Cubitus varus deformity following supracondylar frscture of the humerus in children is one of the major complications. The angle between long axis of humeral shaft and the line formed by connecting lower margin of trochlea and capitellum has been described by authors as a new method of radiological assessment for the indirect measurement of carrying angle. From the author's retrospective radiological study in 115 normal children and 41 supracondylar fractured children, the results were as follows;1. In the 115 normal arms, the mean vslue of T-C angle was 1049±3.8° 2. In the 115 normal arms, a significant relationship was found between the Baumann angle and T-C angle. 3. In the 115 normal arms, a significant relationship was found between the Baumsnn angle and the Carrying angle. 4. In the 115 normal arms, a significant relationship was found between the T-C angle and the Carrying angle. 5. In the 41 injured arms, reliability test was performed for the excluding of effect of the environment. The results was that T-C angle was more reliable than Baumann angle as a indirect measurement method of the Carrying angle. From above results, it is suggested that T-C angle can be reliably used to predict the Carrying angle and prevent cubitus varus deformity in supracondylar fracture of humerus.
Arm ; Child ; Congenital Abnormalities ; Humans ; Humerus ; Methods ; Retrospective Studies

No abstract available.

The slipped capital femoral epiphysis is the condition in which the femoral head slips downward and backward on the femoral neck at the epiphyseal plate. The underlying cause of this disease is unknown. In general, it is believed that endocrine factors may play a part as shown in experimental work. But few endocrine abnormalities have been proved. It is rare in Korea and eight cases have been reported and only one case was associated with diabetes insipidus in hypogonadal Turner mosaicism. Authors report a case of mild, acute on chronic slipped capital femoral epiphysis in a 19 year old male with hypogonadism and diabetes insipidus. It was treated by internal fixation with three Steinmann pins and the result was good.
Diabetes Insipidus ; Femur Neck ; Growth Plate ; Head ; Humans ; Hypogonadism ; Korea ; Male ; Mosaicism ; Slipped Capital Femoral Epiphyses

Open reduction and internal fixation of the displaced fractures of the acetabulum represents one of the greatest challenge in fracture surgery. The purpose of our study is to report the results of operative treatment and establish the guideline for the operative treatment of the displaced acetabular fractures with the analysis of the clinical and radiological results. This retrospective study reports the results of 21 fractures in 21 patients(19 male and 3 female) treated by open reduction and internal fixation from January 1990 to July 1994. The patients were followed up more than 1 year and mean length of follow-up was 2.3 years. According to Letournel's classification, we had 9 elementary fractures(42.8%) and 12 associated fractures(57.2%). Among the elementary fractures, the posterior wall fracture was the most common type(7 cases, 33.3%) and the transverse-posterior wall fracture was the most common type among associated fractures(4 cases, 19.0%). Surgical approaches were 14 Kocher-Langenbeck, 6 Ilioinguinal and 1 extended iliofemoral. Indirect reduction and specially designed reduction method using C-arm and radiolucent operating table were also helpful to achieve satisfactory reduction. Overall quality of clinical results was graded according to the D'Aubigne and Postel rating score. Satisfactory reduction was gained in 16 cases(76.1%). Unsatisfactory reduction was gained in 5 cases(23.8%). Among the cases within category of satisfactory reduction, there were 7 excellent and 8 good clinical results. But among unsatisfactorily reduced 5 cases, there were 2 good clinical results. It seems that the satisfactory operative reduction of the fracture is the factor that correlates with a satisfactory clinical result. There were complications such as 3 secondary osteoarthritis(14.2%), 3 wound infection(14.2%, 2 superficial and 1 deep), 2 iatrogenic nerve palsy(9.5%, 1 sciatic and 1 obturator nerve) and 1 intrapelvic protrusion acetabuli(4.7%) and no postoperative ectopic ossification.
Acetabulum ; Classification ; Follow-Up Studies ; Humans ; Male ; Methods ; Operating Tables ; Ossification, Heterotopic ; Retrospective Studies ; Wounds and Injuries

