Treatment of comminuted segmental tibial shaft fractures with ender nails / 대한정형외과학회잡지

No abstract available.

Osteoid osteoma of the hip in children: a case report / 대한정형외과학회잡지

No abstract available.

A Study of the SOURCIL in Idiopathic Avascular Necrosis of the Femoral Head / 대한정형외과학회잡지

A carefull inspection of an AP X-ray of a normal hip reveals in the weight-bearing surface of the ilium a curved area of dense bone, called SOURCIL by Pauwels (1963). The configuration of this dense area is semilunar and represents subchnodral bony eburnation due to a respose by the articular portion of the ilium to the stress provoked by the compressive force acting on it. However, in many cases of idiopathic avascular necrosis of the femoral head, changes in SOURCIL may be seen. So we reviewed our 49 patients (unilateral 16, bilateral 33) since 1983 with comparison to normal hips (100 persons). The results are as follows; 1. SOURCIL is not visible at birth and by walking, it is developed with age and has the adult configuration at the age of 18. It is thought the configuration and sloping angle of SOURCIL is not changed with age after skeletal growth is completed. 2. Although the position of the X-ray tube may be changed, the shape and angle of SOURCIL is not changed significantly. 3. The average SOURCIL angle is 2.1° in normal hip group and 3.5° for the avascular necrosis group but, there is no meaningful statistical differences. It seems to be meaningful that the mean SOURCIL angle is 10.3° for patients under the age of 35 in avascular necrosis groups (9 persons). 4. If a high SOURCIL angle (about 10° or more) is present, the hemiarthroplasty such as bipolar endoprosthesis should be avoided because there is biomechanically far more wearing of the acetabular roof after that kind of operation. If inevitable, deepening the acetabulum by reaming is recommended for prevention of superolateral migration of prosthesis after operation. 5. With close observation of SOURCIL before and after operation, one can easily point out what is able to predict the prognosis on the biomechanical basis.

A Study on the Method of Description for Mass Casualties Based on Abbreviated Injury Scale and Injury Severity Score / 대한정형외과학회잡지

With the industrial development, vehicle, wars, and natural disasters, there are increasing chsnces of mass casuaities, it is very important to classify the injured patients by their severity, to give them immediate emergency care and to transfer them to the other medical facilities effectively. And it is more essential in the army. But in practice, there is no objective and comprehensive scale for injury severity yet. So we devised a method of comprehensive description for the injuredpatients. It is based on Abbreviated Injury Scale and Injury Severity Score and is composed of five parts of the body (General, Head & Neck, Chest, Abdomen, Extremities) and five degrees of severity (Grade I, Il, III, IV, V). For example, a description of a patient with multiple injuries such as generalized abrasion and cotusion, semicomatose mentality with skull fracture, hemoperitoneum, and fracture of right femoral shaft is very diffcult to understand quickly. But, with our method of description, the above is described as follows ; G(I)+(IV)+A (IV)+E(III), ISS =4+4+3 =41. And the high score is described as ISS makes it clear that the patient is very dangerous, even to death, so intensive care is immediately needed. Using this method, we reviewed 1,256 cases of passenger acidents of vehicles treated at our hospital during the last 2 years. The results were as follows ;1. The average ISS of 56 cases of dead is 33. 2. There are only 2 cases of death below 16 of ISS, and 84% mortality above 40 of ISS. 3. The average ISS of passengers in vehicles such as motocycles is 12, taxies 11, bongo 9, and buses 8. 4. We recommend our method of description for mass casualties, especially in the army. Because it is very useful to the injured patients by their severity, to give them immediate emergency care, to transfer them to the other medical facilities and to comprehend the whole condition of all patients.

