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Case reports
Shunt fracture as a sequela of cervical spine manipulation: a case report
El Kim
J Yeungnam Med Sci. 2023;40(Suppl):S109-S112.   Published online July 17, 2023
DOI: https://doi.org/10.12701/jyms.2023.00479
  • 1,345 View
  • 41 Download
AbstractAbstract PDF
Shunt disconnection is an unreported complication of spinal mobilization and manipulation. We present the case of a young adult who underwent cystoperitoneal (CP) shunt placement for an arachnoid cyst at the age of 6 years. The shunt remained functional during a follow-up period of 11 years. The patient was admitted with headache and diplopia that started after cervical manipulation by a chiropractor. Radiography revealed fracture of the distal catheter and resultant enlargement of the temporosylvian cyst. The patient required replacement of the disconnected tubing caudal to the shunt valve. The distal catheter ruptured immediately below the outlet connector of the valve. The symptoms and signs resolved completely after insertion of a new distal tube into the peritoneum. This case report demonstrates that chiropractic manipulation of the neck may be a cause of tubing breakage in patients with CP shunts.
Transient osteoporosis of the hip with a femoral neck fracture during follow-up: a case report
Yusuke Tabata, Shuhei Matsui, Masabumi Miyamoto, Koichiro Omori, Yoichiro Tabata, Tokifumi Majima
J Yeungnam Med Sci. 2023;40(2):212-217.   Published online September 26, 2022
DOI: https://doi.org/10.12701/jyms.2022.00479
  • 4,434 View
  • 64 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
We report a case of transient osteoporosis of the hip with a femoral neck fracture found during follow-up. A 53-year-old man presented with left hip pain without trauma. The pain did not improve after 2 weeks and he was brought to our hospital by ambulance. Magnetic resonance imaging (MRI) of the left hip joint showed diffuse edema in the bone marrow, which was identified by low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and increased signal intensity on short tau inversion recovery. This edema extended from the femoral head and neck to the intertrochanteric area. He was diagnosed with transient osteoporosis of the left hip. Rest gradually improved his pain; however, 3 weeks later, his left hip pain worsened without trauma. X-ray, computed tomography, and MRI results of the hip joint demonstrated a left femoral neck fracture, and osteosynthesis was performed. Differential diagnoses included avascular necrosis of the femoral head, infection, complex regional pain syndrome, rheumatoid arthritis, leukemia, and other cancers. Transient osteoporosis of the hip generally has a good prognosis with spontaneous remission within a few months to 1 year. However, a sufficient length of follow-up from condition onset to full recovery is necessary to avoid all probable complications such as fractures.

Citations

Citations to this article as recorded by  
  • Hip effusion/synovitis influences results after multiple drilling core decompression for bone marrow edema syndrome of hip
    Hua-zhang Xiong, Yan-li Peng, Yu-hong Deng, Ying Jin, Ming-hong Tu, Shu-hong Wu
    BMC Surgery.2023;[Epub]     CrossRef
Review article
Avulsion injuries: an update on radiologic findings
Changwon Choi, Sun Joo Lee, Hye Jung Choo, In Sook Lee, Sung Kwan Kim
Yeungnam Univ J Med. 2021;38(4):289-307.   Published online August 13, 2021
DOI: https://doi.org/10.12701/yujm.2021.01102
  • 10,127 View
  • 205 Download
  • 4 Crossref
AbstractAbstract PDF
Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.

Citations

Citations to this article as recorded by  
  • Surgical management of posterior ligament complex stripping in an adolescent spinal flexion distraction injury: A case report and literature review
    Dong-Ju Lim
    International Journal of Surgery Case Reports.2024; 114: 109195.     CrossRef
  • Ischial Tuberosity Avulsion Fracture Mimicking Calcified Mass on Plain Films: A Case Report
    Mason A Williams, Lena Naffaa
    Cureus.2024;[Epub]     CrossRef
  • ESR essentials: MRI of the knee—practice recommendations by ESSR
    Anagha P. Parkar, Miraude E. A. P. M. Adriaensen
    European Radiology.2024;[Epub]     CrossRef
  • Isolated fracture of the lesser tuberosity of the humerus – a rare injury that requires surgical treatment
    Miodrag Glisic, Vladan Stevanovic, Aleksandar Jevtic, Uros Jovicevic, Ivan Jankovic
    Vojnosanitetski pregled.2023; 80(3): 279.     CrossRef
Case Report
Treatment of Bilateral Hawkins Type II Talar Neck Fractures.
