Fracture of the tibial shaft is the most common fracture of the long bones, and due to its frequency, mode of injury and sometimes type of treatment, has become a major source of permanent and temporary disability. The treatment of fractures of the tinial shaft has become one of the most controversial subjects in orthopedic surgery. Recently flexible intramedullary nails have been used successfully in treatment of fractures of the tibial shaft. In this paper we are reporting our experience with the method in 29 selected fractures of the tibia in 28 patients. The results were as follows. l. Of 29 cases, 19 cases were male and 10 cases were female. The average age was 33.4 years and the most common cause of injury was traffic accident. 2. Seventeen cases were closed fractures and twelve cases were open fractures. Nineteen cases were comminuted fracture. The most common level of the fracture was middle third of the tinial shaft. 3. Average interval from injury to Ender nailing was 10.3 days and the mean duration of permmit to full weight bearing was 9.8 weeks. 4. The mean duration of clinical bone union was 10.2 weeks and that of roentgenological bone union was 17.8 weeks. 5. 9 cases of complication were noted among the 29 cases of tibial shaft fracture which was treated by Ender nsiling such as angulation, ankle joint stiffness, and one case of delayed union. 6. Ender nailing are relative ease of nailing, allow early weight bearing and decrease complication. So Ender nailing is considered to be a good methods in treating tibial shaft fracture.
Accidents, Traffic ; Ankle Joint ; Female ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Humans ; Male ; Methods ; Orthopedics ; Tibia ; Weight-Bearing

Authors report a rare case of localized osteonecrosis occuring in the medial femoral condyle induced by prolonged steroid administration in a 48 years old male who had kidney transplantation surgery. Initially, he experienced clinical symptoms of discomfort and recurring effusion of both knees after transplantation surgery which did not respond, at all, to conservative treatment even in its early stage.
Cortisone ; Humans ; Kidney Transplantation ; Knee ; Male ; Osteonecrosis

No abstract available in English.
Dislocations ; Ulnar Nerve ; Ulnar Neuropathies

One of a fairly common cause of painful hips in children is the transient synovitis which subcide in short time by bed rest. This transient synovitis is also called as observation hip, irritable hip, coxitis serosa seu simplex, transitory hip arthritis, transitory coxitis, acute transient epiphysitis, toxic synovitis, and intermittent hydrathrosis etc. It is not clear what is the exact cause of transient synovitis but many authors agree infection, trauma and allergic conditions can be cause of that disease. The disease is of interest, not because it is a disabling condition, but because of the difficulties encountered in differentiating it from more serious disease of the hip such as Legg-Calve-Perthes disease, tuberculosis, osteomyelitis and etc. Of the 67 cases so diagnosed at the catholic medical college from 1975 to, 1980, 30 were reviewed and reported. Following observation were made: 1. The main symptom was pain of sudden onset in the region of the hip joint with a limp on the: affected side. 2. The patients mean age was 7.4 yrs and the sex ratio of boy & girl revealed 1. 7:1. 3. Radiological abnormalities of the soft tissue shadow of the affected hip joint was noted at 24 cases (80%), among them the gluteal sign(50%) are more prominent than others Bone scanning with Tc was performed at 13 cases. Increased uptake density of radio-active isotopes found at 6 cases (46%). 4. The treatment was conservative including bed rest, skin traction on the affected leg, non weight bearing, antibiotics and anti-inflammatory drug. 5. Two hips among them revealed later as s Legg-Calve-Perthes disease and tuberculous arthritis of hip joint.
Anti-Bacterial Agents ; Arthritis ; Bed Rest ; Child ; Clinical Study ; Female ; Hip Joint ; Hip ; Humans ; Isotopes ; Leg ; Legg-Calve-Perthes Disease ; Male ; Osteomyelitis ; Serous Membrane ; Sex Ratio ; Skin ; Synovitis ; Traction ; Tuberculosis ; Weight-Bearing

The tibial fracture apt to be encountered many complicationa including delayed or non-union. Many authors reported aeveral methods of early detection of the complication. Among them, it has been known that interoeseous phlebography is one of the simplest and valuable method to predict the delayed or non-union. Puranen and Kaski(1974) reported that the osteomedullography was valuable in early detection of delayed union and in deciding whether a bone graft is indicated. We performed ostemedullogram in the cases of tibial fracture since July, 1974. In this paper, we presented the caaes which showed unusual findings, and dicussed the method of evaluation of these findings. The results obtained as follows; 1. The positive Kaski signs did not always mean the completness of union of fracture. It only indicated that the union was going on. 2. Even in cases in which Kaski signs are positive, the final decision for bone graft have to depend upon the clinical and physical findings and simple roentgenogram. 3. The negative Kaski signs did not always mean the possible development of delayed or non-union. Usually it indicated only delaying of union, and the treatment should not solely depend on only the osteomedullographic findings. 4. Even in cases in which bridging callus is well formed around both fracture ends, also in cases of solidly united fracture Kaski signs were sometimes completely negative. This osteomedullography is clinically easily to apply in all cases of tibial fracture, and give us a lot of information concerning with fracture healing. We have to pay attention to the false nagative cases. In those cases we have to depend more on clinical test and simple roentgenogrm.
Bony Callus ; Fracture Healing ; Methods ; Phlebography ; Tibial Fractures ; Transplants

