Several techniques are now avallable for the treatment of fractuers of the shaft of the femur. We must be aware of the advantages, disadvantages and Ilmitation of each if we are to select the proper treatment for each patient. During last decades treatment had been varied markedly from time to time and from place to place. Before Word War II, most fractures of the femoral shaft were treated conservatively either by skeletal traction or by manipulation and immobilization in a spica cast. After medullary fixation was Introduced during that war, it became popular, and until 1960 many surgeons considered it as the treatment of choice for most of these fractures. If the case is properly selected the medullary fixation is almost perfect, provlded no complications develop; convalescence can be shortened and resldual disability can be decreased. We had experienced 14 complications among the 78 cases of Kuntscher nailing from may, 1974, to May, 1980. The results are as follows: 1. We operated 78 cases with Kuntscher nail among the 121 femoral shaft fractures. 2. 14 (17.95%) complications developed among the 78 cases of the Kuntscher nailing. 3. Technical errors were incarcerated nailing with thick nail, too long nail and thin nailing. 4. Early postoperative complications within a year were infection, bendlng, bursitis, angulation and rotation. 5. Late complications after one year were proximal or distal migration and refracture.
Bursitis ; Convalescence ; Femur ; Humans ; Immobilization ; Postoperative Complications ; Surgeons ; Traction

The common form of diabetic neuropathy is symmetrical peripheral polyneuropathy, which involves the distal part of the lower extremities whereas diabetic amyotrophy is seen in the proximal part of the lower extremities. Although other regions may also be affected, the presence of upper extremity involvement has rarely been emphasized. Diabetic radiculopathy may involve the cervical region before, after, or concurrently with lumbosacral radiculopathy. We report 2 rare cases of diabetic radiculopathy which involves the cervical region without involving the lumbosacral region. To our knowledge, these are the first reported cases of diabetic radiculopathy involving the cervical region only. In our cases, severe adhesive capsulitis in a shoulder was noticed together with cervical radiculopathy. Both diabetic radiculopathy and adhesive capsulitis have a poorly understood pathogenesis and their combined presence is presumed to be rare. Clinical features and management of cervical radiculopathy with adhesive shoulder capsulitis in 2 diabetic patients is described.
Bursitis/*complications ; Diabetes Mellitus, Type II/*complications ; Female ; Human ; Male ; Middle Aged ; Radiculopathy/*etiology ; *Shoulder Joint

The common form of diabetic neuropathy is symmetrical peripheral polyneuropathy, which involves the distal part of the lower extremities whereas diabetic amyotrophy is seen in the proximal part of the lower extremities. Although other regions may also be affected, the presence of upper extremity involvement has rarely been emphasized. Diabetic radiculopathy may involve the cervical region before, after, or concurrently with lumbosacral radiculopathy. We report 2 rare cases of diabetic radiculopathy which involves the cervical region without involving the lumbosacral region. To our knowledge, these are the first reported cases of diabetic radiculopathy involving the cervical region only. In our cases, severe adhesive capsulitis in a shoulder was noticed together with cervical radiculopathy. Both diabetic radiculopathy and adhesive capsulitis have a poorly understood pathogenesis and their combined presence is presumed to be rare. Clinical features and management of cervical radiculopathy with adhesive shoulder capsulitis in 2 diabetic patients is described.
Bursitis/*complications ; Diabetes Mellitus, Type II/*complications ; Female ; Human ; Male ; Middle Aged ; Radiculopathy/*etiology ; *Shoulder Joint

OBJECTIVE: This research aimed to evaluate the relationship of limited joint motion (LJM) and shoulder adhesive capsulitis with diabetic complications and related diseases in type II diabetic patients. METHOD: A cross sectional study in 155 type II diabetic patients was done. The presence of LJM and shoulder adhesive capsulitis was sought. The diseases closely related to diabetes were recorded. The patients were assessed for retinopathy, nephropathy, and neuropathy. RESULTS: The prevalence of LJM and shoulder adhesive capsulitis in type II diabetic patients was 32.3% and 29.7%, respectively. Development of LJM and shoulder adhesive capsulitis was correlated with age and duration of diabetes. Higher blood HbA1c level was noticed in mild and moderate degree of LJM. The prevalence of shoulder adhesive capsulitis was shown association with LJM. The prevalence of LJM was associated with a history of myocardial infarction and chronic diabetic complications. The prevalence of shoulder adhesive capsulitis was associated with retinopathy, carpal tunnel syndrome, and autonomic neuropathy. CONCLUSION: According to the results, around 30% of type II DM patients could have hand LJM and should adhesive capsulitis, which suggested more attention and effort to prevent the LJM and shoulder adhesive capsulitis were needed.
Bursitis ; Carpal Tunnel Syndrome ; Diabetes Complications* ; Hand ; Humans ; Joints* ; Myocardial Infarction ; Prevalence ; Shoulder

