Replantation of Amputed Anke Through the Distal Tibial Epiphysis: A Case Report / 대한정형외과학회잡지

Amputation through the epiphyseal plate is very rare. Authors experienced only one case of ankle amputation through the epiphyseal plate in one huadred seventeen replantation cases during last seven years. It can make severe growth disturbance after replantation especially if the bone shortening is carried out at epiphyseal plate. Authors have developed new idea to make boae shortening during replantation with preservation of the epiphyseal plate in amputation through the epiphyseal plate in three years old female. It is, so called, double osteotomy shortening. Bone shortening is performed at 5cm above amputated epipyaeal plate to avoid further damage in epiphyseal plate, and a bone segment 3cm in length is resected,by double osteotomy shortening technique. After then, bone reduction and internal fixation is followed. With above technique, authors succeeded in replantation without further damage in epiphysis. In three years and ten months follow-up, bony growth in replanted tibia shows normal pattern, and epiphyseal plate in replanted site is working and remained open. The patient can walk without pain, and motor-sensory function have almost completely recoverered.

Arthrography and Arthroscopy for Meniscal Lesions of the Knees / 대한정형외과학회잡지

We assessed the accuracy of clinical evaluation, arthrography, and arthroscopy in the diagnosis of meniscal lesions in twenty-nine knees in which arthrotomy and menisectomy were performed after evaluation by these three methods, At surgery, thirty menisci of twenty-nine knees were removed, of which twenty-eight were abnormal and two were normal. In these thirty menisci, a correct diagnosis was made clinically eighteen times, arthrographically twenty times, and arthroscopically twenty-seven times. Posterior horn tears of medial meniscus and discoid lateral meniscus were well visualized but lateral meniscal tears were poorly visualized on arthrogram. The errors of arthroscopy occurred in two tears confined to outer one half of medial menscal posterior horn, and in a normal meniscus as false positive. Based on this study, it was concluded that both the arthrography and arthroscopy are valuable techniques for the diagnosis of meniscal lesions, and that we can expect correct diagnosis of all the meniscal lesions by the use of complementary roles of the two and by the experiences.

A Study on Wound Infection of Open Fracture / 대한정형외과학회잡지

In 257 open fracture patients, treated from 1972 to 1979 at Kyung Hee University Hospital and analysed retrospectively, the infection rate was 35.8%. The factors thought to be associated with post-operative infection in open fracture were statistically analysed and discussed. The conclusions of this study were follows: 1. Open fractures require adequate debridement and irrigation. 2. Antibiotics should be administered as early as possible, especially before operation. 3. Early determination of local blood clrculation and its improvement are importent. 4. Contaminated open wound should be treated open, but if wound considered clean by adequate debridement may be closed primarlly. 5. If primary bone fixation is required, external flxation is recommended. Internal fixation should be avoided In grade I & II, but in grade III internal fixatlon is not contraindication for Improvement of blood circulation and open wound management.