The Treatment of Tibial Shaft Fractures By Use of Ender's nailing / 대한정형외과학회잡지

Fracture of the tibial shaft is the most common fracture of the long bones, and due to its frequency, mode of injury and sometimes type of treatment, has become a major source of permanent and temporary disability. The treatment of fractures of the tinial shaft has become one of the most controversial subjects in orthopedic surgery. Recently flexible intramedullary nails have been used successfully in treatment of fractures of the tibial shaft. In this paper we are reporting our experience with the method in 29 selected fractures of the tibia in 28 patients. The results were as follows. l. Of 29 cases, 19 cases were male and 10 cases were female. The average age was 33.4 years and the most common cause of injury was traffic accident. 2. Seventeen cases were closed fractures and twelve cases were open fractures. Nineteen cases were comminuted fracture. The most common level of the fracture was middle third of the tinial shaft. 3. Average interval from injury to Ender nailing was 10.3 days and the mean duration of permmit to full weight bearing was 9.8 weeks. 4. The mean duration of clinical bone union was 10.2 weeks and that of roentgenological bone union was 17.8 weeks. 5. 9 cases of complication were noted among the 29 cases of tibial shaft fracture which was treated by Ender nsiling such as angulation, ankle joint stiffness, and one case of delayed union. 6. Ender nailing are relative ease of nailing, allow early weight bearing and decrease complication. So Ender nailing is considered to be a good methods in treating tibial shaft fracture.

Intra-Osseous Venography in Patellofemoral Disorders: Clinical Significance / 대한정형외과학회잡지

We performed intra-osseous venography in 16 patients with chondromalacia patellae or patellofemoral osteoarthritis. Of 16 patients, eight patients had chondromalacia patellae and 6 patellofemoral osteoarthritis. Two patients with normal patellae who underwent meniscectomy were used as controls. The results obtained were as follows: 1. Dye congested in the normal patella was disappeared within 2 minutes after injection and extra-osseous drainage pattern disappeared within 1 minute. 2. in chondromaiacia patellae, large amount of dye was spread throughout the entire patella and remained till 10 minutes, while extra-osseous drainage pattern disappeared at about 5 minutes. 3. In patellefemoral osteoarthritis, venous engorgment in patella was similar to that of chondromalacia patellae and extra-osseous drainage pattern disappeared at about 10 minutes. Conclusively, authors thought the patella I.O.V. was one of the significant clinical methods to define the etiological factors of the various patellofemoral disorders such as patellofemoral osteoarthritis and chondromalacia patellae.

The Clinical Study of Transient Synovitis of the Hip Joint in Children / 대한정형외과학회잡지

One of a fairly common cause of painful hips in children is the transient synovitis which subcide in short time by bed rest. This transient synovitis is also called as observation hip, irritable hip, coxitis serosa seu simplex, transitory hip arthritis, transitory coxitis, acute transient epiphysitis, toxic synovitis, and intermittent hydrathrosis etc. It is not clear what is the exact cause of transient synovitis but many authors agree infection, trauma and allergic conditions can be cause of that disease. The disease is of interest, not because it is a disabling condition, but because of the difficulties encountered in differentiating it from more serious disease of the hip such as Legg-Calve-Perthes disease, tuberculosis, osteomyelitis and etc. Of the 67 cases so diagnosed at the catholic medical college from 1975 to, 1980, 30 were reviewed and reported. Following observation were made: 1. The main symptom was pain of sudden onset in the region of the hip joint with a limp on the: affected side. 2. The patients mean age was 7.4 yrs and the sex ratio of boy & girl revealed 1. 7:1. 3. Radiological abnormalities of the soft tissue shadow of the affected hip joint was noted at 24 cases (80%), among them the gluteal sign(50%) are more prominent than others Bone scanning with Tc was performed at 13 cases. Increased uptake density of radio-active isotopes found at 6 cases (46%). 4. The treatment was conservative including bed rest, skin traction on the affected leg, non weight bearing, antibiotics and anti-inflammatory drug. 5. Two hips among them revealed later as s Legg-Calve-Perthes disease and tuberculous arthritis of hip joint.

Interpretation of the Osteomedullography in the Fracture of Tibial Shaft / 대한정형외과학회잡지

The tibial fracture apt to be encountered many complicationa including delayed or non-union. Many authors reported aeveral methods of early detection of the complication. Among them, it has been known that interoeseous phlebography is one of the simplest and valuable method to predict the delayed or non-union. Puranen and Kaski(1974) reported that the osteomedullography was valuable in early detection of delayed union and in deciding whether a bone graft is indicated. We performed ostemedullogram in the cases of tibial fracture since July, 1974. In this paper, we presented the caaes which showed unusual findings, and dicussed the method of evaluation of these findings. The results obtained as follows; 1. The positive Kaski signs did not always mean the completness of union of fracture. It only indicated that the union was going on. 2. Even in cases in which Kaski signs are positive, the final decision for bone graft have to depend upon the clinical and physical findings and simple roentgenogram. 3. The negative Kaski signs did not always mean the possible development of delayed or non-union. Usually it indicated only delaying of union, and the treatment should not solely depend on only the osteomedullographic findings. 4. Even in cases in which bridging callus is well formed around both fracture ends, also in cases of solidly united fracture Kaski signs were sometimes completely negative. This osteomedullography is clinically easily to apply in all cases of tibial fracture, and give us a lot of information concerning with fracture healing. We have to pay attention to the false nagative cases. In those cases we have to depend more on clinical test and simple roentgenogrm.

Tardy Ulnar Nerve Palsy with Recurrent Ulnar-Nerve Dislocation: Case Report / 대한정형외과학회잡지

No abstract available in English.

Osteonecrosis Occuring in the Medial Femoral Condyle due to Prolonged, Excessive Cortisone Therapy: A Case Report / 대한정형외과학회잡지

Authors report a rare case of localized osteonecrosis occuring in the medial femoral condyle induced by prolonged steroid administration in a 48 years old male who had kidney transplantation surgery. Initially, he experienced clinical symptoms of discomfort and recurring effusion of both knees after transplantation surgery which did not respond, at all, to conservative treatment even in its early stage.