Macrodactyly is a rare congenital malformation characterized by an increase in the size of all the elements or structures of a digit or digits. The phalanges, tendons, vessels, subcutaneous fat, finger nails, and skin are all enlarged, but the metacarpals are not affected. The condition is most frequently found in the index and long fingers, and its etiology remains unexplained. Macrodactylism associated with neurofibroma of the median nerve in the left middle finger, in a 13 year old girl, is presented with a review of the literature, and diagnosis was confirmed by pathological examination. Chief complaints were enlargement of the left middle finger and a soft tissue mass in the left palm since birth. There was no change in motor and sensory function of the hand. X-ray showed enlargement of phalanges and a diffusely enlarged soft tissue shadow in the middle finger. We performed epiphysiodesis of the proximal, middle and distal phalanges of the left middle finger with exploration of the left median nerve to the wrist joint. An enlarged fibromatous median nerve, left side, was found with very large abundant fat lobules around it.
Diagnosis ; Female ; Fingers ; Hand ; Humans ; Median Nerve ; Metacarpal Bones ; Neurofibroma ; Parturition ; Sensation ; Skin ; Subcutaneous Fat ; Tendons ; Wrist Joint

A clinical observation in 8 cases of multiple laminectomies under the age of 16 years who had been followed for more than 3 years was carried out to analyze deformities and its results of treatment, and the following results were obtained. 1. Spinal deformities were developed in 5 cases-4 kyphosis and 1 lordosis. 2. The kyphosis was developed in 1 case at cervical spine, 1 at thoracic, 1 at thoracolumbar junction and 1 at lumbar, and the lordosis was developed in 1 case at lumbar spine. 3. Anterior interbody fusion was carried out on two cases of kyphosis who had severe pain and neurological symptoms and posterolateral spinal fusion was carried out on one case of lumbar lordosis, with satisfactory results in all cases. 4. Since the incidence of spinal deformities following multiple laminectomies in children is high, laminectomy should be performed only when it is definitely indicated, and when it is done, damage to the posterior complex should be minimized. 5. For the prevention and treatment of the spinal deformities, brace or close observation should be necessary postoperatively, and spinal fusion should be performed in increasing or severe deformities.
Animals ; Braces ; Child ; Congenital Abnormalities ; Humans ; Incidence ; Kyphosis ; Laminectomy ; Lordosis ; Spinal Fusion ; Spine

No abstract available.
Extremities* ; Neurilemmoma*

It has been well known that the knee joint is burdened on motion and weight bearing and structurally, it is more frequently injuried than other joints. Injuries to the ligaments of the knee joint are of frequent occurrence because of the increasing traffics and popularity of sports. It seems to be impotant to study on the mechanism of Injury, method of physical examination and treatment of the Iigamentous injuries of the knee. The purpose of this paper is to get accurate diagnosis and proper treatment. 68 cases of ligamentous injuries in 65 patients who were admitted and treated at the Department of Orthopaedic Surgery of Hanyang University Hospital from May, 1975 to April, 1979 have been reviewed. The results of this study were as follows: 1. The ligamentous injuries of the knee were more prevalent in male 4.9 times than female; and frequently occured in 20 to 30 decades (60%). 2. Traffic accident was the most common cause, and the most frequent injury associated with the ligament injuries of the knee was fracture. 3. Medial collateral ligament was ruptured most frequently and its tibial attachement was the most common site of the rupture. 4. Frequently, lateral collateral ligament was detached from the fibular attachment, anterior and posterior cruciate ligaments were ruptured through their substances. 5. There were 3 cases of isolated cruciated ligament injury, one was anterior and others were posterior. 6. Excellent or good result was obtained in 77.3% by operative treatment and in 93.3% by nonoperative treatment. 7. Early repair (under two weeks) gave much better results than late repair.
Accidents, Traffic ; Clinical Study ; Collateral Ligaments ; Diagnosis ; Female ; Humans ; Joints ; Knee Joint ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Male ; Methods ; Physical Examination ; Posterior Cruciate Ligament ; Rupture ; Sports ; Weight-Bearing