Jee Hoon Kim, Jung Rae Kim, Chul Hyun Park
Yeungnam Univ J Med. 2013;30(2):124-127.   Published online December 31, 2013
DOI: https://doi.org/10.12701/yujm.2013.30.2.124
  • 1,852 View
  • 2 Download
AbstractAbstract PDF
Talus fracture is less common than most fractures, and bilateral talar neck fracture is extremely rare. Complications associated with talus fractures are generally deemed common because of the anatomical characteristics of the talus, but few reports have described the methods of treating such complications and the results of bilateral talar neck fracture. We report here a case of bilateral Hawkins type II talar neck fracture that had good clinical results without complications after early surgical treatment.
Original Article
In Vivo and In Vitro Studies of the Steady State Free Precession-Diffusion-Weighted MR Imagings on Low b-value: Validation and Application to Bone Marrow Pathology.
Woo Mok Byun
Yeungnam Univ J Med. 2007;24(2):119-128.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.119
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  • 1 Download
AbstractAbstract PDF
PURPOSE: The purpose of this study was a phantom study to measure the diffusion properties of water molecules by steady-state free precession diffusion-weighted imaging (SSFP-DWI) with a low b-value and to determine if this sequence might be useful for application to the evaluation of bone marrow pathology. MATERIALS AND METHODS: 1. The phantom study: A phantom study using two diffusion weighted sequences for the evaluation of the diffusion coefficient was performed. Three water-containing cylinders at different temperatures were designed: phantom A was 3degrees C, B was 23degrees C and C was 63degrees C. Both SSFP and echo planar imaging (EPI) sequences (b-value: 1000 s/mm2) were performed for comparison of the diffusion properties. The Signal to noise ratios (SNR) and apparent diffusion coefficient (ADC) values of the three phantoms using each diffusion-weighted sequence were assessed. 2. The Clinical study: SSFP-DWI was performed in 28 patients [sacral insufficiency fractures (10), osteoporotic lumbar compression fractures (10), malignant compression fractures (8)]. To measure the ADC maps, a diffusion-weighted single shot stimulated echo-acquisition mode sequence (650s/ mm2) was obtained using the same 1.5-T MR imager RESULTS: For the phantom study, the signal intensity on the SSFP as well as the classic EPI-based DWI was decreased as the temperature increased in phantom A to C. The ADC values of the phantoms on EPI-DWI were 0.13x10(-3) mm2/s in phantom A, 0.22x10(-3) mm2/s in B and 0.37x10(-3) mm2/s. in C. The SSFP can be regarded as a DWI sequence in view of the series of signal decreases. CONCLUSION: Bone marrow pathologies with different diffusion coefficients were evaluated by SSFP-DWI. All benign fractures were hypointense compared to the adjacent normal bone marrow where as the malignant fractures were hyperintense compared to the adjacent normal bone marrow.
Review Article
Ankle Fracture
Jong Chul Ahn
Yeungnam Univ J Med. 2007;24(2 Suppl):S12-23.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S12
  • 1,239 View
  • 3 Download
AbstractAbstract PDF
Ankle fractures are the most common types of fractures treated by orthopaedic surgeons. As a result of a better understanding of the biomechanics of ankle, improvements in fixation techniques, and findings of outcome studies, there has been a gradual evolution in the effective strategics for the treatment of ankle fractures. The goals of treatment continue to be both a healed fracture and an ankle that moves and functions normally without pain. The development of strategies for the treatment of various patterns of ankle injuries revolves around whether these goals can be achieved more predictably with surgical or nonsurgical means. Certain injury patterns have a better outcome after surgical treatment, while other pateerns are better managed without surgery. Surgical treatment is indicated when congruity of the joint cannot be restored with closed method.
Original Article
Treatment of Tibial Condyle Fracture.
