ABSTRACT
The peripheral vascular occlusion in the diabetes was studied in fifty-nine male and forty-six female diabetic patients by means of doppler flow meter performed on the dorsalis pedis arteries & post. tibial arteries of the both lower limbs. Patients were divided into two groups, one with occlusion and the other without occlusion. Various predisposing factors causing peripheral vascular occlusions were examined. The results are summerized as follows: 1. Peripheral vascular occlusions were more prevalent in male than in female (male: 25.4%, female: 17.4%). 2. In male patients age, plasma cholesterol level & smoking were statically significant among the various predisposing factors between occlusion & nonocclusion groups. 3. In female patients, duration of diabetes mellitus and the sugar levels of fasting blood and post prandial 2 hours were statiscally significant.
Subject(s)
Female , Humans , Male , Arteries , Causality , Cholesterol , Diabetes Mellitus , Fasting , Foot , Lower Extremity , Open Bite , Plasma , Smoke , Smoking , Tibial ArteriesABSTRACT
In 1974, bipolar endoprosthesis was first introduced by Bateman & Giliberty. It has theoretical advantages including minimizing acetabular wear, possible reduction of incidence of stem loosening, lessening of dislocation and easy revision procedure. Various methods for the treatment of fracture of the femur neck have been developed & performed, but it is still called “the unsolved fracture” in certain situation. But the role of it as primary treatment of fracture of the femur neck continues to be controversial. Current clinical results encourage its continued use and expansion of indication. Authors reviewed and analysed 21 cases of bicentric endoprosthesis and 1 case of Giliberty endoprosthesis those have been operated at the Department of Orthopaedic Surgery, National Medical Center from 1981 to 1983. Following results were obtained, l. According to disorder distribution, 14 cases were neglected fracture of femur neck, 2 old fracture, 1 idiopathic femoral head necrosis and 2 avascular necrosis & 1 non-union complicated by femoral neck fracture. 2. Among 20 cases, 8 cases were operated within 1/2 1 month after injury and 6 cases within 1 3months 3. Harris lateral appmach was used in 16 cases (80%) and Modified Gibson approach in 4 cases (20%). There were no significant differences in morbidity during operation and postoperative complication. 4. We used femoral stems those head diameter was 22 and 32mm(Charnley & Miiller type) and head pieces those diameter was 48-51 mm in male and 44–48 mm in Ifemale. 5. 3 cases were stiff in inner bearing without acetabular erosion. 6. In 6 cases more than 2 years followup 1 degree CE angle of Wiberg was increased in 2 cases of youngage respectively without associated hip joint pain. 7. Although inclination of head piece was vertical in 8 cases, fracture and dislocation were not found. 8. The circumference of head piece and opposite femoral head was measured and compared. There were 12 cases (mean 12.6 mm) that of head piece larger than opposite femoral head and 3 cases smaller than opposite femoral head. 9. There was 4 cases of complication (3 patients) and still no reoperation and revision converted to T.H.R. 10. With regard to average 18 months of follow-up, 7 cases of 81–90 Harris hip-rating score, 6 of 91–100, 4 of 71–80 and 3 of 61–70.
Subject(s)
Humans , Male , Acetabulum , Joint Dislocations , Femoral Neck Fractures , Femur , Femur Neck , Follow-Up Studies , Head , Hip Joint , Incidence , Neck , Necrosis , Postoperative Complications , ReoperationABSTRACT
After discovery of Penicillin by Fleming in 1939, a great improvement in the treatment of osteomyelitis has been made and the mortality rate in acute stage was markedly decreased. But due to misplacement of antibiotics, and the improper treatment of the osteomyelitis, the tendency to chronicity and various sequellae of the osteomyelitis are still persist. So, it will be of importance to reconsider the management of various sequellae of pyogenic osteomyelilis. We reviewed 3 cases of sepsis, 10 cases of pathologic fracture, 6 cases of sepsis, 6 cases of malignant turnor developed in an old draining sinus, 2 cases of bone defect, 3 cases of joint contracture and 4 cases of deformity and growth disturbance 604 cases of osteomyelitis treated at National Medical Center between 1972 to 1983. The results were as follows: 1. Established sepsis was noted in 3 cases, and one of these patient dead. We treat these patients with high dose of the antibiotics accompanied by decompression of the lesion. 2. Pathologic fracture developed in 10 cases, which was treated with either conservative or operative treatment. All cases obtained good union except one. 3. Spuamous cell carcinoma developed in 6 cases around the old draining sinus. All cases were treated with amputation. Theres no recurrence except one. 4. Bone defect developed in 2 cases. A case of bone defect in humeral shaft was treated with vascularized fibular graft and obtained firm union and good function. 5. Joint contracture was treated with soft tissue release and even joint fusion in severe case. The results were not gratifying. 6. Deformity and growth disturbance of limbs were treated with soft tissue release, osteotomy and stapling. Most of the cases obtained good results, but limb length discrepancy was not recovered satisfactorily.
Subject(s)
Humans , Amputation, Surgical , Anti-Bacterial Agents , Congenital Abnormalities , Contracture , Decompression , Extremities , Fractures, Spontaneous , Joints , Mortality , Osteomyelitis , Osteotomy , Penicillins , Recurrence , Sepsis , TransplantsABSTRACT
Double contrast arthrography has been widely accepted as a method to diagnose the internal derangement of the knee. It is a safe and technically simple procedure permitting accurate diagnosis of lesions of the menisci. In 20 cases operated upon, with the diagnosis of internal derangement of the knee, we performed double contrast arthrography before surgery. We analysed the cases concerning the diagnostic accuracy of arthrography, its clinical significance and discrepancies between arthrographic findings and postoperative lesions. The results were as follows: 1. The cases consisted of 16 cases of meniscal lesion, 4 cases of ligamentous lesion and 3 cases of loose body. 2. In the meniscal lesions, 14 of the 16 cases (87.5%) were diagnosed accurately by arthrography, Therefore arthrography was more useful in diagnosing meniscal lesions as compared with clincal symptoms (69%). 3. In cases of ligamentous lesions arthrography was not significant-ly helfpful, in contrast clinical signs afforded important clues. 4. We encountered 1 case of false positive and 1 case of false negative.