Beyond the usual age of walking, the dysplasia of dislocated hip has become severe and its reversivility limited so that the reduced hip cannot maintained in stable position. The innominate osteotomy redirect cartilage of the hip and provide stability in the functional position of walking. The author have experienced 45 cases out of 42 patients with congenital dislocation of the hip who were treated by innominate osteotomy at Department of Orthopedic Surgery College of Medicine Yonsei University from Jan. 1979 to Dec. 1986. The analysis of result of operation has been Jan. 1979 at least 18 months follw-up study. 1. The mean age was 4.2 years ranging fron 18 months to 14 years.2. The mean value of parameters in preoperative evaluation, acetabular index was 37°, neck shaft angle 146°, CE angle −64° and leg length discrepency 1.5cm. After operation, actabular index was 20°, neck shaft angle 137° and CE angle 39° in average. And operated limb was longer as 0.5cm in average. 3. By anatomical assessment of NcKay, 17 cases were graded excellent, 19 cases good, 7 cases fair and 2 cases poor. Especially among the patients above 6 years old, only 6 cases were graded excellent or good. 4. As to the post-operative complication, limitation of motion was noted in 4 cases, redislocation in 2 cases, subluxation in 1 cases, avascular necrosis of femoral head in 1 case and infection in 1 case.
Acetabulum ; Cartilage ; Dislocations ; Extremities ; Head ; Hip ; Humans ; Leg ; Neck ; Necrosis ; Orthopedics ; Osteotomy ; Walking

Concurrent use of instrumentation has been shown to increase fusion rates and satisfactory results for surgical treatment of the lumbar stenosis. The objectives of the present study were to evaluate clinically and radiologically two groups of lumbar stenosis who were surgically treated with pedicular screw fixation system and posterior lumbar interbody or posterolateral autogenous bone graft following complete posterior decompression. One group was degenerative type and the other group was spondylolisthetic type spinal stenosis. We analyzed the results of 39 cases of lumbar stenosis who underwent pedicular screw and rod fixation system and posterior lumbar interbody or posterolateral autogenous iliac bone fusion following complete posterior decompressive operation during the period from May 1988 to December 1992. There were 27cases of degenerative type and 12 cases of spondylolisthetic type lumbar stenosis. The were 25 women and 14 men. Their age was ranged 20 to 76 years old with an average of 51.7 years old. The follow up period was the interval from 18 months to 6 years with an average of 3.2 years. The radiologic union rate was average 94.9% and 96.3%(26cases) in degenerative spinal stenosis and 91.7%(11 cases) in spondylolisthetic spinal stenosis. The clinical success rate was average 92.3%(36 cases), 88.9%(24 cases) in degenerative spinal stenosis and 100%(12 cases) in spondylolisthetic spinal stenosis. The patients with spondylolytic spinal stenosis showed better result in their life than the patient with degenerative spinal stenosis.
Constriction, Pathologic ; Decompression ; Female ; Follow-Up Studies ; Humans ; Male ; Pedicle Screws ; Spinal Stenosis ; Transplants

No abstract available.
Aging* ; Female* ; Humans ; Korea*

No abstract available.
Aging* ; Female* ; Humans ; Korea*

No abstract available.
Myasthenia Gravis* ; Pregnancy*

Early detection of skeletal disorders was very important role in establishing therapeutic modality and prevention of complications. Since Tc-99m-phosphates derivatives used in bone scan agent, remarkable improvement was noted in effectiveness, cost, radiation hazard to patient and image quality than previously used agents such as strontium or fluoride. Bone scan with Tc-99m-MDP was done in 155 cases for early diagnosis of skeletal disorders at Severance Hospital, College of Medicine, Yonsei University from August, 1980 to May, 1982 were analyzed both clinically and radiologically, and the following results were obtained. l. Among 19 cases of avascular necrosis, positive cases were 17 (89.5%) in bone scan and 6(31.6%) in X-ray. Positive pattern could be classified into 3 types and the radionuclide uptake in the femoral head was decreased in 3 cases which was negative in X-ray and duration of their symptoms was within 4 months. 2. Fifteen among 17 hip fractures or dislocations were positive in bone scan. In 12 (80.0%) among 15 cases, complications were revealed and positive cases in X-ray were 7(58.3%), which were all positive in bone scan. 3. In 20 bone scans for early diagnosis of acute osteomyelitis, positive in bone scan were 17 and 14 (82.4%) of 17 cases were finally diagnosed as acute osteomyelitis. Among 15 cases diagnosed as acute osteomyelitis, positive in X-ray were 8(53.3%) and sensitivity of acute osteomyelitis in bone scan was 93.3%. 4. In 25 cases of the suspected infection of the joint, 15 were positive in bone scan and among them, cases diagnosed as pyogenic arthritis were 12 (80.0%) and positive in X-ray were 2 (16.7%). Only one of 10 cases of transient synovitis of the hip joint was positive in bone scan. 5. In rheumatoid arthritis, 13 of 15 cases were positive in bone scan and 10 among them were revealed the diffuse uptake of the radionuclide in the joint. In degenerative arthritis, 7 of 8 cases were positive in bone scan and they were revealed the focal uptake of the radionuclide in the same site where the bone was changed in x-ray. 6. Among 28 cases showed spine fracture in X-ray after trauma, 15 (53.6%) were positive in bone scan. In spine fracture, it was difficult to differentiate fresh fracture from old fracture with bone scan. The positive duration of bone scen in fracture of weight bearing bone was longer than in spine fracture. Rib fracture which was not found in X-ray could be diagnosed with bone scan.
Arthritis ; Arthritis, Rheumatoid ; Clinical Study ; Cost-Benefit Analysis ; Diagnosis ; Dislocations ; Early Diagnosis ; Fluorides ; Head ; Hip Fractures ; Hip Joint ; Humans ; Joints ; Necrosis ; Osteoarthritis ; Osteomyelitis ; Rib Fractures ; Spine ; Strontium ; Synovitis ; Weight-Bearing

