We clinically reviewed and analysed 19 patients treated as Girdlestone operation with or without Batchelor osteotomy at the Department of Orthopedic Surgery, Busan National University Hospital from April 1979 to June 1981. The results were as follows: 1. The underlying disease were infected pinning and nailing of 8 cases, pyogenic hip of 4 cases, failed total hip arthroplasty of 4 cases, tuberculous hip of 2 cases and femur neck fracture of 1 case. 2. Satisfactory results were obtained in 7 or 8 cases treated as secondary Girdlestone operation over 50 years of age. 3. Postoperative shortening ogleg length was 3.2cm in average (from 1.7cm to 5.0cm), which was average 2.5cm at 12 weeks traction and average 3.7cm at 6 weeks traction. 4. Postoperative average range of motion was; flexion to 80 degrees and abduction to 30 degrees. There was statistical significancy in activity of daily living of hip function at 12 weeks traction in postoperative score. 5. 6 cases out of 11 cases without pain in postoperative condition showed severe bony contacts and ir- regularities of proximal portion of the operated femur radiologically.
Arthroplasty, Replacement, Hip ; Busan ; Femoral Neck Fractures ; Femur ; Hip ; Humans ; Orthopedics ; Osteotomy ; Range of Motion, Articular ; Traction

The management of chronic skin defect over the pretibial region, sacral pressure sore and other bony protuberant area is extremely difficult due to the presence of necrotic and infected bone, avascular and infected scar tissue, dead space and anatomical sparse of available adjacent structure. The present methods of management include versatile varieties and have left much to be revised, but they often despaired of both surgeon and patient, especially due to persistent chronic osteomyelitis and recurrent ulcer. From January, 1975 to April, 1979, we have had treated 20 such cases with application of muscle flap transposition and following has been observed. 1. The cause of lesion were 11 cases of the traffic accident, 4 cases of the industrial accident, 2 cases of the falling from a height, 2 cases of the pressure sore and 1 case of the chronic osteomyelitis. And 15 cases of them were physically active young adult between 2nd decade to 4th decade. 2. The muscles used for pretibial lesion were medial head of gastrocnemius m., soieus m., flexor digitorum longus m. and peroneus brevis m. Used abductor hallucis m. for medial malleolar defect, gluteus maximus m. for sacral pressure sores and sartorius m. for exposed knee joint. 3. There existed hematoma formation in 2 cases, partial necrosis of transposed muscle in 3 cases and persistent infected sinuses in 3 cases. Other cases except the last 3 cases, which needed another surgical procedure and antibiotic therapy, were controlled without difficulty and all of them did not develope any recurrence of ulcer during the follow up duration. 4. There did not appear to be any significant long term functional residua due to loss of original function of the transposed muscle except somewhat unacceptable cosmetic result. 5. It was 2 months average for the healing cases which did not need a bone graft and 5 months average for the cases needed a bone graft.
Accidental Falls ; Accidents, Occupational ; Accidents, Traffic ; Cicatrix ; Follow-Up Studies ; Head ; Hematoma ; Humans ; Knee Joint ; Muscles ; Necrosis ; Osteomyelitis ; Pressure Ulcer ; Recurrence ; Sacrococcygeal Region ; Skin ; Transplants ; Ulcer ; Young Adult

