Clinical Study of Arthrogram in Ankle Fracture / 대한정형외과학회잡지

The Ankle joint is a modified complex hinge joint which plays an importnat role in weight bearing, walking and standing. Injuries about the ankle joint cause destruction of not only bony architecture but also the ligament and soft tissue components. We performed arthrography in 52 cases of ankle fracture. The Result obtained from this study was as follow; The ligament & interosseous membrane injuries were more severe, when fracture of lateral malleolus was occured higher level than ankle joint.

Chevron Osteotomy for the Treatment of hallux Valgus / 대한정형외과학회잡지

Hallux valgus has been defined as a static subluxation of the first metatarsophalangeal joint with lateral deviation of the proximal phalanx on the first metatarsal head from the longitudinal axis of the first metatarsal with medial deviation of the first metatarsal. And first-second metatarsal angle is increased as well as bursal hypertrophy over the medial eminence of the first metatarsal head. Many procedures have been reported for the treatment of the hallux valgus ranging from resection arthroplasty to distal first metatarsal or basal first metatarsal osteotomy. Of these, Johnson and Corless have required sufficiently good results in the modifying Mitchell osteotomy into Chevron osteotomy. The Chevron procedure is an osteotomy involving the distal portion of the first metatarsal, lateral displacement of the metatarsal head with exostosectomy, and tightening of the medial capsular structures. Authors studied 17 cases in 10 patients with the hallux valgus deformity treated by Chevron osteotomy at the Department of Orthopedic Surgery, Capital Armed Forced General Hospital from September 1987 to September 1989. The results were as follows; 1. Seven patients (12 cases) were male and three patients (5 cases) were female. All patients had bilateral hallux valgus deformity. 2. The average first-second intermetatarsal angle was 11 degrees and average valgus angle was 32 degrees, preoperatively. They were corrected to 9 degrees and 14 degrees respectively. 3. The metatarsalgia of the great toe was subsided in all cases and they were satisfied with the result of their operations in respect to cosmetically and functionally. Avascular necrosis of capital fragment, nonunion, and dorsal angulation were not developed in any case. But, one case had marginal skin necrosis, presumably due to excessive compressive dressing. 4. Chevron osteotomy is a technically easy procedure and it can be obtained early bone healing with less complication.

Old Unreduced Isolated Anterior Dislocation of Radial Head: Report of 2 Cases / 대한정형외과학회잡지

Isolated radial head dislocation, without an associated fracture of the ulna in adult, is rare. Two cases which can be thought as old unreduced isolated radial head dislocation were experienced in this hospital. Dislocated radial heads have not been reduced, however the cases revealed normal elbow motion including pronation and supination. We report these cases with a review of the literature.

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

A review of sixteen cases of the modified Bristow operation for recurrent anterior dislocation of the shoulder from Feb. 1987 to Feb. 1989 was presented and the following results were obtained. 1. The age of initial dislocation varied from 12 years to 27 years of age with the average of 17.3 years. 2. The age at operation varied from 21 years to 30 years of age with the average of 23.3 years. 3. The times of dislocation vaaried form 7 to 40 times with the average 23.8 times. 4. The average loss of abduction and external rotation were 5.9 and 12.5 degree respectively. 5. The complications and recurrence were not observed in this period

Synovial Sarcoma in the Calf Muscle Fascia: A Case Report / 대한정형외과학회잡지

Synovial sarcoma is an uncommon, highly malignant soft tissue tumor usually arising from the synovial lining of a joint, bursa and tendon sheath. Occurence in muscle fascia is extremely rare. We present a case of synovial sarcoma of the left calf muscle fascia, which was confirmed by microscopically sarcomatous growth of spindle cells and irregular small multiloculation. Above knee amputation was done.

