Clinical Study of the Discoid Meniscus / 대한정형외과학회잡지

This paper is aimed to study the incidence, age and sex distribution, and type of lateral meniscal lesion including discoid meniscus in Korea. It is reported higher incidence of lateral meniscal lesion in Korea. 132 cases with meniscal lesions were surgically treated at the Department of Orthopedic Surgery, Seoul National University Hospital between 1973 and 1982. Of the 98 patients who had lateral meniscal lesions, forty-four (44.9%) were found to have a discoid meniscus. The mean age of the patients with discoid meniscus was 17.9 years, and 30 patients of them were younger than 20 years of age. The patients with discoid meniscus were followed after meniscectomy for an average of 6 months. The summary of this study are as follows: l. Over-all incidence of discoid meniscus were 44 cases (33.3%) out of 132 cases of the meniscal disease. All forty-four cases had a lateral discoid meniscus, and they formed 44.9% among 98 cases of lateral meniscal injury. 2. The discoid meniscus was most frequent in the age group between 11 and 20 years old (65.9%), and was more prevalent in female by a ratio of 1.4. 3. Qf the 26 patients with torn discoid meniscus, twelve (46.2%) denied the history of trauma. 4. Symptom of click sound was present in 42 cases (95.5%), and the rate of positive McMurray sign was 81.8%.

The Significance of Bone Scan in Pyogenic Bone and Joint Infections / 대한정형외과학회잡지

The value of the bone scan in pyogenic bone and joint infections is demonstrated in patients who had signs and symptoms suggestive of bone or joint infection. Nineteen patients were evaluated with 99m Tc-methylene diphosphonate bone scan and roentgenogram. The diagnosis of acute osteomyelitis was made in eight patients, chronic osteomyelitis in six patients, septic arthritis in three patients and two patients had soft tissue infection only. Seven of the eight patients with acute osteomyelitis had focal increase of radiopharmaceutical uptake in the bone well before the bony change appeared on roentgenogram. Five of six chronic osteomyelitis patients had not only bony change on roentgenogram but also increased radiopharmaceutical uptake of bone. But the remaining one had only the former, and the lesion was interpreted as inactive. In two of three septic arthritis patients, the lesion was in S-I joint and both of them had no abnormality on roentgenogram but had increased uptake of radiopharmaceutical agent in the joint. Two patients with soft tissue infection had no abnormal radiological bony change and no increase of the radiopharmarceutical uptake in bone on bone scan. From the above data, we concluded that bone scan is recommended in the evaluation of the patients with signs and symptoms suggestive of bone or joint infection for the earlier diagnosis and differential diagnosis in acute case and for the determination of the activity and location of the lesion in chronic case.

A Clinical Observation of Hip Fractures / 대한정형외과학회잡지

One hundred and forty eight cases of hip fractures experienced in the Department of Orthopedic Surgery of Seoul National University Hospital were analyzed, and following results were obtained. 1. Femoral neck fractures were 79 cases and trochanteric fractures were 69 cases 2. The most common cause of the hip frsctures was fall-down or slip-down (96 cases-65%). 3. Incidence of the femoral neck fracture was most frequent in the 6th decade, and that of the trochanteric fracture was in the 8th decade. 4. Sex ratio (male: femalein) incidence was 2.9:1 in the age groups before 50 years, and 1:1.8 after 50 years. 5. In classification of the hip fractures, transcervical fracture was most common (74%) in femoral neck fractures. And type 3 & 4 was 57% according to the method of Tronzo in trochanteric fractures. 6. Metals for internal fixation were S-P nail, S-P nail & plate, Knowles pin, Jewett nail, and compression hip screw etc. Especially we performed endoprosthesis frequently in old femoral neck fractures. 7. Significant delayed post-operative complications were head penetrations of the metals (15.5%), avscular necrosis (37.9%), nonunion (15.5%), and varus deformity (20.7%) in femoral neck fractures.