Bony Lesion of Divers in Korea / 대한정형외과학회잡지

Bornstein and plate (1911) and Bassoe (1913), followed by many European and American, described the radiographic appearance of avascular necrosis of the bone in compressed air worker. Divers bone lesions was described for the first time by Grutzmacher in 1941. There is not any report of information on the caisson disease and divers bone lesions in this country. Inview of these considerations, during the period from March to June 1981, 124 traditional civilian divers and 132 Naval divers, were observed in eight Korean coastal cities (In-cheon, Sam-chun-po, Sin-hae, Pu-san, Ul-san, Ku-ryung-po, joo-moon-jin and Sok-cho). For each divers, a record was made of his medical history, diving experiences and frequencies of bends attacks. The clinical examination included blood pressure, body weight, a chest radiograph and routine checks of the shoulders, hips and knees, but an X-ray examination extended to the spines, ankles, elbows when symptoms existed. The results were as follow: l. Out of 256 divers, 113 (44.2%) had bone lesions, seventy-five traditional divers (60.5%) had bone lesions out of 125 divers, but naval divers, only thirty eight (28.8%) of 132 had such lesions. 2. Divers bone lesion incidence is increased with diving experience especially over 10 years. 3. The most frequent bone lesions occured in the upper end of the humerus, the upper end of the femur, the lower end of the femur and proximal tibia. 4. The most frequent divers bone lesions in X-ray was dense areas (Bl). 5. There was a high incidence (93.1%) in man with a history of the bends and significantly relate between the sites of the bends and those of the lesions. 6. Divers bone lesions incidence was increased with the length of diving experiences, diving depth, diving time, ages and with bends experiences.

Replantation of Amputed Anke Through the Distal Tibial Epiphysis: A Case Report / 대한정형외과학회잡지

Amputation through the epiphyseal plate is very rare. Authors experienced only one case of ankle amputation through the epiphyseal plate in one huadred seventeen replantation cases during last seven years. It can make severe growth disturbance after replantation especially if the bone shortening is carried out at epiphyseal plate. Authors have developed new idea to make boae shortening during replantation with preservation of the epiphyseal plate in amputation through the epiphyseal plate in three years old female. It is, so called, double osteotomy shortening. Bone shortening is performed at 5cm above amputated epipyaeal plate to avoid further damage in epiphyseal plate, and a bone segment 3cm in length is resected,by double osteotomy shortening technique. After then, bone reduction and internal fixation is followed. With above technique, authors succeeded in replantation without further damage in epiphysis. In three years and ten months follow-up, bony growth in replanted tibia shows normal pattern, and epiphyseal plate in replanted site is working and remained open. The patient can walk without pain, and motor-sensory function have almost completely recoverered.

Arthrography and Arthroscopy for Meniscal Lesions of the Knees / 대한정형외과학회잡지

We assessed the accuracy of clinical evaluation, arthrography, and arthroscopy in the diagnosis of meniscal lesions in twenty-nine knees in which arthrotomy and menisectomy were performed after evaluation by these three methods, At surgery, thirty menisci of twenty-nine knees were removed, of which twenty-eight were abnormal and two were normal. In these thirty menisci, a correct diagnosis was made clinically eighteen times, arthrographically twenty times, and arthroscopically twenty-seven times. Posterior horn tears of medial meniscus and discoid lateral meniscus were well visualized but lateral meniscal tears were poorly visualized on arthrogram. The errors of arthroscopy occurred in two tears confined to outer one half of medial menscal posterior horn, and in a normal meniscus as false positive. Based on this study, it was concluded that both the arthrography and arthroscopy are valuable techniques for the diagnosis of meniscal lesions, and that we can expect correct diagnosis of all the meniscal lesions by the use of complementary roles of the two and by the experiences.

Clinical Study of Meniscus Tears / 대한정형외과학회잡지

46 knees with injured meniscus diagnosed by the use of history and physical examination as well as by arthrography were meniscectomized from January in 1974 to June in 1978. Statistical analysis of data obtained from the histories, physical examinations and arthrographic studies of 46 knees with a mean follow up 6 months after meniscectomy revealed as follows. 1. Lateral meniscus injuries were higher incidence than medial meniscus. 2. In the posterior horn of the medial meniscus and in the middle third of the lateral meniscus on the injured location were more frequently encountered. 3. To compare the results of twe methods of diagnosis were obtained with 67% accuracy by the use of history and physical examination and with 85% accuracy by arthrography 4. We should be able to diagnosis with 91% armed with a history and physical examination and an arthrogram. 5. As being the excellent results after meniscectomy were classified with 78%.

