The head injuried patient with skeletal trauma is a challege to the orthopedic surgeon. The orthopedist initially may face the difficult management of fracture and dislocation in the patient associated with head injury. The management of the injuries to the head takes precedence over extremity injuries initially, but the orthopedist must be managed aggresively with assumption that full neurologic recovery will occur. This report analysed the treatment and results in 85 cases fracture and dislocation with head injury among the 59 patients at the Chungnam National University Hospital during the period ranging from March, 1980 to March, 1983. End result obtained are as follows: 1. The sex ratio between the male and female was 3.9: 1 and the prevalent age distribution was from 21 to 30 years of age. 2. The motorcycle accident was most common cause of the trauma and the next most frequent one was the automobile accident. 3. Type of head injury were contusion or concussion, intracranial hemorrhage, linear skull fracture, depressed skull fracture and open skull fracture. 4. Better result were obtained by operative treatment in femur fracture, especially spastic group. 5. The incidence of delayed diagnosis was 8 cases and the delay in diagnosis ranged from 15 to 95 days with an average of 38 days. 6. We, consulting with neurosurgeon, must assume that full neurologic recovery will take place and so open reduction and internal fixation should be carried out as quickly as possible.
Age Distribution ; Automobiles ; Chungcheongnam-do ; Clinical Study ; Contusions ; Craniocerebral Trauma ; Delayed Diagnosis ; Diagnosis ; Dislocations ; Extremities ; Female ; Femur ; Head ; Humans ; Incidence ; Intracranial Hemorrhages ; Male ; Motorcycles ; Muscle Spasticity ; Neurosurgeons ; Orthopedics ; Sex Ratio ; Skull Fracture, Depressed ; Skull Fractures

No abstract available.
Decompression* ; Head* ; Osteonecrosis*

Seven patients with average age of 15years and 6 months (range: 8 years and 11 months 25 years and 6 months) underwent forearm lengthening by callotasis. The indications for lengthening were shortening and/or deformity of the forearm due to exostosis of the distal ulna in three cases, growth disturbance due to physeal injury of the distal radius in three, congenital radial dislocation in one. Three had lengthening of the radius, three of the ulna and one of both the radius and the ulna. The average lengthening achieved was 3.8 cm (3.5 - 4.0) in radius, 2.7 cm (2.3 - 3.0) in ulna. Complications encountered were pin tract infection in two cases, nonunion in one and temporary nerve palsy in one. All of these complications were recovered completely without any residua. Retrospective review after average 41 months of follow-up (range: 36 to 78) showed satisfactory improvement in appearance and function. Callotasis was considered as one of the safe and reliable treatment methods for bone lengthening and deformity correction of the forearm.
Bone Lengthening ; Congenital Abnormalities* ; Dislocations ; Exostoses ; Follow-Up Studies ; Forearm* ; Humans ; Osteogenesis, Distraction* ; Paralysis ; Radius ; Retrospective Studies ; Ulna

Between 1984 and 1996, 8 patients who were suffered from stage g Kienbock's disease underwent interpositional arthroplasty using pronator quadratus pedicled bone. Patients comprised 2 males and 6 females, with an average age of 33 years(range 19-47). Range of motion of the wrist, residual pain, grip strength, and carpal height ratio of the patients were analyzed. The follow-up period was between 1.5 years and 12.5 years(average 5.5 years). The arc of flexion-extension of the wrist was increased from average 74 degrees preoperatively to 96 degrees postoperatively. Among eight patients, five were free of pain and three had intermittent pain during heavy work. None of eight patients had any discomfort in daily work and changed his or her occupation. The grip strength was average 83% of the normal side. Carpal height ratio was average 0.48 preoperatively and was not changed postoperatively. Clinical results, assessed by Lichtman-Evans criteria, showed 4 good and 4 fair. The interpositional arthroplasty using pronator quadratus pedicled bone was considered as a very effective method for the treatment of stage III Kienbock's disease.
Arthroplasty* ; Female ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Occupations ; Osteonecrosis* ; Range of Motion, Articular ; Wrist

