Surgical Outcomes of Intra-articular Fractures of Calcaneus using AO Calcaneal Plate / 대한족부족관절학회지

PURPOSE: To evaluate the outcomes of intra-articular calcaneal fractures treated using AO calcaneal plate surgically. MATERAILS AND METHODS:Total 15 cases of intra-articular calcaneal fracture that treated with open reduction and internal fixation using AO calcaneal plate were evaluated. The patients were followed over a mean period of 19.8 months. The mean age was 41.6 years. By Sanders classification, there were 2 cases of type II, 10 cases of type III, and 3 cases of type IV. We evaluated radiological outcomes by Bohler angle, Gissane angle, calcaneal hight, calcaneal width and clinical outcomes by Creighton-Nebraska health foundation score. RESULTS:All fractures united at a mean duration of 13.3 weeks. Radiologically, the mean preoperative Bohler angle was 8.5 degrees and restored to 23.3 degrees . The mean preoperative Gissane angle was 118.7 degrees and restored to 124.2 degrees . The mean preoperative calcaneal hight was 30.8 mm and restored to 38.9 mm. The mean preoperative calcaneal width was 41.3 mm and restored to 35.3 mm. 10 cases had excellent and good clinical outcomes and 5 cases having fair outcome. Conculsion: In our study, open reduction and internal fixation using AO calcaneal plate showed good results with anatomical restoration of articular surface and stable fixation without late collapse

Operative Treatment of Hallux Valgus Deformity in Male Patients / 대한족부족관절학회지

PURPOSE: We evaluated the result of operative treatment of the hallux valgus in male patients. MATERAILS AND METHODS: Total 11 cases (10 patients) of the hallux valgus deformity that treated with operation were evaluated. Following Mann's radiological classification system, there was 1 cases of mild, 8 cases of moderate, and 2 cases of severe. Preoperative, postoperative, postoperative 3 months and postoperative 6 months follow up standing radiographs were used as radiologic evaluation. And we evaluated radiological outcomes by hallux valgus angle (HVA), first-second intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), proximal phalangeal articular angle (PPAA) and clinical outcomes by hallux-metatarsophalangeal scale of American Orthopaedic Foot and Ankle Society (AOFAS) score. RESULT: Radiologically, the mean preoperative HVA 37degrees and IMA 13.7degrees were improved postoperatively as HVA 11.9degrees and IMA 4.7degrees, and the mean preoperative DMMA 29.4degrees and PPAA 8.6degrees were improved postoperatively DMMA 13.9degrees and PPAA 7degrees. But, postoperative 6 months follow up HVA, IMA, DMMA and PPAA was increased at 14.2degrees, 6.3degrees, 16.1degrees and 8.3degrees. Average AOFAS score were improved from 61.2 points to 75.2 points. CONCULSION: In our study, operative treatment of hallux valgus in male patients with proximal metatarsal osteotomy and distal soft tissue procedure showed good results but it was necessary to pay attention to increase aspect of follow up radiologic measurements.

Discriminate between Traumatic and Degenerative Rotator Cuff Lesion in Rotator Cuff Injury Patient

No abstract available.

The Assessment of Bone Mineral Density in The Lumbar Vertebra Using Quantitative Computed Tomography / 대한척추외과학회지

STUDY DESIGN: Retrospective study OBJECTIVES: This study evaluated the relationship between the bone mineral density (BMD) and low back pain and between BMD and the spinal fractures of postmenopausal women and to determine threshold value of the fracture. SUMMARY AND LITERATURE REVIEW: Low back pain was not associated with a decreased BMD, and BMD of the spine fracture group with osteoporosis was significantly lower than the non fracture group. The threshold of fracture was 99 mg/cm3 in the 90th percentile. MATERIALS AND METHODS: Of 324 subjects between January 2003 to December 2004, postmenopausal women, in whom the mean value of BMD and lumbar vertebrae (L2, L3, L4) were measured by quantitative computed tomography (QCT), were given a questionnaire regarding the level of low back pain over the previous twelve months. The low back pain was divided several groups according to frequency: none, some of the time and most of the time. The spinal fracture was assessed by a simple radiology measurement and divided its into the fracture group and non fracture group. In addition, statistical analysis of the BMD with low back pain and with a spinal fracture was performed. The threshold value of the fracture was calculated using the Riggs method. RESULTS: Of the 324 subjects, there were 34 cases of spinal fractures in whom the fracture was not caused by high energy trauma. Among the non-fracture groups, low back pain was not associated with a lower BMD. The BMD of the spinal fracture group with osteoporosis was significantly lower than in the non fracture group (p<0.01). The threshold of fracture was 99 mg/cm3 in the 90th percentile. CONCLUSIONS: It is recommended that the BMD be measured in women in whom more than 5 years has passed since menopause, even if they show no symptoms. In addition, osteoporosis patients with a BMD < 99 mg/cm3 will need to be treated more intensively.

