Clinical Analysis of Long Bone Fracture Occurring in Chronic Patients with Spinal Cord Injury / 대한정형외과학회잡지

During the rehabilitation period, traumatic fracture of the lower extremity in chronic spinal cord injured patients may be occur frequently. In the past, conservative treatment with pillow or plaster splinting was advocated by many clinician, but its treatment is still controversial. This paper presents our experience with fracture of 20 patients(5.7%) of total 350 patients who had spinal cord injuries from Jan. 1980 to Mar. 1987 at Korea Veterans Hospital. The results were as follow. 1. The incidence of fracture was not related to age, sex, type and duration of spinal cord injury. 2. The most common cause of fracture was insignificant trauma(94%). 3. The distribution of fracture was in the following order of frequency;supracondyle of femur (20%), shaft of femur (20%), shaft of tibis (16%). 4. The methods of treatment-Twenty cases were treated by conservative treatment and eleven cases were treated by operative treatment in following order; paster splint with well padded; 9 cases (20%), pillow splint; 4 eases (13%), plate and screw; 3 cases (10%). 5. Total 11 cases of complications were 8 cases in conservative treatment and 3 cases in operative treatment. 6. The duration of bone union was average 10 weeks in nonoperative treatment and average 10.2 weeks in operative treatment. Treatment should strive to achieve fracture healing with minimal danger to the patient and should cause little or no interfrence with patient's daily routine.

A Clinical Analysis of Arthrodesis of the Ankle Joint / 대한정형외과학회잡지

The method of ankle arthrodesis is variable but compression arthrodesis has been widely used because of better results than non-compression arthrodesis. Twenty-one cases of ankle arthrodesis were carried out at department of orthopaedic surgery of Korea Veterans Hospital from January 1980 to June 1986, and were analysed clinically. The results obtained were as follows; l. Among 11 cases of compression arthrodesis, Charnleys method was done in 8 cases and Monofixateur in 3 cases. 2. Among 10 cases of non-compression arthrodesis, Chuinard-Peterson method was done in 7 cases and anterior 'sliding graft in 3 cases. 3. The average duration of immobilization after ankle arthrodesis was 11.7 weeks, and average 4.2 weeks were less needed in the compression arthrodesis than non-compression arthrodesis. 4. The postoperative complications were developed in 8 cases (38%): wound infection in 4 cases,skin necrosis in 3 cases and incisional neuroma in 1 case. 5. Bony union was obtained in 20 cases(95.2%) out of 21 cases at average 15.7 weeks, and in the non-compression arthrodesis and in the cnmpression arthrodesis, respectively, 90% at 17.7 weeks and 100% at 13.9 weeks.

A Clinical Alnalysis of Arthorodesis of the Knee Joint / 대한정형외과학회잡지

In the past, arthrodesjs was a widely used procedure but in recent times, with the development of replacement arthroplasty, decreased in tuberculosis and polio. etc, it is not commonly used by orthopedic surgeons. However, for those in the young age group, people employed in hard labor and patients with acute inflammatory disease, arthrodesis is through to be more appropriate than replacement arthroplasty. From January 1980 to December 1985, 20 cases of arthrodesis of the knee joint were carried out. The results were follows.; 1. Methods of arthrodesis used were Charnley compression arthrodesis in 10 cases, Hoffman compression arthrodesis in 2 cases, cross pinning in 3 cases and and cross pinning with patella graft in 5 cases. 2. Bone union was seen in all 12 cases of compression arthrodesis at an average of 21.3 weeks while bone union was seen in 7 out of 8 cases of non-compression arthrodesis at an average 25 weeks. 3. Among the 20 cases, complication were pseudoarthrthrosis in one case, pin tract infection in 2 cases and skin necrosis in 5 cases. 4. Inconclusion of the above results, bone union was carried out in 19 cases out of total 20 cases, and compression arthrodesis showed faster bone union at an average of 3.7 weeks earlier than non-compression arthrodesis.

Dystrophic Calcification Following Anterior Tibial Compartment Syndrome / 대한정형외과학회잡지

Usually the histologic response of muscle to the ischemia range from mild, reversible change to extensive necrosis and fibrosis in the case of anterior tibial compartment syndrome. But dystmphic calcification in the late stages is very rare condition.Only three cases were previously reported by Gallie and Broder et al in the literature. We are reporting six cases of dystrophic calcification following anterior tibial compartment syndrome in late stages. Onsets of dystrophic calcifications after original injuries ranged from twelve years to thirty-two years. Two out of six cases revealed painless maas in the anterior tibial compartment and remaining four cases revealed painful aases. At surgery, tooth-paste like, calcified material was evacuated in one of five operated cases and yellowish grey, brittle materials were evacuated in the remaining four cases.

Treatment of Painful Amputation Neuromas / 대한정형외과학회잡지

During ten years from Mar. 1973 to Feb. 1982, 2410 amputations of limbs have been experienced in Korea Veterans Hospital. 240 painful neuromas, which developed in 203 amputated limbs of 191 patients were treated with four different methods 1) Stretching and simple transection, 2) Transection and ligation, 3) Ligation and absolute alcohol injection and 4) Implantation into bone. After following up for average 5 years and 7 months, the following results were obtained. 1. The painful neuroma occured in 191 (7.9%) out of 2410 amputees. 2. The painful neuroma developed averege 2 years and 9 months after the first amputation. 3. After transection and ligation of the nerves, the painful neuroma recurred in 19.2% of the cases. The average interval taken to recur was 2 years and 6 months. 5. After ligation and absolute alcohol injection into the nerves, the painful neuroma recurred in 14.8% of the cases. The average interval taken to recur was 2 years and 6 months. 6. After implantation of the nerve into the bone, the painful neuroma recurred in 5.7% of the cases. The average interval taken to recur was 2 years and 2 months. 7. The best results were obtained after implantation of the nerves into the bone.

Total Fibulectomy for the Short Below Knee Stumps / 대한정형외과학회잡지

Although it is evident that even a very short below knee stump is superior to the lengest above knee stump, short below knee stumps present difficult pmblems in fitting prostheses. To solve these problems, twenty-nine short below knee amputees, those could not be fitted prostheses because of stump complications, had been treated by fibulectomy and resection of the peroneal nerve from March 1978 to March 1983. All the cases were followed up average 2 years and 3 months and the following results were obtained: 1. The complications of short below knee stumps decreased significantly after fibulectomy and res ection of the peroneal nerve. 2. After fibulectomy, weight bearing areas under the lateral tibial condyle increased considerably. 3. In group of below knee stumps between 5cm and 7.4cm long, P.T.B. prostheses with metal joints and thigh corsets should be fitted without difficulties. 4. In group of short below knee stumps between 7.5cm and 9.9cm long, P.T.B. prostheses with steel joints and thigh corsets, P.T.B. prostheses with knee cuff only, or supracondylar P.T.B. prostheses (K. B. M.) could be fitted selectively without any difficulty. 5. In group of short below knee stumps between 10cm and 12cm long, P. T.B. prostheses with knee cuff only or supracondylar P. T.B. prostheses could be fitted selectively without any difficulty. 6. After fibulectomy and resection of the peroneal nerve, all the short below knee amputees except for one case of very short stump (4.5cm long) could walk with their prostheses satisfactorily.

A Clinical Study of Squamous Cell Carcinoma as War Wounds / 대한정형외과학회잡지

No abstract available in English.