The authors investigated LD activity and isoenzyme of total serum and joint fiuid in 18 cases of rheumatoid arthritis, 11 cases of degenerative arthritis, 6 cases of traumatic arthritis, and 10 cases of healthy control. The samples of serum examined were obtained from the anterior cubital vein and joint fluid from the knee joint except 2 cases of the rheumatoid arthritis, which were obtained from the wrist joint, in Busan National University Hospital from the April to July 1981. Total serum LD activity was measured by method of Caboud-Wroblewski and isoenzyme fractions were analysed by cellulose acetate electrophoresis. The results obtained were as follows: l. In the patients with joint diseases, total serum LD activity was significantly increased than that of healthy control. 2. The LD1 isoenzyme of joint fiuid was increased in degenerative arthritis than that in rheumatoid arthritis, and LD3 and LD5 isoenzymes were significantly increased in rheumatoid arthritis than that in degenerative arthritis. 3. In correlation between total LD and LD isoenzymes activities in joint fluid, total LD activity of rheumatoid arthritis was correlated with decrease of LD1 isoenzyme and increase of LD5 isoenzyme activity, and total LD activity of the degenerative arthritis was correlated with increase of LD1 isoenzyme activity. 4. In correlation between isoenzyme activity and gamma globulin of joint fluid, LD3 and LD5 isoenzyme activity in rheumatoid arthritis and LD4 in degenerative arthritis was correlated with increase of gamma globulin.
Arthritis ; Arthritis, Rheumatoid ; Busan ; Electrophoresis, Cellulose Acetate ; gamma-Globulins ; Humans ; Isoenzymes ; Joint Diseases ; Joints ; Knee Joint ; Methods ; Osteoarthritis ; Synovial Fluid ; Veins ; Wrist Joint

Supracondylar fracture of the humerus is the most common fracture of the elbow in children and it can also be one of the most difficult fractures to be treated. A number of methods to manage supracondylar fracture of the humerus in children, have been being practiced and the ideal one is generally agreed with prompt, accurate and anatomical. reduction performed with the least possible trauma, and, it will prevent most complications. It is essential to minimize additional trauma to the already traumatized joint and pericapsular tissues including blood vessles and nerves. 105 patients with supracondylar fracture of the humerus managed at the Department of Orthopedic Surgery, Busan National University from January, 1971 to June, 1976 were reviewed and the following results were obtained. 1. The age of the patients ranged from 2 years to 14 years; the average age was 7. 0 year. 70 patients were boys. 2. The left side was involved in 62 patients; The distal fragment was displaced posterioly in 102 patients and anteriorly in 3 patients The medial displacement in the posteriorly displaced distal fragment was 60 patients. 3. 20 fractures were treated by open reduction and internal fixation. The indications for open reduction were failure to obtain accurate reduction after a few attempts of closed reduction in 15, an open fracture in 2, acute vascular embarrassment in 2, and redisplacement after open reduction in 1. 4. 15 of the 20 fractures treated by open reduction were re-examine 1 to 5 years; The results were normal elbow motion in 10, loss of extension (average 24 degree) in 5, loss of flexion in 2 and neuro-vascular complication in 2.
Busan ; Child ; Elbow ; Fractures, Open ; Humans ; Humerus ; Joints ; Orthopedics

Fractures about the knee including the distal femur and the proximal tibia not infrequently result in vaseular injuries of the popliteal artery and the distal part of the femoral artery. This is often followed by circulatory disturbance and jeopadizes the viability of the lower extremity. During the three and a half year period, from January 1973 to June 1976, 20 cases of vascular injuries complicated by fractures about the knee were treated at the Orthopedic Department of Busan National University Hospital. Review of the cases resulted in the following observations. 1. The lower extremity escaped amputation in 45% the cases (9 of the 20 cases) 2. Femoral arteriography showed that the site of injury was proximal to the Soleus insertion. in 17 cases. 3. Types of vascular injury were contusion in 9 cases, laceration in 7 and total disruption in 4. 4. 5 of the 6 extremities that were treated within 12 hours after injury survived, while only 2 out of t he 9 extremities treated after 24 hours following injury escaped amputation. 5. 6 of the 13 extermities (46%) tredted by interval fixation survived, while 1 out of 5 extremities (20%) treated by traction escaped amputation.
Amputation ; Angiography ; Busan ; Contusions ; Extremities ; Femoral Artery ; Femur ; Knee ; Lacerations ; Lower Extremity ; Orthopedics ; Popliteal Artery ; Tibia ; Traction ; United Nations ; Vascular System Injuries