The Clinical Observation of the Femoral Shaft Fracture in Children / 대한정형외과학회잡지

The management of the femoral shaft fracture in children is quite different from that of in adults. This report analysed the treatment and results in 63 children with fractures of the femoral shaft at the Chosun University Hospital during the period ranging from Jan. 1975 to Dec. 1978 and follow up study was made for 2 to 4 years following the fractures. End results obtained are as follows; 1. The sex ratio between the male and the female was 2.3: 1 and the type of fractures observed was transverse fracture(41.2%), oblique fracture (23.8%), spiral fracture (20.6%) etc. 2. The traffic accidents was most common cause of the fracture (60.3%) and the next most frequent one was fall (26.9%). 3. There was no clinical deformity at the fracture site after complete remodeling, when initial angulation was under 20 degrees. 4. The overriding of the fractured fragment in 10mm to 15mm between the age 2 to 10 years was permissible. 5. The average value of the overgrowth was 11.2mm and the growth stimulation caused no significant change under 2 years of age and over 11 years of age.

Patellar Position in the Normal Adult Knee Preliminary Report / 대한정형외과학회잡지

Nine strains (6%) were confirmed as resistant (MIC=20ug/ml) to methicillin (MT) among 150 isolates of staphylococcus aureus. These MT-resistant staphylococcus aureus (MRSA) strains were also turned out to be more less resistant to other antibiotics tested, such as penicillin, chloramphenicol, tetracycline, and gentamicin except for cephaloridine. It was noteworthy, however, that strain MRSA 5 showed a relatively susceptible attitude toward most of the antibiotics tested, while being extremely resistant to MT only. Salt (NaC1) containing (5–3%) media did not have any significant effect on the degree of MT-resistance of MRSA strains. There was, however, such a tendency as that by the addition of salt the degree of MT-resistance was lowered in the highly MT-resistant strains while enhanced in MT-susceptible ones. It was confirmed that penicillinase did not have any effect on the MT-resistance while most of the penicillin- resistant strains produced the enzyme.

An Analysis of the Synovial Fluid in the Rheumatoid Arthritis / 대한정형외과학회잡지

An analysis of the joint fluid should be performed as part of the diagnostic evaluation in any patient with joint disease. It is an important role in the differential diagnosis of the joint disease such as pyogenic arthritis, traumatic arthritis, degenerative and rheumatoid arthritis and others. The authors examined synovial fluid analysis in 33 cases of rheumatoid arthritis at the Department of Orthopedic Surgery, Chosun University Hospital. The following results were obtained. 1. The age and sex distribution was 21 cases in the male and 12 cases in the female. The sex ratio between male and female was 1.8:l. 2. The gross appearance of synovial fluid was greenish-yellow with turbid in 29 cases, and 4 cases were transparent with clear and yellow colored. The range of specific gravity was 1.028, it was more higher than normal values. 3. The range of white blood cell count in the synovial fluid was 5955/cubic mililiter in its average and polymorphonuclear leukocytes found the major part of cell counts (63.6%). 4. The glucose content in the synovial fluid was 72.8 mg/100ml in the range of average. It was tended to decrease compared with increase leukocyte numbers. 5. The latex fixation test in the synovial fluid was positive reaction in 93.9%, and was more higher value than its serum reaction in the blood. 6. The protein content in the synovial fluid was 6.9 gm/100ml) in the range of average, and it was 1.7 times more higher value than the reported literature. The correlationship of protein content between the duration of disease and its prevalences could not found the clinical significance. 7. The relationship between the age and the clinical course in the synovial fluid analysis was not significant finding of its fluid content and others, but the more pronounced pattern was revealed in the acute stage of rheumatoid arthritis in the joint fluid.

A Study on the Vertebral Body and Intervertebral Disk Indices of the Normal Korean People (A Preliminary Report) / 대한정형외과학회잡지

The vertical and sagittal diameter of the vertebral body from the 12th thoracic to the 4th lumbar spine was measured by the true lateral roentgenogram. The material consisted of 110 normal Koreans ranging from the age of newborns up to adolescents, in which the vertebral body index (Ivb = v/s) and the intervertebral disk index (id = d/v) of each spine were measured and its interrelationship with normal growth rate was evaluated. The authors obtained the following results. 1. The vertebral body index showed gradual decrease with the advance of the age. It was significantly high in the group Ⅰ compared with other groups. 2. The difference between the boy and the girl was more significant at the 12th thoracic and 1st lumbar vertebral body than the othervertebrae in the group V. 3. Among children of more than 120 cm in height and older than 12 years of age, girls had a higher index of vertebral body than boys, the latter show a less pronounced vertical growth of the body. 4. The intervertebral disk index began to decrease after the 1st month of life possibly because of the accelerated vertical growth of the body from that period. 5. Of all the age groups, the intervertebral disk index showed a higher value in boys than in girls.

A Clinical Observation of 148 Complications in the Open Fracture / 대한정형외과학회잡지

One hundred forty eight complications in 135 cases of long bone fractures experienced during the period from May 1971 to December 1979, at the Chosun University Hospital and analysed its retrospectively. The results were obtained as follows. 1. The order of incidence of complications were as follows; infection (39.8%), delayed union(23.6%). malunion (13.5%), ankylosis of joint (12.2%). nonunion (8.1%) and peripheral nerve injury (2. 8%). 2. Of all 127 patients, 97 patients were male and 30 patients were female, and 72 patients (56.7%) were cauesd by traffic accidents. The sex ratio between male and female was 3.2: l. 3. The major complications were frequently associated with other fractures and dislocations, brain injuries. 4. Those of open, comminuted fracture and delayed transfer cases to the Orthopedic Surgeon were predisposing factors to development of the severe complication.