Background There is no established principle regarding weight-bearing in conservative and operative management of fifth metatarsal base fractures. Methods We reviewed 86 patients with acute fifth metatarsal base fractures. Conservatively treated late or early weight-bearing patients were assigned to Group A or C, respectively. Operatively treated late or early weight-bearing patients were assigned to Group B or D, respectively. Results were evaluated by clinical union, bone resorption, and the American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analogue Scale (VAS) scores. Results All 4 groups had bone union at a mean of 6.9 weeks (range, 5.1–15.0). There were no differences between the groups in the AOFAS and VAS scores. In the early weight-bearing groups, there were fewer cases of bone resorption, and the bone unions periods were earlier. Conclusions Early weight-bearing may help this patient population. Moreover, conservative treatment could be an option in patients with underlying diseases.

BackgroundTo report the treatment results of 12 patients who underwent a total excision of intradural extramedullary tumors.MethodsTwelve cases of histopathologically confirmed intradural extramedullary tumors were treated surgically between February 2002 and March 2005. There were 8 males and 4 females with an average age of 42.6 years. The mean postoperative follow-up period was 24.2 months. The histopathological findings, locations of the tumors, and clinical results were analyzed. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel classification.ResultsThe histopathological results are as follows: 4 cases of a meningioma, 4 cases of a schwannoma, 2 cases of an epidermoid cyst, 1 case of an arachnoid cyst, and 1 case of an ependymoma. The locations of the tumors were as follows: 7 cases in the thoracic region, 4 cases in the lumbar region, and 1 case in the cervical region. At the final follow-up, a 2-grade and 1-grade improvement was observed in 1 and 7 cases, respectively. There were no changes in the Frankel grade in 4 cases. The preoperative neurological deficit improved within 8 postoperative weeks in most cases and within 1 postoperative year in all cases. Postoperatively, there were 2 cases of cerebrospinal fluid leakage and 2 cases of paresthesia.ConclusionsIntradural extramedullary tumors detected by MRI are mostly benign and good clinical results can be obtained when treated surgically. Therefore, more active surgical approaches by orthopedic surgeons are recommended to decrease morbidity.

Background: We evaluated the need for arthroscopic capsular release (ACR) in refractory primary frozen shoulder (FS) by comparing clinical outcomes of patients treated with ACR and manipulation under anesthesia (MUA). Methods: We assessed patients with refractory primary FS, 54 patients (group A) who were treated with MUA and 22 patients (group B) who were treated with ACR. In group A, manipulation including a backside arm-curl maneuver was performed under interscalene brachial block. In group B, manipulation was performed only to release the inferior capsule before arthroscopic circumferential capsular release, which was carried out for the unreleased capsule after manipulation. Pain, range of shoulder motion, and American Shoulder and Elbow Society score were recorded at 1 week, 3 months, 6 months, and 1 year after surgery. We compared outcome variables between treatment groups and between diabetics and non-diabetics and also evaluated the numbers of patients receiving additional intra-articular steroid injection.Results: Outcome variables at 3 months after surgery and improvements in outcome variables did not differ between groups. Group A showed significantly better results than group B in the evaluation of pain and range of motion at 1 week. Diabetics showed comparable outcomes to non-diabetics for most variables. Eleven patients required additional steroid injections between 8 to 16 weeks after surgery: 12.2% in group A, 18.2% in group B. Additional injections were given three times more often in diabetics compared to non-diabetics.Conclusions: MUA alone can yield similar clinical outcomes to ACR in refractory FS.