The term “ganglion” was given by Hippocrates to designate a knot of tissue filled with mucin. A ganglion may be defined as a cystic benign tumor filled with a mucoid material usually surrounded by a thin wall and occurring in the region of the capsule and connective tissue of joints and tendon sheaths. The regions of the wrist, ankle, and knee and the volar regions of the fingers and hand are most frequently affected. The authors experienced a case of ganglion which had occurred at anteromedial aspect of right hip joint and had been connected with hip joint by cord like band.
Ankle ; Connective Tissue ; Fingers ; Ganglion Cysts ; Hand ; Hip Joint ; Hip ; Joints ; Knee ; Mucins ; Tendons ; Wrist

Congenital muscular torticollis is a distinct entity, in which the primary pathologic picture is limited to the sternocleidomastoid muscle. Associated deformities of the face, head and cervical spine are secondary in character, resulting from an abnormal position of the head both prior and subsequent to birth. The etiology of congenital muscular torticollis is not clear yet. There are various opinions about adequate age and methods for treatment. From January 1970 to December 1984, 53 cases of congenital muscular torticollis were treated surgically at the Department of Orthopedic Surgery, Severance Hospital. From January 1980 to December 1984, 10S cases of congenita muscular torticollis were treated conservatively at the same hospital. Totally, 161 cases were studied and analyzed retrospectively and the results are summerized as follows: 1. Among the 161 cases, thers were 88 males and 73 females. The lesion was on the left side in 89 cases. 2. There were 85 cases of normal spontaneous vaginal delivery and 58 cases of complicated labor including 34 cases of breech delivery. 3. There were 6 cases associated with other congenital anomalies; one of them was combined with congenital subluxation of the hip joint. 4. Results of conservative physiotherapy were good under 1 year of age and results of surgical correction were good under 6 years of age. 5. The failure of conservative physiotherapy did not influence the results of surgical correction performed later. 6. The results of reoperation, when the initial surgical correction failed, were not as good. 7. Facial asymmetry correction results were especially good under 6 years of age when much growth potential remained. 8. There were no differences in results according to the various kinds of cervical braces although the results were good when the cervical brace was worn over 3 months. 9. On pathologic examination, there was no hemorrhagic reaction. The muscle was atrophied and was replaced by fibrous bands. Therefore, congemtal muscular torticollis is thought to be caused by abnormal intrauterine position rather than by birth trauma, and it is expected to get a good result by treating congenital muscular torticollis as early as possible.
Braces ; Clinical Study ; Congenital Abnormalities ; Facial Asymmetry ; Female ; Head ; Hip Joint ; Humans ; Male ; Orthopedics ; Parturition ; Reoperation ; Retrospective Studies ; Spine ; Torticollis

Unicameral bone cyst is an uncommon tumor-like lesion of the bone, containing distended channels or cavities filled with serous fluid. Four cases of cystic lesion at the upper end of the humerus were revealed to be unicameral bone cyst roentgenographically and microscopically. Two cases were treated with radical curettage followed by homogenous and autogenous bone graft, and one case was treated with radical curettage followed by homogenous bone graft. The other was treated with radical curettage followed by autogenous fibula graft. All cases made uneventful recoveries, and they had no complaints and no evidence of recurrence, A brief summary of literatures is submitted.
Bone Cysts ; Curettage ; Fibula ; Humerus ; Recurrence ; Transplants

Tuberculosis of the vertebral column is a slowly developing disease, characterized by pain, spinal deformity, and occasionally paralysis. The following varieties of vertebral tuberculosis are commonly recognized, such as a central variety, metaphysial tuberculosis (inter-vertebral articular type), an anterior or periosteal variety, appendiceal tuberculosis, and a true tuberculous arthritis. Among these appendiceal tuberculosis is rare. This form of Potts disease may be unilateral or bilateral and may be isolated or present at multiple levels. Disk space changes and deformity are minor features, but large paravertebral abscesses are invariable. Extradural extension may lead to the development of paraplegia. Two cases of destructive lesions at the neural arch of 10th. and 11th. thoracic vertebra were revealed to be appendiceal tuberculosis. All cases treated with antituberculous medication, radical curettage and body jaket casts and made recoveries. Patients had no complaints and no evidence of recurrence. A brief summary of the literature is submitted.
Abscess ; Arthritis ; Congenital Abnormalities ; Curettage ; Humans ; Paralysis ; Paraplegia ; Recurrence ; Spine ; Tuberculosis ; Tuberculosis, Spinal