Winging of the scapula is characterized clinically by a prominence of the vertebral border and inferior angle of the scapula. Trauma, neuritis, neural injury during surgical procedure and many other causes may develop winging of scapula. When pain and functional impairment persist, surgical intervention may become appropriate. We report two cases of winged scapula. One case was serratus anterior palsy due to blunt trauma, which was treated by transfer of teres major and pectoralis minor elongated with a tensor fascia strip. Another case was trapezius muscle palsy due to iatrogenic spinal accessary nerve injury, which was treated by transfer of the levator scapulae, rhomboid major and rhomboid minor muscle. In the former case, there was no weakness nor deformity of affected shoulder. In the later case, there was some residual pain and limitation of motion.
Congenital Abnormalities ; Fascia ; Neuritis ; Paralysis ; Scapula* ; Shoulder ; Superficial Back Muscles

No abstract available.
Fracture Fixation, Intramedullary*

In Korea, slipped capital femoral epiphysis is a rare disease. In which the capital femoral epiphysis migrate posteriorly and inferiorly against the neck portion. Sometimes it should be differentiated from other conditions that separate the femoral capital epiphysis. We have experienced a rare case of separation of capital femoral epiphysis due to an osteosarcoma in the proximal femoral metaphysis in the 15 years of old girl.
Epiphyses ; Female ; Humans ; Korea ; Neck ; Osteosarcoma ; Rare Diseases ; Slipped Capital Femoral Epiphyses

Forearm bone fracture is a common injury in childhood. But there are many difficult problem to solve in treatment of the forearm bone fractures which are not encountered in the treatment of fracture of the other long bone. Forearm bone fracture in children differ from those in adult in a number of ways. The rapidity of healing, fuctional recovery together with the frequency of delayed or nonunion consitute the main features. More interesting, a deformity resulting from malunion may correct as bone growth proceeds. From August, 1973 to July, 1983, we have reviewed 66 cases of forearm bone fractures under 14 year old and which were treated in the Department of Orthopedic Surgery, Hanyang University Hospital. The results were as follows: 1. 56 cases(84.8%) were male and most cases occured in school age. 2. 40 cases(60.7%) were both forearm bone fractures and most common site of the fracture was the distal 1/3 3. The most common cause of the fractures was falling from height. Simple fracture was most common and greenstick fracture was next. Closed fractures were 61 cases (92.4%) and open fractures were 5 cases (7.6%) . 4. In roentgenologically, the younger the child was, the more rapid the duration of bone union was. Average duration of roentgenological union in conservative group was 8. 1 weeks, and that in operative group was 10. 1 weeks. So conservative group was more rapid in roentgenological bone union than operative group. 5. Accarding to the follow study of remodelling, the young the child and the nearer the fracture line was to the epiphyseal plate, the greater the potentialities for spontaneous correction were. 6. 62 cases (94.0%) showed excellent fuctionat result. According to 4 cases (6.0%) which showed good fuctional result, posterior angulation 17 degree, anterior angulation 15 degree and medial angulation 17 degree after reduction became more than 10 degree after remodelling.
Accidental Falls ; Adult ; Bone Development ; Child ; Congenital Abnormalities ; Forearm ; Fractures, Bone ; Fractures, Closed ; Fractures, Open ; Growth Plate ; Humans ; Male ; Orthopedics

Sex determination is considered the first and most important process in the identification of unknown skeletal remains. The skull is one of bones with high accuracy to discriminate sexes, but there is no dimorphic studies of Korean skull by discriminant function analysis. The aim of this study was to build and provide an easy and accurate discriminant equation to sex determination by using three-dimensional skull images of Korean. Computed tomography images from 102 cadavers were reconstructed three-dimensional images by computer program. We measured 44 variables using the template in computer program and variables were sorted out items with high accuracy and reliability by intraclass correlation coefficient (ICC), Cohen's d value, and receiver operating characteristic (ROC) curve. The equation with the highest accuracy had 82.7% in males, 82.2% in females, it was constituted bizygomatic diameter, cranial base length, biauricular breadth, upper facial breadth, frontal chord, foramen magnum breadth, and right mastoid length. The cross-validated accuracy had 76.5%~86.7% using 3D skull images in Koreans. The value of variables that matches the other population group study, most of variables had a statistically significant difference among population groups. Male skulls in Koreans were smaller than those in European and female skulls were bigger than in Asian. This result should be helpful to determine sex in Koreans.
Asian Continental Ancestry Group ; Cadaver ; Female ; Foramen Magnum ; Humans ; Imaging, Three-Dimensional* ; Male ; Mastoid ; Population Groups ; ROC Curve ; Skull Base ; Skull*

The most essential biological profiles in physical and forensic anthropology are age, sex, and populations to be determined. In case of dealing intact skeletons, experts can often determine sex with high accuracy. The external occipital protuberance (EOP) is one of the site among morphologic traits which is used to determine human sex. This study suggests the possibility to determine the sexual dimorphism using the EOP and surrounding anatomical structures in Koreans. After three-dimensional reconstruction of the skull model from Digital Korean Human Databse, the three parts were evaluated using a classification system based on Broca, Gulekon and Turgut. To determine for scoring, this study was used two in two different ways to observe the skull model; one was a lateral view and the other was turning the skull models. In a lateral view, the shape of the occipital area was classified as 'flat' or 'convex' type. After then the scores of the anatomical structures were converted into 4-digits code. In females, the skull was more convex in shape than males but the EOP and inion were lesser projection. In the lateral and turning views, the most common pattern was Type 2 in both sexes. The most common digit code was 2-2-2-0 in males, 2-2-2-1 in females. The digit code is better than simple scoring system for determining sex. The skull in Koreans were more feminine than in other populations in both sexes.
Classification ; Female ; Forensic Anthropology ; Humans ; Male ; Skeleton ; Skull