A Clinical Study of Ipsilateral Fracture of Femur and Tibia / 대한정형외과학회잡지

Twenty-six cases of fracture of the femur and tibia on the same leg were treated in Masan Koryo General Hospital during the period 1981 1986. We studied all of these patients, divided by four groups according to the method of treatment, retrospectively with analysis of treatment and end results. The results were as follows : 1. Twenty-two patients were male and four patients were female. Of twenty-six patients, eighteen patients were at their third and fourth decades. 2. The main cause of injuries was traffic accident; 23 patients(88%). 3. The most common concomitant injury was fracture and dislocation in other site(14 cases). The fat embolism developed in one case and one patient had died due to head injury. 4. The average healing time of fracture was 17 weeks in femur and 20 weeks in tibia in group three, that was most rapid of all groups. 5. A good or excellent functional result was achieved in 87% of the patients treated with internal fixation of both fracture, 75% of the patients with internal fixstion for the femur fracture and external fixation for the tibial fracture, and 25% of the patients trested conservatively.

Metastatic Retinoblastoma to Tibia: A Case Report / 대한정형외과학회잡지

Retinoblastoma is a malignant tumor that arises from the retina. The prognosis is very unfavorable if the choroid is affected or the central nervous system is invaded or if metastasis have occurred. We experienced a case of the retinoblastoma with optic nerve involvement in a 3-years-old female had metastasis to the tibia. She was enucleated of the left eye five months ago. We report it with brief review of the literature.

Apert Syndrome: A Report of One Case / 대한정형외과학회잡지

Apert described acrocephalosyndactly as a clinical entity in 1906. The classic description of this syndrome includes patient with a combination of acrocephaly and syndactyly of either fingers, toes or both. More than 200 cases have been reported in the world literature. Authors experienced on case of the classic pattern of Apert syndrome and treated surgically for syndactyly. This one case was reported on this paper with brief review of the relevant literatures.

The Treatment of Acromioclavicular separation / 대한정형외과학회잡지

There are many procedures for treatment of injuries of acromioclavicular separation, but still controversies concerning the best management of these injuries. From March 1981 to August 1984 at Masan Korea Hospital, twelve cases were treated by technique of modified Phemister method, two cases by Dewar and Barrington method, two cases by Stewart method, one case by Neviaser method, three cases by skillful neglect method and two cases by shoulder harness immobilization. The following results were obtained. 1. These injuries were more prevalent in male and more in right side. 2. The most common cause of injuries was traffic accident and followed by falling from the height. 3. Three cases were grade 2 and nineteen cases grade 3 by Allman's classification. 4. We treated these injuries by operative method in seventeen cases and non-operative method in five cases. 5. There were good functional results of treatment in operative method. 6. There were two cases of superficial wound infection, two cases of migration of K-wire and one case of recurrence of deformity in operative method, and two cases of shoulder stiffness and 2 cases of recurrence of deformity in non-operative method.

Studies on the comparative migration patterns of Ascaris suum larvae between primary and re-infected mice

In the present study, the effect of primary infection to reinfection with Ascaris suum larvae was experimented in mouse model. Mice were challenged with l,000 infective stage eggs of Ascaris suum. The embryonated eggs were directly introduced into stomach of mice. Reinfection was performed at 50 days after the primary infection with same method as primary infection. Mice were sacrificed 3, 5, 7, 10, 15 and 20 days after infection in both groups respectively. Larvae collected from livers and lungs with Baermann's apparatus were enumerated and measured after sacrifice. Sera of mice were also collected at same time. The results of the experiment were as follows: With antigen prepared from coelomic fluid of adult Ascaris suum and sera collected from mice before reinfection, the production of antibody in experimental mice was confirmed by the gel-diffusion technique. In the livers of reinfected mice, the larvae were recovered up to 10 days after challenge, otherwhile in the primary infected mice, the larvae were observed up to 7 days. The maximum number of larvae were observed in the lungs of primary infected mice on 10 days after inoculation. In the lungs of reinfected mice, maximum number of larvae were recovered on 7 days after, only few larvae were recovered on 10 days after reinfection. As regards the growth of the larvae, the third stage larvae, over 500 micrometer in length, appeared in livers at 5 days after reinfection, but it couldn't be found on 7 days and 10 days after challenge. The third stage larvae continuously developed were observed in lungs of mice from 5 days after reinfection. In conclusion, it was found that development of larvae in livers of immune mice were probably repressed by the immune mechanisms being rised in livers and defence mechanism is also acting by interfering with the process of larval penetration into the lung from the liver.

The Clinical Observation of the Femoral Shaft Fractures in Children / 대한정형외과학회잡지

The managements of fractures of femoral shaft in children differ in many ways from those in adults. Fourty eight cases of fractures of femoral shaft in children who were treated at Masan Korea General Hospital from March 1981 to February 1984 were analyzed both clinically and radiologically and the following results were obtained. l. Among 48 cases, the ratio of male and female was about 2.7:1 and the highest incidence was between the age of 3 and 8 years(52.1%). 2. The main cause of fracture was traffic accident(66.7%) and the other was falling or slip down injury. 3. Middle 1/3 of femoral shaft was most commonly injured(45.8%) and transverse type was common (41.7 %). 4. The common associated injuries were head injuries, fracture of the lower extremities and fracture of pelvis. 5. 43 cases were treated with traction method and 5 with open reduction and internal fixation. 6. In general, angulation at fracture site was under 10 degrees and no clinical deformity was resulted in. 7. Among 48 cases, overring of fractured fragment was occured in 28 cases and the average length of overring was 7.5mm.

Modified High Tibial Osteotomy / 대한정형외과학회잡지

Treatment of unstable cervical spine fracture by skull traction is time consuming procedure, and treatment by Halo appratus has many advantages but it is very expensive. Bone cement has been applied occasionally as an adjunct to metallic internal fixation in treating patient with malignancy, i.e. limited life expectancy. Internal fixation with bone cement in addition to routine posterior fusion with bone graft is tried eliminate the need of application of complicated external immobilization in treating unstable cervical spine fracture of young patient. We experienced two cases of posterior cervical fusion using bone cement with satisfactory results. The advantages of this method are: 1. Rapid and solid fixation 2. Early ambulation 3. Reduce complicated external support 4. Reduce the date of hospitalization.

Two-Stage Tendon Reconstruction Using Hunter Silicone Rod Prosthesis / 대한정형외과학회잡지

Flexor tendon injuries of the “no man's land”(Zone2) in the hand have long been considered one of the problem areas for hand surgeons because of the frequently unsatisfactory result of treatment. Two-stage tendon reconstruction using the silicone rod prosthesis is one of the recent valuable procedures for management of severely damaged hand. From Aug. 1977 to Jun. 1978, the authors performed this procedure using “Hunter Silicone Rod” on 4 cases of flexor tendon injuries accompanied by deep cicatrix of soft tissue and stiffness of finger joints. The follow-up results were excellent in 3 cases out of the 4, and poor in the remaing case which had marked wound infection and stiffness of finger joints.

Arthrographic Finding of Meniscus Tear / 대한정형외과학회잡지

Double-contrast arthrography of the knee, that is roentgenographic examination of the supporting structures of the knee joint with the aid of the radiopaque dyes, has been utilized infrequently until recent years in our country. A growing appreciation of the advantages of arthrography, increased experience with the technique, and an increasing ability to interprete the arthrogram have led to more frequent use of this diagnostic aid. Double-contrast arthrography of the knee is of particular value in the examination of the patient with an atypical history of in jury and unusual physical findings, or in the individual with an acute injury who cannot tolerate a manipulative physical examination. Its use has led to greater diagnostic acumen prior to operative intervention and in many cases has aided the orthopedic surgeon in determing whether or not surgery indicated and in surgical exploration. And its accuracy of the diagnosis of the meniscus tear has been very high, greater than 90% in many series. The followings are summary of result; 1) Double-contrast arthrography of the knee is a valuable diagnostic procedure. 2) Prolonged observation and procrastination in the treatment of patients with symptomatic knees could be avoided. 3) There were no complications of arthrography and all patients returned to work immediately after the procedure. 4) In this series, 2 cases out of the 6 cases of the torn lateral meniscus were not demonstrated correctly by arthrography. From this result, it is suggested that the interpretation of arthrographic findings is somewhat difficult at present time. In future, further experience and study for arthrography is demanded for more accurate interpretation of the conditions of the structures of the knee joint and also is desired to compare with the arthroscopic findings.