No abstract available.
Child* ; Humans ; Humerus*

A clinical study including physical examination, electromyographic and roentgenological studies of the 2. Taekwondoists hands who mainly practiced the object-breaking maneuver with a hand who were cared at the department of orthopedic surgery, Hanyang University Hospital from November 1, 1981 to January 31, 1982, The results of the survey were as follows. 1. The average age of the athletes was 26.7 years, the average Taekwondo-practicing career was 9.7 years, the average object breaking career was 6.4 years, and the startmg age of breaking was 20.1 years in average. 2. The main parts of the hand for the breaking were Joomeok(fist) and Sonnal (ulnar edge of the palm; hand knife). 3. Bricks and tiles were commonly used as materials for breaking. Seventeen(74%) athletes could break 1 to 2 layers brick blocks, and twenty(87%) could break the 10 to 15 layers roof-tile blocks. 4. Twelve (52.1%) athletes got injuries during breaking practice. The most common injury was metacarpal fracture (7/14, 58.5%), dislocation (2/14, 16.7'lo), subluxation, sprain, and contusion (1 each/14, 8.3%) were less frequent. 5. The thickness of the knuckle pad varied from 2 to 3.9mm in 16/23 (69.5%). The average grasping power of the athletes was 97.6 1bs, and it was stronger than normal person by 9.3 lbs. 6. The electromyographic study showed no isgnificant difference in nerve conduction velocity between the af- fected and unaffected hands, which was within the normal range. It was found that the muscle primarily used was flexor digitorum profundus. 7. In the roentgenological study, the length of the second metacarpal on the affected side was the same or 0 tc 2mm shorter than the unaffected side, and when the athlete was in the growth period, the metacarpal short ness was more marked. 8. Roentgenologically no hypertrophy of the metacarpal and phalangeal bones noted.
Athletes ; Clinical Study ; Contusions ; Dislocations ; Hand Strength ; Hand ; Humans ; Hypertrophy ; Neural Conduction ; Orthopedics ; Physical Examination ; Reference Values ; Sprains and Strains

No abstract available in English.
Clinical Study ; Shoulder Fractures

Congenital synostosis of the proximal ends of the radius and ulna is a rare malformation which often completely prevents pronation and supination of the forearm. The evidence for a genetic etiology is provided by noting its presence in a Klinefelter's syndrome and its positive familial history. Two cases of congenital radioulnar synostosis occurred in brothers have been experienced and are to be reported with review of references.
Forearm ; Humans ; Klinefelter Syndrome ; Pronation ; Radius ; Siblings ; Supination ; Synostosis ; Ulna

Congenital scoliosis is defined as a lateral curvature of the spine caused by congenital anomalies of the vertebral development. In this study seventeen congenital scoliosis patients seen and treated by either Milwaukee brace or surgical intervention at Department of Orthopedic Surgery, Seoul National University Hospital from December 1972 to April 1978 were evaluated according to frequency of the curve pattern, character of the deformity, method of treatment and its correctability. The following results were obtained in this study. 1. Age distribution was from 2 to 39 years and mean age was 13.4 years. 2. The most common deformity pattern was hemivertebra in 8 cases (47.1%), unilateral unsegmented bar in 4 (23.6%) and mixed type in 3 (17.6%). 3. The most common curve level was thoracic in 6 cases (35.3%), followed by thoracolumbar in 4 (23.5%) and lumbar in 4 (23.5%). 4. The best corrected type by Milwaukee brace was trapezoid vertebra (29.4%) and then mixed type(26.1%), followed by block type (20%) and hemivertebra(2.3%). 5. The operative treatment was performed in the cases of unilateral bar and progressive type with Milwaukee brace. In terms of the correctability of the curvature, the surgical intervention was better than the conservative treatment, with the result of its average correction of 33.5% that is compared with 15.9% of Milwaukee brace. 6. Halofemoral traction was effectively applied in the cases of rigid and severe curve; the initial curve 76.3 degress with 21.3% of flexibility. 7. Loss of correction in operative treatment was 2.3 degrees (6.5%).
Age Distribution ; Braces ; Congenital Abnormalities ; Humans ; Methods ; Orthopedics ; Pliability ; Scoliosis ; Seoul ; Spine ; Traction

Unilateral absence of the articular process at a lumbar vertebra is a rare anomaly. The etiology of the congenital absence of articular process is not precisely determined yet, but it was explained as some of the possible embryologic bases. Absence of the articular process at the level of L5-Sl have been reported a few, but anomaly above L4 is rare. We are reporting a case of absence of articular process at the level of the 4th lumbar vertebra.
Spine