To evaluate the efficacy of the retroperitoneal approach when compared with the transperitoneal approach in elective infrarenal aortoiliac reconstruction, retrospective review of consecutive cases was made with multiple intra-and postoperative parameters. Twenty consecutive cases of infrarenal aortoiliac diseases were performed reconstructive surgery from June 1994 to July 1996 at Department of Surgery, Yeungnam University Hospital. Among these patients, 12 cases underwent aortoiliac reconstruction through the transperitoneal approach(8 cases for infrarenal abdominal aortic occlusion and 4 cases for infrarenal abdominal aneurysm) and 8 cases underwent aortoiliac reconstruction through the retroperitoneal approach (5 cases for infrarenal abdominal aortic occlusion and 3 cases for infrarenal abdominal aortic aneurysm). Both groups had similar associated diseases, such as hypertension, myocardial ischemia and COPD. Intraoperative blood loss was minimal and similar in both groups. The intraoperative crystalloid requirements were not significantly higher for the retroperitoneal approach(4800 ml) than the transperitoneal approach(4400 ml)(p>0.05) and perioperative blood requirements were also similar in both groups. The operation time was not taken significantly longer for the retroperitoneal approach(4.4hr) than the trasperitoneal approach(3.9hr)(p>0.05). Nasogastric intubation and initiation of oral feeding was not significantly prolonged in the transperitoneal group(5 days) when compared with the petroperitoneal group(2.5 days)(p>0.05). Postoperative hospitalization was not considerably prolonged in the transperitoneal approach(19 days) when compared with the retroperitoneal approach(16 days)(p>0.05). There noted significant pulmonary complication in the transperitoneal approach group, whereas wound pain was major complication in the retroperitoneal approach group. These experiences demonstrate that the retroperitoneal approach is a preferable alternative to the transperitoneal route in elective aortoiliac reconstruction.
Aorta, Abdominal ; Hospitalization ; Humans ; Hypertension ; Intubation, Gastrointestinal ; Myocardial Ischemia ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Wounds and Injuries

We have compared the computed tomographic(C. T.) findings with those of conventional roentgenogram(simple AP and lateral radiograms) in 18 cases of osteochondritis dissecans of the capitellum humeri available for review. Among the 18 cases, 2 cases of them had a lesion of osteochondritis dissecans on C. T. which, however, had not been found on conventional rentgenograms. Fro the 5 cases, which had not clearly found on conventional rentgenograms, 2 loose body on conventional view, 3 cases had different numbers and locations of loose body on C. T. films. On the bases of our findings, we recommend that C. T. is necessary in early detection and the determination of anatomical location and status of osteochondritis dissecans of capitellum.
Osteochondritis Dissecans ; Osteochondritis

Accompanying to the development of the knowledgment of mechanism and pathology of recurrent dislocation of the shoulder, accurate diagnostic tools to detect that pathology have been developed. During the period from May 1990 to May 1992, we treated 28 cases of recurrent anterior dislocation of the shoulder. Twenty-eight cases were examined with C.T. arthrography before the operation. Among the 28 cases, we identified the Bankart lesion in 20 cases by C.T. arthrography, and in 21 cases intraoperatively. We concluded that the C.T. arthrography is an accurate method for confirming the clinical diagnosis of recurrent dislocation of the shoulder and to be helpful in detecting the Bankart lesion and its severity or pathologic findings.
Arthrography ; Diagnosis ; Dislocations ; Methods ; Pathology ; Shoulder

Entrapment neuropathy of the suprascapular nerve is rare and frequently overlooked in the differential diagnosis of shoulder pain. There have been few published reports on a ganglion compressing the suprascapular nerve. We experienced a case of entrapment neuropathy of the suprascapular nerve by a ganglion that compressed the inferior branch of suprascapular nerve at the spinoglenoid notch.
Diagnosis, Differential ; Ganglion Cysts ; Shoulder Pain

Early stage osteonecrosis of femoral head is a major therapeutic dilemma in orthopedics. Many joint preserving treatment modalities have been proposed, but none of them is entirely satisfactory. Among them, core decompression has been widely performed. The results of twenty two core decompression procedures that were performed for osteonecrosis of the femoral head in fifteen patients were retrospectively reviewed to evaluate the effectiveness of the procedure. From January 1990 to December 1993, we had treated twenty two cases of the osteonecrosis of femoral head. The average follow-up was 31 months, ranging from 12 months to 58 months and the average age at operation was 39.6 years, ranging from 21 to 58 years. By Ficat-Arlet stage, the stages I were 1 case,IIa 6 cases, IIb 7 cases and III 8 cases. The functional and radiological evaluation was done preoperatively and at final follow up by the Harris Hip score and Ficat stage. The results were as follows. The improved cases were 10 cases and the progressed were 12. Radiologically, none of 1 hip(0%) with stage I, two of 6 hips(33%) with stage IIa, four of 7 hips(57%) with stage IIb, and six of 8 hips(75%) with stage III have progressed. Mean preoperative Harris Hip score was 57 points and it improves to 69 (the improved 13 cases; 85, the progressed 9; cases; 49)at final follow up. In six of the progressed 9 cases, the arthroplasties were performed. Among them, five cases are being observed. In conclusion, the core decompression is not only highly effective in preventing further change in femoral head, but also relieving pain and delaying time for arthroplasty at late stage osteonecrosis of femoral head.
Arthroplasty ; Decompression ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Orthopedics ; Osteonecrosis ; Retrospective Studies