The purpose of this study is to evaiuate the results of the reconstruction of acetabular bone defect with morselized bone graft and screw fixed hemispherical cup in revision of failed acetabular cup. Thirty four revisions of an acetabular component that had been performed in 34 patients between 1988 and 1993 at SNUH, and had followed more than four years were included in this study. The revised acetabulum was evaluated clinically by Harris hip score and radiologically by evaluating the osseous union, incorporation and resorption of graft, the amount of migration and cup angle change of revised components and periacetabular radiolucency. The mean Harris hip score was improved 52 to 84. All of the bone grafts united by 6.4 months and incorporated by 13.1 months. The graft bone resorption less than onefourth of the initial graft thickness was 91.2% (31 cases). There was no significant difference between pure allograft and allograft mixed with autograft in clinical and radiological results. Of 34 cases, 2 cases (5.9%) required rerevision of acetabulum for aseptic loosening. The two complications, postoperative infection and trochanteric bursitis were managed successfully with conservative methods. The results of the present study confirm the success of revision of the acetabulum with use of a hemispherical component stabilized with multiple small screws and morselized bone grafts filling bone defects.
Acetabulum* ; Allografts ; Autografts ; Bone Resorption ; Bursitis ; Femur ; Hip ; Humans ; Postoperative Complications ; Transplants*

OBJECTIVETo evaluate the effect of linearly polarized near-infrared irradiation (Super Lizer) combined with aerothermotherapy in the treatment of patients with frozen shoulder and diabetes.

METHODSEighty-four diabetic patients with frozen shoulder were randomized into 3 groups to receive a 20-day treatment with drug therapy and shoulder exercise (control group), daily linearly polarized near-infrared irradiation in addition to the control therapy (Super Lizer group), or daily Super lizer and aerothermotherapy (S+P group) in addition to the control therapy. Visual analogue scale was used to assess the changes in the pain intensity, and the shoulder movement was assessed using shoulder movement disorder degree integral scores.

RESULTSAfter the 20-day treatment, the VAS scores and shoulder movement disorder degree integral scores in the 3 groups all significantly decreased (P<0.05), and these scores in Super Lizer group and S+P group were significantly lower than those in the control group (P<0.05). The cure rate in S+P group was significantly higher than that in the other two groups (P<0.01).

CONCLUSIONLinearly polarized near-infrared irradiation combined with aerothermotherapy is effective for treatment of patients with frozen shoulder and diabetes with a high cure rate and short treatment course.

Bursitis ; complications ; therapy ; Diabetes Complications ; therapy ; Diathermy ; Female ; Humans ; Infrared Rays ; therapeutic use ; Laser Therapy ; Male ; Middle Aged ; Treatment Outcome

PURPOSE: Although nonunion is a relatively common complication in the management of subtrochanteric fractures, there are few studies regarding the treatment of nonunion. The purpose of this study was to evaluate clinical and radiological results for the treatment of subtrochanteric nonunions with a blade plate. MATERIALS AND METHODS: We retrospectively analyzed 16 cases of subtrochanteric nonunions that were treated with a blade plate between April 1997 and June 2008 and were followed for at least one year after the index operation. There were 8 males and 8 females with an average age of 58 years (range, 42-77 years). Outcome variables included the time to union, postoperative complications, Harris hip score, and the functional rating scale of Sanders. The average follow-up period was 26 months (range, 12-63 months). RESULTS: Union was achieved in 15 (94%) of 16 subtrochanteric nonunions after an average of 7 months (range, 4-11 months). One patient who did not reach union after the index operation underwent repeated surgery with a longer blade plate and bone graft, but this patient was eventually treated with total hip arthroplasty because of persistent nonunion and breakage of the blade plate. Two patients developed complications. One patient had bursitis around the greater trochanter and the other developed avascular necrosis of the femoral head. Of these, the patient with avascular necrosis of the femoral head was treated with total hip arthroplasty because of persistent hip pain 2 years after the index operation. At latest follow-up, the mean Harris hip score was 88 points (range, 36-100 points) and the functional rating scale of Sanders was good or excellent in 14 (88%) of 16 patients. CONCLUSION: The treatment of subtrochanteric nonunions with a blade plate is associated with a very high union rate and good clinical results.
Arthroplasty ; Bursitis ; Female ; Femur ; Follow-Up Studies ; Head ; Hip ; Hip Fractures ; Humans ; Male ; Necrosis ; Postoperative Complications ; Retrospective Studies ; Transplants

