No abstract available.
Humans ; Knee*

No abstract available.
Arthrodesis* ; External Fixators* ; Knee*

No abstract available.
Dislocations*

No abstract available.
Child* ; Humans ; Humerus*

It has been generally agreed that most fractures of the humeral shaft are best treated non-operatively although occasionally there are indications for primary operative treatment. Recent advances in internal fixation techniques and instrumentation have led to an expansion of surgical indications, and operative treatment produces higher rates of nonunion, infection and other associated complication when compared with closed treatmet techniques. Because of the significant morbidity of the operative treatment, closed intramedullary fixation techniques that provide stability of the fracture site without opening and reduce the postoperative complications, were developed. In this paper we document forty two fractures of the humeral shafts that were treated by functional bracing(Group I: 24 cases) and intramedullary fixation with functional bracing(Group II: 18 cases) between October, 1982 and August, 1986. And the obtained results were as follows: 1. The everage healing time was 9 weeks in the Group I, and 11 weeks in the Group II . 2. The non-union has not been encountered in the Group I, but non-union and delayed union were 4 cases (22.2%) in the Group II. 3. The complication rate was 9 cases(37.5%) in the Group I, and was 12 cases(66.7%) in the Group II, but deep infection did not occured in all cases. 4. The residual angulation more than 5 degrees was 20 cases(83.3%) in the Group I, and was 2 cases(11.1%) in the Group Il. However the results of the group Il were inferior ot the group I, of more proper selection of the patients, more accurate technique and adequate type of nails have been used, the better results will be taken.
Braces ; Humans ; Postoperative Complications

The thoracolumbar spine is relatively easily traumatized and result in serious complications such as neurologic impairment and instability, so its proper management is very important. Formerly the thoracolumbar spine injury was evaluated mainly by plain radiographs, and tomograms if indicated,but because computed tomography visualizes bone and soft tissues three-dimensionally, we tried to compare its value with that of plain radiographs in potentially unstable thoracolumbar injuries. From January 1984, we determined the stability of the potentially unstable thoracolumbar spine injury according to computed tomography finding and compared with plain radiography finding, and the following results were obtained. 1. By Holdsworth classification, it was difficult to determine the stability of the thoracolumbar spine injury. 2. In cases of compression fracture and burst fracture by Denis classification, it was necessary to determine the stability by computed tomography. 3. In cases of unstable burst fracture by McAfee classification, there was no direct relationship between the degree of canal occlusion and neurological deficit, but above 25% in conus medullaris lesion and above 50% in cauda equina lesion usually manifested neurological deficit. 4. In our cases, the neurological status of initial injury was important factor to determine the improvement rate.
Cauda Equina ; Classification ; Clinical Study ; Fractures, Compression ; Radiography ; Spinal Cord ; Spine

No Abstract Available.
Cadaver* ; Humans* ; Spinal Cord* ; Spine*

We experienced a rare case of thoracic outlet syndrome caused by hypertrophic nonunion of the first rib. A diagnosis was made mainly upon provocative tests and imaging studies. Pain and tingling could be reproduced and the radial pulse obliterated by the hyperabduction test. Abundant callus formation on the posterior aspect of the first rib with fracture line was visible on plain radiograph. Two-dimensional computed tomography showed right thoracic outlet narrowing mainly caused by the mass-effect of the callus. Dynamic arteriographic studies revealed an external compression of the right subclavian artery and duplex ultrasonography demonstrated a reduction in right subclavian artery blood flow when the shoulder is in 90 degrees of abduction. Surgery was performed after the conservative management for three months which failed to relieve the patient of his complaints. Resection of the first rib via transaxillary approach was undergone uneventfully in combination with the myotomy of the scalenus anticus muscle. At postoperative one year follow up, the patient was free of symptoms, and had a full range of motion of the right shoulder with no evidence of arterial insufficiency.
Adult ; Case Report ; Human ; Hypertrophy ; Male ; Ribs/*pathology ; Thoracic Outlet Syndrome/*etiology/surgery

PURPOSE: To find out the factors affecting prognosis after surgical decompression of tarsal tunnel syndrome. MATERIALS AND METHODS: We investigated and followed 11 patients in 12 cases with tarsal tunnel syndrome who underwent surgical decompression in our hospital over a 2-year and 6-month period. Diagnosis was based on the history, thorough physical examination and electrodiagnostic study. Recently, Magnetic Resonance Imaging has also been used to show in extraordinary detail both bony and soft tissue structures of ankle. Operation removed etiologic factors, decompression of flexor retinaculum and neurolysis of the posterior tibial nerve and its medial and lateral plantar nerve branches. It was particularly vital that the mobilization of the posterior tibial nerve be carried out distal to the overlying abductor hallucis. RESULTS: Electrodiagnostic evaluation showed reduced amplitude, increased duration of motor evoked potentials and decreased sensory conduction velocity, The postoperative result was assessed according to Takakura's rating scale. It was excellent in 3 cases, good in 6 cases, fair in 2 cases and poor in 1 case. CONCLUSIONS: The prognosis seemed to be related with age, duration of symptom and definite space occupying lesion.
Ankle ; Decompression ; Decompression, Surgical* ; Diagnosis ; Evoked Potentials, Motor ; Foot ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Prognosis ; Tarsal Tunnel Syndrome* ; Tibial Nerve

PURPOSE: To evaluate the treatment results, of open tibial shaft fracture assess its benefit and investigate ways to prevent deep infection or osteomyelitis. MATERIALS AND METHODS: Thirty-one cases of open tibial shaft fracture treated by primary external fixation and secondary unreamed interlocking intramedullary nailing were investigated and evaluated in terms of items such as fracture location, pattern, bony union, complications, etc. RESULTS: The most common cause was traffic accidents (23 cases, 74.2%), location was mid 1/3 (21 cases, 67.7%), pattern was comminuted one (16 cases, 51.6%) and open type was IIIb (14 cases, 45.1%). Duration of external fixation was 7.6 weeks in average, time interval to nailing after removal of external fixator was 15.7 days in average. Bony union was achieved within an average of 39.2 weeks after external fixation. Complications were 3 cases (9.7%) of delayed union, 5 cases (16.1%) of pin site infection, 1 case (3.2%) of deep infection, 2 cases (6.5%) of malunion and 2 cases (6.5%) of ankle stiffness. But nonunion and chronic osteomyelitis did not occur. CONCLUSION: This method enables early soft tissue reconstruction and minimizes delayed union and nonunion in the severely contaminated or injured open tibial shaft fracture. The timing of secondary nailing should be established under exact principle in order to prevent very serious complications such as deep infection and osteomyelitis.
Accidents, Traffic ; Ankle ; External Fixators ; Fracture Fixation, Intramedullary* ; Fractures, Open ; Osteomyelitis