ABSTRACT
Thirteen patients were operated for cubital tunnel syndrome and followed for an average of 26 months postoperatively. Ten patients had a history of relevant trauma and three patients had degenerative osteoarthritis of the elbow. The average duration of symptoms was 18 months (range, 2 to 96 months). Diagnosis was made by physical examination, electromyography and nerve conduction study. Among these, nerve conduction study was found to be the most valuable diagnostic method for the patients with atypical clinical findings. Most of the operations were performed by anterior transposition of the ulnar nerve. At the most recent follow-up, the result was excellent in two patients, good in eight, and fair in three; thus ten patients(77%) showed satisfactory results. The rating system for ulnar neuropathy based on sensory, motor dysfunction and pain was useful for evaluating the operative results. The postoperative gain of score for pain and sensory function were larger than that of motor function. Factors known to influence the result of the operation (age, duration of symptom, history of trauma, method of operation) did not effect the outcome in this study. For successful operation, the ulnar nerve must be thoroughly examined, all possible levels of compression must be released and new foci of compression must be created.
Subject(s)
Humans , Cubital Tunnel Syndrome , Diagnosis , Elbow , Electromyography , Follow-Up Studies , Methods , Neural Conduction , Osteoarthritis , Physical Examination , Sensation , Ulnar Nerve , Ulnar NeuropathiesABSTRACT
No abstract available.
ABSTRACT
Management of subtrochanteric fractures of the femur is difficult because of the high mechanical stresses in this region; furthermore, the bone here is mainly cortical and comminution is frequent. These two factors, involvement of cortical bone tissue and concentration of stress, have been mentioned as reasons for the high incidence of complication in the treatment of these fractures, such as Relayed union, mechanical failure and rnalunion. Thirty cases of subtrochanteric fractures in twenty-nine patients were reviewed, which have been managed at the Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine from Jan. 1980 to Dec. 1984 and the following results were obtained: l. Of the 29 patients reviewed, 22 were male and 7 were female. Mean age was 45.7 years in male and 67.3 years in female. 2. Traffic accidents were the most common cause of injury(44.8%) 3. Pelvic bone fractures(7 cases) and rib fractures(7 cases) were the most common associated injuries. 4. Fielding's type II (13 cases) fracture and Seinsheimer's type IV (10 cases) fracture were most common. 5. Of the 30 cases, 26(86.7%) were treated by open reduction and internal fixation. Of fixation devices, a Jewett nail was most commonly used in 13 cases (50.0%). 6. The mean duration of bony union was 20.4 weeks. There was no significant difference in union rate between fractures which were treated by operative means and fractures by conservative means. And more longer period was needed in union as fracture goes distally. 7. Weight bearing was allowed earlier in patients treated by operative means (average 10.5 weeks) than in patients by conservative means (average 18.0 weeks.). 8. Of the 30 cases, 8 complications (26.7%) occured, that is: delayed union(4 cases), mechanical failure (3 cases) and angular deformity(1 case). All of them occured in Fielding's type II and III fractures except 1 case. Loss of medial buttress and unstable reduction were considered to be causing factors. 9. Satisfactory result was obtained by stable anatomical reduction and internally fixed by Jewett nail and compression hip screw. In case of intramedullary nail, good result was expected when used in non-comminuted fracture of distal portion. Also, additional supplementary screw fixation, circlage wire and bone graft were recommended, when necessary.
Subject(s)
Female , Humans , Male , Accidents, Traffic , Bone and Bones , Clinical Study , Femur , Hip , Hip Fractures , Incidence , Orthopedics , Pelvic Bones , Ribs , Stress, Mechanical , Transplants , Weight-BearingABSTRACT
Congenital hand anomalies encompass a very broad spectrum of deformity, and precise classification of these deformities has always posed a major problem. We reviewed 50 cases of congenital hand deformities in 47 patients, managed at Department of,Orthopedic Surgery, Severance Hospital from Jan. 1980. to Jun. 1984 and the following results were obtained. 1. There were 26 males and 21 females in 47 patients and the ratio between male and female was 1.2: 1. Right hands were involved in 16 patients and both hands were in 14 patients. 2. The most commomn type of anomalies were polydactylysm(48%), next were syndactylysm (24%) and the follwing anomalies were found: camptodactyly, congenital constriction band syndrome, congenital ulnar deficiency, congenital clasped thumb, clinodactyly, congenital finger deficiency, symphalangism. 3. 9 associated congenital anomalias were found in 5 patients, in which, anomalies of the foot were most common. 4. Prenatal history such as drug ingestion, preeclampsia, breech delivery, prematurity, low birth weight were found and 2 cases of family history were found. 5. Treatment was stressed upon the function of hand and the improvement of the deformity.