Pregnancy Outcomes after Induction of Labor Versus Expectant Management in Cases with Sonographic Diagnosis of Fetal Macrosomia / 대한주산의학회잡지

OBJECTIVE: Macrosomia is associated with increased birth injury and neonatal morbidity as well as a higher rate of cesarean delivery. Our purpose was to determine whether induction of labor after sonographic diagnosis of fetal macrosomia could improve maternal and neonatal outcome. STUDY DESIGN: The hospital records of 180 patients who delivered of an inFant with birth weight over 4000 gm were reviewed. The subjects were divided into three groups based on obstetric management as follows.. expectant management after sonographic diagnosis of fetal macrosomia(group I), induction of labor(group lI), unexpected patients who were underestimated of fetal weight(estimated fetal weight<90th percentile) (groupIII), Patients who underwent elective cesarean delivery and complicated with diabetes were excluded. Outcome variables for comparison in three groups were mode of delivery, 5 minute Apgar score below 7, presence of cephalohematoma, clavicular fracture, brachial plexus injury, and intraventricular hemorrhage. RESULTS: One hundred eighty patients who eligible for the study, of whom 32 patients were included to group I, 57 patients to group lI, and 91 patients to group Ill, respectively. The cesarean rate within elective induction group was 49%, which was significant higher than the 16% rate in expectant management group and 19% in unexpected group(p<0.05). The observed rates of cephalohematoma, clavicular fracture and 5 min Apgar score below 7 were not significantly different in three groups. CONCLUSIONS: There was an significant increased cesarean delivery rate without improvement in neonatal outcomes or reduction in birth injury among pregnancies in which labor was electively induced after sonographic diagnosis of fetal macrosomia. Elective induction of labor should be discharged in cases with fetal macrosomia.

A Clinical Study of parachuting Injury / 대한정형외과학회잡지

Parachuting has become progressively a very popular recreational sports in foreign developed nations, and subsequently injury caused by it is getting more frighten and sometimes severe. Authors in this study clinically analysed 306 cases of parachuting injury who were treated at the department of orthopaedic sugery, C.A.F.G.H. during 3 years period from March, 19xx to February, 19 XX. There results were as followings: l. Of 306 cases, 268 had fracture, 38 soft tissue injuries. 2. Of 268 fracture cases, 208 cases had injuries in the lower extremity, 48 cases in trunk, 15 cases in upper extremity. 3. The most common associated injury was the head injury (26%). 4. The most common injured site was ankle and foot (57.5%), the next spine and pelvis (16.9%). 5. Through this study, it is said that parachuting is a dangerous sports, and the injury caused by parachuting may be largely preventable, if with adequate practical instruction, coaching and wearing protective garments.

Chondroma of Soft Tissue: A Case Report / 대한정형외과학회잡지

A case of chondroma of soft tissue of right hand in 23-year old man was reported. The presenting symptom was a slow growing mass, causing mild tenderness. Radiologic examination revealed a well demarked and lobulated calcified mass, was located extraskeletally. Specimen exised from soft tisssue of the hypothenar area of the hand was 5×4×3.5cm sized mass, had gelatinous and gray-whitish appearance. On microscopical examination, the tumor was classified as a chondroma of soft tissue.

Suprascapular Nerve Entrapment Syndrome: A Case Report / 대한정형외과학회잡지

The suprascapular nerve entrapment syndrome is a rare neuropathy. Clein described the frist case report of this syndrome and operative procedure in 1975. The cardinal sign is pain in and around the shoulder, weakness of abduction and external rotation and atrophy of the supraspinatus and infraspinatus muscles, This syndrome can be diagnosed by clinical symptoms, physical examination, special roentgenogram and electromyogram. We experienced a case of the suprascapular nerve entrapment syndrome. We treated it by resection of the superior transverse ligament of suapula, and obtained good result.

