From January 1985, to June 1986, 7 cases in which supracondylar and intercondylar fractures of the femur were treated at our orthopaedic department using the Extensile Approach for an anatomical reduction and firm internal fixstion, show successful results in follow up stuides. l. All 7 cases were type III fractures of Neers classification. 2. Among the 7 cases treated surgically using the Extensile Approach, 5 cases showed excellent and good results and the remaining 2 csses showed one fair and one failed results. 3. Probably due to the additional open proximal tibia and patella fracture and delayed surgery from trauma one case had a fair results. The case which failed wss due to ipsilsteral ligamentous injuries and a nerve injury in addition to the femur fracture and slso the impossibility of early knee joint exercise due to associated injuries. 4. None of the results of the 7 csses had any relationship with the patients age. 5. One case of postoperative skin necrosis developed around the tibial tuberosity and was treated successfully by a cross leg flap. 6. In comminuted supracondylar and intercondylar fractures of the femur, the Extensile Approach is thought to be an excellent surgical technique by means of a wide surgical field for an anatomical reduction and firm internal fixation with the repair of associated ligamentous injuries.
Adult ; Classification ; Femur ; Follow-Up Studies ; Humans ; Knee Joint ; Leg ; Ligaments ; Necrosis ; Patella ; Skin ; Tibia

Congenital pseudarthrosis of the tibia was accepted as one of the most difficult disease in respect of the frequency and treatment for the orthopaedists. Since April, 1984, we experienced 3 cases of congenital pseudarthrosis of the tibia, one 2 year-old boy involved left tibia only and the other 4 year-old female involved bilaterally, obtained solid bony union in all which were treated by massive surgical management that contained vascularized bone graft and electric stimulation. Several complications were faced such as refracture, valgus deformities of the ankle, skin irritation sign, angular deformities. But refracture was healed without delayed or nonunion by simple plaster cast immobilization. The vascularized bone graft snd electric stimulation is thought to be more improved methods for the treatment of congenital pseudarthrosis of the tibia. Althought solid bony union was obtained in congenital pseudarthrosis of the tibia, periodic follow-up and adequste management must be mandatory up to the end of the bony growth.
Ankle ; Casts, Surgical ; Congenital Abnormalities ; Electric Stimulation ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Pseudarthrosis ; Skin ; Tibia ; Transplants

For the management of adult dysplastic hips with early degenerative arthritis, we can prevent further progress of secondary degenerative changes of the hip by a Rotational Acetabular Osteotomy, which effectively corrects the preoperatively inadequate acetabular coverage of the femoral head. Biomechanical advantages of this procedure are, l. An adequate coverage of tl; femoral head then enlarges the actual weight-bearing surface area, and so diminishes the resultant force per unit area of the acetabular weight-bearing surface and femoral head. 2. The resultant forces are also diminished by a medial shift of the femoral head. 3. The shearing force is decreased by the reduction of roof obliquity. 4. Because of the rotation of the original articular surface, remodeling the post-operative acetabular articular surface as Chiari operation is not necessary, and so can be performed even on elderly patients.
Acetabulum ; Adult ; Aged ; Head ; Hip ; Humans ; Osteoarthritis ; Osteotomy ; Weight-Bearing

Soft tissue coverage of heel defects has long been a difficult problem. In 1982, Iron reported eight cases of heel defects in children using an ipsilateral posterior thigh flap with use of the Hoff-man's skeletal fixation apparatus for immobilization. We report three cases of heel defects treatment in children using ipsilateral posterior thigh flap and detach flap in an average 13 days with aid of single photon emission computed tomography(SPECT) for evaluation of circulation status of flap.
Child ; Fracture Fixation ; Heel ; Humans ; Immobilization ; Iron ; Thigh ; Tomography, Emission-Computed, Single-Photon

