No abstract available.
Child ; Humans ; Mandibular Condyle

No abstract available.

The chronic osteomyeltis of the adult long bones has different problems from the acute osteomyelitis and osteomyelitis of the children. The ischemic scar tissues and infected bones of the chronic csteomyelitis in the adult are resistant to the antibiotic therapy and their healing mechanisms are delayed. The chronic osteomyelitis has no single effective method of treatment since every case reveals different conditions and the treatment should be individualized case by case. 87 cases of chronic osteomyelitis of the adult long bones were studied in the department of orthcpaedic surgery, Fatima Hospital for 7 years during the years between 1973 to 1979. The cases were 65 male and 22 female having ages 35 years in average and the duration of the osteomyelitis was 14 years and 4 months in average ranging from 3 months to 50 years. The cau ative organisms were mostly staphylococcus but Gram (−) bacilli were found in 28% and the adjacent joint problems were found in 38% The cases were analysed in 5 different groups according to x-ray findings as follows; I. Group with sequestrum: 23 cases having sequestra with varying degree of bone sclerosis and destruction. Most cases had draining sinus but the soft tissue involvement was not severe. II. Sclerotic group: 32 cases having significant bone sclerosis with minimal destructicn if any. The soft tissue involvement and scarring were severe but involvement of the bone marrow was not significant. The duration of osteomyelitis was longest having recurrent episodes of the painful swelling in most cases. III. Destructive group: 17 cases with significant bone destruction with varying degree cf sclerosis. The involvement of the bone marrow was significant and soft tissue involvement was not marked The duration of osteomyelitis was short mostly. IV. Group with skin problem: 9 cases having scar problems overlying tibia. V. Group with complication: There were 2 pathologic fractures of the femurs, 3 quamous cell carcinomas on the lower legs and a severe deformity of a leg. Treatment was mostly surgical including 4 amputations. The surgical method was focused on saucerization of the bone and extensive excision of the infected soft tissues and the scar tissues. 23 cases having small or no dead cavity after mobilization and suture of the adjacent healthy soft tissue closed primarily. Otherwise the cavity was packed open for econdary healing in other 23 cases including several cases having big cavity which was unable to close the skin. The cases having big cavity were prepared for continueus irrigation in 14 caes which were able to closed skin. The transposition of muscles to fill the dead cavity was performed in 4 cases that had big cavity and was unable to close skin. The results were healing in 10 weeks in 54% and after 10 weeks in 38% and 8% failed to heal with the first trials. The recurrence of the ostecmyelitis was found in 9 cases among the 42 cases followed for I year and 3 months in average mostly in group II and in cases of primary closure and open packing.
Adult ; Amputation ; Bone Marrow ; Child ; Cicatrix ; Clinical Study ; Congenital Abnormalities ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Joints ; Leg ; Male ; Methods ; Muscles ; Osteomyelitis ; Recurrence ; Sclerosis ; Skin ; Staphylococcus ; Sutures ; Tibia

Four families having identical sacral agenesis were reported in the literatures and an another family is added here. This family has an eleven year old boy and a seven year old girl who have identical complete sacral agenesis without spincter disturbance but with some anomalies in the other spines, rib and progressive club feet. These cases are followed for six years and the foot deformity was corrected by surgery.
Female ; Foot ; Foot Deformities ; Humans ; Male ; Ribs ; Sacrum ; Spine

A number of methods have been introduced for support the orbital floor following a maxillectomy without orbital exenteration or severe facial trauma. These methods including skin graft and muscular sling provided the unsatisfactory results, like as diplopia, orbital ptosis, enophthalmos and severe facial deformity. Therefore the bone and soft tissue reconstructions using microvascular free flaps were performed recently by many surgeons, but long time operation, donor site morbidity, postoperative large scar, and ptosis of the flap were pointed out as disadvantages of free flap reconstruction. Vascularized calvarial bone flap, a modified method of free calvarial bone graft, was adequate for reconstruction of the orbital floor and the infraorbital rim as a horizontal buttress, especially in case of poor vascular bed and postradiated state. The authors introduced the vascularized calvarial bone flap for the orbital floor and the infraorbital rim reconstruction in 3 cases of maxillectomy, and could be obtained satisfactory results aesthetically and functionally.
Cicatrix ; Congenital Abnormalities ; Diplopia ; Enophthalmos ; Free Tissue Flaps ; Humans ; Orbit* ; Skin ; Tissue Donors ; Transplants

No abstract available.

