• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.111-116
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• 2002

Synovial chondromatosis is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue, usually intraarticular, commonly affects the knee, hip and elbow. An extraarticular lesion is rare, most often seen in a synovial sheath and bursa of the hand or foot. We present a case of extraarticular synovial chondromatosis in the left ankle, originated from the FHL tendon sheath of a 31 year-old-female diagnosed by a radiography, MRI confirmed histopathologically.

• Hip & pelvis
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• v.35 no.3
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• pp.193-199
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• 2023

Purpose: Cephalomedullary (CM) nailing is widely performed in treatment of elderly patients with femoral intertrochanteric fractures. However, in cases of fixation failure, re-operation is usually necessary, thus determining factors that may contribute to fixation failure is important. In this study, we examined factors affecting the occurrence of fixation failure, such as age or fracture stability, after CM nailing in elderly patients. Materials and Methods: This study was conducted retrospectively using registered data. From April 2011 to December 2018, CM nailing was performed in 378 cases diagnosed with femoral intertrochanteric fractures, and 201 cases were finally registered. Cases involving patients who were bed-ridden before injury, who died from causes unrelated to surgery, and those with a follow-up period less than six months were excluded. Results: Fixation failure occurred in eight cases. Comparison of the surgical success and fixation failure group showed that the mean age was significantly higher in the fixation failure group compared with the control group (81.3±6.4 vs. 86.4±6.8; P=0.034). A significantly high proportion of unstable fractures was also observed (139/54 vs. 3/5; P=0.040), with a significantly high ratio of intramedullary reduction (176/17 vs. 5/3; P=0.034). A significantly higher ratio of unstable fractures compared with that of stable fractures was observed in the intramedullary reduction group (132/49 vs. 10/10; P=0.033). Conclusion: Fixation failure of CM nailing is likely to occur in patients who are elderly or have unstable fracture patterns. Thus, care should be taken in order to avoid intramedullary reduction.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.143-153
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• 2020

Purpose: To evaluate the timing of the improvement in surgical skills of the direct anterior approach for hip arthroplasty through an analysis of the clinical features and learning curve in 58 cases. Materials and Methods: From November 2016 to November 2018, 58 patients, who were divided into an early half and late half, and underwent hip arthroplasty by the direct anterior approach, were enrolled in this retrospective study. The operation time and complications (fracture, lateral femoral cutaneous nerve injury, heterotopic ossification, infection, and dislocation) were assessed using a chi-square test, paired t-test, and cumulative sum (CUSUM) test. Results: The mean operation times in total hip arthroplasty (26 cases) and bipolar hemi-arthroplasty were 132.1 minutes and 79.7 minutes, respectively, demonstrating a significant difference between the two groups. CUSUM analysis based on the results revealed breakthrough points of the operation time, decreasing to less than the mean operation time because of the 16th case in total hip arthroplasty and 14th case in bipolar hemiarthroplasty. Complications were encountered in the early phase and late phase: five cases of fractures in the early phase, no case in the late phase; eight and two cases of lateral femoral cutaneous nerve injury, respectively; three and two cases of heterotopic ossification, respectively; and one case of dislocation, one case of infection and three cases of others in the early phase. The CUSUM chart for the fracture rate during operation in the early phase revealed the following: five cases fracture (17.2%) in the early phase and no case in the late phase (0%). This highlights the learning curve and the need for monitoring the inadequacy of operation based on the complications. Conclusion: Hip arthroplasty performed by the direct anterior approach based on an anatomical understanding makes it difficult to observe the surgical field and requires a learning curve of at least 30 cases.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.79-87
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• 2010

고관절경을 시행하는 집도의사는 관절경을 통해 관찰되는 정상 고관절의 해부학적 구조물에 대한 정확한 지식과 삽입구 위치에 대한 숙지를 통해 환자의 증상과 비정상 관절경 소견을 임상적으로 연관 시키는 것이 중요하며, 적절한 환자의 선택과 고관절경의 술기에 대한 항상성을 유지할 수 있어야 최소 침습적인 술기의 장점을 가지고 있는 고관절경의 만족할 만한 치료 결과를 기대할 수 있다.

• Journal of Chest Surgery
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• v.47 no.1
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• pp.66-70
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• 2014

A 10-year-old boy with arteriovenous malformation (AVM) of the right lower limb was scheduled for an amputation of the affected limb. Limb amputation was necessary because of the ineffectiveness of previous sclerotherapy and the rapid progression of AVM causing pain and heart failure. Right hip disarticulation was considered the best option to improve his quality of life. To prevent congestive heart failure and uncontrollable hemorrhage during surgery, the disarticulation was done under a partial cardiopulmonary bypass. The patient underwent surgery successfully without complications.

