ABSTRACT
Computerized tomography has been used in the evaluation of the intracranial lesions. Recently the usage of computerized tomography has progressively widened in many fields of clinical practice. In orthopedics computerized tomography has been tried in the diagnosis and the determination of treatment of tumors, spinal disorders, hip disorders and knee problem. Four problem cases in which concentric reduction could not be obtained after closed reduction of hip dislocations were evaluated by computerized tomography from Apr, 1, 1983 to Mar. 31, 1984 in the Capital Armed Forces General Hospital and following conclusiions were obtained: 1. Open reduction revealed that muscles(adductor and pyriformis muscles), joint capsule and osteocartilaginous loose bodies (femoral and acetabular) were interposed to hinder concentric reduction. Large posterior acetabular fragment induced instability and redislocation of the hip. 2. When there were 2-3 mm lack of symmetry of the two femoral heads or any abnormal findings(breakage of Shenton's line etc.) in plain roentgenography, computerized tomography was recommanded, and muscles, osteocartilaginous loose bodies and instability were found. 3. Computerized tomography is an easy simple method and has a great diagnostic value in the evaluation of asymmetry and instability after closed reduction of traumatic hip dislocations.
Subject(s)
Acetabulum , Arm , Diagnosis , Head , Hip Dislocation , Hip , Hospitals, General , Joint Capsule , Knee , Methods , Muscles , Orthopedics , RadiographyABSTRACT
Early chondromalacia patellae is initiated by malalignment in the extensor machaniam and abno-rmal patellofemoral tracking. It is well known that chondromalacia often occurs in recurrent pateIlar subluxation. In the 50 normal and 60 pathologic knees, the following five parameters were studied; 1) Q angle 2) PT ratio by Insall & Salvati method 3) AB ratio dy Blackburne & Peel method 4) sulcus angle 5) congruence angle. The following conclusions were made. l. In 50 normal asymptomatic knees, the average Q angle was 14°. The patellar length was equal to the patellar ligament length and the average congruence angle was −8°. In 40 knees with “Chondromalacia”, the Q angle was increaed (19.5°), and the average congruence angle was −2°. 3. In 20 knees with recurrent subaxation, the patellar was high riding (PT ratio, 0.89), the sulcus angle was shallow (145.1°), and the average congruence angle was +4.35°.
Subject(s)
Cartilage Diseases , Chondromalacia Patellae , Knee , Methods , Patella , Patellar LigamentABSTRACT
This study is concerned with a comparison of lower tibial and fibular epiphyseal growth and deformities of the ankles in normal and paralysed children. The data were based on 87 children with residual paralysis due to poliomyelitis an 20 non-paralysed children who were admitted to Severance Hospital and Sam Yook Children's Rehabilitation Center. The difference in level between the lower tibial and fibular ends and between the lower epiphysial lines of the tibia and fibula in X-rays of the ankles were measured in order to investigate the growth pattern of the lower tibio-fibular epiphysis. The difference between the level of the lower ends of the fibula was an avergage of 15.3mm in the normal and 6.2mm in paraysed children. Thus the fibular ends in paralysed limbs was an average of 9.1mm less than that of the normal. The difference between the level of the lower epiphyseal lines of the tibia and the fibula was an average of 13.7mm in normal and 5.5mm in paralysed children. Therefore, the level of the fibular epiphyseal lines in paralysed limbs was sn average of 8.2mm less than that of normal. In paralysed limbs, the lower tibial epiphyses showed lateral epical wedge shaped deformities. The tilting angle of the ankles and the wedging angle of the of the lower tibial epiphyses were measured in erder to investigate the degree of deformities of the ankles and the lower tibial epiphyses in paralysed limbs. The tilting angle of the ankles averaged 1.3° in normal and 7.6° in paralysed limbs. The wedging angle of the lower tibial epiphyses averaged 3.7° in normal and 11.5° in paralysed limbs. In paralysed children, muscle strength examination was performed to clarify the relationship between the degree of growth disturbance and the severity of the muscular paraysis. This lead us to conclude that: 1. In paralysed children, the growth disturbance of the lower fibular epiphyses was greater than that of the lower tibial epiphyses. 2. The difference of the growth disturbance between the tibial and fibular epiphyses was not due to muscle imbalance of the foot invertors and evertors but to muscle weakness. 3. In paraysed children, the shape of the lower tibial epiphyses changed to a wedge shape, a deformity which might be considered secondary to growth disturbance of the fibula. 4. In paralysed children, the lower tibial ends were tilted upward and laterally. This was thought to be the cause of valgus deformities of the ankles. 5. The relationship between the degree of muscle paralysis and the deformities of the ankles was not proved in this study.
Subject(s)
Child , Humans , Ankle , Congenital Abnormalities , Epiphyses , Extremities , Fibula , Foot , Muscle Strength , Muscle Weakness , Paralysis , Poliomyelitis , Rehabilitation Centers , TibiaABSTRACT
Twenty four cases of acromioclavicular seperation were admitted and treated at Severance Hospital, Yonsei University from October 1964 to September 1975. Of these, six cases were subluxations and eighteen cases were dislocations. Acromioclavicular joint injury is relatively rare and there are many methods of treatment. In our cases, all the six subluxations and seven of the eighteen dislocations were treated by conservative method, while eleven of the eighteen dislocations were treated by operative method. The results of all the subluxated cases were satisfactory. In cases of dislocation, the results were considerably better in operated cases with Weavers method.