Paget's disease is a disorder of middle or older aged persons in which abnormal osteoclastic and osteoblastic activity spontaneously occurs within the affected portion of any particular bone or bones. This causes a gradual gross structural alteration through continuous remodeling. The occurance of Pagets disease is extremely rare in China, Japan, Middle East, and Africa. We have experienced one case of Paget's disease of bone affecting the spine and femur, which is reported in this paper with brief review of literature.
Africa ; China ; Femur ; Humans ; Incidence ; Japan ; Middle East ; Osteitis Deformans ; Osteoblasts ; Osteoclasts ; Spine

In 1868 Charcot described the joint in tabes dorsalis, which since then has been designated as Charcot neuroarthrophathy. It is characterized by painless swelling and abnormal mobility of the affected joint. Arthrophthy of the type described by Charcot has been associated with various other conditions, such as diabetes mellitus, syringomyelia, injury to nerve root, congenital indifference of pain, leprosy, and intra articular use of steroid, etc. Authors present a case of Charcot spine due to tabes dorsalis.
Diabetes Mellitus ; Joints ; Leprosy ; Spine ; Syringomyelia ; Tabes Dorsalis

The authors has been reviewed the 123 cases, 119 patients of ankle fracture that were treated through the admission and outpatient Department of Orthopedic Surgery, Chungnam National University, from September, 1974 to January, 1982. The summary of the' results were follows: l. Among the 123 cases, male was 94 cases(76.4%), female was 29 cases, and the average age of the patients was 34.9 years. 2. The causes of the injury was traffic accidents, fall or slip downs and sports injuries in orders. 3. By the Lauge-Hansens classification, pronation-external rotation ty'pe and supination-adduction type were more common than the others. 4. Open reduction and internal fixation were more commonly used in its treatment than that of the closed method. 5. The better radiological assessment could be achieved by. obtaining the anatomical reduction and the reduction was more satisfactorily by the use of the key role of the lateral malleolus. 6. The overall results were more supported by the radiological results than the clinical results.
Accidents, Traffic ; Ankle Fractures ; Ankle ; Athletic Injuries ; Chungcheongnam-do ; Classification ; Clinical Study ; Female ; Humans ; Male ; Methods ; Orthopedics ; Outpatients

The Clufoot is still controversial in the etiology, the pathology, and the method of the treatment. Turco issued one stage posteromedial soft tissue release in 1971, which is still widely used. But the Turco's procedure is not satisfactory results in forefoot adduction and ankle motion. McKay and Simon were performed one stage complete subtalar soft tissue release and reported better results compared with those who had posteromedial release. So we performed Turco's posteromedial release with lateral release by Cincinnati incision in 12 patients (20 feet) and analysis the results from Oct. 1987 to Jul. 1989 at the department of orthopaedic surgery of CNUH. The results were as followings ; 1. The mean age of the patient at first examination was 1 year 9 months (range from at birth to 5 year 10 months) and the mean age at operation was 2 year 1 month (range from 4 months to 5 year 10 months). 2. The clinical results were excellent in 2 feet, good in 14 feet, fair in 3 feet and unsatisfactory in 1 foot. 3. The radiological results were satisfactory in 18 feet and unsatisfactory in 2 feet. 4. Forefoot adduction was corrected in 14 feet (70%) as normal range, 3 feet as acceptable, and 3 feet as unacceptable 10' over the normal range. 5. Two feet of hind foot overcorrection result was operation as McKay's method. 6. The Clincinnati incision was favorable to visulization and release of the posteromedial, anteromedial and posterolateral structure of the foot.
Ankle ; Clubfoot ; Foot ; Humans ; Methods ; Parturition ; Pathology ; Reference Values

