Delayed and Nonunion of the Carpal Scaphoid Fractrue Treated with Herbert Screw / 대한정형외과학회잡지

14 Cases of delayed and nonunion of the carpal scaphoid fractures who were treated at Department of the Orthopedic Surgery, College of medicine, Kyungpook National University, Taegu, Korea during the period of April, 1984. to March, 1986 were analysed. The results were as follows; l. Of the total 14 cases, there were 13 male and 1 female patients. This result showed marked predominence of right hand (10 cases) over the left and most commonly occured between 21 and 40 of age (11 case). 2. The site of fracture were confined to the middle one third in 12 cases (85.7%), the fracture lines were transverse in 6 cases (42.9%). 3. In 14 cases, union was obtained from 13 cases (92.9%) that were treated with Herbert screw,from 2 cases of delyed union after 2.3 months and from 12 cases of nonunion after 4.3 months. 4. Postoperatve cast immobilization was done for 2 weeks in the cases that were treated with Herbert screw and for 4 weeks in the cases that were treated with Herbert screw and bone graft. 5. The results of treatment were excellent in 7 cases (50%), good in 6 cases (42.9%) and fair in 1 case so that all of 14 patient could treturn to their work.

Ultrastructural Changes of Skeletal Muscle in Tourniquet Ischemic / 대한정형외과학회잡지

Muscles from three patients were obtained during continuous ischemic periods and were investigated ultrastructural changes to know the reversible tourniquet time. Tourniquet was applied for periods lasting between 60 minutes and 90 minutes in the human and muscle biopsies were taken from 10 minutes to 90 minutes ischemic period and at the same periods after release of the tourniquet. All specimens were investigated with electron microscopy and the results were as follows: In 10 minutes tourniquet period, loss of cristae in few mitochondria were observed. In 30 minutes tourniquet period, partial swelling, loss of cristae and myelin figure in many mitochondrias and vacuolar dilatation in T-tubule and sarcoplasmic reticulumn were observed. In 60 minutes tourniquet period, above change were observed in nearly all mitochondrias and total number of mitochondrias were decreased. In 90 minutes tourniquet period, above changes were more distinct. 20 minutes after release of 90 minutes tourniquet period, small sized new mitochondria were appeared and abundant electron dense granule in their matrix and sarcoplasmic reticulumn were visible. 60 minutes after release of 90 minutes tourniquet period, the majority of damaged mitochondrias were replaced by small sized new mitochondrias and electron dense granule were abundant in sarcoplasmic reticulumn. In human, the changes on the ultrastructure were reversible for at least a succeeding 90 minutes ischemic periods.