Supracondylar Quadrilateral Displacement Osteotomy for Cubitus Varus Deformity: New Operative Technique / 대한정형외과학회잡지

Cubitus varus deformity is the late complication of the supracondylar fracture of humerus which is common in growing children. If the deformity is severe it causes tunctional problems as well as cosmetic ones necessitating conective osteotomy. Though many authors devised different methods of corrective osteotomy, the cosmetic results are not always satisfactory because of the development of the lazy S deformity hy the lateral prominence. Technically. the initial stahility of the osteotomy is also poor due to the poor contact of the osteotomy site. So we have devised a new quadrilateral displacement osteotomy to increase the initial stability of the osteotomy by creating a wedge on the osteotomy site & also to prevent the development of the lazy S deformity hy elimination of the Interal prominence. We treated 9 cases of cubitus varus deformity with the new quadrilateral displacement osteotomy. The correction technique was not difficult & the initial stahility of the osteotomy is rather good & the osteotomy is fixed by the conventional methods, & all of the cases were healed uneventfully. There developed no the lazy & deformity after osteotomy. We would like to report the details ot the supracondylnrquadrilateral displacemenl osteotomy.

Clinical Experience of the Ilizarov Application for Correction of Ulnar Defect with a Dislocated Radial Head: 2 Cases report / 대한정형외과학회잡지

2 patients of forearm deformities with ulnar defect and radial head dislocation were treated with the Ilizarov apparatus at Chungnam University Hospital. One patient had a severe hypoplastic remnant-like ulnar fragment and a anterolaterally dislocated radial head due to complicated osteomyelitis of ulnar. We applied an Ilizarov apparatus to transport the radial head distally, and fixed to remaining proximal ulnar fragment. The other had a large bony defect at the ulnar shaft and a dislocated radial head due to complicated osteomyelitis of ulna. We performed internal transport of ulna to decreased the ulnar defect and to descend the dislocated radial head. The clinical-radiological features and functional results of those 2 forearm deformities were described with brief review of the articles about the Ilizarov method for correction of forearm defor- mities.

Hereditary onycho-osteodysplasia (nail-patella syndrome) / 대한정형외과학회잡지

No abstract available.

Varus derotation osteotomy by MacEwen and Shands in congenital dislocation of the hip before the age of five / 대한정형외과학회잡지

No abstract available.

Clinical observation on 10 cases of giant cell tumor in the knee joint / 대한정형외과학회잡지

No abstract available.

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

A review of 15 cases of the modified Bristow operation for recurrent anterior shoulder dislocation from Jan. 1983 to Dec. 1988 was presented. Using arthroscopy, we could examined the pathologic feature of the recurrent anterior dislocation of the shoulder. The results are as following. 1. The ages at the initial dislocation were ranged from 15 to 26 years and operated from 19 to 61 years. 2. The most common injury mechanism of the dislocation was sports injury (5 cases) and followings were traffic accident, military training, hanging with one hand. 3. The 10 cases were dislocated above 10 times before operation and 3 were dislocated above 10 times per year. 4. Bony lesions were detected on routine X-ray at 8, that is A-P and lateral view, Hill-sach's view, Stryker-notch view and West point view, Hermoddson view, and apical obique view. 5. Arthroscopic examination was done at 7 cases and could detect the pathologic lesion more exactly. 6. All were treated with modified Bristow method 7. Mean follow up periods were 2 year and 4 monthes. 8. The range of motion was not limited but external rotation was done about 18. 9. Excellent results were obtained by Rowe's grading system, mean 88.8.

