Pyogenic Spinal Epidural Abscess: A Case Report / 대한정형외과학회잡지

Pyogenic spinal epidural abscess is extremely rare, but a significant disease due to its high mortality rate and remaning neurologic sequela, if it is not diagnosed and treated in time. Recently, it became possible to promptly diagnosis pyogenic epidural abscess by MRI. We report a case who was subjected immediately to surgical drainage under the cover of intravenous antibiotic treatment after diagnosis who recovered completely without any residual.

Comparison of ACL Reconstruction using Autograft of BPTB and Allograft of BPTB and Achilles Tendon

No Abstract Available.

Ulnar Nerve Palsy due to Multiple Ganglion Cysts at the Elbow: A Case Report / 대한정형외과학회잡지

Ulnar nerve compression at the elbow can occur at any site that begins proximally at the arcade of Struthers and end distally where the nerve exits the flexor carpi ulnaris muscle in the forearm. We experienced one case of ulnar nerve palsy due to multiple ganglion cysts which had occured at the elbow joint. A complete excision of ganglion cysts and anterior transposition of the ulnar nerve were performed. The clinical result was satisfactory

Pisiformectomy in Post-traumatic Pisotriquetral Osteoarthritis: A Case Report / 대한정형외과학회잡지

Post-traumatic pisotriquetral osteoarthritis is an unusual condition and its diagnosis is not easy to make. This disease must be distinguished from other conditions that cause ulnar side wrist pain. We experienced a case of post-traumatic pisotriquetral osteoarthritis treated by pisiformectomy.

A Clinical Study of Disruption of the Deltoid Ligament Associated with Fractures of Distal Fibula / 대한정형외과학회잡지

It is been known that the deltoid ligament of the ankle joint plays an important role in the stabiliy of the ankle joint. In cases of deltoid ligament rupture, associated with lateral malleolar fractures, cannot be maintained the integrity of the mortise and the stability of the talus. Controversy remains about the treatment of deltoid ligament injuries. Many authors advocate an operative repair for deltoid ligament ruptures for optimal reduction of lateral malleolar fracture. However, according to recent cadaveric studies and many satisfactory results of clinical studies, excellent results have been reported regarding the ankle joint stability by anatomical reduction of the lateral structure, but only without surgical repair of the medial structure. Fourteen patients with lateral malleolar fractures with associated deltoid ligament injuries treated at Sun General Hospital between January 1990 and June 1995. There were examined clinically and radiologically. We concluded that deltoid ligament repairs should be considered unnecessary as long as fibular fracture are stabilized anatomically with normal medial joint space. However, in cases with higher fracture levels of lateral malleolus, associated with syndesmotic injury, we recommend syndesmotic screw fixation or deltoid ligament repair.

Nonunion after Interlocking intramedullary Nails for Humeral Shaft Fractures / 대한정형외과학회잡지

The intramedullary nailing for humeral shaft fractures has become popular fixation method. It affords less invasive procedure, good stability and early rehabilitation. However many complications were reported such as nonunion, pain and motion limitation of shoulder. We managed 33 patients using interlocking intramedullary nail for the humeral shaft fractures, and nonunion occurred in 9 patients. We reviewed these 9 cases and analyzed the relationship between the nonunions and the fracture sites as well as fracture types. The results were as follows; 1. Nonunion occurred in 9 patients of 25 patients treated closed reduction, but did not occur in 8 patients treated open reduction. 2. The union was obtained in all 6 patients with proximal one third fracture. But nonunion occurred in 6 patients of 19 patients with middle one third fracture and in 3 patients of 8 patients with distal one third fracture. 3. Nonunion after interlocking nails for humeral shaft fractures did not occur in all 6 spiral fracture patients. Nonunion occurred in 5 patients of 8 comminuted fracture patients, in 3 patients of 6 transverse fracture patients and in 1 patient of 3 oblique fracture patients with below the middle one third of humerus. Our study showed that the high rate of nonunion occurred in the comminuted, transverse and oblique fracture below the middle one third of humerus. On the basis of these findings, we recommend that closer attention should be paid when choose the fixation method in these types of the humeral shaft fractures.

The Surgical Treatment of Acute Rupture of the Lateral Ligaments of the Ankle / 대한정형외과학회잡지

Inappropriate treatment of the injury of the lateral collateral ligaments of the ankle produce residual instability, which causes serious disability. There is considerable divergence of opinion as to whether fresh rupture of the lateral ligaments of the ankle are best treated by conservative or opreative method. We have conducted a trial to analyze thirty patients, who were treated by immediate open surgical rupair of rupture of the lateral ligaments of the ankle between April 1991 and February 1992. The results were as follows: 1. All patients were active, young men, Injuries to left ankle were three times more than right side. The most common cause of injury is occurred during sports, especially association football. 2. The decision to operate was based on 1)Talar tilt angle of the injured ankle measures 8-10 degrees more than that of the stress uninjured ankle. 2)A positive arthrogram showing contrast leakage into peroneal tendon she-aths & anterolateral aspect of the lateral malleolus. 3. Diagnostic accuracy rate of arthrography is 94.5%, stress radiography 61.1 %. Arthrography is more reliable than stress radiography in the diagnosis of acute injuries to the lateral ligament of the ankle. 4. At operation, isolated rupture of anterior talofibular ligament was in 5 cases, isolated rupture of middle calcaneofibular ligament in 3 cases, concomittant ruptures of anterior talofibular and middle calcaneofibular ligements in 22 cases. 5. Location of tears of anterior talofibular ligament was mostly mid-portion, middle calcaneofibular ligament in mid-portion or distal portion. 6. On radiologic results, average angle of talar tilt was 14.4° preoperatively, 5.2 preoperatively. There was correction of talar tilt angle of average 9.2°. 7. Clinical results of treatment were excellent in 9 patients, good in 6 patients, fair in 4 patients, poor in 2 patients by authors rating system. The satisfactory result was achieved in 15 patients(71.4%). 8. Postoperative complication was reduced mobility in 4 cases, functional instability 1 case, neuroma in operation scar in 2 cases, minor sensory loss in 4 cases. 9. Primary surgical repair gave good results in the aspect of radiologic & fun ctional instability, but clinical results were not satisfactory, due to high incidence of postoperative complication.

Clinical application of gamma-locking nail in the treatment of pertrochanteric fracture / 대한정형외과학회잡지

No abstract available.

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.