We performed intra-osseous venography in 16 patients with chondromalacia patellae or patellofemoral osteoarthritis. Of 16 patients, eight patients had chondromalacia patellae and 6 patellofemoral osteoarthritis. Two patients with normal patellae who underwent meniscectomy were used as controls. The results obtained were as follows: 1. Dye congested in the normal patella was disappeared within 2 minutes after injection and extra-osseous drainage pattern disappeared within 1 minute. 2. in chondromaiacia patellae, large amount of dye was spread throughout the entire patella and remained till 10 minutes, while extra-osseous drainage pattern disappeared at about 5 minutes. 3. In patellefemoral osteoarthritis, venous engorgment in patella was similar to that of chondromalacia patellae and extra-osseous drainage pattern disappeared at about 10 minutes. Conclusively, authors thought the patella I.O.V. was one of the significant clinical methods to define the etiological factors of the various patellofemoral disorders such as patellofemoral osteoarthritis and chondromalacia patellae.
Chondromalacia Patellae ; Drainage ; Estrogens, Conjugated (USP) ; Humans ; Osteoarthritis ; Patella ; Phlebography

Three combinations of cloths were evaluated for the protective effects of different kinds of clothings in cold environments. Table 1 shows tile components of tile three models of clothings. A prototype was made by putting a sheet of vinyl at the middle layer of raw cotton in a fabric-quilt cloths. A glove mannequin was covered by each of these cloths. The globes contained 1,000 cc of hot water about 40 degrees C. Tele-thermisters were fixed in order to check the temperature of cloths space and water temperature for evaluation of caloric-loss and climate of clothings. Results are summarized as follows : 1) Without wind, there is no significant difference of air temperatures between ski-parka and quilt wear clothing. 2) The prototype with vinyl sheet best protects against wind, the next is the ski-parka. Quilt-wear protects the least. 3) It is well-known that a working-clothing needs not have any separate liners nor outers. 4) For innermost layer of a clothing preventing cold, a cotton-fabrics is recommended and a water-proof cloths for outer layer. 5) Heat-loss was calculated from the cooling degrees of water. Calorie-loss was 910ca1/m2/hr. when bared, but with the prototype of vinyl sheets the calorie-loss was 350cal/m2/hr. (38.5% of bared). Quilt-wear and ski-parka were 380(41.8%) and 440 cal/m2/hr. (48.4%) respectively.
Climate ; Clothing* ; Manikins ; Water ; Wind*

No abstract available.
Animals ; Brain* ; Rats*

Animals ; Dental Implants ; Female ; Hand ; Humans ; Intercellular Signaling Peptides and Proteins ; Male ; Osseointegration ; Osteogenesis ; Plants ; Polymerase Chain Reaction ; Titanium

PURPOSE: The angiographic demonstration of absent cerebral blood flow is presently considered to be the most reliable method of confirming brain death. The purpose of this study is to determine whether CT angiography (CTA) with spiral CT can rapidly and specifically establish a diagnosis of brain death. MATERIALS AND METHODS: A total of fifteen CT angiograms (brain death, n=9;severe coma, n=6 within 24 hours of the study) were obtained prospectively in 12 patients with an established clinical diagnosis; Two patients underwent repeated CTA. Twenty seconds after beginning the injection of contrast media (100 mL at a rate of 3 mL/sec), CT scanning (30 -second continuous exposure and 60 -mm length) was performed with a table speed of 2 mm/sec and a section thickness of 2 mm. For each case, the presence or absence of opacification of inter-nal carotid arteries (ICA), vertebral and basilar arteries (VBA), anterior cerebral arteries (ACA), middle cerebral arteries (MCA), posterior cerebral arteries (PCA), distal branches of cerebral arteries, and superficial temporal arteries (STA) was ascertained. RESULTS: Except in one clinically brain-dead patient, whose EEG was difficult to interpret due to excessive arti-facts, the distal branches of cerebral arteries did not opacify. STA, on the other hand, was always visible on both sides. In all brain-dead patients but three, the ICA and proximal ACA, MCA, or PCA escaped visualiza-tion. In the remaining three cases with large skull defect or skull fracture, however, CT angiography showed faint opacification of the ICA and proximal segments of cerebral arteries. Cerebral arterial flow was preserved in all six patients in whom there was no clinical evidence of brain death. CONCLUSION: CTA may be used as a confirmatory test for the determination of brain death.
Angiography* ; Anterior Cerebral Artery ; Basilar Artery ; Brain Death* ; Brain* ; Carotid Arteries ; Cerebral Arteries ; Coma ; Contrast Media ; Diagnosis ; Electroencephalography ; Hand ; Humans ; Middle Cerebral Artery ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery ; Prospective Studies ; Skull ; Skull Fractures ; Temporal Arteries ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; United Nations