A Clinical Evaluation of Flatfoot / 대한정형외과학회잡지

258 feet of patients with flatfoot were evaluated in this paper. The incidence of flatfoot is about 0.6% of the general population. The longitudinal arch was depressed in all of our cases of flatfoot, and there have been many patients suffering from pain after some kinds of heavy work. But there were no definite correlations found between the depression of the longitudinal arch and clinical symptom. The sag in the naviculo cuneiform joint is the most common X-ray finding in this series (93%), followed by the talo-navicular sagging (27%), Degenerative arthritis of the inter-tarsal joints was frequently found after the adolescent period. The talo-navicular joint was involved in arthritic changes in 60% of the cases, the subtalar joint 46% and the naviculo-cuneiform joint 42%. The prevalence of these changes was not increasing with the increasing age, so it is poatulated that the degenerative changes begin early in adolescent period. Accessory tarsal bones were more frequently seen in patients with flatfoot than in normal population. and the neck of the talus was usually deviated inferomedially. Now that the arthriric changes are very prevalent in the triple joints, there are many cases of flatfoot that should undergo the triple arth odesis inevitably if his conservative treatment was failed.

Lesion in the Sacro-iliac Joint / 대한정형외과학회잡지

Sacro-iliac joint is, as other joints, the prediIection site of tuberculous or pyogenic arthritis as well as primary or metastatic tumor. The writers reviewed twenty cases of sacro-iliac lesion performed at the Department of Orthopedic Surgery, Seoul National University Hospital, for the period of five years from June 1972 till May 1977. 1. They are tuberculous arthritis eleven, pyogenic arthritis five, ankylosing spondylitis two(one associated with spinal stenosis, the other with hip invoIvement), osteosarcomatosis one, metastatic tumor from adenocnrcinoma of prostate one 2. Infection is the predominant Iesion in sacro-iliac joint, and tuberculous arthritis is twice than pyogenic arthritis. 2. Early diagnosis of sacro-iliac lesion is difficult, but S-I stress test is a valuable finding. 4. Two of eleven cases of tuberculous arthritis, two of five cases of pyogenic arthritis with mild involvement were treated conservatively without sequele, but in more advanced cases, surgical intervention was preformed.

Diastematomyelia associated with clubfoot: A Case Report / 대한정형외과학회잡지

Diastematomyelia, a form of spinal dysraphism, is characterized by a division of the spinal cord or canda equina resulting the form a bony or cartilaginous spur which transfixes the neural elements and dura. The presence of a structure of neural crest origin in the subarachnoid space connecting the spicules suggested that the anomaly resulted from delayed closure of the neural tube and its investments. The cinical finding are presumed due to its restriction, tethering of the normal apward migration of the spinal cord. Congenital anomalies of one or both lower extremities and spine are frequently found with this condition. The surgical removal is recommended as a prophylactic measure against further progressive neurological damage. The purpose of this paper is to presented becanse it was associated with clubfoot and adds to understanding of teratogenesis of diastematomyelia.

Anterlor Fusion for the Tuberenlosis of the Spine / 대한정형외과학회잡지

The anterior fusion became the popular measure in the treatment of the tuberculosis of the spine. We analysed the 208 cases of the tuberculosis of the spine (174 anterior fusion) who were treated at our department during the period of 1966 to 1973 and compared these results with that obtained during the period of 1957 to 1966. Following has been observed from this comparison. 1. Spine was the most common site in bone and joint tuberculosis (51.7%) but with decreasing tendency. And it was followed by hip, knee, ankle and sacroiliac joints of order. 2. Common age incidence was below 30 years (72.7%) and most common in below 5 years (20.7%). 3. Average duration of disease was 2 years and 2 months. This value was 6 months lower than in previous study. 4. The most common site was changed from lumbar to thoracic vertebrae. 5. The incidence of sinus, cold abscess formation decreased but paraplegia increased in incedence due to high prevalence in thoracic vertebrae. 6. Anterior fusion was performed in 86.1% of the cases. 7. Postoperative complications was found in 17.2%. Adequate rnanagement of chest tube in thoracic areas and blood vessels in lumbosacral areas may be necessary.

Hemangioma of the Synovial Membrane: 2 Cases Report / 대한정형외과학회잡지

Two cases of synovial hemangioma have been experienced at the Department of Orthopedic surgery, Seoul National University Hospital. In the first case, synovial hemangioma about 1.5cm in diameter was found to be attached to the anterior aspect of the medial condyle of the left femur, which was excised completely with good follow-up result. In another case, cavernous hemangioma was observed diffusely invading tendon sheaths, lower one third of the tibia and also synovium of the ankle joint. Because of diffuse involvement, complete removal was not possible. After partial removal, a total 800 r Roentgen therapy was taken.

Melorheostosis: A Case Report / 대한정형외과학회잡지

A case of melorheostosis, which affected upon left upper extremity as monomelic type, was experienced at the Department of Orthopedic Surgery of Seoul National University Hospital in May 1971. We report this case with reference because of the rarity of melorheostosis and an addition of the case, a case with the literal reference is persented.

Congenital Pseundarthrosis of the Tibia: 3 Cases Report / 대한정형외과학회잡지

Three cases of congenital pseudarthrosis of the tibia were treated at Department of Orthopedic Surgery, Seoul national University Hospital during last four years. In all cases, many Cafe-au-lait spots and subcutaneous nodules were shown on the whoIe body skin, which are suggestive of neuro-fibromatosis. Case 1, A thirteen years old boy was treated with plate and screw fixation with massive iliac cancellous and cortical graft. In a follow-up of three and one half years, solid bony union has been obtained with successful result. Case 2, A 5 years old boy was treated with Boyds dual cortical graft with plate and screw fixation. In a follow-up to eight months, bony union were satisfactory. Case 3, A six months old boy who is young brother of case 2, was treated with Charnleys intramedullary nailing and iliac cancellous and cortical graft. The patient is still in the Iong leg cast, six months postoperatively. The evidence of familial and hereditary factor in pedigree is elicited on case 2 and 3. This congenital pseudarthrosis of the tibia in the sibling is regared as the first report in Korean literature.

The Infection of the Posterior Compartment of the Vertebra: A Report of 3 Cases / 대한정형외과학회잡지

Infectious process involves infrequently the posterior compartment of the vertebra. Three cases of such condition are experienced at the Dept. of Orthopedic Surgery, Seoul National University during the period of August 1962 to June 1971 Two of three cases were from pyogenic infection invoIving the spinous process of third and fourth lumbar vertebra respectively, one of which was complicated by formation of paraspinal abscess and both were treated with total laminectomy of the involved vertebrae. Thee third case was tuberculosis on the transverse process of first thoracic vertebra which was accompanied by irritating sign of left ulnar nerve, and was treated with transversectomy and partial laminectomy. Excellent results were obtained without recurrence and no deformity nor instability of the spine developed postoperativeIy.