The Primary Repair of Acute Cruciate Ligament Injury using Multiple Pull Out Technique / 대한정형외과학회잡지

The cruciate ligaments are important in providing the anterior and posterior stability and usually associated with other ligament injury of the knee joint, and there are many controversies in its treatment. In general, the primary repair for the acute cruciate ligament injury was good, but some had opposite opinions in the treatment of the isolated anterior cruciate ligament injury. In acute injury, early repair of ligament and in delayed case, the reconstrution surgery of ligament was recommended. For good results, it is very important to give prompt management. Authors studies 23 cases in 16 patients with acute cruciate ligament proper injury who were treated by multiple pull out technique at the department of orthopaedic surgery, Chungnam National University Hospital from April, 1984 to July, 1988. The results were as followings: 1. The incidence was high in active male patients. 2. The most common injury was the traffic and automobile accident. 3. the tibial and femoral attachment were the most common detachment site in anterior and posterior cruciate ligament injury, respectively. 4. Isolated cruciate ligament injury was rare. 5. The results were good in 11 cases(47.8%), especially treated within one week.

Hip Joint Pressure in Displaced Fracture of the Femoral Neck / 대한정형외과학회잡지

We studied 16 cases intracapsular pressure in displaced fracture of femoral neck(Garden stage III, IV), the pressures were measured range between 12-62 mmHg(mean, 23.4 mmHg). Aspirated blood amount from hip joint did not exceed 3cc, this amount not correlate with intracaspsular pressure. Of 10 cases examined scintimetry, 2 had incressed uptake after aspiraton, it is suggested that early decompression of hemarthrosis in femur neck fracture regaredless of displacement may be considered.

Clinical application of Halo body Jacket in the Cervical Spine Lesion / 대한정형외과학회잡지

Halo body jacket provides a excellent method of immobilization in unstable cervical spine such as fracture, dislocation, fracture-dislocation, tuberculosis, neurofibromatosis, congenitsal anomalies of the dens. With or with aiding of halo body jacket, we could treated the various unstable cervical spine. The stability of cervical spine can be maintained with halo body jacket. The author's applicated halo body jacket for 22 cases of unstable cervical spine. 1. The application was simple and the control is easy in any plane to achieve stablilty for unstable cervical spine. 2. The fracture dislocation of cervical spine was reduced by halo ring traction and the reduction position was maintained during operation and until bone and soft tissue healing. 3. Early ambulation was possible, so reduce the complcation due to prolongedd bed rest. 4. During operation, it provided a safe position of the patient with ease, and didnot aggravated the neurological status. 5. Provided a good operation fileds and easy taking a grafted bone from ilum than halo body cast.

Comparartive Study of Metaphyseal / 대한정형외과학회잡지

Differential diagnosis between physiologic bow legs and nonphysiologic bow legs is difficult and still not fixed in diagnosis, especially under 5 years old age. Recently the problem exist in differential diagnosis and treatment method of rickets because of non-specific laberatory finding in rickets. Metaphyseal-Diaphyseal angle in distal femur, Diaphyseal-Diaphyseal angle between femur and tibia, and Metaphyseal-Diaphyseal angle in proximal and distal tibia, and Metaphyseal-Metaphyseal angle in tibia are measured and compared for 30 bow legs children. And divided into rickets group and physiologic bow legs group by clinical and laboratory findings. The results are as following 1. Mean age was 1.91 years old at initail examination, 2.08 years old in rickets group, 1.73 years old in phisiologic bow legs group. 2. Diaphyseal-Disphyseal angle between femur and tibia was 18.12 ±6.80 in rickets group. And 10.17±5.36 in phisiologic bow legs group. Metaphyseal-Diaphyseal angle in distal femur was 10.88±3.62 in rickets group. And 8.42±4.42 in physiologic bow group. 3. Metaphyseal-Diaphyseal angle in proximal tibia was 11.50±2.56 in rickets group. And 7.17±2.01 in phisiologic bow legs group. It's angle in distal tibia was 10.50±3.86 in the former and 9.50 ±3.09 in the later group. Metaphyseal-Metaphyseal angle in tibia was 20.68±3.91 in rickets group and 16.78±4.11 in phisiologic bow legs group. According to the above mentioned results. Metaphyseal-Metaphyseal angle and Metaphyseal- Diaphyseal angle in tibia are comparable to gross appearance of bow legs deformed children rater than Diaphyseal-Diaphysealangle between femur and tibia, and Metaphyseal-Diaphyseal angle in distal femur. All values are high in rchekts, statistically. Therfore measurement of above mentioned angle in simple X-ray is valuable in differential diagnosis between phisiologic bow legs and Rickets.

