• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.75-80
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• 2020

Purpose: The purpose of this study is to evaluate the results of Kidner procedure combined with medial displacement calcaneal osteotomy (MDCO) in patients with the symptomatic accessory navicular with hindfoot valgus. Materials and Methods: From January 2014 to January 2019, fifteen patients (15 cases) who had undergone a Kidner procedure combined with MDCO for symptomatic accessory navicular with hindfoot valgus were included. Their mean age was 36.3 years old (19~61 years old) and there were 6 males and 9 females. The clinical results were evaluated using visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, and postoperative subjective satisfaction. The radiographic results were evaluated using the talonavicular coverage angle and the anteroposterior talo-first metatarsal angle, the lateral talo-first metatarsal angle, the calcaneal pitch angle, and the hindfoot alignment angle. The postoperative complications were also evaluated. Results: The VAS and AOFAS midfoot scores continuously improved until 12 months after surgery. Subjective satisfaction after surgery was excellent in 10 cases and good in 5 cases. The hindfoot alignment angle significantly changed after surgery. Pain due to lateral impingement disappeared in five patients, and persisted in one patient. Five patients complained of irritation caused by their fixation devices, and all the symptoms improved after removal of the fixation devices. Conclusion: Kidner procedure combined with MDCO in patients with the symptomatic accessory navicular with hindfoot valgus showed good clinical results with satisfactory correction of hindfoot valgus. In particular, the clinical results showed continuous improvement until 12 months after surgery.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.187-192
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• 2005

Objective: Spinal myeloma has been treated with radiation therapy and chemotherapy. However, the role of surgery was not fully evaluated. This study is performed to evaluate the efficacy of surgery in the treatment of spinal myeloma. Methods: 22 patients who were treated with surgery for spinal myeloma from August 1999 to April 2003 were analyzed. Radiological finding, surgical methods and result were reviewed in retrospective study. For compression fracture due to myeloma infiltration, percutaneous vertebroplasy(PVP) was done. Decompression surgery with or without fixation was performed for patients with neurologic deficit. The modalities of surgery consist of PVP (14 cases), corpectomy and fixation (7 cases), and laminectomy and epidural mass removal (3 cases). To evaluate clinical outcome, visual analogue pain score and Frankel neurological scale were used. Results: In 14 cases of PVP, total 57 vertebral segments were treated including 21 thoracic vertebral bodies and 36 lumbar vertebral bodies. Pain relief was achieved in all cases. The pain score changed from 7.7 (preoperatively) to 2.5 (postoperatively). And pain relief effect was maintained over than one year. Frankel grade improved in decompression cases. Conclusion: Surgical treatment can alleviate pain and improve neurologic deficit immediately in spinal myeloma patients.

• Journal of Korean Neurosurgical Society
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• v.57 no.2
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• pp.100-107
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• 2015

Objective : To report a minimally invasive treatment option using percutaneous pedicle screw fixation with adjuvant treatment for metastatic thoraco-lumbar and lumbar spinal tumors. Methods : This is a retrospective study of charts of patients with spinal metastases. All were older than 18 years of age and were considered to have more than 3 months of life expectancy. The patients had single or two level lesions, and compression fracture or impending fracture. Exclusion criterion was metastasis showing severe epidural compression with definite neurological symptoms. Usually spinal segments from one level above to below pathology were stabilized. Visual analog scale (VAS) score for pain assessment and Frankel scale for neurological deficit were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Twelve patients (nine men, three women; median age 54.29 years) underwent surgery. All patients presented with back pain with/without radicular pain. There were no early complications and perioperative mortalities. Following surgery, a significant difference between average pre- and post-operative VAS scores was found (p=0.003). Overall, 91.8% of patients (11/12) experienced improvement in their ECOG score post-operatively. The mean ambulation time was 196.9 days [95% confidence interval (CI), 86.2-307.6 days; median, 97 days]. During follow-up, nine patients died and the mean overall survival time in enrolled twelve patients was 249.9 days (95% CI, 145.3-354.4 days; median, 176 days). Conclusion : Minimally invasive treatment using percutaneous pedicle screw fixation with adjuvant treatment is a good alternative treatment option for potential instability of the thoraco-lumbar and lumbar spinal metastasis.