A Familial Osteopetrosis / 대한정형외과학회잡지

Osteopetrosis is a very rare bone dysplasia characterized by failure of resorption and persistence of calcified chondroid and primitive bone. In 1904 Albers-Schonberg first described the radiological appearance of marble bone. This is named osteopetrosis by Karshner in 1926. A fulminating form is manifested from birth in which fractures and deformity, hydrocephalus and cranial nerve palsies lead to early death from intractable anemia and intercurrent infection. In other cases the stigmata are delayed until later childhood, when retardation of growth and of mental and sexual development occurs, and not infrequently accompanied by rickets, dental caries and osteomyelitis. We have experienced a familial osteopetrosis, father and three siblings, which was thought to be a autosomal dominant inheritance. One of those family, 20 years old man, has been complained of anemia and low back pain without radiating pain to the lower extremities. The other 3 patients has not been complained of any other clinical symptoms. But X-Ray examination of the entire skeletal survey of those members of the family have revealed the uniform opacity of long bones and flat bones.

Sagittal Fracture of Cervical Spine: Case Report / 대한정형외과학회잡지

Sagittal fracture of the cervical spine is a rara injury and little information exists as to its incidence, the mechanism involved, or the result of treatment. Fracture of the cervical vertebral body in the sagittal plane is splitted it into almost equal right and left halves. Computed tomography has made it possible to analyze the vertebral fracture more thoroughly. Sagittal fracture of the cervical spine is reported with brief review of literature.

Study of Ferritin Concentration in Synovial Fluid and Serum of Rheumatoid Arthritis / 대한정형외과학회잡지

Rheumatoid arthritis is a chronic inflammatory systemic disease of young or middle aged adults, characterized by destructive and proliferative changes in synovial membrane, periarticular structure, skeletal muscle and perineural sheaths. Eventually, joints are destroied, ankylosed and deformed. Moderate anemia is occured frequently in rheumatoid arthritis patients, and these patients show abnormalities of iron metabolism such as lower serum iron concentration and occurance and distribution of iron in the synovial membrane. It has been suggested that the mechanism of iron deposits in rheumatoid arthritis is continuous oozing of blood from vascular granulation tissue into the synovial cavity and this lead the patient to anemia. We collected samples from serum and knee joint fluid in 21 cases of rheumatoid arthritis for chemical estimation of the ferritin concentration by radioimmunoassay, and compared with that of osteoarthritis. The following results were obtained: 1. The mean hemoglobin concentration(11.4gm %) in rheumatoid arthritis was lower than osteoarthritis(13.4gm %). 2. The mean serum ferritin concentration(118. 4ng/ml) in rheumatoid arthritis was lower than osteoarthritis(135. 6ng/ml), on the contrary in synovial fluid rheumatoid arthritis(279.8ng/ml) showed higher than osteoarthritis(190. 4ng/ml). 3. The mean ratio of synovial fluid ferritin on serum ferritin was 2. 36 in rheumatoid arthritis, in contrast with l. 4 in osteoarthritis. There was significant correlation between the ferritin concentration in synovial fluid and serum. 4. Serial check of ferritin concentration in synovial fluid during treatment would be thought meaningful criteria for determination of progress.and effectiveness of treatment.

Clinical Study of the Orthopedic Management on the Fracture and Dislocation in the Patient associated with Head Injury / 대한정형외과학회잡지

The head injuried patient with skeletal trauma is a challege to the orthopedic surgeon. The orthopedist initially may face the difficult management of fracture and dislocation in the patient associated with head injury. The management of the injuries to the head takes precedence over extremity injuries initially, but the orthopedist must be managed aggresively with assumption that full neurologic recovery will occur. This report analysed the treatment and results in 85 cases fracture and dislocation with head injury among the 59 patients at the Chungnam National University Hospital during the period ranging from March, 1980 to March, 1983. End result obtained are as follows: 1. The sex ratio between the male and female was 3.9: 1 and the prevalent age distribution was from 21 to 30 years of age. 2. The motorcycle accident was most common cause of the trauma and the next most frequent one was the automobile accident. 3. Type of head injury were contusion or concussion, intracranial hemorrhage, linear skull fracture, depressed skull fracture and open skull fracture. 4. Better result were obtained by operative treatment in femur fracture, especially spastic group. 5. The incidence of delayed diagnosis was 8 cases and the delay in diagnosis ranged from 15 to 95 days with an average of 38 days. 6. We, consulting with neurosurgeon, must assume that full neurologic recovery will take place and so open reduction and internal fixation should be carried out as quickly as possible.