A radiologic study about effects of multiple osteotomy and intramedullary nail fixation upon changes of diaphyseal thickness in osteogenesis imperfecta / 대한정형외과학회잡지

No abstract available.

“V” Shape Corrective Osteotomy of the Long Bone / 대한정형외과학회잡지

French method of wedge osteotomy has been widely used to correct the cubitus varus deformity, but it is difficult to correct the rotational deformity, gunstock deformity effectively and to fix the distal fragment rigidly because the supracondylar area of the humerus has an anatomical characteristic of short distance in A-P plane. We can design a new method of “V” shape osteotomy to correct the cubitus varus and apply this method to the deformities of the tibia and femur. Ten cases of “V” shape corrective osteotomy were performed in the Department of orthopedic Surgery, Kyung Hee University. Of these, 5 cases were cubitus varus deformities, 3 cases were deformities of tibia and 2 cases were deformities of femur. The results were obtained as follows. 1. The cubitus varus and gunstock deformities are corrected effectively without unnecessary bony loss. 2. The rotational deformity can be corrected in stable position due to the “V” shape contact surface. 3. The contact area is so wide and oblique that it may be ease to manage the distal fragment and we may expect good union process with early ROM exercise due to rigid fixation. 4. Additional change of the corrective angle can be possible. 5. This method is also effective for the correction of the deformity caused by partial epiphyseal closure of the long boen, using partial open wedge osteotomy.

Posteromedial Release in Infancy for Resistant Congenital Clubfoot / 대한정형외과학회잡지

Ten feet from 6 idiopathic congenltal clubfoot patients which had failed to respond to conservative mearsured were treated by aggreasive posteromedial release during infancy with generally good results. A modltication of Denis-Browne splint by splitting both aides and using dial lock to hold the foot still ln correeted position was found quite useful for post-operative maintenance.

Computerized Tomography in Orthopedic Surgery / 대한정형외과학회잡지

The utility of computerized tomogaphy in the study of the anatomy, and pathology of the musculoskeletal system has been the subject of considerable interest since the introduction of CT scanning. It provides an accurate and detailed cross-sectional image of normal anatomical structures and shows the relation of masses to these structures. In order to assess the utility of computed tomography, we analyzed the 92 clinical cases. We divided our experience into three major categories: spinal lesios, pelvic (including hip) lesions, and lesions of extremities. The advent of a new prototype scanning device has made it possible to exam a variety of abonormalities in the orthopedic diseases in a manner not previously possible.

A Study of Congenital Dislocation of the Hip / 대한정형외과학회잡지

The author reviewed eighteen congenitally dislocated hips in Kyung Hee University Hospital during the three and a half year period (rom September, 1973 to March, 1977. The following observations were made. 1. The average age of the patients at the first visit was 17.9 months. 2. All 16 patients were female. 3. There were 2 bilateral dislocations and 14 unilateral dislocations. 4. Left side was dislocated in 12 hips snd right side in 6 hips. 5. Limping was the chief complaint in 12(75%) of the patients. 6. Arthrogram gave valuable information as to make correct diagnosis and treatment. 7. Twelve hips were successfully treated by closed methods and 6 hips required operative treatment. 8. Following reduction, cast immobilization was continued for an average of 5 months in the conservative series. 9. In the conservative series, the acetabular index decreased from 33.4 degree before treatment to 28.1 degree immediately after removal of cast. 10. The results were good or excellent in all except for 2 cases of avascular necrosis and 1 case of redislocation.

The effects of antibiotic Incorporation to Acrylic bone Cement upon Bacterial Viability and its Physical Properties / 대한정형외과학회잡지

Infection is one of the most serious complications following total hip replacement arthroplasty. Many modifications of procedures have been advocated in order to reduce the rate of infection with varying success. Incorporation of antibiotic to bone cement is one such approach. However, there still remains some reluctancy to adopt this method on account of dubious antibiotic effect at the expense of weakening of physical properties. Possible emergence of resistant organisms and hypersensitivity are additional drawbacks to be considered. The present experiments were undertaken to study the effectiveness of antibacterial activity of cement-antibiotic admixtures in vitro and in vivo as well as change of physical properties produced by the incorporation. As conclusions, antibiotic-mixed bone cements have evident effects on growth of inoculated organisms sensitive to added antibiotics whereas cured bone cement itself has been proved not to have any antibacterial activity. The leaching of antibiotics occurs fairly soon, the great majority of the amount within several days. The rest shows slow, delayed leaching over period of three weeks. The weakening of physical properties was not so significant to forbid the application. Resistance to tensile and bending stress was more reduced than that to compression stress. The mixing of two antibiotics(Cephaloridine and Gentamicin powder) together to bone cement revealed double-edged effectiveness to either of gram-positive or negative organisms without any significant illeffects on hardness of cured cement, It is suggested that mixture of two antibiotics to bone cement renders broader blind coverage to unknown causative micro-organisms of postoperative deep infection of total hip replacement arthroplasty.

Review of Trochanteric approach in 285 Total Hip Arthroplasties / 대한정형외과학회잡지

This paper is a consecutive series of total hip arthroplasties were performed over 6 years period by the same group surgeons utilizing the Charnley method as well as the lateral approach with trochanteric osteo. tomy. Trochanteric reattachment was accomplished in 285 hips and method of reattachment were basically standard Charnley technique which we used in most of our series. In addition, some modification of original Charnley technique which we used in early this trial were also included for this study. As far as trochanteric complications are concerned, there are 18 cases of hips where there was wire breakage, proximal drift of greater trochanter and 6 established cases of nonunion also reported. By the use of wire mash, we have performed a revisional surgery which has re-inforced of the greater trochanter. This was the case when the greater trocyhanter was very osteoporotic. Finally, biomechanical considerations of the re-attachment of the greater trochanter and new Charnley staple clamp method were introduced with review of our cases and analysed for technical failures.