• Archives of Plastic Surgery
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• v.43 no.2
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• pp.189-196
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• 2016

Background Several techniques have been designed to treat fifth metacarpal fractures reported to be effective. However, these methods cannot be easily applied to the fourth metacarpal due to its central anatomical position. In this study, we sought to analyze the functional outcomes of patients who underwent transverse pinning for a fourth metacarpal bone fracture. Methods A total of 21 patients were selected and their charts were retrospectively reviewed. After fracture reduction, two transverse Kirchner wires were first inserted from the fifth metacarpal to the third metacarpal transversely at the distal part of the fractured bone, and then another two wires were inserted at the proximal part of the fractured bone. The splint was removed approximately one week postoperatively and the Kirchner wires were removed four to five weeks postoperatively. Patients started active and passive exercise one week after the operation. Pain visual analog scores, total active and passive motion, and the active and passive range of motion of the metacarpophalangeal joint and grip strength were evaluated. Results Dorsal angulation improved from a preoperative value of $44.2^{\circ}$ to a postoperative value of $5.9^{\circ}$. Six weeks after surgery, functional recovery parameters, such as range of motion and grip strength, had improved to 98% of the function of the normal side. No major complication was observed. Conclusions We suggest that the transverse pinning of fourth metacarpal bone fractures is an effective treatment option that is less invasive than other procedures, easy to perform, requires no secondary surgery, minimizes joint and soft tissue injury, and allows early mobilization.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.55-59
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• 2009

Purpose: We tried to evaluate the usefulness of the arthroscopy in the operative treatment of intra-articular calcaneal fracture. Materials and Methods: Between March 2005 and May 2008, 9 patients with intra-articular calcaneal fractures（Tongue type or Sanders type IIC) were treated with arthroscopically assisted percutaneous reduction and screw fixation. American orthopedic foot and ankle society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS), preoperative and postoperative Bohler's angle and the rate of complication were evaluated. Results: AOFAS score at postoperative 1 year was 88.2 (range, 71-92), and mean VAS score was 2.8 (range, 1-4). Bohler angle was improved from preoperative mean $16.2^{\circ}$ to postoperative mean $29.7^{\circ}$. There were no complications such as wound problem, infection or nerve injury. Conclusion: Subtalar arthroscopy provides precise view of posterior facet during the operation. Therefore, it can be a useful tool in treating intra-articular calcaneus fractures, especially tongue type and Sanders type IIC fractures.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.131-140
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• 2019

Purpose : The purpose of this study was to investigate the interrelationship between eye movement and auditory function through the effects of eye lateralization on transient evoked otoacoustic emissions of auditory function. Methods : 25 subjects with complete set of ears were used in this study, which composed of 12 males and 13 females with pure tone threshold of below 25 dB without otolaryngology were evaluated. Each of the patient has a visual acuity of greater than 1.0 after correction, and has no problems with eye disease, eye movement, and human parallel system. In a dark silent room, the subjects sat on a chair with their heads fixed on a headrest. The tests were performed by asking the patients to look at a fixed red light dot on a light bar in front of them. This light was directed to the front, right and left sides of the subject at an angle of 40 ° In the presence of the stimulus sound in the ipsilateral ear, the transient evoked otoacoustic emissions of the ipsilateral ear was measured at the straight, right and left fixation. In order to evaluate the transient evoked otoacoustic emissions through the efferent auditory pathway, the transient evoked otoacoustic emission values of the contralateral ear were measured at the straight, right and left fixation. These measurements were taken at frequencies of 1 kHz, 1.4 kHz, 2.0 kHz, 2.8 kHz and 4 kHz, respectively. Results : Transient evoked otoacoustic emissions caused by lateral movement of the eye showed significant changes at 1.4 KHz and 2 KHz of the afferent pathway of the ipsilateral ear. Also, significant changes were observed at 1.4 KHz and 4 KHz of the efferent pathway of the contralateral ear. Conclusion : These results indicated that there is a close relationship between eye movement and auditory cochlea. In the future, further studies considering more diverse subjects and age groups will be needed.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.234-239
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• 2018

Background: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved <50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation. Methods: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving <50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery. Results: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms. Conclusions: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving <50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.220-226
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• 2018

