Young Joon Ahn

The Use of Allograft Prosthesis Composite for Extensive Proximal Femoral Bone Deficiencies: A 2- to 9.8-Year Follow-Up Study

We report here results for 15 hips that we repaired using allograft prosthesis composite (APC) and monitored for a mean of 4.2 years. Two hips underwent repeat revisions with new APCs after a mean of 83.7 months. The average Harris Hip Score improved from 21.8 before revision surgery to 83.2 afterward, and 12 stems showed good stability. Of the 15 hips repaired with APC, 13 had good junctional union. One of the 2 remaining hips showed nonunion, which was repaired with an onlay graft 3.3 years later, and the other hip showed both infection and nonunion. There was 1 dislocation, and 2 hips had complications related to the greater trochanter. Our findings demonstrate that the use of APC produces satisfactory results.

Ischial Tuberosity Avulsion Stress Fracture after Short Period of Repetitive Training.

Fatigue fracture of the pelvis is the form of fracture due to repetitive micro-stress accumulation, can be affected by a number of factors such as patients nutritional status, biomechanics, social status and so on. Still there is no study about precise standard degree of external force that lead to stress fracture, but it may caused by compression force, traction force or complex force and others. Avulsion stress to ischial tuberosity or anterior superior iliac spine by attached muscle is known as the main factor for the avulsion fracture. This report will deal with 19 years old conscripted policeman who occurred ischial tuberosity avulsion fracture after training of 6-hour running for 5 days accompanying hip hyper-flexion motion. This reports aims to provide case study of stress fracture occurred after 5 days of exercise which is relatively short period who had no specific trauma history or pain.

Characterizing the Progression of Varying Types of Calcific Tendinitis around Hip.

Purpose To assess the progression of clinical symptoms and disease course of calcific tendinitis in the hip region according to types of calcification. Materials and Methods Among patients with the hip pain, 28 patients (21 males and 7 females; mean age 51 years, range 32-74 years) showing calcified lesions in simple radiography without other possible sources of pain were analyzed retrospectively. Twelve patients displayed a symptom duration of less than three weeks (acute; average=1±0.9 week) and 16 displayed greater than three weeks (chronic; average=21.0±19.5 weeks). Lesions were classified as nodular (11, 39.3%), nodular-fragmented (13, 46.4%), or amorphous (4, 14.3%). Initial symptoms, progression of clinical features, radiological findings and prognosis were investigated and analyzed according to calcification type. Results In 15 patients (53.6%), lesions were located superior to the great trochanter. On average, the acute group was younger (44.58 vs. 55.44 years, P=0.006), suffered more (mean pain Numeric Rating Scale [NRS], 6.3 vs. 3.8; P<0.001), and recovered more (difference between initial and follow-up NRS, 5.1 vs. 2.63; <<0.001) than the chronic group. The mean length of initial lesions was longer in the acute group than the chronic group (15.8 vs. 9.1 mm, P=0.008). When compared to patients with distinctive margins (15, 53.6%), those with nondistinctive margins showed better improvement (difference between initial and follow-up NRS, 4.7 vs. 2.8; P=0.01) and more significant decrease in lesion size (difference between initial and follow-up length, 10.8 vs. 2.6 mm; P=0.003). Conclusion Calcific tendinitis occurring in the hip area displayed a variety of characteristics. Although complaining of more severe pain in the initial phase, patients with acute pain or calcific lesions with nondistinctive margins showed better symptom improvement when compared to their counterparts.

Bilateral Necrotizing Fasciitis around the Hips Differentiated from Fournier Gangrene: A Case Report

As an emergency encountered in orthopedic practice requiring prompt diagnosis and aggressive treatment, necrotizing fasciitis around the hip must be discriminated from Fournier gangrene. The current case report describes a patient who suffered from bilateral type I necrotizing fasciitis around the hips, which was alleviated by prompt surgical debridement and intensive postoperative care.

Snapping Knee caused by the Semitendinous Tendon - A Case Report -

Snapping syndrome has rarely been reported in the knee. A snapping knee mainly occurs in the case of a translation of the lateral meniscus or a lateral discoid meniscus. Other causes include biceps femoris tendon, semitendinosus iliotibial band, and popliteus tendon. We recently experienced a case of a snapping knee caused by the semitendinosus tendon passing over the medial tibial condyle as a result of trauma.

The Necessity of Deltoid Ligament Repair in Lateral Malleolar Fracture Combined with Medial Clear Space Widening.

목 적: 족관절의 내측 관절 이개를 동반한 외과골절에 대한 수술적 치료 시 파열된 삼각인대에 대한 수술적 복원의 필요성을 알아보고자 하였다. 대상 및 방법: 1996년 1월부터 2002년 2월까지 내측 관절 이개를 동반한 족관절 외과골절로 진단받은 환자 중, 82명의 환자, 82례를 대상으로 하였다. 6 mm 이상의 이개를 보였던 9례에 대하여는 외측 고정과 함께 삼각인대 봉합술을 시행하였으며, 73례는 외측 도달법 만으로 외과골 절 정복 후 정복이 된 경우에는 수술을 마쳤고, 정복되지 않은 경우에는 관통나사못 고정술 만을 시행하여 정복을 시도하였으며, 삼각인대 봉 합술은 실시하지 않았다. 결 과: 외과골절에 대한 정복 및 내고정 만으로 73례 중 65례에서 만족할만한 정복이 이루어졌고, 관통나사못이 필요하였던 경우는 8례였다. 삼각인대 봉합술이 추가적으로 필요하였던 경우는 한 례도 없었다. 최종 추시 시점에 시행한 임상적 평가에서 족관절 운동제한을 보인 례는 한 례도 없었으나, 6례에서 보행시 경도의 통증을 호소하였으며 92%에서 우수, 8%에서 양호의 결과를 보였으며 보통과 불량은 없었다. 방사 선학적 평가에서 술전 평균 내측 관절 이개는 5.89 mm (4.5~13 mm)였고, 최종 추시 시점에 시행한 단순 방사선 소견 상 평균 내측 관절 이 개는 2.54 mm (1.5~3.5 mm)로 95.2%에서 양호 이상의 결과를 보였다. 결 론: 삼각인대 파열로 인한 내측 관절 이개를 동반한 족관절 외과골절의 치료에 있어서, 외과골절에 대한 해부학적 정복 및 내고정 혹은 외 측 면으로부터의 관통나사못 고정을 추가함으로써 만족할만한 결과를 얻을 수 있으며, 이 경우 내측의 삼각인대 손상에 관한 관혈적 봉합술은 필요치 않을 것으로 사료된다.