Operative Treatment for Cubital Tunnel Syndrome / 대한정형외과학회잡지

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.

The Larsen Procedure for Chronic Ankle Lateral Instability / 대한정형외과학회잡지

Injury of the ankle ligaments is one of the most common sports-related injuries. Although there are some debates as to the best initial treatment for an acute tear of a lateral ligament, persistent functional instability of the ankle develops in approximately 20% of patients regardless of the type of initial treatment. In these patients, late reconstruction of the lateral ankle ligaments may become necessary. Among 13 cases which have been operated with Larsen procedure using peroneus brevis tendon from March 1991 to February 1993, the 11 cases followed up over 1 year were examined clinically and radiologically. We introduced the clinical analysis and results with the brief review of the literatures. 1. The indication of surgical treatment was the ankle instability which had differences over 10° in talar tilting angle or over 3mm in anterior displacement compared wit the uninjured site. 2. The postoperative results were 5 cases in excellent and 4 in good. 3. The Larsen procedure was considered a good method to anatomically and simply stabilize both the ankle and subtalar joint and to fix tendon depending on the type of instability.

Treatment of Painful Amputation Neuromas / 대한정형외과학회잡지

During ten years from Mar. 1973 to Feb. 1982, 2410 amputations of limbs have been experienced in Korea Veterans Hospital. 240 painful neuromas, which developed in 203 amputated limbs of 191 patients were treated with four different methods 1) Stretching and simple transection, 2) Transection and ligation, 3) Ligation and absolute alcohol injection and 4) Implantation into bone. After following up for average 5 years and 7 months, the following results were obtained. 1. The painful neuroma occured in 191 (7.9%) out of 2410 amputees. 2. The painful neuroma developed averege 2 years and 9 months after the first amputation. 3. After transection and ligation of the nerves, the painful neuroma recurred in 19.2% of the cases. The average interval taken to recur was 2 years and 6 months. 5. After ligation and absolute alcohol injection into the nerves, the painful neuroma recurred in 14.8% of the cases. The average interval taken to recur was 2 years and 6 months. 6. After implantation of the nerve into the bone, the painful neuroma recurred in 5.7% of the cases. The average interval taken to recur was 2 years and 2 months. 7. The best results were obtained after implantation of the nerves into the bone.

Total Fibulectomy for the Short Below Knee Stumps / 대한정형외과학회잡지

Although it is evident that even a very short below knee stump is superior to the lengest above knee stump, short below knee stumps present difficult pmblems in fitting prostheses. To solve these problems, twenty-nine short below knee amputees, those could not be fitted prostheses because of stump complications, had been treated by fibulectomy and resection of the peroneal nerve from March 1978 to March 1983. All the cases were followed up average 2 years and 3 months and the following results were obtained: 1. The complications of short below knee stumps decreased significantly after fibulectomy and res ection of the peroneal nerve. 2. After fibulectomy, weight bearing areas under the lateral tibial condyle increased considerably. 3. In group of below knee stumps between 5cm and 7.4cm long, P.T.B. prostheses with metal joints and thigh corsets should be fitted without difficulties. 4. In group of short below knee stumps between 7.5cm and 9.9cm long, P.T.B. prostheses with steel joints and thigh corsets, P.T.B. prostheses with knee cuff only, or supracondylar P.T.B. prostheses (K. B. M.) could be fitted selectively without any difficulty. 5. In group of short below knee stumps between 10cm and 12cm long, P. T.B. prostheses with knee cuff only or supracondylar P. T.B. prostheses could be fitted selectively without any difficulty. 6. After fibulectomy and resection of the peroneal nerve, all the short below knee amputees except for one case of very short stump (4.5cm long) could walk with their prostheses satisfactorily.

A Clinical Study of Squamous Cell Carcinoma as War Wounds / 대한정형외과학회잡지

No abstract available in English.

