Early diagnosis and treatment of congenital dislocation of the hip is the only means of obtaining good results with consistent regularity. But a large number of congenital dislocation of the hip remain undiagnosed before the child begins to walk. One hundred and nine cases of congenital dislocation of the hip had been clinically diagnosed and 48 cases of them were treated conservatively or operatively at Department of Orthopedic Surgery, College of Medicine, Seoul National University from January, 1965 through September, 1975 with following results. 1. Among 109 cases of congenital dislocation of the hip, 48 cases were admitted and treated. In recent 10 years the number of the out-patient was increasing. 2. The preponderance of female to male (4:1) was found. 3. The age ranged between 3 months and 24 years, and 46 cases (42%) between 12 and 24 months. 4. In most cases the chief complaint was limping. 5. The associated congenital anomalies were observed in 3 cases of the series, comprising two cases of arthrogryposis multiplex congenita and one case of hydrocephalus. 6. The scetabular index was increased in affected hip. 7. The ratio of unilateral cases to bilateral ones was 100: 9, and right to left was 47: 53. 8. Closed reduction was satisfactory in 25 cases under 2 years of age. 9. Open reduction was necessary in 18 cases of failed closed reduction and 5 cases of redislocation. 10. Eleven cases of Salter's operation, 4 cases of Pembertons operation, 2 cases of Colonnas operation, and 8 cases of derotational osteotomy were performed to increase the stability of the hip joint.
Arthrogryposis ; Child ; Dislocations ; Early Diagnosis ; Female ; Hip Joint ; Hip ; Humans ; Hydrocephalus ; Male ; Orthopedics ; Osteotomy ; Outpatients ; Seoul

Clubfoot or talipes equinovarus is the most common congenital anomaly of the foot observed in children as well as in adults. This deformity should be treated immediately after birth, and so the cases of old neglected clubfeet are quite rare now. Moreover, in the cases of old neglected clubfoot, it is very difficult to get satisfactory results because there will be secondary adaptive changes in the tarsal bones and surrounding soft tissues. Therefore, clubfeet are considered to be one of many things requiring on or more of the many different types of treatment. The authors have experienced to treat nine cases of old neglected clubfoot from May, 1978 to April, 1988 at the Department of Orthopedic Surgery, St. Mary's Hospital, and reported herewith. 1. Their average age was 14.8 years old (3 to 25 yesrs old). There were one bilateral clubfeet, left foot in 5 cases and right foot in 4 cases. 2. According to the age of the patients and severity of deformities, two patients from three to ten years old were treated with soft-tissue release and serial casting, and seven patients after ten years old were treated by soft-tissue release, various osteotomies and triple arthrodesis. Postoperative management consisted of long leg cast for first four weeks and short leg walking cast for another four to eight weeks. 3. The results were estimated by the talo-calcaneal index according to Beatson et al(3)radiologically and their external appearance of corrected foot subjectively. The talo-calcaneal index was improved from 17.8° to 37° after operation and all of patients satisfied with the results of their operation.
Adult ; Arthrodesis ; Child ; Clubfoot ; Congenital Abnormalities ; Foot ; Humans ; Leg ; Orthopedics ; Osteotomy ; Parturition ; Tarsal Bones ; Walking

No abstract available.
Breast* ; Calcium* ; Magnesium* ; Milk, Human* ; Phosphorus*

In order to clarify the changes of the venous circulation in normal and affected hip with Legg-Ca1ve-Perthes' disease(L.C.P.D.) and to assess the effect of intertrochanteric varus osteotomy on the venous circulation around the proximal femur in L.C.P.D., intra-osseous venography(I.O.V.) was performed before osteotomy and also 8 weeks later when K-wires or staples used at the time of osteotomy were removed. Results obtained were as follows: 1. The material was consisted of 13 normal and 17 hips with L.C.P.D.. There were 14 boys and one girl, with a mean age of 6.1 years ranged from 5 to 9 years; in two patients the disease was bilateral. 2. When the hips with L.C.P.D. were divided into four groups by the method described by Catterall, three hips were included in group II, ten in III and four in IV. 3. In I.O.V. of the proximal femoral metaphysis on 13 normal hips, the opaque medium disappeard rapidly through the local venous system around the proximal femur, and no regurgitation into diaphysis were noted. But gluteal and medial circumflex vein in each one case was not visualized. 4. Of 17 hips with L.C.P.D., an I.O.V. was carried out before and after the intertrochanteric osteotomy. The ligamentum teres and gluteal vein appeared in only 4(24%) and 7 hips (41%) before and after osteotomy. And the lateral and medial circumflex vein visualized in 12(71%) and 15 hips before osteotomy and in 17 hips, both after osteotomy. The diaphyesal regurgitation in 35 % and trochanteric venous pooling of the opaque medium in 47%, indicating venous congestion on the trochanteric region of femur, disappeared after the osteotomy. But no significant differences in their age and group of L.C.P.D. were found. All of these findings suggest that the impaired venous system around the proximal femur and increased intra-osseous pressure on proximal femur may act as one of the important role in pathophysiology of the L.C.P.D., and the intertrochanteric osteotomy might have some positive effect for the normalization of venous circulation and intra-osseous pressure in L.C.P.D..
Diaphyses ; Female ; Femur ; Hip ; Humans ; Hyperemia ; Legg-Calve-Perthes Disease ; Methods ; Osteotomy ; Round Ligaments ; Veins

