Clinical Result of Surgical Treatment of the Idiopathic Club Foot / 대한정형외과학회잡지

Authors reviewed clinical results of idiopathic club foot, of 52 patients have been treated by surgery and followed up more than 2 years at the Department of Orthopaedic Surgery, Korea University, Guro Hospital in order to evaluate the results after surgery for idiopathic club foot and the best time for surgical management. Materials consist of 3 groups regarding the surgical regimen:Group I was of one-stage postermedial release(58 feet/36 patients), Group II of posterolateral release(11 feet/7 patients)and Group III of Lichtblau osteotomy(10 feet/9 patients). Assessment was made by the radiologic(Beatson and Ponsenti's)and clinical(Preson and Fell's)criterias. From the review the following observations were obtained: 1. Percentage of the surgically treated feet was 30% in author's series(97 feet/327 feet). 2. The mean age at the operation was 1 year 11 months in group I, 1 year 11 months in group II, 6 years 2 months in group III and 3 years 4 months(2 months – 12 years) in all groups. 3. The clinical results evaluated by Preston's method were good in 32 feet(55%), fair in 16 feet(28%), poor in 10 feet(17%) for the group I, 58 feet and good in 4 feet(36%), fair in 4 feet(36%), poor in 3 feet(28%) for the group II, 11 feet and good in 6 feet(60%), fair in 2 feet(20%), poor in 2 feet(20%) for the group OOO, 10 feet. 4. The radiologic results evaluated by Beatson and Posenti's criteriae were good in 44 feet(55%), fair in 18 feet(23%), poor in 17 feet(22%) in all groups. 5. The success rate of primary surgical treatment for idiopathic club foot was 81% in all groups and 83% in PMR group. 6. Regarding age at operation, the best result was showed between 1 and 2 years old in PMR group. In conclusion, the surgery was the satisfactory method for the treatment of idiopathic club foot and the posteromedial release was showed better results than the posterolateral release group. Results according to age at operation in PMR group, the best results obtained between 1 year and 2 years old. The results in posterolateral release group was poor because the forefoot adduction deformity was persistant.

The Significance of Tartrate Resistant Acid Phosphatase as a Marker of osteoclast / 대한정형외과학회잡지

Tatrate resistant acid phosphatase (TRAP) has been widely used as histochemical marker to identify osteoclast in studies of bone metabolism. However, the value of TRAP as an osteoclast marker is still in discussion. Authors isolated and characterized the cells from synovium of 6 patients of sero-positive rheumatoid arthritis and 4 patients of osteoarthritis, and observed the activity of acid phosphatase (AP) and TRAP. The activity of TRAP was negative in cell cultures in early phase, but the activity of TRAP was increased with time, and at one week the activity of TRAP was as strong as that of AP. If the cultured tissue contained bone, there were observed TRAP positive mononuclear cells and giant cells even in early phase of cultures (1 day, 3 day), and the phenotype of these cells were same as that of osteoclasts and osteoclast precursors by immunocytochemistry. In conclusion, the activity of TRAP was positive in cultured macrophage. TRAP is not a specific marker for osteoclast, and its use for the identification of osteoclast seems meaningful only in the early stage of cell culture.