Twenty one cases of adult tibial shaft fractures were fixed with flexible intramedullary nails at the Department of Orthopedic Surgery, Kang Nam General Hospital. The results are summerized as follows; l. Average healing time was 17 weeks. No case of nonunion was experienced. 2. As the operation was perfomed by closed method under fluoroscopic control, reduction of operation time is a major advantage. 3. Fixation was usually strong enough to allow immediate weightbearing and mobilization of the adjacent joints without external immobilization. 4. Three cases of delayed union and 2 cases of rotational malunion were experienced, but shortening and angulation were not so severe as to affect overall functional results. 5. In conclusion, Ender nailing is considered to be a valuable method in treating tibial shaft fractures. Even in cases with multiple injuries and in selected open cases, Ender nailing can be a saft procedure.
Adult ; Hospitals, General ; Humans ; Immobilization ; Joints ; Methods ; Multiple Trauma ; Orthopedics ; Tibial Fractures ; Weight-Bearing

Arthrodesis of the knes has lost its nopularity since the development of modern knee replscement arthroplasties, however it still has its place as a salvage procedure when replacement arthroplasties are contraindicated. Various techniques have been in the use including the time-tested Charnleys compressiori arthrodesis. Instead of using Charnley's and other similar compression devices, the authors applied single or double compression plates in 8 knees with severe destruction and deformities, and the results are summerized ss follows: l. Included in this series are 5 cases of tuberculous arthritis, 1 case of septic arthritis, 1 case of resistant scar contracture, and 1 case of Charcots knee. 2. Successful fusion was obtained within 18th week, aversge 13th week. No case of pseudarthrosis was experienced. 3. 3 cases of postop. wound drainage and 1 case of peroneal nerve palsy were experienced, but these did not compromise the final results. 4. It may be concluded that Arthrodesis of the knee using compression plate is rigid enough to permit early mobilization of patients and get the certainty of union.
Arthritis ; Arthritis, Infectious ; Arthrodesis ; Arthroplasty ; Arthroplasty, Replacement ; Cicatrix ; Congenital Abnormalities ; Contracture ; Drainage ; Early Ambulation ; Humans ; Knee ; Paralysis ; Peroneal Nerve ; Pseudarthrosis ; Wounds and Injuries

BACKGROUND: Succinylcholine is still the most frequently used muscle relaxant for rapid-sequence intubation despite its well-known side effects. Rocuronium has been reported to develop a rapid onset of action and may be suitable as a component of a rapid-sequence intubation. The purpose of this study was to compare tracheal intubating conditions by following different rocuronium doses and application techniques versus succinylcholine. METHODS: Fifty nine ASA physical status 1 and 2 adult patients scheduled for elective surgeries were anesthetized with thiopental sodium 5 mg/kg and muscle relaxant using a rapid-sequence technique. Group I (n = 12) received succinylcholine 1.0 mg/kg, group II (n = 15) received rocuronium 1.0 mg/kg, group III (n = 16) received rocuronium 0.6 mg/kg as a single bolus dose, and group IV (n = 16) received a priming dose of rocuronium 0.06 mg/kg followed three minutes later by rocuronium 0.54 mg/kg. Intubation was performed 60 seconds after the administration of muscle relaxant and intubating conditions were evaluated by clinical scoring (Table 1), and train-of-four (TOF) count of the adductor pollicis by accelerography. RESULTS: TOF counts of group I were lower than those of groups III and IV, and those of group II were lower than group III (P < 0.0083). Group II had intubating conditions similar to group I. The intubating conditions of groups I and II were better than those of groups III and IV (P < 0.0083). CONCLUSIONS: Rocuronium 1.0 mg/kg may be a suitable alternative for succinylcholine 1.0 mg/kg during rapid-sequence intubation. Priming principle does not produce faster or better intubating conditions than a single bolus injection.
Adult ; Humans ; Intubation* ; Succinylcholine ; Thiopental

