Open fracture characteristically has higher chances of infection and sof tissue damage in comparison with closed fracture. In spite of the development of operation methods and antibiotics, complications such as infection, nonunion, delayed union, and joint stiffness are continuously confronted as problems in the field of orthopedics. Different methods of treatment have been advocated as regards the care of the open wound and the method of stabilization of the fracture fragments. Therefore a comparative analysis of the type of open fracture and the bone union time according to the initial treatment methods was made from 47 cases over the age of 20, who were followed up until bone union developed among the inpatients who were treated for open fracture of tibia in the period of 7 years from January, 1982 to December, 1988, and the results are as follows: 1. The highest incidence of fractures was encountered in 3rd decade(34%) and male to female ratio was 6:l. 2. The most common cause of fractures was traffic accident(76.6%). 3. The most common level of fracture was in mid one-third and the bone union time was longest in mid one-third. 4. The bone union time was longer, and the rate of complication was greater in order of type 1, 2 & 3 according to Gustilo's classification. 5. The good result was obtained in type 1 fractures, by using the closed reduction & cast immobilization and pin & plaster method; in type 2, the bone union time was shortest in the cases of pin & plater method; in type 3, the bone union time was shortest in the cases of closed reduction or open, reduction & external fixation. 6. Bone union was obtained in all cases of delayed union and nonunion and the bone union time was shortest in cases treated with plate & bone graft.
Anti-Bacterial Agents ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Inpatients ; Joints ; Male ; Methods ; Orthopedics ; Tibia ; Transplants ; Wounds and Injuries

Today, the exact causal relationship between prolapsed intervertebral disk and sciatica remains unclear. Murphy has proposed that inflammation rather than mechanical pressure is the basis of back pain and sciatica, and that causal irritant is likely to be a chemical product of disk degeneration. The administration of steroids into the epidural space reduces the inflammatory process of the neural structure is well known. We have studied the effect of injection of methylprednisolone acetate (Depomedrol) comparing with the effect of operative treatment. One hundred and eleven cases suffuring from diskogenic low back pain had been treated at Wallace Memorial Baptist Hospital during 2.5 years period from May 1979 to Nov. 1981. The results were as follows: 1. Sixteen patients (14%) stated that they had no relief from the injection, 24(22%) were moderately improved, 52(47%) were markedly improved and 19(17%) were completely relieved of symptoms. 2. The candidates for laminectomy which were confirmed by myelogram had complete improvement in 12%, marked improvement in 39%, moderate improvement in 21%, no relief in 28%.
Back Pain ; Epidural Space ; Humans ; Inflammation ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Laminectomy ; Low Back Pain ; Methylprednisolone ; Protestantism ; Sciatica ; Steroids

No abstract available in English.
Transplants

Traumatic afflication of the elbow are so common in both adults and children that the frequency of elbow dislocation is in second to that of the shoulder. Its treatment is so standardized and its complications are well recognized. But there are some differences in biomechsnics of elbow structure of children and adult. We had analized clinically 68 cases of acute dislocation of elbow joint who were treated at Orthopedic Department, medical College of Yon Sei University. The results were as follows 1. The most prevalent age were 4–7 years old in children snd 26–35 years old in sdult. 2. The major mode of injury was slip down accident. 3. The most common type was posterior dislocation. 4. Accessory fractures were more common in child and associated injuries were more common in adult. 5. Good results were obtained from closed reduction and long arm cast immobilization. 6. Immobilization period was shorter in child even though in cases combined with accessory fracture. 7. There were few limitation of motion in children which were immobilized within 3 weeks and in adult which were immobilized within 1 week. But the more prolonged immobilization period, the severe limitation of motion was note. 8. There were less complications in child. 9. The most common mode of limitation of motion was extension.
Adult ; Arm ; Child ; Clinical Study ; Dislocations ; Elbow Joint ; Elbow ; Humans ; Immobilization ; Orthopedics ; Shoulder