Giant Chondroblastoma: A case report / 대한정형외과학회잡지

Chondroblastoma is a rare primary bone tumor, The radiologic findings are so similar as giant cell tumor, osteolytic osteogenic sarcoma, enchondroma, bone tuberculosis, etc, but the treatment and prognosis are quite different, the differential diagnosis is mandatory. We experienced unusual huge giant chondroblastoma (10X7X5cm in size) occured in distal femur.

Microsurgical Nerve Graft in Traumatic Ulnar Defect / 대한정형외과학회잡지

One of the most difficult problems confronting the orthopedic surgeon today is what to do when faced with a large defect in a peripheral nerve. Recent advances in engineering and neurophysiology have improved our technical ability to understand the consequences of severing a nerve. We have treated a large traumatic ulnar nerve defect with microsurgical nerve graft technique. In a follow-up study of twehre monthes post surgery, the results were satisfactory.

Review of Trochanteric approach in 285 Total Hip Arthroplasties / 대한정형외과학회잡지

This paper is a consecutive series of total hip arthroplasties were performed over 6 years period by the same group surgeons utilizing the Charnley method as well as the lateral approach with trochanteric osteo. tomy. Trochanteric reattachment was accomplished in 285 hips and method of reattachment were basically standard Charnley technique which we used in most of our series. In addition, some modification of original Charnley technique which we used in early this trial were also included for this study. As far as trochanteric complications are concerned, there are 18 cases of hips where there was wire breakage, proximal drift of greater trochanter and 6 established cases of nonunion also reported. By the use of wire mash, we have performed a revisional surgery which has re-inforced of the greater trochanter. This was the case when the greater trocyhanter was very osteoporotic. Finally, biomechanical considerations of the re-attachment of the greater trochanter and new Charnley staple clamp method were introduced with review of our cases and analysed for technical failures.

Clinical Study of Total Hip Prosthesis Replacement: Report of 69 cases / 대한정형외과학회잡지

The goals of hip arthroplasty have been to eliminate pain, decrease deformity, increase morbility and obtain stabiIity. Currently total hip replacement is the best avaliable procedure to accomplish these goals. A prospective study of total hip arthroplasty was begun at the orthopedic dept of Kyung Hee Medical College in 1974. Between May, 1974 and June, 1977. 69 total hip replacements of the Charnley type, the Trapesoidal-28 type and the Muller type were peformed by the authors. Of the 60 Patients involved in this study, 9 had bilateral operations. The Charnley type Prosthetic device was used in 56 cases, the Trapesoidal-28 type in 7 cases and the Muller type in 6 cases. Complications included wire breakage, dislocation, loosening, femur shaft perforation, nonunion of greater-trochanter, acetabular protrusion, transient femoral nerve palsy, femur shaft fracture, infection, socket lateralization, ectopic bone formation and death. In 59 patients of the 60 patients, 53 patients felt that they were definitely improved, 5 patients felt their condition was unchanged and 1 patient felt her condition was worse.

A Case of Congenital Atlanto-Occipital Fusion: One case report / 대한정형외과학회잡지

A cases is reported of congenital atlanto-occipital fusion in a 12-years-old girl. The lesion was treated by occipito-cervical arthrodesis by iliac bone grafting with wiring. The congenital atlanto-occipital fusion has not progressed in this 2 years of observation. This is presented with a review of literature.

Giant Cell Tumor of the Patella: Report of One Case / 대한정형외과학회잡지

The giant cell tumor is a primary. neoplasm of bone characterized histollogically by a vascularized network of plumpish or ovoid stromal cells heavily interposed with multinucleated giant cells. The majority of cases occur in patients between 20 and 40 years old and in the long tubular bones, particuarly in proximity to the epiphysis. A rare case of giant cell tumor involving the patella was recently experienced by authors. Case summary with brief review of reference is presented.

Extraskeletal Neoplasm Resembling Ewing's Sarcoma: Report of one case / 대한정형외과학회잡지

Extraskeletal Neoplasm Resembling Ewings Sarcoma was firstly reported with comprehensive review of 39 cases by L. Angervall and F.M. Enzinger in 1975. The tumors chiefly affected young adults and most commonly involved the soft tissue of lower extremity. Microscopically, they were consisted of solidly packed small, round or ovoid cells arranged in sheets or lobules, which were indistinguishable from those of the Ewings sarcoma of bone. The authors recently experienced a soft tissue sarcoma occurring in deltoid area of young male patient, which was diagnosed extraskeletal neoplasm resembling Ewings sarcoma. The case review is presented.

Operative treatment of supracondylar-Condylar Fractures of the Femur / 대한정형외과학회잡지

The previous reports about Supracondylar-Condylar Fracture of the femur which extends to articular surfaces revealed poor results in general, regardless of the methods of treatment. But those results are thought to be much alleviated if they are treated according to the principles of ASIF. Fifteen cases of Supracondylar-condylar fractures of the femur from 13 patients were treated by open reduction and rigid internal fixation during last 3 years at Department of Orthopedic Surgery, Early mobilization of knee joint was permissible in most of the cases without loss of fixation or other complications during convalescence Subsequently, greatifying results were obtained as observed in varying period of follow up days.

