Treatment of Unstable Interochanteric Femoral Fracture using Compression Hip Screw with additional Transfixations Screw / 대한정형외과학회잡지

There are many difficult problems of reduction and its maintaining in the treatment of unstable intertrochanteric fractures. Especially, in cases of elderly patients with marked osteoporosis, prolonged immobilization brings more serious complication. In order to solve these problems, in cases of unstable intertrochanteric fractures with large lesser trochanteric fragment, we have carried out anatomical reduction and rigid internal fixation with compression hip screw and additional transfixation screw on posteromedial fragment. The unstable fractures have been convrted into the stable fractures by transfixation screw. We analyzed the 1 1cases with additional transfixation screw and they showed good results in one year follow up.

Clinical Experiences of Spinal Surgery using TSRH Instrument / 대한정형외과학회잡지

The main goal of spinal surgery using implant is a rigid fixation to provide the stability until solid fusion will occur. Recently, various implant fixation devices have been introduced and transpedicular screw fixation is the usual method. In the past, we obtained the implant-related complications like screw failure and rod breakage after using the modified Harrington rod. However, we obtained good results after follow up over one year using TSRH instrument. We experienced spinal surgery using TSRH instrument in 42 cases since 1991 and followed from one year to 28 months with average 16 months. We analyzed the 28 cases and evaluated the implant-related problems. The results were as follows: 1. Among 28 patients, 10 patients were operated due to fracture and 9 patients operated due to spinal stenosis. 2. The male patients were 16 cases and the female were 12 cases. 3. The TSRH instruments provided the rigid fixation with three points clamping mechanism. 4. The cross-linking plate of TSRH was found to increase stiffness and strength. 5. There were no case of screw breakage. 6. In functional results by Kirkaldy-Willis; foriteria the excellent cases were 15, and the good were 2 cases.

Transcatheter arterial embolization of Aneurysmal Bone Cyst in Pubic Bone: A Case Report / 대한정형외과학회잡지

Aneurysmal bone cyst uncommonly involves the pubic bone and tends to grow eccentrically and thin out overlying cortex. In the following case report, a 19-year-old male patient visited out hospital, because of dull pain in his left groin. He was diagnosed as aneurysmal bone cyst originated from the superior pubic ramus by CT guided needle biopsy. Transcatheter arterial embolization was effective in the treatment of this lesion such as complete consolidation after the procedure. At present, 2 years follow-up, no problem was noted at weight bearing as well as hip function or recurrence.

Peroperative Administration of Epidural Morphine for postoperative Analgesia in Spinal Surgery (A double blind study) / 대한정형외과학회잡지

These days, the epidural administration. of morphine is commonly used for postoperative pain re lief because even small amount of morphine (3mg) is enough to have an effect on specific opiates receptors of the spinal canal. We report a prospective double blind study of the efficacy of a single epidural dose of morphine on pain after spinal decompression. Postoperative pain was assessed by a linear analogue pain score and by the additional require ment for systemic analgesics. The results obtained are as follows:l. In spinal decompression, the adminitration of epidural morphine is easy, effective and safe because the epidural space has been already exposured during operation. 2. After operation the epidural route of morphine administration will give pain relief for up to 12 hours excellently. 3. When epidural morphine is given at the time of operations, the use of systemic analgesics is much reduced. 4. The side effects of epidural morphine are much reduced due to the small amount of morphine required. This simple procedure is recommended as an effective and safe method of reducing postoperative pain.