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.

Intraosseous Ganglion of the Tibia: A Case Report / 대한정형외과학회잡지

The intraosseous ganglion is a rare cystic lesion of bone most frequently located in the subchondral epiphysis of long bones with or without direct communication with a joint cavity. This case is reported to call attention to this lesion which deserves consideration in the differential diagnosis of solitary cystic lesions of bone. We were reported a 59-aged woman without direct communication with the knee joint and osteoarthritis which was treated with the curettage and chip-bone graft.

Medial Displacement and Valgus Nailing with Jewett Nail in Unstable Intertrochanteric Fracture / 대한정형외과학회잡지

Intertrochanteric fractures frequently occur in elderly patients. Early mobilization after rigid internal fixation of unstable intertrochanteric fractures has recently reduced the mortality and morbidity. Between March, 1976 and February, 1980, eighteen patients over 60 years old with unstable intertrochanteric fractures were treated by Jewett nailing after Dimon & Hughstons reduction at the department of Orthopaedic Surgery, Chung Nam University. Among the eighteen patients, twelve patients could be followed, ranging from 6 months to 2.1 years, with an average follow-up of 11 months. The results were obtained as follows: 1. The main causes of fractures were falling down and slip down. 2. In treatment of unstable intertrochanteric fractures by medial displacement and valgus nailing with Jewett nail, early ambulation and early weight bearing were possible with satisfactory results. 3. The average time for fracture union in twelve cases who were followed up were 17.1 weeks, but two cases with severe comminution of posterior and medial fragment of the trochanter revealed delayed union. 4. The medial displacement of distal fragment and valgus nailing in unstable intertrochanteric fracture shortened the operation time and reduced complications by early ambulation, but had disadvantages such as some limitation of motion of affected hip joints, shortening of affected extremities and delayed union.

Fixation with Harrington Rods of Unstable Thorace-Lumbar Spine Fracture and Fracture-Dislocation / 대한정형외과학회잡지

Harrington Instrumentation and Spinal Fusion to treat the unstable fracture and fracture-dislocation of the thoraco-Iumbar spine is a very effective method. This method not only decompresses the spinal cord and nerve roots by anatomical reduction and preserves spinal stability, but also makes possible early rehabilitation and prevention of complications. A clinical study was made of twelve patients who were hospitalized and treated at the Department of Orthopaedic Surgery, Chung-Nam National University Hospital from Oct. 1978 to J une 1980. The following results were obtained: 1. Of twelve patients, five(42%) had a flexion-compression fracture, four(33.3%) had a shear fracture-dislocation, two(16.7%) had a flexion-rotational fracture, and one(8.3%) had a bursting fracture. 2. Seven(58%) had a complete neural deficit and five (42%) had an Incomplete neural deficit. Two (28%) of the seven patients with complete neural deficit showed slight neurological recovery, but two patients(40%) with incomplete neural deficit gained complete recovery. 3. Correction of the kyphotic deformity was 16 degrees on the average, and the displacement was completely corrected in five of the six patients. 4. During the follow-up period, there was a final loss of about five degrees (range 3-16 degree) of kyphotic correction In our patients and there was no difference in loas of correction between laminectomy group and control group. 5. After an average of 18 postoperative days, ambulation was started, and acute hospital days were 77 days on the average. 6. There was no difference in spinal fusion rate between brace-wearing group (4 cases) and cast Immobilized group (8 cases). 7. Two cases (16.6%) of the twelve cases showed spontaneous interbody fusion.