We have recently experienced a rare case of abdominal aortic injury caused by shearing force falling from 8 meter height in upright position. The patient was 43 year old and sustained Ll, L2, L5, compression fractures and both distal tibia and fibula comminuted fractures involving ankle joints. 2 years and 2 months later, marked stenosis of the distal abdominal aorta was found together with clinical manifestations of ischemia of both legs. Aorto-femoral bypass on both sides has completely relieved the symptoms.
Accidental Falls ; Ankle Joint ; Aorta, Abdominal ; Constriction, Pathologic ; Fibula ; Fractures, Comminuted ; Fractures, Compression ; Humans ; Ischemia ; Leg ; Tibia

The tibial plafond fractures result from an axial compression snd rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displscement. It is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws. Basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The suthor analysed the 20 cases of the tibial plafond frsctures in 17 patients, which were trested at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from Jsnuary 1983 to March 1987. The longest durstion of followup was 2 years and 4 months and shortest one was 6 months, and the aversge was one year. The results were as follows : 1. Among the 17 patients, male were 16 and female was one. 2. The major causes of injury were a fall from a height. 3. The most frequent type of fracture was type C by Ruedi and Allgower classification. 4. Regardless of the method of trestment the type A and B were in good and fair result, but the type C were fair in 4 cases and poor in 8 cases. There were 7 cases of snkle fusion in poor group. 5. It is important to remind the basic steps in reconstruction and applied in sn individual csse especially in type C. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, esrly motion of the ankle joint is made possible. This early motion reduces stiffness of the ankle and win yeild the most sstisfying result. But the anatomic reduction of ank1 joint is difficult to be obtained in each case especially in type C and may consider an ankle fusion.
Ankle ; Ankle Joint ; Bone Transplantation ; Classification ; Clinical Study ; Female ; Fibula ; Follow-Up Studies ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Tibia

Smooth muscle hamartoma was first described by Stokes in 1923 as the disease characterized by increase of well-defined bundles of smooth muscle fibers in the dermis. It can be either congenital or acquired. Acquired ones are aften in association with Becker's nevus. We present a case of acquired smooth muscle hamartoma that did not show any pigmentation or hair growth.
Dermis ; Hair ; Hamartoma* ; Muscle, Smooth* ; Nevus ; Pigmentation

Targetoid hemosideric hemangioma represents a distinctive, benign, vascular tumor. Histologically, it is a noncircumscribed vascular proliferation that may extend into the subcutaneous tissue. The superficial component is composed of ectactic dermal vascular lumina with intradermal papillary projections. The deeper component is composed of angular lumina dissecting collagen bundles. We present a case of targetoid hemosideric hemangioma which was presented as solitary nodule on left thigh.
Collagen ; Hemangioma* ; Subcutaneous Tissue ; Thigh

No abstract available.
Axilla* ; Paget Disease, Extramammary*

No abstract available.
Holoprosencephaly*

STUDY DESIGN: The lumbar segmental motions were analysed in asymptomatic volunteers. OBJECTIVES: To obtain normative data on flexibility and Graf's instability degree in sagittal plan of the normal lumbar spine. SUMMARY OF LITERATURE REVIEW: Although several clinical and radiological measurement tech niques are available, little is known about the normal range of lumbar spine motion. As a consequence, the diagnostic evaluation of radiographs are frequently based on subject opinions rather than object reality. MATERIALS AND METHODS: The authors have checked lumbar flexion-extension Yiews of 95asymptomatic volunteers who were divided into 5 groups by the age, and then their flexibility and Graf's instability degree were calculated by Graf's method with using Graf/Bar Mark II(digitalizing table) and personal computer program(RachisR). Evaluation of the sexual difference and comparison of the difference of each age group in spine level were done RESULTS: 1. There were significant differences in flexibility among age groups(p<0.05) and highest flexibility was observed in group 1 (age: 15-19yrs) and 15-19 segment 2. Flexibility was not different between male and female(p>0.05). 3. Graf's instability degree was not different among 5 age groups(p>0.05), and between male and female(p>0.05). 4. The mean Craf's instability degree was below 8o in L2-3, L3-4, and L4-5 segment, but above 8 in L5-S1 segment(male: 11.62+/-9.27 , female. 11.11+/-8.70). CONCLUSIONS: Although we observed small subjects, these results are the basic steps toward more objective and careful interpretation of flexibilty and Graf's instability degree.
Female ; Humans ; Male ; Microcomputers ; Pliability* ; Reference Values ; Spine ; Volunteers