Craniometaphyseal Dysplasia: Report of a Case / 대한정형외과학회잡지

Craniometaphyseal Dysplasia is characterized by hyperostosis of craniofacial bones, with compression of cranial nerves at the foramina, and by changes in the metaphyses of long bones. The changes in long bones resemble to some degree those seen in pyle's disease, but have cretain differences and significant cranial abnormalities with which differential diagnosis could be made with certainty. An interesting and unusual patient diagnosed Craniometaphyseal Dysplasia was recently experienced by authors. The case report with brief review of literstures in presented.

Congenital Hyperextension of the Knee: Report of a Case / 대한정형외과학회잡지

Congenital Hyperextension of the Knee is a extremly rare deformity, in which the tibia is displaced anteriorly in relation to the femur. It is usually classified into three subtypes according to severity of the status: genu recurvatum, subluxation and dislocation. (Curtis and Fisher) We experienced a genu recurvatum type of congenital hyperextension of the knee in June, 1976.

A Case of Eosinophilic Granuloma / 대한정형외과학회잡지

A case of eosinophilic granuloma in 38-year-old male was reported. The patient was admitted with chief complaints of pain on the left thigh, tenderness and limping associated with localized swelling on upper 1/3 of left thigh. The diagnosis was confirmed by radiological evidence and biopsy findings. This case was healed completely by curettage. The review of literature was made briefly.

Malignant Synovioma: Report of a case / 대한정형외과학회잡지

A case of malignant synovioma of the right knee joint is presented. Microscopically it showed sarcomatous growth of spindle cells and irregular slit spaces which were lined by tumor cells. A–K amputation has carried out on 10th hospital day and discharged on 30th hospital day without any complications.

Cleido-Cranial-Dysostosis: A Case Report / 대한정형외과학회잡지

A case of Cleido-Cranial-Dysostosis, which characterized by deficient formation of the clavicle with delayed and imperfect ossification of the cranium, associated with other anatomical errors, was experienced at The Department of Orthopaedic Surgery of Kyung Hee University Hospital in January 73. We report this rare and interest case with reference review.

Tibia Vara (Osteochondrosis Deformans Tibiae, Blount's Disease), Adolescent Type: A Case Report / 대한정형외과학회잡지

The disease Blount called tibia vara in 1937, is characterized by a failure of growth localized to the postero-medial part of the upper tibial metaphysis and epiphysis. The growth of the epiphyseal cartilage as well as that of the metaphysis and the epiphysis is disturbed, with consequent angulation of the tibia at the upper epiphysis which may, in untreated cases, produce bizarre deformities. Blount described two different types of tibia vara, an infantile type and an adolescent type. Presenting case is an adolescent type. He is 11 year old boy. The deformed tibia is corrected by osteotomy.

Hemangioma of the Synovial Membrane of the Knee Joint: A case Report / 대한정형외과학회잡지

A case of very rare synovial hemangioma of the right knee joint is presented. The duration of disease is for fifteen years. A hemangioma about 6X7X1cm in dimension has been found to be originated from lateral capsular synovium just above lateral meniscus and just anterior to lateral collateral ligament. The joint space was occupied with pedunculated mass. The complete excision could be done. The end result is good.

Surgical Treatment of Scoliosis / 대한정형외과학회잡지

Harrington instrumentation with posterior spinal fusion were caried out on 9 patients among 62 scoliotic patients at Department of Orthopedic Surgery, Seoul National University Hospital from January 1968 to September 1972. The youngest patient was 13 years old and the oldest was 17 Six cases were idiopathic and three cases were paralytic type. Preoperative localizer cast was applied and posterior window was made through which snrgery was performed. Harrington inatrumentation was applied in all cases with meticulous posterior fusion and massive autogenous iliac bone graft in Goldstein method. Postoperative immobilization in localizer cast was continued between 25 to 34 weeks, in average of 29.5 weeks. Average preoperative scoliotic curvature was 87.6 degrees ranging from 59 to 118 degrees. Correction obtained by preoperative localizer cast was 37.4 degrees with correction rate of 42.9 percent. Immediate postoperative correction by Harrington instrumentation was from 41 to 69 degrees with average of 50.1 degrees and correction rate of 63.5 percent. The loss of correction in average after two years follow up was 5.2 degrees with rate of 10.2 pecent. Solid bony union was obained in all cases with satifactory result. This treatment is considered excellent method of scoliosis correction and maintainence.