An appreciation of the normal variation of the Talar Tilt angle under stress roentgenogram on the ankle joint may throw some light on the diagnosis and treatment in an ankle joint injuries. The purpose of this study is to show the normal range of the Talar Tilt angleof the ankle joint under various circumstances and has been to compare the results of each angle. The author have undertaken the neutral ankle mortise view and inversion and eversion stress roentgenogram in all ankles and measured its Talar Tilt angle. The data were based on study of free chosen 50 normal Korean adult male 25 and female 25 respectively. The results were summerized as follows; 1. Talar Tilt angle was O degree in neutral ankle mortise view. 2. In inversion stress roentgenogram, Talar Tilt angle ranged from 0 to 15 degrees, 97% of cases were less than 10 degrees. 3. In eversion stress roentgenogram, Talar Tilt angle ranged from 0 to 7 degrees. 4. In inversion stress roentgenoram, the difference between right and left of same male and female ranged from 0 to 7 degrees. 5. It is very important to check accurately Talar Tilt angle under the same method and same conditions.
Adult ; Ankle Joint ; Ankle ; Diagnosis ; Female ; Humans ; Male ; Methods ; Reference Values

Subtalar dislocation of the foot is one in which there is simultaneous dislocation of the talonavicular joint and talocalcaneal joint while the tibiotalar relationship is unchanged. It was described first by Judey and Defourest in 1811. It incidence was 1% to 1.3% of all dislocations and 15% of injuries of the talus. We have experienced one case of a medial subtalar dislocation without fracture. In our case which was followed for 14 months, the head of the talus was palpable on the dorsum of the foot and the heel was displaced medially in relation to the leg. Radiographically, on the lateral view, the head of the talus was shown superior to the navicular and on the A-P view, the normal talonavicular relationship was disturbed with the calcaneus being displaced medially. The closed reduction was carried out successfully.
Calcaneus ; Dislocations ; Foot ; Head ; Heel ; Incidence ; Joints ; Leg ; Subtalar Joint ; Talus

No abstract available in English.
Femur ; Fracture Fixation, Intramedullary

No abstract available.
Child* ; Humans

BACKGROUND: We postulated that loss of epidural negative pressure might affect on the sensory blockade level of spinal anesthesia. METHODS: Thirty nine patients were involved in our study; group 1, spinal anesthsia with 23G spinal needle (n=20): group 2, spinal anesthesia with 27G spinal needle through the 18G Weiss epidural needle (n=19). Sensory blockade level was checked by pinprick test at 5, 10, 15, 20, 25, 30, 40, 60 and 90 minutes after spinal anesthesia. RESULTS: There was no difference of sensory blockade level between group 1 and 2. CONCLUSION: From above result, there was no evidence of loss of epidural negative pressure affecting on the spinal sensory blockade level.
Anesthesia, Spinal* ; Humans ; Needles

Long term follow-up study was done on 38 cases of anterior fusion for spinal tuberculosis especially about effect of buttress graft. The average follow-up period was 16 months. 14 cases of effective buttress group were appeared' to achieve more rapid bony union and prevent further kyphosis or lateral wedging of the involved vertebral body than inadequate buttress group of 7 cases.
Follow-Up Studies ; Kyphosis ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

From May, 1971 to June, 1984, we performed extensive saucerization on the chronic osteomyelitis of long bones eradicating all pathologic foci; not only sequestra but sclerotic involocurum and necrotic original cortex embeded by new bone, which was different from the conventional methods such as sequestrectomy or guttering in its extensiveness. Clinical analysis on the base of radiologic evaluation after saucerization was done on the 16 patients; for average 5 years of follow-up. The results obtained were as follows; 1. The angulatory deformity of the long bones after pathologic fracture complicated by the chronic osteomyelitis was not corrected satisfactorily due to the bony sclerosis or hyperostosis at the fracture site, especially in cases of posterior or medial angulation. 2. The recurrence was closely related to the persisting non-sequestered original cortical lesion after incomplete saucerization, which was embeded by the new bone. So to prevent the recurrence the non-sequestered original cortical lesion must be removed completely. 3. The cortical defect after saucerization was restored completely in patients under the age of 14, but which was not the way in patients over the age of 16.
Congenital Abnormalities ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Hyperostosis ; Osteomyelitis ; Recurrence ; Sclerosis

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

Of the shoulder injuries in trauma, none are more common than those involving the acromioclavicular joint. There are many procedures described for treatment of injuries of the acromioclavicular separation but difficulties continues to be encounted. To know the functional anatomy of this joint and mechanism of injuries makes more proper treatment. We operated the 16 cases of acromioclavicular separation in the Dept of Orthopedic Surgery, Kyung Hee College of Medicine from January 1975 to August 1978. The following results were obtained. 1. This injuries is more prevalent in male with peak incidence in the third and fourth decades. 2. The mechanism of injuries were traffic accident, falling down and the other direct injuries with in orders. 3. The difference of distance between coracoid process and clavicle gives the information of Type II and Type III. 4. The operative procedures in Type II and Type III are good treatment of acromioclavicular separation.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Clavicle ; Humans ; Incidence ; Joints ; Male ; Orthopedics ; Shoulder ; Surgical Procedures, Operative

The vascular graft used for the reconstruction of certain types of vascular occlusive diseases and traumatic damages of the vessel, is very important, especially for the reconstruction of microvascular damages as occuring in hand injuries. Until recently microvascular graft done by microsurgical techniques was rare compared to the many- numbered large vessel grafts. But their biologic fate is currently uncertain. We studied the histologic changes occuring in the microvesseles of 1.5cm in length and 2mm in diameter, which were grafted to the femoral artery of rabbits by recently developed microsurgical techniques. Histologic changes were observed between different donor materials with different time intervals. For 60 rabbits which were used as experimental material, 15 cases received autogenous venous graft (group I). 15 cases autogenous arterial graft (group II) and 15 cases homogenous arterial graft (group I). The observd post-operative dates were 3,7,14.60 and 90 days for each respective group. The results were summerized as follows: 1. The patency rate of grafted vessels using microsurgical technique was 91.2%. 2. The histological changes observed were: a. On the 3rd and 7th day post-operatively, mainly inflammation, formation of thrombus, increased population of endothelium and formation of suture granuloma around the suture site were observed. b. On the 14th day, decreased numbers of inflammatory cells, progressed organization of thrombus, disorganization of the medial muscle layer of the grafted vessels and degeneration of endothelium were observed. c. On the 60th day, inflammatory cells and previously formed thrombi were no longer found and increased amount of fibrosis was prominent instead. 3. The autogenous venous graft group showed less histological changes in every aspect compared to the other two groups. 4. The autogenous arterial graft group showed considerable histological changes, but endothelial lining cells were well preserved. 5. In the homogenous arterial graft group, good patency rate of grafted vessel were observed despite of severe inflammatory change initially. 6. It can be concluded from the above observation that the micrcvascular graft thought to be most useful in recstablishing circulation of injured vessels was the autcgenous venous graft. Homogenous vessel graft and autogenous graft artery were also found to be applicable when autogenous vencous graft is not available.
Arteries ; Endothelium ; Femoral Artery ; Fibrosis ; Granuloma ; Hand Injuries ; Humans ; Inflammation ; Microvessels ; Rabbits ; Sutures ; Thrombosis ; Tissue Donors ; Transplants