Operative Treatment of Dorsolumbar Fractures and Fracture Dilocations: Clinical Experiences / 대한정형외과학회잡지

Since the introduction of Holdsworth's new classification on fracture-dislocations of spine with particular emphasis on the role of posterior ligmaent complex, operative reduction and spinal fusion is considered to be an established procedure in treating unstable injuries of the thoracolumbar spine.By stabilizing unstable fractures,nursing, and rehabilitation become much easier. Among the various methods and devices, Harrington instrumentation and posterior spinal fusion have been used and found to be acceptable in our series. Twenty five consecutive patients with unstable fractures and fracture-dislocations' of thoracolumbar spine were treated by open reduction and spinal fusion with Harrington rod fixation at the Department of Orthopedic Surgery, Kang Nam General Hospital Public Corporation from the period of 1982 to 1985. The following results were obtained from analysis of the cases. l. Among 25 cases, 15 (60%) were due to flexion-rotation violence, 5 pure flexion,3 vertical compression, 1 shear fracture respectively. 2. Among 16 cases with neurologic deficit, 15 cases showed considerabel improvement after surgery. 3. Most of the cases showed satisfactory bony fusion, and average postoperative kyphotic angle was 14.4 after 3 months. 4. Although no particular external fixation was adopted, permitting mobility in bed, postoperative correction was relatively well maintained.

A study on hypophosphatemic vitamin D resistant rickets in a family

Hypophosphatemic vitamin D resistant rickets is a form of rickets characterized by typical structural deformities and roentgenographic and metabolic changes. It has a strong familial tendency and appear to be genetically transmitted. Authors experienced 7 patients with hypophosphatemic vitamin D resistant rickets which have been manifested through three generation in a family at Won-Kwang University Hospital from Dec.1982 to May1984. Authors studied hypophosphatemic vitamin D resistant rickets clinically, radiologically, biochemically andpathologically, and reported with review of literatures.

Radiological evaluation of recurrent pyogenic cholangitis

Recurrent pyogenic cholangitis (RPC) is defined as a condition in which there is a primary bacterial cholangitis, characterized clinically by recurrent attacks of fever, chills, abdominal pain, and jaundice. 17 cases of recurrent pyogenic cholangitis at Won Kwang University Hospital during the past three years were analyzedby clinical, radiological and surgical findings. The results were as follows; 1. Peak incidence was noted at fifth decade (35%) and the raio of male to female was almost eual (1:1.1). 2. Most of patients were undernurished andrural population in low socio-economic state. 3. The characteristic and most frequent symptoms were fever, chills,abdominal pain, and jaundice. 4. Serum alkaline phosphatase level was elevated almost 4 times to the upper limitof normal. 5. There was a history of cholecystectomy with or without T-tube drainage in 65% of 17 cases. 6. The cholangiographic findings in the biliary trees were stricture, stones and dilated ducts, and occured more commonly in the left hepatic duct than right. 7. Most stones of biliary trees were pigment stones, and occasionally muddystones were seen. 8. Most of the organism obtained from bile culture were E. coli, supported an infective etiology.

Ender Nailing for the Femoral Shaft Fractures / 대한정형외과학회잡지

Forearm bone fracture is a common injury in childhood. But there are many difficult problem to solve in treatment of the forearm bone fractures which are not encountered in the treatment of fracture of the other long bone. Forearm bone fracture in children differ from those in adult in a number of ways. The rapidity of healing, fuctional recovery together with the frequency of delayed or nonunion consitute the main features. More interesting, a deformity resulting from malunion may correct as bone growth proceeds. From August, 1973 to July, 1983, we have reviewed 66 cases of forearm bone fractures under 14 year old and which were treated in the Department of Orthopedic Surgery, Hanyang University Hospital. The results were as follows: 1. 56 cases(84.8%) were male and most cases occured in school age. 2. 40 cases(60.7%) were both forearm bone fractures and most common site of the fracture was the distal 1/3 3. The most common cause of the fractures was falling from height. Simple fracture was most common and greenstick fracture was next. Closed fractures were 61 cases (92.4%) and open fractures were 5 cases (7.6%) . 4. In roentgenologically, the younger the child was, the more rapid the duration of bone union was. Average duration of roentgenological union in conservative group was 8. 1 weeks, and that in operative group was 10. 1 weeks. So conservative group was more rapid in roentgenological bone union than operative group. 5. Accarding to the follow study of remodelling, the young the child and the nearer the fracture line was to the epiphyseal plate, the greater the potentialities for spontaneous correction were. 6. 62 cases (94.0%) showed excellent fuctionat result. According to 4 cases (6.0%) which showed good fuctional result, posterior angulation 17 degree, anterior angulation 15 degree and medial angulation 17 degree after reduction became more than 10 degree after remodelling.

The Treatment of Infected Nonunited Fractures of Long Bones / 대한정형외과학회잡지

Treatment of infected nonunions of long bone is confronted with various difficult problem, e.g. eradication of infection and osseous union even in the presence of devastating infection. To solve this problem various method were proved including exerternal fixation, electrical stimulation and functional casting method with some success. Intreating these difficult infected nonunions, we adopted another program which includes through debridment of the infected and necrotic soft tissue and bone, autogenous bone graft, rigid internal fixation of fragments and ope.n drainage of the wound until union of the fracture. We treated 8 cases of infected nonunions with this method from march, 1980 to september 1983 and results are as follows: 1. Satisfactory union was obtained within average 5 months. 2. In some cases pus drainage continued even after osseous union but it was easily controlled after removal of fixation devices. 3. After bone union and removal of internal fixation devices, some kind of protective measures, e.g. crutches and braces were used for about 6 montes to prevent refracture. 4. In conclusion our method is considered to be an effctive means is treating infected nonunion of fractures.