Fusion and Clinical Results of Instrumented Posterolateral Fusion with Autograft or Xenograft Bone / 대한정형외과학회잡지

Recently, xenograft is being increasingly used in spinal fusion to reduce complications such as pain or bleeding following autograft bone grafting. The purpose of this study was to compare the fusion rate and clinical results between autograft and xenograft in 69 patients who had posterolateral lumbar fusion with instrumentation from March 1989 to April 1997. The xenograft was mixed with autogenous bone chips obtained from decompresion. Fusion and clinical results were evaluated with Furguson's method and Modified Smiley-Webster' scale, respectively. The mean follow-up time was 26 months with a minimum of 12 months and a maximum of 41 months. The results are as follows: fusion rates of autograft were 64.6% in Furguson grade A, 25.8% in grade B, 6.4% in grade C and 3.2% in grade D. Xenograft was 15.7% in grade A, 47.6% in grade B, 23.6% in grade C and 13.1% in grade D. Clinical results of autograft were excellent in 29.0%, good in 61.3%, fair in 6.5% and poor in 3,2%. Xenograft was excellent in 23.8%, good in 57,8%, fair in 15.8% and poor in 2.6%. Autograft showed a higher fusion rate of 90.4% than xenograft of 63.3% in grade A and B (P=0.012). Clinical results were not different between autograft and xenograft groups (P=0.494). However, the xenograft group showed lower fusion rate than the autograft group. The results indicated that xenograft is less useful for posteolateral fusion of the lumbar spine.

Physeal Injuries in Association with Severe Osteoporosis / 대한정형외과학회잡지

The physeal injuries in children occur result of trauma, infection, metabolic or ischemic disease, and these conditions cause significant problems, such as growth disturbance, deformity and premature closure of physis. The authors experienced 7 cases of children who had angular deformity of knee and limb shortenings, but no history of obvious causes of physeal injury. All of these cases had severe osteoporosis and underlying disease, which were osteogenesis imperfecta, fibrous dyplasia and long term steroid therapy. The purpose of this study are evaluation of pathomechanism of physeal injuries in severe osteoporotic children. Patients were range of age from 4 to 9 years and had common clinical features, which were angular deformities of knee, limb shortening. Also they had common radiographic findings, that were severe porosis, metaphyseal sclerosis and in some cases, pop corn like calcification around physis. At this, we supposed that chronic mechanical stress in osteoporotic bone make physis be damaged due to loss of capillary circulation and this event appear to result from collapse of bone plate, through which epiphyseal vessel penetrate. In conclusion, the children with severe osteoporosis should be observed carefully about physeal injuries, which pathomechanism are perhaps deprivation of capillary circulation through bone plate. Therefore, We should try to protect bone plate by being conscious of its existence.

Suprapatellar Plica Syndrome Mimicking Soft Tissue Tumor

The plica is remaining synovial septa in adult life which developed in early fetal life. The suprapatellar plica separates the suprapatellar pouch from the knee joint which sometimes has chnical significance according to its shape, but it has been occasionally overlooked and also pathophysiology of symptomatic plicae may be hard to explain. The authors experienced 7 cases of suprapatellar plica syndrome which mimic soft tissue tumor in 7 patients who had complained of vague pain and ill defined mass around the knee and by arthroscopy found the imperforated suprapatellar plica in which increased hydraulic pressure cavity evokes the clinical symptoms and signs exarnination from 1992 to 1997. We suggest that the suprapatellar plica with complete septum might be clinically significant in patients who are in active life.

A Case of Spondylometaphyseal Dysplasia ( Kozlowski type ) / 대한정형외과학회잡지

Spondylometaphyseal dysplasia (SMD) is an extremely rare, which affects the spine and metaphy-ses of the tubular bones on terms of enchondrogenesis. Children who had Kozlowski dwarfism, type of SMD are not recognized until they reach school age since they have normal clinical feature, weight and size in early childhood. Authors experienced a typical case of Kozlowski type of SMD in a 10 years old male who had i) generalized platyspondyly with anterior tapering of vertebrae ii) generalized metaphyseal dysplasia iii) minimal changes in the carpal and tarsal bones. This case is to be reported with review of references.

A clinical study on Legg-Perthes' disease of early onset / 대한정형외과학회잡지

No abstract available.

A radiological study on articulotrochanteric distance index after Legg-Parthes' disease / 대한정형외과학회잡지

No abstract available.