Résumé
In patients with the sequele of poliomyelitis, pyogenic or tuberculous arthritis, or trauma, flexion contracture of the knee could be developed and many difficult problems would be met in treating them. Ilizarov suggested the method of gradual correction of deformities of bone after corticotomy-osteo- clasis, combined with gradual elongation of the shortened soft tissues, and the flexion contracture of knee & limb length discrepancy could be corrected simultaneously or sequentially following a sigle operative procedure. The authors have treated 25 patients with flexion contracture of the knee joint by the principle of Ilizarov treatment at the Sang Gye Paik Hospital between September 1991 and March 1994, The average preoperative flexion contracture of the knee joint, 25° (range, 10°
Sujets)
Humains , Arthrite , Malformations , Contracture , Membres , Fractures de fatigue , Articulation de la hanche , Technique d'Ilizarov , Articulation du genou , Genou , Jambe , Méthodes , Ostéotomie , Poliomyélite , Procédures de chirurgie opératoire , TibiaRésumé
The stiffness of the elbow joint is caused by trauma, infection, and ect. The conventional arthrop lasty and arthrodesis of this joint has been used but the indication is very limited because of unsati sfactory result. The Oganesyan external fixator, which was invented by Mstislav V. Volkov and Oganes V. Oganesyan in 1971, generally employes tne hinged-distraction apparatus to treat joint stiffness and flexion contracture. According to them, regeneration of both cartilage and underlying subchondral bony tissue is possible. These authors consider the main factor for regeneration of the cartilage af a destroyed joint surface to be early restitution of joint functions including unloaded motion and elimination of increased friction between the joint surfaces. From Jan. 1992 to Jan. 1994, We have experienced the 6 cases of stiff elbow who had been undergone biologic arthroplasty. The results were as follows; The gain of the average range of motion of the joint at final follow-up was 50.5°. The complications were mild pain in 2 cases, mild instability on exertion in 2 cases, recurrence of contracture in two cases and ulnar nerve irritation in one case. The complications affected no significant long term results except recurrence.
Sujets)
Arthrodèse , Arthroplastie , Cartilage , Contracture , Articulation du coude , Coude , Fixateurs externes , Études de suivi , Friction , Articulations , Amplitude articulaire , Récidive , Régénération , Nerf ulnaireRésumé
Congenital brachymetatarsia causes minor disability in daily life. However, patients suffer cosmetically or psychologically and often demand correction of the deformity when they reach adolescence. Thirty-eight skeletal lengthenings were performed on twenty-three patients with congenital brachymetatarsia between March 1992 and July 1993. Short metatarsal bones were osteotomized subperiosteally, and held by a small external fixator and then subjected to slow axial distraction. All the patients were female with an average age of patients at the time of operation was twenty-one years. The average lengthenings was 15.8mm. The average healing index was 80.6(day/cm). The average lengthenings percentage was 35.2%. There was a metatarso-phalangeal joint subluxation with pain in one patient. We believe that the callotasis method was no need for bone grafting and permitted early weight bearing. The result was good cosmetically.
Sujets)
Adolescent , Femelle , Humains , Transplantation osseuse , Malformations , Fixateurs externes , Articulations , Os du métatarse , Méthodes , Ostéogenèse par distraction , Mise en chargeRésumé
The intramedullary nailing for the tibial fracture has been used in selected cases of fresh diaphyseal fracture and nonunion. However, with modern technical improvement such as image intensifier and interlocking, the indications have been expanded considerably. Interlocking intramedullary nailing has been popularized because it enables preservation of the range of motion of the joint, early weight bearing and early bony union. Between August, 1989 and July, 1991 interlocking nailing in the tibial fracture has been performed for 53 cases with follow up more than one year. The results were as follows; 1. All were treated with closed nailing and static locking was performed as a principle. Only three cases needed dynamization of the 47 patients treated with static locking nailing. 2. The union rate was 96.296 and mean period of fracture union was 15.2 weeks. 3. In the distal one third of fracture, rigid fixation could be achieved by adjusted length by cutting the distal end. 4. In 7 proximal tibial fractures, 4 fractures were accompanied with complications such as nonunion, angulation deformity and shortening. Therefore, interlocking nail is inadequate treatment of proximal unstable fractures. 5. In the delayed and nonunion treated by interlocking nailing, bony union was achieved in all 3 cases without bone graft and cast immobilization.
Sujets)
Humains , Malformations , Études de suivi , Ostéosynthese intramedullaire , Immobilisation , Articulations , Amplitude articulaire , Tibia , Fractures du tibia , Transplants , Mise en chargeRésumé
No abstract available.