BACKGROUND: Estrogens act on estrogen receptors distributed in articular cartilages, synovial membrane, and ligaments, which are thought to be related with degenerative changes. Meanwhile, progesterone is known to have a weak anabolic action on bone formation This study evaluates the effects of estrogen and progesterone hormone on bone/cartilage turnover in ovariectomized (OVX) rats. METHODS: Thirty-five 7-month-old female Sprague-Dawley rats were randomly divided into 5 groups and then ovariectomized bilaterally except the sham control group. The first and the second group acting as controls did not receive hormonal therapy, the third group received estrogen, the fourth group received progesterone, and the fifth group received combination of both hormones 10 weeks after surgery. Evaluations were done using the serum levels of cartilage oligomeric matrix protein (COMP) for cartilage turnover, collagen type I C-telopeptide (CTX-1) and osteocalcin (OC) for bone turnover at 11, 15, 19 weeks after OVX and histology using the Osteoarthritis Research Society International (OARSI) osteoarthritis (OA) cartilage histopathology assessment system. RESULTS: Significantly less cartilage degradation (decreased levels of COMP) was found in the combined hormone treated group in comparison with OVX group. Similarly, both hormonal treatment resulted in increased bone formation and decreased bone resorption i.e., a low overall bone turnover status (decrease in the serum OC and CTX-1 levels). CONCLUSIONS: Combined estrogen and progesterone therapy was found to be convincing in terms of reducing the severity of OA in this experimental model.
Animals ; Biological Markers/blood/metabolism ; Bone Remodeling/*drug effects ; Bone and Bones/chemistry/drug effects ; Cartilage/chemistry/*drug effects ; Collagen Type I/blood/metabolism ; Disease Models, Animal ; Estrogens/*pharmacology ; Extracellular Matrix Proteins/blood/metabolism ; Female ; Glycoproteins/blood/metabolism ; Histocytochemistry ; Hormone Replacement Therapy/*methods ; Osteoarthritis/blood/*drug therapy ; Osteocalcin/blood/metabolism ; Ovariectomy ; Progesterone/*pharmacology ; Rats ; Rats, Sprague-Dawley

The long-term studies of total knee arthroplasty (TKA) have confirmed reliable relief of pain and maintenance of function. However there have been few generalized studies of factors influencing the results of TKA. We evaluated retrospectively 187 TKAs (137 patients) which had been performed between January 1987 and May 1995. The follow-up period was from one year to eight years (mean, 3 years and 8 months). There were 133 knees of osteoarthritis (OA), 43 knees of rheumatoid arthritis (RA) and 11 knees of other causes including septic knee sequelae. We considered the preoperative factors as age, sex, side (right or left), body weight, height, primary disease, flexion contracture (FC), further flexion (FF), range of motion (ROM) of joint, deformity of varus and valgus and pain score, muscle strength score, instability score, total knee score according to the knee rating scale of the Hospital for Special Surgery (HSS). We considered the clinical results as FC, FF, ROM, pain, muscle strength, instability, total knee score according to the knee rating scale of the HSS and the radiological results as Roentgenographic Evaluation and Scoring System of American Knee Society and radiolucent line more than 2mm in width. We evaluated the clinical and radiological results of TKAs followed up more than I year and analyzed the results based on above factors. The results were as follows: 1. The preoperative factors influencing final FC were not the primary disease and FC, but the FF and ROM. The preoperative factors influencing final FF and ROM were the primary disease, the FF and ROM. 2. The pain, muscle power, instability scores were improved but there was no significant factor influencing them. The HSS knee scores were higher in OA group than RA group postoperatively. 3. There was no preoperative factor influencing the complication, revision, the radiological results. The preoperative factors influencing the results of TKA were the FF, ROM and the primary disease.
Arthritis, Rheumatoid ; Arthroplasty* ; Body Weight ; Congenital Abnormalities ; Contracture ; Follow-Up Studies ; Joints ; Knee* ; Muscle Strength ; Myalgia ; Osteoarthritis ; Range of Motion, Articular ; Retrospective Studies