Supracondylar Osteotomy in Cubitus Varus and Cubitus Valgus / 대한정형외과학회잡지

Cubitus varus and valgus is one of late complication of elbow fracture, and this deformity is caused usually by malunion in supracondylar fracture or epiphysial injury of the elbow joint. 40 supracondylar closed wedge osteotomies (on cubitus varus 25, cubitus valgus 15) were performed at the supracondylar level and were fixed with two K-wires or French method. The following results were obtained: 1. The frequency of deformity of cubitus varus was higher than that of cubitus valgus: cubitus varus, 25 cases and cubitus valgus, 15 cases. 2. Injury of the supracondylar of the humerus frequentry occured between the age of 6 and 15 (65%). 3. In cubitus varus the degree of deformity ranging from −11° to −30° was the most common whereas in cubitus valgus that ranging from 30° to 40°, 4. Incomplete ulnar nerve palsy was revealed in 15 postoperative cases of cubitus varus of which 3 cases were treated by anterior transposition. In all cubitus valgus, tardy ulnar nerve symptom was disappeared after correction. 5. Nerve damage could be avoid by performing the closed wedge osteotomy and upper connection combind with posterolateral incision in cubitus varus and medial incision in cubitus valgue. 6. Internal fixation associated with cross pinning with two K-wires or French method were performed and good result was obtained without complication even though older case.

A 14 Cases of Recurrent Shoulder Dislocation Treated by Modified Bristow Operation / 대한정형외과학회잡지

A recurrent shoulder joint dislocation was performed on fourteen cases who were treated by modified Bristow operation from June, 1978 to April, 1981. and following results were obtained. 1. The age of initial dislocation varied from 13 years to 23 years of age with the average of 18. 6 years. 2. The age at operation varied from 20 years to 28 years of age with the average of 23 years. 3. The duration of recurrent dislocaticn varied from 2 years to 8 years with the average of 4.4 years. 4. The times of dislocation varied from 6 to 50 times with the average of 17.1 times. 5. The roentgenograms showed the Hill-Sachs' Iesion in 10cases (71.4%), subluxation in 4 cases (28.6%), and glenoid rim abnormality in 2 cases. 6. The operative findings were Bankart's lesion in II cases(78.6%), glenoid rim erosion in 2 case, and subscapularis laxity in 2 case. 7. The complication and recurrence were not observed in this period. 8. The average limitation of abduction and external rotation were 5. 7 and 12. 2 degree respectively.

Muscle Transposition for Repair of Skin Defects Over Exposed Bone / 대한정형외과학회잡지

The management of chronic skin defect over the pretibial region, sacral pressure sore and other bony protuberant area is extremely difficult due to the presence of necrotic and infected bone, avascular and infected scar tissue, dead space and anatomical sparse of available adjacent structure. The present methods of management include versatile varieties and have left much to be revised, but they often despaired of both surgeon and patient, especially due to persistent chronic osteomyelitis and recurrent ulcer. From January, 1975 to April, 1979, we have had treated 20 such cases with application of muscle flap transposition and following has been observed. 1. The cause of lesion were 11 cases of the traffic accident, 4 cases of the industrial accident, 2 cases of the falling from a height, 2 cases of the pressure sore and 1 case of the chronic osteomyelitis. And 15 cases of them were physically active young adult between 2nd decade to 4th decade. 2. The muscles used for pretibial lesion were medial head of gastrocnemius m., soieus m., flexor digitorum longus m. and peroneus brevis m. Used abductor hallucis m. for medial malleolar defect, gluteus maximus m. for sacral pressure sores and sartorius m. for exposed knee joint. 3. There existed hematoma formation in 2 cases, partial necrosis of transposed muscle in 3 cases and persistent infected sinuses in 3 cases. Other cases except the last 3 cases, which needed another surgical procedure and antibiotic therapy, were controlled without difficulty and all of them did not develope any recurrence of ulcer during the follow up duration. 4. There did not appear to be any significant long term functional residua due to loss of original function of the transposed muscle except somewhat unacceptable cosmetic result. 5. It was 2 months average for the healing cases which did not need a bone graft and 5 months average for the cases needed a bone graft.