The anterior interosseous nerve is the largest muscular branch of the median nerve and typically supplies the flexor digitorum profundus (radial part), flexor pollicis longus, and the pronator quadratus. Isolated paralysis in the distribution of the interosseou nerve of the forearm has been reported by several workers. This syndrome is distinguished by the absence of sensory involvement combined with partial median nerve paresis. This is a syndrome which is casily overlooked or misconstrued, unless the exact motor distribution of the anterior interosseous nerve is understood. We experienced a case following hard exercise in which the anterior interosseous nerve was compressed by the fibrous compression band on the underside of the flexor digitorum superficialis.
Equipment and Supplies ; Forearm ; Median Nerve ; Paralysis ; Paresis

Accessory hamstring muscle is rare in incidence. In the popliteal region, it often simulates soft tissue tumor since it may be manifest as popliteal swelling. We experienced a case of accessory hamstring muscle which simulated popliteal tumor on physical examination.
Incidence ; Physical Examination

Supracondylar fracture of the Humerus is the most common fracture of the elbow in children and frequently there are accompanying complications. A total of 78 children with supracondylar fracture of the humerus were treated at the Wallace Memorial Baptist Hospital, Busan, Korea, during a recent 5 year period. Of these, 33 patients were treated by lateral skeletal traction through olecranon pin and 14 of these were followed up for more than 6 months. 1. The average age was 7.2 years and the male and female ratio was 2.4:1. The left humerus was involved in 49 patients (62.5%). 2. Of all fractures, 94.4% were the extension type and 5.6% were the flexion type. 3. Satisfactory results wire obtained in 31 of 33 cases who were treated by lateral skeletal traction. Among these, 14 cases were followed up for more than 6 months. Final results were analyzed according to Mitchells classification; excellent results were obtained in 11 cases (78.6%), good results in 3 cases (21.4%) and there were no unsatisfactory results. 4. In 11 cases in which immediate closed reduction or Dunlops traction followed by closed reduction was unsuccessful, satisfactory results were obtained in 10 of 1 1 cases by using lateral skeletal traction. Therefore, we think that it is possible to treat most of the manual reduction failure patients by lateral skeletal traction. 5. There were two treatment failures using lateral skeletal traction. In one case, the brachialis muscle was buttonholed by the proximal fragment, and in the other case, the patient was treated 8 days after injury and marked hematoma formation between the fracture fragment was noted. 6. During treatment by lateral skeletal traction, infection developed through the pin tract in 2 cases. These were treated by the administration of antibiotics and there were no complications such as osteomyelitis nor did this effect the final results. 7. Incomplete radial nerve palsy developed in 3 cases. However, in all cases recovery was spontaneous with 4 weeks. 8. The average hospital stay for patients treated by lateral skeletal traction was 14.2 days. Prologed hospitalization is ane of the chief disadvantages of lateral skeletal traction. However, if we can minimized the number of hospital days by early cast immobiiization when the fracture is stable, lateral skeletal traction will prove to be a good method which can be expected to yield unlformly satisfactory results which are not surpassed by any other method of treatment. Since this method has been instituted at this hospital, very few patients have undergone open reduction because of fracture malalignment.
Anti-Bacterial Agents ; Busan ; Child ; Classification ; Elbow ; Female ; Hematoma ; Hospitalization ; Humans ; Humerus ; Korea ; Length of Stay ; Male ; Methods ; Olecranon Process ; Osteomyelitis ; Paralysis ; Protestantism ; Radial Nerve ; Traction ; Treatment Failure

No abstract available.
Spinal Stenosis*

Since rupture of the Achilles tendon was first reported by Pare in 1575, various caues and diagnostic and therapeutic methods have been described by many workers. Almost all these workers agree that with early diagnosis and early treatment the prognosis is good. But the incidence of misdiagnosis by the physician as well as the patient's own neglect of his condition is disconcertedly high one. Nevertheless, negiected rupture of the Achilles tendon may lead to good results by proper selection of tbe operative method. In this report 16 cases of neglected ruptures of the Achilles tendon, in which treatment had been delayed more than 3 weeks were reviewed. A follow-up study of more than 6 months was made on 14 of these cases treated during the 5 year period from February 1973 to August 1977. The results are summarized as follows: 1. The causes responsible for the neglected ruptures were misdiagnosis by the physician in 62.5% and the patient's own neglect of his condition in 25% of the cases. The patient, in many cases, failed to seek medical treatment because of the rapid disappearance of pain, the absence of an open wound, ability of mild ankle plantar flexion, and the ability to walk. 2. Neglected rupture of the Achilles tendon occured most commonly in man of 4th decade. 3. Left side injuries were more common than right side injuries with a ratio of 9:7. 4. Ruptures by indirect injury were more common than by direct injury with a ratio of 9:7, and were most common during recreation and sports activities. 5. The most frequent site of rupture was 2 to 6 cm above the insertion of the tendon with 81% of the cases. 6. The end-to-end suture with pull-out wire method and Lindholm's operative method gave good (Excellent or Satisfactory) results in neglected rupture of the tendon as well. 7. Even in cases of neglected Achilles tendon rupture, normal function can be regained in approximately 6 months post-operatively if proper method of treatment is selected.
Achilles Tendon ; Ankle ; Clinical Study ; Diagnostic Errors ; Early Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Methods ; Prognosis ; Recreation ; Rupture ; Sports ; Sutures ; Tendons ; 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

