The Clinical Follow-up Study on Total Hip Replacement / 대한정형외과학회잡지

Total Hip Replacement is well documented and widely used procedure for painful arthritic hip in past two decades and each year still seems to be increased in numher of total hip replacement. And recently, there is a few reports of follow-up study on total hip arthroplasty in our country. The aim of this study was to present the clinical material which was performed on 27 hips of 21 patients who were treated at Dept. of Orthopedic Surgery. College of Medicine, Chungnam university from jan, 1979 to Jan. 1982. The longest follow up was 4 years, shortest was 8 months, average time was 2 years and 8months The results were obtained as follow; 1. The age incidence ranged from 26 to 69 years old, and average were 47 years old. 2. There were 17 males (81%) and 4 females (19%). 3, The causes of hip disease were mostly avascular necrosis of the femoral head (67%). 4, The most commonly used prosthesis were Muller type with trochanteric ostcotomy approaches. 5. Several complications were found: perforation of acetabulum with bone cenent in pelvis, postperative pneumonia wire breakage and painful bursitis around the trochanteric area which was on osteotomy sites. 6. Postoperative functional evaluation was evaluated by method of d'Aubigne and Postel, and improved from 10.0 scores to 15.8 scores. Relief of the pain is the most effect of the total hip replacement in this study, But case are not enough to more detail evaluation, especially, the problem of loosening of stem, acetabular cup wearing and heterotopic bone formation after total hip replacement.

Supracondylar Fracture of the Humerus in Children: Clinical Study for Cases with Failed Initial Management / 대한정형외과학회잡지

Supracondylar fracture of the humerus in children is the most common fracture of the elbow in contrast with infant or adult, and there are also many problem in treatment and accompanying complication. These injuries are difficult to manage in case of a delayed initial treatment or repeated close manipulation. We analysed 32 cases which failed and delayed initial management, at department of orthopedic surgery, Chung Nam University Hospital from Jan. 1977 to Dec. 1981. The results obtained were as follows: 1. The cases admitted after unsatisfactory treatment at other hospital among all cases are most common (59.4%). 2. The average duration after trauma are 5.3 days. The average duration until successful reduction after initial trauma are 7.3 days, 3. In types of fracture, there are all displaced supracondylar fracture (Type II, III, IV). 4. In treatments, initial sucessful close reduction are 5 cases (15.6%). The others require other managements, ie, final successful tractions are 5 cases, final sucessful percutaneous pinnings are 5 cases and final open reductions are 16 cases. 5. Cubitus varus deformity was more common in manual reduction and traction groups than in open reduction and percutaneous pinning groups, but limitation of elbow motion was more common in open reduction and percutaneous pinning groups. 6. In complications, there were 5 nerve palsies (4 radial nerves, 1 median nerve), 3 pin tract infections, 1 myositis ossificans, 9 severe cubitus varus and 5 severe limitation of motion.

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.