A Clinical Analysis on Operative Treatment of Displaced Proximal Humeral Fracture / 대한정형외과학회잡지

Most proximal humeral fractures respond satisfactory to simple conservative treatment. But operative treatment is recornmended in the cases that poor results are anticipated by prolonged immobilization, or because of the severe displacement and comminution. After Neer. in 1970, emphasized the need for operative treatment in displaced proximal humeral fractures, many papers reported better results with the operative management. Twenty five cases of displaced fractures and fracture dislocations of the proximal humerus treated at the department of orthopaedic surgery, Keimyung University with open reduction and internal fixation were analyzed clinically and radiologically. The following results were obtained. 1. The prevalent age distribution was the second snd third decades(average 42.6 years) and ratio of male and female was 2.1: 1. 2. In 10 of the 25 cases, wire loop was used for internal fixation, and the result was satisfactory in 8 cases. However, the disadvantage was difficulty in wire removal after bony union because the loop was buried in the callus or cortex. 3. Over-all results were excellent or satisfactory in 64% of 25 cases. There were 4 excellent and 1 satisfsctory in 5 cases of type Il fracture, 7 excellent, 2 satisfactory and 3 unsatisfactory in 12 cases of type III fracture, 1 excellent and 4 unsatisfactory in 5 cases of type 1V fracture, and 1 excellent, 1 unsatisfactory and 1 failure in 3 cases of fracture dislocation. 4. In 6 patients with four part lesions treated with open reduction and internal fixation and followed up for an average of 23 months(from 18 months to 3 years and 2 months), only one case of fracture dislocation revealed avascular necrosis with resorption of the head.

A Clinical Study of Baseball Player's Elbow in Adolescents / 대한정형외과학회잡지

The popularity of baseball has resulted in an increase in medical attention directed toward participating players. This study focuses on injuries of the throwing arm in adolescents which occur during participation in organized youth baseball matches. History taking, physical examination and roentgenographic study of both elbows were made on 67 adolescent baseball players who visited the Department of Orthopaedic Surgery of Hanyang Vniversity Hospital from December, 1981 to January, 1982. The results obtained were as follows: 1. The average age was 12.4 years and average career playing baseball was 1 year 11 months. 2. There were 18(85.7%) overhand type pitchers. This was the most common pitching style. 3. 7(10.4%) complained of elbow pain. In all cases the pain was located on the medial aspect of the elbow. 4, On physical examination, hypertrophy of the forearm was seen in 19(28.4%), hypertrophy of the arm in 27(40.3%), limb length discrepancy in 28(41.8%), cubitus valgus deformity in 2(3.0%), and flexion contracture of the elbow in 6(9.0%) cases. 5. On roentgenographic study, cortico-trabecular hypertrophy of the humerus, and separation and fragmentation of the medial humeral epicondyle were the common findings. 6. The pain and flexion contracture of the elbow were more marked in pitchers. 7. To prevent these injuries of the elbow, the following recommandations were made by authors. Use a pitching machine in batting exercise. Restrict the number of innings pitched per game, Abolish curve ball throwing in this age group. Ensue an adequate warmup period before exercise or games. Inform parents and coaches of the possible harmful nature of excessive throwing.

A Clinical Study on Fractures of the Pelvic Bone / 대한정형외과학회잡지

Recently, the incidence of pelvic bone fractures has been increased with increment of the volume of traffic. We reviewed 318 cases of pelvic bone fractures treated at the department of orthopaedic surgery of Hanyang University Hospital during the period from May, 1972 to December, 1980. The age and sex distribution, cause and classification of fractures, type of treatment, associated injuries and complications were recorded and investigated. The results obtained were as follows: 1. There were one hundred and ninety four (61%) male and one hundred and twenty four (39%) female, and one hundred and ninety seven patients (62%) in this entire series were aged from twenties to forties. The most common victims were in active persons. 2. The most common causative injury was traffic accident. 3. Two hundreds and thirteen (67%) cases were stable fracture and one hundred and five (33%) cases were unstable fracture, which were classified by Kanes classification. 4. The fracture of the femur was most commonly associated bone and joint injuries and the injury of the lower urinary tract was also most commonly associated soft tissue injuries. 5. All of the cases, except 3 cases of the avulsion fracture, were treated with conservative treatment. The remaining 3 cases were treated with surgical treatment, 6. The mortality rate was 5.3%, and the most common cause of death was hemorrhagic shock in 70.6% of the entire fatal cases in this series.

Two cases of Sacral Agenesis / 대한정형외과학회잡지

Sacral agenesis is a rare condition. This syndrome was first described by Hohl in 1852 and is usually associated with other anomalies such as vertebral deformities, deformed hypoplastic legs, urologic and gastrointestinal problems. We have experienced two cases of this deformity; one with partial sacral agenesis, and the other with partial lumbar agenesis and complete absence of sacrum.