Reduction of Anterior Shoulder Dislocations by Acromion Upholding Method (Shin's Method): Technical Note / 대한정형외과학회잡지

The most common form of joint dislocation is anterior shoulder dislocation. There are a number of available techniques to reduce, but which have a possibility to be happened many kinds of complications like brachial plexus injury, axillary nerve injury and fracture of the humerus. In addition, the drugs we use for the reduction have potential side effects such as cardiovascular complications and respiratory arrest. We are trying to introduce new reduction technique aimed at minimizing the complications and increasing the success rate, which was used in 23 cases and all of them were successfully reduced without complications.

The Causes of Neurogenic Symptoms in Spondylolytic Spondylolisthesis / 대한정형외과학회잡지

A retrospective study was undertaken to define the factors that cause the neurogenic symptoms in 18 cases of spondylolytic spondylolisthesis who were operated for leg pain and neurologic deficits of motor functions documented by neurologic examination or electromyographic findings in the Department of Orthopaedic Surgery, Fatima Hospital, Daegu for three years since June, 1986. The cases having other combined pathology to cause neurogenic symptoms were excluded. The causes were predetermined by preoperative x-rays, myelograms, electromyograms, and computerized tomograms and the causes were explored at surgery regarding the preoperative findings. The findings were compared with the avilable findings of 13 cases who were operated for low back pain only without any neurogenic pain in the leg during the same period. The cases were quite older and had narrower disc spaces than the back pain group but there were no significant differences in the degree of slipping and stability of slipped level between the two groups. The foraminal stenosis was found in all of the cases and a central stenosis was combined in a case. The intervertebral foramens were narrowed up-down in most of the cases between the bony prominence of proximal pars interarticularis above and the disc and vertebral body below but three cases had soft tissue mass only at the isthmic defect encroaching the foramen. There were hypertrophy of bone and/or soft tissue at the pars interarticularis in all cases. The nerve roots were mainly compressed up-down below pars interarticularis in the foramen in 8 cases and impinged at the anterior foramen in front of the pars interarticularis in 10 cases. The central stenosis was due to marked bony hypertrophy of pars interarticularis and osteophyte of vertebral body. The causes of neurogenic symptoms in spondylolytic spondylolisthesis were foraminal stenosis due to hypertrophy of bone and/or soft tissue at the pars interarticularis combined with narrowing of disc and seemed to be a process of degenerative changes occurring at the motion segment of slipped level.

Clinical Study on the fibular Strut Graft in the Ldiopathic Osteonercrosis of Femoral Head / 대한정형외과학회잡지

The idiopathic osteonecrosis of femoral head is one of the orthopaedic dilemma in regarding the treatment and various trials to preserve the femoral head were known to be effective in the early stage of the disease process. The conventional methods of core decompression and bone graft were not usually indicated in the progressed cases that disclose the subchondral fracture or collapse of the femoral head. Authors reviewed 15 cases of the free fibular strut grafts performed for the progressed idopathic osteonecrosis of femoral head since 1983 at the Department of Orthopaedic Surgery, Daegu Fatima Hospital with follow-up periods from 2 years and 2 months to 4 years and 6 months except for 2 cases who had secondary procedures because of progressive collapse of the femoral head after the bone grafting and the following results were obtained; 1. The cases were 14 males and a female aging from 28 years to 56 years and revealed crescent signs in 9 cases and early collapses in 6 cases on the pre-operative x-rays with involvement in the other sides in 10 cases. 2. The successful results in clinical and roentgenological evaluations were obtained in 8 cases(53%) and progressive collapse was prevented in 10 cases(67%). 3. The exact insertion of the graft up to the subchondral level through the necrotic bone was essential and no weight bearing for 1 year was neccessary for success. 4. The free fibular strut grafts were effective to prevent the progressive collapse in progressed idiopathic osteonecrosis of the femoral head.

A Clinical Study on the Causes of the Nerve Entrapment in the Degenerative Spondylolisthesis / 대한정형외과학회잡지

The degenerative spondylolisthesis is one of the most common causes of the prominent central and recess stenosis which are produced by the hypertrophy of the facet joints and anterior slipping of the posterior arch. The resulting neurogenic symptoms in the legs are the major causes of the surgical treatment in the degenerative spondylolisthesis and the complete decompression is indicated for these types of spinal stenosis. The decompression procedures performed in the degenerative spondylolisthesis makes more unstable and induce the late instability and the post