An Experimental Investigation for Biologic Reactions of Carbon Fiber Implants / 대한정형외과학회잡지

Ligament and tendon prostheses have all suffered because of failure of the particular material that has used in the past. Various materials, including, silk, nylon, Dacron, and combinstions of other synthetic substances, have all enjoyed temporary vogues and have vogues and have all passed out of habitual use because of collapse of the material employed. In an attempt to find an alternative material for use as a tendon or ligament prosthesis, a fundamentally new approach to the problem has been used, namely, that of tendon ligament induction. Carbon fiber has an attraction as a biologic implant because of its inherently inert nature when used in the pure form. Within recent years, it has been possible to manufacture filamentous carbon fiber of high purity and constant filament size, and this material has been examined as a tendon and ligament prosthesis. Both achilles tendons of 14 adult Korean rabbits were replsced with carbon fiber reinforced epoxies(CFRE, it was developed in department of chemical engineering, Chungnam national university, Daejeon, Korea) after artificially rupture, and serial histologic examination of neotendon formations and biologic responces in vivo were done during 8 weeks. The results obtained were as followings ;1. Hemorrhage and inflammatory reactions were observed at 2–3 weeks after operations. 2. Foreign body reactions were developed at 4 weeks after operation, also observed proliferations of foreign body giant cells and histiocytes. 3. Fibroblasts were increased at 4 weeks after operation, and most severe poliferations at 5–6 weeks. 4. Foreign body reactions and fibroblasts were markedly decreased at 7–8 weeks after operation, and examination of the collagen itself showed it to be closely similar to that found on the normsl side.5. Thus, it appeared that the carbon fiber initially acted as a tendon prosthesis.

Lymphangiomatosis of Bone and Soft Tissue: A Case Report / 대한정형외과학회잡지

A case of Lymphangiomatosis of the skeleton and soft tissue in a 23 years old woman is presented. Lymphangiomatosis are benign tumors formed of lymphatic vessel and like hemangiomatosis are probably best thought of as harmatomatous malformation. As term imply, the endothelial space in these lesions are lymph-rather than blood containing. Bone involvement are very rare condition that affect mainly the ilium and features a largely lytic pattern, consisting of tiny elliptical radiolucents slots. Treatment and Prognosis depend on the site and extent of involvement and progression. Although irradiation may be the treatment of choice, the lesions have not been usually successfully treated.

A Case Report of Familial Osteopoikilosis / 대한정형외과학회잡지

Osteopoikilosis is an asymptomatic osteosclerotic dysplasia, initially described by Albers-Schönberg and Ledoux-Lebard and associates. This disorder is described as extremely rare. Inherited and sporadic cases of osteopopikilosis have been reported. A Case of familial osteopoikilosis is presented with a brief review of literatures.

Clinical Study of Computerized Tomography for the Fracture of the Spine / 대한정형외과학회잡지

We have reviewed our experiences of computerized tomography(CT) in the fracture of the spine. Between December 1983 and June 1985, we treated 33 fractures of the spine in 32 patients. We have used CT for the diagnosis of fractures of the spine in 29 cases (28 patients). Also we have used Louis scoring system to evaluate the stability of the fractured spine. The results are as follows. 1. CT has many advantages that were not given from simple radiograp hies or laminagrams. It reveals the vertebral body, vertebral column, posterior compartments and surrounding soft tissues excellently, and it is easy to interpretate. Also it can be done comfortably and rapidly without the need of manipulations. 2. We could acquire many informations from post-operative or long term following up of CT examinations. 3. If the Louis score is higher than 3, we should think it is unstable, and should take internal fixation of the vertebral column. 4. There is a correlation between Louis score and neurologic signs (p < 0.01). If there was a neurologic sign with low Louis score, less than 1, the recovery was soon, less than 24 hours. 5. According to CT findings for fragmentation or location of fragment, we can alternate an anterior decompression or a posterior decompression. 6. It is necessary to use CT as a initial diagnostic procedure with the simple radiographic examination in spine fracture.

