A Comparative Study of Tensile Strength of Three Operative Fixation Techniques for Metacarpal Shaft Fractures in Adults: A Cadaver Study

BACKGROUND: We sought to estimate the ultimate tensile strength after metacarpal shaft fracture repair in adults using three operative fixation methods: plate fixation, Kirschner wire (K-wire) fixation, and intramedullary headless compression screw fixation. We also compared the advantages and disadvantages of each operative technique. METHODS: We acquired 30 metacarpal bones from four Korean adult cadavers without trauma, operative history, or deformities. The 30 metacarpal bones were divided into ten groups consisting of three metacarpal bones each with matching sizes and lengths. They were fractured, reduced, and fixed with plate and screws, K-wires, or headless compression screws. We performed force testing, collected ultimate tensile strength data, and created a stress-strain graph. RESULTS: The ultimate tensile strength of ten groups according to the fixation method was as follows: late and screw fixation, 246.1 N (range, 175.3 to 452.4 N); K-wire fixation, 134.6 N (62.7 to 175.0 N); and intramedullary headless compression screw fixation, 181.2 N (119.2 to 211.7 N). The median tensile strength of each fixation method was significantly different. In addition, the post-hoc test showed significant difference between the plate and screw fixation and K-wire fixation, between the headless compression screw fixation and K-wire fixation, and between the headless compression screw fixation and plate and screw fixation. CONCLUSIONS: The tensile strength median values decreased in the following order showing significant differences among the fixation methods: plate and screw fixation, headless compression screw fixation, K-wire fixation. Significant differences were also observed between the plate and screw fixation and K-wire fixation, between the headless compression screw fixation and K-wire fixation, and between the headless compression screw fixation and plate and screw fixation.

Overview of Various Measurement Tools for Shoulder Kinematics

Shoulder kinematics is important, as it is associated with shoulder arthropathy and pain mechanisms. Various static and dynamic analysis methods are prevalent for shoulder kinematics. These include 2-dimensional plane x-ray, computed tomography, and magnetic resonance imaging, cadaver study, electromagnetic motion analysis, transcortical bone pins technique, and in vivo 3-dimensional motion analysis. Although these methods provide the value of the shoulder kinematics angle, they are unable to explain why such changes occur. Since each method has its pros and cons, it is important to understand all factors accurately, and to choose a method that best meets the purpose of the researcher.

Overview of Various Measurement Tools for Shoulder Kinematics

Shoulder kinematics is important, as it is associated with shoulder arthropathy and pain mechanisms. Various static and dynamic analysis methods are prevalent for shoulder kinematics. These include 2-dimensional plane x-ray, computed tomography, and magnetic resonance imaging, cadaver study, electromagnetic motion analysis, transcortical bone pins technique, and in vivo 3-dimensional motion analysis. Although these methods provide the value of the shoulder kinematics angle, they are unable to explain why such changes occur. Since each method has its pros and cons, it is important to understand all factors accurately, and to choose a method that best meets the purpose of the researcher.

Acute Patellar Osteomyelitis in a Child after a Blunt Trauma: Case Report

Osteomyelitis of the patella is a very uncommon condition that occurs mostly in the pediatric population. In addition to its rarity, nonspecific and variable clinical presentations usually lead to postponement in making the correct diagnosis. Moreover, it is often missed as prepatellar bursitis or septic arthritis of the knee. Nonetheless making early diagnosis and initiating prompt treatment is most important to preventing this condition from becoming chronic. In this case report, the authors encountered this rare condition of the patella in a child that was first misdiagnosed with pyogenic arthritis or prepatellar bursitis of the knee. The delay in making the diagnosis led to intractable progression of the disease, and sequestrectomy was required to stabilize the condition.

Current Status of Prophylaxis for Endocarditis

BACKGROUND AND OBJECTIVES: Antibiotic prophylaxis of infective endocarditis is required before high-risk procedures in patient with high-risk heart diseases. Although guidelines for the prevention of infective endocarditis were proposed by the American Heart Association in 1997, compliance to these recommendations has not been evaluated in Korea. SUBJECTS AND METHODS: This was a retrospective, multicentered study in 8 Korean university hospitals. Patients with high-risk heart diseases, having undergone invasive dental procedures between Jan. 1, 2000 and Dec. 31, 2003, were enrolled. The medical and dental records of the patients were reviewed to evaluate whether the prophylaxis had been appropriate. RESULTS: Of the initial 4,912 patients, 184 that had been treated with invasive dental procedures (255 total episodes, mean 1.4/patient) were evaluated. The most common high-risk heart disease was a prosthetic heart valve (233 procedures), followed by a previous history of infective endocarditis (22 procedures), cyanotic heart diseases (5 procedures) and systemic pulmonic venous shunts (2 procedures). Antibiotic prophylaxis was performed in 231 procedures (90.8%). Amoxicillin was the most common antibiotic used for prophylaxis (88.6%); however, the adequate dosage (2 gm) was administered in only 56% of these cases. Therefore, the appropriate prophylaxis, according to the AHA recommendations, was performed in only 14.1% (36 procedures). The mean duration of prophylaxis and number of antibiotic doses were 2.40 days (2.40+/-2.44) and 7.97 doses (7.97+/-7.18), respectively. A previous history of infective endocarditis (p=0.03) and dental extraction (p<0.01) resulted in a longer duration of prophylaxis. CONCLUSION: Only 14.1% of the high risk group procedures were given appropriate antibiotic prophylaxis according to the AHA recommendations. These data suggest that protocol-based education of both doctors and patients is required for appropriate antimicrobial therapy during high-risk procedures for the prevention of infective endocarditis in patients with high-risk heart disease.

Diversity of Humoral Immune Responses to Recombinant Proteins of Brucella abortus Among Residents in Cheju Province

No Abstract Available.

A Case of Toxoplasma Lymphadenitis / 감염

Toxoplasma lymphadenitis is the most common clinical manifestation of toxoplasmosis in an immunocompetent host. In foreign countries, it is a relatively common etiology of reactive hyperplasia of lymph nodes, but it is still rare in Korea. The cervical lymph nodes are the most commonly involved, whereas systemic manifestations are rare. We are reporting a case of toxoplasma lymphadenitis in an immunocompetent host. A 31-year-old man was admitted to the hospital because of submandibular lymph node enlargement for 3 months. Toxoplasma lymphadenitis was diagnosed by positive IgG and IgM toxoplasma antibody titer and specific pathologic findings of submandibular lymph node, such as reactive follicular hyperplasia, epitheioid histiocytes in the interfollicular area, and infiltrations of subcapsular monocytoid B lymphocytes. In Korea, travels to and from other countries and contacts with foreigners are increasing, possibly increasing the incidence of toxoplasma lymphadenitis, which should be considered in the differential diagnosis of lymphadenitis.