• Korean Journal of Adult Nursing
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• v.18 no.5
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• pp.819-827
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• 2006

Purposes: The purpose of this study was to evaluate the extent of performance on activities in critical pathway (CP) according to eight domains and six admission days on nursing records of patients who received total hip replacement surgery. Methods: We reviewed 90 nursing records of patients who received total hip replacement surgery from June, 2004 to July, 2005 at C University Hospital. Data were collected using Hong's CP (2002) and were analyzed using ANOVA. Results: The domain of diet was valued the highest in CP performance scoring, followed by the domains of assessment, activities, and test. There were differences in the performance scores according to the period of admission in all of the domains. Among 132 activities in the CP, 18 activities were completely performed, of which most included activities belonging to the domain of assessment on the admission day. Twelve activities were never performed, of which most included activities belonging to the domain of treatment on the day of operation and the first day after operation. Conclusions: Therefore, further studies on the development of a new system to increase CP utilization and on updating the contents of CP from the best practice based on evidence is recommended.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.31-39
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• 2008

After the introduction of ultrasound enabling a detailed view of both neonatal hip instability and morphology, two different streams have developed: one arguing that neonatal hip instability is the major pathology warranting treatment, the other including acetabular dysplasia as an important feature. Graf's method including the acetabular dysplasia led to higher treatment and follow-up rate than that based upon neonatal hip instability only. Recent report suggested that improved examination techniques and a better understanding of the findings have enabled a more tailored approach, and no differences in treatment rates exist due to different ultrasound techniques. I'd like to emphasize that enough experiences and the understanding enabling standardized examination and high repeatbility is more important than the choice of different techniques. Here the mothods and meanings of different techniques of ultrasound and its usefulness in the diagnosis and treatment of DDH is discussed.

• Clinical Pain
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• v.19 no.1
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• pp.54-58
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• 2020

Skeletal muscle metastasis of gastric cancer is extremely rare and is associated with various symptoms. Here, we report on a 60-year-old woman with right hip pain after excessive walking. Two years earlier, the patient had been treated for advanced gastric cancer (surgery, adjuvant chemotherapy). Upon magnetic resonance imaging, diffuse muscle swelling and high signal intensity were observed in T2-weighted images of the right hip muscle. However, the FDG uptake in the right gluteal muscles was not obviously increased. Pathological examination of muscle biopsy revealed metastatic adenocarcinoma of stomach origin. The patient was treated with chemotherapy, and the swelling and pain in the right hip are progressively improving.

• Clinical and Experimental Pediatrics
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• v.65 no.5
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• pp.262-268
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• 2022

Background: The delayed diagnosis of developmental dysplasia of the hip (DDH) requires complex treatment and sometimes progresses to hip osteoarthritis. Purpose: This study aimed to evaluate the risk factors and screening time for DDH in preterm infants. Methods: A total of 155 preterm infants with a gestational age <32 weeks screened for DDH with ultrasonography were enrolled in this retrospective chart review. Results: The incidence of DDH was 6.45% (10 of 155). Gestational age, birth weight, sex ratio, and breech presentation did not differ significantly between infants treated for DDH (n=10) and nontreated infants (n=145) (gestational age, 29.2±1.4 weeks vs. 29.6±2.0 weeks, P=0.583; birth weight, 1,240±237 g vs. 1,295±335 g, P=0.607; female sex, 7 of 10 (70.0%) vs. 77 of 145 (53.1%), P=0.346; and breech presentation, 5 of 10 (50.0%) vs. 43 of 145 (29.7%), P=0.286, respectively). Performing the first ultrasonography earlier than 38 weeks of postmenstrual age (PMA) increased the risk of an abnormal finding by 3.76 times compared to performing it at ≥38 weeks of PMA. These abnormal findings on ultrasonography resolved spontaneously. Breech presentation increased the risk of minor abnormal findings on the first ultrasonography by 3.11 times versus nonbreech presentation and resolved spontaneously. DDH in preterm infants did not occur predominantly on the left side or in infants born with breech presentation. Conclusion: Performing ultrasonography screening earlier than 38 weeks of PMA caused unnecessary subsequent ultrasonography and overtreatment. Breech presentation was not a risk factor for DDH in preterm infants. However, breech presentation could increase the risk of minor abnormal findings at the 1st ultrasonography compared to nonbreech presentation, which resolved spontaneously. The etiology and risk factors for DDH in preterm infants are somewhat different from those for DDH in term infants.

• Pediatric Infection and Vaccine
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• v.29 no.3
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• pp.173-178
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• 2022

Streptococcus intermedius is a small, non-motile, Gram-positive, non-sporeforming, and aerotolerant anaerobic coccus. It is a part of the normal microflora in the oral cavity and upper respiratory, gastrointestinal and female urogenital tracts. It is an opportunistic pathogen that causes serious infections in patients with immunocompromised states or cardiac diseases as a result of trauma or invasive procedures. We describe a case of septic arthritis of the hip caused by S. intermedius in an immunocompetent healthy 7-year-old boy without a history of periodontal disease or invasive procedures. He had hip joint pain three weeks ago, and the fever began on the day of the visit. He had been healthy and had not undergone any invasive procedures recently. Septic arthritis of the hip was indicated in the magnetic resonance imaging of the hip. S. intermedius was identified in the hip joint fluid aspiration and blood culture. He was successfully treated with surgical intervention and antibiotic therapy with ceftriaxone followed by amoxicillin for five weeks.