Clinical Observation on the Primary Bone Tumors / 대한정형외과학회잡지

A total of 189 cases of primary bone tumors reviewed and analysed clinically and pathologically at the Department of Orthopedic Surgery, Presbyterian Hospital, Taegu, Korea during the 15 years period from july, 1964 to june, 1979. The results were obtained as follows: 1. In 189 cases of primary bone tumors, 87 cases (46%) were benign and 102 cases (54%) were malignant. 2. Osteochondroma was the most common benign bone tumor (31.0%) and followed by simple bone cyst (14.9%), enchondroma (14.9%) and giant cell tumor (13.8%). 3. Osteosarcoma was the most common primary malignant bone tumor (45.0%) and followed by fibrosarcoma (17.7%) and chondrosarcoma (12.8%). 4. 22 cases were solitary and 5 cases were multiple Iesions of osteochondroma. The knee joint area was the most common site of osteochondroma (59.2%) and peak incidence was in the second decade. 5. Simple bone cyst was 13 cases. The sex distribution of simple bone cyst showed 5.5 times of the male predominence. The knee joint area was the most common site of simple bone cyst (76.9%) and its peak incidence was in the first and second decade (61.5%). Seven of 13 cases of simple bone cyst were seen pathological fracture and three of its cases were recurred. 6. In 13 cases of enchondroma, 6 cases were solitary and 7 cases were multiple lesions. The common site was phalanges of the hand and its peak incidence was in the second and third decade of life. 7. Giant cell tumor was 16 cases and to be divided into pathologically Grade 1 & 11 12 cases (75%) and Grade III 4 cases (25%). The sex distribution of giant cell tumor was 8 males and 8 females. The average age of giant cell tumor was 36.1 years with the peak incidence in the third and forth decade of life. 8. The average age of osteogenic sarcoma was 23.1 years with the peak incidence in the second decade of life. The sex distribution of osteogenic sarcoma was 25 males (54.3%) and 21 females (45.7%). The common sites of osteogenic sarcoma were distal femur and proximal tibia and proximal humerus in 41 cases (89.1%). 9. The average age of fibrosarcoma was 28.1 years with the peak incidence in the second and third decade of life. The sex distribution of fibrosarcoma was 12 males (66.6%) and 6 females (33.3%). The common site of fibrosarcoma were femur and tibia in 9 cases (50%). 10. Chondrosarcoma were 13 cases. The sex distribution of chondrosarcoma showed 5.5 times of the male predominence. The knee joint area was the most common site of chondrosarcoma (46.1%) and its peak incidence was in the third and forth decade of life.

Clinical Observation of 51 Cases of Osteogenic Sarcoma / 대한정형외과학회잡지

Osteosarcoma is a malignant neoplasm arising from the undiferenciated fibroblastic cells of the bone, and one of the most common primary malignant tumor of the bone resulting in high mortality rate. Authors performed clinical observation on 51 cases of osteogenic sarcoma at the Department of Orthopedic Surgery, Presbyterian Hospital, Taegu, Korea during the 17 year period from Jan. 1962 to Dec. 1978. The results were obtained as follows: 1. It was most common in the age group between 11 and 30 years. 2. The sex distribution was 28 cases(55.0%) in males and 23 cases(45.0%) in females. 3. The most commonly affected site was distal femur and next proximal fibia, consisting of 23 cases(45.1%) and 19 cases(36.5%) respectively. 4. The average value of serum alkaline phosphatase in all cases was 6.7 Bodansky units, and 13.9 units was the highest value in these cases. 5. The histopathologic classification revealed the osteoblastic type in 22 cases(43.1%), fibroblastic in 19 cases(37.3%), and chondroblastic in 10 cases(19.6%). 6. Among the 51 cases of osteogenic sarcoma, 29 cases(56.9%) revealed pulmonary metastasis within 1 year of diagnosis. 7 Amoung the 32 cases of osteogenic sarcoma diagnosed before Dec. 1973, 3 cases(9.4%) survived longer than 5 years.

A Case of Diffuse Pigmented Villonodular Synovitis of the Hip Joint / 대한정형외과학회잡지

Pigmented villonodular synovitis, bursitis and tenosynovitis were classically described by Jaffe, Lichtentein and Sutro in 1941. Prior to this time, Simon(1865) reported the first case of xanthoma of the knee joint and since then the manifestations of this disease were known by various names, including villous arthritis, hemorrhagic vilious arthritis, giant cell tumor, xanthogranuloma, myeloplaxoma, and polymorphocellular tumor of the synovial membrane. The exact cause of this lesion is not yet known, but chronic stimulation followed by repeated hemorrhage in the joint is generally accepted as a criminal etiologic factor. Experimental production of this lesion in animal joints by Yong and Hudacek was started in 1954. We have experienced a rare case of pigmented villonodular synovitis which diffusely involved the hip joint.

