Recurrent Dislocation and Subluxation of the Patella: Experience of 22 Knees / 대한정형외과학회잡지

Recurrent dislocation of the patella is a relatively uncommon disease, which is most commonly seen in females in late adolescence. The condition is usually spontaneous and only rarely fallows traumatic dislocation. Dislocation is nearly always lateral and about one thirdis bilateral. The theoretical rationale of the treatment of the recurrent dislocation and subluxation of the patella is the realignment of the extensor mechanisms. We experienced with recurrent dislocation and subluxation of the patella on 22 knees in 18 patients at Seoul National University Hospital from July 1981 to Oct. 1987 and obtained the following results. 1. The age at operation ranged from 4 to 33 years and its mean was 15.8 years. Among 18 patients thirteen were female and five, male. 2. The most common presenting symiptom was pain (11 knees) and the most common presenting sign was quadriceps muscle atrophy (11 knees). 3. The prominent radiologic finding was patella alta in 6 knees (27.3%), genu valgum in 10 knees (45.3%), and hypoplasia of the lateral condyle of the femur in 2 cases (9%). 4. In two knees supracondylar osteotomy were performed and followed by proximal extensor mechanism realignment. In twelve knees only proximal reconstruction was performed. Four knees were treated by Hauser's technique and three knees with Roux-Gold-thwait technique. And these distal reconstruction procedures were performed with other procedures. 5. Mean follow up period was 1 year and 5 months. And the results are excellent in 8 knees, good in 12 knees and fair in 2 knees.

Surgical Treatment of Spine Tumors Part 1 : Surgical Treatment of Primary Spine Tmors: Review of 45 Cases / 대한정형외과학회잡지

Forty-five patients with primary neoplasm of the spine, disgnosed and operated at Dept. of Orthopedic Surgery, Seoul National University Hospital, from 1970 to 1988, were reviewed in an attempt to analyze the incidence of the primary spine tumors and effectiveness of surgical treatment. Mean follow-up was 2.5 years. Among 29 benign tumors, 7 cases of osteoid osteoma, 6 cases of giant cell tumor, 4 cases of osteoblastoma and aneurysmal bone cyst, and 2 cases of fibrous dysplasia and osteochondroma, and others were identified. Of 16 malignant tumors, 6 cases of eosinophilic granuloms, 4 cases of chordoma, 3 cases of solitary plasmacytoms, and others were noted. 17 cases occurred in the anterior compartment, 18 cases in the posterior compartment, and 10 cases involved both compartments. Surgical treatment consisted of complete or near complete excision, decompression, and additional stabilization procedure when the stability of the vertebral column was compromised. Stablization was achieved either by fusion, strut bone graft, or by additional Zielke, Cotrel-Dubousset, or Luque-Harringtion instrumentation. The results were astisfactory in most of the cases with benign tumors except cases of giant cell tumor. The results in malignant tumor were satisfactory especially in eosinophilic granuloma and solitary plasmacytoma with respects to symptoms and survival, and this fact was attaibuted to good response to adjuvant chemotherapy and radiation therapy. Recent application of Cotrol-Dubousset or Zielke instrumentation after agressive resection made early ambulation a clinical reality.

Comparative Functional Evaluation of Cementless Bipolar Endoprosthesis and Cementless Total Hip Replacement Arthroplasty in Avascular Necrosis of the Femoral Head in Adult / 대한정형외과학회잡지

In these days, there are two main ways in the treatment of the avascular necrosis of the femoral head in adult by prosthetic replscement; total hip replacement and bipolar endoprosthesis. So far, no study has been performed on the post-operative functional evaluation of them. Therefore it is difficult to decide which one is preferred to the other in the treatment of avascular necrosis of the femoral head in adult. In order to evaluate the functions of the prosthetic joints, the authors reviewed the results of 18 cases of cementless bipolar endoprosthesis(abbreviated as CBE) and 22 csses of cementless total hip replscement arthroplasty(abbreviated as CTHRA), performed at the Department of Orthopedic Surgery, Seoul National University Hospital, during the period from February, 1984 to May, 1986. The following results were obtained. 1. The average ages of CBE and CTHRA groups at the time of operation were 48.5 years and 37.5 years, respectively. 2. The average follow-ups of CBE and CTHRA were 15.7 months and 30.5 months, respectively. 3. By Meyer's modification of Marcus and Enneking classification, the sverage stages of CBE and CTHRA groups were 3.7 and 4.4 respectively. 4. According to Harris hip rating score system, Harris scores were increased as much as 30.5 in CBE group and 30.6 in CTHRA group. 5. In the aspects of functional improvement and relief of pain, the two groups showed no significant difference. However, the operation was essier, and the damage to the acetabular bone was less in CBE group. For these reasons, CBE was believed to be the preferred choice of treatment of avascular necrosis of femoral head in adult.

A Radiological Study of Normal Wrist in Korean People / 대한정형외과학회잡지

The carpal injury is difficult to diagnose due to anatomical complexity and the like. So, in order to get radiological knowledge of normal wrist, the authors measured the values which will be described on the wrist PA and lateral roengenogram obtained from 440 normal wrists(male : 188 cases, female : 252 cases) in randomly selected patients. The following results were obtained. l. Ulnar variance(mm±standard deviation): Total 1.1±1.2 : negative variance : 9.3%, positive variance : 56.1%, 2. Scapholunate Gap(mm±standard deviation): Total 0.4±0.7, 3. Ulnar Tilt(degrees±standard deviation): Total 23.6±5.3, 4. Volar Tilt, 5. Carpal height rstio : Total 0.52±0.05 male 0.53±0.04 female 0.51±0.05 : Total 13.1±5.9, 6. Carpal ulnsr distance ratio Total 0.05±0.05, 7. Scapholunate Angle : Total 49.9'±10.1', 8. Capitatolunate Angle Total 17.5'±10.0', 9. Radiolunate Angle Total 8.8'±6.7', 10. Carpal width ratio Total 0.72±0.08 11. Carpal thickness ratio Total 0.49±0.07.