The effect of postoperatively applied far-infrared radiation on pain and tendon-to-bone healing after arthroscopic rotator cuff repair:a clinical prospective randomized comparative study

Background@#The effects of far-infrared radiation (FIR) on the treatment of rotator cuff diseases remains unknown. We evaluated the safety and efficacy of FIR after arthroscopic rotator cuff repair with regard to postoperative pain and healing. @*Methods@#This prospective randomized comparative study included 38 patients who underwent arthroscopic rotator cuff repair due to a medium-sized tear. Patients were randomly divided into the FIR or control group (n = 19 per group). In the FIR group, FIR with an FIR radiator started 1 week postoperatively for 30 minutes per session twice daily. It lasted until abduction brace weaning at 5 weeks postoperatively. We assessed pain using a pain visual analogue scale (pVAS) and measured the range of motion (ROM) of the shoulder at 5 weeks, and 3 and 6 months, postoperatively. The anatomical outcome was evaluated using magnetic resonance imaging at 6 months postoperatively. @*Results@#At 5 weeks postoperatively, the average pVAS score was lower in the FIR group than in the control group (1.5 ± 0.8 vs. 2.7 ± 1.7; P = 0.019). At 3 months postoperatively, the average forward flexion was higher in the FIR group (151.6° ± 15.3° vs. 132.9° ± 27.8°;P = 0.045), but there was no significant difference at 6 months postoperatively. There was no significant difference in healing failure between the groups (P = 0.999). @*Conclusions@#FIR after arthroscopic rotator cuff repair could be an effective and safe procedure to reduce postoperative pain, thereby facilitating rehabilitation and better ROM in the early postoperative period.

Fatal Post-Operative Epilepticus after Burr-Hole Drainage for Chronic Subdural Hematoma / 대한신경손상학회지

Incidence of post-operative seizure after burr-hole trephination (BHT) for chronic subdural hematoma (CSDH) is known to be very low. The effect of the prophylactic antiepileptic drug in reducing the development of new seizure after surgery is still unclear. Here, we present a case of fatal status epilepticus with progressive respiratory complication following early discontinuation of prophylactic antiepileptic drug in an 84-year-old man who had undergone bilateral BHT and closed-system drainage for bilateral CSDH. Although the efficacy of the prophylactic anticonvulsants in BHT for CSDH has been controversial, the development of status epilepticus postoperatively seems to be strongly associated with an increased mortality rate in aged patients. Therefore, prophylactic anticonvulsants should be administrated in aged patients who undergo surgery for CSDH, until a definitive clinical treatment guideline is suggested.

Binding Pancreaticojejunostomy Compared with Dunking Pancreaticojejunostomy

PURPOSE: Pancreatic fistulas are a leading cause of mortality and morbidity following pancreaticoduodenectomy. The objective of this study was to evaluate the possibility of controlling pancreatic fistula formation by binding pancreaticojejunostomy into the operative procedure, as proposed by Peng, which results in a 3 cm invagination of the pancreatic remnant by the jejunal segment bearing electrically-destroyed mucosa reinforced by inner and outer sutures. METHODS: Prospectively collected data of patients undergoing pancreaticoduodenectomy in the Department of Surgery of Daejeon St. Mary's hospital between April 2007 and May 2009 were analyzed retrospectively. Thirty-one patients were included in the study; 16 patients underwent dunking pancreaticojejunostomy and 15 patients underwent binding pancreaticojejunostomy. RESULTS: The two groups were comparable with respect to demographic data, pre-operative characteristics, underlying pathologies, pancreatic textures, and duct diameters. The mean operative time did not differ between the two groups (388+/-29 min vs. 459+/-21 min, p=0.060). No difference existed in the post-operative course except for the degree of complications. In contrast to the dunking group, in which 2 cases of grade III/V pancreatic fistulas occurred, the binding group had no severe complications. In addition, transformation of amylase data measured from Jackson-Pratt drains into a natural logarithm demonstrated significant differences on post-operative (POD) days 1, 3, and 7 between the dunking and binding groups (POD1, 6.97+/-0.41 vs. 6.10+/-0.44 [p=0.037]; POD3, 6.97+/-0.41 vs. 6.10+/-0.44 [p=0.032]; POD7, 4.69+/-0.35 vs. 3.88+/-0.25 [p=0.034], respectively). CONCLUSION: Bindning pancreaticojejunostomy is equivalent to dunking pancreaticojejunostomy with respect to operative difficulties, and more effective in preventing complications related to pancreatic fistulas.