A Case of Infantile cortical Hyperostosis / 대한정형외과학회잡지

Infantile cortical hyperostosis is a disease of infants which is characterized by formation of cortical subperiosteal new bone of the the body. Pain and soft tissue swelling over the affected parts, associated with fever and irritability, are found frequently with the disease. Usually self-limiting, it is not as a rule followed by any residual skeletal deformity. A case of Infantile cortical hyperostosis in three months-old baby was diagnosed and followed up to ten months.

A Case of Congenital Atlanto-Occipital Fusion: One case report / 대한정형외과학회잡지

A cases is reported of congenital atlanto-occipital fusion in a 12-years-old girl. The lesion was treated by occipito-cervical arthrodesis by iliac bone grafting with wiring. The congenital atlanto-occipital fusion has not progressed in this 2 years of observation. This is presented with a review of literature.

Giant Cell Tumor of the Patella: Report of One Case / 대한정형외과학회잡지

The giant cell tumor is a primary. neoplasm of bone characterized histollogically by a vascularized network of plumpish or ovoid stromal cells heavily interposed with multinucleated giant cells. The majority of cases occur in patients between 20 and 40 years old and in the long tubular bones, particuarly in proximity to the epiphysis. A rare case of giant cell tumor involving the patella was recently experienced by authors. Case summary with brief review of reference is presented.

Extraskeletal Neoplasm Resembling Ewing's Sarcoma: Report of one case / 대한정형외과학회잡지

Extraskeletal Neoplasm Resembling Ewings Sarcoma was firstly reported with comprehensive review of 39 cases by L. Angervall and F.M. Enzinger in 1975. The tumors chiefly affected young adults and most commonly involved the soft tissue of lower extremity. Microscopically, they were consisted of solidly packed small, round or ovoid cells arranged in sheets or lobules, which were indistinguishable from those of the Ewings sarcoma of bone. The authors recently experienced a soft tissue sarcoma occurring in deltoid area of young male patient, which was diagnosed extraskeletal neoplasm resembling Ewings sarcoma. The case review is presented.

Operative treatment of supracondylar-Condylar Fractures of the Femur / 대한정형외과학회잡지

The previous reports about Supracondylar-Condylar Fracture of the femur which extends to articular surfaces revealed poor results in general, regardless of the methods of treatment. But those results are thought to be much alleviated if they are treated according to the principles of ASIF. Fifteen cases of Supracondylar-condylar fractures of the femur from 13 patients were treated by open reduction and rigid internal fixation during last 3 years at Department of Orthopedic Surgery, Early mobilization of knee joint was permissible in most of the cases without loss of fixation or other complications during convalescence Subsequently, greatifying results were obtained as observed in varying period of follow up days.

Craniometaphyseal Dysplasia: Report of a Case / 대한정형외과학회잡지

Craniometaphyseal Dysplasia is characterized by hyperostosis of craniofacial bones, with compression of cranial nerves at the foramina, and by changes in the metaphyses of long bones. The changes in long bones resemble to some degree those seen in pyle's disease, but have cretain differences and significant cranial abnormalities with which differential diagnosis could be made with certainty. An interesting and unusual patient diagnosed Craniometaphyseal Dysplasia was recently experienced by authors. The case report with brief review of literstures in presented.

Congenital Hyperextension of the Knee: Report of a Case / 대한정형외과학회잡지

Congenital Hyperextension of the Knee is a extremly rare deformity, in which the tibia is displaced anteriorly in relation to the femur. It is usually classified into three subtypes according to severity of the status: genu recurvatum, subluxation and dislocation. (Curtis and Fisher) We experienced a genu recurvatum type of congenital hyperextension of the knee in June, 1976.

Vitamin D Resistant Rickets with Secondary Hyperparathyroidism: Report of a Case / 대한정형외과학회잡지

Rickets is a syndrome, characterised pathophysiologically by a failure of normal mineralization of bone and epiphyseal cartilage and clinically by skeletal deformity in growing children. The four principal causes of rickets are; vitamin D deficency, renal tubular insufficiency, chronic renal insufficiency, and hypophosphatasia. Of these, vitamin D resistant rickets may result from primary defect in function of the renal tubular reabsorption for phosphorus, later accompsnied with secondary hyperparathyroidism. We experiened a rare case of hypophosphstemic vitamin D resistant rickets accompanied with secondary hyperparathyroidism in adolescence.

Bacteriological Studies on Orthopedic Infections: An Analysis of 145 Specimens / 대한정형외과학회잡지

One hundred and forty-five specimens of positive bacteriology, obtained from patients admitted to the Orthopedic Department of Seoul National University Hospital during the period from January, 1970 to March, 1973, were reviewed with respect to their causative microorganisms and antibiotic sensitivity. The results were also compared with reports previously published from the same department. Following observations were made: 1. The identified microorganisms were of 9 species. Of these, the coagulase positive and negative Staphylococcus continues to be the most frequent offender occupying 62.1% of the total. 2. Of the Staphylococcus, the penicillin-resistant strains were proved in 84.6% of the series, a significant increase over the previous reports. 3. The Streptococcus, formerly the second-most frequent causative organism, occupied only 4.0% of the total suggesting a marked decrease in incidence over the last decade. 4. On the other hand, the Pseudomonas occupied 11.7% of the total when mixed infections are included and together with other Gram-negative bacilli revealed a remarkable increase in incidence during the same period.