Résumé
The humerus is anatomically and phyelologically unique, such as, firstly, it is a non weight bearing bone, secondly, it has greatest range of motion, thirdly, when at rest while the person is standing, the axis of bone hangs vertically and is influenced by gravity, and conservative methods usually used in treatment. However, in the event of closed reduction failure, open fracture, multiple fracture, and old age, operative method may be employed. Authors reviewed and analzed 84 humeral shaft fractures which had been treated at the Department Orthopedic Surgery, Paik Hospital from Dec. 1979 to May 1988. The results were as follows : l. Among the 84 patients, male were 63 and female were 21. 2. The major causes of injury were a traffic accident. 3. The most frequent type and site of fracture was comminuted and middle one third. 4. The incident of radial nerve injury was 17 cases. 5. Of 84 cases, 22 cases were treated conservatively and 62 cases operatively. 6. The most common complication was non-union of 14 cases, of which 10 cases were treated with plate and bone graft and 4 cases with only bone graft.
Sujets)
Femelle , Humains , Mâle , Accidents de la route , Fractures multiples , Fractures ouvertes , Gravitation , Humérus , Méthodes , Orthopédie , Nerf radial , Amplitude articulaire , Transplants , Mise en chargeRésumé
We have recently experienced a rare case of abdominal aortic injury caused by shearing force falling from 8 meter height in upright position. The patient was 43 year old and sustained Ll, L2, L5, compression fractures and both distal tibia and fibula comminuted fractures involving ankle joints. 2 years and 2 months later, marked stenosis of the distal abdominal aorta was found together with clinical manifestations of ischemia of both legs. Aorto-femoral bypass on both sides has completely relieved the symptoms.
Sujets)
Humains , Chutes accidentelles , Articulation talocrurale , Aorte abdominale , Sténose pathologique , Fibula , Fractures comminutives , Fractures par compression , Ischémie , Jambe , TibiaRésumé
Fibrous dysplasis is a condition characterized by the metastatic replacement of the medullary component of predominantly long bone with fibrous tissues. This change is responsible for the characteristic features, including bony abnormalities, pathologic fractures and pain. The monostotic form of the fibrous dysplasia occurs more freguent than the polyostotic form. The monostotic fibrous dysplasia does not exhibit the laboratory abnormality, extra-skeletal manifestation or the endocrinopathies associated writh polyostotic disease. Monostotic fibrous dysplasia occurs most frequently in the metaphysis of long bones and the ribs. Only the seven previous cases of vertebral involvement (three cervical, one thoracic, three lumbar spine) in monostotic fibrous dysplsia have been reported. Authors experienced a case of monosotic fibrous dysplasia of the seventh cervical vertebrate, so we report a case with the review of the seven previous reported cases of the monosotic fibrous dysplasia of the spine.
Sujets)
Dysplasie fibreuse monostotique , Fractures spontanées , Côtes , Rachis , VertébrésRésumé
The purpose of this study was the presence of accessory tendon and its anatomical variation of insertion of the abductor pollicis longus and extensor pollicis brevis. 1. Among 46 cases, all had one or more accessory tendon except one which inserted into the base of the first metacarpal bone on its anterolateral surface with a single tendon. 2. Among 45 cases (which had one or more accessory tendon), the abductor pollicis longus tendon inserted into the trapezium in 30 cases(66.6%), and thenar muscles in 38 cases (84.4%). 3. Among 46 cases, the extensor pollicis brevis tendon inserted into the proximal phalanx in 30 cases(65%) and into the distal phalanx with extensor pollicis longus in 8 cases (18%) and into both in 8 cases (18%). 4. Among 22 cadavers, symmetry of insertion of the abductor pollicis longus noticed in 16 cases (88 and extensor pollicis brevis in 21 cases (95%).
Sujets)
Cadavre , Muscles , TendonsRésumé
Pain, premature degenerative arthritis, stiffness and persisting subluxation are common sequalae of fracture dislocations of the proximal interphalangeal joints of the fingers. With disruption of greater than 40% of the volar articular surface of the middle phalanx, it is un- likely that congrous stable reduction can be achieved. And the most severe injuries are caused by longitudinal compression force, which drives the middle phalanx where the middle phalanx eventually comes to rest. Many authors had reported a variety of method for the treatment of the unstable fracture dislocation with no satisfactory results except Eaton(1980). In his ten years experience the volar plate arthroplasty for acute and chronic fracture dislocations got a good results with satisfactory range of motion and no pain on motion. Authors had been treated two cases of chronic fracture dislocations of the proximal interphalangeal joint with Eatons volar plate arthroplasty followed by good results in one year followed-up study.
Sujets)
Arthroplastie , Luxations , Articulation du doigt , Doigts , Articulations , Méthodes , Arthrose , Amplitude articulaireRésumé
Pagets disease is a chronic skeletal disease of middle and later life, beginning insidiously and characterized by progressive structural changes and typical deformities occuring in the long bones, pelvis, and cranium. The occurence of Pagets disease is extremely rare in Korea. We have experienced a case of Pagets disease of bone in 67 year-old female affecting mainly the ilium and skull, and we report the case with brief review of the literatures.