Background: This study introduces a surgical technique with good clinical outcome useful in the treatment of osteoporotic displaced 3- or 4-part proximal humeral fractures. Methods: From May 2014 to February 2016, 16 patients with displaced 3- or 4-part proximal humeral fractures were treated by application of a locking plate with an endosteal strut allograft via a deltoid splitting approach with a minimum follow-up of 12 months. The allograft was inserted through a fractured gap of the greater tuberosity to support the humeral head and then fixed by a locking plate with meticulous soft tissue dissection to protect the axillary nerve. Surgical outcomes were evaluated by the American Shoulder and Elbow Surgeons (ASES) and visual analogue scale (VAS) scores, radiological imaging, and clinical examination. Fixation failure on radiographs was defined as a >$5^{\circ}$ loss of neck shaft angle (NSA) compared to that on an immediate postoperative radiograph. Avascular necrosis (AVN) of the humeral head was also evaluated. Results: In all cases, complete union was achieved. The ASES and VAS scores were improved to $85.4{\pm}2.1$ and $3.2{\pm}1.3$, respectively. Twelve patients (75.0%) had greater than a $5^{\circ}$ change in NSA; the average NSA change was $3.8^{\circ}$. Five patients (31.3%) had unsatisfactory ranges of motion exhibiting a <$100^{\circ}$ active forward flexion. No axillary nerve injuries or AVN were observed at the last follow-up. One patient was converted to reverse total arthroplasty due to severe pain and functional deficit. Conclusions: Minimally invasive fixation via a locking compression plate and an endosteal fibula strut allograft in Neer classification 3-or 4-part fractures with severe osteoporosis in elderly patients can achieve good clinical results.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.288-295
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• 2022

Background: There is no standardized therapeutic strategy for locked posterior shoulder fracture-dislocation (PSFD), and no consensus exists on the analysis of preoperative factors. This retrospective study aimed to evaluate functional results and complications in a series of PSFD cases managed with open surgical treatment. Methods: Patients diagnosed with locked PSFD who underwent open surgical treatment with reduction and osteosynthesis between April 2016 and March 2020 were included. All participants were treated with open reduction and internal fixation. Functional assessment used the modified University of California, Los Angeles (UCLA) mod scale, American Shoulder and Elbow Surgeons (ASES) questionnaire, subjective shoulder value (SSV), and visual analog scale (VAS). Complications were evaluated clinically and radiologically by X-ray and computed tomography. Results: Twelve shoulders were included (11 patients; mean age, 40.6 years; range, 19- 62 years). The mean follow-up duration was 23.3 months (range, 12-63 months). The UCLA mod, ASES, SSV, and VAS scores were 29.1±3.7, 81.6±13.5, 78±14.8, and 1.2±1.4 points, respectively. The overall complication rate was 16.6%, with one case of post-traumatic stiffness, 1 case of chronic pain, and no cases of avascular necrosis. Conclusions: Open surgical treatment of locked PSFD can achieve good functional results. A correct understanding of these injuries and good preoperative planning helped us to achieve a low rate of complications.

• Clinics in Shoulder and Elbow
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• v.26 no.1
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• pp.3-9
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• 2023

Background: Modifications of the medialized design of Grammont-type reverse shoulder arthroplasty (RSA) using a bony increased offset (BIO-RSA) has shown better clinical results and fewer complications. The aim of this study is to compare the clinical results, complications, and radiological outcomes between patients undergoing standard RSA and BIO-RSA. Methods: A retrospective review was performed of 42 RSA procedures (22 standard RSA and 20 BIO-RSA). With a minimum of 1 year of follow-up, range of motion (ROM), Constant shoulder score (CSS), visual analog scale (VAS), and subjective shoulder score (SSS) were compared. Radiographs and computed tomography (CT) scan were examined for scapular notching, glenoid and humeral fixation, and graft healing. Results: At a mean follow-up of 27.6 months (range, 12-48 months), a significant difference was found for active-internal rotation (P=0.038) and for passive-external rotation (P=0.013), with better results in BIO-RSA. No other differences were found in ROM, CSS (P=0.884), VAS score, and SSS. Graft healing and viability were verified in all patients with CT scan (n=34). The notching rate was 28% in the standard RSA group and 33% in the BIO-RSA group, but the standard RSA had more severe notching (grade 2) than BIO-RSA (P=0.039). No other significative differences were found in glenoid and humeral fixation. Conclusions: Bone-graft lateralization is associated with better internal and external rotation and with less severe scapular notching compared to the standard RSA. Integration of the bone graft occurs effectively, with no relevant changes observed on radiographic evaluation. Level of evidence: III.