Congenitial elevation of the scapula, more commonly referred to as Sprengel's deformity, first was described by Eulenberg in 1963. After then, many authors have reported this abnormal condition and many surgical spproaches have been described. When evaluating a patient with congenital elevation of the scapula for surgical correction, cosmetic severity, functional impairment, associated congenital anomalies and the child's age should be consicdered. Since July, 1981, we have tried surgical correction in 8 patients with this deformity, and followed up for more one year except one patient. 6 patients between 3 years and 11 years of age were trested with Green's operation, and 2 patients, 22 years and 26 years of age were treated with supraspinous portion resection only. All of 7 patients, whose follow-up period is more than one year, gained more thsn 1 grade of cosmetic improvement, mean 17 of combined abduction and mean 1.6 cm of acspular lowering. Keloid formation was most common complication and was prevented by meticulous subcutsneous and subcuticular suture. Brschial plexus palsy was most serious complication and was prevented by avoiding overcorrection or by clavicular osteotomy or intraoperative EST.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Keloid ; Osteotomy ; Paralysis ; Scapula ; Sutures

The authors studied the early morphologic changes of peripheral nerve, which is known as relatively radioresistant tissue to the X-ray irradiation, but recently clamied by several clinician through development of neuropathies after radiotherapy of the malignacy. Rabbits were received 1,000 or 2,000 cGy of X-ray on the knee joint areas. Sciatic nerves were extracted out 30 minutes, 1, 2, 4, 24 hours, and 3 and 7 days after irradiation. The morphologic changes were observed by light and electron microscopes. The results were summarized as follows: Light microscopically, only mild edema is noted. Electron microscopically, irregular separation and folding of myelin sheath with spherical body formation are noted. Above features were more prominent at later stages and aggregated nests of fragmented myelin were scattered 16 hours after irradiation. Schwann cell necrosis is noted after 24 hours. But above degenerative changes were scarcely present 7 days after irradiation. There is no remarkable axonal changes. The interstitial tissue revealed swelling and irregularity of surface of endothelial cells, and edema. On the basis of the results, it may be concluded that the peripheral nerve is injured by irradiation in early stages, and the main target of irradiation injury is thought to be myelin sheath and Schwann cells, which would be reversible and could be recovered promptly.
Rabbits ; Animals

PURPOSE: Recently, MRI has been routinely used in detection and treatment of metastatic spine tumors, but no previous study on prediction and prevention of vertebral body collapse was done using MRI. This study was done to analyze the risk factors of collapse and to define criteria of impending collapse using MRI. MATERIALS AND METHODS: Ninety-five vertebrae of 69 patients with metastatic lesions were evaluated using ratio of involved axial area, sagittal area, costovertebral joint, pedicle, facet joint and uncovertebral joint involvement as independent variables. We defined collapse when there was a fracture of the end plate and loss of vertebral body height over 10%, and degree of collapse was measured as ratio of the body height to the mean of the height of adjacent bodies. The ratio of the involved area was measured on T1-weighted images which showed the largest area of tumor involvement. RESULTS: There noted collapse of the bodies in 11 of 14 cervical vertebrae, 24 of 48 thoracic vertebrae and 15 of 33 lumbar vertebrae. Metastatic involvement on axial images was considered as a significant risk factor regardless of the vertebral level, while costovertebral joint destruction and axial involvement were significant risk factors in the thoracic spine. The criteria of impending collapse were: 51-60% axial involvement of the vertebral body in the cervical and lumbar spine; 61-70% axial involvement of the vertebral body with no destruction of other structures, 21-30% involvement of the vertebral body with destruction of one costovertebral joint or destruction of both costovertebral joints regardless of body involvement in thoracic spine. CONCLUSIONS: Using the above criteria with consideration of the patient s general condition and biologic behavior of the primary tumor, prophylactic stabilization can be performed to prevent ver-tebral body collapse which results in severe pain or paralysis.
Body Height ; Cervical Vertebrae ; Female ; Humans ; Joints ; Lumbar Vertebrae ; Magnetic Resonance Imaging* ; Paralysis ; Risk Factors* ; Spine* ; Thoracic Vertebrae ; Zygapophyseal Joint

STUDY DESIGN: We analysed the pre-vertebral soft tissue measurements in cervical spine trauma patients. OBJECTIVES: We tried to determine the sensitivity and specificity of soft tissue measurements in patients with radiographically proven cervical spine fracture and to investigate the diagnostic value of the measurements. SUMMARY OF LITERATURE REVIEW: Widening of the pre-vertebral soft tissue is a well recognized sign in injury of the cervical spine. But the diagnostic value of this widening is still controversial. MATERIALS AND METHODS: Width of the prevertebral soft tissue on lateral cervical spine radiographs was measured for 52 patients with a history of cervical spine trauma and for 53 patients complaining of cervical discomfort without a history of trauma. As a normal Korean adult standard, 7mm at C2 level, 8mm at C3 level, and 16mm at C6 level were considered the upper limit. Width of the prevertebral soft tissue was measured as a distance between antero-inferior margin of the body of cervical spine and the most posterior border of the larynx and trachea. RESULTS: A C2 prevertebral soft tissue measurement of more than 7mm had a sensitivity of 35% and a specificity of 86%. A C3 measurement of more than 8mm had a sensitivity of 35% and a specificity of 72%. A C6 measurement of more than 16mm had a sensitivity of 30% and a specificity of 80%. CONCLUSIONS: The prevertebral soft tissue measurement seems to be of limited diagnostic value. Further study may be required to determine more acceptable limits of normal cervical spine measurement in Korean population.
Adult ; Humans ; Larynx ; Sensitivity and Specificity ; Spine* ; Trachea

No abstract available.

A 20-year-old woman presented with 2-year history of low back pain. She is a basketball player. There was neither major traumatic episode nor history of febrile illness, On plain roentgenograms, sclerosis and slightly decreased height of L5 vertebral body was detected while the intervertebral disc spaces were intact. We found that L5 body was destructed by materials showing high signal intensity on T2 weighted images and connecting the two adjacent disc spaces on MRI. The initial diagonsis included bone tumors. Vertebrectomy was done and the intravertebral material was revealed as degenerated nucleus pulposus.
Basketball ; Female ; Humans ; Intervertebral Disc ; Low Back Pain ; Magnetic Resonance Imaging ; Sclerosis ; Young Adult

No abstract available.
Spine*

No abstract available.

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

Tentative diagnosis of meniscal pathology is very helpful for the successful operative management including arthroscopy. Conventional arthrography has long been used to meet this purpose, but it has some limitations due to complex views and some difficulties in imaging the whole anatomical structures. Recent diagnostic advancement produced post-arthrographic HRCT and MRI for the compensation of these problems of conventional arthrography. Arthrography and post-arthrographic HRCT has been carried out on 49 knees in 43 patients. 38 knees among them could be confirmed by arthroscopy and following results were obtained. 1. Diagnostic accuracies of post-arthrographic HRCT for medial and lateral meniscal injuries of knee were 94.7% and 92.1% repectively. 2. Shape, contour of torn meniscus and the relationships between the torn fragments were better demonstrated with HRCT. 3. Horizontal tear could also be suspected by HRCT. 4. Peripheral detachment could be differentiated with synovial recess on the HRCT, especially in the reformat view, but was more clearly visible in arthrography. 5. Arthrography and HRCT can be used as a good complementary study for the evaluation of meniscal injuries.
Arthrography ; Arthroscopy ; Compensation and Redress ; Diagnosis ; Humans ; Knee ; Magnetic Resonance Imaging ; Pathology ; Tears