Parathyroid Carcinoma Causing Hyperparathyroidism: A Case Report / 대한정형외과학회잡지

A case of carcinoma of the parathyroid gland causing hyperparathyroidism was experienced at the department of orthopaedic surgery, C.A.F.G.H. This patient, a 23 years old male, had complained of a left shoulder pain during the past 3months. And weakness of the lower extremities causing walking disturbance, multiple bone pain, and polyuria had occurred sinoe one month before admission. Physical examination revealed a hard palpable mass in the right anterior region of the neck. Radiologic examination revealed subperiosteal bone resorption in phalanges of the hands and feet, generalized osteoporosis and cystic lesions, and pathologic fracture of the ribs, left humerus, and left femur. Laboratory studies demonstrated hypercalcemia, hypophosphatemia, increased alkaline phosphatase and PTH, hypercalciuria, and hyperphophaturia. Sonogram and C-T scan of the neck revealed a mass in the right inferior portion of the thyroid. Rib biopsy revealed the findings of ostitis fibrosa cystica, and parathyroid gland and regional lymph node biopsy revealed a parathyroid carcinoma with regional lymph node metastasis.

The Fatigue Fracture of the Metatarsal in an Unilateral A-K amputee: A case report / 대한정형외과학회잡지

Together with review of literatures, authors reported a case of fatigue fracture of right 3rd metatarsal bone in an A-K amputee of lefe side, and added an amputation of contralateral lower extremity as a predisposing factor of fatigue fracture of metatarsal bone.

The Role of Y and Greater Trochanteric Growth Cartilage upon the Acetabular Development of Rabbits: An Experimental Study / 대한정형외과학회잡지

It has been known that osseous stability of the hip is dependent upon the inclination, anteversion and depth of acetabulum and also upon neck-shaft angle and anteversion of femur. Acetabulum enlarges from two different growth centers; one from the concave articular surface cartilage and the other from the triradiate cartilage. The former contributes primarily to the thickness of acetabular wall, where as, the latter to the central enlargement of the acetabular socket. Additionally the shape of acetabulum can be changed by deformity of the femoral head and neck, which can be explained by Wolff's and Hueter-Volkmann's laws. Yet there are still many factors to be clarified by clinical researchers in the future Authors in this experiment tried to clarify the role of triradiate cartilage and greater trochanteric growth plate upon the development of acetabulum. The material used for this study consiated of 30 rabbits of both sexes, aged 8 weeks. Animals were divided into 3 groups, and each group consisted of 10 rabbits In group I. hip was not injured and used as a Control: in group II, right greater trochanter with its growth plate was destructed completely; in group III, triradiate cartilage of right side was destructed. Subsequent to injury of Y cartilage ot greater trochanter with its growth plate, radiographs of the pelvis including hips were obtained weekly on each rabbit over 6 weeks period. and to evaluate the effect of injury upon the hip development acetatular angle, C-E angle, and acetabular depth and width were measured. The following results were obtained; 1. The shape of acetabulum of rabbits have showe remarable developmental changes until the 10 weeks of age after birth, but the changes became less remarkable by age of the 14 weeks. Thereafter it remained unchanged. 2. In group II, at the age of 14 weeks, compared with the values of the normal hip, the acetabular angle showed an increase of 1.9 degrees, and the center dege angle and acetabular depth showed a decrease of 3.21 degrees and 0.43mm respectirely. 3. In group III, at the age of 14 weeks, compared with the values of the normal hip, the acetabular angle increased by 18.9 degress while the center-edge angle decreased by 22.8 degrees. The acetabular depth showed a decrease of 1.81mm and the acetabular width showed an increase of 0.73mm. These observations suggest that the development of acetabulum depends largely upon the growth of triradiate cartilage, and also is affected secondarily by valgalization of femoral neck which is resulted by destruction of greater trochanteric growth cartilage.

Patient with Low Back Pain and Cornell Medical Index / 대한정형외과학회잡지

The cornell medical index is self-administered instrument that collects a large body of significant medical and psychiatric data. The original C. M. I. consists of 195 questions, but authors selected 60 questions from the original C. M. I. to simplify it. The purpose of this investigation is to clarify if there are any correlations between low back pain and extraskeletal disorders. This investigation was conducted on 144 in-and out-patients who were treated at the Department of Orthopaedic Surgery,Our Lady of Mercy Hospital, Catholic Medical College from Jan. to July 1977. Among them 75 patients were male,69 patients were female, and 22 patients had decompression laminectomy and discectomy. The results of this investigation are as follows; 1. The majority of patients with low back pain are 2nd to 4th decade. (Male: 30±10.7) (Femal:36.1±10.5) 2. Average number of complaints is 19.9/60 in male, 21.8/60 in female. 3. Complaints in section F(Fatigability) and G(mental) are predominant in all cases. 4. There are no significant difference in number of complaints between the operative and non-operative case, and between each decade.