The Clinical Follow-up Study on Total Hip Replacement / 대한정형외과학회잡지

Total Hip Replacement is well documented and widely used procedure for painful arthritic hip in past two decades and each year still seems to be increased in numher of total hip replacement. And recently, there is a few reports of follow-up study on total hip arthroplasty in our country. The aim of this study was to present the clinical material which was performed on 27 hips of 21 patients who were treated at Dept. of Orthopedic Surgery. College of Medicine, Chungnam university from jan, 1979 to Jan. 1982. The longest follow up was 4 years, shortest was 8 months, average time was 2 years and 8months The results were obtained as follow; 1. The age incidence ranged from 26 to 69 years old, and average were 47 years old. 2. There were 17 males (81%) and 4 females (19%). 3, The causes of hip disease were mostly avascular necrosis of the femoral head (67%). 4, The most commonly used prosthesis were Muller type with trochanteric ostcotomy approaches. 5. Several complications were found: perforation of acetabulum with bone cenent in pelvis, postperative pneumonia wire breakage and painful bursitis around the trochanteric area which was on osteotomy sites. 6. Postoperative functional evaluation was evaluated by method of d'Aubigne and Postel, and improved from 10.0 scores to 15.8 scores. Relief of the pain is the most effect of the total hip replacement in this study, But case are not enough to more detail evaluation, especially, the problem of loosening of stem, acetabular cup wearing and heterotopic bone formation after total hip replacement.

The Correction of Severe Spinal Kyphotic Deformities with Halo-pelvic Apparatus / 대한정형외과학회잡지

Three cases of severe spinal kyphotic deformities were treated with Halo-pelvic Apparatus. Among these three cases, two were tuberculous kyphotic deformities involving the thoracolumbar vertebrae with paraplegia. And the other one was cervical kyphotic deformity due to neurofibromatosis with neurologic involvement. The following results and considering problems were obtained. 1. Two cases of tuberculous kyphosis, 130° and 115°, were corrected to 120° and 100° respectively. And one case of neurofibromatic kyphosis, 90° was corrected to 53°. 2. Among two cases of tuberculosis in which the one was revealed full neurologic recovery, and the other resulted in permanent paraplegia. And a case of neurofibromatosis was fully recovered neurologically. 3. Total period of immobilization with Halo-pelvic Apparatus was 16, 18, 18 weeks in three cases respectively, but there was no avascular necrosis of odontoid process. 4. One case of neurofibromatosis with anterior spinal fusion revealed no loss of correction of kyphosis. But two cases of tuberculosis without anterior spinal fusion showed loss of correction of kyphosis, 20° respectively. 5. Removal of internal kyphosis was not easy, because it is likely to injury the blood supply to spinal cord. 6. During distraction, severe pain was noticed in the rib cage, which prevented further distraction. 7. After 9 weeks, ambulation with Halo-pelvic Apparatus was hindered with pain due to pelvic pin loosening. 8. In order to prevent loss of correction of kyphosis, it was considered that anterior spinal fusion should be followed by posterior spinal fusion.