Binding Pancreaticojejunostomy Compared with Dunking Pancreaticojejunostomy

PURPOSE: Pancreatic fistulas are a leading cause of mortality and morbidity following pancreaticoduodenectomy. The objective of this study was to evaluate the possibility of controlling pancreatic fistula formation by binding pancreaticojejunostomy into the operative procedure, as proposed by Peng, which results in a 3 cm invagination of the pancreatic remnant by the jejunal segment bearing electrically-destroyed mucosa reinforced by inner and outer sutures. METHODS: Prospectively collected data of patients undergoing pancreaticoduodenectomy in the Department of Surgery of Daejeon St. Mary's hospital between April 2007 and May 2009 were analyzed retrospectively. Thirty-one patients were included in the study; 16 patients underwent dunking pancreaticojejunostomy and 15 patients underwent binding pancreaticojejunostomy. RESULTS: The two groups were comparable with respect to demographic data, pre-operative characteristics, underlying pathologies, pancreatic textures, and duct diameters. The mean operative time did not differ between the two groups (388+/-29 min vs. 459+/-21 min, p=0.060). No difference existed in the post-operative course except for the degree of complications. In contrast to the dunking group, in which 2 cases of grade III/V pancreatic fistulas occurred, the binding group had no severe complications. In addition, transformation of amylase data measured from Jackson-Pratt drains into a natural logarithm demonstrated significant differences on post-operative (POD) days 1, 3, and 7 between the dunking and binding groups (POD1, 6.97+/-0.41 vs. 6.10+/-0.44 [p=0.037]; POD3, 6.97+/-0.41 vs. 6.10+/-0.44 [p=0.032]; POD7, 4.69+/-0.35 vs. 3.88+/-0.25 [p=0.034], respectively). CONCLUSION: Bindning pancreaticojejunostomy is equivalent to dunking pancreaticojejunostomy with respect to operative difficulties, and more effective in preventing complications related to pancreatic fistulas.

Arthroscopic Treatment of SLAP Lesion / 대한정형외과학회잡지

This is retrospective study of the 18 patients of SLAP lesion which were found during arthroscopic treatment of 92 patients. The patients were diagnosed as recurrent shoulder dislocation (50 patients), shoulder impingement syndrome (36 patients) and SLAP lesion (four patients), clinically and radiologically, between March 1989 and June 1995. SLAP lesion were found in eleven patients with recurrent shoulder dislocation, three patients with impingement syndromes. Solitary SLAP lesions were found in four patients. Mean follow-up time was 36 months (range, 12 to 72 months) and average age of patients were 26 years old. Type I SLAP lesion by Snyder's classification were eight cases, type II were seven cases, type III were two cases and type IV was one case. Arthroscopic debridement of frayed or degenerated labrum and biceps tendon anchor were per formed in ten cases of type I and III. In type II and IV, six cases were repaired by arthroscopic placement of multiple suture, two cases were repaired by biodegradable tack (Suretac). The result were quantitated with Rowe rating scale. Eleven cases were exellent, four cases were good, and three cases were fair with Rowe rating scale. Our study revealed that these lesions were not uncommon in instability or impingement of shoulder. Type II SLAP lesion was frequently associated with anterior shoulder instability.