Authors analysed 19 cases with Cavernous Hemangiomas of Skeletal Muscles in Extremities. Those were confirmed clinicopathologically for the period of 2 years from October 1976 to September 1978, and following results were obtained. 1. The age of initial visit varied from 6 months to 42 years of age with the average of 17.7 years. Seventeen patients(89.5%) were under 30 years of age. 2. The age of initial onset of symptoms varied from birth to 36 years of age with the average of 13.1 years. Seventeen patients(89.5%) were under 20 years of age. 3. The duration of disease varied from 6 months to 17 years with the average of 4.6 years. 4. The ratio of male and female was 9:10. 5. Chief complaints were a swelling or mass in 17 cases(89.5%), pain in 13 cases(68.4%), tenderness in 6 cases(31.6%), and impairment of function in 5 cases(26.3%). 6 The size of a mass varied from a nut size to an adult fist one, and its shape appeared oval with the average 8.1 by 4.6 cm in 12 cases, and round with the average 5.5 cm in 7 cases. 7. The site of involvement distributed to lower extremities in 10 cases(52.7%), upper ones in 9 cases(47.4%). Among extremities(thigh, leg, arm and forearm) the most common site was forearm. 8. Considering the number of involed muscles, most frequently they developed in a single muscle with 11 cases(57.9%). 9. By history, The symptoms were initiated or aggravated by trauma in 3 cases(15.8%). 10. Plain roentgenograms showed the swelling of soft tissue in 9 cases(47.4%) and phleboliths in 8 cases(42.1%). 11. Considering the methods of treatment, complete resection was possible in 17 cases(85.7%), in the remaining 2 cases only incomplete resection could be done.
Adult ; Arm ; Clinical Study ; Extremities ; Female ; Forearm ; Hemangioma, Cavernous ; Humans ; Leg ; Lower Extremity ; Male ; Muscle, Skeletal ; Muscles ; Nuts ; Parturition

Authors reviewed and clinically analysed 34 cases of trasometatarsal joint injury treated at the Orthopedic department of Pusan National University Hospital during the period from January 1975 to December 1979, and following results were obtained. 1. The incidence was higher in male and the active age group of 20-40. 2. Among the causes, traffic accidents were 22 cases (64.7%) and crushing injuries in the industrial field were 6 cases (17.6%). 3. Fracure-dislocations were higher than simple dislocation. 4. According to the Wilsons Classifications, the injuries were classified as follows. First stage of supination (51), 11 cases (32.4%): First stage of pronation (P1), 8 cases (23.5%): Plantar-flexion alone (PF), 4 cases (11.8%): Second stage of supination (S2), 3 cases (8.8%): Second stage of pronation (P2), 2 casese (5.9%): And finally direct crushing injuries,were 6 cases (17.6%): 5. Associated injuries were fracture of the metatarsal bone in 15 cases (44.1%), fractures of the tarsal bone in 7 cases (20.6%) and severe soft tissue injuries in 6 cases (17.6%), 6. The operative treatments with early anatomical reduction were obtained better results than conservative treatment. 7. As complications, pain in 31 cases (91.2%), bony deformity in 26 cases (76.5%), motion limitation in 32 cases (94.1%), skin necrosis in 3 cases (8.8%) and traumatic arthritis in 23 cases (67.6%) were observed.
Accidents, Traffic ; Arthritis ; Busan ; Classification ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Humans ; Incidence ; Joints ; Male ; Metatarsal Bones ; Necrosis ; Orthopedics ; Pronation ; Skin ; Soft Tissue Injuries ; Supination ; Tarsal Bones