Adhesive capsulitis is a common cause of shoulder pain and limited movement. The objectives of this review were to assess the efficacy and safety of corticosteroid injections for adhesive capsulitis and to evaluate the optimum dose and anatomical site of injections. PubMed and CENTRAL databases were searched for randomised trials and a total of ten trials were included. Results revealed that corticosteroid injection is superior to placebo and physiotherapy in the short-term (up to 12 weeks). There was no difference in outcomes between corticosteroid injection and oral nonsteroidal anti-inflammatory drugs at 24 weeks. Dosages of intra-articular triamcinolone 20 mg and 40 mg showed identical outcomes, while subacromial and glenohumeral corticosteroid injections had similar efficacy. The use of corticosteroid injections is also generally safe, with infrequent and minor side effects. Physicians may consider corticosteroid injection to treat adhesive capsulitis, especially in the early stages when pain is the predominant presentation.
Adrenal Cortex Hormones ; pharmacology ; Bursitis ; complications ; drug therapy ; therapy ; Female ; Humans ; Injections ; Male ; Pain ; complications ; Physical Therapy Modalities ; Primary Health Care ; Randomized Controlled Trials as Topic ; Shoulder ; physiopathology ; Shoulder Joint ; physiopathology ; Treatment Outcome ; Visual Analog Scale

No abstract available.
Aged ; Anti-Bacterial Agents/therapeutic use ; Bursitis/*diagnosis/drug therapy/microbiology ; Cefoperazone/therapeutic use ; Diabetes Mellitus, Type 2/complications/*diagnosis ; Humans ; Male ; Nocardia/genetics/*isolation & purification ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S/chemistry/genetics ; Sequence Analysis, RNA ; Sulbactam/therapeutic use

Total hip replacement arthroplasty has become an established procedure in the management of painful arthritic hip in past two decades. However there is no many reports that concern follow-up study in total hip replacement arthropiasty. This is a follow-up study in 100 total hip replacement arthroplastics in 86 patients of 157 total hip replacement arthroplasties in 135 patients, performed at the Department of Orthopedic Surgery, Seoul National University Hospital, between November 1973 and December 1979. The longest fallow-up was 5 years and the shortest 6 months, the average being 2 years and 6 months. 1. There were 54 males (63%) and 32 females (37%). 2. The underlying diseases of 100 hips were avascular necrosis of 35 hips, septic hip residua of 31 hips, primary osteoarthritis of 9 hips, old hip fracture of 9 hips, Legg-Perthes disease of 7 hips, rheumatoid arthritis of 5 hips, congenital dislocation of 3 hips, and failed endoprosthesis of 1 hip. 3. The types of prosthesis used were Muller ones in 82 hips, T-28 in 17 hips, and Charniey and Harris type one case respectively. 4. In the half cases of a hundred total hip replacement arthroplasties, the anterolateral or posterolateral approach was used without trochanteric osteotomy. 5. Postoperative complications were as follows: 13 cases of wound problem including 3 early deep infections, 2 dislocations, 1 femoral nerve palsy, 3 peroneal nerve palsies, 1 acetabular perforation, 2 femoral shaft perforations, 14 trochanteric problems including 11 cases of wire breakage, 2 nonunions, and 3 cases of trochanteric bursitis 3 ectopic ossifications, 3 cases of radiological loosening including 2 femoral and 1 acetabular. 6. The range of motion were improved from 28 to 5 of flexion contracture, from 91 to 101 of further . flexion, and from 16 to 48 of abduction in the average. 7. The improved ranges of motion were varied with disease group rather than type of prosthesis and the length of neck of prosthesis. 8. The function of each hip was evaluated preoperatively and postoperatively by the method of Harris and d'Aubigne, and improved from 55.3 and to 88.2 by Harris score and from 11.2 to 15.8 d Aubigne respectively.
Acetabulum ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Bursitis ; Contracture ; Dislocations ; Female ; Femoral Nerve ; Femur ; Follow-Up Studies ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Male ; Methods ; Neck ; Necrosis ; Orthopedics ; Osteoarthritis ; Osteotomy ; Paralysis ; Peroneal Nerve ; Postoperative Complications ; Prostheses and Implants ; Range of Motion, Articular ; Seoul ; Wounds and Injuries