Operative Treatment in the Radial Head Fractures / 대한정형외과학회잡지

Sixteen patients who had radial head fractures were treated with open reduction and internal fixation using Herbert screws (10 patients), and with silastic prosthetic replacement (6 patients) from March, 1992 to December, 1994 in Chungnam National University hospital. The average duration of follow up was 19.5 months. The purpose of this study is to examine the role of Herbert screw fixation and silicone replacement arthroplasty and to asscess the clinical results of two groups functionally, radiologically in raidial head fractures. By functional rating index (modified After B.F. Morrey et al), the results were classified as excellent (9 patients), good (6 patients), fair (No patient) and poor (1 patient). Nine of the ten patients treated by open reduction and internal fixation using Herbert screws had resulted in excellent or good. All patients were inserted silastic implants were showed excellent or good results. Especially, in Mason Type III radial head fractures, three of four patients treated by Herbert screws and all 5 patients treated by silastic prosthesis were considered to excellent or good results. We concluded that Herbert screw fixation or silastic prosthetic replacement had satisfactorily appeared to be the alternative treatment option for Mason Type III radial head fractures.

Operative Treatment of the Carpal Scaphoid Nonunions / 대한정형외과학회잡지

We had treated 24 patients who had nonunions of the carpal scaphoid from June 1987 to September 1995. 17 of 24 nonunions of carpal scaphoid were treated by K-wires fixation and autogenous iliac bone grafts. Another 7 cases were treated by Herbert screw fixation and autogenous iliac bone graft. 24 patients were followed up average 42.6 months and obtained following results; l. Among 24 cases, 23 cases were men and 19 cases were the third and fourth decade. Most common injury was the falling accidents (11 cases: 45.8%). 2. Most common pattern of fractures was waist type (20cases: 83.3%) in anatomical site and transverse type (15 cases: 75.0%) in pattern of fracture line. 3. Preoperative scapholunate angles (mean 52.9degrees: K-wires, 69.1degrees: Herbert screw) has been improved after open reduction and internal fixation by K-wires or Herbert screw (mean 46.2degrees: K-wires, 51.1degrees: Herbert screw). 6 cases had DISI deformity preoperatively with scapholunate angles over 70degrees (mean 80.0degrees: K-wires, 84.0degrees: Herbert screw) has been corrected after ORIF (mean 48.0: K-wires, 58.0: Herbert screw). 4. Bony unions were obtained in average 13.2 weeks in K-wires group and 9.8 weeks in Herbert screw group. 5. 13 cases (76.5%) in K-wires group and 6 cases (85.7%) in Herbert screw group were excellent and good result by Maudsley method. 6. The complications and sequalaes were present 4 cases in K-wires group with degenerative arthritis on radioscaphoidal and scapholunate joint and collapse of proximal pole and 1 case in Herbert screw group with screw malposition. So, We were thought that ORIF with K-wires and Herbert screw was effective treatment for nonunions of carpal scaphoid, especially Herbert screw fixation and autogenous iliac bone graft. In comparison of bony union and results of treatment, Herbert screw group was more effective than K- wires group.

Arthroscopic Classification of Bankart Lesion and Modification of Arthroscopic Capsular Suture / 대한정형외과학회잡지

