Baker's Cyst Filled with Hematoma at the Lower Calf.

Baker's cyst is a distension of the gastrocnemius-semimembranosus bursa of the knee, which communicates with the posterior portion of the joint capsule. Baker's cyst is commonly located in the inferomedial or superficial layers of the knee joint and rarely extends laterally or proximally. Complications of Baker's cysts are dissection, rupture, pseudothrombophlebitis, leg ischemia, nerve entrapment, and compartment syndrome. However, hematomas in the Baker's cyst have not been reported in Korea. We report a rare case of hematoma in the Baker's cyst with subfascial extension into the calf. The hematoma was demonstrated by magnetic resonance imaging and removed by mass excision.

Paraspinal muscle changes of unilateral multilevel minimally invasive transforaminal interbody fusion.

PURPOSE: We attempted to identify changes in back muscle atrophy occurring in multilevel minimally invasive transforaminal interbody fusion (MITLIF) and the impact of these changes on clinical outcomes. METHODS: This study was conducted on 92 patients who underwent unilateral MITLIF between 2006 and 2013, had been tracked with a follow-up for at least 1 year, and had been assessed by pre- and postoperative computed tomography (CT). For the clinical evaluation, a pre- and postoperative visualized analog scale (VAS) of the back and legs, and Oswestry Disability Index (ODI) were measured. CT was used for the evaluation of back muscle atrophy and a cross-sectional area (CSA) of the multifidus was measured at the level below a fused segment, excluding metal artifacts. RESULTS: There was no significant difference in the reduction of CSA between groups with one-, two-, or three-plus-segment fusion. In addition, no statistically significant differences were found in the pre- and postoperative VAS of the back, VAS of the legs, and ODI between the three groups. The reduction of CSA showed a statistically significant positive correlation with preoperative VAS of the back (p = 0.025, r = 0.562). On the other hand, no significant difference was found in VAS of the leg (p = 0.437, r = 0.082) and ODI (p = 0.106, r = 0.017). CONCLUSION: When performing unilateral multilevel MITLIF, significant difference was not found in the atrophy of the multifidus according to the number of fused segments. The clinical outcomes also showed no significant difference. Therefore, unilateral MITLIF can be considered to be an effective surgical method to minimize lumbar muscle damage, even at multiple levels.

Restoration of the central slip in congenital form of boutonniere deformity: case report.

We present a case of a congenital form of a boutonniere deformity involving both little fingers with a poorly differentiated extensor mechanism and the absence of the tendinous attachment on the dorsal aspect of the middle phalanx. This complex deformity was evaluated histologically followed by successful reconstruction of the central slip.

Deformity correction by femoral supracondylar dome osteotomy with retrograde intramedullary nailing in varus deformity of the distal femur after pathologic fracture of giant cell tumor.

Angular deformities of the distal femur occur in congenital diseases or due to acquired causes, such as malunion after a fracture of the distal femur. Angular deformities of the lower extremities affect the mechanical axis, causing changes in the weight pressure on the articular surface. As a result, angular deformities quicken the progression of osteoarthritis. Therefore, correction of deformities should be performed to prevent the progression of osteoarthritis. Distal femoral osteotomy is one of the methods to correct angular deformities in unicompartmental osteoarthritis. However, femoral supracondylar dome osteotomy with retrograde intramedullary nailing in the distal femur with a varus deformity has been rarely reported. Herein, we describe a technique for femoral supracondylar dome osteotomy with retrograde intramedullary nailing in a varus deformity after a pathologic fracture of giant cell tumor in the distal femur with a review of the relevant literature.