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

Sensation is the key element that allows the fingertip to participate effectively in virtually all hand functions. Therefore, it is very important to restore sensation as well as well padded, durable skin coverage following severe fingertip injuries. Many ingenious operations have been described to provide the fingertip with sensate coverage. Among them, the innervated cross-finger flap, reported by Cohen et al. in 1983, is very effective and successful in reconstruction of severe fingertip injuries, We report five cases of severe fingertip injuries treated with innervated cross-finger flap. The results are as follows : 1. The level of sensory return and the functional result is excellent in those fingertips reconstructed with the innervated cross-finger flap. 2. Mean time for flap detachment is 16 days post operative and local anesthesis at outpatient department is sufficient. 3. Four of five treated patients achieved excellent sensibility with measurable two-point discrimination(mean 5.0 mm) and ability to recongnize textures and objects.
Fingers ; Hand ; Humans ; Outpatients ; Sensation ; Skin

Rhabdomyosarcoma which was first described by Weber has generally been considered asan uncommon tumor. Pack and Eberhart were of the opinion that rhabdomyosarcoma represented 13.9 percent of soft tissue sarcomata. Recently it was classified as four types such as pleomorphic, embryonal, botryoid and alveolar type by many authors. We have experienced two cases of embryonal rhabdomyosarcoma, one arised within left leg and the other within right foot. The former(3 months old, female) showed tumor mass at birth, the latter(13 months old, male) showed at 1 month after birth.
Chungcheongnam-do ; Foot ; Leg ; Parturition ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal

Severe injuries of hands frequently expose the bone and joint due to the defect of crushing of soft tissues. Although the several methods are introduced, the treatment of bone and joint exposure of finger and hand is very difficult to control satisfactorily. From October 1986 to February 1988, we performed the pedicled skin flap in 11 cases; 9 abdominal skin flaps and 2 pectoral skin flaps. Follow up stuides showed good results. The successful surviving of flaps was accomplished in all cases and the dead bones were regenerated by the creeping substitution. Therefore this pedicled skin flap operation can be considered to be a simple and effective method in treating the bone and joint exposure of fingers.
Fingers ; Follow-Up Studies ; Hand ; Joints ; Methods ; Skin

There are many procedures for stabilizing the foot but all frail feet, all complete drop feet, and all calcaneocavus deformities due to paralysis are best treated by pantalar fusion. Hunt and Thompson advised one stage pantalar arthrodesis by astragalectomy and replacement of the denuded bone in paraiytic feet resulting from poliomyelitis. At the Presbyterian Medical Center, Jeonju, Korea, 12 one stage pantalar arthrodesis were performed between 1973 and 1978 and following observations were made. 1. Seven of the patient had pantalar fusions because of poliomyelitis. 2. Five feet were equinovarus and 4 had frail feet with varying amounts of varus or valgus of the forepart of the foot and of the heel. 3. Nine patients were considered to have a good result, two had a fair and one was failure 4. Length of immobilization was from 13 weeks to 37 weeks and the average length of immobilization was 17 weeks. 5. In one stage pantalar arthrodesis, there was no complication except one non-union and the period of hospitalization was decreased.
Arthrodesis ; Clubfoot ; Congenital Abnormalities ; Foot ; Heel ; Hospitalization ; Humans ; Immobilization ; Jeollabuk-do ; Korea ; Paralysis ; Poliomyelitis ; Protestantism

Fetal hydrops is often serious and associated with a high perinatal motality rate. Cardiac causes of fetal hydrops include congenital heart diseases and rhythm disturbances. An irregular fetal heart rate may indicate atrial fibrillation and atrial flutter with variable AV conduction. Fetal atrial flutter is characterized by the pressence of flutter waves which are regular sawtooth undulations in the baseline that are larger than p waves. Authors experienced a case of fetal atrial flutter with hydrops fetalis at 30 week's gestation which was confirmed by fetal M-mode echocardiogram and electrocardiography. A new born infant had shown to have atrial flutter in utero and after delivery was successfully converted to normal sinus rhythm with digoxin and quinidene.
Atrial Fibrillation ; Atrial Flutter* ; Digoxin ; Edema* ; Electrocardiography ; Female ; Heart Diseases ; Heart Rate, Fetal ; Humans ; Hydrops Fetalis* ; Infant ; Pregnancy