Several measurements were performed about 105 cases of normal stress A-P arthrographic findings in adult knee including discoid without tearing or osteoarthritis, those were selected from 166 cases examined arthrographicaliy under same technical condition due to suspicious internal derangement of the knee from October 1976 to March 1980. After stastistical analysis and comparative study about chondrai thickness, chondral index, meniscal size, meniscal index, intermeniscal distance, type of meniscus, communication between knee and proximal tibiofibular joint, following results were obtained. 1. Chondral thickness of normal articular cartilage was not related to joint size, but almost same value individually. Mean chondral thickness In P and P points was 2.90±0.63mm, 2.90±0.62mm, 2.93±0.64mm, 2.92±0.65mm in lateral, medial femoral condyle and lateral, medial tibial condyle in order. Age change was not seen statistically. 2. The size of meniscus was correlated nearly proportional with that of the joint. Mean lateral meniscus size (transverse meniscal length × meniscal thickness) was 12.55±2.50mm × 6.53±0.7mm in male and 10.13±2.25mm × 6.02±0.52mm in female. That of medial meniscus was 9.79+1.54mm × 5.85+ 0.45mm in male, and 7.72±1.64mm × 5.36±0.92mm in female. Age change was not seen statistically either. 3. Mean intermeniscal distance was 60.21x2.74mm in male, 53.34±3.31mm in female and occupied 83% in male, 82% in female of joint size each other. 4. In types of meniscus, normal type was 8.10%, infantile type dlscoid 12.4%, intermediate type 2.9%, primitive type 3.7% each other. 5. Communications between knee joint and proximal tibiofibular joint were seen in 24%.
Adult ; Cartilage, Articular ; Female ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Menisci, Tibial ; Osteoarthritis ; Tears

The twelve cases of metallic failure after compression plate fixation which were observed and treated at Department of Orthopedic Surgery, Busan National University Hospital were clinically analysed. The results were summerized as follows; 1. Age and sex of the patients was male in his active age in life. 2. The causes of fracture were traffic accidents and industrial accidents. The sites of fracture were femur in 11 cases and tibia 1 case. 3. The types of fracture were comminuted in 11 cases and short oblique in 1 case. 4. The 6 patients were not cooperative and began walking at their will after postoperative 4 weeks despite doctors order of nonweight bearing. Average duration of immobilization was 6 weeks. 5. Metallic failure occurred as screw failure in 1 case, plate failures through empty hole in 4 cases and plate failures through hole filled with screw nearest to the sites of fracture in 7 cases. 6. Interval between operation and metallic failure was 6.25 months average. The 75% of the metallic failure occurred between 4 to 7 months. 7. Treatments of metallic failures were cast immobilization with bone grafting in 1 case at tibia, intramedullary nailing with bone grafting in 1 case at femur and compression plate fixation with bone grafting in 10 cases at femur. 8. Causes of failure after internal fixation 1). Insufficient bone support Inadequate inter-fragmentary compression 9 cases Absence of cancellous bone graft 8 cases Empty plate hole 4 cases Remaining defects 3 cases 2). Inadequate postoperative treatment 6 cases.
Accidents, Occupational ; Accidents, Traffic ; Bone Transplantation ; Busan ; Femur ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Male ; Orthopedics ; Tibia ; Transplants ; Walking

The recent trend in method of long bone fracture had been toward bracing or closed medullary nailing except for certain fractures that fall within well-established surigcal criteria. Functional bracing is gaining widespread acceptance in management of tibial, femoral, and forearm fractures and is well suited to humeral shaft fractures. Twenty four cases of humeral shaft fractures were treated with functional brace and early mobiliza tion from October 19S2 to June 1984 at Busan National University Hospital and the results were as follows. 1. The fracture sites were composed of middle third in 15 cases, distal third in 6 cases, and proximal third in 3 cases and the fracture shapes were transverse in 10 cases, oblique and spiral in 5 cases respectively, and comminuted in 4 cases. 2. The average time from injury to functional bracing was 13.0 days and to discontinuance of the functional brace was 9.0 weeks. 3. Nonunions have not been encountered in all cases. The residual angulation was under 20degrees in all but one and the most common deformity was varus in 20 cases. Minimum limitation of motion, mostly a loss of the last few degrees of external rotation, was detected after follow-up of 2 months but did not present any clinical problem. 4. The achievement of rapid and uninterrupted osteogenesis without undesirable functional or cos- metic deficit could be listed as the advantage.
Braces ; Busan ; Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Fractures, Bone ; Humerus ; Methods ; Osteogenesis