No abstract available.
Spondylolisthesis*

We have experienced 40 cases of the tibial shaft fractures treated with Küntscher nail from 1979 to 1986. Authors analysed these cases and our own experimental study concerned with the shape of Küntscher nail. The shape of Küntscher nail for the tibial shaft fractures should be designed according to the type and location of the fracture. The proximally bent and distally straight nail is used for the extension fracture, proximally and distally bent nail or entirely bent nail is inserted for the flexion fracture of the tibia. The large nail(over 13 mm in diameter) may produce injury to the patella because it has minimal flexibility. In order to permit easy driven down of nail and prevent this injury, the nail should b. bent into three to four segments and the length of the longest segment should not exceed the permissible length of straight nail (Permissible length is distance from entrance of nail to posterior cortex of the upper fragment, where tip of the (nail impinged-about 12cm) The midpoint of the middle segment of dual dent nail is placed at the fracture site. The middle segment of the nail may bent anteriorly for flexion fracture and posteriorly for extension fracture, securing the dynamic fixation of the fracture.
Patella ; Pliability ; Tibia

Authors analylsed 384 hips of 269 patients with osteonecrosis of the femoral head in adult, who were diagnosed and treated between August 1976 and March 1986 at the Department of ()rthopaedic Surgery, Kyung Hee University Hospital. These are investigated in terms of history, clinical data and reontgenogram, retrospectively. In 269 patients, nontraumatic femoral head necrosis (NTFHN) were 199 patients (74.0%) and traumatic femoral head necrosis (TFHN) were 70 patients (26.0%). The male was more affected in ratioof 3.1: 1, especially higher in NTFHN about 4: l. In alcohol-induced necrosis all were male patients, but in polyvinyl pyrrolidone(PVP)-storaged cases 63% were female patients. The peak incidence of age distribution was at 6th decade(average 53.9 years) in the TFHN ahd 5th decade(average 44.2 years) in NTFHN). The most frequent probable etiologic frctor in NTFHN was idiopathic (71 patients, 35.8%), followed by alcohol-induced (68 patients, 34.2%), steroid-induced (27 patients, 13.6%) and PVP-storaged (19 patients, 9.5%). The bilateral involvement in NTFHN was 112 patients (53.6%). The idiopathic cases (42.0%) were lower than steriod-induced (81.9%), alcohol-induced (76.5%) or PVP-storaged (63.2%) in the bilaterality. The associated diseases in NTFHN were hepatopathy (12 patients), diabetes (7 patients), pulmonary tuberculosis (6 patients) and dermatopathy (5 patients). And the underlying diseases in steroid-induced were nephrotic syndrome (4 patients), arthralgia (4 patiehts), rhematiod arthritis (3 patients), dermatopathy (4 patients) and systemic lupus erythematosus (1 patient). 61.4% of TFHN was diagnosed within 2 years after trauma, 56.7% of NTFHN had the duration of symptom over one year. The initial reontgenogram stage according to Ennekings classification was average stage 1V. In NTFHN cases, there were no significant relationship between etiologic factors and initial reotgenographic stage or duration of symptom. But there were significant corelation between Enneking's reontgengraphic stage and clinical findings (range of movement of joint, Harris hip score, duration of symptom). In more severe cases than Enneking's radiologic stage IV, Harris hip score not provide any information to select a proper treatment.
Adult ; Age Distribution ; Arthralgia ; Arthritis ; Classification ; Epidemiologic Studies ; Epidemiology ; Female ; Head ; Hip ; Humans ; Incidence ; Joints ; Lupus Erythematosus, Systemic ; Male ; Necrosis ; Nephrotic Syndrome ; Osteonecrosis ; Polyvinyls ; Retrospective Studies ; Tuberculosis, Pulmonary

1. Thirty one fractures of the shaft of the tibia were treated by Küntscher intramedullary nailing (closed 26 cases) from Dec. 1979 to Oct. 1985. 2. The fractures were classified into extension type(62%) and flexion type(38%). 3. The straingt nail with bent proximally was used for the extension fractures and the nail with a curve near of each end for the flexion type. 4. In the most cases of simple fracture, we used Küntscher nail of 12mm diameter.interlocking were used in addition to a Küntscher nail(static 13 cases, dynamic 8 cases). In the case of interlocking, nail should be at least 13mm in diameter. 5. The nail was inserted just above or superolateral to the tibial tubercle. 6. The bony union was demonstrated radiographically at 14.4 weeks, and hopitalization period was less than 2 weeks in twelve cases and 3 weeks in the three cases. 7. The major complication were delayed union(1 case) and infection(2 cases).Posterior angulatory deformity greater than 5° appeared in two cases. 8. The cross leg pedicle graft combined with Küntscher nailing would be preferable procedure in the case of open fracture with skin defect.
Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Fractures, Open ; Leg ; Skin ; Tibia ; Transplants