During the period from July 1975 to June 1982 we performed 17 Putti-Platt operations on 16 males and one female, ranging from 19 to 39 years. The average follow-up period was 3.8 years in 13 cases of them. The results were as follows: 1. The ages in initial dislocation were ranged from 14 to 31 with an average of 18.5 years. 2. Right side was involved in 15 cases and. left in 2 cases. 3. On radiological finding Hill-Sachs lesion was found in 41%.0n pathological finding at operation of 15 cases, Bankart lesion was seen in 73%, Hill-Sachs lesion in 60%, glenoid erosion in 33%, capsular loosening in 33%, and capsular tear in 13%. 4. Limitation of external rotation compared with sound opposite side was measured in 12 to 40 with an average of 19.2 degrees. 5. The Putti-Platt operation is considered as sound, surgical procedure that gives excellent functional results.
Dislocations ; Female ; Follow-Up Studies ; Humans ; Male ; Shoulder ; Tears

No abstract available.
Histiocytoma, Benign Fibrous* ; Knee*

No abstract available.
Debridement* ; Knee* ; Osteoarthritis*

While the microbiology of cellulitis in the pediatric population and systemic diseases(DM, Cirrhosis, etc) is well known,the causative bacteria and clinical aspect of cellulitis in young adults are less descrihed. this study was undertaken to identify the causative organisms and clinical aspect of adult cellulits. We analysed 121 medical records of 115 young adult patients with cellulitis who had been admitted at the department of orthopaedic surgery, National Police hospital from Jan. 1994. to Dec. 1996. The results were as follows. 1. The age of patient was between 21 yrs and 25 yrs, and the sex of all patients was male. 2. The lower leg and foot were the most frequently involved site of cellulitis as 92 cases(74.2%). 3. The potals were suspected in 65 cases(56.5%),of them, traumas were detected in 43 cases(66.1%), non-traumatic skin lesions in 23 cases(33.9%). 4. In most cases, initial systemic symptoms (fever, chill, headache, etc.) and local symptoms (local heating, tenderness, etc.) were found. 5. The laboratory findings revealed leukocytosis in 19%, elevated ESR in 94%, positive CRP in 80%. 6. Microorganism were detected in 16 of 38 pus cultures. Gram positive microorganisms were detected in 15 of 16 cases culture positive. 7. 6.7% of patients with cellulitis experienced recurrence in same lesions. In conclusion, the retrospective analysis of 115 young adult patients with cellulitis showed that primary cause of young adult cellulit was circulatory disturbance and lymphatic obstruction of the lower extremities most often involved by trauma. therefore, supportive treatments such as rest,elevation,ice packs are considered prior to antibiotic treatment.antibiotic treatment aimed at gram-positive cocci appears to be sufficient.
Adult ; Bacteria ; Cellulitis* ; Fibrosis ; Foot ; Gram-Positive Cocci ; Headache ; Heating ; Hot Temperature ; Humans ; Leg ; Leukocytosis ; Lower Extremity ; Male ; Medical Records ; Police ; Recurrence ; Retrospective Studies ; Skin ; Suppuration ; Young Adult*

Tumor and tumor-like lesion of the patella are extremely rare. The following have been reported: giant cell tumor; osteoblastoma; osteoid osteoma; chondroblastoma; solitary osteochon droma; chondroma; ganglion; simple bone cyst; aneurysmal bone cyst; hyperparathyrodism (brown tumor); malignant lymphoma; haemangioendothelioma; haemangima; primary osteosarcoma; plasmocytoma and metastases. Chodroblastoma in patella were very rare and first repoted by Jerone Cohren in 1963. On review of our literatures, we could not find reported case in Korea. The purpose of this paper is to present an unusual case of chondroblastoma of the patella.
Aneurysm ; Bone Cysts ; Chondroblastoma* ; Chondroma ; Ganglion Cysts ; Giant Cell Tumors ; Korea ; Lymphoma ; Neoplasm Metastasis ; Osteoblastoma ; Osteoma, Osteoid ; Osteosarcoma ; Patella* ; Plasmacytoma