI) is a tragic event that has a major impact on individuals and society as well as the healthcare system. The purpose of this study was to investigate the strength of association between surgical treatment timing and neurological improvement. Methods: Fifty-six patients with neurological impairment due to traumatic SCI were included in this study. From January 2013 to June 2017, all their medical records were reviewed...
December 2018: Clinics in Orthopedic Surgery
Ju-Eun Kim, Dae-Jung Choi, Eugene J Park
Background: Since open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using 0° or 30° endoscopy with better visualization. Methods: We examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment...
December 2018: Clinics in Orthopedic Surgery
Sangbong Ko, Wonkee Choi, Jaejun Lee
Background: Cervical foraminal stenosis (CFS) is one of the degenerative changes of the cervical spine; however, correlations between the severity of stenosis and that of symptoms are not consistent in the literature. Studies to date on the prevalence of stenosis are based on images obtained from the departments treating cervical lesions, and thus patient selection bias may have occurred. The purpose of this study was to investigate the prevalence of CFS according to the site, extent, and morphology of stenosis using cervical computed tomography (CT) images obtained from patients who were visiting not because of symptoms related to the cervical spine, cervical pain, or upper limb pain...
December 2018: Clinics in Orthopedic Surgery
Hyung-Jin Park, Hee-June Kim, Shukho Kim, Seong-Min Kim, Jong-Uk Mun, Jungmin Kim, Hee-Soo Kyung
Background: The purpose of this study was to evaluate the usefulness of sonication technique for microbiological diagnosis and the sterility of the recycled autoclaved femoral components from infected total knee arthroplasty (TKA) using a sonication method. Methods: Nineteen femoral implants explanted from patients with infected TKA were sterilized with a standard autoclave method. Standard culture of the fluid before and after sonication of the sterilized implants was performed to detect pathogenic microorganisms...
December 2018: Clinics in Orthopedic Surgery
Jatin Prakash, Jong-Keun Seon, Hyeon-Woon Ahn, Kyu-Jin Cho, Chae-Jin Im, Eun Kyoo Song
Background: The tibial tuberosity-trochlear groove (TT-TG) distance is used to determine the necessity of tibial tubercle osteotomy. We conducted this study to determine the extent to which each of the tibial tuberosity lateralization, trochlear groove medialization, and knee rotation angle affects the TT-TG distance in both normal and patella dislocated patients and thereby scrutinize the rationale for tuberosity transfer based on the TT-TG distance. Methods: Retrospective analysis of rotational profile computed tomography was done for patella dislocated and control group patients...
December 2018: Clinics in Orthopedic Surgery
Gil Yeong Ahn, Il Hyun Nam, Yeong Hyeon Lee, Yong Sik Lee, Young Duk Choi, Hee Hyung Lee, Sung Hyun Hwang
Background: We aimed to examine the factors that influence synovialization of the grafted tendon after double-bundle anterior cruciate ligament (ACL) reconstruction based on second-look arthroscopic findings. Methods: Out of 205 knees that were treated between August 2008 and May 2016 with double-bundle ACL reconstruction using bio-absorbable cross-pins and Endobuttons for femoral tunnel fixation, we enrolled 65 knees (64 patients) that underwent second-look arthroscopy with hardware removal at 1 year postoperatively...
December 2018: Clinics in Orthopedic Surgery
Dukhwan Ko, Hyeung-June Kim, Seong-Hak Oh, Byung-June Kim, Sung-Jae Kim
Background: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. Methods: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge...
December 2018: Clinics in Orthopedic Surgery
Sarah E Rudasill, Andrew Ng, Atul F Kamath
Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed...
December 2018: Clinics in Orthopedic Surgery
Young-Kyun Lee, Kyung Ho Moon, Jin-Woo Kim, Ji Sup Hwang, Yong-Chan Ha, Kyung-Hoi Koo
Background: The purpose of our study was to evaluate the usefulness of hip arthroscopy including extensive capsulectomy for synovial chondromatosis of the hip. Methods: From 2008 to 2016, 13 patients with synovial chondromatosis of the hip were treated with arthroscopic removal of loose bodies and synovectomy using three arthroscopic portals. An extensive capsulectomy was performed to allow the remaining loose bodies to be out of the extracapsular space, and the excised capsule was not repaired...
December 2018: Clinics in Orthopedic Surgery
Byung Hak Oh, Youn Moo Heo, Jin Woong Yi, Tae Gyun Kim, Jae Sin Lee
Atypical fractures have been reported as a complication of long-standing bisphosphonate therapy and occur commonly in the subtrochanteric region or shaft of the femur showing typical radiographic features. We encountered a case of atypical fracture of the proximal one-third of the shaft of the ulna. Radiographic findings of this case differed from previously reported cases of ulnar fracture in terms of showing a transverse fracture line with cortical thickening and an oblique fracture line with anterior cortical spike...
September 2018: Clinics in Orthopedic Surgery
Woo Jin Shin, Byung Kwon Chang, Jae Woo Shim, Jun Sik Park, Hwan Jin Kwon, Gab Lae Kim
Pincer nail deformity is a severe condition in which the nail bed becomes compressed and the nail shows an overcurvature. We retrospectively analyzed 13 pincer nail deformities treated using our nail plate and bed reconstruction technique. Visual analogue scale scores, the width of nail root, width of nail tip, height of nail tip, width index, and height index were assessed before and after surgery. The overcurvature was corrected after detachment of the nail plate. The nail fold was pushed underneath the nail plate and then fixed...
September 2018: Clinics in Orthopedic Surgery
Won Shik Shin, Dong Ki Ahn, Jung Soo Lee, In Sun Yoo, Ho Young Lee
Background: The incidence of cardiovascular and neurovascular diseases has been increasing with the aging of the population, and antiplatelet drugs (APDs) are more frequently used than in the past. With the average age of spinal surgery patients also increasing, there has been a great concern on the adverse effects of APD on spine surgery. To our knowledge, though there have been many studies on this issue, their results are conflicting. In this study, we aimed to determine the influence of APDs on spine surgery in terms of intraoperative bleeding and postoperative spinal epidural hematoma complication...
September 2018: Clinics in Orthopedic Surgery
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