Osteochondroma in the Soft Tissue: A case report / 대한정형외과학회잡지

The diagnosis of soft tissue osteochondroma should be considered when a well-defined osseous mass is located in the soft tissues. The differential diagnosis includes myositis ossificans, tumoral calcinosis, synovial chondromatosis, and soft tissue osteosarcoma, true osteochondroma which arises from bone. One case of soft tissue osteochondroma in the knee, a lesion of uncertain pathogenesis is reported.

Treatment of Fracture of the Thoraco / 대한정형외과학회잡지

The main goals of surgical teatment of thoracolumbar vertebral fractures are to achieve reduction, stability and early, painless mobilization. A further aim is to avoid late malposition and to preserve mobility and lordosis. The main disadvantage of Harrington instrumentation and similar methods are that this device fixate five to seven vertebrae. The Cotrel-Dubousset(C-D) instrumentation provides a stable construct for fixation of spine fracture. The advantages of C-D pedicle screw for thoracolumbar spinal fractures are that compression or distraction force can be applied in the same rod and used to achieve anatomical reduction of spinal fractures and rigid fixation can be obtained with short instrumentation. The C-D instumentation was done for 15 unstable thoracolumbar spinal fractures at Seoul Red Cross Hospital from January, 1988 to January, 1990. The results were as follows. 1. The most common cause of the spine fracture was fall down, and majority are within 20-40 old age. 2. The most common involved site was T12 and Ll vertebrae (66.7%). 3. The most common type of injury was burst fracture by according to Denis classification(60%). 4. The complication was developed mostly in neurological deficient patient. 5. The advantage of the C-D instrumentation: (1) rigid and short osteosynthesis of spine fracture, (2) compression or distraction force can be applied in the same rod, (3) early mobilization with a brace is possible. 6. The rigid fixation can be obtained.

Fracture of the First Sacral Vertebral Ring Epiphysis Simulating Disc Rupture: A Case Report / 대한정형외과학회잡지

The mechanical derangement, developmental anomaly, infection amd tumor should be considered as a cause of low back pain in adolescents. Disc herniation in adolescents is very rare and some of that are due to fracture of the epiphyseal ring. We report a case of fracture of the first sacral epiphyseal ring simulating disc rupture.

Supracondylar Fracture of the Femur Treated by Ender nail / 대한정형외과학회잡지

Supracondylar fracture of the femur is not as common as the shaft fracture. There is wide range of potential complication in the treatment of these fractures and the method of the treament and the evaluation of it's result is variable and remains controversial. Until 1960, we believed conservative treatment supirior to the operative treatment of the supracondylar fracture of the femur. But recently, anatomical reduction and internal fixation with early joint motion showed satisfactory results and is the trend of treatment of these fracture. The authors of this thesis performed treatment of supracondylar fracture of femur by utilizing Ender nails and screws in 13 cases during the period from October 1987 to November 1988 and it was found that operation was relatively simple, bleeding was little and early exercise of knee was allowed and even for patients of old age internal fixation could be maintained easily.

The Comparison of Sulcus Angle and Congruence Angle in the Patient with and without the Patella Pain Syndrome / 대한정형외과학회잡지

Chondromalacia patella is a symptom complex characterized by aching pain behind the knee cap, retropatella tenderness that is aggravated by the stair climbing. Malalignment is an important factor causing chondromalacia patella. And to recognize it, is important in the diagnosis and treatment. We studied 3 parameters in the chondromalacic knee and nonchondromalacic knee and the following results was obtained. l. In nonchondromalacic knee, the sulcus angle is 141° 7′ and the congruence angle is −5° 1′ 2. In chonduomalacic knee the sulcus sagle is 139° 2′ and the congruence angle is +5° 3′ 3. In the group with abnormal congruence angle, there was much degenerative changes in the patellofemaral joint. So, it can be inferred that chondromalacia is a precursor of the osteoarthritis and the patient with abnormal congruence angle should be treated actively at the early stage if the conservative treatment had failed.

Clinical Analysis about the Injuries of Tendons , Vessels and Nerves in the Wrist / 대한정형외과학회잡지

The wrist joint is exposed to trauma easily which is a small portion of human body. Because there are many structures(tendons, vessels and nerves) in the wrist, it is necessary to examine carefully and treat properly when it is damaged. We have treated 230 cases of soft tissue injuries around the wrist and the result can be summarized as follows; 1. Among the 230 cases, the male ratio was 85% and the highest incidence was in the third decade. 2. Right side injuries were more than left and flexor surface injuries were more than extensor surface. 3, The main cause of injury was glass, 149 cases(64.8%) and the next on was knife, 37 cases(16%). 4. Injuries in the night were more than daytime. 5. Injuries in the summer were more than winter.

Peripheral Neuroblastoma: A Report of One Case / 대한정형외과학회잡지

Neuroblastoma occurs most frequently in children. It, however, may occur in adults. The peripheral neuroblastoma in adult is a primitive neuroectodermal tumor arising from peripheral tumor arising from peripheral nerve. It is exceedingly rare and estimated less than 1% of all malig-peripheral nerve tumors. We report a case of adult peripheral neuroblastoma arising in left lower extremity, who was treated with local excision and radiation.

A Study of Fabella / 대한정형외과학회잡지

The fabella, a sesamoid bone that occasionally is found in humans on the gliding surface of the lateral head of the gastrocnemius, is a sign of an atavistjc pattern. The authors examined radiograph of knees of 817 patients for the presence of fabella and determined the incidence of fabella in traumatic patients as compared with non-traumatic patients with primary osteoarthrosis or vague pain in that knees. The results were as followes: l. 31.0% of 626 adult patients had at least a unilateral fabella. 2. There was no difference in the incidence of fabella according to sex (p<0.01). 3. The youngest boy showing the fabella was aged 12 years & 8 months, the youngest girl 15 years & 2 months. 4. 87.1% of the patients who had a fabella had one bilaterally. 5. Fabellae were more common in the patients with primary osteoarthrosis or vague pain in that knees. 6. It is our opinion that the presence of fabella is more important in the clinical aspect in Korea.