Congenital brachymetatarsia causes minor disability in daily life. However, patients suffer cosmetically or psychologically and often demand correction of the deformity when they reach adolescence. Thirty-eight skeletal lengthenings were performed on twenty-three patients with congenital brachymetatarsia between March 1992 and July 1993. Short metatarsal bones were osteotomized subperiosteally, and held by a small external fixator and then subjected to slow axial distraction. All the patients were female with an average age of patients at the time of operation was twenty-one years. The average lengthenings was 15.8mm. The average healing index was 80.6(day/cm). The average lengthenings percentage was 35.2%. There was a metatarso-phalangeal joint subluxation with pain in one patient. We believe that the callotasis method was no need for bone grafting and permitted early weight bearing. The result was good cosmetically.
Adolescent ; Bone Transplantation ; Congenital Abnormalities ; External Fixators ; Female ; Humans ; Joints ; Metatarsal Bones ; Methods ; Osteogenesis, Distraction ; Weight-Bearing

The stiffness of the elbow joint is caused by trauma, infection, and ect. The conventional arthrop lasty and arthrodesis of this joint has been used but the indication is very limited because of unsati sfactory result. The Oganesyan external fixator, which was invented by Mstislav V. Volkov and Oganes V. Oganesyan in 1971, generally employes tne hinged-distraction apparatus to treat joint stiffness and flexion contracture. According to them, regeneration of both cartilage and underlying subchondral bony tissue is possible. These authors consider the main factor for regeneration of the cartilage af a destroyed joint surface to be early restitution of joint functions including unloaded motion and elimination of increased friction between the joint surfaces. From Jan. 1992 to Jan. 1994, We have experienced the 6 cases of stiff elbow who had been undergone biologic arthroplasty. The results were as follows; The gain of the average range of motion of the joint at final follow-up was 50.5°. The complications were mild pain in 2 cases, mild instability on exertion in 2 cases, recurrence of contracture in two cases and ulnar nerve irritation in one case. The complications affected no significant long term results except recurrence.
Arthrodesis ; Arthroplasty ; Cartilage ; Contracture ; Elbow Joint ; Elbow ; External Fixators ; Follow-Up Studies ; Friction ; Joints ; Range of Motion, Articular ; Recurrence ; Regeneration ; Ulnar Nerve

In patients with the sequele of poliomyelitis, pyogenic or tuberculous arthritis, or trauma, flexion contracture of the knee could be developed and many difficult problems would be met in treating them. Ilizarov suggested the method of gradual correction of deformities of bone after corticotomy-osteo- clasis, combined with gradual elongation of the shortened soft tissues, and the flexion contracture of knee & limb length discrepancy could be corrected simultaneously or sequentially following a sigle operative procedure. The authors have treated 25 patients with flexion contracture of the knee joint by the principle of Ilizarov treatment at the Sang Gye Paik Hospital between September 1991 and March 1994, The average preoperative flexion contracture of the knee joint, 25° (range, 10°
Arthritis ; Congenital Abnormalities ; Contracture ; Extremities ; Fractures, Stress ; Hip Joint ; Humans ; Ilizarov Technique ; Knee Joint ; Knee ; Leg ; Methods ; Osteotomy ; Poliomyelitis ; Surgical Procedures, Operative ; Tibia