Study DesignRetrospective.PurposeTo compare the clinical and radiological outcomes of posterolateral lumbar interbody fusion (PLIF) and posterolateral lumbar fusion (PLF) in monosegmental vacuum phenomenon within an intervertebral disc.Overview of LiteratureThe vacuum phenomenon within an intervertebral disc is a serious form of degenerative disease that destabilizes the intervertebral body. Outcomes of PLIF and PLF in monosegmental vacuum phenomenon are unclear.MethodsMonosegmental instrumented PLIF and PLF was performed on 84 degenerative lumbar disease patients with monosegmental vacuum phenomenon (PLIF, n=38; PLF, n=46). Minimum follow-up was 24 months. Clinical outcomes of leg and back pain were assessed using visual analogue scales for leg pain (LVAS) and back pain (BVAS), and the Oswestry disability index (ODI). The radiographic outcome was the estimated bony union rate.ResultsLVAS, BVAS, and ODI improved in both groups. There was no significant difference in the degree of these improvements between PLIF and PLF patients (p>0.05). Radiological union rate was 91.1% in PLIF group and 89.4% in PLF group at postoperative 24 months (p>0.05).ConclusionsNo significant differences in clinical results and union rates were found between PLIF and PLF patients. Selection of the operation technique will reflect the surgeon's preferences and patient condition.

Brown tumor refers to a change of skeletones that develops as a complication of hyperparathyroidism. As osteoclast is activated to stimulate reabsorption and fibrosis of bone, it causes a cystic change of the bone. Parathyroid carcinoma is being reported as a tumor that induces primary hyperparathyroidism. It causes excessive secretion of the parathyroid hormone and increases the blood parathyroid hormone and calcium. Bone deformation due to brown tumor is known to be naturally recovered through the treatment for hyperparathyroidism. However, there is no clearly defined treatment for lesions that can induce pathological fractures developing in lower extremities. We experienced a case where brown tumor developed in the proximal femur of a 57-year-old female patient due to parathyroid carcinoma. In this case, spontaneous fracture occurred without any trauma, and it was cured by performing intramedullary nailing fixation and parathyroidectomy. We report the treatment results along with a literature review.

Purpose:This study was performed to compare the clinical results and complications of bipolar hemiarthroplasty and internal fixation using proximal femur nail antirotation (PFNA) for unstable elderly femoral intertrochanteric fractures. Materials and Methods:From May 2008 to September 2010, 74 patients older than 65 years who underwent bipolar hemiarthroplasty(33 patients) or PFNA(41 patients) and followed for more than 1 year after surgery were enrolled in this study. The mean blood loss during operation, mean operation time, radiological results, clinical results, and complications were analyzed by the Student t-test and Chi-square test to compare the two groups. Results:The volume of blood loss during the operation was statistically lesser in the PFNA group (P<0.05) and operation time was not statistically different between the two groups (p=0.73). The bipolar hemiarthroplasty group showed a statistically better outcome than the PFNA group in the beginning of weight bearing (p<0.05), the hospital stay (p<0.05). The degradations of Koval score and modified Harris hip score of the bipolar hemiarthroplasty group were statistically better than those of the PFNA group (p=0.03, p=0.02). The bipolar hemiarthroplasty group showed a statistically lower incidence of mechanical(9.1%, p=0.01) and general(12.1%, p=0.00) complications than the PFNA group. Conclusion:In elderly patients, bipolar hemiarthroplasty is thought to be one of the effective treatments for unstable femoral intertrochanteric fracutures when considering complications and clinical outcomes.

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Epidermal cysts are common benign tumors of the skin, but intraosseous epidermal cysts at the phalanx are rare.1,2) Congenital anomalies, trauma, and iatrogenic factors are reported as etiological causes. Phalangeal epidermal cysts commonly involve the distal phalanx. Epidermal cysts occur at periosteal soft tissue and invade the bone, resulting in circular or discoid bony destruction. Treatment involves a combination of curettage and bone grafting, and it has a good prognosis, with a low recurrence rate. 1) Intraosseous epidermal cysts are too rare to be of primary concern. However, it is important to rule out other more common diseases of the distal phalanx that present with similar clinical manifestations and radiological findings.We conducted curettage and bone grafting in 2 cases of intraosseous epidermal cysts of the distal phalanx and obtained good results clinically and radiologically at 1 year follow-up.Case Report Case 1An 11 year-old girl attended our clinic with a mass in the left 4thfinger. She detected the mass 4-5 years earlier, and it had gradually increased in size. She had visited a primary clinic for aggravating pain 2-3 months earlier and was referred to our hospital following An intraosseous epidermal cyst is a rare benign cystic lesion. It is thought to result from congenital factors or trauma and can lead to bone destruction because the cyst develops at the soft tissue around the bone. Radiological findings of intraosseous epidermal cysts are a welldefined radiolucent lesion, with cortical expansion. It is important to differentiate an intraosseous epidermal cyst with other disease developed at distal phalanx because its clinical and radiological findings are similar. We report two rare cases of intraosseous epidermal cysts that developed at the distal phalanx. Key words: intraosseous epidermal cyst, distal phalanxCopyrights ©