Clinical Study of Clavicle Fractures / 대한정형외과학회잡지

A clinical study of 147 clavicle fracture patients (one patient had bilateral fractures) who were admitted and treated by the Department of orthopedic surgery of Wonju Christian Hospital, Wonju Medical College, Yon Sei University. The period covered was from September 1974 to August 1981, a total of seven years. The study focused on three fertors in relation to the pain and limitation of motion and these causes were comminution of fracture, shortening of the clavicle length and external deformity. The results were as followings; l. Of the 148 cases, 125 were male and 22 female (one with bilateral fractures). The majority were between 31 and 40 years of age. 2. The mid 1/3 fracture was most common and both sides showed no difference in incidence(left ; 73 cases, right; 75 cases). 3. The mean follow up ranged from 4 months to H3 months with a mean 49.5 months. 4. The complications resulting from comminution, shortening of clavicle length and malunion were shoulder joint pain-16 cases (10.8%), limitation of motion-17 cases(11.5%) and external deformity-18 cases(12.9%). 5. Using a rating scale of excellent(no apparent factors), good( one factor), fair(two factors), poor(more than three factors) the results showed, 106 excellent, 31 good, 9 fair and 2 poor. 6. On a percentage scale, the pain showed difference of 9 times with initial comminution, 7 times with shortening of clavicle length and 7 times with deformity. 8. On a percentage scale, the limitation of motion of shoulder joint showed difference of 6 times with initial comminution, 6 times with shortening of clavicle length and 17 times with deformity.

Treatment of Complete Acromioclavicular Joint Dislocation by Weaver and Dunn Method / 대한정형외과학회잡지

No abstract available in English.

Traumatic Complete Dislocation of the Knee Joint: Report of 3 Cases / 대한정형외과학회잡지

No abstract available in English.

A Clinical Observation of the Pelvic Bone Fracture / 대한정형외과학회잡지

62 cases of the fracture of the pelvis admitted to the orthpedic department of Wonju Christian Hospital during past 5 years from 1975 to 1979 were reviewed and clinical results were obtained as follows: 1. Males were frequent than females and almost 3rd to 4th decades of life. 2. The causes of injury were traffic accident, coal minor accident, and falling. 3. Stable type is the most common in this series and among the unstable types, lateral compression type is the most common and then straddle type and vertical shear type. 4. The most common complication is uro-genital injury. 5. The residual complications at the end of treatment remained in some cases, Arthritis of sacroiliac joint, Impotence, Urethral stricture, Low back pain, etc. 6. All of the cases were treated conservatively and their results were somewhat good except 4 cases. 7. Surgical treatment would be considered, if necessory, to decrease the complications and reduce hospital days.

Ankle Arthrodesis: A Clinical Review / 대한정형외과학회잡지

Injuries to the ankle or various disease in ankle are one of the most common musculoskeletal problem. The ankle is amazingly tolerant to at least minor anatomic disruption. But in situation of severed ankle it is the anxious problem to solve the pain, disability and so on. Since past time, ankle fusion can solve the pain problem, and there is little disabiiity from walking on standard surfaces, comparing the ankle arthroplasty. So we analyse 48 cases of the ankle fusion at Wonju Christian Hospital, Yonsei University College of Medicine for ten years. The results are summerized as follows: l. Applying method for fusion are distraction-compression bone graft arthrodesis, Charnley compression method, extraarticular arthrodesis, anterior sliding graft-21, 16, 2 and 9 cases respectively. 2. Post-operative complications are wound infection, loss of position of grafted bone, skin necrosis, fracture of the grafted bone and phlebitis

A Clinical Study of Tuberculous Spondylitis / 대한정형외과학회잡지

After development of antituberculous chemotherapy, the prevalence of tuberculous spondylitis has been reduced dramatically, but still this problem has remained as a serious infectious disease in developing areas. For the period of 8 years from January 1972 to December 1979, 148 patients who were treated for tuberculous spondylitis at Wonju Christian Hospital, College of Medicine, Yonsei University, were studied retrospectively and the results are summarized as follows: 1. The prevalent age was under 15 years (41.3%) 2. The lag period to treatment in most cases was one to six months(60.8%) 3. The most common site was thoracolumbar junction (37.2%) and the 10th thoracic vertebrae was especially affected. 4. There were 43 cases of associated tuberculous lesions (29.1%) 5. The involved numbers of vertebral bodies were 3.4 in the child and 2. 3 in the adult. 6. Initial checking of erythrocyte sedimentation rate for patients with tuberculous spondylitis showed over 15 mm/hr in 79.3%, but 77.1% patients on post-operative follow-up came within the normal limit. 7. There were 30 early paraplegics. 8; There were 10 complete and 21 incomplete paraplegics and the spastic type was more common than the flaccid type. 9. The recovery rate from paraplegia was 90.5% in incomplete paraplegics and 80.0% in complete paraplegics. 10. The kyphotic angle was checked by means of Konstams angle. Results were as follows: Total mean changes in angle were 12.9, 2.7, and 1.5 after debridement, anterior fusion and posterior fusion respectively in the adults, and in the children each total mean changes in angle were 7. 2, 4. 0 and 2. 0 respectively.