The incidence of tibial fracture is increasing due to increasing tendency of traffic and industrial accidents. In general, the tibial fracture is treated with closed method but it is difficult because of its anatomical cbaracteristics. We have been treated tibial fractures with total contact short leg cast which supports the 7 points such as tibial condyle, tuberosity, margo anterior, medial malleolus, fibular head, lateral malleolus and heel rigidly and molding it as trangiular shape like the tibia using both palms and fingers The advantages of this cast sre to prevent rotation, to promote osteogenesis with early weight bearing and to prevent ankylosis of knee joint. In fact, the sverage healing time was 14weeks Rotation, nonunion, angulation ove cast sore, nerve injury were not noticed and the shortening was 4. 1mm in closed fractures, 5. 3mm in open fractures.
Accidents, Occupational ; Ankylosis ; Fingers ; Fractures, Closed ; Fractures, Open ; Fungi ; Head ; Heel ; Incidence ; Knee Joint ; Leg ; Methods ; Osteogenesis ; Tibia ; Tibial Fractures ; Weight-Bearing

Recently spondylolysis and spondylolisthesis have become major causes of low back pain in the orthopaedic field and numerous methods have been designed for its treatment. The authors used the LSDS with posterolateral fusion for 12 cases of spondylolisthesis and spondylolysis having low back pain and tenderness, which were operated on during the 4 years from Jan. 1983 to Jan. 1986 at Wallace Memorial Baptist Hospital. The advantages of LSDS with posterolateral fusion are as follows. l. In the case of distraction spondylodesis of interspinous process between L4 and Sl; A. the diameter of intervertebral formaina as well as of the whole spinal canal is widened. B. decompression is accomplished. C. the mechanical stress on the posterior columns of vertebral arch is lessened because the plumb line is anteriorly transferred. 2. Technique of LSDS; the knee-elbow position has the advantages of maximal kyphosis together with expansion of the space between the vertebral arches, as well as a reduction in the tendency to bleed because the blood collects in the abdominal vessels. 3. Internal fixation of grafted bone is not necessary. 4. A large surface area for unit mass of graft is in contact with blood supply. 5. Hypertrophy or displacement of graft can not encroach upon the epidural space; as may occur in certain circumstances following posterior fusion. The results of treatment are follows; l. In the case of improvement of symptoms after facet infiltration and knee-elbow position, satisfa- ctory results after LSDS were obtained. 2. The progression of slipping was not occurred after LSDS. 3. In increased lumbar lordosis, we have noted the instability especially with the changes from the mean values in Fergusons angles. 4. In the slip angle, there is some tendency to the lumbosacral instability correlating with the in- crease in the body weight. 5. We have also noted that the functional result was not closely related with degree of displacement.
Animals ; Body Weight ; Decompression ; Epidural Space ; Hypertrophy ; Kyphosis ; Lordosis ; Low Back Pain ; Lysergic Acid Diethylamide ; Protestantism ; Spinal Canal ; Spinal Fusion ; Spondylolisthesis ; Spondylolysis ; Stress, Mechanical ; Transplants

It had been reported by many authors that the incidence of delayed or nonunion in fracture of clavicle was higher in open reduction and internal fixation than conservative treatment. The purpose of this study is to verify the gratification of the reconstruction plate in fracture of clavicle which needed internal fixation. From March 1993 to September 1995, 32 clavicular fractures were underwent open reduction and internal fixation with reconstruction plate for the wide gap, soft tissue interposition and comminuted fracture etc. The results were as follows 1. The range of motion of the shoulder was returned to normal range within 1.5 weeks except one case who had brachial plexus injury. 2. All cases had bony union. Average time to clinical union was 2.9 weeks and the bony union 7.8 weeks. 3. By functional evaluation of shoulder by Weitzman, final results were excellent in 27, good in 4 and fair in l. 4.Fixation and maintenance of clavicular fragment by reconstruction plate was recommendable for wide separated, soft tissue interposed, comminuted fracture of the clavicle. We concluded that reconstruction plate in fracture of clavicle could be recommended as one of the device for internal fixation.
Brachial Plexus ; Clavicle ; Fractures, Comminuted ; Incidence ; Range of Motion, Articular ; Reference Values ; Shoulder

No abstract available.
Macrophages, Peritoneal* ; Nitric Oxide ; Nitric Oxide Synthase* ; Shock* ; Tumor Necrosis Factor-alpha