No abstract available in English.
Clinical Study ; Extremities ; Fractures, Spontaneous

Birth injury is defined as any condition that affects the fetus adversely during the labor or delivery. These traumatic injuries are subdivided further into those that from hypoxia and mechanical factors. We analyzed 57 patients of birth trauma including fractures, nerve injuries and head injuries during the delivery at Severance Hospital from Jan. 1980. to Dec. 1985 and 24 patients which were transfered from other hospital after delivery and the following results were obtained. 1. The rates of birth trauma in our hospital were 0.36% including clavicle fractures 0.27%,femoral fractures 0.006%, brachial plexus injuries 0.031%, skull fractures 0.025% and intracranial hemorrhage 0.025%. 2. The site of clavicle fractures were all middle one third, and 71.4% of cases were displaced. 3. Five cases of brachial plexus injuries were found, and each type was Erb's palsy 3 cases, Klumpke's palsy 1 case and whole arm palsy 1 case. Three cases were recovered completely and 2 cases were recovered partially. 4. Methods of delivery were as followed; normal delivery 50.6%, breech delivery 3.7%, forcep 7.5%, vacuum 21.0%, and Cesarian section 17.2%. 5. The primipara was 65.4% of the patients of birth trauma. 6. There was no statistical significances in the birth weight, head circumferences, and chest circumferences of the patients comparing to the normal infants.
Anoxia ; Arm ; Birth Injuries ; Birth Weight ; Brachial Plexus ; Brachial Plexus Neuropathies ; Clavicle ; Craniocerebral Trauma ; Fetus ; Head ; Humans ; Infant ; Intracranial Hemorrhages ; Paralysis ; Parturition ; Skull Fractures ; Surgical Instruments ; Thorax ; Vacuum

Osteochondritis dissecans occurs most commonly in knee joint and often in elbow, ankle, shoulder, hip than in other joint. In osteochondiritis dissecans, an area of subchondral bone undergoes avascular necrosis and degenerative change ususlly occurs in cartilage overlying it. During the course of disease, unless interrupted by treatment or spontaneous healing, the necrotic bone and cartilage seperates from adjacent bone and cartilage and together becomes loose body. To promote healing, the proper treatment is necessary before degenerative change developes. The authors reviewed 11 cases of osteochondritis dissecans which recieved treatment at Severance hospital from January 1972 to December 1981. The results were obtained as follows: 1. The incidence of osteochondritis dissecans in male was a little more frequent than that of female and 50% were observed in the age of 16 to 30 years. 2. The most common symptom and sign was pain and limitation of motion, instability senastion, tenderness, snapping sound in order of frequency. 3. The most common area involved was the knee in 9 cases, 5 cases involved the medial femoral condyle, 4 cases involved the lateral femoral condyle. The ankle and elbow was 1 case for each. 4. Eight(72.7%) of 11 cases had history of trauma. 5. Among 9 cases of knee inlovement, 5 (55.6%) cases were associated with rupture of meniscus. 6. The methods of treatment were as follows. Conservative..................................................................1 Operative Curettage and drilling........................................................6 Excision......................................................................3 Curettage and bone graft.......................................................1 Internal fixation..............................................................1 7. Conservative treatment was performed in one case, but failed. So, all 11 cases recieved operative treatment and obtained satisfactory results in 72.8%.
Ankle ; Cartilage ; Curettage ; Elbow ; Female ; Hip ; Humans ; Incidence ; Joints ; Knee ; Knee Joint ; Male ; Necrosis ; Osteochondritis Dissecans ; Osteochondritis ; Rupture ; Shoulder