Clinical Observation of Pyogenic Osteomyelitis / 대한정형외과학회잡지

Pyogenic osteomyelitis is a frequent and difficult disease in treatment in orthopedic surgery. The various manifestation of the disease related to the causative organisms, the sites of involvement, the pathogenesis and the clinical course tend to give a bad prognosis after treatment. This study consists of three hundred and twenty four cases of pyogenic osteomyelitis which are studied at the Department of Orthopedic Surgery, Yonsei University hospital for 7 years and 8 months from January 1973 to August 1979. The results are as follows: 1. The frequency of the disease was highest in 1977 but not significant. 2. Femur and tibia were most frequently involved. (65.4%). 3. Age distribution showed the highest incidence between 6 and 15 years of age. (60.6%) Sex ratio was 2(M):1(F) 4. The causative organism was mostly Staphylococcus. (80.5%) The coagulase(+) Staphylococcus showed the highest sensitivity to cefamezine (88.8%) and the highest resistance to penicillin. (89.7%) 5. The treatment had been carried out case by case with variable methods. Author considered the best method of treatment was early decompression and massive antibiotic therapy in acute osteomyelitis, and saucerization with closed irrigation system in chronic osteomyelitis.

A Clinical Study on Fracture of the Hand / 대한정형외과학회잡지

The hand is a part of the human body, which has a complex structure, various functions and is one of the parts of the body most susceptible to trauma. With the increasing number of the traffic and occupational accidents proportionate to the rapld development of modern culture, fracture of the hand have become one of the commonest fracture of the human body. The object of treatment of fracture of the hand is to restore function the greatest degree possible with exact diagnosis and proper treatment based on the knowledge of anatomical structure and function. The authors have reviewed 228 cases of fractures of the hand (fracture with severe soft tissue injury were excluded) which were treated in the department of orthopedic surgery, Severance hospital from 1969 to 1978. The following results were obtained; 1. Fractures occured more commonly In man (80.3%) than woman. 2. Fractures occured more commonly in the second decade and the group between 10 and 30 years of age accounted for 73.7% of all fractures. 3. There was no significant differnnce between the left and right side. (105:123) 4. The commonest cause of the fracture was traffic accident (38.6%), machinary injury was the second (21.1%). 5. Most of the patients were brought to our hospital within 12 hours after injury (61.8%). 6. The most frequently fractured bone was the metacarpal (34.4%), then the proximal phalanx (28.1%), distal phalanx (16.9%), middle phalanx (10.5%) in decreasing frequency. 7. The average time for clinical union was 4.2 weeks in the case of the distal phalanx, 6.8 weeks in middle phalanx, 7.3 weeks in proximal phalanx and 6.5 weeks in metacarpal. 8. Complications were found in 8.3% of all cases and angulation deformlty was the most frequent.

Subperiostedal Ganglion of the Tibia: A Case Report / 대한정형외과학회잡지

Subperiosteal Ganglion is a rare cystic lession, although ganglions are frequently found in close proximities to joints and tendon sheaths. It is characterized by a thin-walled cyst containing tenacious mucoid fluid and by the pedicle attached to periosteum. This report describes a middle-aged man with a subperiosteal ganglion which occured beneath the periosteam of the tibia. Presenting symptoms were pain and circumscribed swelling over the anteromedial aspect of the right proximal tibia.

Clinical Studies on Spondylolisthesis / 대한정형외과학회잡지

Spondylolisthesis is characterized by forward displacement of the vertebral body with bilateral defects of the partes interarticulares. Because the progression of slipping occurs in young adults, difficult problems are present in the treatment of this condition. Watkins(1953) described the technique of posterolateral fusion between transverse processes, which was accepted in the dynamics of spine motion. In this procedure, grafted bone is placed close to the center of axis of the spine motion and so, bony fusion is not affected by flexion motion but distracted by a Iateral shearing force. The role played by the Norton-Brown back brace is in the restriction of lateral bending. However it pormits somewhat flexion motion of the spine. It is suggested that early ambulation may be possible without the interference of bony union after the posterolateral fusion operation when this brace is applied instead of longterm cast immobilization. In clinical analyses and follow-up studies after operative treatments in 55 patients with spondylolisthesis, the following results were obtained: 1. 30 patients (54.6%) were distributed between 21 and 40 years of age. 2. Males (52.7%) were slightly more than females (47.3%). 3. Among clinical symptoms and signs, low back pain was most common (87.3%). Sciatica was present in 45.5% 4. Duration of symptoms at admission was variable. 5. 15 patients (27.3%) had a previous history of trauma. 6. 5th lumbar vertebra was most commonly involved (74.5%) followed by the 4th lumbar vertebra(23.6%). There was a case(1.9%) in which the 5th and 4th lumbar vertebrae were involved. 7. Degrees of slipping were divided into 4 grades (Grade I–IV) by Meyerdings method. Grade 1 was most common (72.2%), Grade II 22.2% and Grade III 5.6%. 8. In follow-up studies of the operative treatment, laminectomy & H-graft were satisfactory in 84.9% and posterolateral fuion in aII cases (13 patients). 9. Early ambulation was preferred without healng disturbance in a case in which the Norton-Brown back brace was applied after posteroIateraI fusion and also, other advantages were expected as follws: a) Elimination of prolonged cast immobiIization b) Financial aid c) Early return to work d) Mental comfort.

A Case of Synovial Chondromatosis in the Knee / 대한정형외과학회잡지

This is a case of synovial chondromatosis involving the left knee joint of a forty one year old man. Chief complaints were gradual development of pain and limitation of knee joint motion of about 10 years duration. K-ray study revealed a single radio-opaque loose body filling the joint cavity. This body, measuring about 3×2×2cm, was removed surgically and found to have a pedicle from the synovial membrane, consisting of fat and fibrous tissue. The diagnosis of synovial chondromatosis was confirmed by pathological study. The postoperative course was uneventful and three months after the operation, the range of motion of the affected knee joint was good.