Lymphangioma is composed of lymphatic tissue and filled with clear or chylous fluid that develops most often in the skin and subcutaneous tissue of neck but relatively rare in extremities. It is perhaps a congnital malformation rather than a true neoplasm, and so most of these lesions are usually present at birth and have a tendency to grow very slowly. If it is developed with a cavernous type of lymphangioma, it will have more aggressive and infiltrative tendency because their margin is usually adhesive with adjacent normal tissue. A case of cavernous lymphangioma on the right wrist of an eight month old female infant, treated by surgical excision is followed up over one year and presented here with a review of the literature.
Adhesives ; Extremities ; Female ; Humans ; Infant ; Lymphangioma ; Lymphoid Tissue ; Neck ; Parturition ; Skin ; Subcutaneous Tissue ; Wrist

Twenty-three cases of the scaphoid fracture which were treated at the Department of the Orthopaedic Surgery, Catholic University Medical College during the period of december 1978 to december 1987 were analysed. The main purpose of this study was to clarify the significant factors affecting the union rate of the scaphoid fracture. The results obtained were as follows ; 1. The great majority of 23 cases was male with mean age 31. 2. Ulnar deviated stress oblique view with msking a fist was the most reliable means for diagnosing the fracture, location of fracture and stability of wrist after scaphoid fracture. 3. Union rate was obtained from 88.8% in undisplaced fresh fracture, 85.7% in displaced fresh fracture and 71.4% in old neglected fracture. 4. The union rate and associated factors affecting the prognosis after scaphoid frscture seems to be depended on the location of fracture, the severity of initial displacement of fracture fragments, time elapsed of treatment after fracture and accompanied injuries around the ipsilateral wrist.
Humans ; Male ; Prognosis ; Wrist

The occurence of pseudarthroses associated with neurofibromatosis is a well documented phenomenon, with the majority of reported cases in the tibia but quite rare in forearm,Only ten cases in the English-literature and one case in Korean-literature of this lesion revealed appearing in the bones of the forearm till now. Of these, four in solitary pseudarthroses of the ulna(4.5.15), five in a solitary lesion of the radius(7.8.10.16.17), and only two cases was on the both bones of the forearm(9.14). We are presenting the case report of a Korean adult male with the clinical stigmata and a positive familial history of neurofibrormotosis who had congenital pseudarthroses of both the radius and ulna of the right forearm. Therefore, the present case is the third to be reported. We treated him with by production of an one-bone forearm using a dual a onlay bone graft positioned in neutral of supination and pronation. A stable, functional extremity with good union of pseudarthroses were encountered.
Adult ; Christianity ; Extremities ; Forearm ; Humans ; Inlays ; Male ; Neurofibromatoses ; Neurofibromatosis 1 ; Pronation ; Pseudarthrosis ; Radius ; Supination ; Tibia ; Transplants ; Ulna

Osteosarcoma is the most common primary malignant tumor in the orthopaedic field. Recently, the management of osteosarcoma was evolved in many aspects and the improved results were reported in many articles. The purpose of this study is to evaluate the changes of clinical findings and management modalities in osteosarcoma since 1980. We reviewed 127 osteosarcomas managed from 1980 to 1992. The Enneking surgical stage was as follows; stage I 12 cases, stage II 98 cases and stage III 17 cases. They were subclassified into classic(97 cases), parosteal(12 cases), telangiectatic(5 cases), secondary(4 cases), periosteal(2 cases), gnathic(2 cases), high grade surface(1 cases) and undetermined(4 cases). The disease-free survival rate was evaluated for the patients of stage II classic osteosarcomas treated with amputation(27 cases) or limb-salvage operation(23 cases), and average follow up period of them was 49 months. In 27 cases of amputation adjuvant chemotherapy was administered in 23 cases. And in 23 patients treated with limb-salvage operation, neoadjuvant and adjuvant chemotherapy were done in 19 cases and only adjuvant chemotherapy in 2 cases. The clinical changes since 1980 were as follows: (1) The mean duration from symptom onset to diagnosis was decreased gradually from 6.5 months(1980) to 3.1 months(1992). (2) The proportion of curative surgery was increased from 40%(1980) to 87%(1992) in stage I and II. (3) The proportion of limb-salvage operation was rapidly increased upto 88% since 1985. The 5 year disease-free survival rate of stage II classic osteosarcoma was 36% with amputation and 67% with limb-salvage operation.
Amputation ; Chemotherapy, Adjuvant ; Diagnosis ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Osteosarcoma

The authors clinically analyzed 53 cases of patients beyond 18 years of age with closed solitary femoral diaphyseal fractures, and 24 cases of patients with multiple long bone fractures including closed femoral diaphyseal fracture. All theses 77 cases were followed for more than 1 year, during 1988. 1
Clinical Study ; Femoral Fractures ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Comminuted ; Fractures, Multiple ; Humans ; Methods ; Sex Distribution ; Transplants

No abstract available.
Child* ; Heart Septal Defects, Ventricular* ; Humans