Soft tissues, which are wide spread in body, are derived from a common primitive mesenchyme and the tumors are arising from them tend to closely resemble the prototype tissues in varying degree. Some soft tissue tumors have benign course, which can be cured by local excision and the others have malignant course being resistant to therapy and resulting in recurrence or metastasis to other organs or tissues. The authors reviewed 241 cases of soft tissue tumors which had been received treatment at Department of Orthopedic Surgery in Severance Hospital, Yonsei University College of Medicine from January 1972 to December 1981. The results were obtained as follows: l. Among 241 cases of soft tissue tumors, 202 (83.8%) were benign and 39 (16.2%) were malignant. 2. The most common benign tumor was lipoma (68.7%) which was followed by hemangioma (8.4%), neurofibroma (6.4%) and schwannoma (5.0%) in decreasing order of incidence. Among malignant tumors, fibrosarcoma (35.9%) and rhabdomyosarcoma (33.3%) were the two most common ones, liposarcom (12.8%) and Kaposi's sarcoma (7.7%) being the next common group of tumors. 3. There was no apparent sex preference in benign soft tissue tumors, but in malignant tumors, male was affected about 3 times more common than female. 4. There was no predilection sites in benign tumors, which in malignant tumors, lower extremity was predominant site of occurence. 5. Metastasis of the malignant tumors was taken placed 13 cases (33.3%) at the time of admission, and the lung was the most common frequent site of metastasis. 6. Most of the benign tumors were treated by local excision, and malignant tumors were treated by wide excision with combination of chemotherapy and/or irradiation. 7. Local recurrence of benign tumors was developed in 12 (5.9%) out of 202 cases. 8. Among 19 cases, on follow up examination had been made, 13 survived more than 1 year and 2 cases longer than 5 years after surgery.
Clinical Study ; Drug Therapy ; Female ; Fibrosarcoma ; Follow-Up Studies ; Hemangioma ; Humans ; Incidence ; Lipoma ; Lower Extremity ; Lung ; Male ; Mesoderm ; Neoplasm Metastasis ; Neurilemmoma ; Neurofibroma ; Orthopedics ; Recurrence ; Rhabdomyosarcoma ; Sarcoma, Kaposi

OBJECT: Pre-ALL is a very rare preteukemic state, which percedes acute lymphocytic leukemia, while MDS(pre-ANLL), usually the well-known type of preleukemic state, precedes acute non-lymphocytic leukemia. Initially it shows transient pancytopenia without any evidence of leukemia in bone marrow findings, followed by acute lymphocytic leukemia after recovery from pancytopenia of a short period within weeks or months. We report a case with pre-ALL in childhood. CASE: A 15-month-old male baby was admitted with the complaints of fever and cough for 5 days and pallor for 2 weeks prior to admission. On admission, CBC showed pancytopenia without any evidence of leukemia, which was recovered spontaneously in a short period, and then was followed by acute lymphocytic leukemia of CALLA negative, early pre-B cell type. During antileukemic chemotherapy, he had suffered from severe bacterial infections and was finally died of sepsis 8 months after first admission. CONCLUSION: We report a case of pre-ALL in childhood, which was preceded by CALLA negative, early pre-B cell ALL, with a review of the literatures, briefly.
Bacterial Infections ; Bone Marrow ; Cough ; Drug Therapy ; Fever ; Humans ; Infant ; Leukemia ; Male ; Pallor ; Pancytopenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor Cells, B-Lymphoid ; Sepsis

Ossifying fibroma is one of a group of fibro-osseous lesion which arises typically within the jaw bone and only rarely affects the long bones. In 1966, Kempson described two patients with ossifying fibroma of the tibia, noting its unique, aggressive local behavior. This rare lesion resembles monostotic fibrous dysplasia, but can be differentiated from it on histologic and clinical ground. Histologically, ossifying fibroma is characterized by osteoblasstic rimming spicules of bone within a fibrous stroma with evidence of the lamella transformation of bone, and clinically by, frequent recurrence and aggressive progression of the lesion. We experieced three cases of ossifying fibroma, two cases in the tibia and one case in the fibula. In case 1, recurrence was developed after local curettage and bone graft, so reoperation was performed at 11 months after the first opecation. The 2nd case was healed after wide curettage and free vascularized fibula graft, and the 3rd case being followed up after segmental resection of the fibula.
Curettage ; Fibroma ; Fibroma, Ossifying ; Fibrous Dysplasia, Monostotic ; Fibula ; Humans ; Jaw ; Recurrence ; Reoperation ; Tibia ; Transplants

The elbow injury is frequent among the children. The cubitus varus and cubitus valgus deformities are the common late complications of the elbow fracture. Although, these deformities rarely limit elbow function, the correction is frequently requested due to cosmetic problem and/or tardy ulnar nerve palsy. We performed 33 supracondylar closed wedge osteotomies from Jan. 1976 to Jan. 1986, of which 27 cases were cubitus varus, and 6 cases were cubitus valgus at Yonsei University College of Medicine. The results were as follows; 1. Cubitus varus deformity was more common than cubitus valgus; the ratio was 4.5 : 1. 2. The most common initial injury resulted in such angular deformity of elbow was supracondylar fracture of humerus. 3. The duration of plaster-cast immobilization after operation was much longer in cases who operated over 15 years old than under 15 years old. 4. There is no relationship between the duration after initial injury and the result of operation. 5. The result of supracondylar osteotomy was excellent in 11 cases(33.3%), good in 17 cases(51.5 %), and poor in 5 cases(15.2%). 6. Three fourths of cases resulted in excellent and good result were under 15 years old. 7. It is recommeneed that the angular deformity of elbow is corrected early rather than at the conclusion of growth.
Child ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Immobilization ; Osteotomy ; Ulnar Neuropathies

Cystic hygroma is a rare, endothelial lined cystic lesion of lymphatic origin which is encountered most often in children, usually at birth or early in life. The tumor is usually found in the neck and axilla. It is a soft, nontender, semifluctuant freely movable tumor of varying size filled with lymphatic fluid. The mass is sometimes pedunculated and is uaually multilocular, althouh it may be monolocular. The cystic hygroma of the right axilla and the upper arm, in a 4 month-old female infant, is presented with a review of the literature.
Arm ; Axilla ; Child ; Female ; Humans ; Infant ; Lymphangioma, Cystic ; Neck ; Parturition

Forty six cases of Legg-Calve-Perthes disease were reviewed clinically and roentgenographically in order to determine a satisfactory method of assessing the prognosis and to correlate the clinical and roentgenographical results. 1. The patients were children 3 to 12 years of age, with the peak at 6 years. The average age of visit (or diagnosis) was 6.7 years and that of onset was 6.4 years. 2. The total number of hips involved were 49, three cases being bilateral (6. 5%). Boys predominated girls by a ratio of 4.7:1 3. End results in children below 6 years of age were better than those in children above 6 years. The end results of treatment with the containment method were better than those with the noncontainment method. 4. The hips with excellent result had an average of 2.5mm. of uncovering of the femoral head at the time of diagnosis. The degree of uncovering increased as the roentgenographical result deteriorated, in the poor hips the average uncovering being 9mm. The average for the normal side was 2mm. The uncovering at onset is an accurate guide to the likely end result. 5. The Catterall assessment was of reliable prognostic value. In the excellent group, the majority of the hips belonged to Groups 1 and 2, In the poor group, there were no hips in Group 1 and increasing number of hips belonged to Groups 2,3 and 4. 6. The head at risk judged by Gage's sign, calcification of lateral epiphysis, lateral subluxation of the femoral head, and presence of a horizontal epiphyseal line indicated poor prognosis. 7. There was a close correlation between the severity of clinical features and the severity of residual roentgenographic findings.
Child ; Clinical Study ; Containment of Biohazards ; Diagnosis ; Epiphyses ; Female ; Head ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Methods ; Prognosis

The os calcis is fractured more frequently than any other tarsal bone. Fractures involving subtalar joint can, be associated with prolonged and severe disability. So there is no universal agreement in the treatment of these fractures. Calcaneal fractures of 64 feet in 56 patients who were treated at Severance Hospital, Yonsei University College of Medicine from Jan. 1971 to Dec. 1980 were analyzed in clinical and radiological aspects. The results obtained from this study were as follows; 1. Of 56 patients, 46 patients were male and 10 female. 2. The main cause of fractures of calcaneus was a fall from a height in 71.4 percents of cases, and spine injury was associated in 15 patients (26.8%) with calcaneal fractures. 3. The fractures were almostly closed (89.1%). 4. Fractures involving subtalar joint were in 52 feet (81.3%) and Rowe's type 5 were 38 fractures (39.4%). Of these type 5 fractures, 31 fractures were treated by closed reduction and axial pin fixation and then favourable results were obtained. 5. The most common complication after treatment was persistant foot pain. Pain beneath the lateral malleolus was the most common (8 feet), and correlated with the decrease of Bohler's angle.
Calcaneus ; Clinical Study ; Female ; Foot ; Humans ; Male ; Spine ; Subtalar Joint ; Tarsal Bones