Statistical Survey on the Amputees / 대한정형외과학회잡지

We have made a statistical survey on 2441 amputated limbs of 2150 patients who were treated at the Depart- ment of Orthopedic Surgery and who were prescribed the prosthetics at the Prosthetic Center of Veterans Hospital from Mar. 1972 to Feb. 1982. 1. The peak incidence was in the age group from 21 to 30 years with 1546 cases (63.3%). Of 2150 patients only 9 patients were female. 2. The main causes of amputation were trauma with 1901 cases (77.9%), vascular insufficiency with 326 cases (13.4%) and chronic osteomyelitis with 157 cases (6.4%). And the most fre#quent cause of traumatic amputation was explosive injury with 1080 cases (56.8%). 3. Of the 2441 amputated limbs, 1756 cases (71.91°) were at the lower extremity and the most frequent site was below the knee with 1000 cases (57%). 4. Minor limb amputation was performed on 326 cases (13.4%). 5. Multiple limb amputation was performed on 255 patients (11.9%) and of these 12 patients were amputated on 4 extremities. 6. Reoperation was performed on 420 cases (17.2%). It was most prevalent in the lower extremity with 365 cases (86.9%) and their main cause was neuroma with 171 cases (40.7%). The most frequent site was below the knee with 240 cases (57.2%).

Measurement of the Oblique Diameter of the Lumbar Spinal Canal in Korean Army-aged Group by Echographic Method / 대한정형외과학회잡지

The size and configuration of the lumbar spinal canal constitute one of the important factors in the production of symptoms referable to cauda equina and nerve roots of the lumbar spine and the narrowness of the spinal canal. Numerous attempts have been made to measure the size of the lumbar spinal canal, but most of those are not sufficient to measure the oblique diameter of the lumbar spinal canal. Also, echographic diagnosis is much simple, safe, less expensive and non-invasive and furthermore demonstrates much more accuracy than other alternative and radiographic procedures. The purpose of this study is to establish the range of normal values of the oblique diameter of the lumbar spinal canal in Korean Army-aged group by echographic method in the interest of facilitating clinical evaluation of the lumbar spinal canal stenosis. The author measured oblique diamenter of the lumbar spinal canal in thirty healthy persons of both sexes of ages between nineteen and twenty-five years by ultrasound using sonolayergraphy model SSL-21A. Distance from the ligamentum flavum to the posterior longitudinal ligament was measured in millimeters with dial vernier caliper. Actual distance of oblique diameter of the lumbar spinal canal is obtained by multiplication of the distance of echogram by calibration factor 2.22. The results were as follows; 1. The mean values of the oblique diameter of the lumbar spinal canal in male and female between nineteen and twenty-five years of age were 14.77±0.85mm and 14.87±0.82mm in Ll, 13.99±0.87mm and 14.13±0.96mm in L2, 13.40±0.69mm and 13.71±0.75mm in L3, 12.88±0.69mm and 12.93±0.68mm in L4, 14.58±0.79mm and 14.42±0.84mm in L5 respectively. 2. The oblique diameter of the lumbar spinal canal was the widest at the first lumbar vertebra, the next at the fifth lumbar vertebra and the narrowest at the fourth lumbar vertebra. 3. There was no difference of diameter of the lumbar spinal canal between both sexes.

Multifocal Reticulum Cell Sarcoma of Bone: A Case Report / 대한정형외과학회잡지

A Case of multifocal reticulum cell sarcoma in a 61 year old male is reported. The patient had multiple foci of sarcomatous lesion in the olecranon of the right ulna, medial candyle of the left tibia and in both ankle joints. His initial complaints on admission were pain and swelling in his both ankles and the right elbow of three months duration. Biopsy was carried out on his right ankle joint and diagnosis of reticulum cell sarcoma was made. Surgical excision of the right olecranon and below Knee amputation of the right lower extremity were performed. Following the surgical intervention, Cobalt 60 irradiation therapy was given for 20 days with total amount of 4,000 rads. The follow-up study three months after surgery revealed much improvement and no evidence of recurrence.