Aggressive Osteoblastoma: A case report / 대한정형외과학회잡지

Osteoblastoma is a rare tumor which forms osteoid and bone with highly vascular stroma, account for less than 1 percent of all bone tumors. The lesion had been though to be controlled with curettage and local excision. In recent years, osteoblastomas have been described as aggressive osteoblastoma or malignant osteoblastoma, separated from the innocuous behavior of usual osteoblastoma. It represents the histologic characteristics of the presence of epithelioid osteoblasts, trabecular rather than lace-like osteoid, low mitotic rate with no atypical form with prominent giant cells of osteoclastic type. The differential diagnosis between aggressibe osteoblastoma and osteogenic sarcoma is extremely difficult, but its peculiar histologic pattern and its different clinical and radiologic features and better prognosis are helpful. We report here a case of aggressive osteoblastoma of 17 years old female patient with 3 years and 4 months follow-up period and review the literature.

A Clinical Study of Subtrochanteric Fractures of the Femur / 대한정형외과학회잡지

Subtrochanteric fractures of the femur are difficult to manage successfully. Two factors, involvement of cortical bone tissue and concentration of stress, frequently have been mentioned as reasons for the high incidence of failure in the treatment of these fractures. We studied 37 patients with 38 subtrochanteric fractures treated at the Seoul Red Cross Hospital from Feb. 1978 to Nov. 1983. The results were obtained as follows: 1. Of the 37 patients studied, 29 were male and 8 female. The majority of male patients (representing 62.1%) were between 21 and 50 years of age, while 7 of 8 female patients were after 50years of age. 2. In 27 (73.0%) of our patients, the fracture resulted from high-energy trauma, traffic accident or fall from height. 3. Many fractures in the present series could not be classified in the manners described by Fielding, Zickel or Seinsheimer. So, we could not find any correlation between fracture type and used fixation device or its prognosis. 4. The associated injuries, which were relatively common in lower limb (10 cases) and pelvis (8 cases), made the fractures more difficult to treat. 5. Of the 38 fractures, 35 (92.1%) were treated by operative means. The Jewett nail was the device most commonly used, with a total of 11(31.4%) fractures being so treated. 6. The average time from operation to partial weight bearing was 12.9 weeks. 7. The average time untill clinical union was about 14 weeks and radiographic union about 24 weeks. 8. From these series, it was considered that, although early weight bearing is frequently impossihle, Jewett nail, plate and screw, compression hip screw, Judet plate or blade plate can be applied successfully to the treatment of subtrochanteric fractures of the femur if the most proper one which can stabilize the lesion effectively is selected and weight bearing is delayed for a sufficient period.

A Clinical Study of the Ankle Fractures / 대한정형외과학회잡지

Ninety six patients treated at Seoul Red Cross Hospital from Jan. 1979 to Dec. 1982 were analized in clinical and radiological aspect. The results obtained from this study were as followings; 1. Among the 96 patients, male was 67 patients and female was 29 patients (M:F=2.5:1). The average age was 32. 2. The causes of the injury were traffic accident, slipping down, falling down and sports injuries in orders. 3. According to the classification of Lauge-Hansen, supination external rotation type (38.5%) was the most common type. 4. 65 cases (67.7%) were treated by open reduction and 31 cases (32.3%) by closed reduction. The better result was obtained by open reduction than closed reduction. 5. Accurate reduction and rigid internal fixation of the lateral malleolus was most important in treatment of the ankle fractures. 6. Classification of Lauge-Hansen was useful in diagnosis and treatment of the ankle fractures.

A Clinical Study on Pathologic Fractures / 대한정형외과학회잡지

A pathologic fracture is a fracture of a bone with preexisting structural weakness. When considering the local treatment of pathologic fractures, those resulting from disorders which cause a generalized weakness of the whole or part of the skeleton can be largely treated conservatively. And those because of localized bone destruction or weakness often require operative treatment. For ten years from 1973 to 1983, we observed and analysed 26 cases of pathologic fractures, excluding those due to osteoporosis. The results were as follows: 1. The age distribution showed an even pattern, and the male to female ratio was 58% (15 Males): 42% (11 Females). 2. The underlying etiologies were infection in 6 cases (23%), disturbance in skeletal development in 7 cases (27%), benign tumorous lesion in 10 cases (38%) and malignant tumorous lesion in 3 cases (12%). 3. The most common site was femur, 54% (14 cases). 4. Previous treatment was carried on 38% (10 cases). 5. Of the 26 cases, conservative treatment was done in 4 cases (15%) and surgical treatment was done in 22 cases (85%).

Angiosarcoma Arising from Chronic Osteomyelitis One Case Report / 대한정형외과학회잡지

No abstract available in English.

Prosthetic Replacement in Femoral Neck Fracture / 대한정형외과학회잡지

Twenty seven fractures of the femoral neck in 26 elderly patients treated by primary replacement with the endoprosthesis were reviewed. The end results of 18 hips of 17 patients who were followed up at least over 6 months were as follows. The average age was sixty-seven years. Seventeen fractures occurred in women and ten in men. Of these 18 hips, eleven hips were excellent or good. Poor results were in two hips; one developed deep seated infection and the other patient who could walk with crutch after bilateral endoprosthetic replacement because of Lt hip pain. It is considered that this method is the best treatment in the rehabilitation of elderly patients after high femoral neck fracture, because of its low morbidity and high success rate in returning the geriatric orthopaedic patients to independence.