• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.183-189
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• 2021

Arthrodesis is one of the last options available to obtain a stable, painless knee in patients who are unable to undergo reconstructive surgery due to a damaged knee joint. A variety of techniques have been used, including external fixation, internal fixation by compression plates, intramedullary fixation through the knee with a modular nail, and antegrade nailing through the piriformis fossa. Another option is the use of a short nail such as the Neff nail, the Wichita nail, or the Huckstep nail, but there are no commercial short nails available for use in Korea. This technical report describes a technique for knee arthrodesis using a retrograde femoral intramedullary nail.

• Journal of Korean Foot and Ankle Society
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• v.20 no.1
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• pp.50-53
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• 2016

We report on a rare case of an intraosseous epidermoid cyst in the distal phalanx of the great toe with concurrent infection in a 71-year-old woman with diabetes mellitus. The lesion was initially considered simple infectious arthritis and concomitant osteomyelitis in a patient with diabetes. However, after surgery, an intraosseous epidermoid cyst originating from the nail bed and involving the articular surface of the distal phalanx was detected. The epidermoid cyst may have contributed to the infectious arthritis in the interphalangeal joint. The lesion was treated via mass excision, arthrotomy, debridement, and intravenous antibiotics.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.202-207
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• 2014

Purpose: The purpose of this study was to evaluate the radiological and clinical outcomes of tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail for patients with complex hindfoot problems, including Charcot arthropathy, osteonecrosis of talus, combined arthritis of the ankle and subtalar joint, failure of previous ankle arthrodesis, and failed total ankle arthroplasty. Materials and Methods: Eighteen consecutive patients (10 men and 8 women) with an average age of 54 years (range, 42~72 years) underwent tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail fixation. The mean duration of follow-up was 16 months (range, 12~23 months). Radiological evaluation included assessment of the union status of ankle and subtalar joints. Clinical evaluations included visual analogue scale (VAS) for pain and patient satisfaction, and postoperative complications were analyzed. Results: Radiological union was achieved in 14 ankle joints (77%) and 16 subtalar joints (88%) at an average of 16 weeks (range, 14~40 weeks) and 14 weeks (range, 12~24 weeks), respectively. The preoperative VAS were 4.6 (range, 4~8) at rest and 8.2 (range, 7~10) during walking, and the postoperative VAS were 2.2 (range, 0~3) and 4.6 (range, 4~6), respectively (p<0.05). There were 6 nonunions (4 ankle joints and 2 subtalar joints), 3 tibia fractures, 2 delayed union of ankle joints, and 2 breakage of the implant. Conclusion: Tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail may be considered as a viable option in patients with complex hindfoot problems.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.2
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• pp.161-164
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• 2006

Malignant bone tumor in distal tibia is a rare condition which has been treated by amputation. Although widely accepted, limb salvage surgery in this area poses difficulties with respect to reconstruction. We present one patient with distal tibial osteosarcoma treated by performing limb salvage and reconstructing with retrograde IM nail and pasteurized bone.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.1
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• pp.1-9
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• 2013

Purpose: The purpose is to perform objective evaluation for rotator cuff using ultrasonography and validate factors influencing cuff integrity as well as efficacy of follow-up ultrasonography after unreamed antegrade intramedullary nailing for humerus fracture. Materials and Methods: Seventeen patients with an average age of $55.7{\pm}18.6$ years underwent antegrade intramedullary nailing for humerus fracture and follow-up ultrasonography of shoulder joint. Mean follow-up period was $43.5{\pm}32.2$ months. Intraoperative evaluation for preoperative cuff tear was performed, of which four cuffs were repaired by single row repair technique. Clinical evaluation included visual analogue scale (VAS), range of motion, Korean Shoulder Scoring System (KSS) and American Shoulder and Elbow Society (ASES) score. Ultrasonographic evaluation was performed on cuff integrity and protrusion of proximal nail tip as well. Radiographic evaluation included time to union, protrusion of proximal nail tip and migration of proximal interlocking screw which could affect shoulder joint function. Results: Mean VAS at last follow-up was $1.65{\pm}1.84$ points. Range of motion showed forward flexion of $137.0{\pm}33.5^{\circ}$, external rotation of $43.5{\pm}12.7^{\circ}$ and internal rotation of $16.4{\pm}2.0^{\circ}$ while KSS score and ASES score were $79.6{\pm}20.7$ and $83.7{\pm}17.0$ points, respectively. Bone union was demonstrated in all cases and average time to union was $3.4{\pm}1.3$ months. Migration of proximal interlocking screw was shown in 6 cases (35%). On ultrasonographic evaluation, there were normal in 8 (47%), weaving in 4 (24%), partial tear in 5 cases (29%), but no complete tear. Protrusion of proximal nail tip was demonstrated in 8 cases (47%) on plain radiographs whereas in 11 cases (65%) on ultrasonography and was associated with increasing age (p=0.038). Ultrasonographic weaving and partial tear was associated with protrusion of proximal nail tip (p=006), but not with repair of preoperative tear (p>0.05). Conclusion: Because weaving and partial tear on ultrasonography originated from protrusion of proximal nail tip, careful insertion of nail and meticulous repair of cuff during operation lead to stable fixation with satisfactory recovery of shoulder function follow-up ultrasonography can be a useful tool for evaluating protrusion of nail tip and rotator cuff tear, of which diagnosis is difficult on plain X-ray after antegrade intramedullary nailing for humerus fracture.

• Journal of Korean Physical Therapy Science
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• v.5 no.4
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• pp.717-728
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• 1998

The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

• Clinics in Shoulder and Elbow
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• v.18 no.2
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• pp.91-95
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• 2015

Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.2
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• pp.105-111
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• 1997

From 1988 to 1997, we experienced 11 cases of glomus tumor in fingers(10 cases) and toe(1 case). All patients were female, and showed typical pain, tenderness, and cold sensitivity of the lesions. The locations were subungal in nine cases and in pulp from distal phalangeal bone in two cases. Three patients had histories of one or two failed previous operations, and two patients had another glomus tumor in their bodies. All except one had satisfactory results subjectively and without complications. One patient was operated by the excision of the tumor including germinal matrix and surrounding tissues of nail bed, and had a nail deformity in follow-up. The glomus tumor is not malignant to recur or metastasize in the case of complete excision. However, the surgeon should be alert not to injure or repair the nail bed meticulously after the excision of the tumor to prevent a late deformity of nail.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.9-14
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• 2006

Purpose: The proximal tibial sarcoma patients, especially in their growing ages have problems of reconstruction. This study is to devise a methodology which can circumvent this limitations. Materials and Methods: Four cases of proximal tibial osteosarcoma underwent hemiarthroplasty. The mean age was 13 years (11~15) with a mean follow-up of 64 months (47~89). The procedure consists of ultrahigh molecular weight polyethylene (UHMWPE) liner as an substitute for the joint surface and this piece was fixed to the remaining tibial bone stock with Ender nail and bone cement. Results: Final functional score was 23.5 (78.3% of control) by MSTS criteria. All the cases showed stable joint without pain. Hemiarthroplasty related complications were absent. By saving the femoral physis, expected leg length discrepancy could be minimized by this procedure. Conclusions: Hemiarthroplasty of proximal tibia can be an option in pediatric sarcoma patients.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.388-399
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• 1993

The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993, 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft fractures. 3. The Interlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of fracture and then made early joint motion exercise and ambulation.