1.Ipsilateral Fractures of the Hip and Femoral Shaft
The Journal of the Korean Orthopaedic Association 1988;23(3):713-721
Thirteen cases of concomitant hip and shaft fractures of the same femur are reported. The hip fractures was initially missed in one case. Osteosynthesis of both fractures was performed in twelve cases. One except was 12-year-old boy who was managed hip with two Knowles pins and shaft conservatively. Both fractures healed in all followed for average 5.3 months or more. Osteosynthesis of both fractures is recommended as soon as the patient is in a stable condition, preferably by early fixation with AO principle or IM nailing in selected cases.
Child
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Femur
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Hip Fractures
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Hip
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Humans
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Male
2.Histologic changes in dog intraarticular patellar tendon transplants.
The Journal of the Korean Orthopaedic Association 1992;27(3):802-808
No abstract available.
Animals
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Dogs*
;
Patellar Ligament*
3.Experiences in management of Gustilo's type IIIB open tibial and ankle fractures.
Yoon Kyu CHUNG ; Jung Ho RAH ; Heui Jeon PARK
Journal of the Korean Society of Plastic and Reconstructive Surgeons 1992;19(2):292-302
No abstract available.
Ankle Fractures*
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Ankle*
4.A Clinical Study of Children Spinal Injury
Jae In AHN ; Jung Ho RAH ; Seong Ju JEON
The Journal of the Korean Orthopaedic Association 1989;24(2):516-522
We reviewed 23 patients of injury to the spine who were under 15 years of age and treated at Wonju Christian Hospital from January, 1978 to December, 1987. The patients were classified into 3 different categories, that were frsctures(17 cases), dislocations(3cases), and fracture-dislocation(3 cases). We analyzed the cause of injury, sexage distribution, treatment and neurological injuries. The results were as follows : l. Among the 23 cases, there were 16 boys(70%) and 7 girls(30%). The mean age was 11 years of age, and ages of active period, that is 10 to 15 years of age, were most common, 17 cases(74%). 2. The most common cause of injury was fall from a height, 13 cases(57%). The most common location of injury was cervicsl spine, 10 cases(43%) and among these cases, injury to upper cervical portion(C1–C3) was more common than lower cervical portion(C4–C7). 3. The cases of multiple compression fracture were 6 patients(26%), and all cases were located thoracic or thoraclumbar junction. 4. Most cases were stable spinal injury, 18 cases(78%), and the most common mechanism of injury were compreesion injuries due to hyperflexion, 15 cases(65%). 5. The most common associated injury was head injury, 9 cases(39%), and associated neurological complications were in 4 cases, 3 cases of these were recovered. We could ascertain that the prognosis of children spinal cord injury is better than that of adult. 6. Restoration of the height of the involved vertebral bocy occurred in all but one compression fractures of vertebral body. 7. There were 3 cases of epiphyseal injury, 2 of these were epiphyseal separations of odotoid process of atlas, the other was fracture of lumbar vertebral apphysis. 8. All but two were treated conservatively and the results were good. In stable spinal injury, we considerded that the duration of treatment was 4 to 6 weeks.
Adult
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Child
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Clinical Study
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Craniocerebral Trauma
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Fractures, Compression
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Gangwon-do
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Humans
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Prognosis
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Spinal Cord Injuries
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Spinal Injuries
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Spine
5.A Clinical Study of Peri
Jung Ho RAH ; Jae In AHN ; Sung Hirn JOA
The Journal of the Korean Orthopaedic Association 1989;24(2):372-380
Peri-tarsal dislocation occurs rarely and it has a complex joint structure anatomically. So, the injuries of the tarsal joint include many bony and ligament injuries and many complications such as pain on weight bearing and limitation of joint motion. The authors have reviewed a series of 15 cases of Peri-tarsal dislocations and the results obtained are as follows;1. Among the 15 cases of peri-tarsal dislocations, subtalar dislocation were 2 cases, Chop-art dislocation was 1 case, Lisfranc dislocation were 11 cases, and pure ankle dislocation was 1 case. 2. There were 12 cases of associated tarsal bone fractures 6 cases were cuneiform fractures, 4 cases were navicular fractures, and 2 cases were cuboid fractures 3. The clinical and radiological result of treatment was good in 3 cases, fair in 6 cases, and poor in 6 csses. 4. The cause of poor results were open dislocation, associsted tarsal bone fractures, delay of treatment, unstable reduction, and associated long bone fractures. 5. The most common complications after treatment were pain on weight bearing and limitation of joint motion.
