The Effects of Non-invasive Capacitively Coupled Electrical Field on Fracture Healing / 대한정형외과학회잡지

To demonstrate the stimulation effect on fracture healing by capacitively coupled electrical field, the rabbits' fibulae were fractured and treated with a capacitively coupled electrical signal (10V peak to peak, 60 kiloherz, symmetrical quadriangular wave) that was applied non-invasively over the skin surface overlying the approximate site of the fractured fibulae. Each fibula was evaluated with gross, roentgenographic, histological and mechanical tests after 21 days of the electrical stimulation, and compared to control group statistically. Maximum bending moment, Young's modulus of elasticity and bending stiffness were calculated by 3 point bending test, and the ratios of the fractured to the intact fibulae of the electrically stimulated rabbits were compared to the non-stimulated rabbits statistically. The results revealed that the fractured fibulae exposed to capacitively coupled electrical field showed the higher degree of fracture healing than the non-stimulated fibulae.

The Significance of Bone Scan in Pyogenic Bone and Joint Infections / 대한정형외과학회잡지

The value of the bone scan in pyogenic bone and joint infections is demonstrated in patients who had signs and symptoms suggestive of bone or joint infection. Nineteen patients were evaluated with 99m Tc-methylene diphosphonate bone scan and roentgenogram. The diagnosis of acute osteomyelitis was made in eight patients, chronic osteomyelitis in six patients, septic arthritis in three patients and two patients had soft tissue infection only. Seven of the eight patients with acute osteomyelitis had focal increase of radiopharmaceutical uptake in the bone well before the bony change appeared on roentgenogram. Five of six chronic osteomyelitis patients had not only bony change on roentgenogram but also increased radiopharmaceutical uptake of bone. But the remaining one had only the former, and the lesion was interpreted as inactive. In two of three septic arthritis patients, the lesion was in S-I joint and both of them had no abnormality on roentgenogram but had increased uptake of radiopharmaceutical agent in the joint. Two patients with soft tissue infection had no abnormal radiological bony change and no increase of the radiopharmarceutical uptake in bone on bone scan. From the above data, we concluded that bone scan is recommended in the evaluation of the patients with signs and symptoms suggestive of bone or joint infection for the earlier diagnosis and differential diagnosis in acute case and for the determination of the activity and location of the lesion in chronic case.

The Significance of Bone Scan in Malignant Bone Tumors / 대한정형외과학회잡지

Bone scans with 99mTc-methylene diphosphonate were analysed in 44 patients with biopsy proven malignant bone tumor who admitted Department of Orthopedic Surgery in Seoul National University Hospital from March 1979 to June 1981. The results obtained were as follows: 1. Cases, there were 21 cases of primary malignant bone tumors and 23 cases of metastatic bone tumors. 2. Bone scan showed single lesion in 18 cases (86%) of 21 primery malignant bone tumors, and mutiple lesions in 15 csses (65%) of 23 metastatic bone tumors. 3. There were 2 cases of cold area in bone scan of a reticulum cell sarcoma and a metastatic adenocarcinoma. 4. In comparison of bone scan and roentgenogram by number of lesions, 96 lesions were positive in bone scan or roentgenogram in 44 cases. In 21 primary maligmant bone tumors of 29 lesions, 24 lesions (83%) were positive in both bone scan and roentgenograms. In 23 metaatatic bone tumors of 67 lesions, 28 lesions (54%) were positive in both bone scan and roentgenogram, 40 lesions (42%) were positive in bone scan and negative in roentgenogram 5. In only 2 cases of multiple myeloma, showes positive in roentgenogram but normal in bone scan. 6. In metastatic bone tumor, bone scan showed 39 hot lesions without clinical symptoms as well as 27 lesions with clinical symptoms.

Total Hip Replacement for Ankylosed and Deformed Hip / 대한정형외과학회잡지

It is well known that the merit of total hip replacement is to provide rather satisfactory range of motion with relief of pain among reconstructive procedures. Therefore it is presumed that the ankylosed hip could gain range of motion by reconstruction of artificial joint, it the muscles around the hip is adequate. Furthermore when the patient has some problems in the back or knee secondary to ankylosed and deformed hip, any kind of reconstructive surgery, maybe total hip replacement is necessary which gives range of motion and correct deformity of the hip. Our result total hip replacements for fifteen ankylos d hips of twelve patients that were followed more than one year is gratifying to all patients with relief of pain and relatively satisfactory range of motion.

Follow-up Study of total Hip Arthroplasty / 대한정형외과학회잡지

Total hip replacement arthroplasty has become an established procedure in the management of painful arthritic hip in past two decades. However there is no many reports that concern follow-up study in total hip replacement arthropiasty. This is a follow-up study in 100 total hip replacement arthroplastics in 86 patients of 157 total hip replacement arthroplasties in 135 patients, performed at the Department of Orthopedic Surgery, Seoul National University Hospital, between November 1973 and December 1979. The longest fallow-up was 5 years and the shortest 6 months, the average being 2 years and 6 months. 1. There were 54 males (63%) and 32 females (37%). 2. The underlying diseases of 100 hips were avascular necrosis of 35 hips, septic hip residua of 31 hips, primary osteoarthritis of 9 hips, old hip fracture of 9 hips, Legg-Perthes disease of 7 hips, rheumatoid arthritis of 5 hips, congenital dislocation of 3 hips, and failed endoprosthesis of 1 hip. 3. The types of prosthesis used were Muller ones in 82 hips, T-28 in 17 hips, and Charniey and Harris type one case respectively. 4. In the half cases of a hundred total hip replacement arthroplasties, the anterolateral or posterolateral approach was used without trochanteric osteotomy. 5. Postoperative complications were as follows: 13 cases of wound problem including 3 early deep infections, 2 dislocations, 1 femoral nerve palsy, 3 peroneal nerve palsies, 1 acetabular perforation, 2 femoral shaft perforations, 14 trochanteric problems including 11 cases of wire breakage, 2 nonunions, and 3 cases of trochanteric bursitis 3 ectopic ossifications, 3 cases of radiological loosening including 2 femoral and 1 acetabular. 6. The range of motion were improved from 28 to 5 of flexion contracture, from 91 to 101 of further . flexion, and from 16 to 48 of abduction in the average. 7. The improved ranges of motion were varied with disease group rather than type of prosthesis and the length of neck of prosthesis. 8. The function of each hip was evaluated preoperatively and postoperatively by the method of Harris and d'Aubigne, and improved from 55.3 and to 88.2 by Harris score and from 11.2 to 15.8 d Aubigne respectively.