Clinical Study of Parathyroid Adenoma / 대한정형외과학회잡지

The primary hyperparathyroidism, accompanied with a wide scope of bone resorption in every bone matrix of the body, cyst formation, deformity and pathologic fracture, is a generalized disease which causes atrophy and weakness of skeletal muscle and a disturbance of the digestive system as well as renal function. The primary cause of this disease is an adenoma and a hyperplasia of the parathyroid gland. However, all the progress of the disease can be stopped through surgical excision. The authors medically confirmed the diagnoses through typical radiologic findings, electrolyte and enzyme level of serum and urine and by carotid arteriography on four patients(a 41 year ald male, and 28, 35 and 36 year old females) who had complained of generalized weakness, pain and motion limitation. The authors obtained the following results after surgical excision and continuous follow-up study with medication for 7 years, 3 years, 17 months and 13 months each: 1. Of the four cases, 3 cases were female patients and 1 case was a male patient which showed females outnumbered males 3 times in our study. 2. By age distribution, most cases fell in middle age. 3. All the cases were chief cell type of adenoma. 4. It is conjectured that the symptoms has nothing to do with age or history. 5. In all the cases, serun calsium showed a marked decrease immediately after the surgery but recovered to normal limits within 2 months. 6. In all the cases, serum phosphorus showed an irregular increase immediately after the surgery but also stavilized gradually to normal limits within 2 to 3 months. 7. In all the cases, serum alkaline phosphatase was stable for 3 months after the surgery, then gradually decreased. 8. According to the X-rays, subperiosteal resorption of phalangeal bones almost completely disappeared in 3 months. Cyst and brown tumor disappeared in 6~12 months. Granular mottling of the skull almost completely disappeared in 6 months. Intra articular calcification in 2 cases almost completely disappeared in 6 months, 3 cases which showed loss of lamina dura developed edentia during treatment. 9. In 4th case, small multiple cysts and several small brown tumors of the pelvis healed well, but several lager ones were still unhealed after 10 years of treatment. In first case, the cyst in proximal shaft of the left femur is reduced in size but still evident after 7years of treatment. This case needs further study and observation.

Congenital Coxa Vara: Report of one case / 대한정형외과학회잡지

Congenital coxa vara is a rare congenital deformity seen in infancy and childhood and usually not discovered until walking is begun and characterized by a progressive decrease in the angle between the femoral neck and shaft and consequently by a progressive shortening of the limb and also by the presence of a defect in the medial part of the neck We have experienced a case of it treated with valgns osteotomy and the case review is presented.

A case of Guyon's canal syndrome / 대한정형외과학회잡지

Guyons canal syndrome is an uncommon disease characterized by ulnar nerve compression symptoms within Cuyon s canal. The symptoms vary with the level of compression, and the cause of compression may be extrinsic or intrinsic. We have had experience with a case of the syndrome that was caused by a ganglion in the canal.

Skin Grafts on Bare Bone / 대한정형외과학회잡지

Skin grafts on bare bone, denuded of perioteum, is one of the most difficult problems to deal with, but has good clinical application. Most surgeons have stated that skin grafts will not take on unprepared bare bone and have refused to raft skin on bare bone, but they have successfully grafted skin on bare bone after preparation of the recipient site in one of several ways. The authors have treated bare bones with multiple holes drilled through the outer cortex of bone in to the marrow cavity to start growth of granulation from the marrow cavity, followed by skin graft. It has been both successful and has shortened the convalescent period.

Congenital Dislocation of the Hip / 대한정형외과학회잡지

A large number of congenital dislocation of the hip remains undiagnosed before a child begins to walk, unless screening tests are performed on newborns and infants. It is well-known that congenital dislocation of the hip can result in marked acetabluar dysplasia, in deformity of the femoral head and in a change of the femoral-neck angle: conversely, a normal hip joint can be expected when the femoral head is replaced in time in the acetabular socket. The authors studied 33 cases of 37 congenital dislocations of the hip treated with closed reduction and immobilization in a changing cast after adequate premanipulative skeletal traction at the orthopedic department of the Presbyterian Hospital, Taegu. As result of this study, the following conclusions were reached: 1. The preponderance of girls to boys was found to be 3.7 : 1. 2. The ratio of unilateral to bilateral cases was 29 : 4 and of right to left was 12 : 17. All 4 bilateral cases were female. 3. An associated congenital anomaly was observed in a case of thyroglossal duct cyst. There were 2 cases of breech presentation. 4. Instead of a soft tissue releasing operation, in most cases we applied adequate skeletal traction(plus one to two station) in the distal femur for 2 to 3 week before reduction. That was the same as a series of traction stations referred to by Gage and Winter(1972) which relates the position of the femoral head to the acetabulum by traction. 5. The average time of following up was 24 months. 6. There were 2 cases of epiphyseal change. One of the cases did not appear as a proximal femoral epiphysis until the 8th month of postreduction and the other was a fragmentation of the femoral epiphysis without signs of increased density after reduction. These 2 cases resulted from inadequate traction. We will follow up these cases for an adequate time. 7. There were several cases of unsatisfactory results functionally and anatomically, in acetabulum and head relationship and the femoral-neck angle. 8. The duration which required for joint stability clinically was shortened in cases of early treatment. 9. The average time of cast immobilization was 7 months.

Clinical Observation of the Legg-Calve-Perthes Disease: Preliminary Report / 대한정형외과학회잡지

Legg-Calve-Perthes disease is self-limited, but its course may result in irreversible mechanical impairment of the hip. The clinical observation and analysis were carried out on 83 cases of Legg-Calve-Perthes disease in the Department of Orthopaedic Surgery, Presbyterian Hospital, Taegu.