Biomechanical Properties of the Growing Long Bone / 대한정형외과학회잡지

Bone is a heterogenous and anisotrophic material exhibiting elastic, viscoelastis and plasticproperties. A considerable amount of information is now available regarding biomechanical properties and mechanisms of fractures of mature long bones, but less is known about the properties of the growing bones. In order to assess the biomechanical properties under tension, rabbits growing bones were loaded with Instron Modal 1,000 until fracture occurred. Two hundred tibiae of 100 New Zealand white immature rabbits were divided into 6 experimental groups according to maturity and size. Group I-R(40 right tibiae of 1-month old rabbits), Group I-L (40 left tibiae of 1-month old rabbits), Group II-R(20 right tibiae of 3-month old rabbits), Group II-L (20 left tibiae of 3-month old rabbits), Group III-R(40 rigth tibiae of 5-month old rabbits), and Group III-L(40 left tibiae of 5-month old rabbits). The following results were obtained. 1. Fracture type was transverse.or nearly transverse in 170 out of the total 200 tibiae(85%).

A Clinical Study of the patellar Fracture / 대한정형외과학회잡지

The frequency of the patellar fracture is increasing because of increasing traffic accident & sports activities and its treatment is considered very important because the involvement of the articular surface occurs in most of it. The authors experienced 54 cases of patellar fracture from January, 1979 to October, 1980 at the Department of Orthopedic surgery, Capital Armed Forces General Hospital and the results were as follows. 1. The most fractures were encountered in man of 3rd. decade. 2. Thirty-eight (70.4%) fracture were induced by direct blow and the remainders were induced by indirect violence. 3. The most fractures were stellate, communited fractures (44.4%) and transverse fractures (37%) which mostly occured at the middle portion. 4. The most fractures were treated by conservative method, circumferential wiring, tension band technique and patellectomy, and the result of the tension band technique was superior to other operative methods (shorter immobilization time, rehabilitation time, and wide range of motion of the knee joint and longer midthigh circumference). 5. The rehabilitation period was shorter in the group of immobilization in 10° flexion of knee with cylinder cast than in the group of immobilization in full extension of knee. 6. Skin lacerations, femoral fractures, and tibial fractures were associated injuries, and the superficial infections and peroneal nerve palsy were complicated.

Supracondylar Osteotomy for Correction of Deformities of the Knee in Poliomyelitis / 대한정형외과학회잡지

Supracondylar osteotomy was performed on 78 knees in 65 patients with poliomyelitis for correction of deformities of the knee at the Department of Orthopedic Surgery, Seoui National Unlversity Hospital, during the 16 years from January 1963 to December 1978. Following observations were made from the review of statistics, technical problems, and complications of the operation. 1. The ages of the patients ranged from 4 years to 28 years, the average being 15 years. Two thirds of the patients were in the second decade. 2. 37 knees (47.4%) had flexion deformity, 19 knees (24.4%) flexion-valgus deformity, and 13 knees (16.7%) flexion-valgus-external rotation deformity. The amount of flexion deformity ranged from 7 degrees to 90 degrees, the average being 22 degrees. Valgus deformity ranged from 3 degrees to 25 degrees, the average being 12 degrees. External rotation deformity ranged from 5 degrees to 30 degrees, the average being 18 degrees. 3. The operative techniques employed were categorized into 5 types. The most common type was a closed wedge hinged osteotomy (Technique I), which was employed on 50 knees (64.1%). Satisfactory results were obtained by combining other procedures, when necessary, i.e. pre-operative skeletal traction, Yount fasciotomy, high tibial rotation osteotomy hamstring transfer and epiphysiodesis. 4. The time required for union was the shortests in the Technique 1 group, and longest in the Technique III group, a complete osteotomy with bone shortening. 5. The most common complication was stiff knee, which was encountered in 10 knees. Residual or recurrent deformity was observed in 4 knees, in 3 of which hamstring transfer was recommended but was not consumated. Delayed union was observed in 3 knees in the Technique II group (closed wedge complete osteotomy) and in 1 knee in the Technique III group. Nonunion occured in 1 knee in the Technique II group. The incidence of complications were higher in the Technique II and III groups, and lowest in the Technique I group.

Clinical Observations on Acute Pyogenic Osteomyelitis and Arthritis in Infancy / 대한정형외과학회잡지

Clinical observations of 11 cases of acute pyogenic osteomyelitls and 14 cases of acute pyogenic arthritis in infancy during past 11 years were carried out and following results obtained. 1. The highest age incidence was less than 3 months after birth (70.6%). 2. Average duration of symptoms was 7.8 days. 3. The most important underlying cause was multiple femorai vessel puncture (23.5%). 4. The chief symptom or sign on admission was pseudoparalysis or limitation of motion (82.4%), and local swelling (82.4%). But high fever on admission was present in only 29.4% of cases. 5. The femur was the most common site in acute pyogenic osteomyelitis (36.4%), and the hip joint in acute pyogenic arthritis (42.9%). 6. Leucocyte count was Increased more than 20,000/mm in 60.0% of the cases. Erythrocyte sedimentation rate was increased more than 21 mm/hr in 72.0% of cases. The positive result on bacteriologic culture was 76.0%. Coagulase-positive Staphylococcus aureus was cultured in 4 cases of acute pyogenic osteomyelitis and 5 cases of acute pyogenic arthritls. a-hemolytic Streptococcus was cultured in 2 cases of acute pyogenic osteomyelitls and 1 case of acute pyogenic arthritis. Hemophilus influenzae was cultured in 1 case of acute pyogenic osteomyelitls and 2 cases of acute pyogenic arthritis. 7. 45.5% of acute pyogenic osteomyelitis was combined with acute pyogenic arthritis. 8. The longer the duration of symptoms was, the longer the abnormal hematologic picture lasted. Erythrocyte sedimentation rate was the most accurate index of activity in acute infection of bone and joint. 9. Shortening or deformity due to epiphyseal plate damage occured in 1 case of acute pyogenlc osteo-myelitis, and 3 cases of acute pyogenic arthritis. Those complications could be minimized wlth early diagnosis and treatment.

Treatment of Unstable Fracture Dislocation of the Spin / 대한정형외과학회잡지

The results of treatment of injuries of the thoracic and thoracolumbar spine with neurological involvement have been reviewed in a retrospective study of 14 patients who received surgical treatment. Seven patients were treated with open reduction and Harrington instrumentation and the others were treated with anterior fusion, laminectomy only, Roger wiring with H-graft and posterior fusion respectively. In the former group, distraction rods were used in all patients. Three patients with incomplete paraplegia and of the 4 patients with complete paraplegia, two patients showed marked neurological improvement. While, in the latter group, only two patients with incomplete paraplegia showed marked neurological improvement. Harrington instrumentation allowed easier postoperative nursing and early mobilization of the patients.

Treatment of Unstable Intertrochanteric Fracture / 대한정형외과학회잡지

Trochanteric fractures are seen in elderly patients and have high mortality and morbidity. Strong internal fixation and early ambulation is the best way to treat fractures. For this purpose, recently, compression sliding screw plate became popular. The surgical procedure of open reduction and internal fixation were carried on 36 intertrochanteric fractures at Depertment of Orthopedic Surgery, Seoul National University Hospital, from Jan. 1972 to Dec. 1977 and the following results were obtained. 1. Of 36 cases of intertrochanteric fracture, 20 cases were in man, with the peak age at the 5th decade, and 16 cases in woman mostly over the 7th decade. 2. Most common causes were fall or traffic accidents in man and fall in woman. 3. Interval from injury to operation was less than 1 week usually. 4. Unstable fractures were 86% and of these, Tronzo Type III was the most common. 5. The trend of use of internal fixation device was from S-P plate and screw, and Jewett nail to sliding compression plate and screw. 6. Reduction of medial displacement with Dimon-Hughston method was used commonly in Jewett nailing and anatomical reduction in sliding compression plate and screw. 7. Post operative cast immobilization were applied in a few cases of under 50 years old, Other-wise early ambulation were carried out. 8. Post operative complications were encountered in 8 cases (22%), but none were fatal.

Hereditary Motor and Sensory Neuropathy Type I: A case report / 대한정형외과학회잡지

Hereditary motor and sensory neuropathy is an unusual disease which is characterized by deformity of phe foot, acral sensory loss, decreare of deep tendon reflexes, enlargement of peripheral nerve and diminished motor conduction velocity. We report a case of hereditary motor and sensory neuropathy type I.

Hereditary Sensory Neuropathy Type 2 (Congenital sensory neuropathy): A case report / 대한정형외과학회잡지

Hereditary sensory neuropathy is a unusual disease which is charcterized by mutilating acropathy with cutaneous sensory loss and complete absence of sensory apparatus. We experienced a case of bereditary sensory neuropathy Type 2.