Medial Displacement and Valgus Nailing with Jewett Nail in Unstable Intertrochanteric Fracture / 대한정형외과학회잡지

Intertrochanteric fractures frequently occur in elderly patients. Early mobilization after rigid internal fixation of unstable intertrochanteric fractures has recently reduced the mortality and morbidity. Between March, 1976 and February, 1980, eighteen patients over 60 years old with unstable intertrochanteric fractures were treated by Jewett nailing after Dimon & Hughstons reduction at the department of Orthopaedic Surgery, Chung Nam University. Among the eighteen patients, twelve patients could be followed, ranging from 6 months to 2.1 years, with an average follow-up of 11 months. The results were obtained as follows: 1. The main causes of fractures were falling down and slip down. 2. In treatment of unstable intertrochanteric fractures by medial displacement and valgus nailing with Jewett nail, early ambulation and early weight bearing were possible with satisfactory results. 3. The average time for fracture union in twelve cases who were followed up were 17.1 weeks, but two cases with severe comminution of posterior and medial fragment of the trochanter revealed delayed union. 4. The medial displacement of distal fragment and valgus nailing in unstable intertrochanteric fracture shortened the operation time and reduced complications by early ambulation, but had disadvantages such as some limitation of motion of affected hip joints, shortening of affected extremities and delayed union.

Lumbar Epidural Venography in the Diagnosis of Lumbar Disc Herniation / 대한정형외과학회잡지

Epidural venography is a relatively simple and highly accurate method in the diagnosis of lumbar disc herniation. Angiographic visualization of the epidural vein has been tried and investigated by intraosseus injection of contrast agent into lumbar spinous process and intravascular injection into iliac vein since first report in 1954. Recently, lumbar epidural venography is instituted by selective catheterization of ascending lumbar vein or internal iliac vein. Lumbar epidural venography is valuable for the diagnosis of herniated lumbar disc, not demonstrated by myelography. Especially, lumbar epidural venography is more accurate than myelography in the diagnosis of L5-Sl disc herniation and in the case of extreme lateral herniation. Other advantages of epidural venography are low incidence of complication and ease of performance. Epidural venography may be recommended as an alternative rnethod rather than as adjunctive to myelography. We report 20 cases of epidural venography, compared with myelographic and operative findings.

Appendiceal Tuberculosis of Spine / 대한정형외과학회잡지

The appendiceal tuberculosis is a rare from of skeletal tuberculosis in child and adults, arising from a focus or foci in posterior compartment of spine. This from may be unilateral and may be isolated or present at multiple levels, characterieed by slight change of the disk space and deformity, but large psravertebral abscess are invariable. Extradural extension may lead to the development of paraplegia. We had experienced one case of appendiceal tuberculosis at L1 and treated with antituberculosis medication and radical curettage, followed with body jacket cast.