Observation of Fracture Load Index in Tibia Fracture Treated with Patella Tendon Bearing Cast / 대한정형외과학회잡지

The finger flexor injuries are very difficult to treat satisfactorily. It is usually said that the earlier the treatment performed, the better result obtained. But the delicasy of the hand anatomy and its function as well as the absence of the hand surgeon in the first aid care make the problem more complex. Even if we made the primary treatment to the flexor tendon injuries, some disabilities are often remained. We have treated fifty eight cases of old flexor tendon injuries in forty eight patients, the results can be summarized as follows. 1. The cause of the tendon damage is due to the laceration injury in the majorities of the cases. T,he tendon injuries are especially common between the late second and the early third decade. 2. In the injury of the Zone II with pulley distortion, the pulley reconstruction using palmaris longus or fascia from other sites will prevent bowstring and help the tendon function. 3. The Zone II can be subdivided into two subspecific areas. The proximal area is from the distal palmar crease to the midoprtion of porximal phalanx and the distal one is from the midportion of the proximal phalanx to the insertion of the sublimis tendon. In the proximal area one can repair the injured tendon directly after removal of the A1 and about proximal half of the A2 pulley without any subsequent bowstring if the tendon and its tunnel is relatively well preserved. Thus one can convert this proximal portion of Zone II to Zone III. So the proximal area of the Zone II should be differentiated from the remaining distal part of the Zone II. 4. At six months after the operation the result of the operation was analyzed by the percentage of the recovery, which was calculated by the postoperative active range of the interphalangeal joints divided by one hundred seventy five degrees that means the available total range of motion of normal interphalangeal joints. Excluding the cases with the tenodesis or arthrodesis, the total result revealed good or excellent in about ninty percentages with this method. 5. There were two fingers that showed a postoperative lumbrical plus state in Zone II, which were recovered spontaneously within three to four months postoperatively. So it is considered that the relative shortening of the lumbrical muscles can be treated and overcome conservatively by the active use of the fingers, and there is no need to perform an lumbrical tenotomy to correct this kind of muscle imbalance.

Hair Strangulation: A Case Report / 대한정형외과학회잡지

A case of hair strangulation on right toe of two months old female patient is reported together with a brief review of references in this paper. This hair strangulation was on the proximal interphanlangeal joint of the right third toe. The distal portion of the hair strangulation was discolored as black, swollon, cold and no evidence of circulation. Amputationon the metatarsophalangeal joint was done.

Fracture of the Carpal Navicular / 대한정형외과학회잡지

1. Ten cases of fracture of the carpal navicular were observed and analyzed, which were treated by thumb-including short arm cast in the Department of Orthopedic Surgery, Han Kang Sacred Heart Hospital during the period from November 1, 1977 to May 31, 1978. 2. Of the total ten cases eight cases were between the age of twenty and forty. 3. The sites of fracture were confined to the middle one third in ten cases. The fracture lines were-transverse in six cases. 4. There was little difficulty in confirming the diagnosis initially with clinical symptoms and signs and roentgenologic studies available. But, in one case the frature line was not detected by usual roentgenologic studies including the carpal navicular view. 5. Union was obtained from two cases after ten weeks of cast immobilization, from four cases after twelve weeks and from three cases after twenty weeks. In the remaining one case, however, pain was persistent after twenty-four weeks of immobilization. 6. The results of treatment were excellent in four cases and good in five cases so that nine patients could return to their work.

Tissue Pressure Changes following Tibia Fracture / 대한정형외과학회잡지

Delayed diagnosis of the compartmental syndrome and subsequent delay in performing the fasciotomy can result in needless loss of function and possible amputation of the involved extremity. Unfortunately early evidence of this syndrome is difficult to assess. A direct measurement of the tissue pressure within a closed compartment has been developed which provides physicians with reliable information for determining the need for fasciotomy. In the 27 cases of the tibia fracture, tissue pressure was measured directly by method of the needle manometer in the Department of Orthopedic Surgery, Han Kang Sung Sim Hospital from March, 1979 to August, 1979. The results were as follows: 1. The highest mean tissue pressure per hour was 28 mmHg in anterior compartment at 24 hours after trauma, and 28.4 mmHg in deep post compartment at the same hours. 2. The highest pressure measured in all cases was 38 mmHg in anterior compartment at 24 hours and 39 mmHg in deep posterior compartment at 48 hours after trauma. 3. The return of increased tissue pressure to less than 10 mmHg took 122.6 hours in anterior and 124.4 hours in deep posterior compartment. 4. Tissue pressre was higher when there was associated fibula fracture. 5. Tissue pressure was higher in displaced fractures than in undisplaced fractures. 6. Tissue pressure was higher when fracture was in its upper one-third. 7. Tissue pressure was higher in comminuted fracture than simple fracture.

Osteopoikilosis: A Case Report / 대한정형외과학회잡지

Osteopoikilosis is a familial, rare condition only discovered on radiological examination for a coincident disease. It is characterized by numerous nodules of dense bone in the spongiosa of the metaphysis or in the epiphysial nucleus. They are particularly seen in the small bones of the hands and feet and at the ends of the large bones of the extremities. Most of the bones have been reported as being affected but the skull is rarely involved. This condition is usually symptomless and no specific treatment is necessary. A case of osteopoikilosis is presented with a brief review of literatures.

Forestier's Disease: A case report / 대한정형외과학회잡지

Foreatiers disease is a peculiar type of ankylosing hyperostosis of the spine characterized by ossification of the anterior and right lateral aspects of the vertebral column, particularly in the thoracic region. The clinical, pathological and reontgenographic features of the disorder allowed its differentiation from other spinal diseases including ankylosing spordylitis and osteoarthritis. A case of Forestiers disease is presented with brief review of literatures.

Congenital Pseudarthrosis associated with Neurofibromatosis: A case report / 대한정형외과학회잡지

Congenital pseudarthrosis is frequently associated with various stigmata of neurofibromatosis, particularly Cafe-Au-Lait spots and,subcutaneous nodules and in these patients, it is noteworthy that the treatment is very difficult even with extensive operative approach. Also it is interesting to find many controversies on etiological relation between neurofibroma and pseudarthrosis, per se and even the existance of nerve element in and around the tissue of pseudarthrosis. A thirteen years old female patient with definite neurofibromatosis associated with congenital tibial pseudarthrosis treated by intramedullary nailing and massive bone graft is reported.

Internal Derangment of Knee Due to Rupture of Plica Synovialis Mediopatellaris: A case report / 대한정형외과학회잡지

In clinical experience, patients complaining of knee joint pain which is not belong to the category of well documented causative diseases, such as rupture of menisci, collateral ligaments and so forth, have been encountered, Since the report of Mayedas chorda cavi articularis genu in 1918, internal derangement of knee due to rupture of plica synovialis has been presented from time to time, Numerous nomenclatures have been offered and various histologic and clinicopathologic features have been observed. Majority of uncomplicated plica synovialis are asymptomatic and respond well to conservative treatment, whereas in complicated cases operation is often inevitable. Here, a symptomatic case, due to rupture of plica synovialis mediopatellaris which was hard to differentiate from rupture of meniscus in clinical aspect and on operation field is reported with available references.

A Case Report of Osteoid Osteoma in Lumbar Spine with Hamstring Muscle Tightness / 대한정형외과학회잡지

One case of osteoid osteoma in the lamina of the fifth lumbar spine with hamstring muscle tightness was experienced and successfully treated by surgery at the department of orthopedic surgery in Seoul National University Hospital. Literature on the subject was reviewed in detail.