The tibial plateau fracture which involving articular surface of the proximsl tibia is very common in pedestrian injury of the traffic accident and sometimes results in significant disability in knee joint function. The authors analized 40 cases of the tibial plateau fracture treated in our depsrtment during the year 1980 through 1985. The results obtained are as follows : l. 15 cases were treated by conservative methods. 2. 25 cases were treted by operative methods. 3. 33 cases(82.5%) were “Acceptable” group according to Roberts criteria.
Accidents, Traffic ; Knee Joint ; Tibia

No abstract available.
Knee*

No abstract available.
Hip

No abstract available.
Osteoma, Osteoid* ; Spine*

It would be naive to assume that any operative procedure is the solution to the problem of sacral pressure sore in the field of the orthopaedic surgery. The procedures outlined here involve the creation of compound myocutaneous flaps of the gluteus maximus muscle, skin, and the subcutaneous tissue. The myocutaneous flap us- ing the gluteus maximus muscle is a vascular flap instead of a random flap, with better blood supply for healing and advantage of an increased amount of cushion effect. We present an alternative method which will provide satisfactory and substantial soft tissue coverage in sscral pressure sores.
Methods ; Myocutaneous Flap ; Pressure Ulcer ; Skin ; Subcutaneous Tissue ; Surgical Procedures, Operative

Nowdays steroid injection into the epidural space is increasing gradually by pain clinic physician in order to control of low back and radiculating pain. But, there are a few reports about the effect of methylprednisolone that is injected into the epidural space on the plasma cortisol levels. So we undertook to determine the effect of epidural methylprednisolone acetate(Depomedrol) on the hypothalamus-pituitaryadrenal axis by checking plamsa cortisol levels. 9 patients were given 80 mg of methylprednisolone acetate and 10 ml of 0.25% bupicaine epidurally 3 times of injection at weekly intervals and checked the plasma cortisol levels of 1 hour before and after each injection respectively. The levels of plasma cortisol were also checked at first and 4th week after the last injection. The results are as follows: The baseline plasma cortisol level is 11.21+/-6.38mg%. The plasma cortisol levels of 1 hour before and after 2nd injection are 3.94+/-5.38 and 4.11+/-7.10mg%. The plasma cortisol levels of 1 hour before and after 3rd injection are 2.01+/-1.33 and 2.90+/-4.31mg%. The palsma cortisol level of 1st week after the last injection is 1.76+/-1.03mg%. The plasma cortisol level of 4th week after the last injection is 7.45+/-2.38mg%.
Axis, Cervical Vertebra* ; Epidural Space* ; Humans ; Hydrocortisone ; Low Back Pain ; Methylprednisolone* ; Pain Clinics ; Plasma

This paper was prepared to determine the effects of degree of initial angulation and the method of treatment toward the end results, and also to report cases of twenty-one children with a radial neck lowed up more than 12 months. The results are as follows: 1. An average follow up period was 34 months, and were ranged from 12 months to 70 months. 2. Displacement patterns of fracture were angulation in 5 cases, partial translocation in 11cases, and total displacement in 5 cases, and translocated fracture was most frequent. According to the degree of angulation, in 10 cases angulation was minor(below 30 degrees), in 8 cases moderate(30–60 degrees), and in 3 cases severe (above 60 degrees). 3. One case was treated by simple cast immobilization, 9 cases were treated by gentle closed reduction, 3 cases were by percutaneus pin reduction with K-wire, 7 cases were by open reduction and K-wires fixation, and 1 case was by closed reduction and incorporating cast immobilization. 4. The results of 20 cases were excellent in range of motion without specific complication. Without considering about the method of treatment, when angulation was severe, more time was required for recovery(Wilcoxon 2-simple test P < 0.02). When the degree of angulation was less than 60 degree, the functional recovery was faster with closed reduction than with open reduction, but with the angulation more 60 degree, there was no significant difference(Spearman correlation coefficient=0.599, P value < 0.05). In conclusion, the severity of initial displacement and the method of treatment were considered to be factors that could affect the recovery time.
Child ; Follow-Up Studies ; Humans ; Immobilization ; Methods ; Neck ; Range of Motion, Articular

A fracture of the affected extremity in patients with Klippel–Trenaunay–Weber syndrome can be fatal due to massive bleeding and show poor results. A 42-year-old male presented with an old fracture of the right femoral shaft with metal failure. We planned an operation to remove the previously fixed plate and to perform re-fixation using an intra-medullary nail. Preoperative angiography was performed and the arteriovenous malformations were embolized in order to reduce the risk of bleeding. After angiography, the previously fixed plate was removed.After the operation, a second angiography was performed immediately and the venous malformation was embolized. One week after the first operation, a second operation was performed in order to reduce the fracture and to perform re-fixation using an intramedullary nail. The patient is being followed without major complication over a period of seven years after surgery. We recommend careful planning of preoperative and postoperative angiography and embolization in order to reduce the risk of bleeding in patients with Klippel–Trenaunay–Weber syndrome.

Sixteen normal subjects were tested with the Titmus stereotest varying the binocular Snellen's visual acuity from 1.0 to 0.2. From 15 possible combinations, a nomogram describing the relationship of binocular variations of Snellen's visual acuity and stereoacuity was constructed and the relationship of binocular isoacuities to Titmus stereotest performance was expressed as an S-shaped function.
Nomograms ; Telescopes ; Visual Acuity*

BACKGROUND: In anemic patients, it has been usually traditional practice to correct the anemic state with preoperative blood transfusion. But now, there is an increasing tendency of refusing blood transfusion due to the transfusional complications, especially AIDS etc. The purpose of this study is to survey the effects of anesthesia in anemic patients with normal cardiopulmonary function compared to non-anemics. METHOD: 40 patients with uterine myoma were divided into two groups, an experimental group of 20 patients with hemoglobin concentration of 8~10 gm% and a control group of 20 patients with hemoglobin concentration higher than 10 gm%, and their blood pressure, pulse rate and arterial oxygen saturation were monitored and compared. RESULTS: There were no significant differences between two groups in blood pressure, pulse rate and arterial oxygen saturation. CONCLUSION: Preoperative blood transfusion, in patients with moderate anemia, does not seem to be a mandatory practice.
Anemia ; Anesthesia ; Blood Pressure ; Blood Transfusion* ; Heart Rate ; Humans ; Leiomyoma* ; Oxygen