Forty-five modified arthroscopic transglenoid suture capsulorrhaphy were performed between January 1989 and May 1995 with minimum follow-up of one year among sixty-four recurrent anterior shoulder instability in Chungnam National University Hostital. The average age at operation were 25 year and average time interval from injury to surgery were 12 month. we classify the Bankart lesion into 4 type according to the extent of capsulolabral complex detatchment, associated glenoid rim fracture, type II SLAP lesion and absence of glenoid labrum. Type Ia have a separation of labrum and inferior glenohumeral ligament from the glenoid rim and scapular neck (classic Bankart lesion) and type IIa have a capsular separation and glenoid rim fracture. Type IIIa have above mentioned type Ia or type IIa with type II SLAP lesion and type IVa have capsular separation without identifiable labral structure. We also subdivided the each type into subgroup b according to coexistence of capsular laxity. We modify the capsular suture technique according to classification. Type Ia, and type IIa were treated with in situ Bankart repair. Type Ib and type IIb were treated with capsular advancement. Type IIIa and 1IIb were treated with Bankart repair and additional fixation of SLAP lesion. Type IVa and IVb were treated with purse string type suture (capsular shift superiorly) with multiple stitches. All patients had various shape of Bankart lesion, so author s proposed classification of the Bankart lesion can be applied to each type. Arthroscopic finding were as follows. Twelve shoulders (27%) have type Ia Bankart lesion and six patient (13%) have type lIa lesion. Type lIIa were observed in eight shoulders (18%) and four patient (9%) were type IVa. The capsular laxity (subgroup b) were found in 15 patient (33%). None of the 45 patients experienced intraoperative complications or infec tion. All patients had full, painless range of motion and had no recurrence except four patient. One is type IIIa Bankart lesion in which associated type II SLAP was not repaired and the other two patients had sport injury and one patient had severe retrauma on 2 years after operation. We conclude that Bankart lesion is the essential lesion of recurrent anterior shoulder instability and were founded in all cases of recurrent anterior shoulder instability, and modified athroscopic transglenoid suture capsulorrhaphy according to arthroscopic classification is safe and effective method with acceptable recurrence rate.

Value of Axial 3-D Fourier Transformation GRASS MR Images in Diagnosis of Meniscal Tears of the Knee

PURPOSE: The purpose of this study is to compare the sensitivity and specificity of axial 3-D imaging with those of conventional 2-D imaging in the diagnosis of meniscal injuries. MATERIALS AND METHODS: Twenty-nine kneesof 27 patients with clinically suspected meniscal tears were imaged at a 1.5 T MR system. Conventional 2-D imagesand axial 3-D GRASS images were obtained in all cases. Arthroscopic or surgical confirmation was available in allcases and was used as the gold standard. RESULTS: Among the 29 knee-joints evaluated, 21 of 23 meniscal tears and 33 of 35 normal menisci were correctly identified with axial 3-D imaging, yielding a sensitivity of 91.3% and specificity of 94.3%. Conversely, the sensitivity was 82.6% and the specificity was 97.1% for the conventional 2-Dtechnique. A combination of both techniques yielded 95.7% sensitivity and 100% specificity in the diagnosis of meniscal tears. Of the 23 meniscal tears proven at arthroscopy or surgery, there were four discrepancies between the two techniques ; three of the four represented false-negative 2-D images and one was a false-negative axial3-D image. Of 35 normal menisci, two false-positives occurred with axial 3-D imaging and one with 2-D imaging. CONCLUSION: Despite the lack of a statistically significant difference between the efficacy of the two techniques, these results suggest that the sensitivity in the diagnosis of meniscal tears can be improved by adding thin-sliced axial 3-D GRASS imaging to conventional 2-D imaging in the limited cases with clinically suspected meniscal tears.

Clinical Experience of the Ilizarov Application for Correction of Ulnar Defect with a Dislocated Radial Head: 2 Cases report / 대한정형외과학회잡지

2 patients of forearm deformities with ulnar defect and radial head dislocation were treated with the Ilizarov apparatus at Chungnam University Hospital. One patient had a severe hypoplastic remnant-like ulnar fragment and a anterolaterally dislocated radial head due to complicated osteomyelitis of ulnar. We applied an Ilizarov apparatus to transport the radial head distally, and fixed to remaining proximal ulnar fragment. The other had a large bony defect at the ulnar shaft and a dislocated radial head due to complicated osteomyelitis of ulna. We performed internal transport of ulna to decreased the ulnar defect and to descend the dislocated radial head. The clinical-radiological features and functional results of those 2 forearm deformities were described with brief review of the articles about the Ilizarov method for correction of forearm defor- mities.

