The usage of electromyography is customized in the diagnosis of the neuromuscular disorder and the determination of motor conduction velocity is important in the diagnosis of the peripheral nerve lesion and in the posing of the site and severity of nerve damage. Although the radial nerve is frequently involved in generalized neuropathy and in entrapment syndrome, relatively fewer reports have appeared in the literature regarding the radial nerve. The purpose of this study is to determine the normal data of the motor conduction velocity of the proximal and distal segments of the radial nerve. The radial nerve fibers supplying the extensor indicis muscls muscle was stimulated at Erb's point, above the elbow and in the distal forearm and its muscle action potential was sampled. Seventy-four radial nerve were studied in thirty-seven healthy young subjects. The results obtained were as follows; 1. The mean proximal velocity was 70.7±6.8m/sec and the mean distal velocity was 57.6±4.3m/sec. 2. In any case tested, the proximal velcity was over 55m/sec. 3. The proximal velocity was faster than the distal velocity and the mean difference was 13.1m/sec In only 7 of the 74 nerves tested, the proximal velocity was slower than the distal velocity and the difference of Sm/sec was the most reversal. 4. The velocity in dominant limb was faster than that in nondominant limb. 5. There were no significant difference between the sexes.
Action Potentials ; Diagnosis ; Elbow ; Electromyography ; Extremities ; Forearm ; Peripheral Nerves ; Radial Nerve

The carpal tunnel syndroms is the most common peripheral nerve entrapment syndrome. The typical symptom is pain, numbness and paresthesia in the median nerve territory of the hand and progressive thenar atrophy. When the symptom is mild and its duration is short, conservative treatment such as splinting or local steroid injection is considered, but when neurological deficit is promiment and conservative treatment is not effective, surgical decompression is indicated.Authors reviewed 15 patients (23 cases) of carpal tunnel syndrome treated with surgical decomression at the Department of Orthopedic Surgery, Kyung-pook National University Hospital from March 1983 to October 1988. The follow up results are as follows; 1. Preoperatively, Tinel sign was present in 17 cases. Phalen test was positive in 17 cases. Sensory disturbance was present in 8 cases. Thenar muscle atrophy was present in 19 cases. Motor weakness was present in 13 cases. 2. Preoperatively, delay of motor conduction velocity of median nerve was noted in 15 cases (65.2%) and sensory nerve conduction velocity in 20 cases (86.9%). Denervation findings such as fibrillation or sharp waves were seen in 15 cases (65.2%). 3. The operative findings were as follows; Synovial hypertrophy in 12 cases, hypertrophy of transcarpal ligament in 4 cases, pseudoneuroma in 3 cases, ganglion in 2 cases, neurilemmoma in 1 case, gout in 1 case. 4. As the operative findings, median nerve had evidence of compression beneath the transcarpal ligament, consisting of flattening. narrowing and decreased epineurial vascularity. 5. External neurolysis was performed in all cases. 6. In case of long duration and severe thenar atrophy, internal neurolysis would be recommendable. 7. Fllow up period was ranged from 7 months to 6 years. 8. 19 cases (82.6%) were excellent or good results.
Atrophy ; Carpal Tunnel Syndrome ; Decompression, Surgical ; Denervation ; Follow-Up Studies ; Ganglion Cysts ; Gout ; Hand ; Humans ; Hypertrophy ; Hypesthesia ; Ligaments ; Median Nerve ; Muscular Atrophy ; Neural Conduction ; Neurilemmoma ; Orthopedics ; Paresthesia ; Peripheral Nerves ; Splints

We experienced a rare case of thoracic outlet syndrome caused by hypertrophic nonunion of the first rib. A diagnosis was made mainly upon provocative tests and imaging studies. Pain and tingling could be reproduced and the radial pulse obliterated by the hyperabduction test. Abundant callus formation on the posterior aspect of the first rib with fracture line was visible on plain radiograph. Two-dimensional computed tomography showed right thoracic outlet narrowing mainly caused by the mass-effect of the callus. Dynamic arteriographic studies revealed an external compression of the right subclavian artery and duplex ultrasonography demonstrated a reduction in right subclavian artery blood flow when the shoulder is in 90 degrees of abduction. Surgery was performed after the conservative management for three months which failed to relieve the patient of his complaints. Resection of the first rib via transaxillary approach was undergone uneventfully in combination with the myotomy of the scalenus anticus muscle. At postoperative one year follow up, the patient was free of symptoms, and had a full range of motion of the right shoulder with no evidence of arterial insufficiency.
Adult ; Case Report ; Human ; Hypertrophy ; Male ; Ribs/*pathology ; Thoracic Outlet Syndrome/*etiology/surgery

The purpose of this study is to compare 76 cases of fractures of the proximal humerus both clinically and radiologically which were treated at Pusan National University Hospital from January 1987 to December 1996. According to Neers classification, among the 76 patients, there were nine one-part fractures (11.8%), forty two-part fractures (52.6%), eighteen three-part fractures (23.7%), four four-part fractures (5.3%), and five head-splitting fractures (6.6%). In terms of treatment method, among the 76 patients, 49 patients (64.5%) were treated conservatively. Thirty seven patients (75.5%) of one-part and two-part fractures were treated conservatively, and twelve patients (54.5%) of three-part and four-part fractures were treated operatively. The results of the cases were rated by the Neer s assessment, 42 patients (85.7%) had excellent or satisfactory results in one-part and two-part fracture, and 7 patients (31.8%) had unsatisfactory or failed results in three-part and four-part fracture. Total cases with complications were 14 cases (18.4%). From the viewpoint of the type of fracture, the results in two-part and three-part fractures were much better than those of fourpart fractures. The joint stiffness which was the most common complication must be prevented by allowing the early motion of the joint to obtain a better result.
Busan ; Classification ; Humans ; Humerus* ; Joints

No abstract available.
Pelvic Bones*

PURPOSE: To clinically and radiologically assess cemented total knee arthroplasty. MATERIALS AND METHODS: Among the patients with rheumatoid arthritis or degenerative arthritis treated at the Department of Orthopaedic Surgery of Pusan National University Hospital by cemented total knee arthroplasty between January 1990 and October 1992, 21 patients (22 knees) were followed up for more than 5 years. The Knee Rating Scale of Hospital for Special Surgery was used for the clinical assessment and the American Knee Society Roentgenographic Evaluation and Scoring System was adopted for the radiological assessment. RESULTS: The average preoperative knee rating score was 46.4 and improved to 83.2 at the latest follow up. The average range of motion was 88 preoperatively and 120 at the latest follow up in rheumatoid arthritis. In degenerative arthritis, it was 104 preoperatively and 115 at the latest follow up. Four of 22 knees had radiolucent lines at the bone-cement interface, but most of them were nonprogressive and clinically insignificant. In conclusion, cemented TKA can be indicated for the painful arthritic knees in old patients. Rheumatoid arthritis showed better improvement in HSS knee score and ROM than degenerative arthritis. But, similar results were shown in the radiological assessment of rheumatoid arthritis and degenerative arthritis. CONCLUSIONS: Even though cemented TKA for the painful arthritic knee has shown good results, long-term follow up studies will be required to determine both the long-term clinical results as well as the radiological results.
Arthritis, Rheumatoid ; Arthroplasty* ; Busan ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Range of Motion, Articular

PURPOSE: To evaluate the treatment results, of open tibial shaft fracture assess its benefit and investigate ways to prevent deep infection or osteomyelitis. MATERIALS AND METHODS: Thirty-one cases of open tibial shaft fracture treated by primary external fixation and secondary unreamed interlocking intramedullary nailing were investigated and evaluated in terms of items such as fracture location, pattern, bony union, complications, etc. RESULTS: The most common cause was traffic accidents (23 cases, 74.2%), location was mid 1/3 (21 cases, 67.7%), pattern was comminuted one (16 cases, 51.6%) and open type was IIIb (14 cases, 45.1%). Duration of external fixation was 7.6 weeks in average, time interval to nailing after removal of external fixator was 15.7 days in average. Bony union was achieved within an average of 39.2 weeks after external fixation. Complications were 3 cases (9.7%) of delayed union, 5 cases (16.1%) of pin site infection, 1 case (3.2%) of deep infection, 2 cases (6.5%) of malunion and 2 cases (6.5%) of ankle stiffness. But nonunion and chronic osteomyelitis did not occur. CONCLUSION: This method enables early soft tissue reconstruction and minimizes delayed union and nonunion in the severely contaminated or injured open tibial shaft fracture. The timing of secondary nailing should be established under exact principle in order to prevent very serious complications such as deep infection and osteomyelitis.
Accidents, Traffic ; Ankle ; External Fixators ; Fracture Fixation, Intramedullary* ; Fractures, Open ; Osteomyelitis

