PURPOSE: The purpose of this study was to examine the effects of change of polyethylene resin type and manufacturing method on the wear of polyethylene tibial component. MATERIALS AND METHODS: Thirteen MG I and 10 MG II components were retrieved at revision surgery. Each polyethylene tibial component was graded for surface wear damage. Density profiles of the polyethylene were measured to examine the extent of oxidative degradation of the polyethylene. RESULTS: The primary damage mode of the MG I retrievals was scratching and metallic debris, but the primary damage mode of the MG II was delamination (P<0.05). For the implants with implantation time of 5 years or more, the MG II polyethylene had a higher density value (0.959+/-0.002 g/cc, n=7) compared with the MG I (0.948+/-0.004 g/cc, n=11). Both delamination and polyethylene degradation increased with length of implantation time for the MG II components (P<0.01). Even after gamma sterilization, the directly molded 1900 MG I components experienced significantly less delamination and degradation than the machined GUR 415 MG II tibial components. CONCLUSIONS: This study suggests that delamination of polyethylene tibial components is influenced by resin type and/or manufacturing method
Fungi ; Polyethylene* ; Sterilization

Congenital pseudarthrosis of the tibia is a relatively rare but well known entity. Aside from the fibula, which is aften associated with tibia, the clavicle is probably the next preponderant site. Congenital pseudoarthrosis of other bones are extremely rare. We have found 10 cases of congenital pseudarthrosis of either the radius or the ulna in the English literature. Only one case of congenital pseudarthrosis of both bones of the forearm has been reported to our knowledge, A 30 year old man with congenital pseudarthrosis of the radius and the ulna associated with neurofibromatosis was seen at Seoul National University Hospital in March, 1985. Osteosynthesis was successful on the radius, but failed on the ulna. The distal fragment of the ulna eventulally disappeared altogether.
Clavicle ; Fibula ; Forearm ; Neurofibromatoses ; Pseudarthrosis ; Radius ; Seoul ; Tibia ; Ulna

Acute unstable tibial shaft fractures are common in these days of high energy trauma. There are many options for this common and complicated fracture. Flexible intramedullary nailing using closed technique is prevalent in that this has much technical, functional, and physiological advantages. We reviewed 51 cases of acute tibial shaft fractures treated with flexible intramedullary nailing. There were 3 nonunions (6%), and two refractures. Among 46 united cases, 8 cases (17 %) showed no bridging callus formation within 20 weeks. Followings are the results of average time reaching each of radiological bony progression stage for 46 united cases. l. Average time to earliest discernible callus formation (stage I) was 13.3 weeks (range:8-21 weeks). 2. Average time to definite and bridging callus formation (stage II) was 18.1 weeks (range:8-32 weeks). 3. Average time to some oblitetation of fracture line (stage III) was 32.8 weeks (range:17-50 weeks). 4. Average time to complete obliteration of fracture line (stage IV) was 14.0 months(range:12-18 months).
Bony Callus ; Fracture Fixation, Intramedullary ; Tibia

Closed medullary nailing has become increasingly popular in the management of fractures of the femur because of a high rate of union, a low rate of complications, and excellent return of function. But it requires good facility and excellent surgical skill. The authors experienced two cases of iatrogenic femur neck fracture during closed medullary nailing of femur shaft fracture.
Femoral Neck Fractures ; Femur Neck ; Femur

Oncogenous or tumor-induced rickets is recognized as Vitamin D-resistant hypophosphatemic rickets that heals after excision of a coexisting tumor in either bone or soft tissue. Its pathogenesis is not clarified, but it has been suggested that the tumor elaborates a homoral substance inhibiting tubular reabsorption of phosphate or that the tumor inhibits the synthetic process of 1, 25-dihydroxcholecalciferol. We present two cases of vitamin D-resistant rickets, one associated with intrasseous well-differentiated osteosarcoma in the pelvis and the other associated with fibrosarcoma of distal femur. The case with low grade osteosarcoma showed immediate improvement of rickets after excision of the tumor, but the case with fibrosarcoma showed no improvement after amputation and was fatally terminated 5 months later due to lung metastasis.
Amputation ; Femur ; Fibrosarcoma ; Lung ; Neoplasm Metastasis ; Osteosarcoma ; Pelvis ; Rickets ; Rickets, Hypophosphatemic ; Vitamins

Many kinds of operations have been devised to treat Kienböck's disease with variable results. But no one have mentioned about the advantage of early motion in distraction to prevent the fibro-osseous ankylosis and carpal collapse. Two cases with Kienböck's disease were treated by the complete excision of the lunate and replacement of it with pronator quadratus muscle pedicled rectangular bone graft. Once these procedures were accomplished, the distraction-motion devices were used to maintain the joint surfaces separated at predetermined distances while kinematically normal joint motion was gradually restored. Although the experience is limited to two cases, the final results seem to be very promising.
Ankylosis ; Arthroplasty ; Joints ; Transplants

Avascular necrosis of the femoral head is generally localized in the anterosuperior aspect of the head. The posterior part of the head often retains a normal, smooth contour containing healthy cartilage even in much advanced cases. Because of this anatomical localization of the lesion, Y. Sugioka has devised a transtrochanteric rotational osteotomy in young and middle-aged person, which reduces the weight-bearing force on the necrotic area, and transfers shearing forces to the healthy posterior cartilage of the femoral head to prevent progressive collapse of the articular surface and improve alignment when articular collapse followed femoral head subluxiation. The authors reviewed 13 cases of Sugioka operation, performed at the Department of Orthopedic Surgery, Seoul National University Hospital during the period from December 1983 to Feburary 1986 and the following results were obtained. 1. There were 11 males and 1 female. The average age of the 13 cases was 33.3 years. 2. In all the cases of Grade I and Grade II hips, there was not progressiveness of necroticarea of femur heads. 3. By U.C.L.A. hip rating system, preoperative mean scores of pain, walking ability, function and activity were 2.5, 5.7, 4.8 and 4.3, respectively, while postoperative scores of these were increased to 7.7, 9.5, 8.4 and 7.8, respectively. 4. Average ranges of motion of hip joint were increased more postoperatively than preoperatively.
Cartilage ; Female ; Femur Head ; Head ; Hip ; Hip Joint ; Humans ; Male ; Necrosis ; Orthopedics ; Osteotomy ; Seoul ; Walking ; Weight-Bearing

Treatment of femoral shaft fractures in children is varying according to age. Satisfactory results have been obtained with longitudinal skin traction, split Russell traction, ordinary Russell traction, 90-90 skeletal traction, and immediate application of a spica cast(2,4,6,11,15). Most authors use one or more techinques routinely. It is safe and convenient to use single treatment protocol to treat all fractures of same type, Distal femoral skeletal traction with the knee and hip flexed 90 degrees and with the thigh hanging free, using the trunk as counter traction, has been used routinely for femoral shaft fractures in children(age 4-12). We reviewed 30 cases of femoral shaft fractures in children treated with 90-90 skeletal traction. 1. The average age of the patients was 6.8 years(range, 4-12 years), and almost all were caused by pedestrian injury. 2. The average time of traction was 48 days(range, 28-75), and 12 cases(40%) were treated without spica cast application. 3. Four among 30 cases developed angular deformity exceeding acceptable range(15° in AP view, 20° in lateral view), and three of them were proximal third fractures. 4. The older the patient, the longer the duration of limited activity and the more tendency of angular deformity. 5. 90-90 skeletal traction is easy, safe and convenient to treat all femoral shaft fractures of the children between four and ten years old.
Child ; Clinical Protocols ; Congenital Abnormalities ; Hip ; Humans ; Knee ; Skin ; Thigh ; Traction

The Palmaris longus tendon is important not because of its function but because of its usefulness as a donor tendon. Variations in the palmaris longus muscle ar elfrequent and the most common variation of the muscle is its absence. The incidence of absence of this muscle varies in different racial groups. Reinmann and his coworkers found the palmaris longus muscle absent in 12.9% of in their 1,600 limbs surgery. We have experiened 307 cases of palmaris longus graft surgery and found that there were 4 cases of absence of the palmaris longus tendon. We examined 2,000 limbs of Korean to see the presence of the palmaris longus muscle. Among 1,000 persons, the muscle was absent bilaterally in 11 persons(1.1%). It was absent unilaterally in 32 persons(3.2%). The probability that the muscle is absent in any single limb is 2.7%. There was no significant differences in the incidence of absence by sex or right and left side.
Extremities ; Humans ; Incidence ; Tendons ; Tissue Donors ; Transplants

PURPOSE: Cerebrovascular accident is a serious neurological event, it can have temporary or permanent effects on survivors, including memory, cognition and volitional control of voiding. However, the correlation between the brain lesion site and type of voiding dysfunction is less well understood. This study was performed to evaluate the type of voiding dysfunction on the anatomic lesion of brain in patients with urinary symptoms after a cerebrovascular accident. MATERIALS AND METHODS: Urodynamic evaluation was undertaken in 74 patients who had suffered from voiding dysfunction. Computerized tomography(CT) and magnetic resonance imaging(MRI) were performed to localize the lesion in central nervous system. RESULTS: Damage to basal ganglia and/or internal capsule(6 of the 11 patients) and cerebral cortex(12 of the 21 patients) showed frequent detrusor hyperreflexia, while multiple lesion(21 of the 39) exhibited frequent detrusor areflexia. Uninhibited relaxation of sphincter in detrusor hyperreflexia was only observed in cerebral cortex lesion. CONCLUSIONS: Correlation of bladder dysfunction with the anatomical lesion of cerebrovascular accident was not conclusive, but was suggestive of directions to be taken in the future studies for the improvement of the life quality and preservation of renal function
Basal Ganglia ; Brain ; Central Nervous System ; Cerebral Cortex ; Cognition ; Humans ; Memory ; Quality of Life ; Reflex, Abnormal ; Relaxation ; Stroke* ; Survivors ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics