MRI Measurement of the Intercondylar Notch and Correlation to Anterior Cruciate Ligament Injuries / 대한정형외과학회잡지

Notch stenosis had been thought to be related with anterior cruciate ligament (ACL) injury. The purpose of this study is to evaluate the possible relationship between notch stenosis and ACL injury. We measured the notch seen on the axial section in MRI at popliteal groove. We have retrospectively analyzed 116 cases of knee MRI. All cases were divided into three groups ; Group I were fifty six normal knee. Group II were thirty knee with contact ACL injuries. Group III were thirty knee with non contact ACL injuries. The result were as follows; 1. Statistically significant difference was found in the notch width index (NWI) between group I and group III but no significant differences was found in the NWI between group I and group II. 2. Statistically significant correlation to non-contact ACL injuries was found in the NWI at both anterior and posterior outlet of the notch. 3. An unique shape of the notch was found in the majority of group III.There seemed to be an obvious relationship between notch stenosis and non-contact ACL injuries.

Primary Pyogenic Psoas Abscess in Child / 대한정형외과학회잡지

Primary pyogenic psoas abscess is rare lesion, and often is not suspected. Reasons for delayed diagnosis are unfamility with the lesion and the fact that symptoms often resemble those of primary disease of the hip. We present a case of primary pyogenic psoas abscess in child, which was diagnosed by MRI, and completely recovered after surgical treatment.

The Results of Miniplate Fixation for the Fractures of Metacarpal and Phalangeal Bones of the Hand / 대한정형외과학회잡지

Fracture healing in the hand is not an isolated goal. The functional end result is of paramount importance. When the correct techniques are used, miniplate fixation for metacarpal and phalangeal fractures of the hand provides rigid internal fixation, stabilizes the skeleton, preserves the gliding tissue, and therefore allowing immediate active range of motion exercise as well as minimizing joint and tendon complications. The authors have reviewed 39 patients, 52 cases of metacarpal and phalangeal fractures of the hand which were treated with miniplate in the department of orthopaedic surgery, Chang Ang Gil hospital from Sep. 1989 to Feb. 1993. The following results were obtained. 1. Miniplate fixation, in terms of fracture reduction and maintenance, allows on accurate anatomic reduction with rigid fixation which in turn affords on early mobilization without loss of reduction alignment. 2. The roentgenographic union was obtained within 15.1 weeks in average. The mean total acitve motion at the fractured finger was 230°. The complication rate was 11.5%. 3. In the treatment of metacarpal and phalangeal fractures of the hand, especially fractures of metacarpal bones, fixation with miniplate is considered to be an useful method in terms of getting fracture union and good range of motion with relative low complication rates.

A Clinical Study of the Acetabular Fracture / 대한정형외과학회잡지

The clinical observation was performed on 27 patients of acetabular fracture, who had been admitted and treated at Department of Orthopedic Surgery, Choong-ahng Gil Hospital from January 1983 to December 1986. The results obtained were as follows. 1. The prevalent age ranged from 20 to 50 years, and the ratio between males and females was 2.4:1. 2. The most common cause of injury was traffic accident. 3. According to Letournel's classification, 8 cases were posterior wall fractures, 4 cases were pure transverse fractures, 3 cases were “T” shaped fractures, and 3 cases were fractures of both column. 4. The most common associated injury of the another part of the body was pelvic bone fracture and the most common associated soft tissue injury was cerebral contusion. 5. The satisfactory result of conservative treatment was 84.6% and surgical treatment was 78.6%. 6. The complications were degenerative arthritis(66.7%), bed sore(13.3%), ectopic ossification(6.7%), sciatic nerve palsy(6.7%), pin tract infection(6.7%) respectively. 7. The accurate anatomical reduction & rigid fixation was an important factor for intraarticular fracture.

Rigid Fixation with Huckstep Nail in Difficult Femoral Fractures / 대한정형외과학회잡지

Recently, intramedullary nailing has been used classically in a closed transverse fracture in middle one-third of the fernur. But difficult femorsl fracture, such as severe comminution or nonunion, present a much more difficult problem. To treat these difficult femur fractures effectively, several investigators have developed and implemented a interlocking nail. Huckstep nail, one of the variants of the inter-locking nail, is a solid four sided intramedullary nail with screw fixation device and titanium alloy. For the purpose of rigid fixation and compression, screw fixation the nail and both cortice has been used in the difficult femorsl fractures. The author have experienced the 19 cases of Huckstep nailing for the treatment of difficult femoral fracture at the Choongahng Gil Hospital from Jan., 1984 to Dec., 1987. The results are summarized as follows. 1) In the difficult femoral fractures, such as fracture on severe comminuted fracture, nonunion and metal failure etc, Huckstep nailing may be excellent fixation. 2) Open comrninuted femoral frsctures were treated by conservative treatment as antibiotic therapy and skeletal traction, but when general conditions return to normal and risk of infection rate minimized, Huckstep nailing should be done. This generally requires 4 to 6 weeks. 3) The mean duration of bone union was 21.2 weeks. 4) Early joint mobilization can be done. The results of 17 cases were excellent by Denker's criteria. 5) Important complication were metal failure with refracture, screw failure and refracture after extraction of nail, these were caused by incorrect placement of nail, incorrect length of nail and more rapidly early weight bearing. 6) Nail of 11.5 mm in diameter is suitable in our study.