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

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

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

No abstract available.
Posterior Cruciate Ligament*

No abstract available.
Patellar Ligament*

PURPOSE: To compare the results of posterior cruciate ligament reconstruction by open and arthroscopic method. MATERIALS AND METHODS: From 1995 to 1997, 18 reconstructions of posterior cruciate ligament were performed. Group 1 (open method) was composed of 9 cases and group 2 (arthroscopic method) was consisted of 9 cases. After 21-month follow-up, The two groups were compared by clinical and radiologic methods. RESULTS: Clinically, Lysholm knee score was 80 points in group 1 and 83 points in group 2 after operation. Post operative results by Hughston's criteria were good in 5, fair in 2 and poor in 2 cases (group 1) and good in 6, fair in 2 and poor in 1 cases (group 2). Radiologically, post operative average of posterior drawer stress view was 5.2 mm (group 1) and 5.0 mm (group 2). Almost double the operation time was taken to reconstruct posterior cruciate ligament by arthroscopic method than open method. There were technical errors in 2 cases performed by arthroscopic method. CONCLUSIONS: The results of both methods had no significant difference. We think that the reconstruction of PCL using patellar tendon by open method is a recommendable treatment method together with arthroscopic method, if the merits or demerits of both methods are considered carefully. But more long-term follow-up is necessary to compare the results of PCL reconstruction by open and arthroscopic methods.
Follow-Up Studies ; Knee ; Patellar Ligament ; Posterior Cruciate Ligament

MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex (LCLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalls in image interpretation related to evaluation of the LCLC. MR arthrogram of 56 shoulders in 41 asymptomatic young, active, male volunteers were prospectively reviewed to evaluate the labral shapes, capsular insertions and images which may mimic the lesions of glenohumeral instability. The anterior and posterior parts of the labra, respectively, varied in shape: triangular (72%,36%), round (13%,35%), cleaved (8%,1%), notched (2%,0%), flat (5%,24%), and absent (0%,4%). The anterior and posterior capsular insertions, respectively, varied in site: Mosely and Oevergaard type I (82%,62%), type II (13%,36%), and type III (5%2%). A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum (29%) and middle glenohumoral ligament in proximity to anterior labrum (5%) simulated a labral tear. Joint fluid interposed in the central, superior portion of the sublabral sulci (25%) simulated a SLAP lesion. Synovial fold (38%) in the axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral-capsular-ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.
Arthrography* ; Cartilage, Articular ; Humans ; Joints ; Ligaments ; Male ; Prospective Studies ; Shoulder ; Volunteers

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