Ankle
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Clinical Study
;
Dislocations
;
Fractures, Bone
;
Joints
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Ligaments
;
Tarsal Bones
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Tarsal Joints
;
Weight-Bearing
6.Clinical analysis on 26 Delayed Union and Nonunions in Children
Zi Hoan CHA ; Jung Ho RAH ; Jae In AHN
The Journal of the Korean Orthopaedic Association 1990;25(1):177-186
Nonunion is extremely rare in children, Weber et al. concluded that considerable skill is required to induce nonunion in a child and its occurrence always results from a serious error in management. Twenty-six cases of delayed union and nonunion examined and treated at department of Orthopedic Surgery, Yonsei University, Wonju College of Medicine during the period of 1970 to 1988 was observed and analysed. 1. Of the 26 cases, there was 18 male and 8 female patients. The results showed more predominence of male over female patients. 2. Delayed union and nonunions commonly occurred over 5 year of age. 3. The causes of the fractures consisted of 12 Fell from heights, 5 Traffic accidents and others. 4. Of the 26 cases, there were 21 closed fractures and 5 open fractures. 5. Prior to admission to this hospital, 15 were treated conservatively and 10 treated operatively, and one received no treatment at all. 6. The sites of delayed union and nonunion were 10 phalanges, 6 tibia, and 3 ulna in order. 7. Probably causes of the delayed union and nonunion were unsatisfactory immobilization in 13 cases, infections in 6 cases, operative complications in 6 cases, interposition of the soft tissues in 2 cases in 2 cases, persistent seperation of the fragments in 1 case. 8. We are considered that the treatment of the nonunion must be individualizd but usually requires eradication of any infection, excision of the intervening fibrous tissue, bone grafting, and internal fixation.
Accidents, Traffic
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Bone and Bones
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Child
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Female
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Fractures, Closed
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Fractures, Open
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Gangwon-do
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Humans
;
Immobilization
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Male
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Orthopedics
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Tibia
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Transplants
;
Ulna
7.Mechanical Failure In Using Compression Plate in Long Bone Fractures
Sung Kwan HWANG ; Jung Ho RAH ; Jong Soon KIM
The Journal of the Korean Orthopaedic Association 1990;25(1):93-102
The metallic failure is one of the annoying problems after fracture surgery. The seventeen cases of metallic failures after compression plate fixation were treated at the Department of Orthopaedic Surgery. Yonsei University Wonju College of Medicine between January, 1980 and December, 1988. The results were summerized as follows: l. Among 17 cases, 12(70.5%) were under 40 years of age and 14(80%) were male patients. 2. The sites of fracture of the seventeen cases; 12 femurs, 3 tibiae, and 2 radii. Of the cases, there were breakage of plates in 13 cases, bending 1 case and failure of screw in 3 cases. 3. The pattern of fracture: communited fracture
Femur
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Fractures, Bone
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Fractures, Open
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Gangwon-do
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Humans
;
Incidence
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Male
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Osteoporosis
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Radius
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Tibia
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Transplants
;
Weight-Bearing
8.Surgical Treatment for Burst Fracture of the Thoracolumbar Spine: Anterior approach vs posterior approach
Heui Jeon PARK ; Jung Ho RAH ; Han Kyu LEE
The Journal of the Korean Orthopaedic Association 1994;29(2):475-486
We present a prospective, randomized study of acute burst fracture of the thoracolumbar spine. Forty-one patients were treated either by anterior decompression and stabilization with Kaneda device or by posterior distraction instrumentation using the A-O fixateur interne. The mean follow up was 21 months. The result were as follows; 1. The mean preoperative kyphotic angle was 19.2° in those patients treated by anterior surgery and 21.4° in those patients treated by posterior surgery. At last follow-up the mean correction in kyphotic angle was 13.2° in the anterior group and 9.2° in the posterior group. There is no statistically significant difference between those two groups. 2. The mean preoperative midsagittal diameter of the canal compromise 47.4% in anterior group and 49.3% in posterior group. Postoperatively, this was reduced to 2.5% and 7.9%. There is a statistically significant difference between these two groups(P < 0.05). 3. The mean preoperative canal enchroachment 52.)% in anterior group and 47.6% in posterior group. Postoperatively, this was reduced to 3.2% and 6.0%. There is a statistically significant difference between these two group(P < 0.05). 4. Neurologic recovery was 81% in posterior surgery and 85% in anterior surgery. The improvement in Frankel grade was 1 grade in average, and showed no difference between two groups. 5. There was two cases of pedicle screw breadage in posterior group and one case of pyothorax in anterior group but no early or late vascular or neurologic complication.