Recently, much attention has been paid to the gut mucosal oxygenation in shock resuscitation, because many studies has been reported that the ultimate etiologies of death due to shock are mainly due to multiple organ failure caused by translocation of endotoxins and microorganisms from the ischemic gut mucosa. As there has been persistent controvesies over the relative merits of various kinds of resuscitation fluids in regard to the tissue oxygenation during management of shock, we studied the effects of various kinds of resuscitation fluids on the gut mucosal oxygenation with cats which were in hemorrhagic shcok 24 anesthetized cats were subjected to ge to decrease the mean arterial blood pressure to 40~45 mmHg and this pressure was maintained for 120 minutes (oligemic period). After this period, normal saline, hydroxyethyl starch and hypertonic saline/dextran mixture were administered respectively to raise systolic blood pressure up to 85 mmHg over 30 minutes and this level was maintained for another 120 minutes (post-oligemic period). Mesenteric venous oxygen tension, mesenteric venous-arterial lactate difference, carbon dioxide tension difference and arterial-venous pH difference were measured far evaluating the effects of three groups of resucitation fluids in regard to the gut mucosal oxygenation. There were no statistical significances among three groups by measuring the venous oxygen tension, venous-arterial carbon dioxide difference, arterial-venous pH difference. But venousarterial lactate difference in normal saline resuscitation group was significantly elevated from 5.0 +/-l.l mg/dl immediately after fluid resuscitation to 8.4+/-1.8 mg/dl 1 hour after fluid resuscitation (p<0.05). The difference in normal saline group was significantly high compared to the hydroxyethyl starch group which was 4.4+/-0.5 mg/dl and also compared to the hypertonic saline/dextran mixture group which was 4.1+/-0.9 mg/dl (p<0.05). Hydroxyethly starch and hypertonic saline/dextran mixture are more effective than normal saline in regard to the gut mucosal oxygenation in shock resuscitation, based on changes in venous-arterial lactate difference in each group. Further clinical studies may be needad.
Animals ; Arterial Pressure ; Blood Pressure ; Carbon Dioxide ; Cats* ; Endotoxins ; Hydrogen-Ion Concentration ; Lactic Acid ; Mucous Membrane* ; Multiple Organ Failure ; Oxygen* ; Resuscitation* ; Shock ; Shock, Hemorrhagic ; Starch

No abstract available.
Barium* ; Child* ; Humans ; Intussusception* ; Ultrasonography*

BACKGROUND: Intranasal drug administration has been suggested to be method for the treatment of various systemic cardiovascular disorders such as systemic hypertension and angina pectoris. Nifedipine is usually administered sublingually. We examined the efficacy of intranasal nifedipine for the treatment of hypertension during laparoscopic cholesystectomy. METHODS: After CO2 insufflation, we selected patients with blood pressures increased by 25%. Group I (n = 10) received nifedipine 10 mg intranasally and group II (n = 10) nifedipine 10 mg sublingually. Blood pressures and heart rates were recorded at 0, 1, 2, 3, 4, 5, 10, and 15 minutes after nifedipine administration. RESULTS: Significant decreases in blood pressure were observed from 2 to 15 minutes after administration in the intranasal group. Significant decreases in blood pressure in sublingual group were observed later than in the intranasal group. Significant increases in heart rate were observed from 4 to 15 minutes in the intranasal group, but no significant changes of heart rate in the sublingual group. CONCLUSIONS: Our results suggest that the administration of intranasal nifedipine is faster, more effective, and more convenient than sublingual nifedipine for the immediate control of hypertension associated with CO2 insufflation during laparoscopic cholecystectomy.
Administration, Intranasal ; Angina Pectoris ; Blood Pressure ; Cholecystectomy, Laparoscopic* ; Heart Rate ; Humans ; Hypertension* ; Insufflation ; Nifedipine*