ABSTRACT
In management of foot deformity, the operative procedures such as tendon transplantation and bone stabilization are of the relatively recent origin. The first tendon transfer was performed by Nicoladoni in 1881. Since that original report, a voluminous literature was appeared on the subject of tendon trasplantation. During the period, from Jan. 1960 to May. 1992, we have done clinical studies of the 189 feet on 167 patients who had been undergone tendon transfer. The results are as followes, 1. Residual poliomyelitis, leprosy, cerebral palsy and club foot are common etiology. Among them, residual poliomyelitis was the most common, especially in 1960 to 1969. Recently trauma and aged leprosy were increased. 2. Among 189 feet, the equinovaurs deformities were 90 cases. 3. Posterior tibial tendon, peroneus tendons, anterior tibial tendon, Achilles tendon and extensor hallucis tendon were transferred. 4. Posterior tibial tendon was mostly used. 5. The evaluation for surgery, for Good to Excellent was 114 feet 60. 3% 6. The poor results were noticed in the cases of the calcaneal deformity and showed in the age below 5 years old.
Subject(s)
Humans , Achilles Tendon , Cerebral Palsy , Congenital Abnormalities , Foot Deformities , Foot , Leprosy , Poliomyelitis , Surgical Procedures, Operative , Tendon Transfer , TendonsABSTRACT
Ganglia are the most common soft tissue tumors of the hand. Ganglia found on the dorsum of the wrist usually arise from the scapholunate ligament and are usually located between the extensor digitorum communis tendon of the index finger and extensor pollicis longus tendon. Intratendinous ganglion is a very rare lesion of unknown etiology and natural history that originates within the tendon. A patient is described who presented with a painful mass on the dorsolateral aspect of the wrist due to an intratendinous ganglion of the extensor pollicis longus tendon. Treatment consisted of excision of the extensor pollicis longus tendon with ganglion followed by mini free tendon graft using palmaris longus tendon.
Subject(s)
Humans , Fingers , Ganglia , Ganglion Cysts , Hand , Ligaments , Natural History , Tendons , Transplants , WristABSTRACT
Opposition of the thumb is necessary for pinch-one of the three most important functions of the hand. Frequently, opposition is either partially or totally lost in poliomyelitis or median nerve palsy. Several types of operations have been devised for restoration of opposition, and in 1973, Burkhalter et al. announced extensor indicis proprius opponensplasty: the tendon of extensor indicis proprius is brought out in the area of the pisiform and then passed against subcutaneously across the palm to the thumb, being attached to the abductor pollicis brevis and extensor pollicis longus tendon. It is useful in the case of loss of opposition without available finger flexor or wrist motors. Of nine patients who underwent operation-one with Riordan and eight with Burkhalter type of opponensplasty-at National Medical Center, seven had excellent results: one had a fair, and another one had a poor result. Six patients were with low combined median and ulnar nerve injury: one with high combined median and ulnar nerve injury: one with brachial plexus injury: and one with myotmesis of the thenar muscles. From the results, we conclude that Burkhalter type of opponensplasty makes satisfactory result for the hand without opposition movement; it is indicated in high median nerve injury and any combined median and ulnar nerve injury6; early restoration of opposition to the thumb in median nerve injury and in those limbs with multiple tissue trauma adds immeasurably to the over-all early rehabilitative effort.
Subject(s)
Humans , Brachial Plexus , Extremities , Fingers , Hand , Median Nerve , Muscles , Paralysis , Poliomyelitis , Tendons , Thumb , Ulnar Nerve , WristABSTRACT
Fractures of the distal end of the femur are difficult to manage because of the a wide range of potential complications. In the past, there has been a reluctance toward treatment of fractures of the distal end of femur with internal fixation. Recently, however, a trend toward internal fixation has become evident and good results have been reported by several authors. We analyzed 30 cases of distal femur fracture involving knee joint in the Department of Orthopaedic Surgery in National Medical Center from Jan. 1982 to Dec. 1986. 1. There were 30 cases in 29 patients. And were devided in 23 closed and 7 open fractures. 2. Clinical union were taken from 3 to 5 months in conservative and 2 to 3.5 months in operative treatment. 3. Satisfactory results were 5 cases(64%) in conservstive and 16 cases(73%) in operative treatment. 4. Significant complication were stiffness and infection.
Subject(s)
Humans , Clinical Study , Femur , Fractures, Open , Knee Joint , KneeABSTRACT
With improvement of anterior fixation devices, anterior instrumentation-fusion in treatment of thoracolumbar fracture becomes as effective as posterior interbody fusion which has mainly been used up to now. Also, computerized tomography enables us to diagnose the spinal fracture accurately including retropulsive bony fragment and degree of narrowing of spinal canal. We analyzed 18 cases which were treated with anterior interbody fixation in thoracolumbar fracture from Mar. 1977 to Oct. 1986 in Orthopaedic dept. of National Medical Center. The results were as follows ; 1. The mechanism of injury involved falling down in 7 cases, traffic accident 5 cases, and miner injury in 4 cases. 2. The clsssification of fracture by Denis method was compression fracture in 4 cases, bursting fracture in 11 cases, Seat-belt injury in 1 case, Fx-dislocation in 2 cases. 3. The methods of internal fixation were iliac bone graft only in 8 cases, anterior Harrington rod in 2 cases, Webb implant in 6 cases, and Zielke rod in 2 cases. 4. The average preoperative kyphotic angulation was 19.5(range 10 to 22) and immediate postoperative angulation was 10.1(range 2–16). The correction rate was 48%, and the loss of correction was 2.8(range 2–13). The final correction rate was 38.1% with implants, 29.1% without implants. 5. Early operation can get better neurologic recovery. 6. Firm and stsble fixation device is needed.