Decompression
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Empyema, Pleural
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Follow-Up Studies
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Humans
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Pedicle Screws
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Prospective Studies
;
Spine
9.A Clinical Study of Postoperative Infection in Posterior Spinal Surgery with Pedicle Screw System
Jae In AHN ; Heui Jeon PARK ; Jung Ho RAH
The Journal of the Korean Orthopaedic Association 1994;29(3):994-1003
In the treatment of spinal disorder, the introduction of pedicle screw system is an innovation in modern spinal surgery. This kind of new instrumentation provides correction, adjustment, stabilization, firm fixation and short segment fusion. Everybody should know that these complexities of instrumentation will increase the rated of complications, especially postoperative infection. Postoperative infections continue to be a source of frustration for patients and surgeons, and can lead to significant postoperative difficulties. So we analysed the postoperative infection from the 284 cases we operated on during the September 19S8 to August 1992 and obtained following results: 1. There were 17 cases(6.0%) of postoperative infection. Among them Scases(2.8%) were deep infection. 2. Average fused segments were 3.64 and 2. 96 in deep infection and control group respectively. 3. Staphylococcus aureus was the most frequent organism. Other recurring organisms were St. epidermidis, Enterobacter cloacae and so on. Many patients had multiple organisms. 4. Most significant risk factors for postoperative infection were obestity and prolonged surgery. 5. Just preoperative prophylactic antibiotic administation is more valuable than no prophylaxis and too early administration. 6. Postoperative acute deep infection is is not as easily diagnosed. The clinical manifestation such as sudden increase in pain at the operative site is the most valuable sign. 7. Maintaining the instrumentation in place, continuous irrigation system and the appropriate parenteral antibiotics were the choice of treatment.
Anti-Bacterial Agents
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Clinical Study
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Enterobacter cloacae
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Frustration
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Humans
;
Pedicle Screws
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Risk Factors
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Spine
;
Staphylococcus aureus
;
Surgeons
10.Morphometric Study of the Pedicle of Lumbar and Selected Thoracic Vertebrae for Surgical Spinal Fixation
Heui Jeon PARK ; Jung Ho RAH ; Sung Kwan HWANG
The Journal of the Korean Orthopaedic Association 1994;29(3):979-987
The pedicle instrumentation has become a popular way of spinal fixation. Placement of a screw through the pedicle into vertebral body appears to be a very successful way to accomplish spinal fixation. However, the configuration of the pedicle morphometry must be understood. The measurement includes pedicle width, angle of pedicle axis to the transverse plane, ideal screw length, ideal screw entry point and ideal angle. This study was accomplished using computerized axial tomogram(CT) of 704 vertebrae(T10-L5). The results were as follows. 1. Transverse pedicle diameter were narrowest at T10, widest at L5. 2. The pedicle axis is oriented anteromedially at all levels except T11 and T12, then increase from L1 to L5. 3. Screw lengths are fairly constant between all levels, thus the range of screw lengths need is limited. 4. The incidence of pedicle less than 6 mm in the transverse diameter is most common at T10 and followed by levels L1, T12 and L2. Preoperative determination of transpedicular screw diameter and length can be made, by direct measurement from the patient's CT scan.
Incidence
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Thoracic Vertebrae
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Tomography, X-Ray Computed