Dong Chul Lee, Oog Jin Shon, Sung Hyuk Park
Yeungnam Univ J Med. 2003;20(2):177-186.   Published online December 31, 2003
DOI: https://doi.org/10.12701/yujm.2003.20.2.177
  • 1,593 View
  • 1 Download
AbstractAbstract PDF
BACKGROUND
Clinical and radiological results based on fracture types and associated injuries after the treatment of tibial plateau fracture were evaluated for analyzing prognostic factors. MATERIALS AND METHODS: From June 1997 to June 2002, 50 cases were followed for at least 1 year. Mean age was 47.4 years, and mean follow period was 30.0 months. Fracture classification was performed by the Schatzker method. Clinical and radiological evaluation were performed by the Porter and Rasmussen method. Evaluation was based on degree of reduction and associated injuries, etc. RESULTS: The most common cause of injury was traffic accident (37 cases, 74%), The common fracture types by Schatzker classification were type II (14 cases) and VI (12 cases). Methods of treatment were screw fixation (15 cases), plate and screw (21 cases), external fixator (5 cases), and conservative treatment (9 cases). The most common associated injuries were ipsilateral fibular fracture (18 cases) and MCL (medial collateral ligament) injury (8 cases). CONCLUSION: Acceptable results after treatment of tibial plateau fracture were obtained from the anatomical reduction group, non-associated injury group, the young age group, and the early ROM (range of motion) beginning group.
Review
Thoracolumbar Spine Injury.
Myun Whan Ahn
Yeungnam Univ J Med. 2002;19(2):73-91.   Published online December 31, 2002
DOI: https://doi.org/10.12701/yujm.2002.19.2.73
  • 1,505 View
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AbstractAbstract PDF
Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.
Case Report
Non-Surgical Treatment of Mandibular Condylar Fracture with Functional Appliance: Clinical and Radiographic Analysis of 1 Case.
Sang Deuk Chun, Jae Hwan Rho, Jae Chul Song, Byung Rho Chin
Yeungnam Univ J Med. 2002;19(2):144-150.   Published online December 31, 2002
DOI: https://doi.org/10.12701/yujm.2002.19.2.144
  • 1,485 View
  • 10 Download
AbstractAbstract PDF
Mandibular condylar fracture is common in mandibular fractures. Unlike other facial, skeletal fractures, most of mandibular condylar neck or head fractures are treated with closed reduction and subsequent functional therapy is essential for preventing complications including ankylosis, arthrosis and growth disturbance. From January, 2000 to September, 2002, we have treated 15 cases of mandibular condylar fractures with closed reduction by using functional appliance with bite block. Among these cases, we report a case of 14-year-old female with mandibular condylar neck fracture, resulted in good clinical and radiographic progress.
Original Articles
Operative Treatment of Tibial Plateau Fractures.
Duck Seop Shin, Byeong Yeon Seong, Dong Won Kim
Yeungnam Univ J Med. 2001;18(2):187-198.   Published online December 31, 2001
DOI: https://doi.org/10.12701/yujm.2001.18.2.187
  • 1,551 View
  • 1 Download
AbstractAbstract PDF
BACKGROUND
The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. MATERIALS AND METHODS: The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. RESULTS: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. CONCLUSION: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.
Vertebral compression fractures: distinction between benign and malignant causes with Tc-99m labeled antigranulocyte antibody immunoscintigraphy.
Ihn Ho Cho, Hyong Woo Lee, Sang Ho An, Kyu Chang Won, Jang Ho Bae, Soo Ho Cho
Yeungnam Univ J Med. 1998;15(2):254-262.   Published online December 31, 1998
DOI: https://doi.org/10.12701/yujm.1998.15.2.254
  • 1,542 View
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AbstractAbstract PDF
We evaluated the effectiveness of Tc-99m labeled antigranulocyte antibody immunoscintigraphy in differentiating the causes of vertebral compression fracture. This study involved 16 patients with vertebral compression fracture; 8 were due to trauma or osteoporosis, 3 were due to metastasis and 5 were due to tuberculous spondylitis. We retrospectively analyzed the location and the extent of decreased tracer uptake in tomographic images of Tc-99m labeled antigranulocyte antibody immunoscintigraphy. Eight patients had a 16 vertebral compression fractures due to trauma or osteoporosis , three patients had a 3 vertebral compression fractures due to metastasis and 5 patients had a 6 vertebral compression fractures due to tuberculous spondylitis. Sixteen vertebral compression fractures by trauma or osteoporosis showed a normal tracer uptake in pedicle, laminar and spinous process, but there was noted with 6 decreased uptake, 8 absence of tracer uptake and 2 normal tracer uptake in the vertebral body. Two vertebral compression fractures by metastasis showed the absence of uptake in vertebral body, pedicle, laminar and spinous process, and one showed an absence of vertebral body and spinous process. Six vertebral compression fractures by tuberculous spondylitis showed the absence of uptake in six compression fractures, the absence of pedicle in five compression fractures. We concluded Tc-99m labeled antigranulocyte antibody immunoscintigraphy may be helpful to differentiate the causes of vertebral compression fractures.
Anterolaateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture.
Jang Ho Bae
Yeungnam Univ J Med. 1996;13(2):234-242.   Published online December 31, 1996
DOI: https://doi.org/10.12701/yujm.1996.13.2.234
  • 1,444 View
  • 1 Download
AbstractAbstract PDF
Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and bone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient are remained back pain. According to above results we concluded that anterolateral internal fixation combined.with bone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.
The clinical study of the supracondylar fracture of the femur.
Jong Chul Ahn, Se Dong Kim, Jae Sung Seo, Dong Chul Lee, Young Joo Lee
Yeungnam Univ J Med. 1993;10(1):197-211.   Published online June 30, 1993
DOI: https://doi.org/10.12701/yujm.1993.10.1.197
  • 1,732 View
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AbstractAbstract PDF
Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So compliactions of the supracondyle fractures 'including joint.. stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed. 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989. Dec. To 1992. Jan. The results were as follows 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification, 4 cases were type A, 4 in type B, 12 in type C (10 in type C2&C3). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in consevative treatment and 67 in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.
The cervical spinal fractures : comparison of the sites and incidences according to the causes and the types of the injuries.
Jae Ho Cho, Kil Ho Cho, Woo Mock Byun, Sun Yong Kim, Bok Hwan Park
Yeungnam Univ J Med. 1993;10(1):114-126.   Published online June 30, 1993
DOI: https://doi.org/10.12701/yujm.1993.10.1.114
  • 1,541 View
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AbstractAbstract PDF
The fractures of the cervical spine are relatively uncommon, but they may cause serious neurologic deficits temporarily or permanently. So, it is very important to treat the patients early by way of exact evaluation for the sites and the mechanisms of the injuries. The authors reviewed retrospectively 188 cervical spinal fractures in 100 patients from Sep. 1984 to Aug. 1990. Commonly involed levels were C5 and C6 in lower cervical level and C2 in upper cervical level and the sites in each spine were body; lamina and odontoid process. The hyperflexion injury was the most common type of the cervical spinal fractures occupying 53% of all cervical fractures and cause more multipe fractures(2.26 fractures/patient) than in hyperextension (1. 68 fractures/patient). In hyperflexion injuries, body, transverse and spinous process were commonly involved but lamina fracture was relatively common in hyperextension injury. The dislocations associated with fractures were developed most commonly in hyperflexion injury and 70% of these were anterior dislocation and the most commonly involved levels were C5-6 and C6-7. In conclusion, hyperflexion injury needs more close examination for the entire spinal levels than injuries of other mechanisms because it results in more severe fractures with or without dislocation and relatively frequent multiple fractures in different levels.
Clinical observation and treatment of fracture-dislocation of talus.
Dong Chul Lee, Se Dong Kim, Hae Hoon Jung
Yeungnam Univ J Med. 1992;9(2):302-311.   Published online December 31, 1992
DOI: https://doi.org/10.12701/yujm.1992.9.2.302
  • 1,620 View
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AbstractAbstract PDF
Talus is an important structure of the ankle joint and its function is critical for ambulation and weight bearing. The talus fracture is rare, but the complications of fracture and dislocation are serious and resulting in avascular necrosis, osteoarthritis. So its treatment is carefully considered at initial status. Authors reviewed 11 cases of fracture and dislocation of the talus treated at Yeungnam university hospital from 1984 to 1991. The longest follow up was 8 years and shortest, 1 years. The results were as follows. 1. There were all males, the average age was 30 years old. 2. The most common cause was fall down (8 cases), and next traffic accident (2 cases), sports injury (1 case). 3. According to Marti-Weber classification, 1 case was type I, 1 in type II, 4 in type III and 5 in type IV. 4. The method of treatment were open reduction and internal fixation in 6 cases, the others were closed reduction in 5 cases. 5. Final results (by Hawkins grading system) were as follows, 3 cases were excellent, 4 cases were good, 1 case was fair and 3 cases were poor. 6. Complications were AVN in 2 cases, degenerative arthritis in 8 cases, malunion in 1 case. 7. The range of motion of the ankle joint was relatively preserved (74%), but in the subtalar joint it was decreased (43%)

JYMS : Journal of Yeungnam Medical Science