Osteopetrosis / 대한정형외과학회잡지

Osteopetrosis is a rare familial disease, characterized roentgenographically by a marked increase in the radiodensity of bone and by abnormality in the shape of the long bone, especially the metaphysis. It was discovered fist by Albers-Schonberg in 1904 during an X-ray examination of a patient and is known as Albers-Schonberg disease, marble bone or osteosclerosis fragilis generalisata. We experienced a case of osteopetrosis in adult.

An Investigation of Articular Cartilage Degeneration Induced by Compression-Immobilization and Condylar resection of Knee Joint in Rabbits / 대한정형외과학회잡지

Articular cartilage have dual functions of shock absorber and bearing surface in a moving joint. Articular cartilage is avascular, so the chondrocytes in mature adult must receive their nourishment solely from synovial-fluid perfusion, and it is known that alteration of synovial-fluid perfusion causes degeneration of articular cartilage. Now, in orthopedic fields, the corrective cast immobilization and traction is in popular use. In order to study the cartilage changes induced by this long-term cast immobilization and traction, compression-immobilization and condylar resection of knee joint in rabbits were performed, and weekly histoiogic examinations of articular cartilage up to 5 weeks were followed. The observations were as follows: 1. Degenerative changes of articular cartilage were observed respectively with compression-immobilization and condylar resection, and the severity of the histologic changes appeared to be proportional to the duration of compression-immobilization and condylar resection. 2. Earlier degenerative changes of articular cartilage in condylar resection group than in compression-immobilization group were noted, and this earlier degenerative changes in condylar resection group suggests that hemarthrosis may play a role in cartilage degeneration. 3. Histologically unchanged calcific cartilage zone and mildly hypertrophied subchondral bone were noted in compression-immobilization group, but vascular invasion to calcific cartilage zone and subchondral osteoporosis were noted in condylar resection group.

Direct Bone Invasion of the Squamous Cell Carcinoma Arising from Chronic Osteomyelitis and Burn Scar: Report of 4 Cases / 대한정형외과학회잡지

Squamous cell carcinoma is a malignant tumor arising from the epidermis or its appendages, Squamous cell carcinoma of extremity comprises approximately 1 to 2 percent of all squamous celi carcinoma and of these 0.2 to 1.7 percents are secondary to chronic osteomyelitis and 2 percents are secondary to the burn scar. We experienced 4 cases of squamous cell carcinoma invading bone directly, of these 2 cases are secondary to chronic osteomyelitis and 2 cases are secondary to the burn scar. With prompt and aggressive surgical treatment the prognosis is good. Routine regional lymphadenectomy is unnecessary because in most instances enlarged nodes are inflammatory and subside after amputation.

Large Neurilemmoma of the Lumbar Area (Extradural and Paravertebral): A Case Report / 대한정형외과학회잡지

Neurilemmoma is a benign neoplasm arising from the Schwann cell of the nerve sheath. Acoustic nerve is the most common site of neurilemmoma and mandible is the most frequently involved in intraosseous neurilemmoma. Extradurally located dumbbell type neurilemmoma was rarely reported. The histology of neurilemmoma was first described by Verocay in 1908 and elaborated upon by Stout in 1935. Characteristic histologic patterns of neurilemmoma were encapsulation and Verocay bodies, Antoni type A and B areas, palisading nuclei, and lack of malignant characteristics. We experienced such a rare case of neurilemmoma which probably arised from the left first lumbar spinal nerve root, and located extradurally and paravertebrally, and confirmed by radiologic and pathologic findings.