PURPOSE: The study tried to suggest the ways to improve the national disability welfare information projects with evaluating the present condition of the projects. METHOD: Firstly, the study analyzed the disability information system and disability websites. Secondly, the study found out the problems of the registration of disability and management system through the situation analysis. Finally, the study conducted a survey of the disabled and the information system workers and performance evaluation of the information system. RESULTS: The study offered a proposal of The Disability Unity Management System(DUMS) for the disability registration and management. When the disabled visit the hospital or the public health center, their information is registered automatically in The Disability Unity Management System(DUMS), which helps not to miss out the disability registration. Through this system, they are given the proper service which they need, and the information can be shared with the facilities providing the service for the disabled. CONCLUSION: The Disability Unity Management System(DUMS) contributes significantly in avoiding the repetition of the support for the disabled and improving the quality of service.
Disabled Persons ; Humans ; Information Systems* ; Public Health ; Registries

Most of foot pain occurs by the entrapment of the tibial nerve and its branches. Some studies have reported the location of the tibial nerve; however, textbooks and researches have not described the posterior tibial artery and the relationship between the tibal nerve and the posterior tibial artery in detail. The purpose of this study was to analyze the location of neurovascular structures and bifurcations of the nerve and artery in the ankle region based on the anatomical landmarks. Ninety feet of embalmed human cadavers were examined. All measurements were evaluated based on a reference line. Neurovascular structures were classified based on the relationship between the tibial nerve and the posterior tibial artery. The bifurcation of arteries and nerves were expressed by X- and Y-coordinates. Based on the reference line, 9 measurements were examined. The most common type I (55.6%), was the posterior tibial artery located medial to the tibial nerve. Neurovascular structures were located less than 50% of the distance between M and C from M at the reference line. The bifurcation of the posterior tibial artery was 41% in X-coordinate, -38% in Y-coordinate, and that of the tibial nerve was 48%, and -10%, respectively. Thirteen measurements and classification showed statistically significant differences between both sexes (P<0.05). It is determined the average position of neurovascular structures in the human ankle region and recorded the differences between the sexes and amongst the populations. These results would be helpful for the diagnosis and treatment of foot pain.
Ankle ; Ankle Joint* ; Arteries ; Cadaver ; Classification ; Diagnosis ; Foot ; Humans ; Tibial Arteries* ; Tibial Nerve*

The authors investigated the accuracy and reliability of three-dimensional and reformatted computed tomographic images by comparing direct measurements on the dry mandible and the measurements on three-dimensional and reformatted computed tomographic images of the dry mandible. 29 Korean dry mandibles were imaged and 16 items of measurements were measured. The results were as follows; 1. The correlation coefficients between the two methods were between 0.95 and 0.99, except for the measurement of Go-Pg. 2. The mean differences of the measurements between the two methods ranged from -0.52 to 0.42 mm and the range of standard deviations for these mean differences was 0.28 to 2.70 mm. 3. Of the difference scores in total measurements, 75.9% were within 1 mm and 95.9% were within 2mm. In conclusion, the agreement between the two methods was excellent and the measurements of the threedimensional and reformatted computed tomographic images were reliable. The three-dimensional and reformatted computed tomographic images can be an useful method in anthropologic study.
Mandible*

The knowledge of arterial patterns of donor and recipient sites is very important for performing a flap surgery. In order to perform a flap surgery using the rectus abdominis muscle knowledge of the distributions, tributaries, and anastomoses of the inferior epigastric artery is necessary. The aim of this study was to establish the clinical and anatomical characteristics of the inferior epigastric artery for flap surgery in Koreans. Sixteen fresh cadavers were injected bilaterally with a radiopaque dye solution through the brachial and popliteal arteries, radiographic images were obtained after the anterior abdominal wall was removed surgically. Subsequently, the anterior abdominal walls of the cadavers were dissected and measured by using metric and non-metric methods. In a majority of the cadavers (83.9%), the inferior epigastric artery had only one main stem. Between the umbilicus and the xiphoid process, the most common type of the anastomosis was multiple anastomoses (Type IV, in 32.1% of the cases), followed by no anastomosis (Type I) and single anastomosis (Type II) in 25% of the cases, respectively. The intramuscular branch of the inferior epigastric artery originated from below the umbilicus in 60.7% of the cases and above it in 39.3% of the cases. The peritoneal branch was further divided into 3 types: lateral, medial, and umbilical. One of them coexisted with other branch of specimen. The peritoneal branch commonly originated from the intramuscu-lar branch. The perforating branch, with an external diameter of greater than 0.5 mm, was clinically significant, was dis-tributed around the umbilicus. The number of arterial branches directly perforating the rectus abdominis muscle was greater than that of those traveling anteriorly. The results of this study may enhance the anatomical knowledge of clinicians with respect to flap surgery or surgical treatments involving the anterior abdominal wall.
Abdominal Wall ; Cadaver ; Epigastric Arteries ; Humans ; Muscles ; Popliteal Artery ; Rectus Abdominis ; Tissue Donors ; Umbilicus