PURPOSE: To find out the factors affecting prognosis after surgical decompression of tarsal tunnel syndrome. MATERIALS AND METHODS: We investigated and followed 11 patients in 12 cases with tarsal tunnel syndrome who underwent surgical decompression in our hospital over a 2-year and 6-month period. Diagnosis was based on the history, thorough physical examination and electrodiagnostic study. Recently, Magnetic Resonance Imaging has also been used to show in extraordinary detail both bony and soft tissue structures of ankle. Operation removed etiologic factors, decompression of flexor retinaculum and neurolysis of the posterior tibial nerve and its medial and lateral plantar nerve branches. It was particularly vital that the mobilization of the posterior tibial nerve be carried out distal to the overlying abductor hallucis. RESULTS: Electrodiagnostic evaluation showed reduced amplitude, increased duration of motor evoked potentials and decreased sensory conduction velocity, The postoperative result was assessed according to Takakura's rating scale. It was excellent in 3 cases, good in 6 cases, fair in 2 cases and poor in 1 case. CONCLUSIONS: The prognosis seemed to be related with age, duration of symptom and definite space occupying lesion.
Ankle ; Decompression ; Decompression, Surgical* ; Diagnosis ; Evoked Potentials, Motor ; Foot ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Prognosis ; Tarsal Tunnel Syndrome* ; Tibial Nerve

PURPOSE: To evaluate the configuration of the anterior column of the acetabulum and to develop a safe path for screw placement for it. Materials and methods: Ten embalmed cadaveric adult bony-hemipelvis specimen were obtained. Each specimen was sectioned at 1cm intervals, beginning at the level of the inferior border of the acetabulum. The plane of the cross-section was perpendicular to the anterior column. The projection of the medial acetabular boundary on the anterior column was determined by analysis of each cross-section. RESULTS: The average width of the anterior column at 1.0, 2.0 and 3.0 cm superior to the inferior acetabular boundary was 27.9+/-4.3, 31.7+/-3.6 and 35.2+/-4.9 mm, respectively. At 1.0 cm superior to the inferior margin of the acetabulum, the average medial angulation for 0.5, 1.0 and 1.5 cm entry points lateral to the pelvic brim were 26.7+9.1 degree, 37.9+/-6.5 degreeand 46.1+/-5.0 degree, respectively. At 2.0 cm superior to the inferior acetabular margin, the corresponding average medial angulation for 0.5, 1.0 and 1.5 cm entry points were 20.4+/-6.2 degree, 30.4+/-5.6 degree and 41.0+/-5.0 degree, respectively. At 3.0 cm superior to the inferior acetabular margin, these angles were found to be 19.5+/-3.8 degree, 30.5+/-5.1 degree and 40.8+/-4.6 degree, respectively. CONCLUSIONS: This anatomical analysis of the acetabulum shows that it is possible to develop a safe path for screw placement into the anterior column. And the data could be a useful guide line for plate and screws fixation of the anterior column of the acetabulum.
Acetabulum* ; Adult ; Cadaver ; Humans

BACKGROUND AND OBJECTIVES: This study was undertaken to evaluate the effect of superior cervical ganglionectomy (SCG) on anosmia, which is peripherally induced in the mice. MATERIALS AND METHOD: Three groups of mice (BCF1) were studied: normal control (nasal instillation of saline, n=6); zinc sulfate group (nasal instillation of 64 mM zinc sulfate, n=25); SCG group (superior cervical ganglionectomy after nasal instillation of 64 mM zinc sulfate, n=25). Tissues of olfactory mucosa were obtained at 1, 2, 3, 4 and 7 weeks after instillation of zinc sulfate, and processed for immunohistochemistry using antisera to olfactory marker protein (OMP) to evaluate the olfactory regeneration. RESULTS: No OMP-positive cells were observed in the first two weeks after the instillation of zinc sulfate in both zinc sulfate group and the SCG group. However, the OMP-positive cells appeared first at 3 weeks after the instillation in both groups, and gradually increased in number at 4 and 7 weeks. In the SCG group, the increase of OMP-positive cells was significantly greater than those of the zinc sulfate group. The number of OMP-positive cells in the SCG group at 7 weeks was almost similar to that of the normal control group. CONCLUSION: SCG enhances regeneration of olfactory receptor cells at 3 weeks after injury. It was inferred from the above results that SCG has a significant effect on the regeneration of olfactory receptor cells and we suggest that SCG could be an effective treatment modality for olfactory dysfunction.
Animals ; Autonomic Nerve Block ; Ganglionectomy* ; Immune Sera ; Immunohistochemistry ; Mice* ; Olfaction Disorders ; Olfactory Marker Protein ; Olfactory Mucosa ; Olfactory Receptor Neurons ; Regeneration ; Smell* ; Zinc Sulfate