A Comparative Clinical analysis of Arthroscopic Meniscectomy and Arthroscopic Meniscus Repair / 대한정형외과학회잡지

There have been controversies on the rationale, surgicl indication, technique and results of meniscus repair.. Authors comparatively studied 100 cases of meniscus injury in 88 patients (arthroscopic total menisectomy: 16 cases, arthroscopic partial menisectomy: 68 cases, arthroscopic meniscus suturing: 16 cases) from February 1985 to March 1992. The results were as follows: 1. Male (61.4%) was much more affected than female. 2. The third decade group was most commonly affected and the most common causes was sports injury (43.2%) 3. The lateral meniscus was more injured (71%), than the medial (29%) 4. In arthroscopic finding, longitudinal tear (37%) was the most common. 5. According to the Tapper and Hoover's criteria, satisfactory result was 56.3% in arthroscopic meniscus repair group.

Anesthetic analysis of 428 neonatal cases / 대한마취과학회지

Neonates requiring anesthesia present unique challenges for anesthesiologists. They are very different from children and adults in the point of anatomy, cardiovascular response, respiratory system, central and autonomic nervous system, renal system and fluid balance, metabolism and thermal homeostasis, and pharmacology. In addition, they are frequently associated with congenital anomalies. The object of this study is to analyze the neonates' operation and anesthesia and to improve the outcome. We analyzed the 428 neonates who had received operation from 1979 to 1992 retrospectively. We devided them into four groups by age ; 0-1, 1-2, 2-3, and 3-4 weeks old group, and 0-1 week group is subdivided into preterm and full term one. The results were as follows ; 1. The rate of male versus female was 2.2: 1 (68.7: 31.3%) and 54.2% of them had been operated under 1 week old age. 2. The incidence of operated diseases is in order of congenital megacolon (15.9%), imperforate anus (15.9%) and pyloric stenosis (10.5%). 3. Operating time was within 2 hours in almost cases (95.7%) except tracheo-esophageal fistula (141.82+/-43.49 minutes). And the disease having operated in the shortest duration was inguinal hernia (19.29+/-16.15 minutes). 4. Patients with duodenal atresia, gastroschisis, omphalocele, diaphragmatic hemia, and tracheo -esophageal fistula were somewhat associated with congenital anomalies and the mortality was 10.5 to 33.3%. 5. Endotracheal intubation was achieved by mask inhalation in 76.4% and remains by using intravenous drugs. 6. There was not used any neuromuscular blocking agents thorough the operation procedure in 133 cases (48.4%). 7. Breathing circuit for anesthesia was Mapleson F system in all and the airway was kept with endotracheal tube (91.3%), mask (5.1%), and laryngeal mask airway (3.6%). 8. There were about 40% of patients with tracheo-esophageal fistula, sacrococcygeal anomalies, diaphragmatic hernia, omphalocele, and gastroschisis requiring special respiratory care, that is, keeping endotracheal intubation and ventilator for certain postoperative period. 9. Overall rate of emergency operation was 61%, but it was 73% in 0-1 week old neonates. 10. Mortality of operation for neonates was 7.7% and it occurred mainly in the pateints with gastroschisis, omphalocele, duodenal atresia, diaphragmatic hernia, imperforate anus, and tracheo- esophageal fistula. But there was only 1.6% mortality during 24 hours after operation. With the above results I suggested that shortening of operation time and skilled anesthesia could markedly improved the outcome of operation for neonates. And to achieve the goal all neonatal surgeons and anesthesiologists will have to get many experiences and knowledge about the neonate pathophysiologic conditions and pharmacologic responses.

Assessment of Temperature and Humidity in Operating Room, Recovery Room and Intensive Care Unit / 대한마취과학회지

It is recognized that there may be numerous medical hazards associated with the maintenance of relative humidity below 50 percent. These include the danger of producing hypothermia in patients, especially during long operative procedures; the fact that floating particulate matter increased in conditions of low relative humidity, and the fact that the incidence of wound infections is minimized following procedures performed in those operating rooms in which the relative humidity is maintained at the level of 50 to 55 percent. So, we have checked room temperature and relative humidity of operating theater in Hanyang University Hospital during 1 year from January, 1991. The results were as following; 1) Room temperature wae maintained at the level of 23.6+/-0.8 to 27.7+/-1.3 degrees C, and it was somewhat lower in shadowy rooms than in sunny ones. 2) Relative humidity was highest level in July, and it was maintaiaed at the level of 41.7+/-4.9 to 47.0+/-7.7%. Generally, it was decreased unsignificantly in order of ICU, recovery room, newbuilt shadowy rooms, old shadowy rooms, and sunny rooms. 3) Relative humidity was significantly decreased to 2.4+/-3.8-28.9+/-5.0% in spring, autumn, and winter. 4) Absolute humidity was maintained at the level of 11.6+/-1.7 mgH2O/L in summer, and l.l+/-1.4 mgH2O/L in winter. With above results, we recognized that room temperature of operating theater was maintained at the level of recommending degree, but relative humidity(percent) was too low to be suitable for operation and/or special patient care. This means that ventilation of operating theatre should be installed with proper temperature and relative humidity controlled units.

The Treatment of Recurrent Anterior Shoulder Dislocation with Modified Bristow Operation / 대한정형외과학회잡지

A review of 15 cases of the modified Bristow operation for recurrent anterior shoulder dislocation from Jan. 1983 to Dec. 1988 was presented. Using arthroscopy, we could examined the pathologic feature of the recurrent anterior dislocation of the shoulder. The results are as following. 1. The ages at the initial dislocation were ranged from 15 to 26 years and operated from 19 to 61 years. 2. The most common injury mechanism of the dislocation was sports injury (5 cases) and followings were traffic accident, military training, hanging with one hand. 3. The 10 cases were dislocated above 10 times before operation and 3 were dislocated above 10 times per year. 4. Bony lesions were detected on routine X-ray at 8, that is A-P and lateral view, Hill-sach's view, Stryker-notch view and West point view, Hermoddson view, and apical obique view. 5. Arthroscopic examination was done at 7 cases and could detect the pathologic lesion more exactly. 6. All were treated with modified Bristow method 7. Mean follow up periods were 2 year and 4 monthes. 8. The range of motion was not limited but external rotation was done about 18. 9. Excellent results were obtained by Rowe's grading system, mean 88.8.

An Analysis of the Results of the Treatment of the Resistant Clubfoot / 대한정형외과학회잡지

The Clufoot is still controversial in the etiology, the pathology, and the method of the treatment. Turco issued one stage posteromedial soft tissue release in 1971, which is still widely used. But the Turco's procedure is not satisfactory results in forefoot adduction and ankle motion. McKay and Simon were performed one stage complete subtalar soft tissue release and reported better results compared with those who had posteromedial release. So we performed Turco's posteromedial release with lateral release by Cincinnati incision in 12 patients (20 feet) and analysis the results from Oct. 1987 to Jul. 1989 at the department of orthopaedic surgery of CNUH. The results were as followings ; 1. The mean age of the patient at first examination was 1 year 9 months (range from at birth to 5 year 10 months) and the mean age at operation was 2 year 1 month (range from 4 months to 5 year 10 months). 2. The clinical results were excellent in 2 feet, good in 14 feet, fair in 3 feet and unsatisfactory in 1 foot. 3. The radiological results were satisfactory in 18 feet and unsatisfactory in 2 feet. 4. Forefoot adduction was corrected in 14 feet (70%) as normal range, 3 feet as acceptable, and 3 feet as unacceptable 10' over the normal range. 5. Two feet of hind foot overcorrection result was operation as McKay's method. 6. The Clincinnati incision was favorable to visulization and release of the posteromedial, anteromedial and posterolateral structure of the foot.

The Primary Repair of Acute Cruciate Ligament Injury using Multiple Pull Out Technique / 대한정형외과학회잡지

The cruciate ligaments are important in providing the anterior and posterior stability and usually associated with other ligament injury of the knee joint, and there are many controversies in its treatment. In general, the primary repair for the acute cruciate ligament injury was good, but some had opposite opinions in the treatment of the isolated anterior cruciate ligament injury. In acute injury, early repair of ligament and in delayed case, the reconstrution surgery of ligament was recommended. For good results, it is very important to give prompt management. Authors studies 23 cases in 16 patients with acute cruciate ligament proper injury who were treated by multiple pull out technique at the department of orthopaedic surgery, Chungnam National University Hospital from April, 1984 to July, 1988. The results were as followings: 1. The incidence was high in active male patients. 2. The most common injury was the traffic and automobile accident. 3. the tibial and femoral attachment were the most common detachment site in anterior and posterior cruciate ligament injury, respectively. 4. Isolated cruciate ligament injury was rare. 5. The results were good in 11 cases(47.8%), especially treated within one week.

The Reconstruction of Anterior Cruciate Ligament Using Patellar Tendon under Arthroscopy / 대한정형외과학회잡지

Reconstructjon of old anterior cruciate ligament injury was divided into extraarticular and intraarticular group. The intraarticular ligament reconstruction was a reliable method to correct the rotational axis of knee joint instability. Authors studied 10 cases in 10 patients who were treated by reconstruction of anterior cruciate ligament using patellar tendon under arthroscopy from January, 1988 to June, 1989. The follow up period was over 10 months. 7 cases were negative in Lachman test and 2 cases had mild instability of knee joint. The postoperative result was excellent in 3 cases, good in 4 cases, fair in 1 case, and failure in 1 case according to Clancy's evaluation. We concluded that the reconstruction of anterior cruciate ligament injury using patellar tendon under arthroscopy was an effective method in the treatment of old anterior knee instability.

Hip Joint Pressure in Displaced Fracture of the Femoral Neck / 대한정형외과학회잡지

We studied 16 cases intracapsular pressure in displaced fracture of femoral neck(Garden stage III, IV), the pressures were measured range between 12-62 mmHg(mean, 23.4 mmHg). Aspirated blood amount from hip joint did not exceed 3cc, this amount not correlate with intracaspsular pressure. Of 10 cases examined scintimetry, 2 had incressed uptake after aspiraton, it is suggested that early decompression of hemarthrosis in femur neck fracture regaredless of displacement may be considered.

The Reduction of Locked Facet on 12 th Thoracic Vertebra with Harrington Distraction Rods / 대한정형외과학회잡지

Many authers insisted that the fracture-dislocation of the vertebral column with locked facet, bilateral dislocation of articular facets which resistant to closed reduction, were necessary to posterior stabilization with anterior decompression. But using Harrington-Distraction rod, we experienced that the acceptable reduction of locked facet and posterior impinged bony fragments without anterior decompression, were obtained.

Clinical application of Halo body Jacket in the Cervical Spine Lesion / 대한정형외과학회잡지

Halo body jacket provides a excellent method of immobilization in unstable cervical spine such as fracture, dislocation, fracture-dislocation, tuberculosis, neurofibromatosis, congenitsal anomalies of the dens. With or with aiding of halo body jacket, we could treated the various unstable cervical spine. The stability of cervical spine can be maintained with halo body jacket. The author's applicated halo body jacket for 22 cases of unstable cervical spine. 1. The application was simple and the control is easy in any plane to achieve stablilty for unstable cervical spine. 2. The fracture dislocation of cervical spine was reduced by halo ring traction and the reduction position was maintained during operation and until bone and soft tissue healing. 3. Early ambulation was possible, so reduce the complcation due to prolongedd bed rest. 4. During operation, it provided a safe position of the patient with ease, and didnot aggravated the neurological status. 5. Provided a good operation fileds and easy taking a grafted bone from ilum than halo body cast.