Ossification of the ligamentum flavum (OLF) has been recognised as a definite clinical entity as an ossification of the posterior longitudinal ligament. It has been known that the incidence of OLF is high in Japan and OLF usually occurs in the thoracic and lumbar region. Recently OLF has received considerable attention as a cause of myelopathy. OLF is quite distinct from “hypertrophy” of the ligamentum flvum. We experienced 2 cases of OLF with neurological symptom, which were treated by decompressive laminectomy and removal of the ossified ligamentum flavum. So remarkable symptomatic improvement was obtained.
Incidence ; Japan ; Laminectomy ; Ligamentum Flavum ; Longitudinal Ligaments ; Lumbosacral Region ; Spinal Cord Diseases ; Spine

Monteggia fracture-dislocation was described as a fracture of proximal third of the ulnar with a dislocation of radial head by G. Monteggia in 1814. Bado named Monteggia lesion as a fracture of ulnar at any level and a dislocation of radial head. The authors reviewed sixty-three patents of Monteggia fracture who were treated at department of orthopedic surgery, Yonsei university college of medicine from 1980. 1. to 1985. 12. We emphasis especially on cause of injury, classification, direction of radial head dislocation, level of ulnar fracture site, treatment and result. The results were as follows: 1. There were 22 children and 41 adults among 63 patients. 2. The male was affected more frequenty than female (49:14) . The ratio between male and female was 3. 5: l. 3. The most common cause of injury was falling down (54%) in children and car accident (51%) in adults. 4. According to Bado classification, type I was 68%, type II 11%, type III 18% and type IV 3%. 5. The partial posterior interosseous nerve injury was noticed in 12 cases and the superficial radial nerve injury was in 3 cases. The nerve injury was recovered spontaneously in all cases. Dislocation of radial head was as follows: Anterior dislocation was 38%, anterolateral 41%, lateral 8%, posterior 10% and posterolateral 3 % 7. Location of ulnar fracture site was as follows: Metaphysis was 22%, proximal 1/3 24%, junction of proximal 1/3 and middle 1/3 38%, middle 1/3 14% and distal 1/3 2%. 8. Closed reduction of radal head dislocation was done in 45 cases, open reduction in 10 cases and radial head excision in 6 cases. 9. Closed reduction of ulnar fracture was done in 26 cases and open reduction 35 cases. 10. We obtained 93% favorable results in children and 71% in adults. Not only the prognosis of ch ildren was better than adults but also the recovery time of children was shorter than adult's.
Accidental Falls ; Adult ; Child ; Classification ; Clinical Study ; Dislocations ; Female ; Head ; Humans ; Male ; Monteggia's Fracture ; Orthopedics ; Prognosis ; Radial Nerve

Bone grafts are used in the repair of segmental bone loss caused by severe trauma, bone tumors and infection, and to enhance bone healing in ununited fractures. Autograft is the most frequently used and the most effective method, but because of inadquate supply and additional operative morbidity, allograft or heterograft could be used. Heterograft has been shown to be poorly tolerated by the host and ineffective in providing an osteogenic system. The objective of this study is to observe healing process of a segmental defect of long bone following to heterograft, and to compare the difference of histologic process between autograft and hetero graft. Twenty-four white rabbits weighing 1,000 to 2,000 grams were used for the experiment. A segment measuring three times the diameter of the ulna shaft (1.5 to 2cm) of rabbit was resected with its periosteum. Twenty-four white rabbit were divided into three groups (control, autograft, heterograft group) according to graft methods, each group comprising of eight rabbits. The animals were sacrificed at 2, 4, 8 and 12 weeks after the experimental procedures and were periodically evaluated by radiographs and histology. The obtained results were as follows: 1. The results of the radiological evaluation showed that no ungrafted ulnar defects (control group) healed. In the heterograft group, partial union was observed from 8 weeks and complete union was obtained on 12 weeks. In the autograft group, partial union was observed on 2 weeks and complete union was obtained on 4 weeks. 2. The results from histological examination showed that the ungrafted ulnae did not heal across the defect but some immature trabeculae were founded on the edges of the defect. In the heterograft group, immature trabeculae were appeared from 4 weeks and defects were substituted with mature trabeculae on 12 weeks. In autograft group, defects were substituted with immature trabeculae on 2 weeks and with mature trabeculae on 4 weeks. As seen in the results of the experiment, union could be obtained with the heterograft, but needed more long time than autograft. Though the autograft is the most effective graft method in bone defect or non-union, above results suggest the heterograft as the alternative method in the treatment of large bone defect, in a multioperated patient, or in the children or the elderly, combined with autograft or alone.
Aged ; Allografts ; Animals ; Autografts ; Child ; Fractures, Ununited ; Heterografts* ; Humans ; Periosteum ; Rabbits* ; Transplants ; Ulna

OBJECTIVE: There have been several evidences that the central nervous system deflect is one of the etiologic factor in schizophrenia and minor physical anomalies can reflect these deflects indirectly. These central nervous deflects are particularly related to the negative symptoms of schizophrenia. In this study, we examined the relationship between minor physical anomalies and psychopathology in schizophrenia. METHODS: Forty-four patients(22 males, 22 females) satisfying the DSM-IV criteria for schizophrenia were measured for minor physical anomalies by using Waldrop Anomaly Scale(WS) and we used Positive and Negative Syndrome Scale(PANSS), Ulmann-Giovannoni Process-Reactive Questionnaire(PRQ), and Phillips Premorbid Adjustment Scale(PAS) for evaluating psychopathology and clinical variables. RESULTS: Schizophrenic patients had a higher group mean WS score than that found in the control group. Score of WS was correlated with PANSS and PAS score positively, and with PRQ score negatively. CONCLUSION: This study shows minor physical anomalies are associated with clinical variables with regard to symptom severity, poor premorbid adjustment and process of illness in at least some schizophrenics.
Adult* ; Central Nervous System ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Male ; Psychopathology ; Schizophrenia

No abstract available.
Knee* ; Rabbits* ; Tendons*

To fill the large bone defect after bone and soft tissue tumor resection, there are several options such as tumor prosthesis, bone cement with intramedullary nail, autogenous bone graft and allograft. We had used isotrophic autogenous bone graft by using the heat-treated bone removed from tumor site. We analyzed the periods for junctional union and regeneration of autoclaved or low-heat treated groups, and compared these two methods to know which method is better for reconstruction of the bone defect after tumor resection. From Jan. 1987 to Sept. 1993, twelve patients took heat-treated autogenous bone graft: 6 auto- claved, and 6 low heat-treated. Each group had 10 places of junction sites between host and grafted bone. The tumors were 2 cases of osteosarcoma, 3 parosteal osteosarcoma, 2 Ewing's sarcoma, 2 malignant soft tissue tumors, 1 giant cell tumor, and 2 metastases from thyroid cancer and synovial sarcoma. The graft sites were 4 in humerus, 4 pelvis and 4 femur. Two cases showed marginal surgical margin and others wide surgical margin. Here we compare4 the difference between autoclaved group(120℃, 2 atm., 20 min) and low heat-treated group(65℃, 30 min. in water) on the aspect of complications and period to achieve junctional union to host bone. Average follow-up period was 25.3(11 to 88) months. Graft related complications in autoclaved group were bone resorption(2 sites), fracture of grafted bone(2). For low heat-treated group there was no such complication. Nonunion occurred in 3 sites for autoclaved group and 1 for low heat-treated group. Average period for junctional union was 7.3 months(5 to 10 months) for autoclaved group and 6.1 months(5 to 9 months) for low heat-treated group. With these results, heat treated bone autograft may have several advantages such as easy accessi- bility, low cost and anatomical reconstruction of the bone defect. The low heat-treated autogenous bone graft may have more advantages than that of the autoclaved one, and this method may be ratio- nalized to fill the large bone defect made by tumor resection.
Allografts ; Autografts ; Femur ; Follow-Up Studies ; Giant Cell Tumors ; Hot Temperature ; Humans ; Humerus ; Methods ; Neoplasm Metastasis ; Osteosarcoma ; Pelvis ; Prostheses and Implants ; Regeneration ; Sarcoma, Ewing